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Sample records for twenty-five years primary

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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 ...

  7. 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...

  8. 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.

  9. 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.

  10. [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.

  11. 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.

  12. 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...

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

    Directory of Open Access Journals (Sweden)

    H. ASKARI

    1999-03-01

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

  14. 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.

  15. 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

  16. 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.

  17. [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.

  18. 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.

  19. 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.

  20. 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.

  1. [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.

  2. 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.

  3. 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

  4. 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…

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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...

  10. 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

  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

  12. 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.

  13. 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.

  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 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.

  16. 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

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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 ...

  7. A history of the journal of chiropractic education: twenty-five years of service, 1987-2011.

    Science.gov (United States)

    Green, Bart N; Jacobs, Grace E; Johnson, Claire D; Phillips, Reed B

    2011-01-01

    The Journal of Chiropractic Education celebrates its 25th anniversary in the year 2011. The purpose of this article is to chronicle the history of the journal, which is unreported at this time. The entire collection of the journal was reviewed and information pertaining to important events and changes in the format, personnel, and processes of the journal were extracted. This information was used to create a chronology of the journal. The chronology was complemented with information obtained from people who were involved in the evolution of the journal and the Association of Chiropractic Colleges Educational Conferences. Starting as a humble newsletter in 1987 and produced for a small cadre of readers primarily from the United States, the journal is now a full-sized and bound peer-reviewed international journal. Initially cataloged by the Index to Chiropractic Literature and MANTIS, the indexing expanded to interdisciplinary indexing systems such as CINAHL and ultimately PubMed. The journal has grown to serve the needs of chiropractic educators from around the world with representatives on the editorial board from 39 colleges and universities from 15 different countries. The journal has grown in tandem with the profession's leading education and research conference and has been the primary repository for the scholarship of chiropractic education. The history of the journal represents a significant milestone in the development of the chiropractic profession, particularly the discipline of chiropractic education. The journal has had an interesting history and the future promises to bring more opportunities and challenges to the field of chiropractic education and to the journal.

  8. 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

  9. 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

  10. Twenty-five years with the biopsychosocial model of low back pain-is it time to celebrate?

    DEFF Research Database (Denmark)

    Pincus, Tamar; Kent, Peter; Bronfort, Gert

    2013-01-01

    An integrated review of current knowledge about the biopsychosocial model of back pain for understanding etiology, prognosis, and interventions, as presented at the plenary sessions of the XII International Forum on LBP Research in Primary Care (Denmark; October 17-19, 2012)....

  11. 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…

  12. 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.

  13. 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.

  14. 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

  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. One hundred and twenty-five years of the Annals of Botany. Part 1: the first 50 years (1887–1936)

    Science.gov (United States)

    Jackson, Michael B.

    2015-01-01

    Background The Annals of Botany is a peer-reviewed scientific journal publishing papers on a wide range of topics in plant biology. It first appeared in 1887, making it the oldest continuously published botanical title. The present article gives a historical account of events leading to the founding of the Journal and of its development over the first 50 years. Sources of Information Much of the content is drawn from the Journal’s own records and from extensive Minutes, financial accounts, personal letters and notes relating to the Annals of Botany that were repatriated from University College, University of London in 1999. Documents held at the Royal Botanic Gardens, Kew and at the Oxford University Press Museum were also consulted. Content Emphasis is placed on the individuals who instigated, edited and managed the Annals of Botany up to 1937, especially the nine founding members of the Journal and the background that brought them together and motivated them to start the Annals of Botany. A falling out between two of the founders in 1899 is highlighted since not only did this threaten the Journal’s future but also gives much insight into the personalities of those most closely involved in the Journal during its formative years. The article also examines the way the Journal was funded and how it dealt with its publisher (the University of Oxford’s Clarendon Press), turned itself into a registered company (the Annals of Botany Company) and coped with the travails of the First World War, currency inflation and the Great Depression. Plans to re-start the Journal as a New Series, beginning in 1937, are discussed in the context of the competition the Annals of Botany then faced from younger journals. PMID:25561090

  17. One hundred and twenty-five years of the Annals of Botany. Part 1: the first 50 years (1887-1936).

    Science.gov (United States)

    Jackson, Michael B

    2015-01-01

    The Annals of Botany is a peer-reviewed scientific journal publishing papers on a wide range of topics in plant biology. It first appeared in 1887, making it the oldest continuously published botanical title. The present article gives a historical account of events leading to the founding of the Journal and of its development over the first 50 years. Much of the content is drawn from the Journal's own records and from extensive Minutes, financial accounts, personal letters and notes relating to the Annals of Botany that were repatriated from University College, University of London in 1999. Documents held at the Royal Botanic Gardens, Kew and at the Oxford University Press Museum were also consulted. Emphasis is placed on the individuals who instigated, edited and managed the Annals of Botany up to 1937, especially the nine founding members of the Journal and the background that brought them together and motivated them to start the Annals of Botany. A falling out between two of the founders in 1899 is highlighted since not only did this threaten the Journal's future but also gives much insight into the personalities of those most closely involved in the Journal during its formative years. The article also examines the way the Journal was funded and how it dealt with its publisher (the University of Oxford's Clarendon Press), turned itself into a registered company (the Annals of Botany Company) and coped with the travails of the First World War, currency inflation and the Great Depression. Plans to re-start the Journal as a New Series, beginning in 1937, are discussed in the context of the competition the Annals of Botany then faced from younger journals. © The Author 2014. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Twenty-Five Years of Research on Childhood Anxiety Disorders: Publication Trends between 1982 and 2006 and a Selective Review of the Literature

    Science.gov (United States)

    Muris, Peter; Broeren, Suzanne

    2009-01-01

    We examined trends in publications on childhood anxiety disorders over the past 25 years. A PsycINFO search was carried out to find relevant research articles published between 1982 and 2006. Results indicated a gradual and significant rise in the frequency of publications on childhood anxiety disorders during the past 25 years, and this increase…

  19. Twenty-Five year (1982-2007) history of lodgepole pine dwarf mistletoe animal vectors and ethephon control on the Fraser Experimental Forest in Colorado

    Science.gov (United States)

    Thomas. Nicholls

    2009-01-01

    This is a summary of the 25-year history of studies of mammal and bird vectors of lodgepole pine dwarf mistletoe (Arceuthobium americanum), ethephon control of dwarf mistletoe, and the ecology of the most important dwarf mistletoe vector, the gray jay (Persisoreus canadensis), on the USDA Forest Service, Fraser Experimental Forest...

  20. Twenty-five Years of Research on Childhood Anxiety Disorders: Publication Trends Between 1982 and 2006 and a Selective Review of the Literature

    NARCIS (Netherlands)

    P.E.H.M. Muris (Peter); S.M.L. Broeren (Suzanne)

    2009-01-01

    textabstractWe examined trends in publications on childhood anxiety disorders over the past 25 years. A PsycINFO search was carried out to find relevant research articles published between 1982 and 2006. Results indicated a gradual and significant rise in the frequency of publications on childhood

  1. Twenty-five years of HTLV type II follow-up with a possible case of tropical spastic paraparesis in the Kayapo, a Brazilian Indian tribe

    NARCIS (Netherlands)

    Black, FL; Biggar, RJ; Lal, RB; Gabbai, AA; Vieira, JPB

    1996-01-01

    A longitudinal study, spanning 25 years and great demographic and cultural change, found a persistently high prevalence of human T-lymphotropic virus type II (HTLV-II) in the Xikrin Kayapo Indians of Brazil, More than 10% of the children continue to develop immune reactions to the virus in infancy,

  2. 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.

  3. Twenty-five years of the international Bled course for teachers of family medicine in Europe: Glancing back and looking forward.

    Science.gov (United States)

    Klemenc-Ketis, Zalika; Svab, Igor; Petek-Ster, Marija; Bulc, Mateja; Buchanan, Josephine; Finnegan, Henry; Correia de Sousa, Jaime; Yaphe, John

    2016-12-01

    The international Bled course for teacher training has played a central role in faculty development in family medicine for the past 25 years. The course was originally designed to promote faculty development for family medicine teachers in the new academic discipline of family medicine in Slovenia in 1990 and to introduce new topics into the family medicine curriculum. In this background paper, we perform a SCOT analysis (strengths, challenges, opportunities, and threats) of the current course, evaluating participant feedback and reviewing past topics and their impact on local and international teaching programmes. We also review the place of the course in the context of other teacher-training programmes in family medicine in Europe. We found that the structure and learning aims of the Bled course have remained stable over 25 years. It provides a safe, well-structured learning environment for the participants even though the course topic is different every year. The course has had a significant impact on curriculum development and teacher training in Slovenia as well as in many other countries in Europe and beyond. Because of the positive impact of the course and the high degree of satisfaction of the participants and course directors, it seems worthwhile to continue this endeavour. New directions for the course will depend on the learning needs of the participants and the evolving medical curricula in the countries they represent.

  4. 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.

  5. 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.

  6. Distribution of native mussel (unionidae) assemblages in coastal areas of Lake Erie, Lake St. Clair, and connecting channels, twenty-five years after a dreissenid invasion

    Science.gov (United States)

    Zanatta, David T.; Bossenbroek, Jonathan M.; Burlakova, Lyubov E.; Crail, Todd D.; Szalay, Ferenc de; Griffith, Traci A.; Kapusinski, Douglas; Karatayev, Alexander Y.; Krebs, Robert A.; Meyer, Elizabeth S.; Paterson, Wendy L.; Prescott, Trevor J.; Rowe, Matthew T.; Schloesser, Donald W.; Walsh, Mary C.

    2015-01-01

    Over the past 25 years, unionid mussels in the Laurentian Great Lakes of North America have been adversely impacted by invasive dreissenid mussels, which directly (e.g., by attachment to unionid shells) and indirectly (e.g., by competing for food) cause mortality. Despite the invasion, unionids have survived in several areas in the presence of dreissenid mussels. We investigated current spatial patterns in these native mussel refuges based on surveys for unionid mussels across 48 sampling locations (141 sites) in 2011 and 2012, and documented species abundance and diversity in coastal areas of lakes St. Clair and Erie. The highest-quality assemblages of native mussels (densities, richness, and diversity) appear to be concentrated in the St. Clair delta, where abundance continues to decline, as well as in in Thompson Bay of Presque Isle in Lake Erie and in just a few coastal wetlands and drowned river-mouths in the western basin of Lake Erie. The discovery of several new refuge areas suggests that unionids have a broader distribution within the region than previously thought.

  7. 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.

  8. 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.

  9. Twenty-five years of change in scleractinian coral communities of Daya Bay (northern South China Sea)and its response to the 2008 AD extreme cold climate event

    Institute of Scientific and Technical Information of China (English)

    CHEN TianRan; YU KeFu; SHI Qi; LI Shu; Gilbert J. Price; WANG Rong; ZHAO MeiXia; CHEN TeGu; ZHAO JianXin

    2009-01-01

    Coral reefs worldwide are becoming increasingly and detrimentally impacted upon by a variety of factors including significant climate changes, such as global warming and increased EI Nino-Southern Oscillation activity. Generally, the persistence of coral reefs, especially at low-latitudes, is governed, in part, by sea surface temperatures not exceeding the critical limit (~30℃) at which mass mortality can occur. Thus, it is thought that corals living at high-latitudes (i.e., currently cooler sea surface temperatures) will likely respond more favourably to hypothesized future temperature increases than corals living at low-latitudes (i.e., currently warmer sea surface temperatures). Consequently, high-latitude coral communities may have the potential to act as regions of refugia for many coral species in the face of potential future global warming. The Daya Bay (22°31′-22°0′N), northern South China Sea, contains several high-latitude non-reefal coral communities and represents one of the most northerly distributions of scleractinian corals within the region. Significantly, Daya Bay has experienced dramatic warming in both air and sea surface temperatures throughout the past 50 years. In this paper, we analyze 25 years of change in the Daya Bay coral communities, based both on historic surveys and our latest 2006-2008 regional ecological surveys. Our results suggest that, contrary to predictions, there have been significant declines in coral cover within the Daya Bay during the past 25 years (i.e., 76.6%coral cover in 1983/1984 to only 15.3% coral cover by 2008). Such changes also reflect a significant shift in the most abundant coral species, from Acropora pruinosa to Favites abdita. Most of the modern coral communities became established between 15 and 30 years ago, corresponding to a period of increased winter sea surface temperature. However, very few colonies have become established within the last 15 years, despite a more intense period of warming. By

  10. Vinte e cinco anos de reações, estratégias e metodologias em Química Orgânica Twenty five years of strategies, methodologies and reactions in organic chemistry

    Directory of Open Access Journals (Sweden)

    Carlos Roque D. Correia

    2002-05-01

    Full Text Available An overview of the developments that occurred in the field of organic chemistry in Brazil in the last 25 years is presented. These developments are briefly compared to those observed worldwide, including some modern trends. The main source of information was the annual meeting of the Brazilian Chemical Society (RASBQ covering the period 1979-2001 and the biennial Brazilian Meeting on Organic Synthesis (BMOS. All the contributions presented at these two meetings were classified according to six main indicatives, to permit a discussion about the past, present and future activities of Organic Chemistry in Brazil.

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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)

  5. 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.

  6. 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.

  7. 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.

  8. 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…

  9. 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)

  10. 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.

  11. 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.

  12. 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.

  13. 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…

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. 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,…

  20. 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.

  1. 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

  2. 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...

  3. 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...

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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...

  10. 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

  11. 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.…

  12. 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.

  13. Saúde e doença em índios Panará (Kreen-Akarôre após vinte e cinco anos de contato com o nosso mundo, com ênfase na ocorrência de tuberculose (Brasil Central Health and disease among Panará (Kreen-Akarôre Indians in Central Brazil after twenty-five years of contact with our World, with an emphasis on tuberculosis

    Directory of Open Access Journals (Sweden)

    Roberto Geraldo Baruzzi

    2001-03-01

    Full Text Available Em 1973, houve a quebra do estado de isolamento dos Panará (Kren-Akarore no interior da floresta amazônica. Dois anos após estavam reduzidos a 82 indivíduos, de uma população estimada em 400 a 500 em meados dos anos 60. Em 1998, o exame dos Panará, nas cabeceiras do rio Iriri, sul do Pará, levou ao diagnóstico presuntivo de tuberculose em 15 indivíduos, dos quais 10 foram confirmados na cidade de Colider com base em dados clínicos e radiológicos. Desses 10 casos, 6 eram menores de 10 anos de idade e 4 tinham de 40 a 50 anos. Todos da tribo apresentavam cicatriz vacinal do BCG. Em crianças, a prevalência de desnutrição crônica e de anemia ferropriva foi menor do que a relatada em outros grupos indígenas da região amazônica. As medidas de controle da Tb, a nível local, incluíram: a continuidade do tratamento dos pacientes, na aldeia, sob supervisão do Auxiliar de Enfermagem e do Agente Indígena de Saúde; b observância dos critérios de cura; c acompanhamento clínico de comunicantes e não-comunicantes dada a elevada prevalência da doença; d implantação de sistema de referência e contra-referência com serviços de saúde de Colider.The Panará, who had previously lived in isolation from Brazilian national society in the Amazon forest, were first contacted in 1973. Two years later they were moved to another area in Central Brazil. During this same period they were reduced to 82 members, the survivors of a population of 400 to 500 in the mid-1960s. In 1995 they returned to a small area in their old territory still not occupied by outsiders. There, three years later, a health survey showed a presumed diagnosis of tuberculosis in 15 individuals out of a population of 181. Further tests in the town of Colider, based on clinical data and chest X-rays, confirmed the diagnosis in 10 Panará (6 children under 10 years of age and 4 adults from 40 to 50 years old. BCG scars were present in the entire population. The

  14. 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%.

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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.

  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. Twenty-Five Years of Collegial Management: The Dickinson College Model of Revolving Leadership and Holistic Librarianship.

    Science.gov (United States)

    McKinzie, Steve

    2000-01-01

    This case study describes the management system of Dickinson College Library. Highlights include a rotating chair instead of a director; collegiality in decision making; rotating departmental responsibilities; developing an acceptable level of expertise in both technical and public services; and an emphasis on professionalism. (Author/LRW)

  4. Twenty-Five Year Epidemiology of Invasive Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates Recovered at a Burn Center

    Science.gov (United States)

    2009-01-01

    a,b,*, Robert L. Holmes c, Michael W. Ellis b, Katrin Mende a,d, Steven E. Wolf e, Linda K. McDougal f, Charles H. Guymon e, Duane R. Hospenthal a,b...contemporary epidemic clones. Proc Natl Acad Sci 2001;98:9865–70. [6] Enright MC, Robinson DA, Randle G, Feil EJ, Grundmann H, Spratt BG. The

  5. Twenty-five thousand years of fluctuating selection on leopard complex spotting and congenital night blindness in horses.

    Science.gov (United States)

    Ludwig, Arne; Reissmann, Monika; Benecke, Norbert; Bellone, Rebecca; Sandoval-Castellanos, Edson; Cieslak, Michael; Fortes, Gloria G; Morales-Muñiz, Arturo; Hofreiter, Michael; Pruvost, Melanie

    2015-01-19

    Leopard complex spotting is inherited by the incompletely dominant locus, LP, which also causes congenital stationary night blindness in homozygous horses. We investigated an associated single nucleotide polymorphism in the TRPM1 gene in 96 archaeological bones from 31 localities from Late Pleistocene (approx. 17 000 YBP) to medieval times. The first genetic evidence of LP spotting in Europe dates back to the Pleistocene. We tested for temporal changes in the LP associated allele frequency and estimated coefficients of selection by means of approximate Bayesian computation analyses. Our results show that at least some of the observed frequency changes are congruent with shifts in artificial selection pressure for the leopard complex spotting phenotype. In early domestic horses from Kirklareli-Kanligecit (Turkey) dating to 2700-2200 BC, a remarkably high number of leopard spotted horses (six of 10 individuals) was detected including one adult homozygote. However, LP seems to have largely disappeared during the late Bronze Age, suggesting selection against this phenotype in early domestic horses. During the Iron Age, LP reappeared, probably by reintroduction into the domestic gene pool from wild animals. This picture of alternating selective regimes might explain how genetic diversity was maintained in domestic animals despite selection for specific traits at different times.

  6. Twenty five years since the first prospective study by Forman et al. (1991) on Helicobacter pylori and stomach cancer risk.

    Science.gov (United States)

    Sitas, Freddy

    2016-04-01

    Stomach cancer is one of the leading causes of cancer death worldwide, despite its incidence and mortality falling in many places. The discovery in 1984 that a bacterial infection with Helicobacter pylori could cause stomach and duodenal ulcers prompted work in its role in causing gastritis, and led to the first prospective study in 1991 by Forman et al., showing that infection with H.pylori increased the risk of stomach cancer in those infected by almost three-fold. Prior to then, it was hypothesized that stomach was caused by poor diets. While diets may still play a role, the falls in stomach cancer incidence have been associated with reductions in population prevalence of H. pylori. Discovery of the link was accelerated by the use of stored sera from other unrelated studies, and the use of serological assays. Since those discoveries the treatment landscape of gastric disorders has changed significantly, with a rapid uptake of antibiotic and proton pump inhibitors (triple) therapies in those who are H. pylori positive. Over time we have seen falls in gastric cancer, peptic and duodenal ulcers and in many of the procedures previously used to cure peptic ulcer disease, such as vagotomies and gastrectomies. Further still, an oral vaccine against H. pylori, first trialled in China, holds much promise of being the third vaccine against a cancer causing infection. If successful this would lead to a further reduction in H. pylori related conditions, and ultimately gastric cancer, an otherwise lethal disease.

  7. Prejudice and Pride: The Brown Decision After Twenty-Five Years, May 17, 1954-May 17, 1979.

    Science.gov (United States)

    Bailey, Stephen K.

    The contributors to the panel discussion reported here are divided on whether the Brown decision was an attack on racial separation or an affirmation of parents' right to choose which schools their children attend. Nor do they agree on the role social science research has played in school desegregation litigation. Some contributors claim that the…

  8. "What a Long, Strange Trip It's Been...": Twenty-Five Years of Qualitative and New Paradigm Research

    Science.gov (United States)

    Lincoln, Yvonna S.

    2010-01-01

    Tracking the history of qualitative research is to some extent a personal journey, reflective of the individual's own experience in the field. Many scholars participated in the ongoing dialogue around the shift from a solely positivist model of research to a multiple-models context. There still remain some philosophical and practical problems,…

  9. Twenty-Five Years and Counting of "Sweet Valley": Jessica and Elizabeth in Romance Novels for Young Children?

    Science.gov (United States)

    Roberts, Sherron Killingsworth

    2010-01-01

    With the 2008 reissue of Francine Pascal's (1983) "Sweet Valley High", the popular cultural icons of twins Jessica and Elizabeth have been revitalized. Jessica and Elizabeth are the much-beloved protagonists in romance novels strategically targeted for young adults in "Sweet Valley High" or "Sweet Valley U", and for first- and second-grade readers…

  10. Twenty-five years of managing vegetation in conifer plantations in northern and central California: results, application, principles, and challenges

    Science.gov (United States)

    Philip M. McDonald; Gary O. Fiddler

    2010-01-01

    In the late 1970s, the outlook for conifer seedlings in new plantations in the Western United States was dismal&too many were dying or growing below the potential of the site. This situation was untenable, and a large study aimed at increasing the survival and growth of planted conifer seedlings was implemented. This was the National Administrative Study on...

  11. Offshore Installations and Their Relevance to the Coast Guard through the Next Twenty-Five Years. Volume III. Appendices.

    Science.gov (United States)

    1980-11-01

    destruction and other construction impacts had a short term negative effect at a artificial island ( Rincon Island) built at Punta Gorda California, the...ports is variable due to changes in jurisdictions of various agencies. An offshore deepwater port has been proposed at Morro Bay in San Luis Obispo County

  12. Twenty five years of requests for euthanasia and physician assisted suicide in Dutch general practice: trend analysis.

    NARCIS (Netherlands)

    Marquet, R.L.; Bartelds, A.; Visser, G.J.; Spreeuwenberg, P.; Peters, L.

    2003-01-01

    Concerns have been expressed that the Dutch policy on euthanasia (E) and physician assisted suicide (PAS) may lead to an exponential increase in the number of requests and use. Many Dutch general practitioners, nursing home physicians, and pharmacists have a fairly positive attitude and have become

  13. Extended radical mastectomy versus simple mastectomy followed by radiotherapy in primary breast cancer. A fifty-year follow-up to the Copenhagen Breast Cancer randomised study

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, Helge; Kaae, Sigvard (Radium Center, Finsen Inst., Copenhagen (Denmark)); Jensen, Maj-Britt; Mouridsen, Henning T. (DBCG Registry, Copenhagen (Denmark))

    2008-05-15

    From November 1951 to December 1957, 666 consecutive patients with untreated primary breast cancer admitted to the Radium Center in Copenhagen were randomised before their operability was evaluated into two groups, simple mastectomy with postoperative radiotherapy or extended radical mastectomy. Following physical examination 241 of the patients were excluded, primarily due to tumours deemed inoperable due to clinical criteria (n =107) and due to poor general condition (n =69). Twenty-five years results of disease-free free survival and fifty years results of survival are presented, showing no difference between the two groups. Patients with clinical stage I did significantly better than patients with stage II-III tumours. Patients with grade I tumours had a better survival than patients with grade II-III. The breast cancer associated mortality was lower in premenopausal patients compared to postmenopausal patients. An excess mortality due to breast cancer was evident up to 20-25 years following the primary diagnosis

  14. Extended radical mastectomy versus simple mastectomy followed by radiotherapy in primary breast cancer. A fifty-year follow-up to the Copenhagen Breast Cancer randomised study.

    Science.gov (United States)

    Johansen, Helge; Kaae, Sigvard; Jensen, Maj-Britt; Mouridsen, Henning T

    2008-01-01

    From November 1951 to December 1957, 666 consecutive patients with untreated primary breast cancer admitted to the Radium Center in Copenhagen were randomised before their operability was evaluated into two groups, simple mastectomy with postoperative radiotherapy or extended radical mastectomy. Following physical examination 241 of the patients were excluded, primarily due to tumours deemed inoperable due to clinical criteria (n =107) and due to poor general condition (n =69). Twenty-five years results of disease-free free survival and fifty years results of survival are presented, showing no difference between the two groups. Patients with clinical stage I did significantly better than patients with stage II-III tumours. Patients with grade I tumours had a better survival than patients with grade II-III. The breast cancer associated mortality was lower in premenopausal patients compared to postmenopausal patients. An excess mortality due to breast cancer was evident up to 20-25 years following the primary diagnosis.

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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

  18. [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

  19. Middle Years Students' Experiences in Nature: A Case Study on Nature-Play

    Science.gov (United States)

    Francis, Marj; Paige, Kathy; Lloyd, David

    2013-01-01

    Increasingly, children today are becoming disconnected from the natural environments resulting in a diminished sense of self, place and community. In an attempt to find out their perceptions, attitudes and values about the natural world, twenty-five Year 6 and 7 students from a northern Adelaide primary school participated in a nature-play case…

  20. Middle Years Students' Experiences in Nature: A Case Study on Nature-Play

    Science.gov (United States)

    Francis, Marj; Paige, Kathy; Lloyd, David

    2013-01-01

    Increasingly, children today are becoming disconnected from the natural environments resulting in a diminished sense of self, place and community. In an attempt to find out their perceptions, attitudes and values about the natural world, twenty-five Year 6 and 7 students from a northern Adelaide primary school participated in a nature-play case…

  1. Outline of a Twenty-Five Year Plan for Development and Deployment of A Catapult for A Third Generation Space Shuttle

    Science.gov (United States)

    Russell, John M.

    2002-01-01

    This report reviews the rationale for catapult assist in the launching a third generation space shuttle. It then furnishes lists of early design decisions, questions whose answers are prerequisite to later design decisions, preliminary inventories of carriage levitation and carriage propulsion concepts, phases of the project and major milestones, and some sources of expertise to support the project.

  2. Lithospheric rheology constrained from twenty-five years of postseismic deformation following the 1989 Mw 6.9 Loma Prieta earthquake

    Science.gov (United States)

    Huang, Mong-Han; Burgmann, Roland; Pollitz, Fred

    2016-01-01

    The October 17, 1989 Mw 6.9 Loma Prieta earthquake provides the first opportunity of probing the crustal and upper mantle rheology in the San Francisco Bay Area since the 1906 Mw 7.9 San Francisco earthquake. Here we use geodetic observations including GPS and InSAR to characterize the Loma Prieta earthquake postseismic displacements from 1989 to 2013. Pre-earthquake deformation rates are constrained by nearly 20 yr of USGS trilateration measurements and removed from the postseismic measurements prior to the analysis. We observe GPS horizontal displacements at mean rates of 1–4 mm/yr toward Loma Prieta Mountain until 2000, and ∼2 mm/yr surface subsidence of the northern Santa Cruz Mountains between 1992 and 2002 shown by InSAR, which is not associated with the seasonal and longer-term hydrological deformation in the adjoining Santa Clara Valley. Previous work indicates afterslip dominated in the early (1989–1994) postseismic period, so we focus on modeling the postseismic viscoelastic relaxation constrained by the geodetic observations after 1994. The best fitting model shows an elastic 19-km-thick upper crust above an 11-km-thick viscoelastic lower crust with viscosity of ∼6 × 1018 Pas, underlain by a viscous upper mantle with viscosity between 3 × 1018 and 2 × 1019 Pas. The millimeter-scale postseismic deformation does not resolve the viscosity in the different layers very well, and the lower-crustal relaxation may be localized in a narrow shear zone. However, the inferred lithospheric rheology is consistent with previous estimates based on post-1906 San Francisco earthquake measurements along the San Andreas fault system. The viscoelastic relaxation may also contribute to the enduring increase of aseismic slip and repeating earthquake activity on the San Andreas fault near San Juan Bautista, which continued for at least a decade after the Loma Prieta event.

  3. Twenty-Five Years After--Rebuilding the Lifelong Learning System in the Czech and Slovak Republic: Progress, Challenges and Lessons Learnt from a Narrative Research

    Science.gov (United States)

    Sprlak, Tomas

    2016-01-01

    The lifelong learning system in the Czech Republic and Slovakia share some common traits: traditional model with the dominant role of the initial education, low participation rates, lack of incentives and fragmentation. The results of the narrative research on 15 low-skilled persons demonstrated that negative attitudes towards education are often…

  4. Twenty-five years later--what do we know about religion/spirituality and psychological well-being among breast cancer survivors? A systematic review.

    Science.gov (United States)

    Schreiber, Judith A; Brockopp, Dorothy Y

    2012-03-01

    A diagnosis of cancer is a life-changing event for most people. The trauma and uncertainties of a breast cancer diagnosis can affect survivors' psychological well-being. Religion and/or spirituality can provide a means of support for many women as they live with the realities of a diagnosis of cancer. The purpose of this focused review is to critically analyze and synthesize relationships among psychological well-being, religion, and spirituality among women with breast cancer. MEDLINE, CINAHL, Web of Science, Cambridge Scientific Abstracts, Cochrane CENTRAL, and PsycINFO databases were searched: January 1985-March 2010. The search terms religi*(religious/religion), spiritu*(spiritual/spirituality), breast cancer, psychological adjustment, psychological outcomes, psychological distress, psychological well-being, and outcomes were searched for separately and in combination. Eighteen quantitative studies were analyzed in order to examine associations among religion, spirituality, and psychological well-being for women diagnosed with breast cancer. These three variables were operationally defined as follows: (a) religious practice, religious coping, and perception of God; (b) spiritual distress, spiritual reframing, spiritual well-being, and spiritual integration; and (c) combined measure of both the religion and spirituality constructs. Results of this review suggest that within this population, limited relationships exist among religion, spirituality, and psychological well-being. Given the various definitions used for the three variables, the strength and clarity of relationships are not clear. In addition, the time of assessment along the course of the disease varies greatly and in some instances is not reported. Diagnosis and/or prognosis, factors that could influence psychological well-being, are frequently not factored into results. There does, however, appear to be sufficient evidence to include a brief, clinically focused assessment of women diagnosed with breast cancer regarding the importance of a given belief system as they face the diagnosis and treatment of their disease. The implications for cancer survivors are as follows: (a) Psychological well-being of women diagnosed with breast cancer may depend to some extent on their belief system. (b) Coping through "turning to God" for women without a significant prior relationship with God, or minimal spiritual behaviors, may experience diminished well-being. (c) Longitudinal studies suggest that struggling with, or questioning, one's belief system in early survivorship may also be associated with lower levels of well-being. This diminished well-being often resolves over time.

  5. Changes in the economy, the labor market, and expectations for the future: what might Europe and the United States look like in twenty-five years?

    Science.gov (United States)

    Buchholz, Sandra; Blossfeld, Hans-Peter

    2012-01-01

    In times of globalization, modern societies' labor markets have been marked by an increasing segmentation and growing social inequality. Youths in particular have experienced a worsening of their employment chances in the past three decades. However, what will the future bring?

  6. Lithospheric rheology constrained from twenty-five years of postseismic deformation following the 1989 Mw 6.9 Loma Prieta earthquake

    Science.gov (United States)

    Huang, Mong-Han; Bürgmann, Roland; Pollitz, Fred

    2016-02-01

    The October 17, 1989 Mw 6.9 Loma Prieta earthquake provides the first opportunity of probing the crustal and upper mantle rheology in the San Francisco Bay Area since the 1906 Mw 7.9 San Francisco earthquake. Here we use geodetic observations including GPS and InSAR to characterize the Loma Prieta earthquake postseismic displacements from 1989 to 2013. Pre-earthquake deformation rates are constrained by nearly 20 yr of USGS trilateration measurements and removed from the postseismic measurements prior to the analysis. We observe GPS horizontal displacements at mean rates of 1-4 mm/yr toward Loma Prieta Mountain until 2000, and ˜2 mm/yr surface subsidence of the northern Santa Cruz Mountains between 1992 and 2002 shown by InSAR, which is not associated with the seasonal and longer-term hydrological deformation in the adjoining Santa Clara Valley. Previous work indicates afterslip dominated in the early (1989-1994) postseismic period, so we focus on modeling the postseismic viscoelastic relaxation constrained by the geodetic observations after 1994. The best fitting model shows an elastic 19-km-thick upper crust above an 11-km-thick viscoelastic lower crust with viscosity of ˜ 6 ×1018 Pas, underlain by a viscous upper mantle with viscosity between 3 ×1018 and 2 ×1019 Pas. The millimeter-scale postseismic deformation does not resolve the viscosity in the different layers very well, and the lower-crustal relaxation may be localized in a narrow shear zone. However, the inferred lithospheric rheology is consistent with previous estimates based on post-1906 San Francisco earthquake measurements along the San Andreas fault system. The viscoelastic relaxation may also contribute to the enduring increase of aseismic slip and repeating earthquake activity on the San Andreas fault near San Juan Bautista, which continued for at least a decade after the Loma Prieta event.

  7. Malignant ilnesses in men breast. A twenty-five year study Afecciones malignas de la mama en hombre. Estudio de veinticinco años

    Directory of Open Access Journals (Sweden)

    Lidia Torres Ajá

    Full Text Available Background: Breast tumors prevailed in female population, nevertheless in male population appear although it is very infrequent to be found. Objective: to describe the clinical-pathologic behavior of breast cancer in Cienfuegos province. Method: A descriptive-retrospective study of breast tumors in males who were surgically treated at the University Hospital ";Dr. Gustavo Aldereguía Lima” in Cienfuegos, Cuba from January 1st 1981 to December 31st 2005. The variables used were the following: age, affected breast, topographic localization of the tumor, clinical stage at the time of diagnosis, histological variant, type of biopsy used for this purpose, surgical technique applied, and health area belonging to. Results: male breast cancer represented the 0.8 % out of the total of breast cancers which were surgically treated during this studied period. Detection at very advanced clinical stages was confirmed. Conclusions: It is necessary to establish mechanisms for their early detection due to the increment in the incidence of this disease in males.
    Fundamento: Los tumores mamarios prevalecen en la población femenina, sin embargo, en el sexo masculino, aunque es extremadamente infrecuente, también puede aparecer este tipo de afección. Objetivo: Describir el comportamiento clínico patológico del cáncer de mama en hombre, en la provincia Cienfuegos. Método: Se realizó un estudio descriptivo, retrospectivo, de todos los casos de tumores mamarios en hombre, operados en el Hospital Universitario ";Dr. Gustavo Aldereguía Lima” de Cienfuegos, desde el 1ro de enero de 1981, hasta el 31 de diciembre de 2005. Las variables analizadas fueron: edad, mama afectada, localización topográfica del tumor, etapa clínica en el momento del diagnóstico, variante histológica, tipo de biopsia utilizada, técnica quirúrgica aplicada y área de salud de procedencia. Resultados: El cáncer de mama masculino representó el 0,8 % del total de cánceres mamarios operados durante el período estudiado; además se pudo constatar su detección en etapas clínicas muy avanzadas. Conclusiones: La tendencia al alza de la incidencia de esta afección en el hombre, exige que se establezcan mecanismos para su detección precoz.

  8. Malignant ilnesses in men breast. A twenty-five year study Afecciones malignas de la mama en hombre. Estudio de veinticinco años

    OpenAIRE

    Lidia Torres Ajá

    2007-01-01

    Background: Breast tumors prevailed in female population, nevertheless in male population appear although it is very infrequent to be found. Objective: to describe the clinical-pathologic behavior of breast cancer in Cienfuegos province. Method: A descriptive-retrospective study of breast tumors in males who were surgically treated at the University Hospital ";Dr. Gustavo Aldereguía Lima” in Cienfuegos, Cub...

  9. 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

  10. Primary Care Psychologists in the Netherlands: 30 Years of Experience

    NARCIS (Netherlands)

    Derksen, J.J.L.

    2009-01-01

    The primary care psychologist (PCP) in the Netherlands has 30 years of experience. The PCP is a generalist who, in close cooperation with the family physician and other providers of primary health care, has a mindset and manner of working that is largely determined by the context in which the PCP

  11. Primary Care Psychologists in the Netherlands: 30 Years of Experience

    NARCIS (Netherlands)

    Derksen, J.J.L.

    2009-01-01

    The primary care psychologist (PCP) in the Netherlands has 30 years of experience. The PCP is a generalist who, in close cooperation with the family physician and other providers of primary health care, has a mindset and manner of working that is largely determined by the context in which the PCP wo

  12. Esthetic restoration of discolored primary incisors.

    Science.gov (United States)

    Margolis, Fred S

    2005-01-01

    Restoring primary teeth can be a strenuous task for many dentists who would like to have an esthetic, easy-to-use and relatively quick restoration for children. But, the restoration of carious, fractured or discolored primary incisors gives the dentist the satisfaction of knowing that he/she has restored the smile and self-confidence of a growing child. This article describes a technique which is relatively easy and produces a beautiful outcome in a relatively short time. The author has used the technique in hundreds of children for over twenty-five years. Modifications in the technique have been made as newer materials and techniques have evolved.

  13. Primary pulmonary adenocarcinoma in a 16-year-old boy

    DEFF Research Database (Denmark)

    Måreng, Ane Stillits; Langer, Seppo W; Bodtger, Uffe

    2016-01-01

    Primary pulmonary adenocarcinoma in children or adolescents is a rare disease, and as such, there are no randomised studies on lung cancer for this age group. Treatment choice is extrapolated from studies in adults (mean age of participants: 60 years). We present the 5-year follow-up of a 16-year......-old boy who presented with metastatic primary pulmonary adenocarcinoma (T3N3M1a) and was treated aggressively, including radiation therapy for local and distant recurrence. He had complete remission, had completed his education, was employed full-time, and suffered only from mild side effects to treatment....

  14. Primary cardiac osteosarcoma in a 42-year-old woman

    Directory of Open Access Journals (Sweden)

    Zou Jianyong

    2010-11-01

    Full Text Available Abstract We describe here a 42-year-old woman who was admitted to hospital with a pedunculated mass in her left atrium. She was diagnosed with a primary cardiac osteosarcoma with special immunohistochemical characteristics. Echocardiography and computed tomography can be used to differentiate cardiac osteosarcomas from routine intracardiac tumors. The patient was treated by surgical removal of the mass. Two years later, she has shown no evidence of disease recurrence. We discuss primary osteosarcomas in the cardiac cavity and their management.

  15. Math Anxiety and Math Ability in Early Primary School Years

    Science.gov (United States)

    Krinzinger, Helga; Kaufmann, Liane; Willmes, Klaus

    2009-01-01

    Mathematical learning disabilities (MLDs) are often associated with math anxiety, yet until now, very little is known about the causal relations between calculation ability and math anxiety during early primary school years. The main aim of this study was to longitudinally investigate the relationship between calculation ability, self-reported…

  16. [Primary adrenal insufficiency in adults: 150 years after Addison].

    Science.gov (United States)

    Silva, Regina do Carmo; Castro, Margaret de; Kater, Claudio E; Cunha, Andréa Aparecida; Moraes, Andréia M de; Alvarenga, Daniela B de; Moreira, Ayrton C; Elias, Lucila L K

    2004-10-01

    Thomas Addison first described, 150 years ago, a clinical syndrome characterized by salt-wasting and skin hyperpigmentation, associated with a destruction of the adrenal gland. Even today, over a century after Addison's report, primary adrenal insufficiency can present as a life-threatening condition, since it frequently goes unrecognized in its early stages. In the 1850s, tuberculous adrenalitis was present in the majority of patients, but nowadays, autoimmune Addison's disease is the most common cause of primary adrenal insufficiency. In the present report, we show the prevalence of different etiologies, clinical manifestations and laboratorial findings, including the adrenal cortex autoantibody, and 21-hydroxylase antibody in a Brazilian series of patients with primary adrenal insufficiency followed at Divisão de Endocrinologia da Universidade Federal de São Paulo (UNIFESP) and at Faculdade de Medicina de Ribeirão Preto-USP (FMRP-USP).

  17. 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.

  18. Twenty-five gauge vitrectomy in uveitis

    Directory of Open Access Journals (Sweden)

    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.

  19. Antiphospholipid-associated thrombocytopenia or autoimmune hemolytic anemia in patients with or without definite primary antiphospholipid syndrome according to the Sapporo revised classification criteria: a 6-year follow-up study.

    Science.gov (United States)

    Comellas-Kirkerup, Lucía; Hernández-Molina, Gabriela; Cabral, Antonio R

    2010-10-21

    The updated Sapporo classification criteria for antiphospholipid syndrome (APS) only include thrombosis or pregnancy morbidity as clinical criteria. To test this notion, we studied 55 patients (80% women) with hematologic manifestations. All fulfilled the laboratory criteria for primary APS. Thirty-five patients (64%) had thrombocytopenia, 14 (25%) had autoimmune hemolytic anemia, and 6 (11%) had both. Twenty-five patients (22 women, 88%) also fulfilled one clinical criterion for APS after a median follow-up of 13.2 years (range, 1.45-37 years), whereas the remaining 30 patients (22 women, 73%) have not had any thrombotic event nor pregnancy morbidity after a median follow-up of 5.4 years (range, 0.12-24 years). No patient developed systemic lupus erythematosus during follow-up. The hematologic manifestation was asynchronous with the APS onset in 84% of patients. The response to treatment was similar regardless of the APS status. Patients with definite APS were more frequently positive for the lupus anticoagulant (63%) than lupus anticoagulant-positive patients without APS (30%; odds ratio, 3.5; 95% confidence interval, 1.07-11.4; P < .02). Anticardiolipin or anti-β(2)-glycoprotein-I antibodies were highly prevalent among the study groups. Our study suggests that, depending upon their antiphospholipid profile, patients with hemocytopenias appear to comprise a peculiar subset of patients with APS; some develop thrombotic and/or obstetric APS whereas others continue with hematologic APS.

  20. Primary Pleural Angiosarcoma in a 63-Year-Old Gentleman

    Directory of Open Access Journals (Sweden)

    Ahmed Abu-Zaid

    2013-01-01

    Full Text Available Primary pleural angiosarcomas are extremely rare. As of 2010, only around 50 case reports have been documented in the literature. Herein, we report the case of a 63-year-old gentleman who presented with a 3-month history of right-sided chest pain, dyspnea, and hemoptysis. Chest X-ray showed bilateral pleural effusion with partial bibasilar atelectasis. Ultrasound-guided thoracocentesis showed bloody and exudative pleural fluid. Cytologic examination was negative for malignant cells. An abdominal contrast-enhanced computed tomography (CT scan showed two right diaphragmatic pleural masses. Whole-body positron emission tomography/computed tomography (PET/CT scan showed two hypermetabolic fluorodeoxyglucose- (FDG- avid lesions involving the right diaphragmatic pleura. CT-guided needle-core biopsy was performed and histopathological examination showed neoplastic cells growing mainly in sheets with focal areas suggestive of vascular spaces lined by cytologically malignant epithelioid cells. Immunohistochemical analysis showed strong positivity for vimentin, CD31, CD68, and Fli-1 markers. The overall pathological and immunohistochemical features supported the diagnosis of epithelioid angiosarcoma. The patient was scheduled for surgery in three weeks. Unfortunately, the patient died after one week after discharge secondary to pulseless ventricular tachycardia arrest followed by asystole. Moreover, we also present a brief literature review on pleural angiosarcoma.

  1. Primary Vesical Actinomycosis in a 23-Year-Old Man

    Directory of Open Access Journals (Sweden)

    Tevfik Ziypak

    2014-01-01

    Full Text Available Introduction. Actinomycosis can affect any organ of the body, although cutaneous fistulas are common in actinomycotic infections, and other organs such as the bladder are only rarely involved. Case Presentation. Herein we report and discuss a young male patient with primary vesical actinomycosis. A 23-year-old man was hospitalized complaining of intermittent gross hematuria over a 6-month duration. The patient underwent a cystoscopic examination under general anesthesia; an edematous, hyperemic, wide-based mass, which protruded from the dome of the bladder, was seen and incompletely resected. The histopathological examination of the material showed Actinomyces organisms surrounded by inflammation and a photomicrograph showed the microorganism. After confirmation of bladder actinomycosis, the patient received penicillin. A CT scan of the abdomen and pelvis showed no evidence of the mass at the postoperative 6th month. Cystoscopic examination showed complete healing of the transurethral resection area at the dome of the bladder. Conclusion. In conclusion, we believe that the gold standard treatment for vesical actinomycosis should include the combination of a transurethral resection of the mass and long-term penicillin treatment.

  2. [Primary pulmonary artery sarcoma in 36-year-old women: 3-years follow-up after partial resection and radiotherapy].

    Science.gov (United States)

    Drożdż, Jarosław; Warchoł, Ewa; Fijuth, Jacek; Filipiak, Krzysztof; Spych, Michał; Maciejewski, Marek; Piestrzeniewicz, Katarzyna; Ludomir, Stafańczyk; Janaszek-Sitkowska, Hanna; Januszewicz, Andrzej; Zembala, Marian

    2013-01-01

    Intimal sarcoma of the heart and pulmonary artery is a very rare, malignant, primary tumour. The prognosis in patients with primary sarcoma of the pulmonary artery, including intimal sarcoma, is poor. We present the case and 3-years follow-up of 36-year-old woman who was successfully treated with surgical, partial resection of the tumour followed by radiotherapy.

  3. Offshore Installations and Their Relevance to the Coast Guard through the Next Twenty-Five Years. Volume I. Basic Report: Forecast of Offshore Installations and Their Implications to the Coast Guard.

    Science.gov (United States)

    1980-11-01

    Burton, W.J. ; Williams , C.W. PO 50 j9 c’r. 9ngO’gr.to Name. and Address 10. Work Unri No. (TRAIS) CH-AcLE5 W. WILLIAI-:G, 114C. 601 z ,!~Lt Street 11...cender data collection on that universe most relevant to the Coast Guard. z 2idoal/Regional/National - Research and deveiopiiuent - Structure of global...processing Minerals/ores mined From water On beach Beneath floor Energy Generacion system Tidal forces and dams Wind/solar collection and conversion

  4. Twenty-five years of study of the atmospheric contamination by means of proton-induced X-ray emission analysis; Veinticinco anos de estudio de la contaminacion atmosferica mediante microanalisis de rayos X inducidos por particula (PIXE)

    Energy Technology Data Exchange (ETDEWEB)

    Aldape U, F.; Flores M, J., E-mail: francisca.aldape@inin.gob.m [ININ, Departamento de Estudios del Ambiente, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

    2010-07-01

    At the present time, the microanalysis technique PIXE is accepted by the scientific community as one of the basic techniques used in the study of airborne particle matter, due to the multiple qualities that this offers for the study of this type of pollutants. The nuclear techniques have important applications in the study and technology of solid materials, archaeology and biomedical studies, and particularly in the study of the particles suspended in the air where the PIXE technique is more used because provides reliable results for the identification and quantification of chemical elements from the aluminum until the uranium, including all the metallic elements. Among the main reasons that have motivated the study of the particles suspended in the air is the fact that these cause effects in the human health. At the moment, the sanitary problems associated to the particles are a reason of great concern in many countries where in very populated cities the total of particles in suspension often surpasses the limits settled down by the World Organization of the Health. (Author)

  5. Measuring Technological and Content Knowledge of Undergraduate Primary Teachers in Mathematics

    Science.gov (United States)

    Doukakis, Spyros; Chionidou-Moskofoglou, Maria; Mangina-Phelan, Eleni; Roussos, Petros

    Twenty-five final-year undergraduate students of primary education who were attending a course on mathematics education participated in a research project during the 2009 spring semester. A repeated measures experimental design was used. Quantitative data on students' computer attitudes, self-efficacy in ICT, attitudes toward educational software, and self-efficacy in maths were collected. Data analysis showed a statistically non-significant improvement on participants' computer attitudes and self-efficacy in ICT and ES, but a significant improvement of self-efficacy in mathematics.

  6. [Can strategy for primary health care be revitalized 30 years after Alma-Ata?].

    Science.gov (United States)

    Lund, Stine; Probst, Helene Bilsted; Bygbjerg, Ib Christian

    2010-12-06

    Thirty years ago the Alma-Ata declaration on primary health care was developed. Implementation has been compounded by inadequate financing, changing disease patterns and immature health systems, and there is an ongoing discussion between selective and comprehensive primary health care supporters. Globally, child mortality for under-five-year-olds has been reduced by 50%, but there are still large regional differences. This year the WHO development report is about revitalisation of the primary health care strategy. Recognition of this strategy may be the best instrument to improve health globally.

  7. Additional Language Teaching within the International Baccalaureate Primary Years Programme: A Comparative Study

    Science.gov (United States)

    Lebreton, Marlène

    2014-01-01

    The International Baccalaureate Primary Years Programme supports the learning of languages and cultures, but the role of the additional language within this programme is often unclear. There remains a great variability in schools regarding the frequency of lessons and the way that the additional language is taught within the Primary Years…

  8. Critical Literacy in the First Year of Primary School: Some Insights from Greek Cypriot Classrooms

    Science.gov (United States)

    Ioannidou, Elena

    2015-01-01

    The current paper examines teaching practices in three first-grade primary classrooms (age range from five years and nine months old to six years and nine months old) in Greek Cypriot public schools, exploring whether the wider changes in critical literacy education declared on a policy level are influencing classroom literacy practices. Greek…

  9. Hypomineralized second primary molars: Prevalence data in Dutch 5-year-olds

    NARCIS (Netherlands)

    Elfrink, M.E.C.; Schuller, A.A.; Weerheijm, K.L.; Veerkamp, J.S.J.

    2008-01-01

    The aim of this cross-sectional observational study was to report on the prevalence of hypomineralizations in second primary molars in 5-year-old Dutch children. In the study 386 (45% girls) 5-year-old Dutch children, all insured by a Health Insurance Fund, participated. Scoring criteria for molar i

  10. Hypomineralized second primary molars : prevalence data in Dutch 5-year-olds

    NARCIS (Netherlands)

    Elfrink, M E C; Schuller, A A; Weerheijm, K L; Veerkamp, J S J

    2008-01-01

    The aim of this cross-sectional observational study was to report on the prevalence of hypomineralizations in second primary molars in 5-year-old Dutch children. In the study 386 (45% girls) 5-year-old Dutch children, all insured by a Health Insurance Fund, participated. Scoring criteria for molar i

  11. Hypomineralized second primary molars: prevalence data in Dutch 5-year-olds

    NARCIS (Netherlands)

    Elfrink, M.E.C.; Schuller, A.A.; Weerheijm, K.L.; Veerkamp, J.S.J.

    2008-01-01

    The aim of this cross-sectional observational study was to report on the prevalence of hypomineralizations in second primary molars in 5-year-old Dutch children. In the study 386 (45% girls) 5-year-old Dutch children, all insured by a Health Insurance Fund, participated. Scoring criteria for molar i

  12. Metachronous Primary Adenocarcinoma of Distal and Proximal Ureter within Two Years

    Directory of Open Access Journals (Sweden)

    Dominik Abt

    2014-01-01

    Full Text Available Primary adenocarcinoma of the upper urinary tract, particularly of the ureter, is an extremely rare entity. We are reporting on the first case of metachronous appearance in one patient. The 71-year-old man underwent partial ureterectomy (R0 resection for primary adenocarcinoma of the left distal ureter. 3 years later, nephroureterectomy had to be performed because of metachronous primary adenocarcinoma of the left proximal ureter. Extensive examinations revealed no evidence for further malignancies at both times. Primary adenocarcinoma of the upper urinary tract is rare but should be kept in mind, especially in patients with chronic inflammation and urinary tract obstruction. Due to the low incidence, there is a lack of data regarding its pathogenesis, diagnosis, and optimal treatment.

  13. 30 years after Alma-Ata: has primary health care worked in countries?

    Science.gov (United States)

    Rohde, Jon; Cousens, Simon; Chopra, Mickey; Tangcharoensathien, Viroj; Black, Robert; Bhutta, Zulfiqar A; Lawn, Joy E

    2008-09-13

    We assessed progress for primary health care in countries since Alma-Ata. First we analysed life expectancy relative to national income and HIV prevalence to identify overachieving and underachieving countries. Then we focused on the 30 low-income and middle-income countries with the highest average yearly reduction of mortality among children less than 5 years of age, describing coverage and equity of primary health care as well as non-health sector actions. These 30 countries have scaled up selective primary health care (eg, immunisation, family planning), and 14 have progressed to comprehensive primary health care, marked by high coverage of skilled attendance at birth. Good governance and progress in non-health sectors are seen in almost all of the 14 countries identified with a comprehensive primary health care system. However, these 30 countries include those that are making progress despite very low income per person, political instability, and high HIV/AIDS prevalence. Thailand has the highest average yearly reduction in mortality among children less than 5 years of age (8.5%) and has achieved universal coverage of immunisation and skilled birth attendance, with low inequity. Lessons learned from all these countries include the need for a nationally agreed package of prioritised and phased primary health care that all stakeholders are committed to implementing, attention to district management systems, and consistent investment in primary health-care extension workers linked to the health system. More detailed analysis and evaluation within and across countries would be invaluable in guiding investments for primary health care, and expediting progress towards the Millennium Development Goals and "health for all".

  14. Late-onset peritoneal recurrence of advanced gastric cancer 20 years after primary resection

    Directory of Open Access Journals (Sweden)

    Mohri Yasuhiko

    2010-11-01

    Full Text Available Abstract Late onset of peritoneal recurrence of gastric cancer more than 10 years after surgery is extremely rare, and only three cases have been reported. We present the case of a 61-year-old man who was diagnosed finally with peritoneal recurrence of gastric cancer 20 years after primary curative resection. As a result of small-bowel obstruction caused by peritoneal recurrence, diverting ileostomy with partial ileal resection was performed. The resected specimen revealed tubular adenocarcinoma that resembled the primary gastric cancer. The clinical course after the second operation was unfavorable and systemic chemotherapy had no effect. He died at 62 years of age, 21 years and 7 months after initial gastrectomy. Immunohistochemical analysis using antibodies against proliferating cell nuclear antigen (PCNA, Ki-67, and p53 was performed to investigate the phenotype of primary and recurrence cancer. Protein expression of proliferation markers such as PCNA and Ki-67 was down-regulated, but p53 was overexpressed at the site of recurrence. These data suggest that late peritoneal recurrence has a low proliferation rate and is resistant to chemoradiotherapy. In conclusion, we present late onset of peritoneal recurrence of gastric cancer more than 20 years after primary surgery, and speculate on the mechanism of late-onset recurrence in our case.

  15. Aistear vis-à-vis the Primary Curriculum: The Experiences of Early Years Teachers in Ireland

    Science.gov (United States)

    Gray, Colette; Ryan, Anna

    2016-01-01

    Launched in 2009, the Aistear early years curriculum framework sought to complement and extend the primary school curriculum (PSC) at infant class level in the Republic of Ireland. While Aistear focuses on the development of attitudes, values and learning dispositions and is neither statutory nor inspected, the PSC centres on the acquisition of…

  16. Using Google Documents for Composing Projects that Use Primary Research in First-Year Writing Courses

    Science.gov (United States)

    Strasma, Kip

    2010-01-01

    In this article, the author shares how efficient and effective Google Documents is for faculty seeking to engage students in inquiry-based, emergent, and primary research in first-year composition courses. The specific appeal of Google Documents is that it occupies a space between "open source"--defined by the Open Source Initiative as "free,…

  17. Oral ulcer as primary manifestation of HIV infection in an 80-year-old man

    DEFF Research Database (Denmark)

    Ludvigsen, Lene Ugilt Pagter; Søgaard, Ole Schmeltz

    2014-01-01

    Oral lesions such as candidiasis, Kaposi's sarcoma, hairy leukoplakia, herpes simplex infection, and ulcerative periodontitis are associated with HIV infection and may be the primary presentation in persons with undiagnosed HIV. We report a clinical case in which an 80-year-old man presented...

  18. Severe hypercholesterolemia associated with primary biliary cirrhosis in a 44-year-old Japanese woman

    Institute of Scientific and Technical Information of China (English)

    Tatsuo Kanda; Osamu Yokosuka; Hiroshige Kojima; Fumio Imazeki; Keiich Nagao; Ichiro Tatsuno; Yasushi Saito; Hiromitsu Saisho

    2004-01-01

    A 44-year-old woman developed jaundice and was diagnosed as stage Ⅱ of primary biliary cirrhosis (PBC). She showed a severely high total cholesterol level. This article focuses on atypical presentations of PBC and the need to test the total cholesterol level of PBC patients.

  19. Living Transdisciplinary Curriculum: Teachers' Experiences with the International Baccalaureate's Primary Years Programme

    Science.gov (United States)

    Savage, Michael J.; Drake, Susan M.

    2016-01-01

    An integrated curriculum that is transdisciplinary in nature seems to be a good fit for 21st Century learning. There are, however, few examples of transdisciplinary curriculum at the K to 12 level. One exception is the International Baccalaureate's Primary Years Programme (PYP) which features transdisciplinary curriculum for students from ages 3…

  20. Men Managing, Not Teaching Foundation Phase: Teachers, Masculinity and the Early Years of Primary Schooling

    Science.gov (United States)

    Moosa, Shaaista; Bhana, Deevia

    2017-01-01

    In this article we argue that eliminating the divisions of labour between men and women could work towards counteracting gender inequality within professions. Globally women are over-represented in the teaching of young children in the early years of primary school, or Foundation Phase (FP), as it is known in South Africa. We are concerned to go…

  1. The Friendly Schools Friendly Families Programme: Three-Year Bullying Behaviour Outcomes in Primary School Children

    Science.gov (United States)

    Cross, Donna; Waters, Stacey; Pearce, Natasha; Shaw, Therese; Hall, Margaret; Erceg, Erin; Burns, Sharyn; Roberts, Clare; Hamilton, Greg

    2012-01-01

    Purpose: This three-year group randomized controlled trial assessed whether a multi-age, multi-level bullying prevention and intervention with staff capacity building, can reduce bullying among primary school children. Methods: This study comprised two intervention and one comparison conditions. Student self-report data were collected from 2552…

  2. Groin Swelling in a Four-Year-Old Boy: Primary Great Saphenous Vein Aneurysm.

    Science.gov (United States)

    Çiçek, Mustafa Cüneyt; Çiçek, Ömer Faruk; Yalçınkaya, Adnan; Taşoğlu, İrfan

    2015-11-01

    Primary venous aneurysm, especially in pediatric population, is a very rare clinical entity. We report a case of primary great saphenous vein aneurysm in a 4-year-old boy. He was initially suspected of suffering from inguinal hernia because the soft mass was detected at the inguinal region when the patient was in the standing position, but color Doppler ultrasonography demonstrated the swelling to be a great saphenous vein aneurysm. We decided that surgery was the best option because of potential risk for thromboembolism. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Primary Hyperparathyroidism with Extensive Brown Tumors and Multiple Fractures in a 20-Year-Old Woman

    Science.gov (United States)

    Choi, Ju Hee; Kim, Kyoung Jin; Lee, Ye Jin; Kim, Sun Hwa; Kim, Sin Gon; Jung, Kwang Yoon; Choi, Dong Seop

    2015-01-01

    A brown tumor is a benign fibrotic, erosive bony lesion caused by localized, rapid osteoclastic turnover, resulting from hyperparathyroidism. Although brown tumors are one of the most pathognomonic signs of primary hyperparathyroidism, they are rarely seen in clinical practice. In this report, we present a case of 20-year-old woman with recurrent fractures and bone pain. Plain digital radiographs of the affected bones revealed multiple erosive bone tumors, which were finally diagnosed as brown tumors associated with primary hyperparathyroidism due to a parathyroid adenoma. This case shows that multiple, and clinically severe form of brown tumors can even occur in young patients. PMID:26354493

  4. Primary Hyperparathyroidism with Extensive Brown Tumors and Multiple Fractures in a 20-Year-Old Woman

    Directory of Open Access Journals (Sweden)

    Ju Hee Choi

    2015-12-01

    Full Text Available A brown tumor is a benign fibrotic, erosive bony lesion caused by localized, rapid osteoclastic turnover, resulting from hyperparathyroidism. Although brown tumors are one of the most pathognomonic signs of primary hyperparathyroidism, they are rarely seen in clinical practice. In this report, we present a case of 20-year-old woman with recurrent fractures and bone pain. Plain digital radiographs of the affected bones revealed multiple erosive bone tumors, which were finally diagnosed as brown tumors associated with primary hyperparathyroidism due to a parathyroid adenoma. This case shows that multiple, and clinically severe form of brown tumors can even occur in young patients.

  5. A Rare Case of Primary Meningococcal Myopericarditis in a 71-Year-Old Male

    Directory of Open Access Journals (Sweden)

    Odilia I. Woudstra

    2016-01-01

    Full Text Available We describe a case of primary meningococcal C pericarditis with myocardial involvement in a 71-year-old male that is thus far the oldest patient with isolated meningococcal pericardial disease and only the third patient with primary meningococcal myopericarditis described in English literature. Our patient was successfully treated by full sternotomy and surgical drainage combined with intravenous ceftriaxone. Mild symptoms unresponsive to anti-inflammatory treatment and leukocytosis may guide clinicians towards the correct diagnosis. It is important to recognize this cause of pericarditis as the relatively mild clinical presentation may rapidly progress into tamponade and right-sided heart failure.

  6. Predictors of mortality within 1 year after primary ovarian cancer surgery

    DEFF Research Database (Denmark)

    Sjøland, Mette Ørskov; Iachina, Maria; Sørensen, Rikke Guldberg

    2016-01-01

    System. PARTICIPANTS: 2654 women who underwent surgery due to a diagnosis of primary ovarian cancer. OUTCOME MEASURES: Overall survival and predictors of mortality within 0-180 and 181-360 days after the primary surgery. Examined predictors were age, preoperative American Society of Anesthesiologists......: The most important predictors of mortality within 1 year after surgery were residual tumour tissue (0-180 days after surgery) and advanced FIGO stage (181-360 days after surgery). However, our results suggest that the surgeon should not just aim at radical surgery, but also pay special attention...

  7. Primary pulmonary/pleural melanoma in a 13 year-old presenting as pleural effusion.

    Science.gov (United States)

    Baniak, Nick; Podberezin, Mark; Kanthan, Selliah C; Kanthan, Rani

    2017-02-01

    Melanoma in children, adolescents, and young adults is uncommon and reported almost exclusively as cutaneous melanoma. Melanoma presenting as a pleural effusion is very rare in adults and not reported in the pediatric population. Additionally, primary pulmonary melanoma is overall very rare and undocumented in pediatric patients. Furthermore, the distinction between a primary pulmonary/pleural melanoma versus a regressed cutaneous melanoma with pulmonary/pleural metastases remains extremely challenging. We discuss a case of a previously healthy 13-year-old girl that presented with a left-sided pleural effusion. Investigations revealed a large mediastinal mass, left-sided pleural and pulmonary nodules, a sacral mass, and bone marrow infiltration. The neoplasm was subsequently diagnosed by morphology and immunocytochemistry with histological correlation as malignant melanoma. As no mucosal, eye, or cutaneous lesions were identified, we deliberate the likelihood of a regressed cutaneous melanoma with metastases versus primary pulmonary/pleural melanoma with pleural effusion and discuss its diagnostic approach.

  8. Mineral trioxide aggregate as pulp capping agent for primary teeth pulpotomy: 2 year follow up study.

    Science.gov (United States)

    Subramaniam, Priya; Konde, Sapna; Mathew, Somy; Sugnani, Sony

    2009-01-01

    The aim of the present study was to clinically and radiographically evaluate Mineral Trioxide Aggregate (MTA) as an agent for pulpotomy in primary teeth and to compare it with that of formocresol (FC) pulpotomy. Nineteen children between the ages of 6 to 8 years with 40 carious primary molars were treated with pulpotomy using either FC or MTA. All the molars were evaluated clinically and radiographically at regular intervals over a twenty four month period. The observations were tabulated and statistically analyzed. Eighty five percent success was observed with FC pulpotomy whereas MTA showed 95% success. MTA showed a higher clinical and radiographic success rate than FC. MTA may be a favorable material for pulpotomy in primary teeth whose pulps have been compromised by a carious or mechanical pulp exposure.

  9. [Clinical Psychology in Primary Care: A Descriptive Study of One Year of Operation].

    Science.gov (United States)

    Sánchez-Reales, S; Tornero-Gómez, M J; Martín-Oviedo, P; Redondo-Jiménez, M; del-Arco-Jódar, R

    2015-01-01

    Our aim is to present the first year of operation of a Clinical Psychology service in a Primary Care setting. A descriptive study was performed by analysing the requests and the care intervention of the Psychology Service, in collaboration with 36 general practitioners (33% of the staff), belonging to 6 health centres. Within the one year period, 171 outpatients from 15 years and older were referred with mild psychological disorders (> 61 in the global assessment functioning scale, APA, 2002). A total of 111 outpatients received psychological care. The main diagnoses were adaptation disorder, affective disorder, and anxiety. More than half (54.82%) of them achieved a full recovery. After a year follow up, a drop of 25.19% was observed in medicines use. The Primary Care Psychology team is a halfway unit between Primary Care practitioners and specialised units in order to deal with mild mental symptomatology which otherwise could be undertreated. It represents an important support for practitioners. Secondly, the early intervention can prevent mental problems becoming chronic, as shown by the drop in medication use. In spite of the not very high agreement between the practitioner's diagnoses and those made by the Psychology unit, it has set up an important means of communication and with direct and immediate interdisciplinary action. This should eventually lead to savings in economic resources and human suffering. Copyright © 2014. Publicado por Elsevier España, S.L.U.

  10. 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

  11. Primary health care development: where is Nepal after 30 years of Alma Ata Declaration?

    Science.gov (United States)

    Karkee, R; Jha, N

    2010-01-01

    The year 2008 has witnessed the global conversation to return to tenets of Alma-Ata and to review its 30 years of journey. We reviewed Nepal's journey on Primary Health Care development: policy formulation, structure development, progress and constraints. Though Nepal has institutionalised the PHC approach in health policy, strategy and health care delivery system, this has not been effectively translated into actions, and the results are mixed. Nepal has gained impressive achievements in selective primary health care markers: 45.43% maternal mortality and 62.34% child mortality reduction during 1990-2005. But gain in comprehensive health care markers is not impressive: 18.7% Skilled Birth Attendant (4% in poorest quintile and 45% in richest quintile), 39% having access to improved sanitation and 55.7% of females are literate as compared to males. Socio-political environment until recently was not favourable for comprehensive primary health care, allowing limited health sector decentralisation and community empowerment. Health activities were focussed more on selective health care strategy in the form of disease control, immunisation, vitamin A supplementation, oral rehydration solution use and contraceptive use. Nepal's rural hilly geography posed great challenge on logistic supply, communication and retention of health workers rendering public health centres of low quality with negative perceptions of consumers. Nepal is on the pathway to build equitable comprehensive primary health care.

  12. A 12-year epidemiologic study on primary spinal cord tumors in Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Payam Moein

    2013-01-01

    Full Text Available Background: Although primary spinal cord tumors (PSCTs comprise a minority of primary central nervous system tumors, they often impose a great deal of morbidity on their victims. Few epidemiologic studies have addressed PSCTs in Iran. Materials and Methods: We analyzed the demographic/clinical features of all primary intraspinal tumors (with a specific focus on primary intradural spinal cord tumors identified between 1992 and 2004 in three of the major related hospitals in Isfahan, Iran. We also tracked the malignant cases until 2012. Results: 102 patients with primary intraspinal tumors were found; 82 tumors were Intradural (36 intramedullary and 46 extramedullary and 20 extradural. The principal intradural histological subtypes were nerve sheath tumor (33%, ependymoma (22%, astrocytoma (16%, and meningioma (15%. 20 (19% of the tumors were malignant. Local pain (43% and motor disabilities (36% were the most common first-presenting symptoms in the patients. Male-to-female ratio was significant only in ependymoma (male:female ratio = 3.6, P < 0.05. The mean age in meningioma (57 years, standard error [SE]: 15.7 was significantly higher than other types (one-way ANOVA, P < 0.05. Conclusion: Our results reflect analogous frequency of distribution for PSCTs compared with most of the previous counterpart studies worldwide. The only notable exception was the comparatively fewer frequency of spinal cord meningioma in our study.

  13. Formocresol versus calcium hydroxide direct pulp capping of human primary molars: two year follow-up.

    Science.gov (United States)

    Aminabadi, Naser Asl; Farahani, Ramin Mostofi Zadeh; Oskouei, Sina Ghertasi

    2010-01-01

    Clinical and radiographic evaluation of the premedicated direct pulp capping using formocresol (PDC) versus conventional direct pulp capping using calcium hydroxide (CDC) in human carious primary molars. A total of 120 vital primary molars with pinpoint exposure during caries removal in 84 patients aged 4-5 years were selected. In the PDC group (n = 60), 20% Buckley's formocresol solution, and in the CDC group (n = 60), calcium hydroxide powder were applied to the exposure sites followed by placement of zinc oxide-eugenol base. Teeth were restored with preformed stainless steel crowns. Clinical and radiographic evaluations of the treatment outcomes were performed at regular intervals of 6 and 12 months, respectively, for two years post-operatively. The prevalence of spontaneous pain, sensitivity on percussion, and fistula were significantly higher in the CDC group compared to the PDC group (P formocresol premedicated direct pulp capping could safely be used as a substitute for conventional direct pulp capping.

  14. Primary Ewing's Sarcoma of the Spine in a Two-Year-Old Boy

    Science.gov (United States)

    Electricwala, Jaffer T.

    2016-01-01

    Ewing's Sarcoma (ES) is a highly malignant bone tumour. It may involve any part of the skeleton but the most frequent parts are the ilium and diaphysis of femur and tibia (Alfeeli et al., 2005; Zhu et al., 2012). Primary ES of the spine is extremely rare (Yan et al., 2011). It accounts for only 3.5 to 14.9 percent of all primary bone sarcomas. The age of presentation ranges from 12 to 24 years (median 21 years) (Ferguson, 1999; Sharafuddin et al., 1992; Klimo Jr. et al., 2009). We report an unusual case of primary ES of the spine in a two-year-old boy, who presented to us with paraparesis and features of cauda equina syndrome. MRI scan showed a tumour mass arising from the pedicle of L4 vertebra invading the spinal canal. Tc-99 bone scan showed increased tracer uptake in L4 vertebra and normal tracer uptake elsewhere in the skeleton. After reaching the diagnosis of a space occupying lesion invading the lumber spinal canal, we performed a decompressive laminectomy and a biopsy was sent which confirmed the diagnosis of ES. Immunohistochemistry showed tumour cells staining positive for CD-99 (specific stain for ES). Gene testing showed an EWS-FLI 1 chimera. Surgery was followed by good improvement in motor signs. The child was then referred to a specialized oncotherapy centre for further treatment, radiation, and chemotherapy. To the best of our knowledge, we are the first to report primary ES of the spine at the age of two years. PMID:27895949

  15. Primary Ewing’s Sarcoma of the Spine in a Two-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Ali J. Electricwala

    2016-01-01

    Full Text Available Ewing’s Sarcoma (ES is a highly malignant bone tumour. It may involve any part of the skeleton but the most frequent parts are the ilium and diaphysis of femur and tibia (Alfeeli et al., 2005; Zhu et al., 2012. Primary ES of the spine is extremely rare (Yan et al., 2011. It accounts for only 3.5 to 14.9 percent of all primary bone sarcomas. The age of presentation ranges from 12 to 24 years (median 21 years (Ferguson, 1999; Sharafuddin et al., 1992; Klimo Jr. et al., 2009. We report an unusual case of primary ES of the spine in a two-year-old boy, who presented to us with paraparesis and features of cauda equina syndrome. MRI scan showed a tumour mass arising from the pedicle of L4 vertebra invading the spinal canal. Tc-99 bone scan showed increased tracer uptake in L4 vertebra and normal tracer uptake elsewhere in the skeleton. After reaching the diagnosis of a space occupying lesion invading the lumber spinal canal, we performed a decompressive laminectomy and a biopsy was sent which confirmed the diagnosis of ES. Immunohistochemistry showed tumour cells staining positive for CD-99 (specific stain for ES. Gene testing showed an EWS-FLI 1 chimera. Surgery was followed by good improvement in motor signs. The child was then referred to a specialized oncotherapy centre for further treatment, radiation, and chemotherapy. To the best of our knowledge, we are the first to report primary ES of the spine at the age of two years.

  16. Primary omental malignant mixed Müllerian tumor in a 67-year-old woman

    Institute of Scientific and Technical Information of China (English)

    魏丽惠; 王建六; 张岫屏; 崔恒; 沈丹华; 钱和年

    2002-01-01

    @@Malignant mixed Müllerian tumors (MMMTs) are highly aggressive neoplasms composed of sarcomatous and carcinomatous elements commonly encountered in the female genital tract and rarely occur in extragenital sites. Most of extragenital MMMTs develop from the peritoneum. To our knowledge, only 25 cases have been described in the literature. Among them, only 2 cases have arised in the major omentum.1 Here we report a case of a 67-year-old female with primary MMMT of the major omentum.

  17. HANDBALL AS ELECTIVE SPORT IN THE THIRD ROUND OF THE NINE YEARS PRIMARY SCHOOL

    Directory of Open Access Journals (Sweden)

    Radojica Marušić

    2006-06-01

    Full Text Available In the third Round of the nine years Primary school the curriculum anticipates elective subjects. One of the possible choices is the sport for the sportsman and within it are the programs for the handball. This work has proposed operational aims of the handball as the elective sport for the seventh, eight and ninth grade, which would be fulfilled through 198 classes two times a week.

  18. A second primary esophageal cancer developing 7 years after chemoradiotherapy for advanced esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Ryuichiro; Enjoji, Akihito; Okudaira, Sadayuki; Furui, Junichiro; Kanematsu, Takashi [Nagasaki Univ. (Japan). School of Medicine; Matsuo, Takeshi

    2001-07-01

    We report a rare case of advanced carcinoma and a second primary carcinoma of the esophagus, both of which were successfully cured by chemotherapy and operation at different times. In 1991, a 38-year-old Japanese man was diagnosed with advanced esophageal cancer, which was unresectable because of the bronchial invasion of the tumor. He was given chemotherapy with cisplatin (CDDP), combined with radiotherapy. During a 4-year follow-up, neither regrowth of the primary tumor nor distant metastasis occurred. In 1995, esophagoscopy demonstrated a lugol-unstained region located 3 cm distal from the area of radiation to the primary lesion shown by esophagography. Histological examination of a biopsy specimen showed the mucosa to be normal. Nevertheless, yearly surveillance by endoscopy and histological examinations showed that the mucosa of the esophagus gradually began to demonstrate mild dysplasia, followed by severe dysplasia; in 1998, a diagnosis of squamous cell carcinoma was made. Esophagectomy with lymph node dissection was performed. Microscopic examination revealed that there had been pathologic complete response for the original advanced esophageal cancer. (author)

  19. Precipitation legacies in desert grassland primary production occur through previous-year tiller density.

    Science.gov (United States)

    Reichmann, Lara G; Sala, Osvaldo E; Peters, Debra P C

    2013-02-01

    In arid ecosystems, current-year precipitation often explains only a small proportion of annual aboveground net primary production (ANPP). We hypothesized that lags in the response of ecosystems to changes in water availability explain this low explanatory power, and that lags result from legacies from transitions from dry to wet years or the reverse. We explored five hypotheses regarding the magnitude of legacies, two possible mechanisms, and the differential effect of previous dry or wet years on the legacy magnitude. We used a three-year manipulative experiment with five levels of rainfall in the first two years (-80% and -50% reduced annual precipitation (PPT), ambient, +50% and +80% increased PPT), and reversed treatments in year 3. Legacies of previous two years, which were dry or wet, accounted for a large fraction (20%) of interannual variability in production on year 3. Legacies in ANPP were similar in absolute value for both types of precipitation transitions, and their magnitude was a function of the difference between previous and current-year precipitation. Tiller density accounted for 40% of legacy variability, while nitrogen and carryover water availability showed no effect. Understanding responses to changes in interannual precipitation will assist in assessing ecosystem responses to climate change-induced increases in precipitation variability.

  20. The Prognosis of Primary Percutaneous Coronary Intervention after One Year Clinical Follow Up

    Directory of Open Access Journals (Sweden)

    Yahya Dadjoo

    2013-03-01

    Full Text Available Objectives: The aim of this study was to evaluate the clinical outcomes, one year after primary percutaneous coronary intervention(PCI. Patients and Methods: From September 2009 to March 2012, primary PCI was performed on 70 cases, and the data relating to their catheterization were recorded. Peri-interventional treatment data included PCI with drug-eluting or bare-metal stent or balloon angioplasty alone. Results: The mean age of the patients was 61.34+11.31 years, and 72.9% of them were males. The ratios of patients with diabetes, hypertension and, hyperlipidemia were 61.4%, 71.4%, and 52.9% respectively. In clinical follow-up, total incidence of death was 4.3%, with no death occurring during 30 days. However, 3 patients died after one-year, of which one patient (1.4% had cardiac problem and the other 2 (2.9% died because of non-cardiac reasons. Target vessel revascularization, reinfarction within 30 days, and mechanical complication or stroke were not found in any of the patients. Patients with hypertension (6% and those with LAD ST-elevation myocardial infarction (5% died after one year (P= 0.263 and P= 0.319 respectively. However, no mortality was reported in patients with RCA and LCX ST-elevation myocardial infarction. Of subjects with multivessel disease, 7% died after one-year (P= 0.161, but there was no reported mortality in those with single vessel disease.

  1. Number sense of final year pre-service primary school teachers

    Directory of Open Access Journals (Sweden)

    Magret Courtney-Clarke

    2014-05-01

    Full Text Available Number sense studies have indicated that the development of number sense should be the focus of primary school mathematics education. The literature review revealed that learner performance is linked to teacher subject knowledge and that teachers’ confidence in doing and teaching mathematics influences the way they teach and their willingness to learn mathematics. This study was motivated by the poor performance of Namibian primary school learners in both national and international standardised assessment tests and explored the number sense of 47 final-year primary school pre-service teachers (PSTs in Namibia. The data in this mixed method research design were obtained from a number sense questionnaire, a written computations questionnaire, a mental calculations questionnaire and the McAnallen confidence in mathematics and mathematics teaching survey (MCMMTS. Six PSTs, randomly selected from the 47 participants, were interviewed to determine their use of number-sensible strategies. The overall results of this investigation revealed that the final year primary school PSTs demonstrated limited number sense and possessed very few of the indicators of number sense. Unexpectedly, the confidence survey showed that they were confident in their ability to do and to teach mathematics. This study exposed one reason for the low standards of performance of Namibian learners in mathematics and the lack of improvement over the last few decades. It indicates a need for teacher training institutions to identify the mathematics that teachers should know and the ways in which teacher understanding of subject content has to be transformed to enable them to develop the number sense of primary school learners.

  2. Sodium hypochlorite vs formocresol as pulpotomy medicaments in primary molars: 1-year follow-up.

    Science.gov (United States)

    Shabzendedar, Mahboobeh; Mazhari, Fatemeh; Alami, Maliheh; Talebi, Maryam

    2013-01-01

    The study evaluated the effects of 3 percent sodium hypochlorite (NaOCl) and formocresol (FC) as pulp dressing agents in pulpotomized primary molars. One hundred children between three and six years each with at least one primary mandibular second molar requiring pulpotomy were randomly allocated to two groups (of 50 each). All the teeth received stainless steel crown after conventional pulpotomy procedure with either NaOCI (applied for 15 second) or FC (applied for one minute). Clinical and radiographic signs/symptoms were blindly recorded at zero, six. and 12 months. The differences were statistically analyzed using the Fisher's exact test. At six months, 100 percent clinical success was found with both NaOCl, and FC. Radiographic success rates for NaOCl were 98 percent and 92 percent at 6- and 12-month recalls respectively. FC group showed 94 percent and 93 percent radiographic success rates at the same periods respectively. There was no statistically significant difference between the groups. NaOCl can be suggested as a pulpotomy agent for primary teeth pulpotomies. However further clinical studies with long-term follow-ups are needed to test the efficacy of NaOCl as a pulpotomy medicament in primary teeth.

  3. 10 years with Planet Earth essence in the primary school children drawings

    Science.gov (United States)

    D'Addezio, Giuliana

    2016-04-01

    "10 years with Planet Earth" is the title of the 2016 INGV calendar for primary schools representing the review of a project conceived as support and complement of 15 years long INGV dissemination activities with schools. We realized 10 calendars together with and for primary schools, every year with a subject related to a World in constant evolution. Earthquakes, volcanic eruptions, tsunami waves, magnetic storms and other phenomena are manifestations of the complexity and dynamicity, which began more than four billion years ago and never halted. Since the Earth originated to the first presence of water, life and oxygen, the Cambrian explosion of species, the domain of dinosaurs, the great extinctions and glaciations, the surface of our planet experiences continents collisions, mountains and oceans formation and life forms emerging and disappearing. Every year we have launched a competition asking children to send drawings on themes chosen to stimulate learning about Earth Sciences and Planet Earth dynamics. We intended to raise awareness on issues as water resources availability, protection against natural disasters and control of environmental degradation. For each competition, we chose the most significant drawings to be included in the yearly calendar about the Earth. The authors of drawings were awarded by scientists, journalists, artists and science communicators and even by a minister. Besides the competitions, these drawings depict their own impressions and reflections, providing an opportunity to illustrate the children's point of view. From drawings and texts arise a great consideration and respect for the Planet, raising hopes that similar initiatives can contribute to increase the knowledge of the Earth and of the fragile human ecosystem in the hearts and minds of future active citizens. The project was made possible thanks to the teachers and to the wonderful students of more than 200 schools that sent about 10,000 drawings that have intrigued

  4. 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.

  5. [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.

  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. Twenty-million-year relationship between mammalian diversity and primary productivity

    Science.gov (United States)

    Fritz, Susanne A.; Eronen, Jussi T.; Schnitzler, Jan; Hof, Christian; Janis, Christine M.; Mulch, Andreas; Böhning-Gaese, Katrin; Graham, Catherine H.

    2016-09-01

    At global and regional scales, primary productivity strongly correlates with richness patterns of extant animals across space, suggesting that resource availability and climatic conditions drive patterns of diversity. However, the existence and consistency of such diversity-productivity relationships through geological history is unclear. Here we provide a comprehensive quantitative test of the diversity-productivity relationship for terrestrial large mammals through time across broad temporal and spatial scales. We combine >14,000 occurrences for 690 fossil genera through the Neogene (23-1.8 Mya) with regional estimates of primary productivity from fossil plant communities in North America and Europe. We show a significant positive diversity-productivity relationship through the 20-million-year record, providing evidence on unprecedented spatial and temporal scales that this relationship is a general pattern in the ecology and paleo-ecology of our planet. Further, we discover that genus richness today does not match the fossil relationship, suggesting that a combination of human impacts and Pleistocene climate variability has modified the 20-million-year ecological relationship by strongly reducing primary productivity and driving many mammalian species into decline or to extinction.

  9. Primary lung seminoma in a 76-year-old man: a case report

    Science.gov (United States)

    Zhu, Shaojun; Li, Yanhong; Liu, Guiqiu; Han, Xiujuan; Gong, Li; Yao, Li; Lan, Miao; Zhang, Wei

    2010-01-01

    Background: Seminoma is a rare event in old male population. In this report, we present a rare case of primary seminoma in the lung of a 76-years-old man. Case presentation: The patient was a 76-year-old man admitted with respiratory tract symptom and hemoptysis. The Chest Routine Scan and CT showed there was a consolidation area in the basal segments at the lower lobe of left lung. Bronchoscope also exhibited a neoplasm in left lung. During left lower lobectomy, we found that adherence occurred widely in left thoracic wall, and the pleural membrane was shrinkage. No chemotherapy or radiotherapy was given. Patient was died at 140 days after the surgery mainly due to the dyscrasia and secondary seminoma in left 7th to 9th ribs. Placental alkaline phosphatase (PLAP) and CD117 were found to be positive with immunohistochemical studies. Along with other evidences, this case was identified as the manifestations of seminoma. Conclusion: Although primary seminoma of the lung is rare in old male population, the diagnosis should be taken into serious consideration in order to improve the treatment. And in this case, primary lung seminoma is associated with high degree of malignancy and metastasis. PMID:20830245

  10. Twenty-million-year relationship between mammalian diversity and primary productivity.

    Science.gov (United States)

    Fritz, Susanne A; Eronen, Jussi T; Schnitzler, Jan; Hof, Christian; Janis, Christine M; Mulch, Andreas; Böhning-Gaese, Katrin; Graham, Catherine H

    2016-09-27

    At global and regional scales, primary productivity strongly correlates with richness patterns of extant animals across space, suggesting that resource availability and climatic conditions drive patterns of diversity. However, the existence and consistency of such diversity-productivity relationships through geological history is unclear. Here we provide a comprehensive quantitative test of the diversity-productivity relationship for terrestrial large mammals through time across broad temporal and spatial scales. We combine >14,000 occurrences for 690 fossil genera through the Neogene (23-1.8 Mya) with regional estimates of primary productivity from fossil plant communities in North America and Europe. We show a significant positive diversity-productivity relationship through the 20-million-year record, providing evidence on unprecedented spatial and temporal scales that this relationship is a general pattern in the ecology and paleo-ecology of our planet. Further, we discover that genus richness today does not match the fossil relationship, suggesting that a combination of human impacts and Pleistocene climate variability has modified the 20-million-year ecological relationship by strongly reducing primary productivity and driving many mammalian species into decline or to extinction.

  11. Efficacy of risedronate in men with primary and secondary osteoporosis: results of a 1-year study.

    Science.gov (United States)

    Ringe, J D; Faber, H; Farahmand, P; Dorst, A

    2006-03-01

    Osteoporosis is prevalent in men with an estimated one in eight men older than 50 years suffering from osteoporotic fracture, and a higher mortality rate after fracture among men compared with women. There are few approved therapies for osteoporosis in men. This observational study assesses the efficacy and safety of risedronate in the treatment of men with primary and secondary osteoporosis. A single-center, open label, randomized, prospective 1-year study was conducted in men with primary or secondary osteoporosis. Patients were randomized to risedronate (risedronate 5 mg/day plus calcium 1,000 mg/day and vitamin D 800 IU/day) or control groups (alfacalcidol 1 mug/day plus calcium 500 mg/day or vitamin D 1,000 IU/day plus calcium 800 mg/day). Bone mineral density (BMD) measurements, X-rays of the spine, a medical history and physical exam, and patient self-assessments of back pain were performed at baseline and 12 months. Blinded semi-quantitative fracture assessment was conducted by a radiologist. A total of 316 men with osteoporosis were enrolled in the trial (risedronate, n=158; control, n=158). At 1 year lumbar spine BMD increased by 4.7% in the risedronate group versus an increase of 1.0% in the control group (P<0.001). Significant increases in BMD at the total hip and femoral neck were also observed with risedronate compared with the control group. The incidence of new vertebral fracture in the risedronate group was reduced by 60% versus the control group (P=0.028). Daily treatment with risedronate for 12 months significantly increased BMD at the lumbar spine, femoral neck and total hip and significantly reduced the incidence of new vertebral fractures. This is the first prospective, randomized, controlled trial to demonstrate a significant reduction in vertebral fractures in 1 year in men with primary or secondary osteoporosis.

  12. Human Papillomavirus Assays and Cytology in Primary Cervical Screening of Women Aged 30 Years and Above

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Bonde, Jesper; Preisler, Sarah

    2016-01-01

    In women aged ≥30 years, Human Papillomavirus testing will replace cytology for primary cervical screening. We compared Hybrid Capture 2 (HC2), cobas, CLART, and APTIMA HPV assays with cytology on 2869 SurePath samples from women undergoing routine screening at 30-65 years in Copenhagen, Denmark....... Women with cytological abnormalities were managed according to routine recommendations, with 92% completeness. Those with cytology-normal/HPV-positive samples (on any of the four assays) were invited for repeated cytology and HPV testing in 1.5 year, and 58% had additional testing. HPV testing detected...... more ≥CIN3 than cytology (HC2: 35, cobas, CLART: 37, APTIMA: 34, cytology: 31), although statistically the differences were not significant. Cobas and CLART detected significantly more ≥CIN2 than cytology (cobas, CLART: 49, cytology: 39). The proportion of women with false-positive test results...

  13. The social representations of dance in physical education classes in the early years of primary education

    Directory of Open Access Journals (Sweden)

    Fabíola Schiebelbein Capri

    2011-12-01

    Full Text Available This paper presents a survey of social representations of dance in the context of School Physical Education. The survey was conducted in two city schools and two private schools in Ponta Grossa, Paraná, Brazil. The observation and the questionnaire were the instruments used to collect data. Five teachers of Physical Education and 331 students of Primary Education (5th year of Primary Education took part in the research. The results indicate that the social representations of dance teachers are related to holidays and anniversaries of the school and students, to pleasure and to musical preference. The practice of dance in the school has room for choreographic creations, June Festival rehearsals, and school presentations.

  14. Success Rate of MTA Pulpotomy on Vital Pulp of Primary Molars: A 3-Year Observational Study

    Science.gov (United States)

    Tyagi, Rishi

    2016-01-01

    Introduction Vital pulp therapy is a major contributor in the preservation of primary dentition after caries affliction. Introduction of mineral trioxide aggregate (MTA) has revolutionized such treatment. Aim The aim of our study was to evaluate and correlate the effects of MTA clinically and radiographically on pulpotomized primary molars till their exfoliation or extraction followed by histological evaluation. Study design This is an observational study. Materials and methods A total of 25 teeth were selected from 5- to 8-year-old children requiring pulp therapy on the basis of inclusion and exclusion criterion. The teeth were treated by conventional pulpotomy technique under aseptic conditions using MTA and were immediately restored with stainless steel crown. The teeth were assessed postoperatively till 36 months. The exfoliated or extracted teeth were examined histologically. Results The pulpotomized teeth were vital with no adverse clinical findings during the observation period. After 3 months, one tooth showed internal resorption, but the same was not observed after 12 months. Pulp canal obliteration was seen in three cases. At the end of the study, five teeth were exfoliated and one tooth was extracted for maintaining arch symmetry. The histological examination of extracted tooth revealed the presence of healthy pulp and the area of true calcification. Remaining exfoliated teeth presented dentin bridge formation. Statistics Frequencies and percentages were used for descriptive statistics. Fisher’s exact tests were used to see the difference between clinical and radiological findings. The probability value was fixed at 5% level of significance. Conclusion The response of pulp in primary teeth to MTA was favorable in all cases from clinical and radiographic perspective, and histological evaluation confirmed the observation. How to cite this article Godhi B, Tyagi R. Success Rate of MTA Pulpotomy on Vital Pulp of Primary Molars: A 3-Year Observational Study

  15. What happens to cavitated primary teeth over time? A 3.5-year prospective cohort study in China

    NARCIS (Netherlands)

    Hu, X.; Chen, X.; Fan, M.; Mulder, J.; Frencken, J.E.F.M.

    2013-01-01

    OBJECTIVES: Data showed that among 5-year-old Chinese, 96.7% of cavitated primary teeth were left untreated. The study aimed to report on the course of cavitated primary teeth within the Chinese health-care system over a period of 3.5 years. METHODS: Selection of high caries risk children for inclus

  16. Short and long term outcomes of primary angioplasty in patients aged 75 years and over

    Directory of Open Access Journals (Sweden)

    Turgay Işık

    2011-06-01

    Full Text Available The treatment of elderly patients with ST segment elevated myocardial infarction (STEMI remains controversial. This study aimed to investigate the effects of primary angioplasty in elderly patients on in-hospital and long term major adverse cardiac events (MACE.Materials and methods: From October 2003 to March 2008, we retrospectively enrolled 220 patients aged 75 years and over with STEMI who underwent primary angioplasty. Patients’ characteristics, in-hospital and long term events were recorded.Results: Male/Female ratio of patients was 129/91 and mean age was 78.7 ± 3.6 (range, 75-97 years, and 58.6% of male. Of these patients 29.2% were diabetics, 69.8% were hypertensive, 34.4% were smoker and 43.5% were anemic at admission. Anterior myocardial infarction was diagnosed in 52.3% of patients. Mean pain-balloon time was 222 ± 116 minutes. Eighty two (38.2% of these 220 patients had three-vessel disease and 12 (5.7% were diagnosed as cardiogenic shock. Procedural success was observed in 79.6% of patients. Heart failure was observed 27.7% in hospital and intra aortic pump was used in 14.5% of patients. There was no significant difference between age groups in long term major cardiac events and in hospital mortality. Diabetes, leukocyte count at admission and in hospital heart failure were independent predictors of short term MACE and low hemoglobin level at admission and peak CKMB levels were independent predictors of long term MACE.Conclusions: Primary angioplasty in patients aged 75 years and over seems to be associated with low procedural complication, high procedural success, improved short and long term survival.

  17. Neonatal, severe primary hyperparathyroidism: a 7-year clinical and radiological follow-up of one patient

    Energy Technology Data Exchange (ETDEWEB)

    Doria, Andrea S.; Daneman, Alan [Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario (Canada); Huang, Carol; Makitie, Outi; Kooh, Sang W.; Sochett, Etienne [Department of Endocrinology, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8 (Canada); Thorner, Paul [Department of Laboratory Medicine, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario (Canada)

    2002-09-01

    Neonatal primary hyperparathyroidism is a rare entity characterized by marked hypercalcemia, diffuse parathyroid hyperplasia, and skeletal demineralization. It is often lethal unless total parathyroidectomy is performed. Long-term outcome of treated patients is poorly documented. We report the clinical and radiographic outcome of this disease in a 7-year-old boy who underwent a total parathyroidectomy and autotransplantation of a fragment of one parathyroid gland to his thigh in the neonatal period. This paper demonstrates the importance of prompt diagnosis and management in neonatal hyperparathyroidism and the role of various imaging modalities in its diagnosis and follow-up. (orig.)

  18. Cancer survivors’ self-efficacy to self-manage in the year following primary treatment

    OpenAIRE

    Foster, Claire; Breckons, Matthew; Cotterell, P.; Barbosa, D.; Calman, Lynn; Corner, Jessica; Fenlon, Deborah; Foster, R.; Grimmett, Chloe; Richardson, Alison; Smith, P.W.

    2014-01-01

    PURPOSE\\ud Cancer survivors are increasingly expected to manage the consequences of cancer and its treatment for themselves. There is evidence that self-efficacy is important for successful self-management and that this can be enhanced with support. The purpose of this study was to assess self-efficacy to manage problems in the year following primary treatment.\\ud \\ud METHODS\\ud \\ud This cross-sectional online survey included cancer survivors who had completed their treatment within the past ...

  19. [Alma Ata 30 years on. Evolution and perspectives of primary health care].

    Science.gov (United States)

    Maciocco, G

    2008-01-01

    The Alma Ata Declaration (September 1978) was a turning point in the definition of "Primary Health Care". The traditional bio-medical model was based on a paternalistic approach and on the treatment of the individual episodes of disease. The new bio-psycho-social model was based on prevention, continuity of care, integrated health care teams and on a direct role of patients in managing their health. Thirty years on, this approach is still relevant. Actually, it is the only adequate one to answer effectively to the current challenges: epidemiological changes (increasing prevalence of chronic diseases), social changes (increased social inequalities in health), cultural changes (increased patients demand for information and autonomy).

  20. Primary Germ Cell Tumors of the Mediastinum: 10 Years of Experience in a Tertiary Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Chih-Jen Yang

    2005-09-01

    Full Text Available Germ cell tumors occur mostly in the gonad. Extragonadal germ cell tumors are rare, and most occur in the retroperitoneum and mediastinum. Primary mediastinal germ cell tumors are often found in the anterior portion of the mediastinum and include teratomas and non-teratomatous tumors. Non-teratomatous tumors include seminomas and malignant non-seminomatous germ cell tumors (MNSGCTs. MNSGCTs include yolk sac tumors, choriocarcinomas, embryonal carcinomas, and mixed type germ cell tumors. Teratomas are the most common germ cell tumors of the mediastinum, and seminomas are the most common non-teratomatous germ cell tumors of the mediastinum. Cases of primary mediastinal MNSGCT reported in the literature are rare. In this report, we review all primary mediastinal germ cell tumors from a 10-year period at the Chung-Ho Memorial Hospital of Kaohsiung Medical University. A total of 14 cases were reviewed, including 11 patients with mature teratomas, two with yolk sac tumors, and one with seminoma. We discuss the differences in clinical presentation, histopathologic characteristics, treatment, and prognosis.

  1. Primary spinal tumors in childhood: A single institution 15 year experience

    Science.gov (United States)

    Hung, Po-Cheng; Wu, Chieh-Tsai; Jaing, Tang-Her; Sheen, Jiunn-Ming; Chou, Ming-Liang; Lin, Kuang-Lin

    2016-01-01

    Background: Pediatric primary spinal tumors (PST) are fairly uncommon, with little available data regarding incidence and outcomes. Materials and Methods: We conducted a retrospective review of the 22 consecutive patients less than 18 years old diagnosed with PST between March 1997 and May 2011 and treated at Chang Gung Children Hospital. All patients had undergone magnetic resonance imaging (MRI) for pre-operative evaluation and operations for PST. The extent of tumor removal was assessed by surgical report by the neurosurgeon or by post-operative MRI if available. Results: Ten of them had intramedullary tumors and 12 had intradural extramedullary tumors. All patients were treated with surgery to the primary site. A total of 15 patients underwent gross total tumor resection and seven patients received post-operative radiotherapy. Five patients received adjuvant chemotherapy for their primary tumor. Fourteen patients (64%) survived from study entry without tumor progression. Conclusions: PST encompassed a diverse group of pathologic entities that differ markedly based on the location and age of the children. Total resection of pediatric PST in children could be performed with acceptable risk and satisfactory long-term results. PMID:27695552

  2. Predictors of mortality within 1 year after primary ovarian cancer surgery

    DEFF Research Database (Denmark)

    Ørskov, Mette; Iachina, Maria; Guldberg, Rikke;

    2016-01-01

    important predictors of mortality from the multivariable model were residual tumour tissue >2 cm versus no residual tumour (HR=4.58 (95% CI 3.20 to 6.59)), residual tumour tissue ≤2 cm versus no residual tumour (HR=2.50 (95% CI 1.63 to 3.82)) and age >64 years versus age ≤64 years (HR=2.33 (95% CI 1.69 to 3......OBJECTIVES: To identify predictors of mortality within 1 year after primary surgery for ovarian cancer. DESIGN: Prospective nationwide cohort study from 1 January 2005 to 31 December 2012. SETTING: Evaluation of data from the Danish Gynaecology Cancer Database and the Danish Civil Registration...... (ASA) score, body mass index (BMI), International Federation of Gynaecology and Obstetrics (FIGO) stage, residual tumour tissue after surgery, perioperative blood transfusion and calendar year of surgery. RESULTS: The overall 1-year survival was 84%. Within 0-180 days after surgery, the 3 most...

  3. Pulmonary Adenocarcinoma Occurring 5 Years after Resection of a Primary Pancreatic Adenocarcinoma: A Relevant Differential Diagnosis

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    R. F. Falkenstern-Ge

    2014-01-01

    Full Text Available Ductal adenocarcinoma of the pancreas is a lethal disease. Surgical extirpation only offers the slim chance for long-term survival in localized disease. We report on a 73 year old female patient who initially underwent successful resection of pancreatic adenocarcinoma in May 2005. She was treated with adjuvant chemotherapy with gemcitabine. In October 2010 the patient noticed increasing dyspnea with haemoptysis. She was soon referred to our center. After the diagnosis of pulmonary adenocarcinoma with widespread metastasis, she was treated with systemic chemotherapy. For a period of next three years, she was treated with different chemotherapy regimens due to repeated episodes of tumor progression. To the best of our knowledge after reviewing the literature, this case represents an unusually clinical course with metachronous pulmonary adenocarcinoma arising after treatment of a primary pancreatic cancer after a long latency period.

  4. [Role of primary care teams in hospitalization of children under 2 years of age?].

    Science.gov (United States)

    Pardo Crespo, M R; Pérez Iglesias, R; Llorca, J; Rodrigo Calabia, E; Alvarez Granda, L; Delgado-Rodríguez, M

    2000-10-31

    To determine whether the structure of primary care teams on carrying out the healthy child health programme leads to a drop in the risk of admission to hospital of children under two, in comparison with the traditional clinic or out-clinic health system. Case-reference epidemiological study. 40% of the children under 24 months admitted to paediatric or neonate floors of the Marqués de Valdecilla University Hospital. Reference: 15% of the recently born children alive in this hospital. Information was gathered through face-to-face interview and by examining health cards. The study ran from April 1995 to May 1996. Children under two monitored habitually by a doctor belonging to a primary care team showed a drop in risk of hospital admission for all clinical diagnoses of 0.57 (95% CI, 0.35-0.93), after adjustment due to various confusion factors such as maternal education, social class, ethnic background, mother's age, mother's tobacco consumption, natural breast-feeding at birth, admission at birth. There was a drop of risk of hospital admission for high temperature without apparent cause in those children monitored habitually by a team doctor (adjusted RR = 0.41; 95% CI, 0.19-0.90). The advantages of the paediatric health care reform with the structuring of the primary care teams and the accompanying activities performed lead to a drop in the risk of hospital admission of those children under two years old who are habitually monitored by a doctor belonging to a primary care team.

  5. Does a Year Make a Difference? The Classroom Management Practices of Primary Student Teachers before and after a One-Year Teacher Education Programme

    Science.gov (United States)

    Reupert, Andrea; Woodcock, Stuart

    2015-01-01

    The purpose of this study was to examine primary student teachers' use, confidence and success in various classroom management strategies at the start and at the end of a one-year teaching programme and ascertain any significant differences between the two time periods. One hundred and twenty-four English primary student teachers were surveyed at…

  6. Primary care, the ROAD less traveled: what first-year medical students want in a specialty.

    Science.gov (United States)

    Clinite, Kimberly L; Reddy, Shalini T; Kazantsev, Stephanie M; Kogan, Jennifer R; Durning, Steven J; Blevins, Terri; Chou, Calvin L; Diemer, Gretchen; Dunne, Dana W; Fagan, Mark J; Hartung, Paul J; Mechaber, Hilit F; Paauw, Douglas S; Wong, Jeffrey G; DeZee, Kent J

    2013-10-01

    Medical students are increasingly choosing non-primary-care specialties. Students consider lifestyle in selecting their specialty, but how entering medical students perceive lifestyle is unknown. This study investigates how first-year students value or rate lifestyle domains and specialty-selection characteristics and whether their ratings vary by interest in primary care (PC). During the 2012-2013 academic year, the authors conducted a cross-sectional survey of first-year medical students from 11 MD-granting medical schools. Using a five-point Likert-type scale (1 = not important at all; 5 = extremely important), respondents rated the importance of 5 domains of good lifestyle and 21 characteristics related to specialty selection. The authors classified students into five groups by PC interest and assessed differences by PC interest using one-way analysis of variance. Of 1,704 participants, 1,020 responded (60%). The option "type of work I am doing" was the highest-rated lifestyle domain (mean 4.8, standard deviation [SD] 0.6). "Being satisfied with the job" was the highest-rated specialty-selection characteristic (mean 4.7, SD 0.5). "Availability of practice locations in rural areas" was rated lowest (mean 2.0, SD 1.1). As PC interest decreased, the importance of "opportunities to work with underserved populations" also decreased, but importance of "average salary earned" increased (effect sizes of 0.98 and 0.94, respectively). First-year students valued enjoying work. The importance of financial compensation was inversely associated with interest in PC. Examining the determinants of enjoyable work may inform interventions to help students attain professional fulfillment in PC.

  7. Clinicopathological and immunohistochemical features of primary central nervous system germ cell tumors: a 24-years experience.

    Science.gov (United States)

    Gao, Yuping; Jiang, Jiyao; Liu, Qiang

    2014-01-01

    Primary central nervous system (CNS) germ cell tumors (GCTs) are a rare heterogeneous group of lesions, which the clinicopathological features have a marked degree of heterogeneity comparing with that of gonadal GCTs. Accurately diagnosing CNS GCTs might be extremely difficult and requires immunohistochemical verification. This study was to investigate the biological feature of CNS GCTs and diagnostic value of immunohistochemical markers OCT3/4, C-kit, PLAP, and CD30 in CNS GCTs. A retrospective study was performed on 34 patients with CNS germ cell tumors between 1990 and 2014. 34 CNS GCTs account for 9.2% of all primary CNS neoplasms. The sellar region (35.3%) and pineal gland (17.6%) were the most common sites of intracranial GCTs. Hydrocephalus (82.4%) and diplopia (46.9%) were the two most common clinical presentations. The most common histological subtypes were germinoma (67.6%). PLAP, c-kit, OCT3/4 were highly expressed in gernimomas. CD30 and CK AE1/3 stainings were positive in embryonal carcinoma. Yolk sac tumor component showed positive staining for AFP and CK AE1/3. β-HCG staining was positive in choriocarcinoma and STGC. Patients with mature teratomas and germinomas had a better prognosis (a 5-year survival rate) than those with embryonal carcinoma and choriocarcinoma (a 5-year survival rates were 0). Our finding suggest that the incidences of primary CNS GCTs are higher in South China than in the West, but mixed GCTs are uncommon in our study. The judicious use of a panel of selected markers is helpful in diagnosing and predicting the prognosis for CNS GCTs.

  8. Comparison between peritoneal tuberculosis and primary peritoneal carcinoma: a 16-year, single-center experience

    Institute of Scientific and Technical Information of China (English)

    WANG Dan; ZHANG Jun-ji; HUANG Hui-fang; SHEN Keng; CUI Quan-cai; XIANG Yang

    2012-01-01

    Background Peritoneal tuberculosis and primary peritoneal carcinoma can both present as an abdominal mass and ascites with elevated serum CA125.The purpose of our study was to evaluate the clinical features of peritoneal tuberculosis,compare them with features of primary peritoneal carcinoma,and establish definitive diagnostic procedures.Methods We conducted a retrospective study in patients with peritoneal tuberculosis from January 1995 to October 2010 at Peking Union Medical College Hospital.During this time,the data of 38 patients with primary peritoneal carcinoma were reviewed.Results The median age was 34 years (range,19-80 years).The most common symptoms were abdominal distension (16/30,53.3%) and an abdominal mass (12/30,40.0%).The serum CA125 level was elevated in 25 patients (83.3%).The median level of cancer antigen CA125 was 392.5 U/ml (range,0.64-850.0 U/ml).Abdominal ultrasound revealed a pelvic mass in 25 patients and ascites in 20 patients.Diagnostic laparoscopy was performed in 15 patients (50.0%) and exploratory laparotomy was performed in 12 patients (40.0%),and 3 patients (10.0%) who underwent laparoscopy converted to laparotomy because of severe adhesions.The intraoperative findings were adhesions,multiple white tubercles,and ascites.Frozen tissue sections were obtained in 17 patients,and 14 of whom showed chronic granulomatous reactions.Final pathological examinations confirmed the diagnosis.Conclusions Peritoneal tuberculosis should be considered as a differential diagnosis,especially for young women with an abdominal mass,ascites,and elevated serum CA125 levels.Laparoscopy is a useful diagnostic method for peritoneal tuberculosis,and intraoperative frozen sections are recommended when the diagnosis is in doubt.

  9. CLINICAL SPECTRUM OF PRIMARY SKIN DISORDERS IN CHILDREN LESS THAN 10 YEARS

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    Mridula

    2015-01-01

    Full Text Available BACKGROUND: Skin disorders are a major cause of morbidity in children. Skin diseases can affect the quality of life of children t o a great extent and can hinder their normal growth and development. AIMS: This study was done with the objective of assessing the frequency and clinical spectrum of primary skin disorders in children less than 10 yrs at ESI model hospital, a tertiary care hospital catering to the working community insured under ESI scheme. METHODS: T his was a prospective study of 1 year duration. All children less than 10 yr of age presenting to our hospital were screened for skin disorders. Diagnosis was made clinically in all cases. RESULTS: A total of 282 children were found to have primary skin lesions. The frequency of primary skin disorders was found to be 5.75%. There was male preponderance (54%. Maximum Cases were seen in 0 to 5 yr age group (50%. 63% of cases were seen in children from families with income< 5000 per month. Infections and infestations was the commonest condition seen in 33.94% cases of which 48.6% were pyodermas, 21.6% were fungal infections, 10.8% were viral infections and 18.9 % were scabies. Next commonest condition was atopic dermatitis at 13.76% followed by pityriasis alba at 8.25% and insect bite reaction at 5.8%. CONCLUSIONS : A low frequency of skin disorders was seen in this population group. Males in the age group of less than 5 years had th e maximum incidence. Lower income group had a greater incidence. Infections and infestations were more common than allergic skin conditions

  10. [Potentially inappropriate prescribing in patients over 65 years-old in a primary care health centre].

    Science.gov (United States)

    Parodi López, Naldy; Villán Villán, Yuri Fabiola; Granados Menéndez, María Isabel; Royuela, Ana

    2014-01-01

    To identify potentially inappropriate prescriptions (PPI) and prescribing omissions (OP) by means of the STOPP/START criteria, as well as associated factors in ≥65year old patients in a Primary Care setting in Spain. A cross-sectional, descriptive study. Centro de Salud Monóvar, Primary Health Care. 6months. 247patients. ≥65years patients who attended an urban Primary Care clinic 2 or more times were studied. Terminally ill and nursing home residents were excluded. Data were collected from electronic clinical records. STOPP and START criteria were evaluated in each clinical record, including age, sex, co-morbidity, number of chronic prescriptions. PPI and OP identified by STOPP and START criteria, respectively. A total of 81 patients (32.8%) had PPI, with the most common being the long-term use of long-acting benzodiazepines in 17 (6.9%). OP was found in 73 (29.6%) patients, with the most common being the omission of statins in patients diagnosed with diabetes mellitus and/or one or more major cardiovascular risk factors in 21 (8.5%). After adjustment by gender and age, correlations were found between PPI and multiple medication (OR: 2.02; 95%CI: 1.15-3.53; P=.014), and OP and polypharmacy (OR: 2.37; 95%CI: 1.32-4.24; P=0.004). Inappropriate prescribing in older people is frequent, and is mainly associated with long-acting benzodiazepines. There are diabetic patients who do not have statins prescribed. Multiple medication is associated with PPI and OP. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  11. Sixteen years of ICPC use in Norwegian primary care: looking through the facts

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    Bassøe Carl-Fredrik

    2010-02-01

    Full Text Available Abstract Background The International Classification for Primary Care (ICPC standard aims to facilitate simultaneous and longitudinal comparisons of clinical primary care practice within and across country borders; it is also used for administrative purposes. This study evaluates the use of the original ICPC-1 and the more complete ICPC-2 Norwegian versions in electronic patient records. Methods We performed a retrospective study of approximately 1.5 million ICPC codes and diagnoses that were collected over a 16-year period at 12 primary care sites in Norway. In the first phase of this period (transition phase, 1992-1999 physicians were allowed to not use an ICPC code in their practice while in the second phase (regular phase, 2000-2008 the use of an ICPC code was mandatory. The ICPC codes and diagnoses defined a problem event for each patient in the PROblem-oriented electronic MEDical record (PROMED. The main outcome measure of our analysis was the percentage of problem events in PROMEDs with inappropriate (or missing ICPC codes and of diagnoses that did not map the latest ICPC-2 classification. Specific problem areas (pneumonia, anaemia, tonsillitis and diabetes were examined in the same context. Results Codes were missing in 6.2% of the problem events; incorrect codes were observed in 4.0% of the problem events and text mismatch between the diagnoses and the expected ICPC-2 diagnoses text in 53.8% of the problem events. Missing codes were observed only during the transition phase while incorrect and inappropriate codes were used all over the 16-year period. The physicians created diagnoses that did not exist in ICPC. These 'new' diagnoses were used with varying frequency; many of them were used only once. Inappropriate ICPC-2 codes were also observed in the selected problem areas and for both phases. Conclusions Our results strongly suggest that physicians did not adhere to the ICPC standard due to its incompleteness, i.e. lack of many

  12. Chronic kidney disease in hypertensive subjects ≥60 years treated in Primary Care.

    Science.gov (United States)

    Salvador-González, Betlem; Mestre-Ferrer, Jordi; Soler-Vila, Maria; Pascual-Benito, Luisa; Alonso-Bes, Eva; Cunillera-Puértolas, Oriol

    Hypertension (HT) is the second leading cause of kidney failure. In hypertensive patients with chronic kidney disease (CKD), blood pressure (BP) control is the most important intervention to minimise progression. For CKD diagnosis, standardised creatinine and estimated glomerular filtration rate (eGFR) testing by CKD-EPI is recommended. To describe the prevalence and factors associated with a moderate decrease in eGFR (by CKD-EPI) and BP control in subjects with HT. Cross-sectional descriptive study in subjects ≥ 60 years included in the SIDIAP plus database with hypertension and standardised serum creatinine and BP tests in the last 2years. eGFRcardiovascular disease, home care. Primary endpoint: eGFR by CKD-EPI formula. Covariates: demographic data, examination, cardiovascular risk factors, heart failure and auricular fibrillation diagnosis, and drugs (antihypertensive agents acting on renal function, antiplatelet and lipid lowering agents). BP control criteria: ≤130/80mmHg in individuals with albuminuria, ≤140/90 in all other subjects. Prevalence of eGFR factors: age, gender, heart failure, albumin/creatinine ratio, auricular fibrillation, smoking, dyslipidaemia, diabetes and obesity. BP control: 66.14 and 63.24% in eGFR≥60 and eGFR cardiovascular disease ≥60 years in primary care presented with a moderate decrease in eGFR. In addition to age and sex, albuminuria and heart failure were the main associated factors. Despite the increased exposure to drugs, BP control was lower in CKD. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  13. Management of a rare case of impacted primary central incisors in a 3-year-old child

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    A Sharma

    2012-01-01

    Full Text Available Impaction of primary anterior teeth is very rare. A tooth that fails to erupt into normal functional position by the time it normally should is considered impacted. A rare case of impacted dilacerated maxillary primary incisors in a 3-year-old child is presented. The diagnostic position of impacted primary incisors was determined using conical beam computed tomography (CBCT to assist in surgical intervention with least surgical trauma to the tissues.

  14. The relationship between dental caries and obesity among primary school children aged 5 to 14 years

    Directory of Open Access Journals (Sweden)

    Yao Yingshui

    2014-07-01

    Full Text Available Background: Previous study revealed that the link between dental caries and obesity has been controversial. The purpose of this research is to investigate the association between dental caries and obesity among primary school children in Wannan area, China. Methods: A cross-sectional study was designed to collect the routine health screening data for primary school children aged 5-14 years inWannan area,China, Overweight and obesity status were determined using the International Obesity Task Force standard (IOTF BMI cut-off points. Caries status was recorded based on WHO recommendations. Results: Our results revealed that the overall caries prevalence of the subjects was 44.9%, Maximum number of caries affected children belonged to underweight and normal group, followed by overweight, and the least number was obesity. These differences were statistically significant (chi-square test, P < 0.001. Children with obesity were 1.908 times (OR =1.908; CI95%=1.750, 2.079 more likely have caries than children with underweight or health weight. Overweight children were 1.547 times (OR = 1.547; CI95% = 1.479, 1.618 more likely to have caries than children with underweight or health weight. After adjusted the gender and age, a statistically significant association was also observed between body mass index categories and caries. Conclusions: Obesity may have a significant effect on caries prevalence of primary school children in Wannan area, China. The importance of obesity should not only be emphasized with respect to general diseases but also with regard to carious lesions.

  15. The relationship between dental caries and obesity among primary school children aged 5 to 14 years.

    Science.gov (United States)

    Yao, Yingshui; Ren, Xiaohua; Song, Xiuli; He, Lianping; Jin, Yuelong; Chen, Yan; Lu, Wei; Guo, Daoxia; Ding, Lingling; Tang, Hui; Wei, Ningkai; Qiu, Shenwei; Li, Chaopin

    2014-07-01

    Previous study revealed that the link between dental caries and obesity has been controversial. The purpose of this research is to investigate the association between dental caries and obesity among primary school children in Wannan area, China. A cross-sectional study was designed to collect the routine health screening data for primary school children aged 5-14 years in Wannan area,China, Overweight and obesity status were determined using the International Obesity Task Force standard (IOTF) BMI cut-off points. Caries status was recorded based on WHO recommendations. Our results revealed that the overall caries prevalence of the subjects was 44.9%, Maximum number of caries affected children belonged to underweight and normal group, followed by overweight, and the least number was obesity. These differences were statistically significant (chi-square test, P Children with obesity were 1.908 times (OR =1.908; CI95%=1.750, 2.079) more likely have caries than children with underweight or health weight. Overweight children were 1.547 times (OR = 1.547; CI95% = 1.479, 1.618) more likely to have caries than children with underweight or health weight. After adjusted the gender and age, a statistically significant association was also observed between body mass index categories and caries. Obesity may have a significant effect on caries prevalence of primary school children in Wannan area, China. The importance of obesity should not only be emphasized with respect to general diseases but also with regard to carious lesions. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  16. Magnetic resonance imaging evaluation of capsulolabral tears after traumatic primary anterior shoulder dislocation. A prospective comparison with arthroscopy of 25 cases

    DEFF Research Database (Denmark)

    Suder, P.A.; Frich, Lars Henrik; Hougaard, K.;

    1995-01-01

    The purpose of our study was to evaluate the use of static magnetic resonance imaging (MRI) as a preoperative diagnostic tool in young patients with a traumatic primary anterior shoulder dislocation. Twenty-five patients who had acute primary traumatic anterior shoulder dislocation were examined...... with MRI and arthroscopy. The patients (18 male and 7 female) were between 16 and 39 years old (mean age, 27 years). They had no previous shoulder dislocations. The dislocations were confirmed radiographically. Examination with MRI and arthroscopy was performed within 10 days after the trauma. The MRI...... evaluation was performed before the arthroscopic examination, and the images were interpreted by an experienced magnetic resonance radiologist. No information from the MRI examination was available to the orthopedic surgeons before arthroscopy. The standard of reference for comparison was arthroscopy...

  17. Cultivar and Year Rather than Agricultural Practices Affect Primary and Secondary Metabolites in Apple Fruit.

    Science.gov (United States)

    Le Bourvellec, Carine; Bureau, Sylvie; Renard, Catherine M G C; Plenet, Daniel; Gautier, Hélène; Touloumet, Line; Girard, Thierry; Simon, Sylvaine

    2015-01-01

    Many biotic and abiotic parameters affect the metabolites involved in the organoleptic and health value of fruits. It is therefore important to understand how the growers' decisions for cultivar and orchard management can affect the fruit composition. Practices, cultivars and/or year all might participate to determine fruit composition. To hierarchize these factors, fruit weight, dry matter, soluble solids contents, titratable acidity, individual sugars and organics acids, and phenolics were measured in three apple cultivars ('Ariane', 'Melrose' and 'Smoothee') managed under organic, low-input and conventional management. Apples were harvested at commercial maturity in the orchards of the cropping system experiment BioREco at INRA Gotheron (Drôme, 26) over the course of three years (2011, 2012 and 2013). The main factors affecting primary and secondary metabolites, in both apple skin and flesh, were by far the cultivar and the yearly conditions, while the management system had a very limited effect. When considering the three cultivars and the year 2011 to investigate the effect of the management system per se, only few compounds differed significantly between the three systems and in particular the total phenolic content did not differ significantly between systems. Finally, when considering orchards grown in the same pedoclimatic conditions and of the same age, instead of the usual organic vs. conventional comparison, the effect of the management system on the apple fruit quality (Fruit weight, dry matter, soluble solids content, titratable acidity, individual sugars, organic acids, and phenolics) was very limited to non-significant. The main factors of variation were the cultivar and the year of cropping rather than the cropping system. More generally, as each management system (e.g. conventional, organic…) encompasses a great variability of practices, this highlights the importance of accurately documenting orchard practices and design beside the generic

  18. Second Primary Pancreatic Adenocarcinoma Three Years After Successfully Treated Index Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Nina Nandy

    2014-01-01

    Full Text Available Context Development of a second primary malignancy after an index esophageal cancer is a rare event, primarily due to short survival of patients with esophageal cancer. However, the number of long-term esophageal cancer survivors has been increasing due to advances in early detection and therapy. Case report We report herein a case of pancreatic adenocarcinoma that developed three years after a successfully treated early-stage adenocarcinoma of the esophagus. A 70-year-old Caucasian male presented with vague complaints of nausea, vomiting and abdominal distention, with subsequent development of jaundice. A computed tomography scan of abdomen revealed a 2.9 cm soft tissue mass in the head of the pancreas and the patient underwent a Whipple’s procedure, with pathology confirming the diagnosis of pancreatic adenocarcinoma. Three years previously, the patient was successfully treated for adenocarcinoma of the esophagus via minimally invasive esophagogastrectomy. Despite chemoradiotherapy for localized disease and subsequent systemic chemotherapy for metastatic pancreatic cancer, the patient eventually succumbed to his illness. Conclusion We discuss the association between esophageal cancer and subsequent second malignancies, along with implications for surveillance and therapy.

  19. Primary plasmacytoma of the cervix in a 21-year-old female patient.

    Science.gov (United States)

    Schor, Ana Paula T; Moraes, Marcelo P T; Bisson, Frank W; Bisson, Marcelo A M; Luiz, Orlando M R; Bacchi, Carlos E

    2010-05-01

    Extramedullary (extraosseous) plasmacytomas are localized, plasma cell neoplasms that arise in tissues other than bone and bone marrow, and constitute about 4% of all plasma cell neoplasms. Extramedullary (extraosseous) plasmacytomas rarely affects the female lower genital tract; only 6 cases of primary cervix plasmacytomas have been reported to date. Here we describe the case of an otherwise healthy 21-year-old woman who presented for a routine examination with no symptoms. A Pap smear showed an intense inflammatory process with some atypical cells. This was confirmed by microscopic examination of a biopsy, which revealed a metaplastic process of the cervix with a massive infiltration of plasma cells with mild atypia. The atypical plasma cells showed cytoplasmic lambda immunoglobulin light chain restriction with the absence of kappa light chains, indicative of monoclonality. The patient was extensively screened for systemic disease, including bone marrow biopsy, but the disease was restricted to the cervix.

  20. Caries experience in the primary dentition and presence of plaque in 7-year-old Chinese children: A 4-year time-lag study

    NARCIS (Netherlands)

    Hu, X.; Fan, M.; Mulder, J.; Frencken, J.E.F.M.

    2015-01-01

    OBJECTIVES: The aim of the present study was to test the hypothesis that dental caries prevalence and caries experience in primary dentitions has increased over 4 years and to compare the presence of plaque on permanent teeth in child cohorts over 4 years. MATERIALS AND METHODS: A time-lag study des

  1. Epidemiology, management and survival outcomes of primary cutaneous melanoma: a ten-year overview.

    Science.gov (United States)

    Aubuchon, M M F; Bolt, L J J; Janssen-Heijnen, M L G; Verleisdonk-Bolhaar, S T H P; van Marion, A; van Berlo, C L H

    2017-02-01

    Malignant melanoma (MM) is the most aggressive type of skin cancer, accounting for 90% of all the skin cancer mortality. The objective of this study was providing an overview of current patient- and tumour characteristics, treatment strategies, complications and survival in patients with MM over the past ten years. Hereby, an up-to-date view of every day clinical practice is obtained. Files of patients treated for primary cutaneous melanoma (n = 686) in the VieCuri Medical Centre in the Netherlands between January 2002 and December 2013 were retrospectively reviewed. Relevant patient features, tumour characteristics, and (surgical) outcomes were evaluated. The majority of all the patients presented thin tumours (59.1% stage 1A/in situ melanoma). Men showed more ulceration (17.7% vs. 8.4%, p < .01) and a significantly higher Breslow thickness than women (1.2 mm vs. 0.9 mm, p < .01). 14.6% (40/273) underwent sentinel lymph node biopsy (SLNB); 10/40 (25%) showed nodal metastasis, 50 patients (7.3%) developed distant metastases (M: 10.6%, F: 5%, p < .01). One-, 5- and 10- year disease specific survival rates were 96%, 86% and 84%, respectively. Median survival for stage 4 MM was 3 months. Extensive surgery was uncommon (n = 3). Patients generally presented with thin melanomas. Lymph node disease and distant metastases remained infrequently observed during following years, and general 1- and 5-year overall disease-specific survival rates exceeded 85%. Small numbers of rescue surgery and palliative medical treatment warrant further centralisation and investigation.

  2. Characterization of kinetic handling in a primary care center of Antofagasta in year 2011.

    Directory of Open Access Journals (Sweden)

    Andrés Soto B.

    2012-12-01

    Full Text Available INTRODUCTION : Musculoskeletal pathologies are prevalent in primary care, affecting 50.6% of women and 31.4% of men between 45 and 64 years old. In the kinetic care service of CESFAM Corvallis in Antofagasta, physiotherapy management is performed at acute musculoskeletal pathologies. OBJECTIVE : Characterization of kinesiology care of musculoskeletal pathologies in CESFAM Corvallis. MATERIAL AND MET HOD : Cross-sectional study, all treated patients with available data were included, so that there was no exclusion. The daily schedule data were used in the study, analyzing the following variables: age, sex and diagnosis. RESULTS : Of 604 patients, the average age was 56,4 years old, being 78% women. The more frequent age range was between 45 and 64 years old with 48.2%. According to anatomical region, 51.5% were in upper extremities, 33.9% in head and spine and 14.1% in lower extremities. In upper extremities the most frequent was painful shoulder syndrome with 48.1% and rotator cuff tendinitis with 12.3%. In head and spine was mechanical low back pain with 42.9% and cervicobrachialgia with 16.1%. In lower extremities, knee osteoarthritis with 23.5%, ankle sprain with 17.6%, and plantar fasciitis with 15.3%. DISCUSSION : The results are consistent with national studies, showing dominance in women and the most common age range is between 45 and 64 years old. The higher frequency of upper extremities pathologies in this study in comparison with national statistics may be due to overdiagnosis, geographic or biopsycosocial factors. Implementation of an adequate registration system is needed for an adequate patient follow-up.

  3. Primary Hyperparathyroidism: 11-Year Experience in a Single Institute in Thailand

    Directory of Open Access Journals (Sweden)

    Poramaporn Prasarttong-Osoth

    2012-01-01

    Full Text Available Primary hyperparathyroidism (PHPT is not an uncommon disease in the western countries. In Thailand, on the contrary, PHPT was a rare condition with various clinical presentations. All 45 PHPT patients who underwent parathyroidectomy at the Department of Surgery, Siriraj Hospital during January 1997 and December 2007 were retrospectively reviewed. Demographic data, clinical presentation, localizations imaging, operative procedures, findings, complications, and pathological reports were analyzed. Median age was 49 years (range 15–89 years with female: male ratio of 3 : 1. Only one patient (2.2% was asymptomatic PHPT. Of all symptomatic cases, 30 (66.7% had skeletal symptoms, 7 (15.6% had renal impairment, and 39 (86.7% had mixed symptoms. 42 patients (93.3% had parathyroid scan and all had bilateral exploration of the neck. Postoperative hungry bone syndrome was noted in 10 patients (22%. On followup, skeletal and neuropsychiatric symptoms were improved but the renal impairment was remained. The s small number of asymptomatic PHPT in our study may refer to large number of underdiagnosed PHPT in general population. The guideline for screening serum calcium for diagnosis of PHPT in Thai populations will improve the long-term consequence of the disease but will need further information to identify the target group.

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

    LENUS (Irish Health Repository)

    Buckley, Brian S

    2009-01-01

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

  5. [Tuberculosis in a primary care center in a socioeconomically depressed area: variables associated with giving up treatment].

    Science.gov (United States)

    Solá, M; Gardella, A; Llauger, M A; Muñoz, J; Birulés, M; Foz, G

    1990-06-01

    We report the features of 72 patients with tuberculosis of a low socioeconomical level, seen at the primary care center of Perecamps (Barcelona). We identify the factors associated with giving up therapy. We found a predominance of males and of the 40-59 years age group. In 1988 we found an increased rate of young patients (20-39 years) and PDA/HIV+. Twenty-five patients (35%) had had previous episodes of tuberculosis. 19 had had inadequate chemotherapy because of abandonment. The rate of follow-up losses was high (36%). A history of previous PDA/HIV+ were associated with giving up therapy. We indicate the several measures to be applied in our area to improve compliance with chemotherapy in patients with tuberculosis.

  6. Percutaneous balloon compression for primary trigeminal neuralgia in patients older than 80 years

    Institute of Scientific and Technical Information of China (English)

    Yuanfeng Du; Qiao Gu; Dingbo Yang; Xiaoqiao Dong; Quan Du; Hao Wang; Wenhua Yu

    2015-01-01

    Background: It has been demonstrated that the incidence of trigeminal neuralgia in elderly patients is higher and thus, neurosurgeons often encounter elderly patients with this disorder.However, for those with poor basic condition, the optimal surgical treatment remains controversial.In this study, the authors aimed to evaluate the safety and efficacy of percutaneous balloon compression (PBC) for primary trigeminal neuralgia in elderly patients older than 80 years.Methods: From September 2009 to March 2013, a total of 68 patients older than 80 years underwent PBC, and a retrospective study of the clinical data of these patients was performed.Results: After PBC, pain relief was immediate in 66 (97.0 %) patients, 1 (1.5 %) patient had no pain relief, and 1 (1.5 %) patient had some pain that could be controlled with medication.With a mean length of follow-up of 40.1 months, ranging from 24 to 66 months after surgery, 55 (80.9 %) patients were still pain free.Of the 11 patients with recurrence, 9 cases had mild recurrence and 2 cases suffered severe recurrence.The mean time to recurrence was 18.9 months (1-64 months).Postoperative morbidity included common side effects such as facial numbness in 66 (97.1%) patients, masseter muscle weakness in 19 (27.9 %) patients, paresthesia in 7 (10.3 %) patients, and diplopia secondary to abducens nerve weakness in 1 (1.5 %) patient.No corneal anesthesia, subarachnoid hemorrhage, or other serious surgical complications occurred in this study.Conclusions: In this study, the authors reviewed data on a cohort of patient older than 80 years.The PBC procedure has advantages in that it is minimally invasive, safe, effective, and could be performed under general anesthesia.This makes it an optimized choice for elderly patients.

  7. Primary pulmonary adenocarcinoma in a 16-year-old boy - a five-year follow-up

    DEFF Research Database (Denmark)

    Måreng, Ane Stillits; Langer, Seppo W; Bodtger, Uffe

    2016-01-01

    -old boy who presented with metastatic primary pulmonary adenocarcinoma (T3N3M1a) and was treated aggressively, including radiation therapy for local and distant recurrence. He had complete remission, had completed his education, was employed full-time, and suffered only from mild side effects to treatment....

  8. Two cases of primary sclerosing cholangitis - ERCP-documentation in immunesuppressive therapy of the last 3 years

    Energy Technology Data Exchange (ETDEWEB)

    Mendel, R.; Droste, R.; Bade, J.; Hebestreit, H.P.; Georgi, M.

    1985-02-01

    X-ray characteristics of two cases of primary sclerosing cholangitis are described. A discussion of clinical, immunological and histological features of the disease and the 3-years progress of a 40 year old man during treatment with immunesuppressive therapy (Imurek at the beginning with cortisone) is shown. The arrest of the progression of the disease is supposed.

  9. Endoscopic thoracic sympathectomy for primary hyperhidrosis: a 16-year follow up in a single UK centre.

    Science.gov (United States)

    Askari, Alan; Kordzadeh, Ali; Lee, Gui Han; Harvey, Michael

    2013-06-01

    Since the introduction of Endoscopic Thoracic Sympathectomy ( ETS ) by Kux in 1951, the procedure has been performed for treatment of primary hyperhidrosis (PH) of the upper limb. Despite its initial success and minimally invasive nature, the long-term results are yet to be established. The aim of this study is to evaluate the outcome of patients after ETS with particular emphasis on patient satisfaction and its effectiveness over a 16-year period. A patient survey of fifty-one (n = 51) patients who had ETS for PH of palms from 1995 to 2011 was conducted. The data on age, sex, site of the PH, family history, trigger, hospital stay, relief from symptoms, complications, refractory sweating and overall satisfaction with the procedure was analysed with SAS software version 9.1.3. The mean follow-up was 77 months (range, 6-189 months) with equal gender distribution (n = 24 males Vs n = 27 females) and mean age of 19 (range, 13-64 years). The hereditary prevalence was 55%. Forty-six patients (90.2%) reported an immediate (≤24 h) and four patients (7.8%) reported a delay (>24 h) in relief of symptoms. To the best of our knowledge this is longest duration of follow-up reported in the literature. Copyright © 2012 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  10. Chest pain in a 56 year old female with neglected primary hyperparathyroidism, Case Report

    Directory of Open Access Journals (Sweden)

    Gholamreza Mortazavimoghaddam

    2013-02-01

    Full Text Available Primary hyperparathyroidism is a benign disease and is most often diagnosed during routine calcium measurement. It would be astonishing if a patient is symptomatic, but the diagnosis is neglected. A 56-year-old woman was admitted with complaint of localized pain in the chest wall following a regular bending and straightening. CXR showed a mass like lesion of the chest wall on the left and also bulged margin of the rib on the right side of the rib cage. Chest CT images revealed a dumbbell-shaped lesion of the rib on the right and an intramedulary mass on the rib on the left rib cage (brown tumor. Isotope bone scan showed an increased uptake in the skull, pelvis, spine, and ribs suggestive of osteomalacia. The main laboratory findings were: Ca=13.6 mg/dl, phosphorus=2.6mg/dl and PTH=633.6pg/ml. Sestamibi parathyroid scan revealed thyroid adenoma in the right lower lobe. Pathological lab tests confirmed parathyroid adenoma. Therefore, the patient was operated on. Four weeks after surgery, PTH level was 20pg/ml. Although most cases of hyperparathyroidism are patients with asymptomatic hypercalcaemia, it is important to have a good insight into diagnosing patients with localized and unexplained bone pain particularly because the pain may be felt in uncommon sites like the chest cavity.

  11. A 20-year study on 190 patients with primary hyperparathyroidism in a developing country: Turkey experience.

    Science.gov (United States)

    Usta, Arif; Alhan, Etem; Cinel, Akif; Türkyılmaz, Serdar; Erem, Cihangir

    2015-04-01

    The aim of this study was to present our 20-year experience regarding primary hyperparathyroidism (PHPT). PHPT patients who underwent parathyroidectomy in our clinic were reviewed retrospectively. There were 190 PHPT patients, of whom 137 were asymptomatic (72%). The mean serum calcium at the time of diagnosis was 11.9 ± 2.2 mg/dL. The mean parathyroid hormone (PTH) level was 467 ± 78 pg/mL. Ultrasonography (USG) identified all abnormal glands accurately (82.6%) and Technetium-99m sestamibi scintigraphy (MIBI) was used in 89.4% of the patients and magnetic resonance imaging (MRI) in 61%. The common use of USG and MIBI detected 92% of the lesions. Bilateral neck exploration (BNE) was performed in 12.2% of the patients and focused unilateral neck exploration (FUNE) in the remaining 87.8%. Surgical intervention was unsuccessful in 1 patient (0.5%). The conversion ratio from FUNE to BNE was 5.2%. The mean operation time and mean hospital stay decreased significantly in patients with FUNE. Pathologic examination revealed single adenoma in 93% of the patients. New imaging techniques result in the conversion of surgical treatments of PHPT. FUNE in parathyroidectomy performed by an experienced surgeon may provide successful treatment rates.

  12. The Incidence of Primary Systemic Vasculitis in Jerusalem: A 20-year Hospital-based Retrospective Study.

    Science.gov (United States)

    Nesher, Gideon; Ben-Chetrit, Eli; Mazal, Bracha; Breuer, Gabriel S

    2016-06-01

    The incidence of primary systemic vasculitides varies among different geographic regions and ethnic origins. The aim of this study was to examine the incidence rates of vasculitides in the Jerusalem Jewish population, and to examine possible trends in incidence rates over a 20-year period. The clinical databases of inpatients at the 2 medical centers in Jerusalem were searched for patients with vasculitis diagnosed between 1990-2009. Individual records were then reviewed by one of the authors. The significance of trends in incidence rates throughout the study period was evaluated by Pearson correlation coefficient. The average annual incidence rate of polyarteritis nodosa was 3.6/million adults (95% CI 1.6-4.7). Incidence rates did not change significantly during this period (r = 0.39, p = 0.088). The incidence of granulomatosis with polyangiitis (GPA) was 4.1 (2.2-5.9) for the whole period, during which it increased significantly (r = 0.53, p Jerusalem are in the lower range of global incidence rates. While GPA and MPA incidence are increasing, GCA incidence is decreasing.

  13. Atmospheric inversion of SO2 and primary aerosol emissions for the year 2010

    Directory of Open Access Journals (Sweden)

    N. Huneeus

    2013-07-01

    Full Text Available Natural and anthropogenic emissions of primary aerosols and sulphur dioxide (SO2 are estimated for the year 2010 by assimilating daily total and fine mode aerosol optical depth (AOD at 550 nm from the Moderate Resolution Imaging Spectroradiometer (MODIS satellite instrument into a global aerosol model of intermediate complexity. The system adjusts monthly emission fluxes over a set of predefined regions tiling the globe. The resulting aerosol emissions improve the model performance, as measured from usual skill scores, both against the assimilated observations and a set of independent ground-based measurements. The estimated emission fluxes are 67 Tg S yr−1 for SO2, 12 Tg yr−1 for black carbon (BC, 87 Tg yr−1 for particulate organic matter (POM, 17 000 Tg yr−1 for sea salt (SS, estimated at 80 % relative humidity and 1206 Tg yr−1 for desert dust (DD. They represent a difference of +53, +73, +72, +1 and −8%, respectively, with respect to the first guess (FG values. Constant errors throughout the regions and the year were assigned to the a priori emissions. The analysis errors are reduced with respect to the a priori ones for all species and throughout the year, they vary between 3 and 18% for SO2, 1 and 130% for biomass burning, 21 and 90 % for fossil fuel, 1 and 200% for DD and 1 and 5% for SS. The maximum errors on the global-yearly scale for the estimated fluxes (considering temporal error dependence are 3% for SO2, 14% for BC, 11% for POM, 14% for DD and 2% for SS. These values represent a decrease as compared to the global-yearly errors from the FG of 7% for SO2, 40% for BC, 55% for POM, 81% for DD and 300% for SS. The largest error reduction, both monthly and yearly, is observed for SS and the smallest one for SO2. The sensitivity and robustness of the inversion system to the choice of the first guess emission inventory is investigated by using different combinations of inventories for industrial, fossil fuel and biomass burning

  14. Preparing physicians for careers in primary care internal medicine: 17 years of residency experience.

    OpenAIRE

    Perez, J. C.; Brickner, P. W.; Ramis, C. M.

    1997-01-01

    The objective of this survey was to demonstrate whether a primary care track internal medicine residency program emphasizing community-based health care of the urban sick poor trains physicians who will continue to practice in general internal medicine or similar fields. Thirty-five primary care residents (100% of graduates) who trained from 1976 through 1993 in the Adult Primary Care Track of the Internal Medicine Residency Program at St. Vincent's Hospital, New York were used as participants.

  15. Primary signet ring cell carcinoma of the appendix: A rare case report and our 18-year experience

    Institute of Scientific and Technical Information of China (English)

    Yoon Ho Ko; Young Seon Hong; Chan-Kwon Jung; Soon Nam Oh; Tae Hee Kim; Hye Sung Won; Jin Hyoung Kang; Hyung Jin Kim; Won Kyung Kang; Seong Taek Oh

    2008-01-01

    Primary adenocarcinoma of the appendix is a rare malignancy that constitutes < 0.5% of all gastrointestinal neoplasms.Moreover,primary signet ring cell carcinoma of the appendix is an exceedingly rare entity.We have encountered 15 cases of primary appendiceal cancer among 3389 patients who underwent appendectomy over the past 18 years.In the present report,we describe a rare case of primary signet ring cell carcinoma of the appendix with ovarian metastases and unresectable peritoneal dissemination occurring in a 67-year-old female patient.She underwent appendectomy and bilateral salpingo-oophorectomy with a laparoscopy procedure.She then received palliative systemic chemotherapy with 12 cycles of oxaliplatin,5-flurorouracil,and leucovorin (FOLFOX-4).The patient currently is well without progression of disease 12 mo after beginning chemotherapy.

  16. Non-psychogenic polydipsia in 45-year-old man with primary hyperparathyroidism and recurrent bilateral nephrolithiasis

    Directory of Open Access Journals (Sweden)

    Rahmat Cahyanur

    2012-11-01

    Full Text Available Non-psychogenic polydipsia with hyponatremia is a rare clinical presentation. Primary hyperparathyroidism is a disorder of calcium, phosphate, and bone metabolism caused by increased level of parathyroid hormone (PTH. It is estimated the incidence of primary hyperparathyroidism are 21.6 per 100,000 person a year. This case report describe a 45-year-old man presented with non-psychogenic polydipsia. This patient drank a lot of water out of the fear of recurrent kidney stones. He had history of recurrent nephrolithiasis with hypercalcemia. We investigate further the cause of hypercalcemia and we diagnosed primary hyperparathryoidism as the cause. (Med J Indones. 2012;21:230-4Keywords: Hyponatremia, non-psychogenic polydipsia, primary hyperparathyroidism

  17. One Year On: First-Year Primary Teachers' Perceptions of Preparedness to Manage Misbehaviour and Their Confidence in the Strategies They Use

    Science.gov (United States)

    O'Neill, Sue; Stephenson, Jennifer

    2013-01-01

    This article reports the findings of a one-year follow-up study of Australian beginning primary teachers' perceived preparedness to manage a variety of problematic student behaviours, and their confidence and use of behaviour management strategies based on their preservice coursework in classroom behaviour management. A total of 216 primary…

  18. Disaster and primary health care utilization: a 4 year follow-up.

    NARCIS (Netherlands)

    Dorn, T.; Yzermans, J.; Kerssens, J.; Veen, P. ten

    2005-01-01

    Background: Although crucial for the management of the post-disaster phase, the impact of disasters on primary health care utilization is largely unknown. Often, pre-disaster base-line data is lacking. The current study quantified primary health care utilization after a major fire disaster in The Ne

  19. Legacies, Policies and Prospects: One Year on from the Cambridge Primary Review

    Science.gov (United States)

    Alexander, Robin

    2011-01-01

    This article features the "Cambridge Primary Review." The "Review" has been supported from the beginning by Esmee Fairbairn Foundation, and this has given it the independence which is essential to its credibility. Its remit was to investigate, report and make recommendations on the condition and future of primary education in…

  20. Legacies, Policies and Prospects: One Year on from the Cambridge Primary Review

    Science.gov (United States)

    Alexander, Robin

    2011-01-01

    This article features the "Cambridge Primary Review." The "Review" has been supported from the beginning by Esmee Fairbairn Foundation, and this has given it the independence which is essential to its credibility. Its remit was to investigate, report and make recommendations on the condition and future of primary education in England. Its scope…

  1. Clinical and radiographic sequelae to primary teeth affected by dental trauma: a 9-year retrospective study.

    Science.gov (United States)

    Costa, Vanessa Polina Pereira; Goettems, Marilia Leão; Baldissera, Elaine Zanchin; Bertoldi, Andréa Dâmaso; Torriani, Dione Dias

    2016-08-18

    This retrospective study aimed at determining the predicted risks of clinical and radiographic complications in primary teeth following traumatic dental injuries, according to injury type, severity and child's age. Data were collected from records of children treated at a Dental Trauma Center in Brazil for nine years. Records of 576 children were included; clinical sequelae were assessed in 774 teeth, and radiographic sequelae, in 566 teeth. A total of 408 teeth (52.7%) had clinical sequelae and 185 teeth (32.7%), radiographic sequelae. The type of injury with the highest number of clinical sequelae was the crown-root fracture (86.4%). Clinical sequelae increased with injury severity (p teeth with enamel fracture, and 26.0% (95%CI 14-40) for teeth with enamel dentin fracture as well as enamel dentin pulp fracture. Risk of periapical radiolucency was higher for teeth with enameldentinpulp fracture (61.1% 95%CI 35-82) and those with subluxation (15.8% 95%CI 10-22). Risk of premature loss was 27.3% (95%CI 13-45) for teeth with extrusive luxation, and 10.2% (95%CI 5-17) for those with intrusive luxation. The assessment of predicted risks of sequelae showed that teeth with hard tissue trauma tended to present color change, periapical radiolucency and premature loss, whereas teeth with supporting tissue trauma showed color change, abnormal position, premature loss and periapical radiolucency as the most common sequelae. Knowledge about the predicted risks of complications may help clinicians establish appropriate treatment plans.

  2. Experience with cinacalcet in primary hyperparathyroidism: results after 1 year of treatment

    Science.gov (United States)

    García-Martín, Antonia; Luque-Pazos, Alessandra

    2013-01-01

    Objectives: To assess the characteristics of patients with primary hyperparathyroidism (PHPT) treated with cinacalcet and to evaluate its efficacy in reducing serum calcium and parathyroid hormone (PTH) concentrations after 1 year of treatment. Methods: The study included 20 patients with PHPT who had completed at least 12 months of treatment with cinacalcet (eight patients for refusal of parathyroidectomy, three for surgery not possible due to comorbidities and nine for progressive hypercalcemia prior to surgery). We recorded clinical and biochemical data at baseline, and after 3, 6 and 12 months of treatment. We also monitored adverse events. Cinacalcet was administered in increasing doses until normal serum calcium was reached or side effects preventing a further increase occurred. Results: After 3 months of treatment, serum calcium significantly decreased (11.73 ± 0.85 versus 10.71 ± 1.63 mg/dl, p < 0.001) and serum phosphorus significantly increased (2.41 ± 0.48 versus 2.63 ± 0.70 mg/dl, p = 0.004) while no significant change occurred in PTH (181.91 ± 102.37 versus 195.47 ± 111.71 pg/ml, p = 0.695). No further variation was observed after 6 months compared with 3 months of follow up. However, after 12 months of treatment, there was a significant decrease in PTH concentrations compared with baseline (181.91 ± 102.37 versus 152.47± 70.16 pg/ml, p = 0.028) as well as serum calcium (11.73 ± 0.85 versus 10.20± 0.95 mg/dl, p < 0.001); serum phosphorus significantly increased (2.41 ± 0.48 versus 2.71 ± 0.43 mg/dl, p = 0.01). Normocalcemia (S-Ca < 10.2 mg/dl) was achieved in 55% of patients. The medication was usually well tolerated (83.4%). Most common adverse events were nausea and vomiting, especially at the beginning of therapy. Conclusion: Cinacalcet rapidly reduced serum calcium in patients with PHPT and this reduction remained stable after 1 year of treatment. We also observed a decrease in PTH. Cinacalcet is an effective alternative in nonsurgical

  3. Primary care diabetes bundle management: 3-year outcomes for microvascular and macrovascular events

    National Research Council Canada - National Science Library

    Bloom, Jr, Frederick J; Yan, Xiaowei; Stewart, Walter F; Graf, Thomas R; Anderer, Tammy; Davis, Duane E; Pierdon, Stevem B; Pitcavage, James; Steele, Jr, Glenn D

    2014-01-01

    To determine whether a system of care with an all-or-none bundled measure for primary-care management of diabetes mellitus reduced the risk of microvascular and macrovascular complications compared with usual care...

  4. MODIS/TERRA MOD17A3 Net Primary Production Yearly L4 Global 1km

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The MODerate-resolution Imaging Spectroradiometer (MODIS) Gross Primary Productivity (GPP) products are a cumulative composite of GPP values based on the radiation...

  5. Prevalence of primary headaches and cranial neuralgias in men and women aged 55-94 years (Bruneck Study).

    Science.gov (United States)

    Schwaiger, J; Kiechl, S; Seppi, K; Sawires, M; Stockner, H; Erlacher, T; Mairhofer, M L; Niederkofler, H; Rungger, G; Gasperi, A; Poewe, W; Willeit, J

    2009-02-01

    The aim of the current study was to estimate the prevalence of all primary headaches and cranial neuralgias in the general community. As part of the population-based Bruneck Study, 574 men and women aged 55-94 years underwent extensive neurological and laboratory examinations involving a standardized headache interview. In the Bruneck Study population the lifetime prevalence of all primary headaches combined and of cranial neuralgias was 51.7 and 1.6%, respectively. Tension-type headache (40.9%) and migraine (19.3%) emerged as the most common types of headache. In men and women aged 55-94 years the 1-year prevalence of primary headaches was high at 40.5%. In this age range headaches caused significant impairment of health-related quality of life. The Bruneck Study has confirmed the high lifetime prevalence of primary headaches and cranial neuralgias in the general population and provided first valid prevalence data for all primary headaches based on International Classification of Headache Disorders, 2nd edition criteria.

  6. A digital catalogue of primary type specimens in German ornithological collections - a three year project running within GBIF - Germany - Vertebrata

    NARCIS (Netherlands)

    Elzen, van den R.; Frahnert, S.; Quaisser, C.

    2005-01-01

    The Global Biodiversity Information Facility (GBIF) is an international initiative that aims to enable the worldwide exchange of biodiversity-related data through the internet. Within a three year project funded as a German contribution to GBIF the information about primary types of birds (and other

  7. Relationship between the Phonological Awareness Skills and Writing Skills of the First Year Students at Primary School

    Science.gov (United States)

    Erdogan, Ozge

    2011-01-01

    The purpose of this study was to determine the relationship between the phonological awareness skills and writing skills of the first year students at primary school. In the study, the phonological awareness skills and writing skills of the students were measured at the beginning of the term. Students' writing skills were measured in the middle of…

  8. Two-year evaluation of the atraumatic restorative treatment approach in primary molars class I and II restorations

    NARCIS (Netherlands)

    da Franca, C.; Colares, V.; van Amerongen, E.

    2011-01-01

    Background.  Atraumatic restorative treatment (ART) has the advantages of reducing pain and fear and of being more cost-effective than the traditional approach. Aim.  The aim of this study was to investigate the survival of ART class I and II restorations in primary molars at 2 years. Design.  The s

  9. The 5-year survival following the marginal resection of a primary leiomyosarcoma of the distal femur and a stump fracture.

    Science.gov (United States)

    Plath, J; Gurk, S; Strophal, G; Johnson, M; Jansson, V

    2001-09-01

    In this case, we present a 5-year follow-up of a 3-fault-affected primary leiomyosarcoma of the distal femur (spontaneous fracture treated by osteosynthesis; marginal resection; stump fracture after adequate trauma) with an extended local recurrence but without metastasis.

  10. Challenges for a New Bilingual Program: Implementing the International Baccalaureate Primary Years Programme in Four Colombian Schools

    Science.gov (United States)

    Lochmiller, Chad R.; Lucero, Audrey; Lester, Jessica Nina

    2016-01-01

    The International Baccalaureate (IB) has expanded in Latin America. Drawing from a larger multi-sited qualitative case study, we examined the challenges associated with the implementation of the IB Primary Years Programme (PYP) in a Colombian and bilingual context. Findings highlight (1) the intersecting nature of challenges associated with the…

  11. Challenges for a New Bilingual Program: Implementing the International Baccalaureate Primary Years Programme in Four Colombian Schools

    Science.gov (United States)

    Lochmiller, Chad R.; Lucero, Audrey; Lester, Jessica Nina

    2016-01-01

    The International Baccalaureate (IB) has expanded in Latin America. Drawing from a larger multi-sited qualitative case study, we examined the challenges associated with the implementation of the IB Primary Years Programme (PYP) in a Colombian and bilingual context. Findings highlight (1) the intersecting nature of challenges associated with the…

  12. Primary cutaneous tuberculosis in a 27-year-old medical intern from needle-stick injury: a case report.

    Science.gov (United States)

    Karoney, Mercy Jelagat; Kaumbuki, Erastus Kanake; Koech, Mathew Kiptonui; Lelei, Lectary Kibor

    2015-01-01

    The authors report a case of cutaneous tuberculosis in a 27-year-old African male medical intern who contracted primary cutaneous from a needle-stick injury. Cultures of pus aspirated from the finger initially grew Staphylococcus aureus that led to a delay in the diagnosis.

  13. A digital catalogue of primary type specimens in German ornithological collections - a three year project running within GBIF - Germany - Vertebrata

    NARCIS (Netherlands)

    Elzen, van den R.; Frahnert, S.; Quaisser, C.

    2005-01-01

    The Global Biodiversity Information Facility (GBIF) is an international initiative that aims to enable the worldwide exchange of biodiversity-related data through the internet. Within a three year project funded as a German contribution to GBIF the information about primary types of birds (and other

  14. Changes in abiotic influences on seed plants and ferns during 18 years of primary succession on Puerto Rican landslides

    Science.gov (United States)

    Lawrence R. Walker; Aaron B. Shiels; Peter J. Bellingham; Ashley D. Sparrow; Ned Fetcher; Fred H. Landau; Deborah J. Lodge

    2013-01-01

    Abiotic variables are critical drivers of succession in most primary seres, but how their influence on biota changes over time is rarely examined. Landslides provide good model systems for examining abiotic influences because they are spatially and temporally heterogeneous habitats with distinct abiotic and biotic gradients and post-landslide erosion. In an 18-year...

  15. Cross-protection elicited by primary and booster vaccinations against Japanese encephalitis: a two-year follow-up study.

    Science.gov (United States)

    Erra, Elina O; Askling, Helena Hervius; Yoksan, Sutee; Rombo, Lars; Riutta, Jukka; Vene, Sirkka; Lindquist, Lars; Vapalahti, Olli; Kantele, Anu

    2013-12-17

    The inactivated Vero cell-derived vaccine (JE-VC, IXIARO) has replaced the traditional mouse brain-derived preparations (JE-MB) in travelers' vaccinations against Japanese encephalitis. We showed recently that a single JE-VC dose efficiently boosts immunity in JE-MB-primed vaccinees, and that JE-VC elicits cross-protective immunity against non-vaccine genotypes, including the emerging genotype I. While these studies only provided short-term data, the present investigation evaluates the longevity of seroprotection in the same volunteers. The study comprised 48 travelers who had received (1) JE-VC primary series, (2) JE-MB primary series followed by a single JE-VC booster dose, or (3) JE-MB primary series and a single JE-MB booster dose. Serum samples were collected two years after the last vaccine dose, and evaluated with the plaque-reduction neutralization test against seven Japanese encephalitis virus strains representing genotypes I-IV. PRNT50 titers ≥ 10 were considered protective. Two years after the primary series with JE-VC, 87-93% of the vaccinees proved to be cross-protected against test strains representing genotypes II-IV and 73% against those of genotype I. After a single homologous or heterologous booster dose to JE-MB-primed subjects, the two-year seroprotection rates against genotype I-IV strains were 89-100%. After JE-VC primary series, seroprotection appeared to wane first against genotype I. The first booster should not be delayed beyond two years. In JE-MB-primed subjects, a single JE-VC booster provided cross-protective immunity against genotype I-IV strains in almost all vaccinees, suggesting an interval of two years or even longer for the second booster. These data further support the use of a single JE-VC dose for boosting JE-MB immunity. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Prevalence of early loss of primary teeth in 5-10-year-old school children in Chidambaram town

    Directory of Open Access Journals (Sweden)

    S. Syed Shaheed Ahamed

    2012-01-01

    Full Text Available Introduction : The premature loss of primary teeth may reduce arch length required for the succeeding tooth and, hence, predisposes crowding, rotation and impaction of the permanent teeth. There are only limited studies carried out about the prevalence of early loss of primary teeth. Aim : The present study was performed to evaluate the prevalence of early loss of primary teeth in school children in Chidambaram town in Tamilnadu, India. Settings and Design : A total of 1121 school children (561 boys and 560 girls between 5 and 10 years of age were selected for the study. Materials and Methods : An experienced examiner performed all clinical examinations under natural light. Data including age and missing tooth was collected. Statistical Analysis Used : Microsoft Excel/2000 (Microsoft Office XP data spreadsheet was used and later exported to the Statistical Package for Social Science (SPSS for Windows (version 10.0. Descriptive statistics was applied and, from the results, chi-square tests were applied at a level of significance of 5% (P 0.05. The greatest prevalence was found among the 8-year olds (5.08%, and the most commonly missing teeth were the right lower primary first molars (16.82%. It can be concluded that the prevalence of early loss was high and that the lower primary molars were the most commonly missing teeth in the present study

  17. H.J. Lam, 25 years Director of the Rijksherbarium

    NARCIS (Netherlands)

    Dilmy, Anwari

    1958-01-01

    For twenty five years the tie between the two sister-institutions, the Herbaria at Bogor and at Leyden, has been growing stronger. Great distance, financial trouble and political upheaval have not been able to prevent the continuous development of the spirit of co-operation towards a common ideal: T

  18. [Centralization of health services in primary care in summer: Patients and professionals view during two consecutive years].

    Science.gov (United States)

    Giménez, N; Martínez, J M; Clanchet, T

    2015-01-01

    The Spanish primary health care, gateway and pillar of the Health Care System has his resources increasingly constrained by current crisis. To know the opinion of users and professionals on two primary care centers which centralized in August 2011 and 2012 the attendance of seven primary care centers. Two questionnaires were designed: a telephone survey of a random sample of users and a self-completed questionnaire for health care professionals. The variables were scored on a scale of 1-10 (low to high). Cronbach's coefficient α>0,84. 1293 people responded (836 users and 357 professionals). Users rated, in 2011, the satisfaction with 6.7 points in August and 7.3 points the rest of the year (P<.001). And, in 2012, with 7.7 points in August and 8.1 points the rest of the year (P<.001). Health care professionals, rated their satisfaction with 6.8 points in 2011 and 7.3 points in 2012. The waiting time was the only variable best scores in August that the rest of the year. The perception of the solution given in consultation did not change. Satisfaction, marking, care and treatment were highest rated in the regular center than in the reference center (P<.001). The centralization of primary health care during periods of reduced demand could reduce costs while maintaining quality. The experience of centralizing primary care services during August was perceived as acceptable and improved over time. Users showed a slight, but significant, preference for their usual primary care center. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Primary breast sarcoma: A retrospective study over 35 years from a single institution

    DEFF Research Database (Denmark)

    Holm, Maibritt Provstgaard; Aggerholm-Pedersen, Ninna; Mele, Marco

    2016-01-01

    AIM: The aim of this study was to contribute to the collected knowledge of prognostic factors in primary breast sarcomas (PBS) to the benefit of possible future prospective studies and therapeutic guidelines. METHOD: All patients with pathologically verified PBS in the period of 1979-2014 were...

  20. Ten Years of Reform in Primary Mathematics Education in England: A Review of Effectiveness. Technical Report

    Science.gov (United States)

    Vollaard, Ben A.; Rabinovich, Lila; Bowman, Richard; van Stolk, Christian

    2008-01-01

    The UK National Audit Office (NAO) commissioned RAND Europe to look at the evidence showing the effectiveness of reform of mathematics teaching in primary schools in England. This study looked at government-sponsored evaluations of mathematics reform in England, independent evaluations of the educational outcomes of mathematics reforms in England,…

  1. 100 Years of Primary Curriculum Development and Implementation in Ireland: A Tale of a Swinging Pendulum

    Science.gov (United States)

    Walsh, Thomas

    2016-01-01

    There are ongoing initiatives in curriculum development and implementation in Ireland and internationally in order to enhance the educational experiences and outcomes of learners. This article is the first historical longitudinal analysis of primary school curriculum development and implementation in Ireland from the 1890s to the 1990s. The…

  2. 100 Years of Primary Curriculum Development and Implementation in Ireland: A Tale of a Swinging Pendulum

    Science.gov (United States)

    Walsh, Thomas

    2016-01-01

    There are ongoing initiatives in curriculum development and implementation in Ireland and internationally in order to enhance the educational experiences and outcomes of learners. This article is the first historical longitudinal analysis of primary school curriculum development and implementation in Ireland from the 1890s to the 1990s. The…

  3. Mathematics in Primary Schools (MIPS: A Study of Pupil Progress and Teacher Effectiveness, for Mathematics, in Malta, during the Second Year of the Primary School

    Directory of Open Access Journals (Sweden)

    Lara Said

    2006-05-01

    Full Text Available Contextualisation Engaging in school-effectiveness research in Malta is a relatively new activity. Initial research has found that schools do make a difference for literacy in both Maltese and English (Mifsud, Milton, Brooks and Hutchison, 2000. Further research, particularly in mathematics is clearly needed as this curriculum context constitutes both a basic skill, and an area of study, that can be related to future career prospects (Hutchison and Brooks, 1998. This research note reports the beginning of a ground–breaking study, in the Maltese context, into pupil progress in maths education and the role that teacher effectiveness may play in that progress. Abstract: Value-added measures are one indicator of school effectiveness. This research note poses the question of ‘How are pupil progress and teacher effectiveness related?’ It asks this in the context of the Maltese education system by tracking pupil progress in primary school mathematics, from year 1 to year 2, in relation to teacher instructional style and underlying pedagogical orientation. To do so it outlines a three level school effectiveness study. This will adopt a multi-stage sample involving approximately 2,100 pupils and 99 teachers based in 40 schools of different types. The study will employ the Mathematics In Primary Schools (MIPS methodology as its working framework, informed by the view that consistency, at the school level, involves an alignment between effective instruction, the nature of the curriculum materials themselves, grouping procedures and teacher behaviour.

  4. [What a primary health care is: some considerations after almost thirty five years of Alma-Ata].

    Science.gov (United States)

    Tejada de Rivero, David A

    2013-04-01

    Primary health care was conceived in the 70s as a comprehensive, joint and inclusive strategy to achieve the goal of "Health for Everyone". It was the result of important social, political and economic changes which occurred at global level back in those years and which persist until now. Due to an unfortunate combination of words, Primary Healthcare has been mistakenly understood by many as "healthcare at the basic level" or the "provision of basic, and hence insufficient services to the poorest", wrong concepts that contribute to the current social and health inequalities. This article explains what primary healthcare is and what it is not in order to address the subject in its real context.

  5. Comparative evaluation of formocresol and mineral trioxide aggregate in pulpotomized primary molars--2 year follow up.

    Science.gov (United States)

    Airen, Priyanka; Shigli, Anand; Airen, Bhuvnesh

    2012-01-01

    The aim of the present study was to clinically and radiographically evaluate Mineral Trioxide Aggregate (MTA) as an agent for pulpotomy in primary teeth and to compare it with that of Formocresol (FC) pulpotomy. Seventy first and second primary mandibular molars of children were chosen on patients who required minimum two pulpotomies in either arch or same arch. After the standardized technique of Pulpotomy with MTA and Formocresol, all molars were treated with a thick mix of Zinc oxide Eugenol cement into the coronal pulp chamber followed by preformed stainless steel crown. The children were followed up for clinical and radio graphical examination after 6, 12 and 24 month for Pain, Swelling, Sinus/fistula, Periapical changes, Furcation radiolucency and internal resorption. MTA represents 97% clinical success rate in comparison to Formocresol with 85% success. Radiographically also MTA showed more promising results with 88.6% success in comparison to Formocresol with 54.3%. Thus, MTA pulpotomy has emerged as an easier line of treatment to save the premature loss of primary teeth due to caries or trauma.

  6. Mineral trioxide aggregate and formocresol pulpotomy of primary teeth: a 2-year follow-up.

    Science.gov (United States)

    Ansari, G; Ranjpour, M

    2010-05-01

    To compare the clinical and radiographic response of primary teeth to vital pulpotomy using mineral trioxide aggregate (MTA) or formocresol (FC). A group of 17 children aged 4-9 were selected from those referred to the Paedodontic Department at Shahid Beheshti University, Dental School. Cases with at least two matching teeth were selected (40 teeth), showing signs of pulp involvement. A pulpotomy procedure was carried out in all cases with FC in control teeth whilst MTA was placed in experimental teeth. Clinical and radiographic evaluations were performed at 1-, 6-, 12- and 24-month recall. Statistical analysis using a Fischer exact test was performed on the data to determine significant differences between the groups. Overall, 22 second and 18 first primary molars were included. The gender ratio was one male to three female. No significant difference was found between the clinical and radiographic outcomes of the two groups at 6-, 12- and 24-month follow-up (P > 0.05). Internal resorption was seen significantly more often in FC cases after 12 months than MTA cases. Overall radiographic appearance of normal structures at 24th month was seen in more than 95% of the cases in MTA and 90% in the FC-treated group (P > 0.05). Mineral trioxide aggregate for pulp treatment of primary teeth can be considered a replacement for FC.

  7. Kidney biopsy findings in primary Sjögren syndrome.

    Science.gov (United States)

    Kidder, Dana; Rutherford, Elaine; Kipgen, David; Fleming, Stewart; Geddes, Colin; Stewart, Graham A

    2015-08-01

    Renal involvement is rare in primary Sjögren syndrome (PSS). In this study, we examined renal biopsy findings in patients with PSS and correlated them with their clinical and renal findings. Twenty-five patients with PSS who underwent renal biopsies from two renal units in Scotland between 1978 and 2013 were identified from renal biopsy database. We examined the renal morphologic, clinical and renal findings at the time of renal biopsy, renal and patient outcomes. The diagnosis of PSS preceded renal biopsy in 18/25 patients. In this group, the median duration of the disease was 5.5 years. Significant proteinuria, combined microscopic haematuria and proteinuria and reduced renal excretory function were found in 76, 56 and 84% of patients, respectively. The 3-year actuarial patient survival was significantly lower in patients with glomerulonephritis as compared with tubulointerstitial nephritis (66 versus 100%, P = 0.02). There was no difference in 3-year actuarial renal survival between these two groups (92 versus 92%, P = 1.0). Renal biopsy is rare in PSS and often reveals diverse pathological findings. Glomerulonephritis, as compared with tubulointerstitial nephritis, is associated with higher early mortality. Further studies are needed to evaluate the utility of renal biopsy and its impact on disease management. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  8. Sustained efficacy of risedronate in men with primary and secondary osteoporosis: results of a 2-year study.

    Science.gov (United States)

    Ringe, Johann D; Farahmand, Parvis; Faber, Herbert; Dorst, Alfred

    2009-01-01

    The aim of this study was to assess the effect of treatment with risedronate 5 mg daily relative to control in men with primary or secondary osteoporosis over 2 years. Osteoporosis is a common condition in men that can have serious clinical consequences. In an earlier interim report, we found that 1 year of risedronate therapy resulted in significant increases in bone mineral density (BMD) and a significant reduction in vertebral fractures compared to control in men with osteoporosis. We conducted an open-label, prospective, match-control trial on men with primary or secondary osteoporosis in a single center, outpatient setting. Men with primary or secondary osteoporosis, as defined by a baseline lumbar spine BMD T-score vitamin D (800 IU) or to a control group (daily alfacalcidol (1 microg) plus calcium (500 mg) for those with prevalent vertebral fractures; daily vitamin D (800 IU) plus calcium (1,200 mg) for those without previous vertebral fractures). Primary study end points were identified prior to study initiation as the incidence of new vertebral fractures and changes in BMD at the lumbar spine, femoral neck, and total hip. Other end points included incidence of nonvertebral fractures and change in body height and back pain. Compared to control, the incidence of new vertebral fractures was significantly reduced in the risedronate 5 mg daily group at 2 years [14/152 (9.2%) for risedronate vs. 35/148 (23.6%) for control (61% risk reduction; P = 0.0026)]. Treatment with risedronate 5 mg daily also resulted in significant improvements in BMD at 2 years at all three skeletal sites (lumbar spine, 6.5 vs. 2.2%; femoral neck, 3.2 vs. 0.6%; total hip, 4.4 vs. 0.4% (P back pain were also observed in risedronate-treated patients relative to control. In this 2-year study, daily 5 mg risedronate significantly reduced the risk of vertebral and nonvertebral fractures, improved BMD, decreased height loss, and reduced back pain in men with osteoporosis. Efficacy was

  9. Persistence of T-cell immune response induced by two acellular pertussis vaccines in children five years after primary vaccination.

    Science.gov (United States)

    Palazzo, Raffaella; Carollo, Maria; Bianco, Manuela; Fedele, Giorgio; Schiavoni, Ilaria; Pandolfi, Elisabetta; Villani, Alberto; Tozzi, Alberto E; Mascart, Françoise; Ausiello, Clara M

    2016-01-01

    The resurgence of pertussis suggests the need for greater efforts to understand the long-lasting protective responses induced by vaccination. In this paper we dissect the persistence of T memory responses induced by primary vaccination with two different acellular pertussis (aP) vaccines, hexavalent Hexavac® vaccine (Hexavac) (Sanofi Pasteur MSD) and Infanrix hexa® (Infanrix) (Glaxo-SmithKline Biologicals). We evaluated magnitude and duration of T-cell responses to pertussis toxin (PT) by measuring T-cell proliferation, cytokines (IL-2 and IFNγ) production and memory subsets in two groups of children 5 years after primary vaccination. Some of the enrolled children received only primary vaccination, while others had the pre-school boost dose. Positive T-cell responses to PT were detected in 36% of children. Percentage of responsive children, T-cell proliferation and CD4IL-2+ cells were significantly higher in the children primed with Hexavac than in those who received Infanrix vaccine. No major effects of the boost on PT-specific proliferation were observed. Overall, our data documented a persistence of T-cell memory against PT in a minor fraction of children 5 years after primary vaccination. The different responses induced by Hexavac and Infanrix vaccine could rely on differences in PT inactivation process or excipients/adjuvants formulations.

  10. Primary Antiphospholipid Syndrome Associated with Pneumonia: A Case Report of a 16-Year-Old Male Patient

    Directory of Open Access Journals (Sweden)

    Süreyya Yilmaz

    2015-01-01

    Full Text Available Antiphospholipid syndrome (APS is an autoimmune disease characterised by arterial and/or venous thrombosis and/or recurrent pregnancy loss in the presence of antiphospholipid (APL antibodies. It is evaluated as APS when it develops associated with other systemic autoimmune diseases or primary APS if there is no concomitant disorder. In this study, we present a case of a 16-year-old male patient with primary APS. The patient was admitted with presumptive diagnosis of pneumonia, but multiple pulmonary thromboembolism (PTE was observed on computerized tomography (CT pulmonary angiography. APL antibodies positivity and thrombocytopenia developed in our patient. The patient was evaluated as primary APS since another etiology that could explain PTE was not found. Primary APS is a rare disease in children along with adolescents, compared with APS associated with other systemic autoimmune diseases. We present here a young male patient with primary APS and PTE to contribute to the literature. The patient initially had pneumonia but later developed PTE and thrombocytopenia.

  11. Subgingival bacteria in a case of prepubertal periodontitis, before and one year after extractions of the affected primary teeth.

    Science.gov (United States)

    Ram, D; Bimstein, E

    1994-01-01

    The treatment of children with prepubertal periodontitis (PP), may be complicated by the extent of the lesions and the possibility of tetracycline stain of the developing permanent dentition. Therefore, with the purpose of preventing the infection of permanent teeth during the mixed dentition, it has been recommended that the treatment of children with PP, should include the early extraction of the primary teeth affected with alveolar bone loss (ABL). Still, there is little evidence which confirms that extraction of the affected primary teeth do in fact reduce the periodonto-pathogens load of the subgingival plaque. The present study reports values of colony forming units (CFU) of total anaerobic bacteria, Actinobacillus actynomicetemcomitans (Aa) and Porphyromonas gingivalis (Pg) from the subgingival plaque from a child with PP, collected immediately before and 1 year after extractions of the primary teeth affected with ABL. CFU of Aa and Pg developed only from the subgingival plaque collected before the extraction of the primary teeth affected with ABL. These findings suggest that in cases of PP, extraction of the affected primary teeth may reduce the possibility of infection of the periodontum of the permanent teeth during the mixed dentition period.

  12. Primary tuberculosis of the adenoids in an 11-year-old male presenting with hearing loss: a case report.

    Science.gov (United States)

    Taghipour-Zahir, S; Baradaranfar, M H; Zolfaghari, A A

    2013-04-01

    Hypertrophy of adenoids is usually caused by repeated throat infections, especially viral and bacterial infections, that in microscopic examination reveal reactive lymphoid follicular hyperplasia. Herein, we present an 11-year-old boy who developed hearing loss in his left ear three months before admission, and in direct examination the adenoids were hypertrophied. Histopathological study of the resected adenoid revealed caseating granulomatous inflammation. Based on histopathological and clinical findings, primary tuberculosis of adenoids was suggested which was confirmed by PCR.

  13. Evaluation of a primary care adult mental health service: Year 2.

    Science.gov (United States)

    McHugh, Patrick; Brennan, John; Galligan, Niall; McGonagle, Claire; Byrne, Michael

    2013-01-01

    Aims This study aimed to examine the effectiveness of a primary care adult mental health service operating within a stepped care model of service delivery. Methods Supervised by a principal psychologist manager, psychology graduate practitioners provided one-to-one brief cognitive behavioural therapy (CBT) to service users. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) was used to assess service user treatment outcomes. Satisfaction questionnaires were administered to service users and referring general practitioners (GPs). Results A total of 43 individuals attended for an initial appointment, of whom 19 (44.2%) completed brief CBT treatment. Of the 13 service users who were in the clinical range pre-treatment, 11 (84.6%) achieved clinical and reliably significant improvement. Of the six service users who were in the non-clinical range pre-treatment, three (50%) achieved reliably significant improvement. Both service users and GPs indicated high levels of satisfaction with the service, although service accessibility was highlighted as needing improvement. Conclusion The service was effective in treating mild to moderate mental health problems in primary care. Stricter adherence to a stepped care model through the provision of low-intensity, high-throughput interventions would be desirable for future service provision.

  14. Caries experience in the primary dentition and presence of plaque in 7-year-old Chinese children: A 4-year time-lag study.

    Science.gov (United States)

    Hu, Xuan; Fan, Mingwen; Mulder, Jan; Frencken, J E

    2015-01-01

    The aim of the present study was to test the hypothesis that dental caries prevalence and caries experience in primary dentitions has increased over 4 years and to compare the presence of plaque on permanent teeth in child cohorts over 4 years. A time-lag study design was used comprising two cohorts of children aged 7 years from the same five primary schools in Wuhan examined in 2007 and 2011. Two calibrated examiners visually assessed plaque accumulation according to the Greene and Vermillion Index and the dentitions according to the Atraumatic Restorative Treatment (ART) caries criteria. Analysis of variance (ANOVA), logistic regression, and Chi-square test were used to test for differences between dependent and independent variables. The 2007 sample consisted of 817 children and the 2011 sample consisted of 1010 children. The prevalence of dental caries (d3mft) was 68.2% in 2007 and 67.7% in 2011, while that of d2mft was 78.5% in 2007 and 71.4% in 2011 (P educational authorities should collaborate in setting up programs aimed at ensuring good oral health for school children.

  15. Latest developments in biofilm technologies for wastewater treatment: Twenty five years of research of the environmental engineering group (University of Cantabria, Spain); Tecnologias de biopelicula innovadoras para la depuracion de aguas residuales: veinticinco anos de investigacion del Grupo de Ingenieria Ambiental de la Universidad de Camtabria

    Energy Technology Data Exchange (ETDEWEB)

    Tejero Monzon, J. I.; Esteban-Garcia, A. L.; Florio, L. del; Diez Montero, R.; Lobo Garcia de Cortazar, A.; Rodriguez-Hernandez, L.

    2012-07-01

    Biological wastewater treatments are based on the use of active biomass, or set of organisms, in charge of carrying out the removal of contaminants. the biomass can be dispersed in suspension within the bulk liquid (activated sludge processes) or attached to a support media (biofilm processes). Biofilm technology was historically the first to be spread and applied. Nevertheless, since the 1950s, activated sludge technology gained more and more popularity given the supposed operation simplicity and higher quality of the effluent. Recently, new developments pushed forward the biofilm technology again. In this context, the Environmental Engineering Group of the University of Cantabria, since its foundation more than 2 decades ago, has been working on research and development of innovative wastewater treatment technologies based on biofilm. In this article, the know-how of the Group is illustrated, including the development of innovative submerged fixed bed reactors with and without (micro) filtration membranes, processes of biofilm supported by and aerated through membranes, as well as integrated systems (hybrid or combined) aimed at nutrient removal. submerged aerated fixed technologies, especially in hybrid configuration, as much as sludge blanket reactors (combined with biofilm processes) allow for increasing biomass concentration and may provide an attractive solution to upgrade existing WWTP. In combination with membrane filtration, they produce an effluent suitable for reuse o discharge in sensitive areas. On the other, hand, the possibility of aerating (diffusing the gas) directly through the membrane lumen into the biomass thereby grown, without need of oxygenating the whole wastewater flow to be treated, may be a real energetic paradigm shift. The developed technologies are here described alongside their experimental and modeling assessment, ranging from laboratory and bench scale up to pilot scale systems treating real municipal wastewater. (Author)

  16. LIPID PROFILE OF POLISH PRIMARY CARE PATIENTS AGED 35-55 YEARS LIVING IN THE DISTRICT OF PLESZEW.

    Science.gov (United States)

    Hoffmann, Karolina; Matyjaszczyk, Piotr; Zaporowska-STACHOWIAK, Iwona; Kostrzewska, Magdalena; Piorunek, Tomasz; Minczykowskp, Andrzej; Bryl, Wieslaw

    2016-01-01

    In Poland, more than half of the adult population suffers from lipid disorders. Among the 18 million Polish people with hypercholesterolemia, over 10.8 million are unaware of this problem. To estimate the lipid profile of selected primary care patients in the district of Pleszew (Western Poland), general practitioners (GPs) recruited 681 patients aged 35-55 years in 2011. Fasting serum lipids were evaluated. We found statistically significant differences in all lipid parameters between all younger (35-45 years) and older (46-55 years) patients, between all female and male subjects, between women and men ages 35-45 years; in total cholesterol (TC), LDL-cholesterol (LDL-C) and triglycerides (TG) between younger and older female population; in HDL-cholesterol (HDL-C) and TG between women and men ages 46-55 years. Dyslipidemia, both, newly detected and previously treated, was detected in 591 patients (86.8%): 322 females (84.3%) and 269 males (90.0%). The highest percentage of lipid disorders was found in males aged 46-55 years (91.9%) and the lowest among women aged 35-45 years (78.0%). Age and gender differences in the prevalence of dyslipidemia proved of statistical importance. Among 155 patients on lipid-lowering therapy, only 28 subjects (18.1%) reached the target value of serum lipids. The prevalence of lipid disorders among primary care patients aged 35-55 years in the district of Pleszew was significantly high, and it was proved that dyslipidemia is statistically prominent in males and older patients. Polish healthcare professionals should make more efforts to improve the detection and treatment of lipid disorders.

  17. Hypertension Screening and Follow-up Management by Primary Health Care System among Chinese Population Aged 35 Years and Above

    Institute of Scientific and Technical Information of China (English)

    FENG Ya Jing; WANG Hui Cheng; LI Yi Chong; ZHAO Wen Hua

    2015-01-01

    Objective To describe hypertension screening and follow-up management among Chinese population aged 35 years and above within the primary health care system. Methods Data from 2010 China Chronic Disease and Risk Factor Surveillance System were used. We investigated previous hypertension diagnosis, screening, and follow-up assessments within the primary health care system. The prevalence of self-reported and criterion-based hypertension, screening rates, demographic and socioeconomic characteristics associated with screening, and patterns of follow-up assessments were recorded. The SAS software system was used for statistical analyses. Results About 17.1% reported a previous hypertension diagnosis. The rate difference between the two measures of prevalence was 27.2%. Among those without self-reported hypertension, 27.7%reported never visiting a clinic during the past 1 year and 60.4%of those attending a clinic reported ever being screened. Younger age group was associated with lower screening proportion;odds ratios of 35-, 45-, 55-, and≥65 years were 1.7 (95%CI:1.5-1.9), 1.5 (95%CI:1.3-1.7), 1.3 (95%CI:1.2-1.4), and 1.0, respectively. About 35.1% of the patients had undergone follow-up assessments four or more times during the past 1 year. Conclusion Majority of the Chinese population aged 35 years and above, particularly the less educated, elderly population, and rural residents were unaware of that they were suffering from hypertension. Most patients did not receive enough management services by the primary health care system. Thus, strengthening both the screening and follow-up management is needed.

  18. Primary and repeated stapled hemorrhoidopexy for prolapsing hemorrhoids: Follow-up to five years

    DEFF Research Database (Denmark)

    Raahave, D.; Pedersen, I.K.; Jepsen, Lars Vedel

    2008-01-01

    was designed to assess initial results, analyze complications and failures, and document both the need for repeated procedures and the outcomes of follow-up to five years. Methods: From 1998 to 2004, 258 patients underwent modified stapled hemorrhoidopexy. The appearance of the anus was scored preoperatively......, immediately after the procedure, at three months, and at one to five years postoperatively. The anatomy score ranged from 1 (normal anus) to 7 (worst prolapse). We also evaluated operation time, analgesia, staple line position, postoperative pain score, technical failures, postoperative complications, need...... of 258 patients (7 percent). The median anatomy score decreased from 6 (range, 3-7) preoperatively to 1 (range, 1-6) at last follow-up, irrespective of one or a repeated stapled hemorrhoidopexy, surgical excision, or technical failure. The risk of reintervention was greatest during the first year after...

  19. Podcast Lectures as a Primary Teaching Technology: Results of a One-Year Trial

    Science.gov (United States)

    Taylor, Mark Zachary

    2009-01-01

    How useful are podcasts in the political science classroom? Some educators argue that podcasts will revolutionize education; others are less convinced. However, to date, the evidence on podcasts has been slim. This article reports the results of a year-long trial using podcasts to aid in teaching political science to undergraduates at a research…

  20. Prognostic factors in primary adenocarcinoma of the small intestine: 13-year single institution experience

    Directory of Open Access Journals (Sweden)

    Jacobs Michael J

    2008-01-01

    Full Text Available Abstract Background Adenocarcinoma of the small bowel is a relatively rare malignancy as compared to the other malignancies of the gastrointestinal tract. Nonspecific presentation and infrequent occurrence often leads to a delay in diagnosis and consequent poor prognosis. Various other factors are of prognostic importance while managing these tumors. Methods The medical records of a total of 27 patients treated for adenocarcinoma of the small bowel at Providence Hospital and Medical Centers from year 1990 through 2003 were reviewed retrospectively. Data were analyzed using SPSS software (version 10.0; SPSS, Inc., Chicago, IL. Survival analyses were calculated using the Kaplan Meier method with the log rank test to assess the statistical significance. The socio-demographics (age, gender were calculated using frequency analyses. Results The patients included nine males and eighteen females with a median age at diagnosis of 62 years. Only 48% of the patients had an accurate preoperative diagnosis while another 33% had a diagnosis suspicious of small bowel malignancy. None of the patients presented in stage 1. The cumulative five-year survival was 30% while the median survival was 3.3 years. There was no 30-day mortality in the postoperative period in our series. Conclusion The univariate analysis demonstrated that tumor grade, stage at presentation, lymph nodal metastasis and resection margins were significant predictors of survival.

  1. Teacher's Scaffolding over the Year to Develop Norms of Mathematical Inquiry in a Primary Classroom

    Science.gov (United States)

    Makar, Katie; Bakker, Arthur; Ben-Zvi, Dani

    2015-01-01

    Developing mathematical inquiry practices requires that teachers are explicit about classroom norms that support these practices. In this study, we asked: "How can a teacher scaffold the development of norms and practices in mathematical inquiry over time?" Analysis of classroom video over a year showed that the teacher constantly…

  2. A Healthy Start: Promoting Mental Health and Well-Being in the Early Primary School Years

    Science.gov (United States)

    Cefai, Carmel; Camilleri, Liberato

    2015-01-01

    Mental health problems in children represent a significant international health concern, with up to one in five children using mental health services during the course of any given year. Identifying the processes of what prevents social, emotional and behaviour difficulties (SEBD) and promotes healthy development from an early age can make a…

  3. Podcast Lectures as a Primary Teaching Technology: Results of a One-Year Trial

    Science.gov (United States)

    Taylor, Mark Zachary

    2009-01-01

    How useful are podcasts in the political science classroom? Some educators argue that podcasts will revolutionize education; others are less convinced. However, to date, the evidence on podcasts has been slim. This article reports the results of a year-long trial using podcasts to aid in teaching political science to undergraduates at a research…

  4. Factors increasing the caries risk of second primary molars in 5-year-old Dutch children

    NARCIS (Netherlands)

    Elfrink, Marlies E C; Schuller, Annemarie A; Veerkamp, Jaap S J; Poorterman, Jan H G; Moll, Henriette A; ten Cate, Bob J M

    2010-01-01

    BACKGROUND: Caries is still a prevalent condition in 5-year-old children. At present, knowledge regarding some aetiological factors, like deciduous molar hypomineralization (DMH), is limited. AIM: To investigate aetiological factors both directly and indirectly associated with caries in second prima

  5. Teacher's scaffolding over the year to develop norms of mathematical inquiry in a primary classroom

    NARCIS (Netherlands)

    Makar, Katie; Bakker, A.; Ben-Zvi, Dani

    2015-01-01

    Developing mathematical inquiry practices requires that teachers are explicit about classroom norms that support these practices. In this study, we asked: How can a teacher scaffold the development of norms and practices in mathematical inquiry over time? Analysis of classroom video over a year show

  6. Primary localized conjunctival amyloidosis: A case report with a ten-year follow-up period

    Directory of Open Access Journals (Sweden)

    Juan Carlos Mesa-Gutiérrez

    2008-10-01

    Full Text Available Juan Carlos Mesa-Gutiérrez, Tomás Martí Huguet, Noemí Barnils Garcia, Jorge Arruga GinebredaDepartment of Ophthalmology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, SpainAbstract: A 57-year-old woman consulted our department about a plaque that had been present in her left eye for one year. Ophthalmological examination revealed a solid mass in the left conjunctival semilunar fold. An excitional biopsy was peformed, revealing an amyloid deposition. The patient was referred to the Internal Medicine Department for systemic study. All studies were negative for systemic amyloidosis. Throughout ten years of follow-up study, the patient has shown neither conjunctival recurrence nor any evidence of systemic amylodosis. Despite the fact that several authors have described ocular amyloidosis as an ophthalmologic manifestation of systemic amyloidosis, conjunctival location of amyloidosis is a very rare condition. Amyloid characterization in ocular structures should not be considered a final diagnosis since involvement of systemic underlying diseases must be ruled out. We report a case of localized conjunctival amyloidosis with a ten-year follow-up period that excluded ocular or systemic diseases.Keywords: conjuctival amyloidosis, ocular amyloidosis, hyaline protein

  7. Rare case of primary spinal ependymomatosis occurring in a 26-year-old man: a case report

    Directory of Open Access Journals (Sweden)

    Kaliaperumal Chandrasekaran

    2009-10-01

    Full Text Available Abstract Introduction The authors report a rare case of primary spinal ependymomatosis in a young adult man. Multiple primary ependymomatous lesions were seen on magnetic resonance imaging and no anaplasia was identified on the surgical-pathological analysis. The aetio-pathological mechanism and surgical significance of this rare occurrence is discussed. Case presentation A 26-year-old man of Polish origin presented with a ten-day history of pain in the left leg and lower back. This was followed by difficulty in urinating and a decrease in sensation in both legs. Examination revealed pyramidal signs and mild weakness in both lower limbs. He had early sphincter involvement requiring catheterization. Magnetic resonance imaging of the brain was normal. However, that of the spinal cord revealed multiple intradural spinal lesions, both intra- and extramedullary, extending from the cervical cord down to the cauda equina roots. T12-L1 laminectomy was performed. Multiple intradural, extra- and intra-medullary tumors were seen. After the operation, the patient deteriorated with a sensory level at T4. Post-operative cranio-spinal radiotherapy was administered but there was no clinical improvement in the lower limbs. Conclusion Primary spinal ependymomatosis is a rare phenomenon involving multiple spinal segments in the absence of a primary intracranial tumor. Radical excision is unrealistic in this condition. Biopsy followed by radiotherapy is the preferred method of treatment.

  8. Long-term photographic and radiographic assessment of bonded resin composite strip crowns for primary incisors: results after 3 years.

    Science.gov (United States)

    Kupietzky, Ari; Waggoner, William E; Galea, Jon

    2005-01-01

    The aim of this study was to examine the photographic and radiographic success of the treatment of maxillary anterior primary incisors with composite resin strip crowns (SCs) placed in a private-practice setting after a minimum of 18 months. This was a retrospective, clinical study of patients who had SCs placed on primary maxillary incisors, returned for at least one 18-month recall examination, and whose parents consented to participate in the study. Radiographic and photographic examinations were used for evaluation. Two evaluators rated the images independently. One hundred forty-five restorations, placed in 52 children, were evaluated. The evaluations were performed after the crowns had been in place for an average of 31.3 months. None of the restorations were totally lost: 20% were rated as having lost some resin material, resulting in an 80% overall retention rate; 92% of the teeth demonstrated healthy pulps; 6% had some pulpal changes, but did not require immediate attention. Only 2 teeth showed radiographic evidence of pulpal pathology requiring treatment. SCs performed well for restoring primary incisors with large or multisurface caries for periods of over 3 years. This study suggests that SCs are likely to be successful and may be indicated as an excellent treatment choice for carious primary incisors with adequate tooth structure after caries removal, especially if esthetic concerns predominate.

  9. Successful Restoration of Severely Mutilated Primary Incisors Using a Novel Method to Retain Zirconia Crowns - Two Year Results.

    Science.gov (United States)

    El Shahawy, Osama Ibrahim; O'Connell, Anne C

    This manuscript describes a simple reliable technique for restoring severely mutilated primary anterior teeth. A rigid glass ionomer post is created over which zirconia crowns can be fitted to achieve a long-term stable esthetic restoration for primary anterior teeth. Children aged 2-5 years with two up to six extensively decayed upper primary incisors were included. Fuji IX was condensed into an intracanal space created to a depth of 3mm, to provide a core which also extended 3mm supragingivally. Crown preparations were completed upon these cores. Zirconia crowns (Nusmile, Houston Texas USA) were fitted and cemented over the prepared cores. All patients were recalled at regular intervals. Twenty-three healthy children with 86 restorations participated in the study. The overall survival of the restorations was 95.3% after 12 months and 80.2% after 24 months. According to Kaplan-Meier survival analysis, the median survival time was not reached while the estimated mean survival time was 22.9 months. This newly described clinical technique is simple and reliable to use for restoration of extensively decayed primary incisors. Use of zirconia crowns retained using this technique offers superior esthetic, durable restorations with remarkable gingival response up to 24 months.

  10. Depression and Anxiety Screens as Simultaneous Predictors of 10-Year Incidence of Diabetes Mellitus in Older Adults in Primary Care.

    Science.gov (United States)

    Khambaty, Tasneem; Callahan, Christopher M; Perkins, Anthony J; Stewart, Jesse C

    2017-02-01

    To examine depression and anxiety screens and their individual items as simultaneous predictors of incident diabetes mellitus. Ten-year follow-up study of individuals screened for the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) trial. Two large urban primary care clinics in Indianapolis, Indiana. Diverse sample (53% African American, 80% of lower socioeconomic status) of 2,156 older adults initially free of diabetes mellitus. Depression and anxiety screens were completed during routine primary care visits between 1999 and 2001. Incident diabetes mellitus data were obtained from an electronic medical record system and the Centers for Medicare and Medicaid Services analytical files though 2009. Over the 10-year period, 558 (25.9%) participants had diabetes mellitus onset. Cox proportional hazards models adjusted for demographic and diabetes mellitus risk factors revealed that a positive screen for anxiety, but not for depression, predicted incident diabetes mellitus when entered into separate models (anxiety: hazard ratio (HR) = 1.36, 95% confidence interval (CI) = 1.15-1.61, P anxiety: HR = 1.35, 95% CI = 1.12-1.61, P anxiety is a risk factor for diabetes mellitus in older adults independent of depression and traditional diabetes mellitus risk factors. Anxiety requires greater consideration and awareness in the context of diabetes mellitus risk assessment and primary prevention. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  11. Metastatic melanoma after 23 years of primary ocular melanoma.

    LENUS (Irish Health Repository)

    Karde, Supriya Ramesh

    2016-11-23

    We describe a case of 52-year-old man who presented with an episode of tonic-clonic seizures. He had right ocular melanoma 23 years ago with subsequent enucleation which was the standard treatment at that time. CT scans of the brain and of the thorax-abdomen-pelvis revealed widespread metastatic lesions in the brain, lung and liver. Further investigations including bronchoscopy with cytopathology uncovered that the metastatic disease was a recurrence of ocular melanoma. He received palliative radiotherapy and died 6 months later. Ocular melanoma is often associated with fulminant metastatic disease after a period of dormancy. Thus, despite successful treatment of the localised disease at initial presentation, an effort is needed for optimal long-term follow-up plan in order to improve survival in case of recurrence.

  12. Khayelitsha 2001 - 2011: 10 years of primary care HIV and TB programmes

    Directory of Open Access Journals (Sweden)

    Daniela Belen Garone

    2011-12-01

    Full Text Available Tuberculosis (TB and HIV care in Khayelitsha, and in South Africa as a whole, has overcome numerous obstacles in the past three decades. This article highlights what has been achieved in Khayelitsha, describes the key clinical programme and policy changes that have supported universal coverage for HIV and TB care over the last 10 years, and outlines the challenges for the next decade.

  13. Primary radiotherapy of prolactinomas. Eight- to 15-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Mehta, A.E.; Reyes, F.I.; Faiman, C.

    1987-07-01

    Eight women with amenorrhea, galactorrhea, and hyperprolactinemia, of whom six had macroadenomas and two had microadenomas, were treated with conventional (cobalt-60) external radiotherapy, and their progress was monitored for eight to 15 years. Normoprolactinemia was established in five of these patients after two to 13 years (median, nine years). A recurrence was treated surgically in one patient, and stable prolactin values and roentgenographic features have been maintained in two patients. Hypopituitarism has developed in only one patient to date, and no other complications of radiotherapy have been observed. These findings, together with the few previous reports on the long-term effects of radiotherapy on macroprolactinomas, have been compared with the long-term results following surgery or dopamine agonist therapy. The normalization of prolactin values is considerably delayed following radiotherapy compared with the other two therapeutic modalities. However, radiotherapy affords permanent normalization without recurrence in a larger percentage of patients than does surgery and avoids the considerable ongoing cost and inconvenience of daily drug ingestion. The long-term development of hypopituitarism appears to be an acceptably small risk of radiotherapy. Thus, conventional radiotherapy is an attractive treatment option, particularly for macroprolactinomas; adjunctive bromocriptine can be used while awaiting the longer-term benefits of radiotherapy.

  14. Do Well-Balanced Primary TKA Patients Achieve Better Outcomes Within the First Year After Surgery?

    Science.gov (United States)

    Lampe, Frank; Marques, Carlos J; Fiedler, Franziska; Sufi-Siavach, Anusch; Matziolis, Georg

    2016-05-01

    Some surgically modifiable factors are related to soft tissue balance. With computer-assisted surgery, it is possible to access these variables quantitatively. The aim of this analysis was to study the influence of gap balance on clinical outcomes within the first year after computer-navigated total knee arthroplasty (TKA). Based on navigation data, 3 independent variables reflecting gap balance were used to split the patients in 2 groups. The Knee Society Scores (Function [KSS-F] and Knee [KSS-K]) and the maximal knee flexion (MKF) measured preoperatively and at 3, 6 and 12 months were compared using analyses of variance (2×4 design) for repeated measures. Higher flexion-extension gap equality led to statistically higher KSS-F and KSS-K scores at 1 year (P=.02). Higher medial-lateral flexion gap equality led to superior mean MKF at all measurement points; however the differences were statistically only significant at 3 months (P=.01). The coefficients of variation of the variables used to select the patients were overall very low. With computer-assisted navigation, it is possible to access quantitatively the size of the medial and lateral flexion and extension gaps. Higher flexion-extension gap equality values led to statistically significant better KSS-F and KSS-K scores at 1 year. Higher medial-lateral flexion gap equality values led to better MKF values; however the differences were only statistically significant at 3 months. [Orthopedics. 2016; 39(3):S6-S12.].

  15. Knowledge of primary health care and career choice at primary health care settings among final year medical students - challenges to human resources for health in Vietnam.

    Science.gov (United States)

    Giang, Kim Bao; Minh, Hoang Van; Hien, Nguyen Van; Ngoc, Nguyen Minh; Hinh, Nguyen Duc

    2015-01-01

    There is a shortage of medical doctors in primary health care (PHC) settings in Vietnam. Evidence about the knowledge medical students have about PHC and their career decision-making is important for making policy in human resources for health. The objective of this study was to analyse knowledge and attitudes about PHC among medical students in their final year and their choice to work in PHC after graduation. A cross-sectional study was conducted among 400 final year general medical students from Hanoi Medical University. Self-administered interviews were conducted. Key variables were knowledge, awareness of the importance of PHC and PHC career choices. Descriptive and analytic statistics were performed. Students had essential knowledge of the concept and elements of PHC and were well aware of its importance. However, only one-third to one half of them valued PHC with regard to their professional development or management opportunities. Less than 1% of students would work at commune or district health facilities after graduation. This study evidences challenges related to increasing the number of medical doctors working in PHC settings. Immediate and effective interventions are needed to make PHC settings more attractive and to encourage medical graduates to start and continue a career in PHC.

  16. Prevalence and tracking of weight disorders in Italian primary school students: a three-year follow-up.

    Science.gov (United States)

    Toselli, Stefania; Ventrella, Angela R; Brasili, Patricia

    2012-03-01

    Obesity has been widely described as the latest epidemic, and in some areas obesity co-exists with undernutrition. The purpose of this study was to assess the variability of weight status of a cohort of 279 Italian primary school students followed longitudinally for three years. Overweight was the most common weight status disorder in both sexes and generally prevailed in females. Underweight was also more frequent in females than males, while males generally showed a higher incidence of obesity. Overweight showed the highest stability in females. In males, tracking of overweight was 62.5%, while that of normal weight was 89.36%. Overweight tracks through the three consecutive years in a high percentage of both sexes. In the whole sample (regardless of sex and weight category), overweight shows the highest increase over the three-year period. This study provides public health professionals with useful data for policy planning in regard to childhood obesity.

  17. Subjective memory complaints in primary care patients and death from all causes: a four-year follow-up

    DEFF Research Database (Denmark)

    Siersma, Volkert Dirk; Waldemar, Gunhild; Waldorff, Frans Boch

    2013-01-01

    -related quality of life were collected at the enrolment primary care consultation. Dates of death from all causes occurring during the four-year follow-up were retrieved from the national databases. Cox proportional hazard regression models on time to death (censored after four years) were used to examine......OBJECTIVE: To investigate the prognostic value of subjective memory complaints for all-cause mortality in order to determine whether elderly persons with subjective memory complaints may be regarded as a group of vulnerable patients who need close follow-up. DESIGN: Prospective cohort study...... the influence of subjective memory complaints on all-cause mortality. RESULTS: 88 patients died during the four-year follow-up. The association between subjective memory complaints and mortality had a statistically not significant hazard ratio (HR) of 0.91, adjusting for known confounders. Statistically...

  18. Incidental Radiographic Discovery of a Screw in a Primary Molar: An Unusual Case Report in a 6 Year Old Child

    Directory of Open Access Journals (Sweden)

    Farhin Katge

    2013-01-01

    Full Text Available Dentists often find foreign bodies in the primary dentition of children who habitually place objects in their mouths. The objects are frequently embedded in exposures that result from carious or traumatic lesions or from endodontic procedures that have been left open for drainage. Such bodies are often detected on routine radiographs and, less frequently, during clinical examination. We report a case of a 6-year-old boy who had inadvertently embedded a screw in his mandibular right first primary molar and had forgotten about it until it became symptomatic. The screw was impacted in the exposed pulp chamber due to a large carious lesion in the affected molar. This case report considers the possible medical and dental consequences of placing foreign bodies in the mouth.

  19. Maintenance pharmacotherapy for recurrent major depressive disorder in primary care: A 5-year follow-up study.

    Science.gov (United States)

    Riihimäki, K; Vuorilehto, M; Isometsä, E

    2017-03-01

    Most practice guidelines recommend maintenance antidepressant treatment for recurrent major depressive disorder. However, the degree to which such guidance is actually followed in primary health care has remained obscure. We investigated the provision of maintenance antidepressant treatment within a representative primary care five-year cohort study. In the Vantaa Primary Care Depression Study, a stratified random sample of 1119 adult patients was screened for depression using the Prime-MD. Depressive and comorbid psychiatric disorders were diagnosed using SCID-I/P and SCID-II interviews. Of the 137 patients with depressive disorders, 82% completed the prospective five-year follow-up. A graphic life chart enabling evaluation of the longitudinal course of episodes plus duration of pharmacotherapies was used. In accordance with national guidelines, an indication for maintenance treatment was defined to exist after three or more lifetime major depressive episodes (MDEs); maintenance treatment was to commence four months after onset of full remission. Of the cohort patients, 34% (46/137) had three or more lifetime MDEs, thus indicating the requirement for maintenance pharmacotherapy. Of these, half (54%, 25/46) received maintenance treatment, for only 29% (489/1670) of the months indicated. In this cohort of depressed primary care patients, half of patients with indications for maintenance treatment actually received it, and only for a fraction of the time indicated. Antidepressant maintenance treatment for the prevention of recurrences is unlikely to be subject to large-scale actualization as recommended, which may significantly undermine the potential public health benefits of treatment. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. Spontaneous Rupture of Primary Hepatocellular Carcinoma: Experience of Emergency Laparotomy over a 16-Year Period

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE Spontaneous rupture is an uncommon complication of primary hepatocellular carcinoma (HCC). There is no standard method of treatment, and most often treatment depends on the condition of the patient or the assessment by the surgeon. The aim of this study was to evaluate our experience of emergency laparotomy in the management of spontaneous rupture of HCC.METHODS Retrospective analysis documented 49 rupture HCC cases who received emergency laparotomy from Oct. 1990 to Oct. 2006.RESULTS Thirty-nine cases (79.6%) had a history of hepatitis and 39 cases (79.6%) were accompanied with liver cirrhosis. The most frequent manifestation which was present in 47 cases (95.9%) was sudden right hypochondrial or epigastric pain. Shock was seen in 40 cases (81.6%), and 42 cases (85.7%) had signs of peritonitis. The methods of operation were performed in the number of cases as follows: suture in 5; packing in 2; hepatic artery ligation in 4; hepatectomy in 21; microwave coagulation in 5;microwave coagulation combined with packing in 3; microwave coagulation combined with hepatic artery ligation in 9. Morbidity occurred in 11 cases (22.4%). The overall hospital mortality rate was 10.2%. The mean survival time was 8.8 months. The main causes of death were liver failure and massive variceal bleeding.CONCLUSION Spontaneous rupture of HCC represents a life-threatening condition with an overall poor prognosis. Laparotomy should be the first choice for treating HCC rupture if the proper conditions are present. Liver failure is the vital condition influencing the prognosis.

  1. EVALUATION OF TWO SURGICAL TREATMENTS OF PRIMARY VESICOURETERAL REFLUX AMONG CHILDREN: A 15 YEARS EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Memeti Shaban

    2016-07-01

    Full Text Available Aim: aim of the study was to evaluate the efficiency of two different surgical treatments of vesicoureteral reflux (VUR on succesfull rate and patient outcome. Methods: Retrospective study on children with primary VUR and their surgical treatment from 1999 to 2014 in the University Clinic for Pediatric Surgery in Skopje. A total of 76 children (114 ureters with VUR ranging from second to fifth grade were treated surgically, 44 patients (67 ureters with an open surgical technique and 32 patients (47 ureters with endoscopic treatment ”STING” procedure. The following parameters were analyzed: duration of the intervention, duration of the hospitalization, the need for antibiotics and analgesic therapy and the need for blood and blood derivatives transfusion. The result of the surgical treatment was also validated. A good result was considered when reduction of VUR by 2 degrees with the endoscopic method or by 3 degrees in the open surgical technique was noticed. Results: Using open surgical technique, patients were hospitalized for an average of 9 days (range from 5 to 13 days. All children received double antibiotic therapy. The need for analgesics lasted for 3 to 4 days. 90% of treated children needed blood and/or blood derivatives transfusion. Success rate with this method was 93.8%. Endoscopic procedure was performed as a one-day surgical procedure. The average duration was 15 minutes. Single, prophylactic dose of antibiotic was ordinated. There was no need for blood and/or blood derivatives transfusion. The overall success of the treatment was about 70%. Conclusion: Open surgical procedure is used for more complicated cases, VUR grade IV-V or by previously failed. Endoscopic, “STING” procedure was commonly used for patients with VUR grade greater than 2, after previously failed conservative treatment, febrile urinary infection despite antibiotic prophylaxis and/or emergence of new scarring in the renal parenchyma. Patient assessment and

  2. The Study on the Writing Anxiety Levels of Primary School 6, 7 and 8th Year Students in Terms of Several Variables

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    Ucgun, Duygu

    2011-01-01

    The purpose of this study is to examine the writing anxiety levels of primary school 6, 7 and 8th year students in terms of several variables using the "writing anxiety scale" developed by Yaman (2010). The study group is composed of 1407 students enrolled at the 6, 7 and 8th years of 10 primary schools in Sarkisla district of Sivas province. The…

  3. Preschool and Primary School Influences on the Development of Children's Early Numeracy Skills between the Ages of 3 and 7 Years in Germany

    Science.gov (United States)

    Anders, Yvonne; Grosse, Christiane; Rossbach, Hans-Gunther; Ebert, Susanne; Weinert, Sabine

    2013-01-01

    Few studies have investigated how preschool and primary school interact to influence children's cognitive development. The present investigation explores German children's numeracy skills between age 3 (1st year of preschool) and age 7 (1st year of primary school). We first identified the influence of preschool experience on development while…

  4. Primary Prevention of Lead Exposure—Blood Lead Results at Age Two Years

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    Tine Hansen-Turton

    2012-04-01

    Full Text Available Objectives: The Philadelphia Lead Safe Homes (LSH Study was designed to evaluate whether educational and environmental interventions in the first year of life for families of newborns increased knowledge of lead exposure prevention and were associated with less elevation of blood lead levels (BLLs for these children, when compared to children receiving standard care. Methods: The current study performed descriptive statistics on the second-year BLL data for both groups and compared these using chi-square tests for proportions and unpaired t-tests for means. Results: A BLL result was found for 159 (50.6% of the 314 LSH cohort children and 331 (52.7% of the 628 control children (p = 0.1. Mean and standard deviation for age at draw was 23.8 (3.4 months versus 23.6 (3.1 months (P = 0.6. Geometric mean BLLs were 3.7 versus 3.5 µg/dL (P = 0.4. The percentages of the cohort group with a BLL of ≥20, ≥10 and ≥5 μg/dL, respectively, were 0.6%, 5% and 30%; for the controls 1.2%, 6.6%, and 25%. These percentages were not significantly different between groups. Conclusion: A comparison of geometric mean BLLs and percentages above several BLL cut points drawn at age two years in a group of urban newborns benefitting from study interventions versus a group of similar urban children did not yield statistically significant differences. Both groups had relatively lower lead levels when compared to historical cohort groups, which may reflect a continuing downward trend in BLLs in U.S. children. The interventions did result in benefits to the families such as an increase in parental knowledge about lead exposure prevention and in-home wet cleaning activity, and a decrease in lead dust levels in study homes.

  5. Primary renal undifferentiated sarcoma as an infiltrative mass in a 12 year old boy

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    Kim, Yong Hee; Kim, Myung Joon; Lee, Mi Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Se Hwa [Dept. of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-09-15

    Undifferentiated sarcomas are rare tumors not classified into any sarcoma subtype. Due to their rarity, imaging findings of undifferentiated sarcomas are poorly characterized. The purpose of this report was to present imaging findings of a pathologically confirmed undifferentiated sarcoma originated from the left kidney of a 12-year-old boy. The mass was infiltrative involving the renal pelvis. It mimicked massive hilar lymphadenopathy with a preserved renal contour visible by both ultrasonography and CT. Renal vein thrombosis was also observed. Although undifferentiated sarcomas are rare, they should be considered in differential diagnosis of infiltrative renal masses with renal pelvis invasion in children.

  6. Premature Menarche Associated with Primary Hypothyroidism in a 5.5-Year-Old Girl

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    Dhrubajyoti Sharma

    2011-01-01

    Full Text Available Children with hypothyroidism generally have delayed pubertal development. Rare association with precocious puberty may occur especially in long standing untreated patients. The cardinal features of hypothyroidism induced pseudo precocious pubertal development include thelarche, galactorrhea and menarche. Other characteristics features are an absence of sexual hair and retardation of linear growth. Its manifestation as isolated menarche has been rarely reported. Recently, a five and half year old girl presented to us with history of one episode of vaginal bleeding. A pelvic ultrasonogram revealed multiple cysts in both ovaries and subsequent investigations led to a diagnosis of autoimmune hypothyroidism.

  7. Improving Pre-Operative Flexion in Primary TKA: A Surgical Technique Emphasizing Knee Flexion with 5-Year Follow-Up

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    Edward McPherson

    2014-06-01

    Full Text Available This study prospectively reviews a consecutive series of 228 primary total knee arthroplasty (TKA procedures utilizing a technique to optimize knee flexion. The main features include: (1the use of a “patellar friendly” femoral component and reduced thickness patellar components, (2 patient individualized adjustment of the femoral component rotation set strictly to the anterior-posterior femoral axis, (3a rigorous flexion compartment debridement to remove non-essential posterior femoral bone with a Z-osteotome, and (4incorporation of a rapid recovery protocol with features to promote knee flexion. Results were categorized into three groups: low pre-op flexion (90 degrees and below, regular pre-op flexion (91-125 degrees, and high pre-op flexion (126 degrees and above. Average flexion in the low flexion group improved by 20 degrees at 6 weeks, 28 degrees at 3 months, 31 degrees at 1 year, and 30 degrees at 5 years. In the regular flexion group, average flexion improved by 2 degrees at 6 weeks, 10 degrees at 3 months, 12 degrees at 1 year, and 13 degrees at 5 years. Finally, in the high flexion group, average flexion decreased by 7 degrees at 6 weeks, regained preoperative levels at 3 months, and increased by 3 degrees at 1 year and 4 degrees at 5 years. In summary, a technique that emphasizes patellofemoral kinematics can consistently improve flexion in TKA in short and long-term follow-up.

  8. Primary Ewing's Sarcoma of the Kidney in a 73-Year-Old Man.

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    Wedde, T B; Lobmaier, I V K; Brennhovd, B; Lohne, F; Hall, K S

    2011-01-01

    Objective. Ewing's sarcoma of the kidney is rare and is usually found in young adults. We present here a single case study of Ewing's sarcoma found in an elderly man. Material and methods. A 73-year-old man underwent routine surgery for hydrocoele of the testis. He developed urinary obstruction symptoms, and radiological examinations revealed a tumour in the right kidney. Results. Microscopical, immunohistochemical, and molecular pathological analysis of the tumour was consistent with Ewing's sarcoma. FISH showed rearrangement of chromosomes 22q12 (EWSR1). The patient subsequently underwent nephrectomy followed by 6 adjuvant chemotherapy cycles. Follow-up after 7 months shows no recurrence. Conclusion. This case report presents not only the rare finding of Ewing's sarcoma in the kidney, but also the occurrence of this tumour entity in an elderly patient. Treatment options for the different types of renal tumours are vastly different and the need for a correct diagnosis is, therefore, vital.

  9. Langerhans cell histiocytosis: A case report of a three year old boy with primary oral manifestations

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    Seraj B

    2006-06-01

    Full Text Available Langerhans cell histiocytosis (LCH is a rare disease with formation of granulomatous infiltrations consisting of Langerhans cells, histiocytes, lymphocytes and eosinophilic granulocytes. The ethiopathogenesis of the disease has not been fully clarified yet. It can occur as focal or disseminated form - acute or chronic. Oral manifestations may be the first signs. This article reports a case of a 3 year old boy with LCH suffering from severe dental mobility and foul breathe. Radiographically, the lesions appeared as well-defined radiolucent defects in maxilla and mandible. The microscopic findings consisted of sheet like arrangements of histiocytes with a mixture of eosinophils and other inflammatory cells. Biochemical tests were within normal limits.

  10. Primary Management of Squamous Cell Carcinoma of the Anal Canal: A 30-year Community Hospital Experience.

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    Agarwal, Mohit S; Jones, Daniel A; Mendenhall, Charles M; Morris, Christopher G; Johns, Andrew; McAfee, William J; Mendenhall, William M

    2017-09-14

    We reviewed outcomes of 41 patients treated with curative-intent radiotherapy for anal canal carcinoma at a community hospital between 1985 and 2015. Twenty-six (63%) presented with stage I or II disease while 15 (37%) had stage III. Thirty-seven received definitive chemoradiation and 4 radiotherapy alone. Thirteen (31.7%) received ≤59.4Gy. Thirty-two (78%) were treated with 3-dimensional conformal radiotherapy while 9 (22%) received intensity-modulated radiotherapy. At 5 years, local control, regional control, freedom from distant metastasis, cause-specific survival, and overall survival were 80%, 98%, 88%, 77%, and 51%. Of those who received >59.4Gy, local control and overall survival were not improved.

  11. Primary Ewing’s Sarcoma of the Kidney in a 73-Year-Old Man

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    T. B. Wedde

    2011-01-01

    Full Text Available Objective. Ewing’s sarcoma of the kidney is rare and is usually found in young adults. We present here a single case study of Ewing's sarcoma found in an elderly man. Material and methods. A 73-year-old man underwent routine surgery for hydrocoele of the testis. He developed urinary obstruction symptoms, and radiological examinations revealed a tumour in the right kidney. Results. Microscopical, immunohistochemical, and molecular pathological analysis of the tumour was consistent with Ewing's sarcoma. FISH showed rearrangement of chromosomes 22q12 (EWSR1. The patient subsequently underwent nephrectomy followed by 6 adjuvant chemotherapy cycles. Follow-up after 7 months shows no recurrence. Conclusion. This case report presents not only the rare finding of Ewing's sarcoma in the kidney, but also the occurrence of this tumour entity in an elderly patient. Treatment options for the different types of renal tumours are vastly different and the need for a correct diagnosis is, therefore, vital.

  12. Giant primary vaginal calculus secondary to vesicovaginal fistula with partial vaginal outlet obstruction in a 12-year-old girl.

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    Chen, Shushang; Ge, Rong; Zhu, Lingfeng; Yang, Shunliang; Wu, Weizhen; Yang, Yin; Tan, Jianming

    2011-10-01

    A vesicovaginal fistula with vagina obstruction associated with vaginal calculi is an extremely rare medical condition. We report a giant primary vaginal calculus resulting from vesicovaginal fistula with partial vaginal outlet obstruction secondary to perineum trauma and surgery in a 12-year-old girl. Episiotomy was performed and the adhesive labia minora was split. After the removal of a giant calculus in the vagina, approximately 8 cm in diameter, the fistula tract was completely excised, followed by the repair of the vesicovagina fistula and the vagina. The patient was symptom-free at 6-month follow-up examination.

  13. Primary vaginal calculus secondary to urethrovaginal fistula with imperforate hymen in a 6-year-old girl.

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    Oguzkurt, Pelin; Ince, Emine; Ezer, Semire Serin; Temiz, Abdülkerim; Demir, Senay; Hicsonmez, Akgun

    2009-07-01

    Primary vaginal stones are extremely rare in children and may be mistaken for bladder calculi on plain radiography. We present a case of a large vaginal calculus in a 6-year-old girl who had an imperforate hymen and urethrovaginal fistula. Hymenotomy and urethrovaginal fistula repair were performed, and the vaginal stone was extracted. It was postulated that the vaginal calculus originated from stasis of urine through the urethrovaginal fistula in the obstructed vagina. This is a unique case of a vaginal calculus with a congenital urethrovaginal fistula associated with an imperforate hymen.

  14. Primary pineal melanoma presenting with leptomeningeal spreading in a 22-year-old woman: a case report

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    Azimi Parisa

    2012-06-01

    Full Text Available Abstract Introduction Primary malignant melanoma of the pineal region is exceedingly rare. We report a case of primary pineal malignant melanoma and review the literature. Case presentation Our patient was a 22-year-old Iranian woman without any significant past medical history, who was referred to our center with a four-week history of headache and gait disturbance. A magnetic resonance imaging study showed a solid mass in the pineal region causing obstructive hydrocephalus. A brain biopsy was performed and the histological examination indicated melanoma. No other additional melanocytic lesions were found elsewhere. Our patient underwent gross total resection. At the time of discharge she had fully recovered without any neurological deficits. Three weeks after discharge, she was readmitted to hospital with the diagnosis of distal deep vein thrombosis and pulmonary embolism; 12 weeks after the onset of her illness she died of cardiopulmonary arrest. Conclusion We have presented here a rare tumor, a primary malignant melanoma of the pineal region. To the best of our knowledge, this is the second-youngest patient with such a tumor reported in the literature.

  15. Primary Antimicrobial Susceptibility Changes in Children with Helicobacter pylori Infection over 13 Years in Northern Italy

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    Gismondi, Pierpacifico; Maffini, Valentina; Bizzarri, Barbara; Fornaroli, Fabiola; Madia, Carmen; Salerno, Antonino; Cangelosi, A. Marta; de'Angelis, Gian Luigi

    2015-01-01

    The eradication therapy of Helicobacter pylori (H. pylori) infection is still a challenge for gastroenterologists. One of the main causes of failure in H. pylori eradication is the antibiotic resistance mainly to clarithromycin. Culture from biopsies is maybe the most used method among the antimicrobial susceptibility techniques. In this study, we compared the antimicrobial susceptibility changes in children with H. pylori infection over 13 years and we confirmed that clarithromycin resistance has been increased (16% versus 26%) though with no statistically signficant value. Therefore, clarithromycin should not be used in empiric treatment of H. pylori eradication therapy in children, but its use should be limited only to children with known antimicrobial susceptibility. On the other hand, metronidazole resistance has decreased over this time period in statistically significant manner (56% versus 33%, p = 0.014). Furthermore, ampicillin resistance has been confirmed to be very rare (3% versus 0%) in children with H. pylori infection. In conclusion, in H. pylori infection, if we do not know the antibiotic susceptibility of patients, we should recommend an eradication therapy based on the local distribution of antibiotic resistance rates trying to limit the therapeutic failures. PMID:26064096

  16. Traumatic tooth injuries to primary teeth of children aged 0-3 years.

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    Avşar, Aysun; Topaloglu, Bengi

    2009-06-01

    The purpose of this study was to analyze data according to gender, age, cause, number of traumatized teeth, type of tooth and trauma, from the records of traumatized children (0-3 years) referred to the Ondokuz Mayis University, Dental Faculty, Department of Pedodontics in middle Black Sea region of Turkey. A total of 563 boys and girls participated in the study. Traumatic dental injuries were recorded using the classification of the World Health Organization modified slightly by Andreasen & Andreasen. Traumatic dental injuries were identified in 17.4% of the children. The largest percentage of injuries were in the 13-18 months old children with no significant gender differences (P > 0.05). Periodontal tissue injuries were the most common (84.7%) with no statistical difference between different ages or gender (P > 0.05). The main etiological factor of traumatic dental injury was falls (73.5%) and it was not different between age and gender (P > 0.05). The maxillary central incisors were involved in a higher percentage of traumatic injuries (98%), with no differences between the right and the left sides (P > 0.05). Treatment was sought for 37.4% of children within 1-7 days. It is suggested that parents should be informed about prevention of traumatic injuries and to contact a dentist immediately.

  17. Primary extranodal lymphomas - spectrum of distribution and morphology with immunophenotyping: A 3-year institutional study

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    Chinnam Aparna

    2015-01-01

    Full Text Available Background: Malignant lymphomas arising in extranodal sites are intriguing. The histological types of lymphomas vary from one site to another. This study is undertaken to diagnose and categorize extranodal lymphomas using histochemistry and immunohistochemistry (IHC. Materials and Methods: Formalin processed paraffin blocks and hematoxylin and eosin stained sections were used for routine histology. IHC was done in all cases. Results: We have encountered 31 cases of extra nodal lymphomas over a period of 3 years. The tumors occurred at different sites, including brain, nasopharynx, nose, gastrointestinal tract, thyroid, bone, testis, breast, lung, vagina, and skin. Majority of the cases were B-cell lymphomas, while four cases were T-cell lymphomas. Among the B-cell lymphomas diffuse large B-cell lymphoma was the most common variant. Conclusion: This study reiterates the key role of IHC particularly when the differential diagnosis includes an undifferentiated epithelial malignancy and a high-grade lymphoma in the extranodal sites as the treatment modalities and prognosis are different.

  18. Primary Cerebellar Neuroendocrine Tumors: Chimeras or Real Entities? A Case Report with a 6-Year Follow-Up

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    Claudio Vernieri

    2016-08-01

    Full Text Available We report the case of a 38-year-old patient who was diagnosed with a cerebellar well-differentiated neuroendocrine tumor (WDNET in 2009. At first glance, we believed that it was a metastasis from an unrecognized WDNET arising outside the cerebellum. However, despite a prolonged follow-up of 6 years, an extracranial WDNET has never been found. During this time, the tumor recurred locally twice, and the patient was treated with surgery and radiotherapy. At the moment, he enjoys good general conditions and his tumor is under control. Due to the histopathological characteristics and clinical behavior of the tumor, we believe that this is the first report to date of a primary cerebellar WDNET.

  19. Primary Cerebellar Neuroendocrine Tumors: Chimeras or Real Entities? A Case Report with a 6-Year Follow-Up.

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    Vernieri, Claudio; Femia, Daniela; Pusceddu, Sara; Capella, Carlo; Rosai, Juan; Calareso, Giuseppina; Concas, Laura; Prinzi, Natalie; Lo Russo, Giuseppe; de Braud, Filippo; Buzzoni, Roberto

    2016-01-01

    We report the case of a 38-year-old patient who was diagnosed with a cerebellar well-differentiated neuroendocrine tumor (WDNET) in 2009. At first glance, we believed that it was a metastasis from an unrecognized WDNET arising outside the cerebellum. However, despite a prolonged follow-up of 6 years, an extracranial WDNET has never been found. During this time, the tumor recurred locally twice, and the patient was treated with surgery and radiotherapy. At the moment, he enjoys good general conditions and his tumor is under control. Due to the histopathological characteristics and clinical behavior of the tumor, we believe that this is the first report to date of a primary cerebellar WDNET.

  20. The role of interstitial brachytherapy in the management of primary radiation therapy for uterine cervical cancer

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    Naoya Murakami

    2016-10-01

    Full Text Available Purpose : The aim of this study was to report the clinical results of uterine cervical cancer patients treated by primary radiation therapy including brachytherapy, and investigate the role of interstitial brachytherapy (ISBT. Material and methods: All consecutive uterine cervical cancer patients who were treated by primary radiation therapy were reviewed, and those who were treated by ISBT were further investigated for clinical outcomes and related toxicities. Results : From December 2008 to October 2014, 209 consecutive uterine cervical cancer patients were treated with primary radiation therapy. Among them, 142 and 42 patients were treated by intracavitary and hybrid brachytherapy, respectively. Twenty-five patients (12% were treated by high-dose-rate (HDR-ISBT. Five patients with distant metastasis other than para-aortic lymph node were excluded, and 20 patients consisted of the analysis. Three-year overall survival (OS, progression-free survival (PFS, and local control (LC rate were 44.4%, 38.9%, and 87.8%, respectively. Distant metastasis was the most frequent site of first relapse after HDR-ISBT. One and four patients experienced grade 3 and 2 rectal bleeding, one grade 2 cystitis, and two grade 2 vaginal ulcer. Conclusions : Feasibility and favorable local control of interstitial brachytherapy for locally advanced cervical cancer was demonstrated through a single institutional experience with a small number of patients.

  1. Characteristics of immune memory 10-15 years after primary hepatitis B vaccination.

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    Brunskole Hummel, Irena; Zitzmann, Anita; Erl, Monika; Wenzel, Jürgen J; Jilg, Wolfgang

    2016-01-27

    The definition of immune memory after hepatitis B vaccination is still under debate. Therefore, we analysed hepatitis B surface antigen (HBsAg)-specific memory in more detail by investigating the kinetics of humoral and cellular responses after hepatitis B booster vaccination. The anti-HBs kinetics of 23 individuals with anti-HBs titres below 10 IU/l, who had been vaccinated 10-15 years ago, was monitored at day 0, 3, 7, 14 and 28 after booster vaccination. HBsAg-specific IFNγ- and IL5-secreting cells in enriched CD4(+) fraction were measured at day 0, 7 and 28 post-booster by enzyme-linked immunospot assay (ELISpot). 22 of 23 subjects showed similar anti-HBs kinetic curves, including 3 of 4 subjects who did not reach anti-HBs titres of 10 IU/l. The steep anti-HBs increase started between day 3 and 7 and peaked around day 14. A plateau or only minimal changes were visible between day 14 and 28. 17.4% of subjects showed pre-booster cellular responses, and this rate had increased to 47.8% and 56.5% after 7 and 28 days, respectively. The kinetic patterns of T cell responses differed considerably among subjects. A dominance of Th2 responses (IL5 secretion) over Th1 responses (IFNγ secretion) could be observed. The presence of B cell memory could be shown by a typical anamnestic anti-HBs response curve after a booster dose in all but one individual. In contrast, T cell responses to booster vaccination, which occurred in approximately 50% of participants, were rather heterogeneous. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Seed production and recruitment in primary and harvested Nothofagus pumilio forests: Influence of regional climate and years after cuttings

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    Ana D. Torres

    2015-04-01

    Full Text Available Aim of study: Harvesting proposals (e.g. variable retention for Nothofagus pumilio forests are based on canopy opening, to increase recruitment and enhance seedling growth, by modifying light and soil moisture. Seed production and seedling recruitment will define the success of harvesting, where remnant forest structure are the main influence factors, as well as biotic and abiotic factors. The objective was to analyse seed production, seedling recruitment and recruitment efficiency in primary and harvested forests through variable retention along the first 10 years after harvesting, as well as the influence of regional climate. Area of study: The study were conducted in a pure Nothofagus pumilio forest located in central Tierra del Fuego (54°18’ S, 67°49’ W, where harvested stands with variable retention and unmanaged forests were sampled in long-term permanent plots. Material and methods: Data of forest regeneration plots were used (n = 72 (2007 a 2014, and forest structure and seed production (2006 a 2013 were also measured. Regional climate was characterised for these years from satellite images (Sea Surface Temperature and climate re-analysis models (rainfall and temperature of land surface. Main results: Harvesting modified forest structure; however, aggregated retention maintained some characteristics of the primary unmanaged forests. These changes influenced seed production and recruitment. Seed production and recruitment were related to crown cover and the amount of seed production; however, recruitment efficiency was not affected by harvesting. The studied variables significantly changed along the years after harvesting. Seed production and recruitment were also related to regional climate factors, where it was possible to explain their variations through temperature (e.g. summer temperature and rainfall (e.g. winter rainfall for the different retention types in harvested forests and the primary forests. Research highlights

  3. Density and morphologic features of primary epidermal laminae in the feet of three-year-old racing Quarter Horses.

    Science.gov (United States)

    Lancaster, Lisa S; Bowker, Robert M; Mauer, Whitney A

    2007-01-01

    To quantify the density of primary epidermal laminae (PELs) around the solar circumference and evaluate the relationship between regional PEL density and hoof capsule morphology in horses. Forefeet from nine 3-year-old Quarter Horse cadavers. Data pertaining to gross features of hoof morphology and PEL variables, including number, density, and distribution patterns around the perimeter of the hoof wall and number of bar PELs, were collected. Tissues of the laminar junction were examined histologically. No significant differences were found between left and right forefeet with respect to gross hoof morphologic measurements. Mean +/- SD number of PELs, including those at the bars of the hoof, was 551 +/- 30. Primary epidermal laminar density in the toe was significantly higher, compared with that in the quarter and heel regions, and was higher on the lateral aspect of the foot, compared with the medial aspect. Feet were significantly wider on the lateral aspect of the foot, compared with the medial aspect, as measured across the widest point of the solar surface. Histologic examination revealed atypical laminar morphology at the toe. Variations were detected in PEL density and morphology around the solar circumference of hooves from 3-year-old racing Quarter Horses. A better understanding of relationships between laminar density, laminar morphology, and gross morphology of the hoof capsule in different populations of horses may aid practitioners in diagnosis and treatment of disease involving the hoof wall in horses.

  4. Multidisciplinary approach on rehabilitation of primary teeth traumatism repercussion on the permanent successor: 6-year follow-up case report.

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    Mello-Moura, A C V; Bonini, G A V C; Suga, S S; Navarro, R S; Wanderley, M T

    2009-01-01

    Traumatic lesions in primary teeth are frequent in pediatric patients and can cause problems both to the deciduous tooth and permanent successor. The impact strength on deciduous tooth can reach the growing permanent tooth, affecting its morphology, structure and position, or even hampering its proper development. This report describes an aesthetic-functional rehabilitation process in an 8 year 10 month old boy during a multidisciplinary treatment held at the Clinical Center of Dental Trauma in Primary Teeth of the Pediatric Dentistry of Dental College of University of São Paulo, Brazil. The patient presented bilateral posterior cross bite and the permanent left upper central incisor with ectopic eruption and enamel hypoplasy, preceded by avulsion of element 61, occurred when the patient was 1.6 years old. After diagnosis and treatment planning, a quick expansion of jaws was recommended with Hass-type rapid expander and orthodontic leveling with fixed braces. Due to the ectopic eruption, the gingival contour had been altered and hypertrophia was found, compromising aesthetics and avoiding local hygienic procedures. Gingivoplasty was carried out with high-intensity Diode Laser, followed by aesthetic restoration with compound resin. It was concluded that after deciduous teeth traumatism it is important that the patient undergoes clinic and radiographic assistance until the permanent teeth erupt so that an adequate multidisciplinary treatment can be offered to the patient.

  5. Multidisciplinary approach on rehabilitation of primary teeth traumatism repercussion on the permanent successor: 6-year follow-up case report

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    Mello-Moura ACV

    2009-06-01

    Full Text Available Traumatic lesions in primary teeth are frequent in pediatric patients and can cause problems both to the deciduous tooth and permanent successor. The impact strength on deciduous tooth can reach the growing permanent tooth, affecting its morphology, structure and position, or even hampering its proper development. This report describes an aesthetic-functional rehabilitation process in an 8 year 10 month old boy during a multidisciplinary treatment held at the Clinical Center of Dental Trauma in Primary Teeth of the Pediatric Dentistry of Dental College of University of São Paulo, Brazil. The patient presented bilateral posterior cross bite and the permanent left upper central incisor with ectopic eruption and enamel hypoplasy, preceded by avulsion of element 61, occurred when the patient was 1.6 years old. After diagnosis and treatment planning, a quick expansion of jaws was recommended with Hass-type rapid expander and orthodontic leveling with fixed braces. Due to the ectopic eruption, the gingival contour had been altered and hypertrophia was found, compromising aesthetics and avoiding local hygienic procedures. Gingivoplasty was carried out with high-intensity Diode Laser, followed by aesthetic restoration with compound resin. It was concluded that after deciduous teeth traumatism it is important that the patient undergoes clinic and radiographic assistance until the permanent teeth erupt so that an adequate multidisciplinary treatment can be offered to the patient.

  6. Comparison Efficacy of Interferential Currents and Desmopressin in Primary Enuresis Children of 5-15 Years Old

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    P Yazdanpanah

    2007-10-01

    Full Text Available Introduction & Objective: Nocturnal enuresis as a common disorder in children can create many problems. A variety of modalities has been used for its treatment but applying new and effective modalities can be of much interest. In this study efficacy of interferential currents (IFC, as a new modality, has been compared with nasal spray of desmopressin in treatment of primary nocturnal enuresis in 5-15 year old children. Materials & Methods: This is a prospective, randomized, clinical trial in which 39 patients received desmopressin (20µg/day for 3 weeks and left off gradually in six months, if it was responsive. The other 36 patients received IFC therapy (5 times/week, 20 minutes each session, up to 15 sessions. Efficacy of treatment was evaluated after completion of therapeutic sessions and recurrence rate was calculated one month later. Results: About 66.7% of patients were 5-10 and 33.3% were 11-15 years old. Of all subjects, 58.7% were male and 41.3% were female. In those patients who received IFC, complete response was observed in 25%, partial response in 36.1% and 38.9% had no response while in desmopressin group, complete response was achieved in 61.5%, and partial response in 25.6% of cases and 12.8% had no response to the treatment. The recurrence rate in IFC and desmopressin groups were 16.7 % and 23.1%, respectively. In 11-15 year old children, response rate was better than those for 5-10 years old. Male patients had the most rate of recurrence. Therapeutic side effects were not observed in any of the patients in both groups. Conclusion: Desmopressin and IFC are effective and safe modalities for treatment of primary nocturnal enuresis of children with less recurrence in females. Moreover, desmopressin had better efficacy while IFC had less recurrence rate. In addition, desmopressin showed better efficacy in females. IFC can be recommended as an effective and safe modality for treatment of primary nocturnal enuresis, with less

  7. The Internationalization of Bloom's Learning for Mastery: A 25-Year Retrospective-Prospective View.

    Science.gov (United States)

    Hymel, Glenn M.; Dyck, Walter E.

    Twenty-five years have elapsed since the publication of Benjamin S. Bloom's article titled "Learning for Mastery." With approximately 2,000 master learning/testing citations in the ERIC data base alone, Bloom's 1968 piece is indeed one of the most generative works to appear in the educational psychology literature in decades. At this…

  8. Culture and diet among Chinese American children aged 9–13 years: A qualitative study

    Science.gov (United States)

    This study examined Chinese American children's behaviors, food preferences, and cultural influences on their diet. Qualitative individual interviews were conducted with twenty-five Chinese American children aged 9-13 years in community centers and Chinese schools in Houston, TX using constructs fro...

  9. Ten Thousand Years of Solitude

    Energy Technology Data Exchange (ETDEWEB)

    Benford, G. (Los Alamos National Lab., NM (USA) California Univ., Irvine, CA (USA). Dept. of Physics); Kirkwood, C.W. (Los Alamos National Lab., NM (USA) Arizona State Univ., Tempe, AZ (USA). Coll. of Business Administration); Harry, O. (Los Alamos National Lab., NM (USA)); Pasqualetti, M.J. (Los Alamos National Lab., NM (USA) Arizona State Univ., Tempe, AZ (USA))

    1991-03-01

    This report documents the authors work as an expert team advising the US Department of Energy on modes of inadvertent intrusion over the next 10,000 years into the Waste Isolation Pilot Project (WIPP) nuclear waste repository. Credible types of potential future accidental intrusion into the WIPP are estimated as a basis for creating warning markers to prevent inadvertent intrusion. A six-step process is used to structure possible scenarios for such intrusion, and it is concluded that the probability of inadvertent intrusion into the WIPP repository over the next ten thousand years lies between one and twenty-five percent. 3 figs., 5 tabs.

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

    Science.gov (United States)

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

    2013-05-01

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

  11. Fine motor skills predict maths ability better than they predict reading ability in the early primary school years

    Directory of Open Access Journals (Sweden)

    Nicola J. Pitchford

    2016-05-01

    Full Text Available Fine motor skills have long been recognised as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths development in two studies with primary school children of low-to-mid socio-economic status in the U.K. Two key findings were revealed. First, despite being in the first two years of primary school education, significantly better performance was found in reading compared to maths across both studies. This may reflect the protective effects of recent national-level interventions to promote early literacy skills in young children in the U.K. that have not been similarly promoted for maths. Second, fine motor skills were a better predictor of early maths ability than they were of early reading ability. Hierarchical multiple regression revealed that fine motor skills did not significantly predict reading ability when verbal short-term memory was taken into account. In contrast, Fine Motor Integration remained a significant predictor of maths ability, even after the influence of non-verbal IQ had been accounted for. These results suggest that fine motor skills should have a pivotal role in educational interventions designed to support the development of early mathematical skills.

  12. Fine Motor Skills Predict Maths Ability Better than They Predict Reading Ability in the Early Primary School Years.

    Science.gov (United States)

    Pitchford, Nicola J; Papini, Chiara; Outhwaite, Laura A; Gulliford, Anthea

    2016-01-01

    Fine motor skills have long been recognized as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths development in two studies with primary school children of low-to-mid socio-economic status in the UK. Two key findings were revealed. First, despite being in the first 2 years of primary school education, significantly better performance was found in reading compared to maths across both studies. This may reflect the protective effects of recent national-level interventions to promote early literacy skills in young children in the UK that have not been similarly promoted for maths. Second, fine motor skills were a better predictor of early maths ability than they were of early reading ability. Hierarchical multiple regression revealed that fine motor skills did not significantly predict reading ability when verbal short-term memory was taken into account. In contrast, Fine Motor Integration remained a significant predictor of maths ability, even after the influence of non-verbal IQ had been accounted for. These results suggest that fine motor skills should have a pivotal role in educational interventions designed to support the development of early mathematical skills.

  13. Primary vaginal Ewing's sarcoma or primitive neuroectodermal tumor in a 17-year-old woman: a case report

    Directory of Open Access Journals (Sweden)

    Kurkure Purna

    2010-03-01

    Full Text Available Abstract Introduction Primary Ewing's sarcoma or primitive neuroectodermal tumor of the genital tract of women is uncommon. Rarer still is its occurrence in the vagina, with only five cases described so far. Out of these, only one case was confirmed using molecular analysis. Case presentation We present an extremely rare case of Ewing's sarcoma or primitive neuroectodermal tumor in a 17-year-old Indian girl. She presented with a vaginal mass that was initially diagnosed as a malignant round cell tumor. Immunohistochemistry showed diffuse positivity for vimentin, membranous positivity for MIC2, and positivity for BCL2 and FLI-1. On the other hand, she was negative for cytokeratin, epithelial membrane antigen, desmin, Myo D-1, myogenin and smooth muscle actin. A diagnosis of primitive neuroectodermal tumor was thus offered. Furthermore, a molecular analysis of our patient using reverse transcription-polymerase chain reaction technique showed positivity for t(11; 22 (q24; q12 (EWSR1-FLI1, thus confirming the diagnosis of a Ewing's sarcoma/primitive neuroectodermal tumor. Our patient was offered chemotherapy on Institutional protocol EFT 2001. Conclusion This is a rare case of primary vaginal Ewing's sarcoma or primitive neuroectodermal tumor, which was confirmed with molecular analysis, in the youngest patient known so far. This study reinforces the value of integrating morphological features with membranous MIC2 positivity, along with application of molecular techniques in objective identification of an Ewing's sarcoma or primitive neuroectodermal tumor at uncommon sites.

  14. "They're Telling Me What I Already Know Instead of What I Don't Know": Dyslexic Pupils' Experiences of Withdrawal Tuition during the Later Primary Years

    Science.gov (United States)

    Anderson, Rosemary

    2009-01-01

    This article reports findings from a qualitative case study whose main focus was on how four 10-11-year-old dyslexic pupils coped with the demands of classroom reading during their final two years (Years 5-6) at a primary school in the north of England. Data were also collected on more general issues associated with the pupils' experiences of…

  15. The ten-year course of depression in primary care and long-term effects of psychoeducation, psychiatric consultation and cognitive behavioral therapy

    NARCIS (Netherlands)

    Conradi, Henk Jan; Bos, Elisabeth H; Kamphuis, Jan H; de Jonge, Peter

    BACKGROUND: While the majority of depressed patients are treated in primary care, long-term follow-up data on the naturalistic course of depression and treatment effectiveness in this setting are scarce. This study examined the ten-year course of depression in primary care patients who had

  16. A rare case of primary mediastinal non-seminomatous germ cell carcinoma in a 18 year old boy

    Directory of Open Access Journals (Sweden)

    Kundu S

    2006-01-01

    Full Text Available A 18 year old Hindu boy presented with left sided chest pain, shortness of breath, high fever and swelling of left side of chest and left arm. He was anaemic with fea-tures of Superior Venacaval (SVC Obstruction. CT Scan of Thorax revealed huge heterogeneous anterior mediastinal mass. He had very high level of serum alpha fetoprotein. CT guided Fine Needle Aspiration Cytology (FNAC gives the diagno-sis of Yolk sac tumour . As USG of abdomen and testes were normal, it is a case of primary mediastinal Yolk sac ( Endodermal sinus tumour. Although nonseminomatous germ cell tumour is 30-40% more common in Klinefelter′s syndrome [1] , Karyotyping of this patient was normal.

  17. PRIMARY ENDOPROSTHETIC REPLACEMENT OF THE ANOPHTHALMIC ORBIT IN PATIENTS WITH UVEAL MELANOMA: SIX-YEAR FOLLOW-UP RESULTS

    Directory of Open Access Journals (Sweden)

    A. A. Yarovoy

    2012-01-01

    Full Text Available A locomotor stump was formed in 36 patients (28 women and 8 men, by implanting an endoprosthesis for enucleation of the eyeball with uveal melanoma (UM. The indication for endoprosthesis implantation was no signs of extrabulbar growth. A modified 17–19 mm silicone implant covered with strips from a dura mater graft and medical mesh fabric was used as an orbital implant. The follow-up was 3 to 72 months (mean 32.5 months. All the patients achieved a satisfactory cosmetic effect. None patient was found to have a recurrent orbital tumor. Out of the complications, anterior implant surface denudation was noted in 4 patients. Two patients developed metastases. The absence of recurrent orbital UM at a 6-year follow-up enables primary endoprosthetic replacement of the orbit for UM to be regarded as a safe and reasonable method for patient cosmetic rehabilitation. 

  18. Clinicopathological features and molecular analysis of primary glioblastomas in Moroccan patients.

    Science.gov (United States)

    Hilmani, Said; Abidi, Omar; Benrahma, Houda; Karkouri, Mehdi; Sahraoui, Souha; El Azhari, Abdessamad; Barakat, Abdelhamid

    2013-03-01

    Glioblastoma is the most frequent and most aggressive primary brain tumor. Primary and secondary glioblastomas develop through different genetic pathways. The aim of this study was to determinate the genetic and clinical features of primary glioblastoma in Moroccan patients. The blood and tumor samples were obtained from a group of 34 Moroccan patients affected with primary glioblastoma. The tumors were investigated for TP53, IDH1, and IDH2 mutations using PCR sequencing analysis. Clinicopathological data showed that the mean age at diagnosis of patients was 50.06 years, the sex ratio was 11 F/23 M, and the median of Karnofsky performance score was 60. About 18 % of patients were initially treated by total tumor resection, 41 % by subtotal, and 38 % by partial resection, but biopsy was performed for a single patient (3 %). Twenty-five patients (74 %) received radiotherapy. In addition, the median survival of the all patients was 13 months following diagnosis. There was a significant impact of higher Karnofsky performance score (KPS) (≥80) on overall survival, p-log-rank test = 0.0002, whereas other parameters did not show any significant differences. The molecular analysis revealed TP53 mutations in 3/34 (8.82 %) cases; R273H, R306X, and Q136X. However, none of the analyzed samples contained the R132-IDH1 or R172-IDH2 mutations. These results showed the absence of IDH1 mutation in primary glioblastoma, confirming that this mutation is a hallmark of secondary glioblastoma. It can be used to distinguish primary from secondary glioblastomas. We found also that higher KPS was a significantly favorable factor in patients with primary glioblastoma.

  19. Asthma, chronic obstructive pulmonary disease, or both? Diagnostic labeling and spirometry in primary care patients aged 40 years or more

    Directory of Open Access Journals (Sweden)

    Melbye H

    2011-11-01

    Full Text Available Hasse Melbye1, Elin Drivenes1, Lene G Dalbak2, Tone Leinan1, Svein Høegh-Henrichsen2, Anders Østrem21General Practice Research Unit, Department of Community Medicine, University of Tromsø, 2General Practice Research Unit, Department of Health and Society, University of Oslo, NorwayAims: To describe symptoms and lung function in patients registered with asthma or chronic obstructive pulmonary disease (COPD in primary care and to examine how spirometry findings fit with general practitioners’ (GPs diagnoses.Methods: Patients aged ≥40 years with a diagnosis of asthma or COPD registered in the electronic medical record during the previous 5 years were recruited at seven GP offices in Norway in 2009–2010. Registered diagnosis, spirometry results, comorbidity, and reported symptoms were compared.Results: Among 376 patients, 62% were women. Based on Global Initiative for Chronic Obstructive Lung Diseases criteria, a spirometry diagnosis of COPD could be made in 68.1% of the patients with a previous COPD diagnosis and in 17.1% of those diagnosed with asthma only (P < 0.001. The κ agreement between last clinical diagnosis of COPD and COPD based on spirometry was 0.50. A restrictive spirometry pattern was found in 19.4% and more frequently in patients diagnosed with both asthma and COPD (23.9% than in patients diagnosed with COPD only (6.8%, P = 0.003.Conclusion: The ability of GPs to differentiate between asthma and COPD seems to have considerably improved during the last decade, probably due to the dissemination of spirometry and guidelines for COPD diagnosis. A diagnosis of COPD that cannot be confirmed by spirometry represents a challenge in clinical practice, in particular when a restrictive pattern on spirometry is found.Keywords: asthma, COPD, diagnosis, primary care

  20. Evaluation of the Health Screening on Students in the First Year of Primary School: Example of Bolu Province

    Directory of Open Access Journals (Sweden)

    Sebahat Gucuk

    2012-10-01

    Full Text Available ABSTRACT Objectives: : The aim of the current study is to analyze some of the health parameters and to emphasize the importance of general health examination for early identification and resolution of health problem in first year students attending elementary schools in our province Materials and methods: This descriptive study was performed on Bolu city center and central villages all first grade students in primary schools in the 2010 – 2011 academic year. It was evaluated that family physician were performed check-up examinations on the basis of student health examination form in the family health centers. Results: Students participating in the study 50.9% boy and 49.1% 'u girl. Of the students in the study of 2.4% strabismus, 3.7% decrease in visual acuity in eyes, 2.7% ear plug, 2.4% asthma, 0.9% of undescended testes were detected. Of the students 20.1% blood pressure, 8.7% weight, 10% height, 6.1% the number of dental caries, 3% visual acuity values were missing. The mean height and weight of students’ was 117.81±5.8 and 22.31±4.1, respectively. The number of dental caries was significantly greater in girls (p <0.05. Students who have the habit of tooth brushing had significantly fewer numbers of dental caries than have not habit (p <0.001. Conclusions: Students getting started with primary school to undergo health screenings in the family health center may be more effective and results-oriented than general school health screening and also family health center that can be interviewed face to face with parents can be done early intervention for the improvement of health parameters because of possible problem. [TAF Prev Med Bull 2012; 11(5.000: 565-570

  1. Potential drug-drug interactions in prescriptions to patients over 45 years of age in primary care, southern Brazil.

    Directory of Open Access Journals (Sweden)

    Jorge Juarez Vieira Teixeira

    Full Text Available BACKGROUND: Few cross-sectional studies involving adults and elderly patients with major DDIs have been conducted in the primary care setting. The study aimed to investigate the prevalence of potential drug-drug interactions (DDIs in patients treated in primary care. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study involving patients aged 45 years or older was conducted at 25 Basic Health Units in the city of Maringá (southern Brazil from May to December 2010. The data were collected from prescriptions at the pharmacy of the health unit at the time of the delivery of medication to the patient. After delivery, the researcher checked the electronic medical records of the patient. A total of 827 patients were investigated (mean age: 64.1; mean number of medications: 4.4. DDIs were identified in the Micromedex® database. The prevalence of potential DDIs and major DDIs was 63.0% and 12.1%, respectively. In both the univariate and multivariate analyses, the number of drugs prescribed was significantly associated with potential DDIs, with an increasing risk from three to five drugs (OR = 4.74; 95% CI: 2.90-7.73 to six or more drugs (OR = 23.03; 95% CI: 10.42-50.91. Forty drugs accounted for 122 pairs of major DDIs, the most frequent of which involved simvastatin (23.8%, captopril/enalapril (16.4% and fluoxetine (16.4%. CONCLUSIONS/SIGNIFICANCE: This is the first large-scale study on primary care carried out in Latin America. Based on the findings, the estimated prevalence of potential DDIs was high, whereas clinically significant DDIs occurred in a smaller proportion. Exposing patients to a greater number of prescription drugs, especially three or more, proved to be a significant predictor of DDIs. Prescribers should be more aware of potential DDIs. Future studies should assess potential DDIs in primary care over a longer period of time.

  2. MODIS/AQUA MYD17A3H Net Primary Production Yearly L4 Global 500m SIN Grid Version 6

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Version 6 product provides information about annual (yearly) Net Primary Production at 500 meter pixel resolution. Annual NPP is derived from the sum of the 45,...

  3. MODIS/TERRA MOD17A3H Net Primary Production Yearly L4 Global 500 m SIN Grid Version 6

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Version 6 product provides information about annual (yearly) Net Primary Production at 500 meter pixel resolution. Annual NPP is derived from the sum of the 45,...

  4. Association of Door-to-Balloon Time and Mortality in Patients ≥65 Years With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

    OpenAIRE

    Rathore, Saif S.; Curtis, Jeptha P.; Nallamothu, Brahmajee K.; Wang, Yongfei; Foody, JoAnne Micale; Kosiborod, Mikhail; Masoudi, Frederick A; Havranek, Edward P.; Krumholz, Harlan M.

    2009-01-01

    Current guidelines recommend ST-elevation myocardial infarction (STEMI) patients receive primary percutaneous coronary intervention (PCI) within 90 minutes of admission, although there is conflicting data regarding the relationship between time to treatment and mortality in these patients. We used logistic regression analyses employing fractional polynomial model to evaluate the association between door-to-balloon time and one-year mortality in STEMI patients age ≥65 years undergoing primary ...

  5. Scientific publications on primary biliary cirrhosis from 2000 through 2010: an 11-year survey of the literature.

    Science.gov (United States)

    Qin, Baodong; Liang, Yan; Yang, Zaixing; Zhong, Renqian

    2012-01-01

    Primary biliary cirrhosis (PBC) is a chronic liver disease characterized by intrahepatic bile-duct destruction, cholestasis, and fibrosis. It can lead to cirrhosis and eventually liver failure. PBC also shows some regional differences with respect to incidence and prevalence that are becoming more pronounced each year. Recently, researchers have paid more attention to PBC. To evaluate the development of PBC research during the past 11 years, we determined the quantity and quality of articles on this subject. We also compared the contributions of scientists from the US, UK, Japan, Italy, Germany, and China. The English-language papers covering PBC published in journals from 2000 through 2010 were retrieved from the PubMed database. We recorded the number of papers published each year, analyzed the publication type, and calculated the accumulated, average impact factors (IFs) and citations from every country. The quantity and quality of articles on PBC were compared by country. We also contrasted the level of PBC research in China and other countries. The total number of articles did not significantly increase during the past 11 years. The number of articles from the US exceeded those from any other country; the publications from the US also had the highest IFs and the most citations. Four other countries showed complex trends with respect to the quantity and quality of articles about PBC. The researchers from the US have contributed the most to the development of PBC research. They currently represent the highest level of research. Some high-level studies, such as RCTs, meta-analyses, and in-depth basic studies should be launched. The gap between China and the advanced level is still enormous. Chinese investigators still have a long way to go.

  6. Three-year prognosis of first-ever primary pontine hemorrhage in a hospital-based registry.

    Science.gov (United States)

    Ye, Zusen; Huang, Xiaoya; Han, Zhao; Shao, Bei; Cheng, Jianhua; Wang, Zhen; Zhang, Zheng; Xiao, Meijuan

    2015-07-01

    Our aim was to evaluate the mortality rate of primary pontine hemorrhage (PPH) and to determine the factors related to the prognosis. Limited data exist on the long-term prognosis and determinants of death in patients with PPH in China. Our study analyzed consecutive cases of first-ever PPH from April 2007 to March 2011 in a hospital-based stroke registry. Mortality rates during 30 day and 3 year follow-ups were analyzed. We used the Kaplan-Meier method to estimate the event rates and binary logistic regression analysis, and Cox proportional hazard regression analysis to identify predictors of short-term and long-term prognosis, respectively. A total of 76 patients were identified, 44 (57.89%) were men. Both 30 day and 3 year overall mortalities in men were higher than women but this different was not statistically significant. Coma on admission, hematoma ⩾ 4 mL and a massive hemorrhage were significantly related to 30 day mortality of PPH. Multivariate Cox proportional hazard regression revealed that coma on admission (hazard ratio [HR] 2.18; 95% confidence interval [CI] 1.16-4.13; p = 0.02) and hematoma ⩾ 4 mL (HR 2.23; 95% CI 1.25-3.96; p = 0.01) were independent predictors of 3 year mortality. In conclusion, the short-term mortality rate and factors related to the prognosis of Chinese patients with PPH are similar to those reported for other populations. A low Glasgow coma scale score on admission and a large hematoma volume may be related to poor 3 year prognosis after PPH.

  7. A single center 14 years study of infectious complications leading to hospitalization of patients with primary antibody deficiencies

    Directory of Open Access Journals (Sweden)

    Setareh Mamishi

    2010-08-01

    Full Text Available Primary antibody deficiencies (PADs are a heterogeneous group of disorders, characterized by hypogammaglobulinemia and increased susceptibility to bacterial infections, leading to hospitalizations. This study was performed to determine the main infectious causes of hospital admissions in selective Iranian patients with PADs. Forty patients with PADs, who were admitted to the Infectious Ward of Children's Medical Center Hospital during a 14-year period, were reviewed in this study. There were 115 documented episodes of hospital admission during a 14-year period. The average length of hospital stay was 33.30 ± 25.72 days. Pneumonia was the most prominent infection leading to hospitalization among these patients (n = 48, followed by gastroenteritis (n = 23. Other less frequent causes of hospitalization were fever and neutropenia, septic arthritis, encephalitis, orbital cellulitis, sepsis, urinary tract infection, meningitis, oral ulcer, and lung abscess. The most common causative organisms of diarrhea were: Giardia lamblia, followed by Candida albicans, and Salmonella sp. Many patients with PADs suffer from repeated infections leading to hospitalization, in spite of immunoglobulin replacement therapy. Respiratory tract infections were the prominent cause of hospitalization among studied patients, followed by gastrointestinal infections.

  8. Prenatal methamphetamine exposure, home environment, and primary caregiver risk factors predict child behavioral problems at 5 years.

    Science.gov (United States)

    Twomey, Jean; LaGasse, Linda; Derauf, Chris; Newman, Elana; Shah, Rizwan; Smith, Lynne; Arria, Amelia; Huestis, Marilyn; DellaGrotta, Sheri; Roberts, Mary; Dansereau, Lynne; Neal, Charles; Lester, Barry

    2013-01-01

    This study investigated the prospective association between prenatal methamphetamine (MA) exposure and child behavioral problems at 5 years while also examining the home environment at 30 months and several primary caregiver (PC) risk factors. Participants were 97 MA-exposed and 117 comparison children and their PCs enrolled in the Infant Development, Environment and Lifestyle Study. Hypotheses were that child behaviors would be adversely impacted by (a) prenatal MA exposure, (b) home environments that provided less developmental stimulation and emotional responsiveness to the child, and (c) the presence of PC psychological symptoms and other risk factors. Prenatal MA exposure was associated with child externalizing behavioral problems at 5 years. Home environments that were more conducive to meeting children's developmental and emotional needs were associated with fewer internalizing and externalizing behavioral problems. Independent of prenatal MA exposure, PC parenting stress and psychological symptoms were associated with increased child behavioral problems. Findings suggest prenatal MA exposure may contribute to externalizing behavioral problems in early childhood and the importance of considering possible vulnerabilities related to prenatal MA exposure in the context of the child's caregiving environment.

  9. Effect of Symptom Duration until Surgery on First-Year Outcome in Pseudophakic Primary Rhegmatogenous Retinal Detachment.

    Science.gov (United States)

    Enders, Philip; Schick, Tina; Kemper, Carolin; Schaub, Friederike; Fauser, Sascha

    2017-01-01

    To investigate the effect of symptom duration in pseudophakic primary rhegmatogenous retinal detachment (RRD) with or without macular involvement on functional and anatomical outcome during first-year follow-up. Retrospective review of cases with pars plana vitrectomy for retinal detachment repair. Symptom duration, functional outcome, and redetachment rates were analyzed. Symptom duration was grouped (1-3, 4-7, 8-14, 15-30, >30 days) and correlated to outcome in the first year of follow-up. 371 macula-off and 230 macula-on RRDs could be included. In macula-off RRDs, longer symptom duration was associated with higher redetachment rates (10-21%; p = 0.032). Patients presenting symptoms for less than 8 days showed significantly lower rates than those with a longer symptom duration (p = 0.046). In macula-on RRDs, symptom duration and outcome were not associated (p > 0.6). In macula-off RRD, early reattachment surgery is necessary to lower the risk for retinal redetachment. The aim in macula-on RRD is to prevent conversion to a macula-off situation. © 2017 S. Karger AG, Basel.

  10. A single center 14 years study of infectious complications leading to hospitalization of patients with primary antibody deficiencies

    Directory of Open Access Journals (Sweden)

    Setareh Mamishi

    Full Text Available Primary antibody deficiencies (PADs are a heterogeneous group of disorders, characterized by hypogammaglobulinemia and increased susceptibility to bacterial infections, leading to hospitalizations. This study was performed to determine the main infectious causes of hospital admissions in selective Iranian patients with PADs. Forty patients with PADs, who were admitted to the Infectious Ward of Children's Medical Center Hospital during a 14-year period, were reviewed in this study. There were 115 documented episodes of hospital admission during a 14-year period. The average length of hospital stay was 33.30 ± 25.72 days. Pneumonia was the most prominent infection leading to hospitalization among these patients (n = 48, followed by gastroenteritis (n = 23. Other less frequent causes of hospitalization were fever and neutropenia, septic arthritis, encephalitis, orbital cellulitis, sepsis, urinary tract infection, meningitis, oral ulcer, and lung abscess. The most common causative organisms of diarrhea were: Giardia lamblia, followed by Candida albicans, and Salmonella sp. Many patients with PADs suffer from repeated infections leading to hospitalization, in spite of immunoglobulin replacement therapy. Respiratory tract infections were the prominent cause of hospitalization among studied patients, followed by gastrointestinal infections.

  11. Changes of net primary productivity in China during recent 11 years detected using an ecological model driven by MODIS data

    Institute of Scientific and Technical Information of China (English)

    Yibo LIU; Weimin JU; Honglin HE; Shaoqiang WANG; Rui SUN; Yuandong ZHANG

    2013-01-01

    Net primary productivity (NPP) is an important component of the terrestrial carbon cycle.Accurately mapping the spatial-temporal variations of NPP in China is crucial for global carbon cycling study.In this study the process-based Boreal Ecosystem Productivity Simulator (BEPS) was employed to study the changes of NPP in China's ecosystems for the period from 2000 to 2010.The BEPS model was first validated using gross primary productivity (GPP) measured at typical flux sites and forest NPP measured at different regions.Then it was driven with leaf area index (LAI) inversed from the Moderate Resolution Imaging Spectroradiometer (MODIS) reflectance and land cover products and meteorological data interpolated from observations at753 national basic meteorological stations to simulate NPP at daily time steps and a spatial resolution of 500 m from January 1,2000 to December 31,2010.Validations show that BEPS is able to capture the seasonal variations of tower-based GPP and the spatial variability of forest NPP in different regions of China.Estimated national total of annual NPP varied from 2.63 to 2.84Pg C·yr-1,averaging 2.74Pg C.yr-1 during the study period.Simulated terrestrial NPP shows spatial patterns decreasing from the east to the west and from the south to the north,in association with land cover types and climate.South-west China makes the largest contribution to the national total of NPP while NPP in the North-west account for only 3.97%of the national total.During the recent 11 years,the temporal changes of NPP were heterogamous.NPP increased in 63.8% of China's landmass,mainly in areas north of the Yangtze River and decreased in most areas of southern China,owing to the low temperature freezing in early 2008 and the severe drought in late 2009.

  12. Changes of net primary productivity in China during recent 11 years detected using an ecological model driven by MODIS data

    Science.gov (United States)

    Liu, Yibo; Ju, Weimin; He, Honglin; Wang, Shaoqiang; Sun, Rui; Zhang, Yuandong

    2013-03-01

    Net primary productivity (NPP) is an important component of the terrestrial carbon cycle. Accurately mapping the spatial-temporal variations of NPP in China is crucial for global carbon cycling study. In this study the process-based Boreal Ecosystem Productivity Simulator (BEPS) was employed to study the changes of NPP in China's ecosystems for the period from 2000 to 2010. The BEPS model was first validated using gross primary productivity (GPP) measured at typical flux sites and forest NPP measured at different regions. Then it was driven with leaf area index (LAI) inversed from the Moderate Resolution Imaging Spectroradiometer (MODIS) reflectance and land cover products and meteorological data interpolated from observations at 753 national basic meteorological stations to simulate NPP at daily time steps and a spatial resolution of 500 m from January 1, 2000 to December 31, 2010. Validations show that BEPS is able to capture the seasonal variations of tower-based GPP and the spatial variability of forest NPP in different regions of China. Estimated national total of annual NPP varied from 2.63 to 2.84Pg C·yr-1, averaging 2.74 Pg C·yr-1 during the study period. Simulated terrestrial NPP shows spatial patterns decreasing from the east to the west and from the south to the north, in association with land cover types and climate. South-west China makes the largest contribution to the national total of NPP while NPP in the North-west account for only 3.97% of the national total. During the recent 11 years, the temporal changes of NPP were heterogamous. NPP increased in 63.8% of China's landmass, mainly in areas north of the Yangtze River and decreased in most areas of southern China, owing to the low temperature freezing in early 2008 and the severe drought in late 2009.

  13. Progressive pituitary hyperplasia over the course of 2 years demonstrated on magnetic resonance imaging in a patient with long standing, profound primary hypothyroidism

    Directory of Open Access Journals (Sweden)

    Kathryn J. Stephens

    2013-02-01

    Full Text Available Pituitary hyperplasia secondary to primary hypothyroidism and subsequent regression following thyroid replacement has been well described. We report a 12 year-old male who was retrospectively found to have progressive pituitary hyperplasia over the course of 2 years prior to his diagnosis of primary hypothyroidism, as documented on annual brain magnetic resonance imaging (MRI for Arnold Chiari Type 1 malformation. He presented to Endocrinology with a 2-year history of fatigue, worsening daily headaches and linear growth deceleration. The diagnosis of primary hypothyroidism as the cause for his pituitary hyperplasia was made. He was started on levothyroxine with subsequent regression of pituitary hyperplasia demonstrated on repeat brain MRI six months later. This case is the first that demonstrates progressive pituitary hyperplasia from early in the course to diagnosis of hypothyroidism. It also illustrates that pituitary hyperplasia noted on routine brain MRI can be a presenting sign of primary hypothyroidism that should prompt endocrinologic evaluation.

  14. The Effects of Indexical and Phonetic Variation on Vowel Perception in Typically Developing 9- to 12-Year-Old Children

    Science.gov (United States)

    Jacewicz, Ewa; Fox, Robert Allen

    2014-01-01

    Purpose: The purpose of this study was to investigate how linguistic knowledge interacts with indexical knowledge in older children's perception under demanding listening conditions created by extensive talker variability. Method: Twenty-five 9- to 12-year-old children, 12 from North Carolina (NC) and 13 from Wisconsin (WI), identified 12 vowels…

  15. 25 YEARS EXPERIENCES OF CHINA MADE SMALL HYDROELECTRIC UNITS WITH USA MADE DIGITAL TECHNOLOGY INSTALLED IN USA AND CENTRAL AMERICA

    Institute of Scientific and Technical Information of China (English)

    DR.ALEXANDERA

    2005-01-01

    Twenty-five years ago America's small hydroelectric power generations were reactivated by private, municipal, and local governments to utilize the renewable energy from the small hydro sties available 10,000 existing dams, small rivers and/or streams, and energy recovery facilities at many water transmission and delivery systems.

  16. Power Polarity In The Far Eastern World System, 1025 BC–AD 1850: Narrative And 25-Year Interval Data

    Directory of Open Access Journals (Sweden)

    David Wikinson

    2015-08-01

    Full Text Available Power polarity in the Far Eastern macro-social system is assessed at twenty five year intervals 1050 BC-AD 1850. Consistent with analysis of Indic system data, there is no support for the theory that the normal world-system power configuration is multipolar, hegemonic, or universal-empire. Instead several different "stability epochs" are discerned.

  17. The Contribution of the New South Wales Primary Schools Sports Association towards Developing Talent in Australian 12-Year-Old Female Swimmers

    Science.gov (United States)

    Light, Richard

    2012-01-01

    This article reports on a case study that inquired into the influence of the New South Wales Primary Schools Sports Association competitive swimming structure on the development of talented 12-year old female swimmers. The study focused on ten 12-year old girls in the New South Wales team that contested the 2009 national swimming championships…

  18. The Contribution of the New South Wales Primary Schools Sports Association towards Developing Talent in Australian 12-Year-Old Female Swimmers

    Science.gov (United States)

    Light, Richard

    2012-01-01

    This article reports on a case study that inquired into the influence of the New South Wales Primary Schools Sports Association competitive swimming structure on the development of talented 12-year old female swimmers. The study focused on ten 12-year old girls in the New South Wales team that contested the 2009 national swimming championships…

  19. Metastatic Pulmonary Adenocarcinoma 6 Years After Curative Resection for Ampullary Adenocarcinoma. Metastatic Disease from Initial Primary or Metachronous Tumour?

    Directory of Open Access Journals (Sweden)

    Alexandros Giakoustidis

    2011-01-01

    Full Text Available Context With patients surviving longer after pancreatic resection, the challenges now is the management of the unresolved longerterm issues. Case report A 53-year-old woman with painless obstructive jaundice, underwent a pylorous preserving pancreaticoduodenectomy for a pT3N0M0 ampullary adenocarcinoma in 2001 (patchy chronic pancreatitis with mucinous metaplasia of background pancreatic duct epithelium and acinar atrophy were noted. Despite adjuvant chemotherapy, at month 54 she required a pulmonary wedge resection for metastatic adenocarcinoma, followed by a pulmonary relapse at 76 months when she underwent 6 neoadjuvant cycles of gemcitabine/capecitabine and a left pneumonectomy. Finally 7 years after the initial Whipple’s, a single 18F fluorodeoxyglucose (FDG avid pancreatic tail lesion led to completion pancreatectomy for a well-differentiated ductal adenocarcinoma with clear resection margins albeit peripancreatic adipose tissue infiltration. On review all resected tumour cells had identical immunophenotype (CK7+/CK20-/MUC1+/MUC2- as that of the primary. She is currently asymptomatic on follow-up. Conclusions These findings suggest that in selected cases even in the presence of pulmonary metastasis, repeat resections could result in long-term survival of patients with metachronous ampullary cancer. Second, even ampullary tumours maybe should be regarded as index tumors in the presence of ductal precursor lesions in the resection specimen. Three distant metastases, particularly if long after the initial tumour, should instigate a search for metachronous tumour, especially in the presence of field change in the initial specimen. Risk-adapted follow-up protocols with recognition of such factors could result in cost-effective surveillance and potentially improved outcomes.

  20. “It is the Law”: the 9-year Primary School from the perspective of Pedagogy professionals/students

    Directory of Open Access Journals (Sweden)

    Maria Silvia P. de M. L. da Rocha

    2012-09-01

    Full Text Available This article is the result of a qualitative research with the general objective of identifying the opinions of Pedagogy professionals and students with regards to the new 9-year Primary School (EF – Ensino Fundamental. The methodological procedures applied were the production of a text about the EF and semi-structured interviews. In this article, the focus is on the results obtained from the text production. The research was based on 33 Pedagogy students from a private university in the countryside of São Paulo, who were to graduate in 2010. The empirical material has been analyzed based on categories defined a posteriori, after intensive reading of the material, searching for thematic cores recurrent in the productions, interpreted through the historical-cultural theory. From the results, it is possible to highlight essentially positive opinions about the new EF, comments on the importance of the teachers and schools preparation, and the incipient approach of recreational activities (with a predominantly generic treatment to them These results allow us to (i locate the important points to be approached on the initial and continuous formation of the teachers who work and will work on building the new EF, and (ii problematize the way the Pedagogy professional/ student interprets the regulations in the Education area.

  1. An evaluation of career paths among 30 years of general internal medicine/primary care internal medicine residency graduates.

    Science.gov (United States)

    Chen, Dan; Reinert, Steven; Landau, Carol; McGarry, Kelly

    2014-10-01

    Interest in primary care careers has been dwindling among medical trainees over the past decade, with poor quality of life among the perceived disadvantages. We sought to evaluate factors influencing career satisfaction among graduates of Brown's General Internal Medicine (GIM)/Primary Care residency program and assess its contribution to the primary care work force. Using an anonymous online survey, we queried GIM alumni from 1981-2012 to obtain information about demographics, job characteristics and career satisfaction measures. Fifty-nine percent of Brown's GIM/Primary Care residency graduates practice primary care, a rate higher than most primary care track programs. Seventy-six percent of respondents were "satisfied" or "very satisfied" with their current jobs. Career satisfaction correlated with self-rating of physical and emotional health and did not correlate with age, gender, income, debt burden, or practice setting. Among the diverse factors associated with attaining career satisfaction, attention to personal health plays a central role.

  2. Rural primary care physician payment 2006-2009: what a difference three years doesn't make.

    Science.gov (United States)

    MacKinney, A Clinton; Mueller, Keith J; Charlton, Mary

    2009-11-01

    (1) The 2007 Medicare Physician Fee Schedule Final Rule that increased compensation for cognitive (Evaluation and Management) services at a rate exceeding increases for procedural services resulted in modest increases in rural primary care physician income in a prototypical practice. (2) A prototypical cognitive primary care practice realized a higher percentage increase in income, but a prototypical procedural practice realized a larger dollar increase in income (due to a higher 2007 baseline income). (3) However, additional changes to the Medicare Physician Fee Schedule between 2006 and 2009 reduced intended primary care physician compensation increases, resulting in only minimal increases in primary care physician income when adjusted for inflation.

  3. Primary non-Hodgkin's lymphoma of the female genital tract in a 27-year-old female: A rare case report

    Directory of Open Access Journals (Sweden)

    Pooja Srivastava

    2016-01-01

    Full Text Available Primary non-Hodgkin's lymphoma (NHL of the female genital tract is a rare tumor mainly affecting the elderly age group. A preoperative diagnosis is difficult to reach due to varied clinical presentation and lack of diagnostic features on radiological investigations. We present an unusual case of primary NHL affecting uterus, cervix, and bilateral ovaries in a 27-year-old female.

  4. [Appropriateness of antibiotic prescribing in a primary care area: a cross-sectional study].

    Science.gov (United States)

    Fernández-Urrusuno, Rocío; Flores-Dorado, Macarena; Vilches-Arenas, Angel; Serrano-Martino, Carmen; Corral-Baena, Susana; Montero-Balosa, M Carmen

    2014-05-01

    To assess the profile of patients receiving antibiotics and the appropriateness of these prescriptions for the clinical conditions. Cross-sectional study of prescription-indication. A primary health care area in Andalusia. Patients assigned to primary care centres. Patients with antibiotic prescriptions during 2009 were selected by simple random sampling (confidence level: 95%, accuracy: 5%). Primary endpoint: appropriateness of antibiotics prescribing to recommendations included in local guidelines. Data were obtained through the billing computerised prescriptions system and medical histories. Twenty-five per cent of the population area received antibiotics during 2009. The 1,266 patient samples showed the following characteristics: 57.9% were women, with a mean age of 41 (±1) years. There were 39.3% pensioners. The percentage of appropriate antibiotic prescriptions was 19.9%, with no difference due to gender. Statistically significant differences were related to age, being those over 65 years the group of patients with the highest percentage of inappropriateness. The main reasons for inappropriateness were: no recording of the infectious process (44.5%), a wrong treatment duration (15.5%), and the use of an inadequate antibiotic (11.5%). There is a high level of inappropriateness in antibiotic prescribing in primary care. The high level of under-recording of diagnoses, mainly in elderly patients, followed by the use of wrong schedules, and the wrong type of antibiotics were the main reasons of inappropriateness. Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  5. Does the chronic inflammatory demyelinating polyradiculoneuropathy due to secondary cause differ from primary?

    Directory of Open Access Journals (Sweden)

    Vaibhav Wadwekar

    2011-01-01

    Full Text Available Background: The clinical presentation, neurophysiological findings, and outcome may vary between primary and secondary chronic inflammatory demyelinating polyradiculopathy (CIDP. Objective: To compare clinical and electrodiagnostic features of primary and secondary CIDP. Setting: Tertiary care teaching referral hospital. Materials and Methods: The CIDP patients who were diagnosed as per European Federation of Neurological Societies/Peripheral Nerve Society criteria were included and subjected to detailed history and examinations. The clinical disability was graded on a 0-10 scale. Neurophysiology included motor and sensory nerve conductions and F wave studies of all four limbs. Based on investigations for underlying diseases, the patients were categorized into primary or secondary CIDP. Prednisolone was prescribed in all and azathioprine added in resistant cases. The secondary CIDP group received specific treatment in addition. The outcome was assessed at 3 months, 6 months, and last follow-up. Results: A total of 65 patients aged 17 to 72 years were included and 20 were females. Twenty-five patients had secondary CIDP and include diabetes mellitus (16, POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (4, monoclonal gammopathy of undetermined significance (2, myeloma (1, lymphoma (1, and malignancy (1. The secondary CIDP patients were older (48.35 vs 41.0 years, had less relapsing remitting (0 vs 6 and more frequent dysautonomia (7 vs 1. The demyelinating features were more marked in primary CIDP group and had better outcome compared with secondary CIDP. Conclusions: Of the total patients with CIDP, 38.5% of patients had secondary CIDP which was associated with progressive course, less demyelinating features, and worse prognosis.

  6. Rare case of primary spinal ependymomatosis occurring in a 26-year-old man: a case report.

    LENUS (Irish Health Repository)

    Kaliaperumal, Chandrasekaran

    2009-01-01

    The authors report a rare case of primary spinal ependymomatosis in a young adult man. Multiple primary ependymomatous lesions were seen on magnetic resonance imaging and no anaplasia was identified on the surgical-pathological analysis. The aetio-pathological mechanism and surgical significance of this rare occurrence is discussed.

  7. The Effects of Nutrition Education on 6th Graders Knowledge of Nutrition in Nine-Year Primary Schools in Slovenia

    Science.gov (United States)

    Kostanjevec, Stojan; Jerman, Janez; Koch, Verena

    2011-01-01

    Incorporating nutrition topics in the primary school curricula should support the acquisition of nutrition knowledge in different ways and indirectly the development of healthy eating habits in children and teenagers. In Slovenia, nutrition education is part of all primary school education levels and may take the form of compulsory and/or elective…

  8. The Effects of Nutrition Education on 6th Graders Knowledge of Nutrition in Nine-Year Primary Schools in Slovenia

    Science.gov (United States)

    Kostanjevec, Stojan; Jerman, Janez; Koch, Verena

    2011-01-01

    Incorporating nutrition topics in the primary school curricula should support the acquisition of nutrition knowledge in different ways and indirectly the development of healthy eating habits in children and teenagers. In Slovenia, nutrition education is part of all primary school education levels and may take the form of compulsory and/or elective…

  9. [Juvenile primary lung cancer in a 17-year-old girl as a 2nd malignant neoplasm after osteosarcoma treatment in childhood].

    Science.gov (United States)

    Konoeda, Chihiro; Murakawa, Tomohiro; Sano, Atsushi; Kawashima, Mitsuaki; Nakajima, Jun

    2012-12-01

    The patient was a 17-year-old girl. She underwent treatment for osteosarcoma when she was around 10 ~ 11 years old. A follow-up chest computed tomography(CT) revealed one small pulmonary nodule 6 years later. The orthopedist thought it was metastasis. The patient was referred to our division and treated with thoracoscopic partial resection. The final pathological diagnosis was a primary lung adenocarcinoma. This case is unique because the patient is juvenile and had a history of another cancer, i.e., osteosarcoma. Her primary lung cancer is a 2nd malignancy. The incidence of 2nd malignant neoplasm is one of the significant late effects of pediatric cancer treatment. When pulmonary lesions are detected in young patient with histories of neoplasms, primary lung cancer as a 2nd malignant neoplasm as well as pulmonary metastasis from 1st neoplasm, should be considered as differential diagnosis.

  10. Myopic shift and outdoor activity among primary school children: one-year follow-up study in Beijing.

    Directory of Open Access Journals (Sweden)

    Yin Guo

    Full Text Available PURPOSE: To assess whether a change in myopia related oculometric parameters of primary school children in Beijing was associated with indoors and outdoors activity. METHODS: The longitudinal school-based study included school children who were examined in 2011 and who were re-examined in 2012. The children underwent a comprehensive eye examination including ocular biometry by optical low-coherence reflectometry and non-cycloplegic refractometry. Parents and children had a detailed interview including questions on time spent indoors and outdoors. RESULTS: Out of 681 students examined at baseline, 643 (94.4% returned for follow-up examination. Within the one-year period, mean time spent daily outdoors increased by 0.4±0.9 hours, mean axial length by 0.26±0.49 mm, the ratio of axial length divided by anterior corneal curvature (AL/CC by 0.03±0.06, and myopic refractive error by -0.06±0.89 diopters. In multivariate analysis, elongation of axial length was significantly associated with less total time spent outdoors (P = 0.02; standardized coefficient beta -0.12 and more time spent indoors with studying (P = 0.007; beta: 0.14 after adjustment for maternal myopia (P = 0.02; beta: 0.12. An increase in AL/CC was significantly associated with less time spent outdoors (P = 0.01; beta:-0.12 after adjustment for paternal myopia (P = 0.003; beta: 0.15 and if region of habitation was excludedors for leisure (P = 0.006; beta:-0.13, with less total time spent outdoors (P = 0.04; beta:-0.10, or with more time spent i. An increase in myopic refractive error, after adjustment for age, was significantly associated with less time spent outdo ndoors with studying (P = 0.005; beta: 0.13. CONCLUSIONS: A change in oculometric parameters indicating an increase in myopia was significantly associated with less time spent outdoors and more time spent indoors in school children in Greater Beijing within a study period of one year. Our

  11. Primary Hyperparathyroidism. Statistical Study about Patient to bed in Imam Khomeiny and Shariaty Hospitals (67-1376 Years

    Directory of Open Access Journals (Sweden)

    Kafie N

    1998-09-01

    Full Text Available In this study we try to clear the prevalance of age and sex and clinical and radiographic"nmanifestations of primary hyperparathyroidism. In this duration 47 patients with primary"nhyperparathyroidism that bed in two important hospitals in Tehran were studied."nThe ratio between women to men was 7 to 1 and most prevalance of disease were in fouyth decade. The pain boon was the cheif complain of patients and osteopenia was the most radiographic findings."nIn addition a case of primary hyperparathyroidism with mandibular and other bone involvement was reported.

  12. Comparison of Immediate and 2-Year Outcomes between Excimer Laser-Assisted Angioplasty with Spot Stent and Primary Stenting in Intermediate to Long Femoropopliteal Disease

    Directory of Open Access Journals (Sweden)

    Tien-Yu Wu

    2013-01-01

    Full Text Available Background. To compare the clinical outcomes between excimer laser-assisted angioplasty (ELA with spot stent (group A and primary stenting (group B in intermediate to long femoropopliteal disease. Methods. Outcomes of 105 patients totaling 119 legs treated with two different strategies were analyzed retrospectively in a prospectively maintained database. Results. Baseline characteristics were similar in both groups. Better angiographic results and lesser increase of serum C-reactive protein levels (0.60 ± 0.72 versus 2.98 ± 0.97 mg/dL, P<0.001 after the intervention were obtained in Group B. Group A had inferior 1-year outcomes due to higher rate of binary restenosis (67% versus 32%, P=0.001 and lower rate of primary patency (40% versus 58%, P=0.039. Rates of amputation-free survival, target vessel revascularization, assisted primary patency, and stent fracture at 24 months were similar in both groups (80% versus 82%, P=0.979, 65% versus 45%, P=0.11, 78% versus 80%, P=0.75 and 6.3% versus 6.8%, P=0.71, resp.. Conclusion. Greater vascular inflammation after ELA with spot stent resulted in earlier restenosis and inferior 1-year clinical outcomes than primary stenting. This benefit was lost in the primary stenting group at 2 years due to late catch-up restenosis. Active surveillance with prompt intervention was required to maintain the vessel patency.

  13. Five-year extension of a clinical trial comparing the EX-PRESS glaucoma filtration device and trabeculectomy in primary open-angle glaucoma.

    Science.gov (United States)

    de Jong, Leo; Lafuma, Antoine; Aguadé, Anne-Sophie; Berdeaux, Gilles

    2011-01-01

    This study compared the efficacy of the EX-PRESS(®) glaucoma filtration device and trabeculectomy in primary open-angle glaucoma up to five years after surgery. Patients from a previously reported randomized, open-label, parallel-arm clinical trial in which 78 patients received either the EX-PRESS glaucoma filtration device or underwent a trabeculectomy were followed for up to an additional four years (five total) beyond the original study (39 eyes per treatment group). Risk-benefit data were obtained for up to five years after glaucoma surgery. Outcome variables were intraocular pressures and intraocular pressure medications. Complete success was denoted by intraocular pressure values ≤ 18 mmHg without medication. The EX-PRESS glaucoma filtration device controlled intraocular pressure more effectively without medication for more patients from year 1 (86.8% versus 61.5%, P = 0.01) to year 3 (66.7% versus 41.0%, P = 0.02) than trabeculectomy. At year 1, only 12.8% of patients required intraocular pressure medication after EX-PRESS implantation, compared with 35.9% after trabeculectomy. The proportions became closer at year 5 (41% versus 53.9%). The responder rate was higher with EX-PRESS and time to failure was longer. In addition, surgical interventions for complications were fewer after EX-PRESS implantation. This five-year analysis confirmed and extended the results reported after one year. Compared with trabeculectomy, EX-PRESS provided better intraocular pressure control in the first three years, and patients required fewer intraocular pressure medications and fewer surgical interventions during the five-year study period. For patients with primary open-angle glaucoma, the EX-PRESS glaucoma filtration device, implanted under a superficial scleral flap, produced significantly higher success rates than trabeculectomy. EX-PRESS is an effective device for long-term treatment of primary open-angle glaucoma.

  14. Meta-analysis of studies using statins as a reducer for primary liver cancer risk

    Science.gov (United States)

    Zhong, Guo-Chao; Liu, Yan; Ye, Yuan-Yuan; Hao, Fa-Bao; Wang, Kang; Gong, Jian-Ping

    2016-01-01

    A protective effect of statins on primary liver cancer (PLC) risk has been suggested. However, issues about the dose–response relationship, the protective effect of individual statins, and PLC risk reduction among at-risk populations remain unsolved. Therefore, a meta-analysis was conducted. PubMed and EMBASE were searched for studies providing the risk ratio (RR) on statins and PLC risk. Summary RRs were calculated using a random-effects model. Twenty-five studies were identified. Stain use was significantly associated with a reduced risk of PLC (RR = 0.60, 95% confidence interval (CI) = 0.53–0.69). The summary RR for every additional 50 cumulative defined daily doses per year was 0.87 (95% CI = 0.83–0.91). Evidence of a non-linear dose–response relationship between statins and PLC risk was found (Pnon-linearity < 0.01). All individual statins significantly reduced PLC risk, and the risk reduction was more evident with rosuvastatin. The inverse association between statins and PLC risk remained among populations with common risk factors. Subgroup analyses revealed more significant reduction in PLC risk by statins in high- versus non-high-risk populations (Pinteraction = 0.02). Overall, these findings add to our understanding of the association between statins and PLC risk. Whether statin use is causally associated with a reduced risk of PLC should be further studied. PMID:27198922

  15. Response of plant species richness and primary productivity in shrublands along a north-south gradient in Europe to seven years of experimental warming and drought: reductions in primary productivity in the heat and drought year of 2003

    NARCIS (Netherlands)

    Penuelas, J.; Prieto, P.; Beier, C.; Cesaraccio, C.; Angelis, de P.; Dato, de G.; Emmett, B.A.; Estiarte, M.; Garadnai, J.; Gorissen, A.; Lang, E.K.; Kroel-Dulay, G.; Llorens, L.; Pellizzaro, G.; Riis-Nielsen, T.; Schmidt, I.K.; Sirca, C.; Sowerby, A.; Spano, D.; Tietema, A.

    2007-01-01

    We used a nonintrusive field experiment carried out at six sites - Wales (UK), Denmark (DK), the Netherlands (NL), Hungary (HU), Sardinia (Italy - IT), and Catalonia (Spain - SP) - along a climatic and latitudinal gradient to examine the response of plant species richness and primary productivity to

  16. Symptomatic primary HIV infection in a 49-year-old man who has sex with men: Beware of the window phase

    NARCIS (Netherlands)

    van Oosten, H.E.; Damen, M.; de Vries, H.J.C.

    2009-01-01

    A 49-year-old man with a history of receptive unprotected anal intercourse with multiple anonymous men presented with a symptomatic primary HIV infection. Upon his initial visit the rapid HIV antibody screening test was negative but a p24 antigen test suggested a highly infectious phase in the HIV i

  17. Lifestyle counseling for type 2 diabetes risk reduction in Dutch primary care: results of the APHRODITE study after 0.5 and 1.5 years

    NARCIS (Netherlands)

    Vermunt, P.W.; Milder, I.E.J.; Wielaard, F.; Vries, de J.H.M.; Oers, van H.; Westert, G.P.

    2011-01-01

    OBJECTIVE To study the overall effect of the Active Prevention in High-Risk Individuals of Diabetes Type 2 in and Around Eindhoven (APHRODITE) lifestyle intervention on type 2 diabetes risk reduction in Dutch primary care after 0.5 and 1.5 years and to evaluate the variability between general

  18. Prognosis and Continuity of Child Mental Health Problems from Preschool to Primary School: Results of a Four-Year Longitudinal Study

    Science.gov (United States)

    Beyer, Thomas; Postert, Christian; Muller, Jorg M.; Furniss, Tilman

    2012-01-01

    In a four-year longitudinal study, changes in and continuity of behavioral and emotional problems were examined in 814 subjects from kindergarten to primary school. Mental health problems were assessed by means of the Child Behavior Checklist (CBCL). The distribution of the CBCL broadband groups revealed a high level of continuity of internalizing…

  19. Education in the Mother-Tongue: A Nigerian Experiment--the Six-Year (Yoruba Medium) Primary Education Project at the University of Ife, Nigeria

    Science.gov (United States)

    Fafunwa, A. Babs

    1975-01-01

    This project was launched as a medium of instruction throughout the six-year primary course, predicted on the hypotheses that the child benefits culturally, socially, linguistically and cognitively through native language instruction, and that his command of English will be improved if it is taught as a separate subject by a specially trained…

  20. Teacher journal as a research instrument (research – the first year in the life in primary school through the eyes of novice teachers)

    OpenAIRE

    Wiegerová, Adriana

    2013-01-01

    The paper offers authentic statements of teachers and analyses problem situations in adaptation of teachers in the school terrain. Critical events are viewed through statements of novice teachers in interviews and in diaries of teachers. Teachers kept diaries throughout the fi rst year in the primary school.

  1. Exploring Musical Expectations: Understanding the Impact of a Year-Long Primary School Music Project in the Context of School, Home and Prior Learning

    Science.gov (United States)

    Pitts, Stephanie E.

    2014-01-01

    This article reports on a year-long project carried out in three UK primary schools, which aimed to understand the expectations and experiences of children participating in a series of workshops delivered by the chamber music organisation, Music in the Round. Through drawings, discussions, questionnaires and observations, the children's developing…

  2. Immunogenicity of Simulated PCECV Postexposure Booster Doses 1, 3, and 5 Years after 2-Dose and 3-Dose Primary Rabies Vaccination in Schoolchildren

    Directory of Open Access Journals (Sweden)

    Thavatchai Kamoltham

    2011-01-01

    Conclusion. ID rabies PrEP with PCECV is safe and immunogenic in schoolchildren and the anamnestic response to a two booster dose vaccination series was found to be adequate one, three, and five years after a two- or three-dose primary PrEP vaccination series.

  3. [EQA-17: proposing a synthetic indicator to measure the outcomes of primary care teams in people over 14 years].

    Science.gov (United States)

    Vila Córcoles, Angel; Ansa Echevarría, Xabier; Gómez Sorribes, Albert; Fort Sabaté, Joan; Llorens, Jordi Grifoll; Pascual Morón, Ignacio

    2006-01-01

    There are many indicators to measure different aspects of the Primary Health Care activities. However, the interpretation of most of them it is difficult because the majority give partial information. This work proposes a standardised model to calculation of a synthetic indicator to measure the product of primary care teams. We made this work based on the sequential realization of a bibliographical review, a retrospective study to know registered morbidity, and the consent of a working group. For the design of the synthetic indicator we carried out a sequential working methodology in six phases: (1) identification and selection of components for the indicator; (2) determination of theoretical prevalences and coverages; (3) ponderation of the components; (4) establishment of standards; (5) formulation of the components; (6) application of the scale and calculation of the indicator. Ten health problems were selected; that supposed a standardised scale of 17 items (EQA-17). The 10 problems of health which composed this synthetic indicator contemplate the realization of activities of promotion of the health (smoking cessation), activities of primary prevention (tetanus and influenza vaccination), care of acute problems (prescription of antibiotics), and care of chronic diseases (diabetes, chronic obstructive pulmonary disease, hypertension, patients with high-risk cardiovascular index, atrial fibrillation, and heart failure). The concept of a synthetic indicator to measure the level of quality of the product generated by the primary care teams could be useful for the improvement of the current evaluation models in primary care services.

  4. Clinical and Serum-Based Markers Are Associated with Death within 1 year of de novo Implant in Primary Prevention ICD Recipients

    Science.gov (United States)

    Zhang, Yiyi; Guallar, Eliseo; Blasco-Colmenares, Elena; Dalal, Darshan; Butcher, Barbara; Norgard, Sanaz; Tjong, Fleur V. Y.; Eldadah, Zayd; Dickfeld, Timm; Ellenbogen, Kenneth A.; Marine, Joseph E.; Tomaselli, Gordon F.; Cheng, Alan

    2014-01-01

    Background Implantable cardioverter defibrillator (ICD) implantation is contraindicated in those with <1 year life expectancy. Objective To develop a risk prediction score for 1-year mortality in patients with primary prevention ICDs and to determine the incremental improvement in discrimination when incorporating serum-based biomarkers to traditional clinical variables. Methods We analyzed data from the PROSE-ICD study, a large prospective observational study of patients undergoing primary prevention ICD implantation who were extensively phenotyped for clinical and serum markers. We identified variables predicting 1-year mortality and synthesized them into a comprehensive risk scoring construct using backward selection. Results Among 1,189 patients deemed by their treating physicians as having reasonable 1 year life expectancy, 62 patients died within 1 year of ICD implantation. The risk score, comprised of 6 clinical factors (age ≥75 years, New York Heart Association class III/IV, atrial fibrillation, eGFR <30mL/min/1.73m2, diabetes, and use of diuretics), had good discrimination (AUC=0.77) for 1-year mortality. Addition of 3 biomarkers (TNF-αRII, pro-BNP, and cTnT) further improved model discrimination to 0.82. Patients with 0-1, 2-3, 4-6, or 7-9 risk factors had 1-year mortality rates of 0.8%, 2.7%, 16.1% and 46.2%, respectively. Conclusions Individuals with more co-morbidities and elevations of specific serum biomarkers were at increased risk for all-cause mortality despite being deemed as having reasonable 1 year life expectancy. A simple risk score comprised of readily available clinical data and serum biomarkers may better identify patients at high risk of early mortality and improve patient selection and counseling for primary prevention ICD therapy. PMID:25446153

  5. Imaging Features of Primary Tumors and Metastatic Patterns of the Extraskeletal Ewing Sarcoma Family of Tumors in Adults: A 17-Year Experience at a Single Institution

    Science.gov (United States)

    Huh, Jimi; Park, Seong Joon; Kim, Hyoung Jung; Lee, Jong Seok; Ha, Hyun Kwon; Tirumani, Sree Harsha; Ramaiya, Nikhil H.

    2015-01-01

    Objective To comprehensively analyze the spectrum of imaging features of the primary tumors and metastatic patterns of the Extraskeletal Ewing sarcoma family of tumors (EES) in adults. Materials and Methods We performed a computerized search of our hospital's data-warehouse from 1996 to 2013 using codes for Ewing sarcoma and primitive neuroectodermal tumors as well as the demographic code for ≥ 18 years of age. We selected subjects who were histologically confirmed to have Ewing sarcoma of extraskeletal origin. Imaging features of the primary tumor and metastatic disease were evaluated for lesion location, size, enhancement pattern, necrosis, margin, and invasion of adjacent organs. Results Among the 70 patients (mean age, 35.8 ± 15.6 years; range, 18-67 years) included in our study, primary tumors of EES occurred in the soft tissue and extremities (n = 20), abdomen and pelvis (n = 18), thorax (n = 14), paravertebral space (n = 8), head and neck (n = 6), and an unknown primary site (n = 4). Most primary tumors manifested as large and bulky soft-tissue masses (mean size, 9.0 cm; range, 1.3-23.0 cm), frequently invading adjacent organs (45.6%) and showed heterogeneous enhancement (73.7%), a well-defined (66.7%) margin, and partial necrosis/cystic degeneration (81.9%). Notably, 29 patients had metastatic disease detected at their initial diagnosis. The most frequent site of metastasis was lymph nodes (75.9%), followed by bone (31.0%), lung (20.7%), abdominal solid organs (13.8%), peritoneum (13.8%), pleura (6.9%), and brain (3.4%). Conclusion Primary tumors of EES can occur anywhere and mostly manifest as large and bulky, soft-tissue masses. Lymph nodes are the most frequent metastasis sites. PMID:26175577

  6. Primary School Sun Protection Policies and Practices 4 Years after Baseline--A Follow-Up Study

    Science.gov (United States)

    Reeder, Anthony I.; Jopson, Janet A.; Gray, Andrew

    2012-01-01

    Before the 2005 launch of the New Zealand SunSmart Schools Accreditation Programme (SSAP), 242 randomly sampled primary schools completed a mail survey about sun protection policies, practices, curriculum and environment. A 2009 follow-up included 189 (78%) and their mean Total Accreditation Score (TAS = total SSAP requirements met, range 0-12),…

  7. Conservative treatment of a pathological fracture in a 3-year-old boy with primary hyperoxaluria type I

    NARCIS (Netherlands)

    Dierselhuis, Edwin F.; Maathuis, Patrick G. M.

    Primary hyperoxaluria type I is a rare inherited disease that presents a disturbed metabolism of glyoxylate. Consequently, patients suffer from hyperoxaluria, leading to renal failure and subsequent skeletal calcium oxalate deposition. Areas with high concentrations of calcium oxalate, so-called

  8. Influence of different isolation methods on the survival of proximal ART restorations in primary molars after two years

    NARCIS (Netherlands)

    A.M. Kemoli; W.E. van Amerongen; G.N. Opinya

    2010-01-01

    AIM: This was to evaluate the influence of two methods of tooth-isolation on the survival rate of proximal ART restorations in the primary molars. METHODS: The study was conducted in two rural divisions in Kenya, with 7 operators randomly paired to a group of 8 assistants. A total of 804 children ea

  9. Clinical Success Rate of Compomer and Amalgam Class II Restorations in First Primary Molars: A Two-year Study.

    Science.gov (United States)

    Ghaderi, Faezeh; Mardani, Ali

    2015-01-01

    Background and aims. The majority of failures in Class II amalgam restorations occur in the first primary molar teeth; in addition, use of compomer instead of amalgam for primary molar teeth restorations is a matter of concern. The aim ofthe present study was to compare the success rate of Class II compomer and amalgam restorations in the first primary molars. Materials and methods. A total of 17 amalgams and 17 compomer restorations were placed in 17 children based on a split-mouth design. Restorations were assessed at 12- and 24-month intervals for marginal integrity, the anatomic form and recurrent caries. Data were analyzed with SPSS 11. Chi-squared test was applied for the analysis. Statistical significance was set at Pamalgam restorations. Cumulative success rate at 24-month interval was significantlyhigher in compomer restorations compared to amalgam restorations. There was no statistically significant difference inanatomic form between the two materials. Conclusion. Compomer appears to be a suitable alternative to amalgam for Class II restorations in the first primary mo-lars.

  10. [Persistence of immune memory to hepatitis B vaccine among infants with normal or high antibody response to primary vaccination: a five-year following-up study].

    Science.gov (United States)

    Zhang, Li; Yan, Bingyu; Liu, Jiaye; Lyu, Jingjing; Feng, Yi; Xu, Aiqiang; Song, Lizhi; Liang, Xiaofeng; Li, Li; Cui, Fuqiang; Zhang, Guomin; Wang, Fuzhen

    2015-12-01

    To examine the immune memory status to hepatitis B vaccine among infants with normal or high antibody response to primary vaccination, 5 years after the primary vaccination and the risk factors associated with the immune memory. Titers of the antibody against hepatitis B surface antigen (anti-HBs) were detected, five years after the primary vaccination among children who appeared normal or high response to hepatitis B primary vaccination in infancy. Those whose anti-HBs titers were low than protective level (10 mIU/ml) were given a challenge dose of hepatitis B vaccine and titers of anti-HBs were detected 14 days after the challenge. Positive rate and geometric mean titer (GMT) of anti-HBs were calculated. Level of the anti-HBs titers after primary vaccination, at following-up and after the challenge periods were divided into different levels, respectively. Risk factors associated with the levels of anti-HBs titer after the challenge were examined by univariate analysis that and multivariable analysis. Anti-HBs waned to the level below protective standard among 37.98% of the children with normal or high antibody response to hepatitis B primary vaccination; among those children whose anti-HBs were below the protection standard. The seroconversion rate and GMT of anti-HBs after the challenge dose were 98.95% (757/765) and 2 811.69 mIU/ml [95% Confidence Interval (CI) :2 513.55-3 145.19 mIU/ml] , respectively. Titers and levels of anti-HBs after the challenge, appeared an increase with anti-HBs after primary vaccination and the anti-HBs in the following-up (F=5.46, 10.23 respectively; Pimmune memory could be found among those children with normal or high responses to hepatitis B vaccination, 5 years after the primary vaccination. The intensity of immune memory might be associated with the anti-HBs titer after primary vaccination as well as the anti-HBs titers before the challenge dose was given.

  11. The Appearance of a Candidate Site for a Primary Melanoma: A 5 Year-gap with a Melanoma of an Unknown Site.

    Science.gov (United States)

    Lee, Sangsin; Lee, Hyo-Jin; Oh, Sang-Ha; Im, Myung; Lee, Jeung-Hoon; Seo, Young-Joon; Lee, Young

    2011-10-01

    Although more than 90% of melanomas have cutaneous origins, melanomas sometimes present metastatically with no apparent primary lesion. A 62-year-old female presented with black pigmentation on her left thumbnail that had begun 2 years earlier and after the biopsy, she was diagnosed with malignant melanoma. Interestingly, 7 years earlier, a 4 cm palpable mass on her left axilla had been diagnosed as melanoma from an unknown primary site (MUP) with the involvement of an axillary lymph node. We speculate that the melanoma of the left thumb was the primary site and the melanoma in the axilla was a metastasis from the left thumb, and suggest several hypotheses explaining the appearance of the primary lesion as acral lentiginous melanoma after detecting a metastatic site. We consider this case interesting because it helps us to understand the pathogenesis of MUP and reminds physicians to conduct careful periodical work-ups of melanoma patients, and highlights the importance of continued long-term follow-up, especially for patients with MUP.

  12. Low back pain as the presenting sign in a patient with primary extradural melanoma of the thoracic spine - A metastatic disease 17 Years after complete surgical resection

    Directory of Open Access Journals (Sweden)

    Katalinic Darko

    2011-11-01

    Full Text Available Abstract Primary spinal melanomas are extremely rare lesions. In 1906, Hirschberg reported the first primary spinal melanoma, and since then only 40 new cases have been reported. A 47-year-old man was admitted suffering from low back pain, fatigue and loss of body weight persisting for three months. He had a 17-year-old history of an operated primary spinal melanoma from T7-T9, which had remained stable for these 17 years. Routine laboratory findings and clinical symptoms aroused suspicion of a metastatic disease. Multislice computed tomography and magnetic resonance imaging revealed stage-IV melanoma with thoracic, abdominal and skeletal metastases without the recurrence of the primary process. Transiliac crest core bone biopsy confirmed the diagnosis of metastatic melanoma. It is important to know that in all cases of back ore skeletal pain and unexplained weight loss, malignancy must always be considered in the differential diagnosis, especially in the subjects with a positive medical history. Patients who have back, skeletal, or joint pain that is unresponsive to a few weeks of conservative treatment or have known risk factors with or without serious etiology, are candidates for imaging studies. The present case demonstrates that complete surgical resection alone may result in a favourable outcome, but regular medical follow-up for an extended period, with the purpose of an early detection of a metastatic disease, is highly recommended.

  13. A Unique Case of Primary Ewing’s Sarcoma of the Cervical Spine in a 53-Year-Old Male: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Marshall T. Holland

    2015-01-01

    Full Text Available Extraskeletal Ewing’s sarcoma (EES is a rare presentation, representing only 15% of all primary Ewing’s sarcoma cases. Even more uncommon is EES presenting as a primary focus in the spinal canal. These rapidly growing tumors often present with focal neurological symptoms of myelopathy or radiculopathy. There are no classic characteristic imaging findings and thus the physician must keep a high index of clinical suspicion. Diagnosis can only be definitively made by histopathological studies. In this report, we discuss a primary cervical spine EES in a 53-year-old man who presented with a two-month history of left upper extremity pain and acute onset of weakness. Imaging revealed a cervical spinal canal mass. After undergoing cervical decompression, histopathological examination confirmed a diagnosis of Ewing’s sarcoma. A literature search revealed fewer than 25 reported cases of primary cervical spine EES published in the past 15 years and only one report demonstrating this pathology in a patient older than 30 years of age age=38. Given the low incidence of this pathology presenting in this age group and the lack of treatment guidelines, each patient’s plan should be considered on a case-by-case basis until further studies are performed to determine optimal evidence based treatment.

  14. The association of the vitamin D status with the persistence of anti-HBs antibody at 20years after primary vaccination with recombinant hepatitis B vaccine in infancy.

    Science.gov (United States)

    Jafarzadeh, A; Keshavarz, J; Bagheri-Jamebozorgi, M; Nemati, M; Frootan, R; Shokri, F

    2017-02-01

    Vitamin D has potent immunoregulatory effects due to the expression of its receptor on the majority of immune cells. The aim was to evaluate the association of the vitamin D status with the persistence of anti-HBs antibody and immune response to booster immunization at 20years after primary vaccination with hepatitis B (HB) vaccine. Blood samples were collected from 300 adults 20years after completion of the primary HB vaccination in infancy. The serum levels of vitamin D and anti-HBs antibody were measured by ELISA. A single booster dose of a recombinant HB vaccine was administered to a total of 138 subjects, whose anti-HBs titer wasanti-HBs antibody, 4weeks after booster vaccination. At 20years after primary vaccination, the mean vitamin D concentrations were significantly higher in seroprotective subjects as compared to non-seroprotective individuals (Panti-HBs were significantly increased with advanced concentrations of vitamin D (Pvaccination. The concentrations of vitamin D were significantly higher in subjects with an anamnestic response to booster vaccination as compared with subjects without this response (Panti-HBs antibody and durability of protection after primary vaccination with a recombinant HB vaccine in infancy. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Primary Mitral Valve Regurgitation Outcome in Patients With Severe Aortic Stenosis 1 Year After Transcatheter Aortic Valve Implantation: Echocardiographic Evaluation.

    Science.gov (United States)

    Florentino, Thiago Marinho; Bihan, David Le; Abizaid, Alexandre Antonio Cunha; Cedro, Alexandre Vianna; Corrêa, Amably Pessoa; Santos, Alexandre Roginski Mendes Dos; Souza, Alexandre Costa; Bignoto, Tiago Costa; Sousa, José Eduardo Moraes Rego; Sousa, Amanda Guerra de Moraes Rego

    2017-07-10

    Mitral valve regurgitation (MR), present in up to 74% of the patients with severe aortic stenosis (AS), can be a negative prognostic factor when moderate or severe. The outcome of MR after percutaneous transcatheter aortic valve implantation (TAVI) and predictors associated with that outcome have not been well established in the literature. To assess the outcome of primary MR in patients submitted to TAVI and to identify associated factors. Observational study of patients with symptomatic severe AS submitted to TAVI from January 2009 to April 2015 at two specialized centers. Echocardiographic outcome was assessed with data collected before and 1 year after TAVI. Of the 91 patients with MR submitted to TAVI and followed up for at least 12 months, 67 (73.6%) had minimum/mild MR before the procedure and 24 (26.4%) had moderate/severe MR. Of those with minimum/mild MR, 62 (92.5%) had no change in the MR grade (p literatura. Avaliar a evolução da IM primária em pacientes submetidos ao TAVI e identificar fatores associados a essa evolução. Realizou-se um estudo observacional em pacientes com EA grave sintomática, submetidos ao TAVI no período de janeiro de 2009 a abril de 2015 em dois centros especializados. Foram avaliados desfechos ecocardiográficos com dados antes e 1 ano após a intervenção. Dos 91 pacientes com IM que realizaram TAVI e tinham acompanhamento de pelo menos 12 meses, 67 (73,6%) apresentavam IM mínima ou discreta antes da realização do procedimento e 24 (26,4%), IM moderada ou grave. Entre os com IM mínima ou discreta, 62 (92,5%) não apresentaram mudança no grau de refluxo (p < 0,001) e 5 (7,5%) tiveram piora. Entre os com IM moderada ou grave, 8 (33,3%) permaneceram na mesma classe e 16 (66,7%) tiveram melhora (p = 0,076). Pacientes com IM moderada ou grave que melhoraram o grau de insuficiência apresentavam menores valores de EuroSCORE II (p = 0,023) e STS morbidade (p = 0,027), quando comparados aos que continuaram na mesma classe

  16. Three Years Sustained Complete Remission Achieved in a Primary Refractory ALK-Positive Anaplastic T Large Cell Lymphoma Treated with Crizotinib

    Science.gov (United States)

    Mahuad, Carolina Valeria; Repáraz, María de los Ángeles Vicente; Zerga, Marta E.; Aizpurua, María Florencia; Casali, Claudia; Garate, Gonzalo

    2016-01-01

    The prognosis of the primary refractory anaplastic lymphoma kinase (ALK+) anaplastic T large cell lymphoma is ominous. The identification of molecular targets with potential to drive oncogenesis remains a cornerstone for the designing of new selective cancer therapies. Crizotinib is a selective ATP-competitive inhibitor for ALK, approved for its use in lung cancer with rearrangements on ALK gene. The reported cases describe the use of crizotinib as a bridging strategy prior to allotransplantation; there are no reported prolonged survivals under monotherapy with Crizotinib. We report a case of a primary refractory ALK+ anaplastic large-cell lymphoma that sustains complete response after 3 years of crizotinib monotherapy. PMID:27441079

  17. Prevalence of prematurely lost primary teeth in 5–10-year-old children in Thamar city, Yemen: A cross-sectional study

    OpenAIRE

    Murshid, Sakhr A.; Al-Labani, Mohammed A.; Aldhorae, Khalid A.; Rodis, Omar M. M.

    2016-01-01

    Objectives: The premature loss of primary teeth is a potential risk factor for poor arch length development. Adequate arch length is important to the progression of the permanent teeth. Poor arch length can lead to crowding, ectopic eruption, or impaction of these teeth. This study is designed to assess the prevalence of premature loss of primary teeth in the 5-10-year-old age group. Materials and Methods: The study group included 185 children, that is, 91 boys and 94 girls. The dental examin...

  18. Thirty years of Alma Ata pledges: is devolution in Pakistan an opportunity for rekindling primary health care?

    Science.gov (United States)

    Shaikh, Babar T; Kadir, Muhammad Masood; Pappas, Gregory

    2007-05-01

    The 1978 Alma Ata Conference presented the manifesto to attain global health for the next century by providing basic health care aimed at the urban and rural poor of the developing world. While the goals of Alma Ata were noble, they were untenable. Today, developing countries face serious issues of equity in health care delivery and fairness in health care management with even a greater need to transform the management systems and practice. Primary health care remains a cornerstone of building the capacity of health systems. Devolution in health sector in Pakistan seems like a chance to re-exert Alma Ata agenda. To achieve the millennium development goals by 2015, revitalization and effective implementation of primary health care will be a vital reform.

  19. Prevalence of prematurely lost primary teeth in 5–10-year-old children in Thamar city, Yemen: A cross-sectional study

    Science.gov (United States)

    Murshid, Sakhr A.; Al-Labani, Mohammed A.; Aldhorae, Khalid A.; Rodis, Omar M. M.

    2016-01-01

    Objectives: The premature loss of primary teeth is a potential risk factor for poor arch length development. Adequate arch length is important to the progression of the permanent teeth. Poor arch length can lead to crowding, ectopic eruption, or impaction of these teeth. This study is designed to assess the prevalence of premature loss of primary teeth in the 5-10-year-old age group. Materials and Methods: The study group included 185 children, that is, 91 boys and 94 girls. The dental examination was conducted by an experienced examiner under sufficient artificial light. Data including patient age and missing teeth were collected. Descriptive statistics were applied for data analysis, and from the results, Chi-square tests were used at a level of significance of 5% (P space problems associated with the early loss of primary teeth would help in reducing malocclusion problems. PMID:27652244

  20. Primary alveolar rhabdomyosarcoma of breast in a 13 year old female with cardiopulmonary metastases and cyto-histological correlation: A case report

    Directory of Open Access Journals (Sweden)

    Wamala D

    2013-07-01

    Full Text Available Introduction: Rhabdomyosarcoma is the commonest soft tissue sarcoma of childhood. The tumour commonly occurs in the body regions of the head and neck, genitourinary and extremities. Primary rhabdomyosarcoma of the breast is extremely rare and present diagnostic challenges especially in resource limited centers. It is an aggressive tumour with a poor prognosis especially when diagnosed late. Case presentation: We present a case of 13 year old female with primary rhabdomyosarcoma of breast metastasized to regional axillary lymph nodes, lung and heart. The patient failed to respond to chemotherapy mainly due diagnostic challenges and succumbed to the disease. Conclusion: Breast masses in young patients should be diagnosed early and accurately, and optimal treatment promptly instituted. The incidence of primary rhabdomyosarcoma of breast is increasing in teenagers, and the tumour has a bad prognosis especially in late stage. We think this case will add knowledge and skills required in histological and cytological diagnosis of breast rhabdomyosarcoma.

  1. Primary hypothyroidism with growth failure and pituitary pseudotumor in a 13-year-old female: a case report

    OpenAIRE

    Larson, Noelle S; Pinsker, Jordan E.

    2013-01-01

    Introduction Primary hypothyroidism is a well-known cause of poor linear growth in children. A rare finding with profound or long-standing disease is anterior pituitary enlargement (pituitary pseudotumor). This case highlights this uncommon finding, discusses clinical situations in which gradual dose escalation of levothyroxine may be advisable and reviews adjuvant therapies that have been previously attempted to improve final height in the setting of profound hypothyroidism. Case presentatio...

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. The 'Women's Lifestyle Study', 2-year randomized controlled trial of physical activity counselling in primary health care: rationale and study design

    Directory of Open Access Journals (Sweden)

    Dowell Anthony C

    2007-07-01

    Full Text Available Abstract Background Physical inactivity is an independent risk factor for diabetes and heart disease. There is evidence that increasing physical activity can reduce the risk of developing these chronic diseases, but less evidence about effective ways to increase adherence to physical activity. Interventions are therefore needed that produce sustained increases in adherence to physical activity, are cost-effective and improve clinical endpoints. Methods The Women's Lifestyle Study is a two year randomized controlled trial involving a nurse-led intervention to increase physical activity in 40–74 year old physically inactive women recruited from primary care. Baseline measures were assessed in a face-to-face interview with a primary care nurse. The intervention involved delivery of a 'Lifestyle script' by a primary care nurse followed by telephone counselling for nine months and a face-to-face nurse visit at six months. Outcome measurements are assessed at 12 and 24 months. The primary outcome is physical activity measured using a validated physical activity questionnaire. Secondary outcomes include blood pressure, weight, waist circumference, physical fitness (step test, serum HbA1c, fasting glucose, lipids, insulin, and quality of life (SF36. Costs were measured prospectively to allow a subsequent cost-effectiveness evaluation if the trial is positive. Discussion Due to report in 2008, the Women's Lifestyle Study tests the effectiveness of an enhanced low-cost, evidence-based intervention in increasing physical activity, and improving cardiovascular and diabetes risk indicators over two years. If successful in demonstrating improvements in health outcomes, this randomized controlled trial will be the first to demonstrate long-term cardiovascular and diabetes risk health benefit, in addition to improvements in physical activity, from a sustainable physical activity intervention based in primary care. Trial Registration Australian Clinical Trials

  8. A 92-year-old man with primary cutaneous diffuse large B-cell non-Hodgkin's lymphoma manifesting as a giant scalp mass

    Science.gov (United States)

    Liao, Chenlong; Yang, Min; Liu, Pengfei; Zhang, Wenchuan

    2017-01-01

    Abstract Rationale: Primary cutaneous non-Hodgkin's lymphoma (NHL) is an uncommon entity, representing 10% of all extranodal NHLs. Among all cutaneous sites, the scalp is a rare site of representation. Patient concerns: A 92-year-old Chinese man visited our hospital with a multiple-nodular huge scalp mass on the right parieto-occipital regions. The mass was of 7-month duration and progressively enlarging in size. Diagnoses: On the basis of the result of biopsy, diffuse large B-cell NHL was diagnosed. Interventions: The mass was partially resected by surgery and no further treatment was conducted due to the advanced age and poor physical status. Outcomes: The tumor relapsed in situ after 6 months and the patient died after 2 years. Lessons: This case highlighted the limited access to standard treatment options in patients with advanced age. A thorough examination is necessary to decide upon the treatment for the primary cutaneous lymphoma. PMID:28272240

  9. Prevalence and impact of primary headache disorders among students and working population in 18-25 years age group

    Directory of Open Access Journals (Sweden)

    Gowri Aishwarya S, Eswari N, Chandrasekar M, Chandra Prabha J

    2014-04-01

    Full Text Available Background: Headache or cephalalgia is defined as pain in the head. Headache is an extremely common symptom that may have a profound impact on peoples’ functioning and quality of life. According to International Classification of Headache Disorders (ICHD, they are Primary and Secondary headaches. Primary Headaches are triggered by stress, alcohol, changes in sleep pattern, anxiety, poor posture, all of which are part and parcel our day-to-day life. The study was performed to investigate the prevalence of primary headache disorders and its severity of impact among students and working population in the age group 18-25. Methods: The study was conducted on 718 subjects of which 483 subjects were medical and engineering students from the age group 18-21 and 235 subjects were working people from the age group 22-25. Written consent was taken from each of them. Headache Impact Test-6 (version 1.1 and the HARDSHIP Questionnaire by Timothy Steiner et al. were the questionnaires used to diagnose the severity of impact and the type of headache respectively. The study was ethically approved by Ethical Clearance Board of MAHER University. People suffering from psychiatric illness were excluded from the study. Result: There was increased prevalence of migraine in the age group 18-21 and tension type headache in the age group 22-25.Over 50%of subjects from both the age groups had headaches that have substantial to severe impact on their lives. There was no significant gender variation in headache prevalence.

  10. 1-Year Outcomes With Intracoronary Abciximab in Diabetic Patients Undergoing Primary Percutaneous Coronary Intervention

    DEFF Research Database (Denmark)

    Piccolo, Raffaele; Eitel, Ingo; Galasso, Gennaro;

    2016-01-01

    BACKGROUND: Diabetic patients are at increased risk for future cardiovascular events after ST-segment elevation myocardial infarction (STEMI). Administration of an intracoronary abciximab bolus during primary percutaneous coronary intervention (PCI) may be beneficial in this high-risk subgroup.......68 to 1.33; p = 0.77), resulting in a significant interaction (p = 0.034). Among diabetic patients, intracoronary versus intravenous abciximab bolus was associated with a significantly reduced risk of death (5.8% vs. 11.2%; HR: 0.51; 95% CI: 0.26 to 0.98; p = 0.043) and definite/probable stent thrombosis...

  11. Acute Corneal Hydrops in Children with Primary Infantile Glaucoma: A Report of 31 Cases over 23 Years at the LVPEI.

    Directory of Open Access Journals (Sweden)

    Anil K Mandal

    Full Text Available Relatively little data exist regarding the outcomes of children with primary infantile glaucoma presenting with acute corneal hydrops. The aim of our study was to determine the surgical outcome of children of infantile glaucoma who presented with acute corneal hydrops.In total, 38 eyes of 31 consecutive children of infantile glaucoma presented with acute corneal hydrops who underwent primary combined trabeculotomy-trabeculectomy (CTT by a single surgeon from January 1990 to December 2012 at the LV Prasad Eye Institute (LVPEI, a tertiary eye care centre in Southern India were enrolled in this retrospective study. Primary outcome measures were intraocular pressure (IOP control (IOP ≤ 16 mmHg under anaesthesia or IOP ≤ 21 mmHg without anaesthesia and clearance of corneal edema. Secondary outcome measures were visual acuity (VA, corneal diameter, bleb appearance, intraoperative and postoperative complications.Mean age at presentation was 6.4 months (range, 2-11 months and seven eyes (23% had bilateral affliction. At presentation, all eyes (100% had moderate to severe degree of corneal edema with a mean preoperative IOP of 25.6 ±5.1 mmHg. Postoperatively, the IOP reduced to 12.0 ± 3.8 mmHg (difference = -13.6, 95% CI = -15.7 to -11.5, t = -13.18, p<0.0001, and the percentage reduction in IOP was 53.05%. Preoperatively 83% of the eyes were on antiglaucoma medication, and postoperatively 2 eyes (5.3% required 1 antiglaucoma medication for control of IOP. Preoperatively, corneal edema was present in all eyes and postoperatively it cleared in all of them. Significant myopic astigmatism was present in 28 eyes (74%, the commonest being compound myopic astigmatism (75% followed by simple myopic astigmatism (21%. Normal VA (best-corrected VA; BCVA ≥ 20/60 was achieved in 44.4% of the eyes and 22.2% eyes had low vision (BCVA, <20/60 to 20/400. Complete success (IOP control and clearance of corneal oedema was obtained in 94.7% eyes. There were no

  12. Five-year efficacy of pulmonary vein antrum isolation as a primary ablation strategy for atrial fibrillation : a single-centre cohort study

    OpenAIRE

    Teunissen, Cas; Kassenberg, W; van der Heijden, Jeroen F.; Hassink, RJ; van Driel, Vincent J H M; Zuithoff, NPA; Pieter A Doevendans; Loh, KP

    2016-01-01

    AIMS: Pulmonary vein antrum isolation (PVAI) is the cornerstone of atrial fibrillation (AF) ablation. There is an ongoing discussion on whether and when to add substrate modification to PVAI. This study evaluates (1) long-term efficacy of PVAI as a primary ablation strategy in all patients independently from AF type and (2) predictors of arrhythmia recurrence. METHODS AND RESULTS: A total of 509 consecutive patients (mean age 57 years, 38.9% non-paroxysmal AF) with AF underwent PVAI. In redo ...

  13. The persistence of anti-HBs antibody and anamnestic response 20 years after primary vaccination with recombinant hepatitis B vaccine at infancy.

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    Bagheri-Jamebozorgi, Masoomeh; Keshavarz, Jila; Nemati, Maryam; Mohammadi-Hossainabad, Saeed; Rezayati, Mohammad-Taghi; Nejad-Ghaderi, Mohsen; Jamalizadeh, Ahmad; Shokri, Fazel; Jafarzadeh, Abdollah

    2014-01-01

    Hepatitis B (HB) vaccine induces protective levels of antibody response (anti-HBs≥10 mIU/mL) in 90-99% of vaccinees. The levels of anti-HBs antibody decline after vaccination. The aim of this study was to evaluate the persistence of anti-HBs antibodies and immunologic memory in healthy adults at 20 years after primary vaccination with recombinant HB vaccine. Blood samples were collected from 300 adults at 20 years after primary HB vaccination and their sera were tested for anti-HBs antibody by ELISA technique. A single booster dose of HB vaccine was administered to a total of 138 subjects, whose anti-HBs antibody titer was anti-HBs antibody levels at 4 weeks after booster vaccination. At 20 years after primary vaccination 37.0% of participants had protective levels of antibody with geometric mean titer (GMT) of 55.44±77.01 mIU/mL. After booster vaccination, 97.1% of vaccinees developed protective levels of antibody and the GMT rose from 2.35±6.49 mIU/mL to 176.28±161.78 mIU/mL. 125/138 (90.6%) of re-vaccinated subjects also showed an anamnestic response to booster vaccination. At 20 years after primary vaccination with HB vaccine, low proportion of the subjects had protective levels of antibody. However, the majority of the re-vaccinated subjects developed protective levels of anti-HBs and showed an anamnestic response after booster vaccination. Additional follow-up studies are necessary to determine the duration of immunological memory.

  14. Sealant versus Fluoride in Primary Molars of Kindergarten Children Regularly Receiving Fluoride Varnish: One-Year Randomized Clinical Trial Follow-Up.

    Science.gov (United States)

    Honkala, Sisko; ElSalhy, Mohamed; Shyama, Maddi; Al-Mutawa, Sabiha A; Boodai, Hanan; Honkala, Eino

    2015-01-01

    The objectives of this study were to measure the caries preventive effect of sealants applied to occlusal surfaces of primary molars compared to fluoride varnish applications, and to assess the retention rate of sealants after 1 year. 147 first-grade pupils from two kindergarten schools in Kuwait, whose parents gave their written consent, were included. The children were examined by one dentist using the International Caries Detection and Assessment System. After the examination, sealants and fluoride varnish were applied on the selected occlusal surfaces of primary molars by another dentist. The jaw quadrant for intervention was selected randomly; molars on the contralateral side of the mouth received the contralateral intervention. Examinations and intervention were provided on the school premises in the mobile dental unit with a portable spotlight. Moisture was controlled by cotton rolls, suction and air drying. The follow-up examinations were conducted after 1 year. All children received fluoride varnish before and 6 months after the intervention. From 267 matched pairs of occlusal surfaces of primary molars, varnished surfaces were significantly more likely to develop new caries lesions than the sealed ones (odds ratio = 2.92; 95% confidence interval = 1.82-4.71) during the 1-year follow-up. The majority (73.0%) of the sealants were completely retained and 15.1% partially. Sealing fissures seems to be better in preventing occlusal caries lesions in primary molars than applying only fluoride varnish. After 1 year, the majority of sealants were retained sound. © 2015 S. Karger AG, Basel.

  15. Patterns of care and treatment outcomes for primary thyroid lymphoma: A single institution study

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    Cha, Hye Jung; Kim, Jun Won; Suh, Chang Ok; Kim, Jin Seok; Cheong, June Won; Lee, Jeong Shim; Keum, Ki Chang; Lee, Chang Geol; Cho, Jae Ho [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2013-12-15

    The aim of this study was to analyze the patterns of care and treatment outcomes in patients with primary thyroid lymphoma (PTL) in a single institution. Medical records of 29 patients with PTL treated between April 1994 and February 2012 were retrospectively reviewed. Diagnosis was confirmed by biopsy (n = 17) or thyroidectomy (n = 12). Treatment modality and outcome were analyzed according to lymphoma grade. The median follow-up was 43.2 months (range, 3.8 to 220.8 months). The median age at diagnosis was 57 years (range, 21 to 83 years) and 24 (82.8%) patients were female. Twenty-five (86.2%) patients had PTL with stage IEA and IIEA. There were 8 (27.6%) patients with mucosa-associated lymphoid tissue (MALT) lymphoma and the remaining patients had high-grade lymphoma. Patients were treated with surgery (n = 2), chemotherapy (n = 7), radiotherapy (n = 3) alone, or a combination of these methods (n = 17). Treatment modalities evolved over time and a combination of modalities was preferred, especially for the treatment of high-grade lymphoma in recent years. There was no death or relapse among MALT lymphoma patients. Among high-grade lymphoma patients, 5-year overall survival (OS) and 5-year progression-free survival (PFS) were 75.6% and 73.9%, respectively. Complete remission after initial treatment was the only significant prognostic factor for OS (p = 0.037) and PFS (p = 0.003). Patients with PTL showed a favorable outcome, especially with MALT lymphoma. Radiotherapy alone for MALT lymphoma and chemotherapy followed by radiotherapy for high-grade lymphoma can be effective treatment options for PTL.

  16. Relationship between Untreated Dental Caries and Weight and Height of 6- to 12-Year-Old Primary School Children in Bangladesh

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    Masuma Pervin Mishu

    2013-01-01

    Full Text Available Background. Children in low-income developing countries are likely to suffer from undergrowth. Dental caries is another common problem in these countries. Aim. To examine the association between untreated dental caries in primary and permanent teeth with age-adjusted height and weight among 6–12-year-old children in Bangladesh. Design. Social, behavioural, and clinical data were collected from 1699 children in nine different randomly selected primary schools in socially deprived areas of Bangladesh. The associations of age-adjusted weight and height and being underweight with dental caries were examined adjusting for sex, area of residence, socioeconomic position, skipping meals, tooth cleaning, and doctor visits. Results. 26% of the children were underweight and 55% had untreated dental caries. Children with at least one decayed tooth were significantly underweight with odds ratios 1.6 (95% CI 1.1, 2.3 and 1.5 (95% CI 1.1, 2.0 for 6–8-years and 9–12-year-old children, respectively, in the adjusted model. The number of decayed teeth was inversely and significantly associated with the standardized age-adjusted weight. Conclusions. The findings highlight the association between untreated dental caries and being underweight in primary school children in socially deprived areas in low-income developing countries and emphasize the need to integrate oral and general health policies with social policies.

  17. A primary primitive neuroectodermal tumor of the central nervous system in a 51-year-old woman: a case report and literature review.

    Science.gov (United States)

    Ašmonienė, Virginija; Skiriutė, Daina; Gudinavičienė, Inga; Tamašauskas, Šarūnas; Skauminas, Kęstutis; Deltuva, Vytenis Pranas; Tamašauskas, Arimantas

    2011-01-01

    Primitive neuroectodermal tumors are a group of rare, aggressive, and highly malignant embryonal tumors of unknown etiology of the central and peripheral nervous systems. It is a term for a group of small round cell tumors thought to be derived from fetal neuroectodermal precursor cells. Primitive neuroectodermal tumor is usually described as a tumor of children younger than 15 years and is very rare in adults. The article presents a short literature review and a rare case of a primary primitive neuroectodermal tumor of the central nervous system diagnosed in a 51-year-old woman.

  18. [Primary care research in the Valencia community. Original articles published over a 4-year period (1990-1993)].

    Science.gov (United States)

    Soler Torró, J M; Solanas Prats, J V; Ros García, A

    1995-10-15

    To evaluate the quality of Primary Care (PC) research in the Community of Valencia through research articles. Descriptive study. Primary Care in the community of Valencia. Research articles on PC published 1990-1993 by professionals from the Community of Valencia in: Atención Primaria, Medicina Clínica, Revista Clínica Española and Gaceta Sanitaria. 43 articles published between 1990 and 1993 (6, 6, 9 and 22, respectively) were obtained from the Medline and Indice Médico Español (Spanish Medical Index) bases. Characteristics of the study, authors and bibliographic references were analysed. The greatest number of studies were published in Atención Primaria (81%), making up consistently about 10% of the annual total of articles in this journal. A descriptive design and inferential statistical analysis (comparison of proportions) were mainly used. Average number of authors was 5.14 (C.I. 95%, 4.7 - 5.6). The participation of residents (39%) was greater than that of family doctors and below that of other specialists, suggesting a certain disenchantment with research. The collaboration of different centres (49%) was high, fundamentally Health Centres among themselves and with universities. PC research in the Community of Valencia appears to be experiencing similar growth to that in the rest of Spain.

  19. Primary Teachers’ Views Concerning the Assessment Methods Used by Them

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    Kader Birinci Konur

    2011-12-01

    Full Text Available Purpose of this study is to determine primary teachers’ views about assessment methods which are used by them. Semi-constructed interview which consists of five open-ended questions has been used as data gathering instrument. While the scope of research is the teachers who are teaching in primary schools in Rize, the samples are twenty-five primary schools teachers who were selected from the five schools. In conclusion, teachers are using both traditional assessment methods and alternative assessment methods. But, they don’t think that all of the assessment methods which in new curriculum are useful in their school because of lack of time and source. Teachers have used these methods which are changed according to environment conditions. Based on this conclusions, importance should be given to alternative assessment approaches in classes which are given to students in university and information should be presented about how use this assessment methods.

  20. Development of mental disorders one year after exposure to psychosocial stressors; a cohort study in primary care patients with a physical complaint

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    Herzig Lilli

    2012-08-01

    Full Text Available Abstract Background Mental disorders, common in primary care, are often associated with physical complaints. While exposure to psychosocial stressors and development or presence of principal mental disorders (i.e. depression, anxiety and somatoform disorders defined as multisomatoforme disorders is commonly correlated, temporal association remains unproven. The study explores the onset of such disorders after exposure to psychosocial stressors in a cohort of primary care patients with at least one physical symptom. Method The cohort study SODA (SOmatization, Depression and Anxiety was conducted by 21 private-practice GPs and three fellow physicians in a Swiss academic primary care centre. GPs included patients via randomized daily identifiers. Depression, anxiety or somatoform disorders were identified by the full Patient Health Questionnaire (PHQ, a validated procedure to identify mental disorders based on DSM-IV criteria. The PHQ was also used to investigate exposure to psychosocial stressors (before the index consultation and during follow up and the onset of principal mental disorders after one year of follow up. Results From November 2004 to July 2005, 1020 patients were screened for inclusion. 627 were eligible and 482 completed the PHQ one year later and were included in the analysis (77%. At one year, prevalence of principal mental disorders was 30/153 (19.6% CI95% 13.6; 26.8 for those initially exposed to a major psychosocial stressor and 26/329 (7.9% CI95% 5.2; 11.4 for those not. Stronger association exists between psychosocial stressors and depression (RR = 2.4 or anxiety (RR = 3.5 than multisomatoforme disorders (RR = 1.8. Patients who are “bothered a lot” (subjective distress by a stressor are therefore 2.5 times (CI95% 1.5; 4.0 more likely to experience a mental disorder at one year. A history of psychiatric comorbidities or psychological treatment was not a confounding factor for developing a principal mental

  1. Long-term Immunogenicity of a Single Dose of Japanese Encephalitis Chimeric Virus Vaccine in Toddlers and Booster Response 5 Years After Primary Immunization.

    Science.gov (United States)

    Kosalaraksa, Pope; Watanaveeradej, Veerachai; Pancharoen, Chitsanu; Capeding, Maria Rosario; Feroldi, Emmanuel; Bouckenooghe, Alain

    2017-04-01

    Japanese encephalitis (JE) is an important mosquito-borne viral disease that is endemic in Asia, Western Pacific countries and Northern Australia. Although there is no antiviral treatment, vaccination is effective in preventing this disease. We followed a cohort of 596 children for 5 years after primary vaccination at 12-18 months of age with JE chimeric virus vaccine (JE-CV; IMOJEV) in a multicenter, phase III trial in Thailand and the Philippines to assess antibody persistence and safety. At the end of the 5 years, a subgroup of 85 participants, at 1 site in Thailand, was followed after administration of a JE-CV booster vaccination. JE antibody titers were measured annually after primary vaccination and 28 days after booster vaccination using a 50% plaque reduction neutralization test. Seroprotection was defined as a JE-CV neutralizing antibody titer ≥10 (1/dil). Kaplan-Meier survival analysis was used to estimate the proportion of participants maintaining protective JE-CV neutralizing antibody titers. At 1, 2, 3, 4 and 5 years after vaccination with JE-CV, 88.5%, 82.9%, 78.2%, 74.0% and 68.6% of the participants followed remained seroprotected. Geometric mean titers in the subgroup assessed after receipt of a booster dose increased from 61.2 (95% confidence interval: 43.8-85.7) pre-booster to 4951 (95% confidence interval: 3928-6241) 28 days post-booster, with all participants seroprotected. There were no safety concerns identified. Protective immune responses persisted for at least 5 years after a JE-CV primary immunization in the majority of participants. JE-CV booster induced a robust immune response even after a 5-year interval.

  2. Occurrence of dental caries in primary and permanent dentition, oral health status and treatment needs among 12-15 year old school children of Jorpati VDC, Kathmandu.

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    Shrestha, N; Acharya, J; Sagtani, A R; Shrestha, R; Shrestha, S

    2014-12-01

    Dental caries occurrence, distribution, oral health status and corresponding treatment needs in 12 - 15 year old children are useful tools for evaluation of oral health. Dental caries status along with its treatment needs was recorded according to World Health Organization (WHO) index (1997) in 366 children from five schools within Jorpati Village Development Committee (VDC), Kathmandu. Dental caries was diagnosed in 156 (42.6%) children, out of which 122 (78.21%) had caries in permanent teeth, 26 (16.67%) had caries in primary teeth, and 8 (5.13%) had caries in both dentition. The age wise distribution of dental caries showed the highest prevalence among 12 year old students (23.8%) and the lowest among 15 year olds (3.8%). Among the female students (177), 43.5% showed presence of dental caries, while the prevalence among male students (179) was 41.8%.Out of the total number of teeth affected by dental caries (336), 273 (81.25%) were permanent teeth and 63 (18.75%) were primary teeth. The intra arch distribution of dental caries in permanent as well as primary dentition was statistically significant (P < 0.05). Restorative treatment (89.38%) was the main need in permanent dentition, and endodontic treatment (60.32%) in primary dentition. Chronologic enamel hypoplasia was found in 14 (3.83%) of the total population, and 62 (16.94%) required oral prophylaxis. These findings are significant as they can initiate further research in this area, which may help establish reliable baseline data for implementation of preventive oral health programs.

  3. The prevalence and pattern of cavitated carious lesions in primary dentition among children under 5 years age in Sirsa, Haryana (India).

    Science.gov (United States)

    Sachdeva, Anshul; Punhani, Neha; Bala, Madhu; Arora, Suraj; Gill, Gurdeep Singh; Dewan, Neeraj

    2015-01-01

    To determine the prevalence and pattern of cavitated carious lesions in primary dentition in children below 5 years of age in Sirsa, Haryana. The aim of this study was to evaluate the status of dental caries in primary dentition and compute data for planning anticipatory programs in children aged less than 5 years. The study was conducted among children attending the outpatient department of pedodontics, JCD Dental College, Sirsa, Haryana (India) from April to December 2014. This study consisted of 576 children of both sexes (311 males and 265 females) up to 5 years of age. Dentition status and treatment proforma (WHO, 1997) was used to assess the prevalence of cavitated carious lesions. Selection of children for the study was done by simple random sampling method. Chi-square test and t-test were used to compute data for statistical analysis. 33.85% of children in the study population showed presence of cavitated carious lesions. Males showed slightly higher prevalence of cavitated carious lesions than females (P = 0.35). Incidence of caries was higher in mandibular arch in both the sexes (males P = 0.9, females P = 0.7) and in posterior teeth (both sex wise and arch wise). Higher caries prevalence was noticed in maxillary anterior teeth (P = 0.04) and mandibular posterior teeth (P = 0.7). Primary second molars showed highest caries prevalence (P = 0.39) in both the arches and sexes. The mean prevalence of cavitated carious lesions in primary dentition was found to be 33.85%. Males were more affected than females. Mandibular molars and maxillary anterior teeth were the predominantly affected teeth. Mandibular anterior teeth were least affected. The increase in incidence of cavitated carious lesions shows that there is necessity of implementing dental health awareness programs and modifications in types of food consumed are needed to eliminate the cause of decay.

  4. Primary internal carotid artery aneurysm in a 15-year-old male: case report and review of the literature.

    Science.gov (United States)

    Lopez, Daniel; Sarac, Timur; Lorenz, Robert

    2015-01-01

    Extracranial internal carotid artery aneurysms are a rare entity in the adult population. Very little information is known in the pediatric population. We present a case of a 15-year-old male with an isolated internal carotid artery aneurysm and a review of the literature. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Massive primary cerebellopontine angle melanocytoma in an 11 year old child: A case report and review of literature

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    Amresh Bhaganagare

    2013-01-01

    Full Text Available A rare case of meningeal melanocytoma in an 11 year-old girl is reported. The tumor was sub-totally resected. She received no adjuvant treatment and is symptom-free at the follow-up of 8 months.

  6. The First-Year Experiences of Principals in Low-Performing Public Primary Schools in Barbados: A Narrative Inquiry

    Science.gov (United States)

    Walton, Monica Walton

    2016-01-01

    Deficits in school leadership and student achievement have occurred when principals were not adequately prepared. Similarly, assigning educators to administrative roles in low-performing schools without first training and preparing them have seemingly created situations that first-year principals described as particularly stressful. This narrative…

  7. The Presence of Matthew Effects in Dutch Primary Education, Development of Language Skills over a Six-Year Period

    NARCIS (Netherlands)

    Luyten, Johannes W.; ten Bruggencate, G.C.

    2011-01-01

    Using a nationally representative sample of 5,150 Dutch students who have been followed over a 6-year period, the presence of the Matthew effect was investigated for general language skills. The analyses do not reveal unmistakable evidence for the supposition that the rich get richer and the poor po

  8. Improving Pupil Group Work Interaction and Dialogue in Primary Classrooms: Results from a Year-Long Intervention Study

    Science.gov (United States)

    Baines, Ed; Rubie-Davies, Christine; Blatchford, Peter

    2009-01-01

    Findings are reported from a year-long evaluation of the effectiveness of the SPRinG programme relative to a control group. SPRinG aimed to address the wide gap between the potential of group interaction to promote learning and its limited use in schools. The project involved working with teachers to develop strategies for enhancing pupil group…

  9. Incidence of primary skin cancer after organ transplantation: An 18-year single-center experience in Korea.

    Science.gov (United States)

    Park, Gyeong-Hun; Chang, Sung Eun; Won, Chong Hyun; Lee, Mi Woo; Choi, Jee Ho; Moon, Kee Chan; Han, Duck Jong; Park, Su Kil; Kim, Jae-Joong; Lee, Jae Won; Lee, Sung-Gyu

    2014-03-01

    Skin cancer is the most common malignancy to arise after organ transplantation in Caucasians, but limited data are available on its incidence in Asian transplant recipients. We sought to assess the incidence of skin cancer after organ transplantation in a Korean cohort. A cohort study was conducted to determine the incidence and risk factors for skin cancers among kidney, liver, heart, or pancreas transplant recipients, treated at the Asan Medical Center in Seoul, Korea. The cumulative incidences of skin cancer were 0.70% at 5 years, 1.66% at 10 years, and 2.31% at 15 years. For all skin cancers, squamous cell carcinoma, basal cell carcinoma, and Kaposi sarcoma, the standardized incidence ratios between the recipients and the Korean general population were 30.9 (95% confidence interval, 12.4-63.6), 61.9 (12.8-180.8), 11.9 (0.3-66.1), and 565.2 (68.4-2041.6) after the end of the fifth posttransplantation year, respectively. We cannot exclude the possibility of both the underestimation because of potential missing cases and the overestimation because of the ascertainment bias. The incidence of posttransplantation skin cancer is very low in Korean patients. However, the risk of skin cancer in organ transplant recipients may be considerably higher than that in the Korean general population. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  10. Unusual Transalveolar and Transmuco-Gingival Root Avulsion of a Fractured Primary Central Incisor: A Case with an 8-Year Follow-Up

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    E. Ferrés-Amat

    2015-01-01

    Full Text Available The purpose of this unique case report is to describe a very unusual dentoalveolar fracture associated with avulsion of the near-complete root. A 3-year-old male patient came for consultation after a dentoalveolar trauma with a “fragment that looks like canine” found in his mouth by his mother. This boy suffered root fracture of the upper primary central right incisor, accompanied by transalveolar and transmuco-gingival avulsion of the tooth root fragment, leaving the crown in its position in the dental arch. Clinical and radiological examinations were performed in order to follow up the case: 15 days, one month, and three months after trauma, the crown had a slight mobility without other clinical or radiological signs. After six months, the upper primary central right incisor’s crown was exfoliated. Open bite due to the persistence of the pacifier habit favored the crown retention in the mouth. This case emphasizes the importance of primary diagnosis and follow-up of trauma cases. To the best of our knowledge, this kind of dental injury has not been previously described in the literature nor in the current Dental Trauma guidelines for the management of traumatic dental injuries in the primary dentition.

  11. 3D analysis of effects of primary surgeries in cleft lip/palate children during the first two years of life.

    Science.gov (United States)

    Sakoda, Karine Laskos; Jorge, Paula Karine; Carrara, Cleide Felício Carvalho; Machado, Maria Aparecida de Andrade Moreira; Valarelli, Fabrício Pinelli; Pinzan, Arnaldo; Oliveira, Thais Marchini

    2017-06-05

    This study aimed at monitoring the maxillary growth of children with cleft lip/palate in the first two years of life, and to evaluate the effects of primary surgeries on dental arch dimensions. The sample consisted of the three-dimensional digital models of 25 subjects with unilateral complete cleft lip and palate (UCLP) and 29 subjects with isolated cleft palate (CP). Maxillary arch dimensions were measured at 3 months (before lip repair), 1 year (before palate repair), and at 2 years of age. Student's ttest was used for comparison between the groups. Repeated measures ANOVA followed by Tukey's test was used to compare different treatment phases in the UCLP group. Paired ttest was used to compare different treatment phases in the CP group. Plip repair in UCLP. After palate repair, maxillary dimensions increased significantly, except for the intercanine distance in UCLP and the intertuberosity distance in both groups. At the time of palate repair and at two years of age, the maxillary dimensions were very similar in both groups. It can be concluded that the maxillary arches of children with UCLP and CP changed as a result of primary surgery.

  12. Mortality in primary angioplasty patients starting antiplatelet therapy with prehospital prasugrel or clopidogrel: a 1-year follow-up from the European MULTIPRAC Registry

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    Goldstein P

    2016-04-01

    Full Text Available Patrick Goldstein,1 Niccolò Grieco,2 Hüseyin Ince,3,4 Nicolas Danchin,5 Yvonne Ramos,6 Jochen Goedicke,7 Peter Clemmensen8,9 On behalf of the MULTIPRAC study investigators 1Emergency Department, Lille Regional University Hospital, Lille, France; 2Department of Cardiology, Hospital Niguarda Cà Granda Milano, Milan, Italy; 3Internal Medicine Centre, Cardiology Department, Rostock University Clinic, Rostock, Germany; 4Department of Cardiology, Vivantes Klinikum im Friedrichshain and Am Urban, Berlin, Germany; 5Department of Cardiology, European Hospital Georges-Pompidou, Paris, France; 6Medical Department, Daiichi Sankyo Europe, Munich, 7Medical Department, Lilly Deutschland GmbH, Bad Homburg, Germany; 8Department of Medicine, Division of Cardiology, Rigshospitalet Copenhagen University Hospital, 9Department of Medicine, Division of Cardiology, Nykoebing F Hospital, Copenhagen, Denmark Aim: MULTIPRAC was designed to provide insights into the use and outcomes associated with prehospital initiation of antiplatelet therapy with either prasugrel or clopidogrel in the context of primary percutaneous coronary intervention. After a previous report on efficacy and safety outcomes during hospitalization, we report here the 1-year follow-up data, including cardiovascular (CV mortality. Methods and results: MULTIPRAC is a multinational, prospective registry of patients with ST-elevation myocardial infarction (STEMI from 25 hospitals in nine countries, all of which had an established practice of prehospital start of dual antiplatelet therapy in place. The key outcome was CV death at 1 year. Among 2,036 patients followed-up through 1 year, 49 died (2.4%, 10 during the initial hospitalization and 39 within 1 year after hospital discharge. The primary analysis was based on the P2Y12-inhibitor, used from prehospital loading dose through hospital discharge. Prasugrel (n=824 was more commonly used than clopidogrel (n=425. The observed 1-year rates for CV death

  13. Do patients have worse outcomes in heart failure than in cancer? A primary care-based cohort study with 10-year follow-up in Scotland.

    Science.gov (United States)

    Mamas, Mamas A; Sperrin, Matthew; Watson, Margaret C; Coutts, Alasdair; Wilde, Katie; Burton, Christopher; Kadam, Umesh T; Kwok, Chun Shing; Clark, Allan B; Murchie, Peter; Buchan, Iain; Hannaford, Philip C; Myint, Phyo K

    2017-05-03

    This study was designed to evaluate whether survival rates in patients with heart failure (HF) are better than those in patients with diagnoses of the four most common cancers in men and women, respectively, in a contemporary primary care cohort in the community in Scotland. Data were obtained from the Primary Care Clinical Informatics Unit from a database of 1.75 million people registered with 393 general practices in Scotland. Sex-specific survival modelling was undertaken using Cox proportional hazards models, adjusted for potential confounders. A total of 56 658 subjects were eligible for inclusion in the study. These represented a total of 147 938 person-years of follow-up (median follow-up: 2.04 years). In men, HF (reference group; 5-year survival: 55.8%) had worse mortality outcomes than prostate cancer [hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.57-0.65; 5-year survival: 68.3%], and bladder cancer (HR 0.88, 95% CI 0.81-0.96; 5-year survival: 57.3%), but better outcomes than lung cancer (HR 3.86, 95% CI 3.65-4.07; 5-year survival: 8.4%) and colorectal cancer (HR 1.23, 95% CI 1.16-1.31; 5-year survival: 48.9%). In women, HF (reference group; 5-year survival: 49.5%) had worse mortality outcomes than breast cancer (HR 0.55, 95% CI 0.51-0.59; 5-year survival 77.7%), but better outcomes than colorectal cancer (HR 1.21, 95% CI 1.13-1.29; 5-year survival 51.5%), lung cancer (HR 3.82, 95% CI 3.60-4.05; 5-year survival 10.4%), and ovarian cancer (HR 1.98, 95% CI 1.80-2.17; 5-year survival 38.2%). Despite advances in management, HF remains as 'malignant' as some of the common cancers in both men and women. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  14. Prevalence of persistent pain 3 to 5 years post primary root canal therapy and its impact on oral health-related quality of life: PEARL Network findings.

    Science.gov (United States)

    Vena, Donald A; Collie, Damon; Wu, Hongyu; Gibbs, Jennifer L; Broder, Hillary L; Curro, Frederick A; Thompson, Van P; Craig, Ronald G

    2014-12-01

    The frequency of persistent pain 3-5 years after primary root canal therapy and its impact on the patient's perceived oral health-related quality of life was determined in a practice-based research network. All patients presenting to participating network practices who received primary root canal therapy and restoration for a permanent tooth 3-5 years previously were invited to enroll. Persistent pain was defined as pain occurring spontaneously or elicited by percussion, palpation, or biting. The patient also completed an oral health-related quality of life questionnaire (Oral Health Impact Profile-14). Sixty-four network practices enrolled 1323 patients; 13 were ineligible, 12 did not receive a final restoration, and 41 were extracted, leaving 1257 for analysis. The average time to follow-up was 3.9 ± 0.6 years. Five percent (63/1257) of the patients reported persistent pain, whereas 24 of 63 (38%) exhibited periapical pathosis and/or root fracture (odontogenic pain). No obvious odontogenic cause for persistent pain was found for 39 of 63 (62%). Teeth treated by specialists had a greater frequency of persistent pain than teeth treated by generalists (9.3% vs 3.0%, respectively; P tooth type, type of dentist, and arch were not found to be associated with nonodontogenic persistent pain; however, ethnicity and a preoperative diagnosis of pulpitis without periapical pathosis were. Patients reporting pain with percussion tended to experience pain with other stimuli that negatively impacted quality of life including oral function and psychological discomfort and disability. These results suggest that a small percentage (3.1%) of patients experience persistent pain not attributable to odontogenic causes 3-5 years after primary root canal therapy that may adversely impact their quality of life. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  15. Endomedullary radiofrequency ablation of metastatic lesion of the right femur 5 years after primary breast carcinoma: a case report.

    Science.gov (United States)

    Majerović, Mate; Augustin, Goran; Jelincić, Zeljko; Buković, Damir; Burcar, Ivan; Smud, Dubravko; Kekez, Tihomir; Kinda, Emil; Matosević, Petar; Turcić, Josip

    2008-12-01

    Metastatic tumors of the long bones usually present with severe pain refractory to analgesic therapy. Pathologic fractures of the bone may lead to the significant decrease of patient's quality of life and necessitate further surgical therapy. We present 66 year old female with metastatic left breast carcinoma (T2N0M0) diagnosed 5 years before presentation of the metastatic lesion of the right femur causing severe pain in the middle of the right upper leg. Pain persisted after palliative irradiation therapy. We performed radiofrequency ablation of the metastatic lesion of the right femur using R.I.TA. Medical System Generator. This resulted in total necrosis of the tumor mass that caused osteolysis of the internal part of the femoral cortex. First three months after RFA procedure, the pain and tenderness were absent and normal daily activities were performed without restrictions.

  16. Reading comprehension in english with audio media input among year 6 primary school students with or without dyslexia

    OpenAIRE

    Deželan, Tadeja

    2017-01-01

    The findings of scientific research in recent years have begun to emphasize the importance of early detection of general and specific learning difficulties of pupils in schools. Among the specific learning difficulties dyslexia is the most recognizable as well as mostly studied. The latter causes pupils great difficulties in acquiring basic literacy and language skills. Since pupils with dyslexia, among other difficulties, experience problems with reading and consequently reading comprehensio...

  17. Immunohistochemical Examination of a Resected Advanced Hilar Cholangiocarcinoma Arising in a 29-Year-Old Male without Primary Sclerosing Cholangitis

    Directory of Open Access Journals (Sweden)

    Taketoshi Suehiro

    2010-05-01

    Full Text Available A 29-year-old man with advanced hilar cholangiocarcinoma was successfully treated with an extended right lobectomy. The carbohydrate antigen 19-9 (CA19-9 level was elevated to 939 IU/l, and the pathological findings revealed moderately differentiated tubular adenocarcinoma which involved almost the entire thickness of the hepatic duct and the adjacent liver tissue (T3 and which was associated with lymph node metastasis (N1. It was a stage IIB (T3N1M0 tubular adenocarcinoma according to UICC pathological staging. Immunohistochemical examination revealed that Ki-67, cyclin D1, and MMP-7 were positive, and 14-3-3σ and p27 were negative. The pathological and immunohistochemical findings indicated high malignant potential indicating poor prognosis. We administrated the postoperative adjunct gemcitabine combined with S-1 chemotherapy. The patient is alive without recurrence and doing well two years after surgery. We also review other reports of cholangiocarcinoma patients aged less than 30 years.

  18. Primary care physicians' knowledge of and confidence in their referrals for special education services in 3- to 5-year-old children.

    Science.gov (United States)

    Hastings, Elizabeth A; Lumeng, Julie C; Clark, Sarah J

    2014-02-01

    Children 3 to 5 years old with developmental delays are eligible for special education services. To assess primary care physicians' (PCPs) knowledge, attitudes, and practices regarding their referrals to the special education system on behalf of children 3 to 5 years old. Mail survey of 400 office-based general pediatricians and 414 family physicians in Michigan, fielded in fall 2012 and winter 2013, with a response rate of 44%. The 4-page survey included knowledge questions about special education eligibility, PCPs' role in accessing school-based services, and self-confidence in ability to help patients access these services. PCPs neither fully understood requirements for special education services nor were they very confident in identifying 3- to 5-year-old children eligible for special education services. PCPs recognize interacting with special education as a relative weakness, and they may be accepting of interventions to improve their knowledge and skills.

  19. PRIMARY PREVENTION OF MYOCARDIAL INFARCTION IN MIDDLE-AGED MALES (15-YEAR FOLLOW-UP: CLINICAL AND ECONOMIC ASPECTS OF THE PROBLEM

    Directory of Open Access Journals (Sweden)

    A. M. Kalinina

    2015-09-01

    Full Text Available Aim. To estimate incidence rate of first myocardial infarction (MI with different outcomes and factors, it is influenced by, depending on the intensity of preventive measures in a population of middle-aged men during 15-year follow-up; to evaluate economic efficiency of primary medical prevention.Material and methods. Two populations of middle-aged men with a total of 6656 males (3488 men the group of active prevention and 3168 the group of comparison were followed up over 15 years.Results. The group of active prevention revealed 22.1% reduced MI incidence rate during 5-year follow-up as compared to the second group, fatal MI incidence rate was 42.4% lower, p<0.05. Mortality rate in new cases of MI was 35.8% in the group of active prevention and 48.5% at routine treatment (p<0.05. The group of active prevention continued to have 17.9% reduced MI incidence rate during the 10-year follow-up as compared to the group of routine management (p>0.05, while patients with clinical signs of ischemic heart disease (IHD and no history of previous MI kept significant distinctions in first MI incidence rate (41% less in the first group, p<0.05. First MI incidence for the 10-year period was the least at risk factors (RF absence and twice higher even at single RF presence. Combination of RF caused 4-5 fold increase in risk for MI. Life status of 81.3% of the enrolled men (5410 of 6656 followed over 15 years was received along with the monitoring of prognosis.Such indices as “life years saved” (LYS and “quality-adjusted life years saved” (QALYS for 1000 persons in the active prevention group were 53 and 51 years, respectively during the 5-year follow-up, 147 and 143 years – during the 10-year follow-up. In the long-term actual expenses for 1 LYS were 3.4-fold less than annual gross domestic product (GDP value, at that charges for primary prevention – 4-fold less, which has been for the first time demonstrated using factual data and not mathematic

  20. PRIMARY PREVENTION OF MYOCARDIAL INFARCTION IN MIDDLE-AGED MALES (15-YEAR FOLLOW-UP: CLINICAL AND ECONOMIC ASPECTS OF THE PROBLEM

    Directory of Open Access Journals (Sweden)

    A. M. Kalinina

    2014-01-01

    Full Text Available Aim. To estimate incidence rate of first myocardial infarction (MI with different outcomes and factors, it is influenced by, depending on the intensity of preventive measures in a population of middle-aged men during 15-year follow-up; to evaluate economic efficiency of primary medical prevention.Material and methods. Two populations of middle-aged men with a total of 6656 males (3488 men the group of active prevention and 3168 the group of comparison were followed up over 15 years.Results. The group of active prevention revealed 22.1% reduced MI incidence rate during 5-year follow-up as compared to the second group, fatal MI incidence rate was 42.4% lower, p<0.05. Mortality rate in new cases of MI was 35.8% in the group of active prevention and 48.5% at routine treatment (p<0.05. The group of active prevention continued to have 17.9% reduced MI incidence rate during the 10-year follow-up as compared to the group of routine management (p>0.05, while patients with clinical signs of ischemic heart disease (IHD and no history of previous MI kept significant distinctions in first MI incidence rate (41% less in the first group, p<0.05. First MI incidence for the 10-year period was the least at risk factors (RF absence and twice higher even at single RF presence. Combination of RF caused 4-5 fold increase in risk for MI. Life status of 81.3% of the enrolled men (5410 of 6656 followed over 15 years was received along with the monitoring of prognosis.Such indices as “life years saved” (LYS and “quality-adjusted life years saved” (QALYS for 1000 persons in the active prevention group were 53 and 51 years, respectively during the 5-year follow-up, 147 and 143 years – during the 10-year follow-up. In the long-term actual expenses for 1 LYS were 3.4-fold less than annual gross domestic product (GDP value, at that charges for primary prevention – 4-fold less, which has been for the first time demonstrated using factual data and not mathematic

  1. Student teachers' conceptions of how to recognise a ``Good'' primary science teacher: Does two years in a teacher education program make a difference?

    Science.gov (United States)

    Skamp, Keith

    1995-12-01

    Several studies have suggested that preservice teacher education has little impact on student teacher conceptions about various facets of teaching and learning. Most of these studies refer to generic teaching and learning, and very few have related to primary science in particular. To explore this area eight primary student teachers were interviewed on six occasions during the first two years of their Bachelor of Teaching degree. This paper reports the findings from part of these interviews. It describes the (sometimes changing) conceptions which these eight students held about how they would recognise a “good” teacher of science and the people and experiences they believed influenced the formation of these views. The differential impact of past and present teachers and the teacher education program revealed possible implications for practica and science curriculum units in particular, if teacher education is going to have an influence on preservice teachers' conceptions about teaching and learning.

  2. Primary erythromelalgia in a 12-year-old boy: positive response to sodium channel blockers despite negative SCN9A mutations.

    Science.gov (United States)

    Jakob, A; Creutzfeldt, R; Staszewski, O; Winterpacht, A; Berner, R; Hufnagel, M

    2012-09-01

    Erythromelalgia is a rare disorder characterized by recurrent pain attacks, swelling and redness in the distal extremities. The primary forms of the disorder are caused by mutations in voltage-gated sodium channels. Treatment is difficult and controlled therapeutic studies offer little to no guidance. We report on a 12-year-old boy and his first occurrence of primary erythromelalgia. Genetic findings for mutations in the SCN9A gene, which encodes for the α-subunit of sodium channel NaV1.7, were negative. Although initial treatment with sodium nitroprusside was ineffective, subsequent medication with lidocaine and mexiletine, in combination with gabapentin, was successful. Despite negative findings for mutations in the sodium channels, the use of sodium channel blockers should be considered in these patients.

  3. Primary Ewing's sarcoma of the vertebral column

    Energy Technology Data Exchange (ETDEWEB)

    Ilaslan, Hakan; Sundaram, Murali [Department of Radiology, Mayo Clinic, Ch2-290 200 First Street, SW, Rochester, 55905, MN (United States); Unni, K.Krishnan [Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street, SW, 55905, Rochester, MN (United States); Dekutoski, Mark B. [Department of Orthopedic Surgery, Mayo Clinic, 200 First Street, SW, 55905, Rochester, MN (United States)

    2004-09-01

    To determine the demographics, imaging findings, clinical symptoms, and prognosis of primary vertebral Ewing's sarcoma (PVES). A retrospective review of medical records and radiological studies of patients diagnosed with PVES from 1936 through 2001 in our institution and Department of Pathology consultation files was undertaken. Metastatic and soft tissue Ewing's sarcoma cases were excluded. From a total of 1,277 cases of Ewing's sarcoma, 125 (9.8%) had a primary vertebral origin. There were 48 females and 76 males. Patient ages ranged from 4 to 54 (mean 19.3, standard deviation 10.7, median 16) years. Vertebral column distribution was four cervical (3.2%), 13 thoracic (10.5%), 31 lumbar (25%), and 67 sacrum (53.2%). More than one vertebral segment was involved in ten cases (8%). Satisfactory imaging studies were available in 51 patients: 49 radiographs, 27 computerized tomography (CT), and 23 magnetic resonance imaging (MRI) studies. The majority of tumors were lytic (93%). Three cases were mixed lytic and sclerotic (6%) and one sclerotic. In the nonsacral spine, the majority of lesions (12/20) involved the posterior elements with extension into the vertebral body. Five cases were centered in the vertebral body with extension into the posterior elements. Two cases were limited to the posterior elements, and one case solely involved the vertebral body. Ala was the most frequently affected site in the sacrum (18/26). Spinal canal invasion was frequent (91%). Detailed clinical information was available in 53 patients. Duration of symptoms ranged from 1 to 30 (mean 7) months. Local pain was the first symptom and seen in all cases. Neurological deficits were present in 21 (40%) cases. All patients received radiation in various dosages; 70% additionally received chemotherapy. Twenty-five patients had surgery, and two patients received bone marrow transplantation. Forty-five patients had follow-up; the five-year disease-free survival probability is 0

  4. PLAYgrounds: Effect of a PE playground program in primary schools on PA levels during recess in 6 to 12 year old children. Design of a prospective controlled trial

    Directory of Open Access Journals (Sweden)

    Verhagen Evert ALM

    2011-05-01

    Full Text Available Abstract Background The relative number of children meeting the minimal required dose of daily physical activity remains execrably low. It has been estimated that in 2015 one out of five children will be overweight. Therefore, low levels of physical activity during early childhood may compromise the current and future health and well-being of the population, and promoting physical activity in younger children is a major public health priority. This study is to gain insight into effects of a Physical Education based playground program on the PA levels during recess in primary school children aged 6-12. Methods/design The effectiveness of the intervention program will be evaluated using a prospective controlled trial design in which schools will be matched, with a follow-up of one school year. The research population will consist of 6-12 year old primary school children. The intervention program will be aimed at improving physical activity levels and will consist of a multi-component alteration of the schools' playground. In addition, playground usage will be increased through altered time management of recess times, as well as a modification of the Physical Education content. Discussion The effects of the intervention on physical activity levels during recess (primary outcome measure, overall daily physical activity and changes in physical fitness (secondary outcome measures will be assessed. Results of this study could possibly lead to changes in the current playground system of primary schools and provide structured health promotion for future public health. Trial registration Netherlands Trial Register (NTR: NTR2386

  5. PLAYgrounds: Effect of a PE playground program in primary schools on PA levels during recess in 6 to 12 year old children. Design of a prospective controlled trial

    Science.gov (United States)

    2011-01-01

    Background The relative number of children meeting the minimal required dose of daily physical activity remains execrably low. It has been estimated that in 2015 one out of five children will be overweight. Therefore, low levels of physical activity during early childhood may compromise the current and future health and well-being of the population, and promoting physical activity in younger children is a major public health priority. This study is to gain insight into effects of a Physical Education based playground program on the PA levels during recess in primary school children aged 6-12. Methods/design The effectiveness of the intervention program will be evaluated using a prospective controlled trial design in which schools will be matched, with a follow-up of one school year. The research population will consist of 6-12 year old primary school children. The intervention program will be aimed at improving physical activity levels and will consist of a multi-component alteration of the schools' playground. In addition, playground usage will be increased through altered time management of recess times, as well as a modification of the Physical Education content. Discussion The effects of the intervention on physical activity levels during recess (primary outcome measure), overall daily physical activity and changes in physical fitness (secondary outcome measures) will be assessed. Results of this study could possibly lead to changes in the current playground system of primary schools and provide structured health promotion for future public health. Trial registration Netherlands Trial Register (NTR): NTR2386 PMID:21548998

  6. Do high-risk infants have a poorer outcome from primary repair of coarctation? Analysis of 192 infants over 20 years.

    LENUS (Irish Health Repository)

    McGuinness, Jonathan G

    2012-02-01

    BACKGROUND: Balloon angioplasty for infant coarctation is associated with a high recurrence rate, making operative repair the gold standard for low-risk infants. Debate exists as to whether high-risk infants might be better served with primary angioplasty. We compared the outcome in high-risk versus low-risk infants over 20 years, in a center that always used surgical repair as the primary intervention. METHODS: Of 192 infants from 1986 to 2005, 56 were considered "high-risk," defined as requiring prostaglandin infusion together with either epinephrine infusion for 24 hours preoperatively, or ventilation and milrinone infusion for 24 hours preoperatively. All high-risk patients had a period of ventricular dysfunction prior to surgery, ranging from mild to severe. Outcomes were compared using Bonferroni comparison of means or the Fischer exact test as appropriate. RESULTS: Although the high-risk patients were smaller (3.3 +\\/- 0.1 vs 4.2 +\\/- 0.2 kg, p < 0.01), younger (18 +\\/- 4 vs 57 +\\/- 7 days, p < 0.01), and more often required a concomitant pulmonary artery band (25% vs 15%, p = 0.05), their cross-clamp times were the same as the low-risk patients (18.9 +\\/- 0.9 vs 18.0 +\\/- 0.4 minutes, p = 0.27) and there was no difference in postoperative morbidity (7% vs 3%, p = 0.11). However, there was a trend toward higher perioperative mortality (7% vs 2%, p = 0.07). When compared with the published studies of primary angioplasty in comparable high-risk infants, the mortality rate in our surgically treated high-risk group is much lower. Additionally, only 11% of our high-risk group required reintervention, with two-thirds treated successfully with a single angioplasty at 3.8 +\\/- 2.2 years later, far lower than recurrence rates with primary angioplasty. CONCLUSIONS: We propose that primary surgical repair of coarctation in infants who are high risk should be the primary treatment, with angioplasty reserved for recurrent coarctation.

  7. Representational change and strategy use in children's number line estimation during the first years of primary school

    Directory of Open Access Journals (Sweden)

    White Sonia LJ

    2012-01-01

    Full Text Available Abstract Background The objective of this study was to scrutinize number line estimation behaviors displayed by children in mathematics classrooms during the first three years of schooling. We extend existing research by not only mapping potential logarithmic-linear shifts but also provide a new perspective by studying in detail the estimation strategies of individual target digits within a number range familiar to children. Methods Typically developing children (n = 67 from Years 1-3 completed a number-to-position numerical estimation task (0-20 number line. Estimation behaviors were first analyzed via logarithmic and linear regression modeling. Subsequently, using an analysis of variance we compared the estimation accuracy of each digit, thus identifying target digits that were estimated with the assistance of arithmetic strategy. Results Our results further confirm a developmental logarithmic-linear shift when utilizing regression modeling; however, uniquely we have identified that children employ variable strategies when completing numerical estimation, with levels of strategy advancing with development. Conclusion In terms of the existing cognitive research, this strategy factor highlights the limitations of any regression modeling approach, or alternatively, it could underpin the developmental time course of the logarithmic-linear shift. Future studies need to systematically investigate this relationship and also consider the implications for educational practice.

  8. Single High Intensity Focused Ultrasound Session as a Whole Gland Primary Treatment for Clinically Localized Prostate Cancer: 10-Year Outcomes

    Directory of Open Access Journals (Sweden)

    Ksenija Limani

    2014-01-01

    Full Text Available Objectives. To assess the treatment outcomes of a single session of whole gland high intensity focused ultrasound (HIFU for patients with localized prostate cancer (PCa. Methods. Response rates were defined using the Stuttgart and Phoenix criteria. Complications were graded according to the Clavien score. Results. At a median follow-up of 94months, 48 (44.4% and 50 (46.3% patients experienced biochemical recurrence for Phoenix and Stuttgart definition, respectively. The 5- and 10-year actuarial biochemical recurrence free survival rates were 57% and 40%, respectively. The 10-year overall survival rate, cancer specific survival rate, and metastasis free survival rate were 72%, 90%, and 70%, respectively. Preoperative high risk category, Gleason score, preoperative PSA, and postoperative nadir PSA were independent predictors of oncological failure. 24.5% of patients had self-resolving LUTS, 18.2% had urinary tract infection, and 18.2% had acute urinary retention. A grade 3b complication occurred in 27 patients. Pad-free continence rate was 87.9% and the erectile dysfunction rate was 30.8%. Conclusion. Single session HIFU can be alternative therapy for patients with low risk PCa. Patients with intermediate risk should be informed about the need of multiple sessions of HIFU and/or adjuvant treatments and HIFU performed very poorly in high risk patients.

  9. Two years survival rate of class II composite resin restorations prepared by ART with and without a chemomechanical caries removal gel in primary molars.

    Science.gov (United States)

    Topaloglu-Ak, Asli; Eden, Ece; Frencken, Jo E; Oncag, Ozant

    2009-09-01

    The aim was to test the null hypotheses that there is no difference: (1) in carious lesion development at the restoration margin between class II composite resin restorations in primary molars produced through the atraumatic restorative treatment (ART) with and without a chemomechanical caries removal gel and (2) in the survival rate of class II composite resin restorations between two treatment groups after 2 years. Three hundred twenty-seven children with 568 class II cavitated lesions were included in a parallel mouth study design. Four operators placed resin composite (Filtek Z 250) restorations bonded with a self-etch adhesive (Adper prompt L pop). Two independent examiners evaluated the restorations after 0.5, 1, and 2 years using the modified Ryge criteria. The Kaplan-Meier survival method was applied to estimate survival percentages. A high proportion of restorations were lost during the study period. Therefore, the first hypothesis could not be tested. No statistically significant difference was observed between the cumulative survival percentages of restorations produced by the two treatment approaches over the 2-year period (ART, 54.1 +/- 3.4%; ART with Carisolv, 46.0 +/- 3.4%). This hypothesis was accepted. ART with chemomechanical gel might not provide an added benefit increasing the survival percentages of ART class II composite resin restorations in primary teeth.

  10. The presence of Matthew effects in Dutch primary education, development of language skills over a six-year period.

    Science.gov (United States)

    Luyten, Hans; ten Bruggencate, Gerdy

    2011-01-01

    Using a nationally representative sample of 5,150 Dutch students who have been followed over a 6-year period, the presence of the Matthew effect was investigated for general language skills. The analyses do not reveal unmistakable evidence for the supposition that the rich get richer and the poor poorer. On the contrary, in schools with low starting levels students make more progress than in schools with higher starting levels. On the other hand, the analyses do show a widening gap between students with well educated and poorly educated parents. The gap between delayed and accelerated students was found to increase as well, but the initial disadvantage of boys was found to disappear.

  11. Primary hemorrhagic stroke in a 12-year-old female with sickle cell disease and normal transcranial Doppler.

    Science.gov (United States)

    Wolf, Michael; Cangemi, Carla; Drachtman, Richard; Masterson, Margaret

    2008-06-01

    Stroke is a well-known complication of sickle cell disease (SCD). It is estimated to occur in approximately 11% of patients with SCD by the age of 20. The most frequent cause of cerebrovascular accident (CVA) is blockage of the intracranial internal carotid and middle cerebral arteries. Hemorrhagic stroke is less common, occurring in approximately 3% of children by age 20. Transcranial Doppler (TCD) is the standard test for prediction of stroke risk in children with sickle cell anemia. The authors present a case of a 12-year-old female with SCD transferred to their institution after suffering a catastrophic intracranial hemorrhage. Her most recent TCD was normal 6 months prior to her admission.

  12. Simultaneous Low- and High-Grade Primary Leiomyosarcomas in Two Separate Organs in a Thirty-Year Survivor of Hereditary Retinoblastoma

    Science.gov (United States)

    Moore, Katherine; Tawfik, Ossama; Hays, Allyson; Opole, Isaac

    2015-01-01

    Patients with hereditary retinoblastoma have a heightened risk of developing subsequent bone and soft tissue sarcomas, exacerbated by radiation and alkylating chemotherapy. Secondary leiomyosarcomas are rare. A 29-year-old patient with bilateral retinoblastoma history presented with concurrent, independent malignancies found to be Rb-suppressed uterine and Rb-positive bladder leiomyosarcomas. She had undergone both ifosfamide chemotherapy and radiation therapy but demonstrated rare simultaneous primary leiomyosarcomas not previously described in association with ifosfamide. This rare case underlines the protean genetic predisposition to malignancy in this patient population, heightening awareness of lifelong malignancy potential, and the necessity for continuous periodic screening. PMID:26843997

  13. Kleine-Levin Syndrome in an 8-Year-Old Girl with Autistic Disorder: Does Autism Account a Primary or Secondary Cause?

    Science.gov (United States)

    Hakim Shoushtari, Mitra; Ghalebandi, Mirfarhad; Tavasoli, Azita; Pourshams, Maryam

    2015-01-01

    Objective Kleine-Levin syndrome (KLS) is a rare disorder with an unknown etiology. Autism spectrum disorder is characterized by various degrees of impairment in social communication, repetitive behavior and restricted interests. Only four patients of KLS with autistic spectrum disorder (ASD) have been reported so far. This report presents an 8-year-old girl with history of autistic disorder and epilepsy that superimposed KLS. Because of the rarity of KLS and related studies did not address whether autism accounts for a primary or secondary cause, the area required attention further studies.

  14. Parents' socioeconomic factors related to high antibiotic prescribing in primary health care among children aged 0-6 years in the Capital Region of Denmark

    DEFF Research Database (Denmark)

    Jensen, Jette Nygaard; Bjerrum, Lars; Boel, Jonas

    2016-01-01

    -based registers from Statistics Denmark. SETTING: Antibiotic prescriptions in 2012 from primary health care in the Capital Region of Denmark. SUBJECTS: The population of children aged 0-6 years (n = 139,398) in the Capital Region of Denmark. MAIN OUTCOME MEASURES: High use of antibiotics identified by number...... and the association between high antibiotic use and low educational level. This would provide valuable information in the planning of strategies to promote rational use of antibiotics among children. KEY POINTS The Capital Region of Denmark has the highest rate of antibiotic prescribing in Denmark. Preschool children...

  15. Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance

    Directory of Open Access Journals (Sweden)

    Usui Takeshi

    2011-01-01

    Full Text Available Abstract Background A randomized control trial was performed to test whether a lifestyle intervention program, carried out in a primary healthcare setting using existing resources, can reduce the incidence of type 2 diabetes in Japanese with impaired glucose tolerance (IGT. The results of 3 years' intervention are summarized. Methods Through health checkups in communities and workplaces, 304 middle-aged IGT subjects with a mean body mass index (BMI of 24.5 kg/m2 were recruited and randomized to the intervention group or control group. The lifestyle intervention was carried out for 3 years by public health nurses using the curriculum and educational materials provided by the study group. Results After 1 year, the intervention had significantly improved body weight (-1.5 ± 0.7 vs. -0.7 ± 2.5 kg in the control; p = 0.023 and daily non-exercise leisure time energy expenditure (25 ± 113 vs. -3 ± 98 kcal; p = 0.045. Insulin sensitivity assessed by the Matsuda index was improved by the intervention during the 3 years. The 3-year cumulative incidence tended to be lower in the intervention group (14.8% vs.8.2%, log-rank test: p = 0.097. In a sub-analysis for the subjects with a BMI > 22.5 kg/m2, a significant reduction in the cumulative incidence was found (p = 0.027. Conclusions The present lifestyle intervention program using existing healthcare resources is beneficial in preventing diabetes in Japanese with IGT. This has important implications for primary healthcare-based diabetes prevention. Trial registration number UMIN000003136

  16. Prevalence and factors influencing smoking amongst Malay primary school children in Tumpat, Kelantan.

    Science.gov (United States)

    Norbanee, T H; Norhayati, M N; Norsa'adah, B; Naing, N N

    2006-01-01

    The aims of this study were to determine the prevalence, knowledge and factors that influence smoking in Malay primary school children in Tumpat, Kelantan. A cross-sectional study was conducted in February 2004 among primary school children in Tumpat District. Two hundred-twelve children in standard one to six were randomly selected from three rural schools. An interview that included information on history of ever smoking, knowledge related to smoking and health, and potential factors that could influence smoking was done. Twenty-five children had previously smoked, with a prevalence of 11.8% (95%CI=8.0, 17.0) and 8 were current smokers (3.8%, 95%CI=1.2, 6.4). More than half (64.6%) of the children had a good knowledge of smoking. However, only 105 (49.5%) of them knew that passive smokers have a higher risk of developing diseases. Of those who had ever smoked, 12 (36.6%) were influenced by peers and 17 (51.5%) had a self-desire to smoke. The earliest age to start smoking was at 6 years. Factors found to be significantly associated with smoking on multivariate analysis were increasing age (OR=2.8, 95%CI=1.6, 5.1), being boys (OR=5.8, 95%CI=2.0, 16.8), being at second school level (standard 4, 5, 6)(OR=7.8, 95%CI=1.3, 45.3) and having other family members (excluding father) who smoked (OR=2.8, 95%CI=1.2, 6.5). However, having a father who smoked and a good knowledge were not reported as influencing factors.

  17. Gangrenous cutaneous mucormycosis caused by Rhizopus oryzae: a case report and review of primary cutaneous mucormycosis in China over Past 20 years.

    Science.gov (United States)

    Li, HouMin; Hwang, Sonia Kay; Zhou, Cheng; Du, Juan; Zhang, JianZhong

    2013-08-01

    Cutaneous mucormycosis is a rare opportunistic infection caused by zygomycetes that can be rapidly fatal if unrecognized. We describe the clinical, histopathological, fungal and molecular features of a case of gangrenous cutaneous mucormycosis. The patient presented with great necrosis on his right forearm at the site of detained intravenous cannula needle. He had type II diabetes and chronic renal insufficiency. KOH mount of black eschar showed many broad, aseptate fungal hyphae with right-angle branching. PAS staining of the tissue sample revealed similar broad hyphae in the dermis and cutis. Fungal culture and ITS sequence analysis identified this fungus as Rhizopus oryzae. As no organ involvement was detected, the patient was diagnosed with primary cutaneous mucormycosis. Considering the poor state of the patient, complete excision of the infectious tissue was performed without skin graft instead of amputation. At the same time, intravenous liposomal amphotericin B was given, starting from a small dosage and increased to a total dosage amount of 5.45 g. The wound recovered well with granulation. We emphasize that early recognition and prompt therapy including the control of the primary diseases were important. In this article, we also reviewed the features of primary cutaneous mucormycosis reported in China over the last 20 years.

  18. Clinical and Radiographic Evaluation of the Effectiveness of Formocresol, Mineral Trioxide Aggregate, Portland Cement, and Enamel Matrix Derivative in Primary Teeth Pulpotomies: A Two Year Follow-Up.

    Science.gov (United States)

    Yildirim, Ceren; Basak, Feridun; Akgun, Ozlem Marti; Polat, Gunseli Guven; Altun, Ceyhan

    2016-01-01

    The aim of this study was to evaluate and to compare clinical and radiographic outcomes of 4 materials (formocresol, mineral trioxide aggregate (MTA), Portland cement and enamel matrix derivative) using in primary teeth pulpotomies. Sixty-five patients aged 5-9 years (32 female, 33 male) were included in this study. A total of 140 primary first and second molars with deep caries were treated with pulpotomy. All teeth were then restored with stainless steel crowns. The treated teeth were evaluated clinically and radiographically at 3, 6, 12, 18 and 24 months. At 24 months, the clinical success rates of formocresol, MTA, Portland cement, and enamel matrix derivative were 96.9%, 100%, 93.9%, and 93.3%, respectively. The corresponding radiographic success rates were 84.4%, 93.9%, 86.7% and 78.1%, respectively. Although there were no statistically significant differences in clinical and radiographic success rates among the 4 groups, MTA appears to be superior to formocresol, Portland cement, and enamel matrix derivative as a pulpotomy agent in primary teeth.

  19. Family related factors associated with caries prevalence in the primary dentition of five-year-old children

    Directory of Open Access Journals (Sweden)

    Amrita Sujlana

    2015-01-01

    Full Text Available Background: Habits formed in childhood dictate lifestyle choices made as adults. These encompass both oral hygiene and dietary habits which in turn affect dental caries status. Children largely acquire these habits from modeling/observing parents and other family members. Aim: The purpose of this study was to assess the caries status of 5-year-olds, and evaluate associations between dental caries and family-related factors. Materials and Methods: A cohort of 400 children were examined for dental caries using the WHO criteria. Parents were interviewed using a self-structured questionnaire to collect data with regard to variables under evaluation. Statistical analysis: Collected data was subjected to descriptive analysis using the SPSS 12.0 version. Risk factor association with dental caries was investigated using a stepwise logistic regression analysis with P-values 0 were: Mother with low basic education (OR = 1.3, higher number of siblings (OR = 1.4, high snacking frequency (OR = 2.0, parental inability to control sugar consumption (OR = 1.0 parental laxness about the child′s tooth brushing (OR = 1.5, parents brushing their own teeth less than twice daily (OR= 2.0 and unassisted brushing by the child (OR = 1.8. Conclusion: It is thus mandatory to focus on parents′ education level, attitudes and family-structure when planning preventive programs for young children.

  20. Family related factors associated with caries prevalence in the primary dentition of five-year-old children.

    Science.gov (United States)

    Sujlana, Amrita; Pannu, Parampreet Kaur

    2015-01-01

    Habits formed in childhood dictate lifestyle choices made as adults. These encompass both oral hygiene and dietary habits which in turn affect dental caries status. Children largely acquire these habits from modeling/observing parents and other family members. The purpose of this study was to assess the caries status of 5-year-olds, and evaluate associations between dental caries and family-related factors. A cohort of 400 children were examined for dental caries using the WHO criteria. Parents were interviewed using a self-structured questionnaire to collect data with regard to variables under evaluation. Collected data was subjected to descriptive analysis using the SPSS 12.0 version. Risk factor association with dental caries was investigated using a stepwise logistic regression analysis with P-values children suffered from dental caries. Statistically significant risk indicators for a child having dmft > 0 were: Mother with low basic education (OR = 1.3), higher number of siblings (OR = 1.4), high snacking frequency (OR = 2.0), parental inability to control sugar consumption (OR = 1.0) parental laxness about the child's tooth brushing (OR = 1.5), parents brushing their own teeth less than twice daily (OR= 2.0) and unassisted brushing by the child (OR = 1.8). It is thus mandatory to focus on parents' education level, attitudes and family-structure when planning preventive programs for young children.

  1. Primary Leiomyosarcoma of the Mandibular Alveolar Mucosa of a 12-Year-Old Child from Ethiopia: A Case Report.

    Science.gov (United States)

    Kenea, Tewodros Tefera; Kebede, Betel Abebe; Gozjuze, Fekadu Mesele; Kiros, Hagos; Wilde, Frank

    2017-03-01

    Leiomyosarcomas (LMSs) are rare malignant mesenchymal tumors which show smooth-muscle differentiation. Most LMSs involving the oral tissues primarily affect the maxillary sinus, the maxillary or mandibular bone. We present a case of LMS of the mandibular alveolar mucosa, arising in a 12-year-old male child from Ethiopia. A malignant spindle cell-like neoplasm was diagnosed on clinical and radiographic findings as well as on incisional biopsy. The tumor was resected with wide margins. The following histopathologic examination with additional immunohistochemical studies secured the diagnosis LMS. Microscopically, the spindle-shaped tumor cells were arranged in an interlacing fascicular pattern and contained oval to elongated, blunt-ended (cigar-shaped) nuclei. The immunohistochemical examination showed immunoreactive tumor cells for vimentin, actin, desmin, and H-caldesmon, which is pathognomonic for LMS. Immunohistochemical studies are mandatory to differentiate the LMS from other similar spindle cell neoplastic lesions. Radical resection with safety margins and a lifelong periodic follow-up has to be recommended.

  2. Five-year cost-effectiveness of the Patient Empowerment Programme (PEP) for type 2 diabetes mellitus in primary care.

    Science.gov (United States)

    Lian, Jinxiao; McGhee, Sarah M; So, Ching; Chau, June; Wong, Carlos K H; Wong, William C W; Lam, Cindy L K

    2017-09-01

    This study evaluated the short-term cost-effectiveness of the Patient Empowerment Programme (PEP) for diabetes mellitus (DM) in Hong Kong. Propensity score matching was used to select a matched group of PEP and non-PEP subjects. A societal perspective was adopted to estimate the cost of PEP. Outcome measures were the cumulative incidence of all-cause mortality and diabetic complication over a 5-year follow-up period and the number needed to treat (NNT) to avoid 1 event. The incremental cost-effectiveness ratio (ICER) of cost per event avoided was calculated using the PEP cost per subject multiplied by the NNT. The PEP cost per subject from the societal perspective was US$247. There was a significantly lower cumulative incidence of all-cause mortality (2.9% vs 4.6%, P < .001), any DM complication (9.5% vs 10.8%, P = .001) and CVD events (6.8% vs 7.6%, P = .018), in the PEP group. The costs per death from any cause, DM complication or case of CVD avoided were US$14 465, US$19 617 and US$30 796, respectively. The extra amount allocated to managing PEP was small and it appears cost-effective in the short-term as an addition to RAMP. © 2017 John Wiley & Sons Ltd.

  3. Knowledge and skills of primary health care workers trained on integrated management of neonatal and childhood illness: Follow-up assessment 3 years after the training

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    J Venkatachalam

    2011-01-01

    Full Text Available Background: The primary health care workers of a district in northern India were trained in the year 2006 for Integrated Management of Neonatal and Childhood Illness (IMNCI using two different training methods: conventional 8-day training and new interrupted 5-day training. Knowledge and skills may decline over a period of time. Rate of decline may be associated with the type of training. A study was thus conducted to see the retention of knowledge and skills in the two training groups, 3 years after the initial training. Materials and Methods: This study was done in the Panchkula district of Haryana state in northern India. In the year 2006, 50 primary health care workers were given new interrupted 5-day training and another 35 workers were given conventional 8-day training on IMNCI. Knowledge and skills of the same workers were evaluated in the year 2009, using the same methodology and tools as were used in the year 2006. Data analysis was done to see the extent of decline in knowledge and skills in these 3 years and whether decline was more in any particular training group. Results: Compared to post-training score in the year 2006, composite knowledge and skill scores for Auxilliary Nurse Midwives (ANMs and Anganwari workers (AWWs together declined significantly in the year 2009 from 74.6 to 58.0 in 8-day training group and from 73.2 to 57.0 in 5-day training group (P < 0.001. Follow-up composite scores in the two training groups were similar. Whereas the decline was more for knowledge scores in 8-day training group and for skill score in 5-day training group, the pattern of decline was inconsistent for different health conditions and among ANMs and AWWs. Conclusion: Long-term retention of knowledge and skills in 5-day group was equivalent to that in 8-day training group. Refresher trainings may boost up the decline in the knowledge and skills.

  4. Results of a Second-generation Constrained Condylar Prosthesis in Complex Primary and Revision Total Knee Arthroplasty: A Mean 5.5-Year Follow-up

    Institute of Scientific and Technical Information of China (English)

    Chen-Yi Ye; De-Ting Xue; Shuai Jiang; Rong-Xin He

    2016-01-01

    Background:The application of second-generation constrained condylar knee (CCK) prostheses has not been widely studied.This retrospective study was carried out to evaluate the clinical and radiographic outcomes of a second-generation CCK prosthesis for complex primary or revision total knee arthroplasty (TKA).Methods:In total,51 consecutive TKAs (47 patients) were performed between June 2003 and June 2013 using second-generation modular CCK prostheses.The follow-up was conducted at 3rd day,1st,6th,and 12th months postoperatively and later annually.Anteroposterior (AP),lateral,skyline,and long-standing AP radiographs of the affected knees were taken.The Hospital for Special Surgery (HSS) Knee Score,the Knee Society Knee Score (KSKS),the Knee Society Function Score (KSFS),and range of motion (ROM) were also recorded.Heteroscedastic two-tailed Student's t-tests were used to compare the HSS score and the Knee Society score between primary and revision TKAs.A value ofP < 0.05 was considered statistically significant.Results:Four knees (two patients) were lost to follow-up,and 47 knees (31 primary TKAs and 16 revision TKAs) had a mean follow-up time of 5.5 years.The mean HSS score improved from 51.1 ± 15.0 preoperatively to 85.3 ± 8.4 points at the final follow-up (P < 0.05).Similar results were observed in terms of the KSKS and KSFS,which improved from 26.0 ± 13.0 to 80.0 ± 12.2 and from 40.0 ± 15.0 to 85.0 ± 9.3 points,respectively (P < 0.05).No significant difference in the HSS,KSKS,KSFS,or ROM was found between primary and revision TKAs (P> 0.05).Two complications were observed in the revision TKA group (one intraoperative distal femur fracture and one recurrence of infection) while one complication (infection) was observed in the primary TKA group.No prosthesis loosening,joint dislocation,patella problems,tibial fracture,or nerve injury were observed.Radiolucent lines were observed in 4% of the knees without progressive osteolysis

  5. Malign Recurrence of Primary Chest Wall Hemangiopericytoma in the Lung after Four Years: A Case Report and Review of the Literature

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    Tulay Akman

    2014-01-01

    Full Text Available Hemangiopericytoma (HPC may develop in every site where the endothelial tissue exits and primarily develops in the skeletal-muscular system or the skin. Adult cases of HPC generally exhibit a benign course. 20–30% of the cases may show a malign course. The tumors that show more than four mitoses, a focal area of necrosis, and increased cellularity on a magnification ×10 are considered as malign. In our paper, we presented our case who showed a lung metastasis at the end of 4 years and who developed a pathological fracture of the right humerus at the end of approximately 2 years, because hemangiopericytoma is rarely seen in the chest wall as a primary tumor.

  6. Gulf of Mexico continental slope study annual report, year 2. Volume 2. Primary volume. Interim report 1985-1986. [Sampling for hydrocarbons

    Energy Technology Data Exchange (ETDEWEB)

    1986-09-01

    This report, which was prepared in three volumes (Executive Summary, Primary Volume, and Appendix), details the findings of two years of sampling on the continental slope of the northern Gulf of Mexico at depths of 300-3000 m. Preliminary results from a third year of sampling are also presented. Physical and chemical measurements included: CTD casts at 35 stations; sediment characteristics, including hydrocarbons and bulk sediment parameters from 60 stations; tissue hydrocarbon levels of representative benthic organisms; and delta carbon-13 values from sediments and organisms, including comparison of areas of natural petroleum seepage to prevailing slope conditions. The biological oceanography section provides detailed enumeration of megafaunal specimens collected by trawling and of macro- and meiofaunal specimens collected with a 600 sq cm box core. Major megafaunal groups treated are Arthropoda, Echinodermata, and demersal fishes.

  7. Long-term effectiveness of a school-based primary prevention program for anorexia nervosa: A 7-to 8-year follow-up.

    Science.gov (United States)

    Adametz, Luise; Richter, Felicitas; Strauss, Bernhard; Walther, Mario; Wick, Katharina; Berger, Uwe

    2017-04-01

    This is the first study to evaluate the long-term effectiveness of a school-based prevention program in Germany. The aim is to determine the long-term effects of the primary prevention program PriMa (Primary prevention of anorexia nervosa in preadolescent girls) on disordered eating and body self-esteem from childhood to young adulthood. PriMa was conducted and successfully evaluated in a quasi-experimental pre-post design with a control group from 2007 to 2008 consisting of 11-13year old girls (N=1508) from Thuringian schools in Germany. Seven to eight years after the intervention, the same cohort (mean age 19.8years) was invited to complete an online survey. Disordered eating (EAT-26), body self-esteem (FBeK) and BMI were assessed via self-report. The response rate at seven-to-eight-year follow-up was very low (7%). Data of N=100 girls were analyzed. Concerning changes in disordered eating, results revealed no significant long-term effect of PriMa seven to eight years after the intervention. During this time, disordered eating remained stable without a significant increase or decrease. Regarding changes in body self-esteem, group courses differed significantly from each other. The results revealed a significant main effect of group, indicating significant differences in changes of body self-esteem between the intervention and the control group. Following the analysis of these changes of body self-esteem over time, it was found that the intervention group revealed an increase of body self-esteem after program participation and remained stable over time. By contrast, the control group revealed a decrease of body self-esteem over time. Long-term intervention effects of PriMa could be found for body self-esteem but not for disordered eating. The findings suggest that PriMa prevented a decrease of body self-esteem from childhood to young adulthood. For a broader dissemination it is necessary to implement prevention programs consistently in school settings. In order to

  8. Relationship between obesity and leptin serum among low socioeconomic primary school children aged 5-7 years

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    Soenarto Soenarto

    2010-06-01

    Full Text Available Background Obesity has become a major health problem globally, indicates as an epidemic problem by World Health Organization (WHO. Adiposity rebound period may represent critical period for the development of adiposity. Recent data suggest that, in industrialized countries, people of low socioeconomic group are more likely to be obese than their high socioeconomic counterparts. Level of serum leptin was reported to be higher in obese subjects. There has been lack of data regarding leptin serum level in Indonesian obese children. Objective This study aimed to investigate leptin serum level in low socioeconomic obese children.  Methods This was a cross sectional study perfonned in Tuminting District, Manado. Obesity was defined based on body mass index for AsiaPacific condition, i.e., grade I obesity (BMI 25/29.9 kg/ mL, grade II (BM] 30-40 kg/ml, and grade III (BM] > 40 kg/m2 Low socioeconomic status was detennined based on Government's program Cash Direct Aid Program. loBod sample was obtained from inclusion subjects, consisted of leptin serum. Results Fiftytwo low socioeconomic obese children were eligible \\\\lith age ranged between 5 to 7 years. They were divided into grade ] obesity (43 or 82.7%, and grade II (9 or 17.3%. The lowest leptin blood level was 10,291 pg/mL, while the highest was 41,500 pg/dL. All girls had nonnal serum leptin level; in contrast all boys had increased serum leptin level.  Conclusions Leprin level increased in those subjects whose BMI increased.

  9. Point-Counterpoint: Cervical Cancer Screening Should Be Done by Primary Human Papillomavirus Testing with Genotyping and Reflex Cytology for Women over the Age of 25 Years.

    Science.gov (United States)

    Stoler, Mark H; Austin, R Marshall; Zhao, Chengquan

    2015-09-01

    Screening for cervical cancer with cytology testing has been very effective in reducing cervical cancer in the United States. For decades, the approach was an annual Pap test. In 2000, the Hybrid Capture 2 human papillomavirus (HPV) test was approved by the U.S. Food and Drug Administration (FDA) for screening women who have atypical squamous cells of underdetermined significance (ASCUS) detected by Pap test to determine the need for colposcopy. In 2003, the FDA approved expanding the use of the test to include screening performed in conjunction with a Pap test for women over the age of 30 years, referred to as "cotesting." Cotesting allows women to extend the testing interval to 3 years if both tests have negative results. In April of 2014, the FDA approved the use of an HPV test (the cobas HPV test) for primary cervical cancer screening for women over the age of 25 years, without the need for a concomitant Pap test. The approval recommended either colposcopy or a Pap test for patients with specific high-risk HPV types detected by the HPV test. This was based on the results of the ATHENA trial, which included more than 40,000 women. Reaction to this decision has been mixed. Supporters point to the fact that the primary-screening algorithm found more disease (cervical intraepithelial neoplasia 3 or worse [CIN3+]) and also found it earlier than did cytology or cotesting. Moreover, the positive predictive value and positive-likelihood ratio of the primary-screening algorithm were higher than those of cytology. Opponents of the decision prefer cotesting, as this approach detects more disease than the HPV test alone. In addition, the performance of this new algorithm has not been assessed in routine clinical use. Professional organizations will need to develop guidelines that incorporate this testing algorithm. In this Point-Counterpoint, Dr. Stoler explains why he favors the primary-screening algorithm, while Drs. Austin and Zhao explain why they prefer the cotesting

  10. Fifteen-Year Follow-Up Results of Presurgical Orthopedics Followed by Primary Correction for Unilateral Cleft Lip Nose in Program SEHATI in Indonesia.

    Science.gov (United States)

    Sulaiman, Farida Kamil; Haryanto, Inge Gustiningsih; Hak, Syafrudin; Nakamura, Norifumi; Sasaguri, Masaaki; Ohishi, Masamichi

    2013-03-01

    Objective : To assess long-term effects of nasal correction in infancy on nasal form and growth in patients with unilateral cleft lip, alveolus, and palate (UCLP). Design : Retrospective longitudinal study. Patients : Seventeen patients with complete UCLP treated in Program SEHATI in Harapan Kita Children and Maternity Hospital, Indonesia, and followed for approximately 15 years were enrolled. Interventions : Subjects received presurgical orthopedics using a Hotz's plate and simultaneous primary lip and nose repair in which the lower lateral cartilage was repositioned through a reverse-U incision. Main Outcome Measures : Preoperative and postoperative nasal forms, including the nostril height and width ratio, the ratio of the height of the top of the alar groove, and the ratio of nostril surface areas were analyzed using color photos taken serially. One-way analysis of variance was used for statistical analyses. Results : The nostril height and width ratio and the height of the alar groove were significantly improved postoperatively and maintained for 15 years. The mean ratio of nostril surface areas was 1.01 ± 0.12 fifteen years postoperatively, and there was no significant difference from the ratio 1 year postoperatively. The major persistent deformities were septal deviation and a small skin web on the nostril rim. Conclusions : Our primary cleft lip nose correction has provided an acceptable nose form and absence of disturbance of the nasal growth in patients with UCLP. However, the repositioning of the nasal cartilage at infancy might not eliminate the need for secondary correction after puberty.

  11. Parents' socioeconomic factors related to high antibiotic prescribing in primary health care among children aged 0-6 years in the Capital Region of Denmark.

    Science.gov (United States)

    Jensen, Jette Nygaard; Bjerrum, Lars; Boel, Jonas; Jarløv, Jens Otto; Arpi, Magnus

    2016-09-01

    To investigate the distribution of antibiotic prescriptions in primary health care among children aged 0-6 years and its association with socioeconomic factors. A cross-sectional study describing antibiotic prescriptions and socioeconomic factors, using different population-based registers from Statistics Denmark. Antibiotic prescriptions in 2012 from primary health care in the Capital Region of Denmark. The population of children aged 0-6 years (n = 139,398) in the Capital Region of Denmark. High use of antibiotics identified by number of antibiotic prescriptions (≥ 3 prescriptions per year) and defined daily doses (DDD). A multinomial logistic regression analysis estimating the association between high antibiotic use and parents' education, employment status, income, child's sex, and ethnic background. Ten percent of children accounted for 25% of the total use DDD. There was a clear tendency that the risk for high antibiotic use increased as parental educational level decreased. The risk for high use was the highest among children of mothers and fathers with basic schooling ≤10 years (OR 1.60, 95% CI 1.29-1.98, and OR 1.60, 95% CI 1.34-1.91, respectively). Low income and unemployment were not associated with high antibiotic use. Socioeconomic factors can only partially explain differences in antibiotic use. Further research is needed to clarify the unequal distribution of antibiotic prescribing and the association between high antibiotic use and low educational level. This would provide valuable information in the planning of strategies to promote rational use of antibiotics among children. KEY POINTS The Capital Region of Denmark has the highest rate of antibiotic prescribing in Denmark. Preschool children are among the age groups with the highest use. Ten percent of the children accounted for 25% of the total antibiotic use. Low parental educational level was associated with increased antibiotic use. Parents' income or employment status was not found

  12. Underlying Primary Causes of Chronic Renal Failure: A Three-Year Study in Al-Thawra General Hospital, Sana'a, Yemen

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    Mogahid Y. Nassar

    2016-12-01

    Full Text Available Objective: To estimate the underlying primary diseases of chronic renal failure (CRF among patients attending Al-Thawra General Hospital, Sana'a, and Yemen. Methods: This was a cross-sectional, hospital-based study of 566 patients diagnosed with chronic kidney diseases (CKD. It studied the cases attending Al-Thawra General Hospital over a three‐year period from January 2013 to De-cember 2015. Results: Out of 566 patients, 339 (59.9% were males. The mean age of the patients at diagnosis of CKD was 39.51 years, most of whom (36.6% were of the age group of 21–35 years. Hypertension was the most frequent cause (43.2% of CRF, followed by different infectious diseases such as malaria, schistosomiasis and bacterial infections (19% and obstructive nephropathy (17.9%. On the other hand, CRF of unknown etiology represented 15.2% of cases. Other causes of CRF diabetic nephropathy (9.7%, effect of antibiotics and analgesics (7.0%, ischemic heart disease (4.8%, polycystic kidney disease (3.5% and congenital anomalies (3.4%. The least common causes were autoimmune diseases, bleeding, traumatic accidents and chronic diarrhea, being responsible for 2.2%, 1.8%, 0.9% and 0.4% of CRF cases, respectively. Conclusions: The majority of CKD cases in our study were males aged between 21 and 35 years old. In addition, most cases of CKD are due to hypertension, followed by infections and obstructive nephropathy. Application of future prevention and control measures are highly recommended to reduce the burden of CRF in Yemen for early detection and proper management of its underlying primary conditions/diseases.

  13. [CASERIA program (Healthy Habits in Primary School Questionnaire). Responses of 6 to 10 year-old children].

    Science.gov (United States)

    Rodríguez Huertas, E; Solana Moreno, M I; Rodríguez Espinosa, F; Rodríguez Moreno, M J; Aguirre Rodríguez, J C; Alonso Ródenas, M

    2012-01-01

    In schoolchildren examinations, carried out periodically, we detect a continuous increase in obesity and sedentarism in our schoolchildren. In this study we attempt to compare, with objective data, the real situation of the childhood population in our area, as regards their eating habits, physical activity and hygiene. Questionnaires on eating habits, preferences as regards diet, doing exercise, and dental hygiene, were handed out to 430 schoolchildren between 6 and 10 years-old. A total of 366 were valid for the study. The majority (85.8%) of those surveyed lived within a "traditional" family; 22% had family members who were overweight; 96.7% had breakfast before going to school, with milk products being the most consumed; the cake and pastry industry was well used, both at breakfast (7.4%) and at playtime (16.9%). The favourite food was pasta in 29.8% of cases, followed by potatoes, particularly fried (10.4%). The least liked foods were vegetables (26.2%) and fish (8.2%). Television was watched for more than 2 hours by 70%; 34% exceeded 2 hours or more per day playing with video consoles or similar. On the other hand, homework and studying took up more than 2 hours daily for 50% of pupils. A majority (55%) of those surveyed ate sweets 2 or more time a day, and to eat and watch television at the same time was an almost constant habit in more than 60%. Of the participants in the study, 9.29% never brushed their teeth. The theoretical knowledge of what should be a correct diet seems adequate, but its putting into practice is not. The population studies had fairly sedentary habits, with little fruit and they did not like pulses or vegetables or fish. All these factors decrease the cardiovascular protection associated with its practice and consumption. We have shown that they are already present since childhood in our population, which without a doubt will have repercussions in their future health status and well-being, if it is not changed. Copyright © 2011 Elsevier

  14. Questionable effect of lavage for treatment of painful jaw movements at disc displacement without reduction: a 3-year randomised controlled follow-up.

    Science.gov (United States)

    Baker, Z; Eriksson, L; Englesson Sahlström, L; Ekberg, Ec

    2015-10-01

    The present randomised controlled study compared the 3-year outcome of local anaesthetics with anaesthetics and lavage in patients suffering from painful temporomandibular joint (TMJ) locking. The study included 45 patients referred for treatment of temporomandibular disorders (TMD) to the Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden. All patients received a history questionnaire and clinical examination according to the Research Diagnostic Criteria for TMD, panoramic radiographs and magnetic resonance imaging at baseline. Twenty-five patients were randomised to anaesthetics alone and 20 patients to anaesthetics and lavage. Three years after treatment, we sent the 37 patients who were available for follow-up a questionnaire that evaluated pain intensity, physical and emotional functioning, and global improvement. Thirty-four patients responded. The primary outcome was defined as ≥ 30% pain relief. In an intention-to-treat analysis, 28 of 45 patients (62%) reported ≥ 30% pain relief at the follow-up. At 3 years, improvement in pain relief, physical functioning, emotional functioning and global improvement differed non-significantly between local anaesthetics and anaesthetics and lavage. Compared with baseline, significant improvements (P displacement without reduction, use of lavage (50 mL saline) has an equivalent effect as local anaesthetics. © 2015 John Wiley & Sons Ltd.

  15. Primary care consultation, hospital admission, sick leave and disability pension owing to neck and low back pain: a 12-year prospective cohort study in a rural population

    Directory of Open Access Journals (Sweden)

    Holmberg Sara AC

    2006-08-01

    Full Text Available Abstract Background Neck and low back pain are common musculoskeletal complaints generating large societal costs in Western populations. In this study we evaluate the magnitude of long-term health outcomes for neck and low back pain, taking possible confounders into account. Method A cohort of 2,351 Swedish male farmers and rural non-farmers (40–60 years old was established in 1989. In the first survey, conducted in 1990–91, 1,782 men participated. A 12-year follow-up survey was made in 2002–03 and 1,405 men participated at both times. After exclusion of 58 individuals reporting a specific back diagnosis in 1990–91, the study cohort encompassed 1,347 men. The health outcomes primary care consultation, hospital admission, sick leave and disability pension were assessed in structured interviews in 2002–03 (survey 2. Symptoms and potential confounders were assessed at survey 1, with the exception of rating of depression and anxiety, which was assessed at survey 2. Multiple logistic regression generating odds ratios (OR with 95% confidence intervals (95% CI was performed to adjust the associations between reported symptoms and health outcomes for potential confounders (age, farming, workload, education, demand and control at work, body mass index, smoking, snuff use, alcohol consumption, psychiatric symptoms and specific back diagnoses during follow up. Results Of the 836 men reporting current neck and/or low back pain at survey 1, 21% had had at least one primary care consultation for neck or low back problems, 7% had been on sick leave and 4% had disability pension owing to the condition during the 12 year follow up. Current neck and/or low back pain at survey 1 predicted primary care consultations (OR = 4.10, 95% CI 2.24–7.49 and sick leave (OR = 3.22, 95% CI 1.13–9.22 after potential confounders were considered. Lower education and more psychiatric symptoms were independently related to sick leave. Lower education and snuff use

  16. Lymphatic microsurgical preventing healing approach (LYMPHA) for primary surgical prevention of breast cancer-related lymphedema: over 4 years follow-up.

    Science.gov (United States)

    Boccardo, Francesco; Casabona, Federico; De Cian, Franco; DeCian, Franco; Friedman, Daniele; Murelli, Federica; Puglisi, Maria; Campisi, Corrado C; Molinari, Lidia; Spinaci, Stefano; Dessalvi, Sara; Campisi, Corradino

    2014-09-01

    Breast cancer-related lymphedema (LE) represents an important morbidity that jeopardizes breast cancer patients' quality of life. Different attempts to prevent LE brought about improvements in the incidence of the pathology but LE still represents a frequent occurrence in breast cancer survivors. Over 4 years ago, Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) was proposed and long-term results are reported in this study. From July 2008 to December 2012, 74 patients underwent axillary nodal dissection for breast cancer treatment together with LYMPHA procedure. Volumetry was performed preoperatively in all patients and after 1, 3, 6, 12 months, and once a year. Lymphoscintigraphy was performed in 45 patients preoperatively and in 30 also postoperatively after at least over 1 year. Seventy one patients had no sign of LE, and volumetry was coincident to preoperative condition. In three patients, LE occurred after 8-12 months postoperatively. Lymphoscintigraphy showed the patency of lymphatic-venous anastomoses at 1-4 years after operation. LYMPHA technique represents a successful surgical procedure for primary prevention of arm LE in breast cancer patients.

  17. Outcome and consequences according to the type of transient loss of consciousness: 1-year follow-up study among primary health care patients.

    Science.gov (United States)

    Martikainen, Kirsti K; Seppä, Kaija; Viita, Paula M; Rajala, Sulo A; Luukkaala, Tiina H; Keränen, Tapani

    2011-01-01

    The prognosis of transient loss of consciousness (LOC) was studied in a one-year follow-up survey. Included were adult patients referred by primary health care physicians for a non-acute specialist consultation during the 2-year period from 01.10.1999 to 30.9.2001. The main outcome measures were recurrence of LOCs during the follow-up, fear of recurrence, injuries, and employment. Altogether, 109 consecutive patients were followed and 39 (36%) suffered a recurrence during the one-year follow-up: 17 (30%) with syncope, 16 (43%) with seizure and six (38%) with uncertain type of LOC. The first ever seizure recurred in 5/9 (56%) during the first year, but only 1 of 17 (6%) first syncope attacks. There was no difference in the recurrence rate if the patient had had previous attacks prior to the index LOC. Injuries, mainly minor, were associated with LOCs in 56% of patients. The risk of injury was highest (83%) with alcohol-related seizures. The unemployment rate was especially high in the seizure group. Fear of recurrence was more common at the beginning than at the end of the follow-up. Seizures recur relatively often, but also recurrent syncope needs more attention--both may cause fear and lead to injuries.

  18. Physical activity on prescription (PAP): self-reported physical activity and quality of life in a Swedish primary care population, 2-year follow-up

    Science.gov (United States)

    Rödjer, Lars; H. Jonsdottir, Ingibjörg; Börjesson, Mats

    2016-01-01

    Objective To study the self-reported level of physical activity (PA) and quality of life (QOL) in patients receiving physical activity on prescription (PAP) for up to 24 months. Design Observational study conducted in a regular healthcare setting. Setting A primary care population in Sweden receiving physical activity on prescription as part of regular care was studied alongside a reference group. Subjects The group comprised 146 patients receiving PAP at two different primary care locations (n = 96 and 50, respectively). The reference group comprised 58 patients recruited from two different primary care centres in the same region. Main outcome measurements We used two self-report questionnaires – the four-level Saltin-Grimby Physical Activity Level Scale (SGPALS) to assess physical activity, and SF-36 to assess QOL. Results A significant increase in the PA level was found at six and 12 months following PAP, with an ongoing non-significant trend at 24 months (p = .09). A clear improvement in QOL was seen during the period. At 24 months, significant and clinically relevant improvements in QOL persisted in four out of eight sub-scale scores (Physical Role Limitation, Bodily Pain, General Health,Vitality) and in one out of two summary scores (Physical Component Summary). Conclusion Patients receiving PAP showed an increased level of self-reported PA at six and 12 months and improved QOL for up to 24 months in several domains. The Swedish PAP method seems to be a feasible method for bringing about changes in physical activity in different patient populations in regular primary healthcare. While increased physical activity (PA) is shown to improve health, the implementation of methods designed to increase activity is still being developed. Key points The present study confirms that the Swedish physical activity on prescription (PAP) method increases the self-reported level of PA in the primary care setting at six and 12 months. Furthermore, this study shows

  19. Low-Dose Aspirin for Primary Prevention of Cardiovascular Events in Patients With Type 2 Diabetes Mellitus: 10-Year Follow-Up of a Randomized Controlled Trial.

    Science.gov (United States)

    Saito, Yoshihiko; Okada, Sadanori; Ogawa, Hisao; Soejima, Hirofumi; Sakuma, Mio; Nakayama, Masafumi; Doi, Naofumi; Jinnouchi, Hideaki; Waki, Masako; Masuda, Izuru; Morimoto, Takeshi

    2017-02-14

    The long-term efficacy and safety of low-dose aspirin for primary prevention of cardiovascular events in patients with type 2 diabetes mellitus are still inconclusive. The JPAD trial (Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes) was a randomized, open-label, standard care-controlled trial examining whether low-dose aspirin affected cardiovascular events in 2539 Japanese patients with type 2 diabetes mellitus and without preexisting cardiovascular disease. Patients were randomly allocated to receive aspirin (81 or 100 mg daily; aspirin group) or no aspirin (no-aspirin group) in the JPAD trial. After that trial ended in 2008, we followed up with the patients until 2015, with no attempt to change the previously assigned therapy. Primary end points were cardiovascular events, including sudden death, fatal or nonfatal coronary artery disease, fatal or nonfatal stroke, and peripheral vascular disease. For the safety analysis, hemorrhagic events, consisting of gastrointestinal bleeding, hemorrhagic stroke, and bleeding from any other sites, were also analyzed. The primary analysis was conducted for cardiovascular events among patients who retained their original allocation (a per-protocol cohort). Analyses on an intention-to-treat cohort were conducted for hemorrhagic events and statistical sensitivity. The median follow-up period was 10.3 years; 1621 patients (64%) were followed up throughout the study; and 2160 patients (85%) retained their original allocation. Low-dose aspirin did not reduce cardiovascular events in the per-protocol cohort (hazard ratio, 1.14; 95% confidence interval, 0.91-1.42). Multivariable Cox proportional hazard model adjusted for age, sex, glycemic control, kidney function, smoking status, hypertension, and dyslipidemia showed similar results (hazard ratio, 1.04; 95% confidence interval, 0.83-1.30), with no heterogeneity of efficacy in subgroup analyses stratified by each of these factors (all interaction P>0

  20. Measles Humoral and Cell-Mediated Immunity in Children Aged 5–10 Years After Primary Measles Immunization Administered at 6 or 9 Months of Age

    Science.gov (United States)

    Gans, Hayley A.; Yasukawa, Linda L.; Sung, Phillip; Sullivan, Barbara; DeHovitz, Ross; Audet, Susette; Beeler, Judy; Arvin, Ann M.

    2013-01-01

    Background. Given the high infant measles mortality rate, there is interest in whether a measles immunization regimen beginning at Measles-specific immune responses were evaluated in 70 children aged 5–10 years after primary measles vaccine administered at 6, 9, or 12 months. Results. At 5–10 years of age, the stimulation index for measles T-cell proliferation was 11.4 (SE, 1.3), 10.9 (SE, 1.5), and 14.4 (SE 2.1) when the first measles dose was given at 6, 9, or 12 months, respectively. Neutralizing antibody concentration (geometric mean titer [GMT]) in those immunized at 6 months of age was 125 mIU/mL (95% confidence interval [CI], 42–377) in the presence of passive antibodies (PAs) and 335 mIU/mL (95% CI, 211–531) in those without PAs; in those immunized at 9 months, GMTs were 186 mIU/mL (95% CI, 103–335) and 1080 mIU/mL (95% CI, 642–1827) in the presence and absence of PAs, respectively. The GMT was 707 mIU/mL (95% CI, 456–1095) when vaccine was administered at 12 months (P ≤ .04). Conclusions. Measles-specific T-cell responses were sustained at 5–10 years of age regardless of age at time of primary measles immunization. Neutralizing antibody concentrations were lower in cohorts given the first vaccine dose at 6 months of age and in the presence of PAs; however, responses could be boosted by subsequent doses. Starting measles vaccination at measles outbreaks or in endemic areas. PMID:23300162