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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. 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

  18. 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

  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

    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

  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 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

  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. 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.

  12. 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.

  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. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

  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. 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

  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. 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

  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. 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…

  13. 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…

  14. 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...

  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. 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.

  7. [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

  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. 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

  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. 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

  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. 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

  9. 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

  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. 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

  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 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.

  15. 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

  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. 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

  1. 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

  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. 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

  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. 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.

  8. 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.

  9. 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

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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.

  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. 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…

  17. 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

  18. 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

  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. 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

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. [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

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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.

  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. 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

  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. 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

  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. 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

  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. 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

  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. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. [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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. “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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  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. 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

  7. 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.).

  8. 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

  9. 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

  10. 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

  11. 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

  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. 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

  14. 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

  15. 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

  16. 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.

  17. 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…

  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. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  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. [The meaning of specialist and adequate documentation for retrospective analysis of sicknesses (author's transl)].

    PubMed

    Scheibe, O

    1981-01-01

    The example of a historic comparative study on the value of the application of inhibitions on thrombocyte aggregation (inhibition of thrombocyte function) was used to prove how important such data can be. Mistakes can also be discovered. Clinical comparisons can only be made when investigations have been made using a planned form to note anamnesis and other data. Special pre-illness history, the findings and course of the illness are not noted on a planned form. These conditions also allow an opinion to be formed from retrospective study of a case. The results help to build a prospective and randomized work. PMID:7339378

  11. 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

  12. How will Climate Change Affect Agriculture over the Next 10-30 Years

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Agriculture is dependent upon the climate resources of temperature, sunlight, precipitation, and carbon dioxide. Efficient production depends upon optimum conditions of temperature and water supply and changes in these climatic variables will affect plant and animal systems over the next 10- 30 year...

  13. 30 years of preserving clonal genetic resources in the U.S. National Plant Germplasm System

    Technology Transfer Automated Retrieval System (TEKTRAN)

    For more than 30 years, the U.S. Department of Agriculture (USDA) Agricultural Research Service (ARS) National Plant Germplasm System (NPGS) has preserved clonal plant genetic resources of horticultural crops in field gene banks. Facilities in Hilo, Hawaii; Mayaguez, Puerto Rico; Miami, Florida; and...

  14. Recovering from 30 Years of War: Refugee Women and Children in Angola.

    ERIC Educational Resources Information Center

    Women's Commission for Refugee Women and Children, New York, NY.

    After 30 years of war, Angola faces the challenge of creating a civil society. This report presents key findings of a visit to Angola, December 1-13, 1996, by the Women's Commission for Refugee Women and Children. The report describes conditions facing women and children affected by war in Angola, addresses the return process of refugees from…

  15. Physical Performance of Individuals with Intellectual Disability: A 30-Year Follow up

    ERIC Educational Resources Information Center

    Lahtinen, Ulla; Rintala, Pauli; Malin, Antero

    2007-01-01

    Physical performance of Finnish adolescents (33 females, 44 males) with moderate intellectual disability (ID) was studied over a 30-year period. This study is an extension of Lahtinen's previous work on documenting the performance of individuals with intellectual disabilities over time. This study consisted of analyzing data from a total of four…

  16. Planting Misinformation in the Human Mind: A 30-Year Investigation of the Malleability of Memory

    ERIC Educational Resources Information Center

    Loftus, Elizabeth F.

    2005-01-01

    The misinformation effect refers to the impairment in memory for the past that arises after exposure to misleading information. The phenomenon has been investigated for at least 30 years, as investigators have addressed a number of issues. These include the conditions under which people are especially susceptible to the negative impact of…

  17. Leadership and Change in Schools: Personal Reflections over the Last 30 Years

    ERIC Educational Resources Information Center

    Seashore, Karen R.

    2009-01-01

    The two fields of leadership studies and school change have increasingly converged over the last 30 years. This paper reviews the origins of the intersection, and the development of research themes in three areas: The role of leaders in shaping and using organizational culture, the agency of teachers in the change process, and the importance of…

  18. Educational Co-operation in Asia and the Pacific: 30 Years of NIER's Activities.

    ERIC Educational Resources Information Center

    Watanabe, Ryo, Ed.; Numano, Taro, Ed.; Nagata, Yoshiyuki, Ed.

    The history of the regional cooperation program of the National Institute for Educational Research (NIER) is recorded in this document. Specifically, the report outlines the past 30 years of the program in Asia and the Pacific. Throughout those years, 93 seminars, workshops, and symposia have been organized. In addition, information about the…

  19. Studies Using Single-Subject Designs in Sport Psychology: 30 Years of Research

    ERIC Educational Resources Information Center

    Martin, G. L.; Thompson, K.; Regehr, K.

    2004-01-01

    A prominent feature of behavior-analytic research has been the use of single-subject designs. We examined sport psychology journals and behavioral journals published during the past 30 years, and located 40 studies using single-subject designs to assess interventions for enhancing the performance of athletes and coaches. In this paper, we…

  20. Great Expectations: Creative Achievements of the Sociometric Stars in a 30-Year Study

    ERIC Educational Resources Information Center

    Torrance, E. Paul

    2004-01-01

    The creative achievements and characteristics of a group of ten high school students identified as the most creative by their high school peers were compared to those of ten participants from the same group who had the greatest number of publicly recognized creative achievements approximately 30 years later (Sociometric Stars vs. Beyonders).…

  1. Factors in African Americans Pursuing Higher Education after Age 30 Years

    ERIC Educational Resources Information Center

    Henderson, Davetta A.

    2011-01-01

    Many African Americans are leaving high school prior to graduation and are entering college for the first time beyond the age of 30 years, a phenomenon that has an effect on school systems, the community, and society as a whole. The research problem addressed was the need to understand the experience of an increasing number of African Americans…

  2. Challenges Facing Rural Community Colleges: Issues and Problems Today and over the Past 30 Years

    ERIC Educational Resources Information Center

    Pennington, Kevin; Williams, Mitchell R.; Karvonen, Meagan

    2006-01-01

    For over 30 years, researchers and practitioners have identified challenges unique to small, rural community colleges. The purpose of this study was to examine the distinctive problems facing rural community colleges today and the challenges those institutions must address to fulfill their mission in rural America. There are 5 current challenges…

  3. "Fear of Success" Revisited: A Replication of Matina Horner's Study 30 Years Later.

    ERIC Educational Resources Information Center

    Engle, Jennifer

    This study updated and extended the classic "fear of success" study conducted by Matina Horner more than 30 years ago. Horner (1970) asked college students to respond to a scenario in which "Anne" or "John" is at the top of her/his medical school class. Based on the negative responses of students to "Anne," Horner concluded that women have a…

  4. 7 CFR 1467.8 - Compensation for easements and 30-year contracts.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Compensation for easements and 30-year contracts. 1467.8 Section 1467.8 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS WETLANDS...

  5. 7 CFR 1467.11 - Easement and 30-year contract participation requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Easement and 30-year contract participation requirements. 1467.11 Section 1467.11 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS...

  6. Bullying in Childhood, Externalizing Behaviors, and Adult Offending: Evidence from a 30-Year Study

    ERIC Educational Resources Information Center

    Fergusson, David M.; Boden, Joseph M.; Horwood, L. John

    2014-01-01

    This study examined the developmental processes linking childhood bullying to criminal offending in adulthood, using data from a 30-year longitudinal study. The linkages between bullying in childhood and three criminal offending outcomes in adulthood were estimated both before and after control for a range of confounding factors. A series of…

  7. Left ventricular pseudoaneurysm found after mitral valve replacement performed 30 years earlier.

    PubMed

    Castilla, Elena; Gato, Manuel; Ruiz, José Ramón

    2010-03-01

    Pseudoaneurysm of the left ventricle (LV) is a rare cardiac disease that occurs after myocardial infarction or cardiac surgery. Because patients frequently present with nonspecific symptoms, a high index of suspicion is needed to make the diagnosis. This report describes an unusual case demonstrating a large LV pseudoaneurysm after mitral valve replacement performed 30 years earlier. PMID:20197588

  8. Is 30 Years of Age Over-the-Hill for Outdoor Professionals?

    ERIC Educational Resources Information Center

    Kirk, Liz

    2012-01-01

    The author is now 30 years old. For more than a decade, she has been paid to facilitate an array of outdoor-based programming with varying groups of participants. With such breadth of experience, she frequently feels like she is a valuable asset to the organizations for which she works. However, at recent staff training and trip preparation days,…

  9. Magma at depth: A retrospective analysis of the 1975 unrest at Mount Baker, Washington, USA

    USGS Publications Warehouse

    Crider, Juliet G.; Frank, David; Malone, Stephen D.; Poland, Michael P.; Werner, Cynthia; Caplan-Auerbach, Jacqueline

    2011-01-01

    Mount Baker volcano displayed a short interval of seismically-quiescent thermal unrest in 1975, with high emissions of magmatic gas that slowly waned during the following three decades. The area of snow-free ground in the active crater has not returned to pre-unrest levels, and fumarole gas geochemistry shows a decreasing magmatic signature over that same interval. A relative microgravity survey revealed a substantial gravity increase in the ~30 years since the unrest, while deformation measurements suggest slight deflation of the edifice between 1981-83 and 2006-07. The volcano remains seismically quiet with regard to impulsive volcano-tectonic events, but experiences shallow (10 km) long-period earthquakes. Reviewing the observations from the 1975 unrest in combination with geophysical and geochemical data collected in the decades that followed, we infer that elevated gas and thermal emissions at Mount Baker in 1975 resulted from magmatic activity beneath the volcano: either the emplacement of magma at mid-crustal levels, or opening of a conduit to a deep existing source of magmatic volatiles. Decadal-timescale, multi-parameter observations were essential to this assessment of magmatic activity.

  10. Is Statin Use Associated With Tendon Rupture? A Population-Based Retrospective Cohort Analysis.

    PubMed

    Contractor, Tahmeed; Beri, Abhimanyu; Gardiner, Joseph C; Tang, Xiaoqin; Dwamena, Francesca C

    2015-01-01

    Previous case reports and small studies have suggested that 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors (HMG-CoA-Is) may increase the risk of tendon rupture. We conducted a population-based retrospective cohort evaluation to better assess this relationship. From approximately 800,000 enrollees of a private insurance database, those who were aged ≤64 years with at least 1 year of continuous enrollment were selected. Exposure was defined as initiation of HMG-CoA-I after the beginning of the study period. Each exposed person was matched with 2 controls of similar age and gender. Baseline characteristics, including known risk factors for tendon rupture, were compared between exposed and control cohorts with fidelity to the study's matched design. After adjusting for differences in follow-up and baseline characteristics, incidence rate ratios for tendon rupture was assessed in HMG-CoA-I users and nonusers. A total of 34,749 exposed patients were matched with 69,498 controls. There was no difference in the occurrence of tendon ruptures in HMG-CoA-I users versus nonusers. The results remained unchanged after adjustment for age and gender. In conclusion, this population-based retrospective cohort evaluation suggests that use of HMG-CoA-Is as a group are not associated with tendon rupture. PMID:24451300

  11. Prelinguistic communication development in children with childhood apraxia of speech: a retrospective analysis.

    PubMed

    Highman, Chantelle; Leitão, Suze; Hennessey, Neville; Piek, Jan

    2012-02-01

    In a retrospective study of prelinguistic communication development, clinically referred preschool children (n = 9) aged 3-4 years, who as infants had failed a community-based screening program, were evaluated for features of childhood apraxia of speech (CAS). Four children showed no features and either delayed or normal language, five had from three-to-seven CAS features and all exhibited delayed language. These children were matched by age with 21 children with typically-developing (TD) speech and language skills. Case-control comparisons of retrospective data from 9 months of age for two participants with more severe features of CAS at preschool age showed a dissociated pattern with low expressive quotients on the Receptive-Expressive Emergent Language Assessment-Second Edition (REEL-2) and records of infrequent babbling, but normal receptive quotients. However, other profiles were observed. Two children with milder CAS features showed poor receptive and expressive development similar to other clinically referred children with no CAS features, and one child with severe CAS features showed poor receptive but normal expressive developmental milestones at 9 months and records of frequent babbling. Results suggest some but not all children with features of suspected CAS have a selective deficit originating within speech motor development. PMID:22257070

  12. Retrospection of Chernobyl nuclear accident for decision analysis concerning remedial actions in Ukraine

    SciTech Connect

    Georgievskiy, Vladimir

    2007-07-01

    It is considered the efficacy of decisions concerning remedial actions when of-site radiological monitoring in the early and (or) in the intermediate phases was absent or was not informative. There are examples of such situations in the former Soviet Union where many people have been exposed: releases of radioactive materials from 'Krasnoyarsk-26' into Enisey River, releases of radioactive materials from 'Chelabinsk-65' (the Kishtim accident), nuclear tests at the Semipalatinsk Test Site, the Chernobyl nuclear accident etc. If monitoring in the early and (or) in the intermediate phases is absent the decisions concerning remedial actions are usually developed on the base of permanent monitoring. However decisions of this kind may be essentially erroneous. For these cases it is proposed to make retrospection of radiological data of the early and intermediate phases of nuclear accident and to project decisions concerning remedial actions on the base of both retrospective data and permanent monitoring data. In this Report the indicated problem is considered by the example of the Chernobyl accident for Ukraine. Their of-site radiological monitoring in the early and intermediate phases was unsatisfactory. In particular, the pasture-cow-milk monitoring had not been made. All official decisions concerning dose estimations had been made on the base of measurements of {sup 137}Cs in body (40 measurements in 135 days and 55 measurements in 229 days after the Chernobyl accident). For the retrospection of radiological data of the Chernobyl accident dynamic model has been developed. This model has structure similar to the structure of Pathway model and Farmland model. Parameters of the developed model have been identified for agricultural conditions of Russia and Ukraine. By means of this model dynamics of 20 radionuclides in pathways and dynamics of doses have been estimated for the early, intermediate and late phases of the Chernobyl accident. The main results are following

  13. Evaluation of the Modern Era Retrospective-Analysis for Research and Applications (MERRA) Global Water and Energy Budgets

    NASA Technical Reports Server (NTRS)

    Bosilovich, Michael G.; Robertson, F. R.; Chen, J.

    2010-01-01

    The Modern Era Retrospective-analysis for Research and Applications (MERRA) reanalyses has completed 27 years of data) soon to be caught up to present. Here) we present an evaluation of those years currently available) including comparisons with the existing long reanalyses (ERA40) JRA25 and NCEP 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, but that the magnitude of energy imbalance in the system is improved with more observations. 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).

  14. Public accessibility of biomedical articles from PubMed Central reduces journal readership—retrospective cohort analysis

    PubMed Central

    Davis, Philip M.

    2013-01-01

    Does PubMed Central—a government-run digital archive of biomedical articles—compete with scientific society journals? A longitudinal, retrospective cohort analysis of 13,223 articles (5999 treatment, 7224 control) published in 14 society-run biomedical research journals in nutrition, experimental biology, physiology, and radiology between February 2008 and January 2011 reveals a 21.4% reduction in full-text hypertext markup language (HTML) article downloads and a 13.8% reduction in portable document format (PDF) article downloads from the journals' websites when U.S. National Institutes of Health-sponsored articles (treatment) become freely available from the PubMed Central repository. In addition, the effect of PubMed Central on reducing PDF article downloads is increasing over time, growing at a rate of 1.6% per year. There was no longitudinal effect for full-text HTML downloads. While PubMed Central may be providing complementary access to readers traditionally underserved by scientific journals, the loss of article readership from the journal website may weaken the ability of the journal to build communities of interest around research papers, impede the communication of news and events to scientific society members and journal readers, and reduce the perceived value of the journal to institutional subscribers.—Davis, P. M. Public accessibility of biomedical articles from PubMed Central reduces journal readership—retrospective cohort analysis. PMID:23554455

  15. Tolerability of intravenous pamidronate for the treatment of osteoporosis and other metabolic osteopathies: A retrospective analysis

    PubMed Central

    Sarli, Marcelo; Spivacow, Rodolfo; Pedroarias, Viviana; Roldán, Emilio J.A.; Zanchetta, José R.

    2007-01-01

    Background: Intravenous disodium pamidronate has been described in the treatment of several osteopathies. Although tolerability has been found to be good in clinical trials, some mild to serious adverse events (AEs) have been reported. Objectives: The aims of this study were to analyze the toelrability of IV pamidronate in patients being treated for osteoporosis and other metabolic osteopathies and to describe particular patients with relative contraindications, because such cases are not commonly seen in daily clinical practice. Methods: We performed a retrospective analysis of patients with different osteopathies who were administered IV infusions of pamidronate at doses ranging from 15 to 90 mg/infusion and 15 to 900 mg/year. The study was conducted in patients who had received treatment at the Institute of Metabolic Investigations, University of Salvador, Buenos Aires, Argentina, between January 1995 and December 2003. To rule out dose-related AEs, a comparison was made between patients who received fewer IV infusions and had cumulative doses of 120 to 180 mg/y (less frequent administration [LFA] group) and those patients who received regular infusions and had cumulative doses of >180 mg/year (frequent administration [FA] group). To confirm data obtained from medical records and to assess the occurrence of AEs, attempts were made to interview all patients by phone. The following information was verified for each patient included in the study: the reason for treatment, documented evidence of current diagnostic criteria, and whether the dose administered was adequate to treat the patient's condition. Results: Six hundred eight patients (464 [76.3%]women, 144 [23.7%]men; mean [SD] age, 69 [10] years) with various osteopathies (osteoporosis, 367 [60.4%] of the patients; Paget's disease, 172 [28.3%]; Sudeck's disease, 63 [10.4%]; multiple myeloma, 3 [0.5%]; and bone metastases, 3 [0.5%]) were administered a total of 2933 IV infusions of pamidronate during the study

  16. High Incidence of Methotrexate Associated Renal Toxicity in Patients with Lymphoma: A Retrospective Analysis

    PubMed Central

    May, Jori; Carson, Kenneth R.; Butler, Sara; Liu, Weijian; Bartlett, Nancy L.; Wagner-Johnston, Nina D.

    2014-01-01

    High dose methotrexate (HDMTX), defined by doses of methotrexate (MTX) ≥ 1g/m2, is a widely used regimen known to cause renal toxicity. The reported incidence of renal toxicity in osteosarcoma patients is 1.8%, but the incidence in hematologic malignancies is not well characterized. In this retrospective study of 649 cycles of HDMTX in 194 patients, renal toxicity occurred in 9.1% of cycles in patients with lymphoma compared to 1.5% in patients with sarcoma. Older age, male sex, decreased baseline CrCl, and increased proton pump inhibitor use among the lymphoma population likely contributed to the observed difference. The incidence of renal toxicity was independent of the incidence of delayed MTX elimination, suggesting that kidney function is only one factor involved in MTX clearance. Renal toxicity prolonged the duration of hospitalization but severe renal insufficiency was uncommon. No significant impact on progression free or overall survival was observed. PMID:24004183

  17. Non-Occupational Post-Exposure Prophylaxis for HIV: 10-Year Retrospective Analysis in Seattle, Washington

    PubMed Central

    McDougal, Sarah J.; Alexander, Jeremiah; Dhanireddy, Shireesha; Harrington, Robert D.; Stekler, Joanne D.

    2014-01-01

    Despite treatment guidelines in place since 2005, non-occupational post-exposure HIV prophylaxis (nPEP) remains an underutilized prevention strategy. We conducted a retrospective chart review of patients presenting to a publicly-funded HIV clinic in Seattle, Washington for nPEP between 2000 and 2010 (N = 360). nPEP prescriptions were provided for 324 (90%) patients; 83% of prescription decisions were appropriate according to Centers for Disease Control and Prevention guidelines, but only 31% (N = 111/360) of patients were considered “high risk.” In order to use limited resources most efficiently, public health agencies should target messaging for this high-cost intervention to individuals with high-risk HIV exposures. PMID:25140868

  18. Distribution of lameness lesions in beef cattle: A retrospective analysis of 745 cases.

    PubMed

    Newcomer, Benjamin W; Chamorro, Manuel F

    2016-04-01

    The objective of this retrospective study was to characterize the relative prevalence of diagnoses and location of lameness lesions in beef cattle. Medical records from 2005 to 2012 were reviewed and 745 cases of beef cattle that had presented for lameness were identified. Information regarding signalment, lesion location, and cause of lameness was analyzed. The cause of lameness was localized to the foot in approximately 85% of cases; a hind limb was affected over 70% of the time. The lateral claw was most commonly affected in cases of both fore- and hind-limb lameness. The most common diagnoses of noninfectious etiology were screw claw, vertical fissure, and interdigital fibroma. Infectious foot disease accounted for only 20% of foot lameness. Routine foot trimming may be warranted in some herds to improve weight-bearing balance and alleviate lameness. PMID:27041758

  19. Predicting reading success in a multilevel schoolwide reading model: a retrospective analysis.

    PubMed

    Chard, David J; Stoolmiller, Mike; Harn, Beth A; Wanzek, Jeanne; Vaughn, Sharon; Linan-Thompson, Sylvia; Kame'enui, Edward J

    2008-01-01

    Despite recent research findings that implicate a long list of student variables that predict reading success or failure, these predictor variables have not been considered in the context of contemporary models of multitiered schoolwide reading intervention. This longitudinal, retrospective study follows 668 kindergarten and first-grade students identified as at risk for later reading difficulties through third grade. Key predictor variables were examined to determine their validity for predicting initial status and growth on oral reading fluency, third-grade oral reading fluency, and third-grade performance on a standardized test of reading. Results are provided in light of the instructional model provided. Implications for instruction and assessment are discussed. PMID:18354936

  20. A retrospective analysis of possible triggers of Guillain-Barre syndrome.

    PubMed

    Yang, Bing; Lian, Ying; Liu, Ying; Wu, Bing-Yun; Duan, Rui-Sheng

    2016-04-15

    Antecedent infections have been found to be the most common trigger for Guillain-Barre syndrome (GBS). In the present study, we retrospectively analyzed 36 adult patients with GBS and found that surgery, trauma and treatment with ganglioside were also common before the onset of GBS. The proportion of the axonal subtype of GBS in post-surgical/traumatic patients was higher than that in non-surgical/traumatic patients (P=0.013) in the present study. In conclusion, this study has shown that prior infection, surgery, trauma and ganglioside may be clinical contributors to the onset of GBS and raised the possibility that they may act synergistically as triggers for the development of GBS. PMID:27049556

  1. Skeletal Metastasis of Unknown Primary Origin at the Initial Visit: A Retrospective Analysis of 286 Cases

    PubMed Central

    Takagi, Tatsuya; Katagiri, Hirohisa; Kim, Yongji; Suehara, Yoshiyuki; Kubota, Daisuke; Akaike, Keisuke; Ishii, Midori; Mukaihara, Kenta; Okubo, Taketo; Murata, Hideki; Takahashi, Mitsuru; Kaneko, Kazuo; Saito, Tsuyoshi

    2015-01-01

    Background Skeletal metastasis is a common metastatic event for several carcinomas, and the treatment for skeletal metastasis of unknown primary (SMUP) are a critical issue in cancer therapy. Making a diagnosis of the primary site is the most crucial step in the treatment of SMUP; however, the procedures are sometimes difficult and time-consuming, and the primary site often remains unknown. Therefore, to establish optimal diagnostic strategies and elucidate the overall survival rates of SMUP, we conducted this retrospective study. Methods We retrospectively analyzed the clinical data for 286 SMUP cases from a total of 2,641 patients with skeletal metastases who were treated between 2002 and 2014 at our initiations. Results The primary sites were identified in 254/286 patients (88.8%), while 32 (11.2%) primary sites were not detected by our diagnostic strategies. Lung cancer was identified in 72 (25.2%) cases, and was the most frequently observed primary lesion. The median survival time of the SMUP patients was 20.0 months, while the median survival times of solitary bone metastasis cases and multi-bone metastasis cases were 39.0 months and 16.0 months, respectively. The median survival times of prostate cancer cases was over 120 months, that of patients with primary lung cancers was 9.0 months and the median survival time of cases who were finally diagnosed with an unknown primary was 11.0 months. Conclusions We believe that our study would contribute to establishing an optimal strategy for diagnosing the primary site in SMUP patients, and our data provide definite indications for the survival times for different SMUP situations. PMID:26115010

  2. Cervicofacial infection in a Nigerian tertiary health institution: a retrospective analysis of 77 cases

    PubMed Central

    Ononiwu, Charles N

    2015-01-01

    Objectives Infection involving the orbit, zygomatic space, lateral pharyngeal space, or hemifacial and oral floor phlegmon is referred to as cervicofacialvinfection (CFI). When diagnosis and/or adequate treatment are delayed, these infections can be life-threatening. Most cases are the result of odontogenic infections. We highlight our experiences in the management of this life-threatening condition. Materials and Methods This was a retrospective study of patients who presented with CFI from December 2005 to June 2012 at the Oral and Maxillofacial Surgery Clinic or the Accident and Emergency Unit of Ahmadu Bello University Teaching Hospital (Zaria, Nigeria). The medical records of all patients who presented with either localized or diffuse infection of the maxillofacial soft tissue spaces were retrospectively collected. Data collected was analyzed using SPSS version 13.0 and are expressed as descriptive and inferential statistics. Results Of the 77 patients, 49 patients (63.6%) were males, a male to female ratio of 1:7.5. The ages ranged from two years to 75 years with a mean of 35.0±19.3 years, although most patients were older than 40 years. The duration of symptoms prior to presentation ranged from 6 to 60 days, with a mean of 11.0±9.4 days. More than 90% of the patients presented to the clinic within the first 10 days. The most commonly involved anatomical space was the submandibular space (n=29, 37.7%), followed by hemifacial space (n=22, 28.6%) and buccal space (n=7, 9.1%). Ludwig angina accounted for about 7.8% of the cases. Conclusion CFI most commonly involves the submandibular space, typically affects individuals with a low level of education, and is influenced by traditional medical practices. Despite improved health care delivery, CFI remains a significant problem in developing countries. PMID:26734555

  3. Retrospective analysis of lung function abnormalities of Bhopal gas tragedy affected population

    PubMed Central

    De, Sajal

    2012-01-01

    Background & objectives: A large numbers of subjects were exposed to the aerosol of methyl isocyanate (MIC) during Bhopal gas disaster and lung was one of the most commonly affected organs. The aim of the present study was to analyze retrospectively the lung function abnormalities among the surviving MIC exposed population (gas victims) and to compare it with the non-MIC exposed (non gas exposed) population. Methods: The spirometry data of both gas victims and non gas exposed population who attended the Bhopal Memorial Hospital & Research Centre for evaluation of their respiratory complaints from August 2001 to December 2009, were retrospectively evaluated and compared. Results: A total 4782 gas victims and 1190 non gas exposed individuals performed spirometry during the study period. Among the gas victims, obstructive pattern was the commonest (50.8%) spirometric abnormality followed by restrictive pattern (13.3%). The increased relative risk of developing restrictive abnormality among gas victims was observed in 20-29 yr age group only (adjusted relative risk: 2.94, P<0.001). Male gas victims were more affected by severe airflow obstruction than females and the overall increased relative risk (1.33 to 1.45, P<0.001) of developing obstructive pattern among gas victims was observed. Interpretation & conclusions: The present study showed that the relative risk for pulmonary function abnormalities in gas victims was significantly more among those who were young at the time of disaster. Increased smoking habit among gas victims might have played an additive effect on predominance of obstructive pattern in spirometry. PMID:22446861

  4. Intraoperative Radiotherapy for Pancreatic Cancer: 30-Year Experience in a Single Institution in Japan

    SciTech Connect

    Jingu, Keiichi; Tanabe, Takaya; Nemoto, Kenji; Ariga, Hisanori; Umezawa, Rei; Ogawa, Yoshihiro; Takeda, Ken; Koto, Masashi; Sugawara, Toshiyuki; Kubozono, Masaki; Shimizu, Eiji; Abe, Keiko; Yamada, Shogo

    2012-07-15

    Purpose: To analyze retrospectively the results of intraoperative radiotherapy (IORT) with or without external beam radiotherapy ({+-} EBRT) for localized pancreatic cancer in the past three decades and to analyze prognostic factors by multivariate analysis. Methods and Materials: Records for 322 patients with pancreatic cancer treated by IORT {+-} EBRT in Tohoku University Hospital between 1980 and 2009 were reviewed. One hundred ninety-two patients who had no distant organ metastases or dissemination at the time of laparotomy were enrolled in the present study. Results: Eighty-three patients underwent gross total resection (R0: 48 patients, R1: 35 patients), and 109 patients underwent only biopsy or palliative resection. Fifty-five patients underwent adjuvant EBRT, and 124 underwent adjuvant chemotherapy. The median doses of IORT and EBRT were 25 and 40 Gy, respectively. The median follow-up period was 37.5 months. At the time of the analysis, 166 patients had disease recurrence, and 35 patients had local failure. The 2-year local control (LC) and overall survival (OS) rates were 71.0% and 16.9%, respectively. Comparison of the results for each decade showed that OS was significantly improved decade by decade (2-year: 25.0% vs. 18.8% vs. 4.2%, p < 0.001). Multivariate analysis showed that degree of resection (R0-1 vs. R2, hazard ratio = 1.97, p = 0.001) and adjuvant chemotherapy (yes vs. no, hazard ratio = 1.54, p = 0.028) had significant impacts on OS. Late gastrointestinal morbidity of Common Terminology Criteria for Adverse Events version 3.0 grade 4 or 5 was observed in four patients. Conclusion: Excellent local control for pancreatic cancer with few cases of severe late toxicity was achieved by using IORT. OS of patients with pancreatic cancer treated by IORT {+-} EBRT improved significantly decade by decade. Multivariate analysis showed that degree of resection and adjuvant chemotherapy had significant impacts on OS.

  5. Revisiting 30 years of biofunctionalization and surface chemistry of inorganic nanoparticles for nanomedicine

    PubMed Central

    Conde, João; Dias, Jorge T.; Grazú, Valeria; Moros, Maria; Baptista, Pedro V.; de la Fuente, Jesus M.

    2014-01-01

    In the last 30 years we have assisted to a massive advance of nanomaterials in material science. Nanomaterials and structures, in addition to their small size, have properties that differ from those of larger bulk materials, making them ideal for a host of novel applications. The spread of nanotechnology in the last years has been due to the improvement of synthesis and characterization methods on the nanoscale, a field rich in new physical phenomena and synthetic opportunities. In fact, the development of functional nanoparticles has progressed exponentially over the past two decades. This work aims to extensively review 30 years of different strategies of surface modification and functionalization of noble metal (gold) nanoparticles, magnetic nanocrystals and semiconductor nanoparticles, such as quantum dots. The aim of this review is not only to provide in-depth insights into the different biofunctionalization and characterization methods, but also to give an overview of possibilities and limitations of the available nanoparticles. PMID:25077142

  6. Forecasting California's earthquakes: What can we expect in the next 30 years?

    USGS Publications Warehouse

    Field, Edward H.; Milner, Kevin R.; The 2007 Working Group on California Earthquake Probabilities

    2008-01-01

    In a new comprehensive study, scientists have determined that the chance of having one or more magnitude 6.7 or larger earthquakes in the California area over the next 30 years is greater than 99%. Such quakes can be deadly, as shown by the 1989 magnitude 6.9 Loma Prieta and the 1994 magnitude 6.7 Northridge earthquakes. The likelihood of at least one even more powerful quake of magnitude 7.5 or greater in the next 30 years is 46%?such a quake is most likely to occur in the southern half of the State. Building codes, earthquake insurance, and emergency planning will be affected by these new results, which highlight the urgency to prepare now for the powerful quakes that are inevitable in California?s future.

  7. Revisiting 30 years of biofunctionalization and surface chemistry of inorganic nanoparticles for nanomedicine.

    PubMed

    Conde, João; Dias, Jorge T; Grazú, Valeria; Moros, Maria; Baptista, Pedro V; de la Fuente, Jesus M

    2014-01-01

    In the last 30 years we have assisted to a massive advance of nanomaterials in material science. Nanomaterials and structures, in addition to their small size, have properties that differ from those of larger bulk materials, making them ideal for a host of novel applications. The spread of nanotechnology in the last years has been due to the improvement of synthesis and characterization methods on the nanoscale, a field rich in new physical phenomena and synthetic opportunities. In fact, the development of functional nanoparticles has progressed exponentially over the past two decades. This work aims to extensively review 30 years of different strategies of surface modification and functionalization of noble metal (gold) nanoparticles, magnetic nanocrystals and semiconductor nanoparticles, such as quantum dots. The aim of this review is not only to provide in-depth insights into the different biofunctionalization and characterization methods, but also to give an overview of possibilities and limitations of the available nanoparticles. PMID:25077142

  8. Eco-region dependent lengthening of vegetation period over the past 30 years in Europe

    NASA Astrophysics Data System (ADS)

    Garonna, I.; De Jong, R.; De Wit, A.; Mücher, C. A.; Schmid, B.; Schaepman, M. E.

    2013-12-01

    Land Surface Phenology (LSP) is the most direct representation of intra-annual dynamics of vegetated land surfaces as observed from satellite observations. As such, LSP plays a key role in understanding the terrestrial carbon budget, as well as the response of terrestrial ecosystems to environmental change. Various studies have highlighted significant increases in vegetation activity over time (i.e. greening) over Europe in recent decades (e.g. Stöckli and Vidale, 2004), associated both with climatic changes and with large-scale human interventions including land-use change (de Jong et al., 2013). In this study, we characterize LSP changes in Europe's eco-regions for the last 30 years. We used the latest version of the 8-km Global Inventory Modeling and Mapping Studies (GIMMS) Normalized Difference Vegetation Index dataset (third generation, or NDVI-3g) to retrieve LSP metrics for Europe for the last three decades (1982-2011). Each year of NDVI data was processed using the Harmonic Analysis of Time Series (HANTS) algorithm, producing smooth NDVI annual profiles on a pixel-by-pixel basis. In order to derive LSP metrics for each year, namely Start, End and Length of Growing Season, we selected the Midpoint-pixel local threshold method, based on the White et al. (2009) inter-comparison. A landscape-based stratification, using the European Landscape Classification (LANMAP) (Mücher et al., 2010) allowed us to examine LSP characteristics and trends for the different European eco-regions. We demonstrate significant shifts in LSP metrics over the study period, with a general lengthening of the growing season in Europe of approximately 0.4 days year-1. LSP trends varied significantly between eco-regions, and we discuss potential reasons for these spatially diverse trends. de Jong, R., et al. (2013), Spatial relationship between climatologies and changes in global vegetation activity, Global Change Biology, 19(6), 1953-1964. Mücher, C. A., J. A. Klijn, D. M. Wascher, and

  9. Stem Cell Therapy for the Treatment of Hip Osteonecrosis: A 30-Year Review of Progress

    PubMed Central

    Trousselier, Matthieu; Roubineau, François; Bouthors, Charlie; Chevallier, Nathalie; Rouard, Helene; Flouzat-Lachaniette, Charles-Henri

    2016-01-01

    Avascular necrosis of the femoral head is caused by a multitude of etiologic factors and is associated with collapse with a risk of hip arthroplasty in younger populations. A focus on early disease management with the use of stem cells was proposed as early as 1985 by the senior author (PH). We undertook a systematic review of the medical literature to examine the progress in cell therapy during the last 30 years for the treatment of early stage osteonecrosis. PMID:26929793

  10. The Right Gastroepiploic Artery Graft for Coronary Artery Bypass Grafting: A 30-Year Experience

    PubMed Central

    Suma, Hisayoshi

    2016-01-01

    Throughout its 30-year history, the right gastroepiploic artery (GEA) has been useful for in situ grafts in coronary artery bypass grafting (CABG). The early graft patency rate is high, and the late patency rate has improved by using the skeletonized GEA graft and proper target selection, which involves having a target coronary artery with a tight >90% stenosis. Total arterial revascularization with the internal thoracic artery and GEA grafts is an option for achieving better outcomes from CABG procedures. PMID:27525230

  11. Studies using single-subject designs in sport psychology: 30 years of research

    PubMed Central

    Martin, Garry L.; Thompson, Kendra; Regehr, Kaleigh

    2004-01-01

    A prominent feature of behavior-analytic research has been the use of single-subject designs. We examined sport psychology journals and behavioral journals published during the past 30 years, and located 40 studies using single-subject designs to assess interventions for enhancing the performance of athletes and coaches. In this paper, we summarize that body of research, discuss its strengths and limitations, and identify areas for future research. PMID:22478434

  12. A new model of Tidal EOP variations from VLBI data spanning 30 years

    NASA Astrophysics Data System (ADS)

    Gipson, John M.; Ray, Richard D.

    2009-04-01

    We report on a new solution for tidal EOP variations derived from VLBI data. This solution uses approximately 6.5 million VLBI delay measurements spanning almost 30 years, and is the most precise VLBI solution to date. We compare this solution to earlier VLBI solutions, solutions from other techniques, and theoretical predictions. We give theoretical and empirical estimates of the error of the estimates. We also compare the predictions from the VLBI tidal solution with hourly VLBI and GPS measurements of EOP.

  13. Validation of a high-resolution precipitation database (CHIRPS) over Cyprus for a 30-year period

    NASA Astrophysics Data System (ADS)

    Katsanos, Dimitrios; Retalis, Adrianos; Michaelides, Silas

    2016-03-01

    A study for a 30-year period (1981-2010) for a new precipitation database is performed over the island of Cyprus. Climate Hazards Group Infrared Precipitation with Station data (CHIRPS) is a more than 30-year quasi-global rainfall dataset, spanning 50°S-50°N (and all longitudes). Starting in 1981 to near-present, CHIRPS incorporates 0.05° resolution satellite imagery with in situ station data to create gridded rainfall time series. In this study, CHIRPS database is firstly compared to other precipitation databases over the Mediterranean basin. In the following, this study focuses over Cyprus, where a dense and reliable network of rain gauges is available. CHIRPS data are compared for the first time with in situ measurements in this area, for the aforementioned 30-year period. Monthly and annual comparisons are presented for each of the 0.05 × 0.05 degree cells overlaying the island of Cyprus. Results showed good correlation between CHIRPS values and recorded precipitation, although an overestimation of the in situ rainfall data has been noted during the last decade.

