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  1. Radiographic evaluation of mandibular ramus for gender estimation: Retrospective study

    PubMed Central

    Damera, Ajit; Mohanalakhsmi, Jonnala; Yellarthi, Pavan Kumar; Rezwana, Begum Mohammed

    2016-01-01

    Background and Aims: Gender estimation is a very important part of a study in the field of anthropology and forensic sciences. In the skeleton, gender estimation is the first step of the identification process as subsequent methods for age and stature estimation are sex-dependent. Skeletal components such as the pelvis and skull are investigated for gender estimation and the mandible is a practical element to analyze sexual dimorphism in fragmented bones. The aim of the present study is to measure, compare, and evaluate various measurements of the mandibular ramus, observed in digital orthopantomographs and also to assess the usefulness of the mandibular ramus as an aid in gender estimation. Materials and Methods: A radiographic retrospective study was conducted using 80 digital orthopantomographs to measure, compare, and evaluate the measurements of the mandibular ramus such as maximum ramus breadth, maximum ramus height, and coronoid heightusing Planmeca ProMax® digital machine to assess the usefulness of mandibular measurements in gender estimation. Results: Descriptive statistics of various measurements and associated univariate F ratios for both the sexes were determined. Four variables were significant predictor in classifying a given sample (P < 0.001). The F-statistic values indicated that measurements expressing the greatest sexual dimorphism were noticed in the maximum ramus height. Conclusion: Mandibular ramus can be considered as a valuable tool in gender estimation and the most reliable measurements were obtained of linear objects in the horizontal plane by digital panoramic imaging.

  2. CT maxillary sinus evaluation-A retrospective cohort study

    PubMed Central

    Vaz, Paula; Faria-Almeida, Ricardo; Braga, Ana-Cristina; Felino, António

    2015-01-01

    Background Proximity of the dental roots to the sinus floor makes dental disease a probable cause of maxillary sinusitis. The aim of this study was to find out if maxillary sinus pathologic changes were more prevalent in patients with dental disease and to evaluate the performance of computed tomography (CT) in analyzing and detecting apical periodontitis and other odontogenic causes on the maxillary sinusitis etiology in a Portuguese Caucasian population. Material and Methods Retrospective cohort study. The total sample of 504 patients and their CT was included in this study. The patients were from a private dental clinic, specializing in oral surgery, where the first complaint was not directly related to sinus disease, but with dental pathology. For each patient, the etiological factors of maxillary sinusitis and the imaging CT findings were analyzed. All the axial, coronal and sagittal CT slices were evaluated and general data were registered. The latter was selected based on the maxillary sinus CT published literature. Results 32.40% of patients presented normal sinus (without any etiological factor associated), 29.00% showed presence of etiological and imaging findings in the maxillary sinus, 20.60% had only imaging changes in the maxillary sinus and 18.00% of patients presented only etiological factors and no change in the maxillary sinus. Conclusions Radiological imaging is an important tool for establishing the diagnosis of maxillary sinus pathology. These results indicate that the CT scan should be an excellent tool for complement the odontogenic sinusitis diagnosis. Key words: Maxillary sinusitis/etiology, odontogenic, computed tomography, maxillary sinus. PMID:25858084

  3. 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

  4. Computed tomography in the evaluation of metastatic adenocarcinoma from an unknown primary site: a retrospective study

    SciTech Connect

    McMillan, J.H.; Levine, E.; Stephens, R.H.

    1982-04-01

    Abdominal computed tomography (CT) and other studies were evaluated retrospectively in 46 patients with metastatic adenocarconoma or undifferentiated carcinoma in whom the primary tumor site was not evident from the history, physical examination, or chest radiograph. The primary site was ultimately located in 21 patients (45.7%). CT of the abdomen in particular detected it in 16 patients (34.8%) and demonstrated additional and often unsuspected metastatic disease in 65%. CT proved superior to sonography in both diagnosis and assessment of the extent of disease and had a significantly higher diagnostic yield than contrast studies of the urinary and gastrointestinal tracts. Abdominal CT is recommended as the initial modality in patients with metastatic adenocarcinoma of unknown primary origin. If the abdominal scan is negative, it should be followed by pelvic sonography or CT, particularly in women. Contrast studies should be limited to patients with specific organic dysfunction.

  5. Trauma in elderly patients evaluated in a hospital emergency department in Konya, Turkey: a retrospective study

    PubMed Central

    Kara, Hasan; Bayir, Aysegul; Ak, Ahmet; Akinci, Murat; Tufekci, Necmettin; Degirmenci, Selim; Azap, Melih

    2014-01-01

    Purpose Trauma is a common cause of admission to the hospital emergency department. The purpose of this study was to evaluate the cause of admission, clinical characteristics, and outcomes of patients aged ≥65 years admitted to an emergency department in Turkey because of blunt trauma. Materials and methods Medical records were retrospectively reviewed for 568 patients (314 women and 254 men) aged ≥65 years who were admitted to an emergency department of a tertiary care hospital. Results Trauma was caused by low-energy fall in 379 patients (67%), traffic accident in 79 patients (14%), high-energy fall in 69 patients (12%), and other causes in 41 patients (7%). The most frequent sites of injury were the lower extremity, thorax, upper extremity, and head. The femur was the most frequent fracture site. After evaluation in the emergency department, 377 patients (66%) were hospitalized. There were 31 patients (5%) who died. Risk of hospitalization after trauma was significantly associated with trauma to the lower extremity, thorax, and spine; fractures of the femur and rib; and intracranial injury. Conclusion Emergency department admission after trauma in patients aged ≥65 years is common after low-energy falls, and most injuries occur to the extremities. It is important to focus on prevention of falls to decrease the frequency of trauma in the elderly. PMID:24376346

  6. Evaluation of the Association between Oral Lichen Planus and Hypothyroidism: a Retrospective Comparative Study

    PubMed Central

    Lavaee, Fatemeh; Majd, Marjan

    2016-01-01

    Statement of the Problem Oral Lichen planus (OLP) is an autoimmune mucocutaneous disease. There are some reports of thyroid diseases, especially hypothyroidism, to have association with OLP in some studies. Purpose Based on the controversial results of former studies in other populations about the association of hypothyroidism and OLP, the current study aimed to evaluate this association in a sample of Iranian population. Materials and Method This retrospective comparative study evaluated 523 patients with OLP referring to the Oral and Maxillofacial Department of Shiraz Dental Faculty as the test group and 523 age- and sex-matched patients as the control group. Those participants with oral lichenoid reactions and other mucosal lesions were excluded. The odds ratio (OR) with 95% confidence intervals (CI) for the association of OLP and thyroid diseases were estimated by logistic regression adjusted for the matched age and sex. Results In the test group, 74% (n=387) and in the control group 73.8% of the patients were female (n=386). In the test group, 26% (n=136) and in the control group 26.2% of the samples were male (n=137). A total of 4% of the patients in the control group (n=21) and 6.7% in the case group (n=35) had a history of hypothyroidism. The reported OR for association of thyroid disease and OLP was 1.714 (CI=0.984-2.987). Conclusion The results of this study showed no significant association between hypothyroidism and OLP in comparison with the age- and sex-matched control group. PMID:26966707

  7. [Postoperative evaluation of different surgical procedures in genuine stress urinary incontinence: a retrospective study].

    PubMed

    Rodríguez-Colorado, S; Pérez-Soriano, P; Alvarez-Mercado, R L; Herbert, A; Kunhardt-Rasch, J

    1996-06-01

    An evaluation of the surgical treatment for stress and mixed urinary incontinence and pelvic relaxation. One-year follow-up, was done. A retrospective study with 144 files from the surgeries performed between February 1993 and June 1994, at the Clínica de Urología Ginecológica del Instituto Nacional de Perinatología. We excluded 37 files because of incomplete information. The age, parity, hormonal stage, preoperative diagnosis by urodynamic studies, surgical treatments and one-year follow-up were analyzed. The mean age was 45.5 years. Pereyra procedure was performed in 53, Burch procedure in 47, anterior colporrhaphy in 5, and sling procedure in 2 patients. The incidence of complications was similar between the different groups. Resumption of spontaneous postsurgical voiding was delayed in the Pereyra group. The Burch urethropexy and Pereyra procedures were equally effective, with no statistical differences observed. Burch vaginal suspension was not more effective for the correction of urinary stress incontinence than Pereyra procedure. PMID:8754724

  8. Evaluation of the minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: A retrospective cohort study

    PubMed Central

    Toriie, Sayoko; Sugimoto, Takeki; Hokimoto, Norihiro; Funakoshi, Taku; Ogawa, Maho; Oki, Toyokazu; Dabanaka, Ken; Namikawa, Tsutomu; Sakurai, Akihiro; Hanazaki, Kazuhiro

    2016-01-01

    Introduction An accurate differential diagnosis between single adenoma (SA) and multiglandular disease (MGD) remains difficult in Technetium-99m sestamibi scintigraphy (MIBI)-negative patients with primary hyperparathyroidism (PHPT). The aim of the present study was to evaluate the minimally invasive parathyroidectomy (MIP) in patients with PHPT. Methods Clinical records of 48 patients who underwent neck exploration between November 2002 and June 2012 in Kochi Medical School Hospital were reviewed retrospectively to identify candidates that underwent for MIP which was defined as the selective removal of a SA using less invasive surgery. Results The preoperative detection rate of lesions using ultrasonography, MIBI, computed tomography, and magnetic resonance imaging was 90%, 83%, 76%, and 55%, respectively. Although all 39 patients in the MIBI-positive group were diagnosed with an SA and subsequently underwent curative MIP, 3 patients in MIBI-negative group (n = 6) were MGD, who underwent neck exploration. Preoperative mean intact parathyroid hormone (419 pg/ml vs. 149 pg/ml; P < 0.01) and alkaline phosphatase levels (746 U/l vs. 277 U/l; P < 0.01) were significantly higher in the SA than MGD group. Conclusions In MIBI-negative patients with indications for surgery, MIP should not be carried out without a clear localization of SA, or in MGD. PMID:27054033

  9. EVALUATION AND MANAGEMENT OF DIFFICULT AIRWAY IN OBESITY A SINGLE CENTER RETROSPECTIVE STUDY.

    PubMed

    Ayhan, Asude; Kaplan, Serife; Kayhan, Zeynep; Arslan, Gulnaz

    2016-03-01

    The primary aim of this single center retrospective study was to evaluate difficult mask ventilation (DMV) and difficult laryngoscopy (DL) in a unique group of obese patients. A total of 427 adult patients with body mass index (BMI) ≥ 25 and surgically treated for endometrial cancer from 2011 to 2014 were assessed. Additional increase in BMI, comorbidities, bedside screening tests for risk factors, and the tools used to manage the patients were noted and their effects on DMV and/or DL investigated. Every escalation in the number of risk factors increased the probability of DMV 2.2-fold, DL 1.8-fold and DMV+DL 3.0-fold. Among bedside tests, limited neck movement (LNM), short neck (SN) and absence of teeth were significant for DMV (p < 0.05), LNM, SN and obstructive sleep apnea for DL (p < 0.05), and LNM and SN for DMV+DL (p < 0.05). However, a 10-point increase of BMI was not an independent risk factor when patients with BMI > 25% were considered. In conclusion, LNM and SN are independent risk factors for developing DMV and/or DL in obese endometrial cancer patients, while BMI increase over 30 was not additionally affecting difficult airway. PMID:27276769

  10. Evaluation of timings and outcomes in category-one caesarean sections: A retrospective cohort study

    PubMed Central

    Dunn, Clare Newton; Zhang, Qianpian; Sia, Josh Tjunrong; Assam, Pryseley Nkouibert; Tagore, Shephali; Sng, Ban Leong

    2016-01-01

    Background and Aims: A decision-to-delivery interval (DDI) of 30 min for category-one caesarean section (CS) deliveries is the standard of practice recommended by clinical guidelines. Our institution established a protocol for category-one (‘crash’) CS to expedite deliveries. The aim of this study is to evaluate DDI, factors that affect DDI and the mode of anaesthesia for category-one CS. Methods: This retrospective cohort study evaluated 390 women who underwent category-one CS in a tertiary obstetric centre. We analysed the factors associated with DDI, mode of anaesthesia and perinatal outcomes. Summary statistics were performed for the outcomes. The association factors were considered significant at P < 0.05. Results: The mean (standard deviation) DDI was 9.4 (3.2) min with all deliveries achieved within 30 min. The longest factor in the DDI was time taken to transfer patients. A shorter DDI was not significantly associated with improved perinatal outcomes. The majority (88.9%) of women had general anaesthesia (GA) for category-one CS. Of those who had an epidural catheter already in situ (34.4%), 25.6% had successful epidural extension. GA was associated with shorter DDI, but worse perinatal outcomes than regional anaesthesia (RA). Conclusions: Our ‘crash’ CS protocol achieved 100% of deliveries within 30 min. The majority (88.9%) of the patients had GA for category-one CS. GA was found to be associated with shorter anaesthesia and operation times, but poorer perinatal outcomes compared to RA. PMID:27601736

  11. Clinical Evaluation of Removable Partial Dentures on the Periodontal Health of Abutment Teeth: A Retrospective Study

    PubMed Central

    Dula, Linda J; Ahmedi, Enis F; Lila-Krasniqi, Zana D; Shala, Kujtim Sh

    2015-01-01

    The aim of this retrospective study was to evaluate the effect of removable partial dentures in periodontal abutment teeth in relation to the type of denture support and design of RPD in a five-year worn period. Methods : A total of 64 patients with removable partial dentures (RPDs), participated in this study. It were examined ninety-one RPDs. There were seventy-five RPDs with clasp-retained and sixteenth were RPDs with attachments. There were 28 females and 36 males, aged between 40-64 years, 41 maxillary and 50 mandible RPDs. For each subjects the following data were collected: denture design, denture support, and Kennedy classification. Abutment teeth were assessed for plaque index (PI), calculus index (CI), blending on probing (BOP), probing depth (PD), gingival recession (GR), tooth mobility (TM). Level of significance was set at p<0.05. Results : According to denture support of RPD, BOP, PD, PI, GR, CI and TM-index showed no statistically significant difference. Based on the denture design of RPD’s, BOP, PD, PI, CI, and TM-index proved no statistically significant difference. Except GR-index according to denture design confirmed statistically significant difference in RPD with clasp p<0.01. The higher values of all periodontal parameter as BOP, PD, PI, CI and TM were in patients with RPD’s with claps comparing with RPD’s with attachment. Conclusion : RPD’s with clasp increased level of gingival inflammation in regions covered by the dentures and below the clasp arms in abutment teeth. PMID:25926896

  12. Clinical evaluation of removable partial dentures on the periodontal health of abutment teeth: a retrospective study.

    PubMed

    Dula, Linda J; Ahmedi, Enis F; Lila-Krasniqi, Zana D; Shala, Kujtim Sh

    2015-01-01

    The aim of this retrospective study was to evaluate the effect of removable partial dentures in periodontal abutment teeth in relation to the type of denture support and design of RPD in a five-year worn period. Methods : A total of 64 patients with removable partial dentures (RPDs), participated in this study. It were examined ninety-one RPDs. There were seventy-five RPDs with clasp-retained and sixteenth were RPDs with attachments. There were 28 females and 36 males, aged between 40-64 years, 41 maxillary and 50 mandible RPDs. For each subjects the following data were collected: denture design, denture support, and Kennedy classification. Abutment teeth were assessed for plaque index (PI), calculus index (CI), blending on probing (BOP), probing depth (PD), gingival recession (GR), tooth mobility (TM). Level of significance was set at p<0.05. Results : According to denture support of RPD, BOP, PD, PI, GR, CI and TM-index showed no statistically significant difference. Based on the denture design of RPD's, BOP, PD, PI, CI, and TM-index proved no statistically significant difference. Except GR-index according to denture design confirmed statistically significant difference in RPD with clasp p<0.01. The higher values of all periodontal parameter as BOP, PD, PI, CI and TM were in patients with RPD's with claps comparing with RPD's with attachment. Conclusion : RPD's with clasp increased level of gingival inflammation in regions covered by the dentures and below the clasp arms in abutment teeth. PMID:25926896

  13. Evaluation of vaginal agenesis treated with the modified McIndoe technique: A retrospective study

    PubMed Central

    Karapınar, Oya Soylu; Özkan, Mustafa; Okyay, Ayşe Güler; Şahin, Hanifi; Dolapçıoğlu, Kenan Serdar

    2016-01-01

    Objective Retrospective analysis of cases that have undergone neovagina operation because of congenital vaginal agenesis was objected. Material and Methods Seven cases applying with the complaints of primary amenorrhea or inability to have sexual intercourse were in the study. The cases were diagnosed with congenital vaginal agenesis and operated at Mustafa Kemal University Training and Research Hospital between 2011 and 2014. Vaginoplasty by the modified McIndoe method was performed in all cases. The main complaint, chromosomal analysis, duration of operation, preoperative and postoperative vaginal length, complications, postoperative treatment, and satisfaction from the sexual intercourse were all evaluated. Results Average age of our patients was 28.14±8.61 (19–39) years. One patient was 46XX-45X0 mosaic Turner syndrome), 1 patient was 46XY (testicular feminization), and other 5 patients were 46XX. The average duration of operation was 2.7±0.56 (2–3.5 h). Postoperative infection was observed in 1 patient. In this infected patient, graft failure occurred and debridement was performed in reoperation. No early complications were seen in the others. Preoperative and postoperative average vaginal lengths were 1.85±0.62 (1–3 cm) and 8.71±1.11 (7–10 cm), respectively. Dyspareunia occurred in 2 cases that were not able to use dilatator regularly: 1 because of cancelation of marriage and the other because of postoperative infection; regular sexual life was achieved in remaining 5 (71%) cases. Conclusion Although there is no consensus about the ideal method of making a functioning vagina among different specialties. The modified McIndoe technique is the most applied method by gynecologists and simple, minimally invasive and with low morbidity. PMID:27403077

  14. Causal Inference in Retrospective Studies.

    ERIC Educational Resources Information Center

    Holland, Paul W.; Rubin, Donald B.

    1988-01-01

    The problem of drawing causal inferences from retrospective case-controlled studies is considered. A model for causal inference in prospective studies is applied to retrospective studies. Limitations of case-controlled studies are formulated concerning relevant parameters that can be estimated in such studies. A coffee-drinking/myocardial…

  15. Tacrolimus for Remission Induction and Maintenance Therapy in Patients with Ulcerative Colitis: A Retrospective Evaluation Study

    PubMed Central

    Ito, Ayumi; Iizuka, Bunei; Omori, Teppei; Nakamura, Shinichi; Tokushige, Katsutoshi

    2016-01-01

    Background. In this retrospective study, we compared the efficacy of tacrolimus (TAC) or prednisolone (PSL) for maintenance therapy in patients with ulcerative colitis (UC) at remission. Methods. The study patients were followed up for at least one year after induction of remission with either PSL (n = 55, between April 2004 and March 2014) or TAC (n = 40, between April 2009 and March 2014). The clinical features and relapse rates were compared in the two groups. Maintenance therapy in the TAC group included TAC alone, AZA alone, and TAC plus AZA. Results. The recurrence rates at 1500 days after remission were 61% and 46% for the PSL and TAC groups, respectively (P < 0.05). The recurrence rates at 600 days for TAC, AZA, and TAC + AZA maintenance groups were 24%, 49%, and 55%, respectively. Nephrotoxicity developed in 16 patients on TAC maintenance therapy. Conclusions. TAC monotherapy is a potential alternative especially for PSL nonresponders or those intolerant to AZA. However, patients on TAC therapy should be regularly monitored for adverse effects including nephrotoxicity. PMID:27413367

  16. Evaluation of factors affecting mortality in Fournier’s Gangrene: Retrospective clinical study of sixteen cases

    PubMed Central

    Oymacı, Erkan; Coşkun, Ali; Yakan, Savaş; Erkan, Nazif; Uçar, Ahmet Deniz; Yıldırım, Mehmet

    2014-01-01

    Objective: Fournier’s gangrene is a progressive, necrotizing fasciitis due to synergistic infection of the perineum and external genitalia that is associated with high mortality and morbidity. The purpose of this study is to review the diagnostic and treatment methods that effect mortality in Fournier’s gangrene. Material and Methods: Sixteen patients who were diagnosed and treated at our clinic between 2011 and 2013 due to Fournier’s gangrene were retrospectively analyzed. The surviving and non-surviving patient groups were compared in terms of age, sex, onset time of symptoms, isolated microorganisms, concomitant diseases, Fournier’s gangrene severity index (FGSI), and length of hospital stay. Results: Ten of our cases (62.5%) were male and six (37.5%) were female, with a mean age of 61.2±12.3 (42–73) years. The mortality rate was 18.8% (3 cases). The mean duration of symptoms before admission was 4.31±1.81 (2–8) days. This period was 6.67±1.52 days in patients who succumbed to death, and 3.77±1.42 days in patients who survived (p=0.007). Ten cases (62.5%) had concomitant diabetes mellitus. The most common organism isolated in wound cultures was Escherichia coli (68.7%), and Acinetobacter baumannii, Proteus mirabilis, methicillin-resistant Staphylococcus aureus and Enterococcus spp. in the remaining patients. The mean FGSI of surviving patients was 3.84±1.77, and 7.66±0.57 in fatal cases (p=0.003). The mean length of hospital stay was 25.5 days (2–57) and duration of hospitalization was significantly longer in survivors (p<0.05). Conclusion: The delay in diagnosis and higher FGSI may be responsible for worsening of prognosis and mortality in Fournier’s gangrene. Early diagnosis and determination of the severity of the disease, aggressive surgical debridement and appropriate antimicrobial therapy may improve prognosis. PMID:25931901

  17. Educational Evaluation: A Retrospective View.

    ERIC Educational Resources Information Center

    Tyler, Ralph W.

    A broad review of educational assessment during the past 40 years (1930's to 1970's) is presented. The review begins with the birth of the term "evaluation", when the depression made educators aware of the need for new programs and ways to appraise them, and continues into an explanation of the Eight-Year Study (1933-41), which gave attention to…

  18. Staged re-evaluation of non-culprit lesions in ST segment elevation myocardial infarction: a retrospective study

    PubMed Central

    Thim, Troels; Egholm, Gro; Olesen, Kevin Kris Warnakula; Kaltoft, Anne; Terkelsen, Christian Juhl; Krusell, Lars Romer; Kristensen, Steen Dalby; Bøtker, Hans Erik; Christiansen, Evald Høj; Maeng, Michael

    2016-01-01

    Objective It remains unknown whether complete revascularisation is optimally performed in patients with ST segment elevation myocardial infarction (STEMI) during the index or at staged procedures. The aims of this study were to quantify the number of primary percutaneous coronary intervention (PCI) procedures in which non-culprit lesions needed further evaluation, to determine the consequence of the re-evaluation and to quantify adverse cardiac events during the waiting time for re-evaluation and intervention. Methods The study was observational and retrospective and included all patients with STEMI treated with primary PCI during 1 year at our centre. Results Among the 507 patients with STEMI, 374 were considered sufficiently treated with culprit lesion PCI only. Complete primary multivessel revascularisation was performed in 11 patients. Non-culprit lesion re-evaluation was planned for 122 patients (24%). Of these 122 patients, 3 patients died during their index admission. Follow-up data were not available for 3 patients. Among the 116 patients, 187 non-culprit lesions were re-evaluated and 77 patients (66.4%) underwent revascularisation with treatment of 119 lesions (63.3%). Re-evaluation was performed after a median of 30 days (25th centile: 9 days, 75th centile: 35 days). During the waiting time for re-evaluation, two patients underwent a new primary PCI due to stent thrombosis of the index culprit lesion. Conclusions Staged re-evaluation of non-culprit lesions observed in patients with STEMI was required in 24% of a primary PCI cohort. Intervention was performed in 66.4% of patients scheduled for re-evaluation. We observed no adverse events related to the non-culprit lesions during the waiting time for a staged re-evaluation or intervention. PMID:27403331

  19. A retrospective study evaluating response time and survival from a cardiopulmonary arrest: a creative inquiry project with undergraduate nursing students.

    PubMed

    Whitcomb, John J; Seawright, Jenna; Wadsworth, Rachel; Flehan, Allison; Duncan, Emily; Easler, Anna Grace; Echols, Lindsey

    2013-01-01

    Cardiopulmonary arrest is a major health problem that claims lives daily in the United States. The adoption of a new standard of care or healthcare technology needs to be evaluated based on patient outcomes. This review focuses on this problem and possible solutions. This retrospective study reviews clinical characteristics of cardiac resuscitative events associated with "code blue" team response. Team-based investigations are led by a faculty mentor and typically span 2 to 4 semesters. Students take ownership of their projects and take the risks necessary to solve problems and get answers. This review indicates areas of concern that need to be improved to create better patient outcomes. Findings include that improved documentation will provide data elements for review analysis that then may be utilized to improve care related to cardiac arrest. PMID:23222232

  20. Evaluating The Effective Factors in Pregnancy after Intrauterine Insemination: A Retrospective Study

    PubMed Central

    Ghaffari, Firoozeh; Sadatmahalleh, Shahideh Jahanian; Akhoond, Mohammad Reza; Eftekhari Yazdi, Poopak; Zolfaghari, Zahra

    2015-01-01

    Background Controlled ovarian hyperstimulation (COH) in conjunction with intrauterine inseminations (IUI) are commonly used to treat infertile couples. In this study we evaluated the relationship between IUI outcome and special causes of infertility. We also aimed to examine parameters that might predict success following IUI. Materials and Methods In this cross-sectional study, we included 994 IUI cycles in 803 couples who referred to the infertility Institute. All statistical analyses were performed by using SPSS program, t tests and chi-square. Stepwise multiple linear regression analysis was performed to compare the association between dependent and independent variables. Logistic regression was conducted to build a prediction model of the IUI outcome. Results Overall pregnancy rate per completed cycle (16.5%) and live birth rate per cycle (14.5%). The mean age in the pregnant group was significantly lower than that of the non-pregnant group (P=0.01).There was an association between cause of infertility and clinical pregnancies (P<0.001). Logistic regression identified four significant factors in determining the success of the IUI [menstrual irregularites (OR:2.3, CI:1.6-3.4, P<0.001), duration of infertility (OR:0.8, CI:0.8-0.9, P<0.001), total dose of gonadotropin (OR:1.02, CI:1.003-1.04, P=0.02) and semen volume (OR:1.1, CI:1.008-1.2, P=0.03)] which were the most predictive of IUI success. Conclusion Our study defined prognostic factors for pregnancy in COH+IUI. These variables can be integrated into a mathematical model to predict the chance of pregnancy rate in subsequent COH+IUI cycles. PMID:26644852

  1. A retrospective study on annual evaluation of radiation processing for frozen bone allografts complying to quality system requirements.

    PubMed

    Ramalingam, Saravana; Mohd, Suhaili; Samsuddin, Sharifah Mazni; Min, N G Wuey; Yusof, Norimah; Mansor, Azura

    2015-12-01

    Bone allografts have been used widely to fill up essential void in orthopaedic surgeries. The benefit of using allografts to replace and reconstruct musculoskeletal injuries, fractures or disease has obtained overwhelming acceptance from orthopaedic surgeons worldwide. However, bacterial infection and disease transmission through bone allograft transplantation have always been a significant issue. Sterilization by radiation is an effective method to eliminate unwanted microorganisms thus assist in preventing life threatening allograft associated infections. Femoral heads procured from living donors and long bones (femur and tibia) procured from cadaveric donors were sterilized at 25 kGy in compliance with international standard ISO 11137. According to quality requirements, all records of bone banking were evaluated annually. This retrospective study was carried out on annual evaluation of radiation records from 1998 until 2012. The minimum doses absorbed by the bones were ranging from 25.3 to 38.2 kGy while the absorbed maximum doses were from 25.4 to 42.3 kGy. All the bones supplied by our UMMC Bone Bank were sterile at the required minimum dose of 25 kGy. Our analysis on dose variation showed that the dose uniformity ratios in 37 irradiated boxes of 31 radiation batches were in the range of 1.003-1.251, which indicated the doses were well distributed. PMID:25687771

  2. The pros and cons of intraoperative CT scan in evaluation of deep brain stimulation lead implantation: A retrospective study

    PubMed Central

    Servello, Domenico; Zekaj, Edvin; Saleh, Christian; Pacchetti, Claudio; Porta, Mauro

    2016-01-01

    Background: Deep brain stimulation (DBS) is an established therapy for movement disorders, such as Parkinson's disease (PD), dystonia, and tremor. The efficacy of DBS depends on the correct lead positioning. The commonly adopted postoperative radiological evaluation is performed with computed tomography (CT) scan and/or magnetic resonance imaging (MRI). Methods: We conducted a retrospective study on 202 patients who underwent DBS from January 2009 to October 2013. DBS indications were PD, progressive supranuclear palsy, tremor, dystonia, Tourette syndrome, obsessive compulsive disorder, depression, and Huntington's disease. Preoperatively, all patients underwent brain MRI and brain CT scan with the stereotactic frame positioned. The lead location was confirmed intraoperatively with CT. The CT images were subsequently transferred to the Stealth Station Medtronic and merged with the preoperative planning. On the first or second day after, implantation we performed a brain MRI to confirm the correct position of the lead. Results: In 14 patients, leads were in suboptimal position after intraoperative CT scan positioning. The cases with alteration in the Z-axis were corrected immediately under fluoroscopic guidance. In all the 14 patients, an immediate repositioning was done. Conclusions: Based on our data, intraoperative CT scan is fast, safe, and a useful tool in the evaluation of the position of the implanted lead. It also reduces the patient's discomfort derived from the transfer of the patient from the operating room to the radiological department. However, intraoperative CT should not be considered as a substitute for postoperative MRI. PMID:27583182

  3. Comparative Evaluation of Prevalence of Upper Cervical Vertebrae Anomalies in Cleft Lip/Palate Patients: A Retrospective Study

    PubMed Central

    Datana, Sanjeev; Kumar, Prasanna; Kumar Roy, Supriya; Londhe, Sanjay

    2014-01-01

    ABSTRACT% Purpose: The patients with cleft lip and palate have a higher risk of cervical vertebrae anomalies than do patients in general population. The aim of present study was to determine the prevalence of various upper cervical spine anomalies in different type of clefts. Procedures: Lateral cephalograms of 128 patients (66 males, 62 females) with cleft lip and palate, and 125 (60 males, 65 females) non syndromic patients without cleft lip and palate were selected at random from archive. Cephalograms of the patients were traced and the diagnosis of any cervical vertebrae anomaly was noted. Anomalies were categorized as either: posterior arch deficiency or fusions. Main findings: Prevalence of cervical vertebrae anomalies in the c lef t group was 20. 3% while it was 6.4% in the control group. Further cervical vertebrae anomalies were 16.6% in the CPO group, 19.1% in the BCLP group, and 22.2% in the UCLP group. Conclusion: A higher prevalence of cervical vertebrae anomalies was observed in cleft lip and palate patients. The prevalenc e obser ved is 3 times more in clef t group than c ontrol group. How to cite this article: Datana S, Bhalla A, Kumar P, Roy SK, Londhe S. Comparative Evaluation of Prevalence of Upper Cervical Vertebrae Anomalies in Cleft Lip/Palate Patients: A Retrospective Study. Int J Clin Pediatr Dent 2014;7(3):168-171. PMID:25709295

  4. Retrospective study evaluating the performance of a first-trimester combined screening for trisomy 21 in an Italian unselected population

    PubMed Central

    Padula, Francesco; Cignini, Pietro; Giannarelli, Diana; Brizzi, Cristiana; Coco, Claudio; D’Emidio, Laura; Giorgio, Elsa; Giorlandino, Maurizio; Mangiafico, Lucia; Mastrandrea, Marialuisa; Milite, Vincenzo; Mobili, Luisa; Nanni, Cinzia; Raffio, Raffaella; Taramanni, Cinzia; Vigna, Roberto; Mesoraca, Alvaro; Bizzoco, Domenico; Gabrielli, Ivan; Di Giacomo, Gianluca; Barone, Maria Antonietta; Cima, Antonella; Giorlandino, Francesca Romana; Emili, Sabrina; Cupellaro, Marina; Giorlandino, Claudio

    2014-01-01

    Objectives to assess the performance of a combined first-trimester screening for trisomy 21 in an unselected Italian population referred to a specialized private center for prenatal medicine. Methods a retrospective validation of first-trimester screening algorithms [risk calculation based on maternal age and nuchal translucency (NT) alone, maternal age and serum parameters (free β-hCG and PAPP-A) alone and a combination of both] for fetal aneuploidies evaluated in an unselected Italian population at Artemisia Fetal-Maternal Medical Centre in Rome. All measurements were performed between 11+0 and 13+6 weeks of gestation, between April 2007 and December 2008. Results of 3,610 single fetuses included in the study, we had a complete follow-up on 2,984. Fourteen of 17 cases of trisomy 21 were detected when a cut-off of 1:300 was applied [detection rate (DR) 82.4%, 95% confidence interval (CI) 64.2–100; false-positive rate (FPR) 4.7%, 95% CI 3.9–5.4; false-negative rate (FNR) 17.6%, 95% CI 0–35.8%]. Conclusion in our study population the detection rate for trisomy 21, using the combined risk calculation based on maternal age, fetal NT, maternal PAPP-A and free β-hCG levels, was superior to the application of either parameter alone. The algorithm has been validated for first trimester screening in the Italian population. PMID:26266002

  5. Three-Dimensional Evaluation of Implant Positioning in the Maxillary Sinus Septum: A Retrospective Study

    PubMed Central

    Dragan, Eliza; Guillaume, Odri A.; Haba, Danisia; Olszewski, Raphael

    2015-01-01

    Background The aim of this study was to simulate implant placement in the maxillary sinus septum, as a potential alternative site to avoid sinus grafting. Material/Methods One hundred partially or completely edentulous patients, with their maxillary sinus septum present in the edentulous region, were selected from the database of the Department of Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Bruxelles, Belgium. Three-dimensional (3D) reconstructions were created using 3D planning software. 3D reconstructions were performed for each maxillary sinus. Using the software implant library, the implants that presented the best fit with the maxillary sinus septum and that followed the established inclusion criteria were selected. Results All of the implants were inserted in premolar and molar regions. Most implants were inserted in the position of the second molar (21 of 55) or in the position of the first molar (17 of 55). In all sites the most frequently used implant was 4 mm in diameter and 7 mm in height. The mean coronal angle for the implant was 80.19±17.13 degrees and the mean sagittal angle was 94.83±9.94 degrees. The septal height represents 38.13% of the total available bone height (ABH). The mean percentage of the septum used to insert the implants was 47.33±2.47%. The septum increased the available bone height by a mean value of 2.18±1.47 mm. In 45 cases, the septa did not permit implant placement. Conclusions In completely edentulous patients, inserting implants in sinus septa does not exclude the need for sinus grafting, but in partially edentulous patients, this minimally invasive technique is an alternative to subantral augmentation. PMID:26363865

  6. Evaluation of the effectiveness of early or delayed treatment upon healing of mandibular fractures: A retrospective study

    PubMed Central

    Gazal, Giath

    2015-01-01

    Objectives: This study was aimed to assess the impacts of delay treatment of mandibular fracture and its complications. In addition risk variables related such as time to repair, fracture types, substance abuse, causes, surgical management, muddling or complications and duration of clinic stay were also evaluated. Materials and Methods: The data of patients attending the Newcastle General Hospital, UK for the management of mandibular fractures were probed. This retrospective clinical trial conducted over 6 months, included 91 patients attending trauma operating theatre during weekdays or weekends. Data were analyzed for time to admission and treatment and its relationships to various factors using SPSS version 20 (SPSS Inc., Chicago, IL). Results: Time to treatment from the point of admission was 31.50 ± 3.83 h during week days that has been significantly more for patients attending the hospital at weekends or nights. Similar trend was observed for total summative time from the incident to treatment analysis. Conclusions: This investigation has demonstrated that the rate of infection and postoperative complications following surgical treatment of mandible fractures can be eased off by reducing the waiting time from presentation to the emergency and to the operating theater. PMID:25713490

  7. Evaluation of dental panoramic radiographic findings in edentulous jaws: A retrospective study of 743 patients "Radiographic features in edentulous jaws"

    PubMed Central

    Kose, Taha Emre; Cakir Karabas, Hulya; Ozcan, Ilknur

    2015-01-01

    PURPOSE The aim of this study was to determine the frequency of significant panoramic radiographic findings and eventual treatment requirements before conventional or implant supported prosthetic treatment in asymptomatic edentulous patients. MATERIALS AND METHODS A total of 743 asymptomatic edentulous patients were retrospectively evaluated using a digital panoramic system. We analyzed the radiographic findings, including impacted teeth, retained root fragments, foreign bodies, severe atrophy of the posterior maxillary alveolar bone, mucous retention cysts, soft tissue calcifications and radiopaque-radiolucent conditions. RESULTS Four-hundred-eighty-seven (65.6%) patients had no radiographic finding. A total of 331 radiographic findings were detected in 256 (34%) patients. In 52.9% (n=175) of these conditions, surgical treatment was required before application of implant-supported fixed prosthesis. However, before application of conventional removable prosthesis surgical treatment was required for 6% (n=20) of these conditions. CONCLUSION The edentulous patients who will have implant placement for implant-supported fixed prosthesis can frequently require additional surgical procedures to eliminate pathological conditions. PMID:26576254

  8. Evaluation of pulmonary sequestration with multidetector computed tomography angiography in a select cohort of patients: A retrospective study

    PubMed Central

    Long, Qihua; Zha, Yunfei; Yang, Zhigang

    2016-01-01

    OBJECTIVES: This study aimed to evaluate the role of multidetector computed tomography angiography in diagnosing patients with pulmonary sequestration. METHODS: We retrospectively analyzed the computed tomography studies and clinical materials of 43 patients who had undergone preoperative multidetector computed tomography angiography in our hospital and had pathologically proven pulmonary sequestration. Each examination of pulmonary sequestration was reviewed for type, location, parenchymal changes, arterial supply and venous drainage on two-dimensional and three-dimensional computed tomography images. RESULTS: Multidetector computed tomography successfully detected all pulmonary sequestrations in the 43 patients (100%). This included 40 patients (93.0%) with intralobar sequestration and 3 patients (7.0%) with extralobar sequestration. The locations of pulmonary sequestration were left lower lobe (28 cases, 70% of intralobar sequestrations), right lower lobe (12 cases, 30% of intralobar sequestrations) and costodiaphragmatic sulcus (3 cases). Cases of sequestered lung presented as mass lesions (37.2%), cystic lesions (32.6%), pneumonic lesions (16.3%), cavitary lesions (9.3%) and bronchiectasis (4.6%). The angioarchitecture of pulmonary sequestration, including feeding arteries from the thoracic aorta (86.1%), celiac truck (9.3%), abdominal aorta (2.3%) and left gastric artery (2.3%) and venous drainage into inferior pulmonary veins (86.0%) and the azygos vein system (14.0%), was visualized on multidetector computed tomography. Finally, the multidetector computed tomography angiography results of the sequestered lungs and angioarchitectures were surgically confirmed in all the patients. CONCLUSIONS: As a noninvasive modality, multidetector computed tomography angiography is helpful for making diagnostic decisions regarding pulmonary sequestration with high confidence and for visualizing the related parenchymal characteristics, arterial supply, and venous drainage

  9. Retrospective Evaluation of Anaesthetic Techniques for Caesarean

    PubMed Central

    Sarı, Melek Aksoy; Küçükgüçlü, Semih; Özbilgin, Şule; Günenç, Ferim Sakize; Mercan, Sümeyye; Esen, Ayşenur; Yetim, Büşra

    2015-01-01

    Objective This study aimed to evaluate the maternal, foetal and neonatal effects of anaesthetic techniques used in caesarean sections (C/S) retrospectively over 6 years at the Hospital of Medical School of Dokuz Eylül University and to compare the results with the literature from Turkey and developed countries. Methods After obtaining approval from the ethics committee, anaesthetic and gestational data from all caesarean operations performed over a 6-year period between 2005 and 2010 was retrospectively obtained from hospital archives. Results During this period, a total of 10,819 labours was conducted and C/S ratio was 55% with 5953 patients. General anaesthesia was performed in 1479 patients (24.8%) and regional anaesthesia was performed in 4474 patients (75.2%) [Spinal anaesthesia for 1203 patients (26.9%), epidural anaesthesia for 830 patients (18.5%) and combined spinal-epidural anaesthesia for 2441 patients (54.6%)]. In 2010, regional anaesthesia ratio increased to 84.6%, whereas in 2005, it was 63.8%. Regional anaesthesia was used significantly more often in both elective and urgent patients (82% elective and 65.2% emergency). Because of failed regional anaesthesia or surgical complications, anaesthesia was changed to general anaesthesia in 215 patients (4.8%). APGAR scores in 1 and 5 min were significantly higher with regional anaesthesia when compared with general anaesthesia. Conclusion Regional anaesthesia rate for C/S patients in the Hospital of Medical School of Dokuz Eylül University is increased and is higher than Turkey’s average; but these figures are still lower than those in the developed countries. PMID:27366533

  10. Non-Invasive and Minimally Invasive Imaging Evaluation of CSF Rhinorrhoea – a Retrospective Study with Review of Literature

    PubMed Central

    Vimala, Leena Robinson; Jasper, Anitha; Irodi, Aparna

    2016-01-01

    Summary Background Localization of a cerebrospinal fluid [CSF] fistula is a diagnostic challenge. The choice of an optimal imaging technique is necessary to locate the site of CSF leak which is required for surgical/endoscopic repair of the CSF fistula. Material/Methods Retrospective analysis of imaging was performed in 33 patients who presented with symptoms suggestive of CSF rhinorrhoea over a period of two years. Either a bone defect on high resolution CT [HRCT] or CSF column extending extracranially from the subarachnoid space with or without brain/ meningeal herniation on magnetic resonance [MR] cisternography was considered positive for CSF leak. The MR imaging technique included 1-mm heavily T2-weighted [TR 2000 ms; TE-200 ms] fast spin echo study in coronal and sagittal planes. HRCT sections involved 0.625 to 0.8-mm sections in the coronal plane, with or without axial planes, through the paranasal sinuses, reconstructed in a sharp algorithm and acquired with the patient in prone position. Imaging findings were compared with endoscopic findings, being the gold standard for the assessment of CSF rhinorrhea. Results A total of 25 patients had a combination of HRCT and MR cisternography. The sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV] of both MR cisternography and HRCT together were 93%, 100%, 100% and 50% respectively. Two patients underwent only MR cisternography, 5 patients underwent only HRCT and one patient underwent HRCT, MR cisternography and CT cisternography. Though PPV was 100% in the groups with HRCT alone, MR cisternography alone and combined CT cisternography, HRCT and MR cisternography, the results were not statistically significant as the number of patients in those groups was lower. Conclusions Combination of MR cisternography and HRCT appears to be complementary, accurate and non-invasive and should be considered as optimal imaging modality for pre-op imaging in the evaluation of CSF rhinorrhoea

  11. Evaluation of the associations between changes in intraocular pressure and metabolic syndrome parameters: a retrospective cohort study in Japan

    PubMed Central

    Yokomichi, Hiroshi; Kitamura, Kazuyoshi; Yoda, Yoshioki; Tsuji, Masahiro; Sato, Miri; Mizorogi, Sonoko; Suzuki, Kohta; Yamagata, Zentaro

    2016-01-01

    Objective The contributions of highly correlated cardiovascular risk factors to intraocular pressure (IOP) are not clear due to underlying confounding problems. The present study aimed to determine which metabolic syndrome parameters contribute to elevating IOP and to what extent. Design Retrospective cohort study. Setting A private healthcare centre in Japan. Participants Individuals who visited a private healthcare centre and underwent comprehensive medical check-ups between April 1999 and March 2009 were included (20 007 in the cross-sectional study and 15 747 in the longitudinal study). Primary and secondary outcome measures Changes in IOP were evaluated in terms of ageing and changes in metabolic syndrome parameters. Pearson's correlation coefficients and mixed-effects models were used to examine the relationship of changes in IOP with ageing and changes in metabolic syndrome parameters in cross-sectional and longitudinal studies, respectively. Results In the cross-sectional study, IOP was negatively correlated with age and positively correlated with waist circumference, high-density lipoprotein cholesterol (HDL-C) levels, triglyceride levels, systolic blood pressure (SBP), diastolic blood pressure (DBP) and fasting plasma glucose (FPG) levels. In the longitudinal multivariate analysis, the associated IOP changes were −0.12 (p<0.0001) mm Hg with male sex; −0.59 (p<0.0001) mm Hg with 10 years of ageing; +0.42 (p<0.0001) mm Hg with 1 mmol/L increase in HDL-C levels; +0.092 (p<0.0001) mm Hg with 1 mmol/L increase in triglyceride levels; +0.090 (p<0.0001) mm Hg with 10 mm Hg increase in SBP; +0.085 (p<0.0001) mm Hg with 10 mm Hg increase in DBP; and+0.091 (p<0.0001) mm Hg with 1 mmol/L increase in FPG levels. Conclusions Elevation of IOP was related to longitudinal worsening of serum triglyceride levels, blood pressure and FPG and improvement in serum HDL-C levels. PMID:27013596

  12. Osha`s 1974 vinyl chloride standard. Retrospective evaluation of the rulemaking`s feasibility/impact estimates. Case study

    SciTech Connect

    Boroush, M.A.

    1993-11-01

    This report documents a case study of the Occupational Safety and Health Administration`s (OSHA) permanent health standard of 1974 for workplace exposures to vinyl chloride (monomer). OSHA`s assessment of hazard control options and estimates of compliance costs and other regulatory impacts prepared as part of the rationale for the rulemaking are reviewed and then compared and contrasted with the actual post-promulgation outcomes as affected industries adjusted to the new compliance requirements. This case study has been prepared as part of a larger Office of Technology Assessment (OTA) evaluation of the control technology and regulatory impact analyses that OSHA prepares to support its rulemakings. Congress requested in May 1992 that OTA examine OSHA`s procedures and methods in these regards. The case reported here is one of eight OSHA health and safety standards that have been similarly studied on a pre- and post-promulgation basis.

  13. Evaluation of Superselective Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate in Treating Lower Gastrointestinal Bleeding: A Retrospective Study on Seven Cases

    PubMed Central

    Zhao, Yuan; Li, Gang; Yu, Xiang

    2016-01-01

    Background. To investigate the safety and efficacy of superselective transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) in treating lower gastrointestinal bleeding caused by angiodysplasia. Methods. A retrospective study was performed to evaluate the clinical data of the patients with lower gastrointestinal bleeding caused by angiodysplasia. The patients were treated with superselective TAE with NBCA between September 2013 and March 2015. Angiography was performed after the embolization. The clinical signs including melena, anemia, and blood transfusion treatment were evaluated. The complications including abdominal pain and intestinal ischemia necrosis were recorded. The patients were followed up to evaluate the efficacy in the long run. Results. Seven cases (2 males, 5 females; age of 69.55 ± 2.25) were evaluated in the study. The embolization was successfully performed in all cases. About 0.2–0.8 mL (mean 0.48 ± 0.19 mL) NCBA was used. Immediate angiography after the embolization operation showed that the abnormal symptoms disappeared. The patients were followed up for a range of 2–19 months and six patients did not reoccur. No serious complications, such as femoral artery puncture point anomaly, vascular injury, and intestinal necrosis perforation were observed. Conclusion. For the patients with refractory and repeated lower gastrointestinal hemorrhage due to angiodysplasia, superselective TAE with NBCA seem to be a safe and effective alternative therapy when endoscopy examination and treatment do not work. PMID:27528867

  14. Laparoscopic ventral mesh rectopexy for complete rectal prolapse: A retrospective study evaluating outcomes in North Indian population

    PubMed Central

    Chandra, Abhijit; Kumar, Saket; Maurya, Ajeet Pratap; Gupta, Vishal; Gupta, Vivek; Rahul

    2016-01-01

    AIM: To analyze the outcomes of laparoscopic ventral mesh rectopexy in the management of complete rectal prolapse (CRP) in North Indian patients with inherent bulky and redundant colon. METHODS: The study was conducted at a tertiary health care center of North India. Between January 2010 and October 2014, 15 patients who underwent laparoscopic ventral mesh repair for CRP, were evaluated in the present study. Perioperative outcomes, improvement in bowel dysfunction or appearance of new complications were documented from the hospital records maintained prospectively. RESULTS: Fifteen patients (9 female) with a median age of 50 years (range, 15-68) were included in the study. The median operative time was 200 min (range, 180-350 min) and the median post-operative stay was 4 d (range, 3-21 d). No operative mortality occurred. One patient with inadvertent small bowel injury required laparotomy on post-operative day 2. At a median follow-up of 22 mo (range, 4-54 mo), no prolapse recurrence was reported. No mesh-related complication was encountered. Wexner constipation score improved significantly from the preoperative value of 17 (range, 5-24) to 6 (range, 0-23) (P < 0.001) and the fecal incontinence severity index score from 24 (range, 0-53) to 2 (range, 0-53) (P = 0.007). No de novo constipation or fecal incontinence was recorded during the follow-up. On personal conversation, all patients expressed satisfaction with the outcome of their treatment. CONCLUSION: Our experience indicates that laparoscopic ventral mesh rectopexy is an effective surgical option for CRP in North Indian patients having a bulky redundant colon. PMID:27152139

  15. A retrospective evaluation of species-specific sensitivity for neurological signs in toxicological studies: Is the dog more sensitive than the non-human primate?

    PubMed

    Backes, Kathrin; Lorenz, Helga; Laplanche, Loic; Hudzik, Thomas J; Potschka, Heidrun; Hempel, Katja

    2016-01-22

    Selection of the appropriate non-rodent species in preclinical programs is crucial for good translatability and human safety. There is no data available in the literature which provides exact comparison of dog and non-human primate (NHP) sensitivity regarding neurological signs in toxicological studies. We performed a retrospective analysis of 174 toxicity studies with 15 neuroscience substances. Neurological signs in dogs and NHPs were evaluated in correlation to exposure data. Overall incidence of substance induced convulsions was similar in both species and no gender differences were observed. The reported liability of beagles to spontaneous convulsions was not confirmed in our studies. The symptom tremor showed the best inter-species translatability. The current toxicological study design does not include exposure assessment at the time-point of neurological signs, therefore, we propose to include additional toxicokinetic samples. Our analysis revealed factors including housing, handling, and behavior, which prevents direct species comparison. In addition only one non-rodent species is routinely tested in development programs, therefore data for both species is rare. We however, had sufficient data which enabled comparison for one compound. In the spirit of 3Rs further examples should be evaluated. PMID:26732424

  16. Childhood Maltreatment in South Korea: Retrospective Study

    ERIC Educational Resources Information Center

    Lee, Yanghee; Kim, Sangwon

    2011-01-01

    Objective: This study explored the prevalence of childhood maltreatment in South Korea using the retrospective version of ICAST and the associations between perceptions of abuse experienced during childhood and recent interpersonal problems and depression. Methods: 539 young persons, aged 18-24 years, from various universities, work places, and…

  17. Clinical evaluation of chitotriosidase enzyme activity in Gaucher and Niemann Pick A/B diseases: A retrospective study from India.

    PubMed

    Kadali, Srilatha; Kolusu, Anusha; Sunkara, Satish; Gummadi, Maheshwar Reddy; Undamatla, Jayanthi

    2016-06-01

    Plasma chitotriosidase originates from activated macrophages and is reported to be elevated in many Lysosomal Storage Disorders. Measurement of this enzyme activity has been an available tool for monitoring therapy of Gaucher disease. The degree of elevation of chitotriosidase is useful for differential diagnosis of Gaucher disease and Niemann Pick A/B. However the potential utility of this chitotriosidase assay depends on the frequency of deficient chitotriosidase activity in a particular population. We therefore aim to study the clinical utility of this assay Gaucher and Niemann Pick A/B diseases in the backdrop of chitotriosidase deficiency in our population. The study comprises 173 patients with clinical suspicion of either Gaucher disease (n=108) or Niemann Pick A/B (n=65) and 92 healthy controls. The plasma samples of controls, Gaucher disease, and Niemann Pick A/B showed chitotriosidase deficiency of 12%, 25% and 27% respectively. The degree of elevation of chitotriosidase in Gaucher disease and Niemann Pick A/B patients is 40-326 (11,325.7±6395.4nmol/h/ml) and 7-22 folds (1192.5±463.0nmol/h/ml) respectively. In view of these findings of distinguishable fold elevation of chitotriosidase in Gaucher disease or Niemann Pick A/B, it can be a potential surrogate differential diagnostic marker for these groups of diseases, except in the patients in whom this enzyme is deficient. PMID:26975750

  18. Daptomycin Therapy for Osteomyelitis: A Retrospective Study

    PubMed Central

    2012-01-01

    Background Daptomycin is a rapidly bactericidal agent with broad coverage against Gram-positive organisms, including Staphylococcus aureus, the most frequent cause of osteomyelitis. The objective of this study was to describe the clinical outcome of patients with non-hardware associated osteomyelitis, and the safety profile of daptomycin in the treatment of these infections. Methods All patients with osteomyelitis, excluding concurrent orthopedic foreign body infections, treated with daptomycin and identified between 2007–2008 in a retrospective, multicenter, observational registry, were included. Investigators assessed patient outcome (cured, improved, failed, non-evaluable) at the end of daptomycin therapy. Patients with a successful outcome at the end of daptomycin therapy were reassessed in 2009. All patients were included in the safety analysis; evaluable patients were included in the efficacy analysis. Data was assessed using descriptive statistics. A Kaplan Meier analysis was used to assess time to clinical failure. Results Two-hundred and nine osteomyelitis patients successfully completed daptomycin therapy in 2007–2008, 71 of which (34%) had a follow-up visit in 2009 and had an evaluable clinical outcome. The median (min, max) daptomycin dose and duration were 6 mg/kg (4, 10) and 42 days (1, 88), respectively. Of the 52 patients with a documented pathogen, S. aureus was the most common (42%); primarily methicillin-resistant S. aureus. All patients were included in the safety analysis; evaluable patients were included in the efficacy analysis. Clinical resolution was reported in 94% (CI - 86.2%, 98.44%) of patients. A Kaplan Meier analysis of time to clinical failure showed that approximately 85% (CI – 64%, 95%) of patients had a continued successful outcome at the time of re-evaluation. Eighteen patients (25%) in the safety population experienced an adverse event; 13 patients (18%) had an adverse event that was possibly-related to daptomycin

  19. Studies Relative to the Radiosensitivity of Man: Based on Retrospective Evaluations of Therapeutic and Accidental Total-Body Irradiation

    NASA Technical Reports Server (NTRS)

    Ricks, R. C. (Compiler); Lushbaugh, C. C. (Compiler)

    1975-01-01

    The radiobiologic studies carried out with joint (AEC) ERDA and NASA support during the years 1964 to 1974 at the Medical Division of Oak Ridge Associated Universities are presented. The physiologic data generated were similar in many ways to those previously observed in other medical radiobiologic experiences. They differed, however, in the methods of data acquisition and analysis. Instead of more conventional analytical methods, pulmonary impedance was recorded and quantitated as a measure of radiation-induced gastrointestinal distress and fatiguability. While refinements in dose response related to gastrointestinal distress were accomplished, it was also found that through the use of Fourier analysis of pulmonary impedance waveform GI distress could easily be recognized and quantified even when the initial stages of nausea were below the subjects subjective level of recognition. The results demonstrate that change in pulmonary impedance waveform closely parallel well-defined stages of GI distress, i.e., initial nausea, a progressive increase in nausea, and finally vomiting episodes.

  20. Applied Pharmacokinetics: Course Description and Retrospective Evaluation.

    ERIC Educational Resources Information Center

    Beck, Diane E.

    1984-01-01

    An applied course designed to allow students to formulate pharmacokinetic recommendations individually for actual patient data and compare their recommendations to those of a pharmacokinetic consulting service is described and evaluated, and an objective student evaluation method is outlined. (MSE)

  1. A retrospective study of nineteen ataxic horses

    PubMed Central

    Nappert, Germain; Vrins, André; Breton, Luc; Beauregard, Michel

    1989-01-01

    A retrospective study of 19 ataxic horses admitted to the College of Veterinary Medicine of the University of Montreal during the period of January 1985 to December 1988 is presented. There were 11 cases of cervical vertebral malformation, four of equine degenerative myeloencephalopathy, two of equine protozoal myeloencephalitis, one each of vertebral osteomyelitis and intervertebral disc protrusion. The clinical diagnosis of ataxia in horses requires neurological, radiographic, myelographic, and laboratory examinations. ImagesFigure 1.Figure 2.Figure 3. PMID:17423438

  2. [Deep neck infections: a retrospective study].

    PubMed

    Bagnati, Tania; Olina, Massimo; Guglielmetti, Chiara; Borello, Giovanni; Valletti, Paolo Aluffi; Pia, Francesco; Garavelli, Pietro Luigi

    2007-09-01

    A retrospective study was carried out on 79 patients with deep neck infections (DNI) admitted to our Department between 1990 and 2005 in order to review our experience with DNI and verify if diabetic and immunocompromised patients have more aggressive infections and poorer prognosis. Demographics, clinical presentation, etiology, site of infection, associated systemic diseases (26.6%-21/79), microbiology, treatment and complications were considered. PMID:17902568

  3. The Evaluation of the Effectiveness of Austrians Disease Management Program in Patients with Type 2 Diabetes Mellitus - A Population-Based Retrospective Cohort Study

    PubMed Central

    Riedl, Regina; Robausch, Martin; Berghold, Andrea

    2016-01-01

    Aim To evaluate the effectiveness of the Austrian Disease Management Program (DMP) ‘Therapie aktiv—Diabetes im Griff’ for patients with type 2 diabetes mellitus concerning patient-relevant outcomes (mortality, myocardial infarction and stroke) and costs. Methods Based on routine health insurance data, we conducted a population-based retrospective cohort study using a propensity score (PS) matched control group design. The DMP-group consists of participants enrolled in the program during 2008 and 2009 (n = 7181). Out of 208.532 patients with no participation in the DMP up to 2013, PS-matched controls were selected with a matching ratio 1:3. In the PS-model, patient’s characteristics, form of antidiabetic drug therapy, several prescriptions, the number of hospital admissions and days, main discharge diagnoses and costs at baseline were included. Results Over a follow-up period of four years, we observed a significantly lower mortality rate in the DMP-group (9.4%) in comparison with the control group (15.9%, p<0.001). The cumulative number of hospital days and mean annual hospital costs were lower for DMP-participants resulting in significantly lower mean annual total costs, amounting to € 8226.80 per patient in the DMP-group and € 9231.10 in the control group respectively (p<0.001). Conclusions The evaluation shows a survival benefit and an average reduction of costs for participants in the DMP compared with the control-group. Despite we took great effort to ensure comparable groups, we cannot entirely rule out an influence by residual and unmeasured confounding due to the observational study design and the use of routine data. However, the results indicate that the disease management program implemented in Austria improves quality of care for patients with type 2 diabetes mellitus. PMID:27532885

  4. A Controlled and Retrospective Study of 144 Chronic Low Back Pain Patients to Evaluate the Effectiveness of an Intensive Functional Restoration Program in France

    PubMed Central

    Caby, Isabelle; Olivier, Nicolas; Janik, Frédérick; Vanvelcenaher, Jacques; Pelayo, Patrick

    2016-01-01

    Study Design: A controlled and retrospective study of 144 chronic low back pain patients to evaluate the effectiveness of an intensive functional restoration program in France. Objective: Evaluating the efficiency of an intensive, dynamic and multidisciplinary functional restoration program in patients with chronic low back pain (LBP), during 6 and 12 months follow up. Summary of background data: Chronic low back pain disease has a multifactor nature, involving physical, psychological professional and social factors. A functional restoration program (FRP) has been included in a multidisciplinary training program which provides an efficient therapeutic solution. However, the effectiveness of an FRP has not been yet established. Methods: 144 subjects (71 males, 73 females) with chronic low back pain were included in a functional restoration program. The FRP includes physiotherapy and occupational therapy interventions together with psychological counselling. Patients participated as in- or outpatients 6 h per day, 5 days a week over 5 weeks. Pain intensity, trunk flexibility, trunk strength, lifting ability, quality of life and return to work were recorded before, immediately after, and at 6 months and 12 months after the treatment period. Results: All outcome measures were significantly higher just after the FRP (144 patients) and at 6 and 12 months (from available data in 31 subjects) compared to pre-treatment values. This FRP for chronic low back pain maintained its benefits whatever the patient’s activities. Conclusions: The effects reflected on all outcome measures, both on short and long term follow-up. The multidisciplinary FRP for chronic low back pain patients durably stopped the de-conditioning syndrome and involved new life-style habits for the patient, daily pain management and a return to work. PMID:27417611

  5. A retrospective cohort study evaluating efficacy in high-risk patients with chronic lower extremity ulcers treated with negative pressure wound therapy.

    PubMed

    Yao, Min; Fabbi, Matteo; Hayashi, Hisae; Park, Nanjin; Attala, Khaled; Gu, Gousheng; French, Michael A; Driver, Vickie R

    2014-10-01

    The purpose of this study was to evaluate the efficacy of negative pressure wound therapy (NPWT) compared with standard of care on wound healing in high-risk patients with multiple significant comorbidities and chronic lower extremity ulcers (LEUs) across the continuum of care settings. A retrospective cohort study of 'real-world' high-risk patients was conducted using Boston University Medical Center electronic medical records, along with chart abstraction to capture detailed medical history, comorbidities, healing outcomes and ulcer characteristics. A total of 342 patients, 171 NPWT patients with LEUs were matched with 171 non-NPWT patients with respect to age and gender, were included in this cohort from 2002 to 2010. The hazard ratios (HRs) were estimated by COX proportional hazard models after adjusting for potential confounders. The NPWT patients were 2·63 times (95% CI = 1·87-3·70) more likely to achieve wound closure compared with non-NPWT patients. Moreover, incidence of wound closure in NPWT patients were increased in diabetic ulcers (HR = 3·26, 95% CI = 2·21-4·83), arterial ulcers (HR = 2·27, CI = 1·56-3·78) and venous ulcers (HR = 6·31, 95% CI = 1·49-26·6) compared with non-NPWT patients. In addition, wound healing appeared to be positively affected by the timing of NPWT application. Compared with later NPWT users (1 year or later after ulcer onset), early NPWT users (within 3 months after ulcer onset) and intermediate NPWT users (4-12 months after ulcer onset) were 3·38 and 2·18 times more likely to achieve wound healing, respectively. This study showed that despite the greater significant comorbidities, patients receiving NPWT healed faster. Early use of NPWT demonstrated better healing. The longer the interval before intervention is with NPWT, the higher the correlation is with poor outcome. PMID:23163962

  6. Evaluation of cotrimoxazole use as a preventive therapy among patients living with HIV/AIDS in Gondar University Referral Hospital, northwestern Ethiopia: a retrospective cross-sectional study

    PubMed Central

    Gebresillassie, Begashaw Melaku; Gebeyehu, Minaleshewa Biruk; Abegaz, Tadesse Melaku; Erku, Daniel Asfaw; Mekuria, Abebe Basazn; Tadesse, Yokabd Dechassa

    2016-01-01

    Purpose Cotrimoxazole preventive therapy (CPT) is a feasible, inexpensive, and well-tolerated way of using cotrimoxazole intervention for patients living with HIV/AIDS to reduce HIV/AIDS-related morbidities and mortalities caused by various bacteria, fungi, and protozoa. The aim of this study was to evaluate the use of cotrimoxazole as a prophylaxis therapy among patients living with HIV/AIDS at Gondar University Referral Hospital (GURH), northwestern Ethiopia. Materials and methods A retrospective cross-sectional study was used to evaluate the use of cotrimoxazole as a prophylaxis therapy among people living with HIV/AIDS at GURH, northwestern Ethiopia from September 2013 to October 2015. Medical records of 264 patients were selected by using systematic random sampling technique from the sampling frame list of all patients’ medical records. Data were collected from patients’ medical records using the structured checklist and evaluated against World Health Organization (WHO) guidelines on the use of cotrimoxazole prophylaxis. The quantitative data were analyzed using the statistical packages for social sciences Version 20. Descriptive and binary logistic regression analyses were used to describe and assess the association between different variables. Results Approximately 95 (36.0%) patients were at WHO clinical stage III at the start of CPT. The use of CPT was consistent with the guidelines in the rationale for indication 200 (75.75%) and dose 263 (99.62%), despite the presence of contraindications in 24 (9.90%) patients. The occurrence of cotrimoxazole-associated side effects was higher in the first month of therapy. Problems regarding drug–drug interactions were identified in 63 (23.86%) patients, and 92 (34.84%) patients discontinued CPT due to different reasons. Conclusion Although the practice of discontinuation of CPT and follow-up for adverse drug effects were not consistent with WHO guidelines on the rational use of cotrimoxazole prophylaxis, the use

  7. Retrospective studies of operating problems in air transport

    NASA Technical Reports Server (NTRS)

    Billings, C. E.; Lauber, J. K.; Cooper, G. E.; Ruffell-Smith, H. P.

    1976-01-01

    An epidemiological model for the study of human errors in aviation is presented. In this approach, retrospective data are used as the basis for formulation of hypotheses as to system factors which may have contributed to such errors. Prospective experimental studies of aviation operations are also required in order to prove or disprove the hypotheses, and to evaluate the effectiveness of intervention techniques designed to solve operational problems in the aviation system.

  8. Retrospectively evaluated preinjury personality traits influence postconcussion symptoms.

    PubMed

    Yuen, Kit-Man; Tsai, Yi-Hsin; Lin, Wei-Chi; Yang, Chi-Cheng; Huang, Sheng-Jean

    2016-01-01

    Postconcussion symptoms (PCS) are not uncommon following mild traumatic brain injury (mTBI). Personality traits have always been viewed as one of the most important explanations for persistent postconcussion symptoms (PPCS). Unfortunately, studies on the association between preinjury personality traits and the PPCS are still limited. This study thus aimed to examine the relationship between the preinjury personality and PCS in patients with mTBI. A total of 106 participants including 53 healthy participants were recruited. All participants complete the modified Checklist of Postconcussion Symptoms and the Health, Personality, & Habit Scale. Participants were evaluated within 4 weeks and at 4 months, respectively, after injury. The results showed patients reported significantly more PCS than healthy participants did within 4 weeks postinjury. A significant positive association between PCS and retrospectively evaluated preinjury personality was found. Specifically, patients who reported that their preinjury personality was depressive or anxious-related presented more PCS. This study might be the first to directly demonstrate that preinjury personality traits are closely linked to PCS reporting in patients with mTBI. Importantly, PCS reporting might be associated with different personality traits at different periods after injuries, and thus, a careful evaluation for personality characteristics is merited after mTBI. PMID:26786604

  9. Clinical evaluation of implant survival based on size and site of placement: A retrospective study of immediate implants at single rooted teeth sites

    PubMed Central

    Ramalingam, Sundar; Al-Hindi, Maryam; Al-Eid, Raniah Abdullah; Nooh, Nasser

    2015-01-01

    Objectives This retrospective clinical study sought to evaluate the survival of immediate implants placed at maxillary and mandibular single-rooted tooth extraction sites and to determine the relationship among implant size, placement site, and implant survival. Methods Between January 2010 and June 2011, 85 patients (33 males, 52 females; mean age: 45 years) underwent immediate implant placement after extraction of single-rooted teeth. All implants were restored between 12 and 14 weeks after implant placement. The implant survival and its relationship with implant size and implantation site were evaluated by odds ratios (ORs). Results Implants were placed at the following sites: upper central incisor (UCI, n = 35), upper lateral incisor (ULI, n = 27), upper second premolar (U2ndP, n = 36), lower incisor (LI, n = 53), and lower premolar (LP, n = 22). Implants of the following sizes were used: 5 × 10 mm (n = 24), 5 × 8 mm (n = 21), 4.3 × 10 mm (n = 77), 4.3 × 8 mm (n = 36), 3.5 × 10 mm (n = 12), and 3.5 × 8 mm (n = 3). After a mean follow-up time of 47 months, the overall implant survival rate was 96%. Survival rate was highest at the LI site (98.1%) and lowest at the ULI site (92.6%). All of the 5-mm implants survived (100%), as did most of the 4.3 × 10 mm implants (96.1%). Implants of 4.3 × 8 mm and 3.5 × 10 mm were the least successful (91.7%). Mandibular implants had a better survival rate (97.3%) than maxillary implants (94.9%). There was no significant OR of increased survival for any particular implant size or site. Conclusions Immediate implant placement in fresh extraction sockets can give predictable clinical outcomes, regardless of the implant size and site of placement. PMID:26082578

  10. Retrospective study of late febrile seizures.

    PubMed

    Webb, D W; Jones, R R; Manzur, A Y; Farrell, K

    1999-04-01

    This retrospective study documents the clinical features, electroencephalographic data, and outcome of 50 children with a history of seizures with fever that occurred after 5 years of age. Children with afebrile seizures before the onset of febrile seizures were excluded. Outcome was based on a cross-sectional survey and the follow-up period was 1-13 years. Of the 50 children, 40 had two or fewer febrile seizures after 5 years of age, and febrile seizures did not occur after 10 years of age. Twenty had complex febrile seizures, and 16 had a first-degree relative with febrile seizures. Five developed afebrile seizures, and 18 had educational difficulties. Epileptiform electroencephalographic abnormalities were observed in 22 but were not predictive of later afebrile seizures. Febrile seizures that occur after 5 years of age recur infrequently and cease by 10 years of age. The risk of developing afebrile seizures in this group is small. PMID:10328275

  11. Space Adaptation Back Pain: A Retrospective Study

    NASA Technical Reports Server (NTRS)

    Kerstman, E. L.; Scheuring, R. A.; Barnes, M. G.; DeKorse, T. B.; Saile, L. G.

    2008-01-01

    Back pain is frequently reported by astronauts during the early phase of space flight as they adapt to the microgravity environment. However, the epidemiology of space adaptation back pain has not been well defined. The purpose of this retrospective study was to develop a case definition of space adaptation back pain, determine the incidence of space adaptation back pain, and determine the effectiveness of available treatments. Medical records from the Mercury, Apollo, Apollo-Soyuz Test Project (ASTP), Skylab, Mir, International Space Station (ISS), and Shuttle programs were reviewed. All episodes of in-flight back pain that met the criteria for space adaptation back pain were recorded. Pain characteristics, including intensity, location, and duration of the pain were noted. The effectiveness of specific treatments also was recorded. The incidence of space adaptation back pain among astronauts was determined to be 53% (384/722). Most of the affected astronauts reported mild pain (85%). Moderate pain was reported by 11% of the affected astronauts and severe pain was reported by only 4% of the affected astronauts. The most effective treatments were fetal positioning (91% effective) and the use of analgesic medications (85% effective). This retrospective study aids in the development of a case definition of space adaptation back pain and examines the epidemiology of space adaptation back pain. Space adaptation back pain is usually mild and self-limited. However, there is a risk of functional impairment and mission impact in cases of moderate or severe pain that do not respond to currently available treatments. Therefore, the development of preventive measures and more effective treatments should be pursued.

  12. Evaluation of patient care cascade for HIV-positive patients diagnosed in La Romana, Dominican Republic in 2011: a retrospective cohort study.

    PubMed

    Bowman, Alex S; Lerebours, Leonel; Amesty, Silvia; de la Rosa, Milagros; Gil, Elizabeth; Halpern, Mina; Nicholas, Stephen; Lamb, Matthew R

    2016-04-01

    The Caribbean has the highest adult HIV prevalence in the world after sub-Saharan Africa (2011). One sub-population in the Dominican Republic is the migratory Batey community primarily comprised of Haitian immigrants with limited access to healthcare and HIV prevalence rates of between 3.0% and 9.0%, compared to 0.7% nationally. This retrospective cohort study describes the cumulative retention from diagnosis to virological suppression for newly-diagnosed HIV-infected adults presenting to the Clínica de Familia and its Batey programme in La Romana, during 2011. Of the patients diagnosed with HIV, 65% entered into care, 59% completed immunologic testing, 53% were eligible for antiretroviral therapy (ART) initiation, 36% initiated ART within three months of eligibility and 27% were retained in care. Seventeen per cent of those retained on ART with a 12-month viral load measure had undetectable viral load. Attrition primarily occurred before ART initiation. The Batey programme had a first step lost-to-follow-up of 88% compared to 20% at the clinic (p < 0.001). This retrospective study details the continuum of care and indicates where structural changes must occur to increase continuity between steps. The manuscript results are important to help implement programmes to enhance engagement and retention in HIV primary care. PMID:25941055

  13. Oral presentation bias: a retrospective cohort study.

    PubMed

    Decullier, Evelyne; Chapuis, François

    2007-03-01

    The aim of this paper was to assess oral presentation bias at a national level. This was a retrospective cohort study with initial characteristics of the approved protocols extracted from the committee's archives, and follow-up characteristics obtained from a questionnaire mailed to the principal investigators. A representative sample of French research ethics committees (25/48), the only committees legally endorsed for ethical authorisation in biomedical research, were studied. All completed research protocols, which had been approved in 1994 by these committees, were included. Initial characteristics (design, study size, investigator) of completed studies and follow-up information (direction of results, rates of publication and rates of oral presentation) were collected. Complete information on results and their dissemination was available for 248 completed non-confidential protocols. Half of these (49%) were declared as orally presented. The observed ranking for strategies to disseminate results was the following: orally presented and published, published only, neither orally presented nor published and orally presented only. Confirmatory results were more often orally presented, with an adjusted OR of 6.4 (95% CI 2.69 to 15.22). Other associated variables are the following: national/international scope of the study, protocol writer's university status, adverse events and interim analysis. There is a trend to submit or accept confirmatory results for oral presentations: meetings are a biased representation of research, and oral presentation bias could even be higher than publication bias. PMID:17325393

  14. OSL studies of local bricks for retrospective dosimetric application

    NASA Astrophysics Data System (ADS)

    Singh, A. K.; Menon, S. N.; Kadam, S. Y.; Koul, D. K.; Datta, D.

    2016-09-01

    Luminescence properties of quartz extracted from bricks has been reported worldwide for its use in dose estimation in case of nuclear or radiological accident. Accordingly, in this study the feasibility of utilizing the optically stimulated luminescence (OSL) emission of quartz extracted from red bricks collected from three different locations in and around Mumbai, India for retrospective dosimetry was explored. Thermoluminescence and OSL characterization of the samples were carried out. The growth curve, thermal stability and equivalent dose plateau of the OSL signal suggested the signals to be well behaving. Subsequently, the dose recovery tests carried for different administered doses, using single aliquot regenerative protocol, demonstrated the feasibility of the OSL emissions of these samples for dose evaluation in retrospective dosimetry.

  15. Evaluation on the Usability of Physics Module in a Secondary School in Malaysia: Students' Retrospective

    ERIC Educational Resources Information Center

    Alias, Norlidah; Siraj, Saedah; DeWitt, Dorothy; Attaran, Mohammad; Nordin, Abu Bakar

    2013-01-01

    The main objective of this study is to implement and evaluate the Physics module based on technology and learning style using students' retrospective evaluation. Physics has always been thought of as the most difficult subject as it involves abstract concepts. Research has shown that technology has the potential to increase understanding of…

  16. Predisposing factors for positive D-Xylose breath test for evaluation of small intestinal bacterial overgrowth: A retrospective study of 932 patients

    PubMed Central

    Schatz, Richard A; Zhang, Qing; Lodhia, Nilesh; Shuster, Jonathan; Toskes, Phillip P; Moshiree, Baharak

    2015-01-01

    AIM: To investigate, in the largest cohort to date, patient characteristics and associated risk factors for developing small intestinal bacterial overgrowth (SIBO) using the D-Xylose breath test (XBT). METHODS: We performed a retrospective cross-sectional study to analyze patient characteristics who underwent the XBT for evaluation of SIBO. Diagnostic testing with the XBT was performed based on a clinical suspicion for SIBO in patients with symptoms of bloating, abdominal pain, abdominal distension, weight loss, diarrhea, and/or constipation. Consecutive electronic medical records of 932 patients who completed the XBT at the University of Florida between 2005 and 2009 were reviewed. A two-way Analysis of Variance (ANOVA) was used to test for several associations including age, gender, and body mass index (BMI) with a +XBT. A two-way ANOVA was also performed to control for the differences and interaction with age and between genders. A similar analysis was repeated for BMI. Associations between medical conditions and prior surgical histories were conducted using the Mantel-Haenszel method for 2 by 2 contingency tables, stratified for gender. Reported odds ratio estimates reflect the odds of the prevalence of a condition within the +XBT group to that of the -XBT group. P values of less than 0.05 (two-sided) were considered statistically significant. RESULTS: In the 932 consecutive eligible subjects studied, 513 had a positive XBT. A positive association was found between female gender and a positive XBT (P = 0.0025), and females with a positive test were, on average, greater than 5 years older than those with a negative test (P = 0.024). The mean BMI of positive XBT subjects was normal (24.5) and significantly lower than the subjects with a negative XBT (29.5) (P = 0.0050). A positive XBT was associated with gastroesophageal reflux disease (GERD) (OR = 1.35; 95%CI: 1.02-1.80, P = 0.04), peptic ulcer disease (PUD) (OR = 2.61; 95%CI: 1.48-4.59, P < 0.01), gastroparesis

  17. A retrospective, multi-center cohort study evaluating the severity- related effects of cerebrolysin treatment on clinical outcomes in traumatic brain injury.

    PubMed

    Muresanu, Dafin F; Ciurea, Alexandru V; Gorgan, Radu M; Gheorghita, Eva; Florian, Stefan I; Stan, Horatiu; Blaga, Alin; Ianovici, Nicolai; Iencean, Stefan M; Turliuc, Dana; Davidescu, Horia B; Mihalache, Cornel; Brehar, Felix M; Mihaescu, Anca S; Mardare, Dinu C; Anghelescu, Aurelian; Chiparus, Carmen; Lapadat, Magdalena; Pruna, Viorel; Mohan, Dumitru; Costea, Constantin; Costea, Daniel; Palade, Claudiu; Bucur, Narcisa; Figueroa, Jesus; Alvarez, Anton

    2015-01-01

    Traumatic brain injury (TBI) is a leading cause of death and disability for which there is currently no effective drug therapy available. Because drugs targeting a single TBI pathological pathway have failed to show clinical efficacy to date, pleiotropic agents with effects on multiple mechanisms of secondary brain damage could represent an effective option to improve brain recovery and clinical outcome in TBI patients. In this multicenter retrospective study, we investigated severity-related efficacy and safety of the add-on therapy with two concentrations (20 ml/day or 30 ml/day) of Cerebrolysin (EVER Neuro Pharma, Austria) in TBI patients. Adjunctive treatment with Cerrebrolysin started within 48 hours after TBI and clinical outcomes were ranked according to the Glasgow Outcome Scale and the Modified Rankin Disability Score at 10 and 30 days post-TBI. Analyses of efficacy were performed separately for subgroups of patients with mild, moderate or severe TBI according to Glasgow Coma Scale scores at admission. Compared to standard medical care alone (control group), both doses of Cerebrolysin were associated with improved clinical outcome scores at 10 days post-TBI in mild patients and at 10 and 30 days in moderate and severe cases. A dose-dependent effect of Cerebrolysin on TBI recovery was supported by the dose-related differences and the significant correlations with treatment duration observed for outcome measures. The safety and tolerability of Cerebrolysin in TBI patients was very good. In conclusion, the results of this large retrospective study revealed that early Cerebrolysin treatment is safe and is associated to improved TBI outcome. PMID:25924999

  18. [Retrospective evaluation of brucellosis cases inhabiting in Mus province].

    PubMed

    Sit, Dede; Kadiroğlu, Ali Kemal; Kayabaşi, Hasan; Hoşoğlu, Salih

    2006-07-01

    The aim of this study was to evaluate the brucellosis patients inhabiting in Mus province, in Eastern Anatolia of Turkey, retrospectively. The mean age of the patients (n: 87) was 38.1 +/- 12.4 years, and 45% of them were female. The transmission route was the consumption of unpasteurized fresh cheese (in 85%), and unboiled milk (in 45%). The most common symptoms were recorded as chills (89%), fever (87%), and arthralgia (81%). Splenomegaly (71%) and hepatomegaly (63%) were the predominant physical examination signs. Diagnosis was made based on the clinical features and positive Rose-Bengal test result (93%), however, blood cultures could not be performed due to insufficient laboratory equipment. In 92% of the patients at least one complication has been detected indicating delayed admission to the hospital, while the most common complications were sacroileitis (79%) and spondylitis (44%). Streptomycin+doxycyclin, streptomycin+doxycyclin+ ciprofloxacin, and streptomycin+doxycyclin+ rifampicin combination therapies were used in 62%, 24% and 14% of the patients, respectively, for six weeks, resulting with complete cure. PMID:17001861

  19. Use of Viremia to Evaluate the Baseline Case Fatality Ratio of Ebola Virus Disease and Inform Treatment Studies: A Retrospective Cohort Study

    PubMed Central

    Boëlle, Pierre-Yves; Magassouba, N’Faly; Bah, Elhadj Ibrahima; Koivogui, Lamine; Diallo, Boubacar; Diallo, Alpha Amadou; Keita, Sakoba; Konde, Mandy Kader; Fowler, Robert; Fall, Gamou; Cauchemez, Simon; Sall, Amadou Alpha

    2015-01-01

    Background The case fatality ratio (CFR) of Ebola virus disease (EVD) can vary over time and space for reasons that are not fully understood. This makes it difficult to define the baseline CFRs needed to evaluate treatments in the absence of randomized controls. Here, we investigate whether viremia in EVD patients may be used to evaluate baseline EVD CFRs. Methods and Findings We analyzed the laboratory and epidemiological records of patients with EVD confirmed by reverse transcription PCR hospitalized in the Conakry area, Guinea, between 1 March 2014 and 28 February 2015. We used viremia and other variables to model the CFR. Data for 699 EVD patients were analyzed. In the week following symptom onset, mean viremia remained stable, and the CFR increased with viremia, V, from 21% (95% CI 16%–27%) for low viremia (V < 104.4 copies/ml) to 53% (95% CI 44%–61%) for intermediate viremia (104.4 ≤ V < 105.2 copies/ml) and 81% (95% CI 75%–87%) for high viremia (V ≥ 105.2 copies/ml). Compared to adults (15–44 y old [y.o.]), the CFR was larger in young children (0–4 y.o.) (odds ratio [OR]: 2.44; 95% CI 1.02–5.86) and older adults (≥45 y.o.) (OR: 2.84; 95% CI 1.81–4.46) but lower in children (5–14 y.o.) (OR: 0.46; 95% CI 0.24–0.86). An order of magnitude increase in mean viremia in cases after July 2014 compared to those before coincided with a 14% increase in the CFR. Our findings come from a large hospital-based study in Conakry and may not be generalizable to settings with different case profiles, such as with individuals who never sought care. Conclusions Viremia in EVD patients was a strong predictor of death that partly explained variations in CFR in the study population. This study provides baseline CFRs by viremia group, which allow appropriate adjustment when estimating efficacy in treatment studies. In randomized controlled trials, stratifying analysis on viremia groups could reduce sample size requirements by 25%. We hypothesize that

  20. Acute endosulfan poisoning: a retrospective study.

    PubMed

    Moon, Jeong Mi; Chun, Byeong Jo

    2009-05-01

    Endosulfan is a widely used insecticide that is associated with a high fatality rate in humans when ingested accidentally or with the aim of suicide. However, the literature concerning human endosulfan exposure is limited to case reports. Thus, we sought to 1) describe the clinical features of patients with acute endosulfan poisoning and 2) identify independent factors to predict patients' outcome. Fifty-two patients who presented with acute endosulfan poisoning between January 2001 and January 2007 were enrolled in this retrospective study. Sixteen (30.7%) of the 52 patients died, and 48 patients experienced seizures. Endosulfan poisoning caused the hypotension and the abnormalities on electrocardiogram at presentation. Over half of the patients developed complications, such as rhabdomyolysis, hepatic toxicity, and hypotension. These complications resolved without sequelae in the survival group. Refractory status epilepticus was the most common cause of death in this series (75.0%). Amount ingested being greater than 35 g of endosulfan was the most found to be an independent variable that predicted patient mortality. Patients with this risk factor must be treated aggressively during the early stage of endosulfan poisoning. PMID:19755461

  1. Retrospective Evaluation of a Collaborative LearningScience Module: The Users' Perspective

    ERIC Educational Resources Information Center

    DeWitt, Dorothy; Siraj, Saedah; Alias, Norlidah; Leng, Chin Hai

    2013-01-01

    This study focuses on the retrospective evaluation of collaborative mLearning (CmL) Science module for teaching secondary school science which was designed based on social constructivist learning theories and Merrill's First Principle of Instruction. This study is part of a developmental research in which computer-mediated communication (CMC)…

  2. Comparative Evaluation of Retrocrural versus Transaortic Neurolytic Celiac Plexus Block for Pain Relief in Patients with Upper Abdominal Malignancy: A Retrospective Observational Study

    PubMed Central

    Tewari, Saipriya; Agarwal, Anil; Dhiraaj, Sanjay; Gautam, Sujeet K; Khuba, Sandeep; Madabushi, Rajashree; Shamshery, Chetna; Kumar, Sanjay

    2016-01-01

    Aim: To compare retrocrural versus transaortic techniques for neurolytic celiac plexus block (NCPB) in patients suffering from upper abdominal malignancy. Methods: In this retrospective observational study between October 2013 and April 2015, 64 patients with inoperable upper abdominal malignancy received fluoroscopy-guided percutaneous NCPB in our institute. Their case files were reviewed and the patients were divided into two groups depending on the technique used to perform NCPB: retrocrural (Group R; n = 36) versus transaortic (Group T; n = 28). The primary outcome measure was pain as assessed with a numeric rating scale (NRS) from 0 to 10; the secondary outcome measures were morphine consumption per day (M), quality of life (QOL) as assessed by comparing the percent of positive responses in each group, and complications if any. These were noted and analyzed prior to intervention and then on day 1, weeks 1, 2, 3, and months 1, 2, 3, 6 following NCPB. Results: Patients in Group R had significantly reduced NRS pain scores at week 1, 2, 3, month 1 and 2 as compared to Group T (P < 0.05). Morphine consumption also reduced significantly in Group R at day 1, week 1, 2, and 3 (P < 0.05). QOL was found to be comparable between the groups, and no major complications were noted. Conclusion: Retrocrural NCPB provides superior pain relief along with a reduction in morphine consumption as compared to transaortic NCPB in patients with pain due to upper abdominal malignancy.

  3. Evaluation of Dual Therapy in Real Life Setting in Treatment-Naïve Turkish Patients with HCV Infection: A Multicenter, Retrospective Study

    PubMed Central

    Gürbüz, Yunus; Tülek, Necla Eren; Tütüncü, Emin Ediz; Koruk, Süda Tekin; Aygen, Bilgehan; Demirtürk, Neşe; Kınıklı, Sami; Kaya, Ali; Yıldırmak, Taner; Süer, Kaya; Korkmaz, Fatime; Ural, Onur; Akhan, Sıla; Günal, Özgür; Tuna, Nazan; Köse, Şükran; Gönen, İbak; Örmen, Bahar; Türker, Nesrin; Saltoğlu, Neşe; Batırel, Ayşe; Tuncer, Günay; Bulut, Cemal; Sırmatel, Fatma; Ulçay, Asım; Karagöz, Ergenekon; Tosun, Derviş; Şener, Alper; Aynıoğlu, Aynur; Altunok, Elif Sargın

    2016-01-01

    Background: Before the introduction of direct-acting antivirals in the treatment of chronic hepatitis C patients, the combination of peginterferon alpha and ribavirin was the standard therapy. Observational studies that investigated sustained virological response (SVR) rates by these drugs yielded different outcomes. Aims: The goal of the study was to demonstrate real life data concerning SVR rate achieved by peginterferon alpha plus ribavirin in patients who were treatment-naïve. Study Design: A multicenter, retrospective observational study. Methods: The study was conducted retrospectively on 1214 treatment naïve-patients, being treated with peginterferon alpha-2a or 2b plus ribavirin in respect of the current guidelines between 2005 and 2013. The patients’ data were collected from 22 centers via a standard form, which has been prepared for this study. The data included demographic and clinical characteristics (gender, age, body weight, initial Hepatitis C virus RNA (HCV RNA) level, disease staging) as well as course of treatment (duration of treatment, outcomes, discontinuations and adverse events). Renal insufficiency, decompensated liver disease, history of transplantation, immunosuppressive therapy or autoimmune liver disease were exclusion criteria for the study. Treatment efficacy was assessed according to the patient’s demographic characteristics, baseline viral load, genotype, and fibrosis scores. Results: The mean age of the patients was 50.74 (±0.64) years. Most of them were infected with genotype 1 (91.8%). SVR was achieved in 761 (62.7%) patients. SVR rate was 59.1% in genotype 1, 89.4% in genotype 2, 93.8% in genotype 3, and 33.3% in genotype 4 patients. Patients with lower viral load yielded higher SVR (65.8% vs. 58.4%, p=0.09). SVR rates according to histologic severity were found to be 69.3%, 66.3%, 59.9%, 47.3%, and 45.5% in patients with fibrosis stage 0, 1, 2, 3 and 4, respectively. The predictors of SVR were male gender, genotype 2

  4. Pre-Service Teachers' Retrospective and Prospective Evaluations: Program, Self, and Teaching Profession

    ERIC Educational Resources Information Center

    Ulusoy, Mustafa

    2015-01-01

    This study aimed to investigate teacher candidates' retrospective and prospective evaluations about the classroom teacher education program, self, and the teaching profession. Observations, interviews, focus group interviews, and surveys were used to collect data from the 240 subjects. Teacher candidates believed that the teaching profession is…

  5. Evaluation of postoperative pain scores following ultrasound guided transversus abdominis plane block versus local infiltration following day surgery laparoscopic cholecystectomy-retrospective study

    PubMed Central

    Kadam, Vasanth Rao; Howell, Stuart; Kadam, V.

    2016-01-01

    Background and Aims: Postoperative pain for day surgery laparoscopic cholecystectomy has traditionally been managed with the surgeon infiltrating the wound with local anesthetic (LA). However, transversus abdominis plane (TAP) block has recently been used, although its superiority over LA remains uncertain. The primary aim was to compare LA and TAP block pain scores and analgesia used. The secondary aim was to assess satisfaction score and cost. Material and Methods: This retrospective study was commenced after ethics committee approval and ANZ clinical trial registry (ACTRN: 12612000737831). The data were collected from the theatre database and medical records of patients presenting for day case laparoscopic cholecystectomy. The sample included patients who received either bilateral port site LA infiltration with 20 ml of 0.25% Bupivacaine or bilateral TAP block with 20 ml of 0.5% ropivacaine and fentanyl postoperative pain protocol. The patients with incomplete medical records were excluded as were those admitted to an inpatient ward. Demographics and clinical characteristics were obtained from the hospital record along with pain score and postsurgery analgesia use. Postoperative pain satisfaction scores were collected by telephonic interview 30-180 days postsurgery. Results: Of 51 patients analyzed, 19 were in TAP group 29 in LA group. There were no significant differences between the LA and TAP groups with respect to postoperative pain scores (P = 0.31) or patient satisfaction scores (1 and 2+) (P = 0.36). However, fentanyl consumption in the recovery room was significantly lower in TAP group (P = 0.0079.). The consumables cost were >3 times higher in the TAP when compared to LA group. Conclusion: The performance of the TAP block with respect to pain management was comparable to LA. However, LA remains more cost effective. PMID:27006547

  6. Results of a multicentre UK-wide retrospective study evaluating the efficacy of pixantrone in relapsed, refractory diffuse large B cell lymphoma.

    PubMed

    Eyre, Toby A; Linton, Kim M; Rohman, Phillipa; Kothari, Jaimal; Cwynarski, Kate; Ardeshna, Kirit; Bailey, Chris; Osborne, Wendy L; Rowntree, Clare; Eden, Dewi; Shankara, Paneesha; Eyre, David W; Jasani, Parag; Chaidos, Aristeidis; Collins, Graham P; Hatton, Chris S

    2016-06-01

    Relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) in those unfit or ineligible for autologous stem cell transplantation is associated with a poor outcome and new treatment approaches are needed. Pixantrone is a novel aza-anthracenedione which is structurally similar to anthracyclines and is licenced in R/R DLBCL and National Institute for Health and Care Excellence (NICE)-approved following the PIX301 trial. No data exist post-NICE approval. We performed a UK-wide retrospective multi-centre study of 92 R/R DLBCL who received pixantrone. Eighty-five per cent had refractory disease and 72% had an international prognostic index (IPI) 3-5 at commencement of pixantrone. The median progression-free survival (PFS) was 2·0 months (95% confidence interval (CI) 1·5-2·4) and the median overall survival was 3·4 months (95% CI 2·7-4·5). The overall response rate was 24% (complete response 10%; partial response 14%). We demonstrate that pixantrone has limited activity in a cohort of high risk, predominantly refractory DLBCL. Multivariate Cox regression revealed that patients who relapsed >12 months after first line treatment, those with fewer prior lines of therapy and relapsed (non-refractory) DLBCL had improved PFS. The major population of unmet need are those with refractory DLBCL who are poorly represented within trials and in whom pixantrone appears less efficacious compared to relapsed DLBCL. PMID:26956150

  7. Retrospective Study of Japanese Patients with Schizophrenia Treated with Aripiprazole

    PubMed Central

    Tanioka, Tetsuya; Fuji, Syoko; Kataoka, Mika; King, Beth; Tomotake, Masahito; Yasuhara, Yuko; Locsin, Rozzano; Sekido, Keiko; Mifune, Kazushi

    2012-01-01

    Aim. The purpose of this retrospective study was to evaluate changes in clinical indicators which influence the quality of life (QOL) of patients with schizophrenia treated by antipsychotic therapy before and after switching to aripiprazole. Methods. A retrospective chart review of 27 patients diagnosed with schizophrenia and who were switched from one antipsychotic to aripiprazole was performed. Clinical indicators about the daily dosage of antipsychotics and antiparkinsonian drugs, psychiatric condition, and glucose/lipid metabolism, clinical evaluation by nursing observation were used to measure the responsiveness of subjects to aripiprazole. Results. Of the 27 subjects, 14 responded to the switch to aripiprazole with significant improvement of the Brief Psychiatric Rating Scale (BPRS) score (P = 0.04), significant decrease in dosage of antipsychotics in 71% of patients (P = 0.03), and tendency toward reduction in dosage of antiparkinsonian drugs (P = 0.07) and body mass index (BMI) (P = 0.06). However, 8 of 27 subjects had a significant increase in lipid levels after switching to aripiprazole (P = 0.01). Conclusion. QOL for subjects who responded to the switch to aripiprazole improved as indicated by lower doses of antipsychotic and antiparkinson medications, improvement in BPRS score, and a decrease in BMI. Results indicate little influence on patient's QOL. PMID:22970386

  8. How bad was unmodified electroconvulsive therapy! A retrospective study.

    PubMed

    Ray, Anindya Kumar

    2016-01-01

    "Unmodified"-electroconvulsive therapy (ECT) being considered unethical remained away from the scientific literature, but continued in practice in many parts of the world. The Mental Health Care Bill, 2011, proposed for its banning in India. The aim of this study is to retrospectively observe "how bad was unmodified-ECT" to the patients in a naturalistic setting. The study was done at the Central Institute of Psychiatry, India. Files of patients receiving unmodified ECT during 1990-1995 were retrospectively reviewed. Outcome was evaluated in terms of desired effectiveness and the side effects as noted in the files by the treating team. Six hundred and thirty-seven patients (6.94% of total admission) received ECT with meticulous standard-of-care except provision of anesthesia. Satisfactory improvement was noted in 95.45% patients with no noticeable/reported complication in 89.05%. Premature termination of ECT for complications occurred in 2.19% patients. "Unmodified"-ECT, though unethical, still could ensure favorable outcome with proper case selection and meticulous standard-of-care. PMID:27385857

  9. How bad was unmodified electroconvulsive therapy! A retrospective study

    PubMed Central

    Ray, Anindya Kumar

    2016-01-01

    “Unmodified”-electroconvulsive therapy (ECT) being considered unethical remained away from the scientific literature, but continued in practice in many parts of the world. The Mental Health Care Bill, 2011, proposed for its banning in India. The aim of this study is to retrospectively observe “how bad was unmodified-ECT” to the patients in a naturalistic setting. The study was done at the Central Institute of Psychiatry, India. Files of patients receiving unmodified ECT during 1990–1995 were retrospectively reviewed. Outcome was evaluated in terms of desired effectiveness and the side effects as noted in the files by the treating team. Six hundred and thirty-seven patients (6.94% of total admission) received ECT with meticulous standard-of-care except provision of anesthesia. Satisfactory improvement was noted in 95.45% patients with no noticeable/reported complication in 89.05%. Premature termination of ECT for complications occurred in 2.19% patients. “Unmodified”-ECT, though unethical, still could ensure favorable outcome with proper case selection and meticulous standard-of-care.

  10. RETROSPECTIVE EPIDEMIOLOGICAL STUDY OF DISEASE ASSOCIATED WITH WASTEWATER UTILIZATION

    EPA Science Inventory

    A retrospective epidemiological study was carried out on the association between enteric disease incidence and wastewater utilization in 79 kibbutzim (cooperative agricultural settlements) in Israel having a population of 32,672. Medical records on disease incidence were collecte...

  11. A Retrospective Study Evaluating the Impact of Preoperative Breast MRI on Surgical Decision-Making in Young Patients (≤50 Years) with Invasive Breast Cancer

    PubMed Central

    Mukherjee, Som D.; Hodgson, Nicole; Lovrics, Peter J.; Dhamanaskar, Kavita; Minuk, Terry; Chambers, Shelley; Sussman, Jonathan

    2016-01-01

    INTRODUCTION Breast magnetic resonance imaging (MRI) is considered a more sensitive diagnostic test for detecting invasive breast cancer than mammography or breast ultrasound. Breast MRI may be particularly useful in younger premenopausal women with higher density breast tissue for differentiating between dense fibroglandular breast tissue and breast malignancies. The main objective of this study was to determine the impact of preoperative breast MRI on surgical decision-making in young women with breast cancer. METHODS A retrospective review of patients with newly diagnosed invasive breast cancer and age of ≤50 years was performed. All patients underwent physical examination, preoperative mammogram, breast ultrasound, and bilateral breast MRI. Two breast cancer surgeons reviewed the preoperative mammogram report, breast ultrasound report, and physical examination summary and were asked if they would recommend a lumpectomy, a quandrantectomy, or a mastectomy. A few weeks later, the two surgeons were shown the same information with the breast MRI report and were asked what type of surgery they would now recommend. In each case, MRI was classified by two adjudicators as having affected the surgical outcome in a positive, negative, or neutral fashion. A positive impact was defined as the situation where breast MRI detected additional disease that was not found on physical examination, mammogram, or breast ultrasound and led to an appropriate change in surgical management. A negative impact was defined as the situation where breast MRI led the surgeon to recommend more extensive surgery, with less extensive disease actually found at pathology. No impact was defined as the situation where MRI findings did not alter surgical recommendations or outcomes. RESULTS Of 37 patients whose charts were reviewed, five patients were deemed to be ineligible due to having received neoadjuvant chemotherapy, having previous breast implants, or having had their tumor fully excised

  12. Use of imaging tests after primary treatment of thyroid cancer in the United States: population based retrospective cohort study evaluating death and recurrence

    PubMed Central

    Banerjee, Mousumi; Wiebel, Jaime L; Guo, Cui; Gay, Brittany

    2016-01-01

    Objective To determine whether the use of imaging tests after primary treatment of differentiated thyroid cancer is associated with more treatment for recurrence and fewer deaths from the disease. Design Population based retrospective cohort study. Setting Surveillance Epidemiology and End Results-Medicare database in the United States. Participants 28 220 patients diagnosed with differentiated thyroid cancer between 1998 and 2011. The study cohort was followed up to 2013, with a median follow-up of 69 months. Main outcome measures Treatment for recurrence of differentiated thyroid cancer (additional neck surgery, additional radioactive iodine treatment, or radiotherapy), and deaths due to differentiated thyroid cancer. We conducted propensity score analyses to assess the relation between imaging (neck ultrasound, radioiodine scanning, or positron emission tomography (PET) scanning) and treatment for recurrence (logistic model) and death (Cox proportional hazards model). Results From 1998 until 2011, we saw an increase in incident cancer (rate ratio 1.05, 95% confidence interval 1.05 to 1.06), imaging (1.13, 1.12 to 1.13), and treatment for recurrence (1.01, 1.01 to 1.02); the change in death rate was not significant. In multivariable analysis, use of neck ultrasounds increased the likelihood of additional surgery (odds ratio 2.30, 95% confidence interval 2.05 to 2.58) and additional radioactive iodine treatment (1.45, 1.26 to 1.69). Radioiodine scans were associated with additional surgery (odds ratio 3.39, 95% confidence interval 3.06 to 3.76), additional radioactive iodine treatment (17.83, 14.49 to 22.16), and radiotherapy (1.89, 1.71 to 2.10). Use of PET scans was associated with additional surgery (odds ratio 2.31, 95% confidence interval 2.09 to 2.55), additional radioactive iodine treatment (2.13, 1.89 to 2.40), and radiotherapy (4.98, 4.52 to 5.49). Use of neck ultrasounds or PET scans did not significantly affect disease specific survival (hazard

  13. Evaluation of mortality among marines and navy personnel exposed to contaminated drinking water at USMC base Camp Lejeune: a retrospective cohort study

    PubMed Central

    2014-01-01

    Background Two drinking water systems at U.S. Marine Corps Base Camp Lejeune, North Carolina were contaminated with solvents during 1950s-1985. Methods We conducted a retrospective cohort mortality study of Marine and Naval personnel who began service during 1975-1985 and were stationed at Camp Lejeune or Camp Pendleton, California during this period. Camp Pendleton’s drinking water was uncontaminated. Mortality follow-up was 1979-2008. Standardized Mortality Ratios were calculated using U.S. mortality rates as reference. We used survival analysis to compare mortality rates between Camp Lejeune (N = 154,932) and Camp Pendleton (N = 154,969) cohorts and assess effects of cumulative exposures to contaminants within the Camp Lejeune cohort. Models estimated monthly contaminant levels at residences. Confidence intervals (CIs) indicated precision of effect estimates. Results There were 8,964 and 9,365 deaths respectively, in the Camp Lejeune and Camp Pendleton cohorts. Compared to Camp Pendleton, Camp Lejeune had elevated mortality hazard ratios (HRs) for all cancers (HR = 1.10, 95% CI: 1.00, 1.20), kidney cancer (HR = 1.35, 95% CI: 0.84, 2.16), liver cancer (HR = 1.42, 95% CI: 0.92, 2.20), esophageal cancer (HR = 1.43 95% CI: 0.85, 2.38), cervical cancer (HR = 1.33, 95% CI: 0.24, 7.32), Hodgkin lymphoma (HR = 1.47, 95% CI: 0.71, 3.06), and multiple myeloma (HR = 1.68, 95% CI: 0.76, 3.72). Within the Camp Lejeune cohort, monotonic categorical cumulative exposure trends were observed for kidney cancer and total contaminants (HR, high cumulative exposure = 1.54, 95% CI: 0.63, 3.75; log10 β = 0.06, 95% CI: -0.05, 0.17), Hodgkin lymphoma and trichloroethylene (HR, high cumulative exposure = 1.97, 95% CI: 0.55, 7.03; β = 0.00005, 95% CI: -0.00003, 0.00013) and benzene (HR, high cumulative exposure = 1.94, 95% CI: 0.54, 6.95; β = 0.00203, 95% CI: -0.00339, 0.00745). Amyotrophic Lateral Sclerosis (ALS) had HR = 2.21 (95% CI: 0.71, 6.86) at high cumulative vinyl chloride

  14. Space Adaptation Back Pain: A Retrospective Study

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric

    2009-01-01

    Astronaut back pain is frequently reported in the early phase of space flight as they adapt to microgravity. The epidemiology of space adaptation back pain (SABP) has not been well established. This presentation seeks to determine the exact incidence of SABP among astronauts, develop a case definition of SABP, delineate the nature and pattern of SABP, review available treatments and their effectiveness in relieving SABP; and identify any operational impact of SABP. A retrospective review of all available mission medical records of astronauts in the U.S. space program was performed. It was revealed that the incidence of SABP has been determined to be 53% among astronauts in the U.S. space program; most cases of SABP are mild, self-limited, or respond to available treatment; there are no currently accepted preventive measures for SABP; it is difficult to predict who will develop SABP; the precise mechanism and spinal structures responsible for SABP are uncertain; there was no documented evidence of direction operational mission impact related to SABP; and, that there was the potential for mission impact related to uncontrolled pain, sleep disturbance, or the adverse side effects pf anti-inflammatory medications

  15. Accuracy of Cone-beam Computed Tomography and Periapical Radiography in Endodontically Treated Teeth Evaluation: A Five-Year Retrospective Study

    PubMed Central

    Saidi, Anastasia; Naaman, Alfred; Zogheib, Carla

    2015-01-01

    Background: This study aimed to evaluate the accuracy of two imaging methods in detecting the apical pathology in endodontically treated teeth. Material and Methods: A clinical examination from a sample of 156 teeth of patients treated by students of masters in endodontics at the Care Center of the Faculty of Dentistry at St. Joseph University, Beirut was done after 5 years of follow-up. Periradicular digital radiographs and a cone-beam computed tomography (CBCT)scans were taken and analyzed statistically using both the Exact Fisher tests and McNemar tests. Results: The prevalence of lesions was significantly higher with CBCT (34.8%), whereas for digital radiography (13.8%). The CBCT was revealed more precise to identify periapical lesions. As for the clinical success, the rate was 82.5%. Conclusion: Within the limitations of the present study, CBCT was more reliable in detecting periapical lesions compared with digital periapical radiographs. PMID:25878472

  16. The Usability Evaluation of Fakih Method Based on Technology for Students with Hearing Difficulties: The User's Retrospective

    ERIC Educational Resources Information Center

    Sabdan, Muhammad Sayuti Bin; Alias, Norlidah; Jomhari, Nazean; Jamaludin, Khairul Azhar; DeWitt, Dorothy

    2014-01-01

    The study is aimed at evaluating the FAKIH method based on technology in teaching al-Quran, based on the user's retrospective. The participants of this study were five students selected based on hearing difficulties. The study employed the user evaluation framework. Teacher's journals were used to determine the frequency and percentage of…

  17. Diode laser (808 nm) applied to oral soft tissue lesions: a retrospective study to assess histopathological diagnosis and evaluate physical damage.

    PubMed

    Angiero, Francesca; Parma, Luisa; Crippa, Rolando; Benedicenti, Stefano

    2012-03-01

    The diode laser is today widely used in oral pathology to excise lesions; however, some controversy surrounds laser surgery, specifically the accuracy of pathological diagnosis and the control over thermal tissue damage. This study aimed to establish if physical damage induced by the diode laser could affect the histopathological diagnosis and to evaluate the damage caused to the resection margins. Between 2005 and 2010, at S. Gerardo Hospital, Milan, 608 cases of soft tissue lesions localized in the oral cavity (cheek, gingiva, buccal mucosa, tongue, and lips) were examined. Specimens were excised with an 808-nm diode laser, output 1.6-2.7 W, in continuous-wave mode with fibers of 320 μm. Specimens were fixed in 10% buffered formalin solution and examined separately under an optical microscope by two pathologists. In all of the specimens, changes to the epithelium, connective tissue and blood vessels, shape of incision damage, and overall width of modified tissues were evaluated. The data for specimens larger than 3 mm excised with the diode laser were not significant in terms of stromal changes or vascular stasis, while epithelial and stromal changes were significantly more frequent in specimens with a mean size below 3 mm; the diagnosis was not achievable in 46.15%. Our data show that the diode laser is a valid therapeutic instrument for excising oral lesions larger than 3 mm in diameter, but induces serious thermal effects in small lesions (mean size below 3 mm). However, from a clinical standpoint, it is suggested necessary that the specimens taken have in vivo a diameter of at least 5 mm in order to have a reliable reading of the histological sample. PMID:21387158

  18. A retrospective study evaluating the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar vertebral fractures

    PubMed Central

    Su, Yunshan; Ren, Dong; Zou, Yan; Lu, Jian; Wang*, Pengcheng

    2016-01-01

    OBJECTIVE: To evaluate the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar vertebral fractures. METHODS: Fifty-six cases of thoracolumbar vertebral fractures treated in our trauma center from October 2012 to October 2013 were included in this study. The fractures were classified by the anteroposterior classification, whereas the severity of intervertebral disc injury was evaluated using magnetic resonance imaging. The Spearman correlation coefficient was used to analyze the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar fractures, whereas a χ2 test was adopted to measure the variability between different fracture types and upper and lower adjacent disc injuries. RESULTS: The Spearman correlation coefficients between fracture types and the severity of the upper and lower adjacent disc injuries were 0.739 (PU<0.001) and 0.368 (PL=0.005), respectively. It means that the more complex Arbeitsgemeinschaft für Osteosynthesefragen (AO) classifications are the disc injury is more severe. There was also a significant difference in the severity of injury between the upper and lower adjacent discs near the fractured vertebrae (p<0.001). CONCLUSIONS: In thoracolumbar spinal fractures, the severity of the adjacent intervertebral disc injury is positively correlated with the anteroposterior fracture type. The injury primarily involves intervertebral discs near the fractured end plate, with more frequent and severe injuries observed in the upper than in the lower discs. The presence of intervertebral disc injury, along with its severity, may provide useful information during the clinical decision-making process. PMID:27438561

  19. Evaluation of Non-Laboratory and Laboratory Prediction Models for Current and Future Diabetes Mellitus: A Cross-Sectional and Retrospective Cohort Study

    PubMed Central

    Hahn, Seokyung; Moon, Min Kyong; Park, Kyong Soo; Cho, Young Min

    2016-01-01

    Background Various diabetes risk scores composed of non-laboratory parameters have been developed, but only a few studies performed cross-validation of these scores and a comparison with laboratory parameters. We evaluated the performance of diabetes risk scores composed of non-laboratory parameters, including a recently published Korean risk score (KRS), and compared them with laboratory parameters. Methods The data of 26,675 individuals who visited the Seoul National University Hospital Healthcare System Gangnam Center for a health screening program were reviewed for cross-sectional validation. The data of 3,029 individuals with a mean of 6.2 years of follow-up were reviewed for longitudinal validation. The KRS and 16 other risk scores were evaluated and compared with a laboratory prediction model developed by logistic regression analysis. Results For the screening of undiagnosed diabetes, the KRS exhibited a sensitivity of 81%, a specificity of 58%, and an area under the receiver operating characteristic curve (AROC) of 0.754. Other scores showed AROCs that ranged from 0.697 to 0.782. For the prediction of future diabetes, the KRS exhibited a sensitivity of 74%, a specificity of 54%, and an AROC of 0.696. Other scores had AROCs ranging from 0.630 to 0.721. The laboratory prediction model composed of fasting plasma glucose and hemoglobin A1c levels showed a significantly higher AROC (0.838, P < 0.001) than the KRS. The addition of the KRS to the laboratory prediction model increased the AROC (0.849, P = 0.016) without a significant improvement in the risk classification (net reclassification index: 4.6%, P = 0.264). Conclusions The non-laboratory risk scores, including KRS, are useful to estimate the risk of undiagnosed diabetes but are inferior to the laboratory parameters for predicting future diabetes. PMID:27214034

  20. 78 Battered Children: A Retrospective Study.

    ERIC Educational Resources Information Center

    Skinner, Angela E.; Castle, Raymond L.

    The National Society for the Prevention of Cruelty to Children financed this study of the battered-child syndrome and provided case study data on a sample of 78 battered children under the age of 4 years, from low socioeconomic status families. Case study information was transferred to a precoded questionnaire. Tables of demographic and medical…

  1. A 40-year Retrospective Clinicopathological Study of Ameloblastoma in Iran.

    PubMed

    Saghravanian, Nasrollah; Salehinejad, Jahanshah; Ghazi, Narges; Shirdel, Mohammad; Razi, Mahsa

    2016-01-01

    Ameloblastoma is the most common epithelial odontogenic tumor. It may show locally invasive behavior resulting in recurrence and malignancy. Therefore, appropriate diagnosis of this tumor is necessary. The aim of this study was to evaluate clinicopathological characteristics of ameloblastomas in an Iranian population. We present a 40-year retrospective study of patients diagnosed from 1971 to 2010 in the Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mashhad, Iran. Information gathered from patient records included age, gender, tumor location and histologic type. The frequency of odontogenic tumors among all lesions was 2.08% and ameloblastoma with 88 samples demonstrated the greatest prevalence (41.5%). Regarding gender, 60% of samples occurred in males. The mean age of studied patients was 33.02± 15.74 years with a peak of occurrence in the third decade of life. The most frequent location of tumor was the mandibles (93.2%). Eighty five (96.6%) tumors were recorded as benign and 3 (3.4%) as malignant. Of benign tumors, 62 (72.9%), 20 (23.5%) and 3 (3.6%) cases were of conventional, unicyctic and peripheral types, respectively. In contrast to most previous studies, the most common histologic subtype in the present study was plexiform. Knowledge of the incidence of ameloblastoma and its clinicopathologic features including most common location, gender and age distribution in different ethnogeographic backgrounds is necessary for accurate diagnosis and proper treatment. PMID:26925653

  2. Could CCI or FBCI Fully Eliminate the Impact of Curve Flexibility When Evaluating the Surgery Outcome for Thoracic Curve Idiopathic Scoliosis Patient? A Retrospective Study

    PubMed Central

    Ni, Haijian; Zhu, Xiaodong; Li, Ming

    2015-01-01

    Purpose To clarify if CCI or FBCI could fully eliminate the influence of curve flexibility on the coronal correction rate. Methods We reviewed medical record of all thoracic curve AIS cases undergoing posterior spinal fusion with all pedicle screw systems from June 2011 to July 2013. Radiographical data was collected and calculated. Student t test, Pearson correlation analysis and linear regression analysis were used to analyze the data. Results 60 were included in this study. The mean age was 14.7y (10-18y) with 10 males (17%) and 50 females (83%). The average Risser sign was 2.7. The mean thoracic Cobb angle before operation was 51.9°. The mean bending Cobb angle was 27.6° and the mean fulcrum bending Cobb angle was 17.4°. The mean Cobb angle at 2 week after surgery was 16.3°. The Pearson correlation coefficient r between CCI and BFR was -0.856(P<0.001), and between FBCI and FFR was -0.728 (P<0.001). A modified FBCI (M-FBCI) = (CR-0.513)/BFR or a modified CCI (M-CCI) = (CR-0.279)/FFR was generated by curve estimation has no significant correlation with FFR (r=-0.08, p=0.950) or with BFR (r=0.123, p=0.349). Conclusions Fulcrum-bending radiographs may better predict the outcome of AIS coronal correction than bending radiographs in thoracic curveAIS patients. Neither CCI nor FBCI can fully eliminate the impact of curve flexibility on the outcome of correction. A modified CCI or FBCI can better evaluating the corrective effects of different surgical techniques or instruments. PMID:25984945

  3. Retrospective Descriptive Study of Cerebral Palsy in Nepal

    ERIC Educational Resources Information Center

    Thapa, Ritesh

    2016-01-01

    There is very little data pertaining to cerebral palsy (CP) from Nepal. In this retrospective study it was observed that dyskinetic CP was seen in 29% and the sex ratio of males to females was two in the study population of children with CP. Both of these are much higher than data from developed countries. Hence, further randomized cross-sectional…

  4. Toxicity after radiochemotherapy for glioblastoma using temozolomide - a retrospective evaluation

    PubMed Central

    2011-01-01

    Purpose Retrospective evaluation of toxicity and results after radiochemotherapy for glioblastoma. Methods 46 patients with histopathologically proven glioblastoma received simultaneous radiochemotherapy (RCT). The mean age at the beginning of therapy was 59 years, the mean Karnofsky performance index 80%. 44 patients had been operated on before radiotherapy, two had not. A total dose of 60 Gy was applied in daily single fractions of 2.0 Gy within six weeks, 75 mg/m2/day Temozolomide were given orally during the whole radiotherapy period. Results A local progression could be diagnosed in 34/46 patients (70%). The median survival time amounted to 13.6 months resulting in one-year and two-year survival probabilities of 48% and 8%, respectively. Radiotherapy could be applied completely in 89% of the patients. Chemotherapy could be completed according to schedule only in 56.5%, the main reason being blood toxicity (50% of the interruptions). Most of those patients suffered from leucopenia and/or thrombopenia grade III and IV CTC (Common toxicity criteria). Further reasons were an unfavourable general health status or a rise of liver enzymes. The mean duration of thrombopenia and leucopenia amounted to 64 and 20 days. In two patients, blood cell counts remained abnormal until death. In two patients we noticed a rise of liver enzymes. In one of these in the healing phase of hepatitis a rise of ASAT and ALAT CTC grade IV was diagnosed. These values normalized after termination of temozolomide medication. One patient died of pneumonia during therapy. Conclusion Our survival data were well within the range taken from the literature. However, we noticed a considerable frequency and intensity of side effects to bone marrow and liver. These lead to the recommendations that regular examinations of blood cell count and liver enzymes should be performed during therapy and temozolomide should not be applied or application should be terminated according to the criteria given by the

  5. A retrospective study of disease and mortality in zebra finches.

    PubMed

    Prattis, S M; Cioffee, C J; Reinhard, G; Zaoutis, T E

    1990-07-01

    Few published reports exist describing morbidity and mortality in domestic zebra finch colonies maintained in a laboratory animal setting. A retrospective study of clinical disease and mortality in quarantined adult zebra finches was performed. Animals were observed during the 2 week quarantine period and for at least 1 month afterwards (42 days). Signs of disease, including feather and beak abnormalities, oculonasal discharge, increased respiratory rate or stridor, abdominal enlargement, pasty vent, diarrhea, lameness and pectoral muscle loss, were evaluated in our colony during this time. History, physical examination, laboratory testing and postmortem evaluation were used to determine causes of clinical disease. Common clinical findings in sick finches included sudden death, ruffled feathers, increased respiratory rate or gape mouthed breathing, pasty vent or frank diarrhea, and beak discoloration. Organisms frequently isolated were Staphylococcus spp., E. coli, Enterobacter spp., and Coccidia spp. Of the finches that died while in the colony (29.5%), 23.0% died in the first week after arrival. Pathogens frequently isolated from tissues cultured at necropsy included: E. coli, Staphylococcus aureus, Enterobacter spp., and Candida albicans. When observed, pathological lesions consisted of air sacculitis, fibrinopurulent polyserositis and ventriculitis. PMID:2166869

  6. [A retrospective study of infant headache].

    PubMed

    Sánchez-Precioso, S; García-Cantó, E; Villaescusa, O; Barbero, P; Moreno, J A; Mulas, F

    1995-01-01

    Headache either as an isolated syndrome or as part of a symptomatic grouping is a frequent reason for medical consultation or hospitalization during childhood and adolescence. We review 94 clinical histories of patients between three and thirteen years of age. Headache was the reason for being hospitalized in all cases. Our aim was to assess its incidence rate, epidemiology, clinical characteristics and etiology in addition to evaluating as to whether complementary examinations carried out during hospitalization were worthwhile. Among the most significant results were the following: age (73 patients were over seven years old, 77.6%), time elapsed for symptomatology to evolve (exactly or less than one week in 45% of cases); family history of migraine in 55 cases (58.5%). The most frequent accompanying symptoms were vomiting (38.2%), nausea (22.3%) and abdominal pain (19.1%). Physical exam was normal in 63 cases (67%) while sixteen patients (17%) had neurological focal signs and/or signs of endocranial hypertension (ECHT). Electroencephalography was performed on 94.6% of the patients and proved pathological in 22 cases (25%). Brain computerized tomography (CT) scan was carried out on 92.5% of the patients with space occupying lesions in 3.2% of the cases. The most frequent final diagnosis (52% of patients) was one of migraine. We did not find any patients with intracranial expansionary processes not showing signs of ECHT and/or neurological focalization, for which reason we doubt the profitability of the almost routine practice of carrying out brain CT scan on patients when severe headache is the sole symptom and where there are no specific findings during physical examination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7497236

  7. Evaluation of the DAO Retrospective Data Assimilation System

    NASA Technical Reports Server (NTRS)

    Zhu, Yanqiu; Todling, R.; Guo, J.; Cohn, S. E.; Atlas, Robert (Technical Monitor)

    2002-01-01

    We have developed and implemented a retrospective data assimilation system (RDAS) as an upgrade to the operational DAO/Terra data assimilation system. This formulation aims at improving analysis over filter analysis by the dynamically consistent incorporation of observation information past a given analysis time. The current implementation of the RDAS uses the adjoint of the tangent linear model of a simplified version of the Terra general circulation model and extensions to the physical-space statistical analysis system to propagate observation information back in time. The RDAS adopts the same assumptions of the regular data assimilation system, particularly, no explicit propagation of error covariances are involved therefore rendering a procedure that is computationally affordable. In this study, we show results of experiments conducted to investigate the performance of the 6-hour (lag-1) RDAS. Statistical results obtained over one month during a winter season indicate that the RDAS represents considerable improvement over the regular assimilation. Plans for implementation of the RDAS capability in our new finite-volume data assimilation system will also be presented at the time of the conference.

  8. Ion cyclotron emission studies: Retrospects and prospects

    NASA Astrophysics Data System (ADS)

    Gorelenkov, N. N.

    2016-05-01

    Ion cyclotron emission (ICE) studies emerged in part from the papers by A.B. Mikhailovskii published in the 1970s. Among the discussed subjects were electromagnetic compressional Alfvénic cyclotron instabilities with the linear growth rate √ {n_α /n_e } driven by fusion products, -particles which draw a lot of attention to energetic particle physics. The theory of ICE excited by energetic particles was significantly advanced at the end of the 20th century motivated by first DT experiments on TFTR and subsequent JET experimental studies which we highlight. More recently ICE theory was advanced by detailed theoretical and experimental studies on spherical torus (ST) fusion devices where the instability signals previously indistinguishable in high aspect ratio tokamaks due to high toroidal magnetic field became the subjects of experiments. We discuss further prospects of ICE theory applications for future burning plasma (BP) experiments such as those to be conducted in ITER device in France, where neutron and gamma rays escaping the plasma create extremely challenging conditions fusion alpha particle diagnostics.

  9. Ion cyclotron emission studies: Retrospects and prospects

    DOE PAGESBeta

    Gorelenkov, N. N.

    2016-06-05

    Ion cyclotron emission (ICE) studies emerged in part from the papers by A.B. Mikhailovskii published in the 1970s. Among the discussed subjects were electromagnetic compressional Alfv,nic cyclotron instabilities with the linear growth rate similar ~ √(nα/ne) driven by fusion products, -particles which draw a lot of attention to energetic particle physics. The theory of ICE excited by energetic particles was significantly advanced at the end of the 20th century motivated by first DT experiments on TFTR and subsequent JET experimental studies which we highlight. Recently ICE theory was advanced by detailed theoretical and experimental studies on spherical torus (ST) fusionmore » devices where the instability signals previously indistinguishable in high aspect ratio tokamaks due to high toroidal magnetic field became the subjects of experiments. Finally, we discuss prospects of ICE theory applications for future burning plasma (BP) experiments such as those to be conducted in ITER device in France, where neutron and gamma rays escaping the plasma create extremely challenging conditions fusion alpha particle diagnostics.« less

  10. [Infectious sacroiliitis in tunisian centre: retrospective study of 25 cases].

    PubMed

    Bellazreg, Foued; Alaya, Zeineb; Hattab, Zouhour; Lasfar, Nadia Ben; Ayeche, Mohamed Laziz Ben; Bouajina, Elyes; Letaief, Amel; Hachfi, Wissem

    2016-01-01

    Infectious sacroiliitis are rare but they can be complicated by disabling functional sequelae. To describe the clinical and bacteriological characteristics of infectious sacroiliitis among patients treated in Sousse Medical Center, Tunisia. A retrospective, descriptive study, of infectious sacroiliitis among patients hositalized in Sousse between 2000 and 2015. The diagnosis was made on the basis of medical signs, imaging, microbiological indicators. In the study were enrolled twenty five patients, 10 men and 15 women; the average age was 41 years (19-78). Sacroiliitis were due to pyogenic bacteria in 14 cases (56%), brucella bacteria in 6 cases (24%) and tuberculosis bacteria in 5 cases (20%). The mean duration of symptoms was 61, 45 and 402 days respectively. The most common clinical signs were buttock pain (92%) and fever (88%). Standard radiographic evaluation was abnormal in 75% of cases. CT scan and MRI of the sacroiliac joints was performed in all cases. The diagnosis was bacteriologically confirmed in 24 cases (96%). The average duration of antibiotic treatment was 83 days in the pyogenic sacroiliitis, and 102 days in brucellar sacroiliitis. The evolution was favorable in 12 patients (48%), 9 patients (36%) had sequelae of sacroiliac joint pain and 4 patients (16%) died. In our study, time frame of infectious sacroiliitis evolution did not predict the causative bacterium, hence the need for bacteriological documentation in order to prescribe appropriate antibiotic therapy. PMID:27583067

  11. 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…

  12. Causative Microorganisms of Infectious Endophthalmitis: A 5-Year Retrospective Study

    PubMed Central

    Duan, Fang; Liao, Jingyu; Zheng, Yongxin; Tan, Junlian

    2016-01-01

    This study aimed to identify the microbial etiology of infectious endophthalmitis and to determine the antibacterial susceptibilities of bacterial isolates at an eye hospital in South China. A retrospective analysis was carried out on 330 patients with clinically diagnosed infectious endophthalmitis who underwent microbiological evaluation from January 2010 to December 2014. Of the 330 patients, 193 patients (58.5%) had posttraumatic endophthalmitis, 67 patients (20.3%) had postoperative endophthalmitis, 61 patients (18.5%) had endogenous endophthalmitis, and 9 patients (2.7%) had postcorneal infective endophthalmitis. Of the 105 cases (31.8%) of culture-positive endophthalmitis, 79 cases (75.2%) had bacterial growth and 26 cases (24.8%) had fungal growth. In posttraumatic endophthalmitis, Gram-positive bacteria were the predominant species, followed by Gram-negative bacteria and fungi. In endogenous endophthalmitis, Gram-negative bacteria were the predominant species, followed by fungi and Gram-positive bacteria. In postsurgical endophthalmitis, all infections were bacterial. However, in postcorneal infective endophthalmitis, all infections were fungal. Overall, levofloxacin showed the highest activity against bacterial isolates. There was a significant difference in the susceptibility to tobramycin between the isolates from posttraumatic and postoperative endophthalmitis (p < 0.05). The results of this study identify the microbial spectrum of infectious endophthalmitis in this clinical setting. PMID:27413545

  13. Dental aesthetic index: applicability in Indian population: a retrospective study.

    PubMed

    Poonacha, K S; Deshpande, S D; Shigli, Anand L

    2010-01-01

    A variety of indices have been developed to assist professionals in categorizing malocclusion according to treatment needs. Dental aesthetic index (DAI) is one such index. DAI quantifies the normal variations usually seen and the dentofacial anomalies. A retrospective study on hundred available and treated cases was carried out on the casts. This survey was mainly carried out to determine the role of pedodontist in early identification of dental anomalies using DAI and sound referral of the patient to the orthodontist for better comprehensive care during the growth period in children. The materials used to collect data included periodontal probe with millimeter markings, ruler, calipers, pencil, and eraser. The results showed that when grouped according to various malocclusion severity levels by DAI, 3% had no or minor malocclusion indicating no or slight need of treatment, 15% had definite malocclusion and the treatment needed was elective, 27% had severe malocclusion and treatment was highly desirable, and remaining 55% of the casts had very severe or handicapping malocclusion and the treatment was mandatory. This study shows that DAI can be effectively used to evaluate and recognize the orthodontic needs of Indian children with permanent dentition and treated at an early stage so that the treatment is more effective. PMID:20215666

  14. Retrospective study of 289 odontogenic tumors in a Brazilian population

    PubMed Central

    Serpa, Marianna-Sampaio; Tenório, Jefferson-da-Rocha; do Nascimento, George-João-Ferreira; de Souza-Andrade, Emanuel-Sávio; Veras-Sobral, Ana-Paula

    2016-01-01

    Background Odontogenic tumors (OTs) are considered important among oral lesions because of their clinicopathological heterogeneity, and variable biological behavior. This paper aims to determine the frequency and distribution of OTs, over a period of 10 years, at a public university in Northeastern Brazil and compare this data with previous reports. Material and Methods We reviewed all cases of OTs from oral pathology laboratory of University of Pernambuco (UPE), from 2004 to 2014. Diagnoses were re-evaluated and the tumors were classified according to the latest (2005) World Health Organization Classification of Tumors. In addition, we searched in the English-language literature retrospective studies on OTs that used the same classification. Results Data was obtained allowing the analysis of the tissue hemodynamics. We were able to map the vascularization of the face and it was possible to access three arteries of small diameter (0,60mm angular artery; 0,55mm greater palatine artery; 0,45mm infraorbital artery). Conclusions OTs are uncommon neoplasms with geographic variation. Our clinicopathological features are according to literature. In the present study, KCOT was the most frequent one, showing that the new classification of OTs altered the distribution of these lesions and possibly made KCOT the most common OT observed in diagnostic services worldwide. Key words:Odontogenic tumors, jaw neoplasms, epidemiology, oral pathology. PMID:26827068

  15. 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

  16. Bipartite Medial Cuneiform: Case Report and Retrospective Review of 1000 Magnetic Resonance (MR) Imaging Studies

    PubMed Central

    Chang, Geraldine H.; Chang, Eric Y.; Chung, Christine B.; Resnick, Donald L.

    2014-01-01

    Objective. To present a unique case report of a Lisfranc fracture in a patient with a bipartite medial cuneiform and to evaluate the prevalence of the bipartite medial cuneiform in a retrospective review of 1000 magnetic resonance (MR) imaging studies of the foot. Materials and Methods. Case report followed by a retrospective review of 1000 MR imaging studies of the foot for the presence or absence of a bipartite medial cuneiform. Results. The incidence of the bipartite medial cuneiform is 0.1%. Conclusion. A bipartite medial cuneiform is a rare finding but one with both clinical and surgical implications. PMID:24587806

  17. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study.

    PubMed

    Pinto, José Antonio; Ribeiro, Davi Knoll; Cavallini, Andre Freitas da Silva; Duarte, Caue; Freitas, Gabriel Santos

    2016-04-01

    Introduction Obstructive sleep apnea (OSA) is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA) and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women) with a mean age of 50.05 years (range 19-75 years). The prevalence of comorbidities were hypertension (39%), obesity (34%), depression (19%), gastroesophageal reflux disease (GERD) (18%), diabetes mellitus (15%), hypercholesterolemia (10%), asthma (4%), and no comorbidities (33%). Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI) values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations. PMID:27096019

  18. Oral Lymphoma Prevalence in Iranian Population: A Multicenter Retrospective Study

    PubMed Central

    Akbari, Mohammad Esmaeil; Bastani, Zahra; Mokhtari, Sepideh; Atarbashi Moghadam, Saede

    2015-01-01

    Background: Oral lymphoma is the second most common malignancy of the head and neck region after malignant epithelial tumors. Objectives: Considering the lack of a multicenter study on the frequency of oral lymphoma in Iran, this study aimed to assess the relative frequency of oral lymphomas in Iran during a 6-year period. Materials and Methods: This multicenter, retrospective, cross-sectional study was conducted in two phases. In the first phase, cases of oral lymphoma registered in the cancer research center (CRC) of Shahid Beheshti university of medical sciences were extracted. The patient records and pathology reports of these patients were retrieved from the archives and age, sex and microscopic type site of the lesions were evaluated. Results: Oral lymphoma accounts for 1% of head and neck malignancies and 8% of all lymphomas. From 2003 to 2008, a total of 437 new cases of oral lymphomas had been registered in the CRC. Diffuse large B-cell lymphoma was found to be the most common form of oral lymphoma in the 6-year period with 240 (54.9%) registered cases. The majority of detected cases were in the 6th and 7th decades of life with a male to female ratio of 1:84. Tonsils were the most common site of occurrence of lymphoma in the oral cavity (77.8%). Conclusions: The age of onset, site of involvement, sex of patients, and histopathological subtype of oral lymphomas in the Iranian population were found to be similar to those of most other countries. PMID:26855724

  19. Treatment results in advanced stage Hodgkin's lymphoma: A retrospective study

    PubMed Central

    Jain, H; Sengar, M; Nair, R; Menon, H; Laskar, S; Shet, T; Gujral, S; Sridhar, E

    2015-01-01

    Background: Hodgkin's lymphoma displays distinct epidemiological attributes in Asian population thus making it relevant to study whether there are any differences in treatment outcomes too when treated with current standard of care. Aim: To evaluate the treatment outcomes of de-novo advanced stage HL in adults. Materials and Methods: This retrospective study included de-novo advanced stage HL patients (≥15 years) registered at our center from January 2004 to December 2007. Treatment outcomes were measured in terms of response rates, overall survival (OS) and progression-free survival (PFS). Overall and PFS were calculated with Kaplan-Meier methodology and Cox-proportional hazards model was used for multivariate analysis to identify prognostic factors. Results: There were 125 patients (males 77%) who received minimum one cycle of chemotherapy with median age of 32 years (Range 15-65 years). Stage IV disease was seen in (46 patients) 37%; 75% (94 patients) patients had B symptoms. International prognostic score (IPS) ≤4 was seen in 95/112 (85%) patients. ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy was given to 94%. Radiation to residual/bulky sites was given to 36% (45 patients). Response data was available for 112 patients; complete response in 76%; partial response in 10 % and progressive disease in 3 patients. Nineteen deaths (progressive disease-7, toxicity-8, unrelated cause-4) were observed. At median follow-up of 28 months, estimated 5-year OS and PFS were 60% and 58%, respectively. On multivariate analysis, IPS and response to treatment were significant factors for both OS and PFS. Conclusions: The treatment outcomes in this study are comparable with the published literature with limited follow-up data. PMID:25766339

  20. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study

    PubMed Central

    Pinto, José Antonio; Ribeiro, Davi Knoll; Cavallini, Andre Freitas da Silva; Duarte, Caue; Freitas, Gabriel Santos

    2016-01-01

    Introduction Obstructive sleep apnea (OSA) is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA) and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women) with a mean age of 50.05 years (range 19–75 years). The prevalence of comorbidities were hypertension (39%), obesity (34%), depression (19%), gastroesophageal reflux disease (GERD) (18%), diabetes mellitus (15%), hypercholesterolemia (10%), asthma (4%), and no comorbidities (33%). Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI) values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations. PMID:27096019

  1. Caval filters in intensive care: a retrospective study

    PubMed Central

    Ferraro, F; Di Gennaro, TL; Torino, A; Petruzzi, J; d’Elia, A; Fusco, P; Marfella, R; Lettieri, B

    2014-01-01

    Aim To evaluate the effectiveness of a caval vein filter (CVF) peri-implant monitoring protocol in order to reduce pulmonary embolism (PE) mortality and CVF-related morbidity. Background The reduction in mortality from PE associated with the use of CVF is affected by the risk of increase in morbidity. Therefore, CVF implant is a challenging prophylactic or therapeutic option. Nowadays, we have many different devices whose rational use, by applying a strict peri-implant monitoring protocol, could be safe and effective. Materials and methods We retrospectively studied 62 patients of a general Intensive Care Unit (ICU) scheduled for definitive, temporary, or optional bedside CVF implant. A peri-implant monitoring protocol including a phlebocavography, an echo-Doppler examination, and coagulation tests was adopted. Results In our study, no thromboembolic recurrence was registered. We implanted 48 retrievable and only 20 definitive CVFs. Endothelial adhesion (18%), residual clot (5%), cranial or caudal migration (6%), microbial colonization of the filter in the absence of clinical signs of infection (1%), caval thrombosis (1%), and pneumothorax (1%) were reported. Deep-vein thrombosis (DVT) was reported (8%) as early complication. All patients with DVT had a temporary or optional filter implanted. However, in our cohort, definitive CVFs were reserved only to 32% of patients and they were not associated with DVT as complication. Conclusion CVF significantly reduces iatrogenic PE without affecting mortality. Generally, ICU patients have a transitory thromboembolic risk, and so the temporary CVF has been proved to be a first-line option to our cohort. A careful monitoring may contribute to a satisfactory outcome in order to promote CVF implant as a safe prophylaxis option. PMID:25395837

  2. Postperfusion Syndrome in Cadaveric Liver Transplantations: A Retrospective Study

    PubMed Central

    Aydınlı, Bahar; Karadeniz, Ümit; Demir, Aslı; Güçlü, Çiğdem Yıldırım; Kazancı, Dilek; Koçulu, Rabia; Haytural, Candan; Özgök, Ayşegül; Bostancı, Erdal Birol; Zorlu, Ali

    2016-01-01

    Objective To evaluate the factors that affects the postperfusion syndrome in cadaveric liver transplantations and the effect of the postperfusion syndrome on discharge from the hospital. Methods Patients who underwent cadaveric liver transplantations between 2007 and 2013 were scanned retrospectively. Intraoperative anaesthesia records, intensive care unit follow-up forms and discharge reports were examined from patient files. Overall, 43 patients having complete data were included in the study. The postperfusion syndrome is defined as asystoli or a decrease in mean arterial pressure of more than 30%, which occurred in the first 5 min of reperfusion and continued for 1 min. Patients were divided into two groups: those who had the postperfusion syndrome and those who did not. Results The number of patients who had the postperfusion syndrome was 25 of 43 (58.1%). The MELD score of patients without the postperfusion syndrome was calculated as 16.9±3.2 and that of patients with the postperfusion syndrome was 19.7±3.6. A statistically significant relationship was detected between the postperfusion syndrome occurrence and a high MELD score (p=0.013). The diastolic blood pressure just before reperfusion was statistically lower in the group with the postperfusion syndrome than in the other group (p=0.023, 50±8 vs. 58±11). According to the logistic regression analysis, the MELD score and the decrease in diastolic blood pressure before reperfusion were defined as independent predictive factors. Conclusion According to the study, the ratio for having the postperfusion syndrome was found to be 58.1%. The independent predictor factors affecting the postperfusion syndrome were detected as the MELD score and the decrease in diastolic blood pressure before reperfusion. The postperfusion syndrome during orthotropic liver transplantation is an important issue for anaesthesiologists. The awareness of the related factors with the postperfusion syndrome may help in the development

  3. Effects of pulmonary rehabilitation in bronchiectasis: A retrospective study.

    PubMed

    Ong, H K; Lee, A L; Hill, C J; Holland, A E; Denehy, L

    2011-01-01

    There is limited information about the benefits of pulmonary rehabilitation (PR) in patients with bronchiectasis. This study aimed to evaluate the effects of an out-patient PR program in patients with a primary diagnosis of bronchiectasis and to compare them with a matched COPD group who completed the same PR program. A retrospective review was conducted of patients with bronchiectasis or COPD who completed 6 to 8 weeks of PR at two tertiary institutions. The outcome measures were the 6-minute walk distance (6MWD) and Chronic Respiratory Disease Questionnaire (CRQ). Ninety-five patients with bronchiectasis completed the PR (48 male; FEV(1) 63 [24] % predicted; age 67 [10] years). Significant improvements in 6MWD (mean change 53.4 m, 95% CI 45.0 to 61.7) and CRQ total score (mean change 14.0 units, 95% CI 11.3 to 16.7) were observed immediately following PR. In patients with complete follow-up (n = 37), these improvements remained significantly higher than baseline at 12 months (20.5 m, 95% CI 1.4 to 39.5 for 6MWD; 12.1 points, 95% CI 5.7 to 18.4 for CRQ total score). The time trend and changes in the 6MWD and CRQ scores were not significantly different between the bronchiectasis and the COPD groups (all p > 0.05). This study supports the inclusion of patients with bronchiectasis in existing PR programs. Further prospective RCTs are warranted to substantiate these findings. PMID:21339371

  4. Effectiveness of steroid treatment in myasthenia gravis: a retrospective study.

    PubMed

    Cosi, V; Citterio, A; Lombardi, M; Piccolo, G; Romani, A; Erbetta, A

    1991-07-01

    The records of 142 patients with generalized autoimmune myasthenia gravis who had been treated with steroids as the single immunosuppressive agent, collected at regular intervals, were employed for a retrospective evaluation. The effectiveness of treatment was assessed after 24 months; the data from the 6th and 12th months were also considered. After 24 months, 63.4% of the whole sample had improved (33.8% were in clinical or pharmacological remission); 13.4% were unchanged or had worsened and 22.3% had moved to a different immunosuppressive treatment. The rate of positive outcome was higher in patients over the age of 40 at disease onset. PMID:1927259

  5. Retrospective analysis of medicolegal cases and evaluation for erectile function.

    PubMed

    Ozkara, H; Aşicioglu, F; Alici, B; Akkuş, E; Hattat, H

    1999-06-01

    Erectile function (EF) is an important question in lawsuits for divorce, rape, and damages. In this study, a method to evaluate medicolegal cases is defined, and the characteristics of the 265 cases screened for EF between 1989 and 1997 were analyzed. Interview, physical examination, psychometric evaluation, nocturnal penile tumescence, serum hormone levels and blood chemistry, intracavernosal drug injection, penile Doppler ultrasonography, and pharmacocavernosometry and pharmacocavernosography tests were used for diagnosis. The tests performed were selected according to the age of the subject. Of the 265 cases 128 (48.3%) were for divorce, 116 (43.7%) were for rape, and 21 (8%) were for indemnity relating to lawsuits for damages. In only 7 cases (2.7%) was the defendant <15 years of age. Organic pathology for erectile dysfunction (ED) was present in 22% of lawsuits for divorce, 40.5% of lawsuits for rape, and 33.4% of lawsuits for damages. Three men in cases of divorce and 2 men after genital trauma due to traffic accident suffered psychological ED. This study indicates that lawyers may abuse the assertion of ED in lawsuits for divorce and rape. In 128 divorce cases the defendant was accused of being impotent, but evaluation proved that 75.8% had normal EF. In lawsuits for rape, 59.5% of defendants had normal EF although the lawyers of the rapist claimed their clients were impotent. The investigation, interpretation, and characteristics of medicolegal cases may differ in countries with different cultures. PMID:10414654

  6. Comprehensive retrospective evaluation of existing in vitro chromosomal aberration test data by cytotoxicity index transformation.

    PubMed

    Fujita, Yurika; Morita, Takeshi; Matsumura, Shoji; Kawamoto, Taisuke; Ito, Yuichi; Nishiyama, Naohiro; Honda, Hiroshi

    2016-05-01

    New OECD test guidelines have been issued, in which the cytotoxicity index relative cell count (RCC) is replaced with a new index, RICC or RPD (relative increase in cell count/relative population doubling), with the goal of reducing the high proportion of false positive results in in vitro chromosomal aberration tests. Using a mathematical approach to estimate new indices from the RCC, we constructed an evaluation flow that quantitatively estimates how often the previous test conclusions change when applying the updated cytotoxicity criteria. The new evaluation flow was applied to a retrospective evaluation of 285 chemicals in two databases. The effects of the employment of new cytotoxicity indices are investigated at a large scale. Using the new evaluation flow, 90 chemicals were estimated as positive, 39 were designated as estimated negative (13 probably negative and 26 possibly negative), and 140 were designated as negative. Moreover, we also applied a prioritization index to indicate the likelihood of a chemical being re-evaluated as negative and assigned priorities for testing. Most of the chemicals that were designated as estimated negative and had negative results in the in vivo micronucleus tests were considered as false-positives that would be correctly judged under the new test guideline. Furthermore, statistical analysis of the frequency of estimated negatives revealed that the results for Ames-positive chemicals, especially those with a strong response, are unlikely to change. Therefore, we concluded that the new indices would likely reduce the proportion of false positive results and not increase the proportion of false negative results. This study is the first report of a comprehensive re-evaluation of test results in terms of new cytotoxicity indices. The evaluation flow we have developed facilitates efficient retrospective evaluation of genotoxicity. PMID:27169375

  7. A Study on Mental Disorders: 5-year Retrospective Study

    PubMed Central

    Celine, Thalappillil Mathew; Antony, Jimmy

    2014-01-01

    Background: “Mental disorder” is the most common used term in the modern life and the main reason behind this may be the mechanical way of life or stress and strain among youth. Aim: To find the pattern of mental disorders of hospitalized patients in a medical college hospital from 1st April 2005 to 31st March 2010. Settings and Design: A retrospective study conducted among the patients admitted with mental disorders in a medical college hospital from 1st April 2005 to 31st March 2010. Materials and Methods: Data collected from the registers maintained in the medical records department. Statistical Analysis: Z test is used for the comparison of proportions. Results: A total of 7908 mental disorder cases reported in the medical college hospital, 5564 (70.36%) were males and 2344 (29.64%) were females. Most cases occurred in the age group of 30-44 years. Mental disorder was more among females than males in 0-29 years and ≥ 60 years, but in 30-59 years males were more. In each year, mental disorders were reported more in males than females. Of the cases, most of them were mood disorders. Mental and behavioral disorders due to psychoactive substance use were more among males but schizophrenia, delusional disorders, mood disorders, stress-related disorders, mental retardation, and so on were more among females. Conclusion: Mood disorder was the most occurred mental disorder and the next leading mental disorder was mental and behavioral disorders due to psychoactive substance use. Counseling can be helpful for preventing most of the mental disorders. Improve the mental health care facilities will be the solution for controlling the mental disorders. PMID:24791229

  8. A 5-year retrospective clinical study of the Dentium implants

    PubMed Central

    Lee, Jeong-Yol; Park, Hyo-Jin; Kim, Jong-Eun; Choi, Yong-Geun; Kim, Young-Soo; Huh, Jung-Bo

    2011-01-01

    PURPOSE The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION The 5-year CSR of Implantium implants was 97.37%. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated

  9. Autism and epilepsy: a retrospective follow-up study.

    PubMed

    Hara, Hitoshi

    2007-09-01

    So-called "idiopathic" autism, which exhibited no major complications before diagnosis is well-known as one of the risk factors for epilepsy. This retrospective follow-up study aimed to clarify the characteristics of epilepsy in the autism; onset of seizure, seizure types, EEG findings and epilepsy outcome and the differences as a group between the autism with epilepsy and those without epilepsy. One hundred thirty individuals with autistic disorder or atypical autism diagnosed in childhood were followed up over 10 years and were evaluated almost every year up to 18-35 years of age. Their medical records related to perinatal conditions, IQ, social maturity scores and several factors of epilepsy were reviewed in October 2005. Thirty-three of the follow-up group (25%) exhibited epileptic seizures. The onset of epilepsy was distributed from 8 to 26 years of age. Two types of seizure were observed; partial seizure with secondarily generalized seizure and generalized seizure. Twenty of the epileptics (61%) showed the partial seizure. Although 18% of the non-epileptic group exhibited epileptic discharges on EEG, 68% of the epileptic group revealed epileptiform EEG findings before the onset of epilepsy. No differences were observed concerning the sex ratio, autistic disorder/atypical autism and past history of febrile seizures between the epileptic and non-epileptic groups. Lower IQ, lower social maturity score and higher frequency of prescribed psychotropics were observed in the epileptic group compared to the non-epileptics. Idiopathic autism was confirmed as the high risk factor for epilepsy. Epileptiform EEG findings predict subsequent onset of epileptic seizures in adolescence. Epilepsy is one of negative factors on cognitive, adaptive and behavioral/emotional outcomes for individuals with autism. PMID:17321709

  10. A retrospective evaluation of the Perfecting Patient Care University training program for health care organizations.

    PubMed

    Morganti, Kristy Gonzalez; Lovejoy, Susan; Beckjord, Ellen Burke; Haviland, Amelia M; Haas, Ann C; Farley, Donna O

    2014-01-01

    This study evaluated how the Perfecting Patient Care (PPC) University, a quality improvement (QI) training program for health care leaders and clinicians, affected the ability of organizations to improve the health care they provide. This training program teaches improvement methods based on Lean concepts and principles of the Toyota Production System and is offered in several formats. A retrospective evaluation was performed that gathered data on training, other process factors, and outcomes after staff completed the PPC training. A majority of respondents reported gaining QI competencies and cultural achievements from the training. Organizations had high average scores for the success measures of "outcomes improved" and "sustainable monitoring" but lower scores for diffusion of QI efforts. Total training dosage was significantly associated with the measures of QI success. This evaluation provides evidence that organizations gained the PPC competencies and cultural achievements and that training dosage is a driver of QI success. PMID:23572230

  11. Evaluating Community Health Advisor (CHA) Core Competencies: The CHA Core Competency Retrospective Pretest/Posttest (CCCRP).

    PubMed

    Story, Lachel; To, Yen M

    2016-05-01

    Health care and academic systems are increasingly collaborating with community health advisors (CHAs) to provide culturally relevant health interventions that promote sustained community transformation. Little attention has been placed on CHA training evaluation, including core competency attainment. This study identified common CHA core competencies, generated a theoretically based measure of those competencies, and explored psychometric properties of that measure. A concept synthesis revealed five CHA core competencies (leadership, translation, guidance, advocacy, and caring). The CHA Core Competency Retrospective Pretest/Posttest (CCCRP) resulted from that synthesis, which was administered using multiple approaches to individuals who previously received CHA training (N= 142). Exploratory factor analyses revealed a two-factor structure underlying the posttraining data, and Cronbach's alpha indicated high internal consistency. This study suggested some CHA core competencies might be more interrelated than previously thought, and two major competencies exist rather than five and supported the CCCRP's use to evaluate core competency attainment resulting from training. PMID:25416701

  12. A 3-Year Retrospective Evaluation of the Clinical Performance of Fiber Posts.

    PubMed

    Amaral, Marina; Coppo, Priscilla Pessin; Rosalem, Cíntia Gonçalves Carvalho; Suaid, Fabricia Ferreira; Guerra, Selva Maria Gonçalves

    2015-12-01

    This retrospective study evaluated the clinical outcome of 139 teeth restored with carbon fiber posts after 3 years of placement, considering the amount of remaining dentin as the main variable. Eighty-one patients received the fiber posts within a period of 16 months and were recalled after 3 years. The tooth type, amount of remaining dentin, and prosthetic crown material were evaluated. No loss of post or core retention was detected after 3 years of follow up. During the observed time, root or post fracture and secondary caries were not recorded. Only one failure concerning endodontic treatment was detected. The amount of remaining dentin was not an important characteristic in the restorative failure of endodontically treated teeth restored with carbon fiber posts within 3 years. PMID:26963206

  13. Behavioral responses of substance-exposed newborns: a retrospective study.

    PubMed

    Higley, Anne Marie; Morin, Karen H

    2004-02-01

    This study assessed the behavior of infants whose mothers had a drug history by using the Neonatal Behavioral Assessment Scale. Data were collected via retrospective chart review (N = 103). Urine testing was only reported for 66 mothers during pregnancy and at birth. Infants performed within normally expected ranges for all items, except consolability and self-quieting. These findings support the use of NBAS in assessing newborn behavior because the information gained assists the parent in providing a supportive care giving environment that will not only help the infant recover but also enhance interaction between infant and parent. PMID:14991553

  14. Experience of the Spiritist Hospital Chaplaincy Service: A Retrospective Study.

    PubMed

    Anefalos, Alexandre; E Silva, Wilkens Aurélio Buarque; Pinto, Renan Mercuri; Ferrari, Renée Danckwardt; de Fátima Boni, Aparecida; Dos Santos, Hélio Goulart; Duarte, Cleide Borges

    2016-06-01

    The Hospital Chaplaincy service is made of religious volunteer work done by representatives of various religions properly trained to offer spiritual support to hospitalized patients, as well as their families, contributing as a source of protection, comfort and restoring faith in the face of illness. The objective of this study is to present a retrospective analysis of records made by chaplains, guided by the Spiritist Medical Association of Piracicaba, through 7419 calls to 2191 patients admitted at Unimed Hospital of Piracicaba in 2014. The results contributed to the production of scientific documentation about this new holistic model that still lies in acceptance phase in the country. PMID:26272098

  15. A retrospective, longitudinal study to evaluate healing lower extremity wounds in patients with diabetes mellitus and ischemia using standard protocols of care and platelet-rich plasma gel in a Japanese wound care program.

    PubMed

    Sakata, Junichi; Sasaki, Shigeru; Handa, Kazuyoshi; Uchino, Takashi; Sasaki, Tsukasa; Higashita, Ryuji; Tsuno, Norio; Hiyoshi, Toru; Morimoto, Shuhei; Rinoie, Chugo; Saito, Natsuko

    2012-04-01

    Chronic wounds, especially in patients with diabetes mellitus (DM), are a major health challenge in Japan. The goal of wound care centers (WCCs) in Japan is to facilitate healing and prevent lower extremity amputations (LEAs) using standardized protocols of patient and wound care. The standard treatment algorithm includes a complete patient and wound assessment, history, physical exam, and a variety of diagnostic tests that determine the need for infection control intervention, revascularization, excision and debridement, growth factor/platelet rich plasma (PRP) gel therapy, skin graft/ flap, wound protection, and education. All patient and wound data are entered in a secure central database for all WCCs. To evaluate the outcomes of standard care regimens compared to the use of a topical PRP gel treatment in patients with a variety of complex wounds, a retrospective, longitudinal study was conducted. Wound outcomes from 39 patients with 40 chronic, nonhealing, lower extremity wounds were evaluated between two time periods: between first presentation at the WCC (T1) and after using standard topical treatments (T2) and between T2 and after using the PRP gel treatment (T3). Patient average age was 66.8 years (SD: 10.60) and mean wound duration was 99.7 days before treatment (SD: 107.73); and the majority of patients (85%) had DM. Wounds were classified as ischemic diabetic (n = 24), diabetic (n = 10), ischemic (n = 5), and pressure ulcer (n = 1). DFUs were Wagner III (77%) and lV (23%). Of those, 60% were in patients with arteriosclerotic obliterans (ASO). Infection (abscess, cellulitis, osteomyelitis, and/or gangrene) was present in all wounds and treated using debridement, antibiotic therapy, and surgery as deemed appropriate. During the first treatment period (T1 to T2) of 75.3 days, which included revascularization and/or debridement along with standard of care, none of the wounds healed and the average wound area, depth, and volume increased. Following topical

  16. Transurethral resection syndrome in elderly patients: a retrospective observational study

    PubMed Central

    2014-01-01

    Background Transurethral resection of the prostate (TURP) involves the risk of transurethral resection (TUR) syndrome owing to hyponatremia. Irrigation fluid type, duration of operation, and weight of resected mass have been evaluated as risk factors for TUR syndrome. The purpose of the present study was to identify risk factors related to TUR syndrome in the elderly. Methods After obtaining approval from the Institutional Review Board, data on all elderly males (aged 70 years and older) who underwent TURP under regional anesthesia over a 6-year period at our institution were retrospectively reviewed. TUR syndrome was defined as evidence of a central nervous system disturbance such as nausea, vomiting, restlessness, confusion, or even coma with a circulatory abnormality both intra- and post-operatively. Patients were divided into two groups, positive and negative, for the occurrence of the syndrome. Data such as previous medical history, preoperative and postoperative serum data, weight of resected mass, duration of operation, irrigation fluid drainage technique, anesthetic technique, operative infusion and transfusion volume, and neurological symptoms were collected. Only observational variables with p < 0.05 on univariate analyses were included in the multivariate logistic regression model to ascertain their independent effects on TUR syndrome. Results Of the 98 patients studied, 23 had TUR syndrome (23.5%, 95% confidence interval [CI] 14.9–32.0%). Multivariate regression analysis revealed that volume of plasma substitute ≥ 500 ml (odds ratio [OR] 14.7, 95% CI 2.9–74.5), continuous irrigation through a suprapubic cystostomy (OR 4.7, 95% CI 1.3–16.7), and weight of resected mass > 45 g (OR 4.1, 95% CI 1.2–14.7) were associated with significantly increased risks for TUR syndrome (Hosmer-Lemeshow test, p = 0.94, accuracy 84.7%). Conclusions These results suggest that the use of a plasma substitute and continuous irrigation through a

  17. Oral lichen planus – retrospective study of 563 Croatian patients

    PubMed Central

    Budimir, Vice; Richter, Ivica; Andabak-Rogulj, Ana; Vučićević-Boras, Vanja

    2014-01-01

    Objectives: To investigate the epidemiological and clinical characteristics of oral lichen planus (OLP) in a group of Croatian patients seen between 2006 and 2012. Study Design: A group of 563 patients with a diagnosis of OLP was retrospectively reviewed in our clinic. Data regarding age, gender, medical history, drugs, smoking, alcohol, chief complaint, clinical type, localization, histology, treatment and malignant transformation were registered. Results: Of the 563 patients, 414 were females and 149 were males. The average age at the diagnosis was 58 (range 11-94). The most common site was buccal mucosa (82.4%). Most of our patients did not smoke (72.5%) or consume alcohol (69.6%). Patients reported oral soreness (43.3%), mucosal roughness (7%), xerostomia (3%), gingival bleeding (2%) and altered taste (0.5%) as the chief complaint, while almost half of them were asymptomatic (44.2%). The most common types of OLP were reticular (64.8%) and erosive (22.9%). Plaque-like (5.7%) atrophic/erythemtous (4.3%) and bullous (2.3%) type were also observed. Malignant transformation rate of 0.7% was recorded. Conclusions: OLP mostly affects non-smoking middle-aged women. Buccal mucosa is the most commonly affected site. In almost half of the cases patients are asymptomatic. In spite of the small risk for malignant transformation all patients should be regularly monitored. Key words:Oral lichen planus, malignant transformation, epidemiology, retrospective study. PMID:24608217

  18. A Retrospective Study of Congenital Cardiac Abnormality Associated with Scoliosis

    PubMed Central

    Ucpunar, Hanifi; Sevencan, Ahmet; Balioglu, Mehmet Bulent; Albayrak, Akif; Polat, Veli

    2016-01-01

    Study Design Retrospective study. Purpose To identify the incidence of congenital cardiac abnormalities in patients who had scoliosis and underwent surgical treatment for scoliosis. Overview of Literature Congenital and idiopathic scoliosis (IS) are associated with cardiac abnormalities. We sought to establish and compare the incidence of congenital cardiac abnormalities in patients with idiopathic and congenital scoliosis (CS) who underwent surgical treatment for scoliosis. Methods Ninety consecutive scoliosis patients, who underwent surgical correction of scoliosis, were classified as CS (55 patients, 28 female [51%]) and IS (35 patients, 21 female [60%]). The complete data of the patients, including medical records, plain radiograph and transthoracic echocardiography were retrospectively assessed. Results We found that mitral valve prolapse was the most common cardiac abnormality in both patients with IS (nine patients, 26%) and CS (13 patients, 24%). Other congenital cardiac abnormalities were atrial septal aneurysm (23% of IS patients, 18% of CS patients), pulmonary insufficiency (20% of IS patients, 4% of CS patients), aortic insufficiency (17% of IS patients), atrial septal defect (11% of IS patients, 13% of CS patients), patent foramen ovale (15% of CS patients), dextrocardia (4% of CS patients), bicuspid aortic valve (3% of IS patients), aortic stenosis (2% of CS patients), ventricular septal defect (2% of CS patients), and cardiomyopathy (2% of CS patients). Conclusions We determined the increased incidence of congenital cardiac abnormalities among patients with congenital and IS. Mitral valve prolapse appeared to be the most prevalent congenital cardiac abnormality in both groups. PMID:27114761

  19. Evaluating area-level spatial clustering of Salmonella Enteritidis infections and their socioeconomic determinants in the greater Toronto area, Ontario, Canada (2007 – 2009): a retrospective population-based ecological study

    PubMed Central

    2013-01-01

    Background There have been only a few region-level ecological studies conducted in Canada investigating enteric infections in humans. Our study objectives were to 1) assess the spatial clustering of Salmonella enterica serotype Enteritidis (S. Enteritidis) human infections in the Greater Toronto Area, and 2) identify underlying area-level associations between S. Enteritidis infection rates and socioeconomic status (SES) indicators that might explain the clustering of infections. Methods Retrospective data on S. Enteritidis infections from 2007 to 2009 were obtained from Ontario’s reportable disease surveillance database and were grouped at the forward sortation area (FSA) - level. A spatial scan statistic was employed to identify FSA-level spatial clusters of high infection rates. Negative binomial regression was used to identify FSA-level associations between S. Enteritidis infection rates and SES indicators obtained from the 2006 Census of Canada. Global Moran’s I statistic was used to evaluate the final model for residual spatial clustering. Results A spatial cluster that included nine neighbouring FSAs was identified in downtown Toronto. A significant positive curvilinear relationship was observed between S. Enteritidis infection rates and FSA-level average number of children at home per census family. Areas with high and areas with low average median family income had higher infection rates than FSAs with medium average median family income. Areas with a high proportion of visible minority population had lower infection rates than FSAs with a medium proportion of visible minority population. The Moran’s I statistic was not significant, indicating that no residual spatial autocorrelation was present after accounting for the SES variables in the final model. Conclusions Our study demonstrated that FSAs with high and low average median family income, medium proportion of visible minority population, and high average number of children at home per census

  20. Retrospective Descriptive Study of Cerebral Palsy in Nepal.

    PubMed

    Thapa, Ritesh

    2016-07-01

    There is very little data pertaining to cerebral palsy (CP) from Nepal. In this retrospective study it was observed that dyskinetic CP was seen in 29 % and the sex ratio of males to females was two in the study population of children with CP. Both of these are much higher than data from developed countries. Hence, further randomized cross-sectional community based study is recommended to enquire into this pattern. Data regarding early identification was encouraging as majority of the cases (56 %) were diagnosed before 4 years of age. There is a stark necessity of early screening and rehabilitation program with provision for follow-up for the affected children, which must also be accessible to the disadvantaged and marginalized groups in Nepal. PMID:26944590

  1. A retrospective mortality study of substituted anthraquinone dyestuffs workers

    PubMed Central

    Gardiner, J S; Walker, S A; Maclean, A J

    1982-01-01

    ABSTRACT Because short-term bacterial tests have previously shown that about one-third of substituted anthraquinones tested are capable of causing reverse mutation, and two-year feeding studies of three such dyestuffs in rats have shown an excess of hepatocellular carcinomas, a retrospective cohort mortality study was carried out on a population of 1975 male workers employed in a dyestuffs manufacturing plant in Scotland. The population was identified as having worked for more than six months within the factory during the decade 1 January 1956-31 December 1965, and their mortality experience was followed up to 30 June 1980. Age-standardised mortality rates did not show any excess in total or cancer-related mortality. PMID:7138794

  2. A retrospective study of six patients with mandibular metastatic carcinoma

    PubMed Central

    CAI, ZHEN; ZHU, CHAO; WANG, LIZHEN; ZHU, LING; ZHANG, ZHIYUAN; ZHU, HANGUANG; WANG, YAN'AN

    2016-01-01

    Mandibular metastatic carcinoma is a rare lesion that accounts for <1% of all oral malignancies. To provide greater experience in this field, the present study was conducted in which 6 cases of mandibular metastatic carcinoma were retrospectively reviewed. The origin of the lesions was the prostate in 2 cases, the lungs in 2 cases, the breast in 1 case and the thyroid gland in 1 case. The clinical and computed tomography features, surgical management and follow-up outcomes were investigated. The study indicated that surgeons should include the suspicion of metastasis in the differential diagnosis for mandibular tumor, particularly in patients who have a history of malignancy. A poor prognosis was associated with the examined patients. To extend the survival time as long as possible, a treatment strategy using multiple therapies, including segmental mandibulectomy, radiotherapy and chemotherapy, is recommended. PMID:27284368

  3. Dosimetric characterization of two radium sources for retrospective dosimetry studies

    SciTech Connect

    Candela-Juan, C.; Karlsson, M.; Lundell, M.; Ballester, F.; Tedgren, Å. Carlsson

    2015-05-15

    Purpose: During the first part of the 20th century, {sup 226}Ra was the most used radionuclide for brachytherapy. Retrospective accurate dosimetry, coupled with patient follow up, is important for advancing knowledge on long-term radiation effects. The purpose of this work was to dosimetrically characterize two {sup 226}Ra sources, commonly used in Sweden during the first half of the 20th century, for retrospective dose–effect studies. Methods: An 8 mg {sup 226}Ra tube and a 10 mg {sup 226}Ra needle, used at Radiumhemmet (Karolinska University Hospital, Stockholm, Sweden), from 1925 to the 1960s, were modeled in two independent Monte Carlo (MC) radiation transport codes: GEANT4 and MCNP5. Absorbed dose and collision kerma around the two sources were obtained, from which the TG-43 parameters were derived for the secular equilibrium state. Furthermore, results from this dosimetric formalism were compared with results from a MC simulation with a superficial mould constituted by five needles inside a glass casing, placed over a water phantom, trying to mimic a typical clinical setup. Calculated absorbed doses using the TG-43 formalism were also compared with previously reported measurements and calculations based on the Sievert integral. Finally, the dose rate at large distances from a {sup 226}Ra point-like-source placed in the center of 1 m radius water sphere was calculated with GEANT4. Results: TG-43 parameters [including g{sub L}(r), F(r, θ), Λ, and s{sub K}] have been uploaded in spreadsheets as additional material, and the fitting parameters of a mathematical curve that provides the dose rate between 10 and 60 cm from the source have been provided. Results from TG-43 formalism are consistent within the treatment volume with those of a MC simulation of a typical clinical scenario. Comparisons with reported measurements made with thermoluminescent dosimeters show differences up to 13% along the transverse axis of the radium needle. It has been estimated that

  4. Retrospective Evaluation of Testing in ESL Content and Skills Courses.

    ERIC Educational Resources Information Center

    Madsen, Harold S.; Murray, Norma

    Two studies are presented: one study to complement previous empirical investigations in the field of English as a second language (ESL) concerning test anxiety by having examinees reflect on sources of stress during major examinations, and a comparison between anxiety factors in content and skills courses. In the first study, nine university…

  5. Retrospective Evaluation of Earthquake Forecasts during the 2010-12 Canterbury, New Zealand, Earthquake Sequence

    NASA Astrophysics Data System (ADS)

    Werner, M. J.; Marzocchi, W.; Taroni, M.; Zechar, J. D.; Gerstenberger, M.; Liukis, M.; Rhoades, D. A.; Cattania, C.; Christophersen, A.; Hainzl, S.; Helmstetter, A.; Jimenez, A.; Steacy, S.; Jordan, T. H.

    2014-12-01

    The M7.1 Darfield, New Zealand (NZ), earthquake triggered a complex earthquake cascade that provides a wealth of new scientific data to study earthquake triggering and the predictive skill of statistical and physics-based forecasting models. To this end, the Collaboratory for the Study of Earthquake Predictability (CSEP) is conducting a retrospective evaluation of over a dozen short-term forecasting models that were developed by groups in New Zealand, Europe and the US. The statistical model group includes variants of the Epidemic-Type Aftershock Sequence (ETAS) model, non-parametric kernel smoothing models, and the Short-Term Earthquake Probabilities (STEP) model. The physics-based model group includes variants of the Coulomb stress triggering hypothesis, which are embedded either in Dieterich's (1994) rate-state formulation or in statistical Omori-Utsu clustering formulations (hybrid models). The goals of the CSEP evaluation are to improve our understanding of the physical mechanisms governing earthquake triggering, to improve short-term earthquake forecasting models and time-dependent hazard assessment for the Canterbury area, and to understand the influence of poor-quality, real-time data on the skill of operational (real-time) forecasts. To assess the latter, we use the earthquake catalog data that the NZ CSEP Testing Center archived in near real-time during the earthquake sequence and compare the predictive skill of models using the archived data as input with the skill attained using the best available data today. We present results of the retrospective model comparison and discuss implications for operational earthquake forecasting.

  6. Retrospective Evaluation of Efficiency and Safety of an Anterior Percutaneous Approach for Cervical Discectomy

    PubMed Central

    Schubert, Michael

    2014-01-01

    Study Design Retrospective case series. Purpose The purpose of the study was to evaluate the efficiency and complication rate of a percutaneous anterior approach to herniated cervical disks with or without concomitant foraminal stenosis and/or spondylosis. Overview of Literature Recent publications reflect that minimally invasive procedures gain in importance in patients and spine surgeons as they are generally associated with less tissue damage and shorter recovery times. However, for anterior percutaneous cervical discectomy, very little data is available for relevant patient populations. Methods Charts from patients with herniated cervical disc confirmed by magnetic resonance imaging, mainly radicular symptoms and irresponsive to conservative treatment who underwent anterior percutaneous discectomy were evaluated retrospectively. All patients were asked to return questionnaires that included visual analogue scores (VAS), MacNab score as well as subjective satisfaction data 2 years after surgery. Results Ninety-five patients were included. There were no neurological or vascular complications; only one patient suffered from transient hoarseness. During the two years after surgery, 9 patients underwent reoperation. 90.5% of the patients returned the questionnaire at 2 years' follow-up. 87.7% of them reported excellent or good outcome, 11.1% rated results as fair and 1.2% as unsatisfactory. On average, arm and neck pain improved significantly by 6.1 points and 5.8 points respectively on a ten point VAS. 94.5% stated that they would choose the same procedure again. Conclusions This procedure has proved a safe and sufficient option for symptomatic cervical disk herniations with or without concomitant spondylosis and/or foraminal stenosis. PMID:25187857

  7. [Retrospective study on Latrodectus stings in Bahia, Brazil].

    PubMed

    Lira-da-Silva, R M; Matos, G B; Sampaio, R O; Nunes, T B

    1995-01-01

    This work is a retrospective study of latrodectism in the State of Bahia, Brazil, from August 1980 to July 1990. The data concerning the accidents were obtained from file cards at the Antivenom Information Center of Bahia (AVICB). Latrodectus curacavienis was the ethiologic agent identified in 28% of the arachnid accidents. The major incidence was registered in urban area (57%) affecting men (70%) more than women, with 10 to 29 year-old age group (58%). Local pain (56%), erythematous papula (29%) and light oedema (17%) were the principal local symptoms. Pain in the limbs (29%), tremor and rigidities (29%), sweating (28%), limbs and arms paresthesia (21%) and abdominal pain (17%) were systemic ones. The treatment was mainly symptomatic (67%) and antivenin serum was used in 21% of the cases. After serotherapy, 64% of the patients left the hospital within less than 24 hours. PMID:7480914

  8. Intramuscular gluteal injections in the increasingly obese population: retrospective study

    PubMed Central

    Nisbet, Andrew Charles

    2006-01-01

    Aims To examine depth of subcutaneous fat at gluteal intramuscular injection sites. Design Retrospective study. Setting General hospital. Participants 100 consecutive adults who had computed tomography of the pelvis. Main outcome measures Minimum distance between the surface of the skin and the nearest edge of muscle at intramuscular injection sites. Results 12 patients had a ventrogluteal site depth of more than 35 mm, the maximum depth of a green needle, and 26 had a ventrogluteal depth of more than 25 mm, the maximum depth of a blue needle. 43 patients had a dorsogluteal site depth of more than 35 mm, and 72 had a dorsogluteal depth of more than 25 mm. The intramuscular site was likely to be deeper in women. Conclusion Standard green and blue needles do not reach the gluteal muscles in a considerable number of patients. PMID:16524934

  9. Psychometric Evaluation and Comparison of Three Retrospective, Multi-Item Measures of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Hulme, Polly A.

    2007-01-01

    Objective: To evaluate and compare the psychometric qualities of three retrospective, multi-item measures of childhood sexual abuse (CSA): the CSA Frequency Scale, CSA Count Index, and CSA Multiple Characteristics Index. Methods: Two samples of women 20-50 years old who experienced CSA were recruited from a family practice clinic (N=132) and the…

  10. Retrospective Evaluation of Cured-in-Place Pipe Technology for Municipal Gravity Sewer Rehabilitation

    EPA Science Inventory

    One of the top research needs identified at the September 2008 U.S. EPA International Technology Forum on Rehabilitation of Water and Wastewater Systems is to undertake a broad and quantitative retrospective evaluation of the performance of previously rehabilitated systems. Curr...

  11. Anaesthesia for awake craniotomy: A retrospective study of 54 cases

    PubMed Central

    Sokhal, Navdeep; Rath, Girija Prasad; Chaturvedi, Arvind; Dash, Hari Hara; Bithal, Parmod Kumar; Chandra, P Sarat

    2015-01-01

    Background and Aims: The anaesthetic challenge of awake craniotomy is to maintain adequate sedation, analgesia, respiratory and haemodynamic stability in an awake patient who should be able to co-operate during intraoperative neurological assessment. The current literature, sharing the experience on awake craniotomy, in Indian context, is minimal. Hence, we carried out a retrospective study with the aim to review and analyse the anaesthetic management and perioperative complications in patients undergoing awake craniotomy, at our centre. Methods: Medical records of 54 patients who underwent awake craniotomy for intracranial lesions over a period of 10 years were reviewed, retrospectively. Data regarding anaesthetic management, intraoperative complications and post-operative course were recorded. Results: Propofol (81.5%) and dexmedetomidine (18.5%) were the main agents used for providing conscious sedation to facilitate awake craniotomy. Hypertension (16.7%) was the most commonly encountered complication during intraoperative period, followed by seizures (9.3%), desaturation (7.4%), tight brain (7.4%), and shivering (5.6%). The procedure had to be converted to general anaesthesia in one of patients owing to refractory brain bulge. The incidence of respiratory and haemodynamic complications were comparable in the both groups (P > 0.05). There was less incidence of intraoperative seizures in patients who received propofol (P = 0.03). In post-operative period, 20% of patients developed new motor deficit. Mean intensive care unit stay was 2.8 ± 1.9 day (1–14 days) and mean hospital stay was 7.0 ± 5.0 day (3–30 days). Conclusions: ‘Conscious sedation’ was the technique of choice for awake craniotomy, at our institute. Fentanyl, propofol, and dexmedetomidine were the main agents used for this purpose. Patients receiving propofol had less incidence of intraoperative seizure. Appropriate selection of patients, understanding the procedure of surgery, and judicious

  12. Feline conjunctival hemangioma and hemangiosarcoma: a retrospective evaluation of eight cases (1993-2004).

    PubMed

    Pirie, Chris G; Dubielzig, Richard R

    2006-01-01

    The purpose of this retrospective study was to evaluate feline primary conjunctival vascular tumors of endothelial origin. Eight cases (six hemangiomas, two hemangiosarcomas) from a collection of 3460 feline submissions between 1993 and 2004 were evaluated using routine hematoxylin and eosin (H&E). Signalment, location, size, duration, epithelial pigmentation, margins, adjuvant therapy, outdoor activity, and geographic location, comparing ultraviolet (UV) radiation levels by state, were recorded. Follow-up information was available for five cases. In this study, the average age was 10.6 years, with neutered males over-represented. The Domestic Short-haired cat was most commonly affected. The most common anatomic site was the nictitating membrane, with the left eye preferentially affected. The average size and duration, prior to presentation, was 7.5 mm and 4.4 months, respectively. Seven of eight cases were devoid of epithelial pigmentation in nonaffected areas and the majority of cases were from states with high annual UV-light exposure. Only cases of hemangiosarcoma underwent surgical re-excisions following incomplete excision; however, no further recurrences were reported. No cases evaluated had evidence of metastatic disease at the time of excision. Surgical excision alone may be curative. However, recurrence is possible. These tumors demonstrate similar predilection sites and involvement of nonpigmented epithelium, as is true in canine cases, which may relate to risk factors as well. PMID:16771757

  13. RETROSPECTIVE EVALUATION OF HISTOPATHOLOGIC FINDINGS IN CAPTIVE GAZELLE SPECIES.

    PubMed

    Anderson, Kadie; Garner, Michael; Stedman, Nancy

    2016-03-01

    Capturing disease trends among different species has indisputable value to both veterinary clinicians and zoo managers for improving the welfare and management of zoo species. The causes of mortality for eight species of gazelle (addra gazelle, Nanger dama; dorcas gazelle, Gazella dorcas; Grant's gazelle, Nanger granti; sand gazelle, Gazella leptoceros; Saudi goitered gazelle, Gazella subgutturosa; Soemmerring's gazelle, Nanger soemmerringii; Thomson's gazelle, Eudorcas thomsonii; and Speke's gazelle, Gazella spekei) are presented from an 18-yr period (1996 2014). The leading cause of mortality for all species was trauma, followed by bronchopneumonia, and failure to thrive/maternal neglect. Nephritis and rumenitis/abomasitis/enteritis were common ancillary lesions across all species. On average, female gazelle lived twice as long as male gazelle, with an average overall adult survival time of 9.3 yr. Dorcas, Thomson's and addra gazelle females had the longest average survival time (10-13 yr). Calves up to 6 mo of age died most frequently from failure of passive transfer or maternal neglect. Thyroid carcinoma was frequently identified in Thomson's gazelle. Sand and Speke's gazelle frequently died from systemic amyloidosis, and Saudi goitered gazelle were more likely to have renal amyloidosis. Hematuria syndrome was the second most common cause of death in Grant's gazelle. The majority of lesions identified in this study that cause or contribute to mortality are preventable with appropriate management. Knowledge of disease trends in captive gazelle populations can help guide veterinary care, management decisions, and collection management planning. PMID:27010271

  14. Retrospective study on structural neuroimaging in first-episode psychosis

    PubMed Central

    Silva-dos-Santos, Amilcar; Talina, Miguel Cotrim

    2016-01-01

    Background. No consensus between guidelines exists regarding neuroimaging in first-episode psychosis. The purpose of this study is to assess anomalies found in structural neuroimaging exams (brain computed tomography (CT) and magnetic resonance imaging (MRI)) in the initial medical work-up of patients presenting first-episode psychosis. Methods. The study subjects were 32 patients aged 18–48 years (mean age: 29.6 years), consecutively admitted with first-episode psychosis diagnosis. Socio-demographic and clinical data and neuroimaging exams (CT and MRI) were retrospectively studied. Diagnostic assessments were made using the Operational Criteria Checklist +. Neuroimaging images (CT and MRI) and respective reports were analysed by an experienced consultant psychiatrist. Results. None of the patients had abnormalities in neuroimaging exams responsible for psychotic symptoms. Thirty-seven percent of patients had incidental brain findings not causally related to the psychosis (brain atrophy, arachnoid cyst, asymmetric lateral ventricles, dilated lateral ventricles, plagiocephaly and falx cerebri calcification). No further medical referral was needed for any of these patients. No significant differences regarding gender, age, diagnosis, duration of untreated psychosis, in-stay and cannabis use were found between patients who had neuroimaging abnormalities versus those without. Discussion. This study suggests that structural neuroimaging exams reveal scarce abnormalities in young patients with first-episode psychosis. Structural neuroimaging is especially useful in first-episode psychosis patients with neurological symptoms, atypical clinical picture and old age. PMID:27257547

  15. Retrospective study on structural neuroimaging in first-episode psychosis.

    PubMed

    Coentre, Ricardo; Silva-Dos-Santos, Amilcar; Talina, Miguel Cotrim

    2016-01-01

    Background. No consensus between guidelines exists regarding neuroimaging in first-episode psychosis. The purpose of this study is to assess anomalies found in structural neuroimaging exams (brain computed tomography (CT) and magnetic resonance imaging (MRI)) in the initial medical work-up of patients presenting first-episode psychosis. Methods. The study subjects were 32 patients aged 18-48 years (mean age: 29.6 years), consecutively admitted with first-episode psychosis diagnosis. Socio-demographic and clinical data and neuroimaging exams (CT and MRI) were retrospectively studied. Diagnostic assessments were made using the Operational Criteria Checklist +. Neuroimaging images (CT and MRI) and respective reports were analysed by an experienced consultant psychiatrist. Results. None of the patients had abnormalities in neuroimaging exams responsible for psychotic symptoms. Thirty-seven percent of patients had incidental brain findings not causally related to the psychosis (brain atrophy, arachnoid cyst, asymmetric lateral ventricles, dilated lateral ventricles, plagiocephaly and falx cerebri calcification). No further medical referral was needed for any of these patients. No significant differences regarding gender, age, diagnosis, duration of untreated psychosis, in-stay and cannabis use were found between patients who had neuroimaging abnormalities versus those without. Discussion. This study suggests that structural neuroimaging exams reveal scarce abnormalities in young patients with first-episode psychosis. Structural neuroimaging is especially useful in first-episode psychosis patients with neurological symptoms, atypical clinical picture and old age. PMID:27257547

  16. Retrospective mortality study of cadmium workers: An update

    SciTech Connect

    Thun, M.J.; Schnorr, T.M.; Halperin, W.E.

    1986-02-06

    A retrospective cohort mortality study was conducted among a group of workers exposed to cadmium (7440439), to determine specific causes of death among these workers. The report reviewed the findings of the study and presented additional findings concerning exposures to other hazards at the facility. The study examined the causes of death for 292 cadmium workers who worked at least 2 years at a small facility that recovered cadmium from bag house dust. Exposures included dusts of cadmium-oxide (1306190) and cadmium-sulfide (1306236) and to fumes of cadmium itself. Over a two fold excess of deaths from respiratory cancer was noted among these workers when compared with the general population and over a three fold excess of deaths from prostatic cancer among the men. A follow up of the study cohort revealed that all cause mortality was slightly below that of the United States male population. The Standardized Mortality Ratio for circulatory disease was 65. Deaths due to respiratory cancer were 65% above the number expected. All of the 20 deaths from respiratory cancer were due to cancer of the lung, trachea and bronchus. Deaths due to genitourinary cancer were 35% above expected levels.

  17. Retrospective Evaluation of New Chinese Diagnostic Scoring System for Disseminated Intravascular Coagulation

    PubMed Central

    Deng, Jun; Wang, Huafang; Guo, Tao; Mei, Heng; Hu, Yu

    2015-01-01

    Objectives To retrospectively validate the new Chinese DIC scoring system (CDSS). Methods This study retrospectively collected the information of 619 patients (371 cases with non-hematologic malignancies, 248 cases with hematologic malignancies) who suspected of DIC in Wuhan Union Hospital during 2013-4 to 2014-6. We validated CDSS by comparing it with three leading scoring systems, from International Society on Thrombosis and Haemostasis (ISTH), Japanese Association for Acute Medicine (JAAM) and Japanese Ministry of Health and Welfare (JMHW), and evaluated its prognostic value by 28 days mortality, APACHE II and SOFA score. Results In non-hematologic malignancies, CDSS was more specific than JAAM (72.55% vs. 50.49%, p<0.05) and more sensitive than ISTH (77.07% vs. 62.03%, p<0.05). In hematologic malignancies, the area under the ROC curve of CDSS was larger than ISTH and JMHW (0.933 vs. 0.889, p<0.01 with ISTH, 0.944 vs. 0.845, p<0.01 with JMHW). In addition, the 28-day mortality rate, SOFA scores, APACHE II scores of DIC patients diagnosed by CDSS were significantly greater than non-DIC (P <0.05). Conclusions We are the first group to propose CDSS. It emphasized the values of the clinical manifestations, the rapidly declining platelet count, APTT in the diagnosis of DIC and used D-dimer as the fibrin-related maker. DIC with hematological malignancies was treated as a special part. In this study we can see that CDSS displayed an acceptable property for the diagnosis of DIC with appropriate sensitivity and specificity, and also had a good prognostic value for DIC patients. PMID:26076032

  18. A retrospective study of central venous catheters GCRI experience

    PubMed Central

    Jain, Sachin A.; Shukla, Shilin N.; Talati, Shailesh S.; Parikh, Sonia K.; Bhatt, Shivani J.; Maka, Vinayak

    2013-01-01

    Background: The use of central venous catheters (CVCs) has greatly improved the quality-of-care in cancer patients, yet these catheters may cause serious infectious and thrombotic complications. The aim of this retrospective study was to study the various types of CVCs and their complications. Materials and Methods: We studied retrospectively 213 cases of CVCs in our institute with their indications, type and complications from August 2010 to July 2011. Results: A total of 213 CVCs were inserted in patients with hematological (62%) and solid organ malignancies (38%). Ninety-eight patients (46%) had peripheral inserted central catheter (PICC), 90 (42%) patients had Hickman catheters and 25 (12%) had a port. The median duration of retention of Hickman catheters was 104 days (3-365 days), for the peripherally inserted central catheters was 59 days (3-100 days) and for the port it was 280 days (45-365 days). Non-infective complications were more than infective (12% vs. 7%). The most common complication was non-infective occlusion and thrombophlebitis. In one patient with PICC thrombosis occurred in the cephalic, radial and ulnar vein and in one patient with port thrombosis occurred in the superior vena cava. Organisms were isolated in 60% (12 out of 20) of cultures. Common organisms isolated were Pseudomonas aeruginosa in 5 (42%), Staphylococcus aureus in 2 (16%), Escherichia coli in 2 (16%) and Aspergillus in 3 (25%) patients. 7 out of 12 infected patients had negative blood cultures within 7 days of antibiotic treatment, 5 patients remained positive for more than 7 days with antibiotics. In 155 patients (73%), the desired treatment protocol was completed and at present there are still 28 patients (13%) with catheters. 5 patients (2.3%) died of febrile neutropenia and septicemia with multi-organ failure. In 5 patients (2.3%), the catheters (1 Port, 1 Hickman and 3 PICC) were prematurely removed because of thrombosis. Conclusion: CVCs are better options to facilitate

  19. Advanced Orofacial Rhabdomyosarcoma: A Retrospective Study of 31 Cases

    PubMed Central

    Otmani, Naima; Khattab, Mohamed

    2016-01-01

    Introduction  Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma encountered in childhood and adolescence. Early diagnosis of pediatric cases is critical to improving outcomes, especially when socioeconomic status and geographical access to specialist services can reduce opportunities for early cancer detection and treatment. Objective  The objective of this study is to determine factors that can delay referral and treatment in specialist pediatric oncology center upon our population specificities. Methods  This retrospective study involved 31 children between 2003 and 2013. Children affected by histologically confirmed RMS occurring as a primary lesion in the orofacial area were included. Results  The median age was 8 ± 4.22 years (range: 3 months – 15 years). The male to female ratio was 1.8:1. Most of the patients had advanced stage disease at presentation (81.7% group had 3–4 pretreatment staging) with parameningeal involvement in 80.6% of the cases. The 2-year event-free survival rate was 17.7 ± 7.8% for all the patients. Delay of admission to our unit and abandonment of treatment seem to be important factors for the dismal prognosis. Conclusion  Patient's location, socioeconomic status and health care coverage have had an impact on longer delays in seeking care and on follow-up. More studies are needed for implementation of a better management practices and a better supportive care upon specificities of our population.

  20. Exposure assessment in industry specific retrospective occupational epidemiology studies.

    PubMed Central

    Seixas, N S; Checkoway, H

    1995-01-01

    Quantitative estimation of exposure for occupational epidemiology studies has received increasing attention in recent years and, as a result, a body of methodological literature has begun to take form. This paper reviews the generic issues in the methodology of exposure assessment, particularly methods for quantitative retrospective assessment studies. A simple framework, termed an exposure data matrix (EDM), for defining and analysing exposure data is proposed and discussed in terms of the definition of matrix dimensions and scales. Several methods for estimation, interpolation, and extrapolation, ranging from subjective ratings to quantitative statistical modelling are presented and discussed. The various approaches to exposure assessment based on the EDM concept are illustrated with studies of lung disease among coal miners and other dust and chemically induced chronic occupational diseases. The advantages of validated statistical models are emphasised. The importance of analysis and control of errors in exposure assessments, and integration of the exposure assessment and exposure-response processes, especially for emerging occupational health issues, is emphasised. PMID:7489051

  1. Influence of cholesterol on survival after stroke: retrospective study.

    PubMed Central

    Dyker, A. G.; Weir, C. J.; Lees, K. R.

    1997-01-01

    OBJECTIVE: To investigate the association between serum cholesterol concentration and cerebrovascular disease. DESIGN: Retrospective study. SETTING: Acute stroke unit of inner city general hospital. SUBJECTS: 977 patients with acute stroke. MAIN OUTCOME MEASURES: Serum total cholesterol concentration, type of stroke investigated by computed tomography or magnetic resonance imaging, three month outcome (good (alive at home) or bad (dead or in care)), long term mortality. RESULTS: After adjustment for known prognostic factors, higher serum cholesterol concentrations were associated with reduced long term mortality after stroke (relative hazard 0.91 (95% confidence interval 0.84 to 0.98) per mmol/l increase in cholesterol) independently of stroke type, vascular territory and extent, age, and hyperglycaemia. Three month outcome was also influenced independently by serum cholesterol (P = 0.024). CONCLUSIONS: Our data suggest an association between poor stroke outcome and lower serum cholesterol concentration. Until a prospective controlled study has confirmed the benefits of lowering cholesterol concentration in elderly subjects, the application of cholesterol lowering guidelines cannot be justified as secondary prevention of acute stroke. PMID:9169402

  2. Alopecia Areata in the Elderly: A 10-Year Retrospective Study

    PubMed Central

    Jang, Yong Hyun; Park, Kyung Hea; Kim, Sang Lim; Lim, Hyun Jung; Lee, Weon Ju; Lee, Seok-Jong

    2015-01-01

    Background Alopecia areata (AA) is an organ-specific autoimmune disease that typically occurs in young adults. AA in the elderly is relatively rare, thus little data have been reported. Objective This study aimed to understand the clinical characteristics of AA in the elderly. Methods We performed a 10-year retrospective study of AA in the elderly who visited our dermatologic clinic from January 2002 to December 2011. A clinical review of medical records and telephone interviews were performed by two dermatologists. Results Among 1,761 patients with newly diagnosed AA, 61 (3.5%) were older than 60 years at the first visit. Among those who completed a telephone interview, 74.3% (26/35) had less than 50% of scalp-localized hair loss. There was no association between the extent of AA and hair graying (p=0.679). Favorable therapeutic response was observed in 62.9% (22/35) of cases. Conclusion AA in the elderly shows mild disease severity and favorable treatment response. There is no association between graying and the extent of AA. However, the influence of aging on the pathogenesis of AA in the elderly deserves further investigation. PMID:26273157

  3. 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

  4. Correlation of Clinicohaematological Parameters in Paediatric Dengue: A Retrospective Study

    PubMed Central

    Pai Jakribettu, Ramakrishna; Boloor, Rekha; Thaliath, Andrew; Yesudasan George, Sharanya; George, Thomas; Ponadka Rai, Manoj; Rafique Sheikh, Umran; Avabratha, Kadke Shreedhara; Baliga, Manjeshwar Shrinath

    2015-01-01

    Dengue is one of the arthropod-borne (arbo) viral diseases transmitted by female mosquito Aedes aegypti. Dengue fever has a wide spectrum of clinical presentation ranging from flu-like illness to severe complicated stage of dengue hemorrhagic fever leading to mortality. This was a retrospective study conducted in a tertiary care hospital in Coastal Karnataka, South India, to know the correlation between the clinical presentation and haematological parameters in the paediatric cases presented with dengue symptoms. A total of 163 paediatric cases who presented fever and dengue-like illness were included in the study. Of which, 69 were confirmed dengue patients. Critical analysis showed that there was a significant difference in the haematological parameters like total leucocyte count, percent differential leucocyte count, and platelets count, in the erythrocyte sedimentation rate (P < 0.05 to 0.0001). Additionally, when compared to nondengue patients, even the liver function and renal function parameters were significantly deranged (P < 0.05 to 0.0001). Stratification based on NS1, IgG, and IgM showed significant alterations in the haematological, hepatic, and renal parameters. With respect to the treatment a small percentage of patients, that is, 8% (4 patients), required platelet transfusion as their counts went below 20,000/μL. Two patients succumbed to their illness while three required ICU stay. PMID:26819620

  5. Laryngeal Neuroendocrine Carcinomas: A Retrospective Study of 14 Cases

    PubMed Central

    Zhu, Yingying; Gao, Liming; Meng, Yunxiao; Diao, Wenwen; Zhu, Xiaoli; Li, Guojun; Gao, Zhiqiang; Chen, Xingming

    2015-01-01

    Laryngeal neuroendocrine carcinomas (LNECs) are rare and highly heterogeneous which present a wide spectrum of pathological and clinical manifestations. Fourteen patients with histologically demonstrated LNEC were collected and analyzed retrospectively. The 14 cases were classified into 3 subtypes: typical carcinoid in 2, atypical carcinoid in 5, and small cell neuroendocrine carcinoma in 7. The mean survival time of the 14 patients in this study was 112.5 months (95% CI, 81.5–143.6). Surgeries were performed for 2 patients of typical carcinoid, and they were alive with no evidence of recurrence after 24 and 47 months of follow-ups. Patients in the atypical carcinoid group were treated with surgeries and postoperative radiotherapy. After 58.4 months of follow-ups (range: 9–144), 2 patients showed no evidence of disease and 1 was lost to follow-up after 72 months. The other 2 patients died of other unrelated diseases. In the small cell neuroendocrine carcinoma group, a combination of chemotherapy and radiotherapy was applied. The mean survival time was 79.7 months (95% CI, 37.9–121.4), and the 5-year survival rate was 53.6%. In conclusion, the clinical behaviors, treatment protocols, and prognosis are different for each subtype of LNECs. PMID:26258144

  6. Homicides committed by youth assailants: a retrospective study.

    PubMed

    Adeagbo, Bamidele A; Clark, Colin; Collins, Kim A

    2008-09-01

    The pediatric population has received considerable attention in the forensic community; the youth assailant of homicide, however, is understudied. The authors retrospectively reviewed all cases referred to the Forensic Pathology Section of the Medical University of South Carolina between January 1991 and May 2006. Cases included in the study were homicides in which 1 or more assailants were 19 years of age or younger. The cases were examined as to the cause and manner of death, victim age, gender, race, incident location, weapon used, assailant-victim relationship, assailant age, gender, race, motive, and postmortem toxicology results. Assailant information was obtained from forensic records at Medical University of South Carolina, police department records, and online search engines of South Carolina State newspaper archives confirmed by law enforcement reports. The youth assailants were predominantly black men, 15 to 19 years of age (range, 4-19 years). Most victims were black male acquaintances, and the motive was most often an argument. The most common cause of death was cerebral laceration because of a gunshot wound. The incident occurred in the home in 41% of cases, followed by the street in 31%. Victim toxicology was frequently positive for cocaine, marijuana, and alcohol. PMID:18725775

  7. Total thyroidectomy in geriatric patients: a retrospective study.

    PubMed

    Tartaglia, F; Russo, G; Sgueglia, M; Blasi, S; Tortorelli, G; Tromba, L; Krizzuk, D; Merola, R

    2014-01-01

    In the English literature there is no single definition that identifies elderly patients. In our retrospective study, we divided total thyroidectomized patients operated on from 2000 to 2010 in the Department of Surgical Sciences of the "Sapienza" University of Rome, in two groups: group 1 consists of 448 patients over 65 years and group 2 consists of 1275 patients under 65 years. We compared both groups in terms of indications for surgery, histological diagnoses, postoperative complications (laryngeal nerv palsy, hypocalcemia, bleeding and seroma) and mortality. The results showed no statistically significant differences between the two groups with respect to the type of surgical indication, the type of comorbidities, the incidence of postoperative complications and perioperative mortality. The only data discordant with those in the international literature was the incidence of neoplastic disease that is found to be slightly greater in group 2. In conclusion, total thyroidectomy in patients over 65 years is a safe procedure and is not burdened with a higher percentage of postoperative complications, even if requires a careful preoperative assessment of risk factors related to comorbidity. PMID:25167851

  8. Leprosy Reaction in Thai Population: A 20-Year Retrospective Study

    PubMed Central

    Suchonwanit, Poonkiat; Triamchaisri, Siripich; Wittayakornrerk, Sanchawan; Rattanakaemakorn, Ploysyne

    2015-01-01

    Background. Leprosy is a chronic infectious disease that presents with varying dermatological and neurological symptoms. The leprosy reactions occur over the chronic course of the disease and lead to extensive disability and morbidity. Objective. To analyze and identify the risk factors which contribute to leprosy reactions. Methods. In a retrospective study, we reviewed the medical records of leprosy patients registered at the leprosy clinic, Ramathibodi Hospital, Thailand, between March 1995 and April 2015. One hundred and eight patients were included; descriptive analysis was used for baseline characteristics and a binary logistic regression model was applied for identifying risk factors correlated with leprosy reactions. Results. Of the 108 cases analyzed, 51 were male and 57 were female. The mean age of presentation was 45 years. The borderline tuberculoid type was the most common clinical form. Leprosy reactions were documented in 61 cases (56.5%). The average time to reaction was 8.9 months. From multivariate analysis, risk factors for leprosy reactions were being female, positive bacillary index status, and MB treatment regimen. Conclusions. Leprosy reactions are common complications in leprosy patients. Being female, positive bacillary index status, and multibacillary treatment regimen are significantly associated with the reactions. Early detection in cases with risk factors followed by appropriate treatment could prevent the morbidity of leprosy patients. PMID:26508912

  9. The approach to frostbite in Turkey: A retrospective study.

    PubMed

    Emsen, Ilteris Murat

    2006-01-01

    Increased participation in outdoor activities and an epidemic of homelessness have caused the incidence of cold injuries in the civilian population of Turkey to rise dramatically during the past 20 years. Knowledge of treatment is crucial for emergency physicians in rural and urban areas. Recent developments have significantly advanced the understanding of the pathophysiology of hypothermic and frostbite injuries. The authors undertook a retrospective review of frostbite cases in the East Anatolia region of Turkey. The mean altitude of East Anatolia is 1600 m, and temperatures may be -35 degrees C at night and -18 degrees C in the morning in the cities and surrounding villages. Winter is prolonged and harsh, and freezing is a normal condition in this region. The socioeconomic level in this region is lower than other regions of Turkey. During the winter, roads may be closed for as long as five months, and most villages in East Anatolia have no medical units. Erzurum, one of the coldest cities in East Anatolia, is the only city with advanced medical hospitals in this region. Three hospitals in Erzurum were included in the present study: Ataturk University Medical Faculty, Erzurum Numune Hospital and Erzurum SSK Hospital. Frostbite case records and their properties are presented. PMID:19554225

  10. Lichen planopilaris epidemiology: a retrospective study of 80 cases*

    PubMed Central

    Soares, Vanessa Cristina; Mulinari-Brenner, Fabiane; de Souza, Tatiane Elen

    2015-01-01

    BACKGROUND Lichen planopilaris is a frequent presentation of primary cicatricial alopecia. Scalp distribution characterizes the main clinical presentations: classic lichen planopilaris, frontal fibrosing alopecia and Graham-Little Piccardi-Lassueur Syndrome (GLPLS). OBJECTIVE Description of the clinical, dermoscopic and histopathological findings of Lichen planopilaris in public and private practices. METHOD A retrospective observational study was performed by reviewing medical records of patients with lichen planopilaris. RESULTS Eighty patients were included, 73 (91,25%) were female. Prototype II was seen in 53 (66,25%) patients. Classic lichen planopilaris was seen in 62,5% of the cases. Frontal fibrosing alopecia was seen in 31% of the patients and only one patient presented Graham-Little Piccardi-Lassueur Syndrome (GLPLS). Scalp lesions were scattered throughout the scalp in 47 (58,75%) of the patients, while 24 (30%) presented mainly central scalp lesions, 29 (36,25%) presented marginal lesions and only 4 (5%) patents had vertex lesions. CONCLUSIONS Clinical presentation of Lichen planopilaris varies. To recognize the heterogeneity of the clinical appearance in lichen planopilaris is important for differential diagnosis. PMID:26560212

  11. Amebic Liver Abscess in Israeli Travelers: A Retrospective Study.

    PubMed

    Lachish, Tamar; Wieder-Finesod, Anat; Schwartz, Eli

    2016-05-01

    Amebic liver abscess (ALA) is endemic in developing countries. The epidemiology and clinical characteristics of the disease in developing countries are well described. Travelers from nonendemic countries can serve as a model for the natural history of ALA. Currently, the available literature on travelers is limited. This is a retrospective observational study on Israeli travelers diagnosed with ALA. Data regarding travel history, clinical presentation, imaging, and treatment were collected and analyzed. Among 6,867 ill returning Israeli travelers, amebiasis was diagnosed in 53 travelers (0.77%), of whom 14 were with ALA (0.2%). Twelve ALA cases (86%) had an exposure in the Indian subcontinent. The male to female ratio was 1:1, with no significant clinical differences between the sexes. The average lag period between exposure and onset of symptoms was 17.1 months. The lack of male predominance and the prolonged lag period may imply that behavioral factors are pivotal in the development of ALA. Larger case series of travelers are required. PMID:26928829

  12. Retrospective evaluation of urological admissions to emergency service of a training and research hospital

    PubMed Central

    Topaktaş, Ramazan; Altın, Selçuk; Aydın, Cemil; Akkoç, Ali; Yılmaz, Yakup

    2014-01-01

    Objective: Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. Material and methods: We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Results: Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Conclusion: Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies. PMID:26328181

  13. A Multicenter, Retrospective Study of Early Weightbearing for Modified Lapidus Arthrodesis.

    PubMed

    Prissel, Mark A; Hyer, Christopher F; Grambart, Sean T; Bussewitz, Bradly W; Brigido, Stephen A; DiDomenico, Lawrence A; Lee, Michael S; Reeves, Christopher L; Shane, Amber M; Tucker, Daniel J; Weinraub, Glenn M

    2016-01-01

    The modified Lapidus arthrodesis is a long-established surgical technique for management of hallux valgus that provides reproducible results and quality patient outcomes. The data from 367 consecutive patients undergoing unilateral modified Lapidus arthrodesis from January 1, 2007 to December 31, 2008 at participating centers were retrospectively evaluated. The included patients were categorized into early weightbearing (≤ 21 days) and delayed weightbearing (> 21 days) groups. A total of 24 nonunions (6.5%) were identified, with 13 (7.1%) in the early weightbearing group and 11 (6.0%) in the delayed weightbearing group. To date, the present study is the largest multicenter investigation to evaluate early weightbearing after modified Lapidus arthrodesis and the only large study to directly compare early and delayed weightbearing. The findings of the present study have shown that early weightbearing for modified Lapidus arthrodesis does not increase the risk of nonunion when evaluating various fixation constructs. PMID:26763868

  14. Nine year longitudinal retrospective study of Taekwondo injuries.

    PubMed

    Kazemi, Mohsen; Chudolinski, Artur; Turgeon, Matt; Simon, Aaron; Ho, Eric; Coombe, Lianne

    2009-12-01

    This retrospective longitudinal study aims to describe reported Taekwondo injuries and to examine associations between competitor experience level, age and gender, and the type, location, and mechanism of injury sustained. Additionally, we examined whether recent rule changes concerning increased point value of head shots in adult Taekwondo competition had affected injury incidence.This study was a summation of 9 years of data of competition injury reports, which included 904 injury reports spanning 58 individual competitions. The data was collected on standardized injury reports at time of injury during competition. Care was provided to the athletes, but the type of care provided was not included in the study. Participants included athletes injured during competition who sought care by the health care team, and for whom an injury report was filled out. The data analysis was performed at the Canadian Memorial Chiropractic College.The three most common locations of presenting injury were the head (19%), foot (16%), and thigh (9%). The most common mechanism of presenting injury was found to be a defensive kick (44%), followed by an offensive kick (35%). The most commonly diagnosed injuries were contusions (36%), sprains (19%), and strains (15%). Coloured belts had a higher incidence of contusions, while black belts sustained more joint irritation injuries. Black belts were more likely to suffer multiple injuries. Colored belts suffered more injuries while receiving a kick, while black belts had a larger influence of past history of injury. We found no significant difference in location or type of injury when comparing pre versus post rule change. The most common locations of injury are head, foot, and thigh respectively, and are areas for concern when considering preventative measures. Colour belt competitors are more likely to sustain contusions, which the authors believe is due to more aggressive tactics and lack of control. Those more likely to be injured tend to

  15. Hypovitaminosis D in Delirium: a Retrospective Cross-sectional Study

    PubMed Central

    Ford, Jennifer; Hategan, Ana; Bourgeois, James A.; Tisi, Daniel K.; Xiong, Glen L.

    2013-01-01

    Background As vitamin D may have a neuroprotective effect, the authors studied the association of biomarkers of vitamin D status and delirium to see if low vitamin D status was common in delirium cases. Methods Biochemical measures of vitamin D (25-hydroxyvitamin D [25-OHD]) and calcium metabolism were used in this retrospective cross-sectional analysis of adult in-patients with delirium, admitted at three Canadian academic hospitals from January 2011 to July 2012. Primary outcome was to determine estimates of the prevalence of hypovitaminosis D in this group in whom vitamin D was checked. Results Seventy-one (5.8%) out of 1,232 delirium inpatients had their vitamin D measured. Thirty-nine (55%) showed vitamin D insufficiency (25-OHD of 25-75 nmol/L) and 8 (11%) showed vitamin D deficiency (25-OHD < 25 nmol/L). Mean serum 25-OHD levels were lower in males (57.1±7.7 nmol/L) than in females (78.2±6.1 nmol/L), p = .01, even when controlled for age and season. Men were younger than the women (74.4±2.3 vs. 82.4±1.7, p = .005). Mean age was 78.7±1.5 years, and 33 (47%) were male. Conclusions Although vitamin D is rarely checked during delirium workup and/or management, high rates of hypovitaminosis D were found to be common in the delirium in-patients in whom it was checked. Larger studies would be needed to estimate the prevalence of hypovitaminosis D in delirium and whether hypovitaminosis D plays a role in the pathogenesis of delirium. PMID:24278095

  16. Bat Rabies in France: A 24-Year Retrospective Epidemiological Study

    PubMed Central

    Picard-Meyer, Evelyne; Robardet, Emmanuelle; Arthur, Laurent; Larcher, Gérald; Harbusch, Christine; Servat, Alexandre; Cliquet, Florence

    2014-01-01

    Since bat rabies surveillance was first implemented in France in 1989, 48 autochthonous rabies cases without human contamination have been reported using routine diagnosis methods. In this retrospective study, data on bats submitted for rabies testing were analysed in order to better understand the epidemiology of EBLV-1 in bats in France and to investigate some epidemiological trends. Of the 3176 bats submitted for rabies diagnosis from 1989 to 2013, 1.96% (48/2447 analysed) were diagnosed positive. Among the twelve recognised virus species within the Lyssavirus genus, two species were isolated in France. 47 positive bats were morphologically identified as Eptesicus serotinus and were shown to be infected by both the EBLV-1a and the EBLV-1b lineages. Isolation of BBLV in Myotis nattereri was reported once in the north-east of France in 2012. The phylogenetic characterisation of all 47 French EBLV-1 isolates sampled between 1989 and 2013 and the French BBLV sample against 21 referenced partial nucleoprotein sequences confirmed the low genetic diversity of EBLV-1 despite its extensive geographical range. Statistical analysis performed on the serotine bat data collected from 1989 to 2013 showed seasonal variation of rabies occurrence with a significantly higher proportion of positive samples detected during the autumn compared to the spring and the summer period (34% of positive bats detected in autumn, 15% in summer, 13% in spring and 12% in winter). In this study, we have provided the details of the geographical distribution of EBLV-1a in the south-west of France and the north-south division of EBLV-1b with its subdivisions into three phylogenetic groups: group B1 in the north-west, group B2 in the centre and group B3 in the north-east of France. PMID:24892287

  17. 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

  18. Central odontogenic fibroma: Retrospective study of 8 clinical cases

    PubMed Central

    Hrichi, Radia; Gargallo-Albiol, Jordi; Berini-Aytés, Leonardo

    2012-01-01

    Introduction and Objectives: The central odontogenic fibroma (COF) is a benign odontogenic tumour derived from the dental mesenchymal tissues. It is a rare tumour and only 70 cases of it have been published. Bearing in mind the rareness of the tumour, 8 new cases of central odontogenic fibroma have been found by analyzing the clinical, radiological and histopathological characteristics of COF. Patients and Method: A retrospective study was carried out on 3011 biopsies in the Service of Oral and Maxillofacial Surgery of the Dental Clinic of Barcelona University between January 1995 and March 2008. 85 odontogenic tumours were diagnosed of which 8 were central odontogenic fibroma. The radiological study was based on orthopantomographs, periapical and occlusal radiographies and computerised tomographics. The variables collected were: sex, age, clinical characteristics of the lesion, treatment received and possible reappearances of the tumour. Results: The central odontogenic fibroma represents 9.4% of all odontogenic tumours. Of the 8 cases, 5 were diagnosed in men and 3 in women. The average age was 19.9 years with an age range of 11 to 38 years. The most common location of the tumour was in the mandible. All cases were associated with unerupted teeth. Of the 8 tumours, 3 provoked rhizolysis of the adjacent teeth and 4 cases caused cortical bone expansion. 50% of the patients complained of pain associated to the lesion. No case of recurrence was recorded up to 2 years after the treatment. Conclusions: Central odontogenic fibromas usually evolve asymptomatically although they can manifest very aggressively provoking dental displacement and rhizolysis. Radiologically, COF manifest as a uni or multilocular radiotransparent image although they can be indistinguishable from other radiotransparent lesions making diagnosis more difficult. COF treatment involves conservative surgery as well as follow-up patient checks. Key words: Odontogenic tumour, central odontogenic

  19. Natal and Neonatal Teeth: A Retrospective Study of 15 Cases

    PubMed Central

    Basavanthappa, Nagaveni N; Kagathur, Umashankara; Basavanthappa, Radhika N; Suryaprakash, Satisha T

    2011-01-01

    Objectives: To present 17 natal/neonatal teeth in 15 patients and describe their clinical characteristics, associated disorders, complications and treatment. Methods: A retrospective study of neonates who visited the Department of Pedodontics and Preventive Dentistry, College of Dental Sciences, Davangere, India, between 2003 and 2006 was carried out. It was a study of clinical data, such as the age and gender of the patients, the history and chief complaints of mothers, the clinical appearance and location of natal/neonatal teeth, and associated complications and treatments. Results: A total of 17 teeth (6 natal, 11 neonatal) were found in 15 patients. No significant gender predilection (8 male, 7 female) was found. Sixteen natal/neonatal teeth were placed in mandibular incisor area (10 on the right side and 6 on the left side) and one tooth in the maxillary incisor area. In 13 patients, the occurrence of natal/neonatal teeth was unilateral, and in 2 patients, it was bilateral. Three cases were associated with enamel hypoplasia, 3 cases with Riga-Fede disease, and 1 case with gingival hyperplasia. One case involved a patient with cleft lip and palate. Radiographic examination confirmed these teeth to be supernumerary, and all teeth exhibited hypermobility. Extraction had been done in all the cases. Eleven of the extracted teeth exhibited only rudimentary roots, and six teeth showed no roots. Conclusions: The occurrence of a natal/neonatal tooth is a rare phenomenon. When it occurs, the teeth have a variety of clinical characteristics and lead to different complications. Knowledge of the management of these structures is essential for the overall well being of a child. PMID:21494384

  20. The Collaborative Assessment and Management of Suicidality versus Treatment as Usual: A Retrospective Study with Suicidal Outpatients

    ERIC Educational Resources Information Center

    Jobes, David A.; Wong, Steven A.; Conrad, Amy K.; Drozd, John F.; Neal-Walden, Tracy

    2005-01-01

    The Collaborative Assessment and Management of Suicidality (CAMS) is a novel clinical approach used to identify, assess, and manage suicidal outpatients (Jobes & Drozd, 2004). The results of a retrospective study evaluating the impact of CAMS versus treatment as usual (TAU) on suicidal outpatients are presented. Patients in the CAMS treatment…

  1. Retrospective Study of a Series of Choanal Atresia Patients

    PubMed Central

    Manica, Denise; Schweiger, Cláudia; Netto, Cátia C Saleh; Kuhl, Gabriel

    2013-01-01

    Introduction Although it has been more than 250 years since the first description of choanal atresia (CA), there are still doubts about this abnormality. The differences between unilateral and bilateral forms are seldom discussed. Objectives Aggregate data from patients diagnosed with CA, grouping patients with unilateral and bilateral forms. Methods Retrospective study. Results Eighteen patients were included: 12 (66.6%) presented bilateral atresia, of which 77.8% were mixed bony-membranous type and 22.2% were pure bony type. From the 12 patients with bilateral atresia, 10 presented related malformations, 3 of whom had CHARGE syndrome (coloboma, heart defects, choanal atresia, retardation of growth and development, genitourinary problems, ear abnormalities). From the remaining 6 patients with unilateral atresia, only 2 showed malformations, 1 renal and 1 cardiac. All patients with unilateral atresia needed only 1 surgical procedure, and patients with the bilateral form needed a median of 2.85 interventions (p = 0.003). The median age of surgical procedure in the unilateral group was 6 years, ranging from 6 months to 18 years, and in the bilateral group was 25 days, ranging from 6 days to 6 years (p = 0.003). The median interval between diagnosis and surgery was 9 months in the unilateral group, ranging from 1 month to 18 years, and in the bilateral group was 1 day, ranging from 1 day to 2 months (p = 0.001). Discussion and Conclusions Success rates with the endoscopic approach vary from 62 to 100%. Nonetheless, most of these reports present results without considering the number of compromised sides. In our opinion, unilateral and bilateral cases involve distinct patients (taking into account the related malformations), have diverging clinical presentations, and show discrepant restenosis rates and therefore could be considered in different groups of analysis. PMID:25992054

  2. Continuous neurophatic orofacial pain: A retrospective study of 23 cases

    PubMed Central

    Sotorra-Figuerola, Dídac; Sánchez-Torres, Alba; Valmaseda-Castellón, Eduard

    2016-01-01

    Background To determine the clinical characteristics of Continuous Neuropathic Orofacial Pain in patients that suffer Persistent Idiopathic Facial Pain (PIFP), Painful Post-Traumatic Trigeminal Neuropathy (PPTTN) or Burning Mouth Syndrome (BMS) and to describe their treatment. Material and Methods A retrospective observational study was made, reviewing the clinical history of the patients diagnosed with Continuous Neuropathic Orofacial Pain between 2004 and 2011 at the Orofacial Pain Unit of the Master of Oral Surgery and Implantology of the University of Barcelona and at the Orofacial Pain Unit of the Teknon Medical Center of Barcelona. Results The average age of the patients with Continuous Neuropathic Orofacial Pain was 54.5, with a clear female predominance (86.9%, n=20). Of all patients, 60.9% (n=14) were suffering a PIFP, 21.7% (n=5) had a BMS and 17.4% (n=4) were presenting a PPTTN. The pain quality described by the patients with Continuous Neuropathic Orofacial Pain was oppressive (43.47%, n=10), widely represented by patients with PIFP, and burning (39.13%, n=9) being the only quality that described patients with BMS. The treatment carried out with the patients was only pharmacologic. The most used drugs for the treatment of PIFP and PPTTN were clonazepam (50%, n=9) and amitriptyline (44.44%, n=8). However, a 55.5% (n=10) of the patients with PIFP or PPTTN required the association of two or more drugs for a correct pain control. All the patients with BMS responded satisfactorily to clonazepam. Conclusions Continuous Neuropathic Orofacial Pain is a little known condition among the general population, physicians and dentists. This favors a late diagnosis and inaccurate treatments which entail unnecessary suffering. It is important to inform both the general population and health professionals concerning this painful condition. Key words:Continuous neuropathic orofacial pain, persistent idiopathic facial pain, painful post-traumatic trigeminal neuropathy

  3. Weatherization Works--Summary of Findings from the Retrospective Evaluation of the U.S. DOE's Weatherization Assistance Program

    SciTech Connect

    Tonn, Bruce Edward; Carroll, David; Pigg, Scott; Blasnik, Michael; Dalhoff, Greg; Berger, Jacqueline; Rose, Erin M; Hawkins, Beth A.; Eisenberg, Joel Fred; Ucar, Ferit; Bensch, Ingo; Cowan, Claire

    2015-10-01

    This report presents a summary of the studies and analyses that compose the retrospective evaluation of the U.S. Department of Energy s low-income Weatherization Assistance Program (WAP). WAP provides grants to Grantees (i.e., states) that then provide grants to Subgrantees (i.e., local weatherization agencies) to weatherize low-income homes. This evaluation focused on the WAP Program Year 2008. The retrospective evaluation produced twenty separate reports, including this summary. Four separate reports address the energy savings, energy cost savings, and cost effectiveness of WAP across four housing types: single family, mobile home, small multifamily, and large multifamily. Other reports address the environmental emissions, macroeconomic, and health and household-related benefits attributable to WAP, and characterize the program, its recipients, and those eligible for the program. Major field studies are also summarized, including a major indoor air quality study and a follow-up ventilation study, an in-depth in-field assessment of weatherization work and quality, and a study that assesses reasons for variations in energy savings across homes. Results of surveys of weatherization staff, occupants, occupants satisfaction with weatherization services provided, and weatherization trainees are summarized. Lastly, this report summarizes a set of fifteen case studies of high-performing and unique local weatherization agencies.

  4. Porter Physiology Development Program 1967-2001: a retrospective study.

    PubMed

    Matyas, Marsha Lakes; Frank, Martin

    2004-02-01

    have accomplished something [important]. As stated earlier, the goal of the Porter Physiology Fellowship Program is to encourage diversity among students pursuing full-time studies toward the PhD (or DSc) in the physiological sciences, and to encourage their participation in the APS. The findings of this retrospective study suggest that the program has been highly successful in both of these aspects. PMID:15024857

  5. Study of the Cost-Effectiveness of Retrospective Search Systems.

    ERIC Educational Resources Information Center

    King, Donald W.; Caldwell, Nancy W.

    The purpose of this study was to explore cost-effectiveness factors that affect the choice among alternative systems. A cost-effectiveness model that may be used to evaluate potential systems was derived and a statement of the general magnitude of costs that the American Psychological Association (APA) can expect in implementing and operating…

  6. Issues in Retrospective Conversion for a Small Special Collection: A Case Study.

    ERIC Educational Resources Information Center

    Hieb, Fern

    1997-01-01

    Small special collections present unique problems for retrospective conversion of catalogs to machine-readable form. Examines retrospective conversion using the Moravian Music Foundation as a case study. Discusses advantages to automation, options for conversion process, quantifying conversion effort, costs, in-house conversion, national standards…

  7. Congenital Zika syndrome with arthrogryposis: retrospective case series study

    PubMed Central

    Filho, Epitacio Leite Rolim; Lins, Otavio Gomes; Aragão, Maria de Fátima Viana Vasco; Brainer-Lima, Alessandra Mertens; Cruz, Danielle Di Cavalcanti Sousa; Rocha, Maria Angela Wanderley; Sobral da Silva, Paula Fabiana; Carvalho, Maria Durce Costa Gomes; do Amaral, Fernando José; Gomes, Joelma Arruda; Ribeiro de Medeiros, Igor Colaço; Ventura, Camila V; Ramos, Regina Coeli

    2016-01-01

    Objective To describe the clinical, radiological, and electromyographic features in a series of children with joint contractures (arthrogryposis) associated with congenital infection presumably caused by Zika virus. Design Retrospective case series study. Setting Association for Assistance of Disabled Children, Pernambuco state, Brazil. Participants Seven children with arthrogryposis and a diagnosis of congenital infection presumably caused by Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Main clinical, radiological, and electromyographic findings, and likely correlation between clinical and primary neurological abnormalities. Results The brain images of all seven children were characteristic of congenital infection and arthrogryposis. Two children tested positive for IgM to Zika virus in the cerebrospinal fluid. Arthrogryposis was present in the arms and legs of six children (86%) and the legs of one child (14%). Hip radiographs showed bilateral dislocation in seven children, subluxation of the knee associated with genu valgus in three children (43%), which was bilateral in two (29%). All the children underwent high definition ultrasonography of the joints, and there was no evidence of abnormalities. Moderate signs of remodeling of the motor units and a reduced recruitment pattern were found on needle electromyography (monopolar). Five of the children underwent brain computed tomography (CT) and magnetic resonance imaging (MRI) and the remaining two CT only. All presented malformations of cortical development, calcifications predominantly in the cortex and subcortical white matter (especially in the junction between the cortex and white matter), reduction in brain volume, ventriculomegaly, and hypoplasia of the brainstem and cerebellum. MRI of the spine in four children showed apparent thinning of the cord and reduced ventral roots. Conclusions Congenital Zika syndrome should be added to the differential diagnosis of congenital

  8. Heroin impurity profiling. A harmonization study for retrospective comparisons.

    PubMed

    Strömberg, L; Lundberg, L; Neumann, H; Bobon, B; Huizer, H; van der Stelt, N W

    2000-11-13

    Three laboratories present a harmonised system for the retrospective comparison of south west Asian heroin. It consists of an improved gas chromatographic (GC) profiling method and a computerised data retrieval. The investigations of the GC were necessary with a view to improve the reproducibility of the system. The necessity of a strict quality control is emphasized. The peaks of the GC profile were investigated for abundance, intensity, GC behaviour (reproducibility) and correlations; 16 of them were selected for describing the heroin profile in the database. The results from intra-lab profile comparisons are reported. The reproducibility of the analysis was good and the variation between the samples was large, thus, allowing conclusions with a high degree of certainty. The criteria of similarity were defined. The system is successfully running in all three labs. In connection with inter-laboratory comparison, the aspects of method harmonisation and standardisation are discussed. It appeared that the GC method is a very subtile one, urging for a strict standardisation between the three labs. Despite a long cooperation between three well-equipped and experienced labs, a more or less serious loss of reproducibility was noticed in the inter-lab results in comparison with the intra-lab results. The loss could for the greater part be attributed to the (limits of the) GC technique; a number of compounds, necessary for making the discrimination between samples, showed difficult chromatographic behaviour, leading to insufficient inter-lab reproducibility. Using the actual variables, improvements in performance can hardly be expected in the near future. The loss of reproducibilty implies that the number of false positive matches in a database search increases. This may strongly reduce the value of a relatively large, international database. The study shows that so far, the best option for international comparison is the analysis in a central laboratory. The idea of local

  9. Herpes simplex virus 2 meningitis: a retrospective cohort study.

    PubMed

    Miller, Stephanie; Mateen, Farrah J; Aksamit, Allen J

    2013-04-01

    Herpes simplex virus 2 is a leading cause of viral meningitis and the most commonly recognized infectious cause of benign, recurrent meningitis. We report a retrospective, observational cohort study of patients with herpes simplex virus type 2 (HSV-2) meningitis, confirmed by polymerase chain reaction (PCR) in the cerebrospinal fluid (CSF). The terms "herpes simplex," "meningitis," or "encephalitis" were searched in the medical records system of the Mayo Clinic in Rochester, Minnesota (1995-2008). Patients were included if they had a clinical diagnosis of meningitis and HSV-2 detected by PCR in the CSF. There were 28 patients with 33 episodes identified (83 % female; mean age at presentation of meningitis 36 years, range 17-53; mean time to HSV2 detection from symptom onset 3 days, range 0-6; history of genital herpes 23 %). No patient took oral antiviral treatment at the time of presentation. Episodes were most likely to include headache (100 %), photophobia (47 %), self-reported fever (45 %), meningismus (44 %), and nausea and/or vomiting (29 %). CSF at the time of meningitis was notable for elevated protein (mean 156 g/dL, range 60-258) and white cell count (mean 504 cells/μL, range 86-1,860) with normal glucose (mean 54 mg/dL, range 32-80). Mollaret cells were never detected. Neuroimaging was most often normal (83 %) when performed, although some cases showed nonspecific (14 %) or meningeal changes (3 %). There was no consistent relationship to genital herpes. The duration of treatment with intravenous acyclovir ranged from 3 to 14 days for the first meningitic episode (daily dose range from 500 to 1,000 mg and total dose range from 500 mg q8h for 3 days to 800 mg q8h for 14 days). For subsequent episodes, the duration of treatment of intravenous acyclovir ranged from less than 1 to 14 days (total dose range from 1,390 mg for 1 day to 900 mg q8h for 10 days). The dose of valacyclovir ranged from 500 mg once daily to 500 mg four times daily. The median duration

  10. 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

  11. Risk factors associated with postcraniotomy meningitis: A retrospective study.

    PubMed

    Chen, Chang-Hua; Chang, Chih-Yen; Lin, Li-Jhen; Chen, Wei Liang; Chang, Yu-Jun; Wang, Shu-Hui; Cheng, Chun-Yuan; Yen, Hua-Cheng

    2016-08-01

    Postcraniotomy meningitis (PCM) is a major challenge in neurosurgery, and changing patterns of infectious agents in PCM have been noted. The limited epidemiological data and urgent clinical needs motivated this research. We conducted this study to determine a risk assessment for PCM and the current pattern of infectious agents.We performed a retrospective case-control study of significant cases of postcraniotomy meningitis in the Changhua Christian Hospital System between January 1, 2008, and December 31, 2012. Postcraniotomy meningitis was diagnosed in 22 out of 4392 surgical patients; this data was reviewed for risk assessment.This study assessed the risk factors for postcraniotomy meningitis and found that it was more frequently seen in patients who were elderly (OR = 1.57, 95% CI = 1.32-2.98, P = 0.013), underwent emergency procedures (OR = 4.82, 95% CI = 1.50-14.53, P = 0.008), had leak of cerebrospinal fluid (OR = 4.62, 95% CI = 2.03-10.50, P = 0.012), had external ventricular drainage (OR = 4.68, 95% CI = 2.46-8.87, P = 0.006), were admitted to the intensive care unit (OR = 2.41, 95% CI = 1.53-8.08, P = 0.012), had used drain placement >72 hours (OR = 2.66, 95% CI = 1.04-4.29, P = 0.007), had surgery >4.5 hours (OR = 2.38, 95% CI = 1.39-4.05, P = 0.005), had repeat operations (OR = 2.74, 95% CI = 1.31-5.73, P = 0.018), endured trauma (OR = 5.97, 95% CI = 1.57-17.61, P = 0.007), or had 30-days mortality (OR = 5.07, 95% CI = 2.20-11.48, P = 0.001). The predominant pathogens isolated from cerebrospinal fluid were Staphylococcus aureus in 8 patients (36.7%) and Acinetobacter baumannii in 7 patients (31.8%). In our study, the mortality rate was 5.1% among all postcraniotomy patients.Accurate risk assessment, early diagnosis, and choice of appropriate antibiotics in accordance with epidemiologic information are the cornerstones of reducing

  12. Risk factors associated with postcraniotomy meningitis: A retrospective study

    PubMed Central

    Chen, Chang-Hua; Chang, Chih-Yen; Lin, Li-Jhen; Chen, Wei Liang; Chang, Yu-Jun; Wang, Shu-Hui; Cheng, Chun-Yuan; Yen, Hua-Cheng

    2016-01-01

    Abstract Postcraniotomy meningitis (PCM) is a major challenge in neurosurgery, and changing patterns of infectious agents in PCM have been noted. The limited epidemiological data and urgent clinical needs motivated this research. We conducted this study to determine a risk assessment for PCM and the current pattern of infectious agents. We performed a retrospective case-control study of significant cases of postcraniotomy meningitis in the Changhua Christian Hospital System between January 1, 2008, and December 31, 2012. Postcraniotomy meningitis was diagnosed in 22 out of 4392 surgical patients; this data was reviewed for risk assessment. This study assessed the risk factors for postcraniotomy meningitis and found that it was more frequently seen in patients who were elderly (OR = 1.57, 95% CI = 1.32–2.98, P = 0.013), underwent emergency procedures (OR = 4.82, 95% CI = 1.50–14.53, P = 0.008), had leak of cerebrospinal fluid (OR = 4.62, 95% CI = 2.03–10.50, P = 0.012), had external ventricular drainage (OR = 4.68, 95% CI = 2.46–8.87, P = 0.006), were admitted to the intensive care unit (OR = 2.41, 95% CI = 1.53–8.08, P = 0.012), had used drain placement >72 hours (OR = 2.66, 95% CI = 1.04–4.29, P = 0.007), had surgery >4.5 hours (OR = 2.38, 95% CI = 1.39–4.05, P = 0.005), had repeat operations (OR = 2.74, 95% CI = 1.31–5.73, P = 0.018), endured trauma (OR = 5.97, 95% CI = 1.57–17.61, P = 0.007), or had 30-days mortality (OR = 5.07, 95% CI = 2.20–11.48, P = 0.001). The predominant pathogens isolated from cerebrospinal fluid were Staphylococcus aureus in 8 patients (36.7%) and Acinetobacter baumannii in 7 patients (31.8%). In our study, the mortality rate was 5.1% among all postcraniotomy patients. Accurate risk assessment, early diagnosis, and choice of appropriate antibiotics in accordance with epidemiologic information are

  13. Evaluation of three methods for retrospective correction of vignetting on medical microscopy images utilizing two open source software tools.

    PubMed

    Babaloukas, Georgios; Tentolouris, Nicholas; Liatis, Stavros; Sklavounou, Alexandra; Perrea, Despoina

    2011-12-01

    Correction of vignetting on images obtained by a digital camera mounted on a microscope is essential before applying image analysis. The aim of this study is to evaluate three methods for retrospective correction of vignetting on medical microscopy images and compare them with a prospective correction method. One digital image from four different tissues was used and a vignetting effect was applied on each of these images. The resulted vignetted image was replicated four times and in each replica a different method for vignetting correction was applied with fiji and gimp software tools. The highest peak signal-to-noise ratio from the comparison of each method to the original image was obtained from the prospective method in all tissues. The morphological filtering method provided the highest peak signal-to-noise ratio value amongst the retrospective methods. The prospective method is suggested as the method of choice for correction of vignetting and if it is not applicable, then the morphological filtering may be suggested as the retrospective alternative method. PMID:21950542

  14. Retrospective adjustment of self-assessed medical competencies – noteworthy in the evaluation of postgraduate practical training courses

    PubMed Central

    Nagler, Michael; Feller, S.; Beyeler, Christine

    2012-01-01

    Aim: The efficacy of postgraduate practical training courses is frequently evaluated by self-assessment instruments. The present study analyses the effect of a basic course in laparoscopic surgery on self-assessed medical competencies. Methods: The 3-day course included teaching of knowledge and training of practical skills. In relation to course evaluation, a questionnaire for self-assessment was applied at the beginning of the course ('pre-course'), at the end of the course ('post-course') and at the end of the course to reassess pre-course competencies ('retrospective pre-course'). Results: 89 out of 110 participants (81%) attending 10 courses completed all the questionnaires; 83% were postgraduate trainees in surgery and 82% were inexperienced as an independent surgeon. At the beginning of the course most trainees rated themselves as 'moderately competent' or 'fully competent' with respect to the various task levels as well as to specific areas of medical competencies. At the end of the course however pronounced retrospective revisions of self-assessment to lower ratings became apparent. Statistically significant differences were seen for the task 'performing surgical procedures under supervision' and for most of the practical skills trained during the course (p <0.01). In contrast, no significant differences were observed for knowledge taught during the course as well as for 'ability to work in a team' and 'ability to concentrate', which were not foci of the course. Conclusions: Surgeons with little experience change their self-assessment of pre-course competencies to a lower level after participation in a practical postgraduate training course. Evaluations comparing 'pre-course' and 'post-course' ratings only – without 'retrospective pre-course' ratings – may underestimate the training effects. This phenomenon needs to be taken into account when evaluations are dependent exclusively on self-assessment instruments. PMID:22737200

  15. Safety of bevacizumab in clinical practice for recurrent ovarian cancer: A retrospective cohort study

    PubMed Central

    SELLE, FRÉDÉRIC; EMILE, GEORGE; PAUTIER, PATRICIA; ASMANE, IRÈNE; SOARES, DANIELE G.; KHALIL, AHMED; ALEXANDRE, JEROME; LHOMMÉ, CATHERINE; RAY-COQUARD, ISABELLE; LOTZ, JEAN-PIERRE; GOLDWASSER, FRANÇOIS; TAZI, YOUSSEF; HEUDEL, PIERRE; PUJADE-LAURAINE, ERIC; GOUY, SÉBASTIEN; TREDAN, OLIVIER; BARBAZA, MARIE O.; ADY-VAGO, NORA; DUBOT, CORALINE

    2016-01-01

    The poor outcome of patients with recurrent ovarian cancer constitutes a continuous challenge for decision-making in clinical practice. In this setting, molecular targets have recently been identified, and novel compounds are now available. Bevacizumab has been introduced for the treatment of patients with ovarian cancer and is, to date, the most extensively investigated targeted therapy in this setting. However, potential toxicities are associated with the use of this monoclonal antibody. These toxicities have been reported in clinical trials, and can also be observed outside of trials. As limited data is currently available regarding the safety of bevacizumab treatment in daily clinical practice, the current retrospective study was designed to evaluate this. Data from 156 patients with recurrent ovarian cancer who had received bevacizumab treatment between January 2006 and June 2009 were retrospectively identified from the institutional records of five French centers. In contrast to clinical trials, the patients in the present study were not selected and had a heterogeneous profile according to their prior medical history, lines of treatment prior to bevacizumab introduction and number of relapses. The results first confirm the effect of heavy pretreatment on the occurrence of serious and fatal adverse events in clinical practice, as previously reported for clinical trials and for other retrospective cohort studies. Importantly, the data also demonstrates, for the first time, that medical history of hypertension is an independent predictive risk factor for the development of high-grade hypertension during bevacizumab treatment. These results thus suggest that treating physicians must consider all risk factors for managing bevacizumab toxicity prior to its introduction. Such risk factors include the time of bevacizumab introduction, a patient's history of hypertension and a low incidence of pre-existing obstructive disease. PMID:26998090

  16. A comparison of treatment of paraphilias with three serotonin reuptake inhibitors: a retrospective study.

    PubMed

    Greenberg, D M; Bradford, J M; Curry, S; O'Rourke, A

    1996-01-01

    Treatment of the paraphilic disorders using behavioral, cognitive, pharmacological, and social interventions has been shown to have limited success with poorly motivated or noncompliant patients. Researchers have speculated on the role of the serotonergic system in the paraphilic disorders. Recent anecdotal studies have reported successful results with the selective serotonin reuptake inhibitors (SSRIs) in the treatment of the paraphilic disorders. This retrospective study evaluates and compares the effectiveness of three SSRIs in a group of paraphilics (N = 58). The individual effectiveness of fluvoxamine, fluoxetine, and sertraline were examined and compared. Results found that the severity of fantasies decreased and that there were no significant differences in the reported efficacy between fluvoxamine, fluoxetine, and sertraline. Although double blind placebo crossover studies are still needed to assess the efficacy of these agents, this study further supports the growing body of literature on the potential use of these drugs in the treatment of the paraphilias. PMID:9001750

  17. Retrospective Evaluation of Parenteral Nutrition in Alpacas: 22 Cases (2002–2008)

    PubMed Central

    Clore, E.R.S.; Freeman, L.M.; Bedenice, D.; Buffington, C.A. Tony; Anderson, D.E.

    2013-01-01

    Background Parenteral nutrition is an important method of nutritional support in hospitalized animals, but minimal information has been published on its use in camelids. Hypothesis/Objectives The purpose of this study was to characterize the use of total parenteral nutrition (TPN) in alpacas, evaluate the formulations used, and determine potential complications. Animals Twenty-two alpacas hospitalized at the Tufts Cummings School for Veterinary Medicine (site 1: n = 8) and the Ohio State University Veterinary Teaching Hospital (site 2: n = 14). Methods A retrospective analysis of all alpacas that received TPN between 2002 and 2008 was performed to assess clinical indications, clinical and clinicopathologic data, and outcome. Results The most common underlying diseases in animals receiving TPN were gastrointestinal dysfunction (n = 16), hepatic disease (n = 2), and neoplasia (n = 2). Several metabolic abnormalities were identified in animals (n = 20/22) before TPN was initiated, including lipemia (n = 12/22), hyperglycemia (11/22), and hypokalemia (n = 11/22). Median age was significantly lower for site 1 cases (0.1 years; range, 0.01–11.0) compared with those from site 2 (4.9 years; range, 0.1–13.7; P = .03). Animals at site 2 also had a longer duration of hospitalization (P = .01) and TPN administration (P = .004), as well as higher survival rate (P < .02). Twenty-one of 22 alpacas developed at least 1 complication during TPN administration. Metabolic complications were most prevalent (n = 21/22) and included hyperglycemia (n = 8/21), lipemia (n = 7/21), hypokalemia (n = 3/21), and refeeding syndrome (n = 3/21). Conclusions and Clinical Importance TPN is a feasible method of nutritional support for alpacas when enteral feeding is not possible. Prospective studies are warranted to determine optimal TPN formulations for alpacas. PMID:21418323

  18. Retrospective study of mandibular angle fractures treated with three different fixation systems

    PubMed Central

    Bhatt, Krushna; Arya, Satyavrat; Bhutia, Ongkila; Pandey, Sandeep; Roychoudhury, Ajoy

    2015-01-01

    Aim: To evaluate the outcomes of mandibular angle fractures treated with metal 2.0 mm locking, metal 2.0 mm nonlocking, and 2.5 mm resorbable systems. Study Design: Retrospective cohort study. Materials and Methods: Trauma records were screened for linear angle fractures treated with open-reduction and internal semi-rigid fixation with single metal/bioresorbable plates, and baseline variables were tabulated. The outcome variable was the presence or absence of any complication. Statistical Analysis Used: The Fisher's exact test and analysis of covariance (ANCOVA) using STATA 11. Results: A total of 60 case records of over four years were included. The mean age of the patients was 27.4 (SD 9.7) years. Fifty-five were male and five female. There were 20 nonlocking and 16 locking metal miniplates and 24 bioresorbable plates. In 55 (91.6%) cases there was a third molar in the fracture line. In 51/55 (92.7%) cases the third molar was retained. In seven patients postoperative complications were seen. There was no difference between the complication rates of the three treatment groups. Infection was the most common complication followed by delayed union and hardware failure. Conclusions: This retrospective study found no difference in the complication rate when fractures of the mandibular angle were treated with locking or nonlocking miniplates or bioresorbable plates. PMID:26668450

  19. Infectious sacroiliitis: a retrospective, multicentre study of 39 adults

    PubMed Central

    2012-01-01

    Background Non-brucellar and non-tuberculous infectious sacroiliitis (ISI) is a rare disease, with misleading clinical signs that delay diagnosis. Most observations are based on isolated case reports or small case series. Our aim was to describe the clinical, bacteriological, and radiological characteristics of ISI, as well as the evolution of these arthritis cases under treatment. Methods This retrospective study included all ISI cases diagnosed between 1995 and 2011 in eight French rheumatology departments. ISI was diagnosed if sacroiliitis was confirmed bacteriologically or, in the absence of pathogenic agents, if clinical, biological, and radiological data was compatible with this diagnosis and evolution was favourable under antibiotic therapy. Results Overall, 39 cases of ISI were identified in adults, comprising 23 women and 16 men, with a mean age at diagnosis of 39.7 ± 18.1 years. The left sacroiliac joint (SI) was affected in 59% of cases, with five cases occurring during the post-partum period. Lumbogluteal pain was the most common symptom (36/39). Manipulations of the SI joint were performed in seven patients and were always painful. Mean score for pain using the visual analogue score was 7.3/10 at admission, while 16 patients were febrile at diagnosis. No risk factor was found for 30.7% of patients. A diagnosis of ISI was only suspected in five cases at admission. The mean time to diagnosis was long, being 43.3 ± 69.1 days on average. Mean C-reactive protein was 149.7 ± 115.3 mg/l, and leukocytosis (leukocytes ≥ 10 G/l) was uncommon (n = 15) (mean level of leukocytes 10.4 ± 3.5 G/l). Radiographs (n = 33) were abnormal in 20 cases, revealing lesions of SI, while an abdominopelvic computed tomography (CT) scan (n = 27) was abnormal in 21 cases, suggesting arthritis of the SI joints in 13 cases (48.1%) and a psoas abscess in eight. Bone scans (n = 14) showed hyperfixation of the SI in 13 cases. Magnetic

  20. Antiepileptic drug use in a nursing home setting: a retrospective study in older adults

    PubMed Central

    Callegari, Camilla; Ielmini, Marta; Bianchi, Lucia; Lucano, Melissa; Bertù, Lorenza; Vender, Simone

    2016-01-01

    Summary The authors set out to examine qualitatively the use of antiepileptic drugs (AEDs) in a population of older adults in a nursing home setting, evaluating aspects such as specialist prescriptions and changes in dosage. This retrospective prevalence study was carried out in a state-funded nursing home that provides care and rehabilitation for elderly people. The first objective of the study was to determine the prevalence of AED use in this population. The second objective was to monitor AED dosage modifications during the fifteen-month study period, focusing on the safety and the tolerability of AEDs. In the period of time considered, 129 of 402 monitored patients received at least one anti-epileptic therapy. The prevalence of AED use was therefore 32%. Gabapentin was found to be the most commonly prescribed drug, with a frequency of 29%, and it was used mainly for anxiety disorders, psychosis, neuropathic pain and mood disorders. PMID:27358221

  1. A retrospective evaluation method for in vitro mammalian genotoxicity tests using cytotoxicity index transformation formulae.

    PubMed

    Fujita, Yurika; Kasamatsu, Toshio; Ikeda, Naohiro; Nishiyama, Naohiro; Honda, Hiroshi

    2016-01-15

    Although in vitro chromosomal aberration tests and micronucleus tests have been widely used for genotoxicity evaluation, false-positive results have been reported under strong cytotoxic conditions. To reduce false-positive results, the new Organization for Economic Co-operation and Development (OECD) test guideline (TG) recommends the use of a new cytotoxicity index, relative increase in cell count or relative population doubling (RICC/RPD), instead of the traditionally used index, relative cell count (RCC). Although the use of the RICC/RPD may result in different outcomes and require re-evaluation of tested substances, it is impractical to re-evaluate all existing data. Therefore, we established a method to estimate test results from existing RCC data. First, we developed formulae to estimate RICC/RPD from RCC without cell counts by considering cell doubling time and experiment time. Next, the accuracy of the cytotoxicity index transformation formulae was verified by comparing estimated RICC/RPD and measured RICC/RPD for 3 major chemicals associated with false-positive genotoxicity test results: ethyl acrylate, eugenol and p-nitrophenol. Moreover, 25 compounds with false-positive in vitro chromosomal aberration (CA) test results were re-evaluated to establish a retrospective evaluation method based on derived estimated RICC/RPD values. The estimated RICC/RPD values were in good agreement with the measured RICC/RPD values for every concentration and chemical, and the estimated RICC suggested the possibility that 12 chemicals (48%) with previously judged false-positive results in fact had negative results. Our method enables transformation of RCC data into RICC/RPD values with a high degree of accuracy and will facilitate comprehensive retrospective evaluation of test results. PMID:26778504

  2. Tolerance and Efficacy of Sodium Oxybate in Childhood Narcolepsy with Cataplexy: A Retrospective Study

    PubMed Central

    Lecendreux, Michel; Poli, Francesca; Oudiette, Delphine; Benazzouz, Fatima; Donjacour, Claire E.H.M; Franceschini, Christian; Finotti, Elena; Pizza, Fabio; Bruni, Oliviero; Plazzi, Giuseppe

    2012-01-01

    Narcolepsy with cataplexy is a sleep disorder characterized by excessive daytime sleepiness, irresistible sleep episodes, and sudden loss of muscle tone (cataplexy) mostly triggered by emotions. Narcolepsy with cataplexy is a disabling lifelong disorder frequently arising during childhood. Pediatric narcolepsy often results in severe learning and social impairment. Improving awareness about this condition increases early diagnosis and may allow patients to rapidly access adequate treatments, including pharmacotherapy and/or non-medication-based approaches. Even though children currently undergo pharmacotherapy, data about safety and efficacy in the pediatric population are scarce. Lacking international guidelines as well as drugs registered for childhood narcolepsy with cataplexy, physicians have no other alternative but to prescribe in an off-label manner medications identical to those recommended for adults. We retrospectively evaluated 27 children ranging from 6 to 16 years old, suffering from narcolepsy with cataplexy, who had been treated with off-label sodium oxybate and had been followed in a clinical setting. Throughout a semi-structured interview, we documented the good efficacy and tolerability of sodium oxybate in the majority of the patients. This study constitutes a preliminary step towards a further randomized controlled trial in childhood narcolepsy with cataplexy. Citation: Lecendreux M; Poli F; Oudiette D; Benazzouz F; Donjacour CEHM; Franceschini C; Finotti E; Pizza F; Bruni O; Plazzi G. Tolerance and efficacy of sodium oxybate in childhood narcolepsy with cataplexy: a retrospective study. SLEEP 2012;35(5):709-711. PMID:22547897

  3. Retrospective Evaluation of Pediatric Oral Biopsies from A Dental and Maxillofacial Surgery Centre in Salem, Tamil Nadu, India

    PubMed Central

    Krishnan, Ramesh; Ramesh, Maya; Paul, George

    2014-01-01

    Aim: The aim of the study was to evaluate the pediatric oral biopsies received between 2002-2011 from a dental and maxillofacial centre in Salem, Tamilnadu, India retrospectively based on age, sex, site and type of the pathologies. Materials and Methods: The records of dental and maxillofacial surgery centre were taken and a retrospective evaluation of the pediatric lesions biopsied over a period of ten years (2002-2011) was done. Patients aged 15 years and below were considered as pediatric patients and pathologies were grouped into 8 categories, according to age, gender, anatomic location and pathologic diagnosis. Results: A total of nine hundred twenty five biopsies were studied, of which 97 cases were from pediatric patients. The pathologies were predominant in mandible to maxilla (47:29).The distribution of the pathologies were 44 odontogenic pathologies, 18 connective tissue tumours, 3 salivary gland tumours, 5 fibro osseous lesions and 25 tumour like lesions. Out of this 44 odontogenic pathologies, 39 were odontogenic cysts, and 5 were odontogenic tumours. Conclusion: Unlike other studies, the lesions were more common in the mandible with a female predilection. The majority of oral and maxillofacial lesions detected in pediatric population were benign similar to the previous reports. PMID:24596780

  4. A Retrospective Evaluation of Remote Pharmacist Interventions in a Telepharmacy Service Model Using a Conceptual Framework

    PubMed Central

    Murante, Lori J.; Moffett, Lisa M.

    2014-01-01

    Abstract Objectives: This retrospective cross-sectional study evaluated a telepharmacy service model using a conceptual framework to compare documented remote pharmacist interventions by year, hospital, and remote pharmacist and across rural hospitals with or without an on-site rural hospital pharmacist. Materials and Methods: Documented remote pharmacist interventions for patients at eight rural hospitals in the Midwestern United States during prospective prescription order review/entry from 2008 to 2011 were extracted from RxFusion® database (a home-grown system, i.e., internally developed program at The Nebraska Medical Center (TNMC) for capturing remote pharmacist-documented intervention data). The study authors conceptualized an analytical framework, mapping the 37 classes of remote pharmacist interventions to three broader-level definitions: (a) intervention, eight categories (interaction/potential interaction, contraindication, adverse effects, anticoagulation monitoring, drug product selection, drug regimen, summary, and recommendation), (b) patient medication management, two categories (therapy review and action), and (c) health system-centered medication use process, four categories (prescribing, transcribing and documenting, administering, and monitoring). Frequencies of intervention levels were compared by year, hospital, remote pharmacist, and hospital pharmacy status (with a remote pharmacist and on-site pharmacist or with a remote pharmacist only) using chi-squared test and univariate logistic regression analyses, as appropriate. Results: For 450,000 prescription orders 19,222 remote pharmacist interventions were documented. Frequency of interventions significantly increased each year (36% in 2009, 55% in 2010, and 7% in 2011) versus the baseline year (2008, 3%) when service started. The frequency of interventions also differed significantly across the eight hospitals and 16 remote pharmacists for the three defined intervention levels and categories

  5. Nutritional amblyopia. A histopathologic study with retrospective clinical correlation.

    PubMed

    Smiddy, W E; Green, W R

    1987-01-01

    During a 10-year period ending in 1985, we observed atrophy of the maculopapillary bundle in both eyes of 25 cases examined post mortem. We retrospectively examined the clinical history and general autopsy findings for evidence of malnutrition. An adequate clinical history was obtained in 24 patients, and an autopsy was performed on 21 patients. Our review disclosed that all 25 patients had marked nutritional deprivation, most commonly from alcohol abuse (20 patients), advanced carcinoma (8 patients, 7 of whom were also alcohol abusers), and other malnutritional and disabling conditions (4 patients). A history of heavy smoking was documented in 11 patients. Our findings support the contention that dietary deficiency plays a role in the pathogenesis of the condition that in the past has been referred to as tobacco-alcohol amblyopia and more recently has been called nutritional amblyopia. PMID:3666474

  6. Hepatitis E in Israel: A nation-wide retrospective study

    PubMed Central

    Erez-Granat, Ortal; Lachish, Tamar; Daudi, Nili; Shouval, Daniel; Schwartz, Eli

    2016-01-01

    AIM: To investigate the epidemiology, risk factors and clinical course of acute hepatitis E virus (HEV) infection in Israel, an industrialized country. METHODS: A retrospective analysis of acute HEV cases diagnosed in Israel from 1993 to 2013. Acute HEV was defined by ALT/AST elevation and a positive HEV PCR test or positive anti-HEV-IgM serology. HEV RNA was tested by quantitative reverse transcription PCR. Antibodies to HEV were tested retrospectively using an ELISA assay. HEV-RNA was sequenced using RT-PCR of ORF1 and ORF2 regions to diagnose genotype of the virus. Epidemiologic and clinical data were collected by reviewing the clinical files and through a telephone interview according to a structured questionnaire. RESULTS: Acute HEV was diagnosed in 68 patients. Among the 59 patients who gave an informed consent and were interviewed, 41% of infections were autochthonous (acquired in Israel), 44% travel-related and 15% imported by foreign workers. Autochthonous patients were mainly females (62.5%), more than half of them pregnant, 26% recalled consuming food or water in areas with poor sanitation, 44% ate non-kosher meat. Fulminant hepatitis developed in 3 patients (5%), all of them were females, two of them with post-partum infection, all acquired the disease in Israel (autochthonous). Israeli travelers with imported infection were predominantly males (73%), acquired the disease in the Indian subcontinent (81%), with 100% reporting having consumed fresh vegetables and drinks with ice cubes abroad. Six patients’ sera were tested for genotype and revealed HEV genotype 1 (all cases acquired in the Indian subcontinent). CONCLUSION: This is the first report which highlights the existence of hepatitis E as an autochthonous infection in Israel. Imported HEV originates mostly from the Indian subcontinent. PMID:27350735

  7. Scrotal tumors in dogs: a retrospective study of 676 cases (1986-2010).

    PubMed

    Trappler, Michelle C; Popovitch, Cathy A; Goldschmidt, Michael H; Goldschmidt, Kyle H; Risbon, Rebecca E

    2014-01-01

    The objective of this study was to determine common tumor types that occur on the canine scrotum in relation to other cutaneous locations and to identify potential risk factors for specific scrotal tumor development. A retrospective study was conducted and the database of pathology reports from the Surgical Pathology Service of the Department of Pathology and Toxicology, School of Veterinary Medicine, University of Pennsylvania from 1986 to 2010 was searched for canine neoplastic scrotal and non-scrotal cutaneous lesions. Neoplastic lesions were evaluated based on diagnosis, breed, age, and number and location of tumors (scrotal versus non-scrotal cutaneous). Mast cell tumor, melanocytoma, malignant melanoma, vascular hamartoma, hemangiosarcoma, hemangioma, and cutaneous histiocytoma were the most common tumor types identified on the canine scrotum. Breed predispositions and mean age at diagnosis were identified for each tumor type and should be considered when planning surgical excision of a canine scrotal tumor. PMID:24381341

  8. Scrotal tumors in dogs: A retrospective study of 676 cases (1986–2010)

    PubMed Central

    Trappler, Michelle C.; Popovitch, Cathy A.; Goldschmidt, Michael H.; Goldschmidt, Kyle H.; Risbon, Rebecca E.

    2014-01-01

    The objective of this study was to determine common tumor types that occur on the canine scrotum in relation to other cutaneous locations and to identify potential risk factors for specific scrotal tumor development. A retrospective study was conducted and the database of pathology reports from the Surgical Pathology Service of the Department of Pathology and Toxicology, School of Veterinary Medicine, University of Pennsylvania from 1986 to 2010 was searched for canine neoplastic scrotal and non-scrotal cutaneous lesions. Neoplastic lesions were evaluated based on diagnosis, breed, age, and number and location of tumors (scrotal versus non-scrotal cutaneous). Mast cell tumor, melanocytoma, malignant melanoma, vascular hