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Sample records for twenty-five patients underwent

  1. Localized Giant Cell Tumors of the Flexor Tendon Sheath of the Finger: An Analysis of Twenty Five Patients

    Directory of Open Access Journals (Sweden)

    Asli Tanrivermis Sayit

    2014-12-01

    Full Text Available Aim: The aims of this retrospective study were to evaluate localized giant cell tumors of the tendon sheath (GCTTS with Magnetic Resonance (MR imaging findings and to review the epidemiological features of the disease. We also evaluated the literature regarding GCTTS and performed an analysis of the available information. Material and Method: We retrospectively reviewed the MR images of 25 histologically proven cases of GCTTS of the finger during the period between 2012-2014. In addition, a retrospective analysis of the patients’ records was carried out, and age, gender, site and size of lesion, recurrence, and MRI findings were reviewed. Results: The patients were predominantly female (n = 16 and had a mean age of 51.9 ± 12.8 years. Nine patients were male with a mean age of 45.1 ± 13.4 years. The size of the tumors ranged from 6 mm to 30 mm, with a mean size of 15.3±6.8 mm. Tumors were present on the right hand in 15 patients and on the left hand in 10 patients. Among women, 11 tumors were located on the right hand and 5 were found on the left. In men, 4 of the tumors were located on the right hand and 5 were on the left. The most frequent digit on which tumors were found was the index finger, accounting for 40% of cases (n=10. The most frequent location was the index finger for both women (n=6 and men (n=4. All of the lesions were described as well-circumscribed, encapsulated, lobulated, or multilobulated solitary masses with MR imaging. Signal intensity on T1 weighted images (WI was equal to that of skeletal muscle in 23 cases. In two cases, signal intensity was slightly higher. On T2WIs, the signal intensities tended to be between those of skeletal muscle and fat in all of the cases. All of the lesions showed mild to moderate contrast enhancement when compared with precontrast images. There was no statistically significant differences between male and female patients in terms of age, tumor side, involved digit, and highest tumor size

  2. Twenty-five gauge vitrectomy in uveitis

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    Roger Roberto Wada Kamei

    2012-04-01

    Full Text Available PURPOSE: To evaluate anatomical and functional results of 25-gauge transconjunctival sutureless pars plana vitrectomy in patients with uveitis. METHODS: Vitrectomy was performed on 20 eyes with residual vitritis secondary to infectious and noninfectious uveitis. Patients were evaluated 1 week before surgery and after surgery at day 1, week 1, week 4 and week 12. Visual acuity (VA, intraocular pressure, anterior chamber cells and flare and vitreous haze were measured. RESULTS: Mean VA improved from 2.06 ± 0.94 logMAR before surgery to 0.58 ± 0.46 logMAR at week 12 (p<0.05. No case required conversion to standard 20-gauge instrumentation or suture placement, no intraoperative complications were noted. Transient postoperative hypotony was seen in three eyes. One patient with toxoplasmic retinochoroiditis had a relapse during follow-up. CONCLUSION: 25-gauge vitrectomy has proven its efficacy on cleansing vitreous opacities and improving visual acuity on patients with residual vitritis secondary to uveitis with minimal postoperative inflammation and complications.

  3. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

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    S. S. Davydova

    2015-09-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  4. Coronary risk factors in patients underwent coronary artery bypass grafting.

    Science.gov (United States)

    Safaei, Nasser; Alikhah, Hossein; Abadan, Younes

    2011-01-01

    Coronary Artery Disease (CAD) risk increases with increasing number of risk factors. This study was aimed to assess different coronary risk factors among Coronary Artery Bypass Grafting (CABG) surgery patients. A total of 700 patients younger than 45 or older than 65 years and underwent CABG in Tabriz Shahid Madani Heart Center since 2003 to 2007 were enrolled. We examined the probable differences of CAD risk factors between male and female groups and age groups. We also assessed the change of risk factors presentation in last 5 years. There was not significant difference between risk factor numbers in 65 years groups, but smoking and dyslipidemia was more prevalent in patients 65 years old. Hypertension and diabetes mellitus was more prevalent in patients > 65 old than < 45 years old; also differences were found between males and females patients, so that dyslipidemia, diabetes and hypertension were more prevalent in women than men. Some risk factors were recognized as acting more on one gender than the other. Also, the majority of patients have one or more risk factors, but different age and gender groups may have different risk factors that suggest the need for exact programming for appropriate prophylactic and therapeutic interventions in all groups.

  5. Frequency of Helicobacter pylori in patients underwent endoscopy

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    Ahmet Tay

    2012-06-01

    Full Text Available Objectives: The aim of this study was to investigate thefrequency of Helicobacter pylori in patients underwent endoscopyeastern Anatolia.Materials and methods: The patients whose endoscopicantral biopsies were taken for any reason in our endoscopyunit in February-June 2010 period were includedand retrospectively investigated. The frequency of Helicobacterpylori was determined as separating the patientsaccording to general, sex and the age groups. Antral biopsieswere stained with hematoxylin-eosin and modified giemsamethod and examined under light microscope andreported as (+ mild, (++ moderate, (+++ severe positiveaccording to their intensities.Results: Biopsy specimens of 1298 patients were includedinto the study. The mean age was 47.5 ± 17.5 years(range 14-88 and 607 of these patients (47% were male.Histopathological evaluation revealed that, 918 of the patientswere (71% positive and 379 (29% were negativefor Helicobacter pylori. Approximately 60% of our patientshad mild, 29% had moderate and 11% had severe positivityfor Helicobacter pylori. No significant difference wasfound in the frequency of Helicobacter pylori betweenwomen and men. The frequencies of Helicobacter pyloriwere 73.2%, 71.5%, 68.6% and 70.4%, respectively, inthe age groups of 14-30 years, 31-45 years, 46-60 yearsand 61-88 years.Conclusion: The frequency of Helicobacter pylori was71% in Eastern Anatolia Region. No statistically significantdifference was found between genders and agegroups in term of the frequency of Helicobacter pylori.

  6. Pigmented Villonodular Synovitis in a Patient who Underwent Hip Arthroplasty

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    Nevzat Dabak

    2014-09-01

    Full Text Available Pigmented villonodular synovitis (PVNS is a rare, benign, but a locally aggressive tumor. It is characterized by the proliferation of synovial membrane, but it can also be seen in tendon sheaths and bursae. Clinical presentation of solitary lesions include compression and locking of the joint suggesting loose bodies in the joint and a subsequent findings of an effusion, whereas diffuse lesions manifest with pain and chronic swelling. In this article, we presented a curious case of PVNS in a female patient who have been followed up due to an acetabular cystic lesion. She underwent total hip arthroplasty for severe osteoarthritis of the hip joint and associated pain. The diagnosis of PVNS was established intraoperatively. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 235-7

  7. The November $J / \\Psi$ Revolution Twenty-Five Years Later

    CERN Document Server

    Khare, A

    1999-01-01

    Exactly twenty five years ago the world of high energy physics was set on fire by the discovery of a new particle with an unusually narrow width at 3095 MeV, known popularly as the $J/\\Psi$ revolution. This discovery was very decisive in our understanding as well as formulating the current picture regarding the basic constituents of nature. I look back at the discovery, pointing out how unexpected, dramatic and significant it was.

  8. Congenital choledochal cysts in adults: twenty-five-year experience

    Institute of Scientific and Technical Information of China (English)

    LIU Ying-bin; CAO Li-ping; PENG Shu-you; WANG Jian-wei; Khagendra Raj Devkota; JI Zhen-ling; LI Jiang-tao; WANG Xu-an; MA Xiao-ming; CAI Wei-long; KONG Ying

    2007-01-01

    Background Choledochal cyst is rare in western countries. The relatively high incidence of coexistent hepatobiliary disease increases the difficulty of the surgical management of choledochal cyst. Here we analyze the diagnosis and treatment of congenital bile duct cyst in 122 Chinese adults.Methods The clinical data of 122 patients with congenital choledochal cysts admitted from 1981 to 2006 were analyzed.Results Clinical symptoms in most cases were nonspecific, resulting in delayed diagnosis. Sixty-one patients (50%) had coexistent pancreatobiliary disease. Among the 122 patients, 119 patients underwent ultrasonic examination;ERCP/MRCP was performed in 63 cases and CT in 102 cases. Abnormal pancreatobiliary duct junction was found in 48 patients. Sixteen patients had malignant lesions in the bile duct, arising in 11 of them from incomplete choledochal cyst that underwent various operations including cystenterostomy or cystojejunostomy. There was significant difference between the patients who underwent incomplete cyst resection and complete cyst resection in malignancy rate of bile duct (Chi square test, P= 0.000; odds ratio, 7.800; 95 % confidence interval, 2.450 to 24.836).Conclusions ERCP, CT and MRCP had proved their great values in the classification of the disease. Cyst excision with Roux-en-Y hepaticojejunostomy is recommended as the treatment of choice for patients with type Ⅰ or type Ⅳ cysts. For type Ⅴ cyst (Caroli's disease) with recurrent cholangitis, liver transplantation should be considered.

  9. Anti-Interleukin-6 Receptor Tocilizumab for Severe Juvenile Idiopathic Arthritis-Associated Uveitis Refractory to Anti-Tumor Necrosis Factor Therapy: A Multicenter Study of Twenty-Five Patients.

    Science.gov (United States)

    Calvo-Río, Vanesa; Santos-Gómez, Montserrat; Calvo, Inmaculada; González-Fernández, M Isabel; López-Montesinos, Berta; Mesquida, Marina; Adán, Alfredo; Hernández, María Victoria; Maíz, Olga; Atanes, Antonio; Bravo, Beatriz; Modesto, Consuelo; Díaz-Cordovés, Gisela; Palmou-Fontana, Natalia; Loricera, Javier; González-Vela, M C; Demetrio-Pablo, Rosalía; Hernández, J L; González-Gay, Miguel A; Blanco, Ricardo

    2017-03-01

    To assess the efficacy of tocilizumab (TCZ) for the treatment of juvenile idiopathic arthritis (JIA)-associated uveitis. We conducted a multicenter study of patients with JIA-associated uveitis that was refractory to conventional immunosuppressive drugs and anti-tumor necrosis factor (anti-TNF) agents. We assessed 25 patients (21 female; 47 affected eyes) with a mean ± SD age of 18.5 ± 8.3 years. Uveitis was bilateral in 22 patients. Cystoid macular edema was present in 9 patients. Ocular sequelae found at initiation of TCZ included cataracts (n = 13), glaucoma (n = 7), synechiae (n = 10), band keratopathy (n = 12), maculopathy (n = 9), and amblyopia (n = 5). Before TCZ, patients had received corticosteroids, conventional immunosuppressive drugs, and biologic agents (median 2 [range 1-5]), including adalimumab (n = 24), etanercept (n = 8), infliximab (n = 7), abatacept (n = 6), rituximab (n = 2), anakinra (n = 1), and golimumab (n = 1). Patients received 8 mg/kg TCZ intravenously every 4 weeks in most cases. TCZ yielded rapid and maintained improvement in all ocular parameters. After 6 months of therapy, 79.2% of patients showed improvement in anterior chamber cell numbers, and 88.2% showed improvement after 1 year. Central macular thickness measured by optical coherence tomography in patients with cystoid macular edema decreased from a mean ± SD of 401.7 ± 86.8 μm to 259.1 ± 39.5 μm after 6 months of TCZ (P = 0.012). The best-corrected visual acuity increased from 0.56 ± 0.35 to 0.64 ± 0.32 (P uveitis was observed in 19 of 25 patients. Significant reduction in the prednisone dosage was also achieved. The main adverse effects were severe autoimmune thrombocytopenia in 1 patient, pneumonia and then autoimmune anemia and thrombocytopenia in 1 patient, and viral conjunctivitis and bullous impetigo in 1 patient. TCZ appears to be a useful therapy for severe refractory JIA

  10. Interventional radiology procedures in adult patients who underwent liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Roberto Miraglia; Luigi Maruzzelli; Settimo Caruso; Mariapina Milazzo; Gianluca Marrone; Giuseppe Mamone; Vincenzo Carollo; Salvatore Gruttadauria; Angelo Luca; Bruno Gridelli

    2009-01-01

    Interventional radiology has acquired a key role in every liver transplantation (LT) program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplantation. The aim of this paper is to review indications, technical consideration, results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT.

  11. The deep, hot biosphere: Twenty-five years of retrospection.

    Science.gov (United States)

    Colman, Daniel R; Poudel, Saroj; Stamps, Blake W; Boyd, Eric S; Spear, John R

    2017-07-03

    Twenty-five years ago this month, Thomas Gold published a seminal manuscript suggesting the presence of a "deep, hot biosphere" in the Earth's crust. Since this publication, a considerable amount of attention has been given to the study of deep biospheres, their role in geochemical cycles, and their potential to inform on the origin of life and its potential outside of Earth. Overwhelming evidence now supports the presence of a deep biosphere ubiquitously distributed on Earth in both terrestrial and marine settings. Furthermore, it has become apparent that much of this life is dependent on lithogenically sourced high-energy compounds to sustain productivity. A vast diversity of uncultivated microorganisms has been detected in subsurface environments, and we show that H2, CH4, and CO feature prominently in many of their predicted metabolisms. Despite 25 years of intense study, key questions remain on life in the deep subsurface, including whether it is endemic and the extent of its involvement in the anaerobic formation and degradation of hydrocarbons. Emergent data from cultivation and next-generation sequencing approaches continue to provide promising new hints to answer these questions. As Gold suggested, and as has become increasingly evident, to better understand the subsurface is critical to further understanding the Earth, life, the evolution of life, and the potential for life elsewhere. To this end, we suggest the need to develop a robust network of interdisciplinary scientists and accessible field sites for long-term monitoring of the Earth's subsurface in the form of a deep subsurface microbiome initiative.

  12. Twenty-Five Year Site Plan FY2013 - FY2037

    Energy Technology Data Exchange (ETDEWEB)

    Jones, William H. [Los Alamos National Laboratory

    2012-07-12

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

  13. Twenty-five cases of feline bronchial disease (1995-2000).

    Science.gov (United States)

    Foster, S F; Allan, G S; Martin, P; Robertson, I D; Malik, R

    2004-06-01

    Twenty-five cases of feline bronchial disease were identified retrospectively. The criteria for inclusion were consistent clinical signs or histopathology and no other identifiable aetiology. Patient records were analysed to determine historical, clinical, clinicopathologic and radiographic features. The main presenting complaints were coughing and dyspnoea. The most common physical finding was dyspnoea. The majority of radiographs had a bronchial pattern either as the sole change or as a component of a mixed pattern. Bronchoalveolar lavage cytology was neutrophilic or eosinophilic in the majority of cats. There was no association between age, breed, sex, clinical signs, bronchoalveolar lavage cytology or radiographic severity and disease severity.

  14. QUALITY OF LIFE OF FEMALE PATIENTS, WHO UNDERWENT RECTAL CANCER SURGERY

    OpenAIRE

    S. V. Averyanova; L. M. Bardenstein; O. M. Konopazkova; E. A. Dementyeva; Velsher, L.Z.

    2013-01-01

    Quality of life is the second most important clinical outcome criteria for cancer patients after survival. Quality of life shows the completeness of social rehabilitations of patients, who underwent radical treatment. In present study quality of life of 41 rectal cancer patients, who underwent abdominoperineal resection (n = 22) or anterior resection (n = 19) was assessed using SF-36 questionnaire. All patients without permanent colostomy had better postoperative quality of life. The phycho-e...

  15. [Rapidly involuting congenital hemangiomas: twenty five case series].

    Science.gov (United States)

    Larralde, Margarita; Solé, Juan Javier; Luna, Paula Carolina; Mosquera, Tomás; Abad, María Eugenia

    2014-04-01

    Rapidly involuting congenital hemangiomas are very rare vascular tumours, that are characterized for being completely developed at birth and for involuting in a short period of time after birth. We describe a case series of 25 patients with rapidly involuting congenital hemangiomas. Twelve patients were male and 13 female; they were all born at term. Lesions were small in 17 cases and big in 8. No patient needed active intervention and all lesions showed a rapid initial involution.

  16. Twenty-five years of ambulatory laparoscopic cholecystectomy.

    Science.gov (United States)

    Bueno Lledó, José; Granero Castro, Pablo; Gomez I Gavara, Inmaculada; Ibañez Cirión, Jose L; López Andújar, Rafael; García Granero, Eduardo

    2016-10-01

    It is accepted by the surgical community that laparoscopic cholecystectomy (LC) is the technique of choice in the treatment of symptomatic cholelithiasis. However, more controversial is the standardization of system implementation in Ambulatory Surgery because of its different different connotations. This article aims to update the factors that influence the performance of LC in day surgery, analyzing the 25 years since its implementation, focusing on the quality and acceptance by the patient. Individualization is essential: patient selection criteria and the implementation by experienced teams in LC, are factors that ensure high guarantee of success.

  17. QUALITY OF LIFE OF FEMALE PATIENTS, WHO UNDERWENT RECTAL CANCER SURGERY

    Directory of Open Access Journals (Sweden)

    S. V. Averyanova

    2013-01-01

    Full Text Available Quality of life is the second most important clinical outcome criteria for cancer patients after survival. Quality of life shows the completeness of social rehabilitations of patients, who underwent radical treatment. In present study quality of life of 41 rectal cancer patients, who underwent abdominoperineal resection (n = 22 or anterior resection (n = 19 was assessed using SF-36 questionnaire. All patients without permanent colostomy had better postoperative quality of life. The phycho-emotional state of patients with permanent colostomy progres-sively decreases. The present study is important for developing an individualized rehabilitation programme for female rectal cancer patients.

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

    Science.gov (United States)

    Bilbao Jaureguízar, J I

    2016-01-01

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

  19. Serum Zn levels in dysphagic patients who underwent endoscopic gastrostomy for long term enteral nutrition

    National Research Council Canada - National Science Library

    Santos, Carla Adriana; Fonseca, Jorge; Brito, José; Fernandes, Tânia; Gonçalves, Luísa; Sousa Guerreiro, António

    2014-01-01

    .... The aim of the present study was the evaluation of serum zinc in patients who underwent endoscopic gastrostomy and its relationship with serum proteins, whole blood zinc, and the nature of underlying disorder...

  20. The tumor-to-breast volume ratio (TBR) predicts cancer-specific survival in breast cancer patients who underwent modified radical mastectomy.

    Science.gov (United States)

    Wen, Jiahuai; Ye, Feng; Huang, Xiaojia; Li, Shuaijie; Yang, Lu; Xiao, Xiangsheng; Xie, Xiaoming

    2016-06-01

    Breast cancer is the most common cancer in women globally, and tumor size measured as the largest diameter of the tumor focus is currently used in tumor-lymph node-metastasis (TNM) staging for prognosis and treatment decisions. The present study utilized the tumor-to-breast volume ratio (TBR) to evaluate the relative tumor size and determined the prognostic impact of TBR on survival in patients with breast cancer. Two thousand twenty-five consecutive breast cancer patients who underwent modified radical mastectomy between January 2002 and December 2008 at Sun Yat-Sen University Cancer Center were enrolled in this retrospective study. Kaplan-Meier analysis was used to assess the prognostic effect of TBR on cancer-specific survival (CSS), and univariate log-rank test and multivariate Cox proportional hazards regression model were performed to identify independent prognostic factors. The optimal cutoff value of TBR was determined to be 1.70 %, and 1473 and 552 patients were categorized to low-TBR and high-TBR groups, respectively. In the whole patient cohort, CSS was significantly shorter in the high-TBR group (110.2 vs 128.5 months, P breast cancer patients (hazard ratio (HR) 1.489, 95 % CI 1.130-1.961, P = 0.005). High TBR was independently associated with poor prognosis in breast cancer patients. This variable may serve as a valuable parameter to predict the outcomes of breast cancer.

  1. Measurement of recent thymic output function in uremia patients who underwent maintenance hemodialysis

    Institute of Scientific and Technical Information of China (English)

    李永新

    2012-01-01

    Objective To determine the recent thymic output of naive T cells in patients with uremia who underwent maintenance hemodialysis (MHD) . Methods Fifteen consecutive patients with uremia were recruited from Affiliated Oncology Hospital of Zhengzhou University between October 2010 and October 2011 and were subjected to

  2. Mitochondrial DNA haplogroups are associated with severe sepsis and mortality in patients who underwent major surgery.

    Science.gov (United States)

    Jiménez-Sousa, Maria Angeles; Tamayo, Eduardo; Guzmán-Fulgencio, María; Heredia, María; Fernández-Rodríguez, Amanda; Gómez, Esther; Almansa, Raquel; Gómez-Herreras, José I; García-Álvarez, Mónica; Gutiérrez-Junco, Sandra; Bermejo-Martin, Jesús F; Resino, Salvador

    2015-01-01

    To analyse whether mitochondrial DNA (mtDNA) haplogroups are associated with severe sepsis and mortality after major surgery. We performed a case-control study on 240 cardiac or abdominal surgery patients developing severe sepsis (Case-group) and 267 cardiac or abdominal surgery patients without severe sepsis and with systemic inflammatory response syndrome (SIRS, Control-group). Furthermore, a longitudinal substudy was performed for analysing the survival in septic patients. Only European white patients within the N macro-cluster were included. Case-group underwent cardiac surgery had lower frequencies of cluster HV (p = 0.005) and haplogroup H (p = 0.005) and higher frequencies of cluster JT (p = 0.028) than Control-group; but no significant differences were found for abdominal surgery. Besides, both cluster HV and haplogroup H were associated with decreased odds of severe sepsis (adjusted odds ratio (aOR) = 0.45 (95%CI = 0.25; 0.82); p = 0.009 and aOR = 0.48 (95%CI = 0.26; 0.87); p = 0.015, respectively) among patients underwent cardiac surgery. In Case-group, 45.4% (109/240) patients died with a survival median of 39 (95%CI = 31.4; 46.62) days. When the clusters were examined, 41% (55/134) patients within cluster HV died versus 71.4% (10/14) patients within cluster IWX (p = 0.018). Additionally, patients within cluster IWX had an increased risk of death (adjusted hazard ratio (aHR) = 2.22; (95%CI = 1.14; 4.34); p = 0.019). European mitochondrial haplogroups might be related to the onset of severe sepsis in patients who underwent major cardiac surgery, but not in patients underwent major abdominal surgery. Besides, mtDNA haplogroups could have influence on mortality in septic patients. Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  3. [Comparison of body weight loss in gastrectomy patients who underwent only surgery and those who underwent surgery followed up with S-1 adjuvant chemotherapy].

    Science.gov (United States)

    Aoyama, Toru; Yoshikawa, Takaki; Shirai, Junya; Hayashi, Tsutomu; Ogata, Takashi; Cho, Haruhiko; Yukawa, Norio; Oshima, Takashi; Rino, Yasushi; Ozawa, Yukihiro; Kitani, Yuichi; Wada, Hiroo; Masuda, Munetaka; Tsuburaya, Akira

    2012-11-01

    Body weight loss is a common outcome in patients with gastric cancer who have undergone gastrectomy. However, the rate of body weight loss after surgery is unknown. In this retrospective study, we selected patients who underwent radical gastrectomy for gastric cancer and were diagnosed with Stage II or III disease. Further, we compared the body weight loss after surgery between patients in the surgery alone group and the S-1 adjuvant chemotherapy group. We evaluated 163 patients, of which 81 underwent only surgery, and 82 underwent surgery followed up with S-1 adjuvant chemotherapy. The body weight loss rate at 1, 3, and 6 months in the surgery alone group were 93.1%, 92.9%, and 94.9%, while those in the S-1 adjuvant group were 92.9%, 90.4%,and 91.9%, which was a significant difference. Body weight loss after gastrectomy was higher in the S-1 adjuvant group than in the surgery alone group. Further, nutritional support is required for these patients to maintain body weight after surgery.

  4. Evolution of elderly patients who underwent cardiac surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Alain Moré Duarte

    2016-01-01

    Full Text Available Introduction: There is a steady increase in the number of elderly patients with severe cardiovascular diseases who require a surgical procedure to recover some quality of life that allows them a socially meaningful existence, despite the risks.Objectives: To analyze the behavior of elderly patients who underwent cardiac surgery with cardiopulmonary bypass.Method: A descriptive, retrospective, cross-sectional study was conducted with patients over 65 years of age who underwent surgery at the Cardiocentro Ernesto Che Guevara, in Santa Clara, from January 2013 to March 2014.Results: In the study, 73.1% of patients were men; and there was a predominance of subjects between 65 and 70 years of age, accounting for 67.3%. Coronary artery bypass graft was the most prevalent type of surgery and had the longest cardiopulmonary bypass times. Hypertension was present in 98.1% of patients. The most frequent postoperative complications were renal dysfunction and severe low cardiac output, with 44.2% and 34.6% respectively.Conclusions: There was a predominance of men, the age group of 65 to 70 years, hypertension, and patients who underwent coronary artery bypass graft with prolonged cardiopulmonary bypass. Renal dysfunction was the most frequent complication.

  5. Effect of using pump on postoperative pleural effusion in the patients that underwent CABG

    Directory of Open Access Journals (Sweden)

    Mehmet Özülkü

    2015-08-01

    Full Text Available Abstract Objective: The present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting. Methods: A total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish. Proximal anastomoses to the aorta in both on-pump and off-pump techniques were performed by side clamps. The patients were discharged from the hospital between postoperative day 6 and day 11. Results: The incidence of postoperative right pleural effusion and bilateral pleural effusion was found to be higher as a count in Group 1 (on-pump as compared to Group 2 (off-pump. But the difference was not statistically significant [P>0.05 for right pleural effusion (P=0.893, P>0.05 for bilateral pleural effusion (P=0.780]. Left pleural effusion was encountered to be lower in Group 2 (off-pump. The difference was found to be statistically significant (P<0.05, P=0.006. Conclusion: Under the light of these results, it can be said that left pleural effusion is less prevalent in the patients that underwent off-pump coronary artery bypass grafting when compared to the patients that underwent on-pump coronary artery bypass grafting.

  6. Assessment of the epidemiological profile of patients with dentofacial deformities who underwent orthognathic surgery.

    Science.gov (United States)

    Castro, Vanessa; do Prado, Celio Jesus; Neto, Antonio Irineu Trindade; Zanetta-Barbosa, Darceny

    2013-05-01

    The present study aimed to establish the profile of patients who underwent orthognathic surgery in a private clinic by evaluating their demographic characteristics, their facial types, and aspects related to the surgical procedures that were performed. The sample consisted of 419 medical records from male and female patients aged 15 to 62 years who underwent orthognathic surgery between 2001 and 2011. A single examiner collected data by evaluating a database of information extracted from medical records, particularly radiographic and photographic analyses. The following criteria were evaluated: gender, age, skin color, type of orthognathic surgery, type of associated temporomandibular joint (TMJ) surgery, complications, and recurrences. Seventeen patients were rejected because they had incomplete records. The average age of the patients was 28.5 years old; most were females (255 patients) and faioderm (295 patients). The most prevalent facial pattern was Pattern III (n = 166, 41.3%). Orthognathic surgery that affected the maxilla, jaw, and chin was the most prevalent type (n = 199, 49.5% of cases). A genioplasty was performed concurrently with combined surgeries and single-jaw surgery in 76.86% of patients (n = 309). TMJ surgery was performed concomitantly with orthognathic surgery in 4% of cases (n = 16). The most common postoperative complication was infection/inflammation (n = 12). We concluded that there was a higher frequency of orthognathic surgery among women and young people, the brunette skin phenotype was prevalent, and most patients had a combination of maxillary and mandibular problems.

  7. Serum Zn levels in dysphagic patients who underwent endoscopic gastrostomy for long term enteral nutrition

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    Carla Adriana Santos

    2014-02-01

    Full Text Available Background and aims: Dysphagic patients who underwent endoscopic gastrostomy (PEG usually present protein-energy malnutrition, but little is known about micronutrient malnutrition. The aim of the present study was the evaluation of serum zinc in patients who underwent endoscopic gastrostomy and its relationship with serum proteins, whole blood zinc, and the nature of underlying disorder. Methods: From patients that underwent gastrostomy a blood sample was obtained minutes before the procedure. Serum and whole blood zinc was evaluated using Wavelength Dispersive X-ray Fluorescence Spectroscopy. Serum albumin and transferrin were evaluated. Patients were studied as a whole and divided into two groups: head and neck cancer (HNC and neurological dysphagia (ND. Results: The study involved 32 patients (22 males, aged 43-88 years: HNC = 15, ND = 17. Most (30/32 had low serum zinc, 17/32 presented normal values of whole blood zinc. Only two, with traumatic brain injury, presented normal serum zinc. Serum zinc levels showed no differences between HNC and ND patients. There was no association between serum zinc and serum albumin or transferrin. There was no association between serum and whole blood zinc. Conclusions: Patients had low serum zinc when gastrostomy was performed, similar in HNC and ND, being related with prolonged fasting and unrelated with the underlying disease. Decrease serum zinc was unrelated with low serum proteins. Serum zinc was more sensitive than whole blood zinc for identifying reduced zinc intake. Teams taking care of PEG-patients should include zinc evaluation as part of the nutritional assessment, or include systematic dietary zinc supply.

  8. Dysphagia among Adult Patients who Underwent Surgery for Esophageal Atresia at Birth

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    Valérie Huynh-Trudeau

    2015-01-01

    Full Text Available BACKGROUND: Clinical experiences of adults who underwent surgery for esophageal atresia at birth is limited. There is some evidence that suggests considerable long-term morbidity, partly because of dysphagia, which has been reported in up to 85% of adult patients who undergo surgery for esophageal atresia. The authors hypothesized that dysphagia in this population is caused by dysmotility and/or anatomical anomalies.

  9. Sarcopenia: a new predictor of postoperative complications for elderly gastric cancer patients who underwent radical gastrectomy.

    Science.gov (United States)

    Zhou, Chong-Jun; Zhang, Feng-Min; Zhang, Fei-Yu; Yu, Zhen; Chen, Xiao-Lei; Shen, Xian; Zhuang, Cheng-Le; Chen, Xiao-Xi

    2017-05-01

    A geriatric assessment is needed to identify high-risk elderly patients with gastric cancer. However, the current geriatric assessment has been considered to be either time-consuming or subjective. The present study aimed to investigate the predictive effect of sarcopenia on the postoperative complications for elderly patients who underwent radical gastrectomy. We conducted a prospective study of patients who underwent radical gastrectomy from August 2014 to December 2015. Computed tomography-assessed lumbar skeletal muscle, handgrip strength, and gait speed were measured to define sarcopenia. Sarcopenia was present in 69 of 240 patients (28.8%) and was associated with lower body mass index, lower serum albumin, lower hemoglobin, and higher nutritional risk screening 2002 scores. Postoperative complications significantly increased in the sarcopenic patients (49.3% versus 24.6%, P sarcopenia (odds ratio: 2.959, 95% CI: 1.629-5.373, P Sarcopenia, presented as a new geriatric assessment factor, was a strong and independent risk factor for postoperative complications of elderly patients with gastric cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Undergrading and understaging in patients with clinically insignificant prostate cancer who underwent radical prostatectomy

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    Irai S. Oliveira

    2010-06-01

    Full Text Available PURPOSE: The aim of our study is to evaluate the undergrading and understaging rates in patients with clinically localized insignificant prostate cancer who underwent radical prostatectomy. MATERIALS AND METHODS: Between July 2005 and July 2008, 406 patients underwent radical prostatectomy for clinical localized prostate cancer in our hospital. Based on preoperative data, 93 of these patients fulfilled our criteria of non-significance: Gleason score < 7, stage T1c, PSA < 10 ng/mL and percentage of affected fragments less than 25%. The pathologic stage and Gleason score were compared to preoperative data to evaluate the rate of understaging and undergrading. The biochemical recurrence free survival of these operated insignificant cancers were also evaluated. RESULTS: On surgical specimen analysis 74.7% of patients had Gleason score of 6 or less and 25.3% had Gleason 7 or greater. Furthermore 8.3% of cases showed extracapsular extension. After 36 months of follow-up 3.4% had biochemical recurrence, defined by a PSA above 0.4 ng/mL. CONCLUSIONS: Despite the limited number of cases, we have found considerable rates of undergrading and understaging in patients with prostate cancer whose current definitions classified them as candidates for active surveillance. According to our results the current definition seems inadequate as up to a third of patients had higher grade or cancer outside the prostate.

  11. Functional assessment of patients with cervical myelopathy who underwent surgical treatment

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    Thiago Pereira Coutinho

    2014-03-01

    Full Text Available OBJECTIVE: Evaluate and correlate the functional response of patients with cervical myelopathy with the current clinical scores in patients who underwent surgical treatment. METHODS: We analyzed medical records of 34 patients with cervical myelopathy who underwent four different types of surgery. All patients were evaluated preoperatively and postoperatively with the application of the JOA and Nurick questionnaires. RESULTS: Functional clinical improvement was statistically significant. The mean preoperative JOA was 8.5 ± 3.06 and 10.7 ± 3.9 in the postoperative; Nurick was 3.2 ± 1.1 preoperatively and 2.8 ± 1.3 postoperatively. CONCLUSION: There is benefit with the surgical procedure in patients with cervical myelopathy. The neurological function after surgery depends on the previous function (the higher the duration of the previous symptoms, the greater the progression of the disease and, therefore, worse the neurological function and the age is not a relevant factor of improvement, as already shown in other series. The clinical functional improvement of patients is visible with surgical treatment, regardless of surgical technique.

  12. Anesthetic management of patient with Sjogren's syndrome who underwent cesarean section: a case report

    Science.gov (United States)

    Kim, Na Eun; Lee, Jae Hyuk; Lee, Jun Yong

    2016-01-01

    Sjogren's syndrome is one of the most common autoimmune disorders and has a female predominance. Maternal circulating autoantibodies such as anti-Ro/SSA and anti-La/SSB antibodies can cause congenital heart block of fetus, and in severe case, emergency pacemaker implantation may be needed for neonate. Therefore, it is very important to understand maternal and fetal condition and pay attention to the status of the neonate during delivery. In this paper, we present a case of patient with Sjogren's syndrome who underwent cesarean section under spinal anesthesia. PMID:27274376

  13. Surrogate pregnancy in a patient who underwent radical hysterectomy and bilateral transposition of ovaries.

    Science.gov (United States)

    Azem, Foad; Yovel, Israel; Wagman, Israel; Kapostiansky, Rita; Lessing, Joseph B; Amit, Ami

    2003-05-01

    To evaluate IVF-surrogate pregnancy in a patient with ovarian transposition after radical hysterectomy for carcinoma of the cervix. Case report. A maternity hospital in Tel Aviv that is a major tertiary care and referral center. A 29-year-old woman who underwent Wertheim's hysterectomy for carcinoma of the uterine cervix and ovarian transposition before total pelvic irradiation. Standard IVF treatment, transabdominal oocyte retrieval, and transfer to surrogate mother. Outcome of IVF cycle. A twin pregnancy in the first cycle. This is the second reported case of controlled ovarian stimulation and oocyte retrieval performed on a transposed ovary.

  14. Effect of different pneumoperitoneum pressure on stress state in patients underwent gynecological laparoscopy

    Institute of Scientific and Technical Information of China (English)

    Ai-Yun Shen

    2016-01-01

    Objective:To observe the effect of different CO2 pneumoperitoneum pressure on the stress state in patients underwent gynecological laparoscopy.Methods:A total of 90 patients who were admitted in our hospital from February, 2015 to October, 2015 for gynecological laparoscopy were included in the study and divided into groups A, B, and C according to different CO2 pneumoperitoneum pressure. The changes of HR, BP, and PetCO2 during the operation process in the three groups were recorded. The changes of stress indicators before operation (T0), 30 min during operation (T1), and 12 h after operation (T2) were compared. Results: The difference of HR, BP, and PetCO2 levels before operation among the three groups was not statistically significant (P>0.05). HR, BP, and PetCO2 levels 30 min after pneumoperitoneum were significantly elevated when compared with before operation (P0.05). PetCO2 level 30 min after pneumoperitoneum in group B was significantly higher than that in group A (P0.05).Conclusions:Low pneumoperitoneum pressure has a small effect on the stress state in patients underwent gynecological laparoscopy, will not affect the surgical operation, and can obtain a preferable muscular relaxation and vision field; therefore, it can be selected in preference.

  15. Prognostic nomogram for patients with hepatocellular carcinoma underwent adjuvant transarterial chemoembolization following curative resection

    Science.gov (United States)

    Jing, Chu-Yu; Fu, Yi-Peng; Zheng, Su-Su; Yi, Yong; Shen, Hu-Jia; Huang, Jin-Long; Xu, Xin; Lin, Jia-Jia; Zhou, Jian; Fan, Jia; Ren, Zheng-Gang; Qiu, Shuang-Jian; Zhang, Bo-Heng

    2017-01-01

    Abstract Adjuvant transarterial chemoembolization (TACE) is a major option for postoperative hepatocellular carcinoma (HCC) patients with recurrence risk factors. However, individualized predictive models for subgroup of these patients are limited. This study aimed to develop a prognostic nomogram for patients with HCC underwent adjuvant TACE following curative resection. A cohort comprising 144 HCC patients who received adjuvant TACE following curative resection in the Zhongshan Hospital were analyzed. The nomogram was formulated based on independent prognostic indicators for overall survival (OS). The performance of the nomogram was evaluated by the concordance index (C-index), calibration curve, and decision curve analysis (DCA) and compared with the conventional staging systems. The results were validated in an independent cohort of 86 patients with the same inclusion criteria. Serum alpha-fetoprotein (AFP), hyper-sensitive C-reactive protein (hs-CRP), incomplete tumor encapsulation, and double positive staining of Cytokeratin 7 and Cytokeratin 19 on tumor cells were identified as independent predictors for OS. The C-indices of the nomogram for OS prediction in the training cohort and validation cohort were 0.787 (95%CI 0.775–0.799) and 0.714 (95%CI 0.695–0.733), respectively. In both the training and validation cohorts, the calibration plot showed good consistency between the nomogram-predicted and the observed survival. Furthermore, the established nomogram was superior to the conventional staging systems in terms of C-index and clinical net benefit on DCA. The proposed nomogram provided an accurate prediction on risk stratification for HCC patients underwent adjuvant TACE following curative resection. PMID:28296727

  16. Outcome of Patients Underwent Emergency Department Thoracotomy and Its Predictive Factors

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    Shahram Paydar

    2014-08-01

    Full Text Available Introduction: Emergency department thoracotomy (EDT may serve as the last survival chance for patients who arrive at hospital in extremis. It is considered as an effective tool for improvement of traumatic patients’ outcome. The present study was done with the goal of assessing the outcome of patients who underwent EDT and its predictive factors. Methods: In the present study, medical charts of 50 retrospective and 8 prospective cases underwent emergency department thoracotomy (EDT were reviewed during November 2011 to June 2013. Comparisons between survived and died patients were performed by Mann-Whitney U test and the predictive factors of EDT outcome were measured using multivariate logistic regression analysis. P < 0.05 considered statistically significant. Results: Fifty eight cases of EDT were enrolled (86.2% male. The mean age of patients was 43.27±19.85 years with the range of 18-85. The mean time duration of CPR was recorded as 37.12±12.49 minutes. Eleven cases (19% were alive to be transported to OR (defined as ED survived. The mean time of survival in ED survived patients was 223.5±450.8 hours. More than 24 hours survival rate (late survived was 6.9% (4 cases. Only one case (1.7% survived to discharge from hospital (mortality rate=98.3%. There were only a significant relation between ED survival and SBP, GCS, CPR duration, and chest trauma (p=0.04. The results demonstrated that initial SBP lower than 80 mmHg (OR=1.03, 95% CI: 1.001-1.05, p=0.04 and presence of chest trauma (OR=2.6, 95% CI: 1.75-3.16, p=0.02 were independent predictive factors of EDT mortality. Conclusion: The findings of the present study showed that the survival rate of trauma patients underwent EDT was 1.7%. In addition, it was defined that falling systolic blood pressure below 80 mmHg and blunt trauma of chest are independent factors that along with poor outcome.

  17. Study of the seroma volume changes in the patients who underwent Accelerated Partial Breast Irradiation

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    Kim, Dae Ho; Son, Sang Jun; Mun, Jun Ki; Seo, Seok Jin; Lee, Je Hee [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-06-15

    By analyzing seroma volume changes in the patients who underwent Partial breast radiation therapy after breast conserving surgery, we try to contribute to the improvement of radiotherapy effect. Enrolled 20 patients who underwent partial breast radiation therapy by ViewRay MRIdian System were subject. After seeking for the size of the removed sample in the patients during surgery and obtained seroma volume changes on a weekly basis. On the Basis of acquired volume, it was compared with age, term from start of the first treatment after surgery, BMI (body mass index) and the extracted sample size during surgery. And using the ViewRay MRIdian RTP System, the figure was analyzed by PTV(=seroma volume + margin) to obtain a specific volume of the Partial breast radiation therapy. The changes of seroma volume from MR simulation to the first treatment (a week) is 0~5% in 8, 5~10% in 3, 10 to 15% in 2, and 20% or more in 5 people. Two patients(A, B patient) among subjects showed the biggest change. The A patient's 100% of the prescribed dose volume is 213.08 cc, PTV is 181.93 cc, seroma volume is 15.3 cc in initial plan. However, while seroma volume decreased 65.36% to 5.3 cc, 100% of the prescribed dose volume was reduced to 3.4% to 102.43 cc and PTV also did 43.6% to 102.54 cc. In the case of the B patient, seroma volume decreased 42.57% from 20.2 cc to 11.6 cc. Because of that, 100% of the prescribed dose volume decreased 8.1% and PTV also did to 40%. As the period between the first therapy and surgery is shorter, the patient is elder and the size of sample is smaller than 100 cc, the change grow bigger. It is desirable to establish an adaptive plan according to each patient's changes of seroma volume through continuous observation. Because partial breast patients is more sensitive than WBRT patients about dose conformity in accordance with the volume change.

  18. Clinicopathological Features of Cervical Esophageal Cancer: Retrospective Analysis of 63 Consecutive Patients Who Underwent Surgical Resection.

    Science.gov (United States)

    Saeki, Hiroshi; Tsutsumi, Satoshi; Yukaya, Takafumi; Tajiri, Hirotada; Tsutsumi, Ryosuke; Nishimura, Sho; Nakaji, Yu; Kudou, Kensuke; Akiyama, Shingo; Kasagi, Yuta; Nakashima, Yuichiro; Sugiyama, Masahiko; Sonoda, Hideto; Ohgaki, Kippei; Oki, Eiji; Yasumatsu, Ryuji; Nakashima, Torahiko; Morita, Masaru; Maehara, Yoshihiko

    2017-01-01

    The objectives of this retrospective study were to elucidate the clinicopathological features and recent surgical results of cervical esophageal cancer. Cervical esophageal cancer has been reported to have a dismal prognosis. Accurate knowledge of the clinical characteristics of cervical esophageal cancer is warranted to establish appropriate therapeutic strategies. The clinicopathological features and treatment results of 63 consecutive patients with cervical esophageal cancer (Ce group) who underwent surgical resection from 1980 to 2013 were analyzed and compared with 977 patients with thoracic or abdominal esophageal cancer (T/A group) who underwent surgical resection during that time. Among the patients who received curative resection, the 5-year overall and disease-specific survival rates of the Ce patients were significantly better than those of the T/A patients (overall: 77.3% vs 46.5%, respectively, P = 0.0067; disease-specific: 81.9% vs 55.8%, respectively, P = 0.0135). Although total pharyngo-laryngo-esophagectomy procedures were less frequently performed in the recent period, the rate of curative surgical procedures was markedly higher in the recent period (2000-1013) than that in the early period (1980-1999) (44.4% vs 88.9%, P = 0.0001). The 5-year overall survival rate in the recent period (71.5%) was significantly better than that in the early period (40.7%, P = 0.0342). Curative resection for cervical esophageal cancer contributes to favorable outcomes compared with other esophageal cancers. Recent surgical results for cervical esophageal cancer have improved, and include an increased rate of curative resection and decreased rate of extensive surgery.

  19. [Incidence and risk factors of postoperative cognitive dysfunction in patients underwent coronary artery bypass grafting surgery].

    Science.gov (United States)

    Ge, Yali; Ma, Zhengliang; Shi, Hongwei; Zhao, Yamei; Gu, Xiaoping; Wei, Haiyan

    2014-10-01

    To investigate the incidence rate and the risk factors for postoperative cognitive dysfunction (POCD) in patients underwent coronary artery bypass grafting surgery. A total of 147 patients underwent elective coronary artery bypass grafting (CABG) surgery between January to July 2013 were included in this study. POCD was diagnosed using a neuropsychological test battery. All enrolled patients were interviewed on the day before surgery, the seventh day and 3 months after surgery, respectively, by the same researcher, and were divided into two groups based on the results: the POCD group and the non-POCD group. The information, including age, sex, body mass index, educational status, comorbidities, history of smoking and drinking, ASA grade, left ventricular ejection fraction, operation method, duration of operations, regional cerebral oxygen saturation, the lowest haemoglobin concentrations and the haemoglobin concentration decline rate during the operation, tracheal catheter retention time, postoperative pain on visual analogue scales (VAS) and systemic inflammatory response syndrome score (SIRS score), were recorded based on a schedule of survey. Multivariate logistic regression was used to analyze the risk factors for POCD. A total of 101 patients finished this study. On 7 days and 3 months after surgery, 38 and 21 cases showed POCD, with an incidence rate at 37.6% and 20.8%, respectively. Interestingly, there was no significant difference in incidence of POCD between CABG and OPCABG group on both 7 days and 3 months after surgery (P>0.05). The logistic stepwise regression analysis indicated that the risk factors for POCD included advanced age (OR=1.177, 95%CI 1.071-1.292, P=0.001), the haemoglobin concentration decline rate (OR=1.334, 95%CI 1.152-1.545, PSIRS score (OR=2.815, 95%CI 1.014-7.818, P=0.047). The incidence rate of POCD was 37.6% and 20.8% on 7 days and 3 months after surgery respectively. Advanced age, the haemoglobin concentration decline rate and

  20. Newly Developed Sarcopenia as a Prognostic Factor for Survival in Patients who Underwent Liver Transplantation.

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    Ja Young Jeon

    Full Text Available The relationship between a perioperative change in sarcopenic status and clinical outcome of liver transplantation (LT is unknown. We investigated whether post-LT sarcopenia and changes in sarcopenic status were associated with the survival of patients.This retrospective study was based on a cohort of 145 patients from a single transplant center who during a mean of 1 year after LT underwent computed tomography imaging evaluation. The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals. The Cox proportional hazards regression model was used to determine whether post-LT sarcopenia and changes in sarcopenic status affect post-LT survival.The mean age at LT of the 116 male and 29 female patients was 50.2 ± 7.9 years; the mean follow-up duration was 51.6 ± 32.9 months. All pre-LT patients with sarcopenia still had sarcopenia 1 year after LT; 14 (15% patients had newly developed sarcopenia. The mean survival duration was 91.8 ± 4.2 months for non-sarcopenic patients and 80.0 ± 5.2 months for sarcopenic patients (log-rank test, p = 0.069. In subgroup analysis, newly developed sarcopenia was an independent negative predictor for post-LT survival (hazard ratio: 10.53, 95% confidence interval: 1.37-80.93, p = 0.024.Sarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others. Newly developed sarcopenia was associated with increased mortality. Newly developed sarcopenia can be used to stratify patients with regard to the risk of post-LT mortality.

  1. Newly Developed Sarcopenia as a Prognostic Factor for Survival in Patients who Underwent Liver Transplantation

    Science.gov (United States)

    Ock, So Young; Xu, Weiguang; Lee, Jung-Dong; Lee, Jei Hee; Kim, Hae Jin; Kim, Dae Jung; Lee, Kwan Woo; Han, Seung Jin

    2015-01-01

    Introduction The relationship between a perioperative change in sarcopenic status and clinical outcome of liver transplantation (LT) is unknown. We investigated whether post-LT sarcopenia and changes in sarcopenic status were associated with the survival of patients. Method This retrospective study was based on a cohort of 145 patients from a single transplant center who during a mean of 1 year after LT underwent computed tomography imaging evaluation. The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals. The Cox proportional hazards regression model was used to determine whether post-LT sarcopenia and changes in sarcopenic status affect post-LT survival. Results The mean age at LT of the 116 male and 29 female patients was 50.2 ± 7.9 years; the mean follow-up duration was 51.6 ± 32.9 months. All pre-LT patients with sarcopenia still had sarcopenia 1 year after LT; 14 (15%) patients had newly developed sarcopenia. The mean survival duration was 91.8 ± 4.2 months for non-sarcopenic patients and 80.0 ± 5.2 months for sarcopenic patients (log-rank test, p = 0.069). In subgroup analysis, newly developed sarcopenia was an independent negative predictor for post-LT survival (hazard ratio: 10.53, 95% confidence interval: 1.37–80.93, p = 0.024). Conclusion Sarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others. Newly developed sarcopenia was associated with increased mortality. Newly developed sarcopenia can be used to stratify patients with regard to the risk of post-LT mortality. PMID:26619224

  2. High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement

    DEFF Research Database (Denmark)

    Specht, Kirsten; Kjaersgaard-Andersen, Per; Kehlet, Henrik;

    2015-01-01

    Background and purpose - Patient satisfaction is important in fast-track total hip and knee replacement (THR, TKR). We assessed: (1) how satisfied patients were with the treatment; (2) factors related to overall satisfaction; and (3) whether there was a difference between THR and TKR regarding...... length of stay (LOS) and patient satisfaction. Patients and methods - In this follow-up study, a consecutive series of 445 patients undergoing THR and TKR completed a questionnaire 2 weeks after discharge. LOS and short-term patient satisfaction with the fast-track management were measured. Patient...... satisfaction was measured using a numerical rating scale (NRS; 0-10). Results - For THR, the median satisfaction score was 9-10 and for TKR it was 8.5-10 in all parameters. Older THR patients had higher overall satisfaction. No association was found between overall satisfaction following THR or TKR and sex...

  3. Fundus fluorescein angiographic findings in patients who underwent ventricular assist device implantation.

    Science.gov (United States)

    Ozturk, Taylan; Nalcaci, Serhad; Ozturk, Pelin; Engin, Cagatay; Yagdi, Tahir; Akkin, Cezmi; Ozbaran, Mustafa

    2013-09-01

    Disruption of microcirculation in various tissues as a result of deformed blood rheology due to ventricular assist device (VAD) implantation causes novel arteriovenous malformations. Capillary disturbances and related vascular leakage in the retina and choroidea may also be seen in patients supported by VADs. We aimed to evaluate retinal vasculature deteriorations after VAD implantation. The charts of 17 patients who underwent VAD implantation surgery for the treatment of end-stage heart failure were retrospectively reviewed. Eight cases (47.1%) underwent pulsatile pump implantation (Berlin Heart EXCOR, Berlin Heart Mediprodukt GmbH, Berlin, Germany); however, nine cases (52.9%) had continuous-flow pump using centrifugal design (HeartWare, HeartWare Inc., Miramar, FL, USA). Study participants were selected among the patients who had survived with a VAD for at least 6 months, and results of detailed ophthalmologic examinations including optic coherence tomography (OCT) and fundus fluorescein angiography (FA) were documented. All of the 17 patients were male, with a mean age of 48.5 ± 14.8 years (15-67 years). Detailed ophthalmologic examinations including the evaluation of retinal vascular deteriorations via FA were performed at a mean of 11.8 ± 3.7 months of follow-up (6-18 months). Mean best-corrected visual acuity and intraocular pressure were found as logMAR 0.02 ± 0.08 and 14.6 ± 1.9 mm Hg, respectively in the study population. Dilated fundoscopy revealed severe focal arteriolar narrowing in two patients (11.8%), and arteriovenous crossing changes in four patients (23.5%); however, no pathological alteration was present in macular OCT scans. In patients with continuous-flow blood pumps, mean arm-retina circulation time (ARCT) and arteriovenous transit time (AVTT) were found to be 16.8 ± 3.0 and 12.4 ± 6.2 s, respectively; whereas those with pulsatile-flow blood pumps were found to be 17.4 ± 3.6 and 14.0 ± 2.1 s in patients (P=0.526 and P=0

  4. PROPHYLAXIS OF SURGICAL SITE INFECTION WITH VANCOMYCIN IN 513 PATIENTS THAT UNDERWENT TO LUMBAR FUSION

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    Nicolas Scheverin

    2015-09-01

    Full Text Available Objective:To assess the prophylactic effects of local vancomycin on an infection of the surgical site in patients undergoing lumbar instrumented fusion.Methods:Retrospective study from January 2011 to June 2014 in patients with symptomatic and refractory lumbar spine stenosis and listhesis who underwent instrumented pedicle screw spinal fusion. Two groups of patient were analyzed, one using vancomycin on the surgical site, vancomycin group (VG and the control group (CG without topical vancomycin. The routine prophylactic procedures were performed in both groups: aseptic scrub technique, skin preparation, preoperative intravenous antibiotic therapy. The VG received a dose of 1g of vancomycin mixed with the bone graft every three spinal levels fused and the group consisted of 232 patients.Results:513 patients were analyzed, 232 in the VG and 281 in the CG. There was no statistical difference between the groups when the sex, mean surgery length, and mean bleeding volume were considered. The rate of infection for VG was reduced from 4.98% to 1.29% when compared with CG.Conclusion:The use of vancomycin added to the bone graft in posterior spinal fusion is associated with significantly lower rates of infection.

  5. SELENIUM IN DYSPHAGIC PATIENTS WHO UNDERWENT ENDOSCOPIC GASTROSTOMY FOR LONG TERM ENTERAL FEEDING.

    Science.gov (United States)

    Santos, Carla Adriana; Fonseca, Jorge; Carolino, Elisabete; Lopes, Teresa; Guerreiro, António Sousa

    2015-12-01

    endoscopic gastrostomy (PEG) patients usually present protein-energy malnutrition, but little is known about selenium deficiency. We aimed to assess serum selenium evolution when patients underwent PEG, after 4 and 12 weeks. We also evaluated the evolution of albumin, transferrin and Body Mass Index and the influence of the nature of the underlying disease. a blood sample was obtained before PEG (T0), after 4 (T1) and 12 (T3) weeks. Selenium was assayed using GFAAS (Furnace Atomic Absorption Spectroscopy). The PEG patients were fed through homemade meals. Patients were studied as a whole and divided into two groups: head and neck cancer (HNC) and neurological dysphagia (ND). we assessed 146 patients (89 males), between 21-95 years old: HNC-56; ND-90. Normal values of selenium in 79% (n=115); low albumin in 77, low transferrin in 94, low values for both serum proteins in 66. Low BMI in 78. Selenium has slow evolution, with most patients still displaying normal Selenium at T3 (82%). Serum protein levels increase from T0 to T3, most patients reaching normal values. The nature of the underlying disease is associated with serum proteins but not with selenium. low serum selenium is uncommon when PEG is performed, after 4 and 12 weeks of enteral feeding and cannot be related with serum proteins levels or dysphagia cause. Enteral nutrition using customized homemade kitchen meals is satisfactory to prevent or correct Selenium deficiency in the majority of PEG patients. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  6. LOW SERUM CHROMIUM IS RARE IN PATIENTS THAT UNDERWENT ENDOSCOPIC GASTROSTOMY FOR LONG TERM ENTERAL FEEDING.

    Science.gov (United States)

    Santos, Carla Adriana; Fonseca, Jorge; Carolino, Elisabete; Guerreiro, António Sousa

    2017-01-01

    Patients that underwent Percutaneous Endoscopic Gastrostomy (PEG) present with protein-energy malnutrition. Trace elements are required in small quantities and Chromium (Cr) displays a major role in the metabolism. This study aims to evaluate Cr levels and its relationship with serum proteins, BMI and underlying diseases during the first 3 months of PEG feeding. Prospective observational study during 3-months, when PEG was performed (T0), after 4 (T1), and 12 weeks (T3). Initial evaluation included: age, gender, underlying disease, NRS-2002, BMI, serum albumin, transferrin and Cr concentration. At T1 and T3 a blood sample was collected for Cr, albumin and transferrin. A Graphite Furnace Atomic Absorption Spectroscopy was used to assess Cr. According with the underlying disease, patients were divided into two groups: head and neck cancer (HNC) and neurological dysphagia (ND). All patients were fed with homemade meals. A one hundred and twenty-nine patients (80 males), 26-95 years old were studied: HNC-52; ND-77. The observed data included low mean values of BMI from 71 patients; low Cr-8, low albumin-70, low transferrin-85 and 57 with both proteins low. Albumin was associated with survival time ( P =0.024) and there was a significant correlation between albumin and Cr (r=0.217, P =0.012). A good evolution of Cr and proteins values was observed, with no low Cr levels at T3. Low serum Cr is rare in PEG-patients, with no relationship to other studied parameters. For the minority of patients displaying low Cr before gastrostomy, homemade PEG meals seem to be effective.

  7. Comparative analysis of pain in patients who underwent total knee replacement regarding the tourniquet pressure

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leão

    Full Text Available ABSTRACT OBJECTIVES: To evaluate through the visual analog scale (VAS the pain in patients undergoing total knee replacement (TKR with different pressures of the pneumatic tourniquet. METHODS: An observational, randomized, descriptive study on an analytical basis, with 60 patients who underwent TKR, divided into two groups, which were matched: a group where TKR was performed with tourniquet pressures of 350 mmHg (standard and the other with systolic blood pressure plus 100 mmHg (P + 100. These patients had their pain assessed by VAS at 48 h, and at the 5th and 15th days after procedure. Secondarily, the following were also measured: range of motion (ROM, complications, and blood drainage volume in each group; the data were subjected to statistical analysis. RESULTS: After data analysis, there was no statistical difference regarding the incidence of complications (p = 0.612, ROM (p = 0.202, bleeding after 24 and 48 h (p = 0.432 and p = 0.254 or in relation to VAS. No correlation was observed between time of ischemia compared to VAS and bleeding. CONCLUSIONS: The use of the pneumatic tourniquet pressure at 350 mmHg or systolic blood pressure plus 100 mmHg did not influence the pain, blood loss, ROM, and complications. Therefore the pressures at these levels are safe and do not change the surgery outcomes; the time of ischemia must be closely observed to avoid major complications.

  8. Influence of perioperative administration of amino acids on thermoregulation response in patients underwent colorectal surgical procedures

    Directory of Open Access Journals (Sweden)

    Zeba Snježana

    2007-01-01

    Full Text Available Background. Hypothermia in the surgical patients can be the consequence of long duration of surgical intervention, general anesthesia and low temperature in operating room. Postoperative hypothermia contributes to a number of postoperative complications such as arrhythmia, myocardial ischemia, hypertension, bleeding, wound infection, coagulopathy, prolonged effect of muscle relaxants. External heating procedures are used to prevent this condition, but some investigations reported that infusion of aminoacids during surgery can induce thermogenesis and prevent postoperative hypothermia. Case report. We reported two males who underwent major colorectal surgery for rectal carcinoma. One patient received Aminosol 15% solution, 125 ml/h, while the other did not. The esophageal temperatures in both cases were measured every 30 minutes during the operation and 60 minutes after in Intensive Care Unit. We were monitoring blood pressure, heart rate, ECG, and shivering. Patient who received aminoacids showed ameliorated postoperative hypothermia without hypertension, arrhythmia, or shivering, while the other showed all symptoms mentioned above. Conclusion. According to literature data, as well as our findings, we can conclude that intraoperative intravenous treatment with amino acid solution ameliorates postoperative hypothermia along with its complications. .

  9. Evaluation of 118 Thyroid Cancer Patients Who Underwent a Re-operation after Local Resection

    Institute of Scientific and Technical Information of China (English)

    Jianping Hang; Dong Meng; Liqi Li

    2005-01-01

    OBJECTIVE To evaluate the incidence of residual thyroid cancer and cervical lymph node metastasis following a previous local resection for thyroid cancer, and to discuss methods of a reoperation.METHODS From 1994~2005, 118 patients with thyroid cancer who had previously been treated with a nodule-resection or subtotal Iobectomy in other hospitals underwent a surgical re-operation.RESULTS The incidence of residual cancer at the primary site was 38.1%. The lymph node metastasis rate at the central area was 39.8%.The rate of lymph node metastasis in patients with enlarged lymph nodes in the ipsilateral internal jugular chain was 37.5%. The rate of laryngeal recurrent nerve injury was 15.2% in other hospitals while that of the second operation in our hospital was 1.6%.CONCLUSION Nodule-resection or subtotal Iobectomy alone is not indicated for patients with thyroid cancer because of the high rate of local residual cancer. It is important to be familiar with the anatomy of the laryngeal recurrent nerve for thyroid surgery. Exploration to the central area is necessary for differentiated thyroid cancer.

  10. Incidence of venous thromboembolism among patients who underwent major surgery in a public hospital in Singapore

    Directory of Open Access Journals (Sweden)

    Anindya P. Susanto

    2014-03-01

    Full Text Available Background: Venous thromboembolism (VTE is a fatal yet potentially preventable complication of surgery. Routine thromboprophylaxis is still unequivocal prescription is problematic due to perception of low VTE incidence among Asian population. This study aims to investigate the incidence of VTE and thromboprophylaxis prescription among patients undergoing major surgery in a Singapore hospital.Methods: This was a cross-sectional study. Data were obtained from medical record of 1,103 patients who had underwent major orthopaedic or abdominal surgery in 2011-2012 at Khoo Teck Puat Hospital, Singapore. Incidence of VTE events either in the same admission or re-admission in less than one month time were noted as study parameters.Results: Incidence of VTE was 2.1% (95% CI: 1.67 - 2.53 of which 1.3% and 0.8% were DVT and PE cases respectively. Age, gender, history of VTE, ischemic heart disease, and mechanical prophylaxis were associated with VTE incidence based on bivariate analysis. The prescription of pharmacological thromboprophylaxis was associated with prior anticoagulant medication, type of surgery, and incidence of new bleeding. Conclusion: Subsequent to major surgeries, VTE is as common in Asian patients as published data in other populations. Pharmacologic thromboprophylaxis should be considered as recommended in non-Asian guidelines.Keywords: thromboprophylaxis, venous thromboembolism

  11. Assessment of Patients Who Underwent Nasal Reconstruction After Non-Melanoma Skin Cancer Excision.

    Science.gov (United States)

    Uzun, Hakan; Bitik, Ozan; Kamburoğlu, Haldun Onuralp; Dadaci, Mehmet; Çaliş, Mert; Öcal, Engin

    2015-06-01

    Basal and squamous cell carcinomas are the most common malignant cutaneous lesions affecting the nose. With the rising incidence of skin cancers, plastic surgeons increasingly face nasal reconstruction challenges. Although multiple options exist, optimal results are obtained when "like is used to repair like". We aimed to introduce a simple algorithm for the reconstruction of nasal defects with local flaps, realizing that there is always more than one option for reconstruction. We retrospectively reviewed 163 patients who underwent nasal reconstruction after excision of non-melanoma skin cancer between March 2011 and April 2014. We analyzed the location of the defects and correlated them with the techniques used to reconstruct them. There were 66 males and 97 females (age, 21-98 years). Basal cell carcinoma was diagnosed in 121 patients and squamous cell carcinoma in 42. After tumor excision, all the defects were immediately closed by either primary closure or local flap options such as Limberg, Miter, glabellar, bilobed, nasolabial, V-Y advancement, and forehead flaps. Obtaining tumor-free borders and a pleasing aesthetic result are major concerns in nasal reconstruction. Defect reconstruction and cosmesis are as important as rapid recovery and quick return to normal daily activities, and these should be considered before performing any procedure, particularly in elderly patients.

  12. THE EXPERIENCE OF TREGALOZA BASED LUBRICANT USAGE FOR PATIENTS WHO UNDERWENT EXCIMER LASER SURGERY

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    E. Eskina

    2016-01-01

    Full Text Available Purpose: to evaluate the tregalose based eye drops effectiveness in patients who underwent PRK or TransPRK surgery. patients and methods: 50 patients with moderate myopia were examined before, 7 days and 1 month after PRK or TransPRK surgery made by SCHWIND Amaris excimer laser by the same surgeon. In addition to conventional diagnostics, Schirmer test and tear break up time were performed as well as ODSI questionare and Oxford index of ocular surface disorders were investigated. Patients were divided in two groups, Study group — “Thealos” group and “Control” group. In both groups patients have started using non preservative eye drops based on tregalosa and hyaluronic acid 4-th day after surgery respectively. results: The tear film breakup time was significantly better in “Thealos” group (7,22±3,61 sec 7 days postop and 9,36±3,68 sec 1 month postop in comparison to «Control” group 5,21±0,25 (р<0,01 sec and 7,21±2,85 sec respectively (р<0,05 as well as ocular surface index score in “Thealos” group post surgery was less (0,26±0,38 и 0,85±0,31 marks 7 days postop (р<0,05 and 0,09±0,19 and 0,21±0,4 (р<0,05 1 month postop respectively. There were no other statistically significant differences found in analysed data. Conclusion: Using of “Thealoz” non-preservative eye drops leads to faster recovery after surface excimer laser ablations in terms of dry eye manifestation, those as tearfilm stability and ocular surface index score, measured using “Oxford” scale. Moistening properties of tregaloze solution could be compared with those of hyaluronic acid solution.

  13. Association of PTP1B with Outcomes of Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy

    Science.gov (United States)

    Rivera Franco, Monica M.; Leon Rodriguez, Eucario; Martinez Benitez, Braulio; Villanueva Rodriguez, Luisa G.; de la Luz Sevilla Gonzalez, Maria; Armengol Alonso, Alejandra

    2016-01-01

    PTP1B is involved in the oncogenesis of breast cancer. In addition, neoadjuvant therapy has been widely used in breast cancer; thus, a measurement to assess survival improvement could be pathological complete response (pCR). Our objective was to associate PTP1B overexpression with outcomes of breast cancer patients who underwent neoadjuvant chemotherapy. Forty-six specimens were included. Diagnostic biopsies were immunostained using anti-PTP1B antibody. Expression was categorized as negative (<5%) and overexpression (≥5%). Patients’ responses were graded according to the Miller–Payne system. Sixty-three percent of patients overexpressed PTP1B. There was no significant association between PTP1B overexpression and pCR (P = 0.2). However, when associated with intrinsic subtypes, overexpression was higher in human epidermal growth factor receptor 2-positive-enriched specimens (P = 0.02). Ten-year progression-free survival showed no differences. Our preliminary results do not show an association between PTP1B over-expression and pCR; however, given the limited sample and heterogeneous treatment in our cohort, this hypothesis cannot be excluded. PMID:27840578

  14. Predictors of weight regain in patients who underwent Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Shantavasinkul, Prapimporn Chattranukulchai; Omotosho, Philip; Corsino, Leonor; Portenier, Dana; Torquati, Alfonso

    2016-11-01

    Roux-en-Y gastric bypass (RYGB) is a highly effective treatment for obesity and results in long-term weight loss and resolution of co-morbidities. However, weight regain may occur as soon as 1-2 years after surgery. This retrospective study aimed to investigate the prevalence of weight regain and possible preoperative predictors of this phenomenon after RYGB. An academic medical center in the United States. A total of 1426 obese patients (15.8% male) who underwent RYGB during January 2000 to 2012 and had at least a 2-year follow-up were reviewed. We included only patients who were initially successful, having achieved at least 50% excess weight loss at 1 year postoperatively. Patients were then categorized into either the weight regain group (WR) or sustained weight loss (SWL) group based upon whether they gained≥15% of their 1-year postoperative weight. Weight regain was observed in 244 patients (17.1%). Preoperative body mass index was similar between groups. Body mass index was significantly higher and percent excess weight loss was significantly lower in the WR group (Pweight regain was 19.5±9.3 kg and-.8±8.5 in the WR and SWL groups, respectively (Pweight loss. Moreover, a longer duration after RYGB was associated with weight regain. Multivariate analysis revealed that younger age was a significant predictor of weight regain even after adjusting for time since RYGB. The present study confirmed that a longer interval after RYGB was associated with weight regain. Younger age was a significant predictor of weight regain even after adjusting for time since RYGB. The findings of this study underscore the complexity of the mechanisms underlying weight loss and regain after RYGB. Future prospective studies are needed to further explore the prevalence, predictors, and mechanisms of weight regain after RYGB. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  15. Pediatric urolithiasis in the central coast of Tunisia: Epidemiologic changes over the past twenty-five years

    Directory of Open Access Journals (Sweden)

    Najjar M

    2010-01-01

    Full Text Available The incidence of Pediatric urolithiasis has been constantly decreasing during the past twenty-four years (1982-2007 in Tunisia as well as in other Mediterranean countries. This study was undertaken to observe the incidence of stone disease and its composition in children. Our study shows a downward trend of incidence of urolithiasis in pediatric patients over the last 25 years. The prevalence of calcium oxalate stones has constantly increased with decrease in the stones related to infections Whewellite (calcium oxalate was more frequent in children of school age. In conclusion, the decrease in struvite frequency in children patients during the past twenty-five years and the stabilization of calcium phosphate stones are the result of a significant im-provement of diagnostics and the treatment of urinary tract infections in the young children in our country.

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

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    H. ASKARI

    1999-03-01

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

  17. Classification of Groups with Strong Symmetric Genus up to Twenty-Five

    CERN Document Server

    Fieldsteel, Nathan; London, Tyler; Tran, Holden; Xu, Haokun

    2011-01-01

    The strong symmetric genus of a finite group is the minimum genus of a compact Riemann surface on which the group acts as a group of automorphisms preserving orientation. A characterization of the infinite number of groups with strong symmetric genus zero and one is well-known and the problem is finite for each strong symmetric genus greater than or equal to two. May and Zimmerman have published papers detailing the classification of all groups with strong symmetric genus two through four. Using the computer algebra system GAP, we extend these classifications to all groups of strong symmetric genus up to twenty-five. This paper outlines the approach used for the extension.

  18. Screening of twenty five plant extracts for larvicidal activity against Culex quinquefasciatus Say (Diptera:Culicidae)

    Institute of Scientific and Technical Information of China (English)

    Samuel Tennyson; K John Ravindran; S Arivoli

    2012-01-01

    Objective: To determine the larvicidal activity of twenty five plant extracts against Culex quinquefasciatus (Cx. quinquefasciatus). Methods: The larvicidal activity was determined against the third instar larvae of Cx. quinquefasciatus at 1 000 ppm concentration. Larval mortality was assessed after 24 and 48 h. Results: The hexane extracts of Cleistanthus collinus (C. collinus) and Murraya koeingii (M. koeingii) plants showed 100 percent mortality at 24 h bioassay followed by diethyl ether, dichloromethane and ethyl acetate extracts of C. collinus, Leucas aspera (L. aspera), Hydrocotyle javanica (H. javanica), M. koeingii, Sphaeranthus indicus (S. indicus) and Zanthoxylum limonella (Z. limonella) after 48 h exposure. Conclusions: The results indicate larvicidal activity against Cx. quinquefasciatus and further investigations are needed to elucidate this activity against a wide range of all stages of mosquito species and also the active ingredients of the extract responsible for larvicidal activity should be identified.

  19. Microbial adhesion to hydrocarbons: twenty-five years of doing MATH.

    Science.gov (United States)

    Rosenberg, Mel

    2006-09-01

    Twenty-five years ago this past autumn, we published a short article entitled 'Adherence of bacteria to hydrocarbons: a simple method for measuring cell-surface hydrophobicity' in Volume 9 of FEMS Microbiology Letters. Together with my Ph.D. supervisors, Eugene Rosenberg and David Gutnick, we proposed a method of measuring bacterial cell surface hydrophobicity based on bacterial adherence to hydrocarbon ('BATH', later known as 'MATH', for microbial adhesion to hydrocarbon). The method became popular soon after it was published, and the paper was, for at least the following decade, the Journal's most cited article. It became an ISI 'citation classic' in 1991. This minireview is a rather personal look at the development of the method and its various modifications and other scientific offspring, with the perspective of a quarter-century.

  20. New insight into the molecular basis of 3beta-hydroxysteroid dehydrogenase deficiency: identification of eight mutations in the HSD3B2 gene eleven patients from seven new families and comparison of the functional properties of twenty-five mutant enzymes

    National Research Council Canada - National Science Library

    Moisan, A M; Ricketts, M L; Tardy, V; Desrochers, M; Mébarki, F; Chaussain, J L; Cabrol, S; Raux-Demay, M C; Forest, M G; Sippell, W G; Peter, M; Morel, Y; Simard, J

    1999-01-01

    .... To identify the molecular lesion(s) in the HSD3B2 gene in the 11 patients from the seven new families suffering from classical 3betaHSD deficiency, the complete nucleotide sequence of the whole coding region and exon-intron splicing...

  1. Fungal peritonitis in patients on peritoneal dialysis: Twenty five years of experience in a teaching hospital in Argentina Peritonitis fúngica en pacientes en diálisis peritoneal: la experiencia de 25 años en un hospital universitario de la Argentina

    Directory of Open Access Journals (Sweden)

    S. C. Predari

    2007-12-01

    Full Text Available Fungal peritonitis is a rare but serious complication of peritoneal dialysis. The aim of this study was to analyze peritonitis rates, associated factors, clinical course, microbiological aspects, therapeutic regimens, and outcome of patients with fungal peritonitis in the dialysis center of a teaching hospital over the last 25 years. A hundred and eighty three episodes of peritonitis were detected and microbiologically documented in 57 patients. Fungi were identified in eight episodes (4.37% occurring in seven female patients. The fungal peritonitis rate was 0.06 episodes/patient-year. Gram and Giemsa stains were positive in five out of eight dialysate fluids. The causative microorganisms were: Candida albicans in five episodes, and Candida parapsilosis, Candida glabrata, and Neosartorya hiratsukae in the remaining three. Antibiotics were administered to all but one patient, within 3 months before fungal peritonitis was detected. All patients required hospitalization, and antifungal therapy was administered in all episodes. The Tenckhoff catheter was removed in seven out of eight fungal peritonitis. All patients recovered from the fungal episodes. In the group of patients studied, it is concluded that recent exposure to antibiotics and female sex, were strongly associated with the development of fungal peritonitis by yeasts. The peritonitis caused by the environmental filamentous fungus did not require antibiotic pressure. Direct microscopy of the dialysate pellet was extremely useful for the prompt management of the fungal episode. Fungal peritonitis preceded by multiple episodes of bacterial peritonitis always determined the definitive dropout of the patient from the peritoneal dialysis program. Patients with de novo yeastrelated peritonitis could continue on the program.La peritonitis fúngica es una complicación infrecuente pero grave de la diálisis peritoneal. Los objetivos de este trabajo fueron el análisis de las tasas de peritonitis

  2. [A patient with EDTA-dependent pseudothrombocytopenia who underwent emergent clipping surgery for a ruptured aneurysm].

    Science.gov (United States)

    Yamaguchi, M; Mayumi, M; Kasuya, T

    1998-01-01

    A 42-year-old female with EDTA-dependent pseudothrombocytopenia underwent emergent clipping surgery for a ruptured aneurysm. On admission, the platelet count was low, but bleeding time and coagulation test were within normal limits. The blood smear anticoagulated with EDTA revealed remarkable agglutination of platelets, while heparinized blood showed a normal level. Diagnosis of EDTA-dependent pseudothrombocytopenia was made. The progressive drop in platelet count occurred within 10 minutes in the presence of EDTA. The autocounter misjudged the agglutination of platelets as red or white blood cells. The earlier study reported the incidence of this diseases as 0.07%. This disease is often misdiagnosed. Therefore, thrombocytopenia without any clinical symptom should be considered as showing a possible symptom of EDTA-dependent pseudothrombocytopenia.

  3. Comparison of propofol effect with Ketamine for sedation induction in pediatric patients who underwent cardiol catheterization

    Directory of Open Access Journals (Sweden)

    Houshang Shahryari

    2010-04-01

    Full Text Available Background: The goals for sedation in pediatric patients scheduled to undergo cardiac catheterization include immobility, analgesia, cardiovascular and respiratory stability. We investigated the effects of Propofol and Ketamine on hemodynamic, respiratory status, sedation level, pain score and recovery period in pediatric patients undergoing cardiac catheterization. Methods: We preformed a randomized clinical trial study on 40 pediatric patients. The patients were randomly assigned to two groups, so that 20 patients received Ketamine and 20 patients received Propofol. In all patients, sedation was started with Midazolam (0.03mg/kg, then followed by Propofol in the first group and Ketamine in the second one. The hemodynamic responses, respiratory parameters, recovery characteristics (Ramsey scale, pain score VAS and relevant adverse effects of the two groups were recorded. Data was analyzed using Paired T Test, ANOVA and Stearman correlation coefficient. Results: Five patients in the Propofol group andon patients in the Ketamine group experienced a transient decrease in mean systolic blood pressure greater than 10% of baseline(p=0.034. Time to full recovery (mean ± SD was not significantly different in the Propofol group and Ketamine group (1.8 min vs. 2.9 min, P > 0.05. Pain scores were significantly different in both groups (P= 0.010. Patients’ heart rates were significantly higher in Ketamine group(P=0.029. No significant difference in respiratory rate was recorded in both groups(p›0.05. Conclusion: Both Ketamine and Propofol are useful and safe in pediatric patients undergoing cardiac catheterization but it seems that it is better to use Propofol in stable hemodynamic pediatric patients under continuous blood pressure monitoring.

  4. Comparing efficacy of preemptively used dexketoprofen and tramadol for postoperative pain in patients underwent laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Süreyya Özkan

    2015-03-01

    Full Text Available Objective: In our study, we aimed to compare effects of preoperative dexketoprofen and tramadol administered by intravenous route on intraoperative and postoperative analgesic consumption, postoperative pain, durations of hospital stay and patient satisfaction in patients, undergoing laparoscopic cholecystectomy. Methods:After approval of ethic committee and written consent of patients were obtained, 60 patients between 18-70 years old with ASA I-II were included in the study. After routine monitorization and 20 minutes before induction of anesthesia, dexketoprofen 50 mg in 100 cc 0.9% NaCl was administered in Dexketoprofen Group and tramadol 100 mg in 100 cc 0.9% NaCl in Tramadol Group as intravenous infusion during 20 minutes. Intraoperative hemodynamic parameters, analgesic-anesthetic consumptions and complications of patients, on whom standard general anesthesia was applied, were recorded. Pain severity, degree of sedation, morphine consumptions and hemodynamic parameters were recorded at postoperative 30 th minute, and 4 th, 8th, 12th and 24 th hours. Additional analgesia requirement, times for requiring first analgesia, duration of hospital stay, postoperative complications and patient satisfactions were recorded. Results: Intraoperative analgesic-anesthetic consumptions, postoperative visual analogue scale (VAS scores, sedation degrees, intravenous patient controlled analgesia (PCA and morphine consumptions, times for requiring first analgesic, durations of hospital stay, intraoperative-postoperative complications developed and patient satisfactions were similar in both groups. Consequently, postoperative analgesic efficacy of pre-emptive dexketoprofen intravenous 50 mg and tramadol intravenous 100 mg administered was found to be similar in cases, who had laparoscopic cholecystectomy operation. Conclusion:Because VAS scores were low in our patients, morphine consumptions with intravenous PCA were similar in both groups, and there wasn

  5. New insight into the molecular basis of 3beta-hydroxysteroid dehydrogenase deficiency: identification of eight mutations in the HSD3B2 gene eleven patients from seven new families and comparison of the functional properties of twenty-five mutant enzymes.

    Science.gov (United States)

    Moisan, A M; Ricketts, M L; Tardy, V; Desrochers, M; Mébarki, F; Chaussain, J L; Cabrol, S; Raux-Demay, M C; Forest, M G; Sippell, W G; Peter, M; Morel, Y; Simard, J

    1999-12-01

    Classical 3beta-hydroxysteroid dehydrogenase/delta5-delta4 isomerase (3betaHSD) deficiency is a form of congenital adrenal hyperplasia that impairs steroidogenesis in both the adrenals and gonads resulting from mutations in the HSD3B2 gene and causing various degrees of salt-wasting in both sexes and incomplete masculinization of the external genitalia in genetic males. To identify the molecular lesion(s) in the HSD3B2 gene in the 11 patients from the seven new families suffering from classical 3betaHSD deficiency, the complete nucleotide sequence of the whole coding region and exon-intron splicing boundaries of this gene was determined by direct sequencing. Five of these families were referred to Morel's molecular diagnostics laboratory in France, whereas the two other families were investigated by Peter's group in Germany. Functional characterization studies were performed by Simard's group in Canada. Following transient expression in 293 cells of each of the mutant recombinant proteins generated by site-directed mutagenesis, the effect of the 25 mutations on enzyme activity was assessed by incubating intact cells in culture with 10 nM [14C]-DHEA as substrate. The stability of the mutant proteins has been investigated using a combination of Northern and Western blot analyses, as well as an in vitro transcription/translation assay using rabbit reticulocyte lysates. The present report describes the identification of 8 mutations, in seven new families with individuals suffering from classical 3betaHSD deficiency, thus increasing the number of known HSD3B2 mutations involved in this autosomal recessive disorder to 31 (1 splicing, 1 in-frame deletion, 3 nonsense, 4 frameshift and 22 missense mutations). In addition to the mutations reported here in these new families, we have also investigated for the first time the functional significance of previously reported missense mutations and or sequence variants namely, A82T, A167V, L173R, L205P, S213G and K216E, P222H, T259

  6. Twenty-five Years of PTHrP Progress from Cancer Hormone to Multifunctional Cytokine

    Science.gov (United States)

    McCauley, Laurie K.; Martin, T. John

    2016-01-01

    Twenty-five years ago a ‘new’ protein was identified from cancers that caused hypercalcemia. It was credited for its ability to mimic parathyroid hormone, and hence was termed parathyroid hormone-related protein (PTHrP). Today it is recognized for its widespread distribution, its endocrine, paracrine, and intracrine modes of action driving numerous physiologic and pathologic conditions with a central role in organogenesis. The multiple biological activities within a complex molecule with paracrine modulation of adjacent target cells present boundless possibilities. The protein structure of PTHrP has been traced, dissected and deleted comprehensively and conditionally, yet numerous questions lurk in its past that will carry into the future. Issues of the variable segments of the protein including the enigmatic nuclear localization sequence are only recently being clarified. Aspects of PTHrP production and action in the menacing condition of cancer are emerging as dichotomies that may represent intended temporal actions of PTHrP. Relative to PTH, the hormone regulating calcium homeostasis, PTHrP ‘controls the show’ locally at the PTH/PTHrP receptor throughout the body. Great strides have been made in our understanding of PTHrP actions, yet years of exciting investigation and discovery are imminent. PMID:22549910

  7. Twenty-five astronomical observations that changed the world and how to make them yourself

    CERN Document Server

    Marett-Crosby, Michael

    2013-01-01

    Human history is also the record of our fascination with the sky, and to look upwards is to follow in the steps of such greats as Galileo and Newton. What they and others once saw in the heavens for the first time, amateur astronomers can discover anew using this guide to twenty-five of the greatest journeys through space.   Starting with our most visible companion the Moon, each chapter offers a step-by-step walk-through of famous astronomical observations from the history of science. Beginning with the easiest targets, sometimes even accessible with the naked eye, the challenges become progressively more difficult. Beginner astronomers and more experienced hobbyists alike can reacquaint themselves with the wonders of our fellow planets and even reach far beyond our own solar system to touch on such incredible phenomena as the birth of new stars in nebula systems and the deceptive nothingness of black holes. The would-be astronaut can spy the International Space Station in orbit with binoculars or the dooms...

  8. The Twenty-five Maiden Ladies’ Tomb and Predicaments of the Feminist Movement in Taiwan

    Directory of Open Access Journals (Sweden)

    Anru Lee

    2010-01-01

    Full Text Available “The Twenty-five Maiden Ladies’ Tomb” is the collective burial site of the female workers who died in a ferry accident on their way to work in 1973. The fact that of the more than 70 passengers on board all 25 who died were unmarried young women, and the taboo in Taiwanese culture that shuns unmarried female ghosts, made the Tomb a fearsome place. Feminists in Gaoxiong (高雄 had for some years wanted the city government to change the tomb’s public image. Their calls were not answered until the Gaoxiong mayor’s office finally allocated money to clean up the gravesite and, as part of the city’s plans to develop urban tourism, to remake it into the tourist-friendly “Memorial Park for Women Labourers”. Consequently, even though the tomb renovation seemed to indicate a triumph of the feminist endeavour, it was more a result of the Gaoxiong city government’s efforts towards culture-led urban revitalization.

  9. Twenty-five winters of unexpected Eurasian cooling unlikely due to Arctic sea-ice loss

    Science.gov (United States)

    McCusker, Kelly E.; Fyfe, John C.; Sigmond, Michael

    2016-11-01

    Surface air temperature over central Eurasia decreased over the past twenty-five winters at a time of strongly increasing anthropogenic forcing and Arctic amplification. It has been suggested that this cooling was related to an increase in cold winters due to sea-ice loss in the Barents-Kara Sea. Here we use over 600 years of atmosphere-only global climate model simulations to isolate the effect of Arctic sea-ice loss, complemented with a 50-member ensemble of atmosphere-ocean global climate model simulations allowing for external forcing changes (anthropogenic and natural) and internal variability. In our atmosphere-only simulations, we find no evidence of Arctic sea-ice loss having impacted Eurasian surface temperature. In our atmosphere-ocean simulations, we find just one simulation with Eurasian cooling of the observed magnitude but Arctic sea-ice loss was not involved, either directly or indirectly. Rather, in this simulation the cooling is due to a persistent circulation pattern combining high pressure over the Barents-Kara Sea and a downstream trough. We conclude that the observed cooling over central Eurasia was probably due to a sea-ice-independent internally generated circulation pattern ensconced over, and nearby, the Barents-Kara Sea since the 1980s. These results improve our knowledge of high-latitude climate variability and change, with implications for our understanding of impacts in high-northern-latitude systems.

  10. Application of a buprenorphine transdermal patch for the perioperative analgesia in patients who underwent simple lumbar discectomy

    Science.gov (United States)

    Tang, Jian; Fan, Jin; Yao, Yilun; Cai, Weihua; Yin, Guoyong; Zhou, Wei

    2017-01-01

    Abstract This study aimed to investigate the perioperative analgesic effect of a buprenorphine transdermal patch in patients who underwent simple lumbar discectomy. In total, 96 patients were randomly divided into parecoxib intravenous injection (Group A), oral celecoxib (Group B), and buprenorphine transdermal patch groups (Group C). The pain status, degree of satisfaction, adverse effects, and condition in which the patient received tramadol hydrochloride for uncontrolled pain were recorded on the night before surgery, postoperative day 1, postoperative day 3, and postoperative day 5. The degree of patient satisfaction in Group C was higher than that in Groups A and B, with minimal adverse effects. The buprenorphine transdermal patch had a better perioperative analgesic effect in patients who underwent simple lumbar discectomy. PMID:28514299

  11. Autologous Vascularized Dural Wrapping for Temporalis Muscle Preservation and Reconstruction After Decompressive Craniectomy: Report of Twenty-five Cases

    Science.gov (United States)

    Di Rienzo, Alessandro; Iacoangeli, Maurizio; Alvaro, Lorenzo; Colasanti, Roberto; Nocchi, Niccolo; Di Somma, Lucia Giovanna Maria; Scerrati, Massimo

    2013-01-01

    Temporalis muscle reconstruction is a necessary step during frontotemporal cranioplasty ensuing decompressive craniectomy (DC). During this procedure, scarring between the temporalis muscle and the dural layer may lead to complicated muscle dissection, which carries an increased risk of dura and muscle damage. At time of DC, temporalis muscle wrapping by an autologous vascularized dural flap can later on facilitate dissection and rebuilding during the subsequent cranioplasty. In a span of 2 years, we performed 57 DCs for different etiologies. In 30 cases, the temporalis muscle was isolated by wrapping its inner surface using the autologous dura. At cranioplasty, the muscle could easily be dissected from the duraplasty. The inner surface was easily freed from the autologous dural envelope, and reconstruction achieved in an almost physiological position. Follow-up examinations were held at regular intervals to disclose signs of temporalis muscle depletion. Twenty-five patients survived to undergo cranioplasty. Muscle dissection could always be performed with no injury to the dural layer. No complications related to temporalis muscle wrapping were recorded. Face asymmetry developed in four cases but it was always with bone resorption. None of the patients with a good neurological recovery reported functional or aesthetic complaints. In our experience, temporalis muscle wrapping by vascularized autologous dura proved to be effective in preserving its bulk and reducing its adhesion to duraplasty, thereby improving muscle dissection and reconstruction during cranioplasty. Functional and aesthetic results were satisfying, except in cases of bone resorption. PMID:24067769

  12. Analysis of Recurrence Management in Patients Who Underwent Nonsurgical Treatment for Acute Appendicitis.

    Science.gov (United States)

    Liang, Tsung-Jung; Liu, Shiuh-Inn; Tsai, Chung-Yu; Kang, Chi-Hsiang; Huang, Wei-Chun; Chang, Hong-Tai; Chen, I-Shu

    2016-03-01

    The recurrence rate for acute appendicitis treated nonoperatively varies between studies. Few studies have adequately evaluated the management of these patients when appendicitis recurs. We aimed to explore the recurrence rate and management of patients with acute appendicitis that were first treated nonoperatively.We identified patients in the Taiwan National Health Insurance Research Database who were hospitalized due to acute appendicitis for the first time between 2000 and 2010 and received nonsurgical treatment. The recurrence and its management were recorded. Data were analyzed to access the risk factors for recurrence and factors that influenced the management of recurrent appendicitis.Among the 239,821 patients hospitalized with acute appendicitis for the first time, 12,235 (5.1%) patients were managed nonoperatively. Of these, 864 (7.1%) had a recurrence during a median follow-up of 6.5 years. Appendectomy was performed by an open and laparoscopic approach in 483 (55.9%) and 258 (29.9%) patients, respectively. The remaining 123 (14.2%) patients were again treated nonsurgically. Recurrence was independently associated with young age, male sex, percutaneous abscess drainage, and medical center admission by multivariable analysis. In addition, age appendicitis, percutaneous abscess drainage, nor length of first time hospital stay had an influence on the selection of surgical approach.In conclusion, a laparoscopic appendectomy can be performed in recurrent appendicitis cases, and its application may not be related to previous appendicitis severity.

  13. Thromboprophylaxis and Incidence of Venous Thromboembolism in Patients With Hemophilia A or B Who Underwent High-Risk Orthopedic Surgeries.

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    Raza, Shahzad; Kale, Gautam; Kim, Daniel; Akbar, Syed A; Holm, Lisa; Naidzionak, Ulad; Hossain, Akm M; Dong, Xiang; Doll, Donald C; Freter, Carl E; Hopkins, Tamara

    2016-03-01

    Total hip replacement (THR) and total knee arthroplasty (TKA) carry a high risk of postoperative venous thromboembolism (VTE); therefore, anticoagulation prophylaxis is recommended in these patients. Unfortunately, there are no guidelines about VTE prophylaxis in patients with hemophilia who underwent these high-risk surgeries. To determine whether these patients have high risk of VTE, we conducted a retrospective study on patients with hemophilia who underwent elective THR/TKA at our institute from 2004 to 2012. Postoperatively, we collected information on duration and method of factor VIII/IX infusion, VTE-prophylaxis, and complications. There were 23 patients with hemophilia, 18 (78%) with hemophilia A and 5 (22%) with hemophilia B, who underwent high-risk surgeries (39% THR and 61% TKA). The VTE prophylaxis included sequential compression device, 12 (52%), and prophylactic enoxaparin, 1 (4%). Ten (43%) patients did not receive VTE prophylaxis. At 1-year follow-up, we did not find any evidence of clinical VTE in our patients. Better risk stratification is needed to identify patients who would benefit from pharmacological prophylaxis.

  14. Evaluation of fever in the immediate postoperative period in patients who underwent total joint arthroplasty.

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    Athanassious, Christian; Samad, Adil; Avery, Anthony; Cohen, Jason; Chalnick, David

    2011-12-01

    Forty percent to 50% of patients may experience an immediate postoperative fever. Research suggests that these are of aseptic cause due to inflammatory mediators. This is a retrospective analysis of fevers in total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients from 2006 to 2008. Thirty-six percent of THA and 31% of TKA patients developed a fever, with most developing a maximum temperature on postoperative day (POD) 2. The maximum mean temperature between the THA and TKA group was not significantly different. Fevers in the immediate postoperative period are a normal variant in patients undergoing THA or TKA. Urinalysis, urine culture and sensitivity, and chest x-ray are not required during this period because most of these fevers stem from aseptic causes. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Serum zinc evolution in dysphagic patients that underwent endoscopic gastrostomy for long term enteral feeding.

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    Santos, Carla Adriana; Fonseca, Jorge; Lopes, Maria Teresa Martins; Carolino, Elisabete; Guerreiro, António Sousa

    2017-03-01

    Patients undergoing endoscopic gastrostomy (PEG) present with protein-energy malnutrition (PEM) but little is known about zinc status. Our aim was to evaluate serum zinc, its relationship with serum proteins and with the nature of the underlying disorder, during the first 3 months of PEG feeding. Prospective observational study during a 3-month period after gastrostomy. Data was collected at initial PEG procedure (T0), after 4 (T1) and 12 weeks (T3). Initial evaluation included: age, gender, disorder causing dysphagia, Neurological Dysphagia (ND) or Head and Neck Cancer (HNC), NRS-2002, BMI, albumin, transferrin, zinc. At T1 and T3, a blood sample was collected for zinc, albumin, transferrin. Serum zinc evaluation was performed with ICP-AES - Inductively Coupled Plasma-Atomic Emission Spectroscopy. Patients were fed with homemade meals. A total of 146 patients (89 males), 21-95 years were studied: HNC-56, ND-90 and low BMI in 78. Initial low zinc in 122; low albumin in 77, low transferrin in 94; low values for both proteins in 66. Regarding the serum protein evolution, their levels increase T0-T3, most patients reaching normal values. zinc has a slower evolution, most patients still displaying low zinc at T3. Significant differences between the 3 moments for zinc (p=0.011), albumin (p<0.0001) and transferrin (p=0.014). PEG patients are prone to PEM and zinc deficiency. Most patients present decreased zinc, suggesting that zinc deficiency is common in PEG candidates and is not corrected during 3 months of enteral feeding. Zinc deficiency should be expected and teams taking care of PEG patients should use zinc supplementation.

  16. Adenomyosis:Pathologies associated in a set of patients underwent hysterectomy

    Institute of Scientific and Technical Information of China (English)

    Luis Humberto Sordia-Hernandez; Julio Herrero; Arturo Morales Martinez; Jose Mara Gris; Donato Saldivar Rodriguez; Oscar Vidal Gutierrez; Celina Castro

    2012-01-01

    Objective:To determine if a relationship exists between the histopathological diagnosis of adenomyosis and the clinical conditions and pathologies that are more commonly related to it in patients undergoing hysterectomy. Methods:Retrospective, comparative, case-control study was conducted. With previous approval by ethics committee, we included 794 patients undergoing hysterectomy at a University Hospital. The Medical records and pathology reports of patients undergoing hysterectomy over a two-year period were reviwed. Clinical conditions and associated pathologies, in patients with and without adenomyosis, were reviewed and compared. Statistical analysis was done using the Chi-square test. Results:Adenomyosis was reported in 140 out of 794 patients, 17.6%(95%CI:15.1-20.4). No differences in adenomyosis prevalence were found among patients with or without uterine fibroids, 20.2%(75/371) vs. 15.5%(65/423);endometrial polyps, 9.7%(6/62) vs. 18.3%(134/732);and the presence or lack of endometrial hyperplasia 13.9%(5/36) vs. 17.4%(135/758). The prevalence of adenomyosis among patients with endometriosis was 40.7%(11/27), and among those without this diagnosis, 16.8%(129/767). This difference was significant (P=0.001). A history of two or more curettages was also positively related to adenomyosis. Conclusions:There was a statistically significant difference in the prevalence of adenomyosis in women with endometriosis when compared to women without endometriosis. A higher incidence of adenomyosis was found in patients with a history of two or more curettages. Trauma to the endometrium could explain the higher incidence of adenomyosis in both conditions.

  17. Comparison of intraoperative and postoperative complications based on ASA risks in patients who underwent percutaneous nephrolithotomy

    Science.gov (United States)

    Karakaş, Hüseyin Buğra; Çiçekbilek, İzzet; Tok, Adem; Alışkan, Tamer; Akduman, Bülent

    2016-01-01

    Objective In this study we aimed to evaluate intraoperative and postoperative complications which developed according to pre-operative American Society of Anesthesiologists (ASA) risk criteria in patients who had undergone percutaneous nephrolithotomy (PNL). Material and methods Five hundred and sixty patients who had undergone PNL between 2002 and 2014 were included in the study. Patients operated on the ipsilateral kidney, those with solitary kidney or the cases who had previously undergone more than one access were excluded from this study. Preoperative anesthesia risks were determined according to preoperative classification developed by ASA. Postoperative complications were evaluated using Clavien Complication Grading Scale. Results The mean age of the cases was 47±14 years. The 57% (n=319) of the cases were male, 241 (43%) of them were female. The average indwell time of nephrostomy catheter was 2.88±1.00 (1–8), and length of hospital stay was 4.91±1.54 (2–17) days. When the cases were assessed according to ASA risk groups, intraoperative complications were observed in 9 (5.5%) ASA I, 27 (8.6%) ASA II, and 18 (22%) ASA III patients and and distribution of the patients was statistically significant (pPNL operations in terms of intraoperative complications. PMID:27635291

  18. Serum copper evolution in patients that underwent endoscopic gastrostomy for long term enteral feeding

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    Carla Adriana Santos

    Full Text Available Background and aims: Copper (Cu is a well studied trace element but little is known about Cu evolution in long term endoscopic gastrostomy (PEG feeding. We aimed to evaluate the evolution serum Cu since the gastrostomy until 12 weeks after the procedure in PEG patients fed with homemade meals. Methods: A prospective observational study was performed evaluating serum copper, albumin, transferrin and body mass index (BMI at the time of the gastrostomy, 4 weeks and 12 weeks after. Data also included age, gender, NRS 2002 and nature of the underlying disease causing dysphagia: head and neck cancer (HNC or neurological dysphagia (ND. After gastrostomy, patients were fed with homemade PEG meals. Results: One hundred and forty-six patients enrolled, 89 men, aged 21-95 years, 90 with neurologic dysphagia (ND, and 56 with head and neck cancer (HNC. 78 (53% showed low BMI. Initially, Cu ranged 42-160 µg/dl (normal: 70-140 µg/dl; 130 patients (89% presented normal Cu, 16 (11% presented hypocupremia, 53% low albumin (n = 77, and 94 (65% low transferrin. After 4 weeks, 93% presented normal Cu, 7% presented hypocupremia, low albumin was present in 34%, and low transferrin in 52%. After 12 weeks, 95% presented normal Cu, 5% presented hypocupremia, low albumin was present in 25%, and low transferrin in 32%. Comparing age, gender, underlying disease, BMI, albumin and transferrin, there were no significant differences on serum Cu. Conclusions: Most patients present normal serum Cu when gastrostomy is performed. For patients presenting hypocupremia before gastrostomy, homemade meals are effective for normalizing serum Cu.

  19. Concomitant mediastinal and extrarenal retroperitoneal angiomyolipomas in a patient who previously underwent ipsilateral radical nephrectomy

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    Carl Sheng-Chen Wen

    2014-12-01

    Full Text Available The association of the tuberous sclerosis complex with angiomyolipoma (AML arising from the retroperitoneum and mediastinum has not been reported in the literature. We present the first case in which a patient presented with a combined retroperitoneal extrarenal and posterior mediastinal AML. Interestingly, the ipsilateral retroperitoneal AML emerged 15 years after radical nephrectomy for the left renal AML.

  20. Speech and Swallowing Data in Individual Patients Who Underwent Glossectomy after Prosthetic Rehabilitation

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    Viviane de Carvalho

    2016-01-01

    Full Text Available Maintaining oral function in patients undergoing glossectomy boosts interventions such as prosthetic rehabilitation. However, current literature still fails in the presentation of results of prosthetic rehabilitation in relation to speech or swallowing. The objective of this research is to evaluate the effectiveness of prosthetic rehabilitation on voice, speech, and swallowing in patients undergoing glossectomy by performing a systematic literature review and meta-analysis of individual cases. Studies were identified by relevant electronic database and included all dates available. The criteria used were sample with any n; resection due to malignant tumors, restricted to tongue and/or floor of mouth; type of prosthetic rehabilitation; and description of the oral functions outcomes with prosthesis. For the meta-analysis of individual data, associations between the variables of interest and the type of prosthesis were evaluated. Thirty-three of 471 articles met the selection criteria. Results on speech and/or voice and swallowing were reported in 27 and 28 articles, respectively. There were improvement of speech intelligibility and swallowing in 96 patients and in 73 patients, respectively, with prosthesis. Based on the available evidences, this article showed that prosthetic rehabilitation was able to improve oral functions and can be a strategy used with surgical reconstruction in selected cases.

  1. Twenty five years of antismoking movement started by medical students: some further goals.

    Science.gov (United States)

    Zizic-Borjanovic, S; Jerinic, M; Igic, R

    2007-01-01

    Twenty five years ago, medical students of the former Yugoslavia accepted an idea that emerged from the Medical School in Tuzla to carry out a national preventive campaign "January 31st, a Day without Cigarette". This campaign was soon recognized by the World Health Organization (WHO) as one of "the most successful preventive achievement of medical students in Europe". The only contribution that the government made was printing and releasing a postal stamp on January 31st, 1990. During the war in Bosnia, the UN sanctions imposed to Serbia, and the NATO bombing campaign of the F.R. Yugoslavia (Serbia & Montenegro) weakened this antismoking campaign. At the time of the civil war in several Yugoslav republics, more citizens, including children and youth, started to smoke than in previous years. In 2002, January 31st was proclaimed as the National Antismoking Day in Serbia and the "Republic of Srpska" in Bosnia & Herzegovina; the Republic of Slovenia, and to a smaller extent the rest of the "Bosnian Federation", continued to observe this antismoking campaign. In the future, the medical professionals have to look for new ways to help smokers quit smoking and to maintain abstinence. In addition to education and professional advice, they may use smoking cessation interventions, especially to smokers that require elective surgery. Medical students should continue to participate in the national antismoking campaigns, and they could be included in the comprehensive smoking intervention programs to improve their smoking cessation counseling skills. However, the governments should plan and rigorously realize needed measures to control smoking at public places, offices, and other closed working places. Such measures are especially needed in poor and developing countries where many people die unnecessarily.

  2. QOL-associated factors in elderly patients who underwent cardiovascular surgery.

    Science.gov (United States)

    Terashima, Kiyoko; Yoshimura, Yoko; Hirai, Kazuyoshi; Kusaka, Yukinori

    2012-03-01

    Quality of life (QOL) was compared between elderly patients treated with cardiac surgery (cardiac surgery group) and general elderly nonoperated individuals (control group) to clarify differences in QOL-associated factors between the two groups. The cardiac surgery group consisted of 82 patients aged 72.5 years at approximately 2 years after discharge, and the control group consisted of 95 elderly individuals aged 77 years living at home. QOL was measured based on interviews using two scales: disease-specific QOL and Short Form (36) Health Survey (SF-36) in the cardiac surgery group, and SF-36 in the control group. Associated factors included the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence, living with one's spouse, exercise habit, and the number of past medical history items. There was no cardiac surgery procedure-associated significant difference in disease-specific QOL. When comparing SF-36 between groups, the physical health level was significantly lower in the cardiac surgery group, but no significant difference was noted in the mental health level. Regarding physical health level of SF-36-associated factors, mental health level was a negative factor in both groups. In the cardiac surgery group, age was a negative factor. In the control group, the TMIG index and number of past medical history items were positive and negative factors, respectively. As elderly people with high physical health levels after cardiac surgeries may have low mental health levels, physicians and nurses need to be aware and address this situation.

  3. Vaginal and pelvic recurrence rates based on vaginal cuff length in patients with cervical cancer who underwent radical hysterectomies.

    Science.gov (United States)

    Kim, K; Cho, S Y; Park, S I; Kim, B J; Kim, M H; Choi, S C; Ryu, S Y; Lee, E D

    2011-09-01

    The objective of this study was to determine the association of vaginal cuff length (VCL) with vaginal and pelvic recurrence rates in patients with cervical cancer who underwent radical hysterectomies. The clinicopathologic characteristics were collected from the medical records of 280 patients with cervical cancer who underwent radical hysterectomies. The association of VCL with 3-year vaginal and pelvic recurrence rates was determined using a Z-test. The association of VCL with other clinicopathologic characteristics was also determined. The VCL was not associated with 3-year vaginal and pelvic recurrence rates. The 3-year vaginal recurrence rate was 0%-2% and the 3-year pelvic recurrence rate was 7%-8%, independent of VCL. The VCL and the age of patients had an inverse relationship. However, the VCL was not associated with histologic type, FIGO stage, clinical tumor size, tumor size in the surgical specimen, depth of invasion, lymphovascular space invasion, parametrial involvement, lymph node involvement, and adjuvant therapy. One-hundred ninety of 280 patients (68%) underwent adjuvant therapies following radical hysterectomies. Although it is limited by the high rate of adjuvant therapy, the current study suggested that the VCL following radical hysterectomy in patients with cervical cancer was not associated with vaginal and pelvic recurrence rates. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Optical Coherence Tomography Parameters in Morbidly Obese Patients Who Underwent Laparoscopic Sleeve Gastrectomy

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    Berna Dogan

    2016-01-01

    Full Text Available Purpose. To investigate changes in optical coherence tomography parameters in morbidly obese patients who had undergone laparoscopic sleeve gastrectomy (LSG. Methods. A total of 41 eyes of 41 morbidly obese patients (BMI ≥ 40 who had undergone LSG were included in study. The topographic optic disc parameters, central macular thickness (CMT, total macular volume (TMV, and retinal ganglion cell layer (RGCL were measured by spectral-domain optical coherence tomography (SD-OCT. Subfoveal choroidal thickness (SFCT was measured by enhanced deep imaging-optical coherence tomography (EDI-OCT. Results. The mean CMT was 237.4±24.5 μm, 239.3±24.1 μm, and 240.4±24.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean TMV was 9.88±0.52 mm3, 9.96±0.56 mm3, and 9.99±0.56 mm3 preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean RGCL was 81.2±6.5 μm, 82.7±6.6 μm, and 82.9±6.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean SFCT was 309.8±71.8 μm, 331.0±81.4 μm, and 352.7±81.4 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. No statistically significant differences were found between the preoperative values and 3- and 6-month postoperative values in rim area (p=0.34, disc area (p=0.64, vertical cup/disc ratio (p=0.39, cup volume (p=0.08, or retinal nerve fiber layer (p=0.90. Conclusions. Morbidly obese patients who undergo LSG experience a statistically significant increase in CMT, TMV, SFCT, and RGCL at 3 months and 6 months after surgery.

  5. The Mid-Term Results of Patients who Underwent Radiofrequency Atrial Fibrillation Ablation Together with Mitral Valve Surgery

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    Abdurrahim Çolak

    Full Text Available Abstract Objetive: Saline-irrigated radiofrequency ablation, which has been widely used for surgical treatment of atrial fibrillation in recent years, is 80-90% successful in achieving sinus rhythm. In our study, our surgical experience and mid-term results in patients who underwent mitral valve surgery and left atrial radiofrequency ablation were analyzed. Methods: Forty patients (15 males, 25 females; mean age 52.05±9.9 years; range 32-74 underwent surgery for atrial fibrillation associated with mitral valvular disease. All patients manifested atrial fibrillation, which started at least six months before the surgical intervention. The majority of patients (36 patients, 90% were in NYHA class III; 34 (85% patients had rheumatic heart disease. In addition to mitral valve surgery and radiofrequency ablation, coronary artery bypass, DeVega tricuspid annuloplasty, left ventricular aneurysm repair, and left atrial thrombus excision were performed. Following discharge from the hospital, patients' follow-up was performed as outpatient clinic examinations and the average follow-up period of patients was 18±3 months. Results: While the incidence of sinus rhythm was 85.3% on the first postoperative day, it was 80% during discharge and 71% in the 1st year follow-up examination. Conclusion: Radiofrequency ablation is an effective method when it is performed by appropriate surgical technique. Its rate for returning to sinus rhythm is as high as the rate of conventional surgical procedure.

  6. [Evaluation of the antithrombotic strategy in low thrombotic risk patients who underwent aortic valve replacement wth bioprosthesis].

    Science.gov (United States)

    Aceves-Velázquez, Eduardo; Vieyra-Herrera, Gerardo; Rodríguez-Chávez, Laura; Herrera-Alarcón, Valentín

    2017-07-15

    According to current guidelines, in patients without additional risk factors who underwent aortic valve replacement with a bioprosthesis, anticoagulation in the first 3 months after surgery is still a matter of debate. According to current evidence, aspirin in low doses is a reasonable alternative to vitamin K antagonists (VKA). We compared the incidence of thrombotic and hemorrhagic complications in patients with low thrombotic risk who underwent aortic valve replacement with a bioprosthesis in the National Institute of Cardiology of Ignacio Chávez of Mexico. The hypothesis: aspirin as monotherapy has a beneficial effect compared to VKA. The studied patients were the low thrombotic risk patients who underwent aortic valve replacement with a bioprostesis in the National Institute of Cardiology of Ignacio Chávez of Mexico from 2011 to 2015. The groups studied were: aspirin only, VKA only and the combination of VKA plus aspirin. The patients were retrospectively followed during 12 months and the thrombotic and hemorrhagic complications were documented. Two hundred thirty-one patients were analized. Only one patient presented a hemorrhagic complication in the VKA only group. No thrombotic complications were observed. In the present study no thrombotic complications were observed in patients who did not receive anticoagulation in the first 3 months after a aortic valve replacement with a bioprosthesis after a follow up period of 12 months. This suggests that the use of aspirin only is safe during this period. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  7. Analysis of 137 Patients Who Underwent Endoscopic Transsphenoidal Pituitary Adenoma Resection Under High-Field Intraoperative Magnetic Resonance Imaging Navigation.

    Science.gov (United States)

    Zhang, Huaping; Wang, Fuyu; Zhou, Tao; Wang, Peng; Chen, Xiaolei; Zhang, Jiashu; Zhou, Dingbiao

    2017-08-01

    Pure endoscopic resection has become the most popular surgical approach for pituitary adenoma. Intraoperative magnetic resonance imaging (iMRI) systems have been in use for endoscopic resection of pituitary adenomas. This study aimed to evaluate the effectiveness of iMRI and neuroimaging navigation techniques during endoscopic endonasal transsphenoidal surgery of pituitary adenomas. Data from 137 patients who underwent resection of endoscopic pituitary adenoma under 1.5T iMRI navigation were collected and analyzed. Of patients, 92 underwent complete resection and 45 had residual tumor on real-time iMRI. Twenty-three patients underwent further surgery, and total resection was achieved in 19. Extent of total resection increased from 67.15% to 81.02%. iMRI revealed 3 patients with bleeding in the surgical area, which was successfully treated during the surgery. Review images obtained 3 months after surgery showed 26 patients with residual tumor; 14 patients had the same volume as intraoperatively, and 12 patients had a volume less than that observed intraoperatively. Residual tumor volume in the suprasellar region was less than that seen intraoperatively in 11 of 15 (73.3%) patients. The use of iMRI and neuronavigation not only leads to a higher rate of tumor resection but also helps in detecting and removing hematomas in the surgical area. Follow-up examinations of extent of residual tumor at 3 months postoperatively were consistent with intraoperative results. Residual tumor volume in the suprasellar region was usually less than that observed intraoperatively. Copyright © 2017. Published by Elsevier Inc.

  8. Short-term Survival of Patients with Lung Metastases from Colorectal and Non-colorectal Cancer Who Underwent Pulmonary Metastasectomy.

    Science.gov (United States)

    Lumachi, Franco; Mazza, Francesco; Del Conte, Alessandro; Lo Re, Giovanni; Ermani, Mario; Chiara, Giordano B; Basso, Stefano M M

    2015-06-01

    The lung is a common site of metastases, whose prevalence varies as a function of the primary tumor site, which is usually colorectal cancer (CRC), breast carcinoma, or genitourinary cancers, such as ovary, urinary bladder and renal cell carcinomas. The aim of the present study was to analyze whether the site of primitive tumor affects overall survival (OS) of patients with lung metastases (LMs) who underwent pulmonary metastasectomy. The data of 41 patients with surgically treated CRC (Group A=22 patients) and non-colorectal carcinomas (Group B=19 patients), who developed matachronous LMs and underwent pulmonary metastasectomy with curative intent, were analyzed. The origin of non-colorectal LMs was genitourinary cancer in nine and breast cancer in 10 patients. Overall, there were 22 men and 19 women, with a median age of 65 years (range=31-80); 18 patients had a solitary metastatic tumor, while 23 had two or more LMs. Twenty-nine patients underwent wedge resection, through thoracotomy or video-assisted thoracic surgery, while 12 underwent pulmonary lobectomy. Seventy-five LMs were resected with a 5-tear OS of 48.8%. No difference was found between elderly (≥65 year-old) and younger patients (p=0.26), and between those with solitary or multiple LMs (p=0.62) in terms of survival rate. The female patients had a worse OS (31.6% vs. 63.6%; odds ratio (OR)=3.79, 95% confidence interval (CI)=1.03-13.91, p=0.003) compared to males, independent of the origin of primary cancer. There was no difference in the cumulative survival rates (OR=1.65, 95%CI=0.48-5.69, p=0.42) between Groups and the log-rank test (p=0.75) was not significant. In conclusion, the main pathological characteristics of metastatic lesions and advanced age do not appear to be associated with a poor prognosis in patients with LMs, while the female gender is a negative prognostic factor. Thus, the primary tumor site should not be considered a major criterion in selecting patients for pulmonary

  9. Predictors of survival in patients who underwent video‐assisted thoracic surgery talc pleurodesis for malignant pleural effusion

    Science.gov (United States)

    Yoon, Dong Woog; Choi, Yong Soo; Kim, Jhingook; Kim, Hong Kwan; Zo, Jae Ill; Shim, Young Mog

    2016-01-01

    Background Patients with malignant pleural effusion have a limited life expectancy. An increase in pleural and oncological treatment options and more accurate prognostic evaluation may help individualize treatment strategies. The aim of this study was to identify the prognostic indicators of overall survival (OS) after video‐assisted thoracic surgery (VATS) talc pleurodesis for malignant pleural effusion. Methods We examined the medical records of all consecutive patients with malignant pleural effusion who underwent VATS talc pleurodesis from 2006 to 2008 at the Samsung Medical Center. Univariate and multivariate analyses were used to identify predictors of OS after VATS talc pleurodesis. Results During the study period, 91 patients underwent VATS talc pleurodesis to treat malignant pleural effusion. Early (within 30 days) and late (within 90 days) postoperative mortality rates were 9.9% (9 patients), and 25.3% (23), respectively. Median survival time after VATS talc pleurodesis was 10.5 months. The postoperative respiratory complication rate was 11% (10 patients), and included pneumonia (9) and acute respiratory distress syndrome (4). Multivariate analysis revealed that preoperative chemotherapy (P = 0.012), preoperative radiotherapy (P = 0.003), and Eastern Cooperative Oncology Group (ECOG) performance score 3 or 4 (P = 0.013) were independent risk factors of OS after VATS talc pleurodesis. Conclusions We identified previous chemotherapy or radiotherapy and poor performance status (ECOG 3 or 4) as significant predictors of OS after VATS talc pleurodesis. These prognostic factors can help surgeons select candidates for VATS pleurodesis for malignant pleural effusion. PMID:27385980

  10. Tumor deposit is a poor prognostic indicator in patients who underwent simultaneous resection for synchronous colorectal liver metastases

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    Lin Q

    2015-01-01

    Full Text Available Qi Lin,# Ye Wei,# Li Ren,# Yunshi Zhong,# Chunzhi Qin, Peng Zheng, Pingping Xu, Dexiang Zhu, Meiling Ji, Jianmin XuDepartment of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China#These authors contributed equally to this workBackground: Tumor deposits are one of the important influencing factors among the different editions of Tumor, Node, Metastasis classification. Incidence and prognosis of tumor deposits in stage I, II, and III colorectal cancer patients has been explored. The aim of this study was to determine the prognostic value of tumor deposits in stage IV colorectal cancer patients who underwent simultaneous resection for synchronous colorectal liver metastases (SCRLM.Methods: Clinicopathological and outcome data of 146 consecutive SCRLM patients who underwent simultaneous R0 resection between July 2003 and July 2013 were collected from our prospectively established SCRLM database. The prognostic value of tumor deposits was evaluated by Kaplan–Meier and Cox regression analysis.Results: Tumor deposits were detected in 41.8% (61/146 of these SCRLM patients. Tumor deposits were significantly correlated with lymph node metastasis and nerve invasion of the primary tumors (P=0.002, P=0.041; respectively. The Kaplan–Meier survival analysis revealed that the overall survival (OS and disease-free survival (DFS of SCRLM patients with tumor deposits were significantly poorer than those with no tumor deposits (P=0.039, P=0.001; respectively. And with multivariate analysis, we found that positive tumor deposits were significantly associated with shorter DFS independent of lymph node status (P=0.002. Subgroup analysis found that of the 57 SCRLM patients with negative lymph node status, the OS and DFS of patients with positive tumor deposits were significantly shorter than those with negative tumor deposits (P=0.002 and P=0.031, respectively. Of the 89 patients with positive lymph node status, the OS of

  11. Posterior Reversible Encephalopathy Syndrome Resolving Within 48 Hours in a Normotensive Patient Who Underwent Thoracic Spine Surgery

    Science.gov (United States)

    Vakharia, Kunal; Siasios, Ioannis; Dimopoulos, Vassilios G.; Pollina, John

    2016-01-01

    Posterior reversible encephalopathy syndrome (PRES) usually manifests with severe headaches, seizures, and visual disturbances due to uncontrollable hypertension. A patient (age in the early 60s) with a history of renal cell cancer presented with lower-extremity weakness and paresthesias. Magnetic resonance imaging (MRI) of the thoracic spine revealed a T8 vertebral body metastatic lesion with cord compression at that level. The patient underwent preoperative embolization of the tumor followed by posterior resection and placement of percutaneous pedicle screws and rods. Postoperatively, the patient experienced decreased visual acuity bilaterally. Abnormal MRI findings consisted of T2 hyperintense lesions and fluid-attenuated inversion recovery changes in both occipital lobes, consistent with the unique brain imaging pattern associated with PRES. The patient’s blood pressure was normal and stable from the first day of hospitalization. The patient was kept on high-dose steroid therapy, which was started intraoperatively, and improved within 48 hours after symptom onset. PMID:26858804

  12. The Role of Speech Therapy in Patients Who Underwent Laryngeal Microsurgery due to Phonotraumatic Lesions and Lesions Unrelated to Phonotrauma

    Science.gov (United States)

    Macedo, Claudia de Assis Corrêa de; Macedo, Evaldo Dacheux de; Malafaia, Osvaldo; Catani, Guilherme Simas do Amaral; Ido, Jorge Massaki; Stahlke, Henrique Jorge

    2014-01-01

    Introduction The role of the speech-language pathology in the multiprofessional team dealing with laryngology and the voice has been recognized for a long time. Scientific studies in this field recommend therapies for laryngeal microsurgeries; few of the studies, however, effectively evaluate the result of postoperative speech therapy. Objective To compare speech therapy evaluation and treatment among patients with phonotraumatic lesions and patients with lesions unrelated to phonotrauma who underwent laryngeal microsurgery. Methods This study was performed at IPO Hospital (Paranaense Institute of Otorhinolaryngology, Curitiba, Paraná, Brazil) between February 2010 and February 2011. Of 254 patients who underwent laryngeal microsurgery, 208 patients were included in the study and divided in two groups: group A with phonotraumatic lesions (n = 131) and group B with lesions unrelated to phonotrauma (n = 77). The number of sessions and the functional result after speech therapy were evaluated. Results The number of postoperative phonotherapy sessions after microsurgery was up to 10 sessions in 89.31% and 87.71% for groups A and B, respectively. Phonotherapy treatment showed a better functional evolution in group A (92.37%). Conclusion A significant difference was observed only in functional evolution, which was better in the group with phonotraumatic lesions (p < 0.0001). PMID:25992078

  13. The Role of Speech Therapy in Patients Who Underwent Laryngeal Microsurgery due to Phonotraumatic Lesions and Lesions Unrelated to Phonotrauma

    Directory of Open Access Journals (Sweden)

    Macedo, Claudia de Assis Corrêa de

    2014-02-01

    Full Text Available Introduction The role of the speech-language pathology in the multiprofessional team dealing with laryngology and the voice has been recognized for a long time. Scientific studies in this field recommend therapies for laryngeal microsurgeries; few of the studies, however, effectively evaluate the result of postoperative speech therapy. Objective To compare speech therapy evaluation and treatment among patients with phonotraumatic lesions and patients with lesions unrelated to phonotrauma who underwent laryngeal microsurgery. Methods This study was performed at IPO Hospital (Paranaense Institute of Otorhinolaryngology, Curitiba, Paraná, Brazil between February 2010 and February 2011. Of 254 patients who underwent laryngeal microsurgery, 208 patients were included in the study and divided in two groups: group A with phonotraumatic lesions (n = 131 and group B with lesions unrelated to phonotrauma (n = 77. The number of sessions and the functional result after speech therapy were evaluated. Results The number of postoperative phonotherapy sessions after microsurgery was up to 10 sessions in 89.31% and 87.71% for groups A and B, respectively. Phonotherapy treatment showed a better functional evolution in group A (92.37%. Conclusion A significant difference was observed only in functional evolution, which was better in the group with phonotraumatic lesions (p < 0.0001.

  14. Impact of Lipoprotein(a) on Long-term Outcomes in Patients With Diabetes Mellitus Who Underwent Percutaneous Coronary Intervention.

    Science.gov (United States)

    Konishi, Hirokazu; Miyauchi, Katsumi; Shitara, Jun; Endo, Hirohisa; Wada, Hideki; Doi, Shinichiro; Naito, Ryo; Tsuboi, Shuta; Ogita, Manabu; Dohi, Tomotaka; Kasai, Takatoshi; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2016-12-15

    Patients with diabetes mellitus (DM) are at twofold to fourfold higher cardiovascular risk than those without DM. Serum levels of lipoprotein(a) (Lp(a)) can be risk factors for adverse events. However, the clinical implications of Lp(a) in patients with DM who underwent percutaneous coronary intervention (PCI) is unknown. The aim of the study was to determine the role of Lp(a) in patients with DM who underwent PCI. A total of 3,508 patients were treated by PCI from 1997 to 2011 at our institution. Among them, we analyzed consecutive 1,546 patients with DM. Eligible 1,136 patients were divided into 2 groups (high Lp(a) [n = 575] and low Lp(a) [n = 561]) by the median of Lp(a) levels. The number of chronic kidney disease, multivessel disease, and the level of LDL-C were higher in the group with high Lp(a) than with low Lp(a). The median follow-up period was 4.7 years. Event rate of all-cause death was same between the 2 groups (p = 0.37). However, cumulative incidence of cardiac death and acute coronary syndrome was significantly higher in the high Lp(a) than in the low Lp(a) group (p = 0.03). Multivariable analysis selected a high Lp(a) level as an independent predictor of cardiac death and acute coronary syndrome (hazard ratio 1.20; 95% confidence interval 1.00 to 1.42; p = 0.04). In conclusion, a high Lp(a) value could be associated with advanced cardiac events after PCI for patients with DM. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Sepsis associated delirium mimicking postoperative delirium as the initial presenting symptom of urosepsis in a patient who underwent nephrolithotomy.

    Science.gov (United States)

    Nag, Deb Sanjay; Chatterjee, Abhishek; Samaddar, Devi Prasad; Singh, Harprit

    2016-05-16

    We report a case of 70 years old male who underwent percutaneous nephrolithotomy for renal calculi. After an uneventful recovery from anaesthesia, the patient developed delirium which manifested as restlessness, agitation, irritability and combative behavior. All other clinical parameters including arterial blood gas, chest X-ray and core temperature were normal and the patient remained haemodynamically stable. But 45 min later the patient developed florid manifestations of septic shock. He was aggressively managed in a protocolized manner as per the Surviving Sepsis Guidelines in the Critical Care Unit and recovered completely. There are no case reports showing postoperative delirium as the only initial presentation of severe sepsis, with other clinical parameters remaining normal. Both urosepsis and sepsis associated delirium have very high mortality. High index of suspicion and a protocolized approach in the management of sepsis can save lives.

  16. Resistance Pattern of Antibiotics in Patient Underwent Open Heart Surgery With Nosocomial Infection in North of Iran.

    Science.gov (United States)

    Davoudi, Alireza; Najafi, Narges; Alian, Shahriar; Tayebi, Atefe; Ahangarkani, Fatemeh; Rouhi, Samaneh; Heydari, Amirhosein

    2015-08-06

    Patients who undergo cardiac surgery appear to be at increased risk for the development of Nosocomial infections (NIs). The development of antibiotic-resistant infections has been associated with significantly greater hospital mortality rates compared to similar infections caused by antibiotic-sensitive pathogens. The purpose of this study is survey of Nis and antibiotic resistance patterns of causative bacteria among patients who underwent open heart surgery in the north of Iran during a 2-year period between September 2012 and September 2014. In this cross-sectional study we evaluated 187 patients that underwent open heart surgery with NIs. Demographic feature, clinical characteristics and risk factors of each infection were recorded. The antibiotic susceptibility test was performed using the Minimum inhibitory concentration (MIC) method according to the standard protocol of Clinical & Laboratory Standards Institute (CLSI). Detection of Extended-spectrum beta-lactamase (ESBL) producing bacteria was performed by the double-disk synergy (DDS) test; also Methicillin-resistant Staphylococcus (MRSA) strains were identified by MRSA Screen Agar. The collected data were analyzed using the SPSS software (ver. 16) and, descriptive statistics were used. Out Of total of 2253 hospitalized patients who underwent open heart surgery, 187(5.05%) patients had NIs. 51.9% of the patients were female. The rates of surgical site infection (SSI), respiratory tract infection, endocarditis, Urinary tract infection (UTI), blood Infection and mediastinitis were 27.80, 25.66%, 17.64, 17.11% 8.55% and 3.20% respectively. E.coli and S.aureus were the most causative agents of NIs. The rate of ESBL-producing bacteria was 14.28- 71.42% among enterobacteriaceae and the rate of MRSA was 54.2% among S.aureus strains. All isolated Acinetobacter.spp were Multi-drug resistance (MDR). We showed that the rate of NIs among these high-risk patients was in the average level. But the emergence of MRSA and

  17. Comparison of Outcomes in Patients Who Underwent Deep Anterior Lamellar Keratoplasty and Those Converted to Penetrating Keratoplasty

    Directory of Open Access Journals (Sweden)

    Yusuf Koçluk

    2017-03-01

    Full Text Available Objectives: To compare clinical outcomes of cases who underwent deep anterior lamellar keratoplasty (DALK and cases who were converted to penetrating keratoplasty (PKP from DALK surgery. Materials and Methods: The records of 54 patients for whom DALK surgery was planned and were operated for different diagnoses between March 2013 and June 2015 were retrospectively analyzed. Patients were divided into two groups: group 1 (PKP group consisted of 23 cases who were converted to PKP due to Descemet’s membrane perforation at any stage of surgery; group 2 (DALK group consisted of 31 patients whose surgery could be completed as DALK. Preoperative and postoperative follow-up results were evaluated in each group. Results: Corrected distance visual acuity (CDVA increased in the postoperative period according to baseline in both groups. However, there was no statistically significant difference in the rates of CDVA increase between the groups (p=0.142. The mean astigmatism measured by corneal topography at final examination was 5.8±2.3 diopters in group 1 and 5.4±1.8 diopters in group 2. The difference between groups was not statistically significant (p=0.430. The groups were not statistically different regarding postoperative pachymetry (p=0.453. The grafts in all 54 patients (100% were clear at final postoperative examination. There were no statistically significant differences between the groups in terms of postoperative complications. Conclusion: Similar clinical outcomes were obtained in our study for patients who underwent DALK and those whose procedure was converted from DALK to PKP.

  18. Comparison of Outcomes in Patients Who Underwent Deep Anterior Lamellar Keratoplasty and Those Converted to Penetrating Keratoplasty

    Science.gov (United States)

    Koçluk, Yusuf; Alyamaç Sukgen, Emine; Burcu, Ayşe

    2017-01-01

    Objectives: To compare clinical outcomes of cases who underwent deep anterior lamellar keratoplasty (DALK) and cases who were converted to penetrating keratoplasty (PKP) from DALK surgery. Materials and Methods: The records of 54 patients for whom DALK surgery was planned and were operated for different diagnoses between March 2013 and June 2015 were retrospectively analyzed. Patients were divided into two groups: group 1 (PKP group) consisted of 23 cases who were converted to PKP due to Descemet’s membrane perforation at any stage of surgery; group 2 (DALK group) consisted of 31 patients whose surgery could be completed as DALK. Preoperative and postoperative follow-up results were evaluated in each group. Results: Corrected distance visual acuity (CDVA) increased in the postoperative period according to baseline in both groups. However, there was no statistically significant difference in the rates of CDVA increase between the groups (p=0.142). The mean astigmatism measured by corneal topography at final examination was 5.8±2.3 diopters in group 1 and 5.4±1.8 diopters in group 2. The difference between groups was not statistically significant (p=0.430). The groups were not statistically different regarding postoperative pachymetry (p=0.453). The grafts in all 54 patients (100%) were clear at final postoperative examination. There were no statistically significant differences between the groups in terms of postoperative complications. Conclusion: Similar clinical outcomes were obtained in our study for patients who underwent DALK and those whose procedure was converted from DALK to PKP.

  19. Long-term follow-up of clinical symptoms in TMD patients who underwent occlusal reconstruction by orthodontic treatment.

    Science.gov (United States)

    Imai, T; Okamoto, T; Kaneko, T; Umeda, K; Yamamoto, T; Nakamura, S

    2000-02-01

    Fifty-eight patients (mean age 18.4 years) who had received splint therapy for internal derangement of the temporomandibular joint (TMJ) were examined retrospectively to investigate the efficacy of occlusal reconstruction by orthodontic treatment. The subjects were divided into three groups: 18 patients (mean age 18.6 years) who underwent orthodontic treatment combined with the use of splints (ST group); 27 patients (mean age 18.2 years) who underwent orthodontic treatment without the use of splints (NST group); and 13 patients (mean age 17.9 years) who received only splint therapy for temporomandibular joint disorders (TMD; control group). TMJ sound, pain on movement and restriction of mandibular movement were examined at the initial examination (T1), at the end of the splint therapy for TMD or beginning of orthodontic treatment (T2), at the end of orthodontic treatment (T3), and at recall or 1 year after orthodontic treatment (T4). The following results were found. (1) The percentage of patients with no joint sound at T2 was 20-30 per cent. The percentage of such patients in both the ST and NST groups increased to over 50 per cent at T3, but slightly decreased to 39-50 per cent at T4. There were no significant inter-group differences at any time point. (2) The number of patients who had no pain on movement at T2 was 60-80 per cent. The percentage of such patients in both the ST and NST groups increased to over 90 per cent at T3, but then slightly decreased to 80 per cent at T4. There were no significant inter-group differences at any time point. (3) None of the patients showed restriction of movement of the TMJ at T2 or T4. One patient in the ST group was found to have restriction at T3. There were no significant inter-group differences at any time point. (4) The most frequent type of malocclusion in both ST and NST groups was anterior open bite. These results suggest that TMD symptoms that have been eliminated by splint therapy are not likely to recur due to

  20. Elevated Preoperative Serum Hs-CRP Level as a Prognostic Factor in Patients Who Underwent Resection for Hepatocellular Carcinoma.

    Science.gov (United States)

    Liu, Yu-Bin; Ying, Jie; Kuang, Su-Juan; Jin, Hao-Sheng; Yin, Zi; Chang, Liang; Yang, Hui; Ou, Ying-Liang; Zheng, Jiang-Hua; Zhang, Wei-Dong; Li, Chuan-Sheng; Jian, Zhi-Xiang

    2015-12-01

    To evaluate the effects of preoperative highly sensitive C-reactive protein (Hs-CRP) in serum on the prognostic outcomes of patients with hepatocellular carcinoma (HCC) following hepatic resection in Chinese samples.From January 2004 to December 2008, a total of 624 consecutive HCC patients who underwent hepatic resection were incorporated. Serum levels of Hs-CRP were tested at preoperation via a collection of venous blood samples. Survival analyses adopted the univariate and multivariate analyses.In our study, among the 624 screened HCC patients, 516 patients were eventually incorporated and completed follow-up. Positive correlations were found regarding preoperative serum Hs-CRP level and tumor size, Child-Pugh class, or tumor stage (all P Hs-CRP levels at preoperation (both P Hs-CRP-normal group, the overall survival (OS) and recurrence-free survival rates were evidently decreased in the Hs-CRP-elevated group. Further, preoperative serum Hs-CRP level might be having possible prediction effect regarding survival and recurrence of HCC patients after hepatic section in the multivariate analysis.Preoperative increased serum Hs-CRP level was an independent prognostic indicator in patients with HCC following hepatic resection in Chinese samples.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Accuracy of bone SPECT/CT for identifying hardware loosening in patients who underwent lumbar fusion with pedicle screws

    Energy Technology Data Exchange (ETDEWEB)

    Hudyana, Hendrah; Maes, Alex [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Hospital Leuven, Department of Morphology and Medical Imaging, Leuven (Belgium); Vandenberghe, Thierry; Fidlers, Luc [AZ Groeninge, Department of Neurosurgery, Kortrijk (Belgium); Sathekge, Mike [University of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); Nicolai, Daniel [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); Wiele, Christophe van de [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Ghent, Department of Radiology and Nuclear Medicine, Ghent (Belgium)

    2016-02-15

    The aim of this retrospective study was to evaluate the accuracy of bone SPECT (single photon emission computed tomography)/CT (computed tomography) in diagnosing loosening of fixation material in patients with recurrent or persistent back pain that underwent lumbar arthrodesis with pedicle screws using surgery and clinical follow-up as gold standard A total of 48 patients (median age 49 years, range 21-81 years; 17 men) who had undergone lumbar spinal arthrodesis were included in this retrospective analysis. SPECT/CT results were compared to the gold standard of surgical evaluation or clinical follow-up. Positive SPECT/CT results were considered true positives if findings were confirmed by surgery or if clinical and other examinations were completely consistent with the positive SPECT/CT finding. They were considered false positives if surgical evaluation did not find any loose pedicle screws or if symptoms subsided with non-surgical therapy. Negative SPECT/CT scans were considered true negatives if symptoms either improved without surgical intervention or remained stable over a minimum follow-up period of 6 months. Negative SPECT/CT scans were determined to be false negatives if surgery was still required and loosening of material was found. The median length of time from primary surgery to bone SPECT/CT referral was 29.5 months (range 12-192 months). Median follow-up was 18 months (range 6-57) for subjects who did not undergo surgery. Thirteen of the 48 patients were found to be positive for loosening on bone SPECT/CT. Surgical evaluation (8 patients) and clinical follow-up (5 patients) showed that bone SPECT/CT correctly predicted loosening in 9 of 13 patients, while it falsely diagnosed loosening in 4 patients. Of 35 negative bone SPECT/CT scans, 12 were surgically confirmed. In 18 patients, bone SPECT/CT revealed lesions that could provide an alternative explanation for the symptoms of pain (active facet degeneration in 14 patients, and disc and sacroiliac

  3. Transcranial doppler sonography in two patients who underwent decompressive craniectomy for traumatic brain swelling: report of two cases

    Directory of Open Access Journals (Sweden)

    Bor-Seng-Shu Edson

    2004-01-01

    Full Text Available The role of decompressive craniectomy in the treatment of severe posttraumatic cerebral swelling remains quite a controversial issue. To the best of our knowledge, there is no study demonstrating the effect of decompressive craniectomy on cerebral blood flow (CBF velocity by means of transcranial Doppler sonography (TCD. We present two patients who developed traumatic brain swelling and uncontrollable intracranial hypertension with coma and signs of transtentorial herniation. One patient underwent bifrontal, while the second, unilateral, frontotemporoparietal decompressive craniectomy with dural expansion. In both patients, TCD examinations were performed immediately before and after surgery to study the cerebral hemodynamic changes related to the operations. Pre and postoperative TCD examinations demonstrated a significant increase in blood flow velocity in the intracranial arteries in both subjects. In conclusion, our cases suggest that decompressive craniectomy with dural expansion may result in elevation of CBF velocity in patients with massive brain swelling. The increase in CBF velocity appears to occur not only in the decompressed hemisphere, but also on the opposite side.

  4. Prosthetic reconstruction with an obturator using swing-lock attachment for a patient underwent maxillectomy: A clinical report

    Science.gov (United States)

    2016-01-01

    Patients who underwent resection of maxilla due to benign or malignant tumor, or accident will have defect in palatal area. They get retention, support and stability from remaining tissues which are hardly optimal. The advantage of swing-lock attachment design is having multiple contacts on labial and lingual side of the abutment teeth by retentive strut and palatal bracing component. Because the force is distributed equally to abutment teeth, abutment teeth of poor prognosis can be benefited from it. It is also more advantageous to cover soft tissue defects which are hard to reach with conventional prosthesis. A 56-year-old female patient who had undergone a maxillectomy due to malignant melanoma complaining of loose and unstable surgical obturator. Surveyed crowns were placed on #12, 26, and 27. Teeth #11, 21, 22, and 23 had lingual rest seat and #24 had mesial rest seat to improve stability and support of the obturator. This clinical report presents the prosthetic management of a patient treated with obturator on the maxilla using swing-lock attachment to the remaining teeth. PMID:27826392

  5. Single-center report of 5-year follow-up on 94 patients underwent transmyocardial laser revascularization

    Institute of Scientific and Technical Information of China (English)

    QU Zheng; ZHENG Ju-bing; ZHANG Zhao-guang

    2007-01-01

    Background Transmyocardial laser revascularization (TMLR) has been used in the treatment of patients with end-stage coronary artery disease (CAD) since 1990. The aim of this study was to evaluate the long-term effectiveness of TMLR in patients with diffuse CAD.Methods Ninety-four consecutive patients underwent TMLR in one center from July 1997 to December 2000. The follow-up data of these patients were obtained through face-to-face, mail questionnaires, or telephone interviews in July 2004 and December 2004. Four cases failed to respond. Mean follow-up time was (5.5±1.0) years.Results Mean Canadian Cardiovascular Society (CCS) angina scores of TMLR patients were 3.1±0.8 at baseline,1.7±0.9 at 1 year (P<0.05), 1.7±0.9 at 3 years (P<0.05), and 1.9±0.9 at 5 years (P<0.05). At an average of 5 years, 69%of the patients had ≥ 1 angina class reduction, mean NYHA class level (1.9±0.9) ameliorated compared to the baseline (2.5±0.7, P<0.001), the rate of re-hospitalization was 2.7 times/person. Kaplan-Meier survival rate was 87% at 1 year,69% at 3 years and 64% at 5 years. The causes of death were attributed more to heart failure (58.9%) and myocardial infraction (14.7%) after TMLR. The patients with no angina relief, or who died after TMLR, had a higher percentage of preoperative unstable anginas or prior myocardial infraction compared to the survivors. The assorted shapes of myocardial laser channels were detected in some patients by the color Doppler velocity technique.Conclusions TMLR provided a long-term improvement in the quality of life, including CCS angina class or NYHA heart functional class for about 70% of Chinese patients with severely disabling angina pectoris. The various myocardial laser channels would always be visible after TMLR. 5-years after TMLR as a sole therapy, the survival rate of the patients was 64%.

  6. Twenty-Five-Year Experience With Radical Chemoradiation for Anal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tomaszewski, Jonathan M., E-mail: jonathan.tomaszewski@petermac.org [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Link, Emma [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Leong, Trevor [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia); Heriot, Alexander [University of Melbourne, Parkville, Victoria (Australia); Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Vazquez, Melisa [Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Chander, Sarat; Chu, Julie; Foo, Marcus; Lee, Mark T. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Lynch, Craig A. [Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Mackay, John [University of Melbourne, Parkville, Victoria (Australia); Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Michael, Michael [University of Melbourne, Parkville, Victoria (Australia); Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Tran, Phillip [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Ngan, Samuel Y. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia)

    2012-06-01

    Purpose: To evaluate the prognostic factors, patterns of failure, and late toxicity in patients treated with chemoradiation (CRT) for anal cancer. Methods and Materials: Consecutive patients with nonmetastatic squamous cell carcinoma of the anus treated by CRT with curative intent between February 1983 and March 2008 were identified through the institutional database. Chart review and telephone follow-up were undertaken to collect demographic data and outcome. Results: Two hundred eighty-four patients (34% male; median age 62 years) were identified. The stages at diagnosis were 23% Stage I, 48% Stage II, 10% Stage IIIA, and 18% Stage IIIB. The median radiotherapy dose to the primary site was 54 Gy. A complete clinical response to CRT was achieved in 89% of patients. With a median follow-up time of 5.3 years, the 5-year rates of locoregional control, distant control, colostomy-free survival, and overall survival were 83% (95% confidence interval [CI] 78-88), 92% (95% CI, 89-96), 73% (95% CI, 68-79), and 82% (95% CI, 77-87), respectively. Higher T stage and male sex predicted for locoregional failure, and higher N stage predicted for distant metastases. Locoregional failure occurred most commonly at the primary site. Omission of elective inguinal irradiation resulted in inguinal failure rates of 1.9% and 12.5% in T1N0 and T2N0 patients, respectively. Pelvic nodal failures were very uncommon. Late vaginal and bone toxicity was observed in addition to gastrointestinal toxicity. Conclusions: CRT is a highly effective approach in anal cancer. However, subgroups of patients fare relatively poorly, and novel approaches are needed. Elective inguinal irradiation can be safely omitted only in patients with Stage I disease. Vaginal toxicity and insufficiency fractures of the hip and pelvis are important late effects that require prospective evaluation.

  7. Low-intensity Laser (660 NM) has Analgesic Effects on Sternotomy of Patients Who Underwent Coronary Artery Bypass Grafts

    Science.gov (United States)

    Fernandes, Gilderlene Alves; Araújo Júnior, Raimundo de Barros; Lima, Andréa Conceição Gomes; Gonzaga, Isabel Clarisse Albuquerque; de Oliveira, Rauirys Alencar; Nicolau, Renata Amadei

    2017-01-01

    Background: The aim of this study was to evaluate the efficacy of low-level laser therapy for reducing the acute pain of sternotomy in patients who underwent a coronary artery bypass graft (CABG). Methods: This study was conducted with ninety volunteers who electively submitted to CABG. The volunteers were randomly allocated into three groups of equal size (n = 30): control, placebo, and laser (λ of 660 nm and spatial average energy fluency of 1.06 J/cm2). Pain when coughing was assessed by a visual analog scale (VAS) and McGill Pain Questionnaire, according to sensory, affective, evaluative, and miscellaneous domains. The patients were followed for 1 month after the surgery. Results: The laser group had a greater decrease in pain with analogous results, as indicated by both the VAS and the McGill questionnaire (P ≤ 0.05) on sensory and affective scores, on days 6 and 8 postsurgery compared to the placebo and control groups. Conclusion: Laser seems to be effective promoting pain reduction after coronary-arterial bypass grafting. PMID:28074796

  8. Severity of gastroesophageal reflux disease influences daytime somnolence:A clinical study of:t34 patients underwent upper panendoscopy

    Institute of Scientific and Technical Information of China (English)

    Pál Demeter; Katalin Várdi Visy; N(o)ra Gyulai; R(o)bert Sike; Tamás G T(o)th; János Novák; Pál Magyar

    2004-01-01

    AIM: To asses the relationship between severity of gastroesophageal refluxe disease and Epworth sleepiness scale as an indicator of daytime somnolence.METHODS: One hundred and thirty-four patients underwent an upper panendoscopy as indicated by the typical reflux symptoms and were also investigated with regard to somnolence. Sleepiness was evaluated by Epworth Sleepiness Scale, which was compared to the severity of endoscopic findings (Savary-Miller/modified by Siewert). Patients with psychiatric disorders or being on sedato-hypnotics as well as shift workers were excluded from the study. The relationship between the severity of the reflux disease and daytime somnolence was analyzed with the help of multivariate regression analysis.RESULTS: A positive tendency was found between the severity of the reflux disease and the corresponding Epworth Sleepiness Scale. In the case of the more severe type -Savary-Miller Ⅲ - at least a mild hypersomnia was found.For this group daytime somnolence was significantly higher than in the case of the non-erosive type of Gastroesophageal Reflux Disease representing the mildest stage of reflux disease.CONCLUSION: The severity of Gastroesophageal Reflux Disease influences daytime somnolence.

  9. Assessment of quality of life of patients who underwent anterior cruciate ligament reconstruction and a rehabilitation program

    Directory of Open Access Journals (Sweden)

    Moises Cohen

    2004-12-01

    Full Text Available Introduction: Quality of life can be defined as the expression of aconceptual model that tries to represent patient’s perspectivesand his/her level of satisfaction expressed by numbers. Theobjective of this study is to evaluate the parameters of quality oflife of 23 patients who underwent surgery for anterior cruciateligament reconstruction. Methods: We adopted SF-36, a generichealth-related evaluation questionnaire, to obtain informationregarding several aspects of patients’ health conditions, and theLysholm questionnaire, specific to evaluate the symptoms andfunction of the knee. The questionnaires were applied at two stagesof the treatment: pre- and postoperatively (after the rehabilitationprogram. Results: Before surgery, the Lysholm questionnairepresented the following results: excellent in 4% of the cases, goodin 22%, fair in 22%, and poor in 52%. After surgery (Lysholm e SF-36 the correlation level was approximately 44% (p = 0.041.Discussion: The correlation between the Lysholm and the SF-36questionnaires showed the following: the lower the level of pain,the higher the Lysholm score. The high scores presented by theLysholm questionnaire are directly proportional to physical andemotional aspects, and to functional capacity. Conclusion:Analysis of both questionnaires, as well as of their correlation,showed some improvement in patients´ quality of life. We werealso able to demonstrate the importance and usefulness of applyingthe two questionnaires at three different moments: before, duringand after physiotherapeutic intervention.

  10. Cumulative Index to Twenty Five Semiannual Reports of the Commission to the Congress. January 1947 - January 1959

    Energy Technology Data Exchange (ETDEWEB)

    McCone, John A.

    1960-01-31

    The first twenty five semiannual reports of the United States Atomic Energy Commission to Congress cover the major unclassified activities of the Commission from January 1947 through January 1959. In addition to the semiannual summaries, a series of special reports on important atomic energy programs were included in many of the semiannual reports. This cumulative name and subject index provides a guide to the information published in these reports. Beginning in 1960, the Commission will be issuing annual reports, each separately indexed, ceasing the semiannual reporting.

  11. 65. Impact of focused echocardiography in clinical decision of patients presented with STMI, underwent primary percutenouse angioplasty

    Directory of Open Access Journals (Sweden)

    M. Qasem

    2016-07-01

    Full Text Available Echocardiography in coronary artery diseases is an essential, routine echocardiography prior to primary percutaneous angioplasty is not clear. In our clinical practice in primary angioplasty we faced lots of complications either before or during or after the procedure. Moreover, lots of incidental findings that discovered after the procedure which if known will affect the plan of management. One-hundred-nineteen consecutive underwent primary angioplasty. All patients underwent FE prior to the procedure in catheterization lab while the patient was preparing for the procedure. FE with 2DE of LV at base, mid and apex, and apical stander views. Diastology grading, E/E′ and color doppler of mitral and aortic valve were performed. (N = 119 case of STMI were enrolled, mean age 51 ± 12 year. Eleven cases (9.2% had normal coronary and normal LV function. Twenty cases (17% of MI complication detected before the procedures: RV infarction 8.4% (5.1% asymptomatic and 3.3% symptomatic, ischemic MR (8.4%, LV apical aneurysm (0.8%, significant pericardial effusion (0.80%. Acute pulmonary edema in 17 cases (14.3%: six cases (5.1% developed acute pulmonary edema on the cath lab with grade 3 diastolic dysfunction and E/E ′  >20, 9 cases (7.6% develop acute pulmonary edema in CCU with grade 2–3 diastolic dysfunction and E/E′ 15–20. 2 cases (2.7% develop acute pulmonary in CCU with grade 1–2 diastolic dysfunction and E/E′ 9–14. One case (0.8% presented cardiac tamponade 2 h post PCI. Incidental finding not related to STMI were as follow: 2 cases (1.7% with severe fibro degenerative MR, 2 cases (1.7% with mild to moderate AR and 2 cases (1.7% with mild to moderate AS. Isoled CABG 5/4.2% and CABG and MVR 2/1.7%. FE play an important role in guiding the management, early detection the incidental findings and complication post PCI.

  12. Ipsilateral pleural recurrence after diagnostic transthoracic needle biopsy in pathological stage I lung cancer patients who underwent curative resection.

    Science.gov (United States)

    Moon, Seong Mi; Lee, Dae Geun; Hwang, Na Young; Ahn, Soohyun; Lee, Hyun; Jeong, Byeong-Ho; Choi, Yong Soo; Shim, Young Mog; Kim, Tae Jeong; Lee, Kyung Soo; Kim, Hojoong; Kwon, O Jung; Lee, Kyung Jong

    2017-09-01

    The relationship between transthoracic needle biopsy (TTNB) and pleural recurrence of cancer after curative lung resection remains unclear. We aimed to assess whether TTNB increases the ipsilateral pleural recurrence (IPR) rate and identify other potential risk factors for pleural recurrence after surgery. This retrospective study included 392 patients with p-stage I non-small cell lung cancer with solid or part-solid nodules after curative lung resection in 2009-2010. Imbalances among the characteristics were adjusted using an inverse probability-weighted method based on propensity scoring. Multivariate Cox's regression analysis and the Kaplan-Meier method were used to determine independent risk factors for IPR. A total of 243 (62%) patients received TTNB, while 149 (38%) underwent an alternate, or no, diagnostic technique. IPR was significantly more frequent in the TTNB group (p=0.004), while total recurrence was similar between the groups (p=0.098). After applying the weighted model, diagnostic TTNB (hazard ratio [HR], 5.27; 95% confidence interval [CI], 1.49-18.69; p=0.010), microscopic visceral pleural invasion (HR, 2.76; 95% CI, 1.08-7.01; p=0.033) and microscopic lymphatic invasion (HR, 3.25; 95% CI, 1.30-8.10; p=0.012) were associated with an increased frequency of IPR. Among patients who received TTNB, microscopic lymphatic invasion was a risk factor for IPR (HR, 2.74; 95% CI, 1.10-6.79; p=0.030). The diagnostic TTNB procedure is associated with pleural recurrence but may be unrelated to overall recurrence-free survival in early lung cancer. Moreover, microscopic lymphatic invasion could be a risk factor for pleural recurrence. TTNB should be carefully considered before lung resection and close follow-up to detect if pleural recurrence is needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. A systematic review of methods for quantifying serum testosterone in patients with prostate cancer who underwent castration.

    Science.gov (United States)

    Comas, I; Ferrer, R; Planas, J; Celma, A; Regis, L; Morote, J

    2017-03-02

    The clinical practice guidelines recommend measuring serum testosterone in patients with prostate cancer (PC) who undergo castration. The serum testosterone concentration should be <50ng/dL, a level established by using a radioimmunoassay method. The use of chemiluminescent immunoassays (IA) has become widespread, although their metrological characteristics do not seem appropriate for quantifying low testosterone concentrations. The objective of this review is to analyse the methods for quantifying testosterone and to establish whether there is scientific evidence that justifies measuring it in patients with PC who undergo castration, through liquid chromatography attached to a mass spectrometry in tandem (LC-MSMS). We performed a search in PubMed with the following MeSH terms: measurement, testosterone, androgen suppression and prostate cancer. We selected 12 studies that compared the metrological characteristics of various methods for quantifying serum testosterone compared with MS detection methods. IAs are standard tools for measuring testosterone levels; however, there is evidence that IAs lack accuracy and precision for quantifying low concentrations. Most chemiluminescent IAs overestimate their concentration, especially below 100ng/dL. The procedures that use LC-MSMS have an adequate lower quantification limit and proper accuracy and precision. We found no specific evidence in patients with PC who underwent castration. LC-MSMS is the appropriate method for quantifying low serum testosterone concentrations. We need to define the level of castration with this method and the optimal level related to better progression of the disease. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Twenty-five years of RENHIS: a history of histopathological studies within EUVAS.

    Science.gov (United States)

    van Daalen, Emma; Ferrario, Franco; Noël, Laure-Hélène; Waldherr, Rüdiger; Hagen, E Christiaan; Bruijn, Jan A; Bajema, Ingeborg M

    2015-04-01

    In the early 1990s, an international working group of experienced renal pathologists, the Renal Histology group, set up a scoring system for biopsies with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis. This scoring system subdivided glomerular, interstitial and vascular lesions and served as a tool for the evaluation of all renal biopsies from studies of the European Vasculitis Study Group (EUVAS). Histopathological studies gave new insights into the prediction of renal outcome in patients with ANCA-associated glomerulonephritis. Percentage of normal glomeruli and a selected number of interstitial parameters were reliable predictors of long-term follow-up glomerular filtration rate in all studies. Out of these results, a histopathological classification distinguishing focal, crescentic, mixed and sclerotic classes of ANCA-associated glomerulonephritis was developed. Until today, 13 studies have validated this classification system. Future studies will try to determine if and how renal histology could be helpful in guiding treatment of ANCA-associated glomerulonephritis.

  15. Characteristics of speech production in patients with T1 glottic cancer who underwent laser cordectomy or radiotherapy.

    Science.gov (United States)

    Hong, Yong Tae; Park, Min Ju; Hong, Ki Hwan

    2017-10-04

    Laser cordectomy (LC) or radiotherapy (RT) is often recommended in the early stage of laryngeal cancer. We conducted perceptual and acoustic analysis to compare sustained vowel and stop consonants since there is no article evaluating both the sustained vowel and stop consonants. Eventually, we might determine which management is superior in terms of speech production. A total of 28 patients who underwent LC and RT for early T1 glottic cancer were selected. The sustained vowel /a/ and bilabial stop consonants were used to assess the perceptual scores. The fundamental frequency (Fo), jitter, shimmer and noise-to-harmonic ratio (NHR) levels for sustained vowels were evaluated. Voice onset time (VOT), vowel duration (VD) and closure duration of the bilabial plosives were analyzed. A receiver operating characteristic curve analysis was used to evaluate significant results statistically. The GRBAS and discrimination scores were not significantly different between two groups. Fo and jitter were significantly higher in the LC than RT. The cut-off value was statistically higher in the LC group and statistically lower in the RT group. The VOT was significantly longer in the LC than RT. The cut-off value of the /pipida/ VOT was statistically longer in the LC group and statistically shorter in the RT group. The differences may have been due to muscular fibrosis after RT. Movements of vocal cords with fibrosis were sluggish, when impulsion developed to pronounce the initial /p/ sound, so the VOT was shortened and the VD was longer after RT.

  16. Retrospective comparison between preoperative diagnosis by International Consensus Diagnostic Criteria and histological diagnosis in patients with focal autoimmune pancreatitis who underwent surgery with suspicion of cancer

    DEFF Research Database (Denmark)

    Ikeura, Tsukasa; Detlefsen, Sönke; Zamboni, Giuseppe

    2014-01-01

    OBJECTIVE: The objective of this study was to compare the preoperative diagnosis by International Consensus Diagnostic Criteria (ICDC) with histological diagnosis in patients with focal autoimmune pancreatitis (AIP) who underwent surgery. METHODS: Thirty patients (type 1 AIP in 23 and type 2 AIP ...

  17. Estimation of absorbed dose of radiosensitive organs and effective sose in patients underwent abdominopelvic spiral CT scan using impact CT patient dosimetry

    Directory of Open Access Journals (Sweden)

    Ayoub Amirnia

    2017-05-01

    Full Text Available Background: Due to the presence of radiosensitive organs in the abdominopelvic region and increasing the number of requests for CT scan examinations, concerns about increasing radiation doses in patients has been greatly elevated. Therefore, the goal of this study was to determine the absorbed dose of radiosensitive organs and the effective dose in patients underwent abdominopelvic CT scan using ImPACT CT patient dosimetry Calculator (version 1.0.4, Imaging Performance Assessment on Computed Tomography, www.impactscan.org. Methods: This prospective cross-sectional study was conducted in Imam Reza Hospital from November to February 2015 February 2015 in the Imam Reza Hospital, in Urmia, Iran. The demographic and dosimetric information of 100 patients who underwent abdominopelvic CT scan in a 6-slice CT scanner were obtained through the data collection forms. The demographic data of the patients included age, weight, gender, and BMI. The dosimetric parameters included pitch value, CT dose volume index (CTDIvol, dose-length product (DLP, tube voltage, tube current, exposure time, collimation size, scan length, and scan time. To determine the absorbed dose of radiosensitive organs and also the effective dose in patients, ImPACT CT patient dosimetry calculator was used. Results: The results of this study demonstrated that the mean and standard deviation (SD of patients' effective dose in abdominopelvic CT scan was 4.927±0.164 mSv. The bladder in both genders had the greatest mean organ dose, which was 64.71±17.15 mGy for men and 77.56±18.48 mGy for women (P<0.001. Conclusion: The effective dose values of this examination are in the same range as previous studies, as well as International Commission on Radiological Protection (ICRP recommendations. However, the radiation dose from CT scan has the largest contribution to the medical imaging. According to the ALARA principle, it is recommended that the scan parameters, especially mAs, should be

  18. One hundred and twenty-five years of the Annals of Botany. Part 2: the years 1937 to 2012.

    Science.gov (United States)

    Jackson, Michael B

    2016-12-01

    Annals of Botany is a peer-reviewed plant biology journal. It was started in 1887, making it the oldest continuously published plant science title. A previous article [Jackson MB. 2015. One hundred and twenty-five years of the Annals of Botany Part 1: the first 50 years (1887-1936). Annals of Botany 115: : 1-18] summarized events leading to its founding, highlighted the individuals involved and examined the Journal's achievements and management practices over the first 50 years to 1937. This second article covers the next 75 years. The account draws principally on the Journal's own records, minute books, financial accounts, original letters and notes held by the Annals of Botany Company, the Journal's owners and managers. In 1937, its 51st year, the Journal was re-launched as Annals of Botany New Series and its volume numbers were reset to No. I. The present article evaluates the evolution of the New Series up to 2012, Annals of Botany's 125th anniversary year. The period includes a 2-year run-up to World War II, six war years and their immediate aftermath, and then on through increasingly competitive times. The ebb and flow of the Journal's fortunes are set against a roll-call of the often highly distinguished scientists who managed and edited the Journal. The article also examines an internal crisis in the 1980s that radically altered the Journal's organization in ways that were, ultimately, to its benefit. The narrative is set against changes to economic conditions in Great Britain over the period, to the evolving nature and geographical distribution of much experimental plant science and to the digital revolution that, from the late 20th century, transformed the workings of Annals of Botany and of scientific publishing more generally. © The Author 2016. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Retrospective analysis of prognostic factors in 205 patients with laryngeal squamous cell carcinoma who underwent surgical treatment.

    Directory of Open Access Journals (Sweden)

    Si-Yi Zhang

    Full Text Available OBJECTIVES: To investigate the most important factors affecting the prognosis of the patients with squamous cell carcinoma (SCC of the larynx. METHODS: Based on the clinical and follow-up data, 205 patients with SCC of the larynx receiving total laryngectomy, partial laryngectomy, or CO2 laser surgery in GuangDong General Hospital were retrospectively analyzed. A survival analysis was performed by the Kaplan-Meier method and a multivariable analysis of prognostic factors was carried out using the Cox proportional hazard model. RESULTS: Subtypes of carcinoma included 69.8% glottic and 30.2% supraglottic. Most patients were in N0 stage (77.6%, and 22.4% patients were in N1∼N3 stage. Over half of the patients were in T1∼T2 stage (55.1%, 20.0% in T3, and 24.9% in T4. Mean follow-up duration was 49.2 months. The survival rates 1, 2, and 3 years after the surgery were 99.0%, 91.7%, and 81.5%, respectively. The survival rate for those patients with clinical stage IV was significantly lower than for those with clinical stage I and II (p<0.001 and p = 0.013, respectively. The disease-free progression rates 1, 2, and 3 years after the surgery were 83.9%, 74.6%, and 71.2%, respectively. Futhermore, those patients with a Charlson score of 1 to 2 and ≥3 had higher risk of mortality than those with a Charlson score of 0 (hazard ratios of 1.8 and 2.41 p = 0.042 and p = 0.008. Multivariable analysis revealed that clinical stage, surgical margin, and comorbidity were significantly associated with both mortality and disease-free progression. CONCLUSION: The surgical resection margin, clinical stage, and comorbidity were independent factors affecting the laryngeal cancer prognosis. The survival rates were lower for patients with advanced laryngeal cancer, positive surgical margins, or severe comorbidity, suggesting the importance of early diagnosis, early treatment, negative surgical margins, and conditions of comorbidity.

  20. Complete Immediate Paraplegia Reversal after Performing Aorto-Lumbar Bypass on the Patient who Underwent Aortoiliac Reconstruction.

    Science.gov (United States)

    Banzic, Igor; Sladojevic, Milos; Ilic, Nikola; Koncar, Igor; Davidovic, Lazar; Brankovic, Milos

    2016-08-01

    Although both internal iliac arteries were saved during operation, the patient developed paraplegia immediately after aortoiliac reconstruction due to the spinal cord ischemia. We report a successfully treated immediate postoperative paraplegia by performing second operation and creating bypass from the bifurcated Dacron graft to the previously detected nonpaired huge lumbar artery.

  1. Food pattern and quality of life in metabolic syndrome patients who underwent coronary artery bypass grafting in Taiwan.

    Science.gov (United States)

    Tung, Heng-Hsin; Tseng, Li-Hua; Wei, Jeng; Lin, Cheng-Hsin; Wang, Tsae-Jyy; Liang, Shu-Yuan

    2011-12-01

    Metabolic syndrome is associated with poor operative outcomes of coronary artery bypass grafting surgery (CABG). A healthy food pattern for metabolic syndrome patients is necessary not only in the initial stage to prevent cardiovascular disease but for those who experience cardiovascular problems and undergo heart surgery. Empirical studies that explore food pattern and quality of life metabolic syndrome patients who undergo CABG are lacking. Therefore, the objectives of this study are to explore the food pattern and quality of life of metabolic syndrome patients who undergo CABG and to examine the relationship between these two variables. A descriptive, correlational and cross section design was conducted. Through convenience sampling, 104 patients were recruited. Data were collected through three instruments: a demographic questionnaire; the Chinese Food Frequency Questionnaire-Short Form (Short C-FFQ), used to assess food pattern; and the Taiwanese version of the Medical Outcomes Study Short Form 36-Health Survey (SF-36), used to assess quality of life. Descriptive analysis, one-way analysis of variance (ANOVA) and Pearson correlation were used to analyze the data. The results indicated that patients who ate fruit more frequently tended to have a better quality of life, while the intake of fried food was more frequently associated with a poor quality of life. The use of these data gives the health care provider a better understanding of food pattern and their impact on quality of life in this population. Such an understanding can be used to develop targeted interventions to promote health in this and in other populations.

  2. Development and Validation of Risk Matrices for Crohn's Disease Outcomes in Patients Who Underwent Early Therapeutic Interventions.

    Science.gov (United States)

    Dias, Cláudia Camila; Rodrigues, Pedro Pereira; Coelho, Rosa; Santos, Paula Moura; Fernandes, Samuel; Lago, Paula; Caetano, Cidalina; Rodrigues, Ângela; Portela, Francisco; Oliveira, Ana; Ministro, Paula; Cancela, Eugénia; Vieira, Ana Isabel; Barosa, Rita; Cotter, José; Carvalho, Pedro; Cremers, Isabelle; Trabulo, Daniel; Caldeira, Paulo; Antunes, Artur; Rosa, Isadora; Moleiro, Joana; Peixe, Paula; Herculano, Rita; Gonçalves, Raquel; Gonçalves, Bruno; Sousa, Helena Tavares; Contente, Luís; Morna, Henrique; Lopes, Susana; Magro, Fernando

    2017-04-01

    The establishment of prognostic models for Crohn's disease [CD] is highly desirable, as they have the potential to guide physicians in the decision-making process concerning therapeutic choices, thus improving patients' health and quality of life. Our aim was to derive models for disabling CD and reoperation based solely on clinical/demographic data. A multicentric and retrospectively enrolled cohort of CD patients, subject to early surgery or immunosuppression, was analysed in order to build Bayesian network models and risk matrices. The final results were validated internally and with a multicentric and prospectively enrolled cohort. The derivation cohort included a total of 489 CD patients [64% with disabling disease and 18% who needed reoperation], while the validation cohort included 129 CD patients with similar outcome proportions. The Bayesian models achieved an area under the curve of 78% for disabling disease and 86% for reoperation. Age at diagnosis, perianal disease, disease aggressiveness and early therapeutic decisions were found to be significant factors, and were used to construct user-friendly matrices depicting the probability of each outcome in patients with various combinations of these factors. The matrices exhibit good performance for the most important criteria: disabling disease positive post-test odds = 8.00 [2.72-23.44] and reoperation negative post-test odds = 0.02 [0.00-0.11]. Clinical and demographical risk factors for disabling CD and reoperation were determined and their impact was quantified by means of risk matrices, which are applicable as bedside clinical tools that can help physicians during therapeutic decisions in early disease management.

  3. Association ofMitochondrial T16519C polymorphism with Coronary Artery Disease (CAD in Iranian patients underwent coronary angiography

    Directory of Open Access Journals (Sweden)

    Reza Ghadiri Rad

    2016-09-01

    Full Text Available Early diagnosis, before manifestation of symptoms or identifying susceptibility to diseases can reduce the severity and prevalence and may even control or inhibit the disease progression. Now the relationship between the incidence of cardiovascular diseases and certain types of haplotypes of human mtDNA (mitochondrial DNA have been substantiated and investigation of the frequency of particular types of cases and controls can reveal this connection. Substitution of T to C at nucleotide position 16189 in the hypervariable D-loop of the control region (CR of mitochondrial DNA (mtDNA has attracted research interest because of its suspected association with various multifactorial diseases. The objective of the current study was to identify and evaluate different haplotype mtDNA and examine their relationship to the incidence of coronary artery disease in different haplogroups in Iranian patients visiting SINA hospital in Tehran. A total of 70 participants (including 40 males and 30 females visiting the Cath Lab (angiography of SINA hospital were selected according to the index of stenosis (CSI. After obtaining informed consent, approximately 5cc of blood sample from each patient was taken and sent to the laboratory. Total DNA (50 µg of blood samples were extracted using primers of D-Loop- a specific region of mtDNA, the replicative samples (HVS regions were then seperated by electrophoresis process and quality of amplicon (product was confirmed. This step was followed by sequencing and compared with the reference sequence. According to the SNP, polymorphisms and mutations, and the percentage of their presence in case and control populations were studied and the data analyzed. Items have been composed of haplotype 263 A>G (maximum with 62 samples from 34 patients and 23 healthy and 5 mild cases, 310-311 insC with 61 samples from 35 patients, 21 healthy and 5 slight, variant 750 A>G with 59 persons of 33 patients, 20 healthy and 6 average, other SNP

  4. The predictive value of three-dimensional Doppler ultrasonography in determining implantation in patients underwent in vitro fertilization

    Directory of Open Access Journals (Sweden)

    Yusuf Çakmak

    2015-12-01

    Full Text Available Objective: The aim of this study is to evaluate the relationship between endometrial and sub-endometrial blood flow and implantation rate in patients whose undergone in vitro fertilization. Methods: A prospective study was conducted. Long protocol and antagonist regimens were administered to the patients. Endometrial and sub-endometrial blood flow was evaluated by using 3 dimensional Doppler ultrasonography on the day of oocyt retrieval measurement. For comparison pregnant and non-pregnant women in terms of endometrial and sub-endometrial blood flow, t test was used. The p value was considered statistically meaningful as 0.05. In long protocol group, the number of embryo was greater in pregnant women than non-pregnant women (p=0.012. The number of transferred embryo increased pregnancy rate almost 3.5 fold (p=0.002. Conclusion: The endometrial and subendometrial blood flow is not reliable factor in prediction pregnancy or implantation.

  5. 米诺环素软膏治疗牙周炎的效果%Effect of minocycline ointment on the patients underwent periodontitis

    Institute of Scientific and Technical Information of China (English)

    郑艺; 汤洪毅; 陈京华

    2014-01-01

    目的:观察米诺环素软膏治疗牙周炎的效果。方法:90例牙周炎患者随机分为两组:米诺环素组和碘甘油组。米诺环素组患者使用米诺环素软膏,碘甘油组患者使用碘甘油和替硝唑。记录两组患者的治疗效果。结果:米诺环素组患者的治疗效果比碘甘油组的好( P<0.05)。结论:米诺环素软膏治疗牙周炎患者的效果良好。%Objective To observe the effect of Minocycline ointnent on the patients underwent periodontitis. Method Ninety patients underwent periodontitis were randonly divided into two groups:ninocycline group and iodine glycerin group. In the ninocycline group,the patients were adninistrated with ninocycline ointnen. In the iodine glycerin group,the patients were adninistrated with iodine glycerin and tinidazole. The therapeutic effect in both groups were recorded. Results The therapeutic effect in ninocycline group was better than that in iodine glycerin group(P<0. 05). Conclusion Minocycline ointnent is effective for the patients underwent periodontitis.

  6. Comparative Effects of Statin Therapy versus Renin-Angiotensin System Blocking Therapy in Patients with Ischemic Heart Failure Who Underwent Percutaneous Coronary Intervention.

    Science.gov (United States)

    Won, Jumin; Hong, Young Joon; Jeong, Myung Ho; Park, Hyuk Jin; Kim, Min Chul; Kim, Woo Jin; Kim, Hyun Kuk; Sim, Doo Sun; Kim, Ju Han; Ahn, Youngkeun; Cho, Jeong Gwan; Park, Jong Chun

    2016-05-01

    Statins and renin-angiotensin system (RAS) blockers are key drugs for treating patients with an acute myocardial infarction (AMI). This study was designed to show the association between treatment with statins or RAS blockers and clinical outcomes and the efficacy of two drug combination therapies in patients with ischemic heart failure (IHF) who underwent revascularization for an AMI. A total of 804 AMI patients with a left ventricular ejection fraction <40% who undertook percutaneous coronary interventions (PCI) were analyzed using the Korea Acute Myocardial Infarction Registry (KAMIR). They were divided into four groups according to the use of medications [Group I: combination of statin and RAS blocker (n=611), Group II: statin alone (n=112), Group III: RAS blocker alone (n=53), Group IV: neither treatment (n=28)]. The cumulative incidence of major adverse cardiac and cerebrovascular events (MACCEs) and independent predictors of MACCEs were investigated. Over a median follow-up study of nearly 1 year, MACCEs had occurred in 48 patients (7.9%) in Group I, 16 patients (14.3%) in Group II, 3 patients (5.7%) in Group III, 7 patients (21.4%) in Group IV (p=0.013). Groups using RAS blocker (Group I and III) showed better clinical outcomes compared with the other groups. By multivariate analysis, use of RAS blockers was the most powerful independent predictor of MACCEs in patients with IHF who underwent PCI (odds ratio 0.469, 95% confidence interval 0.285-0.772; p=0.003), but statin therapy was not found to be an independent predictor. The use of RAS blockers, but not statins, was associated with better clinical outcomes in patients with IHF who underwent PCI.

  7. Twenty Five Years in Cheminformatics - A Career Path Through a Diverse Series of Roles and Responsibilities (INVITED TALK) (ACS Spring meeting)

    Science.gov (United States)

    Antony Williams is a Computational Chemist at the US Environmental Protection Agency in the National Center for Computational Toxicology. He has been involved in cheminformatics and the dissemination of chemical information for over twenty-five years. He has worked for a Fortune ...

  8. The predictive value of chronic kidney disease for assessing cardiovascular events under consideration of pretest probability for coronary artery disease in patients who underwent stress myocardial perfusion imaging.

    Science.gov (United States)

    Furuhashi, Tatsuhiko; Moroi, Masao; Joki, Nobuhiko; Hase, Hiroki; Masai, Hirofumi; Kunimasa, Taeko; Fukuda, Hiroshi; Sugi, Kaoru

    2013-02-01

    Pretest probability of coronary artery disease (CAD) facilitates diagnosis and risk stratification of CAD. Stress myocardial perfusion imaging (MPI) and chronic kidney disease (CKD) are established major predictors of cardiovascular events. However, the role of CKD to assess pretest probability of CAD has been unclear. This study evaluates the role of CKD to assess the predictive value of cardiovascular events under consideration of pretest probability in patients who underwent stress MPI. Patients with no history of CAD underwent stress MPI (n = 310; male = 166; age = 70; CKD = 111; low/intermediate/high pretest probability = 17/194/99) and were followed for 24 months. Cardiovascular events included cardiac death and nonfatal acute coronary syndrome. Cardiovascular events occurred in 15 of the 310 patients (4.8 %), but not in those with low pretest probability which included 2 CKD patients. In patients with intermediate to high pretest probability (n = 293), multivariate Cox regression analysis identified only CKD [hazard ratio (HR) = 4.88; P = 0.022) and summed stress score of stress MPI (HR = 1.50; P probability. In patients with intermediate to high pretest probability, CKD and stress MPI are independent predictors of cardiovascular events considering the pretest probability of CAD in patients with no history of CAD. In assessing pretest probability of CAD, CKD might be an important factor for assessing future cardiovascular prognosis.

  9. Retrospective, Demographic, and Clinical Investigation of the Causes of Postoperative Infection in Patients With Lumbar Spinal Stenosis Who Underwent Posterior Stabilization.

    Science.gov (United States)

    Yaldiz, Can; Yaldiz, Mahizer; Ceylan, Nehir; Kacira, Ozlem Kitiki; Ceylan, Davut; Kacira, Tibet; Kizilcay, Gokhan; Tanriverdi, Taner

    2015-07-01

    Owing to the increasing population of elderly patients, a large number of patients with degenerative spondylosis are currently being surgically treated. Although basic measures for decreasing postoperative surgical infections (PSIs) are considered, it still remains among the leading causes of morbidity and mortality. The aim of this retrospective analysis is to present possible causes leading to PSI in patients who underwent surgery for lumbar degenerative spondylosis and highlight how it can be avoided to decrease morbidity and mortality. The study included 540 patients who underwent posterior stabilization due to degenerative lumbar stenosis between January 2013 and January 2014. The data before and after surgery was retrieved from the hospital charts. Patients with degenerative lumbar stenosis who were operated upon in this study had >2 levels of laminectomy and facetectomy. For this reason, posterior stabilization was performed for all the patients included in this study. Determining the causes of postoperative infection (PI) following spinal surgeries performed with instrumentation is a struggle. Seventeen different parameters that may be related to PI were evaluated in this study. The presence of systemic diseases, unknown glove perforations, and perioperative blood transfusions were among the parameters that increased the prevalence of PI. Alternatively, prolene sutures, double-layered gloves, and the use of rifampicin Sv (RIS) decreased the incidence of PI. Although the presence of systemic diseases, unnoticed glove perforations, and perioperative blood transfusions increased PIs, prolene suture material, double-layered gloves, and the use of RIS decreased PIs.

  10. Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery

    Science.gov (United States)

    Miranda, Matheus; Branco, João Nelson Rodrigues; Vargas, Guilherme Flora; Hossne Jr, Nelson Americo; Yoshimoto, Michele Costa; da Fonseca, José Honorio de Almeida Palma; Pestana, José Osmar Medina de Abreu; Buffolo, Enio

    2016-01-01

    Background Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC) can have a negative impact on the in-hospital outcomes of these patients. Objectives To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization. Methods Unicentric study on 102 consecutive, unselected dialytic patients, who underwent myocardial revascularization surgery in a tertiary university hospital from 2007 to 2014. Results Sixty-three patients underwent surgery with ECC and 39 without ECC. A high prevalence of cardiovascular risk factors was found in both groups, without statistically significant difference between them. The group "without ECC" had greater number of revascularizations (2.4 vs. 1.7; p <0.0001) and increased need for blood components (77.7% vs. 25.6%; p <0.0001) and inotropic support (82.5% vs 35.8%; p <0.0001). In the postoperative course, the group "without ECC" required less vasoactive drugs, (61.5% vs. 82.5%; p = 0.0340) and shorter time of mechanical ventilation (13.0 hours vs. 36,3 hours, p = 0.0217), had higher extubation rates in the operating room (58.9% vs. 23.8%, p = 0.0006), lower infection rates (7.6% vs. 28.5%; p = 0.0120), and shorter ICU stay (5.2 days vs. 8.1 days; p = 0.0054) as compared with the group with ECC surgery. No difference in mortality was found between the groups. Conclusion Myocardial revascularization with ECC in patients on dialysis resulted in higher morbidity in the perioperative period in comparison with the procedure without ECC, with no difference in mortality though.

  11. Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery

    Directory of Open Access Journals (Sweden)

    Matheus Miranda

    Full Text Available Abstract Background: Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC can have a negative impact on the in-hospital outcomes of these patients. Objectives: To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization. Methods: Unicentric study on 102 consecutive, unselected dialytic patients, who underwent myocardial revascularization surgery in a tertiary university hospital from 2007 to 2014. Results: Sixty-three patients underwent surgery with ECC and 39 without ECC. A high prevalence of cardiovascular risk factors was found in both groups, without statistically significant difference between them. The group "without ECC" had greater number of revascularizations (2.4 vs. 1.7; p <0.0001 and increased need for blood components (77.7% vs. 25.6%; p <0.0001 and inotropic support (82.5% vs 35.8%; p <0.0001. In the postoperative course, the group "without ECC" required less vasoactive drugs, (61.5% vs. 82.5%; p = 0.0340 and shorter time of mechanical ventilation (13.0 hours vs. 36,3 hours, p = 0.0217, had higher extubation rates in the operating room (58.9% vs. 23.8%, p = 0.0006, lower infection rates (7.6% vs. 28.5%; p = 0.0120, and shorter ICU stay (5.2 days vs. 8.1 days; p = 0.0054 as compared with the group with ECC surgery. No difference in mortality was found between the groups. Conclusion: Myocardial revascularization with ECC in patients on dialysis resulted in higher morbidity in the perioperative period in comparison with the procedure without ECC, with no difference in mortality though.

  12. Relation of Coronary Artery Calcium Score and Risk of Cancer (from a Danish Population-Based Follow-up Study in Patients Who Underwent Cardiac Computed Tomography)

    DEFF Research Database (Denmark)

    Vinter, Nicklas; Christesen, Amanda M.S.; Mortensen, Leif S.

    2017-01-01

    of 28,549 cancer-free patients identified in the Western Denmark Heart Registry. All patients underwent cardiac computed tomography for measurement of CACS for suspected coronary artery disease. The outcome was an incident cancer diagnosis: total, tobacco-related, lung, prostate, breast, and colorectal......Evidence of a causal link between atherosclerosis and cancer is sparse and conflicting. Therefore, we examined the association between extent of coronary atherosclerosis determined by coronary artery calcium score (CACS) and risk of cancer. We conducted a historical population-based cohort study...

  13. Increased incidence of hypotension in elderly patients who underwent emergency airway management: an analysis of a multi-centre prospective observational study.

    Science.gov (United States)

    Hasegawa, Kohei; Hagiwara, Yusuke; Imamura, Taichi; Chiba, Takuyo; Watase, Hiroko; Brown, Calvin A; Brown, David Fm

    2013-01-01

    Although the number of elderly increases disproportionately throughout the industrialised nations and intubation-related cardiovascular compromise is associated with hospital mortality, no emergency medicine literature has reported the direction and magnitude of effect of advanced age on post-intubation hypotension. We seek to determine whether advanced age is associated with an increased rate of hypotension at airway management in emergency departments (EDs). We conducted an analysis of a multi-centre prospective observational study of 13 Japanese EDs from April 2010 to March 2012. Inclusion criteria were all adult non-cardiac-arrest patients who underwent emergency intubation. We excluded patients in whom airway management was performed for shock or status asthmaticus as the principal indication. Patients were divided into two groups defined a priori: age ≥ 65 years old (elderly group) and age airway management at 13 EDs. Among these, the database recorded 3,872 intubations (capture rate 96%). Of 1,903 eligible patients, 975 patients were age ≥ 65 years (51%) and 928 patients were age advanced age had an adjusted OR for post-intubation hypotension of 2.6 (95% CI, 1.3-5.6; P = 0.01). In this large multi-centre study of ED patients who underwent emergent airway management, we found that elderly patients have a significantly higher risk of post-intubation hypotension. These data provide implications for the education and practice of ED airway management that may lead to better clinical outcomes and improved patient safety.

  14. Spinopelvic balance evaluation of patients with degenerative spondylolisthesis L4L5 and L4L5 herniated disc who underwent surgery

    Directory of Open Access Journals (Sweden)

    Viviane Regina Hernandez Nunes

    Full Text Available ABSTRACT OBJECTIVE: To correlate spinopelvic balance with the development of degenerative spondylolisthesis and disk herniation. METHODS: This was a descriptive retrospective study that evaluated 60 patients in this hospital, 30 patients with degenerative spondylolisthesis at the L4-L5 level and 30 with herniated disk at the L4-L5 level, all of whom underwent Surgical treatment. RESULTS: Patients with lumbar disk herniation at L4-L5 level had a mean tilt of 8.06, mean slope of 36.93, and mean PI of 45. In patients with degenerative spondylolisthesis at the L4-L5 level, a mean tilt of 22.1, mean slope of 38.3, and mean PI of 61.4 were observed. CONCLUSION: This article reinforces the finding that the high mean tilt and PI are related to the onset of degenerative spondylolisthesis, and also concluded that the same angles, when low, increase the risk for disk herniation.

  15. Clinicopathologic Characteristics and Outcomes of Histiocytic and Dendritic Cell Neoplasms: The Moffitt Cancer Center Experience Over the Last Twenty Five Years

    Energy Technology Data Exchange (ETDEWEB)

    Dalia, Samir, E-mail: samir.dalia@mercy.net [Mercy Clinic Oncology and Hematology-Joplin, 3001 MC Clelland Park Blvd, Joplin, MO 64804 (United States); Jaglal, Michael; Chervenick, Paul [Department of Malignant Hematology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33602 (United States); Cualing, Hernani [IHCFLOW Histopathology Laboratory, University of South Florida, 18804 Chaville Rd., Lutz, FL 33558 (United States); Sokol, Lubomir [Department of Malignant Hematology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33602 (United States)

    2014-11-14

    Neoplasms of histiocytic and dendritic cells are rare disorders of the lymph node and soft tissues. Because of this rarity, the corresponding biology, prognosis and terminologies are still being better defined and hence historically, these disorders pose clinical and diagnostic challenges. These disorders include Langerhans cell histiocytosis (LCH), histiocytic sarcoma (HS), follicular dendritic cell sarcoma (FDCS), interdigtating cell sarcoma (IDCS), indeterminate cell sarcoma (INDCS), and fibroblastic reticular cell tumors (FRCT). In order to gain a better understanding of the biology, diagnosis, and treatment in these rare disorders we reviewed our cases of these neoplasms over the last twenty five years and the pertinent literature in each of these rare neoplasms. Cases of histiocytic and dendritic cell neoplasms diagnosed between 1989–2014 were identified using our institutional database. Thirty two cases were included in this analysis and were comprised of the following: Langerhans cell histiocytosis (20/32), histiocytic sarcoma (6/32), follicular dendritic cell sarcoma (2/32), interdigitating dendritic cell sarcoma (2/32), indeterminate dendritic cell sarcoma (1/32), and fibroblastic reticular cell tumor (1/32). Median overall survival was not reached in cases with LCH and showed 52 months in cases with HS, 12 months in cases with FDCS, 58 months in cases with IDCS, 13 months in the case of INDCS, and 51 months in the case of FRCT. The majority of patients had surgical resection as initial treatment (n = 18). Five patients had recurrent disease. We conclude that histiocytic and dendritic cell neoplasms are very rare and perplexing disorders that should be diagnosed with a combination of judicious morphology review and a battery of immunohistochemistry to rule out mimics such as carcinoma, lymphoma, neuroendocrine tumors and to better sub-classify these difficult to diagnose lesions. The mainstay of treatment for localized disease remains surgical resection

  16. Serum cystatin c is not superior to serum creatinine for early diagnosis of contrast-induced nephropathy in patients who underwent angiography.

    Science.gov (United States)

    Xu, Qian; Wang, Na-Na; Duan, Shao-Bin; Liu, Na; Lei, Rong; Cheng, Wei; Zhou, Shun-Ke

    2017-09-01

    Iodiated contrast-induced nephropathy (CIN) is a serious complication of contrast-enhanced imaging. The aim of this study was to evaluate the diagnostic sensitivities and specificities of serum cystatin C (sCys C) and serum creatinine (sCr) for CIN and to further investigate difference of the incidence, risk factors, and in-hospital and 3-month prognosis of CIN according to sCys C criteria and sCr criteria. We prospectively evaluated 213 patients who underwent angiography. The sCr and sCys C concentrations were detected before and at 48 hours, 72 hours after the procedure. The incidence, risk factors, and in-hospital and 3-month prognosis of CIN were analyzed. Receiver operating characteristic curve (ROC) analysis was performed for sCr and sCys C 48 hours after procedure. The incidence of CIN was 24.4% (sCys C criteria) and 8% (sCr criteria). Diabetes mellitus, dehydration, and hypoalbuminemia were independent risk factors for CIN. Area under the ROC of sCys C 48 hours after procedure was not superior to sCr (0.715 vs 0.790, P=.178). The mortality of patients with CIN in sCr criteria increased significantly (PC was not superior to sCr for predicting CIN in the patients who underwent angiography. © 2016 Wiley Periodicals, Inc.

  17. Comparison of Estimations Versus Measured Oxygen Consumption at Rest in Patients With Heart Failure and Reduced Ejection Fraction Who Underwent Right-Sided Heart Catheterization.

    Science.gov (United States)

    Chase, Paul J; Davis, Paul G; Wideman, Laurie; Starnes, Joseph W; Schulz, Mark R; Bensimhon, Daniel R

    2015-12-01

    Cardiac output during right-sided heart catheterization is an important variable for patient selection of advanced therapies (cardiac transplantation and left ventricular assist device implantation). The Fick method to determine cardiac output is commonly used and typically uses estimated oxygen consumption (VO2) from 1 of 3 published empirical formulas. However, these estimation equations have not been validated in patients with heart failure and reduced ejection fraction (HFrEF). The objectives of the present study were to determine the accuracy of 3 equations for estimating VO2 compared with direct measurement of VO2 and determine the extent clinically significant error occurred in calculating cardiac output of patients with HFrEF. Breath-by-breath measurements of VO2 from 44 patients who underwent cardiac catheterization (66% men; age, 65 ± 11 years, left ventricular ejection fraction, 22 ± 6%) were compared with the derived estimations of LaFarge and Miettinen, Dehmer et al, and Bergstra et al. Single-sample t tests found only the mean difference between the estimation of LaFarge and Miettinen and the measured VO2 to be nonsignificant (-10.3 ml/min ± 6.2 SE, p = 0.053). Bland-Altman plots demonstrated unacceptably large limits of agreement for all equations. The rate of ≥25% error in the equations by LaFarge and Miettinen, Dehmer et al, and Bergstra et al occurred in 11%, 23%, and 45% of patients, respectively. Misclassification of cardiac index derived from each equation for 2 clinically important classifications: cardiogenic shock-21%, 23%, and 32% and hypoperfusion-16%, 16%, and 25%; respectively. In conclusion, these findings do not support the use of these empiric formulas to estimate the VO2 at rest in patients with HFrEF who underwent right-sided heart catheterization.

  18. Outcome of Triple Antiplatelet Therapy Including Cilostazol in Elderly Patients with ST-Elevation Myocardial Infarction who Underwent Primary Percutaneous Coronary Intervention: Results from the INTERSTELLAR Registry.

    Science.gov (United States)

    Jang, Ho-Jun; Park, Sang-Don; Park, Hyun Woo; Suh, Jon; Oh, Pyung Chun; Moon, Jeonggeun; Lee, Kyounghoon; Kang, Woong Chol; Kwon, Sung Woo; Kim, Tae-Hoon

    2017-06-01

    Compared with dual antiplatelet therapy including aspirin and clopidogrel, triple antiplatelet therapy including cilostazol has a mortality benefit in patients with ST-segment elevation myocardial infarction. However, whether the mortality benefit persists in elderly patients is not clear. From 2007 to 2014, 1278 patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention were retrospectively analyzed. The patients were divided into four groups by age (antiplatelet strategy (triple or dual antiplatelet therapy). We compared the mortality rates between the triple and dual antiplatelet therapy groups. There were 1052 (male, 85%; mean age, 56.3 ± 10.4 years) patients in the young group and 241 (male, 52.7%; mean age, 80.3 ± 4.5 years) patients in the elderly group. In the young and elderly groups, 220 (20.9%) and 28 (12.3%) patients were treated with triple antiplatelet therapy. During a 1-year follow-up period, 80 patients died (4.2% in the young group vs. 15.5% in the elderly group). Kaplan-Meier survival analysis revealed that triple antiplatelet therapy was associated with a lower mortality rate in the young group (log-rank, p = 0.005). Although there were more angiographic high-risk patients in the elderly group, similar mortality rates were reported (log-rank, p = 0.803) without increased bleeding rates (1 vs. 3.6% in the elderly group, p = 0.217). Triple antiplatelet therapy might be a better antiplatelet regimen than dual antiplatelet therapy for patients with ST-segment elevation myocardial infarction. Although this benefit was strong in patients aged <75 years, no definite increase in major bleeding was seen for elderly patients (aged ≥75 years).

  19. Effect of advanced blood pressure control with nifedipine delayed-release tablets on the blood pressure in patients underwent nasal endoscope surgery

    Institute of Scientific and Technical Information of China (English)

    Qing-Hua Xiao; Li Yang; Rong-Ping Chen; Wei-Dong Qiu

    2016-01-01

    Objective:To explore the effect of advanced blood pressure control with nifedipine delayed-release tablets on the blood pressure in patients underwent nasal endoscope surgery and its feasibility.Methods:A total of 80 patients who were admitted in ENT department from June, 2012 to June, 2015 for nasal endoscope surgery were included in the study and randomized into the observation group and the control group with 40 cases in each group. The patients in the observation group were given nifedipine delayed-release tablets for advanced blood pressure control before operation, and were given routine blood pressure control during operation; while the patients in the control group were only given blood pressure control during operation. The changes of blood pressure, mean central arterial pressure, and heart rate before anesthesia (T0), after intubation (T1), during operation (T2), extubation when waking (T3), 30 min after extubation (T4), and 3 h after back to wards (T5) in the two groups were compared. The intraoperative situation and the surgical field quality in the two groups were compared.Results: SBP, DBP, and MAP levels at T1-5 in the two groups were significantly lower than those at T0. SBP, DBP, and MAP levels at T2 were significantly lower than those at other timing points, and were gradually recovered after operation, but were significantly lower than those at T0. The effect taking time of blood pressure reducing, intraoperative nitroglycerin dosage, and postoperative wound surface exudation amount in the observation group were significantly less than those in the control group. The surgical field quality scores in the observation group were significantly superior to those in the control group.Conclusions:Advanced blood pressure control with nifedipine delayed-release tablets can stabilize the blood pressure during the perioperative period in patients underwent nasal endoscope surgery, and enhance the surgical field qualities.

  20. Intraoperative dexmedetomidine and postoperative cerebral hyperperfusion syndrome in patients who underwent superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease

    Science.gov (United States)

    Seo, Hyungseok; Ryu, Ho-Geol; Son, Je Do; Kim, Jeong-Soo; Ha, Eun Jin; Kim, Jeong-Eun; Park, Hee-Pyoung

    2016-01-01

    Abstract Dexmedetomidine, a selective α2-agonist, reduces cerebral blood flow and has neuroprotective effects against cerebral ischemia/reperfusion injury in experimental animals. We examined whether intraoperative dexmedetomidine would reduce the incidence of postoperative cerebral hyperperfusion syndrome (CHS) after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with moyamoya disease. The electronic medical records of 117 moyamoya patients who underwent STA-MCA anastomosis were reviewed retrospectively. The patients were divided into 2 groups: 48 patients received intraoperative dexmedetomidine (Group D), while 69 patients did not (Group ND). The incidence (primary outcome), onset, and duration of postoperative CHS were noted. The incidence of postoperative CHS was 45.8% and 40.6% in groups D and ND, respectively (P = 0.708). The duration of postoperative CHS was shorter in group D than in group ND (median [Q1–Q3], 5 [3–7] vs 8 [5–10] days, P = 0.021). There was no significant difference in the onset of CHS between group D and group ND (0 [0–2] vs 1 [0–3] days, P = 0.226). In conclusion, intraoperative dexmedetomidine did not reduce the incidence of postoperative CHS, although it reduced the duration of CHS, in patients who had undergone direct revascularization surgery for moyamoya disease. PMID:28033272

  1. Quality of life after contralateral prophylactic mastectomy in newly diagnosed high-risk breast cancer patients who underwent BRCA1/2 gene testing.

    Science.gov (United States)

    Tercyak, Kenneth P; Peshkin, Beth N; Brogan, Barbara M; DeMarco, Tiffani; Pennanen, Marie F; Willey, Shawna C; Magnant, Colette M; Rogers, Sarah; Isaacs, Claudine; Schwartz, Marc D

    2007-01-20

    Recent studies indicate that high-risk breast cancer patients (ie, women who carry mutations in BRCA1/2 genes) who opt for contralateral prophylactic mastectomy (CPM) have a substantially reduced risk of developing contralateral breast cancer. However, the immediate and long-term impact of this decision on women's quality of life and psychosocial functioning is largely unknown. In this study, we compared the impact of BRCA1/2 genetic test result and CPM on these outcomes among newly diagnosed breast cancer patients who opted for CPM at the time of their definitive surgical treatment versus patients who did not. Participants were 149 high-risk women who underwent genetic counseling and testing for alterations in the BRCA1/2 genes. We measured self-reported quality of life, cancer-specific distress, and genetic testing-specific distress using standardized instruments before receipt of genetic test results and again 1 and 12 months later. Compared with patients who chose breast conservation or unilateral mastectomy, those who chose mastectomy of the affected breast and CPM of the unaffected breast did not report diminished quality of life or elevated distress. With respect to quality of life and distress, patients who choose CPM fare as well as those who do not in the first year after surgery.

  2. Pediatric keratoconus and iontophoretic corneal crosslinking: refractive and topographic evidence in patients underwent general and topical anesthesia, 18 months of follow-up.

    Science.gov (United States)

    Magli, Adriano; Chiariello Vecchio, Elisabetta; Carelli, Roberta; Piozzi, Elena; Di Landro, Felicia; Troisi, Salvatore

    2016-08-01

    To evaluate the efficiency and safety of iontophoretic transepithelial corneal crosslinking in pediatric patients with progressive keratoconus underwent general or topical anesthesia in 18 months follow-up. 13 patients (13 eyes) diagnosed with progressive keratoconus underwent corneal CXL with iontophoresis (I-CXL). Riboflavin solution was administered by iontophoresis for 5 min, and then UV-A irradiation (10 mW/cm) was performed for 9 min. Preoperative and post-operative visits at 1, 6, 12, and 18 months assessed the following parameters: uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, corneal topography, optical tomography, and pachymetry with Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany), endothelial biomicroscopy (Konan Specular Microscope; Konan Medical, Inc., Hyogo, Japan). The paired Student t test was used to compare data during the follow-up. 10 males and 3 females with a mean age of 15.4 ± 1.7 years (range 11-18 years) were included. The results showed a stabilization of the refractive UCVA and BCVA as early as the first post-operative month, with a slight improvement over time. The Kmax remained stable throughout follow-up (p = 0.04). Transepithelial collagen crosslinking by iontophoresis, unlike other transepithelial techniques seems to halt pediatric keratoconus progression over 18 months. This is the second study evaluating CXL with iontophoresis in pediatric patients with progressive keratoconus with 18 months of follow-up using two different ways of anesthesia.

  3. Protein C, protein S, antithrombin III, and hyperfibrinogenemia in deep vein thrombosis (DVT among patients who underwent high risk orthopaedic surgery

    Directory of Open Access Journals (Sweden)

    Ismail Ismail

    2004-03-01

    Full Text Available Post operative DVT  is believed to be rare in Indonesia, and so is trombophilia. It is necessary to know  the incidence of postoperative DVT in Indonesia and thrombophlia profile (protein C, S, AT III deficiency and hyperfibrinogenemia in DVT and non DVT patient who underwent orthopedic surgery involving the hip and knee (high risk surgery. A cross sectional study was conducted in 20 patients who underwent surgery  involving the hip (total hip replacement  and fixation of proximal femoral fracture and knee (total knee replacement and fixation of  distal femoral fracture. Protein C, protein S, antithrombin III, and fibrinogen were examined in day 5 post operative, as well as with compression/Doppler USG between day 10 to 21 post operative, and confirmed by venography  if USG findings was positive. Post operative DVT were found in 5 of  20  patients (25%. Deficiency of protein C (P= 0.46 protein S (P= 0.81, antithrombin III (P= 0.46, and hyperfibrinogenemia (P= 0.0547 did not correlate to post operative DVT. However, hyperfibrinogenemia was found to be a risk factor to post operative DVT (attributable risk= 1. Other confounding factor such as diabetes mellitus (P= 1.0, obesity (P= 0.28, hypertention (P= 1.0, hypertrigliseridemia, and hypercholesterolemia did not correlate to post operative DVT. The study suggested  the existence of postoperative DVT cases  in Indonesia. Hyperfibrinogenemia is a risk factor to promote post operative DVT. Deep vein thrombosis  did not correlate to protein S, protein C, and antithrombin III deficiency. (Med J Indones 2004; 13: 24-30Keywords: Thrombophilia, hip, knee, venography

  4. Twenty-five-year outbreak of Pseudomonas aeruginosa infecting individuals with cystic fibrosis: identification of the prairie epidemic strain.

    Science.gov (United States)

    Parkins, Michael D; Glezerson, Bryan A; Sibley, Christopher D; Sibley, Kristen A; Duong, Jessica; Purighalla, Swathi; Mody, Christopher H; Workentine, Matthew L; Storey, Douglas G; Surette, Michael G; Rabin, Harvey R

    2014-04-01

    Transmissible strains of Pseudomonas aeruginosa have been described for cystic fibrosis (CF) and may be associated with a worse prognosis. Using a comprehensive strain biobank spanning 3 decades, we sought to determine the prevalence and stability of chronic P. aeruginosa infection in an adult population. P. aeruginosa isolates from sputum samples collected at initial enrollment in our adult clinic and at the most recent clinic visit were examined by a combination of pulsed-field gel electrophoresis and multilocus sequence typing and compared against a collection of established transmissible and local non-CF bronchiectasis (nCFB) isolates. A total of 372 isolates from 107 patients, spanning 674 patient-years, including 66 patients with matched isolates from initial and final encounters, were screened. A novel clone with increased antibacterial resistance, termed the prairie epidemic strain (PES), was found in 29% (31/107 patients) of chronically infected patients referred from multiple prairie-based CF centers. This isolate was not found in those diagnosed with CF as adults or in a control population with nCFB. While 90% (60/66 patients) of patients had stable infection over a mean of 10.8 years, five patients experienced strain displacement of unique isolates, with PES occurring within 2 years of transitioning to adult care. PES has been present in our cohort since at least 1987, is unique to CF, generally establishes chronic infection during childhood, and has been found in patients at the time of transition of patients from multiple prairie-based CF clinics, suggesting broad endemicity. Studies are under way to evaluate the clinical implications of PES infection.

  5. Simplified Chinese version of the Forgotten Joint Score (FJS) for patients who underwent joint arthroplasty: cross-cultural adaptation and validation.

    Science.gov (United States)

    Cao, Shiqi; Liu, Ning; Han, Wuxiang; Zi, Yunpeng; Peng, Fan; Li, Lexiang; Fu, Qiwei; Chen, Yi; Zheng, Weijie; Qian, Qirong

    2017-01-14

    The Forgotten Joint Score (FJS) is a newly developed health-related quality of life (HRQoL) questionnaire designed to evaluate the awareness after total knee arthroplasty (TKA). This study cross-culturally adapted and psychometrically validated a simplified Chinese version of the FJS (SC-FJS). Cross-cultural adaptation was performed according to the internationally recognized guidelines. One-hundred and fifty participants who underwent primary TKA were recruited in this study. Cronbach's α and intra-class correlations were used to determine reliability. Construct validity was analyzed by evaluating the correlations between SC-FJS and the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the short form (36) health survey (SF-36). Each of the 12 items was properly responded and correlated with the total items. SC-FJS had excellent reliability [Cronbach's α = 0.907, intra-class correlation coefficient (ICC) = 0.970, 95% CI 0.959-0.978). Elimination of any one item in all did not result in a value of Cronbach's α of  0.05) correlation with mental subscale of SF-36. SC-FJS demonstrated excellent acceptability, internal consistency, reliability, and construct validity, which can be recommended for patients who underwent joint arthroplasty in Mainland China.

  6. A simple protocol for the management of deep sternal surgical site infection: a retrospective study of twenty-five cases.

    Science.gov (United States)

    Shih, Yu-Jen; Chang, Shun-Cheng; Wang, Chih-Hsin; Dai, Niann-Tzyy; Chen, Shyi-Gen; Chen, Tim-Mo; Tzeng, Yuan-Sheng

    2014-12-01

    Deep sternal incisional surgical site infection is a serious and potentially life-threatening complication after open heart surgery. Although a rare post-operative complication, the rates of post-operative morbidity and mortality are greater in patients who develop a deep sternal incisional surgical site infection than in those who do not. We evaluated retrospectively the results of patients who developed a deep sternal incisional surgical site infection who were treated with either a pectoralis major flap or delayed primary closure after previous negative-pressure wound therapy (NWPT). From July 2007 to July 2012, 25 patients had a deep sternal incisional surgical site infection after open heart surgery in the Departments of Plastic Surgery and Cardiac Surgery of the Tri-Service General Hospital Medical Center. Sternal refixation was not performed in our patients. In 15 patients, a unilateral or bilateral pectoralis major advancement flap with a myocutaneous or muscle flap was used. In seven patients, delayed primary closure was performed after NPWT. One patient received a rectus abdominis myocutaneous flap and another received a free anterior lateral thigh flap. One patient died after developing nosocomial pneumonia with severe sepsis after debridement. In our series, no patient required sternal re-fixation. Our findings suggest that delayed primary closure and use of a unilateral or bilateral pectoralis major flap following NPWT for a deep sternal incisional surgical site infection are simple and quick methods for managing such difficult surgical incisions even if the deep sternal surgical site infection is located in the lower one-third of the sternum.

  7. [Prophylactic effect of CsA, MTX, MMF combined with ATG on GVHD in patients underwent unrelated peripheral blood hematopoietic stem cell transplantation].

    Science.gov (United States)

    Li, Xiao-Hong; Gao, Chun-Ji; Da, Wan-Ming; Yu, Li; Wu, Xiao-Xiong; Li, Hong-Hua; Ma, Jian; Cao, Yong-Bin

    2010-04-01

    This study was aimed to investigate the prophylactic effect of CsA, MTX and MMF combined with ATG on graft versus host disease (GVHD) after unrelated donor peripheral blood hematopoietic stem cell transplantation (URD-PBHSCT). 33 patients underwent URD-PBHSCT with unrelated donor of HLA matched or 1 locus mismatched. The clinical data of all cases were retrospectively analyzed. URD-PBHSCT recipients received cyclosporin A+short term MTX+mycophenolate mofetil (MMF)+antithymocyte globulin to prevent GVHD (URD-ATG group), while 13 out of 33 patients were given additionally anti-CD25 antibody (URD-ATG+CD25 group). The results showed that engraftment was successfully achieved in 100% of all patients. In URD-ATG+CD25 group and URD-ATG group, the incidence of aGVHD were 23.07% and 45%, the incidence of cGVHD were 0 and 47.4% respectively. The latter was significantly higher than the former (pMMF+ATG as the prophylaxis of GVHD for UDR-PBSCT is effective. Reducing the dose of ATG may be good for patient in progression status.

  8. Prognostic Nomograms for Pre- and Postoperative Predictions of Long-Term Survival for Patients Who Underwent Liver Resection for Huge Hepatocellular Carcinoma.

    Science.gov (United States)

    Li, Yuntong; Xia, Yong; Li, Jun; Wu, Dong; Wan, Xuying; Wang, Kui; Wu, Mengchao; Liu, Jingfeng; Lau, Wan Yee; Shen, Feng

    2015-11-01

    Liver resection is an effective treatment in select patients with huge hepatocellular carcinoma (HCC, diameter ≥10 cm). This study aimed to develop nomograms for pre- and postoperative predictions of overall survival (OS) for these patients. There were 464 consecutive patients who underwent liver resection for huge HCC at the Eastern Hepatobiliary Surgery Hospital (EHBH) between January 2008 and December 2009. They were collected and divided into a training cohort (n = 310) and an internal validation cohort (n = 154). Another 90 patients who were operated on at the Fujian Medical University (FMU) between January 2008 and April 2010 served as an external validation cohort. The surgical morbidity, mortality, time to recurrence, and OS were observed. Two prognostic nomograms were developed based separately on the data obtained before and after surgery. Discrimination and predictive accuracy of the models were measured using concordance index (C-index), calibration curves, and validation study. The postoperative 4-year tumor recurrence and OS rates were, respectively, 79.0% and 41.2% in the patients from the EHBH and 78.8% and 37.6% in those from the FMU. Independent predictors of OS on multivariable analysis using pre- and postoperative data were respectively incorporated into the 2 nomograms. In the training cohort, calibration curves for the probability of 4-year postoperative survival fitted well. The C-indexes of the pre- and postoperative nomograms in predicting OS were 0.75 (95% CI 0.72 to 0.78) and 0.78 (95% CI 0.75 to 0.81), respectively. The internal and external validation studies optimally supported these results. The 2 nomograms achieved accurate pre- or postoperative predictions of long-term survival for patients with huge HCC after liver resection. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  9. "Blame it on the Comorbidities": A 5-Year Follow-Up of 53 Chronic Dialysis-Dependent Patients Who Underwent Cardiac Surgery.

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    Deutsch, Oliver; Rippinger, Nathalie; Spiliopoulos, Kyriakos; Eichinger, Walter; Gansera, Brigitte

    2016-10-01

    Objectives This study evaluates midterm survival rates and risk factors for mortality of chronic dialysis-dependent patients undergoing cardiac surgery. Methods Fifty-three dialysis-dependent patients (34 males, aged 67 ± 12 years) with end-stage renal disease operated within March 2007 and May 2012 were analyzed retrospectively. Survival rates were calculated using Kaplan-Meier methods. Predictors of midterm survival were identified with multivariate Cox-regression analysis. Results Twenty-three patients received isolated coronary artery bypass graft surgery, 17 received isolated valve replacement, and 13 received combined procedures. Thirty-day mortality was 24.5% (n = 13). Follow-up was complete for 94.3% (n = 50). Survival rates at 1, 3, and 5 years were: 82, 50, and 17%, respectively. Neither age, gender, poor ejection fraction, emergency, ECC/X-clamp (cross-clamp) time, nor use of left internal thoracic artery or right internal thoracic artery had any influence on midterm survival. Causes of death within midterm follow-up period were related to cardiac events in 16% and neurological events in 16%. In the majority (47%), cause of death was associated with peripheral arterial disease (PAD).The only comorbidity, which could be identified as a significant risk factor, was PAD (p = 0.035). Five patients underwent successful renal transplantation within the follow-up period. Conclusion Although 30-day mortality in this high-risk patient population was increased, midterm survival rates were comparable to the results described in the literature. Cause of death within midterm follow-up period was mostly noncardiac related. Given the limited number of patients, predictors for enhanced 30-day mortality, such as preoperative myocardial infarction, prolonged extracorporeal circulation, operation time, and diabetes mellitus, did not have an influence on midterm survival.

  10. Hepaticojejunostomy for the management of sump syndrome arising from choledochoduodenostomy in a patient who underwent bariatric Roux-en-Y gastric bypass: A case report

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    Alqahtani, Mohammed S.; Alshammary, Shadi A.; Alqahtani, Enas M.; Bojal, Shoukat A.; Alaidh, Amal; Osian, Gelu

    2016-01-01

    Introduction Rapid weight loss following bariatric surgery is associated with high incidence of gallstones and complications that may need bilioenteric diversion. This presents a specific challenge in the management of this group of patients. Case presentation A 37 years old female underwent a Roux-en-Y gastric bypass (RYGB) in 2008 for morbid obesity. In 2009 she presented with obstructive jaundice and was diagnosed with choledocholithiasis successfully managed by open cholecystectomy and choledochoduodenostomy. In the following years, she developed recurrent attacks of fever, chills, jaundice, and right upper quadrant pain and her weight loss was not satisfactory. Imaging of the liver showed multiple cholangitic abscesses. Reflux at the choledochoduodenostomy site was suggestive of sump syndrome as a cause of her recurrent cholangitis and a definitive surgical treatment was indicated. Intraoperative findings confirmed sump at the choledochoduodenostomy site and also revealed the presence of a large superficial accessory duct arising from segment four of the liver with separate drainage into the duodenum distal to the choledochoduodenostomy site. A formal hepaticojejunostomy was done after ductoplasty. The Roux limb was created by transecting the jejunum 40 cm distal to the foot anastomosis of the RYGB. The gastric limb was lengthened as part of this procedure which afforded the patient the additional benefit of weight loss. Conclusion Choledochoduodenostomy should be avoided in patients with RYGB due to the risk of sump syndrome which requires conversion to a formal hepaticojejunostomy. PMID:26921534

  11. Evaluation of long-term results and quality of life in patients who underwent rib fixation with titanium devices after trauma.

    Science.gov (United States)

    Billè, Andrea; Okiror, Lawrence; Campbell, Aideen; Simons, Jason; Routledge, Tom

    2013-06-01

    To describe the long-term results, quality of life and chronic pain after chest wall fixation for traumatic rib fracture using a quality of life (QOL) score and a numeric pain score. Retrospective analysis of 10 consecutive patients who underwent surgery for rib fractures after trauma and reconstruction between October 2010 and March 2012. Chest rib fractures were fixed with titanium clips and bars or titanium plates and screws through a posterolateral thoracotomy. Pain was assessed with a numeric pain scale 0-10 and quality of life (QOL) with the EORTC questionnaire QLQ-C30. There were 5 males and 5 females. The median age was 58 years (range 21-80). There were no postoperative deaths. The only postoperative complication observed was a contralateral pleural effusion requiring drainage. Median length of stay of the drain and median length of hospital stay were 2 days (range 0-8) and 4 days (range 1-42 days), respectively. The average follow-up period of operatively managed patients was 14 months (range 8-23.5 months). Seven patients scored the pain as 0, one as 1 (mild), one as 4 (moderate) and one as 8 (severe). Only two patients are taking occasionally pain killers. Only one patient presents severe limitation in his life scoring his QOL as poor. Titanium devices (clips and bars; screws and plates) are effective and safe for repair of rib fractures and showed good long-term results in terms of pain and quality of life after the operation.

  12. Traços psicológicos dos pacientes submetidos a angioplastia transluminal coronária Psychological profile of patients that underwent coronary angioplasty

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    Lourdes Helena de Campos

    1990-12-01

    Full Text Available Este trabalho teve por objetivo a identificação de traços psicológicos e características emocionais comuns aos pacientes que foram, pela primeira vez, submetidos a angioplastia transluminal coronária (ATC, no Instituto Dante Pazzanese de Cardiologia. Foram analisados 84 pacientes, de ambros os sexos, com idade média de 55 anos. Foram realizadas, pela equipe de psicólogos, duas entrevistas semidirigidas, durante cada uma das quais foram aplicados o Inventário de Ansiedade Traço - Estado (IDATE e a Escala de Hamilton. Essas entrevistas foram realizadas imediatamente anterior à ATC e um dia após o procedimento, na alta dos pacientes. Os resultados permitiram-nos concluir que a grande maioria apresentou padrão comportamental tipo A, próprio do coronariano, alto estresse constitucional e ambiental e ansiedade - traço acima da média. Obtiveram alta porcentagem, também, as variáveis tensão, depressão, grau de competitividade e labilidade de humor.This paper presents psychological and emotional characteristics that were found common to patients that underwent a first coronary angioplasty at Instituto Dante Pazzanese de Cardiologia. We studied 84 patients of both sexes, with mean age of 55 years. Two semi-directed interviews were conducted by the psychology team, and during each of them the State-Trait - Anxiety Inventory STAI and the Hamilton Scale were applied. Such interviews were conducted immediately before PTCA and repeated one day after it, at patient's discharge. We concluded that most patients had a type A personality, typical of patients with coronary artey disease, high constitutional stress and anxiety-trace higher than the average population. There was also a high incidence of tension, depression, competitivity and humor lability.

  13. Twenty-five milligrams of clomiphene citrate presents positive effect on treatment of male testosterone deficiency - a prospective study

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    Carlos Teodósio Da Ros

    2012-08-01

    Full Text Available INTRODUCTION: Male testosterone deficiency is associated with bad sexual function and quality of life (QoL. The aim of this study was to determine whether a daily dose of 25 mg clomiphene citrate (CC is effective in stimulating the endogenous testosterone production pathway and to address the applicability of this medication as a therapeutic option for symptomatic hypogonadism. MATERIALS AND METHODS: This was a prospective study. Men with low sexual desire and testosterone levels (T below 400 ng/dL were selected to receive CC. Blood samples were obtained to determine baseline measurements of serum T, estradiol, LH, lipid profile and fasting plasma glucose. Each patient was treated with a daily dose of 25 mg CC for at least 3 months. Patients were asked if they experienced any side effects related to the use of CC and if they experienced any improvement in their sexual profile. Paired samples T-test was utilized to analyze responses to therapy. RESULTS: Our cohort consisted of 125 men with hypogonadism and low libido. Mean age was 62 years (± 11.1 years. Serum T levels ranged from 309 ng/dL (baseline, mean value to 642 ng/dL (3 months after CC initiation, mean value (p < 0.001. Serum cholesterol levels ranged from 197 to 186 mg/dL (p = 0.003. There were no statistically significant differences when comparing pre and post-treatment HDL-Cholesterol, triglycerides, fasting plasma glucose and prolactin. All men reported improvements in the post-treatment QoL scores. No serious adverse events were recorded. CONCLUSIONS: The CC was effective in stimulating the endogenous production of testosterone. A lower level of total cholesterol was verified after three months of treatment. This medication should be considered as a therapeutic option for some patients with symptomatic male testosterone deficiency.

  14. Analysis of incidence of keratoconus in relatives of patients who underwent corneal transplant due to advanced keratoconus using the Orbscan II topographic graphs

    Science.gov (United States)

    López Olazagasti, Estela; Hernández y del Callejo, César E.; Ibarra-Galitzia, Jorge; Ramírez-Zavaleta, Gustavo; Tepichín, Eduardo

    2011-10-01

    Keratoconus is a corneal disease in which the cornea assumes a conical shape due to an irregular alteration of the internal structure of the corneal tissue and sometimes is progressive, especially in young people. Anatomically, the main signs of keratoconus are thinning of the cornea in its central or paracentral region, usually accompanied by an increase in this part of a high irregular astigmatism, with a consequent loss of vision. Its diagnosis requires a thorough study including the family history, a complete ophthalmologic examination and imaging studies. This diagnosis allows classifying the type of keratoconus, which allow determining options of management, with what it is possible to establish a visual prognosis of each eye. One of the indicators that help in the diagnosis of keratoconus is an inherited familiar propensity. The literature reports an incidence of keratoconus of 11%1 in first-degree relatives of patients with keratoconus. Results suggest an ethnic dependence, which implies that the knowledge of the tendency of keratoconus in the Mexican population is important. In this work, we present the preliminary results of the study realized to a group of relatives of patients who underwent corneal transplant by advanced keratoconus using Orbscan II topographic diagnosis, to determine the predisposition to Keratoconus in this group.e

  15. TWENTY-FIVE-GAUGE CANNULA-ASSISTED FINE-NEEDLE ASPIRATION BIOPSY OF CHOROIDAL MELANOMA: Cytopathological Analysis.

    Science.gov (United States)

    Singh, Arun D; Aziz, Hassan A; Pelayes, David; Biscotti, Charles V

    2017-09-01

    To report cytopathological observations on the cells retrieved from the 25-G cannula used during prognostic transvitreal fine-needle aspiration biopsy of choroidal melanoma. Transvitreal fine-needle aspiration biopsy of choroidal melanoma was performed through a 25-G valved cannula. Twenty samples from 20 consecutive patients were obtained. Most tumors were treated with plaque radiation therapy (16/20, 80%) following standard clinical guidelines. Four enucleated globes (4/20, 20%) were subjected to a similar transvitreal biopsy before enucleation. Cytopathological analysis of the cells retrieved from the cannula revealed the absence of any cells in 4 of 20 samples (20%). In the remaining 16 samples, definite melanoma cells and atypical cells (probable melanoma cells) were observed in 2 samples each (total 4, 25%). Histiocytes (4/16, 25%) and lymphocytes (1/16, 6%) were also observed. Thirteen samples (13/16, 81%) contained conjunctival epithelial epithelium. Prognostication could be performed on all fine-needle aspiration biopsy samples (20, 100%). Use of a 25-G valved cannula offers potential advantages by isolating the needle tract and by allowing retrieval of the contaminating cells without affecting the prognostic yield of the fine-needle aspiration biopsy sample.

  16. The results of surgical treatment of 14 patients underwent repeated tricuspid valve operations%三尖瓣再次手术14例

    Institute of Scientific and Technical Information of China (English)

    周明阳; 张健群; 孟旭; 李温斌; 孔晴宇

    2008-01-01

    目的 总结三尖瓣再次手术的治疗效果及经验.方法 2002年至2006年,收治14例三尖瓣再次手术病人,其中三尖瓣成形术后再次出现关闭不全12例,三尖瓣置换术后人工瓣膜功能障碍2例.结果 再次实施三尖瓣成形术5例,三尖瓣置换术9例.死亡2例,余者治愈出院.10例随访2~40个月,1例心功能Ⅲ级,余者均为Ⅰ~Ⅱ级.结论 再次三尖瓣手术治疗效果确切,手术死亡与手术方式的选择以及围术期心、肾功能衰竭有关.%Objective To evaluate the results and surgical treatment of the repeated tricuspid valve operations. Methods The hospital records was reviewed for 14 patients who underwent repeated tricuspid valve operations between 2003 and 2006, including 12 patients with tricuspid regurgitation received first tricuspid valve repair and 2 patients, with prosthetic valve dysfunction. Results Reoperations of tricuspid valve included 5 tricuspid valve repair and 9 tricuspid valve replacement. There were two postoperative deaths. Post-operative heart function (NYHA) was improved significantly, 1 case in Ⅲ and 9 in Ⅰ-Ⅱ. Ten survivors were followed up for 2 - 40 months. Conclusion Tricuspid valve reoperations may be performed with acceptable operative mortality. Perioperative death was associated with surgical methods and heart or renal function failure.

  17. Gender-linked impact of epicardial adipose tissue volume in patients who underwent coronary artery bypass graft surgery or non-coronary valve surgery.

    Science.gov (United States)

    Maimaituxun, Gulinu; Shimabukuro, Michio; Salim, Hotimah Masdan; Tabata, Minoru; Yuji, Daisuke; Morimoto, Yoshihisa; Akasaka, Takeshi; Matsuura, Tomomi; Yagi, Shusuke; Fukuda, Daiju; Yamada, Hirotsugu; Soeki, Takeshi; Sugimoto, Takaki; Tanaka, Masashi; Takanashi, Shuichiro; Sata, Masataka

    2017-01-01

    Traditional and non-traditional risk factors for atherosclerotic cardiovascular disease (ASCVD) are different between men and women. Gender-linked impact of epicardial adipose tissue volume (EATV) in patients undergoing coronary artery bypass grafting (CABG) remains unknown. Gender-linked impact of EATV, abdominal fat distribution and other traditional ASCVD risk factors were compared in 172 patients (men: 115; women: 57) who underwent CABG or non-coronary valvular surgery (non-CABG). In men, EATV, EATV index (EATV/body surface area) and the markers of adiposity such as body mass index, waist circumference and visceral fat area were higher in the CABG group than in the non-CABG group. Traditional ASCVD risk factors were also prevalent in the CABG group. In women, EATV and EATV index were higher in the CABG group, but other adiposity markers were comparable between CABG and non-CABG groups. Multivariate logistic regression analysis showed that in men, CABG was determined by EATV Index and other ASCVD risk factors including hypertension, dyslipidemia, adiponectin, high sensitive C-reactive protein (hsCRP) and type 2 diabetes mellitus (Corrected R2 = 0.262, p < 0.0001), while in women, type 2 diabetes mellitus is a single strong predictor for CABG, excluding EATV Index (Corrected R2 = 0.266, p = 0.005). Our study found that multiple risk factors, including epicardial adipose tissue volume and traditional ASCVD factors are determinants for CABG in men, but type 2 diabetes mellitus was the sole determinant in women. Gender-specific disparities in risk factors of CABG prompt us to evaluate new diagnostic and treatment strategies and to seek underlying mechanisms.

  18. Eating behavior and nutritional status in patients who underwent coronary angioplasty La conducta alimentaria y estado nutricional en pacientes sometidos a angioplastia coronaria

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    L. Proença Vieira

    2012-02-01

    Full Text Available Introduction: The identification of stages of dietary change and the factors affecting food choices can direct more effective nutritional intervention against coronary heart disease progression. Objective: Identify the stages of change of eating behavior and its relation with nutritional status, food consumption and previous cardiovascular events in patients who underwent coronary angioplasty. Methods: A cross-sectional study with 200 hospitalized patients from a specialized cardiology hospital, after elective coronary angioplasty. They were applied an algorithm that identifies the provision of change of eating habits for a healthier pattern. Variables measured were stages of change of eating behavior, nutritional status, food consumption and cardiovascular events (previous myocardial infarction or angioplasty. It was realized comparison of averages by analysis of variance or Student´s test and Chi-square test for qualitative variables. Value of significance was taken at 5%. Results: The patients were classified in the following stages: 36% maintenance, 26% preparation, 17% precontemplation, 12% action and 9% contemplation. It was observed higher cardiovascular events in maintenance/action group (p = 0.04, higher consumption of calories (p = 0.04, meat/eggs (p = 0.01 and sweets (p = 0.03 in preparation stage, comparing to maintenance group, and no association between nutritional status and stages of change (p = 0.13, although 62% of the individuals in maintenance stage were overweight. Conclusions: This work contributed to identifying the stages of change and conditions that favor changes in eating pattern. Even patients that classified themselves into the maintenance stage need to adjust their eating habits in order to reach a healthy weight.Introducción: La identificación de las etapas de cambio en la dieta y los factores que afectan la elección de alimentos puede dirigir una intervención nutricional más eficaz contra la progresión de

  19. The biological activity of propolis-containing toothpaste on oral health environment in patients who underwent implant-supported prosthodontic rehabilitation.

    Science.gov (United States)

    Morawiec, Tadeusz; Dziedzic, Arkadiusz; Niedzielska, Iwona; Mertas, Anna; Tanasiewicz, Marta; Skaba, Dariusz; Kasperski, Jacek; Machorowska-Pieniążek, Agnieszka; Kucharzewski, Marek; Szaniawska, Karolina; Więckiewicz, Włodzimierz; Więckiewicz, Mieszko

    2013-01-01

    The soft and periodontal tissues surrounding dental implants are particularly susceptible to bacteria invasion and inflammatory reactions due to complex histological structures. This study was carried out to investigate the influence of a propolis-containing hygienic agent on selected oral health parameters, oral microflora, and the condition of periodontal health. Sixteen subjects who underwent an oral rehabilitation with dental implants were selected and randomly assigned into two groups, which received a newly formulated propolis-containing toothpaste (3% (CA)) or a negative control without an active ingredient (CC). Approximal plaque index (API), oral hygiene index (OHI, debris component), and sulcus bleeding index (SBI) were assessed in three subsequent stages. During the first and last examinations, the swabs were employed for microbiological inoculation. Propolis-containing toothpaste was found to be distinctively effective in improving oral health and the occurrence of gingivitis triggered by dental plaque. The qualitative and quantitative changes in oral bacteria spectrum were observed. Antibacterial measures containing propolis might be used as a natural adjuvant to other active substances in individuals with a high risk of periodontal problems against pathogenic oral microflora.

  20. The Biological Activity of Propolis-Containing Toothpaste on Oral Health Environment in Patients Who Underwent Implant-Supported Prosthodontic Rehabilitation

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    Tadeusz Morawiec

    2013-01-01

    Full Text Available The soft and periodontal tissues surrounding dental implants are particularly susceptible to bacteria invasion and inflammatory reactions due to complex histological structures. This study was carried out to investigate the influence of a propolis-containing hygienic agent on selected oral health parameters, oral microflora, and the condition of periodontal health. Sixteen subjects who underwent an oral rehabilitation with dental implants were selected and randomly assigned into two groups, which received a newly formulated propolis-containing toothpaste (3% (CA or a negative control without an active ingredient (CC. Approximal plaque index (API, oral hygiene index (OHI, debris component, and sulcus bleeding index (SBI were assessed in three subsequent stages. During the first and last examinations, the swabs were employed for microbiological inoculation. Propolis-containing toothpaste was found to be distinctively effective in improving oral health and the occurrence of gingivitis triggered by dental plaque. The qualitative and quantitative changes in oral bacteria spectrum were observed. Antibacterial measures containing propolis might be used as a natural adjuvant to other active substances in individuals with a high risk of periodontal problems against pathogenic oral microflora.

  1. Three years later: report on the state of well-being of patients with chronic tinnitus who underwent modified tinnitus retraining therapy.

    Science.gov (United States)

    Seydel, Claudia; Haupt, Heidemarie; Szczepek, Agnieszka J; Hartmann, Anne; Rose, Matthias; Mazurek, Birgit

    2015-01-01

    Successful management of patients with chronic tinnitus is an important health issue. One of the tinnitus management strategies used at our Tinnitus Center is a combination of tinnitus retraining therapy (TRT) with physiotherapy and psychological management [called modified TRT (MTRT)]. We have used this type of management for over a decade and have described the protocol in detail elsewhere. In the present study, we wanted to determine the effect of MTRT on the well-being of tinnitus patients 3 years after treatment onset. One hundred and thirty patients with chronic tinnitus were assessed using psychometric instruments immediately before 7-day MTRT, immediately after the therapy and 3 years later. Patients with very severe tinnitus-related distress associated with major depression and a risk of suicide were excluded from this study. MTRT resulted in a sustained reduction of tinnitus-related distress. Moreover, the quality of life of patients had increased, as assessed by a separate questionnaire. The effect of MTRT was influenced by the degree of tinnitus-related distress and by the patients' age, the latter being gender dependent. Hearing loss and tinnitus duration had only a minor influence on the therapeutic effect. Taken together, we report a positive change in the state of well-being of patients with chronic tinnitus measurable with various psychometric instruments 3 years after the onset of MTRT.

  2. The Prevalence of Risk Factors of Coronary Artery Disease in the Patients who Underwent Coronary Artery Bypass Graft, Shiraz, Iran: Suggesting a Model

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    Mohammad Ali Ostovan

    2014-12-01

    Full Text Available Background: Cardiovascular diseases are the main cause of 40% of deaths in Iran annually. Many patients undergoing coronary artery bypass graft surgery have previous cardiovascular risk factors which could be prevented. Objectives: The present study aimed to assess the prevalence of cardiovascular risk factors in the patients undergoing coronary artery bypass graft surgery. Materials and Methods: In this cross-sectional (descriptive – analytical study, a data collecting form was used. A total of 246 patients were selected from six hospitals of Shiraz using random stratification. Descriptive statistics were presented through figures and tables and t-test was used to analyze the continuous variables. All the statistical analyses were performed using the SPSS statistical software (version 15.0. Besides, P < 0.05 was considered as statistically significant. Results: Among the study patients, only 11.67% had no risk factors and 88.33% had one or more risk factors. The most common risk factors observed in the patients were hypertension, obesity and overweight, hyperlipidemia, and diabetes mellitus. The results showed a significant difference between males and females regarding the prevalence of hypertension (P = 0.001, diabetes (P = 0.028, hypercholesterolemia (P = 0.020, and cigarette smoking (P = 0.001. In addition, the patients' mean levels of cholesterol, LDL, triglyceride, and fasting blood sugar were higher than the acceptable level, while that of HDL was lower than the accepted level. Conclusions:: These patients are recommended to be trained regarding lifestyle changes. Also, prevention strategies can play an important role in reducing patient morbidity and mortality.

  3. Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy

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    Choi Eun

    2010-05-01

    Full Text Available Abstract Background The aim of this study was to assess the results of curative surgery with and without radiotherapy in patients with T1-2N0-1 oral tongue squamous cell carcinoma (OSCC and to evaluate survival and prognostic factors. Methods Retrospective analysis of 86 patients with T1-2N0-1 OSCC who received surgery between January 2000 and December 2006. Fourteen patients (16.3% received postoperative radiotherapy (PORT. Patient characteristics, tumor characteristics, treatment modality, failure patterns, and survival rates were analyzed. Results The median follow-up was 45 months. The five-year overall survival (OS and disease-free survival (DFS rates were 80.8% and 80.2%, respectively. Higher tumor grade and invasion depth ≥ 0.5 cm were the significant prognostic factors affecting five-year OS and DFS (OS rate; 65% vs. 91%, p = 0.001 for grade; 66% vs. 92%, p = 0.01 for invasion depth: DFS rate; 69% vs. 88%, p = 0.005 for grade; 66% vs. 92%, p = 0.013 for invasion depth. In the risk group, there was no local failure in patients with postoperative radiotherapy. Conclusions In T1-2N0-1 OSCC, factors that affected prognosis after primary surgery were higher tumor grade and deep invasion depth over 0.5 cm. Postoperative radiotherapy should be considered in early oral tongue cancer patients with these high-risk pathologic features.

  4. CLINICAL CASE OF PERFORMING A TWO-ST AGE LOVER RESECTION BY TYPE ALPPS IN PATIENT WHO PREVIOUSLY UNDERWENT ANATOMIC RESECTION OF THE RIGHT LOBE OF THE LIVER

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    D. V. Sidorov

    2015-01-01

    Full Text Available Abstract:One of the variants for the surgical treatment of patients with bilobal liver metastases is to perform two-stage anatomic resections. Thus, at least in a quarter of the patients it is impossible to perform the second stage of intervention because of absence of hypertrophy of the remaining liver parenchyma or progression of disease during standby. The most modern and promising way of overcoming this obstacle is to perform the so-called ALPPS (Associating Liver Partition and Portal vein Ligation for Staged hepatectomy or «in situ slit» liver resections. In this article we present a clinical case of performing a two-stage hepatectomy by type ALPPS in patients with metastatic colorectal cancer liver, who previously undergone the anatomic bisegmentectomy SVI-SVII. The present observation is the first in the available literature, evidence of justification perform repeated liver resections in patients with metastatic colorectal cancer and demonstrates the possibility of ALPPS techniques when performing extensive anatomical liver resections in patients who have undergone previous removal of the parenchyma of the right lobe.

  5. Impact of Additional Transthoracic Electrical Cardioversion on Cardiac Function and Atrial Fibrillation Recurrence in Patients with Persistent Atrial Fibrillation Who Underwent Radiofrequency Catheter Ablation

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    Deguo Wang

    2016-01-01

    Full Text Available Backgrounds and Objective. During the procession of radiofrequency catheter ablation (RFCA in persistent atrial fibrillation (AF, transthoracic electrical cardioversion (ECV is required to terminate AF. The purpose of this study was to determine the impact of additional ECV on cardiac function and recurrence of AF. Methods and Results. Persistent AF patients received extensive encircling pulmonary vein isolation (PVI and additional line ablation. Patients were divided into two groups based on whether they need transthoracic electrical cardioversion to terminate AF: electrical cardioversion (ECV group and nonelectrical cardioversion (NECV group. Among 111 subjects, 35 patients were returned to sinus rhythm after ablation by ECV (ECV group and 76 patients had AF termination after the ablation processions (NECV group. During the 12-month follow-ups, the recurrence ratio of patients was comparable in ECV group (15/35 and NECV group (34/76 (44.14% versus 44.74%, P=0.853. Although left atrial diameters (LAD decreased significantly in both groups, there were no significant differences in LAD and left ventricular cardiac function between ECV group and NECV group. Conclusions. This study revealed that ECV has no significant impact on the maintenance of SR and the recovery of cardiac function. Therefore, ECV could be applied safely to recover SR during the procedure of catheter ablation of persistent atrial fibrillation.

  6. Predictive value of preoperative tests in estimating difficult intubation in patients who underwent direct laryngoscopy in ear, nose, and throat surgery

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    Osman Karakus

    2015-04-01

    Full Text Available BACKGROUND AND OBJECTIVES: Predictive value of preoperative tests in estimating difficult intubation may differ in the laryngeal pathologies. Patients who had undergone direct laryngoscopy (DL were reviewed, and predictive value of preoperative tests in estimating difficult intubation was investigated. METHODS: Preoperative, and intraoperative anesthesia record forms, and computerized system of the hospital were screened. RESULTS: A total of 2611 patients were assessed. In 7.4% of the patients, difficult intubations were detected. Difficult intubations were encountered in some of the patients with Mallampati scoring (MS system Class 4 (50%, Cormack-Lehane classification (CLS Grade 4 (95.7%, previous knowledge of difficult airway (86.2%, restricted neck movements (cervical ROM (75.8%, short thyromental distance (TMD (81.6%, vocal cord mass (49.5% as indicated in parentheses (p < 0.0001. MS had a low sensitivity, while restricted cervical ROM, presence of a vocal cord mass, short thyromental distance, and MS each had a relatively higher positive predictive value. Incidence of difficult intubations increased 6.159 and 1.736-fold with each level of increase in CLS grade and MS class, respectively. When all tests were considered in combination difficult intubation could be classified accurately in 96.3% of the cases. CONCLUSION: Test results predicting difficult intubations in cases with DL had observedly overlapped with the results provided in the literature for the patient populations in general. Differences in some test results when compared with those of the general population might stem from the concomitant underlying laryngeal pathological conditions in patient populations with difficult intubation.

  7. [Predictive value of preoperative tests in estimating difficult intubation in patients who underwent direct laryngoscopy in ear, nose, and throat surgery].

