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Sample records for 30-year retrospective analysis

  1. Testicular Feminization or Androgen Insensitivity Syndrome (AIS) in Iran: a Retrospective Analysis of 30-Year Data

    PubMed Central

    FARHUD, Dariush. D; ZARIF YEGANEH, Marjan; SADIGHI, Hosein; ZANDVAKILI, Shahram

    2016-01-01

    Background: Androgen insensitivity syndrome (AIS) or testicular feminization is a partial or complete inability of cell response to androgen. The cause is enzymatic defect in synthesis of testosterone, resulting sexually immature phenotypically female, with primary amenorrhea. There are three categories of AIS, complete, partial and mild, depending on the degree of external genital masculinization. The aim of this study was to find out chromosomal abnormalities, and correlation between AIS and maternal/paternal age, parents’ consanguineous marriage, family history and clinical observation, in Iranian AIS patients. Method: This study includes a retrospective data analysis of 72,000 families’ medical records in the Genetic Clinic in Tehran, during a 30-yr period (1984–2014). The essential basis for the patients’ referral to the clinic by gynecologists was primary amenorrhea. Cytogenetic abnormalities has been confirmed by chromosome G-banding and conventional staining methods. Results: Seventy AIS female patients with 46XY pattern were cytogenetically diagnosed and the frequency of AIS syndrome was estimated about 0.05% (∼70/140000). The results showed no association between AIS and maternal or paternal age nor were the marital pattern of the parents. The clinical findings illustrated that primary amenorrhea had the highest indication for referral of AIS patients for genetic counseling and cytogenetic study. Conclusion: No correlation was observed between AIS and maternal or paternal age or consanguineous marriages. Amenorrhea is the most clinically observed sign of AIS patients. PMID:27057514

  2. "JTPE": A 30-Year Retrospective of Published Research

    ERIC Educational Resources Information Center

    Rhoades, Jesse L.; Woods, Amelia M.; Daum, David N.; Ellison, Douglas; Trendowski, Thomas N.

    2016-01-01

    This case study presents an examination of 30 years of "Journal of Teaching in Physical Education" ("JTPE") research. The purpose of this study was to provide a retrospective view of "JTPE" and its contribution to the field of physical education. In this effort the current study employed citation analysis, co-author…

  3. Trends in maternal deaths from epilepsy in the United Kingdom: a 30-year retrospective review

    PubMed Central

    Wallace, Suzanne

    2014-01-01

    Objective Neurological diseases remain the second most common cause of maternal mortality from indirect causes, according to the last United Kingdom confidential enquiry into maternal death. The maternal mortality rate from epilepsy is reported as 0.61 per 100,000 maternities. The aim of this study was to analyse the trends and causes of maternal death from epilepsy in the UK over the last 30 years. Information on sub-standard care associated with fatalities was also consolidated to inform guidance and clinical care by obstetricians and physicians caring for pregnant women with epilepsy. Study design A retrospective review of 10 triennial confidential enquiry into maternal death reports (1979–2008) was performed, encompassing 21,514,457 maternities. Late and coincidental deaths were not included in the analyses. Results Between 1979 and 2008, there were 92 maternal deaths from epilepsy. The proportion of total maternal deaths from epilepsy over 30 years is 3.7% (95% CI 3.0–4.5), which showed an increasing trend. Sudden unexpected death in epilepsy remains the single greatest cause of maternal death from epilepsy followed by aspiration of gastric contents during seizures and drowning during bathing. Conclusion All women with epilepsy should be looked after by specialist combined obstetric and medical or neurological teams in pregnancy to improve maternal and fetal outcomes.

  4. What We Learned From the Oil Crisis of 1973: A 30-Year Retrospective

    ERIC Educational Resources Information Center

    Roeder, John L.

    2005-01-01

    Thirty years ago, the Arab Oil Embargo caused us to stop taking gasoline for granted and caused the author to start teaching students about the importance of energy in our lives. This retrospective shows the same general patterns discerned from a 20-year retrospective a decade ago: a sharp decrease in energy use following each of the two energy…

  5. Philosophic Thinking in Social Work: An Analysis of 30 Years of "Social Work" Editorials

    ERIC Educational Resources Information Center

    Martinez-Brawley, Emilia E.; Zorita, Paz M-B

    2016-01-01

    This article looks at 30 years of editorial perspectives and trends in social work as a profession through the analysis of editorials from the journal "Social Work." It identifies the wax and wane of philosophic (intellectual or scholarly) questions in social work thinking in the past three decades. It defines what philosophic thinking…

  6. Medical thoracoscopy: Analysis on diagnostic yield through 30 years of experience

    PubMed Central

    Valsecchi, Alberto; Arondi, Sabrina; Marchetti, Giampietro

    2016-01-01

    BACKGROUND: Medical thoracoscopy (MT) or pleuroscopy is a procedure performed to diagnose and treat malignant and benign pleural diseases. Totally 2752 pleuroscopies executed in 1984–2013 in our center were considered in this study. METHODS: A retrospective observational study was performed. Observational time was divided into six series of 5 years. We calculated MT diagnostic yield and analyzed trends of main diseases diagnosed along the time. RESULTS: Along the 30 years population became progressively older. Number of pleuroscopies firstly increased, then stabilized and decreased in the last 5 years. The overall diagnostic yield of MT was 71%, increasing from 57% to 79%. The diagnostic yield was significantly higher in the presence of monolateral pleural effusion. Cancer represented more than half of diagnosis; tuberculosis was the most common nonneoplastic disease. The frequency of all cancers, mesothelioma, and lung cancer increased through the time; tuberculosis first decreased and then increased. All specimens resulted appropriate during the last 25 years. CONCLUSION: MT has a great diagnostic yield that can be improved by practice, permitting to achieve a specific histological diagnosis in about 80% of patients. Our experience demonstrates that the accurate selection of the patients undergoing to MT is very important to reach these results. PMID:27512506

  7. Analysis of 30 Years Sea Surface Elevation (sse) Data Obtained From A Global Ocean Model

    NASA Astrophysics Data System (ADS)

    Wenzel, M.

    In this presentation the sea surface elevation (SSE) as obtained from a global OGCM will be analysed. The model used is the Hamburg LSG model with a 2 degree hori- zontal resolution, 23 layers in the vertical and a 10 day timestep. The model has a free surface and includes the thermo- and halosteric effects. It is integrated for 50 years forced by monthly NCEP reanalyzes data (1950-1999). The last 30 years of model output are analyzed on regional to global scale to judge the role of the different contributions to the interannual sea level variations as there are: horizontal redistribution of volume (mass), surface freshwater flux (precipitaion- evaporation) and steric effects. On the global scale the surface freshwater flux can clearly be identified as the main contributor, while on regional to local scale it is the steric effect.

  8. The Relationship of Housing and Population Health: A 30-Year Retrospective Analysis

    PubMed Central

    Jacobs, David E.; Wilson, Jonathan; Dixon, Sherry L.; Smith, Janet; Evens, Anne

    2009-01-01

    Objective We analyzed the relationship between health status and housing quality over time. Methods We combined data from two nationally representative longitudinal surveys of the U.S. population and its housing, the National Health and Nutrition Examination Survey and the American Housing Survey, respectively. We identified housing and health trends from approximately 1970 to 2000, after excluding those trends for which data were missing or where we found no plausible association or change in trend. Results Changes in housing include construction type, proportion of rental versus home ownership, age, density, size, moisture, pests, broken windows, ventilation and air conditioning, and water leaks. Changes in health measures include asthma, respiratory illness, obesity and diabetes, and lead poisoning, among others. The results suggest ecologic trends in childhood lead poisoning follow housing age, water leaks, and ventilation; asthma follows ventilation, windows, and age; overweight trends follow ventilation; blood pressure trends follow community measures; and health disparities have not changed greatly. Conclusions Housing trends are consistent with certain health trends over time. Future national longitudinal surveys should include health, housing, and community metrics within a single integrated design, instead of separate surveys, in order to develop reliable indicators of how housing changes affect population health and how to best target resources. Little progress has been made in reducing the health and housing disparities of disadvantaged groups, with the notable exception of childhood lead poisoning caused by exposure to lead-based paint hazards. Use of these and other data sets to create reliable integrated indicators of health and housing quality are needed. PMID:19440499

  9. Paul Goodman, 30 Years Later: "Growing Up Absurd"; "Compulsory Mis-Education, and The Community of Scholars"; and "The New Reformation"--A Retrospective

    ERIC Educational Resources Information Center

    Kaminsky, James S.

    2006-01-01

    This article is a retrospective account of the legacy of Paul Goodman's major educational works: "Growing Up Absurd"; "Compulsory Mis-education, and The Community of Scholars"; and "The New Reformation." It is argued here that what remains of interest in Goodman's work is to be found in the tropes and the anarchic Zeitgeist of his work. The legacy…

  10. CGM Retrospective Data Analysis

    PubMed Central

    2016-01-01

    Abstract Continuous glucose monitoring (CGM) has increased in popularity as a daily management tool for people with diabetes and a diagnostic instrument for their healthcare providers. Achieving better clinical outcomes hinges on appropriate analysis and interpretation of data collected by CGM systems. This includes device downloading, qualification of data, and generation of applicable reports. An objectives-based analysis of the reports can yield valuable insight for fine-tuning treatment in several areas, including postprandial glucose patterns, overnight/basal stability, duration of bolus insulin action, timing of (and response to) hypoglycemic episodes, the efficacy of meal and correction insulin doses, and the impact of a variety of lifestyle activities. PMID:26784125

  11. Organic Contaminants in Chinese Sewage Sludge: A Meta-Analysis of the Literature of the Past 30 Years.

    PubMed

    Meng, Xiang-Zhou; Venkatesan, Arjun K; Ni, Yi-Lin; Steele, Joshua C; Wu, Ling-Ling; Bignert, Anders; Bergman, Åke; Halden, Rolf U

    2016-06-01

    The production of sewage sludge is increasing in China but with unsafe disposal practices, causing potential risk to human health and the environment. Using literature from the past 30 years (N = 159), we conducted a meta-analysis of organic contaminants (OCs) in Chinese sludge. Most data were available from developed and populated regions, and no data were found for Tibet. Since 1987, 35 classes of chemicals consisting of 749 individual compounds and 1 mixture have been analyzed, in which antibiotics and polycyclic aromatic hydrocarbons (PAHs) were the most targeted analytes. For 13 classes of principal OCs (defined as chemicals detected in over five studies) in sludge, the median (expressed in nanograms per gram dry weight) was the highest for phthalate esters (27 900), followed by alkylphenol polyethoxylates (12 000), synthetic musks (5800), antibiotics (4240), PAHs (3490), ultraviolet stabilizers (670), bisphenol analogs (160), organochlorine pesticides (110), polybrominated diphenyl ethers (100), pharmaceuticals (84), hormones (69), perfluorinated compounds (21), and polychlorinated biphenyls (15). Concentrations of PAHs in sludges collected between 1998 and 2012 showed a decreasing trend. Study findings suggest the need for a Chinese national sewage sludge survey to identify and regulate toxic OCs, ideally employing both targeted as well as nontargeted screening approaches. PMID:27144960

  12. The impact of economic austerity and prosperity events on suicide in Greece: a 30-year interrupted time-series analysis

    PubMed Central

    Branas, Charles C; Kastanaki, Anastasia E; Michalodimitrakis, Manolis; Tzougas, John; Kranioti, Elena F; Theodorakis, Pavlos N; Carr, Brendan G; Wiebe, Douglas J

    2015-01-01

    Objectives To complete a 30-year interrupted time-series analysis of the impact of austerity-related and prosperity-related events on the occurrence of suicide across Greece. Setting Greece from 1 January 1983 to 31 December 2012. Participants A total of 11 505 suicides, 9079 by men and 2426 by women, occurring in Greece over the study period. Primary and secondary outcomes National data from the Hellenic Statistical Authority assembled as 360 monthly counts of: all suicides, male suicides, female suicides and all suicides plus potentially misclassified suicides. Results In 30 years, the highest months of suicide in Greece occurred in 2012. The passage of new austerity measures in June 2011 marked the beginning of significant, abrupt and sustained increases in total suicides (+35.7%, p<0.001) and male suicides (+18.5%, p<0.01). Sensitivity analyses that figured in undercounting of suicides also found a significant, abrupt and sustained increase in June 2011 (+20.5%, p<0.001). Suicides by men in Greece also underwent a significant, abrupt and sustained increase in October 2008 when the Greek recession began (+13.1%, p<0.01), and an abrupt but temporary increase in April 2012 following a public suicide committed in response to austerity conditions (+29.7%, p<0.05). Suicides by women in Greece also underwent an abrupt and sustained increase in May 2011 following austerity-related events (+35.8%, p<0.05). One prosperity-related event, the January 2002 launch of the Euro in Greece, marked an abrupt but temporary decrease in male suicides (−27.1%, p<0.05). Conclusions This is the first multidecade, national analysis of suicide in Greece using monthly data. Select austerity-related events in Greece corresponded to statistically significant increases for suicides overall, as well as for suicides among men and women. The consideration of future austerity measures should give greater weight to the unintended mental health consequences that may follow and the public

  13. Labyrinthine fistulae: a retrospective analysis.

    PubMed

    Vanclooster, C; Debruyne, F; Vantrappen, G; Desloovere, C; Feenstra, L

    1997-01-01

    A retrospective analysis has been conducted of 57 labyrinthine fistulae found in 375 cholesteatoma cases, primarily treated by removal of the matrix of the cholesteatoma and covering the fistula with a mixture of bone paste and fibrin glue. CT-scan with slices of 1 mm demonstrated the fistula in almost 90% of the cases. Eighteen percent of the ears were pre-operatively totally deaf. Large fistulae are riskier than smaller ones for post-operative perceptive losses, but even in very large and multiple fistulae the hearing may be preserved in most cases. PMID:9241379

  14. Retrospective analysis of fatal falls.

    PubMed

    Thierauf, Annette; Preuss, Johanna; Lignitz, Eberhard; Madea, Burkhard

    2010-05-20

    Fatal falls are frequent and inhomogeneous events and affect every age. The criminalistic classification can often only be done on the basis of extensive investigations and the autopsy results. We retrospectively surveyed 291 cases of fatal falls on which a post-mortem examination had been carried out in the institutes of Forensic Medicine in Bonn and Greifswald. In large part, these cases are falls from height (n=123) and ground-level falls (n=122). These are compared to fatal falls down a stairs (n=46); the analysis is confined to injuries to the cranium. In ground-level falls the injury pattern in falls under the influence of alcohol differs from that of falls with no alcohol in the case history: all injuries are seen in higher relative frequency in casualties after the consumption of alcohol. In falls from height, the previous consumption of alcohol did not influence the injury pattern; the intracranial traumas are seen in decreasing frequency with increasing heights. The aim of this retrospective analysis is to present injury patterns and influencing factors like fall heights and alcohol for the different kinds of falls on the basis of our collective and to demonstrate similarities and differences between the subgroups. PMID:20176452

  15. Stable isotope analysis of Pacific salmon: insight into trophic status and oceanographic conditions over the last 30 years

    NASA Astrophysics Data System (ADS)

    Satterfield, Franklin R.; Finney, Bruce P.

    Food web interactions and the response of Pacific salmon to physical processes in the North Pacific Ocean over interannual and interdecadal timescales are explored using naturally occurring stable isotope ratios of carbon ( 13C/ 12C) and nitrogen ( 15N/ 14N). Stable isotope analyses of five species of sexually mature North Pacific salmon from Alaska ( Oncorhynchus spp.) cluster into three groups: chinook salmon ( O. tshawytscha) have the highest values, followed by coho ( O. kisutch), with chum ( O. keta), sockeye ( O. nerka), and pink ( O. gorbuscha) together having the lowest values. Although detailed isotopic data on salmon prey are lacking, there are limited data on relevant prey items from areas in which they are found in high abundance. These data suggest that the characteristics of the sockeye, pink and chum we have analyzed are compatible with their diets including open ocean squid and zooplankton, which are in general agreement with stomach content analyses. Isotope relationships between muscle and scale show consistent relationships for both δ13C ( R2=0.98) and δ 15N ( R2=0.90). Thus, scales, which have been routinely archived for many systems, can be used for retrospective analyses. Archived sockeye salmon scales spanning 1966-1999 from Red Lake, Kodiak Island, Alaska were analyzed for their stable isotope ratios of carbon and nitrogen. The δ15N record displays a decreasing trend of ~3‰ from 1969-1982 and an increasing trend of ~3‰ from 1982-1992, while the variations in δ13C are relatively minor. These trends may result from factors such as shifts in trophic level of feeding and/or feeding location, or may originate at the base of the food web via changes in processes such as nutrient cycling or primary productivity. Detailed studies on prey isotopic variability and its controls are needed to distinguish between these factors, and thus to improve the use of stable isotope analysis as a tool to learn more about present and past ecosystem change

  16. Solid waste 30-year volume summary

    SciTech Connect

    Valero, O.J.; Armacost, L.L.; DeForest, T.J.; Templeton, K.J.; Williams, N.C.

    1994-06-01

    A 30-year forecast of the solid waste volumes to be generated or received at the US Department of Energy Hanford Site is described in this report. The volumes described are low-level mixed waste (LLMW) and transuranic/transuranic mixed (TRU/TRUM) waste that will require treatment, storage, and disposal at Hanford`s Solid Waste Operations Complex (SWOC) during the 30-year period from FY 1994 through FY 2023. The data used to complete this document were collected from onsite and offsite waste generators who currently, or are planning to, ship solid wastes to the Hanford Site. An analysis of the data suggests that over 300,000 m{sup 3} of LLMW and TRU/TRUM waste will be managed at Hanford`s SWOC over the next 30 years. An extensive effort was made this year to collect this information. The 1993 solid waste forecast was used as a starting point, which identified approximately 100,000 m{sup 3} of LLMW and TRU/TRUM waste to be sent to the SWOC. After analyzing the forecast waste volume, it was determined that additional waste was expected from the tank waste remediation system (TWRS), onsite decontamination and decommissioning (D&D) activities, and onsite remedial action (RA) activities. Data presented in this report establish a starting point for solid waste management planning. It is recognized that forecast estimates will vary (typically increasing) as facility planning and missions continue to change and become better defined, but the information presented still provides useful insight into Hanford`s future solid waste management requirements.

  17. A Retrospective Analysis of Ruptured Breast Implants

    PubMed Central

    Baek, Woo Yeol; Lew, Dae Hyun

    2014-01-01

    Background Rupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants. Methods We performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone), duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management. Results Forty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case), microfat graft (2 case), removal only (14 case), and follow-up loss (17 case). Conclusions Saline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs. PMID:25396188

  18. Canine urolithiasis: retrospective analysis of 438 cases.

    PubMed

    Brown, N O; Parks, J L; Greene, R W

    1977-02-15

    In a retrospective analysis of 438 cases of canine urolithiasis, a total of 561 urolithic episodes were found to have occurred in a 6 1/2-year period. The hospital incidence of urolithiasis during that period, defined as the proportion of dogs hospitalized with urolithiasis to the total number of dogs hospitalized, was 2.8%. The major chemical component of the calculus in 307 dogs was phosphate; in 95 dogs, cystine; in 21 dogs, urate; in 12 dogs, oxalate; and in 3 dogs, carbonate. The Miniature Schnauzer, Dachsund, Dalmatian, Pug, Bulldog, Welsh Corgi, Beagle, and Bassett Hound were breeds that had a significantly higher (P less than 0.05) incidence of calculi than did breeds of other dogs hospitalized. Predisposition for calculi, by sex, was not found. Most dogs with calculi were between 3 and 7 years old. Most calculi were radiopaque and were located in the bladder or in the bladder and urethra. Specimens for bacteriologic culture were obtained by catheterization or by swabbing of tissue at the surgical site. Of 259 specimens obtained, 181 were culture-positive. The most common organisms isolated were Staphylococcus spp, Escherichia coli, Proteus spp, Streptococcus spp, and Klebsiella spp. Most of the bacteria were sensitive to gentamicin, chloramphenicol, nitrofurantoin, cephalothin, and methanamine mandelate. PMID:838615

  19. Atmosphere and Counseling Get High Grades (Momentum 30-Year Retrospective).

    ERIC Educational Resources Information Center

    Sorensen, Terri

    2000-01-01

    Asserts that Catholic schools have fewer problems such as teen pregnancy, sex, drugs, and alcohol, but that there needs to be more information provided to students on sex education. States that a great deal of tutoring and counseling are provided for students in Catholic institutions, and that students are treated with more care. (CW)

  20. Asymmetric mandibular prognathism: a 30-year retrospective case report.

    PubMed

    Decker, Jay D

    2006-03-01

    A healthy white man with marked facial and dental asymmetry, a consequence of unilateral mandibular condylar hyperplasia, was treated with conventional fixed edgewise appliance therapy combined with orthognathic surgery (bilateral sagittal split osteotomy of the mandibular ramus). Pretreatment, posttreatment, and long-term follow up records for the patient at ages 26 years 11 months, 28 years 6 months, and 58 years 7 months are presented. Thirty years after treatment, the results remain stable. The pretreatment and posttreatment records were presented to the American Board of Orthodontics in 1976 in partial fulfillment of the requirements for board certification. PMID:16527643

  1. Cognitive Systems Engineering: The Next 30 Years

    NASA Technical Reports Server (NTRS)

    Feary, Michael

    2012-01-01

    This presentation is part of panel discussion on Cognitive Systems Engineering. The purpose of this panel is to discuss the challenges and future directions of Cognitive Systems Engineering for the next 30 years. I intended to present the work we have been doing with the Aviation Safety program and Space Human Factors Engineering project on Work Domain Analysis and some areas of Research Focus. Specifically, I intend to focus on the shift on the need to understand and model attention in mixed-initiative systems, the need for methods which can generate results to be used in trade-off decisions, and the need to account for a range of human behavior in the design.

  2. The bachelor’s to Ph.D. STEM pipeline no longer leaks more women than men: a 30-year analysis

    PubMed Central

    Miller, David I.; Wai, Jonathan

    2015-01-01

    For decades, research and public discourse about gender and science have often assumed that women are more likely than men to “leak” from the science pipeline at multiple points after entering college. We used retrospective longitudinal methods to investigate how accurately this “leaky pipeline” metaphor has described the bachelor’s to Ph.D. transition in science, technology, engineering, and mathematics (STEM) fields in the U.S. since the 1970s. Among STEM bachelor’s degree earners in the 1970s and 1980s, women were less likely than men to later earn a STEM Ph.D. However, this gender difference closed in the 1990s. Qualitatively similar trends were found across STEM disciplines. The leaky pipeline metaphor therefore partially explains historical gender differences in the U.S., but no longer describes current gender differences in the bachelor’s to Ph.D. transition in STEM. The results help constrain theories about women’s underrepresentation in STEM. Overall, these results point to the need to understand gender differences at the bachelor’s level and below to understand women’s representation in STEM at the Ph.D. level and above. Consistent with trends at the bachelor’s level, women’s representation at the Ph.D. level has been recently declining for the first time in over 40 years. PMID:25741293

  3. Retrospective Miscue Analysis with Proficient Adult ESL Readers

    ERIC Educational Resources Information Center

    Wurr, Adrian J.; Theurer, Joan L.; Kim, Koomi J.

    2008-01-01

    This article reports recent research investigating the use of retrospective miscue analysis (RMA) as an instructional strategy with proficient second-language (L2) readers. RMA aims to heighten a reader's awareness of the reading process by involving readers in detailed analysis of their oral reading behavior. Using a cross-case analysis of three…

  4. Arsenic in Drinking Water and Lung Cancer Mortality in the United States: An Analysis Based on US Counties and 30 Years of Observation (1950–1979)

    PubMed Central

    Afari-Dwamena, Nana Ama; Li, Ji; Chen, Rusan; Feinleib, Manning; Lamm, Steven H.

    2016-01-01

    Background. To examine whether the US EPA (2010) lung cancer risk estimate derived from the high arsenic exposures (10–934 µg/L) in southwest Taiwan accurately predicts the US experience from low arsenic exposures (3–59 µg/L). Methods. Analyses have been limited to US counties solely dependent on underground sources for their drinking water supply with median arsenic levels of ≥3 µg/L. Results. Cancer risks (slopes) were found to be indistinguishable from zero for males and females. The addition of arsenic level did not significantly increase the explanatory power of the models. Stratified, or categorical, analysis yielded relative risks that hover about 1.00. The unit risk estimates were nonpositive and not significantly different from zero, and the maximum (95% UCL) unit risk estimates for lung cancer were lower than those in US EPA (2010). Conclusions. These data do not demonstrate an increased risk of lung cancer associated with median drinking water arsenic levels in the range of 3–59 µg/L. The upper-bound estimates of the risks are lower than the risks predicted from the SW Taiwan data and do not support those predictions. These results are consistent with a recent metaregression that indicated no increased lung cancer risk for arsenic exposures below 100–150 µg/L. PMID:27382373

  5. Arsenic in Drinking Water and Lung Cancer Mortality in the United States: An Analysis Based on US Counties and 30 Years of Observation (1950-1979).

    PubMed

    Ferdosi, Hamid; Dissen, Elisabeth K; Afari-Dwamena, Nana Ama; Li, Ji; Chen, Rusan; Feinleib, Manning; Lamm, Steven H

    2016-01-01

    Background. To examine whether the US EPA (2010) lung cancer risk estimate derived from the high arsenic exposures (10-934 µg/L) in southwest Taiwan accurately predicts the US experience from low arsenic exposures (3-59 µg/L). Methods. Analyses have been limited to US counties solely dependent on underground sources for their drinking water supply with median arsenic levels of ≥3 µg/L. Results. Cancer risks (slopes) were found to be indistinguishable from zero for males and females. The addition of arsenic level did not significantly increase the explanatory power of the models. Stratified, or categorical, analysis yielded relative risks that hover about 1.00. The unit risk estimates were nonpositive and not significantly different from zero, and the maximum (95% UCL) unit risk estimates for lung cancer were lower than those in US EPA (2010). Conclusions. These data do not demonstrate an increased risk of lung cancer associated with median drinking water arsenic levels in the range of 3-59 µg/L. The upper-bound estimates of the risks are lower than the risks predicted from the SW Taiwan data and do not support those predictions. These results are consistent with a recent metaregression that indicated no increased lung cancer risk for arsenic exposures below 100-150 µg/L. PMID:27382373

  6. Links between extreme UV-radiation, total ozone, surface albedo and cloudiness: An analysis of 30 years of data from Switzerland and Austria

    NASA Astrophysics Data System (ADS)

    Rieder, H. E.; Staehelin, J.; Weihs, P.; Vuilleumier, L.; Blumthaler, M.; Holawe, F.; Lindfors, A.; Maeder, J. A.; Simic, S.; Wagner, J. E.; Walker, D.; Ribatet, M.

    2009-04-01

    Since the discovery of anthropogenic ozone depletion in the early 1970s (e.g. Molina and Rowland, 1974; Farman et al., 1985) the interest in stratospheric ozone trends and solar UV-B increased within the scientific community and the general public because of the link between reduced total column ozone and increased UV-radiation doses. Stratospheric ozone (e.g. Koch et al., 2005) and erythemal UV-radiation (e.g. Rieder et al., 2008) in the northern mid-latitudes are characterized by strong temporal variability. Long-term measurements of UV-B radiation are rare and datasets are only available for few locations and most of these measurements do not provide spectral information on the UV part of the spectra. During strong efforts in the reconstruction of erythemal UV, datasets of past UV-radiation doses became available for several measurement sites all over the globe. For Switzerland and Austria reconstructed UV datasets are available for 3 measurement sites (Davos, Sonnblick and Vienna) (Lindfors and Vuilleumier, 2005; Rieder et al., 2008). The world's longest ozone time series dating back to 1926 is available from Arosa, Switzerland, and is discussed in detail by Staehelin et al. (1998a,b). Recently new tools from extreme value theory have been applied to the Arosa time series to describe extreme events in low and high total ozone (Rieder et al., 2009). In our study we address the question of how much of the extremes in UV-radiation can be attributed to extremes in total ozone, high surface albedo and cloudiness. An analysis of the frequency distributions of such extreme events for the last decades is presented to gain a better understanding of the links between extreme erythemal UV-radiation, total ozone, surface albedo and clouds. References: Farman, J. C., Gardiner, B. G., and Shanklin, J. D.: Large losses of total ozone in Antarctica reveal seasonal ClOx/NOx interaction, Nature, 315, 207-210, 1985. Koch, G., Wernli, H., Schwierz, C., Staehelin, J., and Peter, T

  7. Relationship between high daily erythemal UV doses, total ozone, surface albedo and cloudiness: An analysis of 30 years of data from Switzerland and Austria

    NASA Astrophysics Data System (ADS)

    Rieder, H. E.; Staehelin, J.; Weihs, P.; Vuilleumier, L.; Maeder, J. A.; Holawe, F.; Blumthaler, M.; Lindfors, A.; Peter, T.; Simic, S.; Spichtinger, P.; Wagner, J. E.; Walker, D.; Ribatet, M.

    2010-10-01

    This work investigates the occurrence frequency of days with high erythemal UV doses at three stations in Switzerland and Austria (Davos, Hoher Sonnblick and Vienna) for the time period 1974-2003. While several earlier studies have reported on increases in erythemal UV dose up to 10% during the last decades, this study focuses on days with high erythemal UV dose, which is defined as a daily dose at least 15% higher than for 1950s clear-sky conditions (which represent preindustrial conditions with respect to anthropogenic chlorine). Furthermore, the influence of low column ozone, clear-sky/partly cloudy conditions and surface albedo on UV irradiance has been analyzed on annual and seasonal basis. The results of this study show that in the Central Alpine Region the number of days with high UV dose increased strongly in the early 1990s. A large fraction of all days with high UV dose occurring in the period 1974-2003 was found especially during the years 1994-2003, namely 40% at Davos, 54% at Hoher Sonnblick and 65% at Vienna. The importance of total ozone, clear-sky/partly cloudy conditions and surface albedo (e.g. in dependence of snow cover) varies strongly among the seasons. However, overall the interplay of low total ozone and clear-sky/partly cloudy conditions led to the largest fraction of days showing high erythemal UV dose. Furthermore, an analysis of the synoptic weather situation showed that days with high erythemal UV dose, low total ozone and high relative sunshine duration occur at all three stations more frequently during situations with low pressure gradients or southerly advection.

  8. Adolescent ovarian masses: A retrospective analysis.

    PubMed

    Gupta, Bindiya; Guleria, Kiran; Suneja, Amita; Vaid, Neelam B; Rajaram, Shalini; Wadhwa, Neelam

    2016-05-01

    A retrospective study was conducted to review incidence, clinical practice, surgical management and histology of adolescent ovarian masses in order to audit and improve future practices. Complete hospital records of all adolescents between 10 and 20 years who had undergone surgery for ovarian masses were analysed between November 2006 to 2014. Parameters analysed were age, clinical features, diagnosis, operative procedure and histopathology. Ninety-four patients were included in the study and among them, 37 had non-neoplastic masses, 30 had benign neoplasms while 27 had malignant tumors. The main clinical presentations were abdominal pain (54%) and abdominal mass (41%). Dermoid was the most common benign neoplasm while germ cell tumor was the most common malignant mass; dysgerminoma being the commonest (68%). Malignancy was more common in early adolescence (12 ± 4.8 years) while non-neoplastic masses were seen more frequently in late adolescence (17.7 ± 2.2 years). There was a fair correlation between ultrasound and histopathological diagnosis. PMID:26789784

  9. Sternal fractures: retrospective analysis of 100 cases.

    PubMed

    Athanassiadi, Kalliopi; Gerazounis, Michalis; Moustardas, Marios; Metaxas, Efstathios

    2002-10-01

    Isolated sternal fractures are seen with increasing frequency in road accidents, especially since the introduction of seatbelt legislation. The medical records of all our patients who were treated with a diagnosis of sternal fracture (SF) over the past two decades were retrospectively reviewed to determine the incidence, morbidity, and mortality of this entity. Between 1984 and 1998, 100 consecutive patients were admitted to the Department of Surge Surgery, General Hospital of Nikea-Piraeus, Greece, for SF. There were 72 men and 28 women ranging in age between 17 and 84 years. Sixty-seven patients sustained an isolated SF and the remaining 33 had a SF in combination with multiple injuries such as flail chest (n = 19), head injury (n = 18), limb fractures (n = 10), spinal fractures (n = 4), hear contusion (n = 1), hemo-pneumothorax (n = 9), pneumothorax (n = 6), hemomediastinum (n = 5), and pericarditis (n = 2), among others. All patients with a radiological diagnosis were admitted for cardiac monitoring for at least 24 hours. Electrocardiogram (ECG), determinations of cardiac enzyme levels such as lactic dehydrogenase, creatine kinase, and creatine kinase-MB, and evaluation by a cardiologist were routinely performed. An echocardiogram was performed as indicated by the cardiologist. Seven patients underwent operation, two for abdominal bleeding, two for chest wall and sternal stabilization, two for open pneumothorax, and one for massive hemothorax. Eight of our patients needed ventilatory support. Four of them died from respiratory insufficiency, myocardial infarction, and heart and lung contusion. Although an isolated SF carries a good prognosis, careful evaluation and clinical observation are essential. PMID:12181604

  10. Eighteen- to 30-year-olds more likely to link to hepatitis C virus care: an opportunity to decrease transmission.

    PubMed

    Young, K L; Huang, W; Horsburgh, C R; Linas, B P; Assoumou, S A

    2016-04-01

    Hepatitis C virus (HCV) infection incidence among 18- to 30-year-olds is increasing and guidelines recommend treatment of active injection drug users to limit transmission. We aimed to : measure linkage to HCV care among 18- to 30-year-olds and identify factors associated with linkage; compare linkage among 18- to 30-year-olds to that of patients >30 years. We used the electronic medical record at an urban safety net hospital to create a retrospective cohort with reactive HCV antibody between 2005 and 2010. We report seroprevalence and demographics of seropositive patients, and used multivariable logistic regression to identify factors associated with linkage to HCV care. We defined linkage as having evidence of HCV RNA testing after reactive antibody. Thirty two thousand four hundred and eighteen individuals were tested, including 8873 between 18 and 30 years. The seropositivity rate among those ages 18-30 was 10%. In multivariate analysis, among those 18-30, diagnosis location (Outpatient vs Inpatient/ED) (OR 1.78, 95% CI 1.28-2.49) and number of visits after diagnosis (OR 5.30, 95% CI 3.91-7.19) were associated with higher odds of linking to care. When we compared linkage in patients ages 18-30 to that among those older than 30, patients in the 18-30 years age group were more likely to link to HCV care than those in the older cohort even when controlling for gender, ethnicity, socioeconomic status, birthplace, diagnosis location and duration of follow-up. Eighteen- to 30-year-olds are more likely to link to HCV care than their older counterparts. During the interferon-free treatment era, there is an opportunity to prevent further HCV transmission in this population. PMID:26572798

  11. Lessons from 30 Years of Flight Software

    NASA Technical Reports Server (NTRS)

    McComas, David C.

    2015-01-01

    This presentation takes a brief historical look at flight software over the past 30 years, extracts lessons learned and shows how many of the lessons learned are embodied in the Flight Software product line called the core Flight System (cFS). It also captures the lessons learned from developing and applying the cFS.

  12. 30 years of squeezed light generation

    NASA Astrophysics Data System (ADS)

    Andersen, Ulrik L.; Gehring, Tobias; Marquardt, Christoph; Leuchs, Gerd

    2016-05-01

    Squeezed light generation has come of age. Significant advances on squeezed light generation have been made over the last 30 years—from the initial, conceptual experiment in 1985 till today’s top-tuned, application-oriented setups. Here we review the main experimental platforms for generating quadrature squeezed light that have been investigated in the last 30 years.

  13. [Revista de Saúde Pública: 30 years of evolution].

    PubMed

    da Silva, L J

    1996-12-01

    Analysis of the main characteristics of the "Revista de Saúde Pública" during the 30 years of its existence. A parallel is traced with the evolution of brazilian public health. The dynamic aspect of the "Revista" is remembered as one of its main virtues. Its future in the constitution of the Mercosul regional block is discussed. PMID:9302818

  14. 77 FR 47572 - Retrospective Analysis of Existing Rules

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    .... 77 FR 8114 (Feb. 14, 2012). This Plan provides that the Commission will, every two years, review its... (76 FR 66004 (Oct. 25, 2011)) will be considered in this review and need not be resubmitted. Examples... COMMISSION 19 CFR Chapter II Retrospective Analysis of Existing Rules AGENCY: International Trade...

  15. 77 FR 8114 - Plan for Retrospective Analysis of Existing Rules

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... sought public comments on its Preliminary Plan for Retrospective Analysis of Existing Rules. 76 FR 66004... and the identification of specific rules to be included in the plan. 76 FR 66004 (Oct. 25, 2011) and... documents filed with the agency will be filed by electronic means. See 76 FR 61937 (Oct. 6, 2011)....

  16. A 30-Year Global Wave Hindcast

    NASA Astrophysics Data System (ADS)

    Durrant, Tom; Hemer, Mark; Trenham, Claire; Greenslade, Diana

    2013-04-01

    Many Pacific Islands are vulnerable to impacts of waves through coastal inundation, coastal and beach erosion, wave driven lagoon circulation, disturbances to reef habitats etc. On steep continental shelves like Pacific island coral atolls, surface waves are the dominant contributor to coastal sea-level extremes via wave set-up. A recent review of the availability of modelled and observed wave data in the Pacific region noted the need for a high-quality multi-decadal wave climate data set. The absence of high temporal resolution spectral wave data was noted, with existing hindcast products assessed as being of inadequate spatial and temporal resolution in general. Wave hindcast resolution has historically been limited by the resolution of available winds. The recently completed National Centers for Environmental Prediction's (NCEP) Climate Forecast System Reanalysis (CFSR) surface winds now provide a consistent product at 0.3°, hourly resolution over the past 30 years, providing a valuable source of forcing for wave hindcasting. As part of the Pacific-Australia Climate Change Science and Adaptation Program (PACCSAP), work is being carried out examining recent, existing and projected future ocean wave conditions with a focus on the Pacific region. As part of this work, a 30-year (1979-2009) global wave hindcast has been produced, using CFSR wind forcing. Details of this hindcast will be presented including an assessment of the quality of the data set using in-situ buoy and satellite altimeter data.

  17. 77 FR 65645 - Retrospective Analysis of Existing Rules: Notice of Staff Memorandum

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-30

    ... Energy Regulatory Commission 18 CFR Chapter I Retrospective Analysis of Existing Rules: Notice of Staff..., 2011 Plan for Retrospective Analysis of Existing Rules prepared in response to Executive Order 13579, which requested independent regulatory agencies issue plans for periodic retrospective analysis of...

  18. 7 CFR 625.12 - 30-year contracts.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false 30-year contracts. 625.12 Section 625.12 Agriculture... AGRICULTURE WATER RESOURCES HEALTHY FORESTS RESERVE PROGRAM § 625.12 30-year contracts. (a) To enroll land in HFRP through the 30-year contract option, a landowner will sign a 30-year contract with NRCS....

  19. Test anxiety inventory: 30 years later.

    PubMed

    Szafranski, Derek D; Barrera, Terri L; Norton, Peter J

    2012-11-01

    Research suggests that test anxiety is associated with a number of maladaptive factors. The majority of test anxiety research includes the Test Anxiety Inventory (TAI) as a primary outcome variable. However, the TAI was normed on college undergraduates in 1980. The academic landscape has altered in a variety of ways in the past 30 years, which may result in out-of-date norms. This study examined changes in TAI scores in college undergraduates (n =437) as well as convergent validity with measures of trait anxiety and academic performance. Results indicated increases in TAI scores for females while holding constant for males. Additionally, females and males displayed positive correlations between the TAI and state-trait anxiety inventory, while only females displayed a significant negative correlation between the TAI and grade point average. Data provide evidence of changes in TAI scores. As a result, researchers should be careful when drawing conclusions based on original TAI norms, especially in the case of female undergraduates. PMID:22380930

  20. 1995 Solid Waste 30-year volume summary

    SciTech Connect

    Valero, O.J.; DeForest, T.J.; Templeton, K.J.

    1995-06-01

    This document, prepared by Pacific Northwest Laboratory (PNL) under the direction of Westinghouse Hanford Company (WHC), provides a description of the annual low-level mixed waste (LLMW) and transuranic/transuranic mixed solid waste (TRU-TRUM) volumes expected to be managed by Hanford`s Solid Waste Central Waste Complex (CWC) over the next 30 years. The waste generation sources and waste categories are also described. This document is intended to be used as a reference for short- and long-term planning of the Hanford treatment, storage, and disposal (TSD) activities over the next several decades. By estimating the waste volumes that will be generated in the future, facility planners can determine the timing of key waste management activities, evaluate alternative treatment strategies, and plan storage and disposal capacities. In addition, this document can be used by other waste sites and the general public to gain a better understanding of the types and volumes of waste that will be managed at Hanford.

  1. A retrospective analysis of 772 patients with hallux limitus.

    PubMed

    Grady, John F; Axe, Timothy M; Zager, Emil J; Sheldon, Lori A

    2002-02-01

    In this retrospective analysis of 772 patients with symptomatic hallux limitus, 428 patients (55%) were successfully treated with conservative care alone; of these 428 patients, 362 (84%) were treated with orthoses. Corticosteroid injections and a change in shoes allowed 24 patients (6% of conservatively treated patients) and 42 patients (10%), respectively, to have less discomfort and return to previous activity levels. Overall, 47% of the patients in this analysis were successfully treated with orthoses. Surgical procedures were performed on 296 patients (38% of all patients) who did not respond to conservative care. In this analysis, 48 of the patients (6% of all patients) who did not respond to conservative care either refused surgery or were not surgical candidates. These data are intended to provide podiatric physicians with expected outcomes for conservative care of hallux limitus. The etiology, symptoms, conservative management, and surgical treatments of hallux limitus and hallux rigidus are also reviewed. PMID:11847262

  2. Auditory neuropathy/dyssynchrony: a retrospective analysis of 15 cases.

    PubMed

    Unal, Murat; Vayisoglu, Yusuf

    2015-04-01

    Introduction Auditory neuropathy/dyssynchrony (AN/AD) comprises a spectrum of pathology affecting the auditory pathways anywhere from the inner hair cells to the brainstem. It is characterized by an absent or atypical auditory brainstem response (ABR) with preservation of the cochlear microphonics and/or otoacoustic emissions (OAEs). Objective Retrospective analysis of patients with AN/AD. Methods Fifteen patients with AN/AD were included in this study and their records were retrospectively investigated. Results Possible etiology of AN/AD was neonatal hyperbilirubinemia in three patients, family history of hearing loss in three patients, consanguineous marriage in two patients, head trauma in two patients, mental motor retardation in one patient, cerebrovascular disease in one patient, and there was no apparent cause in three patients. Conclusion Otolaryngologists should keep in mind the diagnosis of AN/AD especially in patients complaining of difficulty in hearing and speech and audiological evidence of disassociation between pure tone and speech audiometry. ABR and OAE testing is recommended in these patients for AN/AD diagnosis. PMID:25992171

  3. Risk factors for rape re-victimisation: a retrospective analysis.

    PubMed

    Lurie, S; Boaz, M; Golan, A

    2013-11-01

    Sexual re-victimisation refers to a pattern in which the sexual assault victim has an increased risk of subsequent victimisation relative to an individual who was never victimised. The purpose of our study was to identify risks factors for a second rape, the severest form of sexual re-victimisation. All rape victims treated at the First Regional Israeli Center for Sexual Assault Victims between October 2000 and July 2010 were included in this retrospective analysis. We compared characteristics of 53 rape victims who were victimised twice to those of 1,939 rape victims who were victimised once. We identified several risk factors for a second rape, which can be used in prevention programmes. These are: psychiatric background, history of social services involvement, adulthood, non-virginity and minority ethnicity. PMID:24219731

  4. Clinical complications after transvaginal oocyte retrieval: a retrospective analysis.

    PubMed

    Siristatidis, C; Chrelias, C; Alexiou, A; Kassanos, D

    2013-01-01

    There are little systematic data reported in the literature on complications observed after transvaginal oocyte retrieval (OR) guided by ultrasound. We report our experience in 542 in vitro fertilisation cycles. The frequency of severe complications in our patients was 0.72%; of these, two cases were bronchospasm during anaesthesia (0.36%) and two were cases of intraperitoneal bleeding (0.36%); minor vaginal bleeding was the most frequent complication (18.08%), which was treated easily. Through this retrospective analysis, it is evident that clinical suspicion is of particular importance in detecting post-OR complications on one hand, but on the other these complications are rare and most are treated conservatively. PMID:23259882

  5. Silviculture: the next 30 years the past 30 years. Part III. The South

    SciTech Connect

    Boyce, S.G.; Burkhardt, E.C.; Kellison, R.C.; van Lear, D.H.

    1986-06-01

    This paper discussed the need for modern forestry management in the South. The author defined the South as Texas, Oklahoma, Arkansas, Louisiana, Mississippi, Alabama, Tennessee, Georgia, South Carolina, North Carolina, and Virginia. Of the 10 billion cubic feet of softwood harvested in the US in 1976, 44% came from the South. In addition, half of the 4.2 billion cubic feet of hardwoods harvested in the US in 1976 came from the South. Less than half of the southern forests were cultivated by trained foresters. With real forest management, a real potential should exist for increased forest production. The author discussed the history of these forest lands and the need for better forest management over the next 30 years. 12 references, 3 figures, 1 table.

  6. Complications of Hair Restoration Surgery: A Retrospective Analysis

    PubMed Central

    Loganathan, Eswari; Sarvajnamurthy, Sacchidanand; Gorur, Divya; Suresh, Deepak Hurkudli; Siddaraju, Maheshwari Nallur; Narasimhan, Revathi Thimmanhalli

    2014-01-01

    Background: Hair restoration surgery (HRS) is a very promising and sought after aesthetic procedure with very few complications. Complications may occur in the donor or the recipient area, and it may be due to surgical or idiopathic causes. Aim: The aim was to analyze the complications in male patients who underwent HRS for androgenetic alopecia (AGA). Materials and Methods: We conducted a retrospective analysis of male patients who underwent HRS for AGA from December 2010 to August 2014. Data were collected from the registers, telephonic enquiry and electronic mails. All complications during and after surgery, and their subjective feeling about hair growth was recorded. Results: Seventy-three patients were included in the analysis. A total of 65 patients had undergone follicular unit transplant, 7 patients underwent FUE, and one patient had body hair transplantation. Postoperative edema was found in 42.47% of patients, followed by sterile folliculitis in 23.29% of patients, wide donor scar in 15.07% of patients, bacterial folliculitis and numbness/paresthesia in 10.96% of patients. Other complications such as raised scar, hiccups, pruritus, excessive bleeding were found in isolated cases. Conclusion: Thorough preoperative evaluation, skillful surgical techniques, good communication and postoperative follow-up go a long way in giving satisfactory outcome with fewer complications in HRS. PMID:25368473

  7. 76 FR 39796 - Preliminary Plan for Retrospective Analysis of Existing Rules

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-07

    ... Regulation and Regulatory Review. E.O. 13563, 76 FR 3281. The Executive Order directed agencies to develop... United States Patent and Trademark Office 37 CFR Chapter I Preliminary Plan for Retrospective Analysis of... of Commerce's (``DOC'') ``Preliminary Plan for Retrospective Analysis of Existing Rules,''...

  8. Improving diagnostic criteria for Propionibacterium acnes osteomyelitis: a retrospective analysis.

    PubMed

    Asseray, Nathalie; Papin, Christophe; Touchais, Sophie; Bemer, Pascale; Lambert, Chantal; Boutoille, David; Tequi, Brigitte; Gouin, François; Raffi, François; Passuti, Norbert; Potel, Gilles

    2010-07-01

    The identification of Propionibacterium acnes in cultures of bone and joint samples is always difficult to interpret because of the ubiquity of this microorganism. The aim of this study was to propose a diagnostic strategy to distinguish infections from contaminations. This was a retrospective analysis of all patient charts of those patients with >or=1 deep samples culture-positive for P. acnes. Every criterion was tested for sensitivity, specificity, and positive likelihood ratio, and then the diagnostic probability of combinations of criteria was calculated. Among 65 patients, 52 (80%) were considered truly infected with P. acnes, a diagnosis based on a multidisciplinary process. The most valuable diagnostic criteria were: >or=2 positive deep samples, peri-operative findings (necrosis, hardware loosening, etc.), and >or=2 surgical procedures. However, no single criterion was sufficient to ascertain the diagnosis. The following combinations of criteria had a diagnostic probability of >90%: >or=2 positive cultures + 1 criterion among: peri-operative findings, local signs of infection, >or=2 previous operations, orthopaedic devices; 1 positive culture + 3 criteria among: peri-operative findings, local signs of infection, >or=2 previous surgical operations, orthopaedic devices, inflammatory syndrome. The diagnosis of P. acnes osteomyelitis was greatly improved by combining different criteria, allowing differentiation between infection and contamination. PMID:20141491

  9. Analysis of Virechana karma with Danti avaleha: A retrospective study

    PubMed Central

    Chaganti, Sreelakshmi; Prasad, B. S.

    2015-01-01

    Virechana (therapeutic purgation) is a common procedure that is widely practiced among the panchakarma treatments (pentad treatments). Various Virechaka dravyas (purgative drugs) have been described for Virechana. Even after critical analysis of Virechaka dravyas in the literature, still there is difficulty in the fixation of dose. Hence, the retrospective analysis of varied outcomes of Virechana with Danti (Baliospermum montanum) avaleha (linctus) is discussed in this paper. The study included twenty-seven case reports of patients who were administered Virechana with Danti avaleha. These case reports are of patients suffering from various ailments such as irregular menstrual cycles, polycystic ovarian syndrome, primary and secondary infertility, and psoriasis. Danti avaleha was administered at dose of 10 g and 5 g in the Krura (~strong) and Madhyama (~moderate/normal) Koshta (~GI tract) patients, respectively. Among seven Krura koshta patients, three of them resulted with Pravara (excellent) Shuddhi and other four resulted with Madhyama (medium) Shuddhi. In twenty Madhyama koshta patients, sixteen of them resulted with avara (minimum) Shuddhi and remaining four patients resulted with Madhyama shuddhi. Complications like Udara shoola (spasmodic pain of abdomen) and Vamana (emesis) were observed during Virechana. Majority of the patients suffered with Udara shoola were of Madhyama koshta. Vamana was seen in both Krura and Madhyama koshta patients. Irrespective of the type of Shuddhi and complications, all the patients resulted with Samyak Kaphaantiki Virikta lakshana (signs of perfect purgation with end expulsion of Kapha). The study concluded that the Krura koshta patients were tolerable for dose of 10 g and are expected to attain Pravara Shuddhi. Whereas Madhyama koshta patients were intolerable even to mild dose of 5 g, producing Avara shuddhi. PMID:26834432

  10. Acetabular revision with impaction bone grafting and a cemented polyethylene acetabular component: comparison of the Kaplan-Meier analysis to the competing risk analysis in 62 revisions with 25 to 30 years follow-up.

    PubMed

    Te Stroet, M A J; Keurentjes, J C; Rijnen, W H C; Gardeniers, J W M; Verdonschot, N; Slooff, T J J H; Schreurs, B W

    2015-10-01

    We present the results of 62 consecutive acetabular revisions using impaction bone grafting and a cemented polyethylene acetabular component in 58 patients (13 men and 45 women) after a mean follow-up of 27 years (25 to 30). All patients were prospectively followed. The mean age at revision was 59.2 years (23 to 82). We performed Kaplan-Meier (KM) analysis and also a Competing Risk (CR) analysis because with long-term follow-up, the presence of a competing event (i.e. death) prevents the occurrence of the endpoint of re-revision. A total of 48 patients (52 hips) had died or had been re-revised at final review in March 2011. None of the deaths were related to the surgery. The mean Harris hip score of the ten surviving hips in ten patients was 76 points (45 to 99). The KM survivorship at 25 years for the endpoint 're-revision for any reason' was 58.0% (95% confidence interval (CI) 38 to 73) and for 're-revision for aseptic loosening' 72.1% (95% CI 51 to 85). With the CR analysis we calculated the KM analysis overestimates the failure rate with respectively 74% and 93% for these endpoints. The current study shows that acetabular impaction bone grafting revisions provide good clinical results at over 25 years. PMID:26430007

  11. 7 CFR 625.12 - 30-year contracts.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false 30-year contracts. 625.12 Section 625.12 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES HEALTHY FORESTS RESERVE PROGRAM § 625.12 30-year contracts. (a) To enroll land...

  12. The ALMA assembly, integration, and verification project: a retrospective analysis

    NASA Astrophysics Data System (ADS)

    Lopez, B.; Knee, L. B. G.; Jager, H.; Whyborn, N.; McMullin, J.; Murowinski, R.; Peck, A.; Corder, S.

    2014-08-01

    The Atacama Large Millimeter/submillimeter Array (ALMA) is a joint project between astronomical organizations in Europe, North America, and East Asia, in collaboration with the Republic of Chile. ALMA consists of 54 twelve-meter antennas and 12 seven-meter antennas operating as an aperture synthesis array in the (sub)millimeter wavelength range. Assembly, Integration, and Verification (AIV) of the antennas was completed at the end of the year 2013, while the final optimization and complete expansion to validate all planned observing modes will continue. This paper compares the actually obtained results of the period 2008-2013 with the baselines that had been laid out in the early project-planning phase (2005-2007). First plans made for ALMA AIV had already established a two-phased project life-cycle: phase 1 for setting up necessary infrastructure and common facilities, and taking the first three antennas to the start of commissioning; and phase 2 focused on the steady state processing of the remaining units. Throughout the execution of the project this lifecycle was refined and two additional phases were added, namely a transition phase between phases 1 and 2, and a closing phase to address the project ramp-down. A sub-project called Accelerated Commissioning and Science Verification (ACSV) was carried out during the year 2009 in order to provide focus to the whole ALMA organization, and to accomplish the start-of-commissioning milestone. Early phases of CSV focused on validating the basic performance and calibration. Over time additional observing modes have been validated as capabilities expanded both in hardware and software. This retrospective analysis describes the originally presented project staffing plans and schedules, the underlying assumptions, identified risks and operational models, among others. For comparison actual data on staffing levels, the resultant schedule, additional risks identified and those that actually materialized, are presented. The

  13. The Retrospective Iterated Analysis Scheme for Nonlinear Chaotic Dynamics

    NASA Technical Reports Server (NTRS)

    Todling, Ricardo

    2002-01-01

    Atmospheric data assimilation is the name scientists give to the techniques of blending atmospheric observations with atmospheric model results to obtain an accurate idea of what the atmosphere looks like at any given time. Because two pieces of information are used, observations and model results, the outcomes of data assimilation procedure should be better than what one would get by using one of these two pieces of information alone. There is a number of different mathematical techniques that fall under the data assimilation jargon. In theory most these techniques accomplish about the same thing. In practice, however, slight differences in the approaches amount to faster algorithms in some cases, more economical algorithms in other cases, and even give better overall results in yet some other cases because of practical uncertainties not accounted for by theory. Therefore, the key is to find the most adequate data assimilation procedure for the problem in hand. In our Data Assimilation group we have been doing extensive research to try and find just such data assimilation procedure. One promising possibility is what we call retrospective iterated analysis (RIA) scheme. This procedure has recently been implemented and studied in the context of a very large data assimilation system built to help predict and study weather and climate. Although the results from that study suggest that the RIA scheme produces quite reasonable results, a complete evaluation of the scheme is very difficult due to the complexity of that problem. The present work steps back a little bit and studies the behavior of the RIA scheme in the context of a small problem. The problem is small enough to allow full assessment of the quality of the RIA scheme, but it still has some of the complexity found in nature, namely, its chaotic-type behavior. We find that the RIA performs very well for this small but still complex problem which is a result that seconds the results of our early studies.

  14. Retrospective analysis of the clinicopathological characteristics of gastrointestinal neuroendocrine neoplasms

    PubMed Central

    WANG, ZHIQIANG; LI, WENLIANG; CHEN, TIANXING; YANG, JUN; LUO, LILIN; ZHANG, LIANYU; SUN, BAOCUN; LIANG, RUI

    2015-01-01

    The aim of the present study was to analyze and summarize the clinicopathological characteristics and factors affecting prognosis for patients with gastrointestinal neuroendocrine neoplasms (GINENs). Retrospective analysis was conducted on the clinicopathological data of 74 patients who were diagnosed with GINEN, and immunohistochemical methods were used to detect the expression levels of relevant markers [synaptophysin (Syn), chromogranin A (CgA) and Ki-67]. Among the 74 cases with GINEN, there were 39 males and 35 females, with an average age of 56.9 years. There were 32 neoplasms in the rectum, 29 in the stomach, 6 in the colon, 2 in the small intestine and 5 in the appendix. All 74 cases underwent surgical resection. According to the World Health Organization Classification of Tumors of the Digestive System (2010), the diagnosis of the 74 cases showed 41 cases (55.4%) of neuroendocrine tumor (NET; 25 cases of G1 and 16 cases of G2), 21 cases (28.4%) of neuroendocrine carcinoma (NEC) and 12 cases (16.2%) of mixed adenoneuroendocrine carcinoma (MANEC). Additionally, 19 cases had metastasis to lymph nodes. During 10–34 months of follow-up, 15 patients had distant metastasis and 24 patients succumbed, and the accumulative survival rate in 1 or 2 years was 87.8 and 74.3%, respectively. Six factors, namely neoplasm size, depth of invasion, lymph node metastasis, distant metastasis, pathological type and the expression or lack of expression of CgA, significantly affected the survival time of patients. Definitive diagnosis of GINEN mainly relies on pathological diagnosis. GINENs with different histopathological types and grading have different clinicopathological characteristics and prognosis: NETs are mainly early lesions with a good prognosis, whereas NECs and MANECs have high malignancy and strong invasion with a worse prognosis. PMID:26622444

  15. [Retrospective analysis of 23 patients with angioimmunoblastic T cell lymphoma].

    PubMed

    Yang, Ping; Wang, Jing; Zhao, Wei; Jing, Hong-Mei; Ke, Xiao-Yan

    2014-12-01

    This study was aimed to investigate the therapy and prognostic factors of angioimmunoblastic T cell lymphoma (AITL). The clinical data of 23 patients with AITL were collected and the clinical features, laboratorial data, survival and prognostic factor were retrospectively analyzed. The results indicated that the median age of the patients was 62 years. Out of them 21 (91.3%) patients were with intermediate high and high risk according to the international prognostic index (IPI), 14 (60.9%) patients had extranodal disease and 5 (21.7%) patients had autoimmune disease. The overall response rate(ORR) for the whole group was 68.2%, the estimated 3-year and 5-year survival rates were 38.3% and 28.7% respectively. High-dose chemotherapy combined with auto-HSCT improved the outcome of young patients. Immunosuppressive therapy were used in replace/refractory patients. Age more than 65 years, IPI score, LDH level, the number of lymph node involvement, short-term effect, fibrinogen level, β2-MG level and bone marrow involvement were prognostic factors with statistical significance. Cox multivariate analysis showed that the level of LDH, β2-MG and bone marrow involevment were independent prognostic factors, IPI, PIT and mPIT were useful for stratified patients into different prognostic risk groups. It is concluded that AITL is aggressive disease occurred in older patients, and autoimmune dysfunction with infectibility, often appears in AITL patients with poor prognosis. The young patients can be benefited from initial intensive chemotherapy. High-dose chemotherapy combined with auto-HSCT may be a better choice for those patients. Immunosuppressive therapy can be used in replase/refractory patients. PMID:25543480

  16. Retrospective Analysis of Inflight Exercise Loading and Physiological Outcomes

    NASA Technical Reports Server (NTRS)

    Ploutz-Snyder, L. L.; Buxton, R. E.; De Witt, J. K.; Guilliams, M. E.; Hanson, A. M.; Peters, B. T.; Pandorf, M. M. Scott; Sibonga, J. D.

    2014-01-01

    Astronauts perform exercise throughout their missions to counter the health declines that occur as a result of long-term exposure to weightlessness. Although all astronauts perform exercise during their missions, the specific prescriptions, and thus the mechanical loading, differs among individuals. For example, inflight ground reaction force data indicate that subject-specific differences exist in foot forces created when exercising on the second-generation treadmill (T2) [1]. The current exercise devices allow astronauts to complete prescriptions at higher intensities, resulting in greater benefits with increased efficiency. Although physiological outcomes have improved, the specific factors related to the increased benefits are unknown. In-flight exercise hardware collect data that allows for exploratory analyses to determine if specific performance factors relate to physiological outcomes. These analyses are vital for understanding which components of exercise are most critical for optimal human health and performance. The relationship between exercise performance variables and physiological changes during flight has yet to be fully investigated. Identifying the critical performance variables that relate to improved physiological outcomes is vital for creating current and future exercise prescriptions to optimize astronaut health. The specific aims of this project are: 1) To quantify the exercise-related mechanical loading experienced by crewmembers on T2 and ARED during their mission on ISS; 2) To explore relationships between exercise loading variables, bone, and muscle health changes during the mission; 3) To determine if specific mechanical loading variables are more critical than others in protecting physiology; 4) To develop methodology for operational use in monitoring accumulated training loads during crew exercise programs. This retrospective analysis, which is currently in progress, is being conducted using data from astronauts that have flown long

  17. Laparoscopic Supracervical Hysterectomy: a Retrospective Analysis of 1000 Cases

    PubMed Central

    Tchartchian, Garri; Ohlinger, Ralf

    2009-01-01

    Objective: Laparoscopic supracervical hysterectomy (LASH) was analyzed with regard to surgical indications and outcomes. Methods: This is a retrospective analysis of the first 1,000 consecutive laparoscopic supracervical hysterectomies performed by one gynecologist from September 1, 2002 to April 30, 2006. The objective of the study was to find out to what extent the indication and the outcome of surgery changed with the increase in experience of the surgeon and whether a learning curve could be established based on the results. The demographic patient data, indication for surgery, patient history with regard to previous surgery, duration of surgery, intraoperative complications, uterus weight, and length of in-patient stay were collected from the medical records. Results: The main indication in 80.4% of cases was uterus myomatosis. The median duration of surgery was 70.9±26.3 minutes (95% CI, 69.2 to 72.5) with an average uterus weight of 212.5±177.0g (95% CI, 201 to 223.6). This was reduced from 85.4±25.9 minutes (95% CI, 78.5 to 92.3) in 2002 to 72.4±30.1 minutes (95% CI, 66.7 to 78.2) in 2006, in conjunction with an increase in average uterus weight from 192.3±145.4g (95% CI, 153.8 to 230.9) to 228.7±160.3g (95% CI, 198.1 to 259.3). Overall, one intraoperative lesion of the bladder (0.1%) occurred, and in 4 cases the surgeon had to convert to laparotomy instead, due to the size and immobility of the uterus. Sixty-eight patients had a uterus weight of more than 500 g. In 67% of the cases, surgery was performed on patients with at least one previous laparotomy, and 51.4% of the patients required further interventions. Conclusion: An experienced surgeon can rapidly learn the technique of laparoscopic supracervical hysterectomy and can safely perform it. In patients with symptomatic uterine myomatosis, previous laparotomy and/or with a uterine weight of more than 500g, laparoscopic supracervical hysterectomy is a useful alternative to total hysterectomy

  18. Surgeon specialization and operative mortality in United States: retrospective analysis

    PubMed Central

    Dalton, Maurice; Cutler, David M; Birkmeyer, John D; Chandra, Amitabh

    2016-01-01

    Objective To measure the association between a surgeon’s degree of specialization in a specific procedure and patient mortality. Design Retrospective analysis of Medicare data. Setting US patients aged 66 or older enrolled in traditional fee for service Medicare. Participants 25 152 US surgeons who performed one of eight procedures (carotid endarterectomy, coronary artery bypass grafting, valve replacement, abdominal aortic aneurysm repair, lung resection, cystectomy, pancreatic resection, or esophagectomy) on 695 987 patients in 2008-13. Main outcome measure Relative risk reduction in risk adjusted and volume adjusted 30 day operative mortality between surgeons in the bottom quarter and top quarter of surgeon specialization (defined as the number of times the surgeon performed the specific procedure divided by his/her total operative volume across all procedures). Results For all four cardiovascular procedures and two out of four cancer resections, a surgeon’s degree of specialization was a significant predictor of operative mortality independent of the number of times he or she performed that procedure: carotid endarterectomy (relative risk reduction between bottom and top quarter of surgeons 28%, 95% confidence interval 0% to 48%); coronary artery bypass grafting (15%, 4% to 25%); valve replacement (46%, 37% to 53%); abdominal aortic aneurysm repair (42%, 29% to 53%); lung resection (28%, 5% to 46%); and cystectomy (41%, 8% to 63%). In five procedures (carotid endarterectomy, valve replacement, lung resection, cystectomy, and esophagectomy), the relative risk reduction from surgeon specialization was greater than that from surgeon volume for that specific procedure. Furthermore, surgeon specialization accounted for 9% (coronary artery bypass grafting) to 100% (cystectomy) of the relative risk reduction otherwise attributable to volume in that specific procedure. Conclusion For several common procedures, surgeon specialization was an important predictor

  19. 30-year PMC variability modeled by WACCM (Invited)

    NASA Astrophysics Data System (ADS)

    Marsh, D. R.; Merkel, A. W.

    2009-12-01

    It is clear from observational record that polar mesospheric clouds (PMCs) exhibit long-term variability, and it is reasonable to assume that this variability is the result of changes in the background mesopause environment. Factors responsible for these changes include variations in solar irradiance over the 11-year sunspot cycle and trends in mesopause composition and temperature caused by increasing anthropogenic emissions in the troposphere. In this study we use the Whole Atmosphere Community Climate Model (WACCM), modified to include parameterized PMCs, to investigate this long-term variability. WACCM is driven with observed changes in the surface composition and solar spectral irradiance. Using multiple-linear regression analysis of WACCM PMC albedos, we calculate that in the northern hemisphere there was an increase of between 19% and 39% over the last 30 years, and that albedos can be reduced by up to 55% during solar maximum relative to solar minimum. Both responses increase with increasing latitude. In the southern hemisphere the solar response is similar to that in the northern hemisphere, but we find no long-term trend. Good agreement is found between WACCM and observations made by the Solar Backscattered Ultraviolet instrument when PMC detection thresholds are accounted for. Finally, we examine the relative importance of composition versus temperature changes using a series of sensitivity experiments.

  20. Retrospective analysis of institutional scabies outbreaks from 1984 to 2013: lessons learned and moving forward.

    PubMed

    Mounsey, K E; Murray, H C; King, M; Oprescu, F

    2016-08-01

    Scabies outbreaks can be disruptive in institutional settings, and are associated with considerable but under-researched morbidity, especially in vulnerable populations. In this paper, we describe key findings from a retrospective review of scabies outbreaks reported in the literature over the past 30 years. We undertook this review to gain insights into the impact of institutional outbreaks, the burden in terms of attack rates, economic costs, treatment trends, the types of index cases and outbreak progression. We found 84 reports over 30 years, with outbreaks most frequently reported in aged care facilities (n = 40) and hospitals (n = 33). On average, scabies outbreaks persisted for 3 months, and the median attack rate was 38%. While 1% lindane was once the most commonly employed acaricide, 5% permethrin and oral ivermectin are increasingly used. Crusted scabies represented the index case for 83% of outbreaks, and scabies was misdiagnosed in 43% outbreaks. The frequency of reported scabies outbreaks has not declined consistently over time suggesting the disease is still highly problematic. We contend that more research and practice emphasis must be paid to improve diagnostic methods, surveillance and control, health staff education and management of crusted scabies to prevent the development of scabies outbreaks in institutional settings. PMID:27019288

  1. Decadal trends of global precipitation in the recent 30 years

    NASA Astrophysics Data System (ADS)

    Li, Xiaofan; Zhai, Guoqing

    2015-04-01

    In this study, the decadal trends of global precipitation are calculated and compared using the CMAP, GPCP and NCEP/NCAR reanalysis monthly precipitation data over the past 30 years from 1979 to 2008. The major results include the followings: (1) The decadal trend of annually and globally averaged precipitation depends on a decreasing trend for the CMAP data, a flat trend for GPCP data, and an increasing trend for the reanalysis data. (2) The analysis of horizontal distributions of differences in temporally averaged precipitation between the second (1993-2008) and the first (1979-1993) 15 years shows that the decreasing trend in the CMAP data is associated with the reduction in precipitation over the oceans. The further analysis of difference in zonally averaged precipitation rate reveals the increased precipitation rate in both the Tropics and mid-latitudes. The reduction in precipitation over the oceans is significantly weaker in the GPCP data than in the CMAP data, which shows the flat trend in the global GPCP data. The increasing trend of global precipitation average for the reanalysis data is associated with the increase in precipitation off the equator as well as in the mid-latitudes. (3) The further analysis of precipitation statistics reveals that the decreasing trend for the CMAP data is associated with the reduction in high precipitation. The flat trend for the global GPCP data corresponds to the offset between the decrease in low precipitation and the increase in high precipitation. The increasing trend for the reanalysis data is related to the increase in high precipitation.

  2. 30 years of change in water-limited ecosystems

    NASA Astrophysics Data System (ADS)

    Horion, S.; Fensholt, R.; Verbesselt, J.; Tagesson, T.; Grogan, K.; Ehammer, A.; Tian, F.

    2014-12-01

    Water availability limits plant growth and production in most terrestrial ecosystems. However these ecosystems do not show the same sensitivity to changes in precipitation. Water-limited ecosystems are defined here as ecosystems where rainfall is the dominant climate constraint to plant growth. Drought-prone and often characterized by increasing human pressure on land and natural resources, these regions are amongst the most vulnerable on Earth. Despite the many years of research, a clear understanding of changes in vegetation dynamics and species distribution, as well as related drivers, has not been reached yet. In this research we take advantage of the 30years time span offered by the GIMMS FAPAR3g dataset to investigate abrupt and gradual changes in Rain-Use Efficiency (RUE). Using the piece-wise regression method implemented in BFAST (Breaks For Additive Season and Trend) and BFAST01, a change type classification scheme is produced for water-limited ecosystems. Compared to classical non-parametric trend analysis, this approach allows detecting trend shifts during the study period. This global scale analysis revealed that for more than 50% of the cases no significant changes in RUE were registered between 1982 and 2011. Whereas when significant changes were registered, monotonic increase was the predominant type of changes. Large patches of reversing trends were also observed, notably in Asia (China, Kazakhstan), in the Sahelian region (Sudan, Ethiopia, Senegal), and in South America (Peru and Argentina). Even though reversing trends appear to be more frequently observed in regions with high land cover change dynamics, a comprehensive attribution of drivers for all recorded changes is still under discussion. Indeed the co-occurrence of global drivers (such as change in climate and in extreme events) and local drivers (such as land-cover changes) makes it a very delicate task.

  3. Temporomandibular joint ankylosis caused by condylar fractures: a retrospective analysis of cases at an urban teaching hospital in Nigeria.

    PubMed

    Anyanechi, C E

    2015-08-01

    Mandibular condylar fractures are common presentations to hospitals across the globe and remain the most important cause of temporomandibular joint (TMJ) ankylosis. This study aimed to analyze cases of mandibular condylar fracture complicated by TMJ ankylosis after treatment. A 16-year retrospective analysis was performed at the dental and maxillofacial surgery clinic of the study institution; patient data were collected from the hospital records and entered into a pro-forma questionnaire. It was found that 56/3596 (1.6%) fractures resulted in TMJ ankylosis. The age of patients with ankylosis ranged from 12 to 47 years. The age (P=0.03) and gender (P=0.01) distributions were significant, with most cases of ankylosis occurring in those aged 11-30 years (n=43/56, 76.8%). Fractures complicated by ankylosis were intracapsular (n=22/56, 39.3%) and extracapsular (n=34/56, 60.7%). Ankylosis increased significantly with the increase in time lag between injury and fracture treatment (P=0.001). Ankylosis was associated with concomitant mandibular (85.7%) and middle third (66.1%) fractures. Treatment methods were not significantly related to ankylosis (P=0.32). All cases of ankylosis were unilateral, and complete (n=36, 64.3%) and incomplete ankylosis (n=20, 35.7%) were diagnosed clinically. The incorporation of computed tomography scans and rigid internal fixation in the management of condylar fractures will reduce ankylosis. PMID:26008733

  4. 30 years of finite-gap integration theory.

    PubMed

    Matveev, Vladimir B

    2008-03-28

    The method of finite-gap integration was created to solve the periodic KdV initial problem. Its development during last 30 years, combining the spectral theory of differential and difference operators with periodic coefficients, the algebraic geometry of compact Riemann surfaces and their Jacobians, the Riemann theta functions and inverse problems, had a strong impact on the evolution of modern mathematics and theoretical physics. This article explains some of the principal historical points in the creation of this method during the period 1973-1976, and briefly comments on its evolution during the last 30 years. PMID:17594966

  5. Melanoma and non-melanoma skin cancers in hairy cell leukaemia: a Surveillance, Epidemiology and End Results population analysis and the 30-year experience at Memorial Sloan Kettering Cancer Center.

    PubMed

    Watts, Justin M; Kishtagari, Ashwin; Hsu, Meier; Lacouture, Mario E; Postow, Michael A; Park, Jae H; Stein, Eytan M; Teruya-Feldstein, Julie; Abdel-Wahab, Omar; Devlin, Sean M; Tallman, Martin S

    2015-10-01

    Few studies have examined melanoma and non-melanoma skin cancer (NMSC) incidence rates after a diagnosis of hairy cell leukaemia (HCL). We assessed 267 HCL patients treated at Memorial Sloan Kettering Cancer Center (MSKCC) and Surveillance, Epidemiology and End Results (SEER) data for melanoma and NMSC incidence rates after HCL. Incidence data from MSKCC patients demonstrated a 10-year combined melanoma and NMSC skin cancer rate of 11·3%, melanoma 4·4% and NMSC 6·9%. Molecular analysis of skin cancers from MSKCC patients revealed activating RAS mutations in 3/9 patients, including one patient with melanoma. Of 4750 SEER patients with HCL, 55 (1·2%) had a subsequent diagnosis of melanoma. Standardized incidence ratios (SIRs) did not show that melanoma was more common in HCL patients versus the general population (SIR 1·3, 95% CI 0·78-2·03). Analysis of SEER HCL patients diagnosed before and after 1990 (approximately before and after purine analogue therapy was introduced) showed no evidence of an increased incidence after 1990. A better understanding of any potential association between HCL and skin cancer is highly relevant given ongoing trials using BRAF inhibitors, such as vemurafenib, for relapsed HCL, as RAS-mutant skin cancers could be paradoxically activated in these patients. PMID:26115047

  6. Education and HIV/AIDS--30 Years on

    ERIC Educational Resources Information Center

    Aggleton, Peter; Yankah, Ekua; Crewe, Mary

    2011-01-01

    Education has long been identified as having a key role to play in reducing HIV-related risk and vulnerability, and in mitigating the impact of the epidemic on affected individuals and communities. This article reflects on progress over a 30-year period with respect to older and more emergent forms of education concerning HIV and AIDS: treatment…

  7. Historical Lassa fever reports and 30-year clinical update.

    PubMed

    Macher, Abe M; Wolfe, Martin S

    2006-05-01

    Five cases of Lassa fever have been imported from West Africa to the United States since 1969. We report symptoms of the patient with the second imported case and the symptoms and long-term follow-up on the patient with the third case. Vertigo in this patient has persisted for 30 years. PMID:16704848

  8. Historical Lassa Fever Reports and 30-year Clinical Update

    PubMed Central

    Wolfe, Martin S.

    2006-01-01

    Five cases of Lassa fever have been imported from West Africa to the United States since 1969. We report symptoms of the patient with the second imported case and the symptoms and long-term follow-up on the patient with the third case. Vertigo in this patient has persisted for 30 years. PMID:16704848

  9. Social Skills Training for Depression and Comparative Efficacy Research: A 30-Year Retrospective

    ERIC Educational Resources Information Center

    Thase, Michael E.

    2012-01-01

    By the late 1970s it was clear that cognitive and behavioral therapies were promising alternatives to antidepressant medications for treatment of depressed outpatients. One such model of therapy, Social Skills Training, was developed by Michel Hersen and his colleagues specifically for treatment of depressed women. Professor Hersen and his…

  10. Gastrointestinal bezoars: A retrospective analysis of 34 cases

    PubMed Central

    Erzurumlu, Kenan; Malazgirt, Zafer; Bektas, Ahmet; Dervisoglu, Adem; Polat, Cafer; Senyurek, Gokhan; Yetim, Ibrahim; Ozkan, Kayhan

    2005-01-01

    AIM: Bezoars (BZ) are the most common foreign bodies of gastrointestinal tract. Clinical manifestations vary depending on the location of BZ from no symptoms to acute abdominal syndrome. When located in small bowel, they frequently cause small bowel obstruction (SBO). We aimed to present our experience by reviewing literature. METHODS: Thirty-four patients with gastrointestinal BZ were presented. The data were collected from hospital records and analyzed retrospectively. Morbidity and mortality rates were statistically analyzed between the subgroups according to SBO and endoscopic or surgical treatment modalities. RESULTS: The 34 patients had phytobezoars (PBZ). Two patients with mental retardation and trichotillomania had trichobezoars (TBZ). More than half of them (55.88%) had previous gastric surgery. Also most of them had small bowel bezoars resulting in obstruction. Surgical and endoscopic morbidity rates were 32.14% and 14.28% respectively. The total morbidity rate of this study was 29.41%. Four patients in surgically treated group died. There was no death in endoscopically treated group. The total and surgical mortality rates were 11.76% and 14.28% respectively. The differences in morbidity and mortality rates between the subgroups were not statistically significant. CONCLUSION: BZ are commonly seen in stomach and small intestine. SBO is the most common complication. When uncomplicated, endoscopic or surgical removal can be applied easily. PMID:15793871

  11. Retrospective study and immunohistochemical analysis of canine mammary sarcomas

    PubMed Central

    2013-01-01

    Background Canine mammary sarcomas (CMSs) are rarely diagnosed in female dogs, which explains the scarcity of immunohistochemical findings concerning those tumors. This paper presents the results of a retrospective study into CMSs and discusses the clinical features of the analyzed tumors, the expression of intermediate filaments CK, Vim, Des and α-SMA, and the expression of p63, Ki67, ERα, PR and p53 protein. Results Four percent of all canine mammary tumors (CMTs) were classified as CMSs, and they represented 5.1% of malignant CMTs. The mean age at diagnosis was 11.1 ± 2.8 years. Large breed dogs were more frequently affected (38.7%). The majority of observed CMSs were fibrosarcomas (2.1%). All CMSs expressed vimentin, and higher levels of vimentin expression were noted in fibrosarcomas and osteosarcomas. Ki67 expression was significantly correlated with the grade of CMS. Conclusions Our results revealed that CMSs form a heterogeneous group, therefore, immunohistochemical examinations could support differential and final diagnosis. Although this study analyzed a limited number of samples, the reported results can expand our knowledge about CMSs. Further work is required in this field. PMID:24321325

  12. Delusional disorder: retrospective analysis of 86 Chinese outpatients.

    PubMed

    Hsiao, M C; Liu, C Y; Yang, Y Y; Yeh, E K

    1999-12-01

    Patients who visited the psychiatric outpatient service of Chang Gung Medical Centre, Tao-Yuan, Taiwan during an 8-year period were studied retrospectively. Among the 10,418 outpatients, 86 (0.83%) were diagnosed as having DSM-IV delusional disorder (DD), including 61 (70.9%) with persecutory type, 12 (14.0%) with the mixed type, seven (8.1%) with jealous type, two (2.3%) with somatic type, two (2.1%) with unspecified type, one (1.2%) with erotomanic type, and another one with grandiose type. The ratio of women to men was 0.86. The mean age at onset was 42.4 +/- 15.41 years, with women being older than men. Thirty-seven cases (43.0%) presented with depressive symptoms at their first visit. Subjects were divided into four groups: persecutory type, jealous type, mixed type and others. There were no significant differences between the four groups in terms of gender, age at onset, time-lapse before seeking psychiatric help, the presence of hallucination or the presence of depression. PMID:10687749

  13. Myringoplasty in children: retrospective analysis of 60 cases

    PubMed Central

    Abdellatif, Harkani; Youssef, Rouchdi; Omar, Maliki; Hassan, Nouri; Lahcen, Aderdour; Abdelaziz, Raji

    2015-01-01

    Myringoplasty or type 1 tympanoplasty aims the restoration of the anatomic integrity of the tympanic membrane; it's a very common surgery in otology. The objective was to evaluate the anatomic and functional results of this surgery in children using the retro-auricular approach. Sixty young patients with diagnosis of simple tympanic perforation were evaluated; these patients underwent myringoplasty by a retro-auricular approach (underlay technique) between November 2010 and May 2013. It's a retrospective evaluation of the anatomic and functional results of theses myringoplasties. Mean age at surgery was 8, 5 years old, cartilage was used as graft in our entire patient, closure of perforation was successful in 48 cases (80%), and audiometric results showed functional improvement in 27 (45%) patients, no significant change was noted in the remaining patients. The results of myringoplasty in children seem worse than those in adults. However, a large study with a long follow up is warranted in order to come to definitive conclusions. PMID:26090040

  14. Use of Drugs Subject to Controlled Prescriptions: a Retrospective Analysis

    PubMed Central

    Demircan, Dilek; Gülmez, Sinem Ezgi; Dönertaş, Başak; Topcu, İbrahim; Yılmaz, Hüseyin; Berkman, Kemal; Akıcı, Ahmet

    2013-01-01

    Objective: Use of drugs that may lead to abuse or dependence are subject to controlled prescriptions (CPs) in many countries, and these are closely monitored by health authorities. According to national regulations in Turkey, CPs may be red coloured (RCPs) or green coloured (GCPs). The aim of this study was to evaluate the use of such drugs in Istanbul. Study Design: Retrospective case-control study. Material and Methods: During the study period (01/01-31/12 2009), 502874 CPs were reported. Among these, 4000 CPs each month were randomly selected and evaluated. Results: The majority of GCPs were issued to women (55.6%), while the majority of RCPs were issued to men (68.4%). GCPs were most frequently prescribed by physicians working in private hospitals (33.6%) while RCPs by physicians working in university hospitals (39.7%). GCPs were mostly prescribed by psychiatrists (37.6%) while for RCPs were child and adolescent psychiatrists (35.9%). Psycholeptics (ATC code N05) were the most prescribed controlled drugs (CDs) (43.8%). Methylphenidate (53.9%) was the mostly prescribed on RCPs and alprazolam (39.6%) was on GCPs. Conclusion: We demonstrate that utilization of CDs shows demographical and institutional differences. These data could be of help to improve surveillance of CDs as well as to train prescribers and patients. PMID:25207068

  15. Monitoring operating room turnaround time: a retrospective analysis.

    PubMed

    Scagliarini, Michele; Apreda, Mariarosaria; Wienand, Ulrich; Valpiani, Giorgia

    2016-04-18

    Purpose - Operating room (OR) turnaround time is a key process indicator for hospital business management: delays lead to a reduced surgical interventions per day with a consequent increase in costs and decrease in efficiency. The purpose of this paper is to increase understanding by assessing the process' steady-state behaviour and identifying changes that indicate either improvement or deterioration in quality. Design/methodology/approach - With this purpose, the authors retrospectively applied Shewhart control charts and exponentially weighted moving average control charts to data extracted from an hospital information system. Findings - The results showed that statistical process control is able to identify steady-state behaviour process and to detect positive or negative changes in process performance. In particular the authors detected a deterioration in the process performance coinciding with the change in the operating room patient transfer staff. Practical implications - This study showed that statistical quality control is a valuable tool for monitoring performance indicators. Currently, hospital managers are designing an OR dashboard which also includes the control charts. Originality/value - The paper highlights the control chart application to organizational indicators allowing an objective OR system performance assessment. PMID:27120511

  16. Equine-associated maxillofacial injuries: retrospective 5-year analysis.

    PubMed

    Islam, Shofiq; Gupta, Benjamin; Taylor, Christopher J; Chow, Jeffrey; Hoffman, Gary R

    2014-02-01

    We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2-88 years. There was a significant difference in the rate of maxillofacial and associated injuries when groups were analysed for sex and mechanism of injury. Facial injuries caused by falling from a horse were more often associated with other injuries in men than in women (p<0.05), and men were 4 times more likely to present with associated injuries than women (OR 3.9; 95% CI 1.1 to 14) We also found significant differences in the rates of facial fracture. Women who had been kicked by a horse were more likely to sustain bony injuries than men (p<0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management. PMID:24168759

  17. Acute Surgical Pulmonary Embolectomy: A 9-Year Retrospective Analysis

    PubMed Central

    Hartman, Alan R.; Manetta, Frank; Lessen, Ronald; Kozikowski, Andrzej; Jahn, Lynda; Akerman, Meredith; Lesser, Martin L.; Glassman, Lawrence R.; Graver, Michael; Scheinerman, Jacob S.; Kalimi, Robert; Palazzo, Robert; Vatsia, Sheel; Pogo, Gustave; Hall, Michael; Yu, Pey-Jen; Singh, Vijay

    2015-01-01

    Acute pulmonary embolism is a substantial cause of morbidity and death. Although the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines recommend surgical pulmonary embolectomy in patients with acute pulmonary embolism associated with hypotension, there are few reports of 30-day mortality rates. We performed a retrospective review of acute pulmonary embolectomy procedures performed in 96 consecutive patients who had severe, globally hypokinetic right ventricular dysfunction as determined by transthoracic echocardiography. Data on patients who were treated from January 2003 through December 2011 were derived from health system databases of the New York State Cardiac Surgery Reporting System and the Society of Thoracic Surgeons. The data represent procedures performed at 3 tertiary care facilities within a large health system operating in the New York City metropolitan area. The overall 30-day mortality rate was 4.2%. Most patients (68 [73.9%]) were discharged home or to rehabilitation facilities (23 [25%]). Hemodynamically stable patients with severe, globally hypokinetic right ventricular dysfunction had a 30-day mortality rate of 1.4%, with a postoperative mean length of stay of 9.1 days. Comparable findings for hemodynamically unstable patients were 12.5% and 13.4 days, respectively. Acute pulmonary embolectomy can be a viable procedure for patients with severe, globally hypokinetic right ventricular dysfunction, with or without hemodynamic compromise; however, caution is warranted. Our outcomes might be dependent upon institutional capability, experience, surgical ability, and careful patient selection. PMID:25873794

  18. Antenatal Atazanavir: A Retrospective Analysis of Pregnancies Exposed to Atazanavir

    PubMed Central

    Samuel, Miriam; Bradshaw, Daniel; Perry, Melissa; Chan, Sum Yee; Dhairyawan, Rageshri; Byrne, Laura; Smith, Katherine; Zhou, Judith; Short, Charlotte Eve; Naftalin, Claire; Offodile, Ngozi; Mandalia, Sundhiya; Roedling, Sherie; Shah, Rimi; Brook, Gary; Poulton, Mary; Rodgers, Mette; Sarner, Liat; Noble, Heather; Hay, Philip; Anderson, Jane; Natha, Macky; Hawkins, David; Taylor, Graham; de Ruiter, Annemiek

    2014-01-01

    Introduction. There are few data regarding the tolerability, safety, or efficacy of antenatal atazanavir. We report our clinical experience of atazanavir use in pregnancy. Methods. A retrospective medical records review of atazanavir-exposed pregnancies in 12 London centres between 2004 and 2010. Results. There were 145 pregnancies in 135 women: 89 conceived whilst taking atazanavir-based combination antiretroviral therapy (cART), “preconception” atazanavir exposure; 27 started atazanavir-based cART as “first-line” during the pregnancy; and 29 “switched” to an atazanavir-based regimen from another cART regimen during pregnancy. Gastrointestinal intolerance requiring atazanavir cessation occurred in five pregnancies. Self-limiting, new-onset transaminitis was most common in first-line use, occurring in 11.0%. Atazanavir was commenced in five switch pregnancies in the presence of transaminitis, two of which discontinued atazanavir with persistent transaminitis. HIV-VL < 50 copies/mL was achieved in 89.3% preconception, 56.5% first-line, and 72.0% switch exposures. Singleton preterm delivery (<37 weeks) occurred in 11.7% preconception, 9.1% first-line, and 7.7% switch exposures. Four infants required phototherapy. There was one mother-to-child transmission in a poorly adherent woman. Conclusions. These data suggest that atazanavir is well tolerated and can be safely prescribed as a component of combination antiretroviral therapy in pregnancy. PMID:25328370

  19. Retrospective analysis of spinal arachnoid cysts in 14 dogs.

    PubMed

    Rylander, Helena; Lipsitz, David; Berry, Wayne L; Sturges, Beverly K; Vernau, Karen M; Dickinson, Peter J; Añor, Sonia A; Higgins, Robert J; LeCouteur, Richard A

    2002-01-01

    Spinal cord dysfunction secondary to spinal arachnoid cysts (SACs) has been reported previously in dogs. This retrospective study reviews the clinical signs, radiographic findings, and outcome after surgical resection of SACs in 14 dogs. Plain vertebral column radiographs and myelography were done in all dogs. Computed tomography (CT) was done in 7 dogs and magnetic resonance (MR) imaging in 3 dogs. Affected dogs were between 1 and 12 years of age, and 8 of 14 were Rottweilers. Abnormalities detected on neurological examination depended on the location of the SAC. Five dogs had bilobed or multiple SACs. SACs were located in the cervical vertebral column in 11 dogs and in the thoracic vertebral column in 4 dogs. All dogs had dorsally or dorsolaterally located SACs. Two dogs also had additional ventrally located SACs. Spinal cord compression secondary to intervertebral disc extrusion or protrusion was demonstrated at the site of the SACs in 2 dogs. Surgical resection of the SACs was completed in all dogs. Eleven dogs were available for follow-up. Five weeks postoperatively, 7 dogs improved in neurological function, with some residual ataxia and paresis in 6 of these dogs. Neurological function had deteriorated in 4 dogs. It was concluded from this study that Rottweilers have a higher incidence of SACs than other breeds of dog. Furthermore, bilobed or multiple SACs can occur commonly, and myelography effectively localized SACs in dogs. Surgical resection of SACs resulted in improvement in neurological function in the majority of treated dogs. PMID:12465766

  20. INCIDENTAL PARASITIC INFECTIONS IN SURGICALLY REMOVED APPENDICES: A RETROSPECTIVE ANALYSIS.

    PubMed

    Zaghlool, Dina A; Hassan, Amal A; Ahmed, Mona A; Faidah, Hani S

    2015-12-01

    Numerous parasitic infections can cause inflammation of the appendix and can mimic appendicitis clinically. The diagnosis is generally achieved only after surgery. However early diagnosis through stool examination may prevent life-threatening complications. This study investigated the presence of parasitic infections in surgically removed appendices as an etiology of acute appendicitis. A retrospective study included patients who had undergone surgery for acute appendicitis over a period of three years from Jan 2012 to Dec 2014. Demographic data, laboratory investigations, operative data and pathological findings, presence and type of parasites were retrieved. The results showed that out of 1536 patients with appendectomy done, 938 (61.1%) were males and 598 (38.9%) were females. Parasitic infection was demonstrated only in 0.4% (6 patients). Mean average age of these patients was 12 years. Enterobius vennicularis was present in 4 patients (66% of the parasitic affection) and Schistosoma mansoni in 2 patients (34% of the parasitic affection). Other etiologies were acute suppurative appendicitis (94.1%), chronic appendicitis (3.1%), tumors (0.3%), tuberculosis (0.2%) and actinomycosis (0.1%). Appendix was found normal in 2% of patients underwent appendectomy. PMID:26939234

  1. Imported malaria in pregnant women: a retrospective pooled analysis

    PubMed Central

    Käser, Annina K.; Arguin, Paul M.; Chiodini, Peter L.; Smith, Valerie; Delmont, Jean; Jiménez, Beatriz C.; Färnert, Anna; Kimura, Mikio; Ramharter, Michael; Grobusch, Martin P.; Schlagenhauf, Patricia

    2015-01-01

    Summary Background Data on imported malaria in pregnant women are scarce. Method A retrospective, descriptive study of pooled data on imported malaria in pregnancy was done, using data from 1977 to 2014 from 8 different collaborators in Europe, the United States and Japan. Most cases were from the period 1991–2014. National malaria reference centresas well as specialists on this topic were asked to search their archives for cases of imported malaria in pregnancy. A total of 632 cases were collated, providing information on Plasmodium species, region of acquisition, nationality, country of residence, reason for travel, age, gestational age, prophylactic measures and treatment used, as well as on complications and outcomes in mother and child. Results Datasets from some sources were incomplete. The predominant Plasmodium species was P. falciparum in 72% of cases. Among the 543 cases where information on the use of chemoprophylaxis was known, 471 (74.5%) did not use chemoprophylaxis or used incorrect or incomplete chemoprophylaxis. The main reason for travelling was “visiting friends and relatives” VFR (48.6%) and overall, most cases of malaria were imported from West Africa (85.9%). Severe anaemia was the most frequent complication in the mother. Data on offspring outcome was limited, but spontaneous abortion was a frequently reported foetal outcome (n = 14). A total of 50 different variants of malaria treatment regimens were reported. Conclusion Imported cases of malaria in pregnancy are mainly P. falciparum acquired in sub-Saharan Africa. Malaria prevention and treatment in pregnant travellers is a challenge for travel medicine due to few data on medication safety and maternal and foetal outcomes. International, collaborative efforts are needed to capture standardized data on imported malaria cases in pregnant women. PMID:26227740

  2. [Retrospective analysis of 71 cases of multiple myeloma].

    PubMed

    Yang, Ping; Zhang, Wen-Juan; Jing, Hong-Mei; Ke, Xiao-Yan

    2009-12-01

    The aim of this study was to investigate the efficacy of different chemotherapy regimens in patients with multiple myeloma (MM). The therapeutic effects of 71 MM patients receiving standard chemotherapy regimens were retrospectively analyzed and evaluated. The results showed that 44 out of 71 new-diagnosed MM patients gained remission in varying degree, total effective rate was 61.9%, in which the rate of complete remission (CR) plus nearly complete remission (nCR) was 21.1%. 21 MM patients received M2 regimen gained total effective rate of 57.1%, in which the CR plus nCR were found in 5 MM patients, and partial remission (PR) was observed in 7 MM patients. 8 MM patients received MP chemotherapy regimen gained total effective rate of 37.5%, in which the CR + nCR was not found, but the PR was observed in 3 MM patients. 30 MM patients received VAD regimen gained total effective rate of 63.3%, in which CR + nCR and PR were found in 6 and 13 MM patients respectively, 12 MM patients received combined bortezomib regimen gained total effective rate of 83.3%, in which CR + nCR and PR were found in 4 and 6 MM patients respectively. The median time of progression and the median time of survival in 72 MM patients were 22.1 and 29.5 months respectively. The 3 and 5 year survival rates in 72 MM patients were 41.2% and 20.6% respectively. In conclusion, the chemotherapy regimen for new-diagnosed MM patients should be selected according to their clinical features and subtypes, the bortezomib-combined regimen may be considered as a new and effective regimen for MM patients. PMID:20030950

  3. 76 FR 39315 - Preliminary Plan for Retrospective Analysis of Existing Rules; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-06

    ... achieving its regulatory objectives. On March 30, 2011 (76 FR 17572), the Department published a notice and... X 48 CFR Chapter 10 Preliminary Plan for Retrospective Analysis of Existing Rules; Notice of... Analysis of Existing Rules and invites interested members of the public to submit comments on the...

  4. 1995 solid waste 30-year container volume summary

    SciTech Connect

    Templeton, K.J.; DeForest, T.J.; Patridge, M.D.

    1995-07-01

    This report describes a 30-year forecast of the solid waste volumes by container category. The volumes described are low-level mixed waste (LLMW) and transuranic/transuranic mixed (TRU-TRUM) waste. These volumes and their associated container categories will be generated or received at the US Department of Energy Hanford Site for storage, treatment, and disposal at Westinghouse Hanford Company`s Solid Waste Operations Complex (SWOC) during a 30-year period from FY 1995 through FY 2024. The data presented in this report establish a baseline for solid waste management both in the present and future. With knowledge of the volumes by container type, decisions on the facility handling and storage requirements can be adequately made. It is recognized that the forecast estimates will vary as facility planning and missions continue to change and become better defined; however, the data presented in this report still provide useful insight into Hanford`s future solid waste management requirements.

  5. Merkel Cell Carcinoma Analysis of Outcomes: A 30-Year Experience

    PubMed Central

    Liang, Evan; Brower, Jeffrey V.; Rice, Stephanie R.; Buehler, Darya G.; Saha, Sandeep; Kimple, Randall J.

    2015-01-01

    Background Merkel cell carcinoma (MCC) is an aggressive cutaneous malignancy with poor prognosis. Limited data exists to guide treatment decisions. Here we report on our institutional experience and outcomes treating patients with MCC. Methods A database search (1984-2014) of patients treated at the University of Wisconsin Hospital and Clinics was used to identify patients with histologically confirmed MCC. Patient, tumor, and treatment characteristics were examined via review of medical records. Statistical analyses were performed to assess outcomes and associated prognostic factors. Results A total of 87 patients with MCC were identified with a median follow-up of 17 months (mean: 38, range: 0-210 months). Two and five-year overall survival rates were 53.9% and 32.8%, respectively. Recurrence was documented in 31.0% of patients (85.2% locoregional, 48.1% distant and 33.3% both). Patients with a history of immunosuppression exhibited significantly worse survival (hazard ratio, 2.01; 95% CI, 1.1-3.7) when compared to immune-competent individuals. The head and neck region was the most common location of primary lesion (N=49) followed by the extremities (N=31). Upper extremity primaries predicted significantly better overall survival (hazard ratio, 0.48; 95% CI, 0.23-0.99) while lower extremity primaries did not have significantly better results (hazard ratio, 0.5; 95% CI, 0.21-1.2) in comparison to head and neck site of primary. Nodal involvement (hazard ratio, 2.95; 95% CI, 1.5-5.79) was also a negative prognostic factor associated with poor overall survival when compared with clinically node negative patients. Primary tumor size > 2 cm (hazard ratio, 1.76; 95% CI, 0.91-3.4) was not associated with survival. Conclusions This study highlights the role of various factors in determining prognosis of Merkel cell carcinoma; history of immunosuppression, nodal involvement, and head/neck primary predicted worse overall survival. These findings suggest that improvements in both distant and locoregionally directed therapies might play an important role in control of MCC and identify areas for future study. PMID:26053480

  6. Statins and Male Sexual Health: A Retrospective Cohort Analysis

    PubMed Central

    Richard, Davis; Reveles, Kelly R.; Ali, Sayed K.; Mortensen, Eric M.; Frei, Christopher R.; Mansi, Ishak

    2014-01-01

    Introduction Conflicting reports exist regarding the role of statins in male gonadal and sexual function. Some studies report a beneficial effect, particularly for erectile dysfunction (ED), through statins’ anti-inflammatory and cardiovascular protective properties. Others suggest that statins might be associated with sexual dysfunction through negative effects on hormone levels. Aim To compare the risk of gonadal or sexual dysfunction in statin-users versus non-users in a single payer healthcare system. Methods A retrospective cohort study of all male patients (30-85 years) enrolled in Tricare San Antonio market. Using 79 baseline characteristics, we created a propensity score-matched cohort of statin-users and non-users. The study duration was divided into a baseline period (October 1, 2003 to September 30, 2005), to describe patient baseline characteristics, and a follow-up period (October 1, 2005 to March 1, 2012) to determine patient outcomes. Statin-users were defined as those prescribed a statin for ≥3 months between October 1, 2004 and September 30, 2005. Main Outcome Measures Outcomes were identified as the occurrence of benign prostatic hypertrophy (BPH), ED, infertility, testicular dysfunction, or psychosexual dysfunction during the follow-up period as identified by inpatient or outpatient International Classification of Diseases, 9th Revision, Clinical Modification codes. Logistic regression was used to determine the association of statin use with patient outcomes. Results Of 20,731 patients who met study criteria, we propensity score-matched 3,302 statinusers with 3,302 non-users. Statin use in men was not significantly associated with an increased or decreased risk of BPH (OR 1.08; 95% CI 0.97-1.19), ED (OR 1.01; 95% CI 0.90-1.13), infertility (OR 1.22; 95% CI 0.66-2.29), testicular dysfunction (OR 0.91; 95% CI 0.73-1.14), or psychosexual dysfunction (OR 1.03; 95% CI 0.94-1.14). Conclusions Statin use was not associated with increased risk of

  7. Transient Unexplained Shock in 30-year-old Trauma Patient.

    PubMed

    Rahmani, Farzad; Ebrahimi Bakhtavar, Hanieh; Shahsavari Nia, Kavous; Mohammadi, Neda

    2014-01-01

    Shock as an inadequate tissue perfusion is one of the frequent causes of death in trauma patients. In this context, there are various reasons for hemodynamic instability and shock including hypovolemic (hemorrhagic), obstructive (cardiac tamponade, tension pneumothorax), cardiogenic, neurogenic, and rarely septic. In the present report, a 30-year-old trauma patient with full clinical signs and symptoms of shock referred while had unknown origin; it was finally recognized as anaphylactic shock. PMID:26495357

  8. The enduring legacy of Alma Ata: 30 years on

    PubMed Central

    2008-01-01

    The 1978 Alma Ata conference and declaration was a landmark in defining and providing a direction for primary healthcare. Despite the initial enthusiasm for Alma Ata, its impact appeared to have declined in the 1990s. However, in recent years, there has been a revitalisation of primary healthcare. This article reviews the Alma Ata conference and declaration, assesses its waxing and waning, and examines its recent revival. The paper draws conclusions about the relevance of Alma Ata, 30 years on. PMID:25949564

  9. The enduring legacy of Alma Ata: 30 years on.

    PubMed

    Exworthy, Mark

    2008-01-01

    The 1978 Alma Ata conference and declaration was a landmark in defining and providing a direction for primary healthcare. Despite the initial enthusiasm for Alma Ata, its impact appeared to have declined in the 1990s. However, in recent years, there has been a revitalisation of primary healthcare. This article reviews the Alma Ata conference and declaration, assesses its waxing and waning, and examines its recent revival. The paper draws conclusions about the relevance of Alma Ata, 30 years on. PMID:25949564

  10. Evolution of induction chemotherapy for non-small cell lung cancer over the last 30 years: A surgical appraisal

    PubMed Central

    Fabre, Elizabeth; Rivera, Caroline; Mordant, Pierre; Gibault, Laure; Dujon, Antoine; Foucault, Christophe; Le Pimpec-Barthes, Françoise; Riquet, Marc

    2015-01-01

    Background Induction chemotherapy (ICT) is supposed to reduce the risk of micrometastatic progression and improve resectability of non-small cell lung cancer (NSCLC). However, best indications for ICT strategy remain unclear in published meta-analyses. Based on this observation, an evaluation of daily practice is of importance. Therefore, we reviewed indications and efficacy time trends in our 30-year series. Methods A database including all patients with NSCLC who underwent surgical resection in two French centers from 1980 to 2009 (n = 5563) was prospectively set and retrospectively reviewed. The indications, clinical and pathologic response rates, and overall survival of ICT patients (n = 732) were analyzed during three successive time-periods: P1 from 1980 to 1989, P2 from 1990 to 1999, and P3 from 2000 to 2009. Results The proportion of patients who benefited from ICT increased over time, from 2.8% (n = 35) in P1 to 12.5% (n = 274) in P2, and 20.2% (n = 423) in P3. Indications evolved over time with more N2 patients (n = 211; 49.8%) and less initially unresectable patients (n = 72; 17%) in P3. The clinical response rate between P1 and P2 increased. Five and 10-year survival rates of ICT patients were 35.2% and 21.5%, respectively. In multivariate analysis, time-period, age, type of resection, histology, and pathologic response to chemotherapy were significant prognostic factors. Conclusions Our report on the off-trial use of induction therapy during the last 30 years demonstrates an increased use of ICT, a progressive focus on N2 disease, and improved response rates. PMID:26557911

  11. Jovian Mid-Infrared Aurora: Retrospective Analysis of Variability and Cassini Flyby Measurements in Preparation for Juno

    NASA Astrophysics Data System (ADS)

    Kostiuk, Theodor; Hewagama, Tilak; Livengood, Timothy A.; Fast, Kelly E.; Carlson, Ronald; MacDowall, Robert; Jennings, Donald E.; Pitts, Rebecca

    2014-11-01

    With the approaching arrival of the Juno mission at Jupiter it is important to look at the current knowledge of Jovian phenomena that can or cannot be further studied from orbital spacecraft. It is also important to retrospectively investigate previously acquired data using current improved methods and capabilities. The thermal (mid-) infrared aurora from Jupiter’s polar regions has been studied extensively from ground-based observatories as well as by Voyager IRIS and Cassini CIRS during Jupiter flybys. We report on a reexamination and re-analysis of hydrocarbon emission spectra from the polar regions of Jupiter obtained using ground based infrared heterodyne spectroscopy (IRHS) and Cassini CIRS Fourier transform spectroscopy (FTS) during the flyby of Jupiter in 2000-2001. Measurements with IRHS have been made over 30 years, primarily of ethane near 12 micrometer wavelength. IRHS provides fully resolved individual spectral lines whose shape yields unique information on variability of temperature and abundance. CIRS data, at lower spectral resolution, explores extended spatial distributions and covers a broad spectral region that includes auroral response of ethane as well as several other hydrocarbons in the 8-13 micrometer wavelength region (methane, ethylene, and acetylene). These spectra are radiometrically calibrated and can serve as a sensitive thermometer of the Jovian atmosphere. Recently improved analysis techniques show detailed spatial enhancements of the primary hydrocarbons in northern latitudes. Temporal changes of the ethane line emission over three solar cycles and comparison of retrievals from ethane data taken contemporaneously during the Cassini flyby by both techniques will be compared and results discussed. Juno does not have instrumentation in this spectral region and this work provides complementary information and diagnostics for studying Jovian aurora and magnetosphere in a spectral region and altitude range not directly probed by Juno.

  12. RETROSPECTIVE ANALYSIS OF THE RESPONSE OF SAGINAW BAY, LAKE HURON, TO REDUCTIONS IN PHOSPHORUS LOADINGS

    EPA Science Inventory

    A retrospective analysis was conducted of the response of Saginaw Bay, Lake Huron, to a substantial reduction in external phosphorus loadings over the study period 1974-1980. Loadings to Saginaw Bay from the Saginaw River for total phosphorus and dissolved ortho phosphorus were 5...

  13. The Impact of the Desegregation Process on the Education of Black Students: A Retrospective Analysis

    ERIC Educational Resources Information Center

    Irvine, Jacqueline Jordan; Irvine, Russell W.

    2007-01-01

    This article is a retrospective analysis of a commentary we published in "The Journal of Negro Education" 25 years ago in which we discussed the interrelationships between and among the interpersonal, institutional, community, and African American achievement variables before and after the historic 1954 "Brown" decision. We discuss in this piece…

  14. Retrospective Analysis of Cognitive and Affective Responses in Intercultural and Intracultural Conversations

    ERIC Educational Resources Information Center

    Nguyen, Duyen T.; Fussell, Susan R.

    2015-01-01

    We report a study that uses retrospective analysis to understand the relationships between American and Chinese participants' utterances during a conversation and the moment-by-moment feelings and reactions they subsequently described. Intercultural and intracultural pairs of Chinese and American participants talked about a fictional crime story…

  15. Retrospective Miscue Analysis and the Socialization of One Young Adult Reader

    ERIC Educational Resources Information Center

    Theurer, Joan Leikam

    2010-01-01

    The purpose of this case study research was to investigate the use of Retrospective Miscue Analysis (RMA) with a community college student enrolled in a college remedial reading course. This study explored two questions: (1) What types of reading strategies and behavior patterns are used by high school graduates enrolled in a community college…

  16. Collaborative Retrospective Miscue Analysis: A Pathway to Self-Efficacy in Reading

    ERIC Educational Resources Information Center

    Seeger, Victoria Nell

    2009-01-01

    Collaborative Retrospective Miscue Analysis (CRMA) is a process where students participate in a small group discussion about their reading miscues, retellings, and thinking about reading. The purpose of this qualitative case study was to explore the self-efficacy beliefs students hold about their reading skills and abilities while engaged in CRMA.…

  17. Diagnosing the dead: the retrospective analysis of genetic diseases.

    PubMed

    Rushton, A R

    2013-01-01

    The suspected presence of hereditary disease in important historical and political figures has interested researchers for many decades. Whether Abraham Lincoln suffered from Marfan syndrome, if George III became 'mad' because he inherited variegate porphyria, and if the Romanov dynasty collapsed because the heir Alexei inherited haemophilia are important questions; physical illness can adversely affect the ability of leaders to function within the social and political realm of their day. This article will outline an approach to such a medical-historical analysis including assessment of hereditary predisposition, family history and the use of DNA technology to confirm or deny the clinical suspicions of the investigator. PMID:23516684

  18. CIRIL: more than 30 years of interdisciplinary research at GANIL

    NASA Astrophysics Data System (ADS)

    Domaracka, Alicja; Grygiel, Clara; Méry, Alain; Bouffard, Serge; Cassimi, Amine

    2015-07-01

    The CIRIL: 30 years of interdisciplinary research at GANIL meeting was held in Caen, France, in October 2013. The meeting provided an excellent opportunity to present the research performed with ion beams delivered by the GANIL facility (Grand Accélérateur National d'Ions Lourds, Caen, France). This proceedings volume comprises a series of reviews from different disciplines (physics, chemistry, biology, medicine, etc) of the results obtained with GANIL ion beams. Unfortunately, the issue is missing two major research domains concerning the induced damage in metals and insulators. Therefore, we refer the interested readers to the following publications: metals [1] and insulators [2].

  19. Enzymatic biofuel cells: 30 years of critical advancements.

    PubMed

    Rasmussen, Michelle; Abdellaoui, Sofiene; Minteer, Shelley D

    2016-02-15

    Enzymatic biofuel cells are bioelectronic devices that utilize oxidoreductase enzymes to catalyze the conversion of chemical energy into electrical energy. This review details the advancements in the field of enzymatic biofuel cells over the last 30 years. These advancements include strategies for improving operational stability and electrochemical performance, as well as device fabrication for a variety of applications, including implantable biofuel cells and self-powered sensors. It also discusses the current scientific and engineering challenges in the field that will need to be addressed in the future for commercial viability of the technology. PMID:26163747

  20. Plus or Minus 30 Years in the Language Sciences

    PubMed Central

    Newport, Elissa L.

    2010-01-01

    The language sciences – Linguistics, Psycholinguistics, and Computational Linguistics – have not been broadly represented at the Cognitive Science Society meetings of the past 30 years, but they are an important part of the heart of cognitive science. This article discusses several major themes that have dominated the controversies and consensus in the study of language and suggests the most pressing issues of the future. These themes include differences among the language science disciplines in their view of numbers and symbols and of modular and distributed cognition; and the need for an increasing prominence of questions concerning language and the brain. PMID:20730034

  1. Modern Era Retrospective Restrospective-Analysis for Research and Applications (MERRA) Data and Services at the GES DISC

    NASA Technical Reports Server (NTRS)

    Berrick, Stephen W.; Shen, Suhung; Ostrenga, Dana

    2008-01-01

    The Modern Era Retrospective-analysis for Research and Applications (MERRA) dataset is a NASA satellite era, 30 year (1979 - present), reanalysis using the Goddard Earth Observing System Data Assimilation System, Version 5 (GEOS-5). The project, run out of NASA's Global Modeling and Assimilation Office at Goddard Space Flight Center, provides the science and application communities with a state-of-the-art global analysis with emphasis on improved estimates of the hydrological cycle over a broad range of weather and climate time scales. MERRA products are generated as a long-term synthesis that places the NASA EOS suite of observations in a climate context. The MERRA analysis is performed at a horizontal resolution of 2/3 longitude x 1/2 latitude (540x361 global gridpoints) with observational analyses every 6 hours. The MERRA output data will include 3 dimensional state fields for every 6 hourly analysis cycle on 42 pressure levels (or 72 terrain following model coordinate levels) from the surface through the stratosphere. Several data products are specifically designed to support chemistry and stratosphere transport modeling. The 2 dimensional surface and atmospheric diagnostics (numbering 259) are being stored on the native grid at 1 hourly intervals. These include radiation and vertical integrals of the atmosphere for water and energy budget studies and also surface diagnostics where the diurnal cycle is important. The one hourly surface and near surface data product will also facilitate research on the integrated analysis of Earth system observations in the land, ocean and cryosphere. The MERRA products are archived and distributed by the Goddard Earth Sciences Data and Information Services Center (GES DISC) through its Modeling DISC Web (MDISC) portal. Multiple data access methods and services are available for MERRA data through MDISC: (1) Mirador offers a quick, comprehensive search of MERRA and all GES DISC archived data holdings, allowing searches on

  2. Retrospective analysis of 2D patient-specific IMRT verifications

    SciTech Connect

    Childress, Nathan L.; White, R. Allen; Bloch, Charles; Salehpour, Mohammad; Dong, Lei; Rosen, Isaac I.

    2005-04-01

    We performed 858 two-dimensional (2D) patient-specific intensity modulated radiotherapy verifications over a period of 18 months. Multifield, composite treatment plans were measured in phantom using calibrated Kodak EDR2 film and compared with the calculated dose extracted from two treatment planning systems. This research summarizes our findings using the normalized agreement test (NAT) index and the percent of pixels failing the gamma index as metrics to represent the agreement between measured and computed dose distributions. An in-house dose comparison software package was used to register and compare all verifications. We found it was important to use an automatic positioning algorithm to achieve maximum registration accuracy, and that our automatic algorithm agreed well with anticipated results from known phantom geometries. We also measured absolute dose for each case using an ion chamber. Because the computed distributions agreed with ion chamber measurements better than the EDR2 film doses, we normalized EDR2 data to the computed distributions. The distributions of both the NAT indices and the percentage of pixels failing the gamma index were found to be exponential distributions. We continue to use both the NAT index and percent of pixels failing gamma with 5%/3 mm criteria to evaluate future verifications, as these two metrics were found to be complementary. Our data showed that using 2%/2 mm or 3%/3 mm criteria produces results similar to those using 5%/3 mm criteria. Normalized comparisons that have a NAT index greater than 45 and/or more than 20% of the pixels failing gamma for 5%/3 mm criteria represent outliers from our clinical data set and require further analysis. Because our QA verification results were exponentially distributed, rather than a tight grouping of similar results, we continue to perform patient-specific QA in order to identify and correct outliers in our verifications. The data from this work could be useful as a reference for

  3. Salutogenesis 30 Years Later: Where Do We Go from here?

    ERIC Educational Resources Information Center

    Becker, Craig M.; Glascoff, Mary Alice; Felts, W. Michael

    2010-01-01

    In 1979 Aaron Antonovsky introduced the concept of salutogenesis as the study of health development. This approach contrasted with the concept of pathogenesis or the study of disease development. Pathogenesis works retrospectively from disease to determine how individuals can avoid, manage, and/or eliminate that disease. Salutogenesis works…

  4. American Meteorological Society (AMS) - The Modern Era Retrospective-Analysis for Research and Applications (MERRA) Data and Accessibility

    NASA Technical Reports Server (NTRS)

    daSilva, Arlindo

    2009-01-01

    The AM Short Course on The Modern Era Retrospective-analysis for Research and Applications (MERRA) data and accessibility will be held on January 11, 2009 preceding the 89th Annual Meeting in Phoenix, Arizona. Preliminary programs, registration, hotel, and general information will be posted on the AMS Web site in mid-September 2008. Retrospective-analyses (or reanalyses) have been established as an important tool in weather and climate research over the last decade. As computer power increases, the data assimilation and modeling systems improve and become more advanced, the input data quality increases and so reanalyses become more reliable. In 2008, NASA Global Modeling and Assimilation Office began producing a new reanalysis called the Modem Era Retrospective-analysis for Research and Applications (MERRA). The initial data from the reanalysis has been made available to the community and should be complete through 30 years (1979-present) by Fall of 2009. MERRA has taken advantage of the advancement of computing resources to provide users more data than previously available. The native spatial resolution is nominally 1/2 degrees and the surface two dimensional data are one hourly frequency. In addition to the meteorological analysis data, complete mass, energy and momentum budget data and also stratospheric data are provided. The eventual data holdings will exceed 150Tb. In order to facilitate user accessibility to the data, it will be stored in online hard drives (not tape storage) and available through several portals. Subsetting tools will also be available to allow users to tailor their data requests. The goals of this short course are to provide hands on users of reanalyses instruction on MERRA systems and also interactive experience with the online data and access tools. The course is intended for students and research scientists who will be actively interested in accessing and applying MERRA data in their weather, climate or applications work. The course has

  5. The Impact of the Evolving Satellite Data Record on Reanalysis Water and Energy Fluxes During the Past 30 Years

    NASA Technical Reports Server (NTRS)

    Robertson, Franklin R.; Miller, T. L.; Bosilovich, M. G.; Chen, J.

    2010-01-01

    Retrospective analyses (reanalyses) use a fixed assimilation model to take diverse observations and synthesize consistent, time-dependent fields of state variables and fluxes (e.g. temperature, moisture, momentum, turbulent and radiative fluxes). Because they offer data sets of these quantities at regular space / time intervals, atmospheric reanalyses have become a mainstay of the climate community for diagnostic purposes and for driving offline ocean and land models. Of course, one weakness of these data sets is the susceptibility of the flux products to uncertainties because of shortcomings in parameterized model physics. Another issue, perhaps less appreciated, is the fact that the discreet changes in the evolving observational system, particularly from satellite sensors, may also introduce artifacts in the time series of quantities. In this paper we examine the ability of the NASA MERRA (Modern Era Retrospective Analysis for Research and Applications) and other recent reanalyses to determine variability in the climate system over the satellite record ( the last 30 years). In particular we highlight the effect on reanalyses of discontinuities at the junctures of the onset of passive microwave imaging (Special Sensor Microwave Imager) in late 1987 as well as improved sounding and imaging with the Advanced Microwave Sounding Unit, AMSU-A, in 1998. We examine these data sets from two perspectives. The first is the ability to capture modes of variability that have coherent spatial structure (e.g. ENSO events and near-decadal coupling to SST changes) and how these modes are contained within trends in near global averages of key quantities. Secondly, we consider diagnostics that measure the consistency in energetic scaling in the hydrologic cycle, particularly the fractional changes in column-integrated water vapor versus precipitation as they are coupled to radiative flux constraints. These results will be discussed in the context of implications for science

  6. [Hair Analysis for the Retrospective and Prospective Consume-Monitoring: Substance Abuse, Abstinence- and Compliance Control].

    PubMed

    Binz, Tina M; Baumgartner, Markus R

    2016-01-01

    The possibilities and applications of modern hair analytics have rapidly developed in recent years. The compounds that can be detected in hair comprise, next to a multitude of drugs, also medications, alcohol markers, and endogenous compound like the stress hormone cortisol. Hair analysis is suitable for both forensic and clinical applications because it enables a retrospective overview of the consumption behavior during an extended time interval. PMID:26732713

  7. Trends in global monsoon area and precipitation over the past 30 years

    NASA Astrophysics Data System (ADS)

    Hsu, Pang-chi; Li, Tim; Wang, Bin

    2011-04-01

    The analysis of the GPCP and CMAP datasets during the past 30 years (1979-2008) indicates that there are consistent increasing trends in both the global monsoon area (GMA) and the global monsoon total precipitation (GMP). This positive monsoon rainfall trend differs from previous studies that assumed a fixed global monsoon domain. Due to the increasing trends in both the GMA and GMP, a global monsoon intensity (GMI) index, which measures the global monsoon precipitation amount per unit area, is introduced. The GMI measures the strength of the global monsoon. Our calculations with both the GPCP and CMAP datasets show a consistent downward trend in the GMI over the past 30 years. This decreasing trend is primarily attributed to a greater percentage increase in the GMA than in the GMP. A further diagnosis reveals that the decrease of the GMI is primarily attributed to the land monsoon in the GPCP, but to the oceanic monsoon in the CMAP.

  8. Evaluation of prenatal-onset osteochondrodysplasias by ultrasonography: a retrospective and prospective analysis.

    PubMed

    Krakow, Deborah; Alanay, Yasemin; Rimoin, Lauren P; Lin, Victoria; Wilcox, William R; Lachman, Ralph S; Rimoin, David L

    2008-08-01

    The osteochondrodysplasias or skeletal dysplasias are a heterogenous group of over 350 distinct disorders of skeletogenesis. Many manifest in the prenatal period, making them amenable to ultrasound prenatal diagnosis. A retrospective analysis evaluated 1,500 cases referred to the International Skeletal Dysplasia Registry (ISDR) to determine the relative frequency of specific osteochondrodysplasias and correlation of ultrasound versus radiographic diagnoses for these disorders. Within the retrospective cohort of 1,500 cases, 85% of the referred cases represented well-defined skeletal dysplasias, and the other 15% of cases were a mixture of genetic syndromes and probable early-onset intrauterine growth restriction. The three most common prenatal-onset skeletal dysplasias were osteogenesis imperfecta type 2, thanatophoric dysplasia and achondrogenesis 2, accounting for almost 40% of the cases. In a prospective analysis of 500 cases using a standardized ultrasound approach to the evaluation of these disorders, the relative frequencies of osteogenesis imperfecta type 2, thanatophoric dysplasia and achondrogenesis 2 were similar to the retrospective analysis. This study details the relative frequencies of specific prenatal-onset osteochondrodysplasias, their heterogeneity of prenatal-onset skeletal disorders and provides a standardized prenatal ultrasound approach to these disorders which should aid in the prenatal diagnosis of fetuses suspected of manifesting skeletal dysplasias. PMID:18627037

  9. Retrospective North American CFL Experience Curve Analysis and Correlation to Deployment Programs

    SciTech Connect

    Smith, Sarah J.; Wei, Max; Sohn, Michael D.

    2015-07-01

    Retrospective experience curves are a useful tool for understanding historic technology development, and can contribute to investment program analysis and future cost estimation efforts. This work documents our development of an analysis approach for deriving retrospective experience curves with a variable learning rate, and its application to develop an experience curve for compact fluorescent lamps for the global and North American markets over the years 1990-2007. Uncertainties and assumptions involved in interpreting data for our experience curve development are discussed, including the processing and transformation of empirical data, the selection of system boundaries, and the identification of historical changes in the learning rate over the course of 15 years. In the results that follow, we find that that the learning rate has changed at least once from 1990-2007. We also explore if, and to what degree, public deployment programs may have contributed to an increased technology learning rate in North America. We observe correlations between the changes in the learning rate and the initiation of new policies, abrupt technological advances, including improvements to ballast technology, and economic and political events such as trade tariffs and electricity prices. Finally, we discuss how the findings of this work (1) support the use of segmented experience curves for retrospective and prospective analysis and (2) may imply that investments in technological research and development have contributed to a change in market adoption and penetration.

  10. Photosynthetic responses to 30 years of atmospheric change

    NASA Astrophysics Data System (ADS)

    Lunch, C. K.

    2009-12-01

    Plant physiological studies of responses to atmospheric CO2 concentration most frequently involve artificially increasing local CO2 concentration. However, CO2 levels in the atmosphere have already risen by more than 100 ppm over pre-industrial levels, and the response to that increase should also be considered. I measured changes in leaf-level photosynthesis over the most recent 50-60 ppm rise in atmospheric CO2, using photosynthetic studies from the late 1970s and early 1980s as a baseline. The study encompassed 17 plant species at three sites in California. The sites covered a rainfall range of 40 to 1000 mm year-1, and a mean annual temperature range of 12 to 24 oC. Species included annual forbs, perennial shrubs, and trees. Over the 30 years since the previous studies were carried out, leaf-level photosynthesis at ambient CO2 has risen by an average of 0.8 μmol m-2 s-1, a nonsignificant change. Stomatal conductance has declined, such that water use efficiency has increased by an average of 12.7%. The largest changes in photosynthetic characteristics were observed at the desert site.

  11. Acute exercise and oxidative stress: a 30 year history

    PubMed Central

    Fisher-Wellman, Kelsey; Bloomer, Richard J

    2009-01-01

    The topic of exercise-induced oxidative stress has received considerable attention in recent years, with close to 300 original investigations published since the early work of Dillard and colleagues in 1978. Single bouts of aerobic and anaerobic exercise can induce an acute state of oxidative stress. This is indicated by an increased presence of oxidized molecules in a variety of tissues. Exercise mode, intensity, and duration, as well as the subject population tested, all can impact the extent of oxidation. Moreover, the use of antioxidant supplements can impact the findings. Although a single bout of exercise often leads to an acute oxidative stress, in accordance with the principle of hormesis, such an increase appears necessary to allow for an up-regulation in endogenous antioxidant defenses. This review presents a comprehensive summary of original investigations focused on exercise-induced oxidative stress. This should provide the reader with a well-documented account of the research done within this area of science over the past 30 years. PMID:19144121

  12. Drought Prediction in Iran during Next 30 Years

    NASA Astrophysics Data System (ADS)

    Khazanedari, L.; Zabol Abbasi, F.; Ghandhari, Sh.; Kouhi, M.; Malbousi, Sh.

    2009-09-01

    The effects of climate changes, especially due to increasing of greenhouse gasses, caused a lot of problems that affect different sections of society. One of the most important of these effects is the increasing of natural disasters such as flood, drought, tropical cyclones, raising sea level, dust storm, etc. Drought and flood are the most prevalent of these disasters in Iran. Because of the geographical location of Iran and the synoptic systems that affect this region, it is clear that dry is one of the characteristics of this region, and drought is one of the most important of natural disaster that affect this country. Drought affects the different sectors of society such as water resources, agriculture, industry, economy, health, etc therefore drought monitoring is necessary for planning in future. For this purpose, the climate data should be simulated for future period by using outputs of Atmospheric-Ocean General Circulation Model. In this paper precipitation data during 2010-2039 is simulated by downscaling via LARS-WG model. Then, drought situation is estimated according to DI and SPI, by using these data in Iran. The results of this study have showed that during next 30 years, drought conditions will be increase in Iran, and it confirms climate change event in this region. In addition, the most parts of Iran will experience severe and extreme drought in 2011, 2025, 2032, 2034, 2035, 2039, and among these years 2039 will have more critical drought situation. Keywords: Atmospheric General Circulation Models, Downscaling, LARS-WG, Drought, Decile Index, Standard Precipitation Index.

  13. 30 years of lymph node pathology: biomarkers and other advances.