  14. Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: A Retrospective Analysis

    PubMed Central

    Mallhi, Tauqeer Hussain; Khan, Amer Hayat; Adnan, Azreen Syazril; Sarriff, Azmi; Khan, Yusra Habib; Jummaat, Fauziah

    2015-01-01

    Background Dengue induced acute kidney injury (AKI) imposes heavy burden of illness in terms of morbidity and mortality. A retrospective study was conducted to investigate incidence, characteristics, risk factors and clinical outcomes of AKI among dengue patients. Methodology A total 667 dengue patients (2008–2013) were retrospectively evaluated and were stratified into AKI and non-AKI groups by using AKIN criteria. Two groups were compared by using appropriate statistical methods. Results There were 95 patients (14.2%) who had AKI, with AKIN-I, AKIN-II and AKIN-III in 76.8%, 16.8% and 6.4% patients, respectively. Significant differences (P<0.05) in demographics and clinico-laboratory characteristics were observed between patients with and without AKI. Presence of dengue hemorrhagic fever [OR (95% CI): 8.0 (3.64–17.59), P<0.001], rhabdomyolysis [OR (95% CI): 7.9 (3.04–20.49)], multiple organ dysfunction [OR (95% CI): 34.6 (14.14–84.73), P<0.001], diabetes mellitus [OR (95% CI): 4.7 (1.12–19.86), P = 0.034], late hospitalization [OR (95% CI): 2.1 (1.12–19.86), P = 0.033] and use of nephrotoxic drugs [OR (95% CI): 2.9 (1.12–19.86), P = 0.006] were associated with AKI. Longer hospital stay (>3 days) was also observed among AKI patients (OR = 1.3, P = 0.044). Additionally, 48.4% AKI patients had renal insufficiencies at discharge that were signicantly associated with severe dengue, secondary infection and diabetes mellitus. Overall mortality was 1.2% and all fatal cases had AKI. Conclusions The incidence of AKI is high at 14.2% among dengue patients, and those with AKI portended significant morbidity, mortality, longer hospital stay and poor renal outcomes. Our findings suggest that AKI in dengue is likely to increase healthcare burden that underscores the need of clinicians’ alertness to this highly morbid and potentially fatal complication for optimal prevention and management. PMID:26421839

  15. Global dataset of biogenic VOC emissions calculated by the MEGAN model over the last 30 years

    NASA Astrophysics Data System (ADS)

    Sindelarova, K.; Granier, C.; Bouarar, I.; Guenther, A.; Tilmes, S.; Stavrakou, T.; Müller, J.-F.; Kuhn, U.; Stefani, P.; Knorr, W.

    2014-04-01

    The Model of Emissions of Gases and Aerosols from Nature (MEGANv2.1) together with the Modern-Era Retrospective Analysis for Research and Applications (MERRA) meteorological fields were used to create a global emission dataset of biogenic volatile organic compounds (BVOC) available on a monthly basis for the time period of 1980-2010. This dataset is called MEGAN-MACC. The model estimated mean annual total BVOC emission of 760 Tg (C) yr-1 consisting of isoprene (70%), monoterpenes (11%), methanol (6%), acetone (3%), sesquiterpenes (2.5%) and other BVOC species each contributing less than 2%. Several sensitivity model runs were performed to study the impact of different model input and model settings on isoprene estimates and resulted in differences of up to ±17% of the reference isoprene total. A greater impact was observed for a sensitivity run applying parameterization of soil moisture deficit that led to a 50% reduction of isoprene emissions on a global scale, most significantly in specific regions of Africa, South America and Australia. MEGAN-MACC estimates are comparable to results of previous studies. More detailed comparison with other isoprene inventories indicated significant spatial and temporal differences between the datasets especially for Australia, Southeast Asia and South America. MEGAN-MACC estimates of isoprene, α-pinene and group of monoterpenes showed a reasonable agreement with surface flux measurements at sites located in tropical forests in the Amazon and Malaysia. The model was able to capture the seasonal variation of isoprene emissions in the Amazon forest.

  16. Long-term patterns of dental attendance and caries experience among British adults: a retrospective analysis.

    PubMed

    Aldossary, Arwa; Harrison, Victoria E; Bernabé, Eduardo

    2015-02-01

    There is inconclusive evidence on the value of regular dental attendance. This study explored the relationship between long-term patterns of dental attendance and caries experience. We used retrospective data from 3,235 adults, ≥ 16 yrs of age, who participated in the Adult Dental Health Survey in the UK. Participants were classified into four groups (always, current, former, and never regular-attenders) based on their responses to three questions on lifetime dental-attendance patterns. The association between dental-attendance patterns and caries experience, as measured using the decayed, missing, or filled teeth (DMFT) index, was tested in negative binomial regression models, adjusting for demographic (sex, age, and country of residence) and socio-economic (educational attainment, household income, and social class) factors. A consistent pattern of association between long-term dental attendance and caries experience was found in adjusted models. Former and never regular-attenders had a significantly higher DMFT score and numbers of decayed and missing teeth, but fewer filled teeth, than always regular-attenders. No differences in DMFT or its components were found between current and always regular-attenders. The findings of this study show that adults with different lifetime trajectories of dental attendance had different dental statuses. PMID:25521216

  17. Chemotherapeutic Approaches Against Trypanosoma evansi: Retrospective Analysis, Current Status and Future Outlook.

    PubMed

    Rathore, Nitu S; Manuja, Anju; Manuja, Balvinder Kumar; Choudhary, Shalki

    2016-01-01

    Trypanosoma evansi, the causative agent of surra, is pathogenic to a wide variety of wild and domestic animals, including equines, camels, goats, sheep, cattle, buffaloes, pigs, dogs, tigers, elephants etc. The infection is mainly restricted to animals but ability to infect human beings has also been reported due to the lack of efficient apolipoprotein L 1. The parasite is mechanically transmitted by blood-sucking flies such as Tabanus and Stomoxys species. The disease has a major economic impact in tropical countries. The control of trypanosomosis may be aimed either at the fly or against the parasite. Due to difficulties in large scale fly control, trypanocides have been widely used to control the disease. However, current chemotherapeutic agents are limited in number and usually associated with severe side effects. Moreover, current therapeutic agents are far from ideal. The emergence of drug resistant trypanosomes results in failure of prophylaxis and treatment of the disease. Retrospective and prospective studies on drug and delivery against T. evansi will provide an overview of the chemotherapeutic and prophylactic measures in vogue and suggest future strategies for combating this neglected disease. In this perspective, we have reviewed the currently used drugs available for prophylaxis and therapy, their mechanism of action and associated limitations. The options available for prophylaxis and therapy along with potential new molecules/therapeutic agents and novel approaches for delivery of the drugs to enhance their therapeutic value are presented in this review. PMID:27072712

  18. Surgical management of giant neurofibroma in soft tissue: a single-center retrospective analysis

    PubMed Central

    Yuan, Si-Ming; Cui, Lei; Guo, Yao; Wang, Jun; Hu, Xin-Bao; Jiang, Hui-Qing; Hong, Zhi-Jian

    2015-01-01

    Neurofibroma, a common benign tumor in soft tissue, continues to grow, and often appears to be giant. In this study, we retrospectively analyzed the surgical treatment of 26 patients with giant neurofibromas in our clinic in the past 10 years from Jan. 2004 to Dec. 2013. The tumors were located in the head (n = 10), trunk (n = 9), limbs (n = 5), and multi-sites (n = 2). According to the location and extent of the lesion, as well as the adjacent anatomy, surgical management was performed to partially (n = 15) or almost completely (n = 11) resect the tumor. The wounds were repaired by skin flap or skin graft. Among them, one child with a giant tumor in the scalp underwent three times of skin expander treatment, and acquired complete removal of the tumor finally without baldness. Eleven cases underwent the interventional embolization of tumor’s nutrient arteries, which successfully reduced the bleeding in operation. Most of the skin flap and skin graft survived well. After operation, the appearance of the patients and the function of the limbs were improved largely. In conclusion, for the giant neurofibroma, surgical treatment effectively reduces the tumor burden, rehabilitates the appearance and function, and so improves the quality of life. Skin expandor and interventional embolization of nutrient artery can be used when appropriate. PMID:26131098

  19. Retrospective analysis of nosocomial infections in an Italian tertiary care hospital.

    PubMed

    Mancini, Alessio; Verdini, Daniele; La Vigna, Giorgio; Recanatini, Claudia; Lombardi, Francesca Elena; Barocci, Simone

    2016-09-01

    Nosocomial infections are one of the leading causes of morbidity and mortality in hospitalized patients. Studies of their prevalence in single institutions can reveal trends over time and help to identify risk factors. The aim of this study was to investigate the nosocomial infections trend and identify the prevalence of predominant bacterial microorganisms and their drug resistance patterns in an Italian tertiary care hospital. Infections were classified according to the Centres for Disease Control and Prevention definitions. A retrospective study was carried out from March 2011 to June 2014, based on the bacterial isolate reports of a hospital located in Central Italy. During the 40-month study period, a total of 1547 isolates were obtained from 1046 hospitalized patients and tested for their antibiotic sensitivity. The most common isolates belonged to the Enterobacteriaceae family (61.7%), followed by Enterococcus species (12.4%), Pseudomonas species (10.7%) and S. aureus (10.0%). The incidence density rate of nosocomial infections was 7.4 per 1000 patient days, with a significant difference among the 3 annual infection rates (P<0.001). The highest infection prevalence rate was found in Internal Medicine Unit (41.3%), followed by Intensive Care Units (12.4%), Surgical Units (9.0%,) and Cardiology (7.1%). PMID:27602418

  20. Clinical Efficacy of Diphenylcyclopropenone in Alopecia Areata: Retrospective Data Analysis of 50 Patients.

    PubMed

    Chiang, Katherine S; Mesinkovska, Natasha A; Piliang, Melissa P; Bergfeld, Wilma F

    2015-11-01

    Diphenylcyclopropenone (DPCP) is widely considered the most effective topical immunotherapy for refractory or extensive alopecia areata (AA), but questions regarding how long to try DPCP therapy before terminating and what factors are prognostic of therapeutic success still remain unanswered. In this retrospective study of 50 AA patients, we evaluated DPCP efficacy and identified patient factors predictive of therapeutic success/failure. The median duration of DPCP treatment was 3 years, with 47% patients experiencing their first regrowth in the first 6 months of DPCP therapy, 20% between 6 months-1 year, and 8% between 1-2 years. In our study, treatment success, defined as ⩾50% terminal hair regrowth, was reached in 71% of alopecia totalis patients and in 56% of alopecia universalis patients. Three factors were statistically significant predictors of poor treatment outcome-extent of hair loss before DPCP treatment, history of thyroid disease, and extent of body hair involvement. Relapse was observed in 44% of patients and significantly associated with history of thyroid disease. Common side effects were itching, rash, and local lymphadenopathy. The results of this study support our belief that DPCP therapy is a viable treatment option, can be successfully accomplished at home, and should not be terminated before 2 years. PMID:26551948

  1. [Clinical aspects and management of patients with tuberculous meningitis. Retrospective analysis from 1994 to 2005].

    PubMed

    Bémer, P; Boutoille, D; Lepelletier, D; Chamoux, C; Guitton, C; Drugeon, H

    2006-09-01

    Tuberculous meningitis remains a devastating disease with poor prognosis in terms of mortality or invalidating after-effects. Eighteen cases of tuberculous meningitis, occurred between 1994 and 2005, were re-examined retrospectively. Among the 18 patients, 13 were aged from 14 to 64 years, and 5 were older than 64. There was no gender dominance. Factors of risk were identified in 7 patients. British Medical Research Council staging was III in 9 patients, II in 2 patients and I in 7 patients. Protein and glucose levels in the cerebrospinal fluid sample were very variable ranging from 0.4 to 10.7 g/L and 0.4 to 3.7 mmol/L respectively. The cellular reaction was also very variable ranging from 0 to 250 elements, mostly lymphocytes. Antituberculous treatment was given to 15 patients, associated with corticosteroid therapy for 9 patients. Among the 18 patients, 11 died within 1 year, 4 were treated for a recurrence occurring up to 6 years after the diagnosis, 1 presented important neuropsychic after-effects and 2 patients survived without after-effects with a time ranging between 6 months and 1 year. The deceased patients were significantly older than the others. The risk of mortality was 4.5-fold greater among stage III patients than among stage I and II patients. The use of corticosteroids significantly reduced the risk of death. PMID:17075546

  2. Retrospective Analysis of Locally Advanced Noninflammatory Breast Cancer From Chennai, South India, 1990-1999

    SciTech Connect

    Shanta, Viswanathan Swaminathan, Rajaraman; Rama, Ranganathan M.Sc.; Radhika, Ramachandran M.S.

    2008-01-01

    Purpose: This was a retrospective observational study to elicit the outcome of the therapeutic strategy of concurrent neoadjuvant chemoradiotherapy protocol for locally advanced breast cancer. Methods and Materials: A large series of 1,117 consecutive cases of locally advanced breast cancer treated at the Cancer Institute (WIA), in Chennai, South India, between 1990 and 1999 and followed through 2004 formed the basis for this study. Disease-free survival was the main outcome, and nodal and tumor downstaging were the intermediate outcome measures studied. Results: Primary tumor downstaging was observed in 45% and nodal downstaging in 57.5%. The disease-free survival rate of nodal downstaged patients at 5, 10, and 15 years was 75%, 65%, and 58%, respectively. The corresponding rates for pre- and postoperative node-negative patients were 70%, 60%, and 59%. The best survival was seen among those who were tumor and node negative postoperatively. Nodal downstaging halved the risk of disease recurrence and death compared with node positivity, irrespective of tumor sterility. Conclusions: A randomized trial using cyclophosphamide, methotrexate, and 5-fluorouracil vs. an anthracycline-based regimen in the setting of concurrent chemoradiotherapy appears indicated. Additional preoperative chemotherapy to maximize nodal and tumor downstaging should be investigated. A change in postoperative chemotherapy according to nodal status could also be explored.

  3. Mortality and morbidity in children caused by falling televisions: a retrospective analysis of 71 cases

    PubMed Central

    2011-01-01

    Objectives To quantify injuries in children that result from toppled televisions. Methods Children presenting directly to emergency department due to injuries caused by falling televisions were identified from our digital patient database, and a retrospective chart review of 71 children was performed. Descriptive statistics were applied. Results 71(1.8%) out of 3856 admissions due to injuries sustained at home were TV-related injuries. There were 50 (70.4%) boys and 21(29.6%) girls. Mean age was 39.79 ± 20.14 SD months. Almost three quarters of the children (49/71) sustained various head and facial injuries. There was traumatic brain injury in 14 patients, extremity injuries in 30 patients, thoracic injuries in 13 patients and abdominal injuries in ten patients. 16 patients were hospitalized. 14 of them required follow-up in intensive care unit. Two patients (one with epidural hematoma and one with subdural hematoma) underwent surgical intervention. Four patients with subarachnoid bleeding died. The mean length of hospital stay was 71.25 hours (range, 48-168) in hospitalised patients. The overall mortality rate was 5.6%. Conclusions Falling TVs may cause significant morbidity and mortality in children particularly those younger than 3 years old. Head and facial injuries are the most common body region involved and traumatic brain injury is the major cause of death.

  4. Unusual histopathological findings in appendectomy specimens: A retrospective analysis and literature review

    PubMed Central

    Akbulut, Sami; Tas, Mahmut; Sogutcu, Nilgun; Arikanoglu, Zulfu; Basbug, Murat; Ulku, Abdullah; Semur, Heybet; Yagmur, Yusuf

    2011-01-01

    AIM: To document unusual findings in appendectomy specimens. METHODS: The clinicopathological data of 5262 patients who underwent appendectomies for presumed acute appendicitis from January 2006 to October 2010 were reviewed retrospectively. Appendectomies performed as incidental procedures during some other operation were excluded. We focused on 54 patients who had unusual findings in their appendectomy specimens. We conducted a literature review via the PubMed and Google Scholar databases of English language studies published between 2000 and 2010 on unusual findings in appendectomy specimens. RESULTS: Unusual findings were determined in 54 (1%) cases by histopathology. Thirty were male and 24 were female with ages ranging from 15 to 84 years (median, 32.2 ± 15.1 years). Final pathology revealed 37 cases of enterobiasis, five cases of carcinoids, four mucinous cystadenomas, two eosinophilic infiltrations, two mucoceles, two tuberculosis, one goblet-cell carcinoid, and one neurogenic hyperplasia. While 52 patients underwent a standard appendectomy, two patients who were diagnosed with tuberculous appendicitis underwent a right hemicolectomy. All tumors were located at the distal part of the appendix with a mean diameter of 6.8 mm (range, 4-10 mm). All patients with tumors were alive and disease-free during a mean follow-up of 17.8 mo. A review of 1366 cases reported in the English literature is also discussed. CONCLUSION: Although unusual pathological findings are seldom seen during an appendectomy, all appendectomy specimens should be sent for routine histopathological examination. PMID:21528073

  5. Preliminary Retrospective Analysis of Daily Tomotherapy Output Constancy Checks Using Statistical Process Control

    PubMed Central

    Menghi, Enrico; Marcocci, Francesco; Bianchini, David

    2016-01-01

    The purpose of this study was to retrospectively evaluate the results from a Helical TomoTherapy Hi-Art treatment system relating to quality controls based on daily static and dynamic output checks using statistical process control methods. Individual value X-charts, exponentially weighted moving average charts, and process capability and acceptability indices were used to monitor the treatment system performance. Daily output values measured from January 2014 to January 2015 were considered. The results obtained showed that, although the process was in control, there was an out-of-control situation in the principal maintenance intervention for the treatment system. In particular, process capability indices showed a decreasing percentage of points in control which was, however, acceptable according to AAPM TG148 guidelines. Our findings underline the importance of restricting the acceptable range of daily output checks and suggest a future line of investigation for a detailed process control of daily output checks for the Helical TomoTherapy Hi-Art treatment system. PMID:26848962

  6. Evaluation of mean platelet volume in unruptured ectopic pregnancy: A retrospective analysis.

    PubMed

    Karaman, Erbil; Çim, Numan; Alkış, İsmet; Yıldızhan, Recep; Elçi, Gülhan

    2016-07-01

    We aimed to investigate and compare the mean platelet volume (MPV) levels in ectopic and viable intrauterine pregnancy (IUP). The medical records of 78 unruptured tubal ectopic pregnancy patients (TEP, Group 1) and 150 patients with viable IUP (Group 2) served as control group between May 2014 and February 2015 in our clinic were retrospectively analysed. The demographic characteristics including age, parity, gravida, abortus, haemoglobin levels and leucocyte counts showed no statistically difference between two groups. The mean MPV level was significantly lower in TEP group compared to IUP group (8.69 ± 1.14 and 10.06 ± 1.46, p < 0.001). The platelet (PLT) distribution width was higher in TEP group, however, there was no statistical difference between the two groups (p = 0.078). The early diagnosis of TEP is crucial in order to prevent maternal morbidity and mortality. Our results showed that MPV is lower in TEP than IUP and it seems to be related with the possible inflammation at implantation site of tuba uterina. However, there is need for further studies for employing PLT indices in the diagnosis of TEP. PMID:26923037

  7. Retrospective analysis of clinicopathological features of solid pseudopapillary neoplasm of the pancreas.

    PubMed

    Ugras, Nesrin; Yerci, Ömer; Coşkun, Sinem Kantarcıoğlu; Ocakoğlu, Gökhan; Sarkut, Pınar; Dündar, Halit Ziya

    2016-07-01

    Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare neoplasm that accounts for 2-3% of all primary pancreatic neoplasms. This study aimed to characterize clinicopathological features associated with SPNs and to retrospectively evaluate the relationship of these features with predictive parameters associated with aggressive behavior. We reviewed 16 cases of SPN of the pancreas that had been diagnosed between 2005 and 2014 at our pathology department. A total of 16 cases, 15 female and one male, were evaluated in this study. The patient age ranged from 13 years to 63 years with a median of 35.70 years. The mean tumor diameter ranged from 2 cm to 18 cm with a mean diameter of 5.90 cm. We identified a significant association between the presence of clear cells and perineural invasion (p=0.019), which was considered to be a predictive factor for aggressive behavior. Other features (i.e., localization, nuclear grooves, central hyalinization, myxoid stroma, eosinophilic bodies, foamy histiocyte aggregates, multinucleated cells, and calcification) were not significantly associated with predictive factors for aggressive behavior. One patient died as a result of a pancreatic fistula that developed as a postoperative complication. The remaining 15 patients are alive and have not demonstrated any signs of recurrence or metastasis. The current study suggested that the presence of clear cells might serve as a possible prognostic indicator of perineural invasion, which is a predictive parameter associated with aggressive behavior in SPN. PMID:27450024

  8. Leptomeningeal carcinomatosis from gastric cancer: single institute retrospective analysis of 9 cases

    PubMed Central

    Kim, Nam-Hee; Kim, Ji-Hyun; Chin, Hyung-Min

    2014-01-01

    Purpose The aim of this study is to investigate the clinical features and outcomes of 9 consecutive patients who suffered with leptomeningeal carcinomatosis (LMC) originating from gastric cancer. Methods Between January 1995 and December 2010, we retrospectively reviewed the medical records of 9 patients with gastric LMC who had been treated at St. Vincent's Hospital, The Catholic University of Korea. Results With the exception of 1 patient, the primary gastric cancer was Borrmann type III or IV, and 5 cases had poorly differentiated or signet ring cell histology. TNM stage of the primary gastric cancer was III in 6 patients. The median interval from diagnosis of the primary malignancy to the diagnosis of LMC was 9 months. Headache (6 cases), altered mental status (4 cases), and dysarthria (3 cases) were presenting symptoms of LMC. Computed tomography findings were abnormal in 4 of 7 cases, while magnetic resonance imaging revealed abnormality in 4 of 5 cases. Radiation therapy was administered to 5 patients and intrathecal chemotherapy was administered to only 1 patient. Median overall survival duration from the diagnosis of LMC was 3 months. Conclusion LMC originating from gastric cancer had a fatal clinical course and treatment strategies remain challenging. PMID:24761402

  9. Transfusion transmitted infections – A retrospective analysis from the National Blood Transfusion Service in Eritrea

    PubMed Central

    Fessehaye, Nahom; Naik, Durgadas; Fessehaye, Tesfay

    2011-01-01

    Background The emergence of transfusion transmitted infection (TTI) especially HIV/AIDS has created a huge obstacle in ensuring blood safety. To assess the situation in Eritrea, we carried out a retrospective study of 29,501 blood donors for the prevalence of TTI's i.e. HIV, HBV, HCV and Syphilis. Methods The study population included all donors who donated blood from January 2006 to November 2009. The data was collected from the National Blood Transfusion Services (NTBS) of Eritrea and includes category of donor and result for TTI markers. Results A total of 29,501 units of blood were collected from 23,385(79%) voluntary blood donors and the rest 6,116(21%) units were collected from family replacement donors. The over all prevalence of TTI's were 3.8% with 3.5% in voluntary blood donors and 5.1% in family replacement donors. The sero-prevalence for TTI markers were 0.18% HIV, 2.58% HBV, 0.57% HCV and 0.49% Syphilis. Conclusion In conclusion, even if the TTI prevalence rate among Eritrean blood donors is low, ensuring blood safety has a long way to go. PMID:22145069

  10. Preliminary Retrospective Analysis of Daily Tomotherapy Output Constancy Checks Using Statistical Process Control.

    PubMed

    Mezzenga, Emilio; D'Errico, Vincenzo; Sarnelli, Anna; Strigari, Lidia; Menghi, Enrico; Marcocci, Francesco; Bianchini, David; Benassi, Marcello

    2016-01-01

    The purpose of this study was to retrospectively evaluate the results from a Helical TomoTherapy Hi-Art treatment system relating to quality controls based on daily static and dynamic output checks using statistical process control methods. Individual value X-charts, exponentially weighted moving average charts, and process capability and acceptability indices were used to monitor the treatment system performance. Daily output values measured from January 2014 to January 2015 were considered. The results obtained showed that, although the process was in control, there was an out-of-control situation in the principal maintenance intervention for the treatment system. In particular, process capability indices showed a decreasing percentage of points in control which was, however, acceptable according to AAPM TG148 guidelines. Our findings underline the importance of restricting the acceptable range of daily output checks and suggest a future line of investigation for a detailed process control of daily output checks for the Helical TomoTherapy Hi-Art treatment system. PMID:26848962

  11. Can Peripheral Bronchopleural Fistula Demonstrated on Computed Tomography be Treated Conservatively? A Retrospective Analysis

    PubMed Central

    Tsubakimoto, Maho; Murayama, Sadayuki; Iraha, Rin; Kamiya, Hisashi; Tsuchiya, Nanae; Yamashiro, Tsuneo

    2016-01-01

    Purpose Peripheral bronchopleural fistulas (BPF) are communications between a peripheral bronchus or the lung parenchyma and the pleural space. Although reported cases with peripheral BPF might have typical symptoms, we postulate that there may be BPF patients without typical symptoms who are diagnosed on computed tomography (CT) for the first time. Materials and Methods We searched retrospectively for how frequently BPF is found on CT in cases with known or suspected empyema or hydropneumothorax. Also, we examined the clinical charts to ascertain if a diagnosis of BPF was suspected in the CT reports or clinically, and to determine the outcome of each case. Results Thirteen thoracic cavities of 12 patients were included in this study. Of these, BPF was suspected clinically in only 1. Mention in the CT report about the presence of BPF was found in 2 cases. An apparent finding of BPF on CT was found in 7 of 13 (53%) thoracic cavities of 6 cases. The outcomes were that 1 patient died 1 month later due to multiple organ failure, and 1 patient was discharged subsequently after CT. In the other 10 cases, there was no exacerbation of the symptom regardless of definite evidence of BPF on CT. Conclusions In conclusion, when there is hydropneumothorax on CT, it is important for radiologists to diligently search for findings of peripheral BPF and to document it. However, a reference about the need for a surgical approach for BPF may not be required. PMID:26571054

  12. Arterio-venous fistula buttonhole cannulation technique: a retrospective analysis of infectious complications

    PubMed Central

    O'Brien, Frank J.; Kok, Hong Kuan T.; O'Kane, Claire; McWilliams, Johanna; O'Kelly, Patrick; Collins, Paula; Walshe, Joseph; Magee, Colm C.; Denton, Mark D.; Conlon, Peter J.

    2012-01-01

    Background There are two main methods of accessing arterio-venous fistulas (AVFs); the ‘buttonhole’ and the ‘rope-ladder’ cannulation technique. Several small studies have hypothesized that the buttonhole technique is associated with increased rates of fistula-associated infection. This study addresses this hypothesis. Methods A retrospective review of all patients attending a large outpatient haemodialysis clinic was performed. Data were collected on the method of cannulation, infection rates, implicated microorganisms, complications of infection and time on haemodialysis. Results A total of 127 patients had received haemodialysis via an AVF: 53 via the rope-ladder technique and 74 via the buttonhole technique. Nine episodes of clinically significant bacteraemia were recorded in the buttonhole group. This equated to a rate of 0.073 bacteraemia events per 1000 AVF days. There were no episodes of bacteraemia in the rope-ladder group. Eight infections were due to methicillin-sensitive Staphylococcus aureus (MSSA); one was due to Staphylococcus epidermidis. Three patients with MSSA bacteraemia subsequently developed infective endocarditis. Five patients who developed bacteraemia events had been undergoing home haemodialysis. Conclusions This study highlights the infectious complications associated with buttonhole cannulation techniques. All organisms isolated in our cohort were known skin colonizers. The reason for the increased rates of infection is unclear. Given this high rate of often life-threatening infection, we recommend regular audit of infection rates. We currently do not recommend this technique to our patients receiving haemodialysis. PMID:26069795

  13. High Prevelance of Rifampin-Monoresistant Tuberculosis: A Retrospective Analysis among Iranian Pulmonary Tuberculosis Patients

    PubMed Central

    Velayati, Ali Akbar; Farnia, Parissa; Mozafari, Mohadese; Sheikholeslami, Maryam Fatemeh; Karahrudi, Mona Afraei; Tabarsi, Payam; Hoffner, Sven

    2014-01-01

    We determined the prevalence of rifampin-monoresistant tuberculosis (RMR-TB) in Iran. Because development of RMR-TB is not common, we also identified the major risk factors associated with RMR-TB reported from different provinces of Iran. Data for 3,020 TB patients who remained or became smear positive after two, four, six, and nine months of standard first-line chemotherapy were retrospectively analyzed. Of 3,020 patients, 1,242 patients (41.1%) were culture and DNA positive for Mycobacterium tuberculosis. Of these patients, 73 (7.4%) patients had monoresistant isolates to rifampin, which was significantly higher than that for multidrug-resistant TB (5.8%). The average rate of RMR-TB in the studied population ranged from 5% to 10%. Classical investigation showed that 33.6% of patients had either a previous or family history of TB. Molecular epidemiology methods (i.e., spoligotyping and Mycobacterium intespersed repetitive unit–variable number tandem repeat), defined transmission link in three clusters (13%). These results outline the urgent need for a comprehensive plan for detection and treatment of RMR-TB cases. PMID:24189362

  14. Trend Analysis of Malaria Occurrence in Wolaita Zone, Southern Ethiopia: Retrospective Cross-Sectional Study

    PubMed Central

    Legesse, Deresse; Haji, Yusuf; Abreha, Solomon

    2015-01-01

    Background. Malaria is a major public health problem in Ethiopia. The trend of malaria occurrence remains unknown in the study area. This study is aimed at determining the last five years' trend of malaria occurrence from 2008/09 to 2012/13 in Wolaita Zone, Southern Ethiopia. Methods. A health facility-based retrospective study was conducted in Wolaita Zone from March to August, 2014. Five years' laboratory confirmed malaria record review was made from six health centers. Result. A total of 105,755 laboratory confirmed malaria cases were reported, with total slide positivity rate of 33.27% and mean annual occurrence of 21,151 cases. Malaria occurred with a fluctuating trend in the study area, with its peak occurring at the year 2011/12. Overall, no remarkable decline in the total laboratory confirmed malaria was observed in the last five years. P. falciparum was the predominantly reported species, accounting for 75,929 (71.80%) of cases. The highest slide positivity rate was observed in the age group of 5–14 years (40.5%) followed by 1–4 years (35.5%). Two malaria peak seasons occurred: one from September to December and the other from April to June. Conclusion. No remarkable decline in laboratory confirmed malaria in the last five years was observed. PMID:26770866

  15. Pyogenic liver abscess: a retrospective analysis of 107 patients during a 3-year period.

    PubMed

    Chan, Khee-Siang; Chen, Chin-Ming; Cheng, Kuo-Chen; Hou, Ching-Cheng; Lin, Hung-Jung; Yu, Wen-Liang

    2005-12-01

    Pyogenic liver abscess (PLA) is a potentially life-threatening disease, and early diagnosis may be difficult. In order to provide diagnostic clues and to enhance the prompt management of such cases, we retrospectively investigated the clinical characteristics of PLA during a 3-year period in a tertiary-care hospital. The crude incidence rate of PLA in our study was 446.1 per 100,000 hospital admissions. Male predominance and a mean age of 57.6 +/- 14.4 years were observed. Diabetes mellitus was the most common concomitant disease, and biliary pathologies were the most common predisposing cause of this type of abscess. The most common clinical features were fever, chills, and abdominal pain. Leukocytosis was found in 67.3% of the patients, and the observed C-reactive protein (CRP) values were high. The most common pathogen was Klebsiella pneumoniae. The mortality rate was 6.5%. A complete history, physical examination, evaluation of the white blood cell count and CRP, and the prompt arrangement of imaging studies may lead to an earlier diagnosis. The aggressive performance of image-guided catheter drainage and the appropriate administration of antibiotics may reduce the mortality rate of PLA. PMID:16377869

  16. Analysis of Dermatologic Diseases in Neurosurgical In-Patients: A Retrospective Study of 463 Cases

    PubMed Central

    Kim, Kyung Min; Kim, Hei Sung; Yu, Jeesuk

    2016-01-01

    Background Both the skin and the neurologic system are derived from the ectoderm during embryogenesis, and thus patients with neurologic disorders may have accompanying dermatologic diseases. For example, seborrheic dermatitis is more frequently observed in patients with Parkinsonism and other neurologic disorders. To date, however, there has been limited review on dermatologic diseases in neurosurgical in-patients. Objective The purpose of this study was to characterize dermatological problems encountered in a neurosurgery unit and to compare these data to previous reports of in-patient dermatologic consultations. Methods A retrospective review was conducted over all in-patient dermatology consultations from the neurosurgery unit during a 3-year period. Results Of 2,770 dermatology consultations, 463 (16.7%) came from the department of neurosurgery. The most frequent age group was the 6th decade of life, and the ratio of men to women was 1.07. Consults were most frequently placed from patients with intracranial hemorrhage (23.8%). Eczema/dermatitis (36.5%; n=204) and cutaneous infections (27.0%; n=151) accounted for more than half of all dermatological consultations, followed by cutaneous adverse drug reactions (11.8%; n=66). Additionally, seborrheic dermatitis was significantly more frequent (p=0.048, odds ratio=1.96) in patients with intracranial hemorrhage. Conclusion This study characterizes the distribution of skin disorders in patients admitted to the neurosurgery service based on the consultations that have been made for dermatologic evaluation. Collaboration between the neurosurgeons and dermatologists may improve the quality of patient care and help to better predict the occurrence of these conditions. PMID:27274629

  17. Corticosteroids in IgA Nephropathy: A Retrospective Analysis from the VALIGA Study

    PubMed Central

    Tesar, Vladimir; Troyanov, Stéphan; Bellur, Shubha; Verhave, Jacobien C.; Cook, H. Terence; Feehally, John; Roberts, Ian S.D.; Cattran, Daniel

    2015-01-01

    Current guidelines suggest treatment with corticosteroids (CS) in IgA nephropathy (IgAN) when proteinuria is persistently ≥1 g/d despite 3–6 months of supportive care and when eGFR is >50 ml/min per 1.73 m2. Whether the benefits of this treatment extend to patients with an eGFR≤50 ml/min per 1.73 m2, other levels of proteinuria, or different renal pathologic lesions remains unknown. We retrospectively studied 1147 patients with IgAN from the European Validation Study of the Oxford Classification of IgAN (VALIGA) cohort classified according to the Oxford-MEST classification and medication used, with details of duration but not dosing. Overall, 46% of patients received immunosuppression, of which 98% received CS. Treated individuals presented with greater clinical and pathologic risk factors of progression. They also received more antihypertensive medication, and a greater proportion received renin angiotensin system blockade (RASB) compared with individuals without immunosuppressive therapy. Immunosuppression was associated with a significant reduction in proteinuria, a slower rate of renal function decline, and greater renal survival. Using a propensity score, we matched 184 subjects who received CS and RASB to 184 patients with a similar risk profile of progression who received only RASB. Within this group, CS reduced proteinuria and the rate of renal function decline and increased renal survival. These benefits extended to those with an eGFR≤50 ml/min per 1.73 m2, and the benefits increased proportionally with the level of proteinuria. Thus, CS reduced the risk of progression regardless of initial eGFR and in direct proportion to the extent of proteinuria in this cohort. PMID:25677392

  18. Morphologic patterns and imaging features of intracranial hemangiopericytomas: a retrospective analysis

    PubMed Central

    Pang, Haopeng; Yao, Zhenwei; Ren, Yan; Liu, Guobing; Zhang, Jiawen; Feng, Xiaoyuan

    2015-01-01

    Objectives Hemangiopericytomas (HPCs) are rare intracranial tumors. Their differential diagnosis using computed tomography (CT) and magnetic resonance imaging (MRI) is difficult because of similarities in morphologic features with other intracranial tumors and meningiomas. Methods We retrospectively analyzed the clinical data and CT and MRI findings of 32 patients diagnosed with HPCs via histopathology. We evaluated the location, shape, morphologic patterns, density, and signal intensity of the tumors and classified them into four types. Results The number of tumors analyzed was 32; 29 were supratentorial and three were infratentorial. Eighteen tumors were lobular, while 14 were oval in shape. Further, 28 tumors had cystic areas, and 16 had signal-void vessels. Among the 20 tumors that had been scanned by MRI; eleven showed isointensity, eight slight hyperintensity, and one slight hypointensity on T1-weighted image. Moreover, 12 showed isointensity, and eight showed slight hyperintensity on T2-weighted image and T2-weighted-fluid-attenuated-inversion recovery. Diffusion-weighted images showed isointensity (9/13) or slight hyperintensity (4/13). Of the 15 tumors scanned by contrast-enhanced MRI, one showed poor enhancement; six, moderate enhancement; and eight, intense enhancement. Only one tumor exhibited the “dural tail” sign. Moreover, calcification was observed in just one tumor on CT imaging (1/22). All tumors (5/5) showed intense enhancement on CT angiography, whereas some exhibited dual blood supply (2/5). Conclusion We conclude that tumors present outside the brain parenchyma, with isointense to slightly intense regions on MRI scans, oval/lobular shape, well-/ill-defined margins, signal-void vessels, apparent cystic areas, dual blood supply, and intense enhancement on CT or MRI scans, but without calcification or a “dural tail” sign, may be diagnosed as HPCs. PMID:26347312

  19. Retrospective analysis of quality improvement when using liposome bupivacaine for postoperative pain control

    PubMed Central

    King, Nicole M; Quiko, Albin S; Slotto, James G; Connolly, Nicholas C; Hackworth, Robert J; Heil, Justin W

    2016-01-01

    Background/objective Liposome bupivacaine, a prolonged-release bupivacaine formulation, recently became available at the Naval Medical Center San Diego (NMCSD); before availability, postsurgical pain for large thoracic/abdominal procedures was primarily managed with opioids with/without continuous thoracic epidural (CTE) anesthesia. This retrospective chart review was part of a clinical quality initiative to determine whether postsurgical outcomes improved after liposome bupivacaine became available. Methods Data from patients who underwent laparotomy, sternotomy, or thoracotomy at NMCSD from May 2013 to May 2014 (after liposome bupivacaine treatment became available) were compared with data from patients who underwent these same procedures from December 2011 to May 2012 (before liposome bupivacaine treatment became available). Collected data included demographics, postoperative pain control methods, opioid consumption, perioperative pain scores, and lengths of intensive care unit and overall hospital stays. Results Data from 182 patients were collected: 88 pre-liposome bupivacaine (laparotomy, n=52; sternotomy, n=26; and thoracotomy, n=10) and 94 post-liposome bupivacaine (laparotomy, n=49; sternotomy, n=31; and thoracotomy, n=14) records. Mean hospital stay was 7.0 vs 5.8 days (P=0.009) in the pre- and post-liposome bupivacaine groups, respectively, and mean highest reported postoperative pain score was 7.1 vs 6.2 (P=0.007), respectively. No other significant between-group differences were observed for the overall population. In the laparotomy subgroup, there was a reduction in the proportion of patients who received CTE anesthesia post-liposome bupivacaine (22% [11/49] vs 35% [18/52] pre-liposome bupivacaine). Conclusion Surgeons and anesthesiologists have changed the way they manage postoperative pain since the time point that liposome bupivacaine was introduced at NMCSD. Our findings suggest that utilization of liposome bupivacaine may be a useful alternative

  20. Immune checkpoint blockade with concurrent electrochemotherapy in advanced melanoma: a retrospective multicenter analysis.