    Science.gov (United States)

    Karakus, Osman; Kaya, Cengiz; Ustun, Faik Emre; Koksal, Ersin; Ustun, Yasemin Burcu

    2015-01-01

    Predictive value of preoperative tests in estimating difficult intubation may differ in the laryngeal pathologies. Patients who had undergone direct laryngoscopy (DL) were reviewed, and predictive value of preoperative tests in estimating difficult intubation was investigated. Preoperative, and intraoperative anesthesia record forms, and computerized system of the hospital were screened. A total of 2611 patients were assessed. In 7.4% of the patients, difficult intubations were detected. Difficult intubations were encountered in some of the patients with Mallampati scoring (MS) system Class 4 (50%), Cormack-Lehane classification (CLS) Grade 4 (95.7%), previous knowledge of difficult airway (86.2%), restricted neck movements (cervical ROM) (75.8%), short thyromental distance (TMD) (81.6%), vocal cord mass (49.5%) as indicated in parentheses (p<0.0001). MS had a low sensitivity, while restricted cervical ROM, presence of a vocal cord mass, short thyromental distance, and MS each had a relatively higher positive predictive value. Incidence of difficult intubations increased 6.159 and 1.736-fold with each level of increase in CLS grade and MS class, respectively. When all tests were considered in combination difficult intubation could be classified accurately in 96.3% of the cases. Test results predicting difficult intubations in cases with DL had observedly overlapped with the results provided in the literature for the patient populations in general. Differences in some test results when compared with those of the general population might stem from the concomitant underlying laryngeal pathological conditions in patient populations with difficult intubation. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  8. Evaluation of Sociodemographic Characteristics and the Relationship Between Initial Complaints and Histopathological Diagnosis of Patients Who Underwent Kidney Biopsy Procedure Between 2007-2011

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    Servet YÜKSEL

    2013-09-01

    Full Text Available OBJECTIVE: The aim of this study is to evaluate the relationship between patients’ age, gender, body mass index, family history, initial complaints and histopathological diagnosis and progression to end stage renal failure. MATERIAL and METHODS: 268 patients, who had renal biopsy in GATA Nephrology Department between 2007 and 2011, included to the study. All of the patients had native renal biopsy. The patients’ clinical and pathological findings were compared with age, gender and other sociodemographic features. RESULTS: The mean age was 34±15 years among men and 47±17 years among women. The most common histopathological diagnosis was FSGS with the rate of 20.9% (n=56 and the second was IgA nephropathy with the rate of %18.7 (n=50. The rate for completely asymptomatic patients without any complaints or abnormal test results or patients who were determined during routine examination before the operation found to be 25,7% (n=69. Face and leg edema found to be the most common complaint. CONCLUSION: Fighting against risk factors (hypertension, diabetes, smoking, obesity, etc. even before the disease presents, which actually is the basis of preventive medicine; will slow down the progression of CKD, decrease mortality and morbidity, and thus will contribute to the country’s economy.

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

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    Paweł Rodziński

    2015-12-01

    The results confirm effectiveness of intensive psychotherapy as a treatment method that leads to comprehensive improvement encompassing reduction of neurotic personality disorders (neuroticism and of majority of neurotic personality traits, as well as SI reduction. The revealed associations weigh in favor of hypothesis on neuroticism as SI predisposing factor in patients with neurotic, behavioral and personality disorders.

  10. Autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation: analysis of 533 adult patients who underwent transplantation at King's College Hospital.

    Science.gov (United States)

    Wang, Meng; Wang, Wenjia; Abeywardane, Ayesha; Adikarama, Malinthi; McLornan, Donal; Raj, Kavita; de Lavallade, Hugues; Devereux, Stephen; Mufti, Ghulam J; Pagliuca, Antonio; Potter, Victoria T; Mijovic, Aleksandar

    2015-01-01

    Autoimmune hemolytic anemia (AIHA) is a recognized complication of hematopoietic stem cell transplantation (HSCT); it is often refractory to treatment and carries a high mortality. To improve understanding of the incidence, risk factors, and clinical outcome of post-transplantation AIHA, we analyzed 533 patients who received allogeneic HSCT, and we identified 19 cases of AIHA after HSCT (overall incidence, 3.6%). The median time to onset, from HSCT to AIHA, was 202 days. AIHA was associated with HSCT from unrelated donors (hazard ratio [HR], 5.28; 95% confidence interval [CI], 1.22 to 22.9; P = .026). In the majority (14 of 19; 74%) of AIHA patients, multiple agents for treatment were required, with only 9 of 19 (47%) patients achieving complete resolution of AIHA. Patients with post-transplantation AIHA had a higher overall mortality (HR, 2.48; 95% CI, 1.33 to 4.63; P = .004), with 36% (4 of 11 cases) of deaths attributable to AIHA.

  11. Clinical and echocardiographic characteristics of pericardial effusion in patients who underwent echocardiographically guided pericardiocentesis: Yonsei Cardiovascular Center experience, 1993-2003.

    Science.gov (United States)

    Cho, Byoung Chul; Kang, Seok Min; Kim, Dae Hyuck; Ko, Young Guk; Choi, Donghoon; Ha, Jong Won; Rim, Se Joong; Jang, Yangsoo; Chung, Namsik; Shim, Won Heum; Cho, Seung Yun; Kim, Sung Soon

    2004-06-30

    Percutaneous pericardiocentesis guided by two-dimensional echocardiography was introduced in 1983 as an alternative to electrocardiographically or fluoroscopically guided puncture for the management of pericardial effusion. The objective of this study was to investigate echocardiographically (echo)- guided pericardiocenteses performed at Yonsei Cardiovascular Center from January 1, 1993 to December 31, 2003, and also to determine whether patient profiles, etiology, and practice patterns have changed over this 11-year period. The medical records of 272 patients were examined and a follow-up survey was conducted. Patient clinical profiles, etiology, echocardiographic findings, and procedural details were determined for 2 periods: January, 1993 through December, 1997 (period 1); and January 1998 through December, 2003 (period 2). During the 11-year study period, 291 therapeutic, echo-guided pericardiocenteses with pericardial catheter drainage were performed in 272 patients. The number of pericardiocentesis in period 2 was increased compared with period 1 (191 cases vs. 100 cases). The mean age at pericardiocentesis increased from 49 +/- 17 years in period 1 to 55 +/- 16 years in period 2 (p < 0.05). The procedural success rate was 99% overall with a major complication rate of 0.7% (2 cases of right ventricular free wall perforation which required emergency operation). Only one procedure-related mortality (< 30 days) was noted. Malignancy was the leading cause of a pericardial effusion requiring pericardiocentesis (45.6%). The incidence of pericardial effusion following cardiothoracic surgery and percutaneous coronary intervention procedures accounted for nearly 20% of all pericardiocenteses performed. Echo-guided pericardiocentesis has become a safe, standard practice for clinically significant pericardial effusion, in line with the changes of patients profiles over the 11 years of the study.

  12. Study on Patients Who Underwent Suspected Diagnosis of Allergy to Amide-Type Local Anesthetic Agents by the Leukocyte Migration Test

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    Mikio Saito

    2014-01-01

    Conclusions:: There is a high possibility that these adverse reactions were caused by pseudoallergy to drug. Even by allergic reactions, it was assumed that 80% of them might be caused by antiseptic agents such as paraben. In addition, it was suggested that ALAs, especially lidocaine hydrochloride preparations have high antigenicity (sensitizing property. Furthermore, it was considered that patients with past history of drug or food allergies have a high potential for manifestation of the reactions.

  13. Lack of an Association between Neutrophil-to-Lymphocyte Ratio and PSA Failure of Prostate Cancer Patients Who Underwent Radical Prostatectomy

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    Yoko Maeda

    2016-01-01

    Full Text Available Introduction. The neutrophil-to-lymphocyte ratio (NLR, which can be easily calculated from routine complete blood counts of the peripheral blood, has been suggested to serve as a prognostic factor for some solid malignancies. In the present study, we aimed to determine the relationship between NLR in prostate cancer patients undergoing radical prostatectomy (RP and their prognosis. Materials and Methods. We assessed NLR in 73 men (patients who received RP for their prostate cancer. We also performed immunohistochemistry for CD8 and CD66b in a separate set of RP specimens. Results. The median NLR in the 73 patients was 1.85. There were no significant correlations of NLR with tumor grade (p=0.834, pathological T stage (p=0.082, lymph node metastasis (p=0.062, or resection margin status (p=0.772. Based on the area under the receiver operator characteristic curve (AUROC to predict biochemical recurrence after RP, potential NLR cut-off point was determined to be 2.88 or 3.88. However, both of these cut-off points did not precisely predict the prognosis. There were no statistically significant differences in the number of CD66b-positive neutrophils or CD8-positive lymphocytes between stromal tissues adjacent to cancer glands and stromal tissues away from cancer glands and between different grades or stages of tumors. Conclusions. There was no association between NLR and biochemical failure after prostatectomy.

  14. Manejo da osteorradionecrose em pacientes submetidos à radioterapia de cabeça e pescoço =Osteoradionecrosis management in patients underwent head and neck radiotherapy

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    Vier, Fabiana Vieira et al.

    2005-01-01

    Full Text Available Os efeitos colaterais da radioterapia instituída para tratamento de pacientes com câncer da região de cabeça e pescoço interferem significativamente na qualidade de vida desses indivíduos. Entre esses efeitos, podem-se citar mucosite, hipossialia, ageusia, cáries por radiação, trismo e osteorradionecrose (ORN. Esta última constitui uma complicação grave e de difícil tratamento. A presente revisão da literatura objetiva enfatizar aspectos da osteorradionecrose, abordando fatores etiológicos, características clínicas e radiográficas, prevalência, tratamento e prognóstico da enfermidade. O cumprimento de medidas protocolares antes, durante e após a radioterapia de cabeça e pescoço previne e minimiza a ocorrência de complicações como a ORN. As consultas de controle após o término da radioterapia são imprescindíveis e devem ser garantidas pela conscientização do paciente sobre a importância das mediadas preventivas. Radiotherapy appointed for the treatment of patients with head and neck cancer presents side effects which interfere significantly with the patients’ quality of life. Mucous inflammation, hyposialia, loss of taste, radiation caries, trismus, and osteoradionecrosis (ORN are among these side effects. ORN represents a serious complication of difficult treatment. The present literature review aims to emphasize aspects of ORN approaching the pathology’s etiologic factors, clinical and radiographic characteristics, prevalence, treatment and prognosis. Compliance with protocol procedures both prevents and reduces the development of complications such as ORN. After finishing radiotherapy, follow-up consultations are indispensable and to assure them the patient should be aware of the importance of preventive procedures.

  15. Effect of Programmatic Emergency Care on the Patients Underwent Cheat Trauma in ICU%ICU胸外伤患者实施程序化急救护理的效果观察

    Institute of Scientific and Technical Information of China (English)

    钟衬珠; 钟玉娱; 钟爱娟; 温冬娣

    2014-01-01

    目的:观察ICU胸外伤患者实施程序化急救护理的效果。方法:选择笔者所在医院ICU收治的47例胸部外伤患者,制定和采用相应的程序化急救护理措施,观察患者的预后情况。结果:44例患者抢救成功,3例患者死亡。结论:程序化急救护理可提高患者抢救成功率。%Objective:To observe the effect of programmatic emergency care on the patients underwent cheat trauma in ICU.Method:47cases of patients underwent cheat trauma were chose.Programmatic emergency care measure were established and carried out .The prognosis of the patients was observed. Result:44 patients were rescued successfully. 3patients died. Conclusion:Programmatic emergency care can increase the rescue success rate of the patients.

  16. 53例结肠造口病人适应状况及相关因素调查%Survey of adaptation and related factors of 53 cases of patients underwent colostomy

    Institute of Scientific and Technical Information of China (English)

    宋秋香; 赵晓艳; 李婧婧; 孙慧卿; 丰艳; 李敏; 靳璐璐

    2016-01-01

    Objective:To know about the adaptive condition of 53 cases of patients underwent colostomy,and an-alyze its related factors.Methods:A total of 53 cases of patients underwent colostomy in 3 third grade A hospi-tals in Taiyuan city received questionnaire by using general data questionnaire,colostomy adaptive scale and co-lostomy related self efficacy questionnaire.Results:The score of adaptive level of patients underwent colostomy was(127.40±18.95);the adaptive condition of patients underwent colostomy was different who were in differ-ent ages,culture levels,colostomy time and self care situation (P <0.05 or P <0.01);regression analysis re-sults showed that the factors influencing adaptive condition of patients underwent colostomy were self effica-cy,colostomy time,cultural degree and age.Conclusion:Adaptive level of patients underwent colostomy was at the medium level and needed to be further improved.The self efficacy of patients underwent colostomy was closely related to adaptive level.The patient's self efficacy could be improved,so as to promote adaption of colon colostomy and improve their quality of life.%[目的]了解结肠造口病人适应状况,分析其影响因素。[方法]采用一般资料问卷、造口适应量表和造口相关自我效能问卷对太原市3所三级甲等医院53例结肠造口病人进行问卷调查。[结果]结肠造口病人适应水平为(127.40±18.95)分;②不同年龄、文化程度、造口时间和自理情况的结肠造口病人适应状况不同(P <0.05或 P <0.01);回归分析结果显示,影响结肠造口病人适应状况的因素为自我效能、造口时间、文化程度、年龄。[结论]结肠造口病人适应水平处于中等水平,有待于进一步提高,结肠造口病人的自我效能与适应水平密切相关,可通过提升病人自我效能促进其适应造口生活,提高生活质量。

  17. Minimal percentage of dose received by 90% of the urethra (%UD90 is the most significant predictor of PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy for prostate cancer

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    Tanaka Nobumichi

    2012-09-01

    Full Text Available Abstract Background To clarify the significant clinicopathological and postdosimetric parameters to predict PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy for prostate cancer. Methods We studied 200 consecutive patients who received LDR-brachytherapy between July 2004 and November 2008. Of them, 137 patients did not receive neoadjuvant or adjuvant androgen deprivation therapy. One hundred and forty-two patients were treated with LDR-brachytherapy alone, and 58 were treated with LDR-brachytherapy in combination with external beam radiation therapy. The cut-off value of PSA bounce was 0.1 ng/mL. The incidence, time, height, and duration of PSA bounce were investigated. Clinicopathological and postdosimetric parameters were evaluated to elucidate independent factors to predict PSA bounce in hormone-naïve patients who underwent LDR-brachytherapy alone. Results Fifty patients (25% showed PSA bounce and 10 patients (5% showed PSA failure. The median time, height, and duration of PSA bounce were 17 months, 0.29 ng/mL, and 7.0 months, respectively. In 103 hormone-naïve patients treated with LDR-brachytherapy alone, and univariate Cox proportional regression hazard model indicated that age and minimal percentage of the dose received by 30% and 90% of the urethra were independent predictors of PSA bounce. With a multivariate Cox proportional regression hazard model, minimal percentage of the dose received by 90% of the urethra was the most significant parameter of PSA bounce. Conclusions Minimal percentage of the dose received by 90% of the urethra was the most significant predictor of PSA bounce in hormone-naïve patients treated with LDR-brachytherapy alone.

  18. 25国基本药物目录循证评价%Evidence-Based Evaluation of National Essential Medicine Lists in Twenty-five Countries

    Institute of Scientific and Technical Information of China (English)

    王莉; 周帮旻; 宋佳佳; 彭静; 袁强; 许晓波; 李幼平

    2009-01-01

    Objective To provide the evidence on the selection and related policies of essential medicine for policy-makers through systematic review of the National Essential Medicine List(NEML) around the world. Method We systematically searched the official websites of the health authorities, like the departments of health and pharmaceutical administrations. We selected the published NEML. Two reviewers independently selected literature and extracted data. We analyzed the time of NEML published and updated, NEML committees, selection criteria, medicine category, number of medicines, and medicine information in NEML and standard treatment guidelines (STGs) as well. Results Thirty-six NEMLs from 25 countries were included with 34 in English and 2 in Chinese. From 1982 to 2009, Twenty-five countries developed their NEMLs respectively. They were updated from four months to eight years. The NEML committee members came from central government, ministry of health, pharmaceutical administrations, ministry of public health, ministry of education, essential medicine division, etc. The committees were composed of clinical specialists, health officials, pharmacists (pharmacologists), medicine educators, economist, statisticians, epidemiologist and experts from WHO/ UNICEF, etc. Most of the countries took the WHO's concept of essential medicine and selection criteria as standard. The applications of essential medicine were reviewed by considering the following aspects: safety, effectiveness, economic characteristics, the main disease burden, rational use of drug and supply. The medicines in NEMLs of 25 countries varied from 103 to 2 033, and the median is 447. The Anatomical Therapeutic Chemical (ATC) classification was used to classify the medicines in NEMLs of 12 countries. The drug information was provided, including generic name, dosage,form of medication and administration route as well. The STGs or formularies covered from 73 to 167 common diseases, including the diagnosis

  19. Peripheral neuropathies in systemic lupus erythematosus: clinical features, disease associations, and immunologic characteristics evaluated over a twenty-five-year study period.

    Science.gov (United States)

    Oomatia, A; Fang, H; Petri, M; Birnbaum, J

    2014-04-01

    To characterize peripheral neuropathy subtypes, ancillary studies, and immunologic profiles associated with peripheral neuropathies in patients with systemic lupus erythematosus (SLE). In this 25-year study of 2,097 SLE patients, we characterized peripheral neuropathies due to SLE and compared clinical and SLE-related features in patients with versus those without neuropathy. The prevalence of peripheral neuropathies was 5.9% (123 of 2,097 patients), and 66.7% of these patients (82 of 123) had peripheral neuropathies attributable to SLE. We noted that 17.1% of the patients with peripheral neuropathies due to SLE (14 of 82 patients) had small-fiber neuropathy, which is a painful neuropathy not included in the American College of Rheumatology (ACR) neuropsychiatric SLE (NPSLE) case definitions. SLE patients with small-fiber neuropathies could present with unorthodox neuropathic pain patterns not consistent with a stocking-glove distribution and had associated skin biopsy results suggestive of dorsal root ganglion neuronal cell loss. Compared to SLE patients without peripheral neuropathies, those with peripheral neuropathies had lower mean disease activity (P = 0.01) and higher disease damage (P neuropathies, is warranted. Copyright © 2014 by the American College of Rheumatology.

  20. Low-Level Laser and Light-Emitting Diode Therapy for Pain Control in Hyperglycemic and Normoglycemic Patients Who Underwent Coronary Bypass Surgery with Internal Mammary Artery Grafts: A Randomized, Double-Blind Study with Follow-Up.

    Science.gov (United States)

    Lima, Andréa Conceição Gomes; Fernandes, Gilderlene Alves; Gonzaga, Isabel Clarisse; de Barros Araújo, Raimundo; de Oliveira, Rauirys Alencar; Nicolau, Renata Amadei

    2016-06-01

    This study aimed to evaluate the efficacy of low-level laser therapy (LLLT) and light-emitting diodes (LEDs) for reducing pain in hyperglycemic and normoglycemic patients who underwent coronary artery bypass surgery with internal mammary artery grafts. This study was conducted on 120 volunteers who underwent elective coronary artery bypass graft (CABG) surgery. The volunteers were randomly allocated to four different groups of equal size (n = 30): control, placebo, LLLT [λ = 640 nm and spatial average energy fluence (SAEF) = 1.06 J/cm(2)], and LED (λ = 660 ± 20 nm and SAEF = 0.24 J/cm(2)). Participants were also divided into hyperglycemic and normoglycemic subgroups, according to their fasting blood glucose test result before surgery. The outcome assessed was pain during coughing by a visual analog scale (VAS) and the McGill Pain Questionnaire. The patients were followed for 1 month after the surgery. The LLLT and LED groups showed a greater decrease in pain, with similar results, as indicated by both the VAS and the McGill questionnaire (p ≤ 0.05), on the 6th and 8th postoperative day compared with the placebo and control groups. The outcomes were also similar between hyperglycemic and normoglycemic patients. One month after the surgery, almost no individual reported pain during coughing. LLLT and LED had similar analgesic effects in hyperglycemic and normoglycemic patients, better than placebo and control groups.

  1. Ewing's sarcoma in children: twenty-five years of experience at the Instituto Portugês de Oncologia de Francisco Gentil (I.P.O.F.G.).

    Science.gov (United States)

    Patricio, M B; Vilhena, M; Neves, M; Raposo, S; Catita, J; De Sousa, V; Martins, A G

    1991-05-01

    Fifty children with Ewing's sarcoma were consecutively treated from 1962 to 1987 and retrospectively analyzed at the I.P.O.F.G. of Lisbon. At first diagnosis, 10 cases had distant metastases. The remaining 40 patients had clinically localized disease, and different protocols were followed over the years. The best results were obtained with chemotherapy and radiotherapy with or without surgery; and for these children the two-year survival rate was 42.8% vs. 8.3% for the group of patients submitted to local treatment alone. Besides the treatment modality, other factors influenced the prognosis, such as inflammatory signs, sex, tumor volume, and tumor site as well as evidence of distant metastases.

  2. Risk factors of depression in coronary heart disease patients who underwent revascularization therapy%冠心病再血管化治疗后发生抑郁的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    解存; 丛洪良; 李曦铭; 张茹艳

    2015-01-01

    Objective To explore the incidence and risk factors of depression in coronary heart disease patients who underwent revascularization therapy. Methods A total of 493 patients who were admitted in Tianjin chest hospital from April 2012 to February 2013 were enrolled, among whom 258 patients acceptted coronary artery bypass grafting (CABG) and the rest 235 patients underwent percutaneous coronary intervention (PCI). Self-rating depression scale (SDS) was employed to assess the state of patients at both1 day before and 7 days after the operations. According to the postopera⁃tive scores, CABG group was divided into the depression group (n=90) and non-depression group (n=168) while PCI group was also divided into depression group (n=54) and non-depression group (n=181). Basic clinical datum of patients were col⁃lected and analyzed and independent risk factors of depression was analyzed though logistic multi-variant regression. Results The incidence of postoperative depression among CABG patients was significantly higher than that in PCI patients (P<0.05).(1)In the CABG group, age, ratio of female gender, alcohol intake, rate of past depression, length of anaesthesia, length of staying in ICU and incidence of postoperative cognitive dysfunction(POCD)were all higher in depression subgroup than those in non-depression subgroup. Female and preoperative depression were both independent risk factors for postoper⁃ative depression in patients underwent CABG.(2)In PCI group, ratio of female gender, blood pressure, incidence of Diabe⁃tes Mellitus, the rate of past Myocardiac infaction (MI), length of intervention therapy and the number of planted stents were all higher in depression subgroup than non-depression subgroup. Female, past MI and length of intervention therapy are all independent factors of post-operative depression in patients underwent PCI. Conclusion Incidence of depression in pa⁃tients underwent revascularization is high. Female is the dependent risk

  3. Twenty-five years after Chernobyl: outcome of radioiodine treatment in children and adolescents with very high-risk radiation-induced differentiated thyroid carcinoma.

    Science.gov (United States)

    Reiners, Christoph; Biko, Johannes; Haenscheid, Heribert; Hebestreit, Helge; Kirinjuk, Stalina; Baranowski, Oleg; Marlowe, Robert J; Demidchik, Ewgeni; Drozd, Valentina; Demidchik, Yuri

    2013-07-01

    After severe reactor emergencies with release of radioactive iodine, elevated thyroid cancer risk in children and adolescents is considered the main health consequence for the population exposed. We studied thyroid cancer outcome after 11.3 years' median follow-up in a selected, very high-risk cohort, 234 Chernobyl-exposed Belarusian children and adolescents undergoing postsurgical radioiodine therapy (RIT) in Germany. Cumulatively 100 children with or (without; n = 134) distant metastasis received a median 4 (2) RITs and 16.9 (6.6) GBq, corresponding to 368 (141) MBq/kg iodine-131. Outcomes were response to therapy and disease status, mortality, and treatment toxicity. Of 229 patients evaluable for outcome, 147 (64.2%) attained complete remission [negative iodine-131 whole-body scan and TSH-stimulated serum thyroglobulin (Tg) 10 μg/L, decrease from baseline in radioiodine uptake intensity in ≥ 1 focus, in tumor volume or in Tg). Except for 2 recurrences (0.9%) after partial remission, no recurrences, progression, or disease-specific mortality were noted. One patient died of lung fibrosis 17.5 years after therapy, 2 of apparently thyroid cancer-unrelated causes. The only RIT side effect observed was pulmonary fibrosis in 5 of 69 patients (7.2%) with disseminated lung metastases undergoing intensive pulmonary surveillance. Experience of a large, very high-risk pediatric cohort with radiation-induced differentiated thyroid carcinoma suggests that even when such disease is advanced and initially suboptimally treated, response to subsequent RIT and final outcomes are mostly favorable.

  4. Assessment of peri- and postoperative complications and Karnofsky-performance status in head and neck cancer patients after radiation or chemoradiation that underwent surgery with regional or free-flap reconstruction for salvage, palliation, or to improve function

    Directory of Open Access Journals (Sweden)

    Sertel Serkan

    2011-09-01

    Full Text Available Abstract Background Surgery after (chemoradiation (RCTX/RTX is felt to be plagued with a high incidence of wound healing complications reported to be as high as 70%. The additional use of vascularized flaps may help to decrease this high rate of complications. Therefore, we examined within a retrospective single-institutional study the peri--and postoperative complications in patients who underwent surgery for salvage, palliation or functional rehabilitation after (chemoradiation with regional and free flaps. As a second study end point the Karnofsky performance status (KPS was determined preoperatively and 3 months postoperatively to assess the impact of such extensive procedures on the overall performance status of this heavily pretreated patient population. Findings 21 patients were treated between 2005 and 2010 in a single institution (17 male, 4 female for salvage (10/21, palliation (4/21, or functional rehabilitation (7/21. Overall 23 flaps were performed of which 8 were free flaps. Major recipient site complications were observed in only 4 pts. (19% (1 postoperative haemorrhage, 1 partial flap loss, 2 fistulas and major donor site complications in 1 pt (wound dehiscence. Also 2 minor donor site complications were observed. The overall complication rate was 33%. There was no free flap loss. Assessment of pre- and postoperative KPS revealed improvement in 13 out of 21 patients (62%. A decline of KPS was noted in only one patient. Conclusions We conclude that within this (chemoradiated patient population surgical interventions for salvage, palliation or improve function can be safely performed once vascularised grafts are used.

  5. 术中给予艾塞那肽对心脑血管的保护作用研究%Protective effects of Exenatide on cardiovascular function of patients underwent cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    冯丽娜

    2014-01-01

    Objective To study the protective effect of exenatide on cardiovascular function of patients underwent cardiac surgery. Methods From March 2012 to August 2013,168 patients enrolled in our hospital were randomly divided into 2 groups including 80 cases of control group and 88 cases of exenatide group. Results Compared with the control group,exenatide group has lower blood sugar after surgery (P0. 05).Conclusion For cardiac surgery patients,exenatide could reduce cardiovascular disease complications caused by surgery by protecting effect on heart and brain.%目的:探讨术中给予艾塞那肽对心脑血管的保护作用。方法收集2012年3月-2013年8月我院择期心脏外科手术患者168例,随机分为对照组80例和艾塞那肽组88例。结果2组手术后血糖比较差异有统计学意义(P0.05)。结论艾塞那肽对心脏外科手术患者具有保护心脑血管的作用,可以减少手术引起的心脑血管疾病并发症,值得推广。

  6. 苏芬太尼联合地佐辛对开胸手术患者胰岛素抵抗的影响%The effect of sufentanil plus dezocine on insulin resistance of patients underwent thoracotomy

    Institute of Scientific and Technical Information of China (English)

    韩念平

    2013-01-01

    Objective To study the effect of sufentanil plus dezocine on insulin resistance of patients underwent thoracotomy.Methods 80 patients underwent thoracotomy were randomly divided into the observation group (n =40 cases) and the control group (n =40 cases).The patients in the control group were anesthetized through sufentanil,while the patients in the observation group were anesthetized through sufentanil plus dezocine.The analgesic effect and insulin resistance index were compared.Results There wasn't significant difference between two groups in VAS,Ramsay and BCS 2,12 and 24 hours after operation (all P > 0.05).Insulin resistance index in both two groups was increased after operation and it in the control group was higher than that in the observation group(t =5.0233,P<0.05).Conclusion The analgesic.effect of sufentanil plus zuoxin is the same as sufentanil alone,but can reduce insulin resistance.%目的 探讨苏芬太尼联合地佐辛对开胸手术患者胰岛素抵抗的影响.方法 将80例开胸手术患者采用随机数字表法分为观察组、对照组各40例,对照组采用苏芬太尼,观察组采用苏芬太尼联合地佐辛镇痛.观察两组镇痛效果和测定胰岛素抵抗指数.结果 两组术后2、12、24 h VAS、Ramsay和BCS评分差异均无统计学意义(均P>0.05).两组术后胰岛素抵抗均有明显升高,但对照组较观察组升高更明显(t=5.0233,P<0.05).结论 苏芬太尼联合地佐辛与单用苏芬太尼镇痛效果相当,但可以减轻胰岛素抵抗.

  7. 抗凝管理服务在心房颤动导管消融术后患者中的应用评价%Evaluation of anticoagulation management service in patients who underwent catheter ablation for atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    田颖; 刘兴鹏; 齐淑媛; 卢晓英; 陈汝明; 尹先东; 周旭; 石亮; 王彦江; 杨新春

    2012-01-01

    Objective To evaluate the effectiveness of anticoagulation management service (AMS) in patients who underwent catheter ablation for atrial fibrillation (AF).Methods Two hundreds and forty-five consecutive patients [134 males; age (64 ± 11) years] with AF were enrolled.All patients received warfarin therapy for 3 ~ 6 months after catheter ablation for AF.Patients adjusted their warfarin doses either by visiting the outpatient clinic (the former 116 patients,non-AMS group) or under the guidance of one well-trained nurse (the latter 129 patients,AMS group).The percentage of patients in whom the international normalized ratio (INR) value achieved therapeutic anticoagulation range (2.0 ~ 3.0),the effective anticoagulation rate that defined as more than 70% of INR values were between 2.0 ~ 3.0 after titration period,and the INR fluctuation index after titration period were compared between the 2 groups.Results Warfarin therapy rendered 119 patients (92.2%) in AMS group and 93 patients (80.2%) in non-AMS group achieved therapeutic anticoagulation range (P=0.008).The effective anticoagulation rate in AMS group (59.8%) was significantly higher than that in non-AMS group (42.7%,P =0.027),while the INR fluctuation index in AMS group were significantly less than that in non-AMS group(0.64±0.74 vs 1.01±1.03,P=0.004).Conclusion This study demonstrates that the application of AMS in patients who underwent catheter ablation of AF is helpful in achieving higher effective anticoagulation rate while keeping therapeutic INR value more stable.%目的 评价抗凝管理服务(AMS)在心房颤动(房颤)导管消融术后患者中的应用价值.方法 连续245例[男134例,年龄(64±11)岁]接受导管消融治疗的房颤患者,所有患者术后均接受口服华法林抗凝治疗3~6个月.其中,前116例随机就诊于心内科门诊并接受华法林剂量调整(非AMS组),后129例接受经过培训的专业护士指导下的华法林剂量调整(AMS组).

  8. 腹腔镜直肠癌根治术对病人生活质量影响的分析%Quality-of-life analyses for patients with rectal cancer underwent radical laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    许菡; 胡艳艳; 金艳; 奚蓓华; 施晓群; 吴蓓雯

    2012-01-01

    目的:比较腹腔镜直肠癌根治术与传统开腹手术对病人术后生活质量(quality of life,QOL)的影响.方法:对照研究25例腹腔镜直肠癌根治术(腹腔镜组)和29例开腹直肠癌根治术(开腹组),采用欧洲癌症研究与治疗组织的癌症病人QOL评价量表QLQ-C30,评价和比较手术前后QOL的变化特征.结果:两组病人在年龄、性别、肿瘤与肛缘距离、TNM分期方面差异均无统计学意义.两组病人术后早期除情绪功能和认知功能以外的QOL总体评价较术前均明显下降,术后3~6个月,各项功能分值呈逐渐恢复趋势,腹腔镜组恢复显著早于开腹组(P<0.05).总体健康状况量表的评价结果显示,腹腔镜组病人QOL恢复到中等以上水平的时间也显著早于开腹组.结论:腹腔镜直肠癌根治术不但创伤小、痛苦少、恢复快,且病人术后QOL恢复较开腹手术佳.%Objective To compare the impacts of radical laparoscopic surgery and conventional laparotomy on the quality of life (QOL) in patients with rectal cancer. Methods Quality of life questionnaire module, European Organisation for Research and Treatment of Cancer QLQ-C30, was used to evaluate the quality of life for all enrolled rectal cancer patients peri-operatively. Results No significant difference was observed in terms of age, gender, tumor location, as well as TNM staging between the groups. Overall QOL early after operation decreased significantly in both groups of patients comparing with preoperative data, except for emotional function and cognitive function. The trend of QOL recovery was observed in both groups 3—6 months after operation. Furthermore, the QOL recovery was earlier in laparoscopic group than in open group (P<0.05). Overall rating scales of health condition showed that recovery was earlier for patients underwent laparoscopic surgery than for patients underwent conventional open laparotomy. Conclusions Laparoscopic rectal surgery is safe

  9. Paleolithic nutrition: twenty-five years later.

    Science.gov (United States)

    Konner, Melvin; Eaton, S Boyd

    2010-12-01

    A quarter century has passed since the first publication of the evolutionary discordance hypothesis, according to which departures from the nutrition and activity patterns of our hunter-gatherer ancestors have contributed greatly and in specifically definable ways to the endemic chronic diseases of modern civilization. Refinements of the model have changed it in some respects, but anthropological evidence continues to indicate that ancestral human diets prevalent during our evolution were characterized by much lower levels of refined carbohydrates and sodium, much higher levels of fiber and protein, and comparable levels of fat (primarily unsaturated fat) and cholesterol. Physical activity levels were also much higher than current levels, resulting in higher energy throughput. We said at the outset that such evidence could only suggest testable hypotheses and that recommendations must ultimately rest on more conventional epidemiological, clinical, and laboratory studies. Such studies have multiplied and have supported many aspects of our model, to the extent that in some respects, official recommendations today have targets closer to those prevalent among hunter-gatherers than did comparable recommendations 25 years ago. Furthermore, doubts have been raised about the necessity for very low levels of protein, fat, and cholesterol intake common in official recommendations. Most impressively, randomized controlled trials have begun to confirm the value of hunter-gatherer diets in some high-risk groups, even as compared with routinely recommended diets. Much more research needs to be done, but the past quarter century has proven the interest and heuristic value, if not yet the ultimate validity, of the model.

  10. Twenty-five questions for string theorists

    Energy Technology Data Exchange (ETDEWEB)

    Binetruy, Pierre; /Orsay, LPT; Kane, G.L.; /Michigan U., MCTP; Lykken, Joseph D.; /Fermilab; Nelson, Brent D.; /Pennsylvania U.

    2005-09-01

    In an effort to promote communication between the formal and phenomenological branches of the high-energy theory community, we provide a description of some important issues in supersymmetric and string phenomenology. We describe each within the context of string constructions, illustrating them with specific examples where applicable. Each topic culminates in a set of questions that we believe are amenable to direct consideration by string theorists, and whose answers we think could help connect string theory and phenomenology.

  11. Neutrino masses twenty-five years later

    CERN Document Server

    Valle, José W F

    2003-01-01

    The discovery of neutrino mass marks a turning point in elementary particle physics, with important implications for nuclear and astroparticle physics. Here I give a brief update, where I summarize the current status of three-neutrino oscillation parameters from current solar, atmospheric, reactor and accelerator neutrino data, discuss the case for sterile neutrinos and LSND, and also the importance of tritium and double beta decay experiments probing the absolute scale of neutrino mass. In this opininated look at the present of neutrino physics, I keep an eye in the future, and a perspective of the past, taking the oportunity to highlight Joe Schechter's pioneering contribution, which I have had the fortune to share, as his PhD student back in the early eighties.

  12. Diagnostic Accuracy of Detecting Hashimoto's Thyroiditis in Thyroid Cancer Patients Who Underwent Thyroid Surgery: Comparison of Ultrasonography, Positron Emission Tomography/CT, Contrast Enhanced CT, and Anti-Thyroid Antibody

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Gyun; Lee, Tae Hyun; Park, Dong Hee; Nam, Sang Been [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2012-11-15

    To compare the diagnostic accuracy of ultrasonography (US), F18-fluorodeoxyglucose positron emission tomography/CT (PET/CT), contrast enhanced CT (CECT), serum anti-thyroid antibody for detecting Hashimoto's thyroiditis in thyroid cancer patients who underwent neck surgery. A total of 150 patients with suspicious for thyroid cancer, who had previously undergone US guided needle aspiration of thyroid, were evaluated with the use of US, PET/CT, CECT and serum anti-thyroid antibody. The four studies were performed within two months before neck surgery. Hashimoto's thyroiditis was confirmed by histopathological results. The diagnostic accuracy of US, PET/CT, CECT and serum anti-thyroid antibody were calculated statistically. Hashimoto's thyroiditis was diagnosed in 51 out of the 150 patients, following neck surgery. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US were 76.5%, 92.9%, 84.8%, 88.5%, and 87.3%, respectively. The corresponding values of PET/CT were 37.3%, 96.0%, 82.6%, 74.8%, and 76.0%, and CECT were 62.7%, 89.9%, 76.2%, 82.4%, and 80.7%, and serum anti-thyroid antibody level were 90.2%, 93.9%, 88.5%, 94.9%, and 92.7%, respectively. McNemar test revealed significant difference among PET/CT and others, but no significant differences among US, CECT and serum anti-thyroid antibody. Overall, serum anti-thyroid antibody showed most accurate diagnostic performance. In detecting Hashimoto's thyroiditis, serum anti-thyroid antibody showed higher diagnostic accuracy than others. US also showed relatively high diagnostic accuracy.

  13. 妇科肿瘤患者术后切口感染的综合防治措施%The Prevention and Control Measures of Postoperative Wound Infections in Patients Underwent Gynecological Tumor Resection Surgery

    Institute of Scientific and Technical Information of China (English)

    葛莉娜

    2012-01-01

    Objective To analyze the postoperative wound infections in patients underwent gynecological tumor resection surgery,and develop prevention and control measures. Methods Totally 310 gynecologic tumor patients were recruited as experimental group,in which integrated nursing measures were carried out. Meanwhile,298 gynecologic tumor cases were selected as control group and regular nursing measures were performed. The infection rate and healing status of wound were assessed. Results The infection rate of experiment group is significantly lower than control group (control group: 10 infection cases,3.36%;experimental group:3 infection case,0.96% ;P < 0.05).The patients with wound infection were cured after systemic treatment and nursing care. Conclusion Systemic prevention and treatment measures can reduce wound infection rate and accelerate infection healing.%目的 分析妇科肿瘤术后切口感染情况及防治措施.方法 对接受手术治疗的妇科肿瘤患者术后分别采用防治感染的综合护理措施(实验组,n =310)和常规护理措施(对照组,n=298).比较2组感染率的差异和感染创口的愈合情况.结果 对照组感染10例,感染率3.36%.实验组感染3例,感染率0.96%.实验组术后感染率显著低于对照组(P<0.05).结论 个体化的综合防治措施明显降低妇科肿瘤患者术后切口感染发生率,且使切口感染均在短期内顺利治愈.

  14. 规范化疼痛管理在上腹部术后患者应用中的效果评价∗%The Efficacy of Standardlized Pain Management in the Patients underwent Upper Abdominal Surgery

    Institute of Scientific and Technical Information of China (English)

    王静; 唐小丽; 顾琼; 陈晓琴; 姜淑

    2014-01-01

    目的:评价规范化疼痛管理在上腹部术后患者临床应用中的效果。方法:将160例患者随机分为对照组和观察组,对照组采用传统的术后疼痛干预,观察组实施规范化疼痛管理,比较对两组患者手术镇痛认知度的影响、术后3d疼痛控制效果、术后生理功能恢复方面的指标。结果:观察组对疼痛知识的认知程度明显高于对照组,术后3d疼痛分值明显低于对照组,睡眠时间多于对照组,肛门排气时间、下床活动时间、住院时间及并发症发生率均明显少于对照组,两组比较差异均有统计学意义(P<0.05)。结论:规范化疼痛管理改变了患者错误的疼痛认知,有效提高开腹术后的镇痛效果,促进患者康复。%Objective: To evaluate the efficacy of standardlized pain management in the patients who had accepted upper abdominal surgery. Methods:One hundred and sixty patients were randomly allocated into the control group and ob-servation group. Patients in the control group underwent the conventional postoperative pain management, whereas patients in the observation group accepted the standardized postoperative pain management. The awareness of analgesia, pain control effect on 3 days after surgery and status of physiological function recovery were compared between these two groups. Re-sults:Compared with the control group, awareness of analgesia in the observation group was significantly higher, however, pain scores were significantly lower. In addition, patients in the observation group had longer sleep time, shorter time to flatus and out-of-bed activity, lower incidence of complication and shorter hospitalization time than those in the control group. The differences were statistically significant (P<0. 05). Conclusion:Standardized pain management can alter pa-tients’ awareness of analgesia, effectively improve the analgesic effect after abdominal surgery, and promote the rehabilita-tion of

  15. Compendium in astronomy a volume dedicated to professor John Xanthakis on the occasion of completing twenty-five years of scientific activities as fellow of the National Academy of Athens

    CERN Document Server

    Theocaris, Pericles; Mavridis, L

    1982-01-01

    When we first approached some colleagues allover the world to sound them about a volume dedicated to Professor John Xanthakis on the occasion of completing twenty-five years of scientific activities as fellow of the National Academy of Athens, any possible doubts as to the feasibility of the project were quickly dispelled by their warm and encouraging response. In a short time 50 authors from 15 countries, coming from a wide range of Professor Xanthakis' immediate colleagues, pupils and friends joined to produce the 36 contributions included in this volume. Some of those who where originally approached found themselves un­ able to contribute, because of the time-limit necessarily imposed. Happi­ ly, they were only few in number, and we should like to record our grat­ itude to them for their good wishes for the success of the venture. Their warm words were among the many sources of inspiring encouragement extended to us.

  16. 负压吸引在低位肛周脓肿根治术后引流效果的临床观察%Negative pressure drainage in patients underwent primary radical surgical procedure for low perianal abscess

    Institute of Scientific and Technical Information of China (English)

    岳中文; 张建余

    2011-01-01

    目的 探讨负压吸引装置在低位肛周脓肿根治术后的应用效果.方法 将60例低位肛周脓肿患者随机分为两组,治疗组30例,采用负压吸引装置引流;对照组30例,采用生理盐水纱条引流,就一次治愈率、愈合时间及住院天数进行对比分析.结果 肛周脓肿根治术后应用负压吸引装置提高了愈合率,加快切口愈合,缩短住院时间.结论 负压吸引装置操作简便,安全可靠,是低位肛周脓肿根治术后引流有效的方法之一.%Objective To evaluate the effect of negative pressure drainage in patients underwent primary radical surgical procedure for low perianal abscess. Methods Sixty patients with low perianal abscess were divided randomly into the treatment group (30 cases) and the control group (30 cases). After primary radical surgical procedure, the treatment group was treated by negative pressure drainage, and the control group drained by normal saline gauze. Results The treatment group had a higher cure rate, shorter wound healing time and hospital stay than those of the control group. Conclusion Negative pressure drainage is a simple, safe and effective method for low perianal abscess after primary radical surgical procedure.

  17. Multiple biomarkers including cardiac troponins T and I measured by high-sensitivity assays, as predictors of long-term mortality in patients with chronic renal failure who underwent dialysis.

    Science.gov (United States)

    Hickman, Peter E; McGill, Darryl; Potter, Julia M; Koerbin, Gus; Apple, Fred S; Talaulikar, Girish

    2015-06-01

    There is a high cardiac mortality in patients on long-term renal dialysis. No studies have reported long-term outcomes relating to both high-sensitivity cardiac troponin T (hs-cTnT) and high-sensitivity cardiac troponin I (hs-cTnI) in these patients. Patients who underwent long-term dialysis at the Canberra Hospital had blood samples collected for both cardiac and other biomarkers. Samples were stored at -80°C until analysis. Mortality data were collected at 5 years, and univariate and multivariate analyses were performed to identify which biomarkers were predictive of mortality at 5 years. After multivariate analysis, albumin, C-reactive protein (CRP), and hs-cTnT remained independently predictive of all-cause mortality, with hs-cTnT having the highest hazard ratio. If hs-cTnT was excluded from the analysis, then hs-cTnI was independently predictive of mortality. For hs-cTnT, for both genders, the ninety-ninth percentile, derived from a population with subjects with subclinical disease excluded, served as an excellent partition between survivors and nonsurvivors. Receiver-operating characteristic curve analysis for hs-cTnT had area under the curve of 0.798 and for hs-cTnI of 0.774. Kaplan-Meier curves for the aggregation of albumin, CRP, and hs-cTnT showed a stronger predictive power with receiver-operating characteristic area under the curve of 0.805. The addition of echocardiographic data in an analysis of all patients who had an echocardiogram for clinical reasons (n = 105) did not alter the final observations in this subgroup. In conclusion, hs-cTnT retains a superior predictive power in a dialysis-dependent population for identifying those at risk for death and when aggregated with albumin and CRP also has substantial additive value for identifying mortality risk in a renal-dialysis population.

  18. SF-12量表评价全髋关节置换术患者生存质量%Evaluation of quality of life in patients who underwent total hip arthroplasty by SF - 12 health survey

    Institute of Scientific and Technical Information of China (English)

    陈城; 陈继营; 张国强; 柴伟; 苟文隆; 耿磊

    2012-01-01

    [目的]评估SF - 12量表用于评价全髋关节置换术后患者生存质量的适用性.[方法]Harris髋关节功能评分量表(Harris hip score,HHS)、SF - 12生存质量量表(MOS 12 -item Short Form Health Survey,SF - 12)评估接受全髋关节置换术治疗的患者283例381髋,采用内部一致性信度(Cronbach's alpha系数)评估SF - 12量表的信度;采用集合效度、区分效度和结构效度评估SF - 12量表的效度;Pearson相关分析评估HHS与生理总分、心理总分关联度;单因素方差分析评估生理及心理总分分级的组间差异性.[结果] SF-12量表总的Cronbach's alpha系数为0.879,各维度Cronbach's alpha系数均>0.8;集合效度及区分效度定标实验均为100%;结构效度因子分析产生两个公因子生理及心理总分,累积解释72.229%的总方差,8个维度因子负荷与理论假设基本符合;HHS与生理总分、心理总分均为强相关(r1=0.745,r2=0.703,P<0.01);组间差异F1=85.282,F2=61.377,P<0.01.[结论]SF-12量表具有良好的信度和效度,适用于评价全髋关节置换术后患者的生存质量,评估效果良好.%[Objective] To access the applicability of the SF - 12 health survey on measuring quality of life in patients who underwent total hip arthroplasy (THA). [ Methods] Totally 283 patients were measured by Chinese - version 12 - item short -form health survey (SF - 12) and Harris hip score ( HHS). Reliability of the SF - 12 was evaluated by internal consistency reliability. Validity of the SF - 12 was evaluated by discriminant validity, convergent validity and structure validity. Pearson correlation coefficient was used to evaluate the correlation of HHS with physical component summary (PCS) and mental component summary (MCS). One - way analysis of variance (ANOVA) was used to analyze the variance of PCS grading and MCS grading. [ Results] The internal consistency Cronbachs alpha coefficient was 0. 879. The Cronbachs alpha of all

  19. 纤维支气管镜术后痰细胞学检查在肺癌诊断中的意义%Value of Sputum Cytology for Postoperative Patients Underwent Fiberoptic Bronchoscopy in Diagnosis of Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    马家兰; 黄晓霞; 肖卫; 许菊秀; 陈振平; 李芬

    2012-01-01

    Objective To explore the value of sputum cytology in the diagnosis of lung cancer for postoperative patients who underwent fiberoptic bronchoscopy. Methods 120 patients accepted 2-3 sputum cytological examinations before fiberoptic bronchoscopy and 1 -4 days after fiberoptic bronchoscopy. Results Among the 120 cases 79 cases were diagnosed as lung cancer ,75 cases were confirmed by different examinations including sputum cytology before fiberoptic bronchoscopy, brush cytology, biopsy, liquid washing and postoperative sputum cytology- 23 cases of cancer were found in p/eoperative sputum cytology. the positive rale was 29. 1% ,the cytotyping accuracy was 63. 6% in squamous carcinoma,60. 0% in adenocarcinoma and 66. 7% in small cell carcinoma. 42 cases of cancer were found in postoperative sputum cytology,the positive rate was 53. 2% ,the cytotyping accuracy was 87.5% in squamous carcinoma,88.2% in adenocarcinoma and 83.3% in small cell carcinoma. Conclusion Sputum cytology for postoperative patients who underwent fiberoptic bronchoscopy can increase the detectable rate of lung cancer. The positive rate and accuracy of postoperative sputum cytology are better than that of preoperative sputum cytology. The postoperative sputum cytology is noninvasive, safe and repeatable, it is worthy of clinical application.%目的 观察纤维支气管镜术后痰细胞学检查对肺癌的诊断价值.方法 对120例行纤维支气管镜患者术前送2~3次痰细胞学,术后第1~4天送2~3次痰细胞学检查.结果 120例有79例确诊为肺癌,其中75例通过术前痰检,纤支镜刷检、活检、冲洗液及术后痰检联合检查确诊肺癌,术前痰细胞学检出癌23例,阳性率29.1%,其细胞学分类与组织学活检分类符合率鳞癌63.6%、腺癌60.0%、小细胞癌66.7%.术后痰细胞学检出癌42例,阳性率53.20%,术后痰检与组织活检符合率鳞癌87.5%、腺癌88.2%、小细胞癌83.3%%.结论 纤维支气管镜检结

  20. Clinical Observation of Intraoperative Local Chemotherapy with Lobaplatin for Breast Cancer Patients Underwent Modified Radical Mastectomy%乳腺癌改良根治术中局部应用洛铂的疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈伟贤; 李建; 恽文; 于丹丹; 赵建华; 秦建伟; 唐金海

    2016-01-01

    目的:评价乳腺癌改良根治术中局部应用洛铂的临床疗效。方法选择早期乳腺癌患者50例,随机分为观察组和对照组各25例,均行乳腺癌改良根治术。术中观察组用溶有50 mg洛铂的生理盐水冲洗并浸泡创面,15 min后吸出冲洗液。皮瓣缝合前,再将50 mg洛铂多点喷洒于瘤床、腋窝淋巴结清扫区及其他可疑残余癌细胞区域。对照组仅用等量生理盐水处理。对药物安全性、近期及远期疗效进行追踪和对比研究。结果两组术后的不良反应包括骨髓抑制(白细胞和血小板计数)、肝肾功能(血肌酐和谷丙转氨酶)、局部疼痛和胃肠道反应(恶心、呕吐和腹泻),以及Ⅰ期愈合时间等方面比较无显著差异(P>0.05)。观察组引流液脱落癌细胞检查阳性率和局部复发率均低于对照组,差异有统计学意义(P<0.05),而远处转移率和2年生存率比较无统计学意义(P>0.05)。结论乳腺癌患者改良根治术中应用洛铂安全有效,可显著降低局部复发,值得临床进一步推广。%Objective To evaluate the clinical efficacy of intraoperative local chemotherapy with lobaplatin for breast cancer patients underwent modified radical mastectomy .Methods 50 cases of breast cancer patients treated with modified radical mastectomy were randomly divided into 2 groups,25 cases in each group .In the observation group ,operation wound was washed and steeped by physiological saline containing 50 mg lobaplatin for 15min.After sucking out the washing fluid ,another 50 mg lobaplatin was multi-point sprayed in tumor bed ,axillary lymph node dissection area ,and any other potential area of residual canc-er cells before flap suture.The control group only received a treatment of same amount of physiological saline .Then,drug safety, short-term effects and long-term results were tracked and compared .Results Postoperative adverse effects

  1. Performance characteristics of prostate-specific antigen density and biopsy core details to predict oncological outcome in patients with intermediate to high-risk prostate cancer underwent robot-assisted radical prostatectomy.

    Science.gov (United States)

    Yashi, Masahiro; Nukui, Akinori; Tokura, Yuumi; Takei, Kohei; Suzuki, Issei; Sakamoto, Kazumasa; Yuki, Hideo; Kambara, Tsunehito; Betsunoh, Hironori; Abe, Hideyuki; Fukabori, Yoshitatsu; Nakazato, Yoshimasa; Kaji, Yasushi; Kamai, Takao

    2017-06-23

    Many urologic surgeons refer to biopsy core details for decision making in cases of localized prostate cancer (PCa) to determine whether an extended resection and/or lymph node dissection should be performed. Furthermore, recent reports emphasize the predictive value of prostate-specific antigen density (PSAD) for further risk stratification, not only for low-risk PCa, but also for intermediate- and high-risk PCa. This study focused on these parameters and compared respective predictive impact on oncologic outcomes in Japanese PCa patients. Two-hundred and fifty patients with intermediate- and high-risk PCa according to the National Comprehensive Cancer Network (NCCN) classification, that underwent robot-assisted radical prostatectomy at a single institution, and with observation periods of longer than 6 months were enrolled. None of the patients received hormonal treatments including antiandrogens, luteinizing hormone-releasing hormone analogues, or 5-alpha reductase inhibitors preoperatively. PSAD and biopsy core details, including the percentage of positive cores and the maximum percentage of cancer extent in each positive core, were analyzed in association with unfavorable pathologic results of prostatectomy specimens, and further with biochemical recurrence. The cut-off values of potential predictive factors were set through receiver-operating characteristic curve analyses. In the entire cohort, a higher PSAD, the percentage of positive cores, and maximum percentage of cancer extent in each positive core were independently associated with advanced tumor stage ≥ pT3 and an increased index tumor volume > 0.718 ml. NCCN classification showed an association with a tumor stage ≥ pT3 and a Gleason score ≥8, and the attribution of biochemical recurrence was also sustained. In each NCCN risk group, these preoperative factors showed various associations with unfavorable pathological results. In the intermediate-risk group, the percentage of positive cores showed

  2. Risk factors for patients with hepatocellular carcinoma and liver cirrhosis who underwent major hepatectomy%肝癌合并肝硬化大块肝切除的手术风险性

    Institute of Scientific and Technical Information of China (English)

    何强; 彭宝岗; 梁力建

    2006-01-01

    目的分析肝癌合并肝硬化大块肝切除的风险.方法回顾性分析近8年我院90例肝癌合并肝硬化大块切除病例.结果乙肝感染率81%,肝功能A级55.6%,B级40%,C级4.4%.轻度肝硬化44.4%,中度46.7%,重度8.9%.肝癌大小(8.5±4.0)cm,手术时间为(188±89)min,失血量(1 281±1 831)mL,输血量(1109±1 213)mL.术后总并发症为24%,严重并发症17.8%,肝功能衰竭及肝功不全发生率8.9%.手术死亡率为6.7%.单变量分析示术前AST、肝功能、手术时间及失血量为肝功能衰竭发生的独立因素,多变量分析提示手术时间及肝功能为肝功能衰竭发生的独立危险因素(P<0.01,P<0.05).结论术前肝功C级应避免手术切除.术中缩短手术时间对预防肝功能衰竭起关键作用.%[Objective] To evaluate risk factors for patients with hepatocellular carcinoma (HCC) and liver cirrhosis who underwent major hepatectomy. [Methods] 90 HCC patients with liver cirrhosis who underwent major hepatectomy in recent years were reviewed, retrospectively. [Results] The hepatitis B infection was found in 81% (73/90) of cases. Liver function tests showed that Child A, Child B and Child C were found in 55.6% (50/90), 40% (36/90) and 4.4% (4/90) of cases, respectively. Cases of slight, moderate and severe cirrhosis were found in 44.4% (40/90), 46.7% (42/90) and 8.9% (8/90) of cases, respectively. The tumor size was (8.5±4.0) cm in diameter. The operation duration was (188±89) min with blood loss of (1281±1831) mL and blood transfusion of (1109±1213) mL.The overall morbidity was 24.4% (22/90), compared with 21% (31/181) in local resection group (P =0.537). The severe complications incidence was 18% (18/90), significantly higher than 6.1% (12/181) in local resection group (P <0.01). The liver failure incidence was 8.9% (12/90), compared with 4.9% (9/181) in local resection group (P =0.286).The operative mortality was 6.7% (6/90), compared with 1.1% (2/181) in local resection group (P =0

  3. Anatomia patológica da sinóvia de pacientes submetidos à liberação do túnel do carpo Pathological study of the synovial tissue of patients who underwent open carpal tunnel release

    Directory of Open Access Journals (Sweden)

    Pedro José Pires Neto

    2010-01-01

    Full Text Available OBJETIVO: Verificar se a biópsia da sinóvia do túnel do carpo é capaz de identificar patologias sistêmicas que não foram diagnosticadas clinicamente ou por exames laboratoriais. MÉTODO: 46 exames anatomopatológicos da sinóvia dos tendões flexores no túnel do carpo de pacientes submetidos à liberação aberta para o tratamento desta síndrome compressiva foram, retrospectivamente, analisados. Os autores propuseram uma nova classificação para a lesão de acordo com a intensidade do processo inflamatório. RESULTADOS: O exame anatomopatológico mostrou que 56,6% das lâminas foram classificadas como grau I (sem alterações inflamatórias, 32,6%, grau II (infiltrado leucocitário e fibrose discretos, além de hialinose, 4,3%, grau III (infiltrado leucocitário e fibrose intensos, presença de fibrina e neoformação vascular e 6,5%, grau IV (as alterações acima descritas associadas à presença de calcificação local e células gigantes. Dois pacientes com amiloidose foram classificados como graus I e II e não foram encontrados depósitos de material amilóide em suas lâminas. Dois pacientes portadores de hiperparatireoidismo e outro com insuficiência renal crônica foram classificados como grau IV. CONCLUSÃO: A realização da biópsia da sinóvia do túnel do carpo, além de agregar custos adicionais ao procedimento, não possibilitou o diagnóstico precoce de doenças sistêmicas em pacientes portadores de síndrome do túnel do carpo.OBJECTIVE: To determine whether a biopsy of the synovia of the carpal tunnel is able to identify systemic diseases that were not diagnosed by clinical examination and laboratory tests. METHODS: Anatomical pathology P examinations of synovial tissue were performed in 46 patients that underwent open carpal tunnel release. Anatomical pathology examination with hematoxylin-eosin staining determined the intensity of the inflammatory process and the authors proposed a new classification of the injury

  4. 右美托咪定在胆囊微创手术老年患者中的全麻维持效果研究%Effect of dexmedetomidine on elderly patients underwent laparoscopic cholecystectomy under general anesthesia

    Institute of Scientific and Technical Information of China (English)

    李峥

    2015-01-01

    Objective To investigate the effect of dexmedetomidine on elderly patients underwent laparoscopic cholecystectomy under general anesthesia. Methods One hundrad patients underwent laparoscopic cholecystectomy in Central Hospital of Nanyang from January 2011 to December 2013 were selected and randomly divided into control group (propofol combined with remifentanil)and the study group(dexmedetomidine combined with remifentanil),with 50 pa-tients in each group. The control group was not treated with any preoperative medication,while study group was treated with loading dose of 0. 5 μg/ kg dexmedetomidine intravenously completed within 10 minutes. Induction of anesthesia were same in both groups. Maintenance of anesthesia in control group treated with propofol 2. 0 ~ 3. 0 μg/ ml + 4. 5 ~ 5. 5 ng/ ml TCI, Maintenance of anesthesia in study group treated with dexmedetomidine 0. 25 μg/(kg·h) + remifentanil 4. 5 ~ 5. 5 ng/ ml (TCI). HR,SBP,DBP,BIS values,and Steward awakening scores and OAA/ S rating were recorded at different time points. Results No significant difference was found between BIS value of two groups at different time points. Compared with control group,HR at different time in study group were significantly lower,SBP,DBP were significantly decreased (P ﹤ 0. 05). There was no significant difference in Steward awakening score and modified OAA/ S score at recovery and ex-tubation time between the two groups. Conclusions Compared with propofol given in minimally invasive laparoscopic gall-bladder surgery in elderly patients maintain anesthesia effect,dexmedetomidine is more secure,more efficient and more sta-ble hemodynamics. Therefore,it is worthy of clinical application.%目的:探讨右美托咪定在腹腔镜胆囊微创手术老年患者中全麻维持效果。方法2011年1月至2013年12月在南阳市中心医院行腹腔镜胆囊切除术的患者共100例,随机分为对照组(丙泊酚+瑞芬太尼麻醉)和研究组(右美托咪定

  5. Meta Analysis of Robotic Nissen Fundoplication for Patients Underwent Gynecological Surgery%达芬奇手术机器人在妇科手术中应用疗效的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    周凡; 陈香

    2015-01-01

    Objective To evaluate the efifcacy and feasibility of robotic Nissen fundoplication for the patients underwent gynecological surgery through Meta-analysis.Methods We searched the electronic bibliographic databases, including The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP database and Wanfang database to assemble the randomized controlled trials of thoracoscopic surgery for advanced lung cancer with malignant pleural effusion. The deadline of the retrieval time was June 2014. Data were extracted and evaluated by two reviewers independently with a designed extraction. The RevMan 5.0 software was used for meta-analysis on homogeneous studies.Results Fore studies met the criteria ifnally, which included 299 patients. Meta analysis showed: except the operative time and cost, statistical differences were not observed in the other outcomes between conventional laparoscopic group and robotic Nissen fundoplication group, including blood loss, conversions, hospital stay, intraoperative and postoperative complications (P>0.05).Conclusion Robotic Nissen fundoplication is not superior to the traditional laparoscopic surgery for patients underwent gynecological surgery. Therefore, we should select the indications carefully.%目的:探讨达芬奇手术机器人在妇科手术中应用的临床疗效和安全性。方法计算机检索Cochrane图书馆(2014年第3期)、PubMed、EMBASE、CBM、CNKI、VIP、万方(截至2014年6月)。收集达芬奇手术机器人对比腹腔镜在妇科手术中应用的随机对照试验,采用Cochrane系统评价的方法,提取数据并由2名评价者独立评价并交叉核对纳入研究的质量,对同质研究采用RevMan5.0软件进行Meta分析。结果共纳入4个RCT包括299例患者。Meta分析结果显示:①手术时间:两组间差异有统计学意义[WMD=43.78,95%CI(23.32,64.23)],提示达芬奇手术机器人的妇科手术时间明显长于腹腔镜手术组。②术中出血量:达芬奇手

  6. Nursing measures and retention time of central venous catheter in esophageal cancer patients underwent radical operation%食管癌术后中心静脉导管留置时间与护理

    Institute of Scientific and Technical Information of China (English)

    姜萍; 林玉琴; 刘新

    2010-01-01

    Objective To explore nursing measures and retention time of central venous catheter in esophageal cancer patients underwent radical operation. Methods According to retention time of central venous catheters, a total of 90 cases of esophageal carcinoma patients were randomly divided into three groups: 31 cases with 5 days retention time in group Ⅰ , 29 cases with 7 days retention time in group Ⅱ; 30 cases with 10 days retention time. Complications of central venous catheter including swelling and pain in punition site, fever,extravasation, extrusion and block of catheter and the bacterial culture of central venous catheter were compared among three groups. Results Incidence of complications in group Ⅰ,group Ⅱ and group Ⅲ were 3.2%,20.6% and 46.7% respectively. The differences were significant( P < 0.01 ). As for the positive of bacteria culture, differences among three groups were significant too, with no case in group Ⅰ , one case in group Ⅱ and 4cases in group Ⅲ. Conclusions Retention time of central venous catheter should under 7 days. Retention time depends on the quality of nursing care.%目的 探讨食管癌术后中心静脉导管留置时间与护理方法.方法 择期食管癌根治术患者90例,按中心静脉导管留置时间随机分为3组,留置5 d组(n=31),留置7 d组(n=29)和留置10 d组(n=30).观察中心静脉导管留置期间的局部红肿、疼痛、发热、液体外渗以及导管脱出、堵塞等一般并发症.观察期结束后拔除中心静脉导管,用无菌剪刀剪下尖端5 cm,放置于无菌容器内,送细菌培养.结果 一般并发症发生率留置5 d组为3.2%,留置7 d组为20.6%,留置10 d组为46.7%,差异有统计学意义(P<0.01).静脉导管尖端细菌培养结果留置5 d组均为阴性,留置7 d组有1例阳性,留置10 d组有4例阳性,导管相关性感染的发生率比较,差异有统计学意义(P<0.05).结论 食管癌根治术后中心静脉导管留置时间一般不应超过7 d,

  7. Terminal ileum of patients who underwent colonoscopy: endoscopic, histologic and clinical aspects Íleo terminal de pacientes submetidos a colonoscopia: aspectos endoscópicos, histológicos e clínicos

    Directory of Open Access Journals (Sweden)

    Marcelo Maia Caixeta de Melo

    2009-06-01

    Full Text Available CONTEXT: For the diagnosis of the diseases which affect the terminal ileum, the colonoscopy allows macroscopic evaluation and the performing of biopsies. Studies with criteria for the endoscopic and histological characterization of this segment are scarce and there are still some doubts about the need of biopsies in patients with normal ileoscopy. OBJECTIVE: Study the terminal ileum of patients who underwent colonoscopy considering: endoscopic and histological correlation; agreement between results of the initial histological evaluation and slides review, and the chance of subjects with normal ileoscopy with abdominal pain and/or chronic diarrhea to show histological alterations. METHODS: In a prospective study, 111 patients who presented smooth mucosa without enanthema in the endoscopic exam of the terminal ileum were selected. Biopsies of the ileal mucosa of such patients were performed, being the slides routinely examined and reviewed afterwards. RESULTS: The correlation between patients with normal ileoscopy and ileum with preserved histological architecture was of 99.1%. The agreement between initial histological evaluation and slides review calculated by the Kappa test was 0.21. In patients with abdominal pain and/or chronic diarrhea, the chance of showing histological alterations was 2.5 times higher than the others. CONCLUSIONS: The correlation between endoscopic and histological findings was high. The agreement between the initial histologic evaluation and slides review was not satisfactory. The chance of subjects with normal ileoscopy with abdominal pain and/or chronic diarrhea, showing histological alterations was higher in relation to the asymptomatic ones or with other symptoms, although the clinical importance of this datum was not evaluated.CONTEXTO: Para o diagnóstico de doenças que afetam o íleo terminal, a colonoscopia permite avaliação macroscópica e realização de biopsias. Estudos com critérios para caracteriza

  8. 右美托咪定对老年人髋部手术后认知功能障碍的影响%Dexmedetomidine on cognitive function of elderly patients who underwent hip orthopedic surgery

    Institute of Scientific and Technical Information of China (English)

    张云飞; 高伟忠; 马世颖; 刘金碧

    2015-01-01

    目的:观察硬膜外麻醉复合不同剂量右美托咪定对老年人髋部手术后循环和认知功能障碍(POCD)的影响。方法选择2013年6月—2014年9月,65岁以上髋部手术患者120例,行硬膜外麻醉联合右美托咪定静脉泵注,按右美托咪定的泵注量不同,分为A组0.2μg·h-1·kg-1,B组0.4μg·h-1·kg-1和C组0.6μg·h-1·kg-1,每组40例。观察并记录3组患者入室时(T0)、用药后10 min(T1)、用药后20 min(T2)、停药即刻(T3)、停药后10 min(T4)以及手术完毕时(T5)的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)。应用简易智力状态量表(MMSE)测试3组患者术前24 h(t1)、术后12 h(t2)、术后24 h(t3)及术后72 h(t4)认知功能。结果3组患者在T0时MAP、HR及SpO2比较差异无统计学意义;C组T2、T3时HR和MAP均较A组、B组明显下降(均P0. 05).A significant decrease in MAP and HR were ob⁃served in Group C at T2 and T3 time points compared to those in Group A or Group B (P 0.05). However, compared to that in group A or group C, MMSE increased significantly at time point T2, T3 in group B (P<0.05). In addition, compared to group A or group C, the pa⁃tients in group B exhibited lower incidence of postoperative cognitive function disorder (P < 0.05). Conclusion Continu⁃ous intravenous infusion of Dexmedetomidine can be used in elderly patient who underwent hip orthopedic surgery at the dose of 0.4μg·h-1·kg-1 safely with little interference to circulatory and cognitive function in perioperative period.

  9. Fatal Renal Failure in a Spinal Cord Injury Patient with Vesicoureteric Reflux Who Underwent Repeated Ureteric Reimplantations Unsuccessfully: Treatment Should Focus on Abolition of High Intravesical Pressures rather than Surgical Correction of Reflux

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2012-01-01

    Full Text Available A 29-year-old man developed paraplegia at T-10 level due to road traffic accident in 1972. Both kidneys were normal and showed good function on intravenous urography. Division of external urethral sphincter was performed in 1973. In 1974, cystogram showed retrograde filling of left renal tract, which was hydronephrotic. Left ureteric reimplantation was performed. Following surgery, cystogram revealed marked retrograde filling of left renal tract as before. Penile sheath drainage was continued. In 1981, intravenous urography revealed bilateral severe hydronephrosis. Left ureteric reimplantation was performed again in 1983. Blood pressure was 220/140 mm Hg; this patient was prescribed atenolol. Cystogram showed gross left vesicoureteral reflux. Intermittent catheterisation was commenced in 2001. In 2007, proteinuria was 860 mg/day. This patient developed progressive renal failure and expired in 2012. In a spinal cord injury patient with vesicoureteral reflux, the treatment should focus on abolition of high intravesical pressures rather than surgical correction of vesicoureteric reflux. Detrusor hyperactivity and high intravesical pressures are the basic causes for vesicoureteral reflux in spinal cord injury patients. Therefore, it is important to manage spinal cord injury patients with neuropathic bladder by intermittent catheterisations along with antimuscarinic drug therapy in order to abolish high detrusor pressures and prevent vesicoureteral reflux. Angiotensin-converting enzyme inhibitors or angiotensin-receptor-blocking agents should be prescribed even in the absence of hypertension when a spinal cord injury patient develops vesicoureteral reflux and proteinuria.

  10. Improvement of quality of life in serous cavity inflammation patients underwent pigtail tube drainage%猪尾导管心包引流治疗浆膜腔炎患者改善生存质量的观察

    Institute of Scientific and Technical Information of China (English)

    傅恩清; 金发光; 何勇; 刘同刚; 谢永宏; 曹义战

    2002-01-01

    Objective To observe the effect of drainage of pericardium with pigtail tube associated with drainage tube or puncture of pleural cavity. Method Saving cardiac tamponade and treating serious multiple serous cavity inflammation through percutaneous catheterization with pigtail tube infra- xiphoid associating with percutaneous drainage tube or puncture and chemotherapy. Resutls The 4 cases of patients with serous poly serous cavity inflammation were all cured on the whole. They were all not only lived fro 4- 6 months longer, but also got better existing mass and they could live on themselves. Conclusion It is a good way to cure patients with serious poly serous cavity inflammation of percutaneous catheterizatin with pigtail tube infra- xiphoid associating with percutaneous drainage tube or puncture and chemotherapy. It can also save pericardiac tamponade patients.It is worth application in clinic. ``

  11. Characteristics of flexed knee gait and functional outcome of a patient who underwent knee reconstruction with a hingeless prosthesis for bone tumor resection: a case report with gait analysis and comparison with healthy subjects.

    Science.gov (United States)

    Okita, Y; Tatematsu, N; Nagai, K; Nakayama, T; Nakamata, T; Okamoto, T; Toguchida, J; Ichihashi, N; Tsuboyama, T

    2013-12-01

    We report on a patient after knee reconstruction for osteosarcoma in the distal femur using a hingeless prosthesis K-MAX KNEE system K-5 who walked without ipsilateral knee extension in the latter half of the stance phase (flexed knee gait). We evaluated the patient using three-dimensional gait analysis and isokinetic knee strength measurement, and compared the patient with five healthy subjects. The Musculoskeletal Tumor Society (MSTS) score was also used for evaluation. The patient kept his operated knee flexed during mid stance. The maximal ankle plantarflexion internal moment was lower on the ipsilateral side than on the contralateral side, and lower than in the healthy subjects. The negative ankle power during the stance phase was generally stronger on the ipsilateral side than on the contralateral side, and also in the healthy subjects. Unusual contralateral hip flexion occurred after the initial contact, indicating increased joint load on the ipsilateral ankle and the contralateral hip. The ratios of the peak knee extension/flexion torque were 0.7 on the ipsilateral side, 1.9 on the contralateral side, and 1.7 in the healthy subjects. The MSTS score of the patient was 23/30 (76.6%). Flexed knee gait might account for the reduction of ipsilateral hip flexion and ankle plantarflexion moment during the late stance phase. These results suggest the importance of focusing more on the ipsilateral ankle joint and the contralateral hip joint to maintain the function of the entire limb joints of the patients with flexed knee gait.

  12. Relevant factors of nosocomial infection in cervical cancer patients underwent radical surgery%宫颈癌根治术患者医院感染相关因素分析

    Institute of Scientific and Technical Information of China (English)

    祝英杰; 王毅; 魏向群

    2011-01-01

    目的 分析宫颈癌根治术后患者医院感染的状况、特点、病原菌分布及其耐药性,探究其预防措施.方法 对2009年10月-2010年9月在医院行宫颈癌根治术患者120例进行医院感染相关因素调查分析.结果 120例宫颈癌根治术患者发生医院感染40例次,例次感染率为33.3%;手术部位感染最多见,占52.5%,其次为消化道感染,占27.5%;检出病原菌24株,以真菌(12株)占首位,其次为大肠埃希菌(9株);大肠埃希菌对亚胺培南的耐药率为0,对头孢他啶、头孢吡肟、阿米卡星耐药率分别为12.5%、12.5%、12.5%.结论 为减少医院感染的发生,除应严格无菌技术操作及加强术后切口的引流外,合理使用抗菌药物是预防医院感染的重要环节.%OBJECTIVE To analyze the status, characteristics, pathogenic distribution and drug resistance of nosocomial infection (NI) in cervical cancer patients after'surgical procedures and explore preventive measures. METHODS Relevant factors of nosocomial infections in 120 patients with cervical cancer after radical hysterectomy and pelvic lymphadenectomy from Oct. 2009 to Sep. 2010 were investigated. RESULTS In the 120 patients with cervical cancer after radical surgery, there were 40 cases of nosocomial infections, with the infection rate of 30. 0%( the main infection site was surgical site infection (SSI) (52. 5%), followed by gastrointestinal infection (27.5%). Among the 24 strains of pathogenic microbes, the predominant microorganisms were fungi (12 strains) .followed by Escherichia coli (9 strains). E. Coli showed the lowest resistance rate to imipenem, followed by ceftazidime, cefepime and amikacin. The drug resistance rates were 0, 12. 5%, 12. 5% and 12. 5% respectively. CONCLUSION It is vital to prevent and control surgical nosocomial infections by strict application of aseptic technique, enhancing incision drain and rational use of antimicrobial agents. OBJECTIVE To analyze the

  13. Cochlear implant patients underwent successful MRI examination after local bandaging:a case report%电子耳蜗植入术患者局部包扎后行MRI检查成功1例

    Institute of Scientific and Technical Information of China (English)

    保国华; 曹克利

    2012-01-01

    Summary A female patient, now 6 years old. received cochlear implant in the right ear at the age of 2(February .2006). In August 16. 2010. a cervical spine MR1 examination was required due to the cervical spine injury in order to confirm the diagnosis. Considering the cochlea coil may interfere with the MKI examination results, a local bandaging around the ear was given to isolate cochlear magnetic field. The results of cervical spine MR1 ex aminations showed no obvious disturbance, which suggests that we could further explore this method clinically.

  14. Avaliação das atividades da vida diária dos pacientes com doença de Parkinson submetidos a cirurgia estereotáxica Daily living activities in Parkinson's disease patients underwent to stereotactic surgery

    Directory of Open Access Journals (Sweden)

    Roberta Arb Saba Rodrigues Pinto

    2002-06-01

    Full Text Available OBJETIVO: Avaliar o impacto da cirurgia estereotáxica sobre a realização das atividades da vida diária dos paciente com doença de Parkinson (DP. MÉTODO: Foram avaliados 30 pacientes com DP forma idiopática submetidos a cirurgia estereotáxica nos períodos pré-operatório, 1º, 3º, 6º e 12º mês pós-operatório, segundo as escala UPDRS - Item II (escala unificada para DP, Schwab & England e Hoehn & Yahr. Destes, nove pacientes foram também avaliados no 24º mês pós-operatório. RESULTADOS: Foram realizadas nove palidotomias póstero-ventrais (PPV, sendo duas à esquerda e sete à direita; duas PPV bilaterais no mesmo tempo cirúrgico; 17 talamotomias ventro-laterais (TVL, sendo 12 à esquerda e cinco à direita; duas TVL à esquerda com PPV à direita no mesmo tempo cirúrgico. Os escores médios, na fase off, das escalas utilizadas foram: 65,6 no pré-operatório,74 no 1º mês, 76,6 no 3º mês, 75,6 no 6º mês e 72,3 no 12º mês pós-operatório (Schwab & England; 21 no pré-operatório, 12,3 no 1º mês, 14,7 no 3º mês, 15,27 no 6º mês e 17,1 no 12º mês pós-operatório (UPDRS; 3,1 no pré-operatório, 2,8 no 1º mês, 2,7 no 3º mês, 2,8 no 6º mês e 2,85 no 12º mês pós-operatório (Hoehn & Yarh. CONCLUSÃO: A TVL e a PPV são procedimentos capazes de melhorar a independência dos pacientes para realização das atividades cotidianas, sendo constatado benefício maior nos seis primeiros meses de pós-operatório.OBJECTIVE: To evaluate the impact of stereotactic surgery on daily activities of Parkinson's disease (PD patients. METHOD: Thirty patients with idiopathic PD were evaluated before surgery and one, three, six and twelve months after surgery. Patients were evaluated with the UPDRS - part II (Unified Parkinson's Disease Rating Scale and the Schwab & England scales. Nine of the patients had also been evaluated after twenty four months. RESULTS: We performed nine posteroventral pallidotomies (PVP, two on the

  15. 化疗对肺癌患者生活质量及焦虑情绪的影响及分析%Changes in Quality of Life and Anxiety of Lung Cancer Patients Underwent Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    李淑芳; 王燕; 辛士珍; 曹建存

    2012-01-01

    背景与目的 通过观察肺癌患者化疗前后生活质量及焦虑情绪的改变,探讨化疗对肺癌患者生活质量及焦虑情绪的影响.方法 随机抽取住院化疗的肺癌患者58例,分别于化疗前、化疗后2周期1星期内、化疗后4周期1星期内评估临床疗效,并进行肺癌患者生活质量量表(QLQ-C30)和ZUNG焦虑自评量表(SAS)评分.结果 化疗前,生活质量功能领域、疲乏、呼吸困难条目得分较高,有焦虑情绪的占56%,SAS得分为49.54±5.64;焦虑症状与失眠轻度相关(P<0.05);化疗后2周期,呼吸困难得分下降,失眠、食欲丧失得分上升,较化疗前相比差异有统计学意义(P<0.05);有焦虑情绪的占80%,SAS得分为52.48±6.10,较化疗前相比差异有统计学意义(P<0.05);有基础病患者SAS得分高于无基础病患者,差异有统计学意义(P<0.05);焦虑症状与疲乏、呼吸困难轻度相关(p<0.05).化疗后4周期,躯体、角色、情绪、社会功能得分下降明显,恶心呕心、食欲不振、便秘、经济困难条目得分上升,较化疗后2周期相比差异有统计学意义(P<0.05);有焦虑情绪的占72%,SAS得分为54.82±6.55,较化疗后2周期相比无统计学差异;SAS得分与KPS呈负相关(P<0.05);焦虑症状与疲乏、失眠相关(P<0.01),与便秘轻度相关(P<0.05).结论 化疗过程中,部分肺癌患者躯体症状得到缓解,焦虑情绪明显增加,生活质量有所下降,医务工作者应及时评价患者生活质量及情绪改变,提高患者生活质量,积极地对患者进行心理疏导治疗.%Background and objective This study aims to observe the changes in quality of life as well as the anxiety among lung cancer patients before and after chemotherapy. This work also aims to explore the effect of chemotherapy on quality of life and anxiety. Methods Fifty-eight lung cancer patients were evaluated based on clinical outcomes, EORTC QLQ-C30, and on SAS

  16. 拉米夫定在乳腺癌化疗期间对肝功能的作用%Protective effect of lamivudine with the preventive application on liver function in patients underwent breast cancer chemotherapy

    Institute of Scientific and Technical Information of China (English)

    王波; 张彤; 王群

    2014-01-01

    目的:观察拉米定夫在乳腺癌化疗期间对肝功能的作用。方法2013年3月—2014年9月收治且诊断为乳腺癌患者共100例,随机分为观察组和对照组各50例,所有患者化疗前检测乙肝表面抗原( HBsAg )、乙型肝炎病毒DNA( HBV-DNA)均显示阴性;观察组患者化疗前采用预防性拉米夫定治疗,对照组采用标准的化疗方案。以WHO标准对患者的肝脏毒性反应进行对比分析。结果化疗后2组患者的TB和ALT、AST水平均显著高于治疗前(P <0¥.05, P <0.01),而观察组显著低于对照组[(20.3±7.4)μmol/L vs.(59.1±35.1)μmol/L, t =3.725, P =0.021;(60.1±20.8)U/L vs.(417.3±185.1)U/L, t =4.627, P <0.001;(372.6±94.7)U/L vs.(126.4±55.6)U/L, P =0.023];出现肝脏损害的比例显著低于对照组(14.0%vs.42.0%,χ2=2.934, P =0.032),且肝脏损害以0~II级为主,对照组的肝脏损害以III~IV级为主,差异均有统计学意义( P <0.05);HBV-DNA定量平均水平显著低于对照组[(0.21±0.01)×109拷贝/ml vs.(0.73±0.04)×109拷贝/ml, t =3.241, P =0.024],乙肝阳性率显著低于对照组(4.0%vs.10.0%,χ2=4.206, P <0.05)。结论预防性应用拉米定夫可以较为显著地减少乳腺癌化疗后肝脏损害的发生,减轻肝脏损害的程度,降低乙肝的阳性率。%Objective To observe the effect of lamivudine on liver function during chemotherapy in patients with breast cancer. Methods From 2013 March to 2014 September , a total of 100 cases of patients who were analyzed and diag-nosed with breast cancer were randomly divided into observation group and control group with 50 cases in each group , hepatitis B surface antigen (HBsAg), hepatitis B virus DNA (HBV-DNA) were detected in all patients before

  17. 经导管肝动脉化疗栓塞术患者围术期抗菌药物应用方案探讨%Disscusion on Antibiotics Program for Patient Underwent Transcatheter Arterial Chemoembolization during Perioperative Period

    Institute of Scientific and Technical Information of China (English)

    戎佩佩

    2016-01-01

    OBJECTIVE:To provide reference for rational use of antibiotics during perioperative period of transcatheter arterial chemoembolization(TACE). METHODS:After full evaluation of 1 cases of primary liver cancerpatient’s conditions,the optimal clinical evidences were retrieved and evaluated,which were related to antibiotics regimen during perioperative period of TACE. Us-ing“hepatocellular carcinoma”“antibiotic prophylaxis”“hepatic cancer”“TACE”as subjects,the evidence were retrieved from Co-chrane Library(issue 4,2015),Medline(1980 to 2015)and CJFD(1990 to 2015)and then evaluated. RESULTS:1 meta-analy-sis or systematic review,10 RCTs and 2 practice guidelines were identified. This patient didn’t need to use antibiotics to prevent in-fection according to literature analysis. CONCLUSIONS:The rational treatment plan according to evidence-based medicine methods for patients can not only promote the rational use of antibiotics,reduce bacterial drug resistence and treatment cost,but also guide both doctors and patients to take the indeterminate risk of medicine.%目的:为经导管肝动脉化疗栓塞术(TACE)围术期合理使用抗菌药物提供参考。方法:临床药师在充分评估1例原发性肝癌患者的病情后,查找并评价当前与TACE围术期抗菌药物给药方案相关的最佳临床证据。以“hepatocellular carcinoma”“antibiotic prophylaxis”“肝癌”“经导管肝动脉化疗栓塞术”等为主题词,计算机检索Cochrane Library(2015年4期)、Medline (1980-2015年)、中国期刊全文数据库(1990-2015年),并对所获证据进行评价分析。结果:共筛选出与临床问题密切相关的1个系统评价/Meta分析,10个随机对照试验和2个临床指南。通过文献分析认为该患者不需要预防性使用抗菌药物。结论:采用循证医学方法,为该患者制订合理的用药方案,不仅可以促进抗菌药物的合理使用,减少细菌

  18. Optimal time-points for minimal residual disease monitoring change on the basis of the method used in patients with acute myeloid leukemia who underwent allogeneic stem cell transplantation: a comparison between multiparameter flow cytometry and Wilms' tumor 1 expression.

    Science.gov (United States)

    Rossi, Giovanni; Carella, Angelo Michele; Minervini, Maria Marta; di Nardo, Francesco; Waure, Chiara de; Greco, Michele Mario; Merla, Emanuela; Cillis, Giovanni Pio de; Di Renzo, Nicola; Melpignano, Angela; Capalbo, Silvana; Palumbo, Gaetano; Pisapia, Giovanni; Cascavilla, Nicola

    2015-02-01

    Minimal residual disease (MRD) of 30 adult AML patients was monitored by multiparameter flow cytometry (MFC) and WT1 expression before and after allogeneic stem cell transplantation (allo-SCT). Diagnostic performance of pre-transplant MRD measured by MFC was higher than that obtained by WT1 expression. Comparable results were displayed at day +30 post-transplant, while better values by WT1 compared to MFC were found at day +90. Positive MRD by MFC predicted a shorter disease free survival (DFS) before and 1 month after transplant (p=0.006 and p=0.005), while only high WT1 levels at 1 month from the transplant significantly impacted on DFS (p=0.010). Our results support the idea that MRD monitoring by MFC should be suggested before and 30 days after the transplant, while WT1 expression should be preferred after this procedure. The assessment of MRD at day +30 from allo-SCT is recommended as post transplant check-point for the predictive role displayed, independently of the method used.

  19. Nursing of 62 patients with osteosarcoma around the knee underwent artificial tumor prosthesis replacement%62例膝关节周围骨肉瘤人工肿瘤型假体置换术的护理

    Institute of Scientific and Technical Information of China (English)

    楼燕凤; 曹爽; 王蔚雯

    2011-01-01

    Objective Using artificial tumor prosthesis replacement to treat osteosarcoma around the knee is a combined surgical therapy mainly for limb salvage. which is different from the simple method of amputation. Whereas, for this surgery, studies related to nursing are relatively rare. In this study, the nursing and the clinical effects of using artificial tumor prosthesis replacement to treat osteosarcoma around the knee has been discussed. Methods 62 cases of osteosarcoma around the knee were extensively resected. Pre-operative care of intervention, the skin preparation and the psychological care were done before the operation. Nursing of drainage , prevention and care of complications were done after the operation. The patients were given early functional exercise guide and their knee functions were followed-up regularly. Results The 62 cases were followed-up for 6 months to 103 months, 4 cases had recurrence and 3 cases had complications. The flexed motion range of articulation was 90 -98° and straight up to 180°, the Mus culoskeletal Tumor Society ( MSTS) rate of good and excellent was 85. 4% . Conclusion Using artificial tumor prosthesis replacement to treat osteosarcoma around the knee is the mainstream of surgical treatment, Good nursing and careful observarion is the key of success for the operation and the recovery of knee function.%目的 膝关节周围骨肉瘤人工肿瘤型假体置换术是以保肢治疗为主的综合外科治疗方法,文中探讨此手术的护理及临床疗效.方法 对62例膝关节周围骨肉瘤进行安全边界切除,术前做好介入护理和皮肤准备,施行心理护理,术后做好引流管的护理,并发症的预防和护理,早期有序的功能锻炼指导.并对膝关节功能锻炼情况定期随访.结果 62例患者随访6~103个月,4例出现肿瘤复发,3例出现并发症.膝关节屈曲90~98°,伸直达180°,骨与软组织肿瘤协会(the Musculoskeletal Tumor Society,MSTS)保肢评分系统对保

  20. 主动脉瓣及二尖瓣机械瓣联合置换术后瓣膜不匹配现象的临床研究%Study of valve prosthesis-patient mismatch in patients underwent combined mitral and aortic valve replacement with mechanical valve

    Institute of Scientific and Technical Information of China (English)

    王律; 白一帆; 刘小刚; 张锡武; 张米; 徐志云

    2013-01-01

    目的:探讨主动脉瓣及二尖瓣机械瓣联合置换术后人工心脏瓣膜-患者不匹配(VP-PM)现象的发生率及其与术前患者情况及预后的关系.方法:比较患者术后瓣膜有效开口面积指数(EOAi)与血流速度的关系.明确不同VP-PM状态患者一般情况及预后有无差异.结果:本研究共纳入729例患者,主动脉瓣中重度VP-PM发生率高于二尖瓣(20.94% vs 2.74%).双瓣均为重度VP-PM患者的身高、体重及体表面积均大于单瓣VP-PM或无VP-PM患者.双瓣均为中重度VP-PM组患者住院期间肾功能衰竭发生率、死亡率显著高于单瓣中重度VP-PM及无VP-PM患者.结论:(1)双瓣置换术后易出现主动脉瓣VP-PM;(2)双瓣均出现VP-PM患者体重及体表面积较大;(3)术后双瓣均为中重度VP-PM患者的死亡率及肾功能衰竭发生率高.%Objective To evaluate the incidence of valve prosthesis-patient mismatch (VP-PM) in patients underwent combined AVR and MVR,and explore the relationship between VP-PM and patient's baseline characteristic,hospital mortality and risk of acute renal dysfunction.Methods Evaluated the baseline in different patients according the degree of VP-PM,and analyzed the effect of VP-PM on hospital mortality and risk of acute renal dysfunction.Results A total of 729 patients were retrospectively evaluated.The number of patients with moderate to severe aortic VP-PM are more than that with mitral valve VP-PM (20.94% vs 2.74%).Patients with moderate to severe VP-PM in both aortic and mitral valve had more height,body weight and body surface area than that of others.Patients with severe VP-PM of both aortic and mitral valve had higher hospital mortality and more risk of acute renal dysfunction (18.2%) than that of the other patients.Conclusions (1) The incidence of aortic VP-PM is higher than that of mitral VP-PM in patients with combined AVR and MVR.(2) Except for body weight and body surface area,patients with combined aortic and

  1. Awake off-pump coronary artery bypass surgery in 25 patients

    Institute of Scientific and Technical Information of China (English)

    GUO Huiming(郭惠明); Murali Chakravarthy; Vivek Jawali; K Jayaprakash; NV Shivananda

    2003-01-01

    Objectives To test the fea-sibility of the use of high thoracic epidural anesthesia as a sole anesthetic in patients undergoing off pump coronary artery bypass surgery, avoiding general anesthesia. Methods Between October 2002 to April 2003, twenty five cases underwent beating heart coronary artery revascularization without endotracheal general anesthesia, using high thoracic epidural anesthesia and analgesia. All the patients underwent epidural catheterization on the evening before the surgery. Results The patients in all received 71 grafts (single n = 11, double n = 5, triple n = 6, quadruple n = 3). Six patients underwent repeat coronary artery bypass. Except one was converted to general anesthesia and cardiopulmonary bypass, the other patients underwent off-pump coronary artery bypass graft surgery, 2 patients underwent grafting via left thoracotomy (MIDCAB) and the rest through mid sternotony. There was no mortality. Mean length of stay in the intensive care tnit was 16.2 ( 4.2 hours and hospital was 3.0(1.2 days. Conclusions Our experience confirms the feasibility of performing multiple coronary artery bypassesin conscious patients without endotracheal general an esthesia.

  2. 中国HIV-1急性期感染25例患者临床特点分析%The clinical characteristics of twenty-five cases of acute HIV-1 infection in China

    Institute of Scientific and Technical Information of China (English)

    李宁; 郭伏平; 李冠群; 韩扬; 谢静; 李雁凌; 祝婷; 李太生

    2015-01-01

    Objective To summarize the clinical features,immunological and virological characteristics of HIV-1 infected patients in the acute phase for the sake of improving the understanding of acute HIV-1 infection and early diagnosis.Methods To retrospectively analyze the clinical manifestation and laboratory data of 25 patients with acute HIV infection,who were admitted to the Department of Infectious Diseases,Peking Union Medical College Hospital from 2006 to 2013.Results Among the total 25 patients,19 (76%) patients were sexually transmitted,including 17 (68%) of whom were homosexual.Twenty two (88%) patients presented significant symptoms.Common symptoms consisted of fever (15 patients,60%),cervical lymphoadenopathy (8 patients,32%),skin rashes (6 patients,24%),diarrhea (5 patients,20%),shortness of breath (3 patients,12%),sore throat (3 patients,12%),and cough (3 patients,12%),while only one case represented as Guillain-Barré syndrome,upper arm cellulitis,headache and vomiting,and perianal abscess.Laboratory examination indicated elevated peripheral lymphocytes (13 patients,52%),abnormal liver function (11 patients,44%),thrombocytopenia (1 patients,4%).Notably,2 patients (8%) revealed negative results of HIV antibody,who were diagnosed with positive plasma viral load.The average viral load was (4.68 ± 0.83) lg copies/ml.CD4+ T cell count was 473 (343,621) cells/μl.CD8+ T cell count was 1 296 (997,2 177) cells/pl with maximal value of 7 984 cells/μl.The CD4/CD8 ratio was 0.33 (0.22,0.53) including 24 (96%) patients with obvious inverted ratio.The positive rates of immune activation markers HLA-DR and CD38 on the surface of CD8+ T cells were (74.9 ± 16.1) % and (84.9 ± 12.5) % respectively.The viral load had a significant positive correlation with the expression of HLA-DR and CD38.Conclusions The most common symptoms of acute HIV-1 infection are fever,cervical lymphadenopathy,skin rashes and diarrhea.Significantly elevated CD8+ T

  3. Twenty-five-year-old Woman with Bilateral Borderline Ovarian Tumour Desiring to Preserve Fertility - Case Report and Literature Review on the Current State of Fertility Preservation in Women with Borderline Ovarian Tumours.

    Science.gov (United States)

    Findeklee, S; Lotz, L; Heusinger, K; Hoffmann, I; Dittrich, R; Beckmann, M W

    2016-11-01

    Borderline ovarian tumours are semimalignant tumours occurring unilaterally or bilaterally with a peak incidence among women of reproductive age. Since the affected women often wish to preserve fertility, particular precautions must be taken when counselling the patient and obtaining consent prior to planning an individual treatment. Options for preserving fertility include an organ-sparing surgical procedure and cryopreservation of oocytes and/or ovarian tissue. In this article, we report on a 25-year-old patient with a bilateral seromucinous borderline tumour who desired all fertility-preserving options. In order to perform the procedure without delay, we opted to perform luteal phase stimulation prior to oocyte retrieval. We conclude by discussing the current literature on the state of fertility preservation in the treatment of borderline ovarian tumours.

  4. The prevalence of disc aging and back pain after fusion extending into the lower lumbar spine. A matched MR study twenty-five years after surgery for adolescent idiopathic scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Danielsson, A.J.; Nachemson, A.L. [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Orthopaedics; Cederlund, C.G.; Ekholm, S. [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Diagnostic Radiology

    2001-03-01

    To determine the long-term outcome after fusion for adolescent idiopathic scoliosis in terms of degenerative disc findings diagnosed using MR imaging and to elucidate the clinical consequences. Material and methods: Thirty-two patients with adolescent idiopathic scoliosis, who had undergone spinal fusion using Harrington rods to the lower lumbar spine with one or two unfused discs below the fusion, were re-examined 25 years after the fusion. The re-examinations included validated questionnaires, clinical examination, full standing frontal and lateral radiographs and MR examination of the lower lumbar region. Curve size and degenerative findings on MR images were evaluated by two unbiased radiologists, blinded to the clinical findings. A matched control group of 32 persons without scoliosis was subjected to the same examinations. Results and conclusion: There were significantly more degenerative disc changes (p<0.0001), disc height reduction (p=0.0010) and end-plate changes (p<0.0001 for both upper and lower end-plates) in the lowest unfused disc in the patient group compared with the control group. The MR findings in the lowest unfused disc, but not the one above, in the patient group correlated to lumbar pain intensity as well as to the diminished lumbar lordosis.

  5. Relationship of abdominal compartment syndrome and multiple organs failure in patients underwent abdominal surgery%腹部手术患者并发腹腔间室综合征与多脏器功能衰竭的关系

    Institute of Scientific and Technical Information of China (English)

    王林; 李丰

    2011-01-01

    Objective To analyze the correlation between abdominal compartment syndrome and multiple organ failure in the patients underwent abdominal surgery. Methods Data of 344 patients underwent abdominal surgery were analyzed retrospectively,who were divided into 2 groups of A(66 cases,with abdominal compartment syndrome) and B(278 cases, without abdominal compartment syndrome). The correlation between abdominal compartment syndrome and multiple organ failure was analyzed. Results Of 66 patients in group A,40 cases were complicated with abdominal compartment syndrome with the incidence rate of 60.61% ,which was significantly higher than 23. 02%(64/278) in group B(P<0.01). The incidence of abdominal compartment syndrome was positively correlated with multiple organ failure (r=0.322, P<0.01). Conclusion The incidence of abdominal compartment syndrome is closely related with multiple organ failure in the patients underwent abdominal surgery.%目的 分析腹部手术患者并发腹腔间室综合征与多脏器功能衰竭的相关性.方法 回顾性分析344例腹部手术患者资料,其中,并发腹腔间室综合征66例(A组),无腹腔间室综合征278例(B组).比较两组患者并发多脏器功能衰竭的发生情况.结果 A组患者有40例发生多脏器功能衰竭,发生率为60.61%(40/66),明显高于B组的23.02%(64/278)(P<0.01).Spearman相关分析显示,腹部手术患者并发腹腔间室综合征与多脏器功能衰竭具正相关(r=0.322,P<0.01).结论 腹部手术患者并发腹腔间室综合征患者容易发生多脏器功能衰竭.

  6. The application of oral enteralnutrition support for senior abdominal aortic aneurysm patients who underwent endovascular aortic repair%口服肠内营养支持在局麻下高龄腹主动脉瘤腔内覆膜支架置入术后的应用

    Institute of Scientific and Technical Information of China (English)

    曾国军; 赵纪春; 马玉奎; 黄斌; 杨轶; 袁丁; 熊飞; 陈熹阳; 吴洲鹏

    2014-01-01

    Objective To investigate the clinical value of oral enteralnutrition support (ENSURE) for senior (> 60 years) abdominal aortic aneurysm (AAA) patients who underwent endovascular aortic repair (EVAR).Methods The data of 30 senior AAA patients who underwent EVAR was restrictively reviewed.The patients were divided into two groups:Group A =15,with postoperative ENSURE,50 g,tid; Group B =15,with postoperative common food.The postoperative data were compared between two groups,including the hospital stay,infection of operative incision rate,and nutritional state in the third and seventh day after operation.Results The postoperative hospital stay and infection rate had no significant difference between two groups.The plasma albumin in group A in the third day and the seventh day were higher (P < 0.05).Conclusions ENSURE improved the nutritional status of AAA patients who underwent EVAR,and shorten postoperative hospital stays.%目的 探讨口服肠内营养支持在局麻下高龄(>60岁)腹主动脉瘤(AAA)腔内覆膜支架置入术后的应用.方法 本院2010年1月至2011年10月经腔内覆膜支架置入术治疗的高龄腹主动脉瘤患者中选取30例,分为2组,每组15例,A组术后8h给予口服肠内营养支持(安素,50 g,3次/d),B组术后8h普食.对比术后切口感染率、血浆白蛋白、术后住院时间.结果 A组患者术后第3、7天白蛋白水平高于B组(P<0.05),两组感染率及术后住院时间比较差异无统计学意义(P>0.05).结论 口服肠内营养支持可促进局麻下经腔内覆膜支架置入术治疗的高龄腹主动脉瘤患者术后恢复,提高营养状态,有利于患者恢复.

  7. Clinical study on nosocomial multidrug-resistant acinetobacter baumanii infections in the patients underwent cardiac surgeries%心脏外科术后患者多药耐药鲍氏不动杆菌医院感染临床研究

    Institute of Scientific and Technical Information of China (English)

    周晔; 张健群; 杨毅; 邵涓涓; 贾明; 万久贺; 贾士杰

    2011-01-01

    OBJECTIVE To investigate the clinical distribution and antibiotics resistance and pronosis of nosocomial multidrug-resistant Acinetobacter baumanii (MDR-AB) infection in the patients underwent cardiac surgeries. METHODS The clinical data of the nosocomial A. baumanii infection patients underwent cardiac surgeries in our hospital between Jul 2007 and Jun 2010 were retrospectively analyzed. RESULTS There were 105 nosocomial A. baumanii infection cases in patients underwent cardiac surgeries and MDR-AB cases accounted for 65.7% (69 cases). Results of susceptibility test showed that cefoperazone/sulbactam (34. 8%) and minocycline (46. 4%) were the most active antibiotics for MDR-AB and MDR-AB presented highly resistant to other antibiotics including the carbapenems antibiotics with the resistant rates more than 70. 0%. There were no significantly different between the mortality between the nosocomial MDR-AB infection patients and the non-MDR A. baumanii cases. CONCLUSION A. baumannii is one of the most common pathogens in the patients underwent cardiac surgeries in our hospital. The prevalence of MDR-AB strains in cardiac surgical settings creates demand on rational selecting the antibiotics the and implementation of strict screening and contact precautions. Curing the primary disease and improving the patients'general status are also important to refine prognosis.%目的 调查医院心脏手术后多药耐药鲍氏不动杆菌(MDRAB)医院感染状况和耐药性及预后.方法 回顾性分析2007年7月-2010年6月医院心脏外科手术后医院感染鲍氏不动杆菌患者的临床资料.结果 共发生鲍氏不动杆菌医院感染105例,其中MDRAB医院感染69例,占65.7%;MDRAB对头孢哌酮/舒巴坦的耐药率为34.8%,米诺环素的耐药率为46.4%,其他包括碳青霉烯类抗菌药物,耐药率均>70.0%;而心外术后非多药耐药鲍氏不动杆菌医院感染患者和MDRAB医院感染患者院内死亡率统计学分析差

  8. Changes of tear film and tear secretion after phacoemulsification in diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Xi LIU; Yang-shun GU; Ye-sheng XU

    2008-01-01

    Objective: To evaluate tear film stability and tear secretion in patients with diabetes after phacoemulsification. Methods: Twenty-five diabetic cataract patients and 20 age-matched non-diabetic cataract patients as control underwent phacoemulsification. Tear film break-up time (TFBUT), Schirmer I test (SIT), corneal fluorescein staining, and dry eye symptoms were measured pre- and postoperatively. Results: Diabetics had a decreased preoperative TFBUT and SIT. TFBUT was reduced on Day 1 and recovered on Day 180 postoperatively in both groups. SIT was increased after phacoemulsification, but returned to preoperative levels by Day 180 in non-diabetics, whereas it was lower than preoperative level in diabetics. Positive corneal fluorescein staining was elevated in both groups, and returned to preoperative levels only in controls. Dry eye symptoms were similar to fluorescein staining in both groups. Conclusion: Tear secretion was reduced in diabetic cataract patients after phacoemulsification, which worsened dry eye symptoms and predisposed those patients to ocular damage.

  9. Influence of family support and personality characteristics on quality of patients" life who underwent total laryngectomy%家庭支持与个性特征对全喉切除术后患者生存质量的影响

    Institute of Scientific and Technical Information of China (English)

    陆关珍; 沈旭慧; 沈玲珠; 杨丽

    2008-01-01

    目的 探讨家庭支持与个性特征对全喉切除术后患者生存质量的影响.方法 采用苏氏生活质量量表、胡氏家庭支持量表、龚氏个性特征测验问卷,对68例全喉切除术后患者进行问卷调查,并进行统计分析.结果 2组家庭支持与生存质量评分进行t检验,身体机能、心理状态均P<0.05;生活能力、社会关系、气管造口均P<0.01.个性特征与生存质量单因素分析,心理状态与4个维度有明显相关性.2组家庭支持与个性特征评分进行t检验,E内外向质P<0.05;P精神质、N神经质均P<0.01.结论 家庭支持与个性特征作为内外环境因素直接影响着全喉切除术后患者的生存质量,三开放四指导五干预的综合护理对策能全面提高其生存质量.%Objective To investigate the influence of family support and personality characteristics on quality of patients' life who underwent total laryngectomy. Methods Patients (68 eases)who underwent total laryngectomy were surveyed with Su life of quality scale,Hu family support scale, Gong personality test and the results were sent for statistical analysis. Results Scores of two family groups in family support and quality of life underwent t test, physical function and psychological state were statistically different (P<0.05), living ability,social relations, tracheal stoma were statistically different(P<0.01). Persona lity and quality of life were subjected to single-factor analysis, psychological states were obviously related with four dimensions.Family support and personality characteristics score of two family groups underwent t test, E(internal and external quality),P(spiritual quality),N(nerval quality)were statistically significant (P <0.01 ). Condusions Family support and personality characteristics as the internal and external environmental factors directly affected patients who underwent total laryngectomy. Three-openfour-guiding-five-integrated-care-intervention measures can overall

  10. A clinical analysis of twenty-five cases of eosinophilic lung disease%嗜酸性肺部疾病25例临床资料分析

    Institute of Scientific and Technical Information of China (English)

    梁琼; 陈一强; 孔晋亮; 潘熠平

    2015-01-01

    目的 通过分析嗜酸性肺部疾病的临床资料,总结诊断和治疗经验,以提高对该类疾病的认识.方法 回顾性分析2004年1月-2012年8月广西医科大学第一附属医院临床诊断为嗜酸性肺部疾病的25例临床资料,包括病因、临床表现、影像、病理特点和诊治等资料.结果 25例嗜酸性肺部疾病者中,慢性嗜酸性粒细胞肺炎(CEP)9例;变应性肉芽肿性血管炎(CSS)6例;10例寄生虫感染所致嗜酸性肺部疾病,其中2例为单纯性肺嗜酸性粒细胞增多症(L(o)ffler综合征).25例患者外周血、支气管肺泡灌洗液(BALF)中嗜酸性粒细胞增多;有不同程度的低氧血症,肺功能呈限制性、阻塞性、混合性通气功能障碍;胸部CT:两肺片状、条索状或弥漫分布片状磨玻璃浸润影和网状影改变浸润影;肺组织病理学检查或皮肤活检见大量嗜酸性粒细胞浸润.糖皮质激素单独或联用免疫抑制剂治疗有效.结论 嗜酸性肺部疾病的主要病因以寄生虫感染最为常见,其次为不明原因的慢性嗜酸性粒细胞性肺炎.除CSS诊断需组织病理学证据外,嗜酸性肺部疾病大部分病例依据临床表现、实验室检查、BALF和胸部影像学资料可做出临床诊断.%Objective To improve the diagnosis and treatment of eosinophilic lung disease.Methods Patients who were diagnosed with eosinophilic lung disease and hospitalized in the First Affiliated Hospital of Guangxi Medical University Hospital were retrospectively analyzed from January 2004 to August 2012.Data of etiology,clinical manifestation,imaging and pathological features,diagnosis and treatment were recorded.Results A total of 25 patients were diagnosed with eosinophilic lung disease including 9 chronic eosinophilic pneumonia,6 churg-strauss syndrome,and 10 cases of parasitic infection of which two patients were the simple pulmonary eosinophilia (L(o)ffler syndrome).Eosinophil counts in peripheral blood and

  11. A clinical study of bilateral non-obstructive acute pyelonephritis with acute kidney injury in patients of type 2 diabetes mellitus.

    Science.gov (United States)

    Yadla, Manjusha; Parvithina, Sriramnaveen; Chennu, Krishna Kishore; Reddy, Sandeep; Sridhar, A V S S N; Vijayalakshmi, B; Lakshmi, A Y; Kalawat, Tek Chand; Sivakumar, V

    2014-03-01

    The aim of our study was to study the clinical profile of type 2 diabetes mellitus patients admitted with the diagnosis of acute kidney injury (AKI) due to bilateral acute non-obstructive pyelonephritis. The bilateral involvement was identified on various imaging modalities (ultrasound, computed tomography, nuclear scintigrapy). All the patients had AKI. Those with severe AKI underwent hemodialysis. The factors associated with the severity of illness were identified. Twenty-five patients of type 2 diabetes mellitus admitted with the diagnosis of AKI due to bilateral acute non-obstructive pyelonephritis were identified. On ultrasound, bilateral involvement was found in 12 patients and in 17 patients on computed tomography and eight patients on nuclear scintigraphy. Fourteen of them needed dialysis support. Bilateral acute pyelonephritis needs to be considered while evaluating the AKI in type 2 diabetes mellitus patients.

  12. Síndrome de Cushing: veinticinco años de experiencia clínica en Navarra Cushing´s syndrome: twenty-five years of clinical experience in Navarre

    Directory of Open Access Journals (Sweden)

    L. Pérez García

    2012-12-01

    Full Text Available Fundamento. El objetivo de este trabajo es conocer la situación del Síndrome de Cushing (CS en cuanto a etiología, diagnóstico, tratamiento y curación en los últimos 25 años en Navarra. Material y métodos. Este estudio -retrospectivo, observacional-, se ha llevado a cabo sobre 36 pacientes diagnosticados de SC entre 1985 y 2010. Resultados. El 80,5% eran mujeres y el 19,5% hombres. La edad media al diagnóstico fue 39,3±13 años. Las principales manifestaciones clínicas fueron: obesidad (85,3%, cara de luna llena (35,3% y miopatía (50%. Etiológicamente, el 58,3 % tenían origen hipofisario, el 36,1% adrenal y el 5,5% ectópico. La media de CLU fue 343,5±310,1 μg/24horas. El cortisol sérico tras el Nugent fue de 15,6±8,6 μg/dl. La media del cortisol plasmático tras el frenado débil fue 15,1±14,2 μg/dl. Existe correlación lineal directa estadísticamente significativa (pBackground. The aim of this work is to determine the situation of Cushing´s Syndrome (CS with respect to aetiology, diagnosis, treatment and cure in the last 25 years in Navarre. Methods. Retrospective, observational study on 36 patients diagnosed with CS between 1985 and 2010. Results. Eighty point five percent were women and 19.5% were men. The average age on diagnosis was 39.3±13 years. The main clinical manifestations were: obesity (85.3%, full moon face (35.3% and myopathy (50%. Aetiologically, in 58.3% the origin was hypophisiary, in 36.1% it was adrenal, and in 5.5% it was ectopic. The UFC average was 343.5±310.1 μg/24hours. Serum cortisol after Nugent test was 15.6±8.6 μg/dl. Low dose plasma cortisol average was 15.1±14.2 μg/dl. There is a statistically significant (p< 0.01 direct lineal correlation between UFC and the Nugent test, as well as between the Nugent test and low dose cortisol test. There are no statistically significant differences between adrenal and hypophisiary aetiology in either demographic factors or analytical results

  13. 放松训练辅助聆听音乐对介入治疗的颅内动脉瘤患者睡眠质量影响的效果评价%Effect of relaxation training in combination with listening to music on sleep quality of patients with intracranial aneurysm who underwent endovascular interventional therapy

    Institute of Scientific and Technical Information of China (English)

    谢春雷; 李春霞; 李爱文; 黄维明; 钟丽丽

    2008-01-01

    Objective To improve the sleep quality of patients by evaluating the effect of relaxation training in combination with listening to music on sleep quality of patients with intracranial aneurysm who underwent endovascular interventional therapy. Methods 55 patients who reached the entrance standard were divided into the observation group (28 cases)and the control group(27 cases).The control group received routine nursing measures. The observation group were given relaxation training in combination with listening to music based on routine nursing measures. The sleep quality was appraised by Pittsburgh Sleep Quality Index (PSQI) and patients subjective feeling was investigated by self-designed questionnaires. Results The relaxation training in combination with listening to music ameliorated the sleep quality in the observation group compared with that of the control group(P<0.01).Conclusion The relaxation training in combination with listening to music could improved the sleep quality of patients with intracranial aneurysm who underwent endovascular interventional therapy.%目的 评价放松训练配合聆听音乐对颅内动脉瘤患者介入治疗前后睡眠质量的影响,以期提高患者的睡眠质量.方法 收集符合纳入标准的55例颅内动脉瘤患者,随机分为观察组28例和对照组27例,对照组患者按照颅内动脉瘤常规护理进行护理,观察组在常规护理的基础上让患者坚持放松训练配合聆听音乐,以匹兹堡睡眠质量指数作为评定工具评价2组患者睡眠质量情况,自制问卷评价患者主观感受.结果 放松训练配合聆听音乐改善了患者的睡眠质量,2组比较,差异有统计学意义(P<0.01).结论 放松训练配合聆听音乐可提高介入治疗的颅内动脉瘤患者睡眠质量.

  14. 不同喉环状软骨上部分切除术式术后误咽发生情况分析%Extent of post-operative deglutition disorder in patients underwent different modalities of supracricoid partial laryngectomy

    Institute of Scientific and Technical Information of China (English)

    林刃舆; 陈建福; 彭建华; 郭志强; 贾明辉

    2011-01-01

    Objective To compare the extent of deglutition disorder in patients with laryngeal carcinoma underwent different modalities of supracricoid partial laryngectomy.Methods Thirty eight patients with laryngeal carcinoma underwent supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL- CHEP) and 28 patients underwent supracricoid partial laryngectomy- cricohyoidopexy (SCPL-CHP) from 2005 to 2009.The extent of post- operative deglutition disorder in both groups was evaluated by Ridit analysis; and its relationship with age of patients was analyzed by Pearson correlation.Results There was significant difference in the extent of deglutition disorder between the two groups (U=25.685,P<0.01); the correlation coefficient was 0.932 (P<0.01) in SCPL- CHEP group and 0.850 (P<0.01) in SCPL- CHP group respectively.There was a positive correlation between age and extent of deglutition disorder.The occurrence of deglutition disorder was 2.6% (1/38)in SCPL- CHEP group and 25% (7/28)in SCPL- CHP group 8 weeks after operation (P <0.01).Conclusion SCPL- CHEP is a safe and effective operational modality for laryngeal carcinoma with less incidence of post- operational deglutition disorder.The extent of deglutition disorder in both groups increases with the age of patients, particularly for those aged over 70.%目的 探讨喉环状软骨上部分切除(SCPL)的不同术式对喉癌患者术后误咽发生及其程度的可能影响.方法 2005至2009年38例喉癌患者采用喉环状软骨上部分切除-环舌骨会厌吻合术(SCPL-CHEP),28例喉癌患者采用喉环状软骨上部分切除-环舌骨吻合术(SCPL-CHP),对两组患者术后误咽的发生率和程度进行评估与比较,并对误咽程度与年龄之间的关系进行分析.结果 两组患者术后误咽程度的差异有统计学意义(P<0.01),SCPL-CHP组患者误咽程度更为明显.术后误咽程度与年龄之间呈正相关关系(P<0.01),年龄是两组患者术后发生误咽

  15. "Doctor-nurse integration"management in the prevention of Deep Vein Thrombosis in patients underwent artificial total hip replacement%医护一体化管理降低人工髋关节置换术患者深静脉血栓发生率的实践

    Institute of Scientific and Technical Information of China (English)

    姜香云; 吴佳倩; 张亚珥; 冯志仙

    2014-01-01

    目的:探讨医护一体化管理降低人工髋关节置换术后深静脉血栓(DVT)发生率的成效。方法:成立医护一体化专项管理小组,制定医护一体化管理流程,分析人工髋关节置换术所致深静脉血栓发生原因并提出对策,医护人员共同参与培训学习,明确责任,共同监督、协作、反馈、持续改进。对比分析实施医护一体化管理前后人工髋关节置换术患者DV T的发生率。结果:实施前髋关节置换术患者DVT发生率为42.1%,经两轮持续质量改进,DVT发生率降低至17.3%,实施前后比较差异有统计学意义(P<0.01)。结论:医护一体化管理可降低人工髋关节置换术患者DVT的发生率,从而提升医疗护理质量。%Objective:To assess the efficacy of"doctor-nurse integration"management in the prevention of Deep Vein Thrombosis (DVT) in patients underwent total hip replacement (THA) surgery. Methods:A"doctor-nurse integration"team was established to investigate the incidence rate of DVT, the proper use of administration of anti-clotting drug, and the rate of intermittent pneumatic compression pump (IPCP) application in patients who underwent THA between January and March in 2013. The team analyzed possible causes of DVT to develop a standard process for the prevention of DVT after THA. The nurses and physicians were trained together to specify their own responsibilities, with substantial interactions, such as co-supervision, co-operation, and in time feedbacks. The pattern of"doctor-nurse integration"was carried out together with physical therapists. The incidence rate of DVT was measured before and after the application of"doctor-nurse integration"management for analysis. Results:After two-round improvements, the incidence rate of DVT in patients underwent THA decreased from 42.1%to 17.3%(P<0.01). Conclusion:The pattern of"doctor-nurse integration"could signiifcantly decrease the incidence of DVT in patients who had

  16. The Twenty-Five Year Lick Planet Search

    CERN Document Server

    Fischer, Debra A; Spronck, Julien F P

    2013-01-01

    The Lick planet search program began in 1987 when the first spectrum of $\\tau$ Ceti was taken with an iodine cell and the Hamilton Spectrograph. Upgrades to the instrument improved the Doppler precision from about 10 m/s in 1992 to about 3 m/s in 1995. The project detected dozens of exoplanets with orbital periods ranging from a few days to several years. The Lick survey identified the first planet in an eccentric orbit (70 Virginis) and the first multi-planet system around a normal main sequence star (Upsilon Andromedae). These discoveries advanced our understanding of planet formation and orbital migration. Data from this project helped to quantify a correlation between host star metallicity and the occurrence rate of gas giant planets. The program also served as a test bed for innovation with testing of a tip-tilt system at the coud{\\'e} focus and fiber scrambler designs to stabilize illumination of the spectrometer optics. The Lick planet search with the Hamilton spectrograph effectively ended when a heat...

  17. Technology Education: Twenty-five years of progress

    OpenAIRE

    De Miranda, Michael A.; Miyakawa, Hidetoshi

    2005-01-01

    The past 25 years has brought significant changes in the field of technology education. Contributing to these changes has been the evolution of a curriculum from the early days of industrial arts that addressed human productive practice to an emerging contemporary technological curriculum shaped by the exponential growth of technology and its impact on the extension of human capabilities, society, and the environment. The recent literature that focuses on the exponential growth of technology ...

  18. TWENTY-FIVE SUBARCSECOND BINARIES DISCOVERED BY LUNAR OCCULTATIONS

    Energy Technology Data Exchange (ETDEWEB)

    Richichi, A. [National Astronomical Research Institute of Thailand, 191 Siriphanich Bldg., Huay Kaew Rd., Suthep, Muang, Chiang Mai 50200 (Thailand); Fors, O. [Departament Astronomia i Meteorologia and Institut de Ciencies del Cosmos (ICC), Universitat de Barcelona (UB/IEEC), Marti i Franques 1, E-08028 Barcelona (Spain); Cusano, F. [INAF-Osservatorio Astronomico di Bologna, Via Ranzani 1, I-40127 Bologna (Italy); Moerchen, M., E-mail: andrea4work@gmail.com [European Southern Observatory, Casilla 19001, Santiago 19 (Chile)

    2013-09-15

    We report on 25 subarcsecond binaries, detected for the first time by means of lunar occultations in the near-infrared (near-IR) as part of a long-term program using the ISAAC instrument at the ESO Very Large Telescope. The primaries have magnitudes in the range K = 3.8-10.4, and the companions in the range K = 6.4-12.1. The magnitude differences have a median value of 2.8, with the largest being 5.4. The projected separations are in the range 6-748 mas and with a median of 18 mas, or about three times less than the diffraction limit of the telescope. Among our binary detections are a pre-main-sequence star and an enigmatic Mira-like variable previously suspected to have a companion. Additionally, we quote an accurate first-time near-IR detection of a previously known wider binary. We discuss our findings on an individual basis as far as made possible by the available literature, and we examine them from a statistical point of view. We derive a typical frequency of binarity among field stars of Almost-Equal-To 10%, in the resolution and sensitivity range afforded by the technique ( Almost-Equal-To 0.''003 to Almost-Equal-To 0.''5, and K Almost-Equal-To 12 mag, respectively). This is in line with previous results using the same technique but we point out interesting differences that we can trace up to sensitivity, time sampling, and average distance of the targets. Finally, we discuss the prospects for further follow-up studies.

  19. TWENTY FIVE YEARS OF THE POLISH SOCIETY OF ECOLOGICAL ENGINEERING

    Directory of Open Access Journals (Sweden)

    Aleksander Kiryluk

    2015-10-01

    Full Text Available Polish Society of Ecological Engineering (PTIE was founded in 1990 and received its legal personality in the same year. It is a continuation of the Polish Committee for Development and Environment Protection (established in 1972 within the framework of the Chief Technical Organization (now Federation of Engineering Associations. The main objective of the PTIE establishment was taking action to adapt to the requirements of economic development environmental protection development. The statutory objectives of PTIE are realized through experts activity and paper publication. In terms of content PTIE activity focuses on popularizing rational use and conservation of natural environment and earth’s natural resources. With the current rapid advances in science, technique, dynamic economic development and overexploitation of natural resources, environmental engineering and its activities in line with the state of environmental policy it contributes to the so-called sustainable development, protection, adapts and creates the conditions necessary for human life, plants and animals. The Society currently has a well-established position in the world of science by issuing two scientific magazines in Polish and English. It cooperates with various research and educational centers, industries and as well as with local government, administration and state in solving local environmental economic problems. This paper presents the rise and activity of PTIE and major Society achievements in the years 1990–2015.

  20. TWENTY FIVE YEARS OF THE POLISH SOCIETY OF ECOLOGICAL ENGINEERING

    OpenAIRE

    2015-01-01

    Polish Society of Ecological Engineering (PTIE) was founded in 1990 and received its legal personality in the same year. It is a continuation of the Polish Committee for Development and Environment Protection (established in 1972) within the framework of the Chief Technical Organization (now Federation of Engineering Associations). The main objective of the PTIE establishment was taking action to adapt to the requirements of economic development environmental protection development. The statu...

  1. [Twenty five years of residency training in the Netherlands].

    Science.gov (United States)

    van Tilburg, W

    2008-01-01

    Over the last 25 years in the Netherlands the residency training programme for psychiatry has been concerned primarily with teaching students to use practice guidelines, providing science education, promoting internationalisation and satisfying society's requirement for transparency. This has led to the transformation of the classical training programme with its paternalistic 'master-apprentice' relationship to a programme in which the required professional competencies are taught and assessed by supervisors who in the future will need to be explicitly qualified in particular areas. The dramatic increase in the number of women wanting to become psychiatrists has made it clear that the classical training programme puts a heavy burden on students who are struggling to combine private life with a heavy work-load and enthusiasm for their chosen subject. The compulsory personal therapy in the curriculum may be helpful in solving this problem.

  2. Increasing Medical Practice Team Commitment: Twenty-Five Strategies.

    Science.gov (United States)

    Hills, Laura

    2016-01-01

    Employee commitment is one of the most important principles of practice man- agement. Yet commitment is delicate; it must be carefully earned, and it can easily deteriorate. This article explores practical strategies the medical practice manager can use to assess, foster, and increase employee commitment. It de- fines commitment and how commitment is manifested in employee attitudes and behavior. It provides a 10-question guide medical practice managers can use to assess employee commitment, and a four-part roadmap that will inspire commitment through leadership. This article also offers 25 hands-on strate- gies to increase employee commitment, and more than a dozen questions to guide difficult conversations with employees when their commitment level to the medical practice is low or unclear. Finally, this article suggest four drivers of employee commitment and a five-part strategy medical practice managers can use to model commitment through their own leadership.

  3. Twenty five years of organic chemistry with diiodosamarium

    Energy Technology Data Exchange (ETDEWEB)

    Kagan, Henri B. [Laboratoire de Synthese Asymetrique (UMR 8075), Institut de Chimie Moleculaire et des Materiaux d' Orsay, Universite Paris-Sud, 91405 Orsay (France)]. E-mail: kagan@icmo.u-psud.fr

    2006-02-09

    An historical account of the introduction of samarium diiodide in organic chemistry is presented in the first section, with the main initial results obtained. The basic organic transformations published in the author laboratory and by other groups during the initial period (1977-1987) are detailed. Some of the progresses subsequently obtained will be selected such as various transformations in synthesis, including asymmetric synthesis and total synthesis of natural products. The possible use of SmI{sub 2} in catalytic amount together with a terminal reducing agent is discussed. In the conclusion is summarized the wide scope of the chemistry induced by SmI{sub 2} with some comments on the future of this chemistry.

  4. Twenty-five years of Social Science in Law.

    Science.gov (United States)

    Monahan, John; Walker, Laurens

    2011-02-01

    In this essay, we take the publication of the seventh edition of the casebook Social Science in Law (2010) as an opportunity to reflect on continuities and changes that have occurred in the application of social science research to American law over the past quarter-century. We structure these reflections by comparing and contrasting the original edition of the book with the current one. When the first edition appeared, courts' reliance on social science was often confused and always contested. Now, courts' reliance on social science is so common as to be unremarkable. What has changed--sometimes radically--are the substantive legal questions on which social science has been brought to bear.

  5. Twenty five years National Astronomical Observatory: Publications and dissertations

    Science.gov (United States)

    Iliev, Ilian

    The idea to estimate the merits and to measure the impact of the National Astronomical Observatory of Bulgaria by creating the list with all publications and dissertations based fully or in part on the data collected during last 25 years with its telescopes is presented. The process of compiling the list is described. Its last version contains complete bibliographical data about more than 1000 publications with total volume of about 5500 journal pages. All of them are printed out in 1980--2005. The accumulated impact-factor exceeds 1000, the number of citations is expected to be between 3000 and 5000. The number of successful dissertations is close to 40, while the bachelor and master theses are near 100.

  6. TESOL at Twenty-Five: What Are the Issues?

    Science.gov (United States)

    Brown, H. Douglas

    1991-01-01

    A survey of current trends in teaching English to speakers of other languages identifies four themes involving: learner motivation and empowerment; an expanding international range of language policy issues; content-centered and task-based curricula and emphasis on peace and environmental education; and cooperative, learner-centered teaching. (42…

  7. Antioxidant activity of twenty five plants from Colombian biodiversity.

    Science.gov (United States)

    Mosquera, Oscar M; Correa, Yaned M; Buitrago, Diana C; Niño, Jaime

    2007-08-01

    The antioxidant activity of the crude n-hexane, dichloromethane, and methanol extracts from 25 species belonging to the Asteraceae, Euphorbiaceae, Rubiaceae, and Solanaceae families collected at natural reserves from the Eje Cafetero Ecorregión Colombia, were evaluated by using the spectrophotometric 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical-scavenging method. The strongest antioxidant activities were showed by the methanol and dichloromethane extracts from the Euphorbiaceae, Alchornea coelophylla (IC50 41.14 mg/l) and Acalypha platyphilla (IC50 111.99 mg/l), respectively. These two species had stronger DPPH radical scavenging activities than hydroquinone (IC50 151.19 mg/l), the positive control. The potential use of Colombian flora for their antioxidant activities is discussed.

  8. FIS, University of Economics in Prague: Twenty Five

    Directory of Open Access Journals (Sweden)

    Iva Pecáková

    2016-12-01

    Full Text Available FIS (Faculty of Informatics and Statistics of the University of Economics in Prague, was founded in 1991. Since 2001, so for 15 years, master’s degree survey is performed at the graduation ceremonies of all the faculties of University of Economics in Prague. Its aim is to explore some of the circumstances of their studies, their jobs during the study, but especially their likely future labor involvement, their salary expectations and their satisfaction with studies at the university. Paper presents some data about students and graduates of the faculty from this survey, but also the information about the students and graduates from the project Reflex 2013. This survey was conducted in 2013 for the third time in a row by SVP PedF of Charles University in Prague with the aim to map out the exercise of university graduates in the labor market shortly after obtaining a diploma. Therein respondents rated their university studies, characterized his professional history, and expressed their professional competencies in relation to the requirements of their employment.

  9. Facial lipohypertrophy in HIV-infected subjects who underwent autologous fat tissue transplantation.

    Science.gov (United States)

    Guaraldi, Giovanni; De Fazio, Domenico; Orlando, Gabriella; Murri, Rita; Wu, Albert; Guaraldi, Pietro; Esposito, Roberto

    2005-01-15

    Of 41 HIV-infected patients with facial lipoatrophy who underwent autologous fat transplantation, disfiguring facial lipohypertrophy at the graft site occurred at the same time as recurrent fat accumulation at the tissue harvest site in 4 patients who had had fat transferred from the dorsocervical fat pad or from subcutaneous abdominal tissue.

  10. Avaliação da qualidade de vida em pacientes submetidos à ressecção colorretal por via laparoscópica ou aberta em período pós-operatório inicial Evaluation of quality of life in patients underwent laparoscopic or open colorectal resection in the early postoperative period

    Directory of Open Access Journals (Sweden)

    Teon Augusto Noronha de Oliveira

    2010-03-01

    laparoscópica apresentaram melhor qualidade de vida ao final do primeiro mês de pós-operatório, quando comparados com os pacientes submetidos à cirurgia aberta.INTRODUCTION: Several studies, including meta-analysis, have demonstrated the safety, effectiveness and oncologic equivalence of laparoscopic resections when compared to open procedures leading minimally invasive colorectal surgery to be adopted in crescent number of services around the world. This study aims to evaluate the quality of life of patients underwent laparoscopic and open colorectal resections in the early postoperative period. METHODS: this is a prospective study which evaluated 42 patients underwent laparoscopic and open colorectal resection between May to November 2008 followed up until 60th postoperative day. Questionnaires of quality of life were applied in 3th, 7th and 30th postoperative days. Statistical analysis consisted of descriptive analysis of global healthy status scores, functional scores and symptoms of EORTC/QLQ 30. Shapiro-Wilk, Mann-Whitney e t de Student statistical tests were used to check the data, with level of significance in 0.05. RESULTS: Most of patients were females (57.1% with mean age of 61.5 years. It was observed significant difference of "global health status" score on the 30th postoperative between groups, with values of 75.0 and 58.3 for patients underwent laparoscopic and open procedures respectively (p = 0.005. There were no differences in terms of physical function and others as, accomplishment, emotional, cognitive and social functions. In relation to symptoms (fatigue, nausea, pain, dyspnea, insomnia, loss of appetite and constipation and financial difficulties, there were also no differences between groups. CONCLUSION: Our results have demonstrated that patients underwent laparoscopic colorectal resections have better quality of life at the end of first postoperative month when compared to patients underwent to open colorectal resections.

  11. Effects of Nursing Intervention on Quality of Life of Patient with Ureteral Stones Underwent Holmium: YAG Laser Ureteroscopic Lithotripsy%护理干预对输尿管镜钬激光碎石术患者生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    钱彦; 瞿青云; 沈敏; 张涛; 吴宗林

    2012-01-01

    目的:探讨护理干预对输尿管镜钬激光碎石术患者生活质量的影响.方法:采取前瞻性随机对照的方法,从2008年5月到2010年12月,共有123例接受榆尿管镜钬激光碎石术的输尿管结石患者被随机分成对照组和护理干预组.使用世界卫生组织生存质量测定量表简表评价输尿管镜钬激光碎石术对患者生活质量的影响.结果:非护理干预组和护理干预组的世界卫生组织生存质量测定量表简表的生活质量评分手术后比手术前有明显改善(P<0.05).输尿管镜钬激光碎石术后,护理干预组患者的生活质量优于非护理干预组.结论:护理干预能明显改善输尿管镜钬激光碎石术患者的生活质量.%Objective: To investigate the effects of nursing intervention on quality of life of patient with ureteral stones underwent holmium: YAG laser ureteroscopic lithotripsy. Methods: From May in 2008 to December in 2010, a total of 123 consecutive patients admitted from a waiting list for surgery for ureteral stones were prospectively randomized to either nursing intervention or non-nursing intervention. Pre-and postoperative WHOQOL-BREF outcome data were obtained. Results; The WHOQOL-BREF in non-nursing intervention and nursing intervention group had significantly improved at post-operation compared to pre-operation. There was significant difference on WHOQOL-BREF scores in two groups at post-operation. Conclusions: Nursing intervention can improve the quality of life of patients with ureteral stones underwent holmium: YAG laser ureteroscopic lithotripsy. Improving the nursing after the procedure makes good prognosis.

  12. Factors Analysis of Fatigue Syndrome of Patients with Primary Gastric Cancer Underwent Radi-cal Surgiery%原发性胃癌外科根治术患者术后疲劳综合征的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    周良弼; 吴定泉; 朱长康; 赵永亮

    2015-01-01

    [Objective]To study the risk and protective factors of POFS of patients with primary gastric cancer underwent radical surgiery.[Methods]60 cases of primary gastric cancer patients underwent radical treatment were selected in our hospital from August 2012 to August 2014.The visual analogue scale (VAS) fatigue and Pittsburgh sleep quality index (PSQI)on the patients were used for postoperative observation to study the effect of patients POFS influenced by the factors like sex,tumor stage,operation method and nutri-tion conditions.[Results]Those related to male,later tumor staging and older age get higher scores in VAS、PSQI,while their postoperative recovery index tended to be lower,the difference had statistical significance (P <0.05).The POFS symptoms of patients with laparoscopic gastric cancer radical therapy are lighter than those underwnt open operation.The POFS symptoms of patients in the SE group is lighter than patients in the EN group,the difference had statistical significance (P <0.05).[Conclusion]Female,early cancer stage,lap-aroscopic surgery,nutrition intervention and younger age compose the protective factors,while male,later tumor stage,open operation and senior age make the risk factors .%【目的】探讨原发性胃癌外科根治手术患者术后疲劳综合征(POFS)的影响因素。【方法】选取2012年8月至2014年8月在本院接受外科手术根治手术治疗的原发性胃癌患者60例。应用视觉模拟疲劳尺(VAS)和匹兹堡睡眠质量指数(PSQI)等指标对患者进行术后评估,并分析性别、年龄、肿瘤分期、手术方式、营养方式等对患者 POFS 的影响。【结果】男性患者、肿瘤分期越晚、年龄越大的患者其 VAS、PSQI 得分越高,术后康复指标越差,差异具有统计学意义(P <0.05)。腹腔镜胃癌根治术患者的 POFS 症状比开腹手术患者的症状轻,SE 组患者比 EN 组患者的 POFS 症状轻,差异具有统计学意义(P <0.05)。【结论】女性、

  13. Perioperative Period Treatments for Patients Underwent One-stage Coronary Artery bypass Grafting and Artificial Heart Valve Repair or Replacement%冠心病合并心脏瓣膜疾病同期手术治疗的围手术期处理要点

    Institute of Scientific and Technical Information of China (English)

    黎昱江; 刘学刚

    2013-01-01

    目的:探讨同期行冠脉旁路移植术和瓣膜置换或瓣膜成形术的围手术期的处理要点和注意事项,以期降低该类手术围手术期的死亡率.方法:通过Pubmed、万方数据库、中国知网等检索近几年国内外关于同期行冠脉旁路移植术和瓣膜置换或瓣膜成形术研究的相关文献,总结其围手术期的处理要点和注意事项.结果:同期行冠脉旁路移植术和瓣膜置换或瓣膜成形术,术前应注意患者各脏器功能情况,积极处理合并症;严格掌握手术适应证,制定合理的手术方式、手术流程;术中需掌握各种手术技巧,注意加强心肌保护;术后积极处理各种并发症.结论:同期行冠脉旁路移植术和瓣膜置换或瓣膜成形术,重视并掌握围手术期的处理要点和注意事项,在提高该类手术病人的生存率上起关键作用,能有效提高病人术后生存质量、降低其死亡率.%Objective:To investigate the perioperative period treatments for patients underwent one-stage coronary artery bypass grafting and artificial heart valve repair or replacement in order to reduce the surgical perioperative morbidity and mortality.Methods:To search the related literature in the database of PubMed,Wanfang Data and CNKI in recent years,to sum up the appropriate perioperative treatments.Results:In the perioperative period treatments for patients underwent one-stage coronary artery bypass grafting and artificial heart valve repair or replacement,it has many critical factors,including organs' condition before operation,correct assessment for operative indications,rational operative plan,operative skills,myocardial preservation in operation and prophylaxis and treatment for operation complications.Conclusions:The operation effect of patients underwent one-stage coronary artery bypass grafting and artificial heart valve repair or replacement will be increased remarkably if we pay attention to above-mentioned perioperative period

  14. Observational Study on the Effect of Evidence-based Nursing for Patients with HBP and DM Underwent Electro-prostatectomy During the Periopera-tive Period%循证护理在合并HBP、DM患者前列腺电切围手术期护理效果的观察研究

    Institute of Scientific and Technical Information of China (English)

    陈惠洪; 詹陈菊; 林立姮; 林争艳; 郑燕华

    2015-01-01

    Objective To study the effect of evidence-based nursing for patients with high blood pressure(HBP) and diabetes melli-tus(DM) underwent electro-prostatectomy during the perioperative period. Methods 60 cases with HBP and DM underwent elec-tro-prostatectomy in our hospital from March 2012 to March 2014 were selected and randomly divided into the control group and the observation group with 30 cases in each. The control group was treated by the traditional nursing mode, while the observation group was treated by the evidence-based nursing mode. The patient satisfaction, length of stay, recovery of spontaneous urination time, total cost of hospitalization, incidence of complications, quality of life (QOL) scores before and after nursing, International Prostate Symptom Score (IPSS) and control of HBP and DM were compared between the two groups. Results The study found the difference in the incidence of complications was not statistically significant between two groups, P>0.05. After intervention, com-pared with the control group, the observation group had shorter length of stay, P0.05. Conclusion For patients with HBP and DM underwent electro-prostatectomy, evidence-based nursing has bet-ter effect, which can significantly control the HBP and DM, improve the quality of life, so it is worthy of wide application.%目的:探讨循证护理在合并高血压(High Blood Pressure, HBP)、糖尿病(Diabetes Mellitus, DM)患者前列腺电切围手术期的护理效果。方法随机选取2012年3月-2014年3月该院经行前列腺电切术治疗且合并有HBP、DM的患者60例,将其随机分成对照组及观察组各30例,分别采用传统护理模式及循证护理模式经行护理,后将两组患者的满意率、住院时间、恢复自主排尿时间、住院总费用、并发症发生率以及护理前后生活质量评分(QOL)及前列腺症状评分(IPSS)和HBP、DM的控制情况进行比较。结果研究发现虽然两组并发症发生

  15. 糖尿病肾病与慢性肾小球肾炎血液透析患者血钙、磷及甲状旁腺激素水平比较%Comparison of calcium, phosphorus, and PTH levels in patients with diabetic nephropathy and chronic glomerulo-nephritis underwent hemodialysis

    Institute of Scientific and Technical Information of China (English)

    潘锐

    2015-01-01

    目的:评估并分析糖尿病肾病及慢性肾小球肾炎血液透析患者血钙、血磷及甲状旁腺激素水平。方法选择2012年2月至2014年6月于洛阳市第一中医院进行血液透析治疗的患者90例,其中糖尿病肾病患者39例,慢性肾小球肾炎患者51例,分别观察分析其血钙、血磷、甲状旁腺素水平及甲状旁腺素达标率。结果糖尿病肾病患者与慢性肾小球肾炎患者血钙水平比较差异未见统计学意义(P >0.05);糖尿病患者血磷水平低于慢性肾小球肾炎患者,甲状旁腺激素水平低于慢性肾小球肾炎,甲状旁腺素水平达标率高于慢性肾小球肾炎,差异均有统计学意义(P 0. 05); The serum phosphorus and PTH levels in patients with diabetes were lower than those of patients with chronic glomerulonephritis (P < 0. 05), and the PTH standard-reaching rate was higher in patients with diabetic nephropathy, all of the differences were significant (P < 0. 05). Conclusions The serum phosphor-us and PTH levels are lower and PTH standard-reaching rate is higher in patients with diabetic nephropathy than that of pa-tients with chronic glomerulonephritis, and therefore individualized treatment should be adopted according to different cau-ses to patients underwent hemodialysis, and closely monitoring their electrolytes and related hormone levels.

  16. Resultado funcional e índice macular em portadores de buraco macular submetidos à cirurgia com remoção da membrana limitante interna Functional outcome and macular index in macular hole patients who underwent surgery with internal limiting membrane removal

    Directory of Open Access Journals (Sweden)

    José Ricardo Diniz

    2008-04-01

    Full Text Available OBJETIVOS: Avaliar o resultado funcional e o índice macular dos portadores de buraco macular submetidos à cirurgia com remoção da membrana limitante interna. MÉTODOS: Quinze olhos de 15 pacientes com buraco macular estágios 2, 3 e 4 foram incluídos no estudo. Todos foram submetidos à cirurgia de buraco macular convencional com remoção da membrana limitante interna corada pelo azul de tripan. Melhor acuidade visual com correção e cortes transversais medidos por tomografia de coerência óptica (OCT foram avaliados no pré- e pós-operatório. O índice macular (razão entre a altura e base do buraco macular foi calculado e correlacionado com o diâmetro mínimo do buraco macular e o ganho de acuidade visual pós-operatória. RESULTADOS: Obteve-se fechamento do buraco macular em todos pacientes operados. Em 86,7%, houve ganho de pelo menos três linhas de visão. O índice macular demonstrou correlação negativa significante com o diâmetro mínimo (r=0,811. Não foi observada correlação significante entre o índice macular e o ganho de acuidade visual pós-operatória (r=0,351. CONCLUSÃO: Os resultados funcionais na cirurgia do buraco macular com remoção da membrana limitante interna foram bons neste grupo de pacientes. O índice macular demonstrou ser compatível com a configuração espacial do buraco macular, porém não foi preditor de resultados visuais.PURPOSE: To evaluate the functional outcome and macular index in patients with macular hole who underwent surgery with internal limiting membrane removal. METHODS: Fifteen eyes of 15 patients with idiopathic macular hole stages 2, 3 or 4 were enrolled in this study. All patients underwent conventional macular hole surgery with trypan blue staining to remove the internal limiting membrane. The best-corrected visual acuity and cross-sectional images of macular hole measured by optical coherence tomography (OCT were evaluated pre- and postoperatively. The macular hole index

  17. Análise da evolução tardia de 291 pacientes submetidos a substituição valvar por próteses metálicas Late follow-up of 291 patients who underwent heart valve replacement with mechanical valves

    Directory of Open Access Journals (Sweden)

    Carlos M. A Brandão

    1995-03-01

    Full Text Available No período de janeiro de 1980 a dezembro de 1993, 291 pacientes foram submetidos a substituição valvar por próteses metálicas, no Instituto do Coração do HCFMUSP. Cento e oitenta e sete (64,3% pacientes eram do sexo masculino, com idade variando de 2 meses a 78 anos (média de 38,3 +/-18,5. A etiologia das lesões foi reumática em 132 (45,4% pacientes. Foram realizadas 201 substituições da valva aórtica, 77 da valva mitral, 15 duplas substituições mitro-aórticas, 2 substituições da valva tricúspide, 1 dupla substituição mitro-tricuspídea e 1 tríplice substituição mitro-aórtico-tricuspídea, totalizando 315 substituições valvares. Cirurgias associadas foram realizadas em 164 (56,4% pacientes, sendo a mais freqüente a correção de aneurisma de aorta ascendente em 49 (16,8% pacientes Cento e quarenta e um (48,4% pacientes foram submetidos anteriormente a cirurgias valvares. Os pacientes foram avaliados clinicamente no pós-operatório tardio, segundo a classe funcional (NYHA e o aparecimento de complicações relacionadas às próteses e à anticoagulação. A mortalidade imediata foi de 36 (12,4% pacientes. Foram estudados 159 pacientes no pós-operatório tardio, com um tempo médio de evolução de 40,6 meses (10078 meses/paciente. As taxas linearizadas para tromboembolismo, hemorragia relacionada à anticoagulação, óbito tardio, endocardite, escape paravalvar e hemólise no pós-operatório tardio foram, respectivamente, 1,33%, 0,95%, 1,9%, 0,19%, 0,57% e 0,57% pacientes/ano. A curva actuarial de sobrevida em 14 anos é de 63,8%. Oitenta e dois porcento dos pacientes encontram-se em classe funcional I no pós-operatório tardio. Podemos concluir que os nossos resultados foram bastante satisfatórios com a utilização de próteses metálicas.Between January 1980 and December 1993, 291 patients underwent valve replacement with mechanical valves in the Heart Institute of HCFMUSP. One hundred and eighty seven (64

  18. Patient satisfaction and functional status after aseptic versus septic revision total knee arthroplasty using the PROSTALAC articulating spacer.

    Science.gov (United States)

    Meek, R M Dominic; Dunlop, David; Garbuz, Donald S; McGraw, Robert; Greidanus, Nelson V; Masri, Bassam A

    2004-10-01

    This study compared the functional results of an articulating antibiotic spacer for 2-stage revision knee arthroplasty for infection, to the functional results of aseptic revision. One hundred twenty-five patients who underwent revision of total knee arthroplasty for infection and aseptic loosening were identified. All of the patients with infection were treated with the PROSTALAC system (DePuy). At a minimum 2-year follow-up, WOMAC, Oxford-12, SF-12, patient satisfaction data, Harris Hip Score knee scores, and range of motion were assessed. The 2 cohorts (4 deaths in total, leaving 54 septic, 57 aseptic) were equivalent for age, gender, and comorbidity scores. At a mean of 41 months, none of the outcomes were significantly worse for the septic group, which had 2 recurrences of infection (4%). The satisfactory functional results of the PROSTALAC system may be related to the design features.

  19. 前列腺穿刺活检患者血清高敏C反应蛋白与Gleason评分的相关性%Relationship of serum high sensitive C-reactive protein and Gleason score in patients underwent prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    莫晓东; 李纲; 孙军; 张学锋; 唐敬; 浦金贤; 侯建全; 温端改

    2013-01-01

    目的 探讨前列腺癌(PCa)和前列腺增生(BPH)患者血清高敏C反应蛋白(hs-CRP)与Gleason评分的关系.方法 分析261例经直肠前列腺穿刺活检患者病理诊断为PCa和BPH患者血清hs-CRP的差异,比较PCa患者hs-CRP增高和正常者高危性(Gleason评分≥7分)PCa患病率,运用Logistic回归分析hs-CRP、前列腺特异性抗原(tPSA)、前列腺特异性抗原密度(PSAD)、前列腺总体积(TPV)和年龄等因素对高危性PCa患病率的影响.结果 PCa患者血清hs-CRP的中位数为3.57 mg/L,明显高于BPH患者的1.20 mg/L(P<0.05).在高危性PCa中hs-CRP为5.05mg/L,明显高于低危性PCa中的0.75 mg/L(P<0.05).PCa患者hs-CRP>3 mg/L组高危性PCa患病率为94.23% (49/52),明显高于hs-CRP≤3 mg/L组高危性PCa患病率59.45% (22/37)(P<0.05).hs-CRP影响高危性PCa患病率的优势比(OR)为1.618(P<0.05).结论 hs-CRP升高明显增加前列腺穿刺活检患者高危性PCa检出率;hs-CRP是影响高危性PCa患病率的独立因素.%Objective To investigate the correlation between serum high sensitive C-reactive protein(hs-CRP) and Gleason score of prostate cancer (PCa) in patients undewent prostate biopsy. Methods A total of 261 consecutive patients underwent prostate biopsy. The difference of serum hs-CRP between the patients with pathologically diagnosed prostate cancer(PCa) and those with benign prostate hyperplasia (BPH) were analyzed. In the patients with PCa, the morbidity of PCa was compared between the patients with high hs-CRP and those with normal hs-CRP but Gleason score≥ 7. The effects of factors such as hs-CRP, tPSA, prostate volume and age on the morbidity of PCa were analyzed. Results The mean serum hs-CRP was higher in PCa patients than that in BPH cases(3. 57 mg/L vs. 1. 20 mg/L)(P3 mg/L, which was higher than 59. 45% in those with nomal hs-CRP(≤3 mg/L)(P<0. 05). The odds ratio of hs-CRP in diagnosing Gleason score≥7 was 1. 618(P<0. 05). Conclusions An elevated serum

  20. Epidural anesthesia combined with remifentanil and propofol intravenous injection in 15 patients underwent Da Vinci robotic radical resection of esophageal cancer%硬膜外阻滞复合全身静脉麻醉应用于15例达芬奇手术机器人食管癌根治术的麻醉体会

    Institute of Scientific and Technical Information of China (English)

    陈浩飞; 李伟彦

    2012-01-01

    Objective: To summarize the epidural anesthesia combined with remifentanil and propofol intravenous injection, in the Da Vinci surgical robot assisted radical resection of esophageal cancer. Methods : Fifteen patients underwent selective robotic radical resection of esophageal cancer. All the patients were generally anesthetized using epidural anesthesia combined with remifentanil and propofol intravenous injection. The patients were intubated with double lumen endobronchial tube after anesthesia induction following epidural puncture, and underwent one-lung ventilation during intrathoracic operation. The blood gas, respiratory and hemodynamics parameters were monitored throughout the whole procedure. Results : All the 15 patients passed through the robotic surgery, and there was no conversion of thoracotomy occurred. The mean PaO2 and PaCO2 after anesthesia induction were (202.4±55.3) mmHg and (37.8±4.1) mmHg, and the mean PaO2 and PaCO2 30 minutes after one lung ventilation were (113.2±33.3) mmHg and (44.4±3.1) mmHg respectively. The anesthesia, operative and carbon dioxide pneumothorax duration were (245.4±40.7) min, (228.3±41.1) min and (210.3±33.1) min respectively. All the patients had (28.1±7.7) mmHg of blood pressure drop when the thorax was inflated with carbon dioxide, which was rectified by fast colloid injection and vasoactive agents. The patient-controlled epidural analgesia was applied and the patients were then transferred to PACU with single lumen intubation. Conclusion: Except that fast-track anesthesia can maintain adequately deep anesthesia and stable hemodynamics, and thus lessen surgical related stress and palliate postoperative pain, fast-track anesthesia can accelerate postoperative consciousness and muscular tension recovery, which may facilitate early extubation. As an important component of fast tract surgery, fast-track anesthesia is safe and reliable during the procedure the robotic surgery.%目的:总结硬膜外阻滞复合全

  1. 前列腺素E1降低心脏瓣膜置换术患者心肌细胞NF-κB活性及血浆TNF-α水平%Effects of prostaglandin E1 on the levels of myocardium NF-κB and plasma TNF-α in patients underwent heart valve replacement

    Institute of Scientific and Technical Information of China (English)

    张文斌; 朱成均; 石泉; 赵振海

    2015-01-01

    目的:评价前列腺素E1(PGE1)对心脏瓣膜置换术患者心肌细胞核转录因子κB(NF‐κB)活性和血浆肿瘤坏死因子α(T N F‐α)水平的影响。方法择期行体外循环下心脏瓣膜置换术的患者40例,年龄32~67岁,体质量指数17~28 kg/m2,美国麻醉师协会(ASA)分级Ⅱ或Ⅲ级,纽约心脏病协会(NYHA)分级Ⅱ或Ⅲ级。采用随机数字表法,将患者分为2组(n=20):对照组(C组)和PGE1组(P组)。麻醉诱导后P组静脉输注PGE120 ng · kg -1· min-1,至手术结束,C组给予等容量生理盐水。于体外循环前(T0,基础值)、体外循环开始后30 min(T1)、体外循环结束时(T2)、体外循环结束后12 h(T3)、体外循环结束后24 h(T4)抽取动脉血,检测血浆TNF‐α水平;于T0和T2时取右心耳组织,观察组织病理学变化,并用蛋白免疫印迹法(Western blot)检测NF‐κB活性。结果与C组比较,P组T1~T4时血浆 TNF‐α水平下降(P<0.05),T2时心肌病理学损伤明显减轻,心肌细胞NF‐κB活性下降(P<0.05)。结论 PGE1可减轻心脏瓣膜置换术患者心肌损伤,其机制与抑制心肌细胞NF‐κB活性,减少血浆TNF‐α水平有关。%Objective To investigate the effects of prostaglandin E1 (PGE1) on the levels of myocardium nuclear factor‐κB (NF‐κB) and plasma tumor necrosis factor‐α (TNF‐α) in patients underwent heart valve replacement .Methods Forty ASA Ⅱ orⅢ degree patients (NYHA Ⅱ or Ⅲ degree) ,aged 32 to 67 years with body mass index of 17 to 28 kg/m2 ,underwent heart valve replacement ,were randomly divided into 2 groups (n=20):control group (group C) and PGE1 group (group P) .After induction of anesthesia ,PGE1 20 ng · kg -1 · min-1 was infused intravenously in group P ,while the equivalent volume of normal saline was giv‐en in group C ,and the infusion was completed at the end of

  2. Preoperative embolization of the splenic artery in patients that underwent splenectomy for immune thrombocytopenic purpura Embolização pré-operatória da artéria esplênica em pacientes submetidos à esplenectomia por púrpura trombocitopênica immune

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    PlínioCarlos Baú

    2007-12-01

    Full Text Available Transfusion of platelets, red blood cells, or both is usually necessary immediately after splenic artery ligature in patients with immune thrombocytopenic purpura who undergo splenectomy. PURPOSE: To investigate whether preoperative embolization of the splenic artery reduced the need for transfusion of platelets, red blood cells, or both. METHODS: Twenty- seven consecutive patients that underwent splenectomy for purpura between October 1999 and March 2006 performed by the same surgical team were enrolled. The first 17 patients did not undergo embolization and were compared with the next 10 patients, who composed the embolization group. RESULTS: The platelet count in the embolization group rose from a mean 7000 u/µl before to 75000 u/µl after the procedure. There was no need for platelet or red blood cell transfusion in the embolization group; in the group without preoperative embolization, 11 patients (p=0.001 required platelet transfusion and 8 (p=0.01, red blood cell transfusion. CONCLUSION: Embolization of the splenic artery before splenectomy is a safe method to avoid blood transfusions in patients with ITP.A transfusão de plaquetas e ou hemácias geralmente é realizada em pacientes submetidos a esplenectomia por Purpura Trombocitopênia Imune (PTI. OBJETIVO: Investigar se a embolização pré-operatória da artéria esplênica é eficaz na redução da necessidade de transfusão de hemácias ou plaquetas. MÉTODOS: Vinte e sete pacientes foram submetidos a esplenectomia por PTI de Outubro de 1999 a Março de 2006 pela mesma equipe cirúrgica. Os primeiros 17 pacientes não foram submetidos a embolização e foram comparados com os outros 10 individuos nos quais a embolização foi realizada. RESULTADOS: A contagem de plaquetas no grupo em que a embolização foi realizada subiu de uma média de 7000u/µl antes do procedimento, para 75000 u/µl após. Não foi necessário transfundir plaquetas ou glóbulos vermelhos no grupo submetido a

  3. Effect of Glutaimne on Immunologic Function and Gastrointestinal Reactions in Advanced Gastric Cancer Patients Underwent Chemotherapy%谷氨酰胺对晚期胃癌患者化疗期间免疫功能及胃肠道反应的影响

    Institute of Scientific and Technical Information of China (English)

    王晓青; 王大中

    2014-01-01

    目的:观察添加谷氨酰胺对晚期胃癌患者化疗期间免疫功能的影响及胃肠道不良反应的预防效果。方法选取51例晚期胃癌患者为研究对象,按照随机数字法分为观察组( n=25)和对照组( n=26)。2组患者均接受奥沙利铂+卡培他滨( XELOX)方案化疗,并给予肠外营养。观察组在肠外营养中添加谷氨酰胺。比较2组患者临床疗效,化疗期间免疫功能的变化、化疗计划完成率及不良反应发生率。结果计划化疗周期完成率对照组为76.9%(20/26);观察组为96.0%(24/25),2组差异有统计学意义(P<0.05)。观察组CR、PR稍高于对照组,但无明显差异(P>0.05)。2组患者肠外营养前 IgG、IgM、IgA 无显著差异,营养7 d后,观察组IgG、IgM、IgA 高于对照组,具有统计学意义( P<0.05)。观察组Ⅲ、Ⅳ级口腔黏膜炎、恶心呕吐、腹痛腹泻发生率显著低于对照组(P<0.05)。结论胃癌晚期患者化疗期间在肠外营养中添加谷氨酰胺,可降低胃肠道反应、改善免疫功能,提高化疗完成率。%Objective To observe the effect of Glutaimne ( Gln) on immunologic function and gastrointestinal reactions in advanced gastric cancer patients underwent chemotherapy .Methods 51 patients with locally advanced gastric cancer were se-lected and divided into the observation group (n=25) and the control group (n=26)randomly.All patients received XELOX chemotherapy .The control group received routine parenteral nutrition and the observation group received parenteral nutrition sup -plemented with Gln .The short-term efficacy ,life quality and side effects were observed during treatment .Results Chemotherapy completion rates of the observation group and the control group were 96.0%and 76.9%,respectively,and the difference had sta-tistical significance(P0.05).The level of IgG,IgM,IgA in the observation group were higher than those

  4. ClassicTM喉罩用于老年患者腰-硬联合阻滞术中镇静的临床研究%CLINICAL RESEARCH ON THE APPLICATION OF LARYNGEAL MASK IN ELDERLY PATIENTS UNDERWENT EPIDURAL-SPINAL ANESTHESIA FOR INTRAOPERATIVE SEDATION

    Institute of Scientific and Technical Information of China (English)

    黄泽波; 罗文报

    2011-01-01

    [目的]评估ClassicTM喉罩(LMA)用于老年患者腰-硬联合阻滞未中镇静的临床效果与可行性.[方法]选择在腰-硬联合阻滞下行下腹部或下肢手术的老年患者40例,年龄60~80岁,其中男22例,女18例,随机分为2组.两组患者蛛网膜下腔均给以0.5%布比卡因重比重混合液2.5 ml.首次静脉注射丙泊酚l mg,kg-1后以10 μg·kg-1,min-1速度持续泵注镇静.面罩组(M组)使用密闭面罩吸氧;喉罩组(LMA组)使用ClassicTM LMA连接麻醉机开放模式吸氧.监测并记录两组患者未前、术中呼吸,循环及动脉血气情况.[结果]LMA组术中SpO2均值为(99.3±1.1)%,出现SpO2< 95%共计2例,面M组相应分别为(97.7±1.6)%,13例,差异有统计学意义(P<0.05).LMA组辅助通气次数以及术中舌后坠例数与M组差异有统计学意义(P<0.05).术中lMA组的pH,PO2,PC02与M组差异有统计学意义(P<0.05).[结论]ClassicTM喉罩用于老年患者腰-硬联合阻滞下术中镇静,利于保持呼吸循环平稳,且安全可行.%[Objective] To evaluate the effect of laryngeal mask in elderly patients underwent epidural-spinal anesthesia for intraoperative sedation. [Methods] 40 ASA II-III patients undergoing selected bythus or lower extremity surgery were divided into 2 groups randomly. After the infusion of 0.5% bupivacaine mixture of heavy specific gravity of 2.5 ml were injected into subarachnoid space. Patients of group facemask (Group M,) inspired oxygen 3L·min-1) through facemasks of anaesthesia apparatuses, after propofol lmg·kg-1 were injected and assisted ventilati·n for 1 min, continuous infusion rate of propofol was l0μg·kg-1·min-1. Patients in group Laryngeal Mask Airway (Croup LMA,) were inserted Classic LMA in digital technique after propofol lmg·kg-1 were injected, and inspired oxygen (3L·mkr-1) through LMA that connected anaesthesia apparatuses. Group LMA were assisted ventilation for 1 min, and continuous infusion rate of

  5. Efecto de la localización del electrodo ventricular derecho (tracto de salida vs. ápex sobre la sincronía ventricular mecánica, en pacientes sometidos a terapia de implante de marcapaso cardiaco Effect of right ventricular electrode location (outflow tract vs. apex on mechanical ventricular synchrony in patients that underwent pacemaker implant therapy

    Directory of Open Access Journals (Sweden)

    Oscar S Rincón

    2008-12-01

    Full Text Available Objetivo: evaluar a profundidad el efecto de la estimulación ventricular desde el tracto de salida del ventrículo derecho y el ápex, sobre la sincronía ventricular mecánica. Materiales y métodos: estudio analítico de cohorte, en el que se realizó ecocardiograma transtorácico pre y post implante de marcapaso a 20 pacientes (diez por cada grupo con indicación de marcapaso definitivo, con implante del electrodo en el tracto de salida del ventrículo derecho y el ápex, sin cardiopatía estructural, fracción de eyección > 50%; QRS y conducción aurículo-ventricular normal, con el fin de evaluar la asincronía ventricular mecánica (modo M y Doppler tisular y los parámetros de implante y programación del dispositivo. Análisis estadístico: los resultados se presentan como promedios, desviación estándar o porcentajes. Las variables continuas se compararon utilizando prueba Chi cuadrado y ANOVA. Se consideró como estadísticamente significativa una p Objective: to assess in depth the effect of ventricular stimulation from the right ventricular outflow tract and the apex on mechanical ventricular synchrony. Materials and Methods: cohort analytical study. 20 patients with indication of definitive pacemaker indication underwent transthoracic echocardiogram before and after pacemaker implant with electrode implantation in the right ventricular outflow tract and in the apex (10 patients in each group. There was no structural cardiopathy, ejection fraction was > 50%, QRS and AV conduction were normal. Mechanical ventricular asynchrony (M mode and tissue doppler and implant and device parameters were evaluated. Statistical Analysis: results are given as mean values, standard deviation or percentages. Continuous variables were compared using Chi-square test and ANOVA. A p <0.05 value was considered statistically significant. Results: in five patients (25% a pre-implant ventricular asynchrony was found; in seven (70% ventricular asynchrony

  6. 慢性阻塞性肺疾病急性加重期伴呼衰患者有创机械通气撤机拔管的影响因素%Influence Factors of Withdraw Machine and Extubation in AECOPD and Serious Respiratory Failure Patients Who Underwent Invasive Mechanical Ventilation

    Institute of Scientific and Technical Information of China (English)

    陈红菊

    2016-01-01

    目的:探讨慢性阻塞性肺疾病急性加重期(AECOPD)伴重度呼吸衰竭(呼衰)患者有创机械通气成功撤机拔管的影响因素。方法:回顾性分析2013年1月-2015年6月本院ICU收治的100例接受有创机械通气的AECOPD伴重度呼吸衰竭患者的临床资料,其中成功撤机拔管患者作为有效组,撤机拔管失败和死亡患者作为无效组。对成功撤机拔管影响因素进行单因素分析,采用多因素Logistic回归分析进行独立影响因素分析。结果:单因素分析结果显示:有效组年龄,插管前血红蛋白,插管后血浆白细胞计数、中性粒细胞比率、血红蛋白、白蛋白、C反应蛋白水平,通气时间及器官功能障碍综合征方面均优于无效组,比较差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示:年龄、插管前HGB、插管后中性粒细胞比率及白蛋白水平、多脏器功能衰竭、机械通气时间为成功撤机拔管的独立影响因素(P<0.05)。结论:机械通气是AECOPD伴严重呼衰的有效救治措施,成功撤机拔管的影响因素较多,积极干预影响因素对提高撤机拔管率具有重要临床意义。%Objective:To investigate the influence factors of successful withdraw machine and extubation in acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and serious respiratory failure patients who underwent invasive mechanical ventilation.Method:The clinical data of 100 cases of AECOPD and serious respiratory failure patients who underwent invasive mechanical ventilation in our hospital from January 2013 to June 2015 were retrospectively analyzed.Patients who successful withdrew machine and extubation were selected as the effective group,patients who were failure to withdraw machine and extubation and death were selected as the invalid group.The single factor analysis was used to analyze the influencing factors of successful withdraw

  7. Effects of the different temperatures rinse solution on rehabilitation of patients underwent transurethral resection of prostate%不同温度冲洗液对经尿道前列腺汽化电切病人的康复影响

    Institute of Scientific and Technical Information of China (English)

    彭顺秀; 郑洁; 欧红桃; 李莉; 马晓华

    2009-01-01

    目的 探讨术后不同温度冲洗液对经尿道前列腺汽化电切病人康复的影响,选择最佳的术后冲洗液温度.方法 将150例病人随机分为5组,每组30例,每组冲洗液温度分别为25℃、28℃、31℃、34℃、37℃.对各组病人体温、膀胱痉挛发生的频率、冲洗前后血红蛋白浓度、病人术后平均住院时间进行对比.结果 随着冲洗液温度的升高,低体温、膀胱痉挛发生率逐渐下降;34℃组平均住院时间短于25 ℃、28 ℃、31 ℃组,差异有统计学意义(P<0.05);34 ℃组冲洗前后血红蛋白浓度差值与其他各组相比有统计学意义(P<0.05).结论 经尿道前列腺汽化电切术后应用34 ℃膀胱冲洗液是最佳选择.%Objective To analyze effects of different temperatures of postoperative rinse solution on rehabilitation of patients underwent transurethral resection of prostate (TURP), and to select the optimal temperature of postoperative rinse solution. Methods A total of 150 cases were divided into 5 groups at random,30 cases per group. Temperatures of postoperative rinse solution of each group were 25 ℃, 28 ℃, 31 ℃, 34 ℃, 37 ℃ separately, then body temperature, incidence rate of cyst spasm , the difference of HB concentration between pre-rinse and post-rinse,and average stay postoperatively of each group were contrasted. Results Incidence rate of low body temperature and cyst spasm fall off gradually with increase of temperature of rinse solution; average stay of the group( 34 ℃ ) was shorter than the groups( 25 ℃ ,28 ℃ ,31 ℃ ), which had statistical significance( P < 0.05 ) ; Compared with the other groups, the difference of HB concentration between pre-rinse and post-rinse of the group (34 ℃ ) had statistical significance( P < 0.05 ). Conclusions The optimal temperature of postoperative rinse solution is 34 ℃.

  8. Efficacy Observation and Pharmacokinetic Study of Dexmedetomidine Combined with Propofol for Sepsis In-fection Deliration in Patients Underwent Continuous Intravenous Blood Replacement%右美托咪啶联合丙泊酚治疗连续静脉血液置换患者脓毒症感染谵妄的效果观察及药动学研究

    Institute of Scientific and Technical Information of China (English)

    李根区; 李东; 郭学军

    2015-01-01

    目的:观察右美托咪啶联合丙泊酚用于连续静脉血液置换患者脓毒症感染谵妄的效果,并进行药动学研究.方法:选择连续静脉血液置换脓毒症感染谵妄患者60例,随机分为观察组和对照组各30例.对照组患者给予丙泊酚0.5 mg/kg,观察组患者给予右美托咪啶+丙泊酚.对比分析两组患者的疗效,并研究丙泊酚的药动学参数.结果:观察组丙泊酚的药动学参数消除半衰期(t1/2β)、缓慢分布半衰期(t1/2α)等均短于文献参考值,差异具有统计学意义(P0.05).治疗后两组患者谵妄症评分表(ICDSC)评分较治疗前明显下降,差异有统计学意义(P0.05);观察组患者平均住院时间明显短于对照组,差异具有统计学意义(χ2=6.263 4,P=0.000);对照组患者的不良事件发生率显著高于观察组,差异具有统计学意义(P0.05). After treatment,ICDSC score of 2 groups were decreased significantly,with statistical significance(P0.05);the average hospital stay of observation group was significantly shorter than that of control group,with statistical signifi-cance(χ2=6.263 4,P=0.000);the incidence of ADR in control group was significantly higher than the observation group,with statistical significance(P<0.05). CONCLUSIONS:Dexmedetomidine combined with propofol have good effect on sepsis infec-tion deliration in patients underwent continuous intravenous blood replacement,and can reduce the length of hospital stay and the incidence of ADR.

  9. 营养护理对血液透析治疗终末期肾病患者营养不良及生活质量的影响%Effect of Nutritional Care on the Quality of Life in Patients with End-stage Renal Disease and Malnutrition Underwent Hemodialysis

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    李玉辉

    2015-01-01

    Objective To study the clinical effect of nutritional care on patients with end-stage renal disease underwent hemodialysis. Methods A study was carried out in 88 cases with end-stage renal disease admitted in our hospital. The patients were randomly divided into the observation group and the control group with 44 cases in each. The control group were treated by the usual care, and the observation group were given the nutritional care intervention based on the usual care. And the changes in nutritional status and quality of life after intervention were compared between the two groups. Results Two groups were given different nursing regimen. Compared with the control group, the observation group had better improvement in malnutrition, higher scores of physiological function, emotional function, cognitive function, social function, mental health and role function and the grand average, with statistically significant difference (P<0.05). Conclusion For end-stage renal disease patients, nutritional care can effectively improve the malnutrition and reduce the infection rate and enhance the prognosis and quality of life.%目的探讨终末期肾病行血液透析治疗患者给予营养护理措施的临床效果。方法整群选取该院收治的88例终末期肾病患者展开研究,随机将其分为观察组和对照组,每组44例;对照组行常规护理措施,观察组在常规护理基础上行营养护理干预措施,观察观察组与对照组预后的营养状况及生活质量变化情况。结果两组患者给予不同的护理方案,观察组营养不良改善效果优于对照组,且观察组患者的生理职能评分、情绪职能评分、认知职能评分、社会职能评分、心理健康评分、角色职能评分及总评均比对照组高,差异有统计学意义(P<0.05)。结论终末期肾病患者行营养护理措施能有效改善患者存在的营养不良情况,降低感染率,从而提升患者预后生活质量。

  10. Outcomes of Bariatric Surgery in Morbidly Obese Patients with Multiple Sclerosis

    Science.gov (United States)

    Jammoul, Adham; Aminian, Ali; Shimizu, Hideharu; Fisher, Carolyn J.; Schauer, Philip R.; Rae-Grant, Alexander; Brethauer, Stacy A.

    2017-01-01

    Obesity is common in patients with multiple sclerosis (MS); however, safety and efficacy of bariatric surgery in this population remain unclear. A database of 2,918 was retrospectively reviewed, yielding 22 (0.75%) severely obese patients with MS who underwent bariatric surgery. Sixteen surgical patients with complete follow-up data were matched to a nonsurgical control group of MS patients, based on age, BMI, MS subtype, and length of follow-up. MS relapse rates and trends in the timed twenty-five foot walk test (T25FW) were compared. In the surgical group (gastric bypass n = 19, sleeve gastrectomy n = 3), preoperative BMI was 46.5 ± 7.2 Kg/m2 and average excess weight was 60.4 kg. Follow-up data was collected at 59.0 ± 29.8 months. There were two major and four minor complications. Five patients required readmission and there were no mortalities. Percent excess weight loss was 75.5 ± 27.0%. In the 16 patients with follow-up data, patients who underwent bariatric surgery were significantly faster on the T25FW compared to the nonsurgical population. In conclusion, bariatric surgery is relatively safe and effective in achieving weight loss in patients with MS. In addition, surgery may help patients maintain ambulation. Findings support the need for further studies on bariatric surgery and disease-specific outcomes in this population. PMID:28299203

  11. High-flux dialysis vs low-flux dialysis in the treatment of restless legs syndrome in uremic patients underwent maintenance hemodialysis%高通量透析与低通量透析治疗尿毒症患者不安腿症状的疗效比较

    Institute of Scientific and Technical Information of China (English)

    张宇; 龙刚; 张敏; 周玟

    2013-01-01

    目的 观察高通量透析与低通量透析方法改善接受维持性血液透析治疗者不安腿症状的疗效.方法 纳入于2011年1月至2011年12月在我院门诊规律接受接受维持性血液透析且伴有不安腿症状的72例尿毒症患者,采用数字表法随机分为高通量透析组及低通量透析组,各36例,分别接受高通量透析及低通量透析,共1年.比较透析前后血尿素氮、肌酐、钙、磷、β2微球蛋白及甲状旁腺素变化,计算溶质清除率和尿素清除指数(Kt/V比值),通过问卷调查评估不安腿症状缓解率.结果 透析后,高通量透析组和低通量透析组血尿素氮、肌酐、Kt/V比值差异无统计学意义(均P>0.05);高通量透析组甲状旁腺素显著低于低通量透析组[(26±19)vs(45±20)pmol/L,P<0.05],不安腿症状缓解率明显高于低通量透析组[75.0% vs 16.7%,P<0.05].结论 高通量透析在清除中大分子毒素、纠正钙磷代谢紊乱、减轻不安腿症状、改善患者营养状态方面明显优于低通量透析.%Objective To compare the effects of high-flux dialysis vs low-flux dialysis on restless leg syndrome among patients underwent maintenance hemodialysis.Methods Seventy-two uremic patients with restless legs syndrome were randomly assigned to the high-flux dialysis (HFD) group and the conventional hemodialysis (CHD) group.All the patients were follow-up for 1 year.Blood urea nitrogen (BUN),creatinine,calcium,phosphate,β2-microglobulin and parathyroid hormone (PTH) were tested,and solute clearance rate and Kt/V value were calculated.Results There was no significant difference between the two groups in the decrease of BUN and creatinine (P > 0.05).The decrease of phosphate in the HFD group was higher than that in the CHD group (31.50% ± 12.95% vs 21.48% ± 9.57%,P < 0.05).The decreases of β2-microglobulin in the HFD group were higher than that in the CHD group (34.25% ± 15.17% vs 1.58% ± 4.36

  12. Efficacy of preoperative biliary tract decompression in patients with obstructive jaundice.

    Science.gov (United States)

    Gundry, S R; Strodel, W E; Knol, J A; Eckhauser, F E; Thompson, N W

    1984-06-01

    Fifty consecutive matched patients with benign or malignant biliary tract obstruction were compared to determine the efficacy of preoperative percutaneous biliary drainage (PBD). Twenty-five patients underwent PBD for an average of nine days before operation; 25 patients underwent percutaneous transhepatic cholangiography ( PTHC ) followed immediately by operation. Serum bilirubin levels before PTHC were 16.5 +/- 7.6 mg/dL and 14.9 +/- 7.6 mg/dL in PBD and non-PBD groups, respectively. Serum bilirubin levels decreased to 6.5 +/- 6.2 mg/dL preoperatively in patients having PBD. One week after operation, bilirubin levels were 4.2 +/- 4.3 mg/dL and 9.0 +/- 5.2 mg/dL in the PBD and non-PBD groups, respectively. Major morbidity (sepsis, abscess, renal failure, or bleeding) occurred in two patients (8%) having PBD and in 13 patients (52%) without PBD. One patient (4%) with PBD, and five patients (20%) without PBD, died. The mean hospital stay was shorter for the PBD group. Preoperative PBD reduces operative mortality and morbidity and results in a more rapid resolution of hyperbilirubinemia during the postoperative period.

  13. Effect of Kidney-qi-tonifying Pills on the Endometriosis Patients with Infertility Who Underwent Laparoscopy%金匮肾气丸对子宫内膜异位症患者术后的促孕效果评价

    Institute of Scientific and Technical Information of China (English)

    邝爱华

    2015-01-01

    Objective To evaluate the effect of kidney‐qi‐tonifying pills on the endometriosis patients with in‐fertility who underwent laparoscopy.Methods Seventy endometriosis cases with infertility were randomly divided into observation group and control group.Both groups were given common treatment and the observation group was added kidney‐qi‐tonifying pills orally.Dysmenorrhea visual pain score (VAS) ,natural killer (NK) cells and macrophages (MF) and CA125 level of two groups were evaluated before and after the treatment.The pregnancy rate after treatment was compared between two groups.Results After treatment ,VAS and CA125 in two groups decreased significantly when compared with those before treatment (P<0.05).After treatment ,VAS and CA125 of observation group was significantly lower than that of control group (P<0.05).NK and MF in the two groups after treatment increased significantly when compared with those before treatment (P<0.05).NK and MF in ob‐servation group were significantly higher than those in control group (P< 0.05).After treatment ,there were 26 and 22 pregnant cases in observation group and control group with in 1 years ,accounted for 74.29% and 62.86% , respectively ,with significantly higher pregnancy rate in observation group than in control group (χ2 =9.657 ,P=9.657).Above pregnant 26 and 22 patients had 20 and 15 cases of full term birth ,with 76.92% and 68.18% term labor rate ,respectively ,and significantly higher term labor rate in observation group than in control group (χ2 =10.083 ,P=0.001).Conclusion Kidney‐qi‐tonifying pills can modulate immunity of infertile EM T patients with kidney Yang deficiency and has a certain effect on promoting gestation.%目的:评价金匮肾气丸联合腹腔镜治疗子宫内膜异位症(endometriosis,EMT)致不孕的肾阳虚患者的促孕效果。方法搜集EMT患者70例,随机分为观察组和对照组,2组均给予常规治疗,观察组加用

  14. [Clinical anatomy: anthropometry for nutritional assessment of 367 adults who underwent endoscopic gastrostomy].

    Science.gov (United States)

    Fonseca, Jorge; Santos, Carla Adriana

    2013-01-01

    Patients suffering from long standing dysphagia need tube feeding through gastrostomy. Nutritional assessment of these patients is challenging and must be supported on objective data, including anthropometric evaluation. The aim of this study was the evaluation of the usefulness of anthropometry for identifying and grading malnutrition, as part of the initial assessment of patients that underwent endoscopic gastrostomy. From the files of consecutive adults underwent gastrostomy we selected patients with anthropometric data obtained before the procedure: Body Mass Index, Mid Upper Arm Circumference, Triceps Skinfold Thickness and Mid Arm Muscle Circumference. Nutritional status was classified according with World Health Organization criteria for Body Mass Index, and for Mid Upper Arm Circumference, Triceps Skinfold Thickness and Mid Arm Muscle Circumference using comparison with Frisancho reference-tables. Were selected 367 patients (median of ages: 74.1 years): neurological disease: 172; head and neck cancer: 176; other diseases: 19. Body Mass Index identified 136 underweight and 231 eutrophic or overweight patients. Mid Upper Arm Circumference identified 310 malnourished and 57 eutrophic or overweight patients. Triceps Skinfold Thickness identified 301 malnourished and 66 eutrophic or overweight patients. Mid Arm Muscle Circumference identified 269 malnourished, 97 eutrophic and one with MAMC above normal. Anthropometry identified the malnourished endoscopic gastrostomy-patients, contributed for malnutrition grading and demonstrated the impact on muscle and fat reserves. Mid Upper Arm Circumference, Triceps Skinfold Thickness and Mid Arm Muscle Circumference identified malnutrition in nearly 80% of the patients, most clearly with fat tissue wasting than muscle. Easily accessible e inexpensive, anthropometry allowed personalized nutritional therapy. Anthropometry must be recognized as a fundamental tool for enteral feeding teams.

  15. The Incidence of Concomitant Precancerous Lesions in Cases Who Underwent Hysterectomy for Prolapse

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    Serdar Aydin

    2016-09-01

    Full Text Available Aim: The aim of the study was is to assess the incidence of unexpected gynecological cancers and pre-cancerous lesions following hysterectomy for pelvic organ prolapse to better understand the risks of uterine sparing surgery. Material and Method: This was a retrospective analysis of histopathology findings after hysterectomy for uterine prolapse surgery who underwent preoperative diagnostic work including cervical cytology, transvaginal ultrasonography and endometrial histopathological examination for a high risk group (Postmenopausal women with an endometrial thickness of %u22655 mm and premenopausal women with abnormal bleeding. Patients with a history of endometrial, cervical and/or adnexal precancerous or cancerous pathological conditions and with incomplete medical records were excluded.Results: Results were taken from 106 women who underwent hysterectomy. The abdominal route was used in 22 cases (21.7 %, the vaginal route in 82 patients (77.4 % and laparoscopic-assisted vaginal route in two (1.9 % women. Oophorectomy was performed in 35 (33 % cases. None of the patients had malignant histopathology specimens from hysterectomy. Total premalignant pathology incidence was 7.5 % (8/106. Six (5.7% patients had simple endometrial hyperplasia and 2 patients (1.9 % had cervical intraepithelial neoplasia. Discussion: The incidence of unexpected endometrial, cervical or ovarian malignancy among women who underwent hysterectomy after preoperative diagnostic workup including transvaginal ultrasonograhy, endometrial pathological examination to high risk cases was negligible. The inclusion of low risk endometrial and cervical precancerous lesions increased the incidences. Our results could provide precious data to extrapolate to similar populations with uterine prolapse who desire surgical correction sparing uterus.

  16. Analyze the effectiveness of modified maze procedure by irrigated radiofrequency ablation in the 144 patients with valvular heart disease and atrial fibrillation who underwent surgical operation%144例心脏瓣膜病合并心房颤动外科手术同期行单极冲洗射频消融改良迷宫术的疗效

    Institute of Scientific and Technical Information of China (English)

    王嬿; 胡大清

    2012-01-01

    目的 分析本院心脏瓣膜病伴发心房颤动(简称房颤)的患者外科手术同期行单极冲洗射频消融改良迷宫术MazeⅢ型手术疗效.方法 调查2007年11月至2010年8月收治的心脏瓣膜病合并房颤患者在心内直视手术下同期行单极冲洗射频消融改良迷宫术MazeⅢ型手术,观察随访6个月时的心律情况,根据节律分为窦性心律(简称窦律)组和非窦律组,分析影响术后转律的原因.结果 144例入选,2例安置永久起搏器,1例因瓣周漏而行二次手术.出院时窦律88例(61.11%),房颤39例(27.08%),随访6个月窦律88例(61.11%),房颤25例(17.36%).窦律组左房小于非窦律组,房颤时间短于非窦律组.左房内径≥6.5 cm者,可达龙的转复率高于非可达龙组(53.8% vs 28.6%,P<0.05).结论 心脏病伴发房颤的病人,在心脏外科手术中同期行单极冲洗射频消融改良迷宫术,对窦律的恢复仍不失为一种安全有效的方法.术前左房内径大小及房颤持续时间是房颤转复的主要危险因素,可达龙在一定程度上可提高大左房(≥6.5 cm)的转复成功率.%Objective To analyze the effectiveness of modified maze procedure by irrigated radiofrequeney ablation in the patients of valvular heart diseases with atriai fibrillation ( AF) who underwent open-heart surgery. Methods All the cases of valvular heart diseases with AF undergoing modified maze procedure by irrigated radioirequency ablation with concomitant open-heart surgery during November 2007 to August 2010 were investigated. All the patients were followed up for 6 months and divided into two groups:sinus-rhythm group and non-sinus-rhythm group according to the rhythm. Analyze the influencing factors of the rhythm. Results One hundred and forty-four cases were collected,2 cases were implanted permanent pacemakers,1 case was re-operated because of paravalvulur leak,88 cases were recorded sinus rhythm and 39 remained in AF when discharged from

  17. Laparoscopic Cholecystectomy of Patients with Cardiac Disease in Our Clinic; Retrospective Study

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    Ömer Faruk Şavluk

    2013-03-01

    Full Text Available Introduction: The application of laparoscopic cholecystectomy is investigated to effected on patients with cardiac surgery or examination of patients that were identified with cardiac problem.Patients and Methods: Between 2008-2010 total of 233 patients with laporoscopiccholecystectomy were retrospectively analyzed follow up papers. Systolic blood pressure, diastolic blood pressure, heart rate, X-rays and ECGs were evaluated in preoperative examination in all patients. ECG, SpO2 monitoring was performed to all patients in the operating room. In all patients systolic blood pressure, diastolic blood pressure, heart rate and SpO2 values before the operation and during the operation were recorded. End-tidal CO2 was monitored during the operation. Additional disease duration of surgery, duration of intubation, preoperative, perioperative and postoperative need to inotropic support were recorded. Results: One hundred and one (43% patients were men and 132 (57% female. Forty five of 233 patients with cardiac problems are sick. Twenty five patients of these patients had coronary bypass surgery and eight patients underwent prosthetic valve surgery. As a result of preoperative transthoracic echocardiography in 12 patients were diagnosed with valve insufficiency. Demographic characteristics were similar than between the two groups. The mean operation time, insuflation time, extubation time, staying hospital time and hemodynamic data were similar than between the two groups. Conclusion: Laparoscopic cholecystectomy safely and easily can apply for application of the balanced anesthesia, low-pressure pneumoperitoneum after being stable cardiac status in patients with cardiac problem.

  18. Clinical Analysis of Risk Factors for Recurrence in Patients with Chronic Subdural Hematoma Undergoing Burr Hole Trephination.

    Science.gov (United States)

    Jeong, Seong Il; Kim, Si On; Won, Yu Sam; Kwon, Young Joon; Choi, Chun Sik

    2014-04-01

    Chronic subdural hematoma (CSDH) is one of the most common types of intra-cranial hemorrhages usually associated with trauma. Surgical treatment is the treatment of choice and burr hole trephination (BHT) is widely performed. The recurrence rate in the patients with CSDH is 3.7-30%. This study investigated the risk factors associated with the recurrence of patients with CSDH who underwent BHT. One hundred twenty-five patients with CSDH underwent BHT. Eight of 125 patients (6.4%) underwent reoperation for recurrent CSDH. We retrospectively analyzed demographic, clinical and radiological findings, catheter tip location and drainage duration as the risk factors for the recurrence of CSDH. Recurrence of CSDH in the high- or mixed-density groups was significantly higher than those in the low- or iso-density groups (p<0.001). Placement of catheter tip at the temporoparietal area was associated with a significantly higher recurrence rate of CSDH than placement at the frontal area (p=0.006) and the brain re-expansion rate (BRR) was much lower than placement at the frontal area (p<0.001). The operation may be delayed in high- and mixed-density groups, unless severe symptoms or signs are present. In addition, placing the catheter tip at the frontal area helps to reduce the incidence of postoperative recurrence of CSDH and to increase the BRR.

  19. Clinical and pathological investigation of adnexal masses in adolescents who underwent surgery in a tertiary center

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    Hediye Dağdeviren

    2015-06-01

    Full Text Available Objective: Adnexal masses are the most common reason for gynecologic surgery in adolescent patients. Early detection and adequate management of adnexal lesions are very important for saving lives and preserving fertility. In this study, we analyzed the clinical characteristics of 106 Turkish adolescent women who underwent surgery for adnexal masses. Methods: The study included 106 patients aged ≤20 years that underwent surgery for adnexal masses at our hospital between January 2008 and December 2013. Clinical profiles were retrospectively collected from the hospital medical records. The records were analyzed for demographic profiles, initial symptoms, preoperative radiologic findings, operative approach, surgical procedure, pathology findings, and the maximum diameter of the adnexal mass. Results: The age of the patients ranged from 12 to 20 years (median, 18.8 years. The most common initial symptom in these patients was abdominal pain (56.6%. Non-neoplastic ovarian lesions in the patients included 7 (6.6% corpora hemorrhagica, 10 (9.4% corpus luteal cysts, 4 (3.8% paratubal cysts, and 7 (6.6% simple cysts. Benign neoplastic tumors included 20 (18.9% mature cystic teratomas (i.e., dermoid tumors, 10 (9.4% serous cystadenomas, 1 (0.9% mucinous cystadenomas, and 7 (6.6% endometriomas. The most common surgical approach and procedure were laparoscopy (67.0% and cystectomy (60.4%, respectively. Conclusion: Laparoscopy can be performed in many adolescent patients and conservative, adnexal-sparing surgery should be encouraged for all patients. Ovarian-preserving techniques should be a priority when surgery is performed for benign masses in order to optimize future fertility potential. J Clin Exp Invest 2015; 6 (2: 96-101

  20. Meralgia paresthetica affecting parturient women who underwent cesarean section -A case report-.

    Science.gov (United States)

    Chung, Kum Hee; Lee, Jong Yeon; Ko, Tong Kyun; Park, Chung Hyun; Chun, Duk Hee; Yang, Hyeon Jeong; Gill, Hyun Jue; Kim, Min Ku

    2010-12-01

    Meralgia paresthetica is commonly caused by a focal entrapment of lateral femoral cuteneous nerve while it passes the inguinal ligament. Common symptoms are paresthesias and numbness of the upper lateral thigh area. Pregnancy, tight cloths, obesity, position of surgery and the tumor in the retroperitoneal space could be causes of meralgia paresthetica. A 29-year-old female patient underwent an emergency cesarean section under spinal anesthesia without any problems. But two days after surgery, the patient complained numbness and paresthesia in anterolateral thigh area. Various neurological examinations and L-spine MRI images were all normal, but the symptoms persisted for a few days. Then, electromyogram and nerve conduction velocity test of the trunk and both legs were performed. Test results showed left lateral cutaneous nerve injury and meralgia paresthetica was diagnosed. Conservative treatment was implemented and the patient was free of symptoms after 1 month follow-up.

  1. Clinical Characteristics of Dry Eye Patients With Chronic Pain Syndromes

    NARCIS (Netherlands)

    Vehof, Jelle; Smitt-Kamminga, Nicole Sillevis; Kozareva, Diana; Nibourg, Simone A.; Hammond, Christopher J.

    2016-01-01

    PURPOSE: To investigate clinical characteristics of dry eye disease (DED) patients with a chronic pain syndrome. DESIGN: Cross-sectional. study. METHODS: Four hundred twenty-five patients of a tertiary care DED patient cohort in the Netherlands were included. Chronic pain syndromes irritable bowel s

  2. Sigmoid resection with primary anastomosis and ileostomy versus laparoscopic lavage in purulent peritonitis from perforated diverticulitis: outcome analysis in a prospective cohort of 40 consecutive patients.

    Science.gov (United States)

    Catry, Jonathan; Brouquet, Antoine; Peschaud, Frédérique; Vychnevskaia, Karina; Abdalla, Solafah; Malafosse, Robert; Lambert, Benoit; Costaglioli, Bruno; Benoist, Stéphane; Penna, Christophe

    2016-10-01

    This prospective study aimed to compare outcomes after laparoscopic peritoneal lavage (LPL) and sigmoid resection with primary colorectal anastomosis (RPA). From June 2010 to June 2015, 40 patients presenting with Hinchey III peritonitis from perforated diverticulitis underwent LPL or RPA. Patients with Hinchey II or IV peritonitis and patients who underwent an upfront Hartmann procedure were excluded. Primary endpoint was overall 30-day or in-hospital postoperative morbidity after surgical treatment of peritonitis. Twenty-five patients underwent RPA and 15 LPL. Overall postoperative morbidity and mortality rates were not significantly different after RPA and LPL (40 vs 67 %, p = 0.19; 4 vs 6.7 %, p = 1, respectively). Intra-abdominal morbidity and reoperation rates were significantly higher after LPL compared to RPA (53 vs 12 %, p < 0.01; 40 vs 4 %, p = 0.02, respectively). Multivariate analysis showed that LPL (p = 0.028, HR = 18.936, CI 95 % = 1.369-261.886) was associated with an increased risk of postoperative intra-abdominal septic morbidity. Among 6 patients who underwent reoperation after LPL, 4 had a Hartmann procedure. All surviving patients who had a procedure requiring stoma creation underwent stoma reversal after a median delay of 92 days after LPL and 72 days after RPA (p = 0.07). LPL for perforated diverticulitis is associated with a high risk of inadequate intra-abdominal sepsis control requiring a Hartmann procedure in up to 25 % of patients. RPA appears to be safer and more effective. It may represent the best option in this context.

  3. The Results of Open-Label, Multicenter, Non-Randomized Study on the Efficacy and Safety of Insulins: Insuman Basal®, Insuman Comb 25®, Insuman Rapid® in Patients with Diabetes Mellitus Type 2 Who Underwent Basic Training in Diabetes Schools (SPIRIT

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    A.S. Larin

    2015-06-01

    Conclusions. Treatment with Insuman® insulins of patients with DM-2, who were not compensated while taking OADs, was associated with improved glycemic control without an increase in the incidence of severe hypoglycemia. There was no statistically significant increase in the effectiveness of therapy in patients, who have successfully completed a training program at diabetes school, compared with evaluation of overall efficiency. The state of young studied population of patients with inadequate control at baseline, and those who had developed cardiovascular complications associated with DM, improved in most cases in terms of glycemic control, and, at that, episodes of severe hypoglycemia were not detected. This may be due to the positive influence of training in diabetes school.

  4. Outcome of non surgical hepatic decompression procedures in Egyptian patients with Budd-Chiari

    Institute of Scientific and Technical Information of China (English)

    Ahmed Eldorry; Eman Barakat; Heba Abdella; Sara Abdelhakam; Mohamed Shaker; Amr Hamed; Mohammad Sakr

    2011-01-01

    AIM:To evaluate outcome of patients with Budd- Chiari syndrome after balloon angioplasty ± stenting or transjugular intrahepatic portosystemic shunt (TIPS).METHODS:Twenty five patients with Budd-Chiari syndrome admitted to Ain Shams University Hospitals,Tropical Medicine Department were included.Twelve patients (48%) with short segment occlusion were candidates for angioplasty;with stenting in ten cases and without stenting in two.Thirteen patients (52%) had Transjugular Intrahepatic Portosystemic Shunt.Patients were followed up for 12-32 mo.RESULTS:Patency rate in patients who underwent angioplasty ± stenting was 83.3% at one year and at end of follow up.The need of revision was 41.6% with one year survival of 100%,dropped to 91.6% at end of follow up.In patients who had Transjugular Intrahepatic Portosystemic Shunt,patency rate was 92.3% at one year,dropped to 84.6% at end of follow up.The need of revision was 38.4% with one year and end of follow up survival of 100%.Patients with patent shunts showed marked improvement compared to those with occluded shunts.CONCLUSION:Morbidity and mortality following angioplasty ± stenting and TIPS are low with satisfactory outcome.Proper patient selection and management of shunt dysfunction are crucial in improvement.

  5. Risk and relevance of open lung biopsy in pediatric ECMO patients: the Dutch experience.

    Science.gov (United States)

    Houmes, Robert Jan; Ten Kate, Chantal A; Wildschut, Enno D; Verdijk, Rob M; Wijnen, René M H; de Blaauw, Ivo; Tibboel, Dick; van Heijst, Arno F

    2017-03-01

    Open lung biopsy can help differentiate between reversible and irreversible lung disease and may guide therapy. To assess the risk-benefit ratio of this procedure in pediatric extracorporeal membrane oxygenation (ECMO) patients, we reviewed data of all patients who underwent an open lung biopsy during ECMO in one of the two pediatric ECMO centers in a nationwide study in the Netherlands. In nineteen neonatal and six pediatric patients (0-15.5years), twenty-five open lung biopsies were performed during the study period. In 13 patients (52%), a classifying diagnosis of underlying lung disease could be made. In another nine patients (36%), specific pathological abnormalities were described. In three patients (12%), only nonspecific abnormalities were described. The histological results led to withdrawal of ECMO treatment in 6 neonates with alveolar capillary dysplasia/misalignment of pulmonary veins (24%) and in another 6 patients, corticosteroids were started (24%). All patients survived the biopsy procedure. Hemorrhagic complications were rare. An open lung biopsy during an ECMO run in neonates and children is a safe procedure with a minimum risk for blood loss and biopsy-related death. It can be very useful in diagnosing the underlying pathology and can guide cessation of ECMO treatment and thereby avoid continuation of futile treatment, especially in neonatal patients. III. Diagnostic study. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Avaliação da lordose da coluna cervical nos pacientes com escoliose do tipo Lenke I submetidos ao tratamento cirúrgico Evaluación de la lordosis de la columna cervical en los pacientes con escoliosis del tipo Lenke I sometidos al tratamiento quirúrgico Evaluation of cervical behavior in patients with scoliosis Lenke who underwent surgery

    Directory of Open Access Journals (Sweden)

    José Lucas Batista Junior

    2011-01-01

    Full Text Available OBJETIVO: Avaliar a angulação da lordose cervical nos pacientes portadores de Escoliose Idiopática do Adolescente (EIA do tipo Lenke I, no período pré- e pós-operatório. MÉTODO: Estudo prospectivo e descritivo em que foram avaliados pacientes com EIA, sendo documentadas medidas antropométricas. Foram avaliadas as angulações das radiografias (posição ortostática em perfil cervical de C3 a C7 no período pré- e pós-operatório, estabelecendo como normal a lordose cervical entre 10 e 30 graus. RESULTADOS: Participaram 26 pacientes com EIA, sendo a maioria do sexo feminino (73%, com média de idade de 14,3 anos. Observamos que no período pré-operatório 80,9% dos pacientes apresentavam angulação cervical não fisiológica, sendo que 42,3% dos pacientes apresentavam diminuição da lordose cervical (OBJETIVO: Evaluar el ángulo de la lordosis cervical en pacientes con Escoliosis Idiopática del Adolescente (EIA, clasificados en Lenke I en el pre y posoperatorio. MÉTODOS: Estudio prospectivo y descriptivo, en el que se evaluó a pacientes con EIA y se documentaron mediciones antropométricas. Se evaluó la angulación de las radiografías (posición ortostásica de perfil de columna cervical de C3 a C7, en el entorno de pre y posoperatorias, estableciéndose como normal la lordosis cervical entre 10 y 30 grados. RESULTADOS: Un total de 26 pacientes fue evaluado, en su mayoría mujeres (73% con edad promedio de 14,3 años. Observamos que, en el período preoperatorio, 80,9% de los pacientes presentaban angulación cervical no fisiológica, siendo que 42,3% de los pacientes habían reducido la lordosis cervical (OBJECTIVE: This study was to evaluate the angle of cervical lordosis in patients with Adolescent Idiopathic Scoliosis (AIS ranked in Lenke I pre- and postoperatively. METHODS: Prospective and descriptive study, which evaluated patients with AIS and documented anthropometric measures. We assessed the angulations of the

  7. Avaliação dos níveis basais de FSH em pacientes inférteis com endometriose profunda de ovário tratadas cirurgicamente Evaluation of basal FSH serum levels in infertile patients with deep ovarian endometriosis who underwent surgery

    Directory of Open Access Journals (Sweden)

    Sandra Frankfurt

    2009-07-01

    Full Text Available OBJETIVO: avaliar a reserva ovariana de pacientes inférteis portadoras de endometriose profunda de ovário, submetidas à cirurgia excisional dos endometriomas, atendidas entre os meses de Fevereiro e Novembro de 2008. MÉTODOS: estudo prospectivo que incluiu 30 pacientes portadoras de endometriose graus III e IV com comprometimento profundo de ovário submetidas à cirurgia excisional dos endometriomas e 30 pacientes portadoras de endometriose graus I e II que foram alocadas como Grupo Controle. A reserva ovariana foi avaliada indiretamente a partir do valor do hormônio folículo estimulante (FSH basal (U/L, entre o terceiro e quinto dias do ciclo, após um período de 12 meses da cirurgia. O índice de massa corpórea (IMC foi calculado conforme a fórmula de Quetelet [peso (kg/estatura (cm²]. Para a comparação das variáveis "idade", "IMC" e "valores de FSH basal" entre os grupos, foi utilizado o teste não paramétrico U de Mann-Whitney. RESULTADOS: não foi encontrada diferença significativa entre os grupos em relação à idade e ao IMC. Em relação ao FSH basal, observou-se que, no grupo das pacientes com endometriose profunda, o valor médio foi de 7,0 U/L, enquanto que, no Grupo Controle, foi de 5,6 U/L (p=0,3, o que demonstra que a diferença no valor médio de FSH encontrado nos dois grupos não foi significativa. CONCLUSÕES: a cirurgia não influenciou de forma deletéria a reserva ovariana das pacientes com endometriose profunda de ovário.PURPOSE: to evaluate the ovarian reserve of infertile patients with severe ovarian endrometriosis, submitted to excisional surgery of endometriomas and attended from February to November, 2008. METHODS: prospective study, including 30 patients with endometriosis grades III and IV, with severe ovarian impairment, submitted to excisional surgery of the endometriomas, and 30 patients with endometriosis grades I and II, allocated as a Control Group. The ovarian reserve was indirectly assessed

  8. Risk of contrast-induced nephropathy in hospitalized patients with cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Nilesh Lodhia; Michael Kader; Thalia Mayes; Parvez Mantry; Benedict Maliakkal

    2009-01-01

    AIM:To evaluate the incidence of contrast-induced nephropathy (CIN) in cirrhotic patients and to identify risk factors for the development of CIN. METHODS:We performed a retrospective review of 216 consecutive patients with cirrhosis who underwent computed tomography (CT) with intravenous contrast at the University of Rochester between the years 2000-2005. We retrospectively examined factors associated with a high risk for CIN, defined as a decrease in creatinine clearance of 25% or greater within one week after receiving contrast. RESULTS:Twenty-five percent of our patients developed CIN, and 74% of these patients had ascites seen on CT. Of the 75% of patients who did not develop CIN, only 46% had ascites. The presence of ascites was a significant risk factor for the development of CIN ( P = 0.0009, OR 3.38, 95% CI 1.55-7.34) in multivariate analysis. Patient age, serum sodium, Model for End-stage Liver Disease score, diuretic use, and the presence of diabetes were not found to be significant risk factors for the development of CIN. Of the patients who developed CIN, 11% developed chronic renal insufficiency, defined as a creatinine clearance less than baseline for 6 wk. CONCLUSION:Our results suggest that in hospitalized cirrhotic patients, especially those with ascites, the risk of CIN is substantial.

  9. Value of iodine-123 metaiodobenzylguanidine scintigraphy in patients with vasospastic angina

    Energy Technology Data Exchange (ETDEWEB)

    Taki, Junichi; Nakajima, Kenichi; Matsunari, Ichiro; Takayama, Teruhiko; Tonami, Norihisa [Kanazawa Univ. School of Medicine (Japan). Dept. of Nuclear Medicine; Yasuhara, Shuichiro; Takamatsu, Tsuyoshi; Tatami, Ryozo; Ishise, Syozo [Maizuru Kyosai Hospital (Japan). Dept. of Internal Medicine

    1998-03-01

    To assess the presence and location of presynaptic myocardial sympathetic abnormality in patients with vasospastic angina, iodine-123 labelled metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPET) was performed. Fifty patients suspected of having vasospastic angina pectoris were enrolled in the study. All patients underwent a provocative test with intracoronary ergonovine infusion during coronary angiography, in which 99%-100% obstructive spasm was defined as a positive result. Twenty-five patients were diagnosed as having vasospastic angina based on a positive provocative test. MIGB SPET was performed at 20 min and 3 h after administration of 111 MBq of MIBG. On early images, only 5 of 25 patients with vasospastic angina showed a mild reduction in MIBG uptake, whereas 3-h delayed images demonstrated MIBG abnormality in 20 patients (80%). The location of the MIBG abnormality was completely or partially consistent with the spastic coronary territory in 18 patients. On the other hand, only 4 of 25 patients (16%) with a negative provocative test demonstrated reduced MIBG uptake. Accordingly, positive and negative predictive values of MIBG SPET for the provocative test were 83% (20/24) and 81% (21/26) respectively. In conclusion, MIBG scintigraphy with SPET can permit the non-invasive detection and evaluation of suspected vasospastic angina. (orig.)

  10. QT dispersion in patients with arrhythmogenic right ventricular dysplasia

    DEFF Research Database (Denmark)

    Benn, Marianne; Hansen, P S; Pedersen, A K

    1999-01-01

    , of electrical instability. The present study was conducted to assess the occurrence of QT dispersion and its modulation during treatment with sotalol. Methods Twenty-five patients with the diagnosis of arrhythmogenic right ventricular dysplasia were studied retrospectively. Fourteen patients were considered low...

  11. Treatment of Dientamoeba fragilis in patients with irritable bowel syndrome

    DEFF Research Database (Denmark)

    Engsbro, Anne Line; Stensvold, C Rune; Nielsen, Henrik V

    2012-01-01

    The role of Dientamoeba fragilis in irritable bowel syndrome (IBS) is incompletely known. We aimed to investigate whether eradication of D. fragilis alleviates symptoms in IBS. Twenty-five D. fragilis-positive IBS patients were treated with Metronidazole (MZ) or Tetracycline. The patients were...

  12. Percutaneous treatment of hepatocellular carcinoma in patients with cirrhosis: A comparison of the safety of cryoablation and radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Dunne, Ruth M., E-mail: rmdunne@partners.org [Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women' s Hospital, 75 Francis Street, Boston, MA 02115 (United States); Shyn, Paul B., E-mail: pshyn@partners.org [Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women' s Hospital, 75 Francis Street, Boston, MA 02115 (United States); Sung, Jeffrey C., E-mail: jcsung@gmail.com [Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women' s Hospital, 75 Francis Street, Boston, MA 02115 (United States); Tatli, Servet, E-mail: statli@partners.org [Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women' s Hospital, 75 Francis Street, Boston, MA 02115 (United States); Morrison, Paul R. [Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women' s Hospital, 75 Francis Street, Boston, MA 02115 (United States); Catalano, Paul J., E-mail: pcata@jimmy.harvard.edu [Department of Biostatistics and Computational Biology, Dana Farber Cancer Institute, 450 Brookline Avenue, CLSB 11007, Boston, MA 02215 (United States); Department of Biostatistics, Harvard School of Public Health, Boston, MA 02215 (United States); Silverman, Stuart G., E-mail: sgsilverman@partners.org [Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women' s Hospital, 75 Francis Street, Boston, MA 02115 (United States)

    2014-04-15

    Purpose: To compare the safety of image-guided percutaneous cryoablation and radiofrequency ablation in the treatment of hepatocellular carcinoma in patients with cirrhosis. Materials and methods: This retrospective HIPAA-compliant study received institutional review board approval. Forty-two adult patients with cirrhosis underwent image-guided percutaneous ablation of hepatocellular carcinoma from 2003 to 2011. Twenty-five patients underwent 33 cryoablation procedures to treat 39 tumors, and 22 underwent 30 radiofrequency ablation procedures to treat 39 tumors. Five patients underwent both cryoablation and radiofrequency ablation procedures. Complication rates and severity per procedure were compared between the ablation groups. Potential confounding patient, procedure, and tumor-related variables were also compared. Statistical analyses included Kruskal–Wallis, Wilcoxon rank sum, and Fisher's exact tests. Two-sided P-values <0.05 were considered significant. Results: The overall complication rates, 13 (39.4%) of 33 cryoablation procedures versus eight (26.7%) of 30 radiofrequency ablation procedures and severe/fatal complication rates, two (6.1%) of 33 cryoablation procedures versus one (3.3%) of 30 radiofrequency ablation procedures, were not significantly different between the ablation groups (both P = 0.26). Severe complications included pneumothoraces requiring chest tube insertion during two cryoablation procedures. One death occurred within 90 days of a radiofrequency ablation procedure; all other complications were managed successfully. Conclusion: No significant difference was seen in the overall safety of image-guided percutaneous cryoablation and radiofrequency ablation in the treatment of hepatocellular carcinoma in patients with cirrhosis.

  13. Effect of intraoperative care on deep vein thrombosis in patients under-went hip-joint replacement surgery%术中护理对髋关节置换手术患者下肢深静脉血栓形成的影响

    Institute of Scientific and Technical Information of China (English)

    钟敏兰; 向福胜

    2015-01-01

    目的:探讨术中护理对髋关节置换手术患者下肢深静脉血栓形成的影响。方法选择2013年6月~2014年12月湖北省鄂州市中心医院收治的157例髋关节置换手术患者,按住院号单双分为观察组83例,对照组74例。对照组采用常规术中护理,观察组采用改进术中护理。比较两组手术前后血液流变学和凝血功能变化及下肢深静脉血栓形成情况。结果观察组出血量、术中输血量明显少于对照组(P0.05). In the control group, 1 d after surgery, high shear whole blood viscosity, low shear viscosity of whole blood, plasma viscosity, erythrocyte aggregation index, prothrombin time, fibrinogen had no significantly different with 1 d before surgery (P > 0.05). After surgery, 2 cases (2.41%) in the observation group and 8 cases (10.81%) in the control group had deep vein thrombosis, with statistically significant difference (P<0.05). Conclusion Improved intraoperative care can improve high blood coagulation state in patients with hip joint replacement, reduce the incidence of postoperative deep venous thrombosis.

  14. Estudo da função pulmonar em pacientes submetidos a revascularização do miocárdio sem circulação extracorpórea com derivação intraluminal Pulmonary function study in patients who underwent myocardial revascularization without cardiopulmonary bypass with an intraluminal shunt

    Directory of Open Access Journals (Sweden)

    Ana Maria Rocha Pinto

    1998-12-01

    Full Text Available As alterações da função pulmonar nos pacientes submetidos a cirurgias com auxílio da Circulação Extracorpórea (CEC têm sido relatadas na literatura. O objetivo do presente estudo foi analisar a função pulmonar de um grupo de pacientes submetidos a cirurgia de revascularização do miocárdio sem o uso da CEC. Foram estudados de maneira prospectiva 23 pacientes portadores de insuficiência coronariana e submetidos a cirurgia de revascularização do miocárdio sem CEC. A idade variou de 36 a 69 anos, sendo 16 pacientes do sexo masculino e sete do sexo feminino. A avaliação da função pulmonar foi feita através de espirometria e prova alvéolo-respiratória, realizadas no período pré-operatório, no quarto dia (PO4 e no décimo dia (PO10> pós-operatório. A análise dos dados revelou redução da Capacidade Vital (CV em 37,84% (pPulmonary complications are a major cause of postoperative morbidity and mortality in those patients undergoing operations utilizing cardiopulmonary bypass. The purpose of this study was to evaluate the pulmonary function after myocardial revascularization without cardiopulmonary bypass using a intraluminal shunt. Twenty-three patients with coronary disease were submitted to surgery by this technique and pulmonary function testing was conducted consecutively. The surgeries were performed via a median sternotomy with a reversed saphenous vein and/or an internal mammary artery graft. The age ranged from 36 to 69 years (mean 56,3 years. The group was comprised by 16 men and seven women. The pulmonary function tests consisted of spirometric investigations and blood gases measurements with evaluation of intrapulmonary shunt degree, both analyzed during the preoperative period, at the 4th (PO4 and at the 10th (PO10 postoperative day. In spirometry were determinated the vital capacity (VC, forced vital capacity (FVC, forced expiratory volume at one second (FEV, forced expiratory flow over middle half of FVC (FEF

  15. Surgical interventions in patients undergoing percutaneous balloon mitral valvotomy : a retrospective analysis of anaesthetic considerations.

    Directory of Open Access Journals (Sweden)

    Tempe Deepak

    2004-01-01

    Full Text Available Between 1990 and 2000, 5499 balloon mitral valvotomies were performed at GB Pant Hospital. Amongst these, 45 patients required surgical intervention, which form the basis of this report. There were 18 males and 27 females with the mean age of 26.5+/-8.3 years and weight of 42.9+/-7.39 kg. Thirty-five patients underwent open-heart surgery and 10 closed-heart surgery. Twenty-five patients developed acute severe mitral regurgitation during balloon mitral valvotomy and required emergency open-heart surgery. Morphine based anaesthetic technique with careful attention to haemodynamic monitoring was used in these patients. All patients required a high inotropic support to terminate the cardiopulmonary bypass. The closed-heart surgical procedures included emergency exploration for cardiac tamponade (4, exploration + closed mitral valvotomy (4, and elective closed mitral valvotomy (2. The overall mortality was 9%, which is much higher than the reported mortality for elective mitral valve replacement. Morphine based anaesthetic technique is useful in these patients. Adequate oxygenation, vasodilators, inotropes and diuretics are required for preoperative stabilisation of patients who develop acute mitral regurgitation, while those who develop cardiac tamponade need volume replacement along with inotropes and immediate surgical decompression of the tamponade.

  16. Primary early-stage intestinal and colonic non-Hodgkin's lymphoma: Clinical features, management, and outcome of 37 patients

    Institute of Scientific and Technical Information of China (English)

    Shu-Lian Wang; Ye-Xiong Li; Zhong-Xing Liao; Xin-Fan Liu; Zi-Hao Yu; Da-Zhong Gu; Tu-Nan Qian; Yong-Wen Song; Jing Jin; Wei-Hu Wang

    2005-01-01

    AIM: To analyze the clinical features, management, and outcome of treatment of patients with primary intestinal and colonic non-Hodgkin's lymphoma (PICL).METHODS: A retrospective study was performed in 37 patients with early-stage PICL who were treated in our hospital from 1958 to 1998. Their clinical features,management, and outcome were assessed. Prognostic factors for survival were analyzed by univariate analysis using the Kaplan-Meier product-limit method and log-rank test.RESULTS: Twenty-five patients presented with Ann Arbor stage I PICL and 12 with Ann Arbor stage Ⅱ PICL. Thirty-five patients underwent surgery (including 31 with complete resection), 22 received postoperative chemotherapy or radiotherapy or both. Two patients with rectal tumors underwent biopsy and chemotherapy with or without radiotherapy. The 5- and 10-year overall survival (OS) rates were 51.9% and 44.5%. The corresponding diseasefree survival (DFS) rates were 42.4% and 37.7%. In univariate analysis, multiple-modality treatment was associated with a better DFS rate compared to single treatment (P = 0.001).While age, tumor size, tumor site, stage, histology, or extent of surgery were not associated with OS and DFS,use of adjuvant chemotherapy significantly improved DFS (P = 0.031) for the 31 patients who underwent complete resection. Additional radiotherapy combined with chemotherapy led to a longer survival than chemotherapy alone in six patients with gross residual disease after surgery or biopsy.CONCLUSION: Combined surgery and chemotherapy is recommended for treatment of patients with PICL.Additional radiotherapy is needed to improve the outcome of patients who have gross residual disease after surgery.

  17. Intraocular lens power estimation by accurate ray tracing for eyes underwent previous refractive surgeries

    Science.gov (United States)

    Yang, Que; Wang, Shanshan; Wang, Kai; Zhang, Chunyu; Zhang, Lu; Meng, Qingyu; Zhu, Qiudong

    2015-08-01

    For normal eyes without history of any ocular surgery, traditional equations for calculating intraocular lens (IOL) power, such as SRK-T, Holladay, Higis, SRK-II, et al., all were relativley accurate. However, for eyes underwent refractive surgeries, such as LASIK, or eyes diagnosed as keratoconus, these equations may cause significant postoperative refractive error, which may cause poor satisfaction after cataract surgery. Although some methods have been carried out to solve this problem, such as Hagis-L equation[1], or using preoperative data (data before LASIK) to estimate K value[2], no precise equations were available for these eyes. Here, we introduced a novel intraocular lens power estimation method by accurate ray tracing with optical design software ZEMAX. Instead of using traditional regression formula, we adopted the exact measured corneal elevation distribution, central corneal thickness, anterior chamber depth, axial length, and estimated effective lens plane as the input parameters. The calculation of intraocular lens power for a patient with keratoconus and another LASIK postoperative patient met very well with their visual capacity after cataract surgery.

  18. Nitric oxide monocyte production levels in patients with the hepatosplenic form of Scistosoma mansoni infection who underwent splenectomy, ligature of the left gastric vein and auto implantation of spleen tissue in the major omentum Níveis de óxido nítrico produzidos por monócitos em portadores de esquistossomose hepatoesplênica que se submeteram a esplenectomia, ligadura da veia gástrica esquerda e auto-implante de tecido esplênico no omento maior

    Directory of Open Access Journals (Sweden)

    Carlos Teixeira Brandt

    2006-10-01

    Full Text Available PURPOSE: To measure the levels of NO production by monocytes in patients with the hepatosplenic form of schistosomiasis mansoni who underwent splenectomy, ligature of the left gastric vein and auto implantation of spleen tissue in the major omentum. METHODS: Four groups of volunteers were enrolled in the investigation: G1 - 12 patients with S. mansoni infection in its hepatosplenic form without any kind of treatment (SMH; G2 - 13 SMH patients who underwent medical treatment and portal hypertension decompression splenectomy and ligature of the left gastric vein (SMH/SLGV; G3 - 19 patients similar to the later group, but additionally received auto implantation of spleen morsels in the major omentum (SMH/SLGV/AI; and G4 - 15 individuals with no S. mansoni infection coming from the same geographical area and presenting similar socio economical status (CG. Nitrite production by monocytes was determined by a standard Griess reaction adapted to microplates. The results were presented by mean ± SD for each group. Significant differences in NO production by monocytes were determined by Tukey-Kramer multicomparisons test. Probability values of 0.05 were considered significant. RESULTS: Patients from G1 (SMH showed lower level of NO production by monocytes (5.28 ± 1.28µmol/ml. Patients from G2 (SMH/SLGV showed similar results (6.67 ± 0.44µmol/ml - q = 2.681 p > 0.05. Individuals of G4 (CG showed higher level of NO production by monocytes (8.19 ± 2.74µmol/ml. Patients from G3 (SMH/SGLV/AI showed similar NO production by PBMC as compared to individuals of G4 (CG - (7.41 ± 1.65µmol/ml - q = 1.615 p > 0.05. The volunteers from G4 (CG and G3 (SMH/SLGV/AI showed significantly greater levels of NO production by monocytes as compared to those from G1 (SMH - (q = 5.837 p OBJETIVO: Mensurar os níveis de produção de ON por monócitos do sangue periférico (MSP em portadores de esquistossomose na forma hepatoesplênica que tinham se submetido a

  19. 接受直接经皮冠状动脉介入治疗的ST段抬高型急性心肌梗死患者血小板体积的变化及与冠状动脉影像的关系%Platelet volume and its association with coronary angiograms in patients with ST-segment elevation acute myocardial infarction underwent primary percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    许文亮; 王旭; 邵一兵; 惠波; 武越; 要英杰; 张纯全

    2012-01-01

    Objective To assess the platelet volume in patients with ST-segment elevation acute myocardial infarction ( STEMI) underwent primary percutaneous coronary intervention ( PPCI) and its association with coronary angiograms flow. Methods Total 163 patients with STEMI who underwent PPCI were enrolled. Mean platelet volume ( MPV) and platelet large cell ratio (P-LCR) and other biochemical parameters were measured on admission. The TIMI flow for the infarct-related artery (IRA) were evaluated before and after PPCI, and the IRA's corrected Thrombolysis In Myocardial Infarction frame count (CTFC) were also calculated. One hundred and seven in-hospital patients with stable angina pectoris were taken as control. Results MPV and P-LCR were increased significantly in STEMI patients compared to patients with stable angina pectoris [(10.30 ±0. 82) fl vs. (9. 89 ± 0. 98) fl,t = 3. 656,P = 0. 000; (27.24 ±6.43)% vs. (24. 51 ±5. 88)% ,t =3. 524,P =0. 000]. Patients with multiple coronary lesions showed much higher MPV and P-LCR than patients with single coronary lesions [ (10. 40 ± 0. 85) fl vs. (10. 04 ± 0. 69) fl, t =-2.558, P=0. 011; (27.96 ±6.64)% vs. (25. 40 ±5. 52)% ,t = - 2. 319,P = 0. 022]. Compared to those with left circumflex artery as IRA, patients with anterior descending coronary artery as IRA had markedly increased MPV and P-LCR [ (10. 42 ± 0. 86) fl vs. (9. 98 ± 0. 62) fl, P < 0. 05; (28. 07 ± 6. 63) % vs. (24. 48 ± 4. 76) % , P < 0. 05 ]. If the IRA' s coronary flow was TIMI grade 1 to 3 before PPCI, it was defined as spontaneous reperfusion. Patients without spontaneous reperfusion had markedly increased MPV and P-LCR than those with spontaneous reperfusion [ ( 10. 39 ± 0. 84) fl vs. ( 10. 04 ± 0. 69 ) fl, t = - 2. 460, P = 0.015; (27.83 ±6.61)% vs. (25. 64 ± 5. 70)% ,t = - 2. 082,P = 0. 040]. After PPCI, patients whose IRAs TIMI flow was less than grade 3 had significantly elevated MPV and P-LCR than patient with TIMI flow grade 3 [ (10. 68 ± 1

  20. Sensory deficits in ipsilesional upper-extremity in chronic stroke patients

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    Núbia Maria Freire Vieira Lima

    2015-10-01

    Full Text Available Objective To investigate somatosensory deficits in the ipsilesional wrist and hand in chronic stroke patients and correlate these deficits with contralesional sensorimotor dysfunctions, functional testing, laterality and handedness.Methods Fifty subjects (twenty-two healthy volunteers and twenty-eight stroke patients underwent evaluation with Semmes-Weinstein monofilaments, the sensory and motor Fugl-Meyer Assessment, the Nottingham Sensory Assessment in both wrists and hands and functional tests.Results Twenty-five patients had sensory changes in the wrist and hand contralateral to the stroke, and eighteen patients (64% had sensory deficits in the ipsilesional wrist and hand. The most significant ipsilesional sensory loss was observed in the left-handed patients. We found that the patients with brain damage in the right hemisphere had better scores for ipsilesional tactile sensation.Conclusions A reduction in ipsilesional conscious proprioception, tactile or thermal sensation was found in stroke subjects. Right hemisphere damage and right-handed subjects had better scores in ipsilesional tactile sensation.

  1. Low-dose versus standard-dose CT protocol in patients with clinically suspected renal colic.

    Science.gov (United States)

    Poletti, Pierre-Alexandre; Platon, Alexandra; Rutschmann, Olivier T; Schmidlin, Franz R; Iselin, Christophe E; Becker, Christoph D

    2007-04-01

    The purpose of our study was to compare a low-dose abdominal CT protocol, delivering a dose of radiation close to the dose delivered by abdominal radiography, with standard-dose unenhanced CT in patients with suspected renal colic. One hundred twenty-five patients (87 men, 38 women; mean age, 45 years) who were admitted with suspected renal colic underwent both abdominal low-dose CT (30 mAs) and standard-dose CT (180 mAs). Low-dose CT and standard-dose CT were independently reviewed, in a delayed fashion, by two radiologists for the characterization of renal and ureteral calculi (location, size) and for indirect signs of renal colic (renal enlargement, pyeloureteral dilatation, periureteral or renal stranding). Results reported for low-dose CT, with regard to the patients' body mass indexes (BMIs), were compared with those obtained with standard-dose CT (reference standard). The presence of non-urinary tract-related disorders was also assessed. Informed consent was obtained from all patients. In patients with a BMI 3 mm. Low-dose CT was 100% sensitive and specific for depicting non-urinary tract-related disorders (n = 6). Low-dose CT achieves sensitivities and specificities close to those of standard-dose CT in assessing the diagnosis of renal colic, depicting ureteral calculi > 3 mm in patients with a BMI < 30, and correctly identifying alternative diagnoses.

  2. MRI of the breast in patients with DCIS to exclude the presence of invasive disease

    Energy Technology Data Exchange (ETDEWEB)

    Deurloo, Eline E. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); Sriram, Jincey D.; Rutgers, Emiel J.T. [Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Surgery, Amsterdam (Netherlands); Teertstra, Hendrik J.; Loo, Claudette E. [Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); Wesseling, Jelle [Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Pathology, Amsterdam (Netherlands); Gilhuijs, Kenneth G.A. [Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); University Medical Center Utrecht, Department of Radiology, Image Sciences Institute, Utrecht (Netherlands)

    2012-07-15

    Core biopsy underestimates invasion in more than 20% of patients with preoperatively diagnosed ductal carcinoma in situ (DCIS) without evidence of invasion (pure DCIS). The aim of the current study was to evaluate the efficacy of preoperative magnetic resonance imaging (MRI) to discriminate between patients with DCIS who are at high risk of invasive breast cancer and patients at low risk. One hundred and twenty-five patients, preoperatively diagnosed with pure DCIS (128 lesions; 3 bilateral) by core-needle biopsy, were prospectively included. Clinical, mammographic, histological (core biopsy) and MRI features were assessed. All patients underwent breast surgery. Analyses were performed to identify features associated with presence of invasion. Eighteen lesions (14.1%) showed invasion on final histology. Seventy-three lesions (57%) showed suspicious enhancement on MRI with a type 1 (n = 12, 16.4%), type 2 (n = 19, 26.0%) or type 3 curve, respectively (n = 42, 57.5%). At multivariate analysis, the most predictive features for excluding presence of invasive disease were absence of enhancement or a type 1 curve on MRI (negative predictive value 98.5%; A{sub Z} 0.80, P = 0.00006). Contrast medium uptake kinetics at MRI provide high negative predictive value to exclude presence of invasion and may be useful in primary surgical planning in patients with a preoperative diagnosis of pure DCIS. (orig.)

  3. Serum Zn levels in dysphagic patients who underwent endoscopic gastrostomy for long term enteral nutrition.

    Science.gov (United States)

    Santos, Carla Adriana; Fonseca, Jorge; Brito, José; Fernandes, Tânia; Gonçalves, Luísa; Sousa Guerreiro, António

    2014-02-01

    Objetivos: Pacientes con disfagia sometidos a Gastrostomía Endoscópica (PEG) presentan malnutrición calórico- proteica, mas poco se conoce acerca da malnutrición en micronutrientes. El objetivo del presente trabajo fue el estudio del zinc sérico en pacientes portadores de PEG y su relación con proteínas séricas, zinc de sangre total y enfermedades de base. Métodos: De los pacientes portadores de PEG se ha obtenido antes del procedimiento. La determinación del zinc del suero y total se ha obtenido por lo método Wavelength Dispersive X-ray Fluorescence Spectroscopy. Fueron consideradas la albumina y la transferrina. Se estudiaron pacientes como un todo y se dividieron en: cáncer de cabeza y cuello (CCC) y enfermedad neurológica (EN). Resultados: 32 pacientes (22 hombres), 43-88 años: CCC = 15, EN = 17. La mayoría (30/32) presento lo zinc en suero bajo. Solo dos, con lesión cerebral traumática, tenían valores normales de zinc. En la sangre total, 17/32 estaban dentro del rango normal. Sin diferencias entre los grupos CCC-EN. Sin asociación entre lo zinc sérico y la albumina o transferrina. Sin asociación entre lo zinc en suero y total. Conclusiones: los enfermos presentaran zinc sérico bajo no momento de la PEG, relacionado con el ayuno prolongado y no con la enfermedad subyacente. La reducción del zinc sérico no está relacionada con las proteínas. Lo zinc sérico fue más sensible para la identificación de reducción de la ingesta. Los grupos que se ocupan de enfermos con PEG deben incluir la determinación del zinc en la evaluación o incluir el suministro de zinc.

  4. Evaluation of surgery risk factor associated to antithrombotic therapy in patients who underwent colorectal surgery.

    Science.gov (United States)

    Del Rio, Paolo; Sozzi, Francesco; Bertocchi, Elisa; Dell'Abate, Paolo; Perrone, Gennaro; Arcuri, Maria Francesca; Sianesi, Mario

    2016-01-01

    I trattamenti antipiastrinici sono comuni nel mondo occidentale ed il rischio di sanguinamento correlato a procedure chirurgiche o comunque invasive è di conseguenza elevato e pertanto abbiamo volute analizzare la correlazione tra la chirurgia del colon.retto ,la terapia antipiastrinica e le complicanze chirurgiche postoperatorie. Sono stati studiati 176 pazienti operati per tumori del colon-retto considerando i seguenti dati:tipo di intervento xchirurgico,l’indice di massa corporea (BMI), il valore dell’emoglobina (Hb); PT preoperatorio e le trasfusioni di sangue pre epost-operatorie e durante lo stesso intervento chirurgico. L’analisi si è concentrata su due gruppi :pazienti sottoposti a trattamento antipiastrinico (ATterapia antiaggregante) e pazienti non trattati ( NAT: non terapia antiaggregante piastrinica). Nei gruppi di pazienti sottoposti a emicolectomia destra, i valori di emoglobina erano più bassi neri pazienti che hanno ricevuto la terapia antitrombotica rispetto ai pazienti che non hanno ricevuto questa terapia, con una significatività statistica (p terapia antiaggregante avevano valori più bassi di emoglobina senza significatività statistica (valore di p non significativo). I pazienti in sovrappeso sottoposti a trattamento antiaggregante hanno presentato valori di Hb inferiori a quelli non trattati (p terapia antiaggregante rispetto al secondo grippo indipendentemente dal peso. In conclusione, la terapia antiaggregante in pazienti sottoposti ad interventi chirurgici invasivi cambia l’incidenza di alcuni fattori di rischio, cone il sanguinamento e le complicanze post-operatorie.Questo risultato sottolinea l’importanza di una corretta manipolazione e preparazione nei pazienti trattai con agenti antitreombotici che devono subire un intervento chirurgico invasivo.

  5. [Waist-hip ratio and perioperative bleeding in patients who underwent radical prostatectomy].

    Science.gov (United States)

    León-Ramírez, Víctor; Santiago-López, Janaí; Reyes-Rivera, Juan Gabriel; Miguel-Soto, Edgar

    2016-01-01

    Introducción: la prostatectomía radical se asocia con sangrado perioperatorio y múltiples transfusiones. La obesidad abdominal representa un factor de riesgo perioperatorio. Sugerimos un efecto protector del adipocito en pacientes oncológicos sometidos a prostatectomía radical. El objetivo fue evaluar el efecto del índice cintura-cadera (ICC) sobre la magnitud del sangrado y los requerimientos perioperatorios de transfusiones en pacientes oncológicos sometidos a prostatectomía radical. Métodos: estudio de cohorte en 156 pacientes. Se integraron dos grupos: el control (ICC  0.95); se registraron la magnitud del sangrado y las fracciones transfundidas durante la cirugía y en el postoperatorio. Se utilizaron medidas de tendencia central y dispersión, así como chi cuadrada, t de Student, U de Mann-Whitney y ANOVA. Una p < 0.05 fue significativa. Resultados: encontramos diferencias significativas en el peso, índice de masa corporal, cintura, índice cintura-cadera, sangrado perioperatorio, fracciones transfundidas, permanencia de la sonda y días de hospitalización. Conclusión: los pacientes sometidos a prostatectomía radical con ICC ≥ 0.95 tuvieron un sangrado y requerimientos transfusionales perioperatorios menores que aquellos con un ICC < 0.95.

  6. Effectiveness of highly purified urofollitropin treatment in patients with idiopathic azoospermia before testicular sperm extraction.

    Science.gov (United States)

    Cocci, Andrea; Cito, Gianmartin; Russo, Giorgio I; Falcone, Marco; Capece, Marco; Timpano, Massimiliano; Della Camera, Pier Andrea; Morselli, Simone; Tasso, Giovanni; Morelli, Girolamo; Morgia, Giuseppe; Minervini, Andrea; Serni, Sergio; Carini, Marco; Natali, Alessandro; Gacci, Mauro

    2017-08-07

    Recent evidences demonstrated that male factor alone is responsible for about 30% cases of infertility. Human follicle-stimulating hormone (hFSH) has been introduced to increase sperm concentration, spermatogonial population, or both natural or assisted pregnancy rates (PRs) in oligozoospermic subjects with normal concentrations of gonadotropins. Fifty infertile men affected by idiopathic azoospermia were enrolled in this study, after undergoing medical history, physical and clinical examination, baseline semen parameters and hormonal plasma concentrations. Inclusion criteria were infertility for at least 2 years, idiopathic azoospermia, FSH <12 mIU/ml. Twenty-five patients were allocated to treatment with hFSH three times/week per 3 months (Fostimon), and 25 patients underwent just testicular sperm extraction (TESE) without medical treatment. All patients underwent, after 3 months, assisted reproduction techniques (ARTs) with TESE. The primary outcome was represented by the differences in the sperm retrieval rate (SRR) between groups, while the secondary outcomes were the differences in PR and fertilization rate (FR). We observed a PR of 15% (3/25) and 28% (7/25) in control and treated group, respectively. SRR after medical treatment and ART was 24% (6/25), while in the control group was 12.5% (2/25). The sperm in the ejaculate of five patients (20%) after medical treatment exhibited a mean concentration of 0.9 million/ml and a mean motility of 12%. The FR was significantly greater in the treatment group with respect to the control group, 30% and 20%, respectively. FSH treatment showed greater efficacy rather than control by increasing the rate of PR and FR in azoospermic patients who underwent TESE.

  7. The Effect of Endoscopic Sinus Surgery in Chronic Rhinosinusitis Patients With Concurrent Asthma

    Directory of Open Access Journals (Sweden)

    Taheri

    2016-07-01

    Full Text Available Background Chronic rhinosinusitis (CRS and asthma are among the most important health-related conditions with evident socio-economic effects. The relationship between asthma and CRS has been considered in medical references for centuries. Previous studies have shown that treatment interventions targeting disease in one part of the airway are effective for general asthma management. However, the effect of endoscopic sinus surgery (ESS in CRS patients with concurrent asthma remains controversial. Therefore, we aimed to assess the effects of ESS on improvement of asthma in CRS patients with concurrent asthma. Objectives The aim of this study was to evaluate the impact of ESS on asthma in CRS patients. Methods Twenty-five CRS patients with asthma who met our inclusion criteria after taking a complete history underwent physical examination and diagnostic nasal endoscopy, and the asthma control test (ACT questionnaire was administered to them. Six months after ESS, the patients’ asthma was again assessed using the ACT questionnaire. Results Overall, the mean ACT score significantly increased from 12.56 at the baseline to 20.71 after a six-month follow up period (0.001. Conclusions Given the remarkable improvement in asthma control levels, ESS can be considered a useful method for treating CRS patients suffering from asthma.

  8. Use of neuromuscular electrostimulation in the treatment of dysphagia in patients with multiple sclerosis

    NARCIS (Netherlands)

    H. Bogaardt; D. van Dam; N.M. Wever; C.E. Bruggeman; J. Koops; W.J. Fokkens

    2009-01-01

    OBJECTIVES: We explored the possible effects of neuromuscular electrostimulation on the swallowing function of patients with multiple sclerosis and swallowing problems. METHODS: Twenty-five patients (average age, 53.1 years; SD, 9.8 years) with multiple sclerosis and swallowing problems were treated

  9. Ocular Manifestations of Noonan Syndrome: A Prospective Clinical and Genetic Study of 25 Patients

    NARCIS (Netherlands)

    Trier, D.C. van; Vos, A.M. de; Draaijer, R.W.; Burgt, I. van der; Draaisma, J.M.T.; Cruysberg, J.R.M.

    2016-01-01

    PURPOSE: To determine the full spectrum of ocular manifestations in patients with Noonan syndrome (NS). DESIGN: Prospective cross-sectional clinical and genetic study in a tertiary referral center. PARTICIPANTS: Twenty-five patients with NS (mean age, 14 years; range, 8 months-25 years) clinically

  10. Undertreatment of anxiety and depression in patients with an implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Hoogwegt, Madelein T; Kupper, Nina; Theuns, Dominic A M J

    2012-01-01

    Twenty-five to 33% of patients with an implantable cardioverter-defibrillator (ICD) experience anxiety and depression, but it is not known whether their symptoms are adequately treated. We investigated (a) whether patients with clinically relevant symptoms of distress received appropriate treatment...

  11. Low Utility of Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography for Detecting Hepatocellular Carcinoma in Patients Before Liver Transplantation.

    Science.gov (United States)

    Alotaibi, Faisal; Kabbani, Monther; Abaalkhail, Faisal; Chorley, Alicia; Elbeshbeshy, Hany; Al-Hamoudi, Waleed; Alabbad, Saleh; Boehnert, Markus U; Alsofayan, Mohammad; Al-Kattan, Wael; Ahmed, Baderaldeen; Broering, Dieter; Al Sebayel, Mohamed; Elsiesy, Hussien

    2017-02-01

    Our program routinely used fluorodeoxyglucose-positron emission tomography/computed tomography as part of the liver transplant evaluation of patients with hepatocellular carcinoma. The aim of this study was to evaluate the role of this imaging modality in the pretransplant work-up. This was a retrospective chart review of our liver transplant database from January 2011 to December 2014 for all patients with hepatocellular carcinoma who underwent a liver transplant. Collected data included age, sex, cause of liver disease, imaging modality, fluorodeoxyglucose-positron emission tomography/computed tomography results, explant tissue analysis, type of transplant, and transplant outcome. During the study period, 275 liver transplants were performed. Fifty-three patients had hepatocellular carcinoma; 41 underwent fluorodeoxyglucose-positron emission tomography/computed tomography. Twenty-nine patients underwent living-donor liver transplant, and 12 patients underwent deceased-donor liver transplant. One of the 41 patients with negative FDG-imaging results had no evidence of hepatocellular carcinoma in the explant and was excluded from the study. The patients' average age was 58 years (range, 22-72 y), and 28 patients were men. The cause of liver disease was hepatitis C virus in 24 patients, cryptogenic cirrhosis in 12 patients, and hepatitis B virus in 5 patients. One patient had no hepatocellular carcinoma on explants and was excluded from the study. Twenty-five patients had hepatocellular carcinoma that met the Milan criteria, 7 were within the UCSF (University of California, San Francisco) criteria, and 8 exceeded the UCSF criteria. Of the 40 patients, 11 had positive fluorodeoxyglucose-positron emission tomography/computed tomography results (27.5%) with evidence of hepatocellular carcinoma in the explant; the remaining 29 patients (72.5%) had negative results. The fluorodeoxyglucose-positron emission tomography/computed tomography results were positive in 16% (4 of

  12. Risk of cardiac arrhythmias during hypoglycemia in patients with type 2 diabetes and cardiovascular risk.

    Science.gov (United States)

    Chow, Elaine; Bernjak, Alan; Williams, Scott; Fawdry, Robert A; Hibbert, Steve; Freeman, Jenny; Sheridan, Paul J; Heller, Simon R

    2014-05-01

    Recent trials of intensive glycemic control suggest a possible link between hypoglycemia and excess cardiovascular mortality in patients with type 2 diabetes. Hypoglycemia might cause arrhythmias through effects on cardiac repolarization and changes in cardiac autonomic activity. Our aim was to study the risk of arrhythmias during spontaneous hypoglycemia in type 2 diabetic patients with cardiovascular risk. Twenty-five insulin-treated patients with type 2 diabetes and a history of cardiovascular disease or two or more risk factors underwent simultaneous continuous interstitial glucose and ambulatory electrocardiogram monitoring. Frequency of arrhythmias, heart rate variability, and markers of cardiac repolarization were compared between hypoglycemia and euglycemia and between hyperglycemia and euglycemia matched for time of day. There were 134 h of recording at hypoglycemia, 65 h at hyperglycemia, and 1,258 h at euglycemia. Bradycardia and atrial and ventricular ectopic counts were significantly higher during nocturnal hypoglycemia compared with euglycemia. Arrhythmias were more frequent during nocturnal versus daytime hypoglycemia. Excessive compensatory vagal activation after the counterregulatory phase may account for bradycardia and associated arrhythmias. QT intervals, corrected for heart rate, >500 ms and abnormal T-wave morphology were observed during hypoglycemia in some participants. Hypoglycemia, frequently asymptomatic and prolonged, may increase the risk of arrhythmias in patients with type 2 diabetes and high cardiovascular risk. This is a plausible mechanism that could contribute to increased cardiovascular mortality during intensive glycemic therapy.

  13. Intradetrusorial Botulinum Toxin in Patients with Multiple Sclerosis: A Neurophysiological Study.

    Science.gov (United States)

    Conte, Antonella; Giannantoni, Antonella; Gubbiotti, Marilena; Pontecorvo, Simona; Millefiorini, Enrico; Francia, Ada; Porena, Massimo; Berardelli, Alfredo

    2015-08-26

    Patients with multiple sclerosis (MS) often complain of urinary disturbances characterized by overactive bladder syndrome and difficulties in bladder emptying. The aim of the study was to investigate the pathophysiology of bladder dysfunction and the neurophysiological effects of intradetrusorial incobotulinum toxin A (BoNT/A) in patients with MS having both brain and spinal MS-related lesions. Twenty-five MS patients with neurogenic detrusor overactivity (NDO) underwent clinical evaluation and soleus Hoffmann reflex (H reflex) study during urodynamics. Of the 25 patients, 14 underwent a further session one month after intradetrusorial BoNT/A injection. Eighteen healthy subjects acted as the control. In healthy subjects, the H reflex size significantly decreased at maximum cystometric capacity (MCC), whereas in MS patients with NDO, the H reflex remained unchanged. In the patients who received intradetrusorial BoNT/A, clinical and urodynamic investigations showed that NDO improved significantly. Volumes at the first, normal and strong desire to void and MCC increased significantly. Despite its efficacy in improving bladder symptoms and in increasing volumes for first desire, normal and strong desire to void, BoNT/A left the H reflex modulation during bladder filling unchanged. In the MS patients we studied having both brain and spinal MS-related lesions, the H reflex size remained unchanged at maximum bladder filling. Since this neurophysiological pattern has been previously found in patients with spinal cord injury, we suggest that bladder dysfunction arises from the MS-related spinal lesions. BoNT/A improves bladder dysfunction by changing bladder afferent input, as shown by urodynamic findings on bladder filling sensations, but its effects on H reflex modulation remain undetectable.

  14. Intradetrusorial Botulinum Toxin in Patients with Multiple Sclerosis: A Neurophysiological Study

    Directory of Open Access Journals (Sweden)

    Antonella Conte

    2015-08-01

    Full Text Available Patients with multiple sclerosis (MS often complain of urinary disturbances characterized by overactive bladder syndrome and difficulties in bladder emptying. The aim of the study was to investigate the pathophysiology of bladder dysfunction and the neurophysiological effects of intradetrusorial incobotulinum toxin A (BoNT/A in patients with MS having both brain and spinal MS-related lesions. Twenty-five MS patients with neurogenic detrusor overactivity (NDO underwent clinical evaluation and soleus Hoffmann reflex (H reflex study during urodynamics. Of the 25 patients, 14 underwent a further session one month after intradetrusorial BoNT/A injection. Eighteen healthy subjects acted as the control. In healthy subjects, the H reflex size significantly decreased at maximum cystometric capacity (MCC, whereas in MS patients with NDO, the H reflex remained unchanged. In the patients who received intradetrusorial BoNT/A, clinical and urodynamic investigations showed that NDO improved significantly. Volumes at the first, normal and strong desire to void and MCC increased significantly. Despite its efficacy in improving bladder symptoms and in increasing volumes for first desire, normal and strong desire to void, BoNT/A left the H reflex modulation during bladder filling unchanged. In the MS patients we studied having both brain and spinal MS-related lesions, the H reflex size remained unchanged at maximum bladder filling. Since this neurophysiological pattern has been previously found in patients with spinal cord injury, we suggest that bladder dysfunction arises from the MS-related spinal lesions. BoNT/A improves bladder dysfunction by changing bladder afferent input, as shown by urodynamic findings on bladder filling sensations, but its effects on H reflex modulation remain undetectable.

  15. Intradetrusorial Botulinum Toxin in Patients with Multiple Sclerosis: A Neurophysiological Study

    Science.gov (United States)

    Conte, Antonella; Giannantoni, Antonella; Gubbiotti, Marilena; Pontecorvo, Simona; Millefiorini, Enrico; Francia, Ada; Porena, Massimo; Berardelli, Alfredo

    2015-01-01

    Patients with multiple sclerosis (MS) often complain of urinary disturbances characterized by overactive bladder syndrome and difficulties in bladder emptying. The aim of the study was to investigate the pathophysiology of bladder dysfunction and the neurophysiological effects of intradetrusorial incobotulinum toxin A (BoNT/A) in patients with MS having both brain and spinal MS-related lesions. Twenty-five MS patients with neurogenic detrusor overactivity (NDO) underwent clinical evaluation and soleus Hoffmann reflex (H reflex) study during urodynamics. Of the 25 patients, 14 underwent a further session one month after intradetrusorial BoNT/A injection. Eighteen healthy subjects acted as the control. In healthy subjects, the H reflex size significantly decreased at maximum cystometric capacity (MCC), whereas in MS patients with NDO, the H reflex remained unchanged. In the patients who received intradetrusorial BoNT/A, clinical and urodynamic investigations showed that NDO improved significantly. Volumes at the first, normal and strong desire to void and MCC increased significantly. Despite its efficacy in improving bladder symptoms and in increasing volumes for first desire, normal and strong desire to void, BoNT/A left the H reflex modulation during bladder filling unchanged. In the MS patients we studied having both brain and spinal MS-related lesions, the H reflex size remained unchanged at maximum bladder filling. Since this neurophysiological pattern has been previously found in patients with spinal cord injury, we suggest that bladder dysfunction arises from the MS-related spinal lesions. BoNT/A improves bladder dysfunction by changing bladder afferent input, as shown by urodynamic findings on bladder filling sensations, but its effects on H reflex modulation remain undetectable. PMID:26343721

  16. Lower-limb MRI in the staging and re-staging of osteonecrosis in paediatric patients affected by acute lymphoblastic leukaemia after therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ippolito, D.; Masetto, A.; Franzesi, C.T.; Bonaffini, P.A.; Sironi, S. [University of Milano-Bicocca Milan, School of Medicine, Monza (Italy); Department of Diagnostic Radiology, H. San Gerardo, Monza (Italy); Sala, A.; Biondi, A. [University of Milano-Bicocca Milan, School of Medicine, Monza (Italy); H. San Gerardo, Department of Paediatric Haematology, Monza (Italy)

    2016-04-15

    To assess the diagnostic value of MRI examination in detecting and monitoring osteonecrotic lesions (ON) in childhood acute lymphoblastic leukaemia (ALL) after chemotherapy (CHT) and/or bone marrow transplantation (BMT). Seventy-three patients (37 males, mean age 12.4 years old) with ALL after treatment underwent a lower-limb MR examination between November 2006 and March 2012. In 47 there was clinical suspicion of ON, 26 were asymptomatic. Studies were performed with a 1 T and a 1.5 T scanner, acquiring short tau inversion recovery (STIR) and T1-weighted sequences in coronal plane from the hips to the ankles. The average acquisition time was 18 min. Considering baseline and follow-up examinations, the overall number of MRI studies was 195. Fifty-four of 73 patients showed ON at MRI study, with an overall number of 323 ON (89 involving articular surface, 24 with joint deformity, JD). Twenty-five of 47 symptomatic patients showed subchondral ON lesions, 11 developed JD. Three of 26 asymptomatic patients showed subchondral bone ON at baseline examination but no JD at follow-up. Twenty-two of 28 BMT, 32/45 CHT patients developed ON. Our MRI protocol proved to be feasible in evaluating ON in paediatric patients. Studies should be addressed only to symptomatic patients. (orig.)

  17. Determining the relationship between sleep architecture, seizure variables and memory in patients with focal epilepsy.

    Science.gov (United States)

    Miller, Laurie A; Ricci, Monica; van Schalkwijk, Frank J; Mohamed, Armin; van der Werf, Ysbrand D

    2016-06-01

    Sleep has been shown to be important to memory. Both sleep and memory have been found to be abnormal in patients with epilepsy. In this study, we explored the effects that nocturnal epileptiform discharges and the presence of a hippocampal lesion have on sleep patterns and memory. Twenty-five patients with focal epilepsy who underwent a 24-hr ambulatory EEG also completed the Everyday Memory Questionnaire (EMQ). The EEG record was scored for length of time spent in the various sleep stages, time spent awake after sleep onset, and rapid eye movement (REM) latency. Of these sleep variables, only REM latency differed when the epilepsy patients were divided on the bases of either presence/absence of nocturnal discharges or presence/absence of a hippocampal lesion. In both cases, presence of the abnormality was associated with longer latency. Furthermore, longer REM latency was found to be a better predictor of EMQ score than either number of discharges or presence of a hippocampal lesion. Longer REM latency was associated with a smaller percentage of time spent in slow-wave sleep in the early part of the night and may serve as a particularly sensitive marker to disturbances in sleep architecture. (PsycINFO Database Record

  18. Prevalence of sarcopenia in older patients with colorectal cancer.

    Science.gov (United States)

    Broughman, James R; Williams, Grant R; Deal, Allison M; Yu, Hyeon; Nyrop, Kirsten A; Alston, Shani M; Gordon, Brittaney-Belle; Sanoff, Hanna K; Muss, Hyman B

    2015-11-01

    Sarcopenia is the age-related loss of muscle mass, strength, and function. It is a common finding in older patients and is associated with decreased life expectancy and potentially higher susceptibility to chemotherapy toxicity. This study describes the prevalence of sarcopenia in older adults with early stage colorectal cancer. Patients ≥70 years old who underwent surgical resection for stage I-III colorectal cancer between 2008 and 2013 were identified from the medical record. Sarcopenia was assessed by measuring the total muscle area on computerized tomography (CT) images obtained prior to surgery. Total muscle area was measured at the level of L3 and normalized using each patient's height to produce a skeletal muscle index (SMI). Sarcopenia was defined using sex- and body mass index (BMI)-specific threshold values of SMI. Eighty-seven patients were included, with a median age of 77 years (70-96). Twenty-five men (60% of 42) and 25 women (56% of 45) had sarcopenia. Sarcopenic patients had significantly lower BMI (p=0.03) compared to non-sarcopenic patients. There was a positive correlation between BMI and SMI for both men (r=0.44) and women (r=0.16). Sarcopenia is highly prevalent among older patients with early stage colorectal cancer. BMI alone is a poor indicator of lean body mass and improved methods of screening for sarcopenia are necessary. CT scans are a viable option for identifying sarcopenic patients in whom timely interventions may improve survival, quality of life, and functional outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Ranitidine for improvement of delayed hypersensitivity response in patients with sepsis

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Witt, K; Moesgaard, F;

    1989-01-01

    Twenty-five patients admitted to intensive or high-dependency surgical care units were randomized to receive ranitidine intravenously 50 mg every 6 hours for 8 days or no ranitidine. All had septicemia or intra-abdominal sepsis, with body temperature greater than or equal to 38.5 degrees C for more...

  20. Determining the relationship between sleep architecture, seizure variables and memory in patients with focal epilepsy

    NARCIS (Netherlands)

    Miller, Laurie A; Ricci, Monica; van Schalkwijk, Frank J; Mohamed, Armin; van der Werf, Ysbrand D

    2016-01-01

    Sleep has been shown to be important to memory. Both sleep and memory have been found to be abnormal in patients with epilepsy. In this study, we explored the effects that nocturnal epileptiform discharges and the presence of a hippocampal lesion have on sleep patterns and memory. Twenty-five patien

  1. Autotransplantation of spleen tissue in children with mansonic schistosomiasis who underwent splenectomy: Evaluation of splenic residual functions

    Directory of Open Access Journals (Sweden)

    Brandt Carlos Teixeira

    1998-01-01

    Full Text Available Autotransplantation of spleen tissue is an attempt for maintenance of splenic functions when splenectomy is indicated in children. It minimizes the risks of overwhelming postsplenectomy infection and it has been done in children with severe portal hypertension due to hepatosplenic mansonic schistosomiasis that underwent splenectomy. The purposes of this investigation were to study the morphology of the residual splenic tissue; to evaluate the residual filtration function of this splenosis; and to assess the immune response to polyvalent pneumococcal vaccine of these patients. Twenty-three children with portal hypertension from mansonic schistosomiasis who underwent splenectomy, ligature of the left gastric vein, autotransplantation of spleen tissue into an omental pouch were evaluated for residual splenic parenchyma and functions. Tc-99m sulfur colloid liver-spleen scans were used for detection of splenic nodules. The search for Howell Jolly bodies were used for assessing the filtration function and Enzyme-linked immunosorbent assay was used for measuring the relative rise in titter of specific pneumococcal antibodies. Splenosis was evident in all children; however, in two there were less than five splenic nodules in the greater omentum, which was considered insufficient. Howell-Jolly bodies were found in the peripheral blood only in these two patients with less evident splenosis. The immune response was adequate in 15 patients; it was intermediate in 4 patients and inadequate in 4 patients. Autotransplantation of spleen tissue into an omental pouch is efficient in maintaining the filtration splenic function in more than 90% of the cases and the immune response to pneumococcal vaccination in approximately 65% of the children.

  2. Safety and caregiver satisfaction with gastrostomy in patients with Ataxia Telangiectasia

    Science.gov (United States)

    2011-01-01

    Background Ataxia Telangiectasia (A-T) is a rare monogenetic neurodegenerative disease with pulmonary, nutritional, and dysphagic complications. Gastrostomy tube (GT) feedings are commonly recommended to manage these co-morbidities. In general, outcomes of GT placement in patients with progressive diseases that develop during childhood are not well characterized. The primary purposes of this study were to determine whether GT placement in patients with A-T would be tolerated and associated with caregiver satisfaction. Methods We completed a retrospective review of 175 patients who visited the A-T Children's Center at Johns Hopkins Hospital from 2001 through 2008, and identified 28 patients with A-T (19 males, 9 females) who underwent GT placement for non-palliative reasons. Information was obtained from medical records, interviews with primary health care providers, and 24 (83%) caregivers of patients with GT's who responded to survey requests. Results Twenty-five (89%) patients tolerated GT placement and were a median of 5.0 (0.4-12.6) years post GT placement at the time of this investigation. Three (11%) patients died within one month of GT placement. In comparison to patients who tolerated GT placement, patients with early mortality were older when GT's were placed (median 24.9 vs. 12.3 years, p = 0.006) and had developed a combination of dysphagia, nutritional, and respiratory problems. Caregivers of patients tolerating GT placement reported significant improvements in mealtime satisfaction and participation in daily activities. Conclusions GT placement can be well tolerated and associated with easier mealtimes in patients with A-T when feeding tubes are placed at young ages. Patients with childhood onset of disorders with predictable progression of the disease process and impaired swallowing may benefit from early versus late placement of feeding tubes. PMID:21569628

  3. A Case of Type 2 Amiodarone-Induced Thyrotoxicosis That Underwent Total Thyroidectomy under High-Dose Steroid Administration

    Directory of Open Access Journals (Sweden)

    Koshi Hashimoto

    2015-01-01

    Full Text Available Amiodarone is used commonly and effectively in the treatment of arrhythmia; however, it may cause thyrotoxicosis categorized into two types: iodine-induced hyperthyroidism (type 1 amiodarone-induced thyrotoxicosis (AIT and destructive thyroiditis (type 2 AIT. We experienced a case of type 2 AIT, in which high-dose steroid was administered intravenously, and we finally decided to perform total thyroidectomy, resulting in a complete cure of the AIT. Even though steroid had been administered to the patient (maximum 80 mg of prednisolone, the operation was performed safely and no acute adrenal crisis as steroid withdrawal syndrome was found after the operation. Few cases of type 2 AIT that underwent total thyroidectomy with high-dose steroid administration have been reported. The current case suggests that total thyroidectomy should be taken into consideration for patients with AIT who cannot be controlled by medical treatment and even in those under high-dose steroid administration.

  4. Nail changes in female pemphigus vulgaris patients on immunosuppressive therapy

    OpenAIRE

    M.M. El-Komy, MD; D.M. Abdel Halim, MD; N. Samir, MD; R.A. Hegazy, MD; H.I. Gawdat, MD; S.A. Shoeb, MD

    2015-01-01

    Background: Pemphigus vulgaris (PV) patients receiving immunosuppressive therapy may develop nail alterations resulting from infection, skin disorder, or drug regimen. Objective: This study aims to describe nail changes in PV female patients receiving immunosuppressive therapy and to report the frequency of associated fungal and bacterial growth in the patients’ nails. Methods: Twenty-five female PV patients who had at least one acquired finger or toenail abnormality and had been admini...

  5. Actual Situations and Problems of Postoperative Nursing Care for the Elderly who Underwent Neurosurgical Operation

    OpenAIRE

    2014-01-01

    The objective of the study is to identify nursing care and related problems involved in extending the daily life and supporting self-care of the elderly who underwent neurosurgical operation, and to determine the direction of nursing care. Subjects were six nurses who had been working in anacute-phase department for five years or longer. Collected data was analyzed by the qualitative synthesis method (KJ method). The results clarified [nursing care to enhance the treatment effect of neurosurg...

  6. Policy towards the elderly : Twenty-five years of Dutch experience

    NARCIS (Netherlands)

    VandenHeuvel, W

    1997-01-01

    This article describes the developments in national policy, formulated by the stare and discussed in parliament, towards the elderly in the Netherlands during the last 25 years. A first policy memorandum was published in 1970, based on work of governmental bodies in the sixties. This memorandum serv

  7. From Unity to Diversity: Twenty-Five Years of Language-Teaching Methodology

    Science.gov (United States)

    Larsen-Freeman, Diane

    2012-01-01

    This article was written for the 25th anniversary of "English Teaching Forum" and published in 1987. In this article, the author describes methodological developments in the field of English language teaching over the past 25 years. The author has found it helpful to think of methodology being depicted as a triangle, with each angle of the…

  8. Managing the culturally diverse medical practice team: twenty-five strategies.

    Science.gov (United States)

    Hills, Laura

    2014-01-01

    A common misconception is that the phrase workplace diversity means meeting certain quotas in employee race or gender categories. In fact, diversity is much more than that. This article explores the unique benefits and challenges of managing a culturally diverse medical practice team and offers practice managers 25 practical strategies. It describes the two types of diversity training that are beneficial to practice managers and the kinds of policies, practices, and procedures that foster and promote diversity. This article also explores ethnocentrism, racism, ageism, sexism, stereotyping, and other potentially divisive issues among a diverse medical practice team. It provides an assessment instrument practice managers can use to evaluate their own diversity management skills. Finally, this article defines specifically what is meant by the term diversity and explores the top 10 diversity issues in workplaces today.

  9. Twenty-five years of sport performance research in the Journal of Sports Sciences.

    Science.gov (United States)

    Nevill, Alan; Atkinson, Greg; Hughes, Mike

    2008-02-15

    In this historical review covering the past 25 years, we reflect on the content of manuscripts relevant to the Sport Performance section of the Journal of Sports Sciences. Due to the wide diversity of sport performance research, the remit of the Sport Performance section has been broad and includes mathematical and statistical evaluation of competitive sports performances, match- and notation-analysis, talent identification, training and selection or team organization. In addition, due to the academic interests of its section editors, they adopted a quality-assurance role for the Sport Performance section, invariably communicated through key editorials that subsequently shaped the editorial policy of the Journal. Key high-impact manuscripts are discussed, providing readers with some insight into what might lead an article to become a citation "classic". Finally, landmark articles in the areas of "science and football" and "notation analysis" are highlighted, providing further insight into how such articles have contributed to the development of sport performance research in general and the Journal of Sports Sciences in particular.

  10. 基本药物今昔25年%Twenty - five years of essential medicine

    Institute of Scientific and Technical Information of China (English)

    Jonathan D. Quick; Hans V. Hogerzeil; German Velasquez; Lembit Rago

    2003-01-01

    @@ 二十世纪初,广为普及的现代药物只有一个:乙酰水杨酸(阿司匹林).二十世纪四十年代,人类发现第一种抗菌素、第一种批量生产的抗疟药和第一种抗痨药.

  11. Peter L. Berger's "Invitation to Sociology:" Twenty-Five Years of RSVPs.

    Science.gov (United States)

    Christiano, Kevin J.

    1990-01-01

    Reconsiders the place of Peter Berger's "Invitation to Sociology," in teaching undergraduate sociology courses. Traces the success and intellectual impact of the work. Describes the image of sociology it presents. Reviews its treatment of human freedom as a sociological issue. Examines its world vision and evaluates its usefulness in teaching. (NL)

  12. Twenty-five years of quantitative PCR for gene expression analysis.

    Science.gov (United States)

    VanGuilder, Heather D; Vrana, Kent E; Freeman, Willard M

    2008-04-01

    Following its invention 25 years ago, PCR has been adapted for numerous molecular biology applications. Gene expression analysis by reverse-transcription quantitative PCR (RT-qPCR) has been a key enabling technology of the post-genome era. Since the founding of BioTechniques, this journal has been a resource for the improvements in qPCR technology, experimental design, and data analysis. qPCR and, more specifically, real-time qPCR has become a routine and robust approach for measuring the expression of genes of interest, validating microarray experiments, and monitoring biomarkers. The use of real-time qPCR has nearly supplanted other approaches (e.g., Northern blotting, RNase protection assays). This review examines the current state of qPCR for gene expression analysis now that the method has reached a mature stage of development and implementation. Specifically, the different fluorescent reporter technologies of real-time qPCR are discussed as well as the selection of endogenous controls. The conceptual framework for data analysis methods is also presented to demystify these analysis techniques. The future of qPCR remains bright as the technology becomes more rapid, cost-effective, easier to use, and capable of higher throughput.

  13. Gasification of waste. Summary and conclusions of twenty-five years of development

    Energy Technology Data Exchange (ETDEWEB)

    Rensfelt, Erik [TPS Termiska Processer AB, Nykoeping (Sweden); Oestman, Anders [Kemiinformation AB, Stockholm (Sweden)

    2000-04-01

    An overview of nearly thirty years development of waste gasification and pyrolysis technology is given, and some major general conclusions are drawn. The aim has been to give new developers an overview of earlier major attempts to treat MSW/RDF with thermochemical processes, gasification or pyrolysis. Research work in general is not covered, only R and D efforts that have led to substantial testing in pilot scale or demonstration. For further details, especially related to ongoing R and D, readers are referred to other recent reviews. The authors' view is that gasification of RDF with appropriate gas cleaning can play an important role in the future, for environmentally acceptable and efficient energy production. A prerequisite is that some of the major mistakes can be avoided, such as: (1) too rapid scale-up without experimental base, (2) unsuitable pretreatment of MSW to RDF and poor integration with material recycling, and (3) too limited gas/flue gas cleaning.

  14. TWENTY-FIVE YEARS OF SCHOLARSHIP ON SECOND LANGUAGE COMPOSING PROCESSES: 1976-2000

    Directory of Open Access Journals (Sweden)

    Melinda Reichelt

    2001-12-01

    Full Text Available This work is divided into two sections: (1 an annotated bibliography of full-length, published, (mostly basic research on second language writing and overviews thereof, and (2 an unannotated bibliography of both basic and applied research (mostly unpublished and commentary on second language composing. Both sections have been arranged in chronological order to allow readers to follow the development of scholarship in this area. Entries are listed alphabetically within a given year. While this bibliography is extensive, it is not meant to be exhaustive, and while the focus here is on research, many of the studies included address pedagogical matters in a substantive manner.

  15. Twenty-five years of aerodynamic research with IR imaging: A survey

    Science.gov (United States)

    Gartenberg, Ehud; Roberts, A. Sidney, Jr.

    1991-01-01

    Infrared imaging used in aerodynamic research evolved during the last 25 years into a rewarding experimental technique for investigation of body-flow viscous interactions, such as heat flux determination and boundary layer transition. The technique of infrared imaging matched well its capability to produce useful results, with the expansion of testing conditions in the entire spectrum of wind tunnels, from hypersonic high-enthalpy facilities to cryogenic transonic wind tunnels. With unique achievements credited to its past, the current trend suggests a change in attitude towards this technique: from the perception as an exotic, project-oriented tool, to the status of a routine experimental procedure.

  16. Twenty-Five Years of Groupthink Theory and Research: Lessons from the Evaluation of a Theory.

    Science.gov (United States)

    Turner; Pratkanis

    1998-02-01

    In this paper, we examine the historical development of the groupthink model and discuss recent responses to the body of empirical evidence amassed on the model. We conclude by articulating general lessons implied by the evolution of research on the groupthink model. Copyright 1998 Academic Press.

  17. Twenty-five years of environmental radionuclide concentrations near a nuclear power plant.

    Science.gov (United States)

    Harris, Charles; Kreeger, Danielle; Patrick, Ruth; Palms, John

    2015-05-01

    The areas in and along a 262-km length of the Susquehanna River in Pennsylvania were monitored for the presence of radioactive materials. This study began two months after the 1979 Three Mile Island (TMI) partial reactor meltdown; it spanned the next 25 y. Monitoring points included stations at the PPL Susquehanna and TMI nuclear power plants. Monthly gamma measurements document concentrations of radionuclides from natural and anthropogenic sources. During this study, various series of gamma-emitting radionuclide concentration measurements were made in many general categories of animals, plants, and other inorganic matter. Sampling began in 1979 before the first start-up of the PPL Susquehanna power plant. Although all species were not continuously monitored for the entire period, an extensive database was compiled. In 1986, the ongoing measurements detected fallout from the Chernobyl nuclear accident. These data may be used in support of dose or environmental transport calculations.

  18. Twenty-five years of progress in understanding pollination mechanisms in palms (Arecaceae)

    Science.gov (United States)

    Barfod, Anders S.; Hagen, Melanie; Borchsenius, Finn

    2011-01-01

    Background With more than 90 published studies of pollination mechanisms, the palm family is one of the better studied tropical families of angiosperms. Understanding palm–pollinator interactions has implications for tropical silviculture, agroforestry and horticulture, as well as for our understanding of palm evolution and diversification. We review the rich literature on pollination mechanisms in palms that has appeared since the last review of palm pollination studies was published 25 years ago. Scope and Conclusions Visitors to palm inflorescences are attracted by rewards such as food, shelter and oviposition sites. The interaction between the palm and its visiting fauna represents a trade-off between the services provided by the potential pollinators and the antagonistic activities of other insect visitors. Evidence suggests that beetles constitute the most important group of pollinators in palms, followed by bees and flies. Occasional pollinators include mammals (e.g. bats and marsupials) and even crabs. Comparative studies of palm–pollinator interactions in closely related palm species document transitions in floral morphology, phenology and anatomy correlated with shifts in pollination vectors. Synecological studies show that asynchronous flowering and partitioning of pollinator guilds may be important regulators of gene flow between closely related sympatric taxa and potential drivers of speciation processes. Studies of larger plant–pollinator networks point out the importance of competition for pollinators between palms and other flowering plants and document how the insect communities in tropical forest canopies probably influence the reproductive success of palms. However, published studies have a strong geographical bias towards the South American region and a taxonomic bias towards the tribe Cocoseae. Future studies should try to correct this imbalance to provide a more representative picture of pollination mechanisms and their evolutionary implications across the entire family. PMID:21831852

  19. Community Energy Systems and the Law of Public Utilities. Volume Twenty-five. Minnesota

    Energy Technology Data Exchange (ETDEWEB)

    Feurer, D.A.; Weaver, C.L.

    1981-01-01

    A detailed description is given of the laws and programs of the State of Minnesota governing the regulation of public energy utilities, the siting of energy generating and transmission facilities, the municipal franchising of public energy utilities, and the prescription of rates to be charged by utilities including attendant problems of cost allocations, rate base and operating expense determinations, and rate of return allowances. These laws and programs are analyzed to identify impediments which they may present to the implementation of Integrated Community Energy Systems (ICES). This report is one of fifty-one separate volumes which describe such regulatory programs at the Federal level and in each state as background to the report entitled Community Energy Systems and the Law of Public Utilities - Volume One: An Overview. This report also contains a summary of a strategy described in Volume One - An Overview for overcoming these impediments by working within the existing regulatory framework and by making changes in the regulatory programs to enhance the likelihood of ICES implementation.

  20. India's NHPC celebrates . . .twenty-five years on

    Energy Technology Data Exchange (ETDEWEB)

    Sahai, I.M.

    2000-12-01

    The paper commemorates the 25th anniversary of India's National Hydroelectric Power Corporation (NHPC) by reviewing the history and achievements of the organisation. A list of NHPC projects, together with some details, are given. NHPC is finally overcoming the problems of the state government developing sites themselves and then handing them over to the NHPC. Some of the problems faced by NHPC, its current financial position and its future prospects are all discussed.

  1. Twenty-five years of co-management of caribou in northern Québec

    Directory of Open Access Journals (Sweden)

    René Dion

    2003-04-01

    Full Text Available The Hunting Fishing and Trapping Co-ordinating Committee (HFTCC, created at the signature of the James Bay and Northern Quebec Agreement has been meeting regularly since 1977. Early in the process, it became clear that the perception of the role and powers of the Committee were not commonly shared by the native and non-native members of the Committee. Nevertheless, the Committee has been used primarily as a consultative body for wildlife related issues. Of all the files on which the Committee worked, Caribou management, (including the development of outfitting and commercial hunting for this species has been among one of the most discussed subjects during the meetings. An analysis of important decisions taken and of the process that led to them reveal that very rarely was the Committee able to formulate unanimous resolutions to the Governments concerning caribou management. In fact, only a few unanimous resolutions could be traced and many were ignored. This took place during a period of abundance and growth of the caribou herds. As a result, the Committee has gone through the cycle of growth of the George River Herd without a management plan, without a long term outfitting management plan and for the last 8 years, without a population estimate of the herds. This situation did not prevent the Committee from allocating quotas for a commercial hunt, open a winter sport hunt and to give permanent status to outfitting camps that were once established as mobile camps. It was hoped then that increased harvest would help maintain the population at carrying capacity. This short-term reaction however, never evolved into a more elaborate plan. Of course this must be looked at in the context of the HFTCC having a lot more to worry about than the Caribou. Although all members know of the population cycles of caribou, the decision process that must be triggered, should a crisis occur is not in place. This presently results into a polarization of concerned users (fall outfitters vs. winter outfitters, subsistence and sport hunters vs. commercial hunt, Outfitters Associations vs. HFTCC and eventually George River Herd users vs. Leaf River Herd users. The HFTCC may have to make difficult decisions during the coming years but did not gain much constructive experience through its first 25 years of existence. It is unfortunate that the authority of the Committee is binding the governments only in times of crisis when an upper limit of kill needs to be established. Because of the unpredictability of caribou herd numbers, the upper limit of kill should be established on a yearly basis. This would insure that the committee is fed information continuously in order to make informed decisions and would also re-establish the authority of the HFTCC over this resource.

  2. Disturbance frequency and community structure in a twenty-five year intervention study

    Science.gov (United States)

    Trexler, J.C.; Loftus, W.F.; Perry, S.

    2005-01-01

    Models of community regulation commonly incorporate gradients of disturbance inversely related to the role of biotic interactions in regulating intermediate trophic levels. Higher trophic-level organisms are predicted to be more strongly limited by intermediate levels of disturbance than are the organisms they consume. We used a manipulation of the frequency of hydrological disturbance in an intervention analysis to examine its effects on small-fish communities in the Everglades, USA. From 1978 to 2002, we monitored fishes at one long-hydroperiod (average 350 days) and at one short-hydroperiod (average 259 days; monitoring started here in 1985) site. At a third site, managers intervened in 1985 to diminish the frequency and duration of marsh drying. By the late 1990s, the successional dynamics of density and relative abundance at the intervention site converged on those of the long-hydroperiod site. Community change was manifested over 3 to 5 years following a dry-down if a site remained inundated; the number of days since the most recent drying event and length of the preceding dry period were useful for predicting population dynamics. Community dissimilarity was positively correlated with the time since last dry. Community dynamics resulted from change in the relative abundance of three groups of species linked by life-history responses to drought. Drought frequency and intensity covaried in response to hydrological manipulation at the landscape scale; community-level successional dynamics converged on a relatively small range of species compositions when drought return-time extended beyond 4 years. The density of small fishes increased with diminution of drought frequency, consistent with disturbance-limited community structure; less-frequent drying than experienced in this study (i.e., longer return times) yields predator-dominated regulation of small-fish communities in some parts of the Everglades. ?? Springer-Verlag 2005.

  3. Regularities, Verification, and Systematization: Twenty-five Years of Research in Political Science.

    Science.gov (United States)

    Aldrich, John H.; Ostrom, Charles W., Jr.

    1980-01-01

    Discusses the basis on which the behavioral orientation to political science has been constructed: that there are discoverable uniformities in political behavior that can be expressed in generalizations; that the validity of such generalizations must be testable; and that theory and research are closely intertwined. Discusses both American and…

  4. Spatial variability studies in São Paulo, Brazil along the last twenty five years

    Directory of Open Access Journals (Sweden)

    Sidney Rosa Vieira

    2010-01-01

    Full Text Available Soil properties vary in space due to many causes. For this reason it is wise to know the magnitude and behaviour of the variability for adequate data analysis and decision making. Our work on spatial variability of soil properties in São Paulo, Brazil began in 1982 with a very simple soil sampling in a small field. Much progress has been made since then on sampling designs, field equipment and methods, and mostly on computation equipment and softwares. This paper reports the results corresponding to some aspects of this progress, as far as the field, analysis and computation work are concerned. The objective of this study was to illustrate the use of geostatistics in data analysis for three sampling conditions on long term no-tillage system. The analysis is done on a wide range of field scales, variables, sampling schemes as well as repeating sampling scheme for the same variable in different years. Semivariograms are compared for the same variables in different scales and sampling dates and depths as to provide a guide for sampling spacing and number of samples. Normalized crop yield parameters for many years are used in the discussion of time variability and on the use of yield maps to locate management zones. The time of the year in which measurements of soil physical properties are made affected the results both in terms of descriptive statistical and spatial dependence parameters. Crop yields changed (soybean decrease and maize increase with time of no-tillage but the real cause was not identified. The length of time with no-tillage affected the range of dependence for the main crops (increased for soybean, maize and oats and therefore increased the size of the homogeneous management zones. The evolution of the sampling grid from 20 m with 63 sampling points to 10 m with 302 sampling points allowed for a much better knowledge of the spatial variability of crop yields but it had the reverse effect on the spatial variability of soil physical properties.

  5. 1972-1997, Twenty-five years of energy and environmental history : lessons learned.

    Energy Technology Data Exchange (ETDEWEB)

    Drucker, H.

    1997-12-17

    Given the events of the past 25 years concerning energy and environmental issues and our reaction to them, what lessons can we learn? First, the individual American consumer wants and expects energy to be a stable commodity with low prices and easy availability. As evidenced by the heated debate over increasing the federal gasoline tax by $.05 per gallon (which would still leave Americans paying only one-third of what Europeans pay for gasoline), increases in energy prices elicit very strong public and political opposition. As further evidence, it has been argued that the general public support of the Gulf War was due, in part, to a recognition of the need to maintain a stable source of cheap oil from the region. The American public wants to maintain the benefits of cheap and abundant energy and expects its political leaders to make it happen. A second lesson is that if constraints on the energy supply do occur (e.g., the OPEC-imposed oil embargo) ardor environmental impacts from energy use do appear to be significant (e.g., SO{sub 2} and CO{sub 2} emissions), the preference is for a technology fix rather than a behavioral change. This is evidenced by our reliance on moving low-sulfur coal more than 1,000 miles from Wyoming to burn in Illinois power plants rather than reducing the demand for electricity with energy-efficient measures in residential, commercial, and industrial activities. National research programs to produce an automobile that gets 80+ miles per gallon take higher priority over working to get people to use mass transit to reduce their driving mileage. Americans expect that advanced technology can be relied upon to come up with solutions to energy and environmental problems without having to change their lifestyles. The experience with natural gas, in which a regulatory change (deregulation) was combined with technology developments (horizontal drilling and improved gas turbines for electricity generation) to increase available supply and hold prices down, has added to the confidence in the efficacy of technology fixes to solve energy and environmental problems. Third, it is difficult for government to tamper with energy markets and achieve the desired results.The energy system has shown itself to be a complex adaptive system that adjusts to even the most strenuous burdens in ways that are not easy to predict. Governmental attempts to predict and then prescribe the development of the future energy system are bound to meet with limited, if any, success. Rather, the more appropriate goal seems to be development of a robust and flexible energy system that can evolve and adjust to changing conditions. Given the experiences of the past and the lessons learned from these experiences, what might the future bring? Some predictions can be made with considerable confidence. It is highly likely that the trend of deregulating the energy sector will continue, with electricity deregulation a virtual certainty. It is also highly probable that the demand and consumption of energy from developing countries will soon surpass those of the US, Europe, and Japan, thus making them serious competitors for limited fossil fuel resources. In the environmental arena, some form of emission control of greenhouse gases from the energy sector will be agreed upon soon by the international community. More stringent regulations in the US for the emissions of some air and water pollutants are also likely. Preservation of biological diversity will also likely continue to be an issue of increasing importance.

  6. Twenty-Five-Month-Old Children Do Not Have a Grammatical Category of Verb.

    Science.gov (United States)

    Olguin, Raquel; Tomasello, Michael

    1993-01-01

    A study of two year olds investigated the nature and development of children's early productivity with verb-argument structure and verb morphology. Results indicated that the children showed no signs of productive verb morphology, but they did use newly learned verbs in some creative ways involving nounlike uses and the appending of locatives.…

  7. Review of the international symposium, sister chromatid exchanges: twenty-five years of experimental research

    Energy Technology Data Exchange (ETDEWEB)

    Tice, R.R.; Lambert, B.; Morimoto, Kanehisa; Hollaender, A.

    1983-01-01

    The purpose of this symposium was to honor initial research at Brookhaven by bringing internationally recognized leaders in the fields of genetics, cytogenetics, carcinogenesis, mutagenesis, radiation biology, toxicology, and environmental health together into an open forum to present and discuss: (1) current knowledge of the induction and formation of SCEs and their relationship to other biological endpoints, including carcinogenesis, mutagenesis, transformation, clastogenesis, DNA damage and repair, and cellular toxicity; (2) the optimal strategies for the utilization of SCEs in genetic toxicology testing schemes involving in vitro and in vivo exposure situations; (3) the most valid statistical methods for analyzing SCE data obtained from cells in culture, from cells in intact organisms, and from cells in humans; (4) the relevance of SCEs as an indicator of human disease states, both inherited and acquired, and of progress in disease treatment; and (5) the use of SCEs as an indicator of human exposure to genotoxic agents and their relevance as a prognosticator of future adverse health outcomes. This report summarizes the presentations. 7 references. (ACR)

  8. Twenty-Five Years of Applications of the Modified Allan Variance in Telecommunications.

    Science.gov (United States)

    Bregni, Stefano

    2016-04-01

    The Modified Allan Variance (MAVAR) was originally defined in 1981 for measuring frequency stability in precision oscillators. Due to its outstanding accuracy in discriminating power-law noise, it attracted significant interest among telecommunications engineers since the early 1990s, when it was approved as a standard measure in international standards, redressed as Time Variance (TVAR), for specifying the time stability of network synchronization signals and of equipment clocks. A dozen years later, the usage of MAVAR was also introduced for Internet traffic analysis to estimate self-similarity and long-range dependence. Further, in this field, it demonstrated superior accuracy and sensitivity, better than most popular tools already in use. This paper surveys the last 25 years of progress in extending the field of application of the MAVAR in telecommunications. First, the rationale and principles of the MAVAR are briefly summarized. Its adaptation as TVAR for specification of timing stability is presented. The usage of MAVAR/TVAR in telecommunications standards is reviewed. Examples of measurements on real telecommunications equipment clocks are presented, providing an overview on their actual performance in terms of MAVAR. Moreover, applications of MAVAR to network traffic analysis are surveyed. The superior accuracy of MAVAR in estimating long-range dependence is emphasized by highlighting some remarkable practical examples of real network traffic analysis.

  9. Lesson Twenty-five Prevalence and Prognostic significance of Short QT Interval

    Institute of Scientific and Technical Information of China (English)

    鲁端; 王劲

    2008-01-01

    @@ Background-Short-QT syndrome is an inherited disorder characterized by a short QT interval and an increased risk of sudden cardiac death.The clinical significance of a short OT interval observed in a randomly recorded ECG is not known.Therefore,we assessed the prevalence and prognostic significance of a short QT interval in a general population.

  10. Twenty-five years of psychology in the Journal of Sports Sciences: a historical overview.

    Science.gov (United States)

    Williams, A Mark; Hardy, Lew; Mutrie, Nanette

    2008-02-15

    We provide an overview of some of the outstanding papers published in the Journal over the last 25 years within the discipline of psychology. Altogether, almost 300 papers had been published in the Journal under the psychology banner at the start of its silver anniversary year. The greatest contribution of papers has come from the motor control and learning and sport psychology sub-areas, with papers focusing on exercise psychology being a more recent addition. Prominent research themes that have emerged from each of the different sub-areas are reviewed and some notable omissions highlighted. Finally, some issues for sport and exercise psychologists to consider in coming years are briefly highlighted.

  11. Twenty-five-year atraumatic restorative treatment (ART) approach: a comprehensive overview

    NARCIS (Netherlands)

    Frencken, J.E.; Leal, S.C.; Navarro, M.F.

    2012-01-01

    BACKGROUND: The atraumatic restorative treatment (ART) approach was born 25 years ago in Tanzania. It has evolved into an essential caries management concept for improving quality and access to oral care globally. RESULTS: Meta-analyses and systematic reviews have indicated that the high effectivene

  12. Looking backwards, looking forward: hopes for bioethics' next twenty-five years.

    Science.gov (United States)

    Sherwin, Susan

    2011-02-01

    I reflect on the past, present, and future of the field of bioethics. In so doing, I offer a very situated overview of where bioethics has been, where it now is, where it seems to be going, where I think we could do better, and where I dearly hope the field will be heading. I also propose three ways of re-orienting our theoretic tools to guide us in a new direction: (1) adopt an ethics of responsibility; (2) explore the responsibilities of various kinds of actors and relationships among them; (3) expand the types of participants engaged in bioethics.

  13. Twenty-five years of excellence: a retrospective glance of Acta Mechanica Sinica

    Institute of Scientific and Technical Information of China (English)

    Geng-Dong Cheng

    2010-01-01

    @@ The first version of Acta Mechanica Sinica (AMS) was launched in June 1985 in Beijing, aimed at delivering the cutting-on-edge progress and achievement in Mechanics in China to the world, allowing world-round colleagues to access the work of Chinese mechanician, and supplying an international forum in the field.

  14. A Summer at the University: A twenty five years experience with High School Students

    Science.gov (United States)

    Zamorano, Nelson

    2014-03-01

    After running a summer school for enthusiastic high school students for 25 years, we reached the point where three of my colleagues at the physics department, are exstudents from two physics courses offered (more than ten years ago) within our program. There are also graduates in some others Faculties in different universities. Here we would like to describe the evolution of this project since its beginning, with 60 students in an introductory physics class to the 3000 now attending (January 2014) the around 60 courses offered in almost all areas of knowledge, from theater to Biotechnology. Lately, as we became aware of the relevance of teaching sciences to young kids in elementary school, we started a winter section addressing this group of students. The courses are mainly a hands on experience. In this talk we will comment about our learning experience working on this kind of projects and our projections for the future. Partial travel support from Escuela de Verano.

  15. Twenty-five-year atraumatic restorative treatment (ART) approach: a comprehensive overview

    NARCIS (Netherlands)

    Frencken, J.E.; Leal, S.C.; Navarro, M.F.

    2012-01-01

    BACKGROUND: The atraumatic restorative treatment (ART) approach was born 25 years ago in Tanzania. It has evolved into an essential caries management concept for improving quality and access to oral care globally. RESULTS: Meta-analyses and systematic reviews have indicated that the high

  16. Twenty-five years of serving the health care needs of rural North Carolina.

    Science.gov (United States)

    Walker, Franklin

    2015-01-01

    The Community Practitioner Program seeks to improve access to quality health care for North Carolina's most vulnerable people by providing educational loan repayment grants to primary care physicians, physician assistants, and nurse practitioners in return for their service in rural and underserved communities.

  17. Managing Pessimistic, Gloomy, and Cynical Employees: Twenty-Five Do's and Don'ts.

    Science.gov (United States)

    Hills, Laura

    2015-01-01

    Every medical practice manager has to deal with a certain amount of employee pessimism at times. But one overly pessimistic employee can spread his or her negativity to the entire medical practice team if the manager doesn't intervene. This article suggests practical strategies managers can use to deal effectively with a pessimistic, defeatist, gloomy, or cynical employee. It describes two kinds of pessimism medical practice managers may encounter and offers 25 specific management do's and don'ts for managing a pessimist. This article also offers managers guidance for firing a pessimistic employee, including sample language they can use. It provides 10 self-care strategies for practice managers so they can keep themselves from succumbing to an employee's negativity. It also suggests eight ways that pessimism can hurt the medical practice team and describes five kinds of negative thinking managers may encounter. Finally, this article explores defensive pessimism theory and the surprising benefits for managers of some pessimistic thinking.

  18. Twenty-five years of monitoring a Townsend's Big-Eared Bat (Corynorhinus townsendii) maternity roost

    Science.gov (United States)

    Fellers, Gary M.; Halstead, Brian J.

    2015-01-01

    A Corynorhinus townsendii maternity roost located in an abandoned ranch house in central California was monitored for 25 y. Prior to the discovery of the bats in 1987, the house was broken into regularly and disturbance levels were quite high. Upon discovery of the roost, the house was fortified and vandalism was greatly reduced. The number of females and the number of volant young greatly increased during our study and was directly correlated with the decline in vandalism. Bats emerged from the house 43.6 (± 10.9 SD) min after local sunset. Bats emerged later in the evening during spring and fall, when it was warmer, and when it was windier. We also evaluated duration of emergence (47.11 [45.0–49.7] min), and seasonal patterns of re-entry into the roost. Several factors suggested that potential predation, most likely by owls, influenced both the timing and duration of evening emergences.

  19. Twenty-five-year atraumatic restorative treatment (ART) approach: a comprehensive overview

    NARCIS (Netherlands)

    Frencken, J.E.; Leal, S.C.; Navarro, M.F.

    2012-01-01

    BACKGROUND: The atraumatic restorative treatment (ART) approach was born 25 years ago in Tanzania. It has evolved into an essential caries management concept for improving quality and access to oral care globally. RESULTS: Meta-analyses and systematic reviews have indicated that the high effectivene

  20. Twenty-five-year atraumatic restorative treatment (ART) approach: a comprehensive overview

    OpenAIRE

    Frencken, Jo E.; Leal, Soraya Coelho; Navarro,Maria Fidela

    2012-01-01

    Background The atraumatic restorative treatment (ART) approach was born 25 years ago in Tanzania. It has evolved into an essential caries management concept for improving quality and access to oral care globally. Results Meta-analyses and systematic reviews have indicated that the high effectiveness of ART sealants using high-viscosity glass ionomers in carious lesion development prevention is not different from that of resin fissure sealants. ART using high-viscosity glass ionomer can safely...

  1. Twenty-Five Years of the Fuzzy Factor: Fuzzy Logic, the Courts, and Student Press Law.

    Science.gov (United States)

    Plopper, Bruce L.; McCool, Lauralee

    A study applied the structure of fuzzy logic, a fairly modern development in mathematical set theory, to judicial opinions concerning non-university, public school student publications, from 1975 to 1999. The study examined case outcomes (19 cases generated 27 opinions) as a function of fuzzy logic, and it evaluated interactions between fuzzy…

  2. The United States Air Force Academy’s First Twenty-Five Years, Some Perceptions.

    Science.gov (United States)

    1979-01-01

    263 (Introduction to Life Science), Life Sci 431-432 ( Microbiology I & II), and Life Sci 461-462 (Developmental Anatomy I & II). II Lt Col John R...The Ecuador -Peru Dispute; and (with Robin Higham) A Short History of Warfare. .-. ? 170 Dean of the Faculty sponsored by the National Archives to

  3. Twenty-five years requests for euthanasia and physician-assisted suicide in Dutch general practice.

    NARCIS (Netherlands)

    Marquet, R.L.; Visser, G.J.; Spreeuwenberg, P.; Peters, L.; Bartelds, A.

    2003-01-01

    Background: World-wide there is a great deal of interest in Dutch policy on euthanasia (E) and physician-assisted suicide (PAS). Apart from appreciation there is also concern that the increasing acceptance of E/PAS might lead to an ever growing number of requests for help to implement E/PAS.

  4. Twenty-five years requests for euthanasia and physician-assisted suicide in Dutch general practice.

    NARCIS (Netherlands)

    Marquet, R.L.; Visser, G.J.; Spreeuwenberg, P.; Peters, L.; Bartelds, A.

    2003-01-01

    Background: World-wide there is a great deal of interest in Dutch policy on euthanasia (E) and physician-assisted suicide (PAS). Apart from appreciation there is also concern that the increasing acceptance of E/PAS might lead to an ever growing number of requests for help to implement E/PAS. Method

  5. [Twenty-five years of the amyloid hypothesis of alzheimer disease: advances, failures and new perspectives].

    Science.gov (United States)

    Levin, O S; Vasenina, E E

    2016-01-01

    Amyloid hypothesis of Alzheimer's disease (AD) has been long the primary one. During the 25-year history the concept has been dramatically changed. Accumulation of β-amyloid is associated not only with the disruption of its synthesis (as it seemed after the discovery of genetic mechanisms of some familial cases of AD) but rather with the disruption of its clearance and elimination from the brain tissue via the microcirculatory system. It has been recognized that soluble oligomers of β-amyloid, but not senile plaques that consisted of insoluble conjugates described by A. Alzheimer 100 years ago, play a key pathogenic role in the brain. Interrelation of vascular and degenerative processes is confirmed by common risk factors, clinical, neuroimaging, pathomorphological and experimental data. Insulin-resistance is also one of the links between AD degenerative and vascular processes. Based on the current state of the amyloid hypothesis, perspectives of new multimodal treatment strategies are discussed.

  6. Mission possible: twenty-five years of university and college collaboration in baccalaureate nursing education.

    Science.gov (United States)

    Zawaduk, Cheryl; Duncan, Susan; Mahara, M Star; Tate, Betty; Callaghan, Doris; McCullough, Deborah; Chapman, Marilyn; Van Neste-Kenny, Jocelyne

    2014-10-01

    In Canada, nurse educators from five postsecondary institutions in the province of British Columbia established a collaborative nursing education initiative in 1989, with a vision to transform RN college diploma programs to baccalaureate degree programs. The principles, processes, and structures that served to develop and sustain this nursing education initiative are briefly reviewed. Curriculum, scholarship, and education legislation serve as platforms to critically explore a 25-year history (1989-2014) of successes, challenges, and transitions within this unique nursing education collaboration. The importance of curriculum development as faculty development, program evaluation as an adjunct to pedagogical scholarship, diversity of cross-institutional mandates, political interplay in nursing education, collegiality, and courageous leadership are highlighted. Nurse educators seeking to create successful collaborations must draw upon well-defined principles and organizational structures and processes to guide pedagogical practices and inquiry while remaining mindful of and engaged in professional and societal developments.

  7. Twenty-five additional cases of trisomy 9 mosaic: Birth information, medical conditions, and developmental status.

    Science.gov (United States)

    Bruns, Deborah A; Campbell, Emily

    2015-05-01

    Limited literature exists on children and adults diagnosed with the mosaic form of trisomy 9. Data from the Tracking Rare Incidence Syndromes (TRIS) project has provided physical characteristics and medical conditions for 14 individuals. This article provides TRIS Survey results of 25 additional cases at two data points (birth and survey completion) as well as developmental status. Results confirmed a number of phenotypic features and medical conditions. In addition, a number of cardiac anomalies were reported along with feeding and respiratory difficulties in the immediate postnatal period. In addition, developmental status data indicated a range in functioning level up to skills in the 36 and 48-month range. Strengths were also noted across the sample in language and communication, fine motor and social-emotional development. Implications for professionals caring for children with this genetic condition are offered.

  8. Twenty-five years of bicycle helmet promotion for children in Skaraborg District, Sweden.

    Science.gov (United States)

    Ekman, Diana Stark; Ekman, Robert

    2012-01-01

    The purpose of this study is to describe some of the results of a long-term bicycle helmet campaign for children in Skaraborg District, Sweden. The hospital discharge data for bicycle-related injuries occurring in children under the age of 15 were reviewed, to assess changes in patterns for head and other body injuries. The study shows that head injuries to children as a result of bicycle injuries were reduced between 94 and 99% in the study areas. The tremendous gains in safety for children who ride bicycles in Skaraborg District were the result of not only national policy changes that occurred in the latter half of this study period but also the result of local collaborations based on the Safe Communities model, which were organised during the first part of the study period.

  9. A Meta-Analysis of Motivational Interviewing: Twenty-Five Years of Empirical Studies

    Science.gov (United States)

    Lundahl, Brad W.; Kunz, Chelsea; Brownell, Cynthia; Tollefson, Derrik; Burke, Brian L.

    2010-01-01

    Objective: The authors investigated the unique contribution motivational interviewing (MI) has on counseling outcomes and how MI compares with other interventions. Method: A total of 119 studies were subjected to a meta-analysis. Targeted outcomes included substance use (tobacco, alcohol, drugs, marijuana), health-related behaviors (diet,…

  10. Joint Commission on Accreditation of Hospitals--twenty-five years of promoting improved health care services.

    Science.gov (United States)

    McCleary, D

    1977-09-01

    A brief history of the Joint Commission on Accreditation of Hospitals (JCAH), as well as its structure, purpose and activities, is presented. The procedure for developing JCAH standards for health care facilities is discussed. Also presented are the survey and accreditation processes. It is concluded that as long as the United States values its tradition of voluntarism and believes in positive motivation, the JCAH will be an effective influence on improved health care services.

  11. Hydrography of Bahia Todos Santos, Baja California: Results of more than twenty five years of investigations.

    Science.gov (United States)

    Bustos-Serrano, H.; Canino-Herrera, S. R.; Morales-Chavez, R.; Martinez-Garcia, G. M.

    2007-05-01

    The first study of Bahia Todos Santos (BTS) was reported by Walton in 1955. We conducted oceanographic studies in BTS since 1979. The BTS has a connection with a coastal lagoon named Estero de Punta Banda (EPB), two islands at the western portion and the Port of Ensenada. The general hydrographic characteristics are: In winter the water became homogeneous, less saline (33.6) low temperature (13°C), low oxygen (~3mL L-1) and rich in nutrient concentration. The isothermal top layer has relatively high temperature (>17°C) and oxygen concentration (>6mL L-1). The intermediate transition layer (seasonal thermocline) has minimum salinity, maximum oxygen and high stability. During fall there is distribution of heat from the surface layer to the entire water column. The thermic waves propagate with decrease amplitude in ~3 months, from surface to bottom water. The California Current flow generally southward off the western United States and northern Mexico and is one of the major coastal upwelling of the word oceans. The upwelling events in BTS appear regularly at the SW portion and were typically characterized by an increase in pCO2, decrease of O2, increase of nutrients and a lower temperature. Upwelling activity increases surface nutrient availability causing rise in the primary productivity and hence increased zooplankton biomass. The annual upwelling event which had a maximum strength on May, the seasonal warming and cooling, and the water advection were the dominant modifying processes for the variability of seawater characteristics. Higher salinities are located close to the coastline and lower off the bay. The levels of oxygen, alkalinity, pH and chlorophyll indicate that the maximum concentration of phytoplankton is located at the center of the bay. The nitrification support the primary productivity and the NO3 levels were below detection limits; the N/P ratio in 2005 was from 10 to 25; and for 2006 was below 5. There is a net enrichment of anthropogenic nutrients at BTS. The heavy metals and pesticides studies started since the early 80's with problems still to solve for Tl, Cd. There is a net Pb enrichment and higher Cr concentrations at the NE of the bay. The EPB is a wetland ~7 Km. long located at the SE part of the BTS. The EPB is a net source of DIP (deltaDIP = +0.13 mmol m-2 day-1), that brings agricultural runoff to the BTS. It is typically a hypersaline system during summer and a net heterotrophic (p-r = -14 mmol m-2 day-1), and a net denitrifying (nfix-denit = -2.1 mmol m-2 day-1) system. Some anomalies were in 2005 the presence of a huge red tide observed inside BTS (about 50% of the bay) that last for more than six months, this HAB's has killed many fishes (anoxia) and marine mammals. The hydrographic conditions during the red tide were, temperature anomalies higher than 2°C above normal; high nutrient concentration above the normal. In 2006 the values were normal again. The Port of Ensenada, increased in size and activities (tourism, transportation, coastguards for national security, cement industry, research) these developments generate some management problems, like the beach and coastline modification. The aground of the APL Panama, activates the management agencies to prevent and control pollution.

  12. The VELA Program. A Twenty-Five Year Review of Basic Research

    Science.gov (United States)

    1985-01-01

    30 Reyes Sacrame’nto Fairfield 4 0 ~Berkee 5 San Francisco 42 Concord a w rd Livermore Stockton Palo Alto 30* Mount HamiltonMoet MontCru 29tro4uction...July 7 60,0 2-0 4-5SAN FERNANDO 34-4N 118,4W 1401 1971 February 9 7520,0 10.0 6-5SAN FERNANDO 34-4 N 118-4W 0517 1971 February 10 18-0 0,8 4-6NTS 36-9 N...2.5%. Figures Sc and 5d cortes - pond to Figs. 5a and 51b after adding on the Q absorption. C.Y. Wang amd R.B. Hetnwann 387 i X, x SH 0 w-- 500 I I I I

  13. [Twenty Five Years of Cuadernos de Bioética (1990-2015): Present and Future].

    Science.gov (United States)

    Ferrer Colomer, Modesto; Aranda García, Ana; Pastor, Luis Miguel

    2015-01-01

    In this article a brief history of the journal ″Cuadernos de Bioética″ is made, a general analysis of the published works in the diverse journal sections is realized. The last changes in it over recent years are also indicated. The article ends with some considerations on the recent history of the magazine and stating some of the lines of improvement that has raised the current editorial board for the next years.

  14. Twenty-five year Consolidation project for the CERN’s Injector Machines of the LHC

    CERN Document Server

    Chohan, V

    2010-01-01

    The 25 year consolidation project was a result of a major re-thinking of CERN’s strategy for consolidating the LHC operation and the decision not to build a new PS Ring or a new Superconducting Proton Linac in early 2010. The work packages envisaged under this consolidation exercise came to a budget estimation of nearly 500 MCHF and were subjected to risk analyses to establish priorities and allocated funds based on limited spending profiles permitted under the CERN’s rolling Medium Term Plan, MTP.

  15. Twenty-five years of collecting and taxonomy of wild potatoes

    Science.gov (United States)

    Wild and cultivated potatoes (Solanum section Petota) are a difficult group taxonomically, complicated by interspecific hybridization, introgression, allopolyploidy, a mixture of sexual and asexual reproduction, and possible recent species divergence. Various workers have interpreted the variation t...

  16. Twenty five years of invasion: management of the round goby Neogobius melanostomus in the Baltic Sea

    DEFF Research Database (Denmark)

    Ojaveer, Henn; Galil, Bella S.; Lehtiniemi, Maiju

    2015-01-01

    The round goby, Neogobius melanostomus (Pallas, 1814), is one of the most invasive non-indigenous species in the Baltic Sea. It dominates coastal fisheries in some localities and is frequently found in offshore pelagic catches. This paper identifies management issues and suggests actions to be co...

  17. Twenty-five years on: still working toward a theory of conservation?

    Directory of Open Access Journals (Sweden)

    Paolo Fancelli

    2012-12-01

    Full Text Available During the 1980s conservation was still based on the scientific experimentation of the 1800s and only became operationally efficient in the 1960s. It has been interpreted and described in several ways, such as pure-conservative, a term which was first used at the beginning of 1971. However, conservation without the adjectival prefixes and resisting any form of retrospection has continued to advance both in laboratories and on archaeological sites, becoming more defined, elaborate and even authoritative in the aftermath of natural disasters. Nevertheless, it has had difficulty in being consid­ered within the traditional theories and practices of restoration; it is only recently that it has become an advantageous association. This is due to the fact that on the one hand, there has been growing awareness regarding the necessity of using conserva­tive intervention in the strict sense of the word and on the other it is evident that this intervention must be carried out in conjunction with other measures of an inhibitory and contrasting nature, using architectural instruments when faced with possibly inevitable deterioration. The result is a fruitful convergence between conservation and critical restoration in terms of a critical-conservative(or vice-versa approach.

  18. Twenty-five years of artificial photosynthesis research at Ernest Orlando Lawrence Berkeley National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Otvos, J.W.; Calvin, M.

    1996-02-01

    This report summarizes the research done on artificial photosynthesis by the Calvin Group between 1970 and 1995 when the program was terminated. It contains a compilation of the personnel involved as well as a bibliography of publications supported by the project.

  19. Twenty-five year trends in body mass index by education and income in Finland

    Directory of Open Access Journals (Sweden)

    Prättälä Ritva

    2012-10-01

    Full Text Available Abstract Background The socioeconomic gradient in obesity and overweight is amply documented. However, the contribution of different socioeconomic indicators on trends of body mass index (BMI over time is less well known. The aim of this study was to investigate the associations of education and income with (BMI from the late 1970s to the early 2000s. Methods Data were derived from nationwide cross-sectional health behaviour surveys carried out among Finns annually since 1978. This study comprises data from a 25-year period (1978–2002 that included 25 339 men and 25 330 women aged 25–64 years. BMI was based on self-reported weight and height. Education in years was obtained from the questionnaire and household income from the national tax register. In order to improve the comparability of the socioeconomic position measures, education and income were divided into gender-specific tertiles separately for each study year. Linear regression analysis was applied. Results An increase in BMI was observed among men and women in all educational and income groups. In women, education and income were inversely associated with BMI. The magnitudes of the associations fluctuated but stayed statistically significant over time. Among the Finnish men, socioeconomic differences were more complicated. Educational differences were weaker than among the women and income differences varied according to educational level. At the turn of the century, the high income men in the lowest educational group had the highest BMI whereas the income pattern in the highest educational group was the opposite. Conclusion No overall change in the socio-economic differences of BMI was observed in Finland between 1978 and 2002. However, the trends of BMI diverged in sub-groups of the studied population: the most prominent increase in BMI took place in high income men with low education and in low income men with high education. The results encourage further research on the pathways between income, education, living conditions and the increasing BMI.

  20. Twenty-five years of breast-feeding research in Midwifery.

    Science.gov (United States)

    Dykes, Fiona

    2011-02-01

    This paper explores some of the significant changes that have taken place with regard to the protection, promotion and support of breast feeding during the past three decades. The period covered since the first issue of Midwifery in 1985, has been marked by some dramatic reversals of harmful discourses and detrimental practices with regard to infant and young child feeding and more specifically breast feeding. Midwifery has spanned this period with the publication of 80 papers on breast feeding. This collection of papers has both influenced and reflected upon changes in international and national breast-feeding strategies and practices. Six papers have been selected for a special virtual edition of Midwifery to reflect the diversity of breast-feeding research in terms of issues explored, methodology and country of origin (www.midwiferyjournal.com). Considerable progress is reflected in these papers. However, there are still enormous challenges ahead in working towards the optimisation of infant and young child feeding. In addition to continuing to conduct and collate robust scientific and epidemiological research we need further studies that explore the political, economic, socio-cultural and psychological factors influencing women's infant feeding practices. Our professional practice needs to continue to improve in order to provide women and families with appropriate support, encouragement and resources to enable them to breastfeed effectively. Finally, we need to continue to challenge the systems and approaches at organisational and community levels that impede women in their endeavours to feed their infants in optimum ways. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. Prefronto–cerebellar transcranial direct current stimulation improves visuospatial memory, executive functions, and neurological soft signs in patients with euthymic bipolar disorder

    Directory of Open Access Journals (Sweden)

    Minichino A

    2015-08-01

    Full Text Available Amedeo Minichino, Francesco Saverio Bersani, Laura Bernabei, Francesco Spagnoli, Lucilla Vergnani, Alessandra Corrado, Ines Taddei, Massimo Biondi, Roberto Delle Chiaie Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy Objective: The aim of the study was to improve neuropsychological functioning of euthymic patients with bipolar disorder (BD using transcranial direct current stimulation (tDCS applied to cerebellar and prefrontal cortices.Methods: Twenty-five BD outpatients underwent prefrontal (anodal and cerebellar (cathodal tDCS for 3 consecutive weeks. All participants were assessed through the Rey Complex Figure Test delay and copy and the Neurological Examination Scale at baseline and after therapy with tDCS.Results: After tDCS treatment, patients showed significant improvements in visuospatial memory tasks. Patients with worse baseline cognitive performances also showed a significant improvement in executive functioning tasks. Neurological Examination Scale total score and motor coordination subscale significantly improved.Conclusion: Prefrontal-excitatory and cerebellar-inhibitory stimulations in euthymic BD patients may lead to better neurocognitive performances. This improvement could result from the modulation of prefronto–thalamic–cerebellar circuit activity pattern, which can be disrupted in BD. Keywords: cerebellum, dorsolateral prefrontal cortex, neuropsychology, cognition 

  2. Frontal D2/3 Receptor Availability in Schizophrenia Patients Before and After Their First Antipsychotic Treatment

    DEFF Research Database (Denmark)

    Nørbak-Emig, Henrik; Ebdrup, Bjørn H; Fagerlund, Birgitte

    2016-01-01

    the relation between frontal D2/3 receptor availability and treatment effect on positive symptoms. METHODS: Twenty-five antipsychotic-naïve first-episode schizophrenia patients were examined with the Positive and Negative Syndrome Scale, tested with the cognitive test battery Cambridge Neuropsychological Test...

  3. Thermodynamic correction of particle concentrations measured by underwing probes on fast-flying aircraft

    Science.gov (United States)

    Weigel, Ralf; Spichtinger, Peter; Mahnke, Christoph; Klingebiel, Marcus; Afchine, Armin; Petzold, Andreas; Krämer, Martina; Costa, Anja; Molleker, Sergej; Reutter, Philipp; Szakáll, Miklós; Port, Max; Grulich, Lucas; Jurkat, Tina; Minikin, Andreas; Borrmann, Stephan

    2016-10-01

    Particle concentration measurements with underwing probes on aircraft are impacted by air compression upstream of the instrument body as a function of flight velocity. In particular, for fast-flying aircraft the necessity arises to account for compression of the air sample volume. Hence, a correction procedure is needed to invert measured particle number concentrations to ambient conditions that is commonly applicable to different instruments to gain comparable results. In the compression region where the detection of particles occurs (i.e. under factual measurement conditions), pressure and temperature of the air sample are increased compared to ambient (undisturbed) conditions in certain distance away from the aircraft. Conventional procedures for scaling the measured number densities to ambient conditions presume that the air volume probed per time interval is determined by the aircraft speed (true air speed, TAS). However, particle imaging instruments equipped with pitot tubes measuring the probe air speed (PAS) of each underwing probe reveal PAS values systematically below those of the TAS. We conclude that the deviation between PAS and TAS is mainly caused by the compression of the probed air sample. From measurements during two missions in 2014 with the German Gulfstream G-550 (HALO - High Altitude LOng range) research aircraft we develop a procedure to correct the measured particle concentration to ambient conditions using a thermodynamic approach. With the provided equation, the corresponding concentration correction factor ξ is applicable to the high-frequency measurements of the underwing probes, each of which is equipped with its own air speed sensor (e.g. a pitot tube). ξ values of 1 to 0.85 are calculated for air speeds (i.e. TAS) between 60 and 250 m s-1. For different instruments at individual wing position the calculated ξ values exhibit strong consistency, which allows for a parameterisation of ξ as a function of TAS for the current HALO

  4. Long-term follow-up of children who underwent severe hypospadias repair using an online survey with validated questionnaires.

    Science.gov (United States)

    Fraumann, Sarah A; Stephany, Heidi A; Clayton, Douglass B; Thomas, John C; Pope, John C; Adams, Mark C; Brock, John W; Tanaka, Stacy T

    2014-06-01

    Few studies of hypospadias repair in childhood have used validated questionnaires to investigate outcomes of cosmesis, urinary function, and sexual function in adulthood. We sought to investigate long-term outcomes in adult patients who had undergone severe hypospadias repair as children using an existing web-based application available to multiple institutions in order to develop an online patient survey of previously validated questionnaires. Patients aged 18 years or older who underwent severe hypospadias repair between 1992 and 1997 at our institution were contacted to complete an online survey. Through medical chart reviews, we analyzed the location of meatus, type of repair, and complications. The online survey included questions about penile appearance, and validated questionnaires to assess urinary and sexual function. Of 58 patients who met the inclusion criteria, we contacted 19, and 13 completed the survey. Fifty-nine percent had complications, with an average of 2.2 procedures per patient. Most (85.0%) were satisfied with penile appearance, although 38.0% had residual penile curvature. Hypospadias patients had mean lower orgasmic function than normal controls. Mean scores for urinary function and other domains of sexual function were similar to normal controls. Although the majority of adult patients were satisfied with the outcomes of penile appearance, urinary function, and sexual function, our online survey suggests decreased lower orgasmic function as measured by validated questionnaire. An online survey accessible to multiple institutions with validated questionnaires may facilitate assessment of long-term hypospadias results. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  5. HLA-G regulatory haplotypes and implantation outcome in couples who underwent assisted reproduction treatment.

    Science.gov (United States)

    Costa, Cynthia Hernandes; Gelmini, Georgia Fernanda; Wowk, Pryscilla Fanini; Mattar, Sibelle Botogosque; Vargas, Rafael Gustavo; Roxo, Valéria Maria Munhoz Sperandio; Schuffner, Alessandro; Bicalho, Maria da Graça

    2012-09-01

    The role of HLA-G in several clinical conditions related to reproduction has been investigated. Important polymorphisms have been found within the 5'URR and 3'UTR regions of the HLA-G promoter. The aim of the present study was to investigate 16 SNPs in the 5'URR and 14-bp insertion/deletion (ins/del) polymorphism located in the 3'UTR region of the HLA-G gene and its possible association with the implantation outcome in couples who underwent assisted reproduction treatments (ART). The case group was composed of 25 ART couples. Ninety-four couples with two or more term pregnancies composed the control group. Polymorphism haplotype frequencies of the HLA-G were determined for both groups. The Haplotype 5, Haplotype 8 and Haplotype 11 were absolute absence in ART couples. The HLA-G*01:01:02a, HLA-G*01:01:02b alleles and the 14-bp ins polymorphism, Haplotype 2, showed an increased frequency in case women and similar distribution between case and control men. However, this susceptibility haplotype is significantly presented in case women and in couple with failure implantation after treatment, which led us to suggest a maternal effect, associated with this haplotype, once their presence in women is related to a higher number of couples who underwent ART.

  6. Circulating S100B and Adiponectin in Children Who Underwent Open Heart Surgery and Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Alessandro Varrica

    2015-01-01

    Full Text Available Background. S100B protein, previously proposed as a consolidated marker of brain damage in congenital heart disease (CHD newborns who underwent cardiac surgery and cardiopulmonary bypass (CPB, has been progressively abandoned due to S100B CNS extra-source such as adipose tissue. The present study investigated CHD newborns, if adipose tissue contributes significantly to S100B serum levels. Methods. We conducted a prospective study in 26 CHD infants, without preexisting neurological disorders, who underwent cardiac surgery and CPB in whom blood samples for S100B and adiponectin (ADN measurement were drawn at five perioperative time-points. Results. S100B showed a significant increase from hospital admission up to 24 h after procedure reaching its maximum peak (P0.05 have been found all along perioperative monitoring. ADN/S100B ratio pattern was identical to S100B alone with the higher peak at the end of CPB and remained higher up to 24 h from surgery. Conclusions. The present study provides evidence that, in CHD infants, S100B protein is not affected by an extra-source adipose tissue release as suggested by no changes in circulating ADN concentrations.

  7. Non-verbal behavioral interactions of depressed patients with partners and strangers : The role of behavioral social support and involvement in depression persistence

    NARCIS (Netherlands)

    Hale, WW; Jansen, JHC; Bouhuys, AL; Jenner, JA; vandenHoofdakker, RH

    1997-01-01

    Excessive support seeking and lack of receiving social support have been associated with depression onset and unfavorable course of depression. It has been assumed that social support is effected by observable behaviors that express involvement. Twenty-five patients with major depression were studie

  8. Future singularities if the universe underwent Starobinsky inflation in the past

    CERN Document Server

    Carlson, Eric D; Einhorn, John R; Hicks, Bradley; Lundeen, Andrew J

    2016-01-01

    The effects which quantum fields and an $R^2$ term in the gravitational Lagrangian have on future singularities are investigated in the case that the universe underwent Starobinsky inflation in the past. The dark energy is modeled as a perfect fluid, and the focus is on type I-IV singularities and little rips which result when the classical Einstein equations are solved with various types of dark energy as a source. First, evidence is provided that the energy densities of massive conformally coupled scalar fields approach that of the conformally invariant scalar field as a type III singularity is approached. Then, solutions to the semiclassical backreaction equations are investigated when conformally invariant fields and an $R^2$ term in the gravitational Lagrangian are present. General proofs regarding the behaviors of the solutions in cases where the dark energy results in classical singularities of the above types are given. These indicate that backreaction effects always make little rips, where the scale ...

  9. Association between Seminal Vesicle Invasion and Prostate Cancer Detection Location after Transrectal Systemic Biopsy among Men Who Underwent Radical Prostatectomy.

    Directory of Open Access Journals (Sweden)

    Young Ik Lee

    Full Text Available Our hypothesis is that the location of the seminal vesicles near the base of the prostate, the more positive cores are detected in the base, the greater the risk of seminal vesicle invasion. Therefore we investigate the clinical outcomes of base dominant prostate cancer (BDPC in transrectal ultrasound (TRUS -guided biopsies compared with anteromiddle dominant prostate cancer (AMPC.From November 2003 to June 2014, a total of 990 intermediate and high risk prostate cancer (PCa patients who underwent radical prostatectomy (RP were enrolled and stratified into two groups according to proportion of positive cores-BDPC group had ≥ 33.3% ratio of positive cores from the prostate base among all positive cores and AMPC group < 33.3% in systemic biopsy. Between two groups, we compared the rate of pathologic outcomes and biochemical recurrence (BCR. We performed multivariate logistic regression model to confirm the significance of BDPC to seminal vesicle invasion (SVI and Cox proportional hazard analysis to BCR.Among these 990 PCa patients, the 487 patients in BDPC group had more advanced clinical stage (p<0.001, a higher biopsy GS (p = 0.002, and a higher rate of extracapsular extension (ECE, SVI and BCR (all p<0.001 than AMPC group. The patients in BDPC group had poor BCR free survival rate via Kaplan-meier analysis (p<0.001. The ratio of the base positive cores was a significant predictor to SVI in multivariate analysis (p < 0.001 and significant predictor of BCR in multivariate Cox proportional analysis (hazard ratio: 1.466, p = 0.004.BDPC in TRUS-guided prostate biopsies was significantly associated with SVI and BCR after adjusting for other clinical factors. Therefore, BDPC should be considered to be a more aggressive tumor despite an otherwise similar cancer profile.

  10. Comparison of the patient-activated event recording system vs. traditional 24 h Holter electrocardiography in individuals with paroxysmal palpitations or dizziness.

    Science.gov (United States)

    de Asmundis, Carlo; Conte, Giulio; Sieira, Juan; Chierchia, Gian-Battista; Rodriguez-Manero, Moises; Di Giovanni, Giacomo; Ciconte, Giuseppe; Levinstein, Moises; Baltogiannis, Giannis; Saitoh, Yukio; Casado-Arroyo, Rubén; Brugada, Pedro

    2014-08-01

    Electrocardiographic documentation of symptomatic episodes of palpitations by means of traditional methods such as 24 h Holter monitoring (HM) or loop recorders is challenging. Patient-activated electrocardiography (ECG) recorders have been proved to be a useful tool in the diagnosis of arrhythmias in these patients. However, no comparison studies between the two techniques have been conducted. The aim of this study was to compare the diagnostic value of Holter ECG and a patient-activated event recorder (OMRON portable HeartScan ECG Monitor(®)) (HeartScan) in the detection of arrhythmias in patients with paroxysmal palpitations or dizziness suggestive of cardiac arrhythmias. Patients with paroxysmal palpitations or dizziness were eligible for this study. All patients underwent an HM for 24 h and a 15-day HeartScan after the HM. Six hundred and twenty-five patients (48% male, mean age: 37 ± 11 years) were included in the study. All patients present with normal heart structure, normal baseline 12-lead ECG, and normal echocardiogram. Indications for ECG monitoring were palpitations in 577 patients (92.3%) and dizziness in 48 (7.7%). Holter monitoring offered a clinical diagnosis in 11 patients (1.8%). Conversely, HeartScan diagnosed the clinical arrhythmia in 558 individuals (89%). Detection of symptoms-related arrhythmias by means of HeartScan was significantly higher when compared with HM (P < 0.01). The studied system proved to be an efficient event recorder providing the diagnosis of the clinical arrhythmia in 89% of patients with paroxysmal palpitations or dizziness. Further studies are needed to confirm our results. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  11. Quality of life in the patients with central diabetes insipidus assessed by Nagasaki Diabetes Insipidus Questionnaire.

    Science.gov (United States)

    Nozaki, Aya; Ando, Takao; Akazawa, Satoru; Satoh, Tsuyoshi; Sagara, Ikuko; Horie, Ichiro; Imaizumi, Misa; Usa, Toshiro; Yanagisawa, Robert T; Kawakami, Atsushi

    2016-01-01

    Central diabetes insipidus (CDI) is characterized by polyuria and polydipsia due to a deficiency of vasopressin. Currently, the treatment goal for CDI is improvement of quality of life (QOL) by desmopressin (DDAVP) without developing hyponatremia. However, there is no reliable measure for QOL in CDI patients. We evaluate our original questionnaire for QOL, consisting of 12 questions focusing on polyuria, polydipsia, and DDAVP treatment, in CDI patients who underwent a switch from nasal spray to oral disintegrating tablets of DDAVP. Twenty-five CDI patients under nasal DDAVP treatment, six with newly developed CDI, and 18 healthy individuals without known polyuric/polydipsic disorders as control subjects were enrolled. QOL scores were determined by our questionnaire at the enrollment and 3 months after the start of oral DDAVP treatment and were examined by the Wilcoxon signed-rank test. Eleven questions detected improvement in QOL. The sum of the QOL scores of the eleven questions increased from 29.2 ± 5.6 under nasal to 36.8 ± 4.5 under oral DDAVP (p < 0.001). There were no clinically relevant changes in serum levels of Na. After eliminating two questions about DDAVP treatment, the sum of QOL scores was 15.3 ± 6.5 in untreated CDI patients, 24.4 ± 5.2 in those with nasal treatment, 28.9 ± 4.9 in those with oral DDAVP, and 29.5 ± 3.6 in healthy controls. The difference among groups was significant (p < 0.05 in Steel-Dwass test) except between patients treated with oral DDAVP and healthy controls. Our questionnaire can be used to accurately assess QOL in CDI patients.

  12. Outcomes of Chinese Patients with End-stage Pulmonary Disease while Awaiting Lung Transplantation: A Single-center Study

    Institute of Scientific and Technical Information of China (English)

    Wen-Xin He; Yu-Ling Yang; Yan Xia; Nan Song; Ming Liu; Peng Zhang; Jiang Fan

    2016-01-01

    Background: The factors affecting the outcome of patients referred for lung transplantation (LTx) still have not been investigated extensively.The aim of this study was to characterize the patient outcomes and identify the prognostic factors for death while awaiting the LTx.Methods: From January 2003 to November 2013, the clinical data of 103 patients with end-stage lung disease that had been referred for LTx to Department of Thoracic Surgery, Shanghai Pulmonary Hospital were analyzed retrospectively.The relationship between predictors and survival was evaluated using the Kaplan-Meier method and the Cox proportional hazards model.Results: Twenty-five patients (24.3%) died while awaiting the LTx.Fifty patients (48.5%) underwent LTx, and 28 patients (27.2%) were still on the waitlist.Compared to the candidates with chronic obstructive pulmonary disease (COPD), patients with idiopathic pulmonary fibrosis (IPF) had a higher mortality while awaiting the LTx (40.0% vs.12.3%, P =0.003).Patients requiring mechanical ventilation (MV) had a higher mortality while waiting than others (50.0% vs.20.2%, P =0.038).Two variables, using MV and IPF but not COPD as primary disease, emerged as significant independent risk factors for death on the waitlist (hazard ratio [HR] =56.048, 95% confidence interval [CI]: 3.935-798.263, P =0.003 and HR =14.859, 95% CI: 2.695-81.932, P =0.002, respectively).Conclusion: The type of end-stage lung disease, pulmonary hypertension, and MV may be distinctive prognostic factors for death while awaiting the LTx.

  13. Repeated otilonium bromide administration prevents neurotransmitter changes in colon of rats underwent to wrap restraint stress.

    Science.gov (United States)

    Traini, Chiara; Evangelista, Stefano; Girod, Vincent; Faussone-Pellegrini, Maria Simonetta; Vannucchi, Maria Giuliana

    2017-04-01

    Otilonium bromide (OB) is a spasmolytic drug successfully used for the treatment of irritable bowel syndrome (IBS). Its efficacy has been attributed to the block of L- and T-type Ca(2+) channels and muscarinic and tachykinin receptors in the smooth muscle. Furthermore, in healthy rats, repeated OB administration modified neurotransmitter expression and function suggesting other mechanisms of action. On this basis, we investigated whether repeated OB treatment prevented the functional and neurochemical changes observed in the colon of rats underwent to wrap restrain stress (WRS) a psychosocial stressor considered suitable to reproduce the main IBS signs and symptoms. In control, WRS and OB/WRS rats functional parameters were measured in vivo and morphological investigations were done ex vivo in the colon. The results showed that OB counteracts most of the neurotransmitters changes caused by WRS. In particular, the drug prevents the decrease in SP-, NK1r-, nNOS-, VIP-, and S100β-immunoreactivity (IR) and the increase in CGRP-, and CRF1r-IR. On the contrary, OB does not affect the increase in CRF2r-IR neurons observed in WRS rats and does not interfere with the mild mucosal inflammation due to WRS. Finally, OB per se increases the Mr2 expression in the muscle wall and decreases the number of the myenteric ChAT-IR neurons. Functional findings show a significantly reduction in the number of spontaneous abdominal contraction in OB treated rats. The ability of OB to block L-type Ca(2+) channels, also expressed by enteric neurons, might represent a possible mechanism through which OB exerts its actions. © 2016 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  14. Vitellogenin underwent subfunctionalization to acquire caste and behavioral specific expression in the harvester ant Pogonomyrmex barbatus.

    Science.gov (United States)

    Corona, Miguel; Libbrecht, Romain; Wurm, Yannick; Riba-Grognuz, Oksana; Studer, Romain A; Keller, Laurent

    2013-01-01

    The reproductive ground plan hypothesis (RGPH) proposes that the physiological pathways regulating reproduction were co-opted to regulate worker division of labor. Support for this hypothesis in honeybees is provided by studies demonstrating that the reproductive potential of workers, assessed by the levels of vitellogenin (Vg), is linked to task performance. Interestingly, contrary to honeybees that have a single Vg ortholog and potentially fertile nurses, the genome of the harvester ant Pogonomyrmex barbatus harbors two Vg genes (Pb_Vg1 and Pb_Vg2) and nurses produce infertile trophic eggs. P. barbatus, thus, provides a unique model to investigate whether Vg duplication in ants was followed by subfunctionalization to acquire reproductive and non-reproductive functions and whether Vg reproductive function was co-opted to regulate behavior in sterile workers. To investigate these questions, we compared the expression patterns of P. barbatus Vg genes and analyzed the phylogenetic relationships and molecular evolution of Vg genes in ants. qRT-PCRs revealed that Pb_Vg1 is more highly expressed in queens compared to workers and in nurses compared to foragers. By contrast, the level of expression of Pb_Vg2 was higher in foragers than in nurses and queens. Phylogenetic analyses show that a first duplication of the ancestral Vg gene occurred after the divergence between the poneroid and formicoid clades and subsequent duplications occurred in the lineages leading to Solenopsis invicta, Linepithema humile and Acromyrmex echinatior. The initial duplication resulted in two Vg gene subfamilies preferentially expressed in queens and nurses (subfamily A) or in foraging workers (subfamily B). Finally, molecular evolution analyses show that the subfamily A experienced positive selection, while the subfamily B showed overall relaxation of purifying selection. Our results suggest that in P. barbatus the Vg gene underwent subfunctionalization after duplication to acquire caste- and

  15. Vitellogenin underwent subfunctionalization to acquire caste and behavioral specific expression in the harvester ant Pogonomyrmex barbatus.

    Directory of Open Access Journals (Sweden)

    Miguel Corona

    Full Text Available The reproductive ground plan hypothesis (RGPH proposes that the physiological pathways regulating reproduction were co-opted to regulate worker division of labor. Support for this hypothesis in honeybees is provided by studies demonstrating that the reproductive potential of workers, assessed by the levels of vitellogenin (Vg, is linked to task performance. Interestingly, contrary to honeybees that have a single Vg ortholog and potentially fertile nurses, the genome of the harvester ant Pogonomyrmex barbatus harbors two Vg genes (Pb_Vg1 and Pb_Vg2 and nurses produce infertile trophic eggs. P. barbatus, thus, provides a unique model to investigate whether Vg duplication in ants was followed by subfunctionalization to acquire reproductive and non-reproductive functions and whether Vg reproductive function was co-opted to regulate behavior in sterile workers. To investigate these questions, we compared the expression patterns of P. barbatus Vg genes and analyzed the phylogenetic relationships and molecular evolution of Vg genes in ants. qRT-PCRs revealed that Pb_Vg1 is more highly expressed in queens compared to workers and in nurses compared to foragers. By contrast, the level of expression of Pb_Vg2 was higher in foragers than in nurses and queens. Phylogenetic analyses show that a first duplication of the ancestral Vg gene occurred after the divergence between the poneroid and formicoid clades and subsequent duplications occurred in the lineages leading to Solenopsis invicta, Linepithema humile and Acromyrmex echinatior. The initial duplication resulted in two Vg gene subfamilies preferentially expressed in queens and nurses (subfamily A or in foraging workers (subfamily B. Finally, molecular evolution analyses show that the subfamily A experienced positive selection, while the subfamily B showed overall relaxation of purifying selection. Our results suggest that in P. barbatus the Vg gene underwent subfunctionalization after duplication to

  16. Vitellogenin Underwent Subfunctionalization to Acquire Caste and Behavioral Specific Expression in the Harvester Ant Pogonomyrmex barbatus

    Science.gov (United States)

    Wurm, Yannick; Riba-Grognuz, Oksana; Studer, Romain A.; Keller, Laurent

    2013-01-01

    The reproductive ground plan hypothesis (RGPH) proposes that the physiological pathways regulating reproduction were co-opted to regulate worker division of labor. Support for this hypothesis in honeybees is provided by studies demonstrating that the reproductive potential of workers, assessed by the levels of vitellogenin (Vg), is linked to task performance. Interestingly, contrary to honeybees that have a single Vg ortholog and potentially fertile nurses, the genome of the harvester ant Pogonomyrmex barbatus harbors two Vg genes (Pb_Vg1 and Pb_Vg2) and nurses produce infertile trophic eggs. P. barbatus, thus, provides a unique model to investigate whether Vg duplication in ants was followed by subfunctionalization to acquire reproductive and non-reproductive functions and whether Vg reproductive function was co-opted to regulate behavior in sterile workers. To investigate these questions, we compared the expression patterns of P. barbatus Vg genes and analyzed the phylogenetic relationships and molecular evolution of Vg genes in ants. qRT-PCRs revealed that Pb_Vg1 is more highly expressed in queens compared to workers and in nurses compared to foragers. By contrast, the level of expression of Pb_Vg2 was higher in foragers than in nurses and queens. Phylogenetic analyses show that a first duplication of the ancestral Vg gene occurred after the divergence between the poneroid and formicoid clades and subsequent duplications occurred in the lineages leading to Solenopsis invicta, Linepithema humile and Acromyrmex echinatior. The initial duplication resulted in two Vg gene subfamilies preferentially expressed in queens and nurses (subfamily A) or in foraging workers (subfamily B). Finally, molecular evolution analyses show that the subfamily A experienced positive selection, while the subfamily B showed overall relaxation of purifying selection. Our results suggest that in P. barbatus the Vg gene underwent subfunctionalization after duplication to acquire caste- and

  17. Changes in Body Mass Index and Lipid Profile in Psoriatic Patients After Treatment With Standard Protocol of Infliximab.

    Science.gov (United States)

    Ehsani, Amir Houshang; Mortazavi, Hossein; Balighi, Kamran; Hosseini, Mahboubeh Sadat; Azizpour, Arghavan; Hejazi, Seyyedeh Pardis; Goodarzi, Azadeh; Darvari, Seyyedeh Bahareh

    2016-09-01

    Psoriasis is a chronic and inflammatory dermatologic disease. Psoriasis may predispose to cardiovascular disease and diabetes. However, the role of tumor necrosis factor (TNF) inhibitor in mediating this risk is controversial. Regarding frequent use of infliximab in psoriasis, and the hypothesis that anti TNF-α treatment may increase Body Mass Index (BMI) and alter lipid profile in these patients, the aim of this study was to assess changes in BMI and Lipid Profile and level of leptin in Psoriatic Patients under Treatment of Standard Protocol of Infliximab in a 24 week period. This study was accomplished as a before-after study. Twenty-seven psoriatic patients were included, and standard infliximab therapy was applied. All patients underwent 3 times of blood collection and in each session; LDL, HDL, Total Cholesterol, Triglycerides, Leptin, and PASI score were measured at the start of the study and at the 12th and 24th week of follow-up. Twenty-five patients consisted of 18 (72%) male and 7 (28%) female subjects were evaluated. The mean age of the patients was 36.91±13.31 years. PASI score demonstrated significant decrease after 24 weeks; however, BMI and HDL and leptin showed a significant increase during treatment. Significant negative correlation was seen between Leptin and PASI score changes (r=0.331, P=0.042). HDL and BMI had the most correlations with leptin (positive correlation) and PASI score (negative correlation). Results demonstrated a dramatic decrease in PASI, increase in BMI and HDL and increased in leptin; somewhat correlated to each other. These results suggest that patients taking infliximab should take more care of their weight and lipid profile, while on treatment.

  18. Turner Syndrome with 45,X/46,XY mosaicism underwent gonadectomy: Report of 3 cases

    OpenAIRE

    Tokmak, Aytekin; Akselim, Burak; Yeşilyurt, Hüseyin

    2015-01-01

    Turner syndrome (TS) classically is characterized by complete or partial absence of one X chromosome. A Y chromosome can be detected in some of the TS patients called mosaicism. In this study we report three cases of TS with a female phenotype and a 45,X/46,XY karyotype. All of the cases were referred or applied to our hospital for gonadectomy at third decade of their lives. They had many of the stigmata of TS. We performed gonadectomy to our patients. In one of them histopathology was sugges...

  19. Physical activity in the elderly who underwent joint replacement surgery in the course of rheumatic diseases

    Science.gov (United States)

    Komorowski, Arkadiusz; Przepióra, Wiktor; Księżopolska-Orłowska, Krystyna

    2016-01-01

    According to the forecasts of the Central Statistical Office of Poland, in 2030 people at the age of 65 and older will account for 23.8%, i.e. their number will amount to approx. 8.5 m people. Geriatric rheumatic patients more often decide to undergo surgical joint replacement. According to the National Health Fund, the number of joint replacement services provided in 2014 increased by 93%, as compared to 2005. Improving the physical performance of this constantly expanding group of patients requires taking into account many factors to raise their functional status, reduce the risk of falling, teach rules of proper functioning with an artificial joint and encourage unassisted physical activity. Restoring fitness and independence is a difficult but necessary task due to an increasing number of seniors with replaced joint. PMID:27504021

  20. Physical activity in the elderly who underwent joint replacement surgery in the course of rheumatic diseases.

    Science.gov (United States)

    Prusinowska, Agnieszka; Komorowski, Arkadiusz; Przepióra, Wiktor; Księżopolska-Orłowska, Krystyna

    2016-01-01

    According to the forecasts of the Central Statistical Office of Poland, in 2030 people at the age of 65 and older will account for 23.8%, i.e. their number will amount to approx. 8.5 m people. Geriatric rheumatic patients more often decide to undergo surgical joint replacement. According to the National Health Fund, the number of joint replacement services provided in 2014 increased by 93%, as compared to 2005. Improving the physical performance of this constantly expanding group of patients requires taking into account many factors to raise their functional status, reduce the risk of falling, teach rules of proper functioning with an artificial joint and encourage unassisted physical activity. Restoring fitness and independence is a difficult but necessary task due to an increasing number of seniors with replaced joint.

  1. Functional connectivity-based signatures of schizophrenia revealed by multiclass pattern analysis of resting-state fMRI from schizophrenic patients and their healthy siblings

    Directory of Open Access Journals (Sweden)

    Yu Yang

    2013-02-01

    Full Text Available Abstract Background Recently, a growing number of neuroimaging studies have begun to investigate the brains of schizophrenic patients and their healthy siblings to identify heritable biomarkers of this complex disorder. The objective of this study was to use multiclass pattern analysis to investigate the inheritable characters of schizophrenia at the individual level, by comparing whole-brain resting-state functional connectivity of patients with schizophrenia to their healthy siblings. Methods Twenty-four schizophrenic patients, twenty-five healthy siblings and twenty-two matched healthy controls underwent the resting-state functional Magnetic Resonance Imaging (rs-fMRI scanning. A linear support vector machine along with principal component analysis was used to solve the multi-classification problem. By reconstructing the functional connectivities with high discriminative power, three types of functional connectivity-based signatures were identified: (i state connectivity patterns, which characterize the nature of disruption in the brain network of patients with schizophrenia; (ii trait connectivity patterns, reflecting shared connectivities of dysfunction in patients with schizophrenia and their healthy siblings, thereby providing a possible neuroendophenotype and revealing the genetic vulnerability to develop schizophrenia; and (iii compensatory connectivity patterns, which underlie special brain connectivities by which healthy siblings might compensate for an increased genetic risk for developing schizophrenia. Results Our multiclass pattern analysis achieved 62.0% accuracy via leave-one-out cross-validation (p  Conclusions Based on our experimental results, we saw some indication of differences in functional connectivity patterns in the healthy siblings of schizophrenic patients compared to other healthy individuals who have no relations with the patients. Our preliminary investigation suggested that the use of resting-state functional

  2. Prognostic factors for perioperative myocardial infarction and immediate mortality in patients who underwent coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Mirtha López Ramírez

    2016-03-01

    Conclusions: Older age and higher body mass index were protective prognostic factors for perioperative acute myocardial infarction events. Prolonged surgical time and complications were independently associated with perioperative infarction and mortality after coronary artery bypass graft surgery. Low preoperative glomerular filtration rate was also associated with mortality.

  3. Functional evaluation of patient after arthroscopic repair of rotator cuff tear.

    Science.gov (United States)

    Kumar, Rohit; Jadhav, Umesh

    2014-06-01

    Rotator cuff tear is a common problem either after trauma or after degenerative tear in old age group. Arthroscopic repair is the current concept of rotator cuff repair. Here, we are trying to evaluate the functional outcome after arthroscopic repair of full thickness rotator cuff tear (single row) in Indian population. Twenty five patients (14 males and 11 females) who underwent arthroscopic repair of full thickness rotator cuff tear at a single institution were included in the study. Postoperatively patient's shoulder was rated according to UCLA score, pain was graded according to the visual analog score. The range of motion was analysed and documented. The mean age of the patients were 50.48 years. The preoperative VAS score mode was 7 and post operative VAS was 1 (p value fair in 12% (n = 3), excellent in 8% (n = 2) and poor results were seen in none of the patients. The mean UCLA improved from a score of 15.84 to 30.28 with a p value <0.001. Mean postoperative forward flexion was 161.6°, mean abduction was 147.6° and mean external rotation was 45.4°. Arthroscopic repair is a good procedure for full thickness rotator cuff tear with minimal complications. The newer double row repair claims to be biomechanically superior with faster healing rates without functional advantages, hence we used a single row repair considering the Indian population and the cost effectiveness of the surgery with good to excellent results.

  4. The Effectiveness of the Latarjet Procedure in Patients with Chronic Locked Anterior Shoulder Dislocation: A Retrospective Study.

    Science.gov (United States)

    Li, Yue; Jiang, Chunyan

    2016-05-18

    Chronic locked anterior shoulder dislocation is a difficult clinical problem for patients and surgeons. Prior studies have proposed a variety of surgical techniques to address this problem; however, the failure rate is high. To our knowledge, there have been no previously published studies on the clinical outcome of the Latarjet procedure for the treatment of chronic locked anterior shoulder dislocation. The purpose of this study was to evaluate the short-term subjective, objective, and radiographic outcomes of patients with chronic locked anterior shoulder dislocation after a Latarjet procedure. From January 2005 to January 2013, 43 patients with chronic locked anterior shoulder dislocation were treated surgically in our institution. Open Latarjet procedures were performed in 35 patients. A subscapularis tenotomy or split was chosen on the basis of the ability to achieve open reduction. Outcomes were assessed preoperatively and postoperatively with the American Shoulder and Elbow Surgeons (ASES) score, the visual analog scale (VAS) for pain, the University of California Los Angeles (UCLA) shoulder rating scale, and the Constant-Murley rating scale. A comparison of the clinical outcomes among the patients who underwent subscapularis tenotomy and repair, those who underwent a procedure that used the subscapularis-splitting technique, and those who underwent a concomitant humeral head replacement was performed. Twenty-five shoulders of 25 patients were available for a mean follow-up of 31.6 months. At the time of the latest follow-up, the range of motion and the shoulder functional evaluations (VAS [p = 0.02], ASES [p = 0.01], Constant score [p = 0.01], and UCLA score [p = 0.04]) were significantly improved. The overall redislocation or subluxation rate was 48% (12 of 25): 0% (0 of 5) for the subscapularis-splitting group, 53% (8 of 15) for the subscapularis tenotomy and repair group, and 80% (4 of 5) for the humeral head replacement group. The ASES score (p = 0

  5. Direct mixed antiglobulin reaction (MAR) test in semen at follow-up after testicular biopsy of maldescended testes operated in puberty

    DEFF Research Database (Denmark)

    Cortes, Dina; Brandt, B; Thorup, Jørgen Mogens

    1990-01-01

    In thirty patients bilateral orchiopexy was performed in puberty. At the operation twenty-five patients underwent bilateral testicular biopsies, and five patients underwent unilateral biopsies only. In adulthood the semen was analysed for antisperm antibodies by the direct mixed antiglobulin...

  6. Influence of testosterone replacement therapy on metabolic disorders in male patients with type 2 diabetes mellitus and androgen deficiency.

    Science.gov (United States)

    Janjgava, Shota; Zerekidze, Tamar; Uchava, Lasha; Giorgadze, Elene; Asatiani, Ketevan

    2014-10-23

    Multiple epidemiological studies have shown that low testosterone levels are associated with and predict the future development of type 2 diabetes mellitus and the metabolic syndrome. The aim of our study was to show the influence of testosterone replacement therapy on obesity, HbA1c level, hypertension and dyslipidemia in patients with diabetes mellitus and androgen deficiency. One hundred and twenty-five male patients with diabetes mellitus were screened; 85 subjects aged 41 to 65 years, with BMI from 27.0 to 48.0 kg/m(2), were randomized in a placebo-controlled study. They also underwent a routine physical examination and selected by free testosterone examination. We divided patients into two groups: 1) treatment group, where we used diet, physical activity, patient's antidiabetic therapy and testosterone replacement therapy; 2) placebo group, where we used diet, physical activity, patient's antidiabetic therapy and placebo. After 6 months of treatment we repeated the diagnostic assessments: lipid profile was improved in both groups but in first group it was clinically significant. Free testosterone level increased in all groups, but in group I was clinically significant. HbA1c decreased in both groups, but in group I we obtained the best result. Leptin level after treatment was approximately the same in both groups. Also, blood pressure was reduced in both groups but results were similar. Our study demonstrated that it is possible to break this metabolic vicious circle by raising testosterone levels in diabetic men with androgen deficiency. Re-instituting physiological levels of testosterone, as the study has shown, has an important role in reducing the prevalence of diabetic complications.

  7. [Arteriovenous fistula in patients with a complicated postphlebitic syndrome].

    Science.gov (United States)

    Quiñones Castro, M; Fernández de la Vara Sánchez, L; Perera González, F; Alvarez Sánchez, J A

    1991-01-01

    An investigation, which goal is to evidencing AV fistulas in patients with a complicated postthrombotic syndrome, as well as to determinate the efficacy of noninvasive methods used for the study of AV fistulas in such patients, is presented. So, patients with a complicated postphlebitic syndrome interned into the Instituto de Angiología were studied. Twenty-five patients were included in the study, 9 of these patients (36%) had arteriovenous fistulas, arteriographically evidenced. Haemodynamic study do not support the evidence of such communications.

  8. Risk factor analysis of coexisting endometrial carcinoma in patients with endometrial hyperplasia: a retrospective observational study of Taiwanese Gynecologic Oncology Group

    OpenAIRE

    Chen, Yu-Li; Wang, Kung-Liahng; Chen, Min-Yu; Yu, Mu-Hsien; Wu, Chen-Hsuan; Ke, Yu-Min; Chen, Yi-Jen; Chang, Yin-Yi; Hsu, Keng-Fu; Yen, Ming-Shyen

    2013-01-01

    Objective To evaluate the clinical outcome and parameters related to coexisting endometrial carcinoma in women with tissue-diagnosed endometrial hyperplasia. Methods Between January 1991 and December 2009, three hundred and eighty-six patients with the presumptive diagnosis of endometrial hyperplasia were retrieved. Among these, one hundred and twenty-five patients were identified as having coexisting endometrial carcinoma in hysterectomy specimens. The three hundred and eighty-six patients w...

  9. Heyde syndrome in a 71-year-old man who underwent chest radiotherapy at young age

    Directory of Open Access Journals (Sweden)

    V.M. Santos

    2013-08-01

    Full Text Available We report the case of a 71-year-old man with diagnosis of aortic valve stenosis for ten years, who came to hospital because of breathlessness during the previous two months and recent low intestinal hemorrhage. On admission, laboratory tests and upper gastrointestinal endoscopy and colonoscopy revealed anemia and bleeding cecal angiodysplasia. The echocardiography study showed a severe aortic stenosis. Classical Heyde syndrome is described as the association of aortic stenosis, bleeding gastrointestinal angiodysplasia and secondary anemia. The antecedent of mediastinal radiotherapy for treatment of Hodgkin´s disease during his youth, and eventual late cardiac adverse effects that may include aortic or mitral valve disturbances are highlighted. Electrocoagulation with argonium was performed on the sites of active bleeding during the colonoscopy. In sequence, surgical replacement by bioprothesis was done on the aortic valve. The patient remains asymptomatic, under long-term outpatient surveillance, with normal control evaluations. The aim of this case study is to emphasize difficulties related to diagnosis, and to highlight the role of endoscopy and imaging studies to confirm a hypothesis of this underestimated condition.

  10. Impact of Helicobacter pylori resistance in unsuccessfully pluritreated patients in a Department of Infectious Diseases in Rome

    OpenAIRE

    Maria Teresa Mascellino; Barbara Porowska; Rosa Nicosia; Alessandra Oliva; Priscilla Boccia; Carola Severi

    2010-01-01

    Twenty-five pluritreated patients were examined. Fifty-six percent yielded Helicobacter pylori (H. Pilory); of these, 9 patients showed a concomitant colonization of the three gastric regions. The highest resistance rate was found for metronidazole (71.8%) followed by chlaritromycin (53.1%). Amoxycillin showed the best susceptibility (only 6% of resistance), tetracycline showed 12% of resistant strains and levofloxacin appeared to be a promising antibacterial agent (18% of resistance). The E...

  11. Risk of malignancy in women who underwent hysterectomy for uterine prolapse.

    Science.gov (United States)

    Wan, Osanna Y K; Cheung, Rachel Y K; Chan, Symphorosa S C; Chung, Tony K H

    2013-04-01

    To evaluate the risk of missing a malignancy in surgical specimens following hysterectomy for uterine prolapse if routine pathological examination is not performed. Additionally, information on the risk of missing an hitherto unsuspected malignancy if uterine preservation is the preferred management option will be provided. A retrospective study was performed on all cases of surgery performed for uterine prolapse in a tertiary referral institution from 2003 to 2011. Those with confirmed malignancy before operation were excluded. The study subjects had their clinical history, investigations, the type of operations and histopathology report analysed. They were classified into symptomatic or asymptomatic, depending on whether they reported symptoms that were suggestive of uterine malignancy. A total of 640 women were studied. Three cases of hitherto unsuspected uterine malignancy were found, giving an incidence of 0.47%. Among the 456 asymptomatic women, both pre- and postmenopausal, the risk of incidental malignancy was 0.22%. Within the postmenopausal group, risk of incidental malignancy was 0.26%. Another 3 cases of uterine premalignant conditions were identified, giving an overall risk of premalignant and malignant uterine condition of 0.94%. Five cases of cervical intra-epithelial neoplasia were found, contributing to a risk of 0.78%. The risk of missing an uterine malignancy in patients with uterine prolapse is low if appropriate investigations are carried out prior to surgery. If hysterectomy is to be performed, we recommend that all surgical specimens be subjected to histopathological examination. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  12. Arthroscopic-Assisted Fixation of Tibial Plateau Fractures: Patient-Reported Postoperative Activity Levels.

    Science.gov (United States)

    Kampa, John; Dunlay, Ryan; Sikka, Robby; Swiontkowski, Marc

    2016-05-01

    Tibial plateau fractures may result in significant limitations postoperatively. Studies have described outcomes of arthroscopic-assisted percutaneous fixation (AAPF) of these injuries but have rarely reported postoperative activity levels. Between 2009 and 2013, patients who sustained a lateral split, split depression, or pure depression type tibial plateau fracture (Schatzker types I-III fractures) and underwent outpatient AAPF were eligible for the study. Outcomes were assessed using Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm score, and Marx activity score. Twenty-five consecutive patients were eligible for the study, and 22 (88%) were included in the final analysis, with average follow-up of 2.5 years (range, 1-5.2 years). Thirteen women and 9 men with an average age of 48.3 years (range, 23-65 years) comprised the study population. Average number of screws used for fixation was 2 (range, 1-4). The average depression was 8 mm preoperatively and 0.9 mm (range, 0-3 mm) postoperatively. Four patients (18%) had complications: 2 with hardware removal and 2 with postoperative deep venous thrombosis. Average postoperative Marx activity score was 5.7. Average postoperative KOOS Symptoms, Sports, and Quality of Life scores were 88 (range, 68-100), 85 (range, 45-100), and 77 (range, 50-100), respectively. Average IKDC and Lysholm scores were 81 (range, 55-97) and 87 (range, 54-100), respectively. The AAPF surgical technique, which was performed in an outpatient setting, facilitated excellent postoperative range of motion, outcomes, and activity scores with minimal complications. [Orthopedics. 2016; 39(3):e486-e491.].

  13. Morphision: A method for subjective evaluation of metamorphopsia in patients with unilateral macular pathology (i.e., full thickness macular hole and epiretinal membrane

    Directory of Open Access Journals (Sweden)

    Marta Ugarte

    2013-01-01

    Full Text Available Background: Lack of clinical tests to quantify spatial components of distortion in patients with full thickness macular holes (FTMH and epiretinal membranes (ERM. Aim: To develop a test for subjective evaluation of visual distortion in the central visual field around fixation in patients with unilateral FTMH or ERM. Settings and Design: Prospective case-control study carried out at tertiary referral center. Materials and Methods: Twenty-five patients with unilateral macular disease (13 macular epiretinal membranes, 12 full-thickness macular holes, and nine controls (without ocular pathology underwent ophthalmological examination with logMAR ETDRS visual acuity, near vision and contrast sensitivity assessed. Macular optical coherence tomography and metamorphopsia assessment using Morphision test was also carried out. This test consists of a set of modified Amsler charts for detection, identification, and subjective quantification of visual distortion in the central visual field around fixation. Morphision test content and construct validity, and reliability (test-retest method were evaluated. Sixteen patients completed an unstructured survey on test performance and preference. Results: Every patient with unilateral FTMH or ERM identified a particular chart using Morphision test (content validity. None of the normal subjects without symptoms of metamorphopsia identified any distortion (construct validity. Test-retest showed a 100% consistency for frequency and 67% for amplitude. The mean amplitude difference between measurements was 0.02 degrees (SD = 0.038. The coefficient of repeatability was 0.075. There was a correlation between Morphision amplitude score and visual acuity and contrast sensitivity, individually. Conclusions: Morphision test allowed detection and subjective quantification of metamorphopsia in the clinical setting in our patients with unilateral macular epiretinal membranes and full thickness macular holes.

  14. Treatment of Solitary Painful Osseous Metastases with Radiotherapy, Cryoablation or Combined Therapy: Propensity Matching Analysis in 175 Patients

    Science.gov (United States)

    Zugaro, Luigi; Bonfili, Pierluigi; Gregori, Lorenzo; Franzese, Pietro; Marampon, Francesco; Vittorini, Francesca; Moro, Roberto; Tombolini, Vincenzo; Di Cesare, Ernesto; Masciocchi, Carlo

    2015-01-01

    Purpose aim of this study was to identify outcomes in pain relief and quality of life in patients with a solitary painful osseous metastasis treated by radiotherapy, cryoablation or the combination using a propensity score matching study design. Materials and Methods 175 patients with painful bone metastases were included in the study. Twenty-five of them underwent a radiation course (20 Gy in five daily fractions) 15 days after the cryoablation. These subjects were retrospectively matched by propensity analysis with a group of subjects treated by radiotherapy (125 subjects) and with a group treated byCryoablation (25 subjects). The pain relief in terms of complete response, rate of subjects requiring analgesics after treatments and the changes in self-rated quality of life were measured. Informed consent was obtained from the subject and the study was approved by the local Ethical Committee. Results An higher proportion of subjects treated by cryoablation (32%) or cryoablation followed by RT (72%;) experienced a complete response compared with patients treated by radiotherapy alone (11.2%). After Bonferroni correction strategy, the addition of radiotherapy to cryoablation significantly improved the rate of complete response compared with cryoablation alone (p = 0.011) and this paralleled with an improved self-rated quality of life. Seventeen subjects (13.6%) of patients in the radiotherapy group, 9 (36%) in the cryoablation group, and 19 (76)% in the cryoablation- radiotherapy group did not require narcotic medications. Conclusions The addition of radiotherapy to cryoablation favorably impacts on perceived pain, with a favorable toxicity profile. However, our data should be interpreted with caution and could serve as a framework around which to design future trials. PMID:26103516

  15. Drug screen in patient cells suggests quinacrine to be repositioned for treatment of acute myeloid leukemia

    OpenAIRE

    Eriksson, Anna; Österroos, Albin; Hassan, Sadia Bashir; Gullbo, Joachim; Rickardson, Linda; Jarvius, Malin; Nygren, Peter; Fryknäs, Mårten; Höglund, Martin; Larsson, Rolf

    2015-01-01

    To find drugs suitable for repositioning for use against leukemia, samples from patients with chronic lymphocytic, acute myeloid and lymphocytic leukemias as well as peripheral blood mononuclear cells (PBMC) were tested in response to 1266 compounds from the LOPAC1280 library (Sigma). Twenty-five compounds were defined as hits with activity in all leukemia subgroups (<50% cell survival compared with control) at 10 mu M drug concentration. Only one of these compounds, quinacrine, showed low...

  16. Post-therapy surveillance of patients with uterine cancers: value of integrated FDG PET/CT in the detection of recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Sironi, Sandro [University of Milano-Bicocca, School of Medicine, Milan (Italy); IBFM-CNR, Institute for Molecular Bioimaging and Physiology, Milan (Italy); H S. Gerardo Monza, Department of Diagnostic Radiology, Milan (Italy); Picchio, Maria; Bettinardi, Valentino [Scientific Institute San Raffaele, Department of Nuclear Medicine, Milan (Italy); Landoni, Claudio [University of Milano-Bicocca, School of Medicine, Milan (Italy); Scientific Institute San Raffaele, Department of Nuclear Medicine, Milan (Italy); Galimberti, Stefania [University of Milano-Bicocca, School of Medicine, Milan (Italy); University of Milano-Bicocca, Department of Clinical Medicine Prevention and Biotechnology, Section of Medical Statistics, Milan (Italy); Signorelli, Mauro [H S. Gerardo Monza, Department of Gynecology and Obstetrics, Milan (Italy); Perego, Patrizia [H S. Gerardo Monza, Department of Pathology, Milan (Italy); Mangioni, Costantino [University of Milano-Bicocca, School of Medicine, Milan (Italy); H S. Gerardo Monza, Department of Gynecology and Obstetrics, Milan (Italy); Messa, Cristina [University of Milano-Bicocca, School of Medicine, Milan (Italy); IBFM-CNR, Institute for Molecular Bioimaging and Physiology, Milan (Italy); H S. Gerardo Monza, Department of Nuclear Medicine, Milan (Italy); Fazio, Ferruccio [University of Milano-Bicocca, School of Medicine, Milan (Italy); IBFM-CNR, Institute for Molecular Bioimaging and Physiology, Milan (Italy); Scientific Institute San Raffaele, Department of Nuclear Medicine, Milan (Italy)

    2007-04-15

    The purpose of this study was to prospectively determine the diagnostic accuracy of PET/CT in the detection of recurrence in patients with treated uterine cancers. Twenty-five women, ranging in age from 37 to 79 years (mean 58.9 years), who underwent primary surgical treatment for either a cervical or an endometrial cancer met the inclusion criterion of the study, which was suspicion of recurrence based on results of routine follow-up procedures. PET/CT was performed after administration of {sup 18}F-fluorodeoxyglucose (FDG); two readers interpreted the images in consensus. Histopathological findings or correlation with results of subsequent clinical and imaging follow-up examinations served as the reference standard. Diagnostic accuracy of PET/CT was reported in terms of the proportion of correctly classified patients and lesion sites. Tumour recurrence was found at histopathological analysis or follow-up examinations after PET/CT in 14 (56%) of the 25 patients. Patient-based sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT for detection of tumour recurrence were 92.9%, 100.0%, 100.0%, 91.7% and 96.0%, respectively. Lesion site-based sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT were 94.7%, 99.5%, 94.7%, 99.5% and 99.0%, respectively. This preliminary study shows that PET/CT may be an accurate method for the evaluation of recurrence in patients who have been treated for uterine cancers and are undergoing follow-up. (orig.)

  17. Machine learning for prediction of all-cause mortality in patients with suspected coronary artery disease: a 5-year multicentre prospective registry analysis.

    Science.gov (United States)

    Motwani, Manish; Dey, Damini; Berman, Daniel S; Germano, Guido; Achenbach, Stephan; Al-Mallah, Mouaz H; Andreini, Daniele; Budoff, Matthew J; Cademartiri, Filippo; Callister, Tracy Q; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Chow, Benjamin J W; Cury, Ricardo C; Delago, Augustin; Gomez, Millie; Gransar, Heidi; Hadamitzky, Martin; Hausleiter, Joerg; Hindoyan, Niree; Feuchtner, Gudrun; Kaufmann, Philipp A; Kim, Yong-Jin; Leipsic, Jonathon; Lin, Fay Y; Maffei, Erica; Marques, Hugo; Pontone, Gianluca; Raff, Gilbert; Rubinshtein, Ronen; Shaw, Leslee J; Stehli, Julia; Villines, Todd C; Dunning, Allison; Min, James K; Slomka, Piotr J

    2017-02-14

    Traditional prognostic risk assessment in patients undergoing non-invasive imaging is based upon a limited selection of clinical and imaging findings. Machine learning (ML) can consider a greater number and complexity of variables. Therefore, we investigated the feasibility and accuracy of ML to predict 5-year all-cause mortality (ACM) in patients undergoing coronary computed tomographic angiography (CCTA), and compared the performance to existing clinical or CCTA metrics. The analysis included 10 030 patients with suspected coronary artery disease and 5-year follow-up from the COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry. All patients underwent CCTA as their standard of care. Twenty-five clinical and 44 CCTA parameters were evaluated, including segment stenosis score (SSS), segment involvement score (SIS), modified Duke index (DI), number of segments with non-calcified, mixed or calcified plaques, age, sex, gender, standard cardiovascular risk factors, and Framingham risk score (FRS). Machine learning involved automated feature selection by information gain ranking, model building with a boosted ensemble algorithm, and 10-fold stratified cross-validation. Seven hundred and forty-five patients died during 5-year follow-up. Machine learning exhibited a higher area-under-curve compared with the FRS or CCTA severity scores alone (SSS, SIS, DI) for predicting all-cause mortality (ML: 0.79 vs. FRS: 0.61, SSS: 0.64, SIS: 0.64, DI: 0.62; PMachine learning combining clinical and CCTA data was found to predict 5-year ACM significantly better than existing clinical or CCTA metrics alone.

  18. Spinal sagittal imbalance in patients with lumbar disc herniation: its spinopelvic characteristics, strength changes of the spinal musculature and natural history after lumbar discectomy

    OpenAIRE

    Liang, Chen; Sun, Jianmin; Cui, Xingang; Jiang, Zhensong; Zhang, Wen; Li, Tao

    2016-01-01

    Background Spinal sagittal imbalance is a widely acknowledged problem, but there is insufficient knowledge regarding its occurrence. In some patients with lumbar disc herniation (LDH), their symptom is similar to spinal sagittal imbalance. The aim of this study is to illustrate the spinopelvic sagittal characteristics and identity the role of spinal musculature in the mechanism of sagittal imbalance in patients with LDH. Methods Twenty-five adults with spinal sagittal imbalance who initially ...

  19. Colonoscopic polypectomy in anticoagulated patients

    Institute of Scientific and Technical Information of China (English)

    Shai Friedland; Daniel Sedehi; Roy Soetikno

    2009-01-01

    AIM: To review our experience performing polypectomy in anticoagulated patients without interruption of anticoagulation.METHODS: Retrospective chart review at the Veterans Affairs Palo Alto Health Care System. Two hundred and twenty five polypectomies were performed in 123 patients. Patients followed a standardized protocol that included stopping warfarin for 36 h to avoid supratherapeutic anticoagulation from the bowel preparation. Patients with lesions larger than 1 cm were generally rescheduled for polypectomy off warfarin. Endoscopic clips were routinely applied prophylactically.RESULTS: One patient (0.8%, 95% CI: 0.1%-4.5%)developed major post-polypectomy bleeding that required transfusion. Two others (1.6%, 95% CI:0.5%-5.7%) had self-limited hematochezia at home and did not seek medical attention. The average polyp size was 5.1 ± 2.2 mm.

  20. An evaluation of quality of life in women with endometriosis who underwent primary surgery: a 6-month follow up in Sabah Women & Children Hospital, Sabah, Malaysia.

    Science.gov (United States)

    M F, Ahmad; Narwani, Hussin; Shuhaila, Ahmad

    2017-10-01

    Endometriosis is a complex disease primarily affecting women of reproductive age worldwide. The management goals are to improve the quality of life (QoL), alleviate the symptoms and prevent severe disease. This prospective cohort study was to assess the QoL in women with endometriosis that underwent primary surgery. A pre- and post-operative questionnaire via ED-5Q and general VAS score used for the evaluation for endometrial-like pain such as dysmenorrhoea and dyspareunia. A total of 280 patients underwent intervention; 224 laparoscopically and 56 via laparotomy mostly with stage II disease with ovarian endometriomas. Improvements in dysmenorrhoea pain scores from 5.7 to 4.15 and dyspareunia from 4.05 to 2.17 (p improved; 6.66-4.68 post-operatively (p intervention. There was no correlation between the stage of disease and endometrial pain; (p = .289), method of intervention (p = .290) and usage of post-operative hormonal therapy (p = .632). This study concluded that surgical treatment improved the QoL with added hormonal therapy post-intervention, despite not reaching statistical significance, showed a promising result. Impact statement Surgical intervention does improve the QoL for women with endometriosis however post interventional hormonal therapy is remain inconclusive.

  1. Monitorization of the effects of spinal anaesthesia on cerebral oxygen saturation in elder patients using near-infrared spectroscopy.

    Science.gov (United States)

    Kusku, Aysegul; Demir, Guray; Cukurova, Zafer; Eren, Gulay; Hergunsel, Oya

    2014-01-01

    Central blockage provided by spinal anaesthesia enables realization of many surgical procedures, whereas hemodynamic and respiratory changes influence systemic oxygen delivery leading to the potential development of series of problems such as cerebral ischemia, myocardial infarction and acute renal failure. This study was intended to detect potentially adverse effects of hemodynamic and respiratory changes on systemic oxygen delivery using cerebral oxymetric methods in patients who underwent spinal anaesthesia. Twenty-five ASA I-II Group patients aged 65-80 years scheduled for unilateral inguinal hernia repair under spinal anaesthesia were included in the study. Following standard monitorization baseline cerebral oxygen levels were measured using cerebral oximetric methods. Standardized Mini Mental Test (SMMT) was applied before and after the operation so as to determine the level of cognitive functioning of the cases. Using a standard technique and equal amounts of a local anaesthetic drug (15mg bupivacaine 5%) intratechal blockade was performed. Mean blood pressure (MBP), maximum heart rate (MHR), peripheral oxygen saturation (SpO2) and cerebral oxygen levels (rSO2) were preoperatively monitored for 60min. Pre- and postoperative haemoglobin levels were measured. The variations in data obtained and their correlations with the cerebral oxygen levels were investigated. Significant changes in pre- and postoperative measurements of haemoglobin levels and SMMT scores and intraoperative SpO2 levels were not observed. However, significant variations were observed in intraoperative MBP, MHR and rSO2 levels. Besides, a correlation between variations in rSO2, MBP and MHR was determined. Evaluation of the data obtained in the study demonstrated that post-spinal decline in blood pressure and also heart rate decreases systemic oxygen delivery and adversely effects cerebral oxygen levels. However, this downward change did not result in deterioration of cognitive functioning

  2. [Monitorization of the effects of spinal anaesthesia on cerebral oxygen saturation in elder patients using near-infrared spectroscopy].

    Science.gov (United States)

    Kusku, Aysegul; Demir, Guray; Cukurova, Zafer; Eren, Gulay; Hergunsel, Oya

    2014-01-01

    Central blockage provided by spinal anaesthesia enables realization of many surgical procedures, whereas hemodynamic and respiratory changes influence systemic oxygen delivery leading to the potential development of series of problems such as cerebral ischemia, myocardial infarction and acute renal failure. This study was intended to detect potentially adverse effects of hemodynamic and respiratory changes on systemic oxygen delivery using cerebral oxymetric methods in patients who underwent spinal anaesthesia. Twenty-five ASA I-II Group patients aged 65-80 years scheduled for unilateral inguinal hernia repair under spinal anaesthesia were included in the study. Following standard monitorization baseline cerebral oxygen levels were measured using cerebral oximetric methods. Standardized Mini Mental Test (SMMT) was applied before and after the operation so as to determine the level of cognitive functioning of the cases. Using a standard technique and equal amounts of a local anaesthetic drug (15mg bupivacaine 5%) intratechal blockade was performed. Mean blood pressure (MBP), maximum heart rate (MHR), peripheral oxygen saturation (SpO2) and cerebral oxygen levels (rSO2) were preoperatively monitored for 60min. Pre- and postoperative haemoglobin levels were measured. The variations in data obtained and their correlations with the cerebral oxygen levels were investigated. Significant changes in pre- and postoperative measurements of haemoglobin levels and SMMT scores and intraoperative SpO2 levels were not observed. However, significant variations were observed in intraoperative MBP, MHR and rSO2 levels. Besides, a correlation between variations in rSO2, MBP and MHR was determined. Evaluation of the data obtained in the study demonstrated that post-spinal decline in blood pressure and also heart rate decreases systemic oxygen delivery and adversely effects cerebral oxygen levels. However, this downward change did not result in deterioration of cognitive functioning

  3. Monitorization of the effects of spinal anaesthesia on cerebral oxygen saturation in elder patients using near-infrared spectroscopy

    Directory of Open Access Journals (Sweden)

    Aysegul Kusku

    2014-07-01

    Full Text Available OBJECTIVE: Central blockage provided by spinal anaesthesia enables realization of many surgical procedures, whereas hemodynamic and respiratory changes influence systemic oxygen delivery leading to the potential development of series of problems such as cerebral ischemia, myocardial infarction and acute renal failure. This study was intended to detect potentially adverse effects of hemodynamic and respiratory changes on systemic oxygen delivery using cerebral oxymetric methods in patients who underwent spinal anaesthesia. METHODS: Twenty-five ASA I-II Group patients aged 65-80 years scheduled for unilateral inguinal hernia repair under spinal anaesthesia were included in the study. Following standard monitorization baseline cerebral oxygen levels were measured using cerebral oximetric methods. Standardized Mini Mental Test (SMMT was applied before and after the operation so as to determine the level of cognitive functioning of the cases. Using a standard technique and equal amounts of a local anaesthetic drug (15 mg bupivacaine 5% intratechal blockade was performed. Mean blood pressure (MBP, maximum heart rate (MHR, peripheral oxygen saturation (SpO2 and cerebral oxygen levels (rSO2 were preoperatively monitored for 60 min. Pre- and postoperative haemoglobin levels were measured. The variations in data obtained and their correlations with the cerebral oxygen levels were investigated. RESULTS: Significant changes in pre- and postoperative measurements of haemoglobin levels and SMMT scores and intraoperative SpO2 levels were not observed. However, significant variations were observed in intraoperative MBP, MHR and rSO2 levels. Besides, a correlation between variations in rSO2, MBP and MHR was determined. CONCLUSION: Evaluation of the data obtained in the study demonstrated that post-spinal decline in blood pressure and also heart rate decreases systemic oxygen delivery and adversely effects cerebral oxygen levels. However, this downward change did

  4. Radionuclide esophageal transit test to detect esophageal disorders in patients with mitral valve prolapse

    Energy Technology Data Exchange (ETDEWEB)

    Kao Chiahung [Dept. of Nuclear Medicine, Taichung Veterans General Hospital (Taiwan); Tsai Shihchuan [Dept. of Nuclear Medicine, Show-Chwan Memorial Hospital, Changhua (Taiwan); Hsieh Jihfang [Dept. of Nuclear Medicine, Chi-Mei Foundation Hospital, Tainan (Taiwan); Ho Yungjen [Dept. of Radiology, Jen-Ai Hospital, Taichung (Taiwan); Ding Hueischjy [Dept. of Nuclear Medicine, Kaohsiung Medicine Coll. (Taiwan)

    2000-06-01

    Aim: The origin of chest discomfort in patients with mitral valve prolapse (MVP) is controversial. Our aim was to prospectively determine the incidence of esophageal disorders in MVP patients with or without chest pain. Methods: Twenty-five MVP patients with chest pain (group A) and 25 MVP patients without chest pain (group B) underwent evaluation of esophageal motility. None of the total of 50 MVP patients had significant coronary artery disease on cardiac catheterization. Esophageal motility including esophageal mean transit time (MTT), residual fraction (RF), and retrograde index (RI) was analyzed by the radionuclide esophageal transit test (RETT). Results: In comparison with 25 age and sex-matched healthy volunteers, the results showed that: (1) 19 patients in group A (76%) had abnormal RETT findings (48% of cases with prolonged MTT, 44% of cases with higher RF, and 60% of cases with higher RI); (2) 3 patients in group B (12%) had abnormal RETT findings (8% of cases with prolonged MTT, 4% of cases with higher RF, and 8% of cases with higher RI). In addition, mean values of MTT, RF, and RI in group A patients were significantly higher than in group B patients and healthy volunteers. Conclusion: We found that the chest pain in some MVP patients may be related to abnormal esophageal motility, based on the evidence from a simple and noninvasive RETT. (orig.) [German] Ziel: Die Ursache thorakaler Beschwerden bei Patienten mit Mitralklappenprolaps (MVP) wird kontrovers diskutiert. Wir bestimmten prospektiv die Haeufigkeit oesophagealer Stoerungen in MVP-Patienten mit oder ohne thorakale Beschwerden. Methode: Bei jeweils 25 MVP-Patienten mit thorakalen Beschwerden (Gruppe A) und 25 MVP-Patienten ohne thorakale Beschwerden (Gruppe B) wurde die oesophageale Motilitaet untersucht. Keiner der 50 MVP-Patienten hatte eine koronarangiographisch nachweisbare koronare Herzkrankheit. Mittels der Oesophagus-Funktionsszintigraphie (OeFZ) wurden oesophageale Motilitaet inklusive

  5. Robotic Shaving Technique in 25 Patients Affected by Deep Infiltrating Endometriosis of the Rectovaginal Space.

    Science.gov (United States)

    Pellegrino, Antonio; Damiani, Gianluca Raffaello; Trio, Claudia; Faccioli, Paolo; Croce, Paolo; Tagliabue, Fulvio; Dainese, Emanuele

    2015-01-01

    Minimally invasive surgery represents the gold standard for the management of deep infiltrating endometriosis (DIE) involving the rectovaginal septum (RVS). This analysis aimed to evaluate the feasibility of robotic-assisted laparoscopy (RAL) and clinical outcomes in terms of long-term complications, pain relief, and recurrence rate for the treatment of DIE of the RVS. A prospective cohort study of robotic procedures was performed between October 2010 and July 2014, including removal of endometriotic nodules from the RVS with rectal shaving alone or in combination with accessory procedures. In all cases, the revised American Society for Reproductive Medicine (rASRM) score for endometriosis was >40 points (stage IV). Twenty-five consecutive patients underwent RAL, with a successful complete nodule debulking by the wall shaving technique. Pathology confirmed the adequacy of the surgical specimen and the median largest endometriotic nodule was of 21 mm (range, 10-60 mm), with free margins in all cases. The median operative time from skin opening to closure was 174 minutes (range, 75-300 minutes), and blood loss was close to 0 mL. The median revised Enzian score for location A (RVS) was 2 (range, 1-3). The most frequent Enzian class was A2B0C0 (48%), followed by A3B0C0 (12%). In 3 cases (12%), partial vaginal resection was required to remove endometriotic nodules of the RVS (1 each in classes A3B0C1FI, A3B0C0FO, and A3B0C0). No intraoperative complications occurred. This series has a median long-term follow up of 22 months (range, 6-50 months) currently available with an optimal operative time, demonstrating good long-term outcomes. Our data support robotics as a safe and attractive alternative for comprehensive surgical treatment of DIE.

  6. The Association of Academic Health Sciences Libraries Annual Statistics: an exploratory twenty-five-year trend analysis.

    Science.gov (United States)

    Byrd, Gary D; Shedlock, James

    2003-04-01

    This paper presents an exploratory trend analysis of the statistics published over the past twenty-four editions of the Annual Statistics of Medical School Libraries in the United States and Canada. The analysis focuses on the small subset of nineteen consistently collected data variables (out of 656 variables collected during the history of the survey) to provide a general picture of the growth and changing dimensions of services and resources provided by academic health sciences libraries over those two and one-half decades. The paper also analyzes survey response patterns for U.S. and Canadian medical school libraries, as well as osteopathic medical school libraries surveyed since 1987. The trends show steady, but not dramatic, increases in annual means for total volumes collected, expenditures for staff, collections and other operating costs, personnel numbers and salaries, interlibrary lending and borrowing, reference questions, and service hours. However, when controlled for inflation, most categories of expenditure have just managed to stay level. The exceptions have been expenditures for staff development and travel and for collections, which have both outpaced inflation. The fill rate for interlibrary lending requests has remained steady at about 75%, but the mean ratio of items lent to items borrowed has decreased by nearly 50%.

  7. Dengue: twenty-five years since reemergence in Brazil Dengue: vinte e cinco anos da reemergência no Brasil

    Directory of Open Access Journals (Sweden)

    Maria Glória Teixeira

    2009-01-01

    Full Text Available This article revisits the epidemiology of dengue in Brazil, 25 years after its reemergence in the country, discussing the main determinants and implications for its control. The authors emphasize the clinical and epidemiological peculiarities of this viral disease in Brazil, which leads the world in both the number of cases reported and risk of occurrence of the disease. The article presents the changes occurring in the dengue epidemiological pattern in recent years, like the sudden age shift in the incidence of dengue hemorrhagic fever, and discusses possible associated factors. The article focuses specifically on the epidemic in Rio de Janeiro in 2008, this episode's impact on the international community, and the fear that the disease could spread to Europe. The authors conclude that the current situation emphasizes the need for the international scientific community to renew its efforts to generate knowledge allowing improvement and progress in the development of new tools and strategies for dengue prevention.Este artigo revisita a epidemiologia da dengue no Brasil após 25 anos da sua reemergência discutindo os principais determinantes e implicações no seu controle. Destacam-se peculiaridades clínicas e epidemiológicas desta virose neste país, que ocupa uma das primeiras posições no que diz respeito tanto ao número de casos notificados como no risco de ocorrência desta doença no mundo. Apresentam-se as mudanças que vêm ocorrendo no padrão epidemiológico da doença nos últimos anos, a exemplo do súbito deslocamento de faixa etária na incidência da febre hemorrágica da dengue, discutindo-se os possíveis fatores envolvidos. Particulariza-se a epidemia do Rio de Janeiro, em 2008, o reflexo deste episódio na comunidade internacional e o temor de disseminação da doença para a Europa. Os autores consideram que esta conjuntura aponta para a necessidade da comunidade científica mundial renovar esforços para gerar conhecimentos que possibilitem o aperfeiçoamento e avanço no desenvolvimento de novas ferramentas e estratégias de prevenção da dengue.

  8. Why institutions are not the only thing that matters: twenty-five years of health care reform in New Zealand.

    Science.gov (United States)

    Starke, Peter

    2010-08-01

    The literature on the causes of health care reform is dominated by institutionalist accounts, and political institutions are among the most prominent factors cited to explain why change takes place. However, institutionalist accounts have difficulty explaining both the timing and the content of reforms. By applying a range of explanatory approaches to a case study of health reform in New Zealand since the 1970s, this article explores some of the theories of reform beyond institutionalism, particularly those that take into account problem pressure, policy ideas, and the more agency-centered factor of partisan ideology. The aim is not to dismiss institutionalism but to try to fill some of the gaps that cannot be addressed with institutionalist theories alone. The detailed analysis shows that various factors played a role in conjunction, namely, problem pressure, policy ideas, and the ideology of parties in government. Partisan ideology, in particular, has perhaps been prematurely ignored by health care scholars.

  9. Twenty-Five Years after Early Intervention: A Follow-Up of Children with Down Syndrome and Their Families.

    Science.gov (United States)

    Hanson, Marci J.

    2003-01-01

    Children with Down syndrome and their families who participated in an early intervention program between 1974 and 1977 were interviewed 25 years later. Parents reported challenges such as medical complications, teasing or ostracism, and lack of adequate services and supports as children reached adulthood. Parents also described joys and…

  10. True ileal digestible tryptophan to lysine ratios in ninety- to one hundred twenty-five-kilogram barrows.

    Science.gov (United States)

    Kendall, D C; Gaines, A M; Kerr, B J; Allee, G L

    2007-11-01

    Three experiments were conducted to determine the optimal true ileal digestible (TID) Trp:Lys ratio for 90- to 125-kg barrows. Basal diets contained 0.55% TID Lys and were either corn-based (Exp. 1) or corn- and soybean meal-based (Exp. 2 and 3) diets supplemented with crystalline AA. In addition, each experiment contained a corn-soybean meal control diet. The number of pigs per pen progressively increased, with pigs housed in 2 (n = 82; initial and final BW of 88.5 and 113.6 kg, respectively), 7 (n = 210, initial and final BW of 91.2 and 123.3 kg, respectively), or 20 to 22 (n = 759; initial and final BW of 98.8 and 123.4 kg, respectively) pigs per pen for each successive experiment. Pigs in Exp. 1 were fed 6 incremental additions of L-Trp, equating to TID Trp:Lys ratios of 0.109, 0.145, 0.182, 0.218, 0.255, and 0.290. For the 28-d period, there was a quadratic improvement in G:F (P = 0.05) and ADG (P = 0.08) with increasing TID Trp:Lys, characterized by an improvement in performance of pigs fed the basal diet compared with those consuming diets with a 0.145 TID Trp:Lys ratio, with a plateau thereafter as TID Trp:Lys increased. Pigs fed the control diet had less increase in backfat depth than the average of pigs fed the titration diets (1.30 vs. 4.09 mm, respectively; P = 0.02), but pork quality was unaffected by dietary treatment. Pigs in Exp. 2 were fed 4 incremental additions of L-Trp, equating to TID Trp:Lys ratios of 0.130, 0.165, 0.200, and 0.235. Average daily gain and ADFI increased in a linear fashion with increasing TID Trp:Lys for the 29-d trial (P < 0.01), with quadratic improvements in d-29 BW (P = 0.06) and G:F (P = 0.05). Pigs fed the diet containing a TID Trp:Lys ratio of 0.165 had greater d-29 BW, ADG, G:F, and lower serum urea N concentration than pigs fed the basal diet (P < 0.05), but were similar to pigs fed TID Trp:Lys ratios of 0.200 and 0.235 for all criteria measured. In Exp. 3, TID Trp:Lys ratios of 0.13, 0.15, 0.17, 0.19, and 0.21 were evaluated. The response to increasing TID Trp:Lys was limited to a quadratic (P < 0.10) improvement in G:F with increasing TID Trp:Lys ratios. Maximum G:F was noted at a TID Trp:Lys ratio of 0.17. No relationship was noted between TID Trp:Lys and carcass characteristics. These experiments demonstrate that the minimum TID Trp:Lys ratio for pigs from 90 to 125 kg of BW is at least 0.145, but not greater than 0.17.

  11. Phylogeny and taxonomy of Ophiognomonia (Gnomoniaceae, Diaporthales), including twenty-five new species in this highly diverse genus

    Science.gov (United States)

    Species of Ophiognomonia are leaf-inhabiting endophytes, pathogens, and saprobes that infect plants in the families Betulaceae, Fagaceae, Juglandaceae, Lauraceae, Malvaceae, Platanaceae, Rosaceae, Salicaceae, and Sapindaceae. Based on extensive collecting, this species-rich genus is now known to hav...

  12. Twenty-five years of the WHO vaccines prequalification programme (1987-2012): lessons learned and future perspectives.

    Science.gov (United States)

    Dellepiane, Nora; Wood, David

    2015-01-01

    The World Health Organization (WHO) vaccines prequalification programme was established in 1987. It is a service provided to United Nations procurement agencies to ensure that the vaccines supplied through these agencies are consistently safe and effective under conditions of use in national immunization programmes. This review describes the purpose and aims of the programme, its evolution during 25 years of existence, its added value, and its role in the context of the WHO strategy to ensure the global availability of vaccines of assured quality. The rationale for changes introduced during the implementation of the programme is provided. The paper also discusses the resources involved, both human and financial, its performance, strengths and weaknesses and steps taken to maximize its efficiency. This historical perspective is used to inform proposed future changes to the service. Copyright © 2013 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

  13. Offshore Installations and Their Relevance to the Coast Guard through the Next Twenty-Five Years. Volume II. Detailed Forecasts.

    Science.gov (United States)

    1980-11-01

    operation. As the numbers increase to the point of increasing con- gestion --among the structures or in commercial traffic patterns-the demand on the Coast...installs and maintains a network of short-and long- range navigational aids and maintains navigable waterways in ice-free conflition insofar as

  14. Twenty-five years quaternium-15 in the European baseline series : does it deserve its place there?

    NARCIS (Netherlands)

    de Groot, Anton C.; Coenraads, Pieter-Jan

    2010-01-01

    For allergens to be included in the European baseline series, they should have allergy rates of at least 1%. In several studies quaternium-15 had lower scores. Also, many cases of sensitization are already detected by formaldehyde contact allergy. The aim of this study was to evaluate whether quater

  15. Twenty-Five Years of Ecological Recovery of East Fork Poplar Creek: Review of Environmental Problems and Remedial Actions

    Energy Technology Data Exchange (ETDEWEB)

    Smith, John G [ORNL; Loar, James M [ORNL; Stewart, Arthur J [ORNL

    2011-01-01

    In May 1985, a National Pollutant Discharge Elimination System permit was issued for the Department of Energy s Y-12 National Security Complex (Y-12 Complex) in Oak Ridge, Tennessee, USA, allowing discharge of effluents to East Fork Poplar Creek (EFPC). The effluents ranged from large volumes of chlorinated oncethrough cooling water and cooling tower blow-down to smaller discharges of treated and untreated process wastewaters, which contained a mixture of heavy metals, organics, and nutrients, especially nitrates. As a condition of the permit, a Biological Monitoring and Abatement Program (BMAP) was developed to meet two major objectives: demonstrate that the established effluent limitations were protecting the classified uses of EFPC, and document the ecological effects resulting from implementing a Water Pollution Control Program at the Y-12 Complex. The second objective is the primary focus of the other papers in this special series. This paper provides a history of pollution and the remedial actions that were implemented; describes the geographic setting of the study area; and characterizes the physicochemical attributes of the sampling sites, including changes in stream flow and temperature that occurred during implementation of the BMAP. Most of the actions taken under the Water Pollution Control Program were completed between 1986 and 1998, with as many as four years elapsing between some of the most significant actions. The Water Pollution Control Program included constructing nine new wastewater treatment facilities and implementation of several other pollution-reducing measures, such as a best management practices plan; area-source pollution control management; and various spill-prevention projects. Many of the major actions had readily discernable effects on the chemical and physical conditions of EFPC. As controls on effluents entering the stream were implemented, pollutant concentrations generally declined and, at least initially, the volume of water discharged from the Y-12 Complex declined. This reduction in discharge was of ecological concern and led to implementation of a flow management program for EFPC. Implementing flow management, in turn, led to substantial changes in chemical and physical conditions of the stream: stream discharge nearly doubled and stream temperatures decreased, becoming more similar to those in reference streams. While water quality clearly improved, meeting water quality standards alone does not guarantee protection of a waterbody s biological integrity. Results from studies on the ecological changes stemming from pollution-reduction actions, such as those presented in this series, also are needed to understand how best to restore or protect biological integrity and enhance ecological recovery in stream ecosystems. With a better knowledge of the ecological consequences of their decisions, environmental managers can better evaluate alternative actions and more accurately predict their effects.

  16. Beyond agrification : twenty five years of policy and innovation for non-food application of renewable resources in the Netherlands

    NARCIS (Netherlands)

    Bos, H.L.; Slingerland, M.A.; Elbersen, H.W.; Rabbinge, R.

    2008-01-01

    The first part of this review describes policy developments in the Netherlands since the 1980s around innovations for non-food application of renewable resources. Next, these developments are analyzed using the Strategic Niche Management (SNM) theory. The drivers at the regime level and the quality

  17. [Air pollution and mortality in twenty-five Italian cities: results of the EpiAir2 Project].

    Science.gov (United States)

    Alessandrini, Ester Rita; Faustini, Annunziata; Chiusolo, Monica; Stafoggia, Massimo; Gandini, Martina; Demaria, Moreno; Antonelli, Antonello; Arena, Pasquale; Biggeri, Annibale; Canova, Cristina; Casale, Giovanna; Cernigliaro, Achille; Garrone, Elsa; Gherardi, Bianca; Gianicolo, Emilio Antonio Luca; Giannini, Simone; Iuzzolino, Claudia; Lauriola, Paolo; Mariottini, Mauro; Pasetto, Paolo; Randi, Giorgia; Ranzi, Andrea; Santoro, Michele; Selle, Vittorio; Serinelli, Maria; Stivanello, Elisa; Tominz, Riccardo; Vigotti, Maria Angela; Zauli-Sajani, Stefano; Forastiere, Francesco; Cadum, Ennio

    2013-01-01

    this study aims at presenting the results from the Italian EpiaAir2 Project on the short-term effects of air pollution on adult population (35+ years old) in 25 Italian cities. the short-term effects of air pollution on resident people died in their city were analysed adopting the time series approach. The association between increases in 10µg/m(3) in PM10, PM2.5, NO2 and O3 air concentration and natural, cardiac, cerebrovascular and respiratory mortality was studied. City-specific Poisson models were fitted to estimate the association of daily concentrations of pollutants with daily counts of deaths. The analysis took into account temporal and meteorological factors to control for potential confounding effect. Pooled estimates have been derived from random effects meta-analysis, evaluating the presence of heterogeneity in the city specific results. it was analysed 422,723 deaths in the 25 cities of the project among people aged 35 years or more, resident in each city during the period 2006-2010. daily counts of natural, cardiac, cerebrovascular, and respiratory mortality, obtained from the registries of each city. Demographic information were obtained by record linkage procedure with the civil registry of each city. mean number of deaths for natural causes ranged from 513 in Rovigo to 20,959 in Rome. About 25% of deaths are due to cardiac diseases, 10% to cerebrovascular diseases, and 7% to respiratory diseases. It was found an immediate effect of PM10 on natural mortality (0.51%; 95%CI 0.16-0.86; lag 0-1). More relevant and prolonged effects (lag 0-5) have been found for PM2.5 (0.78%; 95%CI 0.12-1.46) and NO2 (1.10%; 95%CI 0.63-1.58). Increases in cardiac mortality are associated with PM10 (0.93%; 95%CI 0.16-1.70) and PM2.5 (1.25%; 95%CI 0.17-2.34), while for respiratory mortality exposure to NO2 has an important role (1.67%; 95%CI 0.23-3.13; lag 2-5), as well as PM10 (1.41%; 95%CI - 0.23;+3.08). Results are strongly homogeneous among cities, except for respiratory mortality. No effect has been found for cerebrovascular mortality and weak evidence of association has been observed between ozone and mortality. a clear increase in mortality associated to air pollutants was observed. More important are the effects of NO2 (on natural mortality), mostly associated with traffic emissions, and of PM2.5 (on cardiac and respiratory mortality). Nitrogen dioxide shows an independent effect from the particulate matter, as observed in the bi-pollutant models.

  18. Twenty-five years of geodetic measurements along the Tadjoura-Asal rift system, Djibouti, East Africa

    Science.gov (United States)

    Vigny, Christophe; de Chabalier, Jean-Bernard; Ruegg, Jean-Claude; Huchon, Philippe; Feigl, Kurt L.; Cattin, Rodolphe; Asfaw, Laike; Kanbari, Khaled

    2007-06-01

    Since most of Tadjoura-Asal rift system sits on dry land in the Afar depression near the triple junction between the Arabia, Somalia, and Nubia plates, it is an ideal natural laboratory for studying rifting processes. We analyze these processes in light of a time series of geodetic measurements from 1978 through 2003. The surveys used triangulation (1973), trilateration (1973, 1979, and 1981-1986), leveling (1973, 1979, 1984-1985, and 2000), and the Global Positioning System (GPS, in 1991, 1993, 1995, 1997, 1999, 2001, and 2003). A network of about 30 GPS sites covers the Republic of Djibouti. Additional points were also measured in Yemen and Ethiopia. Stations lying in the Danakil block have almost the same velocity as Arabian plate, indicating that opening near the southern tip of the Red Sea is almost totally accommodated in the Afar depression. Inside Djibouti, the Asal-Ghoubbet rift system accommodates 16 ± 1 mm/yr of opening perpendicular to the rift axis and exhibits a pronounced asymmetry with essentially null deformation on its southwestern side and significant deformation on its northeastern side. This rate, slightly higher than the large-scale Arabia-Somalia motion (13 ± 1 mm/yr), suggests transient variations associated with relaxation processes following the Asal-Ghoubbet seismovolcanic sequence of 1978. Inside the rift, the deformation pattern exhibits a clear two-dimensional pattern. Along the rift axis, the rate decreases to the northwest, suggesting propagation in the same direction. Perpendicular to the rift axis, the focus of the opening is clearly shifted to the northeast, relative to the topographic rift axis, in the "Petit Rift," a rift-in-rift structure, containing most of the active faults and the seismicity. Vertical motions, measured by differential leveling, show the same asymmetric pattern with a bulge of the northeastern shoulder. Although the inner floor of the rift is subsiding with respect to the shoulders, all sites within the rift system show uplift at rates varying from 0 to 10 mm/yr with respect to a far-field reference outside the rift.

  19. Twenty-Five Years Using the Intermodal Preferential Looking Paradigm to Study Language Acquisition: What Have We Learned?

    Science.gov (United States)

    Golinkoff, Roberta Michnick; Ma, Weiyi; Song, Lulu; Hirsh-Pasek, Kathy

    2013-05-01

    The intermodal preferential looking paradigm (IPLP) has proven to be a revolutionary method for the examination of infants' emerging language knowledge. In the IPLP, infants' language comprehension is measured by their differential visual fixation to two images presented side-by-side when only one of the images matches an accompanying linguistic stimulus. Researchers can examine burgeoning knowledge in the areas of phonology, semantics, syntax, and morphology in infants not yet speaking. The IPLP enables the exploration of the underlying mechanisms involved in language learning and illuminates how infants identify the correspondences between language and referents in the world. It has also fostered the study of infants' conceptions of the dynamic events that language will express. Exemplifying translational science, the IPLP is now being investigated for its clinical and diagnostic value. © The Author(s) 2013.

  20. Twenty-Five Years of Ecological Recovery of East Fork Poplar Creek: Review of Environmental Problems and Remedial Actions

    Science.gov (United States)

    Loar, James M.; Stewart, Arthur J.; Smith, John G.

    2011-06-01

    In May 1985, a National Pollutant Discharge Elimination System permit was issued for the Department of Energy's Y-12 National Security Complex (Y-12 Complex) in Oak Ridge, Tennessee, USA, allowing discharge of effluents to East Fork Poplar Creek (EFPC). The effluents ranged from large volumes of chlorinated once-through cooling water and cooling tower blow-down to smaller discharges of treated and untreated process wastewaters, which contained a mixture of heavy metals, organics, and nutrients, especially nitrates. As a condition of the permit, a Biological Monitoring and Abatement Program (BMAP) was developed to meet two major objectives: demonstrate that the established effluent limitations were protecting the classified uses of EFPC, and document the ecological effects resulting from implementing a Water Pollution Control Program at the Y-12 Complex. The second objective is the primary focus of the other papers in this special series. This paper provides a history of pollution and the remedial actions that were implemented; describes the geographic setting of the study area; and characterizes the physicochemical attributes of the sampling sites, including changes in stream flow and temperature that occurred during implementation of the BMAP. Most of the actions taken under the Water Pollution Control Program were completed between 1986 and 1998, with as many as four years elapsing between some of the most significant actions. The Water Pollution Control Program included constructing nine new wastewater treatment facilities and implementation of several other pollution-reducing measures, such as a best management practices plan; area-source pollution control management; and various spill-prevention projects. Many of the major actions had readily discernable effects on the chemical and physical conditions of EFPC. As controls on effluents entering the stream were implemented, pollutant concentrations generally declined and, at least initially, the volume of water discharged from the Y-12 Complex declined. This reduction in discharge was of ecological concern and led to implementation of a flow management program for EFPC. Implementing flow management, in turn, led to substantial changes in chemical and physical conditions of the stream: stream discharge nearly doubled and stream temperatures decreased, becoming more similar to those in reference streams. While water quality clearly improved, meeting water quality standards alone does not guarantee protection of a waterbody's biological integrity. Results from studies on the ecological changes stemming from pollution-reduction actions, such as those presented in this series, also are needed to understand how best to restore or protect biological integrity and enhance ecological recovery in stream ecosystems. With a better knowledge of the ecological consequences of their decisions, environmental managers can better evaluate alternative actions and more accurately predict their effects.

  1. Oral Communication across the Curriculum: The State of the Art after Twenty-five Years of Experience.

    Science.gov (United States)

    Cronin, Michael W.; Grice, George L.; Palmerton, Patricia R.

    2000-01-01

    Claims that oral communication across the curriculum (OCXC) offers unique pedagogical advantages in three areas: (1) active learning; (2) discipline-specific application of communication; and (3) continued instruction and practice throughout college for non-communication majors. Provides a guide for administrators and faculty in developing OCXC…

  2. The US Navy and National Strategy in East Asia: An Outlook for the Next Twenty-Five Years

    Science.gov (United States)

    1990-06-01

    first is tne logic oehina the maritme oalance of Dower theory and the second -s renresenlative of the range of proposals, which the public and pernaps...US enaine manufacturer Prat. S Wnitnev signea a co-aevelooment/co-oroauction agreement witn the Japanese to proauce a new engine to Dower tne next...generation of commercial aircraft. It will be tne worias most powerful commercial engine and, will reouire the most advanced design ana manufacturing

  3. Neutral detergent-soluble fiber im