    PubMed

    Ramsay, Alan D

    2013-03-01

    Over the last 30 years there has been a massive change in both the clinical and pathologic aspects of malignant lymphomas. Pathologists are now able to evaluate cellular phenotypes and lineages of tumor cells using a wide variety of biomarkers and molecular techniques. The ability to identify tumor cell phenotypes has revolutionized the classification of lymphomas, leading to an internationally agreed system based on the reliable recognition of specific clinico-pathologic entities. The World Health Organization classification combines clinical features, histomorphology, immunohistochemistry, and molecular and genetic marker data to precisely categorize lymphomas. On the clinical front the increasing use of needle core biopsies has made it easier and quicker to obtain tissue samples, and the development of (18)F-fluorodeoxyglucose positron emission tomography has revolutionized the assessment of patients both at presentation and after treatment. To improve overall outcomes for lymphoma patients there have been advances in the UK organization of cancer services. Cancer networks have been established, often with network multidisciplinary team meetings, and new diagnoses of lymphoma are reviewed on a network basis by pathologists specializing in the field. National and supranational quality control systems are in place for immunohistochemistry and for molecular techniques and multicenter clinical trials provide information about the efficacy of treatment regimens. The outcome of these advances is that a patient presenting in 2012 with suspected lymphoma can expect to be biopsied rapidly, to receive an accurate pathologic diagnosis by an expert hematopathologist, which will include prognostic marker information, and to have comprehensive disease assessment and discussion by a multidisciplinary team before embarking on the most appropriate treatment for his or her clinical situation. PMID:23417072

  14. Last line therapy with sorafenib in colorectal cancer: A retrospective analysis

    PubMed Central

    Martchenko, Ksenia; Schmidtmann, Irene; Thomaidis, Thomas; Thole, Verena; Galle, Peter R; Becker, Marc; Möhler, Markus; Wehler, Thomas C; Schimanski, Carl C

    2016-01-01

    AIM: To analyze the efficacy of last line sorafenib treatment in colorectal cancer patients. METHODS: All patients receiving chemotherapy for colorectal cancer in the outpatient clinic of the University of Mainz since 2006 were retrospectively analyzed for last line sorafenib exposure. Charts of identified patients were analyzed for clinic-pathological parameters, like data on gender, age, date of initial diagnosis, UICC stage, number and kind of the pre-therapies, therapy start and end of sorafenib, sorafenib mediated treatment cessation, side effects, response rates, time to progression and overall survival. RESULTS: Ten patients with a median of 3.0 prior chemotherapy lines had received a last line sorafenib therapy either alone (10%) or in combination with 5-fluorouracil derivates (90%). All patients suffered from colorectal cancer stage UICC 4 and were routinely seen in 2-wk intervals in the oncology outpatient clinic. Median duration of treatment was 142.0 d. At 8 wk 80% of patients showed stable disease but we did not observe any remissions. Median time to progression was 140.5 d (4.7 mo), while median overall survival reached 176.5 d. One patient ceased treatment due to side effects. Reason for treatment stop was bleeding complication in one case and non-specified sorafenib intolerance in another case. Due to the retrospective approach we did not further quantify side effects. CONCLUSION: This retrospective analysis encourages further investigation of sorafenib in colorectal cancer last line therapy. PMID:27340356

  15. Recruiting Minority Geoscientists: A 30 Year Success Story

    NASA Astrophysics Data System (ADS)

    Serpa, L.; Pavlis, T. L.; Hall, F.

    2003-12-01

    The University of New Orleans (UNO) is located in a city rich in diversity and industries that employ geoscientists. Thus, it is an ideal place to develop a strong diversity program in geology and geophysics. In 1974, Dr. Louis Fernandez received a grant from the NSF to formally develop a minority recruiting program. The focus of that initial program was a field trip for local minority high school students and that trip has gone continuously every year since then. It is still our best tool for recruiting outstanding minority students into our department. The initial NSF funding disappeared long ago and was replaced variously by support from private industry and creative use of departmental funds which kept the program alive through some lean funding years. As a result of this effort UNO has graduated more minority, particularly African-American, geoscientist than any other institution in the US for most of the past 30 years. The field trip is not the only reason for our success. Indeed, retaining and graduating students, regardless of their ethnicity, required a serious commitment to education on the part of our department. There are six universities in the city of New Orleans and several more within commuting distance from the city. Three of the six local universities are HBCU's with excellent reputations but, fortunately for us, no geoscience degree programs. There are several strong geoscience departments in the non-minority serving institutions in our area that attract many outstanding local students. To meet the competition, we have worked with local K-12 teachers, developed additional programs to interest local 7-12 students, and worked closely with our majors to keep them in the program and help them succeed once they are recruited. This has required a cohesive effort on the part of our faculty and students that is constantly changing to meet new demands as our department has expanded in size and developed its research activities sometimes at the expense of

  16. TORUS2015: The AGN unification scheme after 30 years

    NASA Astrophysics Data System (ADS)

    Gandhi, P.; Hoenig, S. F.

    2015-09-01

    The torus paradigm has proved to be remarkably successful at unifying the observed zoo of active galaxy (AGN) classes, despite having many manifest holes. The field is still data-driven with novel observational results at multiple wavelengths emerging rapidly. We are only now beginning to map out the structure of dusty gas feeding and obscuring AGN, and to model its evolution in galaxy growth. But these have also brought out several apparently contradictory results which must hold the key to future progress. As we celebrate 30 years of the paradigm, this is the perfect time to draw together our current knowledge and reassess the state of the field. This will be an international workshop at the University of Southampton, UK, with the objective of laying out the major challenges to the field and paving future research directions. Our hope is to facilitate plenty of informal discussions between multiwavelength observers and theorists, addressing some key issues: * What is the main driver in the unification scheme? What are the roles of orientation, mass accretion rate and feedback? * What is the nature and structure of gas and dust in the torus? Do we have a self-consistent picture across multiple wavelengths? * How critical is the role of the torus as an interface between small nuclear scales and large galactic scales? Does galaxy evolution necessarily require tori? * How close are we to self-consistently simulating nuclear activity including AGN feeding and nuclear star-formation? Workshop Rationale The three themes of accretion, orientation, and evolution will be covered through invited and solicited contributions. Different to other conferences, we are building each session around some key papers that have shaped the field or those with great future potential to do so. We specifically pit competing ideas against each other to help painting a realistic picture of the state-of-the-art. Each session will end with discussion rounds delving into important future

  17. Paracrinicity: The Story of 30 Years of Cellular Pituitary Crosstalk

    PubMed Central

    Denef, C

    2008-01-01

    Living organisms represent, in essence, dynamic interactions of high complexity between membrane-separated compartments that cannot exist on their own, but reach behaviour in co-ordination. In multicellular organisms, there must be communication and co-ordination between individual cells and cell groups to achieve appropriate behaviour of the system. Depending on the mode of signal transportation and the target, intercellular communication is neuronal, hormonal, paracrine or juxtacrine. Cell signalling can also be self-targeting or autocrine. Although the notion of paracrine and autocrine signalling was already suggested more than 100 years ago, it is only during the last 30 years that these mechanisms have been characterised. In the anterior pituitary, paracrine communication and autocrine loops that operate during fetal and postnatal development in mammals and lower vertebrates have been shown in all hormonal cell types and in folliculo-stellate cells. More than 100 compounds have been identified that have, or may have, paracrine or autocrine actions. They include the neurotransmitters acetylcholine and γ-aminobutyric acid, peptides such as vasoactive intestinal peptide, galanin, endothelins, calcitonin, neuromedin B and melanocortins, growth factors of the epidermal growth factor, fibroblast growth factor, nerve growth factor and transforming growth factor-β families, cytokines, tissue factors such as annexin-1 and follistatin, hormones, nitric oxide, purines, retinoids and fatty acid derivatives. In addition, connective tissue cells, endothelial cells and vascular pericytes may influence paracrinicity by delivering growth factors, cytokines, heparan sulphate proteoglycans and proteases. Basement membranes may influence paracrine signalling through the binding of signalling molecules to heparan sulphate proteoglycans. Paracrine/autocrine actions are highly context-dependent. They are turned on/off when hormonal outputs need to be adapted to changing demands of

  18. Method for Visually Integrating Multiple Data Acquisition Technologies for Real Time and Retrospective Analysis

    NASA Technical Reports Server (NTRS)

    Bogart, Edward H. (Inventor); Pope, Alan T. (Inventor)

    2000-01-01

    A system for display on a single video display terminal of multiple physiological measurements is provided. A subject is monitored by a plurality of instruments which feed data to a computer programmed to receive data, calculate data products such as index of engagement and heart rate, and display the data in a graphical format simultaneously on a single video display terminal. In addition live video representing the view of the subject and the experimental setup may also be integrated into the single data display. The display may be recorded on a standard video tape recorder for retrospective analysis.

  19. Solvent/detergent-treated plasma: a tale of 30 years of experience.

    PubMed

    Liumbruno, Giancarlo Maria; Marano, Giuseppe; Grazzini, Gioia; Capuzzo, Enrico; Franchini, Massimo

    2015-06-01

    Solvent/detergent-treated plasma was licensed >30 years ago. It has several specific characteristics, the most important being the standardized content of clotting factors, the lack of antibodies implicated in transfusion-related acute lung injury pathogenesis and the very high level of safety against transfusion-related viral infections. Since 1992, many clinical studies have confirmed its safety and efficacy in a wide range of congenital and acquired bleeding disorders. After a brief analysis of the pharmaceutical characteristics of solvent/detergent plasma, this review will focus on the clinical experience with this virus-inactivated plasma. PMID:25695198

  20. A 30 year High -Spatial Resolution Cloud Climatology from NOAA's PATMOS-x Project

    NASA Astrophysics Data System (ADS)

    Heidinger, A. K.; Walther, A.; Foster, M. J.

    2010-12-01

    The Pathfinder Atmospheres Extended (PATMOS-x) project at NOAA has recently developed a new higher spatial resolution data set derived from over 30 years of data from the Advanced Very High Resolution Radiometer. The PATMOS-x data is now online and has been submitted into the GEWEX cloud climatology assessment library of cloud climate data sets. This data also benefits from a recent recalibration of the solar reflectance channels. This work will present our latest analysis and provide our insights into the strengths and limitations of this new data. Comparisons with GEWEX data sets and to the recently generated AVHRR cloud climatology from EUMETSAT will be shown.

  1. Botulinum toxin type A treatment to the upper face: retrospective analysis of daily practice

    PubMed Central

    Prager, Welf; Huber-Vorländer, Jürgen; Taufig, A Ziah; Imhof, Matthias; Kühne, Ulrich; Weissberg, Ruth; Kuhr, Lars-Peter; Rippmann, Volker; Philipp-Dormston, Wolfgang G; Proebstle, Thomas M; Roth, Claudia; Kerscher, Martina; Ulmann, Claudius; Pavicic, Tatjana

    2012-01-01

    Background Botulinum toxin type A treatment has been used for over 20 years to enhance the appearance of the face. There are several commercially available botulinum toxin type A products used in aesthetic clinical practice. The aim of this retrospective analysis was to compare the clinical efficacy of the most commonly used botulinum toxin type A preparations in daily practice. Methods Physicians from 21 centers in Germany completed questionnaires based on an inspection of subject files for subjects 18 years of age or over who had received at least two, but not more than three, consecutive treatments with incobotulinumtoxinA, onabotulinumtoxinA, or abobotulinumtoxinA within a 12-month period in the previous 2 years. Data on subject and physician satisfaction, treatment intervals, dosages, and safety were collected from 1256 subjects. Results There were no statistically significant differences between incobotulinumtoxinA and onabotulinumtoxinA with respect to physician and subject satisfaction, dosages, and adverse effects experienced. Both botulinum toxin type A preparations were well tolerated and effective in the treatment of upper facial lines. Due to low treatment numbers, abobotulinumtoxinA was not included in the statistical analysis. Conclusion The results of this retrospective analysis confirm the results of prospective clinical trials by demonstrating that, in daily practice, incobotulinumtoxinA and onabotulinumtoxinA are used at a 1:1 dose ratio and display comparable efficacy and safety. PMID:22791996

  2. Modern Era Retrospective-analysis for Research and Applications (MERRA) Global Water and Energy Budgets

    NASA Technical Reports Server (NTRS)

    Bosilovich, Michael G.; Robertson, Franklin R.; Chen, Junye

    2008-01-01

    The Modern. Era Retrospective-analysis for Research and Applications (MERRA) reanalyses has produced several years of data, on the way to a completing. the 1979-present modern satellite era. Here, we present a preliminary evaluation of those years currently available, includin g comparisons with the existing long reanalyses (ERA40, JRA25 and NCE P I and II) as well as with global data sets for the water and energy cycle Time series shows that the MERRA budgets can change with some of the variations in observing systems. We will present all terms of the budgets in MERRA including the time rates of change and analysis increments (tendency due to the analysis of observations)

  3. The cost of cancer: a retrospective analysis of the financial impact of cancer on young adults.

    PubMed

    Landwehr, Michelle S; Watson, Samantha E; Macpherson, Catherine F; Novak, Katherine A; Johnson, Rebecca H

    2016-05-01

    Young adult cancer survivors (YAs) are confronted with immense financial challenges in the wake of their treatment. Medical bills and loss of savings may cause YAs to forgo recommended medications or follow-up appointments. Young survivors with financial concerns also report depression, stress and anxiety. The Samfund is a national nonprofit organization that provides financial support to YAs post-treatment. To quantify the financial burden of cancer in YAs, a retrospective analysis was performed of data collected from Samfund grant applications of 334 YA cancer survivors. Grants were awarded between 2007 and 2013 and grant recipients were consented electronically in 2014 for retrospective data analysis. Recipients ranged from 19 to 39 years of age at the time of their grant applications. Descriptive statistics were calculated and compared to the Medical Expenditure Panel Survey (MEPS) and U.S. census data on age-matched peers. Financial indicators of YA cancer survivors are worse in many domains than those of age-matched controls. Furthermore, YA survivors in their 30s report more perilous prefunding financial situations than younger grant recipients. Cancer has a devastating and age-specific impact on the finances of YAs. Philanthropic grants from the cancer support community, in conjunction with healthcare policy reforms, have the potential to break the cycle of financial need and help YAs move forward with their lives after cancer treatment. PMID:26853096

  4. Laparoscopic colonic resection for rectosigmoid colonic tumours: a retrospective analysis and comparison with open resection.

    PubMed

    Prakash, Kurumboor; Varma, Deepak; Rajan, Mahendra; Kamlesh, Naduthottam Palanisamy; Zacharias, Prakash; Ganesh Narayanan, Ramesh; Philip, Mathew

    2010-08-01

    Laparoscopic approach for treatment of colorectal malignancy is gaining acceptance gradually; however the benefits of laparoscopic surgery in colonic and rectal tumours is still open to debate. This study aims at a retrospective analysis of operative and short term outcome of patients with rectosigmoid tumours. A retrospective analysis of operative, postoperative and short-term outcome of 62 patients who underwent laparoscopic colorectal resection for cancer of rectosigmoid region were compared with a same number of parameters-matched patients who underwent open colorectal resection. Blood transfusion requirement was significantly more in the open group compared to the laparoscopy group (38.7% versus 6.4%, p = 0.001). ICU stay was less in the laparoscopy group (p = <0.05) and they were started on oral liquid diet earlier (p = 0.013). The number of the lymph nodes retrieved, positive distal margin and radial involvement were similar in both groups. The hospital stay was significantly shorter in laparoscopy group (8.4 versus 13.8 days, p < 0.05). Radical operation for rectosigmoid tumors is technically feasible with laparoscopic surgery. Laparoscopic approach is associated with less blood loss, transfusion and significantly less ICU stay. Laparoscopic group recovers early and needs less hospital stay. PMID:21938195

  5. Social media: the key to health information access for 18- to 30-year-old college students.

    PubMed

    Prybutok, Gayle; Ryan, Sherry

    2015-04-01

    This work examines where 18- to 30-year-old college students seek health information on the Internet and how they determine site and message credibility. Using a qualitative methodology, five focus groups were conducted with 18- to 30-year-old college students, and transcripts were analyzed with MaxQDA text analysis software. The study revealed that 18- to 30-year-old college students have Internet health information source preferences, reasons for seeking health information on the Internet, and message design factors that improve their perception of site and message credibility. We conclude that the Internet and social media show great promise as effective health communication channels for 18- to 30-year-old college students and confirm that preferred Internet/social media sites can be utilized by health educators to present important risk management/disease prevention information to 18- to 30-year-old college students. In addition, message design factors can lend credibility to both sites and the health information delivered there. PMID:25887107

  6. Exploring the Effect of Video Used to Enhance the Retrospective Verbal Protocol Analysis: A Multiple Case Study

    ERIC Educational Resources Information Center

    Monroe, Steven D.

    2012-01-01

    The purpose of this study was to explore how the use of video in the cognitive task analysis (CTA) retrospective verbal protocol analysis (RVPA) during a job analysis affects: (a) the quality of performing the CTA, (b) the time to complete the CTA, and (c) the cost to execute the CTA. Research has shown when using the simultaneous VPA during a CTA…

  7. Linking Land Surface Phenology and Growth Limiting Factor Shifts over the Past 30 Years

    NASA Astrophysics Data System (ADS)

    Garonna, I.; Schenkel, D.; de Jong, R.; Schaepman, M. E.

    2015-12-01

    The study of global vegetation dynamics contributes to a better understanding of global change drivers and how these affect ecosystems and ecological diversity. Land-surface phenology (LSP) is a key response and feedback of vegetation to the climate system, and hence a parameter that needs to be accurately represented in terrestrial biosphere models [1]. However, the effects of climatic changes on LSP depend on the relative importance of climatic constraints in specific regions - which are not well understood at global scale. In this study, we analyzed a Phenology Reanalysis dataset [2] to evaluate shifts in three climatic drivers of phenology at global scale and over the last 30 years (1982-2012): incoming radiation, evaporative demand and minimum temperature. As a first step, we compared LAI as modeled from these three factors (LAIre) to remotely sensed observations of LSP (LAI3g, [3]) over the same time period. As a second step, we examined temporal trends in the climatic constraints at Start- and End- of the Growing Season. There was good agreement between phenology metrics as derived form LAI3g and LAIre over the last 30 years - thus providing confidence in the climatic constraints underlying the modeled data. Our analysis reveals inter-annual variation in the relative importance of the three climatic factors in limiting vegetation growth at Start- and End- of the Growing Season over the last 30 years. High northern latitudes, as well as northern Europe and central Asia, appear to have undergone significant changes in dominance between the three controls. We also find that evaporative demand has become increasingly limiting for growth in many parts of the world, in particular in South America and eastern Asia. [1] Richardson, A.D. et al. Global Change Biology 18, 566-584 (2012). [2] Stöckli, R. et al. J. Geophys. Res 116, G03020 (2011). [3] Zhu, Z. et al. Remote Sensing 5, 927-948 (2013).

  8. Determining the utility of veterinary tissue archives for retrospective DNA analysis.

    PubMed

    Abed, Firas M; Dark, Michael J

    2016-01-01

    Histopathology tissue archives can be an important source of specimens for retrospective studies, as these include samples covering a large number of diseases. In veterinary medicine, archives also contain samples from a large variety of species and may represent naturally-occurring models of human disease. The formalin-fixed, paraffin-embedded (FFPE) tissues comprising these archives are rich resources for retrospective molecular biology studies and pilot studies for biomarkers, as evidenced by a number of recent publications highlighting FFPE tissues as a resource for analysis of specific diseases. However, DNA extracted from FFPE specimens are modified and fragmented, making utilization challenging. The current study examines the utility of FFPE tissue samples from a veterinary diagnostic laboratory archive in five year intervals from 1977 to 2013, with 2015 as a control year, to determine how standard processing and storage conditions has affected their utility for future studies. There was a significant difference in our ability to obtain large amplicons from samples from 2015 than from the remaining years, as well as an inverse correlation between the age of the samples and product size obtainable. However, usable DNA samples were obtained in at least some of the samples from all years tested, despite variable storage, fixation, and processing conditions. This study will help make veterinary diagnostic laboratory archives more useful in future studies of human and veterinary disease. PMID:27168995

  9. Determining the utility of veterinary tissue archives for retrospective DNA analysis

    PubMed Central

    Abed, Firas M.

    2016-01-01

    Histopathology tissue archives can be an important source of specimens for retrospective studies, as these include samples covering a large number of diseases. In veterinary medicine, archives also contain samples from a large variety of species and may represent naturally-occurring models of human disease. The formalin-fixed, paraffin-embedded (FFPE) tissues comprising these archives are rich resources for retrospective molecular biology studies and pilot studies for biomarkers, as evidenced by a number of recent publications highlighting FFPE tissues as a resource for analysis of specific diseases. However, DNA extracted from FFPE specimens are modified and fragmented, making utilization challenging. The current study examines the utility of FFPE tissue samples from a veterinary diagnostic laboratory archive in five year intervals from 1977 to 2013, with 2015 as a control year, to determine how standard processing and storage conditions has affected their utility for future studies. There was a significant difference in our ability to obtain large amplicons from samples from 2015 than from the remaining years, as well as an inverse correlation between the age of the samples and product size obtainable. However, usable DNA samples were obtained in at least some of the samples from all years tested, despite variable storage, fixation, and processing conditions. This study will help make veterinary diagnostic laboratory archives more useful in future studies of human and veterinary disease. PMID:27168995

  10. Chemotherapy Outcomes for the Treatment of Unresectable Intrahepatic and Hilar Cholangiocarcinoma: A Retrospective Analysis

    PubMed Central

    Eckmann, Karen R.; Patel, Dina K.; Landgraf, Andrea; Slade, Julian H.; Lin, E.; Kaur, Harmeet; Loyer, Evelyne; Weatherly, Jacqueline M.; Javle, Milind

    2011-01-01

    ABSTRACT Background: Recent clinical trials for “biliary cancers” include a heterogenous group of patients with cholangiocarcinoma, gallbladder, and ampullary cancers. Limited data exist regarding the relative effectiveness of known chemotherapeutic regimens specifically in intrahepatic or hilar cholangiocarcinoma. Methods: Records of M D Anderson Cancer Center patients with unresectable intrahepatic and hilar cholangiocarcinoma who received first-line chemotherapy from January 1, 2005, to October 31, 2009, were retrospectively reviewed. The primary objective of this research was to determine overall tumor control rates with chemotherapeutic regimens used for first-line treatment of unresectable intrahepatic and hilar cholangiocarcinoma. Secondary objectives included duration of response, overall survival, and prognostic factors. Results: Eighty-five patients met inclusion criteria and were eligible for analysis. The most commonly used regimen was gemcitabine/cisplatin (62%), followed by oxaliplatin and capecitabine (16%). There was no significant difference between tumor control rates with gemcitabine/cisplatin (72% PR + SD) and other regimens (69% PR + SD). There was no significant difference between overall survival with the use of gemcitabine/cisplatin (15.2 months) or alternative regimens (13.9 months). A decrease in overall survival was seen with elevated baseline CA 19–9 (p < .0001), an initial diagnosis of unknown primary tumor (p = .0001), and prior treatment with chemoradiation (p = .0018). Conclusion: In this retrospective review, both gemcitabine/cisplatin and alternative doublets (including capecitabine/oxaliplatin, gemcitabine/capecitabine, and gemcitabine/oxaliplatin) were effective regimens in maintaining disease control in intrahepatic and hilar cholangiocarcinoma. PMID:22295126

  11. Changes in Tropical Cyclone Intensity Over the Past 30 Years: A Global and Dynamic Perspective

    NASA Technical Reports Server (NTRS)

    Wu, Liguang; Wang, Bin; Braun, Scott A.

    2006-01-01

    The hurricane season of 2005 was the busiest on record and Hurricane Katrina (2005) is believed to be the costliest hurricane in U. S. history. There are growing concerns regarding whether this increased tropical cyclone activity is a result of global warming, as suggested by Emanuel(2005) and Webster et al. (2005), or just a natural oscillation (Goldenberg et al. 2001). This study examines the changes in tropical cyclone intensity to see what were really responsible for the changes in tropical cyclone activity over the past 30 years. Since the tropical sea surface temperature (SST) warming also leads to the response of atmospheric circulation, which is not solely determined by the local SST warming, this study suggests that it is better to take the tropical cyclone activities in the North Atlantic (NA), western North Pacific (WNP) and eastern North Pacific (ENP) basins as a whole when searching for the influence of the global-scale SST warming on tropical cyclone intensity. Over the past 30 years, as the tropical SST increased by about 0.5 C, the linear trends indicate 6%, 16% and 15% increases in the overall average intensity and lifetime and the annual frequency. Our analysis shows that the increased annual destructiveness of tropical cyclones reported by Emanuel(2005) resulted mainly from the increases in the average lifetime and annual frequency in the NA basin and from the increases in the average intensity and lifetime in the WNP basin, while the annual destructiveness in the ENP basin generally decreased over the past 30 years. The changes in the proportion of intense tropical cyclones reported by Webster et a1 (2005) were due mainly to the fact that increasing tropical cyclones took the tracks that favor for the development of intense tropical cyclones in the NA and WNP basins over the past 30 years. The dynamic influence associated with the tropical SST warming can lead to the impact of global warming on tropical cyclone intensity that may be very

  12. Predictive Factors of In-Stent Restenosis in Renal Artery Stenting: A Retrospective Analysis

    SciTech Connect

    Vignali, Claudio Bargellini, Irene; Lazzereschi, Michele; Cioni, Roberto; Petruzzi, Pasquale; Caramella, Davide; Pinto, Stefania; Napoli, Vinicio; Zampa, Virna; Bartolozzi, Carlo

    2005-04-15

    Purpose. To retrospectively evaluate the role of clinical and procedural factors in predicting in-stent restenosis in patients with renovascular disease treated by renal artery stenting. Methods. From 1995 to 2002, 147 patients underwent renal artery stenting for the treatment of significant ostial atherosclerotic stenosis. Patients underwent strict clinical and color-coded duplex ultrasound follow-up. Ninety-nine patients (111 stents), with over 6 months of continuous follow-up (mean 22{+-}12 months, range 6-60 months), were selected and classified according to the presence (group A, 30 patients, 32 lesions) or absence (group B, 69 patients, 79 lesions) of significant in-stent restenosis. A statistical analysis was performed to identify possible preprocedural and procedural predictors of restenosis considering the following data: sex, age, smoking habit, diabetes mellitus, hypertension, serum creatinine, cholesterol and triglyceride levels, renal artery stenosis grade, and stent type, length and diameter. Results. Comparing group A and B patients ({chi}{sup 2} test), a statistically significant relation was demonstrated between stent diameter and length and restenosis: the risk of in-stent restenosis decreased when the stent was {>=}6 mm in diameter and between 15 and 20 mm in length. This finding was confirmed by multiple logistic regression analysis. Stent diameter and length were proved to be significantly related to in-stent restenosis also when evaluating only patients treated by Palmaz stent (71 stents). Conclusion. Although it is based on a retrospective analysis, the present study confirms the importance of correct stent selection in increasing long-term patency, using stents of at least 6 mm in diameter and with a length of approximately 15-20 mm.

  13. Retrospective analysis of molecular scores for the prediction of distant recurrence according to baseline risk factors.

    PubMed

    Sestak, Ivana; Dowsett, Mitch; Ferree, Sean; Baehner, Frederick L; Cuzick, Jack

    2016-08-01

    Clinical variables and several gene signature profiles have been investigated for the prediction of (distant) recurrence in several trials. These molecular markers are significantly correlated with overall and late distant recurrences. Here, we retrospectively explore whether age and body mass index (BMI) affect the prediction of these molecular scores for distant recurrence in postmenopausal women with hormone receptor-positive breast cancer in the transATAC trial. 940 postmenopausal women for whom the Clinical Treatment Score (CTS), immunohistochemical markers (IHC4), Oncotype Recurrence Score (RS), and the Prosigna Risk of Recurrence Score (ROR) were available were included in this retrospective analysis. Conventional BMI groups were used (N = 865), and age was split into equal tertiles (N = 940). Cox proportional hazard models were used to determine the effect of a molecular score for the prediction of distant recurrence according to BMI and age groups. In both the univariate and bivariate analyses, the effect size of the IHC4 and RS was strongest in women aged 59.8 years or younger. Trends tests for age were significant for the IHC4 and RS, but not for the CTS and ROR, for which most prognostic information was added in women aged 60 years or older. The CTS and ROR scores added significant prognostic information in all three BMI groups. In both the univariate and bivariate analyses, the IHC4 provided the most prognostic information in women with a BMI lower than 25 kg/m(2), whereas the RS did not add prognostic information for distant recurrence in women with a BMI of 30 kg/m(2) or above. Molecular scores are increasingly used in women with breast cancer to assess recurrence risk. We have shown that the effect size of the molecular scores is significantly different across age groups, but not across BMI groups. The results from this retrospective analysis may be incorporated in the identification of women who may benefit most from the use of these

  14. Retrospective analysis of "new" flame retardants in the global atmosphere under the GAPS Network.

    PubMed

    Lee, Sum Chi; Sverko, Ed; Harner, Tom; Pozo, Karla; Barresi, Enzo; Schachtschneider, JoAnne; Zaruk, Donna; DeJong, Maryl; Narayan, Julie

    2016-10-01

    A retrospective analysis was conducted on air samples that were collected in 2005 under the Global Atmospheric Passive Sampling (GAPS) Network around the time period when the Stockholm Convention on Persistent Organic Pollutants came into force. Results are presented for several new flame retardants, including hexabromocyclododecane (HBCD), which was recently listed under the Convention (2013). These results represent the first global-scale distributions in air for these compounds. The targeted compounds are shown to have unique global distributions in air, which highlights the challenges in understanding the sources and environmental fate of each chemical, and ultimately in their assessments as persistent organic pollutants. The study also demonstrates the feasibility of using the PUF disk passive air sampler to study these new flame retardants in air, many of which exist entirely in the particle-phase as demonstrated in this study using a KOA-based partitioning model. PMID:26857525

  15. Retrospective Analysis of Communication Events - Understanding the Dynamics of Collaborative Multi-Party Discourse

    SciTech Connect

    Cowell, Andrew J.; Haack, Jereme N.; McColgin, Dave W.

    2006-06-08

    This research is aimed at understanding the dynamics of collaborative multi-party discourse across multiple communication modalities. Before we can truly make sig-nificant strides in devising collaborative communication systems, there is a need to understand how typical users utilize com-putationally supported communications mechanisms such as email, instant mes-saging, video conferencing, chat rooms, etc., both singularly and in conjunction with traditional means of communication such as face-to-face meetings, telephone calls and postal mail. Attempting to un-derstand an individual’s communications profile with access to only a single modal-ity is challenging at best and often futile. Here, we discuss the development of RACE – Retrospective Analysis of Com-munications Events – a test-bed prototype to investigate issues relating to multi-modal multi-party discourse.

  16. [Retrospective analysis of 24 recurrent glioblastoma after chemoradiation and treated with nitrosoureas or irinotecan and bevacizumab].

    PubMed

    Vauleon, Elodie; Mesbah, Habiba; Gedouin, Daniel; Lecouillard, Isabelle; Louvel, Guillaume; Hamlat, Abderrahmane; Riffaud, Laurent; Carsin, Béatrice; Quillien, Véronique; Audrain, Odile; Lesimple, Thierry

    2012-02-01

    Despite progress in the initial management of glioblastoma (GB), the vast majority of patients will experience recurrence within 2-3 years. The medical treatment of these recurrences is being modified by the use of antiangiogenic therapies. Twenty-four patients, who relapsed from GB after chemoradiation followed by adjuvant temozolomide in Rennes, were treated by conventional chemotherapy (nitrosourea) or by the combination of irinotecan and bevacizumab. In this retrospective analysis, overall survival from diagnosis of recurrence was significantly longer in patients treated with the combination of bevacizumab and irinotecan than with nitrosourea (5 months versus 11.5 months). The combination of irinotecan and bevacizumab appeared to provide clinical benefit to patients with recurrent GB. PMID:22257744

  17. Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis

    PubMed Central

    Leca, Daniela A.; Juganariu, Gabriela; Teodor, Andra; Hurmuzache, Mihnea; Nastase, Eduard V.; Anton-Paduraru, Dana T.

    2015-01-01

    Background Tuberculous meningitis (TBM) is the most lethal form of Mycobacterium tuberculosis infection, which has a high rate of neurological complications and sequelae. Objectives Our study offers a real-world infectious disease clinic perspective, being thus representative for the clinical environment of developing countries. Methods We performed a retrospective analysis of the 127 adult and 77 pediatric cases diagnosed with TBM in the Infectious Disease Hospital of the School of Medicine of Iasi, Romania between 2004–2013. Results Definite diagnosis of TBM was established in 31% of children but in only 20% of adults (p = 0.043). A contact with an individual with pulmonary tuberculosis was documented in 30% of children vs. 13% of adults (p = 0.0007). Coma occurred in 19% of patients (similar in children and adults); other consciousness abnormalities were seen in 27% of children and in 72% of adults (p = 0.000001). Cranial nerve palsies occurred prior to therapy in 9% of cases (12% vs 7% of children and adults, respectively, p>0.05), and developed 2–7 days after treatment initiation in 10% (12 vs 9%). CSF cultures were positive for M. tuberculosis in 24% of patients (31% vs. 20%, p>0.05). Overall mortality was 7.35%, similar for children and adults. Yet, permanent neurological sequelae, which were seen in 23% of patients occurred significantly more frequent in children vs. adults (36% vs. 14%, respectively, p = 0.0121). In conclusion, our retrospective analysis on a significant number of cases of TBM identified striking differences between children and adults: while children were in an earlier stage at the admission, they associated a higher frequency of neurological sequelae and miliary pattern, and they were more likely to have normal CSF protein levels and positive cultures of CSF. PMID:26186004

  18. Unidata: 30 Years of FOSS for the Geosciences

    NASA Astrophysics Data System (ADS)

    Davis, E.; Ramamurthy, M. K.; Young, J. W.; Fisher, W. I.; Rew, R. K.

    2015-12-01

    Unidata's core mission is to serve academic research and education communities by facilitating access and use of real-time weather data. To this end, Unidata develops, distributes, and supports several Free and Open Source Software (FOSS) packages. These packages are largely focused on data management, access, analysis and visualization. This presentation will discuss the lessons Unidata has gathered over thirty years of FOSS development, support, and community building. These lessons include what it takes to be a successful FOSS organization, how to adapt to changing "best practices" and the emergence of new FOSS tools and services, and techniques for dealing with software end-of-life. We will also discuss our approach when supporting a varied user community spanning end users and software developers. Strong user support has been an important key to Unidata's successful community building.

  19. Identification of transformation products of pesticides and veterinary drugs in food and related matrices: use of retrospective analysis.

    PubMed

    Gómez-Pérez, María Luz; Romero-González, Roberto; Vidal, José Luis Martínez; Frenich, Antonia Garrido

    2015-04-10

    Retrospective analysis has been applied in different samples, including honey, meat, feed and nutraceutical products from ginkgo biloba, soya, royal jelly and green tea, with the aim of searching transformation products of pesticides and veterinary drugs, which were not included in an initial analysis. Generic extraction and analytical procedures based on high resolution mass spectrometry (Exactive-Orbitrap analyser was used) have been applied. All obtained data have been reprocessed and some compounds as anhydroerythromycin in honey and 3,5,6-trichloro-2-pyridinol in feed have been detected, demonstrating the applicability and the utility of the procedure. Advantages and disadvantages of retrospective approach have been highlighted. PMID:25748536

  20. Ultratrace LC-MS/MS analysis of segmented calf hair for retrospective assessment of time of clenbuterol administration in Agriforensics.

    PubMed

    Duvivier, Wilco F; van Beek, Teris A; Meijer, Thijs; Peeters, Ruth J P; Groot, Maria J; Sterk, Saskia S; Nielen, Michel W F

    2015-01-21

    In agriforensics, time of administration is often debated when illegal drug residues, such as clenbuterol, are found in frequently traded cattle. In this proof-of-concept work, the feasibility of obtaining retrospective timeline information from segmented calf tail hair analyses has been studied. First, an ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) hair analysis method was adapted to accommodate smaller sample sizes and in-house validated. Then, longitudinal 1 cm segments of calf tail hair were analyzed to obtain clenbuterol concentration profiles. The profiles found were in good agreement with calculated, theoretical positions of the clenbuterol residues along the hair. Following assessment of the average growth rate of calf tail hair, time of clenbuterol administration could be retrospectively determined from segmented hair analysis data. The data from the initial animal treatment study (n = 2) suggest that time of treatment can be retrospectively estimated with an error of 3-17 days. PMID:25537490

  1. Multiyear Serological Surveillance of Notifiable Influenza A Viruses in Belgian Poultry: A Retrospective Analysis.

    PubMed

    Marché, Sylvie; Houdart, Philippe; van den Berg, Thierry; Lambrecht, Bénédicte

    2016-05-01

    Surveillance of notifiable avian influenza (NAI) virus is mandatory in European member states, and each year a serological survey is performed to detect H5 and H7 circulation in poultry holdings. In Belgium, this serological monitoring is a combination of a stratified and a risk-based approach and is applied to commercial holdings with more than 200 birds. Moreover, a competitive nucleoprotein (NP) ELISA has been used as first screening method since 2010. A retrospective analysis of the serological monitoring performed from 2007 through 2013 showed sporadic circulation of notifiable low-pathogenicity avian influenza (LPAI) viruses in Belgian holdings with a fluctuating apparent flock seroprevalence according to years and species. Overall, the highest apparent flock seroprevalence was detected for the H5 subtype in domestic Anatidae, with 20%-50% for breeding geese and 4%-9% for fattening ducks. Positive serology against non-H5/H7 viruses was also observed in the same species with the use of the IDScreen influenza A antibody competition ELISA kit (ID-vet NP ELISA), and confirmed by isolation of H2, H3, H6, and H9 LPAI viruses. Among Galliformes, the apparent flock seroprevalence was lower, ranging between 0.3% and 1.3%. Circulation of notifiable LPAI viruses was only observed in laying hens with a similar seroprevalence for H5 and H7. Based on ID-vet NP ELISA results, no circulation of LPAI viruses, regardless the subtype, was observed in breeding chickens and fattening turkeys. Retrospectively, the use of an ELISA as first-line test not only reduced the number of hemagglutination inhibition tests to be performed, but also gave a broader evaluation of the prevalence of LPAI viruses in general, and might help to identify the most at-risk farms. PMID:27309088

  2. Multiyear Serological Surveillance of Notifiable Influenza A Viruses in Belgian Poultry: A Retrospective Analysis.

    PubMed

    Marché, Sylvie; Houdart, Philippe; van den Berg, Thierry; Lambrecht, Bénédicte

    2015-12-01

    Surveillance of notifiable avian influenza (NAI) virus is mandatory in European member states, and each year a serological survey is performed to detect H5 and H7 circulation in poultry holdings. In Belgium, this serological monitoring is a combination of a stratified and a risk-based approach and is applied to commercial holdings with more than 200 birds. Moreover, a competitive nucleoprotein (NP) ELISA has been used as first screening method since 2010. A retrospective analysis of the serological monitoring performed from 2007 through 2013 showed sporadic circulation of notifiable low-pathogenicity avian influenza (LPAI) viruses in Belgian holdings with a fluctuating apparent flock seroprevalence according to years and species. Overall, the highest apparent flock seroprevalence was detected for the H5 subtype in domestic Anatidae, with 20%-50% for breeding geese and 4%-9% for fattening ducks. Positive serology against non-H5/H7 viruses was also observed in the same species with the use of the IDScreen influenza A antibody competition ELISA kit (ID-vet NP ELISA), and confirmed by isolation of H2, H3, H6, and H9 LPAI viruses. Among Galliformes, the apparent flock seroprevalence was lower, ranging between 0.3% and 1.3%. Circulation of notifiable LPAI viruses was only observed in laying hens with a similar seroprevalence for H5 and H7. Based on ID-vet NP ELISA results, no circulation of LPAI viruses, regardless the subtype, was observed in breeding chickens and fattening turkeys. Retrospectively, the use of an ELISA as first-line test not only reduced the number of hemagglutination inhibition tests to be performed, but also gave a broader evaluation of the prevalence of LPAI viruses in general, and might help to identify the most at-risk farms. PMID:26629630

  3. The 30-year evolution of airway pressure release ventilation (APRV).

    PubMed

    Jain, Sumeet V; Kollisch-Singule, Michaela; Sadowitz, Benjamin; Dombert, Luke; Satalin, Josh; Andrews, Penny; Gatto, Louis A; Nieman, Gary F; Habashi, Nader M

    2016-12-01

    Airway pressure release ventilation (APRV) was first described in 1987 and defined as continuous positive airway pressure (CPAP) with a brief release while allowing the patient to spontaneously breathe throughout the respiratory cycle. The current understanding of the optimal strategy to minimize ventilator-induced lung injury is to "open the lung and keep it open". APRV should be ideal for this strategy with the prolonged CPAP duration recruiting the lung and the minimal release duration preventing lung collapse. However, APRV is inconsistently defined with significant variation in the settings used in experimental studies and in clinical practice. The goal of this review was to analyze the published literature and determine APRV efficacy as a lung-protective strategy. We reviewed all original articles in which the authors stated that APRV was used. The primary analysis was to correlate APRV settings with physiologic and clinical outcomes. Results showed that there was tremendous variation in settings that were all defined as APRV, particularly CPAP and release phase duration and the parameters used to guide these settings. Thus, it was impossible to assess efficacy of a single strategy since almost none of the APRV settings were identical. Therefore, we divided all APRV studies divided into two basic categories: (1) fixed-setting APRV (F-APRV) in which the release phase is set and left constant; and (2) personalized-APRV (P-APRV) in which the release phase is set based on changes in lung mechanics using the slope of the expiratory flow curve. Results showed that in no study was there a statistically significant worse outcome with APRV, regardless of the settings (F-ARPV or P-APRV). Multiple studies demonstrated that P-APRV stabilizes alveoli and reduces the incidence of acute respiratory distress syndrome (ARDS) in clinically relevant animal models and in trauma patients. In conclusion, over the 30 years since the mode's inception there have been no strict

  4. Home telehealth and hospital readmissions: a retrospective OASIS-C data analysis.

    PubMed

    Thomason, Tanna R; Hawkins, Shelley Y; Perkins, Katherine E; Hamilton, Elissa; Nelson, Betty

    2015-01-01

    Technology holds potential to improve the quality of healthcare delivery. The use of remote patient monitoring, or telehealth (TH), has been widely adopted by many home care agencies to facilitate early identification of disease exacerbation, particularly for patients with chronic diseases such as heart failure. TH has been successfully used to improve symptom detection and potentially reduce rehospitalization rates. Quantifying program effectiveness through data analysis is a critical step for program improvement, resource allocation, and future strategic planning. Using the Outcome and Assessment Information Set-C database, a retrospective analysis was conducted examining 22 months of heart failure patient data from one home care agency in southern California. Seventy patients receiving TH were compared to patients who received usual home care nursing services. No major differences in baseline socio-demographics were found between the 2 groups. While receiving home healthcare services, the non-TH patients had a 21% all-cause hospital readmission rate, compared to the home TH patients with a 10% all-cause readmission rate. Statistical differences were found between groups on the variables of fall risk, vision, smoking, shortness of breath, the ability to bathe and take oral meds, along with having been discharged from a skilled nursing facility in the last 2 weeks. These results indicate that aggregate data analysis is useful in providing insight into program effectiveness. This study suggests TH programs have the potential to reduce the burden associated with rehospitalizations in the heart failure population. PMID:25654342

  5. 30-year International Pediatric Craniofacial Surgery Partnership: Evolution from the “Third World” Forward

    PubMed Central

    Swanson, Jordan W.; Skirpan, Jan; Stanek, Beata; Kowalczyk, Maciej

    2016-01-01

    Background: Craniofacial diseases constitute an important component of the surgical disease burden in low- and middle-income countries. The consideration to introduce craniofacial surgery into such settings poses different questions, risks, and challenges compared with cleft or other forms of plastic surgery. We report the evolution, innovations, and challenges of a 30-year international craniofacial surgery partnership. Methods: We retrospectively report a partnership between surgeons at the Uniwersytecki Szpital Dzieciecy in Krakow, Poland, and a North American craniofacial surgeon. We studied patient conditions, treatment patterns, and associated complications, as well as program advancements and limitations as perceived by surgeons, patient families, and hospital administrators. Results: Since partnership inception in 1986, the complexity of cases performed increased gradually, with the first intracranial case performed in 1995. In the most recent 10-year period (2006–2015), 85 patients have been evaluated, with most common diagnoses of Apert syndrome, Crouzon syndrome, and single-suture craniosynostosis. In the same period, 55 major surgical procedures have been undertaken, with LeFort III midface distraction, posterior vault distraction, and frontoorbital advancement performed most frequently. Key innovations have been the employment of craniofacial distraction osteogenesis, the use of Internet communication and digital photography, and increased understanding of how craniofacial morphology may improve in the absence of surgical intervention. Ongoing challenges include prohibitive training pathways for pediatric plastic surgeons, difficulty in coordinating care with surgeons in other institutions, and limited medical and material resources. Conclusion: Safe craniofacial surgery can be introduced and sustained in a resource-limited setting through an international partnership. PMID:27200233

  6. A retrospective analysis of pegylated liposomal doxorubicin in ovarian cancer: do we still need it?

    PubMed Central

    2013-01-01

    Background Ovarian cancer (OC) is the sixth most common cancer in women. Currently, carboplatin/paclitaxel ± bevacizumab is the cornerstone of front-line treatment. Conversely, the therapeutic options for recurrent or progressive disease are not well defined. For platinum-sensitive patients the best therapeutic approach is still a re-challenge with a platinum-based regimen. Pegylated liposomal doxorubicin (PLD), is considered one of the most active therapeutic options for recurrent or progressive OC. In this retrospective mono-institutional analysis, we evaluated the impact of PLD on the outcome of OC patients. Patients and methods We performed the retrospective study on a cohort of 108 patients with histologically confirmed serous papillary OC, followed at our Institution between 2001 and 2011. 80 patients were in stage III/IV and 55 of them received a second-line treatment. Thirty patients were treated with PLD. Both groups (PLD-treated versus PLD-untreated) underwent a median of 3 treatment lines and were prognostically balanced. The median follow-up was 60 months. Survival endpoints, toxicity and correlations between patients’ baseline characteristics and treatment efficacy were evaluated. Results Patients who had undergone PLD treatment (PLD group) showed a median overall survival (OS) of 45 months as compared to 65 months of patients not treated with PLD (PLD-free group) (HR 2.50 [0.95-6.67; p = 0.06]). Moreover, the median progression-free survival was 6 months in the PLD group versus 10 months in the PLD-free group (HR 1.75 [0.94-3.34; p = 0.07]). The overall objective response rate in II line treatment was 43% (13% in PLD group versus 57% in PLD-free group). Furthermore, we investigated survival endpoints in platinum-refractory patients who received PLD at least once during the course of disease. No OS advantage was achieved by PLD administration when compared to other therapeutic options (30 versus 32 months; HR 1.16 [0.31-4.34; p = 0.81]). No

  7. Science Engagement and Literacy: A retrospective analysis for students in Canada and Australia

    NASA Astrophysics Data System (ADS)

    Woods-McConney, Amanda; Colette Oliver, Mary; McConney, Andrew; Schibeci, Renato; Maor, Dorit

    2014-07-01

    Given international concerns about students' pursuit (or more correctly, non-pursuit) of courses and careers in science, technology, engineering and mathematics, this study is about achieving a better understanding of factors related to high school students' engagement in science. The study builds on previous secondary analyses of Programme for International Student Assessment (PISA) datasets for New Zealand and Australia. For the current study, we compared patterns of science engagement and science literacy for male and female students in Canada and Australia. The study's secondary analysis revealed that for all PISA measures included under the conceptual umbrella of engagement in science (i.e. interest, enjoyment, valuing, self-efficacy, self-concept and motivation), 15-year-old students in Australia lagged their Canadian counterparts to varying, albeit modest, degrees. Our retrospective analysis further shows, however, that gender equity in science engagement and science literacy is evident in both Canadian and Australian contexts. Additionally, and consistent with our previous findings for indigenous and non-indigenous students in New Zealand and Australia, we found that for male and female students in both countries, the factor most strongly associated with variations in engagement in science was the extent to which students participate in science activities outside of school. In contrast, and again for both Canadian and Australian students, the factors most strongly associated with science literacy were students' socioeconomic backgrounds, and the amount of formal time spent doing science. The implications of these results for science educators and researchers are discussed.

  8. Granulosa cell tumor of the ovary: retrospective analysis of 45 cases.

    PubMed

    Uygun, Kazim; Aydiner, Adnan; Saip, Pinar; Basaran, Mert; Tas, Faruk; Kocak, Zafer; Dincer, Maktav; Topuz, Erkan

    2003-10-01

    Adult granulosa cell tumors of the ovary are rare neoplasms, accounting for less than 5% of all ovarian malignancies. In addition to the tumor stage, residual disease, patient age, tumor size, extent of surgery, and also some histologic factors have been reported to be of prognostic importance. Tumor registries were screened for all patients treated between 1979 and 1998 for ovarian tumors at the University of Istanbul. There were 952 ovarian carcinomas, of which 47 were granulosa cell tumors. All charts were reviewed, and the clinical data were extracted. Prognostic factors and treatment results were evaluated retrospectively. The median follow-up was 84 (range: 6-141 months) months. According to univariate analysis, there were only two significant factors for overall survival (OS): stage and presence of residual disease. The OS of the 23 patients with early stage (mean, 122 months; median, unreached) was significantly (p = 0.0001) better than the OS of the 22 patients with advanced stage (mean, 34 months; median, 21 months). A significant difference (p = 0.0004) in OS was also observed between patients with residual (mean, 42 months; median, 21 months) and nonresidual (mean, 108 months; median, unreached) disease. In a multivariate analysis, only stage remained statistically significant (p = 0.0001). The overall 5-year survival rate was 55% and median survival after recurrence was 21 months. Despite the small number of patients, the study showed that stage and macroscopic residual disease are significant prognostic factors. The benefit of chemotherapy and radiotherapy remains controversial. PMID:14528083

  9. What happens after a single surgical intervention for hidradenitis suppurativa? A retrospective claims-based analysis.

    PubMed

    Jemec, Gregor B E; Guérin, Annie; Kaminsky, Michael; Okun, Martin; Sundaram, Murali

    2016-07-01

    Objective Hidradenitis suppurativa (HS) is often treated by surgery. The risk of recurrence after surgery is common and the consequences are substantial, but neither has been quantified using a claims database. This study aimed to estimate the burden associated with non-curative surgery in HS patients. Methods A retrospective analysis was performed of health insurance claims data from Q1 1999 to Q2 2011 in a US claims database. The analysis included 2668 adults with ≥1 diagnosis of HS and ≥1 claim for skin surgery within 6 months after diagnosis. Healthcare resource utilization and medical costs were compared using multivariate regressions. Results Overall, 46% of HS patients had ≥1 indicator of non-curative surgery. The incidences of inpatient, emergency department, and outpatient visits were 88%, 40%, and 30% higher, respectively, for patients with non-curative surgery vs patients without indicator of non-curative surgery (all p < 0.001). Average medical costs were $11,858 and $6427 for patients with and without indicators of non-curative surgery, respectively. The difference of $4185 (p < 0.001) was mainly driven by inpatient costs (difference = $2685; p < 0.001). Limitations Indicators of non-curative HS surgery were defined based on an empirical algorithm. Conclusions Non-curative HS surgery occurred in almost half of all cases and represents a significant burden on patients and payers in terms of resource utilization and costs. PMID:26938967

  10. Modern Era Retrospective-analysis for Research and Applications (MERRA) Global Water and Energy Budgets

    NASA Technical Reports Server (NTRS)

    Bosilovich, Michael G.; Chen, Junye

    2009-01-01

    In the Summer of 2009, NASA's Modern Era Retrospective-analysis for Research and Applications (MERRA) will have completed 28 years of global satellite data analyses. Here, we characterize the global water and energy budgets of MERRA, compared with available observations and the latest reanalyses. In this analysis, the climatology of the global average components are studied as well as the separate land and ocean averages. In addition, the time series of the global averages are evaluated. For example, the global difference of precipitation and evaporation generally shows the influence of water vapor observations on the system. Since the observing systems change in time, especially remotely sensed observations of water, significant temporal variations can occur across the 28 year record. These then are also closely connected to changes in the atmospheric energy and water budgets. The net imbalance of the energy budget at the surface can be large and different signs for different reanalyses. In MERRA, the imbalance of energy at the surface tends to improve with time being the smallest during the most recent and abundant satellite observations.

  11. NASA's Modern Era Retrospective-Analysis for Research and Applications (MERRA): Early Results and Future Directions

    NASA Technical Reports Server (NTRS)

    Schubert, Siegfried

    2008-01-01

    This talk will review the status and progress of the NASA/Global Modeling and Assimilation Office (GMAO) atmospheric global reanalysis project called the Modern Era Retrospective-Analysis for Research and Applications (MERRA). An overview of NASA's emerging capabilities for assimilating a variety of other Earth Science observations of the land, ocean, and atmospheric constituents will also be presented. MERRA supports NASA Earth science by synthesizing the current suite of research satellite observations in a climate data context (covering the period 1979-present), and by providing the science and applications communities with of a broad range of weather and climate data with an emphasis on improved estimates of the hydrological cycle. MERRA is based on a major new version of the Goddard Earth Observing System Data Assimilation System (GEOS-5), that includes the Earth System Modeling Framework (ESMF)-based GEOS-5 atmospheric general circulation model and the new NOAA National Centers for Environmental Prediction (NCEP) unified grid-point statistical interpolation (GST) analysis scheme developed as a collaborative effort between NCEP and the GMAO. In addition to MERRA, the GMAO is developing new capabilities in aerosol and constituent assimilation, ocean, ocean biology, and land surface assimilation. This includes the development of an assimilation capability for tropospheric air quality monitoring and prediction, the development of a carbon-cycle modeling and assimilation system, and an ocean data assimilation system for use in coupled short-term climate forecasting.

  12. Characterization of papillary thyroid microcarcinomas using sonographic features in malignant papillary thyroid cancer: a retrospective analysis.

    PubMed

    Gu, Wei-jun; Yan, Hui-xian; Luo, Yu-kun; Wang, Fu-lin; Yang, Guo-qing; Guo, Qing-hua; Jin, Nian; Zang, Li; Chen, Kang; Du, Jin; Wang, Xian-ling; Yang, Li-juan; Ba, Jian-ming; Dou, Jing-tao; Mu, Yi-ming; Pan, Chang-yu; Lv, Zhao-hui

    2015-05-01

    The diagnosis of malignant thyroid nodules is still a clinical challenge. This study aimed to determine the ultrasonographic characteristics of papillary thyroid carcinoma. The ultrasonographic and pathological data of 2453 thyroid nodules in a cohort of 1895 Chinese patients who underwent thyroidectomy from January 2010 to December 2012 were retrospectively reviewed. Anteroposterior and transversal (AP/TR) diameters ≥1, solid structure, infiltrative margins, hypoechoic appearance, and microcalcifications were more common in malignant nodules than in benign nodules (P < 0.01). These ultrasonographic features were independent risk factors of malignancy (P < 0.01) as determined by logistic regression analysis. Based on multivariate analysis, these characteristics were also present in large nodules (diameter >10 mm). However, in small nodules (diameter ≤10 mm), only AP/TR ≥1 and infiltrative margins were independent risk factors of malignancy (P < 0.01). Ultrasonography is of high diagnostic value for malignant thyroid nodules and may help to improve the differential diagnosis. Small and large nodules have distinct ultrasonographic features. PMID:26020388

  13. Video content analysis on body-worn cameras for retrospective investigation

    NASA Astrophysics Data System (ADS)

    Bouma, Henri; Baan, Jan; ter Haar, Frank B.; Eendebak, Pieter T.; den Hollander, Richard J. M.; Burghouts, Gertjan J.; Wijn, Remco; van den Broek, Sebastiaan P.; van Rest, Jeroen H. C.

    2015-10-01

    In the security domain, cameras are important to assess critical situations. Apart from fixed surveillance cameras we observe an increasing number of sensors on mobile platforms, such as drones, vehicles and persons. Mobile cameras allow rapid and local deployment, enabling many novel applications and effects, such as the reduction of violence between police and citizens. However, the increased use of bodycams also creates potential challenges. For example: how can end-users extract information from the abundance of video, how can the information be presented, and how can an officer retrieve information efficiently? Nevertheless, such video gives the opportunity to stimulate the professionals' memory, and support complete and accurate reporting. In this paper, we show how video content analysis (VCA) can address these challenges and seize these opportunities. To this end, we focus on methods for creating a complete summary of the video, which allows quick retrieval of relevant fragments. The content analysis for summarization consists of several components, such as stabilization, scene selection, motion estimation, localization, pedestrian tracking and action recognition in the video from a bodycam. The different components and visual representations of summaries are presented for retrospective investigation.

  14. Risk factors for mediastinitis after cardiac surgery – a retrospective analysis of 1700 patients

    PubMed Central

    Diez, Claudius; Koch, Daniel; Kuss, Oliver; Silber, Rolf-Edgar; Friedrich, Ivar; Boergermann, Jochen

    2007-01-01

    Background Mediastinitis is a rare, but serious complication of cardiac surgery. It has a significant socioeconomic impact and high morbidity. The purpose of this study was to determine pre-, intra-, and postoperative predictors of mediastinitis. Methods and results In 1700 consecutive patients, who underwent cardiac surgery in 2001, 49 variables were retrospectively assessed. Forty-five patients (2.65%, 95% CI [1.88; 3.41]) developed postoperative mediastinitis. None of these patients died during their hospitalization. Multivariate analysis identified three of the 49 variables as highly significant independent predictors for the development of mediastinitis: obesity (OR 1.03, 95% CI [1.01; 1.04] p = 0.001), chronic obstructive pulmonary disease (OR 3.30, 95% CI [1.58; 6.88], p = 0.001), and bilateral grafting of the internal mammary artery (OR 3.18, 95% CI [1.20; 8.43] p = 0.02). The model is reliable in terms of its goodness of fit, it also discriminates well. Additionally, univariate analysis identified diabetes mellitus, CCS class and the number of intraoperatively transfused units of fresh frozen plasma as variables with a significant impact. Conclusion The present study suggests that bilateral IMA grafting, chronic obstructive pulmonary disease and obesity are important predictors of mediastinitis. PMID:17511885

  15. 7 CFR 625.8 - Compensation for easements and 30-year contracts.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Compensation for easements and 30-year contracts. 625.8 Section 625.8 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL... § 625.8 Compensation for easements and 30-year contracts. (a) Determination of easement payment...

  16. Analysis of Sexual Assault Survivours in a Tertiary Care Hospital in Delhi: A Retrospective Analysis

    PubMed Central

    Singh, Alpana; Vaid, Neelam Bala; Behera, Sanjeeta

    2014-01-01

    Introduction: Rape and abuse of women are common occurrences, which, many a times go unspoken due to social stigma or fear of retribution. Rape is a crime not against a single human being but against the entire humanity. For granting justice to the rape survivor it becomes necessary that such matters are properly presented before the Courts of Law. Healthcare workers play an important role in this regard because they are the first person who examine the rape victims. They prepare a documented record of medical condition of rape victim and do relevant sample collection. Aim: The objective of this study is to analyse demographic and event characteristics of rape victims who presented to the Emergency Department in tertiary care, Delhi after sexual assault. Materials and Methods: Data was retrospectively collected from the medico legal register of the Department of Obstetrics and Gynecology between June 2010 to December 2013. Result: We noted a marked increase in the number of cases. Mean age of victims was 17 and most belonged to the lower socio-economic strata of the society. Use of sedatives and physical trauma was not common. Victims often knew the perpetrator of the event. Most (58%) of them reported within one day of the incident. Major degrees of perineal tears were seen in young victims. Conclusion: By understanding the demography of the sexual assault victims, we need to train our doctors for proper evidence collection not just in a government set up but also in private clinics, to help rape victims get justice and proper medical treatment. PMID:25386486

  17. The Retrospection and Elicitation of China's Teacher Education Reform and Opening-Up More Than 30 Years

    ERIC Educational Resources Information Center

    Tian-Ping, Yang

    2012-01-01

    Since implementation of reform and opening-up policy, China's teacher education has got significant success on policy design, legislation process, theory research, system reform, model innovation and teaching qualification system building. Teachers' educational background level has been increased. Teachers' professional ethics and teaching…

  18. Integrating diversity into graduate social work education: a 30-year retrospective view by MSW-level African American social workers.

    PubMed

    Bowie, Stan L; Hall, J Camille; Johnson, Oliver J

    2011-01-01

    The study surveyed a national sample of 100 African American master of social work graduates to retroactively assess perceived diversity content in Human Behavior courses before and after the Council on Social Work Education (CSWE) established accreditation standards on diversity. Seventy-one percent of the respondents were females, the mean age was 45.8 years, and their graduation years ranged from 1958 to 2002. Most graduated from northeastern schools (34%), followed by midwestern (28%), southeastern (22%), northwestern (11%), and southwestern (5%) schools. Investigators used the Preparation for Graduate Education Social Work Education Scale and the Human Behavior Survey Addendum (alpha = .97). There were no statistically significant differences on diversity content scores for participants enrolled before and after CSWE diversity standards were established, but graduates of historically Black colleges gave higher diversity content scores in every area. Study includes discussion and implications for Afrocentric theory and the need to prepare practitioners for future social work careers in multicultural communities. PMID:22165422

  19. A retrospective analysis for patient-specific quality assurance of volumetric-modulated arc therapy plans

    SciTech Connect

    Li, Guangjun; Wu, Kui; Peng, Guang; Zhang, Yingjie; Bai, Sen

    2014-01-01

    Volumetric-modulated arc therapy (VMAT) is now widely used clinically, as it is capable of delivering a highly conformal dose distribution in a short time interval. We retrospectively analyzed patient-specific quality assurance (QA) of VMAT and examined the relationships between the planning parameters and the QA results. A total of 118 clinical VMAT cases underwent pretreatment QA. All plans had 3-dimensional diode array measurements, and 69 also had ion chamber measurements. Dose distribution and isocenter point dose were evaluated by comparing the measurements and the treatment planning system (TPS) calculations. In addition, the relationship between QA results and several planning parameters, such as dose level, control points (CPs), monitor units (MUs), average field width, and average leaf travel, were also analyzed. For delivered dose distribution, a gamma analysis passing rate greater than 90% was obtained for all plans and greater than 95% for 100 of 118 plans with the 3%/3-mm criteria. The difference (mean ± standard deviation) between the point doses measured by the ion chamber and those calculated by TPS was 0.9% ± 2.0% for all plans. For all cancer sites, nasopharyngeal carcinoma and gastric cancer have the lowest and highest average passing rates, respectively. From multivariate linear regression analysis, the dose level (p = 0.001) and the average leaf travel (p < 0.001) showed negative correlations with the passing rate, and the average field width (p = 0.003) showed a positive correlation with the passing rate, all indicating a correlation between the passing rate and the plan complexity. No statistically significant correlation was found between MU or CP and the passing rate. Analysis of the results of dosimetric pretreatment measurements as a function of VMAT plan parameters can provide important information to guide the plan parameter setting and optimization in TPS.

  20. Intraoperative Radiotherapy for Unresectable Pancreatic Cancer: A Multi-Institutional Retrospective Analysis of 144 Patients

    SciTech Connect

    Ogawa, Kazuhiko; Karasawa, Katsuyuki; Ito, Yoshinori; Ogawa, Yoshihiro; Jingu, Keiichi; Onishi, Hiroshi; Aoki, Shinichi; Wada, Hitoshi; Kokubo, Masaki; Ogo, Etsuyo; Etoh, Hidehiro; Kazumoto, Tomoko; Takayama, Makoto; Nemoto, Kenji; Nishimura, Yasumasa

    2011-05-01

    Purpose: To retrospectively analyze the results of intraoperative radiotherapy (IORT) + external beam radiotherapy (EBRT) for unresectable pancreatic cancer. Methods and Materials: The records of 144 patients treated with IORT, with or without, EBRT were reviewed. One hundred and thirteen patients (78.5%) were treated with IORT + EBRT and 114 patients (79.2%) were treated in conjunction with chemotherapy. The median doses of IORT and EBRT were 25 Gy and 45 Gy, respectively. The median follow-up of all 144 patients was 9.6 months (range, 0.5-69.7 months). Results: At the time of this analysis, 131 of 144 patients (91.0%) had disease recurrences. Local progression was observed in 60 patients (41.7%), and the 2-year local control (LC) rate in all patients was 44.6%. Patients treated with IORT, with or without, EBRT had significantly more favorable LC (2-year LC, 50.9%) than those treated with IORT without EBRT (p = 0.0004). The 2-year overall survival (OS) rate and the median survival time in all 144 patients were 14.7% and 10.5 months, respectively. Patients treated with chemotherapy had a significantly favorable OS than those treated without chemotherapy (p < 0.0001). On univariate analysis, chemotherapy use alone had a significant impact on OS and on multivariate analysis; chemotherapy use was a significant prognostic factor. Late gastrointestinal morbidity of National Cancer Institute-Common Terminology Criteria Grade 3 was observed in 2 patients (1.4%). Conclusion: IORT + EBRT yields a relatively favorable LC rate for unresectable pancreatic cancer with low frequency of severe late toxicity, and IORT combined with chemotherapy conferred a survival benefit compared with IORT without chemotherapy.

  1. Intraoperative Radiotherapy for Resected Pancreatic Cancer: A Multi-Institutional Retrospective Analysis of 210 Patients

    SciTech Connect

    Ogawa, Kazuhiko; Karasawa, Katsuyuki; Ito, Yoshinori; Ogawa, Yoshihiro; Jingu, Keiichi

    2010-07-01

    Purpose: To retrospectively analyze the results of intraoperative radiotherapy (IORT) with or without external beam radiotherapy (EBRT) for resected pancreatic cancer. Methods and Materials: The records of 210 patients treated with gross complete resection (R0: 147 patients; R1: 63 patients) and IORT with or without EBRT were reviewed. One hundred forty-seven patients (70.0%) were treated without EBRT and 114 patients (54.3%) were treated in conjunction with chemotherapy. The median doses of IORT and EBRT were 25 Gy (range, 20-30 Gy) and 45 Gy (range, 20-60Gy), respectively. The median follow-up of the surviving 62 patients was 26.3 months (range, 2.7-90.5 months). Results: At the time of this analysis, 150 of 210 patients (71.4%) had disease recurrences. Local failure was observed in 31 patients (14.8%), and the 2-year local control rate in all patients was 83.7%. The median survival time and the 2-year actuarial overall survival (OS) in all 210 patients were 19.1 months and 42.1%, respectively. Patients treated with IORT and chemotherapy had a significantly more favorable OS than those treated with IORT alone (p = 0.0011). On univariate analysis, chemotherapy use, degree of resection, carbohydrate antigen 19-9, and pathological N stage had a significant impact on OS and on multivariate analysis; these four factors were significant prognostic factors. Late gastrointestinal morbidity of NCI-CTC Grade 4 was observed in 7 patients (3.3%). Conclusion: IORT yields an excellent local control rate for resected pancreatic cancer with few frequencies of severe late toxicity, and IORT combined with chemotherapy confers a survival benefit compared with that of IORT alone.

  2. Paradoxical Herniation After Unilateral Decompressive Craniectomy Predicts Better Patient Survival: A Retrospective Analysis of 429 Cases.

    PubMed

    Chen, Weiqiang; Guo, Jingfang; Wu, Jin; Peng, Guoyi; Huang, Mindong; Cai, Chuwei; Yang, Yingming; Wang, Shousen

    2016-03-01

    Paradoxical herniation (PH) is a life-threatening emergency after decompressive craniectomy. In the current study, we examined patient survival in patients who developed PH after decompressive craniectomy versus those who did not. Risk factors for, and management of, PH were also analyzed. This retrospective analysis included 429 consecutive patients receiving decompressive craniectomy during a period from January 2007 to December 2012. Mortality rate and Glasgow Outcome Scale (GOS) were compared between those who developed PH (n = 13) versus those who did not (n = 416). A stepwise multivariate logistic regression analysis was carried out to examine the risk factors for PH. The overall mortality in the entire sample was 22.8%, with a median follow-up of 6 months. Oddly enough, all 13 patients who developed PH survived beyond 6 months. Glasgow Coma Scale did not differ between the 2 groups upon admission, but GOS was significantly higher in subjects who developed PH. Both the disease type and coma degree were comparable between the 13 PH patients and the remaining 416 patients. In all PH episodes, patients responded to emergency treatments that included intravenous hydration, cerebral spinal fluid drainage discontinuation, and Trendelenburg position. A regression analysis indicated the following independent risk factors for PH: external ventriculostomy, lumbar puncture, and continuous external lumbar drainage. The rate of PH is approximately 3% after decompressive craniectomy. The most intriguing findings of the current study were the 0% mortality in those who developed PH versus 23.6% mortality in those who did not develop PH and significant difference of GOS score at 6-month follow-up between the 2 groups, suggesting that PH after decompressive craniectomy should be managed aggressively. The risk factors for PH include external ventriculostomy, ventriculoperitoneal shunt, lumbar puncture, and continuous external lumbar drainage. PMID:26945365

  3. Retrospective stable isotope analysis reveals ecosystem responses to river regulation over the last century.

    PubMed

    Turner, Thomas F; Krabbenhoft, Trevor I; Collyer, Michael L; Krabbenhoft, Corey A; Edwards, Melanie S; Sharp, Zachary D

    2015-12-01

    Disruption of natural flow regimes, nutrient pollution, and other consequences of human population growth and development have impacted most major rivers of the world. Alarming losses of aquatic biodiversity coincide with human-caused river alteration, but effects of biotic homogenization on aquatic ecosystem processes are not as well documented. This is because unaltered systems for comparison are scarce, and some ecosystem-wide effects may take decades to manifest. We evaluated aquatic ecosystem responses to extensive river- floodplain engineering and nutrient addition in the Rio Grande of southwestern North America as revealed by changes in trophic structure of, and resource availability to, the fish community. Stable Isotope Analysis (SIA) was conducted on museum-preserved fishes collected over a 70-year period of intensive river management and exponential human population growth. Trophic complexity and resource heterogeneity for fish consumers (measured as "isotopic niche breadth") decreased following sediment deprivation and channelization, and these effects persist into the present. Increased nutrient inputs led to δ15N enrichment in the entire fish community at all affected sites, and a shift to autochthonous sources of carbon at the most proximal site downstream of wastewater release, probably via bottom-up transfer. Overall, retrospective SIA of apex consumers suggests radical change and functional impairment of a floodplain river ecosystem already marked by significant biodiversity loss. PMID:26909427

  4. Morbidity after reversal of Hartmann operation: retrospective analysis of 56 patients

    PubMed Central

    Zarnescu (Vasiliu), EC; Zarnescu, NO; Costea, R; Rahau, L; Neagu, S

    2015-01-01

    Background: Despite patient selection, postoperative morbidity after reversal of Hartmann’s procedure remains significant. Aim: The objective of this study was to investigate risk factors associated with morbidity after conversion of Hartmann’s operation. Patients and methods: We retrospectively analyzed data of 56 patients who underwent reversal procedures between January 2004 and May 2015 in a single center. We evaluated the following variables: demographic characteristics, medical comorbidities, etiology for Hartmann operation, preoperative lab values, intraoperative surgical details and short-term outcomes (hospital stay, medical and surgical complications, mortality). Results: There were 37 men (66.1%) and the mean age was 57 years. The most frequent indications for Hartmann’s procedure were colorectal cancer in 25 patients (44.6%) and complicated diverticulitis in 10 patients (17.9%). The mean time to the reversal procedure was 9 months. Morbidity rate was 16.1% (9 patients) with an anastomotic leakage rate of 3.6% (2 patients) and mortality rate was 3.6% (2 patients). The most common medical complication was diarrhea (4 patients, 7.2%). Bivariate analysis demonstrated that the only factor significantly associated with postoperative complications was presence of multiple comorbidities. Conclusions: Multiple medical comorbidities is the only predictive factor for postoperative complications after Hartmann’s reversal and therefore patient selection for this type of surgery is critical. PMID:26664476

  5. Clinical factors affecting engraftment and transfusion needs in SCT: a single-center retrospective analysis.

    PubMed

    Liesveld, J; Pawlowski, J; Chen, R; Hyrien, O; Debolt, J; Becker, M; Phillips, G; Chen, Y

    2013-05-01

    Successful utilization of SCT modalities often requires utilization of both red cell and platelet transfusions. In this retrospective evaluation of clinical factors affecting transplant engraftment and transfusion utilization at a single transplant center in 505 patients from 2005 through 2009, we found that graft type, donor type and the conditioning regimen intensity significantly affected both the neutrophil engraftment time (P<0.001) and the platelet engraftment time (P<0.001). SCT patients required an average of 6.2 red cell units, and 7.9 platelet transfusions in the first 100 days with a wide s.d. Among auto-SCT patients, 5% required neither RBC nor platelet transfusions. Some reduced-intensity transplants were also associated with no transfusion need, and in allogeneic transplants, conditioning regimen intensity was positively correlated with platelet transfusion events as assessed by multivariate analysis. Other patient characteristics such as gender, graft type, donor type, underlying disease and use of TBI were all independently associated with transfusion needs in SCT patients. Further studies are required to understand the means to minimize transfusions and potential related complications in SCT patients. PMID:23085827

  6. Maintenance of Certification Part IV Quality-Improvement Project for Hypertension Control: A Preliminary Retrospective Analysis

    PubMed Central

    Kolasinski, Vallerie A; Price, David W

    2015-01-01

    Context: A Maintenance of Certification Part IV project was created on the basis of an existing, multifaceted hypertension improvement program. Objective: To evaluate the impact of the Maintenance of Certification project, the effects of the improvement options on blood pressure control in hypertensive patients, and the participants’ perception of the workload related to participation in the project. Design: Nonexperimental retrospective analysis. Setting: Kaiser Permanente hospitals and medical office buildings in Northern California. Intervention: Participants used one or more options from a defined menu of strategies to attempt to increase the percentage of hypertensive patients on their patient panels who had controlled blood pressure. Main Outcome Measure: Proportion of hypertensive patients with blood pressure ≤ 139/89 mm Hg. Results: Fifty-two American Board of Family Medicine and 19 American Board of Internal Medicine certified physicians completed projects. Mean panel blood pressure control improved from 79.49% (standard deviation [SD] = 11.32) to 84.64% (SD = 7.80). The choice of improvement option was not associated with the level of improvement or with the participants’ perception of the workload related to completing the project. Conclusion: Project participants improved the care of their patients without an increased perceived burden to their practice. We found no association between the choice of improvement option and either the level of improvement or the perception of workload. PMID:25785642

  7. A retrospective analysis of a community-based health program in Papua New Guinea.

    PubMed

    Ashwell, Helen Elizabeth Scott; Barclay, Lesley

    2009-06-01

    The Women and Children's Health Project was a large Australian funded aid Project that sought to improve the health of women and children in Papua New Guinea between 1998 and 2004. Community development and health promotion interventions aimed to increase community support for attended birth and children's health. Green and Kreuter's [Green, L. W. and Kreuter, M. W. (2005) Health Program Planning: An Educational and Ecological Approach, 4th edition. McGraw-Hill, New York] precede-proceed model of health program planning was applied retrospectively to critique the design, implementation and evaluation of the Project. An outcome evaluation (2006) provided data for this analysis and investigated long-term impact using a multi-methods approach. Application of the precede-proceed model was useful, but the model fails to sufficiently well identify 'inhibiting factors' as part of the educational and ecological assessment during the planning phase. Pre-defined objectives and contractually obligated outputs in a donor funded business model negatively influenced Project activity and outcomes. Despite this and the challenging context for implementation, Project interventions improved interaction between the community and health systems, and improved use of maternal child health services. PMID:19342392

  8. Experience of a skeletal dysplasia registry in Turkey: a five-years retrospective analysis.

    PubMed

    Kurt-Sukur, Eda Didem; Simsek-Kiper, Pelin Ozlem; Utine, Gülen Eda; Boduroglu, Koray; Alanay, Yasemin

    2015-09-01

    This study shares data on 417 patients with genetic disorders of skeleton including 10 fetal autopsies encountered in a 5-year period at a tertiary university hospital in Ankara, Turkey. We included patients with osteochondrodysplasias, excluding overgrowth syndromes, dysostoses, and craniofacial syndromes. When grouped according to the "International Skeletal Dysplasia Society 2010 classification" the most frequent group is "FGFR3 group" (achondroplasia). "Decreased bone density group" takes the second place, consistent with the literature. We also demonstrated, a relatively higher frequency of recessively inherited skeletal dysplasias when the diagnosis is an entity other than achondroplasia or osteogenesis imperfecta. The literature on the incidence of genetic disorders of skeleton from the Middle East and Eastern Mediterranean is limited to fetal and neonatal autopsies or birth prevelance reports. The higher rate of consanguineous marriages which increases the frequency of autosomal recessive entities makes it difficult to apply data from other parts of the world. Total consanguinity rate among parents in our study was 53% and there were regional differences. The highest (79%) was among parents from South-east Anatolia. This study is the first broad retrospective analysis of genetic disorders of skeleton from our region. We aim to provide a descriptive source for future studies and discuss our findings in comparison to reports from other parts of the world. PMID:25931420

  9. [Neonatal bronchoscopy: a retrospective analysis of 67 cases and a review of their indications].

    PubMed

    Oliveira-Santos, J A; Pereira-da-Silva, L; Clington, A; Serelha, M

    2004-01-01

    The availability of newer, more sophisticated and versatile bronchoscopes has expanded the spectrum and scope of the indications for bronchoscopy in the newborn infant both for diagnostic and therapeutic purposes. The aim of this study was to carry out a retrospective analysis of the bronchoscopies performed on newborn infants, and to review the indications of this procedure in this age group. Sixty-three patients were submitted to 67 bronchoscopies in a period of 13 years, allowing the diagnosis of 45 anomalies and malformations of the tracheo-bronchial tree, and the performance of 24 bronchoalveolar lavages. In six cases, endoscopic removal of secretions helped to resolve resistant atelectasia, while in another case, with esophageal atresia, intra-operative definition of the fistula tract was possible through catheterisation of the fistula with the bronchoscope. The flexible bronchoscope was preferred for diagnosis by direct visualisation, and the rigid bronchoscope for some diagnostic and therapeutic procedures. Stridor, unexplained cyanosis, hemoptysis, persistent or recurrent pulmonary images, difficulties in the intubation or extubation, and persistent disturbances in ventilation are among the main indications for bronchoscopy in the newborn infant. Bronchoscopy also allows the performance of subsidiary techniques, such as bronchoalveolar lavage, biopsy and laser therapy. PMID:16197839

  10. Cardiac septic pulmonary embolism: A retrospective analysis of 20 cases in a Chinese population.

    PubMed

    Song, Xin Yu; Li, Shan; Cao, Jian; Xu, Kai; Huang, Hui; Xu, Zuo Jun

    2016-06-01

    Based on the source of the embolus, septic pulmonary embolism (SPE) can be classified as cardiac, peripheral endogenous, or exogenous. Cardiac SPEs are the most common.We conducted a retrospective analysis of 20 patients with cardiac SPE hospitalized between 1991 and 2013 at a Chinese tertiary referral hospital.The study included 14 males and 6 females with a median age of 38.1 years. Fever (100%), cough (95%), hemoptysis (80%), pleuritic chest pain (80%), heart murmur (80%), and moist rales (75%) were common clinical manifestations. Most patients had a predisposing condition: congenital heart disease (8 patients) and an immunocompromised state (5 patients) were the most common. Staphylococcal (8 patients) and Streptococcal species (4 patients) were the most common causative pathogens. Parenchymal opacities, nodules, cavitations, and pleural effusions were the most common manifestations observed via computed tomography (CT). All patients exhibited significant abnormalities by echocardiography, including 15 patients with right-sided vegetations and 4 with double-sided vegetations. All patients received parenteral antimicrobial therapy as an initial treatment. Fourteen patients received cardiac surgery, and all survived.Among the 6 patients who did not undergo surgery, only 1 survived. Most patients in our cardiac SPE cohort had predisposing conditions. Although most exhibited typical clinical manifestations and radiography, they were nonspecific. For suspected cases of SPE, blood culture, echocardiography, and CT pulmonary angiography (CTPA) are important measures to confirm an early diagnosis. Vigorous early therapy, including appropriate antibiotic treatment and timely cardiac surgery to eradicate the infective source, is critical. PMID:27336870

  11. Retention of retrospective print journals in the digital age: trends and analysis

    PubMed Central

    Kaplan, Richard; Steinberg, Marilyn; Doucette, Joanne

    2006-01-01

    Purpose: The issue of retaining retrospective print journals is examined in light of the shift to electronic titles, the reallocation of library budgets from print to electronic, and the changing research practices of today's library users. This article also examines the evolving role of the physical library and its impact on space allocation. Methods: To determine current practice and opinion, a survey of health sciences librarians and academic librarians was conducted. To demonstrate the use patterns of older journal issues, citation analyses and interlibrary loan statistics were examined. Results: All methods indicate that recent material is accessed more frequently than older material, with a significant drop in use of materials greater than 15 years old. Materials greater than 20 years old constituted less than 5% of interlibrary loans and less than 9% of articles noted in the citation analysis. Conclusions: It is possible to eliminate older years of a print journal collection without a large impact on the needs of researchers. Librarians' preference to maintain full runs of journal titles may be motivated by reasons outside of actual usage or patrons needs. PMID:17082829

  12. Annual performance appraisal: one organization's process and retrospective analysis of outcomes.

    PubMed

    Geddes, E Lynne; Gill, Caroline

    2012-01-01

    Performance assessment of personnel is an important component of an organization's quality management program, benefiting the organization, individuals and clients. Performance appraisal is the most common method. This article describes the three-part performance appraisal tool used at the authors' organization, a private inter-professional healthcare agency providing rehabilitation services to clients in the community, and presents the results of a retrospective analysis of the outcomes. Performance appraisals of 13 personnel were randomly selected, representing 39 chart audits and 25 joint client visits. The achievement of mandatory chart audit standards demonstrated 95 ± 7.2% compliance; expected standards showed 96 ± 3.3% compliance. Qualitative findings from the joint visits and interviews showed that therapists enjoyed the process and experience, valued the feedback and appreciated the support they received. Benefits and challenges of the process were identified, resulting in new initiatives being implemented. The authors confirmed that the tool achieves its intended purpose and is relevant in the home care setting. PMID:22354057

  13. Parents were accurate proxy reporters of urgent pediatric asthma health services—a retrospective agreement analysis

    PubMed Central

    Ungar, Wendy J.; Davidson-Grimwood, Sara R.; Cousins, Martha

    2016-01-01

    Objective To assess agreement between parents’ proxy reports of children’s respiratory-related health service use and administrative data. Study Design and Setting A retrospective analysis of statistical agreement between clinical and claims data for reports of physician visits, emergency department (ED) visits, and hospitalizations in 545 asthmatic children recruited from sites in the greater Toronto area was conducted. Health services use data were extracted from the Ontario Health Insurance Plan and Canadian Institute for Health Information databases for each child for the interval coinciding with the proxy report for each health service type. Results Agreement between administrative data and respondent reports (n =545) was substantial for hospitalizations in the past year (κ =0.80 [0.74, 0.86]), moderate for ED visits in the past year (κ =0.60 [0.53, 0.67]), and slight for physician visits (κ =0.13 [0.00, 0.27]) in the past 6 months. Income, parent’s education, and child quality-of-life symptom scores did not affect agreement. Agreement for ED visits was significantly higher (P <0.05) for children who had an asthma attack in the past 6 months (κ =0.61 [0.54, 0.68]) compared to children who did not (κ =0.25 [0.00, 0.59]). Conclusion Parents of asthmatic children are reliable reporters of their child’s respiratory-related urgent health services utilization. PMID:17938060

  14. Cardiac Arrests in Patients Undergoing Gastrointestinal Endoscopy: A Retrospective Analysis of 73,029 Procedures

    PubMed Central

    Goudra, Basavana; Nuzat, Ahmad; Singh, Preet M.; Gouda, Gowri B.; Carlin, Augustus; Manjunath, Amit K.

    2015-01-01

    Background/Aims: Airway difficulties leading to cardiac arrest are frequently encountered during propofol sedation in patients undergoing gastrointestinal (GI) endoscopy. With a noticeable increase in the use of propofol for endoscopic sedation, we decided to examine the incidence and outcome of cardiac arrests in patients undergoing gastrointestinal (GI) endoscopy with sedation. Patients and Methods: In this retrospective study, cardiac arrest data obtained from the clinical quality improvement and local registry over 5 years was analyzed. The information of patients who sustained cardiac arrest attributable to sedation was studied in detail. Analysis included comparison of cardiac arrests due to all causes until discharge (or death) versus the cardiac arrests and death occurring during the procedure and in the recovery area. Results: The incidence of cardiac arrest and death (all causes, until discharge) was 6.07 and 4.28 per 10,000 in patients sedated with propofol, compared with non–propofol-based sedation (0.67 and 0.44). The incidence of cardiac arrest during and immediately after the procedure (recovery area) for all endoscopies was 3.92 per 10,000; of which, 72% were airway management related. About 90.0% of all peri-procedural cardiac arrests occurred in patients who received propofol. Conclusions: The incidence of cardiac arrest and death is about 10 times higher in patients receiving propofol-based sedation compared with those receiving midazolam–fentanyl sedation. More than two thirds of these events occur during EGD and ERCP. PMID:26655137

  15. Intensive care management of children intubated for croup: a retrospective analysis.

    PubMed

    Gelbart, B; Parsons, S; Sarpal, A; Ninova, P; Butt, W

    2016-03-01

    Croup remains the commonest reason for acute upper airway obstruction in children, yet there are scarce contemporary data of airway management in those requiring intubation. We performed a retrospective analysis of the intensive care management of children intubated for croup in two quaternary Paediatric Intensive Care Units: Royal Children's Hospital Melbourne, Australia and Alberta Children's Hospital Calgary, Canada. Patients intubated for less than three days were compared with those intubated for greater than three days. Patients less than 10 kg body weight were compared to those greater than 10 kg. Demographic, clinical and microbiological data were recorded. Seventy-seven cases of croup requiring intubation were identified. The median duration of intubation was 60 hours. Parainfluenza was the most common viral aetiology, detected in 30% of cases. Antibiotics were prescribed in 51% of patients. Corticosteroids were prescribed pre intubation in two-thirds of patients and all post intubation, with the median dose being prednisolone 3 mg/kg/day. Primary extubation failure occurred in 6.5% of patients. Neither the duration of intubation nor patient size were associated with extubation failure. An air leak test was performed in 69% of patients and poorly predicted extubation success. One non-urgent tracheostomy was performed and there was one death from hypoxic ischaemic encephalopathy. Endotracheal tube leak is poorly recorded and may not predict successful extubation. PMID:27029657

  16. Dysplastic versus proliferative CMML--a retrospective analysis of 91 patients from a single institution.

    PubMed

    Nösslinger, T; Reisner, R; Grüner, H; Tüchler, H; Nowotny, H; Pittermann, E; Pfeilstöcker, M

    2001-09-01

    In chronic myelomonocytic leukemia (CMML) segregation of two subtypes has been suggested depending on WBC count-myelodysplastic (MD-CMML) and myeloproliferative (MP-CMML). In a retrospective analysis of 91 (60/31) previously untreated CMML patients, we compared the presenting clinical, haematological, laboratory and bone marrow features and examined the clinical impact of this reclassification. LDH values and bone marrow cellularity were significantly increased in MP-CMML. Median survival was significantly longer for patients with MD-CMML, progression rate was higher for MP-CMML. Patients with MD-CMML had longer median preleukemic duration; after transition to AML, MP-CMML patients had longer median survival. In MDS phase anemia was more common in MP-CMML and thrombocytopenia more common in MD-CMML whereas transfusion rates showed no difference. Evaluation of prognostic scoring systems for both groups confirmed that patients' characteristics and outcome could be well compared. Our data suggest that segregation into MD-CMML and MP-CMML is justified. PMID:11489467

  17. Results of radiotherapy in recurrent endometrial carcinoma: A retrospective analysis of 51 patients

    SciTech Connect

    Kuten, A.; Grigsby, P.W.; Perez, C.A.; Fineberg, B.; Garcia, D.M.; Simpson, J.R.

    1989-07-01

    A retrospective analysis was performed of 51 patients with locoregional recurrence of endometrial carcinoma, treated by radiotherapy between 1959 and 1986. There were 17 patients (33%) with isolated vaginal recurrence, 12 patients (24%) with vaginal recurrence with pelvic extension, 7 patients (14%) with pelvic recurrence only, and 15 patients (29%) with simultaneous locoregional and distant failure. Eighty percent of the recurrences occurred within 3.5 years from primary treatment; time to relapse was shorter in patients with advanced-stage, high-grade malignancy at original diagnosis. Locoregional control was achieved in 18 patients (35%). Complete tumor regression in the vagina, irrespective of extravaginal pelvic disease status or distant metastasis, occurred in 28 of 34 patients with vaginal involvement (82%). The 5- and 10-year overall actuarial survivals for all patients were 18 and 12.5%, respectively. The 5- and 10-year progression-free survivals of patients with isolated vaginal recurrences were 40% and 29%, respectively; the 5-year progression-free survival of patients with vaginal recurrence with pelvic extension was 20%. There were no survivors beyond 1.5 years among patients with pelvic recurrence (p = 0.02). All patients with simultaneous locoregional and distant failure were dead by 3.5 years. Stage at original diagnosis, time to relapse from primary treatment, histologic pattern, and grade of malignancy were prognosticators of survival. Five patients (10%) developed a total of ten radiation-related sequelae.

  18. Cost and resource utilization in cervical cancer management: a real-world retrospective cost analysis

    PubMed Central

    Cromwell, I.; Ferreira, Z.; Smith, L.; van der Hoek, K.; Ogilvie, G.; Coldman, A.; Peacock, S.J.

    2016-01-01

    Objectives We set out to assess the health care resource utilization and cost of cervical cancer from the perspective of a single-payer health care system. Methods Retrospective observational data for women diagnosed with cervical cancer in British Columbia between 2004 and 2009 were analyzed to calculate patient-level resource utilization patterns from diagnosis to death or 5-year discharge. Domains of resource use within the scope of this cost analysis were chemotherapy, radiotherapy, and brachytherapy administered by the BC Cancer Agency; resource utilization related to hospitalization and outpatient visits as recorded by the B.C. Ministry of Health; medically required services billed under the B.C. Medical Services Plan; and prescriptions dispensed under British Columbia’s health insurance programs. Unit costs were applied to radiotherapy and brachytherapy, producing per-patient costs. Results The mean cost per case of treating cervical cancer in British Columbia was $19,153 (standard error: $3,484). Inpatient hospitalizations, at 35%, represented the largest proportion of the total cost (95% confidence interval: 32.9% to 36.9%). Costs were compared for subgroups of the total cohort. Conclusions As health care systems change the way they manage, screen for, and prevent cervical cancer, cost-effectiveness evaluations of the overall approach will require up-to-date data for resource utilization and costs. We provide information suitable for such a purpose and also identify factors that influence costs. PMID:26985142

  19. Deterioration of marble. A retrospective analysis of tombstone measurements in the New York City area

    SciTech Connect

    Husar, R.B.; Patterson, D.E.; Baer, N.S.

    1985-03-01

    A data base of tombstone thickness and depth of emblem inscription at Veterans Administration cemeteries has been compiled by New York University. A subset of measurements for two cemeteries in the vicinity of New York City was selected for analysis in this study. For comparable meteorological conditions, different weathering rates of fine grain marble tombstones were observed for the two cemeteries. Tombstones in the Cypress Hills cemetery, which is located within an industrial area, were observed to have higher rates than similar stones in the semi-rural area of the Long Island cemetery. By using a retrospective air-quality model, which is described in another publication, to predict SO/sub 2/ concentrations in New York City from 1880 to 1980, concentration trends of SO/sub 2/ were estimated for both cemeteries. A linear relationship was found to exist between the weathering rates and estimated SO/sub 2/ concentrations. A value of 10 mm per century per ppm of SO/sub 2/ was derived as the best estimate for the weathering coefficient of fine grain marble for the New York City area.

  20. Surgical treatment of synchronous multiple primary lung cancers: a retrospective analysis of 122 patients

    PubMed Central

    Liu, Ming; He, Wenxin; Yang, Jie

    2016-01-01

    Background Synchronous multiple primary lung cancers (SMPLC) become more common in clinical practice. To identify factors attributed to SMPLC treatment outcomes, we have reviewed our experiences with surgical resections of SMPLC and analyzed the treatment outcomes in this paper. Methods We retrospectively analyzed clinical characteristics and treatment outcomes of patients who have been diagnosed as SMPLC and underwent surgical resection between 1990 and 2010. Based on EGFR and KRAS mutations, we identified 27 cases as SMPLC out of 50 cases, which were difficult to distinguish primary lung cancers from metastases. A total of 265 tumors from 122 patients were studied. Results The 5-year survival rate for all patients was 40.5%. There was a significant difference in the 5-year survival between smokers and never-smokers (30.8% vs. 55.6%, P=0.011). Survival rate was also different between patients with same tumor histology and those with different tumor histology (46.9% vs. 24.8%, P=0.036). In addition, Solid nodule and pneumonectomy were associated with the worse survival (P=0.026, P=0.030). Multivariable analysis identified smoking status, stage, lymph node metastasis and pneumonectomy as significant independent predictive factors for overall survival. Conclusions Surgical treatment is a safe approach for patients with SMPLC; pneumonectomy should be avoided as far as possible given the poor prognosis. Mutational status of EGFR and KRAS may be advocated as a diagnostic criteria of synchronous lung cancer rather metastasis mainly in case of adenocarcinoma histology.

  1. Retrospective analysis of bottlenose dolphin foraging: a legacy of anthropogenic ecosystem disturbance

    USGS Publications Warehouse

    Rossman, Sam; Barros, Nélio B.; Ostrom, Peggy H.; Stricker, Craig A.; Hohn, Aleta A.; Gandhi, Hasand; Wells, Randall S.

    2013-01-01

    We used stable isotope analysis to investigate the foraging ecology of coastal bottlenose dolphins (Tursiops truncatus) in relation to a series of anthropogenic disturbances. We first demonstrated that stable isotopes are a faithful indicator of habitat use by comparing muscle isotope values to behavioral foraging data from the same individuals. δ13C values increased, while δ34S and δ15N values decreased with the percentage of feeding observations in seagrass habitat. We then utilized stable isotope values of muscle to assess temporal variation in foraging habitat from 1991 to 2010 and collagen from tooth crown tips to assess the time period 1944 to 2007. From 1991 to 2010, δ13C values of muscle decreased while δ34S values increased indicating reduced utilization of seagrass habitat. From 1944 to 1989 δ13C values of the crown tip declined significantly, likely due to a reduction in the coverage of seagrass habitat and δ15N values significantly increased, a trend we attribute to nutrient loading from a rapidly increasing human population. Our results demonstrate the utility of using marine mammal foraging habits to retrospectively assess the extent to which anthropogenic disturbance impacts coastal food webs.

  2. HER2 status in advanced gastric carcinoma: A retrospective multicentric analysis from Sicily

    PubMed Central

    IENI, A.; BARRESI, V.; GIUFFRÈ, G.; CARUSO, R.A.; LANZAFAME, S.; VILLARI, L.; SALOMONE, E.; ROZ, E.; CABIBI, D.; FRANCO, V.; CERTO, G.; LABATE, A.; NAGAR, C.; MAGLIOLO, E.; BROGGI, B.; FAZZARI, C.; ITALIA, F.; TUCCARI, G.

    2013-01-01

    According to the ToGA trial, HER2 has been shown to be predictive for the success of treatment with trastuzumab in advanced gastric cancer (AGC). A number of studies have analyzed HER-2/neu overexpression in gastric carcinoma and identified the rate of HER2 positivity to be markedly varied. To date, the prevalence of HER2 overexpression in Sicilian people with AGC is unknown. Therefore, in the present study, a retrospective immunohistochemical analysis of HER2 was performed in a cohort of 304 AGC samples that were obtained from the archives of 10 Sicilian anatomopathological diagnostic units in order to verify the positive rate of HER2-positive cases. Furthermore, the characteristics of histotype, grade, stage and Ki-67 expression were also analyzed. HER2 overexpression was encountered in 17.43% of all the gastric adenocarcinomas, which was consistent with the results that have been reported elsewhere in the literature. A progressive increase in HER2 overexpression was observed, from the poorly cohesive histotype to the tubular adenocarcinomas and gastric hepatoid adenocarcinomas. HER2 overexpression was significantly associated with a high grade, advanced stage and high Ki-67 labeling index. Further investigations performed jointly by pathologists and oncologists within the geographical area of the present study should confirm that the association of trastuzumab with chemotherapy results in an improvement of survival in patients with AGC. PMID:24260051

  3. Role of Ki-67 in acromegalic patients with hyperprolactinemia: retrospective analysis in 61 Chinese Patients.

    PubMed

    Huan, Cheng; Cui, Guihua; Lu, Chao; Qu, Xin; Han, Tao

    2015-03-01

    To evaluate the specific characteristics in acromegalic patients with hyperprolactinemia by analyzing the differences between patients with different Ki-67 values. Between 2002 and 2010, a set of data on 61 patients undergoing transsphenoidal surgery was available at the Department of Neurosurgery, Provincial Hospital Affiliated to Shandong University. Patients were divided into Ki-67 >3% group and <3% group. A retrospective analysis of clinical, hormonal, immunohistochemical, and imaging was observed in all patients. There were no significant differences in age, gender, tumor size and apoplexy between the two groups. Time interval in Ki-67 ≥3% group was longer than <3% group (P=0.037). Patients in Ki-67 >3% group had a higher rate of invasiveness (P=0.048), higher incidences of diabetes mellitus (P=0.036), coarse facial features (P=0.048), large hands and feet (P=0.003), higher GH levels (P<0.05), higher diabetes insipidus rate (P<0.001), and more frequent recurrence (P=0.011) than Ki-67 <3% group. Patients with higher Ki-67 value harbored longer time interval, more aggressive tumors, more acromegaly manifestations, higher GH level, and higher recurrence than patients with lower Ki-67 value. PMID:25796164

  4. Gandhi and Mao on manual labour in the school: A retrospective analysis

    NASA Astrophysics Data System (ADS)

    Zachariah, Mathew; Hoffman, Arlene

    1985-12-01

    Mahatma Gandhi's views on relating the world of formal education to the world of work were developed first in his experimental `Tolstoy Farm' in South Africa. On his return to India, Gandhi insisted that a required manual labour component in the curriculum would help regenerate India's village economy, develop in India's children a deeper understanding of India's cultural roots, motivate children to relate `book learning' to life in society, and destroy invidious caste distinctions. The major proposals and suggestions in Gandhi's writing will be discussed in the context of his hopes for using schooling as an agent of progress in India. Mao Ze-Dong's views, on the other hand, were developed in the context of his Yenan experience in the 1930s, i.e. the decision to consolidate a power base in the interior of China before waging a class war against the landlords and capitalists of China. Mao's views were also, to some extent, rooted in the Chinese reality of stagnant, poverty-stricken rural areas. But, Mao's writings indicate that Marxist hopes to relate theory and practice (as understood in dialectical materialism) and to ensure that everyone participated in mental as well as manual labour in a socialist society had led him to formulate his proposals. Both Gandhi's and Mao's views and proposals have been more or less abandoned in India and China respectively. The similar and dissimilar reasons which led to such a fate are examined in this retrospective analysis.

  5. Comparative analysis of carrier-based obturation and lateral compaction: a retrospective clinical outcomes study.

    PubMed

    Hale, Robert; Gatti, Robert; Glickman, Gerald N; Opperman, Lynne A

    2012-01-01

    The purpose of this retrospective study was to compare the outcome of primary endodontic treatment using a standardized cleaning and shaping technique and obturation with either lateral compaction or carrier-based obturation. Patients received primary endodontic treatment in the predoctoral dental clinic using a standardized cleaning and shaping protocol. All root canals were obturated using AH Plus(TM) sealer with lateral compaction of gutta-percha (LC) or carrier-based obturation (CBO). A total of 205 cases met the inclusion criteria. 71 teeth in 60 patients were recalled after 2 years and evaluated both clinically and radiographically by two independent examiners. Success was defined as a lack of clinical symptoms and a normal periodontal ligament space or reduction in size of a previously existing periapical radiolucency. Chi-square and logistic regression were used for statistical analysis with a significance level of P < 0.05. There was no difference in success rates between cases obturated with LC or CBO (P = 0.802); overall success rate was 83%. Molars had a significantly lower success rate (53%) than premolar and anterior teeth (89%) (P = 0.005), irrespective of the obturation technique used. When a standardized cleaning and shaping protocol was used by predoctoral dental students in a controlled university setting, there was no difference in success rates between cases obturated with LC or CBO. PMID:22567010

  6. [Change in procedure and re-osteosynthesis of the femur. Definition and retrospective analysis].

    PubMed

    Erhart, J; Mousavi, M; Schuster, R; Kolonja, A; Bockhorn, G; Vécsei, V

    2001-10-01

    The change of treatment modality in osteosynthesis is based on two principles. On one hand, one can exchange the implant as part of a two step procedure to reduce side effects of stabilizing fractures. On the other hand, a reosteosynthesis may be required for treatment of complications. A retrospective analysis was undertaken to differentiate the situation of indication, technique and results of patients with fractures of the femur. Indications for two step procedure of therapy at the femur are limited to fractures of polytraumatized patients and fractures with severe soft tissue damage. External fixator devices have been used for stabilization of long bone fractures with severe soft tissue damage using the two step procedure in the past decades; nowadays unreamed nailing is commonly preferred. Reosteosynthesis may be appropriate for the treatment of failing of osteosynthesis; they can also be used due to delayed union or nonunion of fractures, osseous deficiency or infection. In the case of failing osteosynthesis, the reasons for failing have to be studied thoroughly and a variety of subsequent procedures has to be taken into consideration for successful treatment. PMID:11699307

  7. Prevention options for ventriculoperitoneal shunt infections: a retrospective analysis during a five-year period

    PubMed Central

    Wu, Xing; Liu, Qin; Jiang, Xiaofei; Zhang, Tao

    2015-01-01

    Shunt infection is the most common and dreaded complication in patients with hydrocephalus. For the purpose of reducing the high morbidity and mortality, how to prevent is a vital step. A retrospective analysis of 384 CSF cerebrospinal fluid (CSF) shunt procedures was undertaken from 2006 to 2010 in our neurosurgery department. Infection diagnosis was established by subjecting the CSF to biochemical and microbiological parameters. The patients’ demographic and clinical characteristics, various treatment procedures and outcome were evaluated. The infection rate of ventriculoperitoneal (VP) shunt was 12.5% in 2006, which dropped to 2% and stabilized at lower level from 2008. The most common causes of hydrocephalus were traumatic injury and brain tumor. Fever and consciousness disturbance were the major clinical symptoms. Gram-negative rods episodes was the most frequently isolated microorganisms accounting for 58%, followed by S. aureus , S. epidermidis and Staphylococcus haemolyticus. With the removal of shunt and intravenous antibiotics therapy, 82% of the patients survived. Majority of the isolates were sensitive to the carbopenem antibiotics and vancomycin. The mean length of hospital stay was 47 days. Prompt shunt removal and perioperative antibiotic prophylaxis seems to be essential for the survival of patients with VP shunt infection. PMID:26770643

  8. Are Meteorological Parameters a Risk Factor for Pulmonary Embolism? A Retrospective Analysis of 530 Patients

    PubMed Central

    Anar, Ceyda; İnal, Tuba; Erol, Serhat; Polat, Gülru; Ünsal, İpek; Ediboğlu, Özlem; Halilçolar, Hüseyin

    2015-01-01

    Background: The influence of meteorological conditions on cardiovascular morbidity and mortality has been known for a long time. However, few reports have been published on the influence of meteorological parameters on the occurrence of acute pulmonary embolism (PE). Aims: In this retrospective study, we compared the meteorological parameters between PE patients with risk factors and idiopathic PE patients. Study Design: Cross-sectional study. Methods: Medical documentation of 1180 patients with suspected acute pulmonary embolism diagnosed between January 2010 and December 2012 was retrospectively analyzed. A total of 530 patients with PE confirmed by computed tomography pulmonary angiography and/or ventilation/perfusion scan were included for further analysis. We divided the patients into two groups: PE with risk factors (provoked) and PE without risk factors (unprovoked). The meteorological data were collected from the relevant time period: temperature, humidity, pressure, and wind velocity. As the exact time of PE onset was unknown, the meteorological values attributed to each patient were the means of the values in the months or weeks at the time of diagnosis of PE. Results: The highest numbers of cases were seen in autumn (29.8%), followed by summer (28.9%), spring (22.1%), and winter (19.2%). In terms of months, the greatest number of cases occurred in June (57), followed by November (56) and October (54). Case distribution according to the months and seasons were statistically significant. The wind direction also affected the incidence of PE. There was a statistically significant positive correlation between case frequency and air temperature (r=0.300; p=0.031). No correlation was found between the unprovoked PE cases’ monthly distribution and pressure, humidity, or temperature. However, there was a statistically significant positive correlation between the monthly distribution of the group with provoked PE cases and air temperature (r=0.586; p=0

  9. A retrospective analysis of hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis

    PubMed Central

    Yuan, Meiqin; Wang, Zeng; Hu, Guinv; Yang, Yunshan; Lv, Wangxia; Lu, Fangxiao; Zhong, Haijun

    2016-01-01

    Peritoneal metastasis (PM) is a poor prognostic factor in patients with gastric cancer. The aim of this study was to evaluate the efficacy and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced gastric cancer with PM by retrospective analysis. A total of 54 gastric cancer patients with positive ascitic fluid cytology were included in this study: 23 patients were treated with systemic chemotherapy combined with HIPEC (HIPEC+ group) and 31 received systemic chemotherapy alone (HIPEC- group). The patients were divided into 4 categories according to the changes of ascites, namely disappear, decrease, stable and increase. The disappear + decrease rate in the HIPEC+ group was 82.60%, which was statistically significantly superior to that of the HIPEC- group (54.80%). The disappear + decrease + stable rate was 95.70% in the HIPEC+ group and 74.20% in the HIPEC- group, but the difference was not statistically significant. In 33 patients with complete survival data, including 12 from the HIPEC+ and 21 from the HIPEC- group, the median progression-free survival was 164 and 129 days, respectively, and the median overall survival (OS) was 494 and 223 days, respectively. In patients with ascites disappear/decrease/stable, the OS appeared to be better compared with that in patients with ascites increase, but the difference was not statistically significant. Further analysis revealed that patients with controlled disease (complete response + partial response + stable disease) may have a better OS compared with patients with progressive disease, with a statistically significant difference. The toxicities were well tolerated in both groups. Therefore, HIPEC was found to improve survival in advanced gastric cancer patients with PM, but the difference was not statistically significant, which may be attributed to the small number of cases. Further studies with larger samples are required to confirm our data. PMID:27446587

  10. Retrospective analysis of changing characteristics of treatment-seeking smokers: implications for further reducing smoking prevalence

    PubMed Central

    Leyro, Teresa M; Crew, Erin E; Bryson, Susan W; Lembke, Anna; Bailey, Steffani R; Prochaska, Judith J; Henriksen, Lisa; Fortmann, Stephen P; Killen, Joel D; Killen, Diana T; Hall, Sharon M; David, Sean P

    2016-01-01

    Objective The goal of the current study was to empirically compare successive cohorts of treatment-seeking smokers who enrolled in randomised clinical trials in a region of the USA characterised by strong tobacco control policies and low smoking prevalence, over the past three decades. Design Retrospective treatment cohort comparison. Setting Data were collected from 9 randomised clinical trials conducted at Stanford University and the University of California, San Francisco, between 1990 and 2013. Participants Data from a total of 2083 participants were included (Stanford, n=1356; University of California San Francisco, n=727). Primary and secondary outcomes One-way analysis of variance and covariance, χ2 and logistic regression analyses were used to examine relations between nicotine dependence, cigarettes per day, depressive symptoms and demographic characteristics among study cohorts. Results Similar trends were observed at both settings. When compared to earlier trials, participants in more recent trials smoked fewer cigarettes, were less nicotine-dependent, reported more depressive symptoms, were more likely to be male and more likely to be from a minority ethnic/racial group, than those enrolled in initial trials (all p's<0.05). Analysis of covariances revealed that cigarettes per day, nicotine dependence and current depressive symptom scores were each significantly related to trial (all p's<0.001). Conclusions Our findings suggest that more recent smoking cessation treatment-seeking cohorts in a low prevalence region were characterised by less smoking severity, more severe symptoms of depression and were more likely to be male and from a minority racial/ethnic group. PMID:27357195

  11. Trends in colorectal cancer mortality in Europe: retrospective analysis of the WHO mortality database

    PubMed Central

    Ait Ouakrim, Driss; Pizot, Cécile; Boniol, Magali; Malvezzi, Matteo; Boniol, Mathieu; Negri, Eva; Bota, Maria; Jenkins, Mark A; Bleiberg, Harry

    2015-01-01

    Objective To examine changes in colorectal cancer mortality in 34 European countries between 1970 and 2011. Design Retrospective trend analysis. Data source World Health Organization mortality database. Population Deaths from colorectal cancer between 1970 and 2011. Profound changes in screening and treatment efficiency took place after 1988; therefore, particular attention was paid to the evolution of colorectal cancer mortality in the subsequent period. Main outcomes measures Time trends in rates of colorectal cancer mortality, using joinpoint regression analysis. Rates were age adjusted using the standard European population. Results From 1989 to 2011, colorectal cancer mortality increased by a median of 6.0% for men and decreased by a median of 14.7% for women in the 34 European countries. Reductions in colorectal cancer mortality of more than 25% in men and 30% in women occurred in Austria, Switzerland, Germany, the United Kingdom, Belgium, the Czech Republic, Luxembourg, and Ireland. By contrast, mortality rates fell by less than 17% in the Netherlands and Sweden for both sexes. Over the same period, smaller or no declines occurred in most central European countries. Substantial mortality increases occurred in Croatia, the former Yugoslav republic of Macedonia, and Romania for both sexes and in most eastern European countries for men. In countries with decreasing mortality, reductions were more important for women of all ages and men younger than 65 years. In the 27 European Union member states, colorectal cancer mortality fell by 13.0% in men and 27.0% in women, compared with corresponding reductions of 39.8% and 38.8% in the United States. Conclusion Over the past 40 years, there has been considerable disparity in the level of colorectal cancer mortality between European countries, as well as between men and women and age categories. Countries with the largest reductions in colorectal cancer mortality are characterised by better accessibility to screening

  12. Prognostic factors and scoring systems in chronic myelomonocytic leukemia: a retrospective analysis of 213 patients.

    PubMed

    Onida, Francesco; Kantarjian, Hagop M; Smith, Terry L; Ball, Greg; Keating, Michael J; Estey, Elihu H; Glassman, Armand B; Albitar, Maher; Kwari, Monica I; Beran, Miloslav

    2002-02-01

    Chronic myelomonocytic leukemia (CMML) is a hematologic malignancy characterized by wide heterogeneity of clinical presentation and course. CMML shares myelodysplastic characteristics with features of myeloproliferative disorders. No treatment has proven effective in modifying the natural course of the disease. To improve the prognostic assessment of clinical outcome, the associations of patient and disease characteristics with survival times of 213 patients with CMML was investigated retrospectively. Median survival was 12 months. Univariate analysis identified low hemoglobin level; low platelet count; high white blood cell, monocyte, and lymphocyte counts; presence of circulating immature myeloid cells, high percentage of marrow blasts, low percentage of marrow erythroid cells, abnormal cytogenetics, and high levels of serum lactate dehydrogenase and beta(2)-microglobulin as characteristics associated with shorter survival. Hemoglobin level below 120 g/L (12 g/dL), presence of circulating immature myeloid cells, absolute lymphocyte count above 2.5 x 10(9)/L, and marrow blasts 10% or more were independently associated with shorter survival by multivariate analysis and were used to generate a prognostic score. The model identified 4 subgroups of patients with median survival of 24, 15, 8, and 5 months for low, intermediate-1, intermediate-2, and high risk, respectively. Researchers could not confer objective evidence suggesting that arbitrary divisions of CMML by white blood cell counts into "dysplastic" and "proliferative" categories reflect clinical entities differing in the risk of acute leukemia development, although a trend of shorter survival in patients with leukocytosis was observed. The prognostic model was compared with 6 previously published scoring systems for myelodysplastic syndrome/CMML. The reported results should provide an improved assessment of prognosis in CMML. PMID:11806985

  13. The Capsaicin 8% Patch for Neuropathic Pain in Clinical Practice: A Retrospective Analysis

    PubMed Central

    Wagner, Till; Poole, Chris; Roth-Daniek, Andrea

    2013-01-01

    Objective To investigate the response of patients with peripheral neuropathic pain (PNP) to capsaicin 8% patch treatment in a clinical setting. Design Retrospective analysis. Setting The Clinic for Pain Therapy and Palliative Medicine at the Medical Centre for the region of Aachen, Germany. Subjects Patients diagnosed with PNP who attended the clinic for capsaicin 8% patch treatment between January 13, 2010 and February 7, 2011. Outcome Measures Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS) at baseline and following each capsaicin 8% patch treatment. Changes in prescribed concomitant neuropathic pain (NP) medications and response duration were recorded. Results Overall, 68 patients with PNP conditions, including facial neuropathy (severe trigeminal neuralgia in V2), polyneuropathy, post-herpetic neuralgia, and mononeuropathies, received 96 treatments with the capsaicin 8% patch. The 53 patients with a follow-up of ≥8 weeks demonstrated a 48.4% mean reduction in NPRS score from baseline to Weeks 1–8. Among the 37 responders (those exhibiting ≥30% reduction in NPRS score from baseline to Weeks 1–8), the median time to re-treatment was 125 days. Following treatment, there was a significant (P < 0.001) 54% reduction in the mean number of prescribed concomitant NP medications taken by patients. Conclusions This analysis demonstrates that in clinical practice, the capsaicin 8% patch provides rapid and sustained pain reductions in patients with a variety of PNP conditions and a significant reduction in prescribed concomitant NP medications. The capsaicin 8% patch can be a valuable addition to the NP treatment armory for certain patients. PMID:23710678

  14. NASA Life Sciences Data Repositories: Tools for Retrospective Analysis and Future Planning

    NASA Technical Reports Server (NTRS)

    Thomas, D.; Wear, M.; VanBaalen, M.; Lee, L.; Fitts, M.

    2011-01-01

    As NASA transitions from the Space Shuttle era into the next phase of space exploration, the need to ensure the capture, analysis, and application of its research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP) based at NASA s Johnson Space Center (JSC) recognizes the need to extract the greatest possible amount of information from the data already captured, as well as focus current and future research funding on addressing the HRP goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. To this end, the Science Management Office and the Medical Informatics and Health Care Systems Branch within the HRP and the Space Medicine Division have been working to make both research data and clinical data more accessible to the user community. The Life Sciences Data Archive (LSDA), the research repository housing data and information regarding the physiologic effects of microgravity, and the Lifetime Surveillance of Astronaut Health (LSAH-R), the clinical repository housing astronaut data, have joined forces to achieve this goal. The task of both repositories is to acquire, preserve, and distribute data and information both within the NASA community and to the science community at large. This is accomplished via the LSDA s public website (http://lsda.jsc.nasa.gov), which allows access to experiment descriptions including hardware, datasets, key personnel, mission descriptions and a mechanism for researchers to request additional data, research and clinical, that is not accessible from the public website. This will result in making the work of NASA and its partners available to the wider sciences community, both domestic and international. The desired outcome is the use of these data for knowledge discovery, retrospective analysis, and planning of future

  15. Retrospective analysis of 140 cases of medullary thyroid carcinoma followed-up in a single institution

    PubMed Central

    SIMÕES-PEREIRA, JOANA; BUGALHO, MARIA JOÃO; LIMBERT, EDWARD; LEITE, VALERIANO

    2016-01-01

    Familial cases of medullary thyroid carcinoma (MTC) may be diagnosed by genetic screening, while in sporadic tumors the diagnosis relies mainly on fine-needle aspiration cytology. The aim of the present study was to determine the demographic, clinical and pathological characteristics of MTC patients followed-up at the Portuguese Institute of Oncology Francisco Gentil (Lisbon, Portugal). For that purpose, a retrospective analysis of 140 MTC patients diagnosed between 1990 and 2010 was performed. The results indicated that patients with hereditary MTC (11.4%) were significantly younger than patients with sporadic MTC. Of the latter, 34.3% had no clinical suspicion of MTC prior to surgery. The sensitivity of cytology and calcitonin (CT) assay in diagnosing MTC were 51.3 and 98.7%, respectively. All familial index cases and 69.0% of sporadic cases presented with advanced stage disease at the time of diagnosis, while 73.0% of familial MTC detected by genetic/pentagastrin screening were diagnosed at the early stage of the disease. Biochemical cure (BC) was achieved in 39.7% of patients and, of these, only 6.5% relapsed. The 5 and 10-year survival rates were 79.3 and 73.6%, respectively. Age >45 years (P=0.026), advanced stage at diagnosis (P<0.001) and absence of BC (P<0.001) were predictors of a worse prognosis on univariate analysis. However, when the patients detected by genetic/pentagastrin screening were excluded from the analysis, age was no longer a prognostic factor, although disease stage remained a significant prognostic factor. On multivariate analysis, BC was the only factor with a significant impact on prognosis (P=0.031). In addition, the present study confirmed that the majority of patients were diagnosed at advanced stages, and CT determination was observed to be more sensitive than cytology to diagnose MTC. Patients at early stages were more prone to achieve BC, which was a favorable prognostic factor. To the best of our knowledge, the present study

  16. Long-term survival after resection of pancreatic cancer: A single-center retrospective analysis

    PubMed Central

    Yamamoto, Takehito; Yagi, Shintaro; Kinoshita, Hiromitsu; Sakamoto, Yusuke; Okada, Kazuyuki; Uryuhara, Kenji; Morimoto, Takeshi; Kaihara, Satoshi; Hosotani, Ryo

    2015-01-01

    AIM: To retrospectively analyze factors affecting the long-term survival of patients with pancreatic cancer who underwent pancreatic resection. METHODS: From January 2000 to December 2011, 195 patients underwent pancreatic resection in our hospital. The prognostic factors after pancreatic resection were analyzed in all 195 patients. After excluding the censored cases within an observational period, the clinicopathological characteristics of 20 patients who survived ≥ 5 (n = 20) and < 5 (n = 76) years were compared. For this comparison, we analyzed the patients who underwent surgery before June 2008 and were observed for more than 5 years. For statistical analyses, the log-rank test was used to compare the cumulative survival rates, and the χ2 and Mann-Whitney tests were used to compare the two groups. The Cox-Hazard model was used for a multivariate analysis, and P values less than 0.05 were considered significant. A multivariate analysis was conducted on the factors that were significant in the univariate analysis. RESULTS: The median survival for all patients was 27.1 months, and the 5-year actuarial survival rate was 34.5%. The median observational period was 595 d. With the univariate analysis, the UICC stage was significantly associated with survival time, and the CA19-9 ≤ 200 U/mL, DUPAN-2 ≤ 180 U/mL, tumor size ≤ 20 mm, R0 resection, absence of lymph node metastasis, absence of extrapancreatic neural invasion, and absence of portal invasion were favorable prognostic factors. The multivariate analysis showed that tumor size ≤ 20 mm (HR = 0.40; 95%CI: 0.17-0.83, P = 0.012) and negative surgical margins (R0 resection) (HR = 0.48; 95%CI: 0.30-0.77, P = 0.003) were independent favorable prognostic factors. Among the 96 patients, 20 patients survived for 5 years or more, and 76 patients died within 5 years after operation. Comparison of the 20 5-year survivors with the 76 non-survivors showed that lower concentrations of DUPAN-2 (79.5 vs 312.5 U/mL, P

  17. Key trends in environmental advertising across 30 years in National Geographic magazine.

    PubMed

    Ahern, Lee; Bortree, Denise Sevick; Smith, Alexandra Nutter

    2013-05-01

    This longitudinal retrospective case study describes the sponsors, ad types, frames and message factors in green advertising over three decades in National Geographic magazine, the bellwether nature publication in the USA. In addition to providing a clearer picture of the extent and nature of environmental strategic messaging over three decades, results provide empirical support for theoretical relationships between the level of green advertising and economic indicators. After providing historical and theoretical context, detailed results are presented for both overall and longitudinal analysis. Limitations and implications for future research are discussed. PMID:23833111

  18. Retrospective Analysis of the Survival Benefit of Induction Chemotherapy in Stage IVa-b Nasopharyngeal Carcinoma

    PubMed Central

    Xiao, Yao; Tang, Jie; OuYang, Pu-Yun; Su, Zhen; Xie, Fang-Yun

    2016-01-01

    Purpose The value of adding induction chemotherapy to chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma (LA-NPC) remains controversial, yet high-risk patients with LA-NPC have poor outcomes after chemoradiotherapy. We aimed to assess the survival benefits of induction chemotherapy in stage IVa-b NPC. Patients and Methods A total of 602 patients with stage IVa-b NPC treated with intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy with or without induction chemotherapy were retrospectively analyzed. Overall survival (OS), locoregional relapse-free survival (LRFS), distant metastasis-free survival (DMFS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method, log-rank test and Cox regression analysis. Results In univariate analysis, 5-year OS was 83.2% for induction chemotherapy plus concurrent chemotherapy and 74.8% for concurrent chemotherapy alone, corresponding to an absolute risk reduction of 8.4% (P = 0.022). Compared to concurrent chemotherapy alone, addition of induction chemotherapy improved 5-year DMFS (83.2% vs. 74.4%, P = 0.018) but not 5-year LRFS (83.7% vs. 83.0%, P = 0.848) or PFS (71.9% vs. 66.0%, P = 0.12). Age, T category, N category, chemotherapy strategy and clinical stage were associated with 5-year OS (P = 0.017, P = 0.031, P = 0.007, P = 0.022, P = 0.001, respectively). In multivariate analysis, induction chemotherapy plus concurrent chemotherapy was an independent favorable prognostic factor for OS (HR, 0.62; 95% CI, 0.43–0.90, P = 0.012) and DMFS (HR, 0.57; 95% CI, 0.38–0.83, P = 0.004). In subgroup analysis, induction chemotherapy significantly improved 5-year DMFS in stage IVa (86.8% vs. 77.3%, P = 0.008), but provided no significant benefit in stage IVb. Conclusions In patients with stage IVa-b NPC treated with IMRT, addition of induction chemotherapy to concurrent chemotherapy significantly improved 5-year OS and 5-year DMFS. This study provides a basis for selection of

  19. Rabbit antithymocyte globulin versus horse antithymocyte globulin for treatment of acquired aplastic anemia: a retrospective analysis.