    PubMed

    Heppt, Markus V; Eigentler, Thomas K; Kähler, Katharina C; Herbst, Rudolf A; Göppner, Daniela; Gambichler, Thilo; Ulrich, Jens; Dippel, Edgar; Loquai, Carmen; Schell, Beatrice; Schilling, Bastian; Schäd, Susanne G; Schultz, Erwin S; Matheis, Fanny; Tietze, Julia K; Berking, Carola

    2016-08-01

    Growing evidence suggests that concurrent loco-regional and systemic treatment modalities may lead to synergistic anti-tumor effects in advanced melanoma. In this retrospective multicenter study, we evaluate the use of electrochemotherapy (ECT) combined with ipilimumab or PD-1 inhibition. We investigated patients with unresectable or metastatic melanoma who received the combination of ECT and immune checkpoint blockade for distant or cutaneous metastases within 4 weeks. Clinical and laboratory data were collected and analyzed with respect to safety and efficacy. A total of 33 patients from 13 centers were identified with a median follow-up time of 9 months. Twenty-eight patients received ipilimumab, while five patients were treated with a PD-1 inhibitor (pembrolizumab n = 3, nivolumab n = 2). The local overall response rate (ORR) was 66.7 %. The systemic ORR was 19.2 and 40.0 % in the ipilimumab and PD-1 cohort, respectively. The median duration of response was not reached in either group. The median time to disease progression was 2.5 months for the entire population with 2 months for ipilimumab and 5 months for PD-1 blockade. The median overall survival was not reached in patients with ipilimumab and 15 months in the PD-1 group. Severe systemic adverse events were detected in 25.0 % in the ipilimumab group. No treatment-related deaths were observed. This is the first reported evaluation of ECT and simultaneous PD-1 inhibition and the largest published dataset on ECT with concurrent ipilimumab. The local response was lower than reported for ECT only. Ipilimumab combined with ECT was feasible, tolerable and showed a high systemic response rate. PMID:27294607

  1. Retrospective Analysis of Levetiracetam Compared to Phenytoin for Seizure Prophylaxis in Adults with Traumatic Brain Injury

    PubMed Central

    Caballero, G. Christina; Hughes, Darrel W.; Maxwell, Pamela R.; Green, Kay; Gamboa, Conrado D.; Barthol, Colleen A.

    2013-01-01

    Background: Phenytoin is standard of care for seizure prophylaxis following traumatic brain injury (TBI). Levetiracetam, an alternative antiepileptic drug, is utilized for seizure prophylaxis despite limited data supporting its use. Objective: Our primary outcome was post-TBI seizure activity measured by electroencephalogram (EEG) for levetiracetam versus phenytoin. Secondary outcomes were length of intensive care unit (ICU) stay, requirement for additional antiepileptic drugs (AED), and drug and monitoring costs. Methods: A retrospective review was performed of patients admitted to neurosurgical or surgical trauma ICU. Adult patients with at least 1 day of EEG monitoring were included. Patients were excluded if they had history of epilepsy, prior TBI, less than 48 hours of AED therapy, or additional AED prior to EEG monitoring. Results: A total 90 patients met inclusion criteria, with 18 receiving levetiracetam and 72 receiving phenytoin. Prevalence of EEG-confirmed seizure activity was similar between the levetiracetam and phenytoin groups (28% vs 29%; P = .99). ICU length of stay (13 vs 18 days; P = .28), time to EEG-confirmed seizure activity (4 vs 6 days; P = .24), and duration of seizure prophylaxis (9 vs 14 days; P = .18) were also similar. The median daily cost of levetiracetam therapy was $43 compared to $55 for phenytoin therapy and monitoring (P = .08). When all anticonvulsant therapy and monitoring were included, costs were lower for the levetiracetam group ($45 vs $83; P = .02). Conclusion: Levetiracetam may provide an alternative treatment option for seizure prevention in TBI patients in the ICU. Total antiepileptic drug and monitoring costs were lower for levetiracetam patients. PMID:24421550

  2. Retrospective Analysis of Pattern of Cutaneous Adverse Drug Reactions in Tertiary Hospital of Pauri Garhwal

    PubMed Central

    Dimri, Deepak; Thapliyal, Swati; Thawani, Vijay

    2016-01-01

    Introduction Cutaneous Adverse Drug Reactions (CADR) are the common drug induced adverse reactions which usually have wide range of manifestations and severity. Aim To describe the prevalence and clinical spectrum of CADR’s in a tertiary hospital of the Garhwal region in Uttarakhand, India. Materials and Methods All patients suspected of having CADRs reported in the various out-patient departments, and in-patients of HNB Base & Teaching Hospital, from 1st January 2012 to 31st December 2014 were retrospectively analysed. Drug history was recorded in a format specified in Indian National Pharmacovigilance Programme. Results Total 111 cases of CADRs were reported from Jan 2012 to Dec 2014. Mean age of patients was 33.34±18.7 years and maximum ADRs were reported in the age group of 20-39 years (36.9%). Female were affected more than male (W:M :: 66:45). Most of the ADRs were exanthematous eruptions (EE) type (33.3%). Medicine department reported maximum cases of CADRs (47.7%), followed by Dermatology. Most of the CADRs were reported with antimicrobial agents (69.4%). Significant associations of different types of various cutaneous reactions were observed in relation to the duration (in days) of ADRs (p = 0.038), types of outcome (p= 0.006), different departments (p= 0.014) and between different groups of medicines (p = 0.008). Conclusion CADRs have proved a significant problem in healthcare for decades. Major bulk of CADR result from physician prescribed drugs. Hence, awareness on part of the physician can help in timely detection of cutaneous reactions, thereby restricting damage from them. PMID:27437240

  3. Synchronous bladder and prostate cancers in the specimens of radical cystoprostatectomy: a multicenter retrospective analysis.

    PubMed

    Ozgür, Berat Cem; Köseoğlu, Ersin; Arık, Ali İhsan; Sarıcı, Haşmet; Bilgin, Ovünç; Yücetürk, Cem Nedim; Ozer, Elif; Güven, Eşref Oğuz; Telli, Onur; Atan, Ali; Eroğlu, Muzaffer

    2014-07-01

    The purpose of this study was to evaluate the features of prostate cancer that have been incidentally detected in radical cystoprostatectomy specimens of bladder cancer patients. The researchers of the current study retrospectively evaluated the data from 119 men who underwent radical cystoprostatectomy at four referral institutions in Ankara, Turkey. Of the 21 prostate cancer patients, 17 (81%) were aged ≥ 60 years; 10 (47.6%) had clinically significant diseases; three had a Gleason score of 6, three had a Gleason score of 7, three had a Gleason score of 8, one had a positive surgical margin along with extracapsular invasion of the tumor and a high Gleason score, and three patients had a tumor volume of ≥ 0.5 cm(3), of which two also had a high Gleason score. Patients were followed-up for a mean of 29 ± 10.2 months; the overall survival was 96.6% (n = 115) during that period. Preoperative digital rectal examination and prostate-specific antigen values did not differ between the benign and prostate cancer groups. There was no survival advantage in the insignificant prostate cancer and benign prostate groups. No additional benefit for predicting prostate cancer was found with digital rectal examination and prostate-specific antigen tests, although some clinicians advised such. In patients aged < 60 years, organ-sparing cystectomy seems reasonable. In prostate-sparing surgery, candidates who are aged >60 years, the preoperative work-up may routinely include prostate biopsy, especially the apex. Preoperative findings of multifocality of bladder cancers and the presence of carcinoma in situ have the risk of prostatic involvement. PMID:24924843

  4. Retrospective analysis of the microbiological spectrum of pneumonia in Turkish patients with lung cancer

    PubMed Central

    Hartavi, Mustafa; Kaçan, Turgut; Bayındır, Murat; Avcı, Mustafa; Özakın, Cüneyt; Engin, Aynur; Deliqönüll, Adem; Evrensel, Turkkan; Akalın, Halis

    2016-01-01

    Aim of the study The spectrum of pulmonary infections in patients with lung cancer is wide, and tools for target-oriented infection control measures are necessary. In this retrospective study we report the microbiological spectrum of pneumonia (based on the results of sputum culture) in a case series of Turkish patients with lung malignancies. Material and methods Between 2010 and 2011 a total of 119 patients (111 males and 8 females, mean age: 59.8 ±9.6 years) with lung cancer and pneumonia were identified at the Department of Medical Oncology of two Turkish Universities (Uludag University, Bursa and Cumhuriyet University, Sivas). Expectorated sputum samples were collected in sterile specimen containers and processed immediately in the hospital bacteriology laboratory. Results Of the 119 study patients, 92 (77.3%) had positive isolates from sputum cultures. The most frequent isolate from the sputum of lung cancer patients with pneumonia was Aspergillus fumigatus (n = 22), followed by Haemophilus influenzae (n = 13) and Pseudomonas aeruginosa (n = 12). The likelihood of having a positive Aspergillus fumigatus sputum culture was significantly and independently associated with febrile neutropaenia (OR = 1.32, 95% CI: 1.17–3.68, p < 0.05) and the development of pneumonia within the first 10 days of chemotherapy initiation (OR = 1.78, 95% CI: 1.37–4.12, p < 0.01). Conclusions We conclude that Aspergillus fumigatus was the most frequent isolate, but the high diversity of pathogens clearly challenges the empirical use of antimicrobial drugs. PMID:27095942

  5. Spectrum of Lesions Affecting the Renal Pelvis and Pelviureteric Junction: A 13-Year Retrospective Analysis

    PubMed Central

    Kini, Hema; Suresh, Pooja Kundapur; Guni, Laxman Prabhu Gurupur; Bhat, Shaila; Kini, Jyoti Ramanath

    2016-01-01

    Introduction Both, the renal pelvis and the ureter, are affected by developmental, reactive and neoplastic disorders, though rare in incidence. Aim This series of cases were analysed to study the clinicopathological characteristics of the common and comparatively rare lesions involving the renal pelvis and pelviureteric junction. Materials and Methods A retrospective collection of 476 nephrectomies and pelviureteric junction resections, received over a period of 13 years from 2001 to 2013 was done. The patients’ clinical details were obtained and the histopathological findings reviewed. The lesions were classified into non-neoplastic and neoplastic categories. Results Primary involvement of the renal pelvis and pelviureteric junction was seen in 105 of 476 specimens. The mean age was 54.5 years with a male to female ratio of 2.2:1. The non-neoplastic lesions accounted for 76.2% of cases with a majority being pelviureteric junction obstruction due to inflammation induced fibromuscular hypertrophy (68.6%) causing hydronephrosis. Urothelial carcinomas were encountered in 20% of the cases. A majority of the urothelial carcinomas were infiltrative (81%) and high grade (71%) tumours. Conclusion Renal pelvis, a conduit to propel urine, can be the site for numerous disorders. Non-neoplastic lesions were more common than neoplasms. Pelviureteric junction obstruction due to inflammation induced fibromuscular hypertrophy was the commonest lesion in our study. In the neoplastic category, urothelial carcinoma was most common. However, rare lesions such as hamartomatous fibroepithelial polyp, Von Brunn’s nests, flat urothelial hyperplasia and intramuscular haemangioma of upper ureter at the pelviureteric junction were encountered along with occasional cases of tuberculosis and squamous cell carcinomas. PMID:27042468

  6. Factors affecting treatment outcome in congenital nasolacrimal duct obstruction: A retrospective analysis from South India

    PubMed Central

    Bhandari, Sahil; Sengupta, Sabyasachi; Yadalla, Dayakar; Rajagopalan, Jayagayathri; Velis, Girish Bharat; Talele, Deepti; Kushwaha, Sameer

    2015-01-01

    Purpose: To investigate outcomes for different treatment modalities in congenital nasolacrimal duct obstruction (CNLDO) in an Indian population. Design: Retrospective, interventional, case series. Materials and Methods: In an institutional setting, case records of patients with CNLDO from January 2008 to 2012, were reviewed, and data on patient demographics, clinical presentation, and treatment details (sac massage, probing, and/or dacryocystorhinostomy) were recorded. Success of treatment was defined as complete resolution of symptoms and negative regurgitation on pressure over lacrimal sac (ROPLAS) area. Results: Two hundred and ninety-eight eyes of 240 patients with a mean age of 22.2 ± 26.14 months (median = 12 months, interquartile range = 17) were analyzed. Sac massage (n = 226) was successful in 67 eyes (30%). Multivariable logistic regression analyses showed that children with mucoid ROPLAS were almost 6 times more likely (odds ratio [OR] = 5.55 vs. clear ROPLAS, 95% confidence interval [CI] = 2.35–13.09, P < 0.001) to experience failure of sac massage. Overall probing (n = 193) was successful for 143 (74%) eyes. Multivariable logistic regression showed that older children were 25% more likely to experience probing failure (OR = 1.25 for every 6 months increment in age, 95%, CI = 1.09–1.42, P = 0.001). Conclusion: Sac massage is successful in only a third of our patients and those with mucoid ROPLAS are more likely to experience failure. Probing is successful in three-quarter of our subjects, and its success declines with a progressive increase in age. Lower socioeconomic status, poor general health, and recurrent respiratory infections are unique to our population and may influence outcomes. PMID:26654998

  7. Comparable Botulinum Toxin Outcomes between Primary and Secondary Blepharospasm: A Retrospective Analysis

    PubMed Central

    Martinez-Ramirez, Daniel; Giugni, Juan C.; Hastings, Erin; Shukla, Aparna Wagle; Malaty, Irene A.; Okun, Michael S.; Rodriguez, Ramon L.

    2014-01-01

    Background Blepharospasm is a focal cranial dystonia, which could be idiopathic in origin or secondary to an underlying disorder that commonly impairs quality of life. Botulinum toxin (BoNT) injections have become the treatment of choice; however, a less favorable response to BoNT is expected in secondary blepharospasm. No studies have been conducted comparing outcomes between blepharospasm cohorts. We therefore aim to compare BoNT outcomes in primary and secondary blepharospasm subjects. Methods A retrospective review of 64 blepharospasm subjects receiving BoNT therapy was conducted. Demographics, BoNT treatment schedules, duration of BoNT therapy, and side effects were recorded. Outcome measures were duration of benefit, peak-dose benefit recorded with the Clinical Global Impressions Scale (CGIS), and related side effects. Results No difference was found between the two cohorts regarding duration of benefit from treatment (primary 9.47 weeks vs. secondary 9.63 weeks, p = 0.88). Perceived peak-dose benefit was more commonly reported as “very much improved” in secondary patients, but this was not significant (p = 0.13). Higher BoNT dosages were required in both groups over time, with a mean increase of 20.5% in primary and 26.5% in secondary blepharospasm. Ptosis (8%) and diplopia (6%) were the most common reported side effects. Mean follow-up in years was similar between groups, 3.6 years for primary vs. 2.4 years for secondary blepharospasm (p = 0.17). Discussion BoNT injections were effective with comparable benefits seen in both primary and secondary blepharospasm populations. Clinicians should be aware of the similar benefit from BoNT reported in secondary blepharospasm patients. The average duration of benefit in this cohort was comparable with previous reports. PMID:25562037

  8. Cabergoline in the Treatment of Male Orgasmic Disorder—A Retrospective Pilot Analysis

    PubMed Central

    Hollander, Adam B.; Pastuszak, Alexander W.; Hsieh, Tung-Chin; Johnson, William G.; Scovell, Jason M.; Mai, Christina K.; Lipshultz, Larry I.

    2016-01-01

    Introduction Male orgasmic disorder is common, with few treatment options. Cabergoline is a dopamine agonist that acts centrally to normalize serum prolactin that could improve orgasmic dysfunction. Aims To determine whether cabergoline increases the potential for orgasm in men with orgasmic disorder. Methods A retrospective chart review of men treated in a single andrology clinic for delayed orgasm or anorgasmia in a pilot study using cabergoline 0.5 mg twice weekly was performed. Duration of treatment and response were noted. Medical records were examined for other factors including history of prostatectomy and concomitant androgen supplementation. Main Outcome Measures Subjective improvement in orgasmic function resulting from cabergoline treatment. Results Of 131 men treated with cabergoline for orgasmic disorder, 87 (66.4%) reported subjective improvement in orgasm and 44 (33.6%) reported no change in orgasm. Duration of therapy (P = .03) and concomitant testosterone therapy (P = .02) were associated with a significant positive response to cabergoline treatment. No differences were found between injectable and non-injectable testosterone formulations (P = .90), and neither age (P = .90) nor prior prostatectomy (P = .41) influenced the outcome of cabergoline treatment. Serum testosterone levels before (P = .26) and after (P = .81) treatment were not significantly different in responders vs non-responders. Conclusion Cabergoline is a potentially effective and easy-to-administer treatment for male orgasmic disorder, the efficacy of which appears to be independent of patient age or orgasmic disorder etiology. Prospective randomized trials are needed to determine the true role of cabergoline in the treatment of this disorder. PMID:26944776

  9. Retrospective analysis of rituximab therapy and splenectomy in childhood chronic and refractory immune thrombocytopenic purpura.

    PubMed

    Ay, Yilmaz; Karapinar, Tuba H; Oymak, Yesim; Toret, Ersin; Demirag, Bengu; Ince, Dilek; Ozcan, Esin; Moueminoglou, Nergial; Koker, Sultan A; Vergin, Canan

    2016-06-01

    Immune thrombocytopenic purpura (ITP) results from accelerated platelet destruction mediated by autoantibodies to platelet glycoproteins. Some patients with chronic ITP are refractory to all therapies [steroids, intravenous immunoglobulin (IVIG), anti-D and immunosuppresive drugs] and have chronic low platelet counts and episodic bleeding. We retrospectively evaluated the efficacy and safety of rituximab treatment and splenectomy in paediatric patients diagnosed with chronic and refractory ITP who were unresponsive to steroids, IVIG, cyclosporine and mycophenolate mofetil. Records of patients with chronic and refractory ITP in 459 patients with primary ITP who were followed up in our hospital from January 2005 to December 2014 were reviewed. Fifteen of patients received rituximab and/or applied splenectomy. Fifteen chronic ITP patients (10 boys, five girls) with a mean age of 10 years were enrolled in the study. Two of these patients were suffering from Evans syndrome. The median time since diagnosis of ITP was 10 years. The median follow-up duration after starting Rituximab and splenectomy were 13 and 9.5 months, respectively.None of the seven patients who were treated with rituximab achieved a response. A splenectomy was performed in six of the seven patients who had been treated with rituximab. Complete and partial responses were achieved in 67 and 33% of the patients, respectively. We evaluated the clinical characteristics and responses of chronic ITP patients who did not receive rituximab therapy and underwent a splenectomy. The success rate was 100% in the eight patients with chronic and refractory ITP. Rituximab therapy might not be beneficial for some children with severe chronic ITP who are refractory to standard agents. A splenectomy might be useful and preferable to rituximab. PMID:26656905

  10. Impaired glucose metabolism in HIV-infected pregnant women: a retrospective analysis.

    PubMed

    Moore, Rebecca; Adler, Hugh; Jackson, Valerie; Lawless, Mairead; Byrne, Maria; Eogan, Maeve; Lambert, John S

    2016-06-01

    Metabolic complications, including diabetes mellitus, have been increasingly recognised in HIV-infected individuals since the introduction of antiretroviral therapy, particularly protease inhibitors (PIs). Pregnancy is also a risk factor for impaired glucose metabolism, and previous studies have given conflicting results regarding the contribution of PIs to impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM) in pregnant HIV-infected women. We conducted a retrospective review of all HIV-infected women attending a combined infectious disease and antenatal clinic between 2007 and 2013 who underwent a 100 g oral glucose tolerance test (OGTT) at 24-28 weeks. We grouped the patients based on whether their OGTT result was normal or abnormal, and compared the groups using standard parametric tests (t-test and Fisher's exact test). Of 263 women with HIV who attended the clinic, 142 (53.9%) attended for OGTT and were eligible for inclusion. The mean age was 31 years (SD 5.37), all women were of European or African origin and 33.7% had a body mass index ≥30 kg/m(2) About 93.7% were on PI-based regimens. At delivery, the mean CD4 count was 526 cells/µL, and 13% of patients had a detectable viraemia. The prevalence of IGT was 2.8%, while the prevalence of GDM was 2.1%. Also, 71.4% (n = 5) of women with abnormal glucose metabolism were taking PIs versus 94.8% (n = 128) of normoglycaemic women (p = 0.06). We did not confirm an increased rate of GDM in HIV-infected women in our patient population and found no association between PI use and GDM. PMID:25999164

  11. Early combined parenteral and enteral nutrition for pancreaticoduodenectomy – Retrospective cohort analysis

    PubMed Central

    Probst, Pascal; Keller, Daniel; Steimer, Johannes; Gmür, Emanuel; Haller, Alois; Imoberdorf, Reinhard; Rühlin, Maya; Gelpke, Hans; Breitenstein, Stefan

    2016-01-01

    Background Suggested guidelines for nutritional support after pancreaticoduodenectomy are still controversial. Recent evidence suggests that combining enteral nutrition (EN) with parenteral nutrition (PN) improves outcome. For ten years, patients have been treated with Early Combined Parenteral and Enteral Nutrition (ECPEN) after PD. The aim of this study was to report on rationale, safety, effectiveness and outcome associated with this method. Methods Consecutive PD performed between 2003 and 2012 were analyzed retrospectively. Early EN and PN was standardized and started immediately after surgery. EN was increased to 40 ml/h (1 kcal/ml) over 24 h, while PN was supplemented based on a daily energy target of 25 kcal/kg. Standard enteral and parenteral products were used. Results Sixty-nine patients were nutritionally supplemented according to ECPEN. The median coverage of kcal per patients related to the total caloric requirements during the entire hospitalization (nutrition balance) was 93.4% (range: 100%–69.3%). The nutritional balance in patients with needle catheter jejunostomy (NCJ) was significantly higher than in the group with nasojejunal tube (97.1% vs. 91.6%; p < 0.0001). Mortality rate was 5.8%, while major complications (Clavien-Dindo 3–5) occurred in 21.7% of patients. Neither the presence of preoperative malnutrition nor the application of preoperative immunonutrition was associated with postoperative clinical outcome. Conclusion This is the first European study of ECPEN after PD. ECPEN is safe and, especially in combination with NCJ, provides comprehensive coverage of caloric requirements during the postoperative phase. Clinical controlled trials are needed to investigate potential benefits of complete energy supplementation during the early postoperative phase after PD. PMID:26955477

  12. Incidence and pattern of 12 years of reported transfusion adverse events in Zimbabwe: a retrospective analysis

    PubMed Central

    Mafirakureva, Nyashadzaishe; Khoza, Star; Mvere, David A.; Chitiyo, McLeod E.; Postma, Maarten J.; van Hulst, Marinus

    2014-01-01

    Background Haemovigilance hinges on a systematically structured reporting system, which unfortunately does not always exist in resource-limited settings. We determined the incidence and pattern of transfusion-related adverse events reported to the National Blood Service Zimbabwe. Materials and methods A retrospective review of the transfusion-event records of the National Blood Service Zimbabwe was conducted covering the period from 1 January 1999 to 31 December 2011. All transfusion-related event reports received during the period were analysed. Results A total of 308 transfusion adverse events (0.046%) were reported for 670,625 blood components distributed. The majority (61.6%) of the patients who experienced an adverse event were female. The median age was 36 years (range, 1–89 years). The majority (68.8%) of the adverse events were acute transfusion reactions consisting of febrile non-haemolytic transfusion reactions (58.5%), minor allergies (31.6%), haemolytic reactions (5.2%), severe allergic reactions (2.4%), anaphylaxis (1.4%) and hypotension (0.9%). Two-thirds (66.6%) of the adverse events occurred following administration of whole blood, although only 10.6% of the blood was distributed as whole blood. Packed cells, which accounted for 75% of blood components distributed, were associated with 20.1% of the events. Discussion The incidence of suspected transfusion adverse events was generally lower than the incidences reported globally in countries with well-established haemovigilance systems. The administration of whole blood was disproportionately associated with transfusion adverse events. The pattern of the transfusion adverse events reported here highlights the probable differences in practice between different settings. Under-reporting of transfusion events is rife in passive reporting systems. PMID:24887217

  13. Trends of Blood and Plasma Donations in Kazakhstan: 12-Years Retrospective Analysis

    PubMed Central

    IGISSINOV, Nurbek; KULMIRZAYEVA, Dariyana; MAGZUMOVA, Raushan; SIBINGA, Cees Th. Smit; ALPEISSOVA, Sholpan

    2014-01-01

    Abstract Background Each country faces a continuing challenge to collect enough blood to meet the national needs. According to WHO, there should be at least 20 blood donations per 1,000 population for developing countries, in Kazakhstan this indicator was only 16.8 in 2011. Thus, we conducted an epidemiological assessment and drew a map of the regional distribution of blood and plasma donations in Kazakhstan during the years 2000-2011. Methods The retrospective study was conducted from 2000 to 2011. Data on blood and its components donations were acquired from the Ministry of Health (annual statistical reporting form N° 39). Results During 2000-2011, number of blood donors decreased to 17.4% and blood donations to 6.3%. The proportion of non-remunerated blood donations and donors decreased from 97.6% to 77.9% and 97.9% to 87.7%, respectively. The paid donations had the opposite trend. Number of plasma donors increased in 2.1 times, plasma donations in 2.4 times, nevertheless the proportion of non-remunerated plasma donations decreased from 60.1% to 29.8%. The average number of blood donations per 1,000 population decreased from 19.8 (2000) to 16.8 (2011), plasma donations increased from 1.4 to 3.1. Regionally, annual average rates of blood and plasma donations per 1,000 population over 12 years varied greatly. Conclusion This is the first study conducted in Kazakhstan to provide detailed information, including the regional characteristics of blood and plasma donations over an extended period of time, which can be used in blood transfusion services work. PMID:26060761

  14. LH supplementation in mild stimulations cycles without pituitary suppression: a retrospective analysis.

    PubMed

    Paragona, Mizar; Rossini, Matteo; Dattilo, Maurizio; Stamm, Juerg

    2013-02-01

    A cohort of patients addressed to a mild stimulation protocol was retrospectively analysed aiming at evaluating the effect of a luteinizing hormone (LH) activity containing stimulation compared to a pure follicle-stimulating hormone (FSH) drive in absence of any pituitary suppression. Due to a referral bias, the two groups (human FSH (hFSH) n = 210; hMG n = 105) were imbalanced for age with the hFSH group (mean age 38.4) being significantly older than the hMG group (mean age 36.8). But the clinical pregnancy rates (20%) did not differ between the groups. Secondary outcome variables showed a higher number of oocytes retrieved (3.02 vs. 2.31) and higher estradiol levels (1148 vs. 820) in the hMG/younger group whereas the fertilization rate (FR) was higher (54.8 vs. 63.8) in the FSH older/group. In spite of the LH content in the hMG product (~10 IU per vial), the LH concentration on the day of human chorionic gonadotropin (hCG) was higher, although non-significantly, in the hFSH group. We suppose hCG contained in hMG inhibited to some extent the natural release of LH from the non-suppressed pituitary. Concluding, the mild stimulation clinical pregnancy rates are satisfactory independently of the treatment choice. The hMG group showed a trend for a lower efficacy. This phenomenon might be limited to non suppressed cycles, but should be taken in due account also when designing full dose controlled ovarian hyperstimulation (COH) treatments. PMID:23256611

  15. Endoscopic treatment of superficial colorectal neoplasms. Retrospective analysis of a single center technique and results

    PubMed Central

    ACQUISTAPACE, G.; MATERNINI, F.; SNIDER, L.; BELLINI, O.; MOGLIA, P.; CAPRETTI, P.

    2015-01-01

    Endoscopic Submucosal Dissection (ESD) is a technique developed in Japan for “en bloc” resection of larger superficial neoplasms of the gastrointestinal tract as an alternative to the traditional Endoscopic Mucosal Resection (EMR), with removal of the lesion in multiple fragments (“piecemeal”). ESD offers a lower recurrence rate and allows a more accurate histopathological examination. This procedure is however considered technically difficult and therefore requires an adequate learning curve, it is time consuming with more discomfort for the patient, it has a higher complication rate, it is more expensive. To overcome these disadvantages, in the Western countries a hybrid technique called Circumferential Submucosal Incision - Endoscopic Mucosal Resection (CSI-EMR) has been developed and is especially employed for colonic lesions. This article analyzes retrospectively the results obtained in a single centre by a single operator in the treatment of 23 patients (12 men and 11 women, average age 65,6 years), all suffering from superficial, larger than ≥ 20 mm colorectal neoplasms: 9 were treated with ESD for rectal lesions and 14 were treated with CSI-EMR for colonic lesions. Findings show a technical success rate of 66,6% for ESD and 78,5% for CSI-EM, and a 0% recurrence rate during follow-up, 4,3% bleeding and 13% perforation complications. The histology of the removed lesions showed 13 (56,5%) low grade dysplasia adenomas, 8 (34,7%) high grade dysplasia adenomas, one grade 1 sigmoid colon adenocarcinoma infiltrating the submucosal layer without lymphovascular invasion, with free margins (R0), treated conservatively, and one grade 1 cecum adenocarcinoma, infiltrating the submucosal layer, with lymphovascular invasion and involved excision margin, treated surgically with no residual neoplastic disease in the surgical specimen. These data are in line with the most significant ones in literature, except for the higher complication rate, which the authors

  16. The impact of a worksite weight management program on obesity: a retrospective analysis.

    PubMed

    Davis, Jeff; Clark, Bobby; Lewis, Geraint; Duncan, Ian

    2014-10-01

    The objective of this study was to examine the efficacy of a worksite weight management program on the reduction of weight and lipid levels in employees and their dependents. This retrospective study examined the impact of a one-on-one worksite weight management program. Patients with a body mass index (BMI)>30, or a BMI>25 and 2 or more risk factors were eligible for inclusion. Laboratory and biometric readings at study end were compared to those at baseline. In addition, the percentage change of patients reaching recommended guideline levels was reported. Of the 310 employees enrolled, 157 completed the program (50.6%) with an average weight loss of 5.6%. Improvement was realized for pre-post weight (-6.0 lbs.; P≤.0001), BMI (-0.9; P≤.0001), blood pressure (systolic: -2.6; P≤.0001; diastolic: -1.9; P≤.0001), total cholesterol (-5.9; P=.0485), low-density lipoprotein cholesterol (LDL; -4.7; P=.0004), and triglycerides (-7.6; P=.0060). The proportion moving to within guideline levels increased for the following metrics: normal BMI category (2.6%; P=.0060),<30 BMI (10%; P≤.0001), systolic and diastolic blood pressure readings (7.7%; P=.0011 and 6.1; P=.0056, respectively), total cholesterol (6.5%; P=.0020), LDL (3.9%; P=.0396), and triglycerides (4.8; P=.0137). Retention in the worksite program was almost twice that seen in some commercial weight loss programs and significant improvements in laboratory and biometric readings were achieved. This study suggests that employer worksite-based programs may have an important role in improving the health of an employee population, which is of particular interest given the high prevalence of obesity and its attendant costs. PMID:24735259

  17. Surgical treatment algorithm for infected shoulder arthroplasty: a retrospective analysis of 17 cases.

    PubMed

    Ghijselings, Stijn; Stuyck, José; Debeer, Philippe

    2013-12-01

    There is no consensus regarding treatment of periprosthetic shoulder infections. We retrospectively reviewed 17 patients diagnosed with a periprosthetic shoulder infection. Patient demographics, preoperative diagnostics, therapeutic management and functional outcome were evaluated. The Constant-Murley score (CMS), Simple Shoulder Test (SST), Visual Analogue Score (VAS) and Disabilities of the Arm, Shoulder and Hand score (DASH) were used to assess clinical outcome. Pre-and intraoperative culture results and laboratory data, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), were analyzed. Three patients were treated by two-stage revision arthroplasty, 5 by resection arthroplasty with implantation of a cement spacer, 8 by resection arthroplasty without spacer and one patient underwent polyethylene exchange and serial debridement. The mean follow-up was 4.7 years (range : 1-93). The CMS was 27.8 for the resection arthroplasty group, 22.7 for the two-stage revision group and 20.6 for the resection arthroplasty with spacer group. No patients received chronic antibiotic suppression. Mean CRP value was 3.7 mg/L (range: 0.2 -11.1). Infection was monobacterial in 8 patients and polymicrobial in 9. The most common organisms were Coagulase negative staphylococcus (CNS) (13/17) and Propionibacterium spp. (7/17). Complications included two humeral fractures. At a mean follow-up of 4.7 years, all but one patient were considered free of infection. Worst functional results were seen with the implantation of a definitive cement spacer. Two-stage revision arthroplasty remains the gold standard in chronic infections, but is associated with a high complication rate. One-stage revision to a reverse shoulder arthroplasty (RSA) is an attractive alternative in selected cases. A surgical treatment algorithm for infected shoulder arthroplasty is proposed. PMID:24563966

  18. MS-22NEOPLASTIC MENINGITIS FROM EPENDYMOMAS OF THE ADULT: A RETROSPECTIVE ANALYSIS

    PubMed Central

    Rudà, Roberta; Magistrello, Michela; Bertero, Luca; Bosa, Chiara; Pellerino, Alessia; Nicolotto, Elisa; Moretto, Francesco; Garbossa, Diego; Soffietti, Riccardo

    2014-01-01

    BACKGROUND: There is lack of information regarding the natural history and treatment outcome of neoplastic meningitis (NM) from ependymomas of the adult. AIM OF THE STUDY: To retrospectively analyze all patients with biopsy proven adult ependymomas with NM, who were diagnosed and treated at a single neuro-oncological Institution over the last decade. PATIENTS AND METHODS: We collected from the database and follow-up visits 15 evaluable patients (12 males, 3 females) with a median age of 45 (range 20-72). Histological diagnosis was as follows: 6 grade III (40%), 4 grade II (27%) and 5 grade I (myxopapillary) (33%) ependymomas. Overall, median time to NM was 2 years (range: 0-24). NM occurred at diagnosis in 5/15 (33%) and during follow-up in 10/15 (67%): among these latter the primary tumor was under control in 6/10 (60%) and progressive in 4/10 (40%). All but 4 patients were symptomatic and MRI of the whole CNS was available in all patients. The diagnosis of NM was CSF-based in 7/15 (47%) and radiologically-based in 8/15 (53%). RT to the bulky disease was applied in 7/15 (47%) and surgery in 2/15 (13%). Medical therapies consisted variably in intrathecal Depocyte, temozolomide, nitrosourea-based regimens and bevacizumab. Four out of 12 symptomatic patients had a significant clinico-radiological response. Median survival was 20 months (range: 1 month-7 years), and 7/15 patients are still alive. CONCLUSIONS: NM from ependymomas in the adult is more indolent compared with other NM types, with longer survivals after multimodality treatment. Prospective studies are warranted.

  19. A retrospective analysis of a human cellular repair matrix for the treatment of chronic wounds.

    PubMed

    Regulski, Matthew; Jacobstein, Douglas A; Petranto, Russell D; Migliori, Vincent J; Nair, Girish; Pfeiffer, Darelle

    2013-12-01

    Despite the introduction of advanced wound care modalities over the last 15 years, chronic wounds are an increasing problem. Few single options are available for clinicians to treat recalcitrant wounds such as diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs). A retrospective, single-center study was conducted at an outpatient wound care center to evaluate the clinical effect of a human cellular repair matrix (h-CRM) on chronic wounds that had failed to heal. Data from all patients who had received this treatment modality during a period of 2 years were abstracted. Standard care included weekly visits, regular debridement, offloading DFUs, compression for VLUs, and h-CRM for wounds >4 weeks duration. A total of 66 patients (30 male, 36 female, mean age 71.1 [± 8.8] years) received h-CRM treatment for 67 wounds (34 VLUs, 27 DFUs, and six other chronic wounds). The average wound size at baseline was 6.65 (± 9.68) cm2, and the average wound duration before h-CRM treatment was 38 (±70.8) weeks. Fifty (50) patients (74.6%) had failed to heal using other advanced therapies. After 12 weeks of care, 51 of the 67 wounds (76.1%) were healed: 23 of 34 (67.6%) VLUs and 23 of 27 (85.2%) DFUs. Average time to closure in these wounds was 5.8 (±2.5) weeks. No significant differences were found between proportions of VLUs and DFUs healed. No adverse events or recurrences occurred during an average follow-up time of 20.4 months (range 11 to 32 months). Overall, patients received an average of 3.8 applications of h-CRM, and 3.2 applications were used among patients that healed. The study results suggest h-CRM may benefit patients with chronic wounds. Prospective, randomized clinical studies are warranted. PMID:24334364

  20. Utilisation of Blood Components in Cardiac Surgery: A Single-Centre Retrospective Analysis with Regard to Diagnosis-Related Procedures

    PubMed Central

    Geissler, Raoul Georg; Rotering, Heinrich; Buddendick, Hubert; Franz, Dominik; Bunzemeier, Holger; Roeder, Norbert; Kwiecien, Robert; Sibrowski, Walter; Scheld, Hans H.; Martens, Sven; Schlenke, Peter

    2015-01-01

    Background More blood components are required in cardiac surgery than in most other medical disciplines. The overall blood demand may increase as a function of the total number of cardiothoracic and vascular surgical interventions and their level of complexity, and also when considering the demographic ageing. Awareness has grown with respect to adverse events, such as transfusion-related immunomodulation by allogeneic blood supply, which can contribute to morbidity and mortality. Therefore, programmes of patient blood management (PBM) have been implemented to avoid unnecessary blood transfusions and to standardise the indication of blood transfusions more strictly with aim to improve patients' overall outcomes. Methods A comprehensive retrospective analysis of the utilisation of blood components in the Department of Cardiac Surgery at the University Hospital of Münster (UKM) was performed over a 4-year period. Based on a medical reporting system of all medical disciplines, which was established as part of a PBM initiative, all transfused patients in cardiac surgery and their blood components were identified in a diagnosis- and medical procedure-related system, which allows the precise allocation of blood consumption to interventional procedures in cardiac surgery, such as coronary or valve surgery. Results This retrospective single centre study included all in-patients in cardiac surgery at the UKM from 2009 to 2012, corresponding to a total of 1,405-1,644 cases per year. A blood supply was provided for 55.6-61.9% of the cardiac surgery patients, whereas approximately 9% of all in-patients at the UKM required blood transfusions. Most of the blood units were applied during cardiac valve surgery and during coronary surgery. Further surgical activities with considerable use of blood components included thoracic surgery, aortic surgery, heart transplantations and the use of artificial hearts. Under the measures of PBM in 2012 a noticeable decrease in the number of

  1. The use of desmopressin in von Willebrand disease: the experience of the first 30 years (1977-2007).

    PubMed

    Federici, A B

    2008-01-01

    The aim of the treatment for von Willebrand disease (VWD) is to correct the dual defect of haemostasis, i.e. the abnormal platelet adhesion as a result of reduced and/or dysfunctional von Willebrand factor (VWF) and the abnormal coagulation expressed by low levels of factor VIII (FVIII). Correction of both deficiencies can be achieved by administering the synthetic peptide desmopressin (DDAVP) or, in cases unresponsive to this agent, the plasma concentrates containing VWF and FVIII (VWF/FVIII). DDAVP is the treatment of choice for type 1 VWD because it can induce release of normal VWF from cellular compartments, but the drug can be clinically useful also in other VWD types, including acquired von Willebrand syndrome (AVWS). A test dose of DDAVP at the time of diagnosis is recommended to establish the individual patterns of biological response and to predict clinical efficacy during bleeding and surgery. DDAVP is not effective in VWD type 3 and in severe forms of VWD 1 and 2. It can induce transient thrombocytopenia in patients with VWD type 2B. The results of several retrospective studies on the use of DDAVP in VWD management have been reported by many authors in different countries for the last 30 years. However, despite the widespread use of DDAVP in the treatment of VWD, there are only a few prospective clinical trials in a large number of cases on DDAVP efficacy and safety aimed at determining benefits and limits of this therapeutic approach. An investigator-driven observational prospective study on clinical efficacy of DDAVP in 200 patients with VWD types 1 and 2 has been recently organized: the effectiveness and safety of DDAVP will be evaluated prospectively for 24 months during bleeding episodes and minor or major surgeries in the VWD patients who were exposed to an infusion trial at enrollment. PMID:18173689

  2. Arctic Climate Change Analysed By Two 30-year Scenario Regional Climate Model Runs

    NASA Astrophysics Data System (ADS)

    Kiilsholm, S.; Christensen, J. H.

    High-resolution climate change simulations for an area covering the entire Arctic have been conducted with the regional climate model (RCM) HIRHAM. The emission sce- narios used were the IPCC SRES1 marker scenarios A2 and B2. Three 30-year time slice experiments were conducted with HIRHAM for periods representing present-day (1961-1990) and the future (2071-2100) in the two scenarios. Changes of the climate between these two periods will be presented with special emphasize on the climate of Greenland.

  3. The biochemistry and nutrition group: 30 years of research in a developing country.

    PubMed

    Levy Benshimol, A

    1996-12-01

    The most relevant results of 30 years of research from the Group of Biochemistry and Nutrition are presented. Research was focused mainly around the identification and detection of the heatlabile toxic factors present in legume seeds of human consumption, namely protease inhibitors and lectins with special emphasis on their isolation, molecular characterization, mechanistic and nutritional relevance of both protein groups. The antinutritional effect of the polyphenols, thermolabile compounds present in colored seeds, has also been studied as well as the impact of seed complex carbohydrates on the digestive process. PMID:9137631

  4. A Retrospective Analysis of 7 Human Immunodeficiency Virus-Negative Infants Infected by Penicillium marneffei.

    PubMed

    Zeng, Wen; Qiu, Ye; Lu, DeCheng; Zhang, Jianquan; Zhong, Xiaoning; Liu, Guangnan

    2015-08-01

    Infection with Penicillium marneffei has rarely been reported in human immunodeficiency virus (HIV)-negative infants. We aimed to determine the epidemiological, clinical, pathological, and immunological characteristics of 7 HIV-negative infants infected by P. marneffei, and to provide insights into its diagnosis and treatment.We retrospectively reviewed the cases of 7 HIV-negative infants infected by P. marneffei who presented to the First Affiliated Hospital of Guangxi Medical University between January 1, 2003 and December 1, 2014. The infants' median age was 23.43 months (SD = 8.34), and all lived in Guangxi Province in China, where P. marneffei is endemic. The median time from disease onset to diagnosis was 2.29 months (SD = 2.12). Of the cases studied, 5 (71.43%) had medical histories that included frequent pneumonia or bronchopneumonia, thrush, congenital megacolon, glucose-6-phosphate dehydrogenase deficiency, and hemophagocytic syndrome. The most common symptoms were fever, cough, and anemia, followed by lymphadenopathy, hepatosplenomegaly, and being underweight. Four patients had slightly elevated white blood cell counts. The lymphocyte and CD4 T-cell counts were normal. The CD8 T-cell counts, serum immunoglobulin (Ig) G titer, and serum IgA titer were low in 5 patients, and the serum IgM titers were high in 3 infants. Caseous necrosis was observed in 3 patients whose lymph nodes were affected. One case who received intravenous amphotericin B and 3 cases who received intravenous voriconazole improved, and these patients were cured after continual treatment with oral voriconazole for 6 or 12 months. The remaining patients died before they received antifungal treatment.P. marneffei causes severe disease and disseminated infections, and it has high mortality rates in HIV-negative infants in endemic areas. P. marneffei susceptibility may be associated with immunodeficiencies or immune disorders. In endemic areas, clinicians should aware of disseminated

  5. Vinflunine treatment in patients with metastatic urothelial cancer: A Nordic retrospective multicenter analysis

    PubMed Central

    Holmsten, Karin; Dohn, Line; Jensen, Niels Viggo; Shah, Carl-Henrik; Jäderling, Fredrik; Pappot, Helle; Ullén, Anders

    2016-01-01

    In 2009, vinflunine was introduced as a second-line treatment to be used after the failure of platinum therapy in patients with metastatic urothelial carcinoma (mUC). The present study investigated the administered vinflunine to patients with mUC in standard clinical practice with the aim of evaluating treatment patterns, response, survival parameters and side-effects. Data were collected retrospectively from the first 100 mUC patients treated with vinflunine at three Nordic cancer centers associated with the Nordic Urothelial Cancer Oncology Group. The overall response rate was 23% and complete response was observed in one patient. The median progression-free survival (mPFS) and median overall survival (mOS) were 2.8 (range, 0.5–34.3) and 6.3 (range, 0.3–39.7) months, respectively. An Eastern Cooperative Oncology Group performance status (ECOG PS) of 2 was present in 20% of the patients, and those patients exhibited significantly shorter mOS (4.1 vs. 7.0 months, P=0.001) and a significantly higher degree of grade 3/4 toxicity (P=0.026) compared with ECOG PS 0–1 patients. Furthermore, patients without visceral metastases had significantly longer mOS than patients with visceral metastases (10.6 vs. 6.0 months, P=0.008). The median number of cycles of vinflunine was 3 (range, 1–28). The current data confirms that vinflunine is an active agent for second-line treatment in an unselected clinical cohort of patients with mUC. ECOG PS and presence of visceral metastases were significant prognostic parameters. In particular, patients with ECOG PS 2 receiving vinflunine had a shorter mOS and a higher frequency of severe toxicity, and, thus, should be treated with caution. Furthermore, the present study observed large inter-individual differences in radiological response and OS, indicating the need for further development of improved patient selection tools to optimize vinflunine treatment in platinum-refractory mUC patients. PMID:27446429

  6. Diagnosed hematological malignancies in Bangladesh - a retrospective analysis of over 5000 cases from 10 specialized hospitals

    PubMed Central

    2014-01-01

    Background The global burden from cancer is rising, especially as low-income countries like Bangladesh observe rapid aging. So far, there are no comprehensive descriptions reporting diagnosed cancer group that include hematological malignancies in Bangladesh. Methods This was a multi-center hospital-based retrospective descriptive study of over 5000 confirmed hematological cancer cases in between January 2008 to December 2012. Morphological typing was carried out using the “French American British” classification system. Results A total of 5013 patients aged between 2 to 90 years had been diagnosed with malignant hematological disorders. A 69.2% were males (n = 3468) and 30.8% females (n = 1545), with a male to female ratio of 2.2:1. The overall median age at diagnosis was 42 years. Acute myeloid leukemia was most frequent (28.3%) with a median age of 35 years, followed by chronic myeloid leukemia with 18.2% (median age 40 years), non-Hodgkin lymphoma (16.9%; median age 48 years), acute lymphoblastic leukemia (14.1%; median age 27 years), multiple myeloma (10.5%; median age 55 years), myelodysplastic syndromes (4.5%; median age 57 years) and Hodgkin’s lymphoma (3.9%; median age 36 years). The least common was chronic lymphocytic leukemia (3.7%; median age 60 years). Below the age of 20 years, acute lymphoblastic leukemia was predominant (37.3%), followed by acute myeloid leukemia (34%). Chronic lymphocytic leukemia and multiple myeloma had mostly occurred among older patients, aged 50-over. Conclusions For the first time, our study presents the pattern and distribution of diagnosed hematological cancers in Bangladesh. It shows differences in population distributions as compared to other settings with possibly a lower presence of non-Hodgkin lymphoma. There might be under-reporting of affected women. Further studies are necessary on the epidemiology, genetics and potential environmental risk factors within this rapidly aging country. PMID

  7. Pulmonary function abnormalities in adult patients with acute exacerbation of bronchiectasis: A retrospective risk factor analysis.

    PubMed

    Ma, Yanliang; Niu, Yuqian; Tian, Guizhen; Wei, Jingan; Gao, Zhancheng

    2015-08-01

    Lung function impairments, especially airflow obstruction, are important features during acute exacerbation in patients with bronchiectasis. Recognition of the risk factors associated with airflow obstruction is important in the management of these exacerbations. The medical records of adult patients admitted to the Peking University People's Hospital, Beijing, China, from 2004 to 2011 with a diagnosis of bronchiectasis were reviewed retrospectively. Univariate and multivariate analyses were used to evaluate the risk factors associated with airflow obstruction. Airflow obstruction was found in 55.6% of 156 patients hospitalized with acute exacerbation of bronchiectasis, and the risk factors associated with airflow obstruction included young age (≤14 years old) at diagnosis (odds ratio (OR) = 3.454, 95% confidence interval (CI) 1.709-6.982, p = 0.001) as well as the presence of chronic obstructive pulmonary disease (COPD; OR = 14.677, 95% CI 5.696-37.819, p = 0.001), asthma (OR = 3.063, 95% CI 1.403-6.690, p = 0.005), and wheezing on auscultation (OR = 3.279, 95% CI 1.495-7.194, p = 0.003). The C-reactive protein (13.9 mg/dl vs. 6.89 mg/dl, p = 0.005), partial pressure of arterial oxygen (66.7 ± 8.57 mmHg vs. 89.56 ± 12.80 mmHg, p < 0.001), and partial pressure of arterial carbon dioxide (40.52 ± 2.77 mmHg vs. 42.87 ± 5.39 mmHg, p = 0.02) profiles were different between patients with or without airflow obstruction. In addition, patients colonized with potential pathogenic microorganisms had a decreased diffusing capacity (56.0% vs. 64.7%, p = 0.04). Abnormal pulmonary function was common in hospitalized patients with bronchiectasis exacerbations. Airflow obstruction was correlated with the patient's age at diagnosis, as well as the presence of combined COPD and asthma, and wheezing on auscultation, which also resulted in more severe systemic inflammation and hypoxemia. PMID:25882894

  8. Outcomes after Intravitreal Bevacizumab versus Laser Photocoagulation for Retinopathy of Prematurity: A 5-Year Retrospective Analysis

    PubMed Central

    Hwang, Christopher K.; Hubbard, G. Baker; Hutchinson, Amy K.; Lambert, Scott R.

    2014-01-01

    Purpose To determine the relative effectiveness, major complications, and refractive errors associated with intravitreal bevacizumab (IVB) versus panretinal photocoagulation (PRP) to treat Type 1 retinopathy of prematurity (ROP). Subjects Consecutive infants with Type 1 ROP who received either IVB or PRP between January 2008 and December 2012 and had at least six months of follow-up. Design Retrospective case series. Methods The data from infants treated with either IVB or PRP for Type 1 ROP between January 2008 and December 2012 were recorded from two medical centers in Atlanta, Georgia. Main Outcome Measures Recurrence rate, complication rate, refractive error. Results A total of 54 eyes (28 patients) with Type 1 ROP were evaluated: 22 eyes (11 patients) received IVB, and 32 eyes (17 patients) received PRP. Among the 22 eyes treated with IVB, 16 eyes had Zone I ROP and 6 eyes had posterior Zone II ROP. The number of Zone I and Zone II ROP eyes treated with PRP were 5 and 27 eyes, respectively. Mean gestational age, birth weight, postmenstrual age at the initial treatment, and follow-up period for the infants receiving IVB were 24.2 weeks, 668.1 grams, 35.1 weeks, and 21.7 weeks, respectively, and for the infants receiving PRP were 24.8, 701.4 grams, 36.1 weeks, and 34.5 weeks, respectively. ROP recurred in 3/22 (14%) IVB-treated eyes and in 1/32 (3%) PRP-treated eyes. None of IVB-treated eyes progressed to retinal detachment or developed macular ectopia. Only one eye went on to retinal detachment and five eyes developed macular ectopia in PRP-treated eyes. Mean spherical equivalent and postgestational age at the last refraction for IVB-treated eyes were −2.4 D and 22.4 months, respectively, and for PRP-treated eyes were −5.3 D and 37.1 months, respectively. Mean spherical equivalent for Zone I ROP eyes treated with IVB and PRP were −3.7 D and −10.1 D, respectively, and for Zone II ROP eyes were 0.6 D and −4.7 D, respectively. Conclusions Both IVB and

  9. Urinary Strong Ion Difference as a Marker of Renal Dysfunction. A Retrospective Analysis

    PubMed Central

    2016-01-01

    Introduction The kidneys play a crucial role in the regulation of electrolytes and acid-base homeostasis. Urinary Strong Ion Difference (SIDu = NaU + KU—ClU) represents an important aspect of renal acid-base regulation. We evaluated the role of SIDu as a marker of renal dysfunction in critically ill patients. Materials and Methods Patients admitted to the Medical Intensive Care Unit with a diagnosis of AKI for whom concomitant urinary samples available for SIDu calculation were retrospectively reviewed and staged according to KDIGO criteria for 3 days from inclusion. Patients were classified as Recovered (R-AKI) or Persistent-AKI (P-AKI) whether they exited KDIGO criteria within the 3-day observation period or not. A control group with normal renal function and normal serum acid-base and electrolytes was prospectively recruited in order to identify reference SIDu values. Results One-hundred-and-forty-three patients with a diagnosis of AKI were included: 77 with R-AKI, and 66 with P-AKI. Thirty-six controls were recruited. Patients with P-AKI had more severe renal dysfunction and higher mortality than patients with R-AKI (SCr 2.23(IQR:1.68–3.45) and 1.81(IQR1.5–2.5) mg/dl respectively, p<0.001; 24-h UO 1297(950) and 2100(1094) ml respectively, p = 0.003); 30-d mortality, 39% and 13% respectively; p<0.001). SIDu significantly differed between groups, with rising values from controls to P-AKI groups (16.4(12), 30(24) and 47.3(21.5) mEq/l respectively, p<0.001). Discussion SIDu may be a simple and inexpensive tool in AKI patients’ evaluation. Further research is needed to evaluate the ability of SIDu to identify patients with renal dysfunction before derangements in serum creatinine or urine output are observed. PMID:27258049

  10. Oral soft tissue biopsies in Oporto, Portugal: An eight year retrospective analysis

    PubMed Central

    Guedes, Manuel-Moreira; Albuquerque, Rui; Monteiro, Marta; Lopes, Carlos-Alberto; do Amaral, José-Barbas; Pacheco, José-Júlio

    2015-01-01

    Background The diseases that affect the oral cavity are wide and diverse, comprising a broad spectrum of either benign or malignant lesions. However, few histological-based studies were performed for the evaluation of oral cavity lesions, and very few directed to oral soft tissue pathology. The aim of this study was to carry out pioneering research, within a Portuguese population, to determine the frequency and characteristics of oral malignancies, potential malignant disorders, and soft benign tissues pathologies submitted for biopsy in a north Portugal (Oporto) hospital population. Material and Methods We performed a retrospective study of soft tissue, oral cavity biopsies, in a hospital north of Portugal (Oporto) between 1999 and 2006. We analysed information on gender, age, location of the lesion, and the histopathological diagnosis. Results A total of 1042 oral biopsies were observed, 557(53.5%) in females and 485 (46.5%) in males, with a mean age of 51.7 years (S.D. ±17.6). The topographic location most frequently affected was labial mucosa (n=306). Considering the nature of the lesions, 700 (67.2%) corresponded to non-neoplasic lesions, 45 (4.3%) to potentially malignant disorders, and 297 (28.5%) to neoplasms (93 benign and 204 malignant). Non-neoplasic lesions were more prevalent in female gender (59.9%) when compared with potentially malignant disorders (46.7%) and neoplasms (39.4%) (P< 0.001). Non-neoplasic lesions presented the lower mean age (49.2±17.6) and potentially malignant disorders the highest mean age (60.5±14.5) (P< 0.001). The most common lesion of entire sample was fibro-epithelial hyperplasia (n=186; 17.9%), followed by squamous cell carcinoma (n=158; 15.1%). Conclusions Fibro-epithelial hyperplasia, followed by squamous cell carcinoma, was the most common pathologies. This pioneering study provided, for the first time, data about the proportion of squamous cell carcinoma when compared with benign conditions in a Portuguese hospital

  11. Curettage of benign bone tumors and tumor like lesions: A retrospective analysis

    PubMed Central

    Kundu, Zile Singh; Gupta, Vinay; Sangwan, Sukhbir Singh; Rana, Parveen

    2013-01-01

    Background: Curettage is one of the most common treatment options for benign lytic bone tumors and tumor like lesions. The resultant defect is usually filled. We report our outcome curettage of benign bone tumors and tumor like lesions without filling the cavity. Materials and Methods: We retrospectively studied 42 patients (28 males and 14 females) with benign bone tumors who had undergone curettage without grafting or filling of the defect by any other bone graft substitute. The age of the patients ranged from 14 to 66 years. The most common histological diagnosis was that of giant cell tumor followed by simple bone cyst, aneurysamal bone cyst, enchondroma, fibrous dysplasia, chondromyxoid fibroma, and chondroblastoma and giant cell reparative granuloma. Of the 15 giant cell tumors, 4 were radiographic grade 1 lesions, 8 were grade 2 and 3 grade 3. The mean maximum diameter of the cysts was 5.1 (range 1.1-9 cm) cm and the mean volume of the lesions was 34.89 cm3 (range 0.94-194.52 cm3). The plain radiographs of the part before and after curettage were reviewed to establish the size of the initial defect and the rate of reconstitution, filling and remodeling of the bone defect. Patients were reviewed every 3 monthly for a minimum period of 2 years. Results: Most of the bone defects completely reconstituted to a normal appearance while the rest filled partially. Two patients had preoperative and three had postoperative fractures. All the fractures healed uneventfully. Local recurrence occurred in three patients with giant cell tumor who were then reoperated. All other patients had unrestricted activities of daily living after surgery. The rate of bone reconstitution, risk of subsequent fracture or the incidence of complications was related to the size of the cyst/tumor at diagnosis. The benign cystic bone lesions with volume greater than approximately 70 cm3 were found to have higher incidence of complications. Conclusion: This study demonstrates the natural

  12. Corticosteroid prescribing in palliative care settings: a retrospective analysis in New Zealand

    PubMed Central

    2014-01-01

    Background Corticosteroids are a potent group of medicines, with many adverse effects, that are widely prescribed in palliative care for both specific and non-specific indications. The aim of this study was to document current patterns of corticosteroid prescribing in New Zealand palliative care settings and to reflect on whether they were in line with international experience. Methods A retrospective review of inpatient use of corticosteroids was undertaken in a sample of six New Zealand hospices. Data were collected on numbers of patients prescribed corticosteroids, indications for use, choice of agent, doses and dosage changes, duration of course, incidence of adverse effects, method of stopping, use of guidelines, and processes for monitoring and review. Results The case notes of 1179 inpatients were reviewed and 768 patients (65.1%) had received at least one course of corticosteroids. There was a marked consistency in the proportion of patients prescribed corticosteroids among the sample hospices (61-69%). Detailed information was recorded for a sample of 260 patients. Corticosteroids were prescribed most commonly for non-specific reasons (40.4% of prescribing events), followed by neurological (25.3%) and soft tissue infiltration symptoms (14.4%). The agent of choice was dexamethasone with a dose range of 1 mg to 40 mg and a median dose of 8 mg. The median course duration for all corticosteroid prescribing events was 29 days. Abrupt stopping occurred in 72 (23.2%) cases, of these 35 (49%) had been on a course of corticosteroids for more than three weeks. Guidelines were only available in one hospice. Monitoring and review was documented in 135 (52%) of cases, and adverse effects were recorded in 82 (32%); these are likely to be underestimates due to a high level of non-recording. Conclusions This New Zealand study showed that corticosteroids are widely prescribed in palliative care, most commonly for non-specific indications. These findings are consistent

  13. Therapeutic hypothermia in acute liver failure: a multi-center retrospective cohort analysis

    PubMed Central

    Karvellas, Constantine J.; Stravitz, R. Todd; Battenhouse, Holly; Lee, William M.; Schilsky, Michael L.

    2016-01-01

    Background The benefit of therapeutic hypothermia (TH) in Acute Liver Failure (ALF) has not been previously demonstrated in a controlled fashion. This study aimed to determine the impact of TH on 21-day survival and complications in ALF patients at high risk for cerebral edema. Methods Retrospective cohort study of ALF patients in the US ALFSG with Grade III or IV hepatic encephalopathy. TH (32°C – 35°C) was used in 97 (8%) patients; 1135 (92%) not cooled were controls. Results Intracranial pressure (ICP) was monitored in 38 (40%) TH ALF patients (vs. 22% controls, p=0.0001). Rates of bleeding (12% in both), bloodstream (17% vs. 18) and tracheal infections (21% vs. 23%, p> 0.5 for all) were similar. Unadjusted 21-day overall (62% vs. 60%) and transplant-free survival (45 vs. 39%, p>0.4 for both) were similar. Multivariable models were created for acetaminophen (APAP) (n= 582) and non-APAP (n=613) patients. For APAP patients, MELD (Odds ratio 0.91 per increment; 95% CI 0.89–0.94, p <0.001) and vasopressors (OR 0.16; 0.11–0.24, p < 0.0001) were associated with decreased 21-day spontaneous survival. Survival was improved with TH in APAP patients aged < 25y (Age 25: OR 2.735; 95% CI 1.001 – 7.467) but worsened in 64y or older APAP patients (Age = 64: OR 0.167; 95%CI 0.028 – 0.999). For non-APAP patients, MELD (OR 0.93 per increment; 0.91–0.95, p < 0.0001) and vasopressors (OR 0.60; 0.40–0.90, p=0.01) were associated with worse outcomes while TH had no impact (p= 0.93). Conclusions Therapeutic hypothermia in ALF was not associated with increased bleeding or infections. While young APAP-ALF patients may benefit, TH did not consistently impact 21-day survival. A prospective trial is required to clarify the utility of TH in ALF patients. PMID:25308108

  14. Occupational Exposure to Human Immunodeficiency Virus in Health Care Providers: A Retrospective Analysis

    PubMed Central

    Aggarwal, Varun; Seth, Anju; Chandra, Jagdish; Gupta, Rohini; Kumar, Praveen; Dutta, Ashok Kumar

    2012-01-01

    Objectives: To determine the population at risk, risk factors, and outcome of occupational exposure to blood and body fluids in health care providers. Materials and Methods: Retrospective review of two and half year data of ongoing surveillance of occupational exposure to blood and body fluids in a tertiary care hospital. Results: 103 Health Care Providers (HCP) reported an occupational exposure to blood and body fluids during the period under review. These comprised 72 (69.9%) doctors, 20 (19.4%) nursing personnel, and 11 (10.6%) cleaning staff. Of the doctors, 65% were interns. 53.4% HCP had work experience of less than one year. Circumstances of exposure included clinical procedures (48%), sweeping/handling used sharps (29%), recapping (16%), and surgery (6.9%). 74.3% of the exposures were due to non-compliance with universal precautions and were thus preventable. The device most frequently implicated in causing injury was hollow bore needle (n=85, 82.5%). Human Immunodeficiency Virus (HIV) status of the source was positive in 6.8% cases, negative in 53.4% cases, and unknown in remaining 39.8% cases. Postexposure prophylaxis (PEP) was indicated in 100 (97.08%) cases and was initiated within 2 h of exposure in 26.8% HCP. In 23.2% HCP, PEP initiation was delayed beyond 72 h of exposure due to late reporting. Thirteen HCP received expanded and the remaining received basic regime. Of the 82 HCP followed up, 15 completed the full course, while 55 stopped PEP after the first dose due to negative source status. Twelve HCP with exposure to blood of unknown HIV status discontinued PEP despite counseling. Complete follow-up for seroconversion was very poor among the HCP. HIV status at 6 month of exposure is not known for any HCP. Conclusions: Failure to follow universal precautions including improper disposal of waste was responsible for majority of occupational exposures. HCP need to be sensitized regarding hospital waste management, management of occupational exposure

  15. Retrospective analysis of pesticide metabolites in urine using liquid chromatography coupled to high-resolution mass spectrometry.

    PubMed

    López, Antonio; Dualde, Pablo; Yusà, Vicent; Coscollà, Clara

    2016-11-01

    A comprehensive retrospective analysis of pesticide metabolites in urine was developed, using liquid chromatography coupled to Orbitrap high-resolution mass spectrometry (UHPLC-HRMS) that includes both post-run target (suspect screening) and non-target screening. An accurate-mass database comprising 263 pesticide metabolites was built and used for the post-run screening analysis. For non-target analysis, a "fragmentation-degradation" relationship strategy was selected. The proposed methodology was applied to 49 real urine samples from pregnant women. In the post-target analysis 26 pesticide metabolites were tentatively identified, 8 of which (2-diethylamino-6-methyl-pyrimidinol; 3-ketocarbofuran; 4,6-dimethoxy-2-pyrimidinamine; 4-hydroxy-2-isporopyl-6-methylpyrimidine; diethyl malate; diethyl maleate; N-(2-Ethyl-6-methylphenyl)-2-hydroxyacetamide and propachlor oxanilic acid ) were confirmed using analytical standards. Likewise, one unknown degradation product, methyl-N-phenylcarbamate was elucidated in the non-target screening. Finally, the real urine samples were grouped according to their origin applying a metabolomic approach. PMID:27591649

  16. Comparison of temperature, precipitation and snow characteristics in two 30-year periods 1951-1980 and 1981-2010

    NASA Astrophysics Data System (ADS)

    Fasko, Pavel; Švec, Marek; Šťastný, Pavel; Kajaba, Peter

    2014-05-01

    Differences in some characteristics of temperature, precipitation totals and snow cover, for two 30-year periods 1951-1980 and 1981-2010 were examined at selected meteorological stations located in different regions of Slovakia. Stations represent lowland regions (up to 300 meters), mid-altitude regions (300 to 800 meters) and high altitude mountain regions (above 1000 m). The analysis of highest maximum air temperature for individual days showed higher values of maxima for 1981 - 2010 period primarily during the summer months. The differences between corresponding values of two periods were relatively often higher at some stations during the winter months, but unlike the periods in summer months they were more regional in nature. The comparison of long-term average of daily air temperature for two 30-years periods showed increase in 1981 - 2010 period. The most significant change occurred mainly in January, July and August. Warming was not significant in September - December period. The annual regime of mean monthly precipitation amount was different in both 30-years periods in the most of the selected stations with noticeable increase in the average monthly sum in May and decline in June in 1981 - 2010 period. The only exception is the station Košice airport, where on the contrary the increase in June was registered in the 1981-2010 period. Increase of precipitation in May in the second thirty year period was probably caused by a higher number of storms in the spring months as a result of faster warming of the earth's surface and occurrence of more frequent convective precipitation. Average number of days with a snow cover in the period 1981-2010 compared with the period 1951-1980 is significantly lower in January at meteorological stations lying at lower altitudes. This is due to the higher air temperature and a higher amount of mixed and liquid precipitation during this month. In February, small increase in the average number of days with a total snow cover

  17. Prospective risk analysis prior to retrospective incident reporting and analysis as a means to enhance incident reporting behaviour: a quasi-experimental field study.

    PubMed

    Kessels-Habraken, Marieke; De Jonge, Jan; Van der Schaaf, Tjerk; Rutte, Christel

    2010-05-01

    Hospitals can apply prospective and retrospective methods to reduce the large number of medical errors. Retrospective methods are used to identify errors after they occur and to facilitate learning. Prospective methods aim to determine, assess and minimise risks before incidents happen. This paper questions whether the order of implementation of those two methods influences the resultant impact on incident reporting behaviour. From November 2007 until June 2008, twelve wards of two Dutch general hospitals participated in a quasi-experimental reversed-treatment non-equivalent control group design. The six units of Hospital 1 first conducted a prospective analysis, after which a sophisticated incident reporting and analysis system was implemented. On the six units of Hospital 2 the two methods were implemented in reverse order. Data from the incident reporting and analysis system and from a questionnaire were used to assess between-hospital differences regarding the number of reported incidents, the spectrum of reported incident types, and the profession of reporters. The results show that carrying out a prospective analysis first can improve incident reporting behaviour in terms of a wider spectrum of reported incident types and a larger proportion of incidents reported by doctors. However, the proposed order does not necessarily yield a larger number of reported incidents. This study fills an important gap in safety management research regarding the order of the implementation of prospective and retrospective methods, and contributes to literature on incident reporting. This research also builds on the network theory of social contagion. The results might indicate that health care employees can disseminate their risk perceptions through communication with their direct colleagues. PMID:20202731

  18. Possible role of artificial oxygen carriers in transfusion medicine: a retrospective analysis on the current transfusion practice.

    PubMed

    Yoshiba, Fumiaki; Kawaguchi, Akira T; Hyodo, Osamu; Kinoue, Takaaki; Inokuchi, Sadaki; Kato, Shunichi

    2009-02-01

    Artificial oxygen carriers (AOC) are under development as a substitute for red blood cells (RBC) in homologous transfusion (Tx). The lack of surface antigen in AOC makes ABO-typing and antibody-screening (T/S) unnecessary. Pathogen elimination renders it much safer, and long-term stability allows ubiquitous storage for emergency use. To delineate the utility of AOC, we retrospectively examined current Tx practices in Tokai University and the Japanese Red Cross Society. The emergency department of Tokai University Hospital has been using O(+)Rh(+) RBC in patients with hemorrhagic shock before Tx becomes available. Those who received the RBCs within 60 min of injury had a significantly higher survival rate than those who received it later (> or =60 min). The Red Cross Blood Center provided 411 units of RBC for 138 urgent requests for rare blood types. Our analysis suggests that if an AOC were available for the initial six units, 96% of such requests could have been covered to avoid urgent donor allocation, preparation, and Tx. Among 2079 surgical cases who ordered T/S, only 29% actually required Tx, rendering >70% of the T/S unnecessary. Because only 7.4% required nine units or more, more than 92% of T/S and Tx could have been avoided in retrospect if an AOC were available for the initial eight units. The results suggest that an AOC might be useful in various situations to alleviate problems, concerns, and technical burden in the current Tx practices. Because the expected utility is based mainly on physical characteristics, AOC may remain advantageous even when biogenetically derived RBC becomes available. PMID:19178456

  19. Chlorinated, brominated and fluorinated organic pollutants in African Penguin eggs: 30 years since the previous assessment.

    PubMed

    Bouwman, Hindrik; Govender, Danny; Underhill, Les; Polder, Anuschka

    2015-05-01

    The African Penguin population has drastically declined over the last 100 years. Changes in food availability due to over-fishing and other oceanographic changes seem to be major causes. However, it has also been 30 years since organic pollutants as a potential factor have been assessed. We analysed penguin eggs collected in 2011 and 2012 from two breeding colonies 640 km apart: Robben Island near Cape Town on the Atlantic Ocean coast, and Bird Island near Port Elizabeth on the Indian Ocean coast of South Africa. We quantified organochlorine pesticides, brominated flame retardants, and perfluorinated compounds (PFCs). Compared to 30 years ago, concentrations of ΣDDT have remained about the same or slightly lower, while ΣPCBs declined almost four-fold. The use of DDT in malaria control is unlikely to have contributed. PFCs were detected in all eggs. Indications (non-significant) of eggshell thinning associated with ΣDDT and ΣPCB was found. It seems therefore that the concentrations of measured organic pollutants the African Penguin eggs are not contributing directly to its current demise, but concerns remain about thinner shells and desiccation. Effects of combinations of compounds and newer compounds cannot be excluded, as well as more subtle effects on reproduction, development, and behaviour. PMID:25613517

  20. History of echocardiography in the Netherlands: 30 years of education and clinical applications

    PubMed Central

    Kamp, O.

    2008-01-01

    The development of ultrasound has created great opportunities for diagnostic cardiac imaging. For more than 30 years, echocardiography has been the most important and cost-effective diagnostic imaging modality in clinical cardiology. Many developments originated in the Netherlands, including the very first practical real-time crosssectional imaging of the moving heart with a linear array. Milestones include the first portable echo apparatus, early versions of echo catheters and transoesophageal echocardiography probes as well as many clinical ‘firsts’ with reference to the more than 100 Dutch dissertations related to echocardiography. The future of echocardiography promises to be as productive and exciting as it has been in the previous three decades, including threedimensional echocardiography, myocardial perfusion echocardiography, tissue Doppler imaging and speckle tracking. New potential therapeutic applications are upcoming. In this article, the advances of echocardiography in the Netherlands are described, in the past and during 30 years of education, as was recently presented by three Dutch pioneers during the ‘Echomiddagen 2006-2007’ organised by the CVOI. (Neth Heart J 2008;16:16-20.18317539) PMID:18317539

  1. Technical Note: 30 years of HIRS data of upper tropospheric humidity

    NASA Astrophysics Data System (ADS)

    Gierens, K.; Eleftheratos, K.; Shi, L.

    2014-07-01

    We use 30 years of intercalibrated HIRS (High-Resolution Infrared Radiation Sounder) data to produce a 30-year data set of upper tropospheric humidity with respect to ice (UTHi). Since the required brightness temperatures (channels 12 and 6, T12 and T6) are intercalibrated to different versions of the HIRS sensors (HIRS/2 and HIRS/4) it is necessary to convert the channel 6 brightness temperatures which are intercalibrated to HIRS/4 into equivalent brightness temperatures intercalibrated to HIRS/2, which is achieved using a linear regression. Using the new regression coefficients we produce daily files of UTHi, T12 and T6, for each NOAA satellite and METOP-A (Meteorological Operational Satellite Programme), which carry the HIRS instrument. From this we calculate daily and monthly means in 2.5° × 2.5° resolution for the northern midlatitude zone 30-60° N. As a first application we calculate decadal means of UTHi and the brightness temperatures for the two decades 1980-1989 and 2000-2009. We find that the humidity mainly increased from the 1980s to the 2000s and that this increase is highly statistically significant in large regions of the considered midlatitude belt. The main reason for this result and its statistical significance is the corresponding increase of the T12 variance. Changes of the mean brightness temperatures are less significant.

  2. Technical Note: 30 years of HIRS data of upper tropospheric humidity

    NASA Astrophysics Data System (ADS)

    Gierens, K.; Eleftheratos, K.; Shi, L.

    2014-03-01

    We use 30 years of intercalibrated HIRS data to produce a 30 year data set of upper tropospheric humidity with respect to ice (UTHi). Since the required brightness temperatures (channels 12 and 6, T12 and T6) are intercalibrated to different versions of the HIRS sensors (HIRS/2 and HIRS/4) it is necessary to convert the channel 6 brightness temperatures which are intercalibrated to HIRS/4 into equivalent brightness temperatures intercalibrated to HIRS/2, which is achieved using a linear regression. Using the new regression coefficients we produce daily files of UTHi, T12 and T6, for each NOAA satellite and METOP-A, which carry the HIRS instrument. From this we calculate daily and monthly means in 2.5° × 2.5° resolution for the northern mid-latitude zone 30 to 60° N. As a first application we calculate decadal means of UTHi and the brightness temperatures for the two decades 1980-1989 and 2000-2009. We find that the humidity mainly increased from the 1980s to the 2000s and that this increase is highly statistically significant in large regions of the considered mid-latitude belt. The main reason for this result and its statistical significance is the corresponding increase of the T12 variance. Changes of the mean brightness temperatures are less significant.

  3. 30-Year Satellite Record Reveals Contrasting Arctic and Antarctic Decadal Sea Ice Variability

    NASA Technical Reports Server (NTRS)

    Cavalieri, D. J.; Parkinson, C. L.; Vinnikov, K. Y.

    2003-01-01

    A 30-year satellite record of sea ice extents derived mostly from satellite microwave radiometer observations reveals that the Arctic sea ice extent decreased by 0.30+0.03 x 10(exp 6) square kilometers per 10 yr from 1972 through 2002, but by 0.36 plus or minus 0.05 x 10(exp 6) square kilometers per 10yr from 1979 through 2002, indicating an acceleration of 20% in the rate of decrease. In contrast, the Antarctic sea ice extent decreased dramatically over the period 1973-1977, then gradually increased. Over the full 30-year period, the Antarctic ice extent decreased by 0.15 plus or minus 0.08 x 10(exp 6) square kilometers per 10 yr. The trend reversal is attributed to a large positive anomaly in Antarctic sea ice extent in the early 1970's, an anomaly that apparently began in the late 1960's, as observed in early visible and infrared satellite images.

  4. What Can We Learn About Glaciers and Ice Sheets From 30 Years of Landsat Imagery?

    NASA Astrophysics Data System (ADS)

    Gardner, A. S.; Scambos, T.; Fahnestock, M. A.; Moholdt, G.; Nilsson, J.

    2015-12-01

    Glacier and ice sheets are known to be rapidly changing and currently account for two thirds of observed sea level rise. Attributing the causes of the rapid decline in land ice requires separation of mass change processes, i.e. accumulation of precipitation, meltwater runoff, and solid ice discharge. Here we examine a 30 year record of Landsat imagery to determine trends in glacier velocity at a global scale in an attempt to identify anomalies in glacier flow that are contributing to changes in land ice mass. The Landsat archive represents a treasure trove of information with hundreds of thousands of images acquired over glaciers and ice sheets during the past 30 years. Gleaning useful and consistent surface displacement information from a multiple sensor archive that is heavily contaminated by cloud, saturated images, poorly resolved sensor geometry, and data gaps has proved challenging. Temporal stacking of displacement fields (Dehecq et al., 2015) and correcting for unresolved topography (Roseanau et al., 2012) have been shown to greatly improve derived velocities. Here we present results from a global processing of the complete Landsat archive for information on glacier surface displacements. We highlight patterns of coherent regional change as well as well as rapid basin-scale changes in glacier flow.

  5. Lessons from 30 years' data of Korean end-stage renal disease registry, 1985-2015.

    PubMed

    Jin, Dong-Chan; Yun, Sung Ro; Lee, Seoung Woo; Han, Sang Woong; Kim, Won; Park, Jongha; Kim, Yong Kyun

    2015-09-01

    The Korean Society of Nephrology (KSN) launched a nationwide official survey program about dialysis therapy in 1985. Nowadays, the accumulated data for 30 years by this "Insan Prof. Min Memorial end-stage renal disease (ESRD) Registry" program have been providing the essential information for dialysis clinical practice, academic nephrology research, and health management policy. We reviewed 30 years of data to identify important changes and implications for the future improvement of dialysis therapy in Korea. Hemodialysis patients, especially diabetics and elderly patients have increased in number very rapidly during recent years in Korea. The Korean prevalence rate of ESRD patients was about 70% of the United States and about 50% of Japan according to the international comparisons in the annual data report of United States Renal Data System. The blood pressure control, anemia control, and dialysis adequacy have continuously improved year by year. The importance of calcium and phosphorus control has also been increasing because of the increase in long-term dialysis patients. In addition, chronic dialysis complications should be closely monitored and dialysis modifications, such as hemodiafiltration therapy, might be considered. Because of the increase of private clinics and nursing hospitals in dialysis practice, the role of dialysis specialists and continuing education are thought to be essential. For strict cost-effective dialysis control of increasing elderly, diabetic, and long-term dialysis patients, the KSN ESRD patient registration should be run by the KSN and health ministry in cooperation, in which the dialysis fee reimbursement should be accompanied. PMID:26484037

  6. Postoperative epidural analgesia for patients undergoing pectus excavatum corrective surgery: a 10-year retrospective analysis

    PubMed Central

    Siddiqui, Asad; Tse, Andrew; Paul, James E; Fitzgerald, Peter; Teh, Bernice

    2016-01-01

    Introduction Managing postoperative pain in patients undergoing minimally invasive pectus excavatum repair (Nuss procedure) is challenging but essential in facilitating ambulation and minimizing the length of stay. Although multiple epidural regimens with varying opioids are presently used for pain management, there is currently no clinical consensus regarding which epidural regimen provides the best analgesia outcomes with the fewest side effects. This 10-year retrospective cohort study was performed to compare the quality of analgesia and the incidence of side effects associated with the three most common epidural regimens used at a tertiary care children’s hospital, in patients undergoing the Nuss procedure. Methods Seventy-two pediatric patients were identified as having been treated with one of three epidural regimens for postoperative pain management following the Nuss procedure: Group A (n=12) received 0.125% bupivacaine and 5 µg/mL fentanyl, Group B (n=21) received 0.125% bupivacaine and 10 µg/mL hydromorphone, and Group C (n=39) received 0.1% ropivacaine and 20 µg/mL hydromorphone. Our primary outcome was maximal daily pain scores (numerical rating scale 0–10), with an analytical focus on postoperative day 1 scores. The primary outcome was analyzed using linear regression. The secondary outcomes included the length of stay, side-effect profiles as reflected by the number of treatments for nausea and pruritus, pain scores according to epidural site insertion, occurrence of breakthrough pain, and presence of severe pain throughout their hospital stay. Secondary outcomes were analyzed using linear or logistic regression adjusted for pain scores at baseline. The criterion for statistical significance was set a priori at alpha =0.05. Results Group A had significantly higher day-1 pain scores (score 5.42/10) than Group B (4.52/10; P=0.030) and Group C (4.49/10; P=0.015) after adjusting for baseline pain and age. No significant difference in maximum daily

  7. Gender Trends in Radiation Oncology in the United States: A 30-Year Analysis

    SciTech Connect

    Ahmed, Awad A.; Egleston, Brian; Holliday, Emma; Eastwick, Gary; Takita, Cristiane; Jagsi, Reshma

    2014-01-01

    Purpose: Although considerable research exists regarding the role of women in the medical profession in the United States, little work has described the participation of women in academic radiation oncology. We examined women's participation in authorship of radiation oncology literature, a visible and influential activity that merits specific attention. Methods and Materials: We examined the gender of first and senior US physician-authors of articles published in the Red Journal in 1980, 1990, 2000, 2004, 2010, and 2012. The significance of trends over time was evaluated using logistic regression. Results were compared with female representation in journals of general medicine and other major medical specialties. Findings were also placed in the context of trends in the representation of women among radiation oncology faculty and residents over the past 3 decades, using Association of American Medical Colleges data. Results: The proportion of women among Red Journal first authors increased from 13.4% in 1980 to 29.7% in 2012, and the proportion among senior authors increased from 3.2% to 22.6%. The proportion of women among radiation oncology full-time faculty increased from 11% to 26.7% from 1980 to 2012. The proportion of women among radiation oncology residents increased from 27.1% to 33.3% from 1980 to 2010. Conclusions: Female first and senior authorship in the Red Journal has increased significantly, as has women's participation among full-time faculty, but women remain underrepresented among radiation oncology residents compared with their representation in the medical student body. Understanding such trends is necessary to develop appropriately targeted interventions to improve gender equity in radiation oncology.

  8. GENDER TRENDS IN RADIATION ONCOLOGY IN THE UNITED STATES: A 30 YEAR ANALYSIS

    PubMed Central

    Ahmed, Awad A; Egleston, Brian; Holliday, Emma; Eastwick, Gary; Takita, Cristiane; Jagsi, Reshma

    2013-01-01

    Purpose/Objective Although considerable research exists regarding the role of women in the medical profession in the United States, little work has described the participation of women in academic radiation oncology. We examined women’s participation in authorship of radiation oncology literature, a visible and influential activity that merits specific attention. Methods and Materials We examined the gender of first and senior U.S. physician-authors of articles published in the Red Journal in 1980, 1990, 2000, 2004, 2010 and 2012. The significance of trends over time was evaluated using logistic regression. Results were compared to female representation in journals of general medicine and other major medical specialties. Findings were also placed in the context of trends in the representation of women among radiation oncology faculty and residents over the last three decades, using AAMC data. Results The proportion of women among Red Journal first authors increased from 13.4% in 1980 to 29.7% in 2012, and the proportion among senior authors increased from 3.2% to 22.6%. The proportion of women among radiation oncology full-time faculty increased from 11% to 26.7% from 1980 to 2012. The proportion of women among radiation oncology residents increased from 27.1% to 33.3% from 1980 to 2010. Conclusion Female first and senior authorship in the Red Journal has increased significantly, as has women’s participation among full-time faculty, but women remain under-represented among radiation oncology residents as compared to their representation in the medical student body. Understanding such trends is necessary to develop appropriately targeted interventions to improve gender equity in radiation oncology. PMID:24189127

  9. Analysis of the River Tagus morphology during the last 30 years

    NASA Astrophysics Data System (ADS)

    Fernandes, J. N.; Rocha, J. S.

    2009-04-01

    River Tagus has one of the largest watersheds of the Iberia Peninsula. It cuts longitudinally the Peninsula with a dominant East-West orientation covering an area of more than 80,000 km2, 69% being in Spain and 31% in Portugal. The 827 km length in Spain is followed by a reach of 43 km at the border of Spain with Portugal and 230 km in Portugal. After the Portugal-Spain boundary, River Tagus enters in a strong rock reach. Afterwards it reaches a movable river bed with rocky banks and then begins the 70 km estuary. The construction of dams to control the river discharges changed the river regime after 1943, being stabilized since 1983. Presently, there are higher low flow discharges and lower high flow discharges than the natural regime. The annual discharge module is about 360 m3/s, but it may vary between about 1000 m3/s in wet years and 90 m3/s in dry years. In Portugal, the hydrological monitoring system of River Tagus consists in three hydrometric gauges: 1 Tramagal (100 km from the downstream reference, Vila Franca de Xira), 2 Almourol (85 km), 3 Ómnias (45 km). With the purpose of calibrate the rating curve of the hydrometric stations, the river bed was surveyed when velocity measurements were done. In Tramagal and Almourol stations, the analysed data were collected between the hydrological years 1986/1987 and 2004/2005, i.e., a total of 18 years. In the Ómnias station, the analysed data were collected between the hydrological years 1977/1978 and 1998/199, i.e., a total of 21 years. As a result, a total of more than 600 bed profiles are available which allows the researchers to know the variation of the bottom of the river since 1977. This information is continuous and it includes important flood periods. In the present paper, these data are analyzed. Plotting the instantaneous discharge and the bottom level in the same chart for each hydrological station, several conclusions could be made. For instance, during a significant flood event (with a return period of 100 years) the river bottom could decrease more than 5 m. Among other issues, these effects are extremely important for bridge piers design. Analyzing the available data, a persistent feature of river process is recognized, the "elastic" behavior of the river bed. After the generalized erosion caused by a flood event a slower process of deposition restores the river bed level in the following months. This type of indirect measurement leads us to some conclusions about the variation of the river bed and consequently the erosion produced by the river flow.

  10. Bibliometric analysis of research on regenerative periodontal surgery during the last 30 years

    PubMed Central

    Gutiérrez-Vela, María M.; Díaz-Haro, Ana; Berbel-Salvador, Sonia; Lucero-Sánchez, Aldo; Cutando-Soriano, Antonio

    2012-01-01

    Objectics: The evolution of research activity during the last thirty years on regenerative periodontal surgery is studied. Results: A small number of authors are highly productive with more than 10 publications on the subject each. 79,6% of authors have only produced one article on the subject. The co-authorship average is of 2,68 authors per paper, with a collaboration between 2 and 6 authors. Main journals on the field of regenerative periodontal surgery are Journal of Periodontology and Journal of Clinical Periodontology, which are ranked 14th and 1st in their category according to the Journal Citations Reports. The most used language is English, followed by Japanese and Italian, Spanish occupying the eighth position. Conclusions: A significant increase on scientific literature is observed, similar to the one Dentistry has had. A reduced number of authors account for most production. In the same token, there is a scarce professionalization of researchers in this field, where most of the authors are occasional. On the other hand, there are two very specialized journals on this topic. Key words:Bibliometrics, scientometrics periodontal regeneration, surgical periodontal treatment, scientific literature, scopus, scientific output. PMID:24558535

  11. Visual outcome of mega-dose intravenous corticosteroid treatment in non-arteritic anterior ischemic optic neuropathy – retrospective analysis

    PubMed Central

    2014-01-01

    Background To date, non arteritic anterior ischemic optic neuropathy (NAION) is still incurable. We wish to evaluate the effect of intravenous (IV) corticosteroids on the visual outcome of NAION patients. Methods Visual parameters were retrospectively compared between NAION patients treated with IV corticosteroids and untreated NAION patients (control). Visual acuity (VA) and Humphrey automated static perimetry visual field (VF) defects of the affected eye were compared between groups at baseline, 1, 3, 6 months, and end of follow-up visits. The VF analysis consisted of number of quadrant involvements and mean deviation (MD). Results Each group comprised 23 patients (24 eyes). Mean initial VA was similar in the control and treatment groups (p = 0.8). VA at end of follow-up did not improve in either groups (p = 0.8 treated group, p = 0.1 control group). No improvement and no difference in VF defects were found by either quadrant analysis (p = 0.1 treated group, p = 0.5 control group) or MD analysis (p = 0.2, treated group, p = 0.9 control group). VA and VF parameters tended to be worse in the treated group, although without statistical significance. Conclusions Our results suggest that IV corticosteroids may not improve the visual outcome of NAION patients. Since intravenous corticosteroids could potentially cause serious adverse effects, this treatment for NAION is questionable. PMID:24886579

  12. Retrospective studies.

    PubMed

    Silveira, Patrícia Pelufo; Manfro, Gisele Gus

    2015-01-01

    Large retrospective, epidemiological studies accumulated in the late 1980s, providing increasing evidence to the deeply rooted thought that perinatal events could persistently affect the individual's functioning and health/disease patterns throughout the lifetime. Evidences of such associations can be found in the literature since the beginning of the twentieth century, but studies from Barker, Hales, and colleagues serve as an important hallmark. They proposed the "thrifty phenotype" hypothesis, stating that poor nutrition in fetal and early infant life is detrimental to the development and function of the individuals' organism, predisposing them to the later development of adult chronic diseases. At first used to explain the increased risk for type 2 diabetes in low birth weight individuals, the hypothesis was soon adapted to other systems, becoming one of the core assumptions of the Developmental Origins of Adult Health and Disease (DOHaD) model. The central nervous system is also vulnerable to the effects of environmental variation during fetal or neonatal life. Many researchers have explored the effects of perinatal programming on the human neurodevelopment, and some aspects of the brain structure and/or functioning (such as cognitive function, physiological reactivity to stress, and the risk for behavioral disorders or psychopathology) were shown to be modifiable by the exposure to certain adverse events early in life such as neonatal infections, exposure to gestational psychosocial stress, nutrition during gestation, exposure to drugs, or tobacco smoking during pregnancy. Until recently, most studies focused on birth weight as a strong surrogate of the intrauterine environment, investigating the effects of low birth weight (as a marker of suboptimal fetal environment) on a variety of neurodevelopmental outcomes. Despite the fact that literature reviews on this topic are as old as 1940, the more recent retrospective studies are summarized in this chapter

  13. "Studies in Higher Education" 1976-2013: A Retrospective Using Citation Network Analysis

    ERIC Educational Resources Information Center

    Calma, Angelito; Davies, Martin

    2015-01-01

    This paper provides a citation network analysis of the publications in "Studies in Higher Education" from 1976 to 2013 inclusive. This represents the entire history of the journal to date. It analyses the most published authors, most cited authors and most discussed topics using keywords. 1056 articles were taken from Web of…

  14. 76 FR 66004 - Preliminary Plan for Retrospective Analysis of Existing Rules

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-25

    ... and other trade policy-related information are gathered and analyzed. The information and analysis are... facilitate the development of sound and informed U.S. trade policy. The Commission makes most of its... 76 FR 61937 (Oct. 6, 2011). In addition, the Commission staff constantly adapts the...

  15. DETERIORATION OF MARBLE. A RETROSPECTIVE ANALYSIS OF TOMBSTONE MEASUREMENTS IN THE NEW YORK CITY AREA

    EPA Science Inventory

    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 ...

  16. An inter-laboratory retrospective analysis of immunotoxicological endpoints in non-human primates: flow cytometry immunophenotyping.

    PubMed

    Krejsa, Cecile M; Neradilek, Moni Blazej; Polissar, Nayak L; Cox, Nick; Clark, Darcey; Cowan, Laine; Bussiere, Jeanine; Lebrec, Herve

    2013-01-01

    Non-human primates may be the only relevant species for pharmacology or toxicology studies of certain biologics, due to lack of activity in other species. Flow cytometry immunophenotyping is often included as a minimally invasive adjunct to standard toxicity testing. A retrospective inter-laboratory analysis was conducted to assess counts and variability of the main cell types monitored in toxicity studies, and to provide guidance for conduct and interpretation of immunophenotyping assessments in cynomolgus monkeys. Univariate and multivariate models were developed. Study design factors influencing cell counts and variability were identified and a power analysis was performed. Pre-study and on-study counts were generally similar; longitudinal analysis showed little drift in mean counts or within-animal variability over time. Within-animal variability was lower than inter-animal variability. Gender was associated with small but significant differences in mean counts and variability. Age was associated with significant differences in variability. Immunophenotype definitions were associated with significant differences in mean counts and within-animal variability for most cell types. Power analysis for groups of 6-8 animals showed that differences of ≈50% in counts of T-cells, T-cell subsets, and B-cells compared to pre-treatment values may be detected; for NK cells and monocytes, differences of ≈60-90% may be detected. This review yields some general points to consider for immunophenotyping studies, i.e. (a) analysis of log-transformed cell count data and comparisons using each animal as its own reference will improve ability to detect changes, (b) the magnitude of change detectable given study group size should be considered, (c) multiplication of sampling timepoints during a study seems unnecessary, (d) consideration should be given to using only one gender, when applicable, to increase power while minimizing animal usage, and (e) the choice of immunophenotype

  17. [Retrospective analysis of prognostic factors in patients with primary lymphoma of the intestine].

    PubMed

    Avilés, A; Guzmán, R; Huerta, J; Díaz-Maqueo, J C

    1991-01-01

    Forty-six patients with stage IE and IIE malignant lymphoma of the intestine were analyzed to assess the efficacy of prognostic factors to predict the course and therapeutic approach in these patients. Because the lesion was considered unresectable in all cases, chemotherapy was given after surgery. Using Cox's univariate regression analysis, survival was found to correlate with stage (IE vs IIE) and high levels of lactic dehidrogenase, nevertheless in the multivariate analysis only beta 2 microglobulin levels were associated with a shorter survival. We believe that treatment of extranodal lymphomas, like nodal presentations, as those of the intestine, could be based in the determinations of prognostic factors and that beta 2 microglobulin would be considered the most powerful prognostic factor. Most studies on patients with malignant lymphoma of the intestine are necessary to define the role of beta 2 microglobulin as therapeutic prognostic index. PMID:1810010

  18. Traumatic injury pattern analysis in a light rail transit death: a retrospective case study.

    PubMed

    Kendell, Ashley E; Fleischman, Julie M; Fulginiti, Laura C

    2015-05-01

    Within the context of medical examiner's offices, forensic anthropologists are increasingly being asked to assist with the interpretation of traumatic skeletal injury. This case study presents an example of trauma analysis performed by forensic anthropologists at the Maricopa County Forensic Science Center in Phoenix, Arizona. The primary goal of this study is to document an uncommon pattern of traumatic injury-severe grinding abrasions of the lower appendage that macroscopically resemble sharp force trauma, especially as observed in dismemberment cases-resulting from an individual being dragged beneath a Light Rail train for c. 1.7 miles. The abraded skeletal elements include a femoral shaft fragment, a femoral head portion, and the right foot. Second, this study aims to illustrate the efficacy of forensic anthropological analysis of patterned skeletal trauma. Finally, this study demonstrates the critical importance of analyzing scene information before drawing conclusions as to the etiology of a traumatic injury pattern. PMID:25689938

  19. 30-year changes in the nitrogen inputs to the Yangtze River Basin

    NASA Astrophysics Data System (ADS)

    Wang, Qinxue; Koshikawa, Hiroshi; Liu, Chen; Otsubo, Kuninori

    2014-11-01

    To understand both spatial and temporal changes in nitrogen inputs to the Yangtze River Basin (YRB), we collected decadal statistical data for 1980, 1990, 2000 and 2010 at the county level and the annual statistical data for the period 1980-2010 at the provincial level of China. Based on these datasets, we estimated the nitrogen inputs, including the atmospheric deposition, synthetic N fertilizer, biological N fixation and recycling reactive N inputs, such as N from human waste and animal excrement, crop residue recycled as manure, and N emission from burning crop residue. The results showed that, geographically, the variation of the total amount of N input during the last 30 years (δN = N2010 - N1980) has increased about 0-50 kg ha-1 over most of the area of the YRB. Moreover, it has increased dramatically by about 50-300 kg ha-1 in the Sichuan Basin, the Han River Basin, the Poyang and Dongting lake basins, and the Yangtze Delta as well. Temporally, the total amount of N inputs to the whole YRB was approximately 16.4 Tg N in 2010, which was a 2.0-fold increase over 1980. It increased dramatically in the 1990s and then stabilized at a high level in the 2000s. The major N inputs were human and animal wastes as well as synthetic fertilizers, but they varied regionally. Animal waste was the major input to the water source regions, and its contribution percentage gradually decreased from upper to lower reaches. In contrast, the contribution of N fertilizer increased from upper to lower reaches, and became the major input to the middle and lower reaches. The total N inputs changed slightly in the upper reaches, but increased largely in the middle reaches in the last 30 years. However, in the lower reaches, it had increased remarkably before 2000, and then tended to decrease in the last decade. Finally, the atmospheric N deposition over the basin increased continuously in the last 30 years.

  20. Pelvic insufficiency fracture after definitive radiotherapy for uterine cervical cancer: retrospective analysis of risk factors

    PubMed Central

    Uezono, Haruka; Tsujino, Kayoko; Moriki, Keno; Nagano, Fumiko; Ota, Yosuke; Sasaki, Ryohei; Soejima, Toshinori

    2013-01-01

    The purpose of this study is to determine the incidence, clinical characteristics and risk factors of postradiation pelvic insufficiency fracture (PIF) in women with uterine cervical cancer. We reviewed the medical records of 126 patients who received definitive radiotherapy (RT) for uterine cervical cancer between 2003 and 2009 at our institution. Among them, 99 patients who underwent at least one computed tomography (CT) or magnetic resonance imaging of the pelvis during their follow-up at more than 6 months were included in this analysis. The relationship between the incidence of PIF and several patient- and treatment-related factors was analyzed. The median follow-up period was 21 months. Of the 126 patients, 33 (with a total of 50 lesions) were diagnosed with PIF. The 2-year cumulative incidence was 32%. Univariate analysis showed that age ≥70 years (P= 0.0010), postmenopausal state (P = 0.0013), and lower CT density of bone and bone marrow (P= 0.020) significantly related to PIF. In a multivariate analysis, of the 59 patients whose CT densities were evaluable, lower CT density was the only significant factor associated with PIF (P = 0.0026). In conclusion, postradiation PIFs were detected in a considerable number of patients after definitive RT for cervical cancer. Predisposing factors were older age, postmenopausal state, and decreased density of bone and bone marrow on CT. PMID:23685668

  1. A retrospective analysis of cytogenetic alterations in patients with newly diagnosed multiple myeloma: a single center study in Korea

    PubMed Central

    Li, Shuhua; Lim, Hyeon-Ho; Woo, Kwang-Sook; Kim, Sung-Hyun

    2016-01-01

    Background The accurate identification of cytogenetic abnormalities in multiple myeloma (MM) has become more important over recent years for the development of new diagnostic and prognostic markers. In this study, we retrospectively analyzed the cytogenetic aberrations in MM cases as an initial assessment in a single institute. Methods We reviewed the cytogenetic results from 222 patients who were newly diagnosed with MM between January 2000 and December 2015. Chromosomal analysis was performed on cultured bone marrow samples by standard G-banding technique. At least 20 metaphase cells were analyzed for karyotyping. Results Clonal chromosome abnormalities were detected in 45.0% (100/222) of the patients. Among these results, 80 cases (80.0%) had both numerical and structural chromosome abnormalities. Overall hyperdiploidy with structural cytogenetic aberrations was the most common finding (44.0%), followed by hypodiploidy with structural aberrations (28.0%). Amplification of the long arm of chromosome 1 and -13/del(13q) were the most frequent recurrent abnormalities, and were detected in 50 patients (50.0%) and 40 patients (40.0%) with clonal abnormalities, respectively. The most common abnormality involving 14q32 was t(11;14)(q13;q32), which was observed in 19 cases. Conclusion These findings demonstrate that myeloma cells exhibit complex aberrations regardless of ploidy, even from a single center in Korea. Conventional cytogenetic analysis should be included in the initial diagnostic work-up for patients suspected of having MM. PMID:27382557

  2. Retrospective analysis of a listeria monocytogenes contamination episode in raw milk goat cheese using quantitative microbial risk assessment tools.

    PubMed

    Delhalle, L; Ellouze, M; Yde, M; Clinquart, A; Daube, G; Korsak, N

    2012-12-01

    In 2005, the Belgian authorities reported a Listeria monocytogenes contamination episode in cheese made from raw goat's milk. The presence of an asymptomatic shedder goat in the herd caused this contamination. On the basis of data collected at the time of the episode, a retrospective study was performed using an exposure assessment model covering the production chain from the milking of goats up to delivery of cheese to the market. Predictive microbiology models were used to simulate the growth of L. monocytogenes during the cheese process in relation with temperature, pH, and water activity. The model showed significant growth of L. monocytogenes during chilling and storage of the milk collected the day before the cheese production (median increase of 2.2 log CFU/ml) and during the addition of starter and rennet to milk (median increase of 1.2 log CFU/ml). The L. monocytogenes concentration in the fresh unripened cheese was estimated to be 3.8 log CFU/g (median). This result is consistent with the number of L. monocytogenes in the fresh cheese (3.6 log CFU/g) reported during the cheese contamination episode. A variance-based method sensitivity analysis identified the most important factors impacting the cheese contamination, and a scenario analysis then evaluated several options for risk mitigation. Thus, by using quantitative microbial risk assessment tools, this study provides reliable information to identify and control critical steps in a local production chain of cheese made from raw goat's milk. PMID:23212008

  3. An Unprecedented High Incidence of Leptospirosis in Futuna, South Pacific, 2004 - 2014, Evidenced by Retrospective Analysis of Surveillance Data.

    PubMed

    Massenet, Denis; Yvon, Jean-François; Couteaux, Clément; Goarant, Cyrille

    2015-01-01

    Futuna is a small Polynesian island in the South Pacific with a population of 3,612 in 2013. The first human leptospirosis case was confirmed in 1997. Active surveillance started in 2004. Cases were confirmed by PCR or real time PCR, or by serology using MAT or a combination of IgM-ELISA and MAT. A retrospective analysis of surveillance data shows that the disease was endemic with a mean annual incidence of 844 cases per 100,000 over an 11-year period from 2004 to 2014. An epidemic peak as high as 1,945 cases per 100,000 occurred in 2008. Serogroup Australis was predominant until 2007, Icterohaemorrhagiae was dominant afterwards. Cluster analysis revealed different hot spots over time. Lifestyle habits, such as walking barefoot in irrigated taro fields or pig pens probably contributed to contamination from the swine and rodent reservoirs to humans. Severe forms were rare, and the case fatality rate was 0.5%. The medical community and general population were aware of leptospirosis and rapid treatment with amoxycillin was the main treatment, probably contributing to this low fatality rate. PMID:26528546

  4. Tobacco Control in India; A Myth or Reality- Five Year Retrospective Analysis Using WHO MPOWER for Tobacco Control

    PubMed Central

    Gupta, Ritu; Basavaraj, Patthi; Singla, Ashish; Vashishtha, Vaibhav; Pandita, Venisha; Kumar, Jishnu Krishna; Prasad, Monika

    2015-01-01

    Introduction Tobacco use is a major public health challenge in India and government of India has taken various initiatives for tobacco control in the country. India was among the first few countries to ratify WHO the Framework Convention on Tobacco Control (WHO FCTC) in 2004 and to make it easy, WHO introduced the MPOWER measures. Objective This study aimed to quantify the implementation of MPOWER tobacco control policies in India. Materials and Methods In this retrospective analysis information was collected from the WHO report on the Global Tobacco Epidemic Program, India for the year 2009, 2011 and 2013 using MPOWER and this analysis was based on the checklist which was designed previously by Iranian and international tobacco control specialists in their study on tobacco control and its cut-offs were set according to the scoring of key sections of the MPOWER 2011 report. Results In this study India was ranked by scores and these scores were obtained from each indicator for each activity. The highest scores were achieved in 2013 and there are marked increase in scores in health warning on cigarette packages but as far as the cessation programmes and taxation is concerned, there is decline in the progress. Conclusion MPOWER programmes are accepted in the India but there is considerable room for improvement as we are still far from the ideal situation. PMID:26674509

  5. A retrospective content analysis of studies on factors constraining the implementation of health sector reform in Ghana.

    PubMed

    Sakyi, E Kojo

    2008-01-01

    Ghana has undertaken many public service management reforms in the past two decades. But the implementation of the reforms has been constrained by many factors. This paper undertakes a retrospective study of research works on the challenges to the implementation of reforms in the public health sector. It points out that most of the studies identified: (1) centralised, weak and fragmented management system; (2) poor implementation strategy; (3) lack of motivation; (4) weak institutional framework; (5) lack of financial and human resources and (6) staff attitude and behaviour as the major causes of ineffective reform implementation. The analysis further revealed that quite a number of crucial factors obstructing reform implementation which are particularly internal to the health system have either not been thoroughly studied or overlooked. The analysis identified lack of leadership; weak communication and consultation; lack of stakeholder participation, corruption and unethical professional behaviour as some of the missing variables in the literature. The study, therefore, indicated that there are gaps in the literature that needed to be filled through rigorous reform evaluation based on empirical research particularly at district, sub-district and community levels. It further suggested that future research should be concerned with the effects of both systems and structures and behavioural factors on reform implementation. PMID:18536006

  6. An Unprecedented High Incidence of Leptospirosis in Futuna, South Pacific, 2004 – 2014, Evidenced by Retrospective Analysis of Surveillance Data

    PubMed Central

    Massenet, Denis; Yvon, Jean-François; Couteaux, Clément; Goarant, Cyrille

    2015-01-01

    Futuna is a small Polynesian island in the South Pacific with a population of 3,612 in 2013. The first human leptospirosis case was confirmed in 1997. Active surveillance started in 2004. Cases were confirmed by PCR or real time PCR, or by serology using MAT or a combination of IgM-ELISA and MAT. A retrospective analysis of surveillance data shows that the disease was endemic with a mean annual incidence of 844 cases per 100,000 over an 11-year period from 2004 to 2014. An epidemic peak as high as 1,945 cases per 100,000 occurred in 2008. Serogroup Australis was predominant until 2007, Icterohaemorrhagiae was dominant afterwards. Cluster analysis revealed different hot spots over time. Lifestyle habits, such as walking barefoot in irrigated taro fields or pig pens probably contributed to contamination from the swine and rodent reservoirs to humans. Severe forms were rare, and the case fatality rate was 0.5%. The medical community and general population were aware of leptospirosis and rapid treatment with amoxycillin was the main treatment, probably contributing to this low fatality rate. PMID:26528546

  7. Portraits of Students (1969-1999): A Retrospective.

    ERIC Educational Resources Information Center

    Cross, K. Patricia

    This retrospective picture of college students over the past 30 years reflects what has been written about students in "Change" magazine between 1969 and 1999. Using the analogy of a museum gallery, the student portraits are grouped into five eras; each of which dominated the literature for approximately 10 years. The Gallery of Student Protest,…

  8. Parenting Environment and Scholastic Achievement during Adolescence: A Retrospective Study.

    ERIC Educational Resources Information Center

    Taris, Toon W.; Bok, Inge A.

    1996-01-01

    This study examined the effects of perceived parenting style (overly protective versus a warm and loving environment) on the scholastic achievement of 986 Dutch adults age 18-30 years. Retrospective and longitudinal data suggested that respondents with overprotective parents drop out more frequently and have a lower level of educational attainment…

  9. Long term survivors with metastatic pancreatic adenocarcinoma treated with gemcitabine: a retrospective analysis

    PubMed Central

    Goulart, Bernardo HL; Clark, Jeffrey W; Lauwers, Gregory Y; Ryan, David P; Grenon, Nina; Muzikansky, Alona; Zhu, Andrew X

    2009-01-01

    Background Metastatic pancreatic adenocarcinoma has a short median overall survival (OS) of 5–6 months. However, a subgroup of patients survives more than 1 year. We analyzed the survival outcomes of this subgroup and evaluated clinical and pathological factors that might affect survival durations. Methods We identified 20 patients with metastatic or recurrent pancreatic adenocarcinoma who received single-agent gemcitabine and had an OS longer than 1 year. Baseline data available after the diagnosis of metastatic or recurrent disease was categorized as: 1) clinical/demographic data (age, gender, ECOG PS, number and location of metastatic sites); 2) Laboratory data (Hematocrit, hemoglobin, glucose, LDH, renal and liver function and CA19-9); 3) Pathologic data (margins, nodal status and grade); 4) Outcomes data (OS, Time to Treatment Failure (TTF), and 2 year-OS). The lowest CA19-9 levels during treatment with gemcitabine were also recorded. We performed a univariate analysis with OS as the outcome variable. Results Baseline logarithm of CA19-9 and total bilirubin had a significant impact on OS (HR = 1.32 and 1.31, respectively). Median OS and TTF on gemcitabine were 26.9 (95% CI = 18 to 32) and 11.5 (95% CI = 9.0 to 14.3) months, respectively. Two-year OS was 56.4%, with 7 patients alive at the time of analysis. Conclusion A subgroup of patients with metastatic pancreatic cancer has prolonged survival after treatment with gemcitabine. Only bilirubin and CA 19-9 levels were predictive of longer survival in this population. Further analysis of potential prognostic and predictive markers of response to treatment and survival are needed. PMID:19291303

  10. A Retrospective Analysis of the Retreatment of Failed Sinus Bone Grafts.

    PubMed

    Kim, Young-Kyun; Kim, Su-Gwan

    2016-06-01

    This analysis examined the types of retreatment in failed sinus bone grafts due to the development of maxillary sinusitis. Reoperation was performed in 7 patients. The types of reoperation included infection management, reconstruction of the sinus roof using a pedicled buccal fat pad and collagen membrane, oroantral fistula closure, sinus bone graft using an autogenous bone graft, and implant placement. In one case, sinusitis developed 14 months after the reoperation, but it was managed by incision, drainage, and administration of antibiotics. All sinus bone grafts that were performed during the retreatments were successful. PMID:27058356

  11. Cardiac amyloidosis in a heart transplant patient - A case report and retrospective analysis of amyloidosis evolution.

    PubMed

    Kintsler, Svetlana; Jäkel, Jörg; Brandenburg, Vincent; Kersten, Katrin; Knuechel, Ruth; Röcken, Christoph

    2015-02-01

    Cardiac amyloidosis is a very rare cause of heart failure in heart transplant recipients but an important differential diagnosis in cases of progressive cardiac failure. We report a 72-year-old male patient with the diagnosis of senile systemic amyloidosis (SSA) in a transplanted heart 15 years after transplantation by the initial diagnosis of the dilated cardiomyopathy. Additionally performed immunohistochemical analysis with anti-transthyretin antibody of the cardiac biopsies of the last 15 years enabled the possibility to show the evolution of this disease with characteristic biphasic pattern. PMID:25674390

  12. Epidemiological aspects of beryllium-induced nonmalignant lung disease: a 30-year update

    SciTech Connect

    Eisenbud, M.; Lisson, J.

    1983-03-01

    The unusual epidemiology of beryllium disease observed in the early studies of beryllium disease led in 1951 to the hypothesis that the chronic form of the disease is the result of an acquired sensitization to beryllium or its compounds. After 30 years, the role of sensitization has been confirmed in a number of laboratory and clinical studies. The unusual epidemiological features first summarized by Sterner and Eisenbud continue to be evident. The early studies also led to formulation of standards that have resulted in effective control of both the acute and chronic pulmonary forms of beryllium disease. No case of acute chemical pneumonitis has been reported among beryllium workers in about 15 years, and the number of chronic cases has diminished greatly despite a marked increase in the use of beryllium.

  13. 30-Year Satellite Record Reveals Accelerated Arctic Sea Ice Loss, Antarctic Sea Ice Trend Reversal

    NASA Technical Reports Server (NTRS)

    Cavalieri, Donald J.; Parkinson, C. L.; Vinnikov, K. Y.

    2003-01-01

    Arctic sea ice extent decreased by 0.30 plus or minus 0.03 x 10(exp 6) square kilometers per decade from 1972 through 2002, but decreased by 0.36 plus or minus 0.05 x 10(exp 6) square kilometers per decade from 1979 through 2002, indicating an acceleration of 20% in the rate of decrease. In contrast to the Arctic, the Antarctic sea ice extent decreased dramatically over the period 1973-1977, then gradually increased, with an overall 30-year trend of -0.15 plus or minus 0.08 x 10(exp 6) square kilometers per 10yr. The trend reversal is attributed to a large positive anomaly in Antarctic sea ice extent observed in the early 1970's.

  14. Cockroach allergy and asthma in a 30-year-old man.

    PubMed Central

    O'Connor, G T; Gold, D R

    1999-01-01

    A growing body of evidence has implicated allergens derived from cockroaches as an important environmental factor that may aggravate asthma in sensitized persons. We present the case of a 30-year-old man with asthma and a cockroach allergy. Allergy skin testing confirmed hypersensitivity to cockroach extract, and a home visit revealed visual evidence of infestation and the presence of Bla g 1 German cockroach allergen in vacuumed dust. As is typical of patients with a cockroach allergy and asthma, multiple factors in addition to cockroach allergen appeared to aggravate the patient's asthma. A multimodality therapeutic regimen, which included medications as well as cleaning of the home, integrated pest management, and professional application of chemical controls, resulted in substantial clinical improvement. The pathophysiology, epidemiology, and clinical features of cockroach-allergic asthma are reviewed, and an approach to diagnosis and management is suggested. Images Figure 1 Figure 2 PMID:10064555

  15. Anorexia Nervosa: The Course of 15 Patients Treated From 20 to 30 Years Previously

    PubMed Central

    Farquharson, R. F.; Hyland, H. H.

    1966-01-01

    A follow-up study, after 20 to 30 years, of 15 patients with anorexia nervosa, formerly treated by the authors, revealed that only one patient failed to recover from the initial illness, and she ultimately became permanently incapacitated. Three patients have had neurotic symptoms periodically during the years following recovery, and one other became very thin in later life, but these four have been able to carry on fairly adequately for the most part. The remaining 10 patients have lived useful, well-adjusted lives, free of symptoms over the years. This study shows that despite the apparently severe emotional disturbances reflected in the marked physical changes that take place in young people suffering from this syndrome, a deep-rooted psychoneurotic or psychotic predisposition does not necessarily exist; the majority of the patients in this series recovered and remained well after relatively simple treatment. ImagesFig. 1 PMID:5902703

  16. From Cloning Neural Development Genes to Functional Studies in Mice, 30 Years of Advancements.

    PubMed

    Joyner, Alexandra L

    2016-01-01

    The invention of new mouse molecular genetics techniques, initiated in the 1980s, has repeatedly expanded our ability to tackle exciting developmental biology problems. The brain is the most complex organ, and as such the more sophisticated the molecular genetics technique, the more impact they have on uncovering new insights into how our brain functions. I provide a general time line for the introduction of new techniques over the past 30 years and give examples of new discoveries in the neural development field that emanated from them. I include a look to what the future holds and argue that we are at the dawn of a very exciting age for young scientists interested in studying how the nervous system is constructed and functions with such precision. PMID:26970637

  17. Bevacizumab treatment for meningiomas in NF2: a retrospective analysis of 15 patients.

    PubMed

    Nunes, Fabio P; Merker, Vanessa L; Jennings, Dominique; Caruso, Paul A; di Tomaso, Emmanuelle; Muzikansky, Alona; Barker, Fred G; Stemmer-Rachamimov, Anat; Plotkin, Scott R

    2013-01-01

    Bevacizumab treatment can result in tumor shrinkage of progressive vestibular schwannomas in some neurofibromatosis 2 (NF2) patients but its effect on meningiomas has not been defined. To determine the clinical activity of bevacizumab against NF2-related meningiomas, we measured changes in volume of meningiomas in NF2 patients who received bevacizumab for treatment of progressive vestibular schwannomas. A radiographic response was defined as a 20% decrease in tumor size by volumetric MRI analysis. In addition, we determined the expression pattern of growth factors associated with tumor angiogenesis in paraffin-embedded tissues from 26 unrelated meningiomas. A total of 48 meningiomas in 15 NF2 patients were included in this study with a median follow up time of 18 months. A volumetric radiographic response was seen in 29% of the meningiomas (14/48). Tumor shrinkage was not durable: the median duration of response was 3.7 months and the median time to progression was 15 months. There was no significant correlation between pre-treatment growth rate and meningioma response in regression models. Tissue analysis showed no correlation between tumor microvascular density and expression of VEGF pathway components. This data suggests that, in contrast to schwannomas, activation of VEGF pathway is not the primary driver of angiogenesis in meningiomas. Our results suggest that a minority of NF2-associated meningiomas shrink during bevacizumab therapy and that these responses were of short duration. These results are comparable to previous studies of bevacizumab in sporadic meningiomas. PMID:23555840

  18. Four-phase rhinomanometry: a multicentric retrospective analysis of 36,563 clinical measurements.

    PubMed

    Vogt, Klaus; Wernecke, Klaus-Dieter; Behrbohm, Hans; Gubisch, Wolfgang; Argale, Mara

    2016-05-01

    Rhinomanometry can still be considered as the standard technique for the objective assessment of the ventilatory function of the nose. Reliable technical requirements are given by fast digital sensors and modern information technology. However, the xyimaging of the pressure-flow relation typically shows loops as a sign of hysteresis, with the need for resolution of the breath in four phases. The three pillars of 4-phase rhinomanometry (4PR) are the replacement of estimations by measurements, the introduction of parameters related to the subjective sensing of obstruction, and the graphical information regarding the disturbed function of the nasal valve. In a meta-analysis of 36,563 clinical measurements, we analyze the errors of the "classic" parameters (flow in 150 Pa) and reject the further use of these parameters as obsolete, because they correspond to an inaccurate estimation rather than proper measurement. In a pre-study of 1580 measurements, the logarithmic effective resistance (Reff) was found to have the highest correlation with values obtained from a visual analog scale. Next, we classify the inspiratory effective resistance in 20,069 measurements without treatment and 16,494 measurements after decongestion with xylometazoline 0.1 % spray in 20 % percentiles. The gradation of obstruction delivers not only "normal" values but also indications for the severity of the obstruction in adult Caucasian noses. Adoption of the distribution for the growing nose and analysis of the total nasal resistance is addressed, and typical findings of nasal valve phenomena are outlined. PMID:26198284

  19. The prevalence of posticus ponticus: retrospective analysis of radiographs from a chiropractic health center

    PubMed Central

    Kuhta, Patricia; Hart, John; Greene-Orndorff, Laura; McDowell-Reizer, Beth; Rush, Perry

    2010-01-01

    Objective The potential clinical significance of posticus ponticus is controversial because the majority of patients with this finding are asymptomatic. This study sought to estimate the prevalence of posticus ponticus in a chiropractic college clinic patient population. Methods From the archived records in the College Health Center, 304 lateral cervical spine radiographs were randomly selected and assessed by 2 independent examiners for the presence of posticus ponticus in any of its forms. The number of radiographs showing posticus ponticus, as well as analysis of agreement between examiners, was obtained. Results There were 60 radiographs where the examiners disagreed as to the presence or absence of posticus ponticus. These 60 were not counted for prevalence of posticus ponticus but were included in the κ analysis. Among the remaining 246 radiographs, 112 (46%) showed some type of posticus ponticus, whereas 132 (54%) did not show any posticus ponticus finding. Examiners A and B showed a κ score agreement of 0.72, and examiners C and D showed a κ score agreement of 0.51. Discussion The κ scores for both sets of examiners show acceptable agreement. Within this population, the finding of 45.9% prevalence of some type of posticus ponticus was determined. Compared with other studies, the prevalence of posticus ponticus was found to range between 9% and 72%. Conclusion Within this sample, 45.9% of radiographs showed some type of posticus ponticus. PMID:22027107

  20. Associations between safety culture and employee engagement over time: a retrospective analysis.

    PubMed

    Daugherty Biddison, Elizabeth Lee; Paine, Lori; Murakami, Peter; Herzke, Carrie; Weaver, Sallie J

    2016-01-01

    With the growth of the patient safety movement and development of methods to measure workforce health and success have come multiple modes of assessing healthcare worker opinions and attitudes about work and the workplace. Safety culture, a group-level measure of patient safety-related norms and behaviours, has been proposed to influence a variety of patient safety outcomes. Employee engagement, conceptualised as a positive, work-related mindset including feelings of vigour, dedication and absorption in one's work, has also demonstrated an association with a number of important worker outcomes in healthcare. To date, the relationship between responses to these two commonly used measures has been poorly characterised. Our study used secondary data analysis to assess the relationship between safety culture and employee engagement over time in a sample of >50 inpatient hospital units in a large US academic health system. With >2000 respondents in each of three time periods assessed, we found moderate to strong positive correlations (r=0.43-0.69) between employee engagement and four Safety Attitudes Questionnaire domains. Independent collection of these two assessments may have limited our analysis in that minimally different inclusion criteria resulted in some differences in the total respondents to the two instruments. Our findings, nevertheless, suggest a key area in which healthcare quality improvement efforts might be streamlined. PMID:26041813

  1. Spatio-Temporal Variability of Aquatic Vegetation in Taihu Lake over the Past 30 Years

    PubMed Central

    Zhao, Dehua; Lv, Meiting; Jiang, Hao; Cai, Ying; Xu, Delin; An, Shuqing

    2013-01-01

    It is often difficult to track the spatio-temporal variability of vegetation distribution in lakes because of the technological limitations associated with mapping using traditional field surveys as well as the lack of a unified field survey protocol. Using a series of Landsat remote sensing images (i.e. MSS, TM and ETM+), we mapped the composition and distribution area of emergent, floating-leaf and submerged macrophytes in Taihu Lake, China, at approximate five-year intervals over the past 30 years in order to quantify the spatio-temporal dynamics of the aquatic vegetation. Our results indicated that the total area of aquatic vegetation increased from 187.5 km2 in 1981 to 485.0 km2 in 2005 and then suddenly decreased to 341.3 km2 in 2010. Similarly, submerged vegetation increased from 127.0 km2 in 1981 to 366.5 km2 in 2005, and then decreased to 163.3 km2. Floating-leaf vegetation increased continuously through the study period in both area occupied (12.9 km2 in 1981 to 146.2 km2 in 2010) and percentage of the total vegetation (6.88% in 1981 to 42.8% in 2010). In terms of spatial distribution, the aquatic vegetation in Taihu Lake has spread gradually from the East Bay to the surrounding areas. The proportion of vegetation in the East Bay relative to that in the entire lake has decreased continuously from 62.3% in 1981, to 31.1% in 2005 and then to 21.8% in 2010. Our findings have suggested that drastic changes have taken place over the past 30 years in the spatial pattern of aquatic vegetation as well as both its relative composition and the amount of area it occupies. PMID:23823189

  2. Isotretinoin: dose, duration and relapse. What does 30 years of usage tell us?

    PubMed

    Rademaker, Marius

    2013-08-01

    With 30 years of clinical use, it is appropriate to review the use of isotretinoin. We now understand that retinoids influence cellular growth, differentiation, morphogenesis and apoptosis, inhibit tumour promotion and malignant cell growth, exert immuno-modulatory actions and alter cellular cohesiveness. This has expanded the indications of isotretinoin from just acne and rosacea to a wide range of inflammatory and malignant skin disorders. While the standard dose of 0.5 to 1 mg/kg per day for 4 months to a cumulative dose of 120-140 mg/kg per day has served us well in the management of acne vulgaris, there is emerging evidence that much lower dosages (as low as 5 mg/day) are just as effective but have significantly fewer adverse effects. Relapse of acne vulgaris continues to be a problem but we are beginning to recognise that this is related less to the cumulative dose and more to the length of sebaceous gland suppression. Other factors important for relapse include a macrocomedonal pattern of acne, smoking and age, both younger (under 14 years) and older (over 25 years). After 30 years of use, we now understand why isotretinoin is such an effective drug. Not only does it clear acne in almost all patients, long-term remission can be achieved in 70-80% of patients with a single course. Important changes in the use of isotretinoin include using a lower daily dose for a longer period of time. New indications continue to emerge, particularly as a potential treatment for both intrinsic and extrinsic (photo) aging. Teratogenicity however, remains a very significant concern. PMID:23013115

  3. Spatio-Temporal Variability of Aquatic Vegetation in Taihu Lake over the Past 30 Years.

    PubMed

    Zhao, Dehua; Lv, Meiting; Jiang, Hao; Cai, Ying; Xu, Delin; An, Shuqing

    2013-01-01

    It is often difficult to track the spatio-temporal variability of vegetation distribution in lakes because of the technological limitations associated with mapping using traditional field surveys as well as the lack of a unified field survey protocol. Using a series of Landsat remote sensing images (i.e. MSS, TM and ETM+), we mapped the composition and distribution area of emergent, floating-leaf and submerged macrophytes in Taihu Lake, China, at approximate five-year intervals over the past 30 years in order to quantify the spatio-temporal dynamics of the aquatic vegetation. Our results indicated that the total area of aquatic vegetation increased from 187.5 km(2) in 1981 to 485.0 km(2) in 2005 and then suddenly decreased to 341.3 km(2) in 2010. Similarly, submerged vegetation increased from 127.0 km(2) in 1981 to 366.5 km(2) in 2005, and then decreased to 163.3 km(2). Floating-leaf vegetation increased continuously through the study period in both area occupied (12.9 km(2) in 1981 to 146.2 km(2) in 2010) and percentage of the total vegetation (6.88% in 1981 to 42.8% in 2010). In terms of spatial distribution, the aquatic vegetation in Taihu Lake has spread gradually from the East Bay to the surrounding areas. The proportion of vegetation in the East Bay relative to that in the entire lake has decreased continuously from 62.3% in 1981, to 31.1% in 2005 and then to 21.8% in 2010. Our findings have suggested that drastic changes have taken place over the past 30 years in the spatial pattern of aquatic vegetation as well as both its relative composition and the amount of area it occupies. PMID:23823189

  4. Modeling Saturn's Giant Storms: Water, Ammonia, and the 30-Year Periodicity

    NASA Astrophysics Data System (ADS)

    Li, Cheng; Ingersoll, A. P.

    2013-10-01

    A giant planet-encircling storm occured on Saturn at the end of year 2010. The storm produced lightning at a rate greater than 10 SEDs per second. It wrapped around the planet, with a wake depleted in ammonia, and after 6 months it died. These kinds of storms are rare and episodic. They happen every 20-30 years. In this study, we discuss the role of moist convection on the development of the storm and explain the observed post-storm ammonia depletion. The study is composed of two parts. First, thermodynamcis on Saturn indicates that strong convection is prohibited by the waterloading-effect when the troposphere is warm. After 20-30 years, the troposphere has cooled below a critical value so that deep convection develops at the base of the water cloud. The deep water mixing ratio is best estimated as 1.2% relative to H2 so as to match the cooling time. Second, strong convection can produce a warm convective column that overshoots into the stratosphere. We solve the cylindrically symmetric hydrostatic primitive equations to investigate the large scale response of the ambient flow to the geostrophically unbalanced column. We find that during the subsequent large scale adjustment, ammonia vapor condenses and precipitates out of the troposphere, causing high residual brightness temperatures as observed by Cassini/RADAR (Janssen et al., 2013; Laraia et al., 2013). Further, for a deep water mixing ratio of 1.2%, we find that the ammonia vapor is depeleted down to 5 bar, that the speed of remaining anticyclonic vortex is about 30 m/s, and the residual large scale warming is about 10 K. These values are consistent with observation within the measurement uncertainties.

  5. Determining the role of external beam radiotherapy in unresectable intrahepatic cholangiocarcinoma: a retrospective analysis of 84 patients

    PubMed Central

    2010-01-01

    Background Intrahepatic cholangiocarcinoma (ICC) is the second most common type of primary liver cancer. Only few studies have focused on palliative radiotherapy used for patients who weren't suitable for resection by surgery. This study was conducted to investigate the effect of external beam radiotherapy (EBRT) for patients with unresectable ICC. Methods We identified 84 patients with ICC from December 1998 through December 2008 for retrospective analysis. Thirty-five of 84 patients received EBRT therapy five times a week (median dose, 50 Gy; dose range, 30-60 Gy, in fractions of 1.8-2.0 Gy daily; EBRT group); the remaining 49 patients comprised the non-EBRT group. Tumor response, jaundice relief, and survival rates were compared by Kaplan-Meier analysis. Patient records were reviewed and compared using Cox proportional hazard analysis to determine factors that affect survival time in ICC. Results After EBRT, complete response (CR) and partial response (PR) of primary tumors were observed in 8.6% and 28.5% of patients, respectively, and CR and PR of lymph node metastases were observed in 20% and 40% of patients. In 19 patients with jaundice, complete and partial relief was observed in 36.8% and 31.6% of patients, respectively. Median survival times were 5.1 months for the non-EBRT group and 9.5 months for the EBRT group (P = 0.003). One-and two-year survival rates for EBRT versus non-EBRT group were 38.5% versus 16.4%, and 9.6% versus 4.9%, respectively. Multivariate analysis revealed that clinical symptoms, larger tumor size, no EBRT, multiple nodules and synchronous lymph node metastases were associated with poorer prognosis. Conclusions EBRT as palliative care appears to improve prognosis and relieve the symptom of jaundice in patients with unresectable ICC. PMID:20840777

  6. Blast From the Past: A Retrospective Analysis of Blast-induced Head Injury.

    PubMed

    Yu, Kristin E; Murphy, Justin M; Tsao, Jack W

    2016-03-01

    Because of the sharp increase in the number of military personnel exposed to explosive blasts in combat, research has been dedicated toward understanding the impact of explosions on the brain. It is important to consider that potential injuries that military personnel sustain may be both in the form of physical injury as well as "invisible" neuronal and psychological damage. Since the inception of the study of blast science in the Medieval and Renaissance eras, significant improvements have been made in the historical record keeping and biomedical analysis of blast injuries. This editorial comments on the evolution of blast science and the recognition of neurological sequelae from both the historical and scientific perspectives. PMID:26926849

  7. Case reports of aconite poisoning in mainland China from 2004 to 2015: A retrospective analysis.

    PubMed

    Li, Haoran; Liu, Liang; Zhu, Shaohua; Liu, Qian

    2016-08-01

    Aconitum species have long been used in key traditional medicines in China, but cases of fatal aconite poisoning have also been reported. This paper presents a review of 40 single and multi-person cases of fatal aconite poisoning. The cases involved 53 victims in mainland China described in 27 case reports published between January 2004 and September 2015. We summarize the details of the case reports in order to highlight the features of fatal aconite-poisoning cases in China, including victims' sex and age, route of intoxication, clinical symptoms, medicolegal autopsy findings, and results of toxicological analysis. Our results indicate a need for legal medical experts encountering cases of fatal aconite poisoning to pay increased attention to the methods used for collecting biological samples. In addition, prevention strategies should focus on increasing public awareness regarding the potential toxicity of Aconitum, harm caused by medicinal liquors containing aconitine, and possibility of Aconitum alkaloids accumulating in the body. PMID:27266651

  8. Herbert Spencer's contributions to behavior analysis: a retrospective review of principles of psychology.

    PubMed

    Leslie, Julian C

    2006-07-01

    Herbert Spencer's Principles of Psychology (1855, first edition) was regarded by his contemporaries, including William James and John Dewey, as a major contribution to what was then a very new discipline. In this book he first expounded his ideas about both evolution of species and how behavior of the individual organism adapts through interaction with the environment. His formulation of the principle that behavior changes in adaptation to the environment is closely related to the version of the law of effect propounded some years later by Thorndike. He can thus be seen as the first proponent of selectionism, a key tenet of behavior analysis. He also explicitly attacked the then prevailing view of free will as being incompatible with the biologically grounded view of psychological processes that he was advocating, and thus put forward ideas that were precursors of B. F. Skinner's in this important area of debate. PMID:16903496

  9. Assisted reproductive technology in India: A 3 year retrospective data analysis

    PubMed Central

    Malhotra, Narendra; Shah, Duru; Pai, Rishma; Pai, H. D.; Bankar, Manish

    2013-01-01

    Assisted reproductive technology (ART) has grown by leaps and bounds in the last few years. India has one of the highest growths in the ART centers and the number of ART cycles performed every year. Very soon India will be the leader in the world of ART in terms of a number of cycles. With the advances of technology and availability of techniques even in tier II and tier III cities our country, the results still vary dramatically. There is no standardization of protocols and reporting is very inadequate. Furthermore, there are only ART guidelines and no law still exists. Our first and the biggest challenge is to document the tremendous work being done in India and on the basis of analysis of this work, a proper registry can be made and guidance given to all on standardization and improvement. This is the 8th edition of National ART Registry of India being presented and analyzed. PMID:24672161

  10. Adult neurobehavioral outcome of hyperbilirubinemia in full term neonates-a 30 year prospective follow-up study.

    PubMed

    Hokkanen, Laura; Launes, Jyrki; Michelsson, Katarina

    2014-01-01

    Background. Neonatal hyperbilirubinemia (HB) may cause severe neurological damage, but serious consequences are effectively controlled by phototherapy and blood exchange transfusion. HB is still a serious health problem in economically compromised parts of the world. The long term outcome has been regarded favorable based on epidemiological data, but has not been confirmed in prospective follow-up studies extending to adulthood. Methods. We studied the long term consequences of HB in a prospective birth cohort of 128 HB cases and 82 controls. The cases are part of a neonatal at-risk cohort (n = 1196) that has been followed up to 30 years of age. HB cases were newborns ≥ 2500 g birth weight and ≥ 37 weeks of gestation who had bilirubin concentrations > 340 µmol/l or required blood exchange transfusion. Subjects with HB were divided into subgroups based on the presence (affected HB) or absence (unaffected HB) of diagnosed neurobehavioral disorders in childhood, and compared with healthy controls. Subjects were seen at discharge, 5, 9 and 16 years of life and parent's and teacher's assessments were recorded. At 30 years they filled a questionnaire about academic and occupational achievement, life satisfaction, somatic and psychiatric symptoms including a ADHD self-rating score. Cognitive functioning was tested using ITPA, WISC, and reading and writing tests at 9 years of life. Results. Compared to controls, the odds for a child with HB having neurobehavioral symptoms at 9 years was elevated (OR = 4.68). Forty-five per cent of the HB group were affected by cognitive abnormalities in childhood and continued to experience problems in adulthood. This was apparent in academic achievement (p < 0.0001) and the ability to complete secondary (p < 0.0001) and tertiary (p < 0.004) education. Also, the subgroup of affected HB reported persisting cognitive complaints e.g., problems with reading, writing and mathematics. Childhood symptoms of hyperactivity/impulsivity (p < 0

  11. Retrospective Analysis of NIST Standard Reference Material 1450, Fibrous Glass Board, for Thermal Insulation Measurements

    PubMed Central

    Zarr, Robert R; Heckert, N Alan; Leigh, Stefan D

    2014-01-01

    Thermal conductivity data acquired previously for the establishment of Standard Reference Material (SRM) 1450, Fibrous Glass Board, as well as subsequent renewals 1450a, 1450b, 1450c, and 1450d, are re-analyzed collectively and as individual data sets. Additional data sets for proto-1450 material lots are also included in the analysis. The data cover 36 years of activity by the National Institute of Standards and Technology (NIST) in developing and providing thermal insulation SRMs, specifically high-density molded fibrous-glass board, to the public. Collectively, the data sets cover two nominal thicknesses of 13 mm and 25 mm, bulk densities from 60 kg·m−3 to 180 kg·m−3, and mean temperatures from 100 K to 340 K. The analysis repetitively fits six models to the individual data sets. The most general form of the nested set of multilinear models used is given in the following equation: λ(ρ,T)=a0+a1ρ+a2T+a3T3+a4e−(T−a5a6)2where λ(ρ,T) is the predicted thermal conductivity (W·m−1·K−1), ρ is the bulk density (kg·m−3), T is the mean temperature (K) and ai (for i = 1, 2, … 6) are the regression coefficients. The least squares fit results for each model across all data sets are analyzed using both graphical and analytic techniques. The prevailing generic model for the majority of data sets is the bilinear model in ρ and T. λ(ρ,T)=a0+a1ρ+a2T One data set supports the inclusion of a cubic temperature term and two data sets with low-temperature data support the inclusion of an exponential term in T to improve the model predictions. Physical interpretations of the model function terms are described. Recommendations for future renewals of SRM 1450 are provided. An Addendum provides historical background on the origin of this SRM and the influence of the SRM on external measurement programs. PMID:26601034

  12. Prison tobacco control policies and deaths from smoking in United States prisons: population based retrospective analysis

    PubMed Central

    Carson, E Ann; Krueger, Patrick M; Mueller, Shane R; Steiner, John F; Sabol, William J

    2014-01-01

    Objective To determine the mortality attributable to smoking and years of potential life lost from smoking among people in prison and whether bans on smoking in prison are associated with reductions in smoking related deaths. Design Analysis of cross sectional survey data with the smoking attributable mortality, morbidity, and economic costs system; population based time series analysis. Setting All state prisons in the United States. Main outcome measures Prevalence of smoking from cross sectional survey of inmates in state correctional facilities. Data on state prison tobacco policies from web based searches of state policies and legislation. Deaths and causes of death in US state prisons from the deaths in custody reporting program of the Bureau of Justice Statistics for 2001-11. Smoking attributable mortality and years of potential life lost was assessed from the smoking attributable mortality, morbidity, and economic costs system of the Centers for Disease Control and Prevention. Multivariate Poisson models quantified the association between bans and smoking related cancer, cardiovascular and pulmonary deaths. Results The most common causes of deaths related to smoking among people in prison were lung cancer, ischemic heart disease, other heart disease, cerebrovascular disease, and chronic airways obstruction. The age adjusted smoking attributable mortality and years of potential life lost rates were 360 and 5149 per 100 000, respectively; these figures are higher than rates in the general US population (248 and 3501, respectively). The number of states with any smoking ban increased from 25 in 2001 to 48 by 2011. In prisons the mortality rate from smoking related causes was lower during years with a ban than during years without a ban (110.4/100 000 v 128.9/100 000). Prisons that implemented smoking bans had a 9% reduction (adjusted incidence rate ratio 0.91, 95% confidence interval 0.88 to 0.95) in smoking related deaths. Bans in place for longer than

  13. Risk factors for central venous catheter-related thrombosis in children: a retrospective analysis.

    PubMed

    Chen, Kai; Agarwal, Arnav; Tassone, Maria Cristina; Shahjahan, Nadia; Walton, Mark; Chan, Anthony; Mondal, Tapas

    2016-06-01

    Central venous catheter (CVC) placement is associated with increased risk of thrombosis in the paediatric population, particularly in relation to the type of catheter and the manner of its insertion. Here, we investigate risk factors associated with CVC-related thrombosis in children, with particular emphasis on positioning of the catheter tip. Patients aged 0-18 who underwent at least one CVC placement from 2008 to 2013 at a single centre with a subsequent follow-up echocardiogram were included for a total of 104 patients and 147 lines. Data on clinical and catheter-related risk factors were collected from patient charts. Statistical analysis using Pearson's χ tests, independent samples t-test, and odds ratios were used to assess potential risk factors for thrombosis. Neither insertion site (subclavian vein or otherwise), left- vs. right-sided insertion, nor catheter type were significant risk factors for thrombosis. There were no thrombotic events reported at the superior vena cava (SVC)-right atrium junction and no significant differences in thrombotic risk with initial tip placement in the SVC-right atrium junction vs. the SVC, right atrium, or inferior vena cava. Acute lymphoblastic leukaemia was a major clinical risk factor for thrombosis. Tip movement was common and may have been an important factor in the development of CVC-related thrombi. Prospective studies can yield insight into the role of follow-up imaging in the prevention of catheter-related thrombosis in children. PMID:26977751

  14. The role of climatic variables in winter cereal yields: a retrospective analysis

    NASA Astrophysics Data System (ADS)

    Luo, Qunying; Wen, Li

    2015-02-01

    This study examined the effects of observed climate including [CO2] on winter cereal [winter wheat ( Triticum aestivum), barley ( Hordeum vulgare) and oat ( Avena sativa)] yields by adopting robust statistical analysis/modelling approaches (i.e. autoregressive fractionally integrated moving average, generalised addition model) based on long time series of historical climate data and cereal yield data at three locations (Moree, Dubbo and Wagga Wagga) in New South Wales, Australia. Research results show that (1) growing season rainfall was significantly, positively and non-linearly correlated with crop yield at all locations considered; (2) [CO2] was significantly, positively and non-linearly correlated with crop yields in all cases except wheat and barley yields at Wagga Wagga; (3) growing season maximum temperature was significantly, negatively and non-linearly correlated with crop yields at Dubbo and Moree (except for barley); and (4) radiation was only significantly correlated with oat yield at Wagga Wagga. This information will help to identify appropriate management adaptation options in dealing with the risk and in taking the opportunities of climate change.

  15. Tetrodotoxin poisoning caused by Goby fish consumption in southeast China: a retrospective case series analysis

    PubMed Central

    You, Jie; Yue, YaJun; Xing, Feng; Xia, Wei; Lai, ShaoYang; Zhang, FengLei

    2015-01-01

    OBJECTIVES: To investigate an unusual outbreak of tetrodotoxin poisoning in Leizhou, southeast China, a case series analysis was conducted to identify the source of illness. METHODS: A total of 22 individuals experienced symptoms of poisoning, including tongue numbness, dizziness, nausea and limb numbness and weakness. Two toxic species, Amoya caninus and Yongeichthys nebulosus, were morphologically identified from the batches of gobies consumed by the patients. Tetrodotoxin levels in the blood and Goby fish samples were detected using liquid chromatography-tandem mass spectrometry. RESULTS: The tetrodotoxin levels in the remaining cooked Goby fish were determined to be 2090.12 µg/kg. For Amoya caninus, the toxicity levels were 1858.29 µg/kg in the muscle and 1997.19 µg/kg in the viscera and for Yongeichthys nebulosus, they were 2783.00 µg/kg in the muscle and 2966.21 µg/kg in the viscera. CONCLUSION: This outbreak demonstrates an underestimation of the risk of Goby fish poisoning. Furthermore, the relationships among the toxic species, climates and marine algae present should be clarified in the future. PMID:25672425

  16. Evaluating Frequency, Diagnostic Quality, and Cost of Lyme Borreliosis Testing in Germany: A Retrospective Model Analysis

    PubMed Central

    Müller, I.; Freitag, M. H.; Poggensee, G.; Scharnetzky, E.; Straube, E.; Schoerner, Ch.; Hlobil, H.; Hagedorn, H.-J.; Stanek, G.; Schubert-Unkmeir, A.; Norris, D. E.; Gensichen, J.; Hunfeld, K.-P.

    2012-01-01

    Background. Data on the economic impact of Lyme borreliosis (LB) on European health care systems is scarce. This project focused on the epidemiology and costs for laboratory testing in LB patients in Germany. Materials and Methods. We performed a sentinel analysis of epidemiological and medicoeconomic data for 2007 and 2008. Data was provided by a German statutory health insurance (DAK) company covering approx. 6.04 million members. In addition, the quality of diagnostic testing for LB in Germany was studied. Results. In 2007 and 2008, the incident diagnosis LB was coded on average for 15,742 out of 6.04 million insured members (0.26%). 20,986 EIAs and 12,558 immunoblots were ordered annually for these patients. For all insured members in the outpatient sector, a total of 174,820 EIAs and 52,280 immunoblots were reimbursed annually to health care providers (cost: 2,600,850€). For Germany, the overall expected cost is estimated at 51,215,105€. However, proficiency testing data questioned test quality and standardization of diagnostic assays used. Conclusion. Findings from this study suggest ongoing issues related to care for LB and may help to improve future LB disease management. PMID:22242037

  17. Retrospective analysis of absconding behaviour by acute care consumers in one psychiatric hospital campus in Australia.

    PubMed

    Mosel, Krista A; Gerace, Adam; Muir-Cochrane, Eimear

    2010-06-01

    Absconding is increasingly being recognized as a problem within mental health settings with significant risks for consumers. This study examines absconding behaviours across three acute care wards within an Australian psychiatric hospital campus over a 12-month period. A descriptive statistical analysis determined the rate of absconding from 49 consumers who absconded 64 times. The absconding rate was 13.33% (absconding events), with most absconding events arising from males diagnosed with schizophrenia (57.14%) aged between 20 and 29 years, and with 62.50% of absconding events occurring whilst consumers were on their first 21-day detention order. Nearly half of all absconding events were by consumers who had absconded previously, with the highest proportion of events occurring during nursing handover. A profile of people who abscond, time of day of absconding, legal status and repeated absconding behaviours are described. The emergent profile of consumers who absconded within this study bears some similarities to that described in overseas research, although in this study consumers were slightly older and 25% of absconders were female. Of particular interest are findings that identify the timings of absconding events in relation to a consumer's legal status. Implications for practice, including assessment of risk of absconding and management, are considered. PMID:20550641

  18. Retrospective analysis of 1312 patients with haemophilia and related disorders in a single Chinese institute.

    PubMed

    Zhang, L; Li, H; Zhao, H; Zhang, X; Ji, L; Yang, R

    2003-11-01

    With 1.3 billion people, China has the largest population in the world, and therefore has the largest population of persons with haemophilia (PWH). As there is no national registry for haemophilia, it is difficult to ascertain how many PWH have actually been diagnosed. Between January 1983 and June 2002, 1312 patients with coagulation disorders were referred to our hospital, and 1190 patients were evaluable. Among them, 1069 (89.8%) patients had haemophilia, 68 had vWD, 20 had factor XI deficiency, 10 had acquired factor VIII inhibitor and 23 had other coagulation disorders. Of the 1069 PWH, 14.7% were unclassified, 38.4% severe, 35.7% moderate and 11.1% mild. If the unclassified cases were excluded, 45.1% were severe, 41.9% moderate and 13.0% mild. Twenty-nine of the 68 vWD patients had vWF:Ag <5%, and subcategorized as type 3 vWD. Because vWF multimer analysis was not performed in our centre, the remaining vWD patients were not subdivided. PMID:14750935

  19. Retention and Risk Factors for Attrition in a Large Public Health ART Program in Myanmar: A Retrospective Cohort Analysis

    PubMed Central

    Thida, Aye; Tun, Sai Thein Than; Zaw, Sai Ko Ko; Lover, Andrew A.; Cavailler, Philippe; Chunn, Jennifer; Aye, Mar Mar; Par, Par; Naing, Kyaw Win; Zan, Kaung Nyunt; Shwe, Myint; Kyaw, Thar Tun; Waing, Zaw Htoon; Clevenbergh, Philippe

    2014-01-01

    Background The outcomes from an antiretroviral treatment (ART) program within the public sector in Myanmar have not been reported. This study documents retention and the risk factors for attrition in a large ART public health program in Myanmar. Methods A retrospective analysis of a cohort of adult patients enrolled in the Integrated HIV Care (IHC) Program between June 2005 and October 2011 and followed up until April 2012 is presented. The primary outcome was attrition (death or loss-follow up); a total of 10,223 patients were included in the 5-year cumulative survival analysis. Overall 5,718 patients were analyzed for the risk factors for attrition using both logistic regression and flexible parametric survival models. Result The mean age was 36 years, 61% of patients were male, and the median follow up was 13.7 months. Overall 8,564 (84%) patients were retained in ART program: 750 (7%) were lost to follow-up and 909 (9%) died. During the 3 years follow-up, 1,542 attritions occurred over 17,524 person years at risk, giving an incidence density of 8.8% per year. The retention rates of participants at 12, 24, 36, 48 and 60 months were 86, 82, 80, 77 and 74% respectively. In multivariate analysis, being male, having high WHO staging, a low CD4 count, being anaemic or having low BMI at baseline were independent risk factors for attrition; tuberculosis (TB) treatment at ART initiation, a prior ART course before program enrollment and literacy were predictors for retention in the program. Conclusion High retention rate of IHC program was documented within the public sector in Myanmar. Early diagnosis of HIV, nutritional support, proper investigation and treatment for patients with low CD4 counts and for those presenting with anaemia are crucial issues towards improvement of HIV program outcomes in resource-limited settings. PMID:25268903

  20. A retrospective analysis of the effect of discussion in teleconference and face-to-face scientific peer-review panels

    PubMed Central

    Carpenter, Afton S; Sullivan, Joanne H; Deshmukh, Arati; Glisson, Scott R; Gallo, Stephen A

    2015-01-01

    Objective With the use of teleconferencing for grant peer-review panels increasing, further studies are necessary to determine the efficacy of the teleconference setting compared to the traditional onsite/face-to-face setting. The objective of this analysis was to examine the effects of discussion, namely changes in application scoring premeeting and postdiscussion, in these settings. We also investigated other parameters, including the magnitude of score shifts and application discussion time in face-to-face and teleconference review settings. Design The investigation involved a retrospective, quantitative analysis of premeeting and postdiscussion scores and discussion times for teleconference and face-to-face review panels. The analysis included 260 and 212 application score data points and 212 and 171 discussion time data points for the face-to-face and teleconference settings, respectively. Results The effect of discussion was found to be small, on average, in both settings. However, discussion was found to be important for at least 10% of applications, regardless of setting, with these applications moving over a potential funding line in either direction (fundable to unfundable or vice versa). Small differences were uncovered relating to the effect of discussion between settings, including a decrease in the magnitude of the effect in the teleconference panels as compared to face-to-face. Discussion time (despite teleconferences having shorter discussions) was observed to have little influence on the magnitude of the effect of discussion. Additionally, panel discussion was found to often result in a poorer score (as opposed to an improvement) when compared to reviewer premeeting scores. This was true regardless of setting or assigned reviewer type (primary or secondary reviewer). Conclusions Subtle differences were observed between settings, potentially due to reduced engagement in teleconferences. Overall, further research is required on the psychology of

  1. Clinical features of airway malacia in children: a retrospective analysis of 459 patients

    PubMed Central

    Pan, Wei; Peng, Donghong; Luo, Jian; Liu, Enmei; Luo, Zhengxiu; Dai, Jihong; Fu, Zhou; Li, Qubei; Huang, Ying

    2014-01-01

    Aim: To investigate the clinical features of airway malacia in children. Material and methods: A comprehensive analysis was done on information of 459 young patients with airway malacia. Results: Number of children with tracheomalacia, tracheobronchomalacia, and bronchomalacia was 7 (1.5%), 17 (3.7%), and 435 (94.8%), respectively. Incidence of bronchomalacia in left lung was 11.0% (n=48), while that of right lung was 53.3% (n=232). Meanwhile, bronchomalacia of both lungs were noticed in 155 children (35.6%). With regards to the extent of malacia, number of children with slight, moderate and severe malacia was 226, 195, and 38, respectively. All the children enrolled in this study were diagnosed with pulmonary infection, among which 376 were diagnosed with ordinary pneumonia, 83 were diagnosed with severe pneumonia. 227 children showed a disease course of less than 1 month, while 201 children reported a disease course of 1~3 months, and 31 children reported a disease course of more than 3 months. Statistical difference was noticed in the disease condition of respiratory tract infection of patients with various malacia extent (P < 0.05). Re-check of fiberoptic bronchoscopy was performed in 19 patients, among which 14 patients (73.7%) showed improvement compared with the previous conditions. Conclusion: Airway malacia has been frequently noticed in male children aged ≤ 2 years old. Patients with severe airway malacia were apt to develop severe pneumonia compared with those with slight or moderate malacia. Improvements or even elimination of malacia were noticed with the aging of the children and the anti-infection therapy. PMID:25356175

  2. Risk factors for pulmonary complications after percutaneous nephrolithotomy: A retrospective observational analysis.

    PubMed

    Yu, Jihion; Choi, Jae Moon; Lee, Joonho; Kwon, Koo; Kong, Yu-Gyeong; Seo, Hyungseok; Hwang, Jai-Hyun; Park, Hyung Keun; Kim, Young-Kug

    2016-08-01

    Although percutaneous nephrolithotomy is minimally invasive, it is associated with several complications, including extravasation of fluid and urine, the need for a blood transfusion, and septicemia. However, little is known about pulmonary complications after this procedure. Therefore, we aimed to evaluate the risk factors for and outcomes of pulmonary complications after percutaneous nephrolithotomy.All consecutive patients who underwent percutaneous nephrolithotomy between 2001 and 2014 were identified and divided into group A (no clinically significant pulmonary complications) and group B (clinically significant pulmonary complications). Preoperative and intraoperative variables and postoperative outcomes were evaluated. Independent risk factors for postoperative pulmonary complications were evaluated by univariate and multivariate logistic regression analyses.The study included 560 patients: 378 (67.5%) in group A and 182 (32.5%) in group B. Multivariate logistic regression analysis revealed that the independent risk factors for pulmonary complications after percutaneous nephrolithotomy were a higher body mass index (odds ratio = 1.062, P = 0.026), intraoperative red blood cell transfusion (odds ratio = 2.984, P = 0.012), and an intercostal surgical approach (odds ratio = 3.046, P < 0.001). Furthermore, the duration of hospital stay was significantly longer (8.4 ± 4.3 days vs 7.6 ± 3.4 days, P = 0.010) and the intensive care unit admission rate was significantly higher [13 (7.1%) vs 1 (0.3%), P < 0.001] in group B than in group A.Risk factors for pulmonary complications after percutaneous nephrolithotomy were a higher body mass index, intraoperative red blood cell transfusion, and an intercostal surgical approach. Postoperative pulmonary complications were associated with poor outcomes. These results may provide useful information for the perioperative management of pulmonary complications after percutaneous

  3. A qualitative retrospective analysis of positive control data in developmental neurotoxicity studies.

    PubMed

    Crofton, K M; Makris, S L; Sette, W F; Mendez, E; Raffaele, K C

    2004-01-01

    Testing for neurodevelopmental effects commonly involves both functional and neuropathological assessments in offspring during and following maternal exposure. The use of positive controls in neurotoxicity screening has been advocated by numerous expert groups. Evaluation of positive control data allows evaluation of laboratory proficiency in detecting changes in the structure and function of the developing nervous system and comparison of the sensitivity of assessments in different studies and laboratories. This project surveyed approaches taken in contract and industrial laboratories in generating and providing these data. Positive control data submitted in support of 34 developmental neurotoxicity (DNT) studies from 16 different laboratories were summarized by test method for information on the following: age relevance of test subjects, the presence of a dose-response relationship, gender, group size, statistics, report quality, quality assurance, and the year the study was conducted. Endpoints included the following: developmental landmarks, clinical observations (CO), motor activity, startle response, learning and memory, qualitative neuropathology, and quantitative brain morphometry (linear measurements of selected brain regions). Results ranged from no positive control data for three laboratories, to one laboratory that submitted 17 separate positive control reports. The qualitative range was similarly broad, from excellent to poor. Various problems were identified, including the following: inappropriate report structure (e.g., copies of poster presentations), lack of individual data, inadequate methodological details, submission of very old data (>10 years) or data from completely different laboratories, use of inappropriate positive control chemicals or doses that were without effect, lack of statistical analysis, use of only one sex, and use of incompatibly aged animals. Analyses revealed that there were only 3 out of 16 laboratories that had submitted

  4. Retrospective analysis of Bering Sea bottom trawl surveys: regime shift and ecosystem reorganization

    NASA Astrophysics Data System (ADS)

    Conners, M. E.; Hollowed, A. B.; Brown, E.

    2002-10-01

    This paper compiles data from bottom trawl surveys using variations on a 400-mesh eastern trawl gear into a 38-year time series (1963-2000), using a robust index of median catch per unit effort (CPUE) as an indicator of regional abundance. Time series are presented for three index sites in the southeastern Bering Sea: the inner shelf in Bristol Bay, the middle shelf north of Unimak Island, and the outer shelf near the Pribilof Islands. All three sites show strong evidence of a shift in benthic biomass and community structure in the early to mid-1980s. During this period, all three sites showed substantial increases in the abundances of walleye pollock, Pacific cod, rock sole, flathead sole, cartilaginous fishes (skates) and non-crab benthic invertebrates. Species composition, especially of flatfish, differs at the three sites, but the trend for groundfish abundance to increase was consistent at all three sites. The similarity in trends both across the region and across both commercial and unexploited groups suggests to us that a complete reorganization of benthic and demersal food webs may have taken place. The timing of change in trawl catch weight is consistent with effects of the strong regime shift observed in climate indices in 1976-1977. There is little evidence of similar biological responses to subsequent, less pronounced changes in climate. Our data are also consistent with recently documented shifts in ecosystem dynamics resulting from changes in ice cover and thermal structure in the eastern Bering Sea. Our analysis indicates that there was a much higher biomass of groundfish at all three sites during 1980-2000 than in 1960-1980. This result provides evidence against the hypothesis that the overall productivity of the eastern Bering Sea has decreased. The precipitous decline of the endangered Steller sea lion in this region from 1975-1985 was concurrent with an overall increase in abundance of groundfish prey.

  5. Correlates of opium use: retrospective analysis of a survey of tribal communities in Arunachal Pradesh, India

    PubMed Central

    2013-01-01

    Background Household survey data of Changlang district, Arunachal Pradesh, were used in the present study to assess the prevalence of opium use among different tribes, and to examine the association between sociodemographic factors and opium use. Methods A sample of 3421 individuals (1795 men and 1626 women) aged 15 years and older was analyzed using a multivariate logistic regression model to determine factors associated with opium use. Sociodemographic information such as age, education, occupation, religion, ethnicity and marital status were included in the analysis. Results The prevalence of opium use was significantly higher (10.6%) among men than among women (2.1%). It varied according to age, educational level, occupation, marital status and religion of the respondents. In both sexes, opium use was significantly higher among Singpho and Khamti tribes compared with other tribes. Multivariate logistic regression indicated that opium use was significantly associated with age, occupation, ethnicity, religion and marital status of the respondents of both sexes. Multivariate rate ratios (MRR) for opium use were significantly higher (4–6 times) among older age groups (≥35 years) and male respondents. In males, the MRR was also significantly higher in respondents of Buddhist and Indigenous religion, while in females, the MRR was significantly higher in Buddhists. Most of the female opium users had taken opium for more than 5 years and were introduced to it by their husbands after marriage. Use of other substances among opium users comprised mainly tobacco (76%) and alcohol (44%). Conclusions The study reveals the sociodemographic factors, such as age, sex, ethnicity, religion and occupation, which are associated with opium use. Such information is useful for institution of intervention measures to reduce opium use. PMID:23575143

  6. Results of salvage radiotherapy after inadequate surgery in invasive cervical carcinoma patients: A retrospective analysis

    SciTech Connect

    Saibishkumar, Elantholi P. . E-mail: drsaibish@rediffmail.com; Patel, Firuza D.; Ghoshal, Sushmita; Kumar, Vinay; Karunanidhi, Gunaseelan; Sharma, Suresh C.

    2005-11-01

    Purpose: To evaluate the results of salvage radiotherapy (RT) after inadequate surgery in patients with invasive carcinoma of the cervix. Methods and Materials: Between 1996 and 2001, 105 invasive cervical carcinoma patients were treated at our center with external beam RT with or without intracavitary RT after having undergone total/subtotal hysterectomy at outside institutions. Results: The median follow-up was 34 months. The gap between surgery and RT was 23-198 days (median, 80). Clinically visible residual disease was present in 81 patients (77.1%). Total hysterectomy had been done in 82 patients (78%) and subtotal hysterectomy in 23 patients (22%). The 5-year overall survival, disease-free survival, and pelvic control rates of all patients were 55.2%, 53.3%, and 72.4%, respectively. On univariate analysis, older age, total hysterectomy, hemoglobin level >10 g% before RT, nonsquamous histologic type, use of intracavitary RT, a shorter gap between surgery and RT, and the absence of, or a small volume of, residual disease favorably affected the outcome. The 5-year actuarial rate of late toxicity (Radiation Therapy Oncology Group Criteria) was 19% in the rectum, 4.8% in the bladder, 24.8% in the skin, and 14.3% in the small intestine. Conclusions: Inadequate and inappropriate surgery in invasive cervical cancer with resulting gross residual disease is common in India. Factors such as the use of intracavitary RT, the correction of anemia, and a shorter gap between surgery and RT will enable postoperative RT to achieve acceptable results with minimal morbidity.

  7. Disparities in suicide mortality trends between United States of America and 25 European countries: retrospective analysis of WHO mortality database

    PubMed Central

    Fond, Guillaume; Llorca, Pierre-Michel; Boucekine, Mohamed; Zendjidjian, Xavier; Brunel, Lore; Lancon, Christophe; Auquier, Pascal; Boyer, Laurent

    2016-01-01

    The objective was to examine changes in temporal trends in suicide mortality in 26 Western countries by retrospective trend analysis of the WHO mortality database on causes of deaths. From 1990 to 2010, there was a median reduction in suicide mortality of 22.7%, ranging from a 46% reduction in Estonia to a 26.2% increase in Romania. Suicide mortality decreased by ≥20% in 15 countries, and the reduction tended to be greater in countries with higher mortality in 1990. In most of the central European countries mortality strongly declined. The median changes in the age groups were −25.3% (range −62.9% to 72.6%) in people aged 15–24 years, −36.9% (−60.5% to 32.4%) in 25–34 years, −3.6% (−57.1% to 92%) in 35–54 years, −12.2% (−37% to 65,7%) in 55–74 years and −16.1% (−54.5% to 166.7%) in ≥75 years. Suicide prevention programs in youths and in the elderly seem to be effective (at least in females for the elderly) and efforts should be pursued in this way. However, suicide mortality of the people aged 35–54 years has increased in half of the studied countries between 1990 and 2010. Public policies should further orientate their efforts toward this population. PMID:26883796

  8. Efficacy and Safety of Low-Dose Doxepin in Depressed Patients Suffering From Insomnia: A Retrospective, Naturalistic Case Series Analysis

    PubMed Central

    Mews, Marie Rosa; Rombold, Felicitas

    2014-01-01

    Objective: Low-dose doxepin has produced favorable results in healthy adults and elderly persons with chronic or transient insomnia, while exhibiting an amenable adverse event profile. The aim of this article is to investigate the efficacy and safety of low-dose doxepin for insomnia in depressed patients. Method: In this retrospective case series analysis, the files of 17 inpatients diagnosed with major depressive disorder (MDD) and comorbid insomnia between January 1, 2011, and October 1, 2012 who had received a course of off-label doxepin (< 25 mg/d) were analyzed with regard to dose, efficacy, and safety for up to 4 weeks of treatment. Hamilton Depression Rating Scale (HDRS) sleep item scores were used to estimate efficacy. Results: Our results showed no improvement in sleep onset and sleep maintenance insomnia in patients with MDD during the 4 weeks of treatment. We found a significant improvement in insomnia between baseline and week 3 when considering all 3 HDRS sleep items (P = .058). Conclusion: Contrasting previous results in healthy subjects, low-dose doxepin does not seem to improve sleep onset or maintenance in patients with MDD. Further research, preferably placebo-controlled, double-blind sleep laboratory trials, is necessary to determine whether low-dose doxepin may be beneficial in this important patient subgroup. PMID:24940524

  9. Retrospective analysis of patients with carcinoma cervix in a rural/semi-urban setting in Western India

    PubMed Central

    Singh, Ranvijay; Shetty, Nishitha; Naveed, Maryam; Pawar, Suraj B.; Iska, Sindu; Alugubelli, Navya Reddy

    2016-01-01

    Objectives: To compare the presentation of cervical cancer and the treatment modalities received by the patients at a semi-urban/rural area of Western India with that of published literature from urban centers. Materials and Methods: We conducted a retrospective analysis of patients with cervical cancer who presented at a semi-urban/rural cancer center between 2010 and 2013. A total of 141 patients with the median age of 51 years (25-81) were studied. The demographic and clinical variables included age, annual family income, profession, comorbidities, baseline hemoglobin, prior screening, clinical stage, treatment administered, and complications. The pathological variables included tumor type and grade. Results: In our study, all patients presented with vaginal bleeding. Majority of the patients (51 patients, 37.7%) had Stage 3B disease. Since majority presented at later stages (Stage 3B), chemotherapy-radiotherapy was the most common treatment modality used in our population. On histopathology, 127 patients (90%) had squamous cell carcinoma while 14 patients (10%) had adenocarcinoma. In 96 patients (68%), the tumor grade was not known while it was a high, intermediate, and low grade in 6 (4%), 18 (13%), and 21 (15%) patients, respectively. The follow-up data of our study were not adequate; hence, the long-term survival results could not be presented. Conclusion: Patients in rural India setting present at later stages which could be improved by creating awareness, improving their personal hygiene, and adequate screening. PMID:27051153

  10. Disparities in suicide mortality trends between United States of America and 25 European countries: retrospective analysis of WHO mortality database.

    PubMed

    Fond, Guillaume; Llorca, Pierre-Michel; Boucekine, Mohamed; Zendjidjian, Xavier; Brunel, Lore; Lancon, Christophe; Auquier, Pascal; Boyer, Laurent

    2016-01-01

    The objective was to examine changes in temporal trends in suicide mortality in 26 Western countries by retrospective trend analysis of the WHO mortality database on causes of deaths. From 1990 to 2010, there was a median reduction in suicide mortality of 22.7%, ranging from a 46% reduction in Estonia to a 26.2% increase in Romania. Suicide mortality decreased by ≥ 20% in 15 countries, and the reduction tended to be greater in countries with higher mortality in 1990. In most of the central European countries mortality strongly declined. The median changes in the age groups were -25.3% (range -62.9% to 72.6%) in people aged 15-24 years, -36.9% (-60.5% to 32.4%) in 25-34 years, -3.6% (-57.1% to 92%) in 35-54 years, -12.2% (-37% to 65,7%) in 55-74 years and -16.1% (-54.5% to 166.7%) in ≥ 75 years. Suicide prevention programs in youths and in the elderly seem to be effective (at least in females for the elderly) and efforts should be pursued in this way. However, suicide mortality of the people aged 35-54 years has increased in half of the studied countries between 1990 and 2010. Public policies should further orientate their efforts toward this population. PMID:26883796

  11. Design of a computerized system for the retrospective analysis by the physician of his own drug prescriptions.

    PubMed

    Liu, J H; Venot, A

    2001-01-01

    The quality of drug prescription is known to be poor in many medical domains. Feedback information may help the physician to improve this component of his medical activity. The increasing use of computerized drug prescription systems makes possible the retrospective processing of prescriptions made over a given time period. This paper describes the design of a computerized system for providing feedback information to the physician about the quality of his drug prescribing activity. It is designed to be used by the physician himself. The analysis is based on two groups of quantitative indicators, simple and composite. The constraints that must be satisfied to calculate these indices automatically are given. They are related to the coding systems used for drug prescription, knowledge on drugs and patient data. The system design is based on modeling according to UML formalism. We give also a concrete view of the main functions of the system, based on a pictorial illustration with a component of the user interface. Some limitations and the possible extensions of this system for analyzing simultaneously the prescriptions made by set of physicians are discussed. PMID:11604915

  12. Surgical Treatment and Prognosis of Angiosarcoma of the Scalp: A Retrospective Analysis of 14 Patients in a Single Institution

    PubMed Central

    Choi, Jun Ho; Ahn, Kyung Chan; Chang, Hak; Minn, Kyung Won; Jin, Ung Sik; Kim, Byung Jun

    2015-01-01

    Objective. We describe specific surgical methods for angiosarcoma regarding extent of resection and reconstructive options and assess their effect on patients' prognosis. Patients and Methods. We retrospectively examined 14 patients undergoing treatment for angiosarcoma of the scalp at our institute between January 2000 and June 2015. Surgical treatment comprised wide excision of the tumor and reconstruction using a free flap with skin graft. Kaplan-Meier survival analysis was used to assess the survival parameters. Univariate and multivariate analyses were performed to evaluate the association between risk factors and outcome parameters. Results. Mean patient age at diagnosis was 69 years, and the mean follow-up period was 17 months. The overall 5- and 2-year survival rates were 15% and 75%, respectively, whereas the 5- and 2-year disease-free survival rates were 7.7% and 38.7%, respectively. The mean survival duration was 32 months. Metastatic tumor dissemination to the lung or brain was closely associated with the major cause of death. Only a deep excision margin was significantly related to the recurrence rate. Conclusions. Cases of angiosarcoma had a poor prognosis despite the aggressive treatments. Sufficient resection margins are essential for controlling local recurrence. The effect of multidisciplinary approaches needs to be explored. PMID:26713314

  13. Public accessibility of biomedical articles from PubMed Central reduces journal readership--retrospective cohort analysis.

    PubMed

    Davis, Philip M

    2013-07-01

    Does PubMed Central--a government-run digital archive of biomedical articles--compete with scientific society journals? A longitudinal, retrospective cohort analysis of 13,223 articles (5999 treatment, 7224 control) published in 14 society-run biomedical research journals in nutrition, experimental biology, physiology, and radiology between February 2008 and January 2011 reveals a 21.4% reduction in full-text hypertext markup language (HTML) article downloads and a 13.8% reduction in portable document format (PDF) article downloads from the journals' websites when U.S. National Institutes of Health-sponsored articles (treatment) become freely available from the PubMed Central repository. In addition, the effect of PubMed Central on reducing PDF article downloads is increasing over time, growing at a rate of 1.6% per year. There was no longitudinal effect for full-text HTML downloads. While PubMed Central may be providing complementary access to readers traditionally underserved by scientific journals, the loss of article readership from the journal website may weaken the ability of the journal to build communities of interest around research papers, impede the communication of news and events to scientific society members and journal readers, and reduce the perceived value of the journal to institutional subscribers. PMID:23554455

  14. Prognostic factors for patients with cervical cancer treated with concurrent chemoradiotherapy: a retrospective analysis in a Japanese cohort

    PubMed Central

    Endo, Daisuke; Okamoto, Kazuhira; Minobe, Shinichiro; Kato, Hidenori; Nishiyama, Noriaki

    2015-01-01

    Objective Concurrent chemoradiotherapy (CCRT) is the primary treatment for locally advanced cervical cancer. We studied prognostic factors for patients treated with CCRT. Methods We retrospectively reviewed records of 85 consecutive patients with cervical cancer who were treated with CCRT between 2002 and 2011, with external beam radiation therapy, intracavitary brachytherapy, and platinum-based chemotherapy. Survival data were analyzed with Kaplan-Meier methods and Cox proportional hazard models. Results Of the 85 patients, 69 patients (81%) had International Federation of Gynecology and Obstetrics (FIGO) stage III/IV disease; 25 patients (29%) had pelvic lymph node enlargement (based on magnetic resonance imaging), and 64 patients (75%) achieved clinical remission following treatment. Median maximum tumor diameter was 5.5 cm. The 3- and 5-year overall survival rates were 60.3% and 55.5%, respectively. Cox regression analysis showed tumor diameter >6 cm (hazard ratio [HR], 2.3; 95% confidence interval [CI], 1.2 to 4.6), pelvic lymph node enlargement (HR, 2.2; 95% CI, 1.1 to 4.5), and distant metastasis (HR, 10.0; 95% CI, 3.7 to 27.0) were significantly and independently related to poor outcomes. Conclusion New treatment strategies should be considered for locally advanced cervical cancers with tumors >6 cm and radiologically enlarged pelvic lymph nodes. PMID:25310853

  15. Clinical and epidemiological features of leishmaniasis in northwestern-Argentina through a retrospective analysis of recent cases.

    PubMed

    García Bustos, María F; González-Prieto, Gabriela; Ramos, Federico; Mora, María C; Hashiguchi, Yoshihisa; Parodi, Cecilia; Basombrío, Miguel A; Moreno, Sonia; Monroig, Sibila; Beckar, Josefina; Jaime, Daniela; Sajama, Jesús; Yeo, Matthew; Marco, Jorge D; Locatelli, Fabricio M; Barrio, Alejandra

    2016-02-01

    Leishmaniasis is a parasitic disease caused by hemoflagellates of the genus Leishmania and is transmitted to humans by the bite of infected phlebotomine sandflies. Depending on the Leishmania species, the disease has different clinical forms including cutaneous, mucocutaneous, and visceral manifestations. Previous studies performed in endemic zones of northwestern-Argentina, during epidemic outbreaks, have been important for detecting patients suffering from the acute phase of the disease, but have not given a complete representation of the clinical and epidemiological features in the region. Furthermore, due to the resurgence of leishmaniasis worldwide and in particular the large increase of international tourism to the region, it seems pertinent to update the current epidemiological and clinical profile of leishmaniasis in northwestern-Argentina. Here we present a retrospective analysis of 95 Leishmania positive cases, presenting between 2000 and 2014. Patients were derived from hospitals and diagnosed in our lab at the University of Salta, located in a non-endemic area in Salta, Argentina. We detected numerous extensive mucocutaneous cases (34/95, 35.8%) distinct from mucosal affected patients, some instances originating in locations with no previously reported human cases. Additionally patients suffering from concomitant diseases, besides leishmaniasis, were assessed. These included Chagas disease, syphilis, deep mycoses, tuberculosis, toxoplasmosis and intestinal parasitosis. This study updates the clinical and epidemiological features of leishmaniasis in northwestern-Argentina, and discusses the implications and management strategy for patients who acquire the disease in this region. PMID:26611809

  16. Advanced biliary tract carcinomas: a retrospective multicenter analysis of first and second-line chemotherapy

    PubMed Central

    2014-01-01

    Background Gemcitabine/Cisplatin (Gem/CDDP) combination has demonstrated a clear survival advantage over gemcitabine alone and has become a new standard in advanced Biliary Tract Carcinoma (aBTC). However, Gemcitabine/Oxaliplatin (GEMOX) combination and Gemcitabine/Carboplatin (Gem/Carb) combination regimens have shown efficacy in phase II trials and there is no comparative study between different platinum salts. We assessed the efficacy and safety of different platinum-based chemotherapies at first line in aBTC patients. We also analysed the second-line chemotherapy. Methods Sixty-four consecutive patients with aBTC diagnosed between 1998 and 2010 were included for analysis. At first line chemotherapy, 44 patients received one day GEMOX regimen (gemcitabine 1000 mg/m2 and oxaliplatin 100 mg/m2 Day 1, every 2 weeks), and 20 patients received Gem/Carb regimen (gemcitabine at 1000 mg/m2 Days 1 and 8 with carboplatin delivered according to an area-under-the-curve (AUC) 5 at day 1, every 3 weeks). At second line, a total of 16 patients received a fluoropyrimidine-based chemotherapy. Results With GEMOX regimen, median progression-free survival (PFS) was 3.7 months (95%CI, 2.4 to 5) and median overall survival (OS) was 10.5 months (95%CI, 6.4 to14.7). The main toxicity was peripheral neuropathy (20% grade 2 and 7% grade 3). Grade 3/4 haematological toxicities were rare. With Gem/Carb regimen, PFS was 2.5 months (95%CI, 2.1 to 3.7) and OS was 4.8 months (95%CI, 3.7 to 5.8). The main grade 3/4 toxicities were haematological: anaemia (45%), thrombocytopenia (45%), and neutropenia (40%). At second-line, fluoropyrimidine-based chemotherapy was feasible in only a fourth of the patients. The median OS was 5.3 months (95%CI, 4.1 to 6.6), and median PFS was 4.0 months (95%CI, 2.6 to 5.5). Conclusions One day GEMOX regimen has a favourable toxicity profile and could be an alternative to standard Gem/CDDP regimen, in particular in unfit patients for CDDP. At second

  17. The Ofidia Project: a Retrospective Fire Danger Forecast Analysis in Mediterranean Environment

    NASA Astrophysics Data System (ADS)

    Sirca, C.; Bacciu, V. M.; Salis, M.; Mirto, L.; Fiore, S.; Aloisio, G.; Spano, D.

    2015-12-01

    OFIDIA (Operational FIre Danger preventIon plAtform) is a two-year project started in May 2013 funded by the European Territorial Cooperation Programme Greece Italy (2007 - 2013). The project aims to improve the operational capability of forecasting, preventing, and fighting forest wildfires, and enhance the cross-border cooperation for fire danger assessment. More specifically, OFIDIA aims at developing an operational fire danger prevention platform, with the ability for near real-time fire danger forecast and fire behaviour analysis in Apulia (Italy) and Epirus (Greece) regions to help forest fires services in the effective prevention and response to forecasted danger.One of the preliminary activities of the project was the evaluation of fire danger performances by analysing the relationship between the predicted daily fire danger and observed fire activity (number of fires and area burned). To achieve this task, fire activity and danger patterns were characterised and their relationships were investigated for the period 2000-2012. The Italian Forest Service (CFS, Corpo Forestale dello Stato) provided fire statistics at NUT03 level. The data were homogenized and uncertainties corrected, and then burned area and number of fires were analysed according to the main fire regime characteristics (seasonality, fire return interval, fire incidence, fire size distribution, etc). Then, three fire danger models (FFWI, FWI, and IFI) were selected and computed starting from the fifth-generation Pennsylvania State University-National Center for Atmospheric Research Mesoscale Model (MM5) forecast.Results showed a high inter- and intra-annual variability in fire activiy, also considering the different type of affected vegetation. As for other Mediterranean areas, a smaller number of large fires caused a high proportion of burned area. Furthermore, fire activity showed significant correlations with the outputs obtained by the applied models. High relationships were found between

  18. Human fascioliasis in Argentina: retrospective overview, critical analysis and baseline for future research

    PubMed Central

    2011-01-01

    surveys suggest human endemic situations. This analysis highlights that human fascioliasis may have been overlooked in the past and its real epidemiological situation in high risk rural, mainly altitudinal areas, may currently be underestimated. Results provide a valuable baseline on which to design appropriate multidisciplinary studies on humans, animals and lymnaeids to assess up to which level and in which areas, human fascioliasis may represent a health problem in Argentina. PMID:21663691

  19. Identifying Gender-Preferred Communication Styles within Online Cancer Communities: A Retrospective, Longitudinal Analysis

    PubMed Central

    Durant, Kathleen T.; McCray, Alexa T.; Safran, Charles

    2012-01-01

    Background The goal of this research is to determine if different gender-preferred social styles can be observed within the user interactions at an online cancer community. To achieve this goal, we identify and measure variables that pertain to each gender-specific social style. Methods and Findings We perform social network and statistical analysis on the communication flow of 8,388 members at six different cancer forums over eight years. Kruskal-Wallis tests were conducted to measure the difference between the number of intimate (and highly intimate) dyads, relationship length, and number of communications. We determine that two patients are more likely to form an intimate bond on a gender-specific cancer forum (ovarian P = <0.0001, breast P = 0.0089, prostate P = 0.0021). Two female patients are more likely to form a highly intimate bond on a female-specific cancer forum (Ovarian P<0.0001, Breast P<0.01). Typically a male patient communicates with more members than a female patient (Ovarian forum P = 0.0406, Breast forum P = 0.0013). A relationship between two patients is longer on the gender-specific cancer forums than a connection between two members not identified as patients (ovarian forum P = 0.00406, breast forum P = 0.00013, prostate forum P = .0.0003). Conclusion The high level of interconnectedness among the prostate patients supports the hypothesis that men prefer to socialize in large, interconnected, less-intimate groups. A female patient is more likely to form a highly intimate connection with another female patient; this finding is consistent with the hypothesis that woman prefer fewer, more intimate connections. The relationships of same-gender cancer patients last longer than other relationships; this finding demonstrates homophily within these online communities. Our findings regarding online communication preferences are in agreement with research findings from person-to-person communication preference studies

  20. Retrospective Analysis of Recent Flood Events With Persistent High Surface Runoff From Hydrological Modelling

    NASA Astrophysics Data System (ADS)

    Joshi, S.; Hakeem, K. Abdul; Raju, P. V.; Rao, V. V.; Yadav, A.; Diwakar, P. G.; Dadhwal, V. K.

    2014-11-01

    /locations with probable flooding conditions. These thresholds were refined through iterative process by comparing with satellite data derived flood maps of 2013 and 2014 monsoon season over India. India encountered many cyclonic flood events during Oct-Dec 2013, among which Phailin, Lehar, and Madi were rated to be very severe cyclonic storm. The path and intensity of these cyclonic events was very well captured by the model and areas were marked with persistent coverage of high runoff risk/flooded area. These thresholds were used to monitor floods in Jammu Kashmir during 4-5 Sep and Odisha during 8-9 Aug, 2014. The analysis indicated the need to vary the thresholds across space considering the terrain and geographical conditions. With respect to this a sub-basin wise study was made based on terrain characteristics (slope, elevation) using Aster DEM. It was found that basins with higher elevation represent higher thresholds as compared to basins with lesser elevation. The results show very promising correlation with the satellite derived flood maps. Further refinement and optimization of thresholds, varying them spatially accounting for topographic/terrain conditions, would lead to estimation of high runoff/flood risk areas for both riverine and drainage congested areas. Use of weather forecast data (NCMWRF, (GEFS/R)), etc. would enhance the scope to develop early warning systems.

  1. Dental arch changes associated with rapid maxillary expansion: A retrospective model analysis study

    PubMed Central

    D’Souza, Ivor M; Kumar, H. C. Kiran; Shetty, K. Sadashiva

    2015-01-01

    Introduction: Transverse deficiency of the maxilla is a common clinical problem in orthodontics and dentofacial orthopedics. Transverse maxillary deficiency, isolated or associated with other dentofacial deformities, results in esthetic and functional impairment giving rise to several clinical manifestations such as asymmetrical facial growth, positional and functional mandibular deviations, altered dentofacial esthetics, adverse periodontal responses, unstable dental tipping, and other functional problems. Orthopedic maxillary expansion is the preferred treatment approach to increase the maxillary transverse dimension in young patients by splitting of the mid palatal suture. This orthopedic procedure has lately been subject of renewed interest in orthodontic treatment mechanics because of its potential for increasing arch perimeter to alleviate crowding in the maxillary arch without adversely affecting facial profile. Hence, the present investigation was conducted to establish a correlation between transverse expansion and changes in the arch perimeter, arch width and arch length. Methods: For this purpose, 10 subjects (five males, five females) were selected who had been treated by rapid maxillary expansion (RME) using hyrax rapid palatal expander followed by fixed mechanotherapy (PEA). Pretreatment (T1), postexpansion (T2), and posttreatment (T3) dental models were compared for dental changes brought about by RME treatment and its stability at the end of fixed mechanotherapy. After model measurements were made, the changes between T1–T2, T2–T3 and T1–T3 were determined for each patient. The mean difference between T1–T2, T2–T3 and T1–T3 were compared to assess the effects of RME on dental arch measurements. Results are expressed as mean ± standard deviation and are compared by repeated measures analysis of variance followed by a post-hoc test. Arch perimeter changes are correlated with changes in arch widths at the canine, premolar and molar regions

  2. Clinicopathological Characteristics of Mucinous Breast Cancer: A Retrospective Analysis of a 10-Year Study

    PubMed Central

    Chen, Bo; Chen, Zhanhong; Wang, Xiaojia

    2016-01-01

    Background Mucinous breast carcinoma (MC) is a special type of breast cancer that presents with a large amount of extracellular mucin. MC comprises approximately 4% of all invasive breast cancers. This type of tumor has a better prognosis and higher incidence in peri- and post-menopausal patients. Pathologically, there are two main subtypes of MC: pure and mixed. In this study, we describe 10 years of experience with MC at the Zhejiang Cancer Hospital in China, specifically, clinical data, histological findings and immunohistochemical features. Methods We identified MC patients who were diagnosed as operable and completed clinical treatment from January 2001 to January 2011. The clinicopathological data included the age at diagnosis, tumor size, TNM stage, presence and number of lymph node (LN) metastases, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) status and p53 expression. If the tumor was defined as mixed mucinous carcinoma (MMC), IHC was performed on a non-mucinous part, such as invasive ductal and lobular cancer. We evaluated the clinical characteristics of all MC patients using chi-square, one-way ANOVA and LSD tests. We also studied the correlations between all of the clinical parameters and LN metastasis in a binary logistic regression analysis. We used ten consecutive years of data that were collected at Zhejiang Cancer Hospital. Results We identified 48 cases of pure mucinous carcinoma (PMC) and 77 cases of MMC. The 48 PMC cases consisted of 38 PMC-A and 10 PMC-B subtypes. The MMCs were divided into two groups, those with partial mixed mucinous breast carcinoma (pMMC, 58 cases) and those with main mixed mucinous breast carcinoma (mMMC, 19 cases). pMMC was defined by tumors with less than 50% mucinous components, while mMMC was defined by tumors where the mucinous component accounted for 50% to 90% of the tumor. No significant differences in the clinicopathological characteristics were noted

  3. National Library of Medicine Celebrates 30 Years of Progress and Charts the Future | NIH MedlinePlus the Magazine

    MedlinePlus

    ... Celebrates 30 Years of Progress and Charts the Future Past Issues / Summer 2014 Table of Contents The ... years, and help chart its course for the future. They were drawn to "The National Library of ...

  4. A 35-40% Likelihood of a Highly Damaging Tokyo Earthquake in Next 30 Years

    NASA Astrophysics Data System (ADS)

    Stein, R. S.; Toda, S.; Parsons, T.; Bozkurt, S. B.

    2005-12-01

    Tokyo and its outlying cities are home to one-quarter of Japan's 127 million people. Highly destructive earthquakes struck the capital in 1703, 1855 and 1923, the last of which took 105,000 lives. Reoccurrence of any of these shocks today would cost about one trillion dollars, of which perhaps 10% is insured. Fueled by Tokyo's rich data trove but hindered by its complexity, we carried out a new hazard assessment. We used the prehistoric record of great earthquakes preserved in uplifted marine terraces and tsunami deposits (17 M~8 shocks in the past 7,000 years), historical shaking (10,000 intensity observations in the past 400 years), the dense modern seismic network (300,000 earthquakes in the past 30 years), and the world's best geodetic array (150 GPS vectors spanning the past 10 years). We propose that a dislodged block of the Pacific plate is jammed between the Pacific, Philippine Sea and Eurasian plates beneath Tokyo, and controls much of Tokyo's seismic behavior for M≤7.5 shocks, including the damaging 1855 M~7.3 Ansei-Edo shock. On the basis of frequency-magnitude curves, earthquakes similar to the Ansei-Edo event should be quite frequent (25-35% likelihood in an average 30-yr period), and so such events dominate the combined probabilities. In contrast, our renewal model for the great 1703 and 1923 type plate boundary shocks yields a ~1% probability for the next 30 yr, with a time-averaged 30-yr probability of ~8%. The resulting net likelihood for severe shaking in Tokyo, Kawasaki, and Yokohama for the next 30 years is 25%-40%, but how can it be validated? The long historical record in Kanto affords a rare opportunity to calculate the probability of shaking in an alternative manner, based almost exclusively on intensity observations. This approach permits robust estimates for the spatial distribution of shaking, even for sites with few observations. The resulting probability of severe shaking over an average 30-yr period is ~35% in the Tokyo, Kawasaki

  5. Prevalence of metastasis in T1b esophageal squamous cell carcinoma: a retrospective analysis of 258 Chinese patients

    PubMed Central

    Qi, Xiaotong; Li, Mingna; Zhao, Sheng; Luo, Jinhua; Shao, Yongfeng

    2016-01-01

    Background There is controversy regarding the impact of different depths of submucosal invasion on lymph node metastasis (LNM) and overall survival (OS). We evaluated the impact of depth of submucosal invasion on the presence of metastatic lymphadenopathy and survival in a Chinese population with esophageal squamous cell carcinoma (ESCC). Methods A total of 258 patients who underwent esophagectomy from November 2009 to March 2014 were studied. Demographics of patients, tumor characteristics, and surgical information were retrospectively collected through medical records. Submucosal invasion was equally categorized into inner one-third (sm1), middle one-third (sm2), and deep one-third (sm3) invasion by pathologists. The patients were observed at the outpatient department in accordance with appointed time and recurrence, and deaths were recorded. The median follow-up duration was 26 months and the deadline was April 2015. Cancer characteristics and its association with LNM and OS were analyzed. Results The study included 75 (29.1%) sm1, 73 (28.3%) sm2, and 110 (42.6%) sm3 patients, and the rates of LNM were 12% (9/75), 11% (8/73), and 20.9% (23/110), respectively. sm3 might be associated with regional LNM (univariate analysis, P=0.041). Tumor volume >1.856 cm3 (P=0.022) and lymphovascular invasion (LVI) (P=0.004) predicted LNM using multivariate analysis. No significant differences in distant metastases were observed according to the depth of invasion. Only metastatic lymph nodes predicted OS (P<0.001) rather than the depth of invasion. Conclusions Submucosal ESCC showed a substantial rate of LNM. In T1b ESCC, after adjusting for possible covariates, depth of invasion does not predict LNM or OS. PMID:27162673

  6. Health and economic outcomes associated with uncontrolled surgical bleeding: a retrospective analysis of the Premier Perspectives Database

    PubMed Central

    Corral, Mitra; Ferko, Nicole; Hollmann, Sarah; Broder, Michael S; Chang, Eunice

    2015-01-01

    Background Bleeding remains a common occurrence in surgery. Data describing the burden of difficult-to-control bleeding and topical absorbable hemostat use are sparse. This study was conducted to estimate the clinical and economic impact that remains associated with uncontrolled surgical bleeding, even when hemostats are used during surgery. Methods This US retrospective analysis used the Premier Perspectives Database. Hospital discharges from 2012 were used to identify patients treated with hemostats during eight surgery types. Patients were included if they were ≥18 years, had an inpatient hospitalization with one of the eight surgeries, and received a hemostat on the day of surgery. Patients were stratified by procedure and presence or absence of major bleeding (uncontrolled) despite hemostat use. Outcomes were all-cause hospitalization costs, hemostat costs, length of stay, reoperation, and surgery-related complications (eg, mortality). Statistical significance was tested through chi-square or t-tests. Multivariate analyses were conducted for all-cause costs and length of stay using analysis of covariance. Results Among 25,048 procedures, major bleeding events occurred in 14,251 cases. Despite treatment with hemostats, major bleeding occurred in 32%–68% of cases. All-cause costs were significantly higher in patients with uncontrolled bleeding despite hemostat use versus controlled bleeding (US$24,203–$61,323 [uncontrolled], US$14,420–$45,593 [controlled]; P<0.001). Hemostat costs were significantly greater in the uncontrolled bleeding cohort for all surgery types except cystectomy and pancreatic surgery. Reoperation and mortality rates were significantly higher in the uncontrolled bleeding cohort in all surgical procedures except cystectomy and radical hysterectomy. Conclusion Uncontrolled intraoperative bleeding despite hemostat use is prevalent and associated with significantly higher hospital costs and worse clinical outcomes across several surgical

  7. Impact of Preexisting Interstitial Lung Disease on Acute, Extensive Radiation Pneumonitis: Retrospective Analysis of Patients with Lung Cancer

    PubMed Central

    Ozawa, Yuichi; Abe, Takefumi; Omae, Minako; Matsui, Takashi; Kato, Masato; Hasegawa, Hirotsugu; Enomoto, Yasunori; Ishihara, Takeaki; Inui, Naoki; Yamada, Kazunari; Yokomura, Koshi; Suda, Takafumi

    2015-01-01

    Introduction This study investigated the clinical characteristics and predictive factors for developing acute extended radiation pneumonitis with a focus on the presence and radiological characteristics of preexisting interstitial lung disease. Methods Of 1429 irradiations for lung cancer from May 2006 to August 2013, we reviewed 651 irradiations involving the lung field. The presence, compatibility with usual interstitial pneumonia, and occupying area of preexisting interstitial lung disease were retrospectively evaluated by pretreatment computed tomography. Cases of non-infectious, non-cardiogenic, acute respiratory failure with an extended bilateral shadow developing within 30 days after the last irradiation were defined as acute extended radiation pneumonitis. Results Nine (1.4%) patients developed acute extended radiation pneumonitis a mean of 6.7 days after the last irradiation. Although preexisting interstitial lung disease was found in 13% of patients (84 patients), 78% of patients (7 patients) with acute extended radiation pneumonitis cases had preexisting interstitial lung disease, which resulted in incidences of acute extended radiation pneumonitis of 0.35 and 8.3% in patients without and with preexisting interstitial lung disease, respectively. Multivariate logistic analysis indicated that the presence of preexisting interstitial lung disease (odds ratio = 22.6; 95% confidence interval = 5.29–155; p < 0.001) and performance status (≥2; odds ratio = 4.22; 95% confidence interval = 1.06–20.8; p = 0.049) were significant predictive factors. Further analysis of the 84 patients with preexisting interstitial lung disease revealed that involvement of more than 10% of the lung field was the only independent predictive factor associated with the risk of acute extended radiation pneumonitis (odds ratio = 6.14; 95% confidence interval = 1.0–37.4); p = 0.038). Conclusions Pretreatment computed tomography evaluations of the presence of and area size occupied

  8. Prevalence, psychological impact, and risk factors of erectile dysfunction in patients with Peyronie's disease: a retrospective analysis of 309 cases.

    PubMed

    Paulis, Gianni; Romano, Gennaro; Paulis, Andrea

    2016-01-01

    Peyronie's disease (PD) is a chronic inflammatory disease involving the tunica albuginea of the penis. Erectile dysfunction (ED) is a possible invalidating symptom of PD. The aim of this study was to evaluate the prevalence, psychological impact, and risk factors of ED in patients with PD. The study was conducted by carrying out a retrospective analysis of the clinical records of 309 patients with PD who visited our andrology clinic. All patients underwent the following tests: body mass index, common blood tests and hormone assays, questionnaire for erectile function assessment, dynamic penile color Doppler ultrasonography, imaging of the penis at maximum erection with photographic poses according to Kelâmi, psychosexual impact evaluation with PD Questionnaire (symptom bother score), evaluation of depression symptoms with the Patient Health Questionnaire-9, and evaluation of the intensity of penile pain with the pain intensity numeric rating scale. ED was observed in 37.5% of the cases. We divided the cases into two groups: group A (PD + ED), 116 cases, and group B (PD without ED), 193 cases. After multivariate analysis, we concluded that the following comorbidities are independent risk factors for ED: dyslipidemia, obesity, chronic prostatitis, benign prostatic hyperplasia, and autoimmune diseases. A depressive disorder was observed in 62.4%, and it was more frequent in patients with PD + ED (91.37% versus 45.07% group B). Sexual bother was greater in group A compared with group B (9.7 versus 7.6). Intensities of depressive symptoms and sexual bother were significantly higher compared with cases with no curvature when the bend angle was ≥30°. Our study confirms that an integrated psychological support with medical treatment is needed in patients with PD. PMID:27486570

  9. [Italian physician's needs for medical information. Retrospective analysis of the medical information service provided by Novartis Pharma to clinicians].

    PubMed

    Speroni, Elisabetta; Poggi, Susanna; Vinaccia, Vincenza

    2013-10-01

    The physician's need for medical information updates has been studied extensively in recent years but the point of view of the pharmaceutical industry on this need has rarely been considered. This paper reports the results of a retrospective analysis of the medical information service provided to Italian physicians by an important pharmaceutical company, Novartis Pharma, from 2004 to 2012. The results confirm clinicians' appreciation of a service that gives them access to tailored scientific documentation and the number of requests made to the network of medical representatives has been rising steadily, peaking whenever new drugs become available to physicians. The analysis confirms what -other international studies have ascertained, that most queries are about how to use the drugs and what their properties are. The results highlight some differences between different medical specialties: for example, proportionally, neurologists seem to be the most curious. This, as well as other interesting snippets, is worth further exploration. Despite its limits in terms of representativeness, what comes out of the study is the existence of an real unmet need for information by healthcare institutions and that the support offered by the pharmaceutical industry could be invaluable; its role could go well beyond that of a mere supplier to National Healthcare Systems, to that of being recognised as an active partner the process of ensuring balanced and evidence-based information. At the same time, closer appraisal of clinicians' needs could help the pharma industries to improve their communication and educational strategies in presenting their latest clinical research and their own products. PMID:24326704

  10. Trends in consultant clinical activity and the effect of the 2003 contract change: retrospective analysis of secondary data

    PubMed Central

    Bloor, Karen; Freemantle, Nick; Maynard, Alan

    2012-01-01

    Objectives To explore trends in the clinical activity of hospital specialists in English National Health Service (NHS) hospitals, and test the effect of contract reform. Design Retrospective secondary analysis of hospital episode statistics, describing trends and testing for a contract effect using multilevel interrupted time series analysis. Setting Ten surgical and medical specialties in English NHS hospitals from 1999 to 2009. Participants Hospital consultants on full time or maximum part-time English NHS hospitals. Intervention A new contract offered to NHS consultants in October 2003, with higher pay alongside job planning and appraisal. Main outcome measures Inpatient finished consultant episodes (FCEs) per consultant per month, with and without accounting for case-mix differences. Results In most specialties there was a statistically significant downward trend in FCEs per consultant per month. On average in the surgical specialties, FCEs reduced by 0.14 per month (95% CI −0.16 to −0.11) and in medicine there was a smaller reduction of 0.08 FCEs per month (95% CI −0.1 to −0.06). NHS patients symptoms have increased in severity over time, and the downward trend is reduced after case-mix-adjustment, and reversed in general and geriatric medicine. The effect of the contract on clinical activity was minimal. In five specialties there was no statistically significant effect, but in five specialties there was a statistically significant negative effect. Conclusions Consultant clinical activity, as measured by FCEs per month, has shown a general downward trend from 1999 to 2009. The consultant contract was not associated with an increase in consultant clinical activity rates. PMID:23239240

  11. Survival analysis of Y-90 radiosynovectomy in the treatment of haemophilic synovitis of the knee: a 10-year retrospective review.

    PubMed

    Turkmen, C; Kilicoglu, O; Dikici, F; Bezgal, F; Kuyumcu, S; Gorgun, O; Taser, O; Zulfikar, B

    2014-01-01

    Despite recent advances including new therapeutic options and availability of primary prophylaxis in haemophiliacs, haemophilic synovitis is still the major clinical problem in significant patient population worldwide. We retrospectively reviewed our 10-year experience with Y-90 radiosynovectomy to determine the outcome in the knee joints of patients with haemophilic synovitis. Between 2002 and 2012, 82 knee joints of 67 patients with haemophilic synovitis were treated with Y-90 radiosynovectomy. The mean age was 16.8 ± 7.8 years (range: 5-39 years). The mean follow-up period was 39.6 ± 25.6 months (range: 12-95 months). Failure of therapy represented re-bleeding after a radiosynovectomy was used as an end point in patient time to progression (TTP) analysis. The median TTP was calculated as 72.0 ± 3.6 months (95% CI 64.8-79.1 months) in Kaplan-Meier analysis. The 1, 3 and 5-year survival rates were 89%, 73% and 63% respectively. Longer TTP (hazard ratio for progression, 2.5; P = 0.00) was evident in patients who have greater reduction in bleeding frequency within 6 months after radiosynovectomy. We did not find a relationship between the TTP and the following variables: age, type and severity of haemophilia, the presence or absence of inhibitor, the radiological score, range of motion status of joints and the pretreatment bleeding frequency. We concluded that Y-90 radiosynovectomy in knee joint represents an important resource for the treatment of haemophilic synovitis, markedly reducing joint bleeding and long-term durability, irrespective of the radiographic stage and inhibitor status. PMID:23937560

  12. Effect of dual pulmonary vasodilator therapy in pulmonary arterial hypertension associated with congenital heart disease: a retrospective analysis

    PubMed Central

    Monfredi, Oliver; Heward, Elliot; Griffiths, Linda; Condliffe, Robin; Mahadevan, Vaikom S

    2016-01-01

    Background Patients with pulmonary arterial hypertension (PAH) are managed according to evidence-based treatment guidelines. Methods and results In this single-centre retrospective analysis, we examined outcomes of patients with PAH caused by congenital heart disease (PAH-CHD) with respect to exercise capacity and survival of adults treated with either bosentan or sildenafil monotherapy or bosentan-sildenafil dual therapy between January 2007 and January 2014. Of the 82 patients analysed, 29 had Down syndrome; 54 (65.8%) received bosentan monotherapy, 16 (19.5%) sildenafil monotherapy and 12 (14.6%) dual therapy. Mean treatment duration was 2.5 years for all patients and 4.1 years for 38 patients treated for ≥2 years. Pooled patient and treatment data showed initial improvement followed by stabilisation in mean 6 min walk distance (6MWD). For Down and non-Down patients, mean 6MWD increased and then stabilised on bosentan monotherapy. Mean 6MWD of patients on dual therapy at the time of analysis was 246.3 m before PAH-specific therapy initiation, 211.9 m immediately prior to addition of a second therapy and 214.4 m at last visit while on dual therapy. 1, 2 and 3-year survival rates for all patients from time of treatment initiation were 96%, 87% and 80%, respectively. Conclusions For the majority of patients, monotherapy with a PAH-specific medication provided improved and sustained exercise benefits. For the small percentage of patients who required it, add-on therapy appeared to prevent further deterioration in exercise capacity but did not improve 6MWD. PMID:27099763

  13. Prognostic factors for outcomes after whole-brain irradiation of brain metastases from relatively radioresistant tumors: a retrospective analysis

    PubMed Central

    2010-01-01

    Background This study investigated potential prognostic factors in patients treated with whole-brain irradiation (WBI) alone for brain metastases from relatively radioresistant tumors such as malignant melanoma, renal cell carcinoma, and colorectal cancer. Additionally, a potential benefit from escalating the radiation dose was investigated. Methods Data from 220 patients were retrospectively analyzed for overall survival and local control. Nine potential prognostic factors were evaluated: tumor type, WBI schedule, age, gender, Karnofsky performance score, number of brain metastases, extracerebral metastases, interval from diagnosis of cancer to WBI, and recursive partitioning analysis (RPA) class. Results Survival rates at 6 and 12 months were 32% and 19%, respectively. In the multivariate analysis, WBI doses >30 Gy (p = 0.038), KPS ≥70 (p < 0.001), only 1-3 brain metastases (p = 0.007), no extracerebral metastases (p < 0.001), and RPA class 1 (p < 0.001) were associated with improved survival. Local control rates at 6 and 12 months were 37% and 15%, respectively. In the multivariate analyses, KPS ≥70 (p < 0.001), only 1-3 brain metastases (p < 0.001), and RPA class 1 (p < 0.001) were associated with improved local control. In RPA class 3 patients, survival rates at 6 months were 10% (35 of 39 patients) after 10 × 3 Gy and 9% (2 of 23 patients) after greater doses, respectively (p = 0.98). Conclusions Improved outcomes were associated with WBI doses >30 Gy, better performance status, fewer brain metastases, lack of extracerebral metastases, and lower RPA class. Patients receiving WBI alone appear to benefit from WBI doses >30 Gy. However, such a benefit is limited to RPA class 1 or 2 patients. PMID:20977700

  14. Age of stratospheric air unchanged within uncertainties over the past 30years

    NASA Astrophysics Data System (ADS)

    Engel, A.; Möbius, T.; Bönisch, H.; Schmidt, U.; Heinz, R.; Levin, I.; Atlas, E.; Aoki, S.; Nakazawa, T.; Sugawara, S.; Moore, F.; Hurst, D.; Elkins, J.; Schauffler, S.; Andrews, A.; Boering, K.

    2009-01-01

    The rising abundances of greenhouse gases in the atmosphere is associated with an increase in radiative forcing that leads to warming of the troposphere, the lower portion of the Earth's atmosphere, and cooling of the stratosphere above. A secondary effect of increasing levels of greenhouse gases is a possible change in the stratospheric circulation, which could significantly affect chlorofluorocarbon lifetimes, ozone levels and the climate system more generally. Model simulations have shown that the mean age of stratospheric air is a good indicator of the strength of the residual circulation, and that this mean age is expected to decrease with rising levels of greenhouse gases in the atmosphere. Here we use balloon-borne measurements of stratospheric trace gases over the past 30years to derive the mean age of air from sulphur hexafluoride (SF6) and CO2 mixing ratios. In contrast to the models, these observations do not show a decrease in mean age with time. If models are to make valid predictions of future stratospheric ozone levels, and of the coupling between ozone and climate change, a correct description of stratospheric transport and possible changes in the transport pathways are necessary.

  15. Is SfM photogrammetry really the tool we've waited 30 years for?

    NASA Astrophysics Data System (ADS)

    Chandler, Jim; Micheletti, Natan; Lane, Stuart

    2015-04-01

    SFM photogrammetry has evolved rapidly in the last few years, to the point where it is beginning to surpass terrestrial laser scanning for capturing 3-D models of natural surfaces. The ability to generate high resolution digital terrain models using just a consumer grade digital camera, or even a smart phone, is an important advance. The fact that this can be achieved at a range of scales and resolutions and from a variety of platforms, whilst using software which is freely available, appears almost incredible. This invited presentation seeks to place SfM photogrammetry in its proper historical context, by demonstrating just how rapidly techniques have evolved over the last 30 years. However, it is important to look forward and help ensure that future use is effective, even if spatial measurement expertise is limited. Consequently, the presentation will also demonstrate just how well-established lessons learnt in the past continue to remain important, particularly if accurate spatial data is desired. The application of SfM to a range of case studies will help to demonstrate the importance of scene geometry and accurate camera calibration and modelling. In addition, the establishment of external control remains critical for determining true change and the provision of independent checkpoints provides important verification of accuracies actually achieved. Recognition of these traditional photogrammetric principles and well-established practices should help ensure that expectations are both realistic and can be fulfilled, even for a new generation of non-expert users.

  16. Reversible cardiomyopathy after radiofrequency ablation of 30-year persistent atrial tachycardia

    PubMed Central

    Suzuki, Atsushi; Shiga, Tsuyoshi; Arai, Kotaro; Shoda, Morio

    2013-01-01

    Tachycardia-induced cardiomyopathy (TIC) is a reversible form of the left ventricular (LV) systolic dysfunction and is believed to be a relatively acute process. We report a TIC case with a 30-year history of long-lasting persistent atrial tachycardia involving a 44-year-old man previously diagnosed with dilated cardiomyopathy and a low LV ejection fraction (LVEF) of 20%. ECG revealed atrial tachycardia at 110–120 bpm. He was hospitalised with a worsening heart failure. His clinical status was New York Heart Association functional class III, and echocardiography revealed LV dilation and an LVEF of 9%. A two-dimensional speckle-tracking strain measurement revealed LV mechanical dyssynchrony. He underwent radiofrequency ablation for atrial tachycardia. After restoring sinus rhythm, his cardiac symptoms improved immediately. The LV mechanical dyssynchrony decreased a week after ablation, without changes in the LV dilation or LVEF. Thereafter, the LV dilation and systolic function gradually improved, and atrial tachycardia and heart failure remained absent. PMID:24326427

  17. Modeling Saturn's Giant Storms: Water, Ammonia, and the 30-Year Periodicity

    NASA Astrophysics Data System (ADS)

    Li, C.; Ingersoll, A. P.

    2014-12-01

    A giant planet-encircling storm occurred on Saturn on Dec. 5th, 2010 at planetographic latitude 37.7oN. It produced intense lightning, created enormous cloud disturbances and wrapped around the planet in 6 months. Six such storms, called Great White Spots, have erupted since 1876. They have alternated between mid-latitudes and the equator at intervals ranging from 20 to 30 years. The reason for the intermittent explosion is hitherto unclear and there are no similar storms on brother Jupiter. Here we describe the water-loading-mechanism, which could suppress moist convection for decades due to the larger molecular weight of water in a hydrogen-helium atmosphere. We show that this mechanism requires the deep water vapor mixing ratio to be greater than 1.0%. Observations imply that Saturn's atmosphere is more enriched in water than Jupiter, which could explain why Saturn has such storms and Jupiter does not. We further use a two-dimensional axisymmetric dynamic model and a top-cooling convective adjustment scheme to connect our theory to observation. We show that for a deep water mixing ratio of 1.1%, the ammonia vapor is depleted down to 6 bars, the tropospheric warming is about 6 K, and the interval between two consecutive storms at one place is about 70 years. These values are confirmed by both ground-based and spacecraft observations.

  18. From Energy Audits to Home Performance: 30 Years of Articles in Home Energy Magazine

    SciTech Connect

    Meier, Alan

    2014-08-11

    Home Energy Magazine has been publishing articles about residential energy efficiency for 30 years. Its goal has been to disseminate technically reliable and neutral information to the practitioners, that is, professionals in the business of home energy efficiency. The articles, editorials, letters, and advertisements are a kind of window on the evolution of energy conservation technologies, policies, and organizations. Initially, the focus was on audits and simple retrofits, such as weatherstripping and insulation. Instrumentation was sparse sometimes limited to a ruler to measure depth of attic insulation and a blower door was exotic. CFLs were heavy, awkward bulbs which might, or might not, fit in a fixture. Saving air conditioning energy was not a priority. Solar energy was only for the most adventurous. Thirty years on, the technologies and business have moved beyond just insulating attics to the larger challenge of delivering home performance and achieving zero net energy. This shift reflects the success in reducing space heating energy and the need to create a profitable industry by providing more services. The leading edge of the residential energy services market is becoming much more sophisticated, offering both efficiency and solar systems. The challenge is to continue providing relevant and reliable information in a transformed industry and a revolutionized media landscape.

  19. 30 Years on Selected Issues in the Prevention of HIV among Persons Who Inject Drugs

    PubMed Central

    Des Jarlais, D. C.; Pinkerton, S.; Hagan, H.; Guardino, V.; Feelemyer, J.; Cooper, H.; Hatzatkis, A.; Uuskula, A.

    2013-01-01

    After 30 years of extensive research on human immunodeficiency virus (HIV) among persons who inject drugs (PWID), we now have a good understanding of the critical issues involved. Following the discovery of HIV in 1981, epidemics among PWID were noted in many countries, and consensus recommendations for interventions for reducing injection related HIV transmission have been developed. While high-income countries have continued to develop and implement new Harm Reduction programs, most low-/middle-income countries have implemented Harm Reduction at very low levels. Modeling of combined prevention programming including needle exchange (NSP) and antiretroviral therapy (ARV) suggests that NSP be given the highest priority. Future HIV prevention programming should continue to provide Harm Reduction programs for PWID coupled with interventions aimed at reducing sexual transmission. As HIV continues to spread in low- and middle-income countries, it is important to achieve and maintain high coverage of Harm Reduction programs in these locations. As PWID almost always experience multiple health problems, it will be important to address these multiple problems within a comprehensive approach grounded in a human rights perspective. PMID:23840957

  20. Busulfan-melphalan in high-risk neuroblastoma: the 30-year experience of a single institution.

    PubMed

    Proust-Houdemont, S; Pasqualini, C; Blanchard, P; Dufour, C; Benhamou, E; Goma, G; Semeraro, M; Raquin, M-A; Hartmann, O; Valteau-Couanet, D

    2016-08-01

    High-dose chemotherapy (HDC) was investigated in high-risk neuroblastoma (HR-NBL) to reduce the risk of relapse. We report the results of the 30-year experience of a cohort of patients with HR-NBL treated with high-dose (HD) busulfan (Bu)-containing regimens. From 1980 to 2009, 215 patients aged >1 year with stage 4 NBL were treated with HD Bu-containing regimens at Gustave Roussy. These data were prospectively recorded in the Pediatric Transplantation Database. The median age at diagnosis was 40 months (12-218 months). All patients had a stage 4 neuroblastoma. NMYC amplification was displayed in 24% of the tumors. The hematopoietic support consisted of bone marrow or PBSCs in 46% and 49% of patients, respectively. The 5-year event-free survival and overall survival rates of the whole cohort were 35.1% and 40%, respectively. Age at diagnosis, bone marrow involvement and tumor response after induction chemotherapy were significant prognostic factors. Toxicity was manageable and decreased over time, owing to both PBSC administration and better supportive care. Based on this experience, HD Bu-melphalan (Mel) has been implemented in Europe and compared with Carboplatin-Etoposide-Mel in the European SIOP Neuroblastoma (SIOPEN)/HR-NBL randomized protocol. It has now become the standard HDC in the SIOPEN HR strategy. PMID:27042850

  1. The virtual brain: 30 years of video-game play and cognitive abilities

    PubMed Central

    Latham, Andrew J.; Patston, Lucy L. M.; Tippett, Lynette J.

    2013-01-01

    Forty years have passed since video-games were first made widely available to the public and subsequently playing games has become a favorite past-time for many. Players continuously engage with dynamic visual displays with success contingent on the time-pressured deployment, and flexible allocation, of attention as well as precise bimanual movements. Evidence to date suggests that both brief and extensive exposure to video-game play can result in a broad range of enhancements to various cognitive faculties that generalize beyond the original context. Despite promise, video-game research is host to a number of methodological issues that require addressing before progress can be made in this area. Here an effort is made to consolidate the past 30 years of literature examining the effects of video-game play on cognitive faculties and, more recently, neural systems. Future work is required to identify the mechanism that allows the act of video-game play to generate such a broad range of generalized enhancements. PMID:24062712

  2. A glimpse into 30 years of struggle against prostitution by the women's liberation movement in Norway.

    PubMed

    Strøm, Agnete

    2009-11-01

    The Women's Front of Norway has worked against prostitution for 30 years. In 2008 a law criminalizing the purchase of a sexual act was passed in Norway. This article describes the struggle and the main actors in lobbying for the law. In the 1980s, we raised awareness of prostitution and trafficking in women in a study of the pornography industry, and targeted sex tourist agencies organizing trips to the Philippines and Thailand. In the 1990s, our members in trade unions got their unions to take a stand against prostitution and against legalizing prostitution as "work". In 2006, the Norwegian Confederation of Trade Unions Congress supported a law criminalizing the buyer of a sexual act; this had a strong impact on the centre-left coalition Government. We invited leaders of the Coalition Against Trafficking in Women to Norway to meet parliamentarians and trade unionists, and kept up the pressure. From the start, the focus was on ensuring that the situation for women in prostitution was ameliorated. Our demands have been for better social services and job training. Street prostitution, especially in Oslo, has been curbed, and a growth in the indoor market has not been reported. Our next task is participating in the awareness campaign "Buying Sex is not a Sport" in connection with the Soccer World Cup, South Africa, 2010. PMID:19962635

  3. The SLC28 (CNT) and SLC29 (ENT) nucleoside transporter families: a 30-year collaborative odyssey.

    PubMed

    Young, James D

    2016-06-15

    Specialized nucleoside transporter (NT) proteins are required for passage of nucleosides and hydrophilic nucleoside analogues across biological membranes. Physiologic nucleosides serve as central salvage metabolites in nucleotide biosynthesis, and nucleoside analogues are used as chemotherapeutic agents in the treatment of cancer and antiviral diseases. The nucleoside adenosine modulates numerous cellular events via purino-receptor cell signalling pathways. Human NTs are divided into two structurally unrelated protein families: the SLC28 concentrative nucleoside transporter (CNT) family and the SLC29 equilibrative nucleoside transporter (ENT) family. Human CNTs are inwardly directed Na(+)-dependent nucleoside transporters found predominantly in intestinal and renal epithelial and other specialized cell types. Human ENTs mediate bidirectional fluxes of purine and pyrimidine nucleosides down their concentration gradients and are ubiquitously found in most, possibly all, cell types. Both protein families are evolutionarily old: CNTs are present in both eukaryotes and prokaryotes; ENTs are widely distributed in mammalian, lower vertebrate and other eukaryote species. This mini-review describes a 30-year collaboration with Professor Stephen Baldwin to identify and understand the structures and functions of these physiologically and clinically important transport proteins. PMID:27284054

  4. Planting misinformation in the human mind: a 30-year investigation of the malleability of memory.

    PubMed

    Loftus, Elizabeth F

    2005-01-01

    The misinformation effect refers to the impairment in memory for the past that arises after exposure to misleading information. The phenomenon has been investigated for at least 30 years, as investigators have addressed a number of issues. These include the conditions under which people are especially susceptible to the negative impact of misinformation, and conversely when are they resistant. Warnings about the potential for misinformation sometimes work to inhibit its damaging effects, but only under limited circumstances. The misinformation effect has been observed in a variety of human and nonhuman species. And some groups of individuals are more susceptible than others. At a more theoretical level, investigators have explored the fate of the original memory traces after exposure to misinformation appears to have made them inaccessible. This review of the field ends with a brief discussion of the newer work involving misinformation that has explored the processes by which people come to believe falsely that they experienced rich complex events that never, in fact, occurred. PMID:16027179

  5. Leatherback nests increasing significantly in Florida, USA; trends assessed over 30 years using multilevel modeling.

    PubMed

    Stewart, Kelly; Sims, Michelle; Meylan, Anne; Witherington, Blair; Brost, Beth; Crowder, Larry B

    2011-01-01

    Understanding population status for endangered species is critical to developing and evaluating recovery plans mandated by the Endangered Species Act. For sea turtles, changes in abundance are difficult to detect because most life stages occur in the water. Currently, nest counts are the most reliable way of assessing trends. We determined the rate of growth for leatherback turtle (Dermochelys coriacea) nest numbers in Florida (USA) using a multilevel Poisson regression. We modeled nest counts from 68 beaches over 30 years and, using beach-level covariates (including latitude), we allowed for partial pooling of information between neighboring beaches. This modeling approach is ideal for nest count data because it recognizes the hierarchical structure of the data while incorporating variables related to survey effort. Nesting has increased at all 68 beaches in Florida, with trends ranging from 3.1% to 16.3% per year. Overall, across the state, the number of nests has been increasing by 10.2% per year since 1979. Despite being a small population (probably < 1000 individuals), this nesting population may help achieve objectives in the federal recovery plan. This exponential growth rate mirrors trends observed for other Atlantic populations and may be driven partially by improved protection of nesting beaches. However, nesting is increasing even where beach protection has not been enhanced. Climate variability and associated marine food web dynamics, which could enhance productivity and reduce predators, may be driving this trend. PMID:21516903

  6. "Evolving nanoparticle gene delivery vectors for the liver: What has been learned in 30 years".

    PubMed

    Crowley, Samuel T; Rice, Kevin G

    2015-12-10

    Nonviral gene delivery to the liver has been under evolution for nearly 30years. Early demonstrations established relatively simple nonviral vectors could mediate gene expression in HepG2 cells which understandably led to speculation that these same vectors would be immediately successful at transfecting primary hepatocytes in vivo. However, it was soon recognized that the properties of a nonviral vector resulting in efficient transfection in vitro were uncorrelated with those needed to achieve efficient nonviral transfection in vivo. The discovery of major barriers to liver gene transfer has set the field on a course to design biocompatible vectors that demonstrate increased DNA stability in the circulation with correlating expression in liver. The improved understanding of what limits nonviral vector gene transfer efficiency in vivo has resulted in more sophisticated, low molecular weight vectors that allow systematic optimization of nanoparticle size, charge and ligand presentation. While the field has evolved DNA nanoparticles that are stable in the circulation, target hepatocytes, and deliver DNA to the cytosol, breaching the nucleus remains the last major barrier to a fully successful nonviral gene transfer system for the liver. The lessons learned along the way are fundamentally important to the design of all systemically delivered nanoparticle nonviral gene delivery systems. PMID:26439664

  7. Surveillance of Infectious Diseases by the Sentinel Laboratory Network in Belgium: 30 Years of Continuous Improvement

    PubMed Central

    Muyldermans, Gaëtan; Ducoffre, Geneviève; Leroy, Mathias; Dupont, Yves; Quolin, Sophie

    2016-01-01

    In 1983 the sentinel laboratory network was established because of the need to describe the epidemiological evolution of infectious diseases. During the study period of 30 years (1983–2013), microbiology laboratories reported on weekly basis the laboratory diagnosed cases for a selection of infectious diseases. This resulted in a large longitudinal laboratory based database allowing to provide trends over time and distribution by person and place. During this period, adaptations to data collection were made due to changes in diagnostic methods and public health priorities, introduction and application of digital revolution, and multiple reorganizations of the laboratories. Since the surveillance network is dynamic, it necessitates a continuous evaluation to ensure that, over time, it continues to be representative of the general epidemiological trends in the country. Secondly the aim is to examine the robustness and stability of this surveillance system. Here we demonstrated that the flexibility of the data collection methodology by the sentinel laboratory network is unique and that adaptations do not affect the capacity of the system to follow trends. Therefore, the surveillance by this network is representative of the current epidemiological situation in Belgium. To our knowledge, no such surveillance network with such a long-term follow-up and demonstrated stability for multiple infectious diseases in the general population was earlier described. Furthermore, expected trends due to the implementation of vaccination or other events were accurately detected. The collected data obtained from this network allows interesting comparisons with other national and international information sources. PMID:27571203

  8. Chiropractic management of a 30-year-old patient with Parsonage-Turner syndrome

    PubMed Central

    Charles, Eugene

    2011-01-01

    Objectives The purpose of this case report is to describe the chiropractic management of a patient presenting with right arm paralysis and a diagnosis of Parsonage-Turner syndrome. Clinical Features After receiving nerve entrapment release surgery, a 30-year-old man presented with a right arm contracture, atrophy, and weakness with general paralysis of the forearm and index finger of 6 weeks' duration. Intervention and Outcome The patient was provided chiropractic care that included high-velocity/low-amplitude spinal manipulation based upon applied kinesiology manual muscle testing, soft tissue trigger point therapy, exercises, and stretches. The patient demonstrated improvement in range of motion after the first treatment session. By the eighth treatment, he was able to fully straighten his arm. Three years later, the patient reported that he was able to do mountain climbing and that his arm was fully functional and pain-free. Conclusion For this patient, chiropractic care seemed to be successful in relieving his right arm paralysis and restoring normal arm movement. PMID:22654689

  9. Roadmap for Loess/Paleosol Magnetism After 30 Years of Experience

    NASA Astrophysics Data System (ADS)

    Lagroix, F.; Taylor, S. N.; Guyodo, Y. J. B.; Till, J. L.

    2015-12-01

    Over the last 30 years, loess and paleosol deposits have provided the scientific community a unique opportunity to study past climate and environmental change of the continents. Fluctuating magnetic susceptibility of glacial loess and interglacial soil deposits in China, and a few places elsewhere, have been correlated with the marine isotope stages and ice core records, illustrating the loess-climate connection. Furthermore, the logarithm of the magnetic susceptibility and other ferrimagnetism dependant concentration parameters in modern topsoil are found to be linearly related to modern rainfall records. But, the transfer function is site specific. Others have suggested that the relationship is more universal if precipitation and evapotranspiration are considered together. This said, major roadblocks remain for loess/paleosol magnetism to reach its full potential as a quantitative tool in climate and environmental studies. Reaching this full potential is impaired primarily because of the difficulty in identifying iron oxides and oxyhydroxides other than magnetite or maghemite in natural samples and (semi-)quantifying their concentration and grain size. This talk will present results obtained recently through research targeting loess and paleosol magnetism emphasising the need to further consider the following scientific questions. Which environmental and climate variables cause the change in magnetism in soils? How does magnetism evolve with time, quantitatively, when soils are buried under newly deposited loess and become paleosols? Can we overcome the imprecision of paleomagnetic dating inherent to our poor understanding of the magnetization acquisition process in loess and soils?

  10. Seasonal spatial heterogeneity of warming rates on the Tibetan Plateau over the past 30 years

    PubMed Central

    Duan, Jianping; Li, Lun; Fang, Yongjie

    2015-01-01

    Based on temperature data from 79 meteorological stations, we estimate the warming rate by season on the Tibetan Plateau (TP) during 1984–2013. The warming rate was spatially heterogeneous across seasons over the past 30 years. The northern TP (NTP) experienced more warming than the southern TP (STP) (divided near 33°N) in all seasons. The greatest north-south difference in warming was 0.70 ± 0.11 °C for summer (June-August), while the smallest difference was 0.27 ± 0.14 °C for the cold season (November-April). Such seasonal and spatial heterogeneity in the warming rate is consistent with the seasonal precipitation patterns of the NTP and the STP. One possible cause for this phenomenon is that more precipitation occurs in the STP than in the NTP (especially for summer), accompanied by more low cloud cover, which may have slowed the warming rate. Our results imply that dry regions on the TP will possibly experience greater temperature increase than wet regions under future global warming, and this will be more prominent in summer. PMID:26114895

  11. Thoracic Outlet Syndrome: Past and Present—88 Surgeries in 30 Years at Chang Gung

    PubMed Central

    Fang, Frank; Nai-Jen Chang, Tommy; Chuieng-Yi Lu, Johnny

    2016-01-01

    Background: Thoracic outlet syndrome (TOS) is a highly controversial clinical entity. There is much debate on its terminology, existence, diagnosis, and treatment. The purpose of this study was to describe our opinions about these controversial topics of TOS and the treatment of TOS over the past 30 years. Methods: From 1985 to 2014, a total of 80 patients underwent decompressive surgery for TOS. Eight patients requested a second surgery on the contralateral limb. They all had at least 1-year follow-up. Preoperative evaluation included provocative tests, plain X-ray, magnetic resonance angiography/computed tomography angiography, and electromyography. Surgical intervention for each patient involved a supraclavicular approach and near-total resection of the anterior scalene muscle and the first rib and of any cervical rib if it was present. Rib resection was performed with the use of Kerrison bone punch forceps. The operative time was typically 2 hours. Results: Major postoperative complications were rare. Nearly all patients (98%) experienced significant symptom relief, with improvement in soreness and tightness of the shoulder, neck, and arm immediately on the first postoperative day or within a few weeks thereafter. There were no cases with symptoms recurring. Conclusions: It is evident that decompressive surgery through a supraclavicular approach for TOS not only is an effective and safe procedure but also provides a diagnosis of the cause of TOS. For a patient who meets the criteria for surgical indication, decompressive surgery usually results in resolution of symptoms and no recurrence. PMID:27482476

  12. Interannual variability of the Indonesian Throughflow transport: A revisit based on 30 year expendable bathythermograph data

    NASA Astrophysics Data System (ADS)

    Liu, Qin-Yan; Feng, Ming; Wang, Dongxiao; Wijffels, Susan

    2015-12-01

    Based on 30 year repeated expendable bathythermograph (XBT) deployments between Fremantle, Western Australia, and the Sunda Strait, Indonesia, from 1984 to 2013, interannual variability of geostrophic transport of the Indonesian Throughflow (ITF) and its relationships with El Niño Southern Oscillation (ENSO) and the Indian Ocean Dipole (IOD) are investigated. The IOD induced coastal Kelvin waves propagate along the Sumatra-Java coast of Indonesia, and ENSO induced coastal Kelvin waves propagate along the northwest coast of Australia, both influencing interannual variations of the ITF transport. The ITF geostrophic transport is stronger during La Niña phase and weaker during El Niño phase, with the Niño3.4 index leading the ITF variability by 7 months. The Indian Ocean wind variability associated with the IOD to a certain extent offset the Pacific ENSO influences on the ITF geostrophic transport during the developing and mature phases of El Niño and La Niña, due to the covarying IOD variability with ENSO. The ITF geostrophic transport experiences a strengthening trend of about 1 Sv every 10 years over the study period, which is mostly due to a response to the strengthening of the trade winds in the Pacific during the climate change hiatus period. Decadal variations of the temperature-salinity relationships need to be considered when estimating the geostrophic transport of the ITF using XBT data.

  13. Surveillance of Infectious Diseases by the Sentinel Laboratory Network in Belgium: 30 Years of Continuous Improvement.

    PubMed

    Muyldermans, Gaëtan; Ducoffre, Geneviève; Leroy, Mathias; Dupont, Yves; Quolin, Sophie

    2016-01-01

    In 1983 the sentinel laboratory network was established because of the need to describe the epidemiological evolution of infectious diseases. During the study period of 30 years (1983-2013), microbiology laboratories reported on weekly basis the laboratory diagnosed cases for a selection of infectious diseases. This resulted in a large longitudinal laboratory based database allowing to provide trends over time and distribution by person and place. During this period, adaptations to data collection were made due to changes in diagnostic methods and public health priorities, introduction and application of digital revolution, and multiple reorganizations of the laboratories. Since the surveillance network is dynamic, it necessitates a continuous evaluation to ensure that, over time, it continues to be representative of the general epidemiological trends in the country. Secondly the aim is to examine the robustness and stability of this surveillance system. Here we demonstrated that the flexibility of the data collection methodology by the sentinel laboratory network is unique and that adaptations do not affect the capacity of the system to follow trends. Therefore, the surveillance by this network is representative of the current epidemiological situation in Belgium. To our knowledge, no such surveillance network with such a long-term follow-up and demonstrated stability for multiple infectious diseases in the general population was earlier described. Furthermore, expected trends due to the implementation of vaccination or other events were accurately detected. The collected data obtained from this network allows interesting comparisons with other national and international information sources. PMID:27571203

  14. Measuring currents in submarine canyons: technological and scientific progress in the past 30 years

    USGS Publications Warehouse

    Xu, J. P.

    2011-01-01

    The development and application of acoustic and optical technologies and of accurate positioning systems in the past 30 years have opened new frontiers in the submarine canyon research communities. This paper reviews several key advancements in both technology and science in the field of currents in submarine canyons since the1979 publication of Currents in Submarine Canyons and Other Sea Valleys by Francis Shepard and colleagues. Precise placements of high-resolution, high-frequency instruments have not only allowed researchers to collect new data that are essential for advancing and generalizing theories governing the canyon currents, but have also revealed new natural phenomena that challenge the understandings of the theorists and experimenters in their predictions of submarine canyon flow fields. Baroclinic motions at tidal frequencies, found to be intensified both up canyon and toward the canyon floor, dominate the flow field and control the sediment transport processes in submarine canyons. Turbidity currents are found to frequently occur in active submarine canyons such as Monterey Canyon. These turbidity currents have maximum speeds of nearly 200 cm/s, much smaller than the speeds of turbidity currents in geological time, but still very destructive. In addition to traditional Eulerian measurements, Lagrangian flow data are essential in quantifying water and sediment transport in submarine canyons. A concerted experiment with multiple monitoring stations along the canyon axis and on nearby shelves is required to characterize the storm-trigger mechanism for turbidity currents.

  15. Aetiology of maxillofacial fractures: a review of published studies during the last 30 years.

    PubMed

    Boffano, Paolo; Kommers, Sofie C; Karagozoglu, K Hakki; Forouzanfar, Tymour

    2014-12-01

    The epidemiology of facial trauma may vary widely across countries (and even within the same country), and is dependent on several cultural and socioeconomic factors. We know of few reviews of published reports that have considered the sex distribution and aetiology of maxillofacial trauma throughout the world. The aim of this review was to discuss these aspects as they have been presented in papers published during the last 30 years. We made a systematic review of papers about the epidemiology of maxillofacial trauma that were published between January 1980 and December 2013 and identified 69 studies from Africa (n=9), North America and Brazil (n=6), Asia (n=36), Europe (n=16), and Oceania (n=2). In all the studies men outnumbered women, the ratio usually being more than 2:1. In American, African, and Asian studies road traffic crashes were the predominant cause. In European studies the aetiology varied, with assaults and road traffic crashes being the most important factors. In Oceania assaults were the most important. A comparison of the incidence of maxillofacial trauma of different countries together with a knowledge of different laws (seat belts for drivers, helmets for motocyclists, speed limits, and protection worn during sports and at work) is crucial to allow for improvement in several countries. To our knowledge this paper is the first attempt to study and compare the aetiologies of maxillofacial trauma. PMID:25218316

  16. Disability-Free Life Expectancy Over 30 Years: A Growing Female Disadvantage in the US Population

    PubMed Central

    Wolf, Douglas A.; Spillman, Brenda C.

    2016-01-01

    Objectives. To examine changes in active life expectancy in the United States over 30 years for older men and women (aged ≥ 65 years). Methods. We used the 1982 and 2004 National Long Term Care Survey and the 2011 National Health and Aging Trends Study to estimate age-specific mortality and disability rates, the overall chances of survival and of surviving without disability, and years of active life for men and women. Results. For older men, longevity has increased, disability has been postponed to older ages, disability prevalence has fallen, and the percentage of remaining life spent active has increased. However, for older women, small longevity increases have been accompanied by even smaller postponements in disability, a reversal of a downward trend in moderate disability, and stagnation of active life as a percentage of life expectancy. As a consequence, older women no longer live more active years than men, despite their longer lives. Conclusions. Neither a compression nor expansion of late-life disability is inevitable. Public health measures directed at older women to postpone disability may be needed to offset impending long-term care pressures related to population aging. PMID:26985619

  17. Apollo: A retrospective analysis

    NASA Technical Reports Server (NTRS)

    Launius, Roger D.

    1994-01-01

    Since the completion of Project Apollo more than twenty years ago there have been a plethora of books, studies, reports, and articles about its origin, execution, and meaning. At the time of the twenty-fifth anniversary of the first landing, it is appropriate to reflect on the effort and its place in U.S. and NASA history. This monograph has been written as a means to this end. It presents a short narrative account of Apollo from its origin through its assessment. That is followed by a mission by mission summary of the Apollo flights and concluded by a series of key documents relative to the program reproduced in facsimile. The intent of this monograph is to provide a basic history along with primary documents that may be useful to NASA personnel and others desiring information about Apollo.

  18. Apollo: A