    PubMed

    Vallejo, Carlos; Montesinos, Pau; Polo, Marta; Cuevas, Beatriz; Morado, Marta; Rosell, Ana; Xicoy, Blanca; Díez, José L; Salamero, Olga; Cedillo, Ángel; Martínez, Pablo; Rayón, Consolación

    2015-06-01

    Studies comparing rabbit antithymocyte globulin (rATG) and horse ATG (hATG) in patients with aplastic anemia (AA) have shown conflicting results. These studies included fewer than 60 subjects in the rATG arm with relatively short follow-up. A total of 169 patients treated with rATG and 62 treated with hATG were included in this retrospective analysis, across 33 centers. Patients were treated with rATG or hATG plus cyclosporine A. Over half were classified, as having severe AA (SAA) or very severe AA (VSAA), and the mean follow-up was 45 months. There was no significant difference detected in cumulative response to treatment or survival between the rATG and hATG groups. The response to treatment was 63 % in the rATG group versus 66 % in the hATG group at 3 months. By 12 months, this pattern had reversed, and 84 % of rATG patients had responded to treatment versus 76 % in the hATG group (n.s.). Early mortality due to infection tended to be higher with rATG compared to hATG (n.s). rATG and hATG would seem to be therapeutically equivalent in SAA and VSAA. However, patients treated with rATG may take longer to respond than those treated with hATG and may also require more active prevention of early infections. PMID:25672649

  20. Hyaluronidase injection for the treatment of eyelid edema: a retrospective analysis of 20 patients

    PubMed Central

    2014-01-01

    Background Hyaluronidase (Hylase Dessau®) is a hyaluronic acid-metabolizing enzyme, which has been shown to loosen the extracellular matrix, thereby improving the diffusion of local anesthetics. Lower eyelid edema is a common post-interventional complication of cosmetic procedures performed in the lid region, such as the injection of hyaluronic acid fillers for tear-trough augmentation. The purpose of this study was to validate the efficacy of hyaluronidase in the management of lower eyelid edema. Methods We performed a retrospective analysis with 20 patients with lower eyelid edema. Most patients (n = 14) presented with edema following hyaluronic acid injection (tear-trough augmentation), whereas the minority (n = 6) were treated due to idiopathic edema (malar edema or malar mounds). Patients were treated by local infiltration of approximately 0.2 ml to 0.5 ml of hyaluronidase (Hylase Dessau® 20 IU to 75 IU) per eyelid. Photographs were taken prior to and seven days after infiltration. Results Hyaluronidase was found to reduce effectively and rapidly or resolve eyelid edema after a single injection. No relevant adverse effects were observed. However, it must be noted that a hyaluronidase injection may also dissolve injected hyaluronic acid fillers and may therefore negatively affect tear-trough augmentations. While the effects of a treatment for edema due to tear-trough augmentation were permanent, malar edema and malar mounds reoccurred within two to three weeks. Conclusion The infiltration of hyaluronidase is rapid, safe and currently the only effective option for the management of eyelid edema. No relevant adverse effects were observed. PMID:24886711

  1. Neonatal Injury at Cephalic Vaginal Delivery: A Retrospective Analysis of Extent of Association with Shoulder Dystocia

    PubMed Central

    Iskender, Cantekin; Kaymak, Oktay; Erkenekli, Kudret; Ustunyurt, Emin; Uygur, Dilek; Yakut, Halil Ibrahim; Danisman, Nuri

    2014-01-01

    Purpose To describe the risk factors and labor characteristics of Clavicular fracture (CF) and brachial plexus injury (BPI); and compare antenatal and labor characteristics and prognosis of obstetrical BPI associated with shoulder dystocia with obstetrical BPI not associated with shoulder dystocia. Methods This retrospective study consisted of women who gave birth to an infant with a fractured clavicle or BPI between January 2009 and June 2013. Antenatal and neonatal data were compared between groups. The control group (1300) was composed of the four singleton vaginal deliveries that immediately followed each birth injury. A multivariable logistic regression model, with backward elimination, was constructed in order to find independent risk factors associated with BPI and CF. A subgroup analysis involved comparison of features of BPI cases with or without associated shoulder dystocia. Results During the study period, the total number of vaginal deliveries was 44092. The rates of CF, BPI and shoulder dystocia during the study period were 0,6%, 0,16% and 0,29%, respectively. In the logistic regression model, shoulder dystocia, GDM, multiparity, gestational age >42 weeks, protracted labor, short second stage of labor and fetal birth weight greater than 4250 grams increased the risk of CF independently. Shoulder dystocia and protracted labor were independently associated with BPI when controlled for other factors. Among neonates with BPI whose injury was not associated with shoulder dystocia, five (12.2%) sustained permanent injury, whereas one neonate (4.5%) with BPI following shoulder dystocia sustained permanent injury (p = 0.34). Conclusion BPI not associated with shoulder dystocia might have a higher rate of concomitant CF and permanent sequelae. PMID:25144234

  2. Single Center Retrospective Analysis of Conventional and Radial TIG Catheters for Transradial Diagnostic Coronary Angiography

    PubMed Central

    Vorpahl, Marc; Koehler, Till; Foerst, Jason; Panagiotopoulos, Spyridon; Schleiting, Heinrich; Koss, Klaus; Ziegler, Gunda; Brinkmann, Hilmar; Seyfarth, Melchior; Tiroch, Klaus

    2015-01-01

    Current guidelines favor the radial approach for coronary angiography. Therefore, specialty radial diagnostic catheters were designed to engage both coronary arteries with a single device. However, it is unclear if single catheters are superior to conventional catheters. A retrospective analysis was performed of consecutive right radial coronary angiographies to determine catheter use, fluoroscopy time, radiation dosage, and consumption of contrast. Procedures were performed with a single TIG catheter or conventional catheters (CONV). Procedures with coronary artery bypass grafts or ventricular angiographies were excluded. 273 transradial procedures were performed successfully. 95 procedures were performed with CONV and 178 procedures with a TIG. Crossover to additional catheters was higher in TIG (15.2%) compared to CONV (5.3%, p = 0.02). Fluoroscopy time was comparable between CONV and TIG, without crossover (2.2 ± 1.2 min versus 2.3 ± 1.2 min; n.s.), however, greater in the case of crossover for CONV (5.8 ± 0.7) and TIG (7.6 ± 3.0; p = 0.0001). Radiation dosage was similar in CONV and the TIG, without crossover (1419 ± 1075, cGy∗cm2 versus 1690 ± 1138; n.s.), however, greater for CONV (2374 ± 620) and TIG (3733 ± 2281, p = 0.05) with crossover. Overall, the amount of contrast was greater in TIG (56 ± 13 mL) versus CONV (48 ± 3 mL; p = 0.0003). CONV femoral catheters may be the primary choice for radial approach. PMID:26435876

  3. Routine Histopathologic Examination of Appendectomy Specimens: Retrospective Analysis of 1255 Patients

    PubMed Central

    Emre, Arif; Akbulut, Sami; Bozdag, Zehra; Yilmaz, Mehmet; Kanlioz, Murat; Emre, Rabia; Sahin, Nurhan

    2013-01-01

    The objective of this study was to analyze the clinical benefit of histopathologic analysis of appendectomy specimens from patients with an initial diagnosis of acute appendicitis. We retrospectively analyzed the demographic and histopathologic data of 1255 patients (712 males, 543 females; age range, 17–85 years) who underwent appendectomy to treat an initial diagnosis of acute appendicitis. Patients who underwent incidental appendectomy during other surgeries were excluded from the study. Histopathologic findings of the appendectomy specimens were used to confirm the initial diagnosis. Ninety-four percent of the appendectomy specimens were positive for appendicitis. Of those, 880 were phlegmonous appendicitis, 148 were gangrenous appendicitis with perforation, and the remaining 88 showed unusual histopathologic findings. In the 88 specimens with unusual pathology, fibrous obliteration was observed in 57 specimens, carcinoid tumor in 11, Encheliophis vermicularis parasite infection in 8, granulatomous inflammation in 6, appendiceal endometriosis in 2, and 1 specimen each showed mucocele, eosinophilic infiltration, Taenia saginata parasite infection, and appendicular diverticulitis. All carcinoid tumors were located in the distal appendix. Six of the 11 carcinoid tumors were defined by histopathology as involving tubular cells, and the other 5 as involving enterochromaffin cells. Six patients had muscularis propria invasion, 2 patients had submucosa invasion, 2 patients had mesoappendix invasion, and 1 patient had serosal invasion. All patients with tumors remained disease free during the follow-up (range, 1–27 months). We conclude that when the ratio of unusual pathologic findings for appendectomy specimens is considered, it is evident that all surgical specimens should be subjected to careful histologic examination. PMID:24229023

  4. Evaluation of long-term infusion of dexmedetomidine in critically ill patients: A retrospective analysis

    PubMed Central

    Abuhasna, Said; Al Jundi, Amer; Abdelatty, Wael; urRahman, Masood

    2012-01-01

    Background: Dexmedetomidine is an α2-receptor agonist used for sedation in the intensive care unit (ICU). It is currently FDA indicated for short-term use (i.e., less than 24 h). Objectives: To compare the safety and efficacy of dexmedetomidine if given long- term (>24 h) to short-term infusion (up to 24 h) for mechanically ventilated critically ill patients. Materials and Methods: The medical records of 73 patients were evaluated. Primary outcomes were significant changes in blood pressure or heart rate. Secondary outcomes included hospital and intensive care unit (ICU) length of stay (LOS), ventilator time, rate of reintubation, and rate of death. Statistical Analysis: Pair wise comparisons were based on independent student t-test for continuous data and Chi-square test for categorical data. Statistical difference was defined as P value < 0.05. Results: Of the patients evaluated, 50 received dexmedetomidine for more than 24 h and 23 patients received this agent for 24 h. Patients were similar at baseline except for age. Patients who received dexmedetomidine for more than 24 h were similar to the short-infusion arm in terms of the rate of bradycardia (8.6% vs10%; P = 0.22), hypotension episodes (30.4% vs 28%; P= 0.2), requirement of treatment for those episodes (37% vs 42%; P= 0.43), hospital LOS (30 days vs 38 days; P = 0.45), ICU LOS (14 days vs 19 days; P = 0.44), ventilation days (8 days vs 14 days; P =0.58), rate of reintubation (4% vs 10%; P = 0.79) and mortality (P = 0.2). Conclusion: Long-term dexmedetomidine infusion (> 24 h) had similar safety and clinical outcomes in patients receiving this agent for short-term. Due to the retrospective nature of our investigation, more well-designed studies are needed to confirm these findings. PMID:22837894

  5. Total knee arthroplasty using subvastus approach in stiff knee: A retrospective analysis of 110 cases

    PubMed Central

    Shah, Nilen A; Patil, Hitendra Gulabrao; Vaishnav, Vinod O; Savale, Abhijit

    2016-01-01

    Background: Subvastus approach used in total knee arthroplasty (TKA) is known to produce an earlier recovery but is not commonly utilized for TKA when the preoperative range of motion (ROM) of the knee is limited. Subvastus approach is known for its ability to give earlier recovery due to less postoperative pain and early mobilization (due to rapid quadriceps recovery). Subvastus approach is considered as a relative contraindication for TKA in knees with limited ROM due to difficulty in exposure which can increase risk of complications such as patellar tendon avulsion or medial collateral injury. Short stature and obesity are also relative contraindications. Tarabichi successfully used subvastus approach in knees with limited preoperative ROM. However, there are no large series in literature with the experience of the subvatus approach in knees with limited preoperative ROM. We are presenting our experience of the subvastus approach for TKA in knees with limited ROM. Materials and Methods: We conducted retrospective analysis of patients with limited preoperative ROM (flexion ≤90°) of the knee who underwent TKA using subvastus approach and presenting the 2 years results. There were a total 84 patients (110 knees) with mean age 64 (range 49–79 years) years. The mean preoperative flexion was 72° (range 40°–90°) with a total ROM of 64° (range 36°–90°). Results: Postoperatively knee flexion improved by mean 38° (P < 0.05) which was significant as assed by Student's t- test. The mean knee society score improved from 36 (range 20–60) to 80 (range 70–90) postoperatively (P < 0.05). There was one case of partial avulsion of patellar tendon from the tibial tubercle. Conclusions: We concluded that satisfactory results of TKA can be obtained in knees with limited preoperative ROM using subvastus approach maintaining the advantages of early mobilization. PMID:27053806

  6. Intratumoral Mistletoe (Viscum album L) Therapy in Patients With Unresectable Pancreas Carcinoma: A Retrospective Analysis.

    PubMed

    Schad, Friedemann; Atxner, Jan; Buchwald, Dirk; Happe, Antje; Popp, Stephan; Kröz, Matthias; Matthes, Harald

    2014-07-01

    Pancreatic carcinoma remains one of the main causes for cancer-related death. Intratumoral application of anticancer agents is discussed as a promising method for solid tumors such as pancreatic cancer. Endoscopic ultrasound provides a good tool to examine and treat the pancreas. European mistletoe (Viscum album L) is a phytotherapeutic commonly used in integrative oncology in Central Europe. Its complementary use seeks to induce immunostimulation and antitumoral effects as well as alleviate chemotherapeutic side effects. Intratumoral mistletoe application has induced local tumor response in various cancer entities. This off-label use needs to be validated carefully in terms of safety and benefits. Here we report on 39 patients with advanced, inoperable pancreatic cancer, who received in total 223 intratumoral applications of mistletoe, endoscopic ultrasound guided or under transabdominal ultrasound control. No severe procedure-related events were reported. Adverse drug reactions were mainly increased body temperature or fever in 14% and 11% of the applications, respectively. Other adverse drug reactions, such as pain or nausea, occurred in less than 7% of the procedures. No severe adverse drug reaction was recorded. Patients received standard first- and second-line chemotherapy and underwent adequate palliative surgical interventions as well as additive subcutaneous and partly intravenous mistletoe application. A median survival of 11 months was observed for all patients, or 11.8 and 8.3 months for stages III and IV, respectively. Due to the multimodal therapeutic setting and the lack of a control group, the effect of intratumoral mistletoe administration alone remains unclear. This retrospective analysis suggests that intratumoral-applicated mistletoe might contribute to improve survival of patients with pancreatic cancer. In conclusion, the application is feasible and safe, and its efficacy should be evaluated in a randomized controlled trial. PMID:24363283

  7. Failure of Early Diagnosis of Infective Endocarditis in Japan—A Retrospective Descriptive Analysis

    PubMed Central

    Fukuchi, Takahiko; Iwata, Kentaro; Ohji, Goh

    2014-01-01

    Abstract Infective endocarditis (IE) is a severe disease with high morbidity and mortality, and these can be exacerbated by delay in diagnosis. We investigated IE diagnosis in Japan with the emphasis on the delay in diagnosis and its cause and implications. We conducted a retrospective study on 82 definite IE patients at Kobe University Hospital from April 1, 2008, through March 31, 2013. We reviewed charts of the patients for data such as causative pathogens, prescription of inappropriate antibiotic use prior to the diagnosis, existence of risk factors of IE, previous doctor's subspecialty, or duration until the diagnosis, with the primary outcome of 180-day mortality. We also qualitatively, as well as quantitatively, analyzed those cases with delay in diagnosis, and hypothesized its causes and implications. Eighty-two patients were reviewed for this analysis. The average age was 61 ± 14.5-year-old. Fifty percent of patients had known underlying risk factors for IEs, such as prosthetic heart valve (10), valvular heart disease (21), congenital heart disease (3), or cardiomyopathy (2). The median days until the diagnosis was 14 days (range 2 days to 1 year). Sixty-five percent of patients received inappropriate antibiotic before the diagnosis (53). Forty percent of causative organisms were Staphylococcus aureus (MSSA 20, MRSA 13), 32% were viridans streptococci and Streptococcus bovis, 28% were others or unknown (CNS 5, Corynebacterium 3, Cardiobacterium 1, Candida 1). Subspecialties such as General Internal Medicine (15), and Orthopedics (13) were associated with delay in diagnosis. Ten patients (12%) died during follow up, and 8 of them had been received prior inappropriate antibiotics. Significant delay in the diagnosis of IE was observed in Japan. Inappropriate antibiotics were prescribed frequently and may be associated with poor prognosis. Further improvement for earlier diagnosis of IE is needed. PMID:25501088

  8. Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years

    PubMed Central

    Qi, Fei; Zhang, Guo-Xin; She, Dan-Yang; Liang, Zhi-Xin; Wang, Ren-Tao; Yang, Zhen; Chen, Liang-An; Cui, Jun-Chang

    2015-01-01

    Background: Healthcare-associated pneumonia (HCAP) is associated with drug-resistant pathogens and high mortality, and there is no clear evidence that this is due to inappropriate antibiotic therapy. This study was to elucidate the clinical features, pathogens, therapy, and outcomes of HCAP, and to clarify the risk factors for drug-resistant pathogens and prognosis. Methods: Retrospective observational study among hospitalized patients with HCAP over 10 years. The primary outcome was 30-day all-cause hospital mortality after admission. Demographics (age, gender, clinical features, and comorbidities), dates of admission, discharge and/or death, hospitalization costs, microbiological results, chest imaging studies, and CURB-65 were analyzed. Antibiotics, admission to Intensive Care Unit (ICU), mechanical ventilation, and pneumonia prognosis were recorded. Patients were dichotomized based on CURB-65 (low- vs. high-risk). Results: Among 612 patients (mean age of 70.7 years), 88.4% had at least one comorbidity. Commonly detected pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%). Mean age, length of stay, hospitalization expenses, ICU admission, mechanical ventilation use, malignancies, and detection rate for P. aeruginosa, and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group. CURB-65 ≥3, malignancies, and mechanical ventilation were associated with an increased mortality. Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAP. Conclusion: Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach. CURB-65 ≥3, malignancies, and mechanical ventilation may result in an increased mortality. PMID:26481734

  9. [Retrospective analysis of consecutively treated distal radius fractures with the external fixator].

    PubMed

    Melik, N; Togninalli, D; Biegger, P

    1994-12-01

    The purpose of this study was to determine retrospectively some subjective and objective parameters following the operative treatment of 32 patients with "complex" (intraarticular and/or comminuted) fractures of the distal radius using the small AO external fixation device. The mean follow-up period was 20 months (minimum 4, maximum 48) and the mean age of the subjects was 62 years (minimum 27, maximum 91). Subjective results such as "general feeling", mobility, strength and pain, expressed with a scoring system (% of maximum obtainable points), showed an overall good result and ranged between 71% (pain), 81% (strength) and 91% (mobility and "general feeling"). Regarding the objective results, no major skin or soft tissue distress (Sudeck dystrophy) was noted. However, there was a general tendency towards a mobility deficit of the wrist operated on, which was statistically significant (P < 0.01) for flexion, extension, supination and abduction (respectively, -17.7%, -12.4%, -7.1% and -12.5%). The late standard radiological and lateral controls showed a mean radial angle of +2.13 degrees (B or lateral radial angle) and +23.13 degrees (A or AP angle), respectively. The analysis of data, as expressed by time after operation (< or > than 10 months), showed no relevant difference between the two groups (age of both similar), as expressed by age (< or > than 60 years); the data only showed differences in strength and pain (scores by 92% vs 82% for force and 92% vs 76% for pain) and in flexion and extension (-22.8% and -14%, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7855610

  10. A retrospective analysis of changes in inflammatory markers in patients treated with bacterial viruses.

    PubMed

    Miedzybrodzki, Ryszard; Fortuna, Wojciech; Weber-Dabrowska, Beata; Górski, Andrzej

    2009-12-01

    Bacteriophages are increasingly considered an alternative to antibiotics for the treatment of bacterial infections. Clinical improvement may be associated with a lowering of inflammatory markers during the antibiotic treatment of bacterial infections. Some experimental data suggest that phage treatment may have anti-inflammatory properties. We present a retrospective analysis of C-reactive protein (CRP) serum concentration, erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) measured in patients with chronic, symptomatic, antibiotic therapy-resistant bacterial infections who qualified for phage treatment within the protocol "Experimental Phage Therapy of Antibiotic Therapy-Resistant Infections, Including MRSA Infections". Data collected from 37 patients with osteomyelitis (with or without metal implants or joint endoprosthesis) or skin and soft tissue or lower respiratory tract infection induced by, in the majority of cases, S. aureus were analyzed. Phage preparations (natural phage lysates) were administered orally (one 10-ml ampoule three times daily after neutralization of gastric juice with 10 ml of dihydroxyaluminium sodium carbonate) and/or locally (one ampoule two times daily for wet compresses or irrigation of a fistula). No significant changes in mean serum levels of CRP measured after 5-8 days of phage administration were observed compared with the baseline CRP levels measured before therapy (35.7 vs. baseline 38.6 mg/l, n = 11). However, a significant decrease in mean CRP values measured later, between days 9 and 32, was noted (16.1 vs. baseline 23.3 mg/l, n = 26, P < 0.05). Similar tendencies were observed in the changes in mean WBC values, but mean ESR in the patients before, in the early phase, and later during therapy did not change significantly. This is the first report suggesting that the application of phage preparations may probably influence and diminish the inflammatory reaction that accompanies bacterial infection. PMID

  11. Clinical and legal significance of fragmentation of bullets in relation to size of wounds: retrospective analysis

    PubMed Central

    Coupland, Robin

    1999-01-01

    Objective To examine the relation between fragmentation of bullets and size of wounds clinically and in the context of the Hague Declaration of 1899. Design Retrospective analysis of prospectively collected data on hospital admissions. Setting Hospitals of the International Committee of the Red Cross. Subjects 5215 people wounded by bullets in armed conflicts (5933 wounds). Main outcome measures Grade of wound computed from the Red Cross wound classification and presence of bullet fragments on radiography. Results Of the 347 wounds with fragmentation of bullets, 251 (72%) were large wounds (grade 2 or 3)—that is, those with a clinically detectable cavity. Of the 5586 wounds without fragmentation of bullets, 2915 (52.1%) were large wounds. Only 7.9% (251/3166) of large wounds were associated with fragmentation of bullets. Conclusions Fragmentation of bullets is associated with large wounds, but most large wounds do not contain bullet fragments. In addition, bullet fragments may occur in wounds that are not defined as large. Fragmentation of bullets is neither a necessary nor sufficient cause of large wounds, and surgeons should not diagnose extensive tissue damage because of the presence of fragments on radiography. Such findings also do not necessarily represent the use of bullets which contravene the law of war. Future legislation should take into account not only the construction of bullets but also their potential to transfer energy to the human body. Key messagesThe use of certain bullets has been prohibited in warWounds from bullets are caused by transfer of kinetic energy from the bullet to the tissuesThe relation between size of wound and fragmentation of bullets can be examined using the Red Cross wound classification system Fragments of bullets seen on radiographs of wounds sustained in wars do not necessarily represent large wounds or the use of illegal bulletsExisting legislation on the construction of bullets should be supplemented by legislation on

  12. A Retrospective Analysis of Dissemination Biases in the Brief Alcohol Intervention Literature

    PubMed Central

    Tanner-Smith, Emily E.; Polanin, Joshua R.

    2015-01-01

    This study examined dissemination and reporting biases in the brief alcohol intervention literature. We used retrospective data from 179 controlled trials included in a meta-analysis on brief alcohol interventions for adolescents and young adults. We examined whether the magnitude and direction of effect sizes were associated with publication type, identification source, language, funding, time lag between intervention and publication, number of reports, journal impact factor, and subsequent citations. Results indicated that effect sizes were larger for studies that had been funded (b = 0.14, 95% confidence interval [CI] [0.04, 0.23]), had a shorter time lag between intervention and publication (b = −0.03, 95% CI [−0.05, −.001]), and cited more frequently (b = 0.01, 95% CI [+0.00, 0.01]). Studies that were cited more frequently by other authors also had greater odds of reporting positive effects (odds ratio = 1.10, 95% CI [1.02, 1.18]). Results indicated that time lag bias has increased recently: larger and positive effect sizes were published more quickly in recent years. We found no evidence, however, that the magnitude or direction of effects was associated with location source, language, or journal impact factor. We conclude that dissemination biases may indeed occur in the social and behavioral science literature, as has been consistently documented in the medical literature. As such, primary researchers, journal reviewers, editors, systematic reviewers, and meta-analysts must be cognizant of the causes and consequences of these biases, and commit to engage in ethical research practices that attempt to minimize them. PMID:25134044

  13. Retrospective matched-pairs analysis of bortezomib plus dexamethasone versus bortezomib monotherapy in relapsed multiple myeloma

    PubMed Central

    Dimopoulos, Meletios A.; Orlowski, Robert Z.; Facon, Thierry; Sonneveld, Pieter; Anderson, Kenneth C.; Beksac, Meral; Benboubker, Lotfi; Roddie, Huw; Potamianou, Anna; Couturier, Catherine; Feng, Huaibao; Ataman, Ozlem; van de Velde, Helgi; Richardson, Paul G.

    2015-01-01

    Bortezomib-dexamethasone is widely used for relapsed myeloma in routine clinical practice, but comparative data versus single-agent bortezomib are lacking. This retrospective analysis compared second-line treatment with bortezomib-dexamethasone and bortezomib using 109 propensity score-matched pairs of patients treated in three clinical trials: MMY-2045, APEX, and DOXIL-MMY-3001. Propensity scores were estimated using logistic regression analyses incorporating 13 clinical variables related to drug exposure or clinical outcome. Patients received intravenous bortezomib 1.3 mg/m2 on days 1, 4, 8, and 11, in 21-day cycles, alone or with oral dexamethasone 20 mg on the days of/after bortezomib dosing. Median bortezomib cumulative dose (27.02 and 28.60 mg/m2) and treatment duration (19.6 and 17.6 weeks) were similar with bortezomib-dexamethasone and bortezomib, respectively. The overall response rate was higher (75% vs. 41%; odds ratio=3.467; P<0.001), and median time-to-progression (13.6 vs. 7.0 months; hazard ratio [HR]=0.394; P=0.003) and progression-free survival (11.9 vs. 6.4 months; HR=0.595; P=0.051) were longer with bortezomib-dexamethasone versus bortezomib, respectively. Rates of any-grade adverse events, most common grade 3 or higher adverse events, and discontinuations due to adverse events appeared similar between the groups. Two patients per group died of treatment-related adverse events. These data indicate the potential benefit of bortezomib-dexamethasone compared with single-agent bortezomib at first relapse in myeloma. The MMY-2045, APEX, and DOXIL-MMY-3001 clinical trials were registered at, respectively, clinicaltrials.gov identifier: 00908232, 00048230, and 00103506. PMID:25261096

  14. Retrospective analysis for the identification of 4-aminocarminic acid photo-degradation products in beverages.

    PubMed

    Gosetti, Fabio; Chiuminatto, Ugo; Mastroianni, Rita; Mazzucco, Eleonora; Manfredi, Marcello; Marengo, Emilio

    2015-01-01

    This article deals with the identification of the photo-degradation products of 4-aminocarminic acid potentially present in commercial beverages. Sixteen beverages of different composition but all containing the E120 dye were previously analysed by ultra-high-performance liquid chromatography (UHPLC) coupled with quadrupole-time of flight mass spectrometry to identify the common degradation products of the E120 dye. Since it is plausible to find unauthorised 4-aminocarminic acid in beverages which report generic E120 dye on the label, retrospective analysis was employed here not only to search for the possible presence of 4-aminocarminic acid but also to investigate the potential formation of photo-degradation products derived from this compound. For this purpose, a statistical approach based on Student's t-test was used to compare the degraded beverages containing 4-aminocarminic acid with all the others. Five degradation products were identified and their structures were elucidated on the basis of the high-accuracy and high-resolution of mass and mass/mass spectra. The toxicity of the degradation products was evaluated through the Ames Salmonella/microsome mutagenicity assay. No evidence of mutagenicity was obtained for the beverages subjected or not to irradiation, whereas a toxic effect of the 4-aminocarminic acid standard solution already at 100.0 µg l(-1) was found. This leads, once again, to the conclusion that the toxicity study must be carried out on the beverages in order to take into account of all the possible masking/protection interactions among the ingredients. PMID:25562586

  15. Hemorrhagic colitis in postdiarrheal hemolytic uremic syndrome: retrospective analysis of 54 children.

    PubMed

    Rahman, Ricardo C; Cobeñas, Carlos J; Drut, Ricardo; Amoreo, Oscar R; Ruscasso, Javier D; Spizzirri, Ana P; Suarez, Angela Del C; Zalba, Javier H; Ferrari, Celia; Gatti, Marcela C

    2012-02-01

    Hemorrhagic colitis (HC) is a severe manifestation of the hemolytic uremic syndrome (HUS). We performed a retrospective analysis of patients with HC with the following aims: (1) to characterize the clinicopathologic features; (2) to evaluate mortality rate; (3) to analyze severity of renal and central nervous system (CNS) disease. Patients with HC assisted between 1981-2009 were evaluated and compared with a control group of 137 patients without HC. Among 987 patients with diarrheal prodrome (D) + HUS, 54 (5.5%) presented HC. Clinical findings included abdominal pain (96%), distension (93%), hematochezia (44%), and abdominal mass (11%). Surgery was indicated in 35 patients (65%), and 17 (48.5%) required bowel resection. Transverse and ascending colon were most frequently affected. Macroscopic evaluation showed bowel necrosis (18) and perforation (12). Histologic evaluation (29) showed that 25 (86.2%) had necrosis of the affected segment (transmural in 21). A leukocyte count >20,000/mm(3) and hematocrit >30% were more common in HC patients than in controls (p < 0.001 and p < 0.0001, respectively). Mortality rate was higher in HC patients (33.3%) than in controls (1.4%; p < 0.0001). Dialysis >10 days, seizures, and coma were more frequent in HC patients than in controls (p < 0.0001). In summary, most patients had prominent abdominal findings, and almost 2/3 patients required surgery. Transverse/ascending colon was most affected, and the main histologic finding was transmural necrosis. Higher hematocrit and leukocytosis were frequent. Mortality rate was extremely high, and most had long-lasting anuria and severe neurologic involvement. PMID:21809003

  16. Doctors recognized by the British honours systems: A retrospective analysis of the last decade

    PubMed Central

    Islam, Shofiq; Cole, Jennifer L; Taylor, Christopher J

    2011-01-01

    Objectives The British honours system is one of the oldest in the world rewarding individuals, including those of the medical profession. The authors were interested to see if any particular specialty was honoured to a greater extent. We aimed to establish the number of those honoured, the duration of clinical practice involved, as well as additional factors. Design A retrospective analysis of doctors receiving honours (Knight/Dame, CBE, OBE, MBE) in the last decade was performed. Setting UK-registered doctors. Participants Doctors were identified from publicly available listings. Main outcome measures Demographics of all honoured doctors, including number of years of service, specialty affiliation and the number of recipients holding professorial status were collected. Clinicians were stratified into four subgroups: General Practitioners, Physicians, Surgeons and Others. Data were analysed using parametric statistical tests. Results Four hundred and seventeen doctors were identified. Four hundred and two clinicians had a documented subspecialty affiliation. Of the 402: GPs (n = 142), Physicians (n = 100), Surgeons (n = 34) and Others (n = 126). The number of years in clinical practice from registration to conference of honours was significantly shorter for GPs when compared to hospital-based specialties (P < 0.05). The top 10 specialties of individuals honoured are tabulated. Professors constituted 30% (n = 131) of those honoured. These individuals were sub-divided according to specialty affiliation with a significant difference observed (P < 0.05). Conclusions The most honoured specialty was General Practice. However, when corrected for total subspecialty population, the number one ranking specialty was Public Health Medicine. Academic clinicians are well represented. The findings may be of interest to the medical community. PMID:22179295

  17. Single-incision versus conventional laparoscopic appendectomy in 688 patients: a retrospective comparative analysis

    PubMed Central

    Liang, Hung-Hua; Hung, Chin-Sheng; Wang, Weu; Tam, Ka-Wai; Chang, Chun-Chao; Liu, Hui-Hsiung; Yen, Ko-Li; Wei, Po-Li

    2014-01-01

    Background Laparoscopic surgery has become the standard for treating appendicitis. The cosmetic benefits of using single-incision laparoscopy are well known, but its duration, complications and time to recovery have not been well documented. We compared 2 laparoscopic approaches for treating appendicitis and evaluated postoperative pain, complications and time to full recovery. Methods We retrospectively reviewed the cases of consecutive patients with appendicitis and compared those who underwent conventional laparoscopic appendectomy (CLA) performed using 3 incisions and those who underwent single-incision laparoscopic appendectomy (SILA). During SILA, the single port was prepared to increase visibility of the operative site. Results Our analysis included 688 consecutive patients: 618 who underwent CLA and 70 who underwent SILA. Postsurgical complications occurred more frequently in the CLA than the SILA group (18.1% v. 7.1%, p = 0.018). Patients who underwent SILA returned to oral feeding sooner than those who underwent CLA (median 12 h v. 22 h, p < 0.001). These between-group differences remained significant after controlling for other factors. Direct comparison of only nonperforated cases, which was determined by pathological examination, revealed that SILA was significantly longer than CLA (60 min v. 50 min, p < 0.001). Patients who underwent SILA had longer in-hospital stays than those who underwent CLA (72 v. 55 h, p < 0.001); however, they had significantly fewer complications (3.0% v. 14.4%, p = 0.006). Conclusion In addition to its cosmetic advantages, SILA led to rapid recovery and no increase in postsurgical pain or complications. PMID:24869622

  18. The impact of team familiarity and surgical experience on operative efficiency: a retrospective analysis

    PubMed Central

    Maruthappu, Mahiben; Duclos, Antoine; Zhou, Charlie D; Lipsitz, Stuart R; Wright, John; Orgill, Dennis

    2016-01-01

    Summary Objectives The independent impact of individual surgical experience and team familiarity on surgical performance has been widely studied; however, the interplay of these factors and their relative, quantified, contributions to performance is poorly understood. We determined the impact of team familiarity and surgeon, and cumulative team experience on operative efficiency in total knee replacement. Design Retrospective analysis of all total knee replacements conducted at the host institution in 1996–2009. Multivariate generalised-estimating-equation regression models were used to adjust for patient risk and clustering. Setting Tertiary care academic hospital. Participants All patients undergoing TKR at the host institution in 1996–2009. Main outcome measure Operative efficiency. Results A total of 4276 total knee replacements were completed by 1163 different surgical teams. The median experience level was 17.6 years for consultant surgeons and 3.7 years for trainee surgeons. After patient-risk adjustment, consultant surgical experience (p < 0.0001), trainee surgical experience (p < 0.05), cumulative team operative experience (p < 0.0001) and team familiarity (p < 0.0001) were associated with significant reductions in operative time. Surgical experience and team familiarity demonstrated concave and linear relationships with operative time, respectively. For a consultant surgeon, the expected reduction in operative time after 25 years in practice was 51 min, compared to a 21-min reduction over the span of 40 collaborations with the same team members. Conclusions Surgical experience and team familiarity display important and distinct relationships with operative time in total knee replacement. Appreciation of this interplay may serve to guide implementation and allocation of procedure-specific quality improvement strategies in surgery. PMID:27053357

  19. Retrospective analysis showing the water method increased adenoma detection rate - a hypothesis generating observation.

    PubMed

    Leung, Joseph W; Do, Lynne D; Siao-Salera, Rodelei M; Ngo, Catherine; Parikh, Dhavan A; Mann, Surinder K; Leung, Felix W

    2011-01-01

    BACKGROUND: A water method developed to attenuate discomfort during colonoscopy enhanced cecal intubation in unsedated patients. Serendipitously a numerically increased adenoma detection rate (ADR) was noted. OBJECTIVE: To explore databases of sedated patients examined by the air and water methods to identify hypothesis-generating findings. DESIGN: Retrospective analysis. SETTING: VA endoscopy center. PATIENTS: creening colonoscopy. INTERVENTIONS: From 1/2000-6/2006 the air method was used - judicious air insufflation to permit visualization of the lumen to aid colonoscope insertion and water spray for washing mucosal surfaces. From 6/2006-11/2009 the water method was adopted - warm water infusion in lieu of air insufflation and suction removal of residual air to aid colonoscope insertion. During colonoscope withdrawal adequate air was insufflated to distend the colonic lumen for inspection, biopsy and polypectomy in a similar fashion in both periods. Main outcome measurements: ADR. RESULTS: The air (n=683) vs. water (n=495) method comparisons revealed significant differences in overall ADR 26.8% (183 of 683) vs. 34.9% (173 of 495) and ADR of adenomas >9 mm, 7.2% vs. 13.7%, respectively (both P<0.05, Fisher's exact test). LIMITATIONS: Non-randomized data susceptible to bias by unmeasured parameters unrelated to the methods. CONCLUSION: Confirmation of the serendipitous observation of an impact of the water method on ADR provides impetus to call for randomized controlled trials to test hypotheses related to the water method as an approach to improving adenoma detection. Because of recent concerns over missed lesions during colonoscopy, the provocative hypothesis-generating observations warrant presentation. PMID:21686105

  20. “Triple positive” early breast cancer: an observational multicenter retrospective analysis of outcome

    PubMed Central

    Vici, Patrizia; Pizzuti, Laura; Sperduti, Isabella; Frassoldati, Antonio; Natoli, Clara; Gamucci, Teresa; Tomao, Silverio; Michelotti, Andrea; Moscetti, Luca; Gori, Stefania; Baldini, Editta; Giotta, Francesco; Cassano, Alessandra; Santini, Daniele; Giannarelli, Diana; Di Lauro, Luigi; Corsi, Domenico Cristiano; Marchetti, Paolo; Sini, Valentina; Sergi, Domenico; Barba, Maddalena; Maugeri-Saccà, Marcello; Russillo, Michelangelo; Mentuccia, Lucia; D'Onofrio, Loretta; Iezzi, Laura; Scinto, Angelo Fedele; Da Ros, Lucia; Bertolini, Ilaria; Basile, Maria Luisa; Rossi, Valentina; De Maria, Ruggero; Montemurro, Filippo

    2016-01-01

    We recently found that trastuzumab benefit may be lower in a small subset of early breast cancer (BC) patients (pts) with tumors expressing high levels of both hormonal receptors (HRs), i.e. triple positive (TP). To better investigate the role of HRs in HER2 positive BC, we retrospectively identified 872 TP BC pts treated with adjuvant chemotherapy alone (cohort A-366 pts), or plus trastuzumab (cohort B-506 pts). Relapse-free-survival (RFS) and breast-cancer-specific-survival (BCSS) were evaluated. Trastuzumab improved RFS and BCSS in all the subsets analyzed, but the effect on BCSS in tumors expressing both HRs in >30% of cells (TP30), and even on RFS in tumors with both HRs expressed in >50% of cells (TP50) was not significant. Distinct patterns of relapse were observed in TP50 and no-TP50 tumors, the former showing low and constant risk in the first 5 years, a late increase beyond 5 years and modest trastuzumab effect. Trastuzumab effect tended to disappear in pts whose tumors expressed ER in >50% of cells. Multivariate analysis of RFS confirmed a significant interaction between trastuzumab and ER expression, with benefit confined to pts whose tumors expressed ER in ≤50% of cells. Our data suggest that the pattern of relapse of TP tumors with high HRs is similar to that of “luminal”, HER2 negative tumors, without clear benefit from adjuvant trastuzumab, which remains the standard treatment even in TP tumors. Confirmatory findings on the extent to which quantitative expression of HRs may impact clinical behavior of HER2 positive BC are warranted. PMID:26910921

  1. Routine histopathologic examination of appendectomy specimens: retrospective analysis of 1255 patients.

    PubMed

    Emre, Arif; Akbulut, Sami; Bozdag, Zehra; Yilmaz, Mehmet; Kanlioz, Murat; Emre, Rabia; Sahin, Nurhan

    2013-01-01

    The objective of this study was to analyze the clinical benefit of histopathologic analysis of appendectomy specimens from patients with an initial diagnosis of acute appendicitis. We retrospectively analyzed the demographic and histopathologic data of 1255 patients (712 males, 543 females; age range, 17-85 years) who underwent appendectomy to treat an initial diagnosis of acute appendicitis. Patients who underwent incidental appendectomy during other surgeries were excluded from the study. Histopathologic findings of the appendectomy specimens were used to confirm the initial diagnosis. Ninety-four percent of the appendectomy specimens were positive for appendicitis. Of those, 880 were phlegmonous appendicitis, 148 were gangrenous appendicitis with perforation, and the remaining 88 showed unusual histopathologic findings. In the 88 specimens with unusual pathology, fibrous obliteration was observed in 57 specimens, carcinoid tumor in 11, Encheliophis vermicularis parasite infection in 8, granulatomous inflammation in 6, appendiceal endometriosis in 2, and 1 specimen each showed mucocele, eosinophilic infiltration, Taenia saginata parasite infection, and appendicular diverticulitis. All carcinoid tumors were located in the distal appendix. Six of the 11 carcinoid tumors were defined by histopathology as involving tubular cells, and the other 5 as involving enterochromaffin cells. Six patients had muscularis propria invasion, 2 patients had submucosa invasion, 2 patients had mesoappendix invasion, and 1 patient had serosal invasion. All patients with tumors remained disease free during the follow-up (range, 1-27 months). We conclude that when the ratio of unusual pathologic findings for appendectomy specimens is considered, it is evident that all surgical specimens should be subjected to careful histologic examination. PMID:24229023

  2. Retrospective analysis of suicidality in patients treated with the antidepressant desvenlafaxine.

    PubMed

    Tourian, Karen A; Padmanabhan, Krishna; Groark, Jim; Ninan, Philip T

    2010-08-01

    The objective of this analysis was to assess the risk of increased suicidal thoughts and behavior (suicidality) with desvenlafaxine (administered as desvenlafaxine succinate) in patients with major depressive disorder (MDD). Data from 9 double-blind, 8-week studies in outpatients with MDD were analyzed retrospectively. Patients were randomly assigned to desvenlafaxine (n = 1834) or placebo (n = 1116). Adverse events (AEs) related to suicidality were identified by searching the AE database for text strings possibly related to suicidality; false positives were excluded. Narratives for each case were prepared and blinded for review. Events were classified according to the Columbia Classification Algorithm of Suicide Assessment. Odds ratios were calculated; chi tests were used to compare treatment groups. Occurrence of emerging or worsening suicidality, based on the 17-item Hamilton Rating Scale for Depression suicide item, was compared for desvenlafaxine and placebo using chi tests. In all, 17 (0.93%) of 1834 patients receiving desvenlafaxine and 8 (0.72%) of 1116 receiving placebo reported possible suicidality-related AEs. Events were relatively evenly distributed across treatment groups. One patient randomly assigned to desvenlafaxine treatment died of completed suicide during the on-therapy period. There were no significant differences between groups in the risk for any class of suicide-related events, including completed suicide or suicide attempt. Odds of emergence or worsening of suicidality 17-item (Hamilton Rating Scale for Depression suicide item) did not differ significantly between treatment groups. No evidence of a signal for increased suicidality was detected in adult patients treated with desvenlafaxine in short-term MDD trials. As suicidal events were extremely rare, a true increased risk cannot be ruled out. PMID:20631558

  3. Clinical Impact of Pancreatic Metastases from Renal Cell Carcinoma: A Multicenter Retrospective Analysis.

    PubMed

    Grassi, Paolo; Doucet, Ludovic; Giglione, Palma; Grünwald, Viktor; Melichar, Bohuslav; Galli, Luca; De Giorgi, Ugo; Sabbatini, Roberto; Ortega, Cinzia; Santoni, Matteo; Bamias, Aristotelis; Verzoni, Elena; Derosa, Lisa; Studentova, Hana; Pacifici, Monica; Coppa, Jorgelina; Mazzaferro, Vincenzo; de Braud, Filippo; Porta, Camillo; Escudier, Bernard; Procopio, Giuseppe

    2016-01-01

    Pancreatic metastases from renal cell carcinoma are uncommon and their prognostic significance is not well defined. In this analysis we evaluated the outcome of patients with pancreatic metastases treated with either targeted therapies or local treatment to the pancreas. Patients with pancreatic metastases from renal cell carcinoma treated between 1993 and 2014 were identified from 11 European centers. Clinical records were retrospectively reviewed. Kaplan-Meier method and log-rank test were used to evaluate progression-free survival and overall survival. Cox's proportional hazard models were used for survival analysis. In total, 276 PM patients were evaluated, including 77 (28%) patients treated by either surgery or radiotherapy to the pancreas, and 256 (93%) who received systemic therapy. Median time from nephrectomy to diagnosis of pancreatic metastases was 91 months (IQR 54-142). Disease control rate after first-line TTs was 84%, with a median progression-free survival of 12 months (95% CI 10-14). Median overall survival was 73 months (95% CI 61-86) with a 5-year OS of 58%. Median OS of patients treated with local treatment was 106 months (95% CI 78-204) with a 5-year overall survival of 75%. On multivariable analysis, nephrectomy (HR 5.31; 95%CI 2.36-11.92; p<0.0001), Memorial Sloan Kettering/International Metastatic RCC Database Consortium prognostic score (HR 1.45, 95% CI 0.94-2.23 for intermediate vs good vs risk; HR 2.76 95%, CI 1.43-5.35 for poor vs good risk p = 0.0099) and pancreatic local treatment (HR 0.48; 95%CI 0.30-0.78 p = 0.0029) were associated with overall survival. Difference in median OS between patients with PM and that reported in a matched-control group of mRCC patients with extrapancreatic metastases was statistically significant (p < .0001). Pancreatic metastases from renal cell carcinoma usually occur years after nephrectomy, are associated with an indolent behavior and a prolonged survival. Targeted therapies and locoregional

  4. Clinical Impact of Pancreatic Metastases from Renal Cell Carcinoma: A Multicenter Retrospective Analysis

    PubMed Central

    Grassi, Paolo; Doucet, Ludovic; Giglione, Palma; Grünwald, Viktor; Melichar, Bohuslav; Galli, Luca; De Giorgi, Ugo; Sabbatini, Roberto; Ortega, Cinzia; Santoni, Matteo; Bamias, Aristotelis; Verzoni, Elena; Derosa, Lisa; Studentova, Hana; Pacifici, Monica; Coppa, Jorgelina; Mazzaferro, Vincenzo; de Braud, Filippo; Porta, Camillo; Escudier, Bernard; Procopio, Giuseppe

    2016-01-01

    Pancreatic metastases from renal cell carcinoma are uncommon and their prognostic significance is not well defined. In this analysis we evaluated the outcome of patients with pancreatic metastases treated with either targeted therapies or local treatment to the pancreas. Patients with pancreatic metastases from renal cell carcinoma treated between 1993 and 2014 were identified from 11 European centers. Clinical records were retrospectively reviewed. Kaplan-Meier method and log-rank test were used to evaluate progression-free survival and overall survival. Cox’s proportional hazard models were used for survival analysis. In total, 276 PM patients were evaluated, including 77 (28%) patients treated by either surgery or radiotherapy to the pancreas, and 256 (93%) who received systemic therapy. Median time from nephrectomy to diagnosis of pancreatic metastases was 91 months (IQR 54–142). Disease control rate after first-line TTs was 84%, with a median progression-free survival of 12 months (95% CI 10–14). Median overall survival was 73 months (95% CI 61–86) with a 5-year OS of 58%. Median OS of patients treated with local treatment was 106 months (95% CI 78–204) with a 5-year overall survival of 75%. On multivariable analysis, nephrectomy (HR 5.31; 95%CI 2.36–11.92; p<0.0001), Memorial Sloan Kettering/International Metastatic RCC Database Consortium prognostic score (HR 1.45, 95% CI 0.94–2.23 for intermediate vs good vs risk; HR 2.76 95%, CI 1.43–5.35 for poor vs good risk p = 0.0099) and pancreatic local treatment (HR 0.48; 95%CI 0.30–0.78 p = 0.0029) were associated with overall survival. Difference in median OS between patients with PM and that reported in a matched-control group of mRCC patients with extrapancreatic metastases was statistically significant (p < .0001). Pancreatic metastases from renal cell carcinoma usually occur years after nephrectomy, are associated with an indolent behavior and a prolonged survival. Targeted therapies and

  5. Retrospective analysis of changes in land uses on vertic soils of closed mesodepressions on the Azov plain

    NASA Astrophysics Data System (ADS)

    Rukhovich, D. I.; Simakova, M. S.; Kulyanitsa, A. L.; Bryzzhev, A. V.; Koroleva, P. V.; Kalinina, N. V.; Vil'chveskaya, E. V.; Dolinina, E. A.; Rukhovich, S. V.

    2015-10-01

    A retrospective analysis of changes in land uses within the bottoms of closed mesodepressions in Azov district of Rostov oblast for the period from 1968 to 2014 was performed. A cartographic analysis of changes in the degree of waterlogging of these depressions and the related changes in the character of land use was based on remote sensing data. This study was performed within the framework of a general problem-oriented system of the retrospective monitoring of the soil and land cover. It was found that the waterlogged area in the mesodepressions in the particular years does not depend on the anthropogenic loads and is subjected to cyclic variations. Temporal intervals for the wetting-drying cycles were determined. The maximum drying of the bottoms of mesodepressions was observed in 1975, 1990, and 2011.

  6. Retrospective and prospective analysis of policy incentives for wind power in Portugal

    NASA Astrophysics Data System (ADS)

    Pena Cabra, Ivonne A.

    been decommissioned despite being in operation for more than 20 years, favoring from new, detailed and hard-to-follow agreements in the legislation. All wind parks that are currently in operation have received feed-in tariffs since they connected to the grid, and are expected to keep receiving them at least until December 2019, and up to December 2036 - depending on year of connection and agreement under the most recent legislation (Diario da Republica 2013). The 2020 renewable energy goals in Portugal include having 6.8 GW of installed wind capacity, which implies the connection of 2 GW in the next years. If no further grid investments are made and wind capacity increases up to 100 MW to the connection point that we analyze, total annual electricity spill is likely to range the 20% to 40%. If the connection grid policy is designed to allow for wind spill, already 'occupied' connection points will be available to new entrants, lowering the total investment costs for new wind parks and increasing their profitability. This thesis is divided in three main parts: a first introductory section, a retrospective study of wind power in Portugal and a prospective analysis of the Portuguese wind power sector. The introductory section is a brief overview of the global renewable status, described in Chapter 1. Chapter 2 and Chapter 3 compile a retrospective study of wind power and the policies that have incentivized wind diffusion. We include in the discussion some references to the future wind power goals, but the results and policy recommendations are directed towards the existing connected wind power capacity. (Abstract shortened by UMI.).

  7. An Assessment of Actual and Potential Building Climate Zone Change and Variability From the Last 30 Years Through 2100 Using NASA's MERRA and CMIP5 Simulations

    NASA Technical Reports Server (NTRS)

    Stackhouse, Paul W., Jr.; Chandler, William S.; Hoell, James M.; Westberg, David; Zhang, Taiping

    2015-01-01

    Background: In the US, residential and commercial building infrastructure combined consumes about 40% of total energy usage and emits about 39% of total CO2 emission (DOE/EIA "Annual Energy Outlook 2013"). Building codes, as used by local and state enforcement entities are typically tied to the dominant climate within an enforcement jurisdiction classified according to various climate zones. These climate zones are based upon a 30-year average of local surface observations and are developed by DOE and ASHRAE. Establishing the current variability and potential changes to future building climate zones is very important for increasing the energy efficiency of buildings and reducing energy costs and emissions in the future. Objectives: This paper demonstrates the usefulness of using NASA's Modern Era Retrospective-analysis for Research and Applications (MERRA) atmospheric data assimilation to derive the DOE/ASHRAE building climate zone maps and then using MERRA to define the last 30 years of variability in climate zones for the Continental US. An atmospheric assimilation is a global atmospheric model optimized to satellite, atmospheric and surface in situ measurements. Using MERRA as a baseline, we then evaluate the latest Climate Model Inter-comparison Project (CMIP) climate model Version 5 runs to assess potential variability in future climate zones under various assumptions. Methods: We derive DOE/ASHRAE building climate zones using surface and temperature data products from MERRA. We assess these zones using the uncertainties derived by comparison to surface measurements. Using statistical tests, we evaluate variability of the climate zones in time and assess areas in the continental US for statistically significant trends by region. CMIP 5 produced a data base of over two dozen detailed climate model runs under various greenhouse gas forcing assumptions. We evaluate the variation in building climate zones for 3 different decades using an ensemble and quartile

  8. Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons

    PubMed Central

    Ostermann, Julia K.; Reinhold, Thomas; Witt, Claudia M.

    2015-01-01

    Objectives The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group) with the costs for those receiving usual care (control group). Methods Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome) and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs) across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache). Results Data from 44,550 patients (67.3% females) were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14–7,414.29]) than in the control group (EUR 5,857.56 [5,650.98–6,064.13]; p<0.0001) with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48–3,809.53] vs. control EUR 3,092.84 [2,981.31–3,204.37]) and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90–1,102.59] vs. control EUR 867.87 [853.52–882.21]). Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant. Conclusion Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system. PMID:26230412

  9. The Association of Lacking Insurance With Outcomes of Severe Sepsis: Retrospective Analysis of an Administrative Database

    PubMed Central

    Kumar, Gagan; Taneja, Amit; Majumdar, Tilottama; Jacobs, Elizabeth R.; Whittle, Jeff; Nanchal, Rahul

    2016-01-01

    Objective Patients with severe sepsis have high mortality that is improved by timely, often expensive, treatments. Patients without insurance are more likely to delay seeking care; they may also receive less intense care. Design We performed a retrospective analysis of administrative database—Healthcare Costs and Utilization Project’s Nationwide Inpatient Sample—to test whether mortality is more likely among uninsured patients hospitalized for severe sepsis. Patients None. Interventions We used International Classification of Diseases—9th Revision, Clinical Modification, codes indicating sepsis and organ system failure to identify hospitalizations for severe sepsis among patients aged 18–64 between 2000 and 2008. We excluded patients with end-stage renal disease or solid organ transplants because very few are uninsured. We performed multivariate logistic regression modeling to examine the association of insurance status and in-hospital mortality, adjusted for patient and hospital characteristics. We performed subgroup analysis to examine whether the impact of insurance status varied by geographical region; by patient age, sex, or race; or by hospital characteristics such as teaching status, size, or ownership. We used similar methods to examine the impact of insurance status on the use of certain procedures, length of stay, and discharge destination. Measurements and Main Results There were 1,600,269 discharges with severe sepsis from 2000 through 2008 in the age group 18–64 years. Uninsured people, who accounted for 7.5% of admissions with severe sepsis, had higher adjusted odds of mortality (odds ratio, 1.43; 95% CI, 1.37–1.47) than privately insured people. The higher mortality in uninsured was present in all subgroups and was similar in each year from 2000 to 2008. After adjustment, uninsured individuals had a slightly shorter length of stay than insured people and were less likely to receive five of the six interventions we examined. They were

  10. Consumer concerns about paracetamol: a retrospective analysis of a medicines call centre

    PubMed Central

    Lau, Stephanie M; McGuire, Treasure M; van Driel, Mieke L

    2016-01-01

    Objectives To identify consumer information needs about paracetamol, the most commonly used analgesic and antipyretic worldwide. Design Retrospective analysis of medicines questions from the public. Setting Australian consumer medicines call centre. Participants Callers to National Prescribing Service Medicines Line between September 2002 and June 2010 (n=123 217). Main outcome measures Enquiry profile: demographics, enquiry type and concurrent medicines included in paracetamol calls; question themes derived from subset of call narratives. Results Paracetamol comprised part of the enquiry in 5.2% of calls (n=6367). The caller age distribution for paracetamol calls was skewed towards a younger cohort, with 45.2% made by those aged 25–44 vs 37.5% in ‘rest of calls’. Significantly more paracetamol-related calls were made for a child (23.7%) compared with ‘rest of calls’ (12.7%, p<0.001). The most frequent concurrently asked about medicines were codeine (11%, n=1521) and ibuprofen (6.4%, n=884). Questions underpinned by paracetamol risk (interaction, use in pregnancy/lactation or other safety concerns) predominated (55.8%). When individual paracetamol enquiry types were compared with ‘rest of calls’, efficacy was most frequent (24.9% vs 22.8%); however, interaction (21.5% vs 14.8%), administration (15.5% vs 11%) and pregnancy/lactation (13.8% vs 8.3%) categories were more prevalent for paracetamol calls (all p<0.001). Enquiry type frequency also varied by patient age group, with questions about administration more common in younger groups and efficacy dominating in those over 45. Narrative analysis of over-represented paracetamol enquiry types showed specific concerns relevant to life stages: young children, those of reproductive age and the elderly. Conclusions Consumers have many concerns about the use of paracetamol that may be under-recognised by healthcare providers, with the nature of enquiries differing across life stages. These concerns are not

  11. A retrospective analysis of the change in anti-malarial treatment policy: Peru

    PubMed Central

    Williams, Holly Ann; Vincent-Mark, Arlene; Herrera, Yenni; Chang, O Jaime

    2009-01-01

    Background National malaria control programmes must deal with the complex process of changing national malaria treatment guidelines, often without guidance on the process of change. Selecting a replacement drug is only one issue in this process. There is a paucity of literature describing successful malaria treatment policy changes to help guide control programs through this process. Objectives To understand the wider context in which national malaria treatment guidelines were formulated in a specific country (Peru). Methods Using qualitative methods (individual and focus group interviews, stakeholder analysis and a review of documents), a retrospective analysis of the process of change in Peru's anti-malarial treatment policy from the early 1990's to 2003 was completed. Results The decision to change Peru's policies resulted from increasing levels of anti-malarial drug resistance, as well as complaints from providers that the drugs were no longer working. The context of the change occurred in a time in which Peru was changing national governments, which created extreme challenges in moving the change process forward. Peru utilized a number of key strategies successfully to ensure that policy change would occur. This included a) having the process directed by a group who shared a common interest in malaria and who had long-established social and professional networks among themselves, b) engaging in collaborative teamwork among nationals and between nationals and international collaborators, c) respect for and inclusion of district-level staff in all phases of the process, d) reliance on high levels of technical and scientific knowledge, e) use of standardized protocols to collect data, and f) transparency. Conclusion Although not perfectly or fully implemented by 2003, the change in malaria treatment policy in Peru occurred very quickly, as compared to other countries. They identified a problem, collected the data necessary to justify the change, utilized

  12. Harms associated with single unit perioperative transfusion: retrospective population based analysis

    PubMed Central

    Kim, Helen; Auerbach, Andrew D

    2015-01-01

    Objective To determine whether perioperative transfusion of as little as one unit of packed red blood cells in the operating room or the day after surgery is associated with measurably increased odds for perioperative ischemic stroke and myocardial infarction. Design Retrospective cohort study of hospital administrative data. Setting 346 hospitals in the United States participating in the claims based Premier Perspective database from 1 January 2009 to 31 March 2012. Participants 1 583 819 adults who underwent non-cardiac, non-intracranial, non-vascular surgery and required a stay of at least one night in hospital and did not receive packed red blood cells on days two to seven after surgery. Intervention Transfusion of packed red blood cells on the day of surgery or one day after by exposure categories (none or one, two, three or four or more units). Main outcome measures The composite outcome of stroke/myocardial infarction was defined as ischemic stroke, ST elevation myocardial infarction, ventricular tachycardia, or ventricular fibrillation during index admission or as a primary diagnosis for readmission within 30 days. Ventricular tachycardia/ventricular fibrillation were included as a surrogate for myocardial infarction. Results 41 421 (2.6%) patients received at least one unit of packed red blood cells within 48 hours of surgery, and 8044 (0.51%) experienced the composite outcome of stroke/myocardial infarction. Patients who were transfused were older, more likely to be women, and had more comorbid disease. Hierarchical logistic regression adjusted for comorbidities and demographics with random effects by hospital showed that transfusion of as little as one unit was associated with an odds ratio of 2.33 (95% confidence interval 1.90 to 2.86) for perioperative stroke/myocardial infarction, and the odds of stroke/myocardial infarction markedly increased with transfusion of four or more units. Subgroup analysis limiting the cohort to one of several common

  13. Free Delivery of a 30-YEAR Vegetation Product Archive by the Biopar Land Monitoring Core Service

    NASA Astrophysics Data System (ADS)

    Pacholczyk, P.; Makhmara, H.; Lacaze, R. N.; Baret, F.; Weiss, M.; Verger, A.

    2012-12-01

    Geoland2 project is part of the GMES EU-lead initiative and intends to prepare, validate and demonstrate pre-operational service chains and products of the Land Monitoring Core Service. The BioPar Core Monitoring Service distributes through the Geoland 2 portal global products related to biophysical variables : the Leaf Area Index (LAI), the Fraction of green Vegetation Cover (FCover), the fraction of absorbed photosynthetically active radiation (FAPAR) and the Normalized Differential Vegetation Index (NDVI). Long term global biophysical products are of great interest for earth science modeling applications and global change monitoring. Since end of 2011 a 12-year archive (1999-2011) of these biophysical vegetation products derived from SPOT/VEGETATION sensor, called GEOV1_VGT, is available and is continuously updated every ten days. Since this summer, a 20-year archive (1981-2000) of LAI, FAPAR and FCover biophysical vegetation products derived from the AVHRR long term data archive, called GEOV1_AVHRR, has been processed by CNES and is now available through the Geoland 2 portal. The LAI, FAPAR and FCover products issued from VGT and AVHRR data have the same characteristics (temporal resolution 10 days, global coverage) except for the spatial resolution (1/112° for VGT and 0.05° for AVHRR), with an overlap of two years (1999-2000). The evaluation of GEOV1_VGT and GEOV1_AVHRR archive indicates a very good agreement between the two datasets, including a similar level of accuracy in comparison with ground-based measurements made during the 1999-2000 overlap period. Despite that a more consistent 30-year global product at a lower resolution is very useful for communities studying carbon cycle, climate or water cycle. The last step, foreseen for this Autumn, is to process these two archives and to provide to the users a continuous 30-year vegetation product (called GEOV1_GCM) at 0.5° scale. Close to its end the BioPar project has provided demonstration products

  14. Attrition in a 30-year follow-up of a perinatal birth risk cohort: factors change with age

    PubMed Central

    Hokkanen, Laura; Laasonen, Marja; Tuulio-Henriksson, Annamari; Virta, Maarit; Lipsanen, Jari; Tienari, Pentti J.; Michelsson, Katarina

    2014-01-01

    Background. Attrition is a major cause of potential bias in longitudinal studies and clinical trials. Attrition rate above 20% raises concern of the reliability of the results. Few studies have looked at the factors behind attrition in follow-ups spanning decades. Methods. We analyzed attrition and associated factors of a 30-year follow-up cohort of subjects who were born with perinatal risks for neurodevelopmental disorders. Attrition rates were calculated at different stages of follow-up and differences between responders and non-responders were tested. To find combinations of variables influencing attrition and investigate their relative importance at birth, 5, 9, 16 and 30 years of follow-up we used the random forest classification. Results. Initial loss of potential participants was 13%. Attrition was 16% at five, 24% at nine, 35% at 16 and 46% at 30 years. The only group difference that emerged between responders and non-responders was in socioeconomic status (SES). The variables identified by random forest classification analysis were classified into Birth related, Development related and SES related. Variables from all these categories contributed to attrition, but SES related variables were less important than birth and development associated variables. Classification accuracy ranged between 0.74 and 0.96 depending on age. Discussion. Lower SES is linked to attrition in many studies. Our results point to the importance of the growth and development related factors in a longitudinal study. Parents’ decisions to participate depend on the characteristics of the child. The same association was also seen when the child, now grown up, decided to participate at 30 years. In addition, birth related medical variables are associated with the attrition still at the age of 30. Our results using a data mining approach suggest that attrition in longitudinal studies is influenced by complex interactions of a multitude of variables, which are not necessarily evident

  15. Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

    ERIC Educational Resources Information Center

    Klein, Michael C.; Ciotoli, Carlo; Chung, Henry

    2011-01-01

    Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between…

  16. Treatment performances of French constructed wetlands: results from a database collected over the last 30 years.

    PubMed

    Morvannou, A; Forquet, N; Michel, S; Troesch, S; Molle, P

    2015-01-01

    Approximately 3,500 constructed wetlands (CWs) provide raw wastewater treatment in France for small communities (<5,000 people equivalent). Built during the past 30 years, most consist of two vertical flow constructed wetlands (VFCWs) in series (stages). Many configurations exist, with systems associated with horizontal flow filters or waste stabilization ponds, vertical flow with recirculation, partially saturated systems, etc. A database analyzed 10 years earlier on the classical French system summarized the global performances data. This paper provides a similar analysis of performance data from 415 full-scale two-stage VFCWs from an improved database expanded by monitoring data available from Irstea and the French technical department. Trends presented in the first study are confirmed, exhibiting high chemical oxygen demand (COD), total suspended solids (TSS) and total Kjeldahl nitrogen (TKN) removal rates (87%, 93% and 84%, respectively). Typical concentrations at the second-stage outlet are 74 mgCOD L(-1), 17 mgTSS L(-1) and 11 mgTKN L(-1). Pollutant removal performances are summarized in relation to the loads applied at the first treatment stage. While COD and TSS removal rates remain stable over the range of applied loads, the spreading of TKN removal rates increases as applied loads increase. PMID:25945849

  17. Modeling and risk assessment of a 30-Year-old subsurface radioactive-liquid drain field

    NASA Astrophysics Data System (ADS)

    Dawson, Lon A.; Pohl, Phillip I.

    1997-11-01

    The contamination from a 30-year-old radioactive liquid drain field was assessed for movement in the subsurface and potential risks to humans. This assessment included determining field concentrations of cesium 137 (137Cs) and other inorganic contaminants and modeling of the flow and transport of the liquid waste that was sent to the drain field. The field investigation detected no contamination deeper than 15 feet (4.6 m) from the bottom of the drain field. Prediction of the water content of the vadose zone showed no saturated conditions for times greater than 10 years after the known infiltration. Sensitivity analysis of the modeling parameters showed the equilibrium sorption coefficient to be the most important factor in predicting the contaminant plumes. Calibration of modeling results with field data gave a 137Cs sorption coefficient that is within the range of values found in the literature. The risk assessment for the site showed that the contamination poses no significant risk to human health.

  18. A 7-Year Retrospective Multisource Analysis on the Incidence of Anesthesia Awareness With Recall in Cancer Patients

    PubMed Central

    Cascella, Marco; Viscardi, Daniela; Schiavone, Vincenzo; Mehrabmi-Kermani, Farrokh; Muzio, Maria Rosaria; Forte, Cira Antonietta; De Falco, Francesco; Barberio, Daniela; Cuomo, Arturo

    2016-01-01

    Abstract Although randomized controlled studies reported an incidence of anesthesia awareness with recall ∼1 to 2 per 1000 (0.1–0.2%), recent data from the NAP5 study showed an incidence of only 1:19,600. Although in a prospective study many tools for anesthesia awareness detection can be used, a retrospective analysis requires a careful collection of information. The aim of the study was to evaluate the incidence of anesthesia awareness with recall in a cohort of cancer patients through a multisource retrospective analysis, and the clinical description, including the psychological outcome, of the cases detected. We also tested whether our retrospective analysis would be improved by a routinely psycho-oncological assessment. As secondary endpoints we evaluated the use of depth of anesthesia monitoring over a large cohort of patients, and the correlation between the brain monitoring and the incidence of awareness. We have carried out a 7-year retrospective analysis in a large cohort of cancer patients on the incidence of awareness with recall during general anesthesia. Of 35,595 patients assessed for eligibility, 21,099 were studied. We analyzed all data from the operative rooms’ database, the anesthesia records, and from the database of the surgical divisions. In addition we examined reports from psychologists and spontaneous reports to the quality team of the hospital. Two certain cases of awareness were detected, with an incidence of 1:10,550 (0.0095%). They occurred during elective surgery, in female patients without other risk factors. One case came from the report of a psychologist. In both episodes, brain monitoring was not applied and no long-term psychological sequelae were reported. Despite the limitations, our investigation suggests that the incidence of anesthesia awareness is very low, also in a specific cohort of patients, such as the cancer patients, and even when the depth of anesthesia monitoring is rarely used. The limitations caused by both

  19. Acute Fatty Liver of Pregnancy: A Retrospective Analysis of 56 Cases

    PubMed Central

    Zhang, Yan-Ping; Kong, Wei-Qi; Zhou, Sheng-Ping; Gong, Yun-Hui; Zhou, Rong

    2016-01-01

    Background: Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening complication occurring in the third trimester. It is often fatal to both mother and fetus. The complicated clinical manifestations as well as an insufficient understanding of the disease make the precise diagnosis and effective treatment of AFLP challenging. A full understanding of the risk factors, clinical features, and test findings of AFLP is critical for its timely diagnosis and treatment. Methods: We performed a retrospective study of 56 patients with AFLP between June 2008 and July 2013. We analyzed the clinical features, laboratory results, perioperative management, and patient outcomes. Results: The initial symptoms varied considerably, with nausea and vomiting (13/56, 23%) being the most common. Liver-function indexes were remarkable, including elevated levels of serum alanine aminotransferase (262.16 ± 281.71 U/L), aspartate aminotransferase (260.98 ± 237.91 U/L), lactic dehydrogenase (1011.76 ± 530.34 U/L), and direct bilirubin (85.59 ± 90.02 μmol/L). Coagulation disorders were indicated by abnormal levels of fibrinogen (245.95 ± 186.11 mg/dL), D-dimer (2.46 ± 4.01 mg/L), and fibrin degradation products (43.62 ± 48.71 mg/L). The main maternal complications were hypoproteinemia (75%), coagulopathy (54%), and acute renal failure (39%). Multivariate logistic regression analysis identified prothrombin time (PT; odds ratio [OR] = 1.558, 95% confidence interval [CI] =1.248–1.946, P = 0.016) and international normalized ratio (INR; OR = 40.034, 95% CI = 2.517–636.693, P = 0.009) as risk factors. The perinatal infant death rate was related to gestational age at delivery (OR = 1.298, 95% CI = 1.040–1.618, P = 0.021), direct bilirubin (OR = 1.05, 95% CI = 1.008–1.094, P = 0.020), and fibrin degradation products (OR = 0.973, 95% CI = 0.950–0.996, P = 0.021). Conclusions: Nausea and vomiting may be the most common symptoms of AFLP. Indexes of liver dysfunction and

  20. A Retrospective Analysis of the Impact of Myomectomy on Survival in Uterine Sarcoma.

    PubMed

    Gao, Zhenzhen; Li, Li'an; Meng, Yuanguang

    2016-01-01

    Laparoscopic myomectomy is a minimally invasive, conservative surgical approach commonly used for the treatment of uterine fibroids. However, there is a lack of effective means to distinguish the nature of uterine tumors prior to surgery. The impact of fibroid morcellation during laparoscopic surgery on the dissemination of cancerous uterine fibroids and long-term survival of patients has gained increasing attention. A retrospective cohort study was conducted to analyze the impact of different surgical approaches on recurrence-free survival (RFS) and overall survival (OS) in patients with a postoperative pathological diagnosis of uterine sarcoma at a single medical center. Patients who underwent the first surgery for uterine fibroids (confined to the uterus) and had a postoperative pathological diagnosis of uterine sarcoma were selected in the Chinese PLA General Hospital from January 2005 to January 2014. Based on the use of fibroid morcellation, the subjects were divided into fibroid morcellation (FM) and total hysterectomy (TH, non-morcellation) groups. Follow-up outcomes, including RFS and OS times, were observed. In total, 59 patients were included, with 30 cases in the FM group and 29 cases in the TH group. There were no significant differences in RFS and OS time between the two groups (RFS: P = 0.16, OS: P = 0.09). Multivariate correlation analysis showed that the impact of a higher grade level on RFS and OS was nearly 2-fold the impact of a lower grade level (RFS: P = 0.04, odds ratio (OR) = 1.97; OS: P = 0.03, OR = 2.29). Intraoperative morcellation, postoperative adjuvant therapy, age, tumor size, FIGO stage, and surgical approach were not risk factors affecting RFS and OS. Fibroid morcellation during laparoscopic surgery (including laparoscopic, transvaginal and transabdominal approaches) had no significant impact on RFS and OS time in patients. However, the 5-year RFS and OS rates were both lower in the FM group than in the TH group. Grade level was a

  1. Suicidal hanging: fatalities in Istanbul retrospective analysis of 761 autopsy cases.

    PubMed

    Uzün, Ibrahim; Büyük, Yalçin; Gürpinar, Kağan

    2007-10-01

    We retrospectively analyzed the autopsy records of the Institute of Forensic Medicine during the five-year period between 1998 and 2002 to document the characteristics of fatalities resulting from hanging which is the commonest mode of suicide in Istanbul. Upon analysis of death scene investigation and autopsy reports together with the information gathered from the police, the cases of hanging fatalities of suicidal origin were selected. Seven hundred sixty one hanging cases of suicidal origin were detected and evaluated in terms of demographic features, the type of hanging material used for ligature, cause of death, internal findings in neck organs, other traumatic findings suggesting the use of another method for suicide, toxicological findings and microscopic findings in delayed death cases. In 364 of these cases suspension was complete and in 397 incomplete. Five hundred thirty seven of those (70.56%) were male and 224 (29.44%) were female. The preponderance of male cases in our autopsy population was also detected in suicidal hanging cases. There was no case aged lower 10 and the number of the cases in the age group of cases aged over 80 was the lowest (n=3, 0.4%). In 634 of cases, the place of hanging was the subject's own house, most victims selected rope (652 cases) for the ligature with the rest using sheet, belt, cable and necktie. There were traumatic findings showing attempts of suicide other than hanging in 24 cases (tentative marks in 22 cases and non-fatal burning in 2). In 23 of cases, there were bruises of different ages. In these cases females constituted the majority suggesting violence against women that is a social problem in various cultural subgroups of our country. This violence may have played a role in the decision of suicide. Superficial bruises were detected in 56 cases and were attributed to the trauma. Fractures in neck organs were detected in 446 of cases. In fracture-determined cases, fracture in hyoid bone was seen in 177, in

  2. Retrospective analysis of radial EBUS outcome for the diagnosis of peripheral pulmonary lesion: sensitivity and complications

    PubMed Central

    Durakovic, Amal; Andersen, Henrik; Christiansen, Anders; Hammen, Irena

    2015-01-01

    Background The purpose of the current study was to clarify the sensitivity and complication rate of the radial (endobronchial ultrasound, EBUS) without the use of guide-sheath (GS) and fluoroscopy for lung cancer (LC), by measuring the distance from the orifice of the bronchus to the pulmonary lesion, as well as to analyze factors that can predict the diagnostic outcome. Materials and methods A total of 147 patients with peripheral pulmonary lesions (PPL) underwent radial EBUS-guided transbronchial biopsy (TBB) in between August 1, 2013, and August 31, 2014. We analyzed retrospectively radiological data, diagnostic work-up in everyday clinical settings, final diagnosis and complication rates, as well as factors influencing the diagnostic outcome. Results Around 63.9% of PPLs were visualized by ultrasound. A definitive malignant diagnosis was established in 39 patients (26.5%) using radial EBUS. In the remaining 108 patients, additional procedures were performed. We missed LC diagnosis in 40 cases that results in a sensitivity of 49%. For malignant lesions visualized by radial EBUS, the sensitivity was 60%, compared with 24% for not visualized lesions. For malignant lesions, logistic regression was performed to identify the factors that had significant influence on visualization of the lesion and on diagnostic yield. Logistic regression analysis showed significant odds ratios (OR) for visualization depending on location of the lesion; upper lobe lesions were identified more frequent with OR of 3.85 (95% CI 1.42 – 10.98, p=0.009). Size above 30 mm had a non-significant OR of 2.11 (95% CI 0.80−5.73, p=0.134) for visualization. Diagnostic yield was only significantly influenced by visualization with the radial EBUS, OR 3.70 (95% CI 1.35−11.02, p=0.014). Location (p=0.745) and size above 30 mm (p=0.308) showed no significant increase in diagnostic yield. Other lesion characteristics defined on computed tomography, such as distance to carina and pleura, did not

  3. Retrospective Analysis of Ultrasound-guided Flexible Ureteroscopy in the Management of Calyceal Diverticular Calculi

    PubMed Central

    Zhang, Ji-Qing; Wang, Yong; Zhang, Jun-Hui; Zhang, Xiao-Dong; Xing, Nian-Zeng

    2016-01-01

    Background: Percutaneous nephrolithotomy (PCNL) is the most widely recommended treatment for calyceal diverticular calculi, providing excellent stone-free results. However, its invasiveness is not negligible considering its major complication rates. Flexible ureteroscopy (FURS) is currently used to treat calyceal diverticula. However, the greatest drawback of FURS is locating the diverticulum since its neck is narrow and concealed. In such a case, the FURS procedure must be converted to PCNL. The aim of this study was to evaluate ultrasound-guided flexible ureteroscopy (UFURS) identifying diverticulum and the management of calyceal diverticular calculi. Methods: A retrospective analysis was conducted on 24 patients who had calyceal diverticular calculi. In all 12 patients in the UFURS group, direct FURS failed to find evidence of calyceal diverticula but were confirmed with imaging. The other 12 patients in the PCNL group received PCNL plus fulguration of the diverticular walls. Results: Puncture of calyceal diverticulum was successful in all 12 UFURS patients. Two patients in this group had postoperative residual calculi and two patients developed fever. In the PCNL group, percutaneous renal access and lithotomy were successful in all 12 patients. One patient in this group had residual calculi, one had perirenal hematoma, and two patients developed fever. No significant difference was found in the operating time (UFURS vs. PCNL, 91.8 ± 24.2 vs. 86.3 ± 18.7 min), stone-free rate (UFURS vs. PCNL, 9/12 vs. 10/12), and rate of successful lithotripsy (UFURS vs. PCNL, 10/12 vs. 11/12) between the two groups (all P > 0.05). Postoperative pain scores in the FURS group were significantly lower than that in the PCNL group (2.7 ± 1.2 vs. 6.2 ± 1.5, P < 0.05). Hospital stay in the UFURS group was significantly shorter than that in the PCNL group (3.4 ± 0.8 vs. 5.4 ± 1.0 days, P < 0.05). All patients were symptom-free following surgery (UFURS vs. PCNL, 10/10 vs. 12

  4. Analysis of trend of malaria prevalence in south-west Ethiopia: a retrospective comparative study

    PubMed Central

    2014-01-01

    Background The temporal analysis of pertinent malaria data on the health care system is crucially important to measure success or failure of malaria programmes and identify remaining malaria hot spots. The objectives of this study were to analyse and compare trends of malaria prevalence around Gilgel-Gibe Hydroelectric Dam (GGHD), and a control site over an eight-year period. Methods A retrospective record review of health care services was conducted in southwest Ethiopia. Records of malaria cases over an eight-year period in primary health care units of two localities were reviewed. One study site was selected from villages around a man-made lake, GGHD, within a distance of 10 km, and a control site with similar geographic features was identified. Data were summarized in tables; prevalence of malaria was analysed and described by person, place and time using line graphs. Odds ratio was used to examine significant difference of malaria occurrence in the two sites. Results Records of 163,918 malaria cases registered over eight years (September 2003 to August 2011) were explored. Close to one thirds (32.7%) of these cases were from GGHD site and two-thirds (67.3%) of them were from the control site. Among the confirmed cases, Plasmodium falciparum constituted 54.6%, Plasmodium vivax accounted for 41.6%, and mixed infection was 3.8%. There were three peaks of malaria prevalence in the control site whereas only one major peak was identified during the eight-year period in GGHD site; and prevalence of malaria in GGHD site was lower than control site. Children in the age range ten to 14 years were the most affected by the disease, followed by children below the age group five to nine years, which demands due consideration in the effort of malaria control. Conclusions More malaria prevalence was observed in the control site compared to GGHD site almost throughout the time period considered. The present finding did not show evidence of the excess malaria burden in the

  5. Follicular thyroid carcinoma with insular component: a retrospective case study, immunohistochemical analysis and literature review.

    PubMed

    Htwe, T T; Karim, N; Lam, A K

    2012-03-01

    This is a retrospective case study of a 61-year-old woman diagnosed with follicular thyroid carcinoma. The patient underwent thyroidectomy for the treatment of goitre after being admitted for shortness of breath. Microscopic and immunohistochemical studies were performed, which confirmed follicular carcinoma of the thyroid with an insular component. We also conducted a review of the literature on this uncommon entity. PMID:22434304

  6. East Mediterranean region sickle cell disease mortality trial: retrospective multicenter cohort analysis of 735 patients.

    PubMed

    Karacaoglu, Pelin Kardaş; Asma, Suheyl; Korur, Aslı; Solmaz, Soner; Buyukkurt, Nurhilal Turgut; Gereklioglu, Cigdem; Kasar, Mutlu; Ozbalcı, Demircan; Unal, Selma; Kaya, Hasan; Gurkan, Emel; Yeral, Mahmut; Sariturk, Çagla; Boga, Can; Ozdogu, Hakan

    2016-05-01

    Sickle cell disease (SCD), one of the most common genetic disorders worldwide, is characterized by hemolytic anemia and tissue damage from the rigid red blood cells. Although hydroxyurea and transfusion therapy are administered to treat the accompanying tissue injury, whether either one prolongs the lifespan of patients with SCD is unknown. SCD-related mortality data are available, but there are few studies on mortality-related factors based on evaluations of surviving patients. In addition, ethnic variability in patient registries has complicated detailed analyses. The aim of this study was to investigate mortality and mortality-related factors among an ethnically homogeneous population of patients with SCD. The 735 patients (102 children and 633 adults) included in this retrospective cohort study were of Eti-Turk origin and selected from 1367 patients seen at 5 regional hospitals. A central population management system was used to control for records of patient mortality. Data reliability was checked by a data supervision group. Mortality-related factors and predictors were identified in univariate and multivariate analyses using a Cox regression model with stepwise forward selection. The study group included patients with homozygous hemoglobin S (Hgb S) disease (67 %), Hb S-β(0) thalassemia (17 %), Hgb S-β(+) thalassemia (15 %), and Hb S-α thalassemia (1 %). They were followed for a median of 66 ± 44 (3-148) months. Overall mortality at 5 years was 6.1 %. Of the 45 patients who died, 44 (6 %) were adults and 1 (0.1 %) was a child. The mean age at death was 34.1 ± 10 (18-54) years for males, 40.1 ± 15 (17-64) years for females, and 36.6 ± 13 (17-64) years overall. Hydroxyurea was found to have a notable positive effect on mortality (p = 0.009). Mortality was also significantly related to hypertension and renal damage in a univariate analysis (p = 0.015 and p = 0.000, respectively). Acute chest syndrome

  7. Association between use of warfarin with common sulfonylureas and serious hypoglycemic events: retrospective cohort analysis

    PubMed Central

    Romley, John A; Gong, Cynthia; Jena, Anupam B; Goldman, Dana P; Williams, Bradley

    2015-01-01

    Study question Is warfarin use associated with an increased risk of serious hypoglycemic events among older people treated with the sulfonylureas glipizide and glimepiride? Methods This was a retrospective cohort analysis of pharmacy and medical claims from a 20% random sample of Medicare fee for service beneficiaries aged 65 years or older. It included 465 918 beneficiaries with diabetes who filled a prescription for glipizide or glimepiride between 2006 and 2011 (4 355 418 person quarters); 71 895 (15.4%) patients also filled a prescription for warfarin (416 479 person quarters with warfarin use). The main outcome measure was emergency department visit or hospital admission with a primary diagnosis of hypoglycemia in person quarters with concurrent fills of warfarin and glipizide/glimepiride compared with the rates in quarters with glipizide/glimepiride fills only, Multivariable logistic regression was used to adjust for individual characteristics. Secondary outcomes included fall related fracture and altered consciousness/mental status. Summary answer and limitations In quarters with glipizide/glimepiride use, hospital admissions or emergency department visits for hypoglycemia were more common in person quarters with concurrent warfarin use compared with quarters without warfarin use (294/416 479 v 1903/3 938 939; adjusted odds ratio 1.22, 95% confidence interval 1.05 to 1.42). The risk of hypoglycemia associated with concurrent use was higher among people using warfarin for the first time, as well as in those aged 65-74 years. Concurrent use of warfarin and glipizide/glimepiride was also associated with hospital admission or emergency department visit for fall related fractures (3919/416 479 v 20 759/3 938 939; adjusted odds ratio 1.47, 1.41 to 1.54) and altered consciousness/mental status (2490/416 479 v 14 414/3 938 939; adjusted odds ratio 1.22, 1.16 to 1.29). Unmeasured factors could be correlated with both warfarin use and

  8. Autoimmune uveitis: a retrospective analysis of 104 patients from a tertiary reference center

    PubMed Central

    2014-01-01

    Background The aim of this study was to identify the main features of a cohort of Caucasian patients with idiopathic (I) and systemic disease-associated (SDA) autoimmune uveitis (AU) who were followed up at a single tertiary reference center. The study consisted of a retrospective analysis of the demographic, clinical, and laboratory features and the response to treatment of 104 patients with AU evaluated between 2004 and 2013, with a median follow-up of 4.8 years. The primary outcome measure was the response to systemic treatment after 24 months of therapy. The data are expressed as the range, percentage, or mean ± standard error. Categorical variables were assessed by Fisher's exact test. Results The mean age at diagnosis was 40.1 ± 17.8 years for men and 44.1 ± 15.3 years for women. There was a slight female predominance. Of the 104 patients, 72.1% had I-AU and 27.9% SDA-AU. The most frequent associations were with ankylosing spondyloarthritis, autoimmune thyroiditis, inflammatory bowel diseases, and Behcet's disease. Symptoms at presentation consisted of eye redness and pain (28.8%), decreased visual acuity (25.9%), and floaters (18.3%). Complications included cataracts (24%), retinal neovascularization (16.3%), chorio-retinal scars (10.6%), cystoid macular edema (8.6%), glaucoma/ocular hypertension (7.7%), epiretinal membranes (4.8%), and retinal detachment (3.8%). The prevalence of autoantibodies, mostly antinuclear antibodies, was comparable between the I-AU and SDA-AU groups. Fisher's exact test showed a direct correlation between patients with class I HLA B27, Cw8, B5 (51, 52), B51, or Cw2 and the presence of AU, whereas among patients with class II HLA, only DQ1 was a predisposing factor for AU. The therapeutic spectrum included corticosteroids and immunosuppressive agents, given either alone or in various combinations according to the severity of AU and the extent of the clinical response. Among the immunosuppressive drugs

  9. Diagnosis of Depression in Adolescents Following Traumatic Fracture: A Retrospective Analysis

    PubMed Central

    Irvine, James N.; Madaan, Vishal

    2012-01-01

    Objective: To assess how frequently adolescents are clinically diagnosed with depression following hospitalization for traumatic fracture, with the assumption that a retrospective approach would yield lower rates of depression compared to those reported previously in prospective studies. We hypothesized that depression would be less common among adolescents whose injuries were primarily limited to fractures of the appendicular skeleton, vertebral column, and/or thoracic cage compared to those sustaining concomitant spinal cord and/or brain injuries and those suffering from facial/skull fractures. Method: A patient population of 1,121 adolescents, aged 12 to 19 years, who were hospitalized overnight at the University of Virginia (UVA) Health System, Charlottesville, for fractures between 2000 and 2009, was generated using the health system’s Clinical Data Repository. The number of these adolescents who received a new diagnosis of depression (per ICD-9 codes) at the UVA Health System within the first year following their injury was determined. Results: By the end of the first year, 37 of 913 adolescents (4.1%) who had at least 1 follow-up visit after their fracture were diagnosed with depression. When patients with a concomitant spinal cord injury and those with a facial/skull fracture with or without an associated brain injury were excluded, this percentage dropped to 3.2% and 1.1%, respectively. Conclusions: The results support our initial hypothesis that the percentage of adolescents diagnosed with depression following a traumatic fracture determined retrospectively would be lower than the percentages previously reported in related prospective studies. This finding adds to the growing concern that depression in youth is underdiagnosed, even among youth who have contact with health care providers. When compared to our own retrospectively determined data, the much higher rates of depression reported in several prospective studies indicate that more proactive

  10. Severe Adverse Events Related to Tattooing: An Retrospective Analysis of 11 Years

    PubMed Central

    Wollina, Uwe

    2012-01-01

    Background: The incidence of tattoos has been increased markedly during the last 20 years. Aims: To analyze the patient files for severe adverse medical reactions related to tattooing. Settings: Academic Teaching Hospital in South-East Germany. Materials and Methods: Retrospective investigation from March 2001 to May 2012. Results: The incidence of severe adverse medical reactions has been estimated as 0.02%. Infectious and non-infectious severe reactions have been observed. The consequences were medical drug therapies and surgery. Conclusions: Tattooing may be associated with severe adverse medical reactions with significant morbidity. Regulations, education and at least hygienic controls are tools to increase consumer safety. PMID:23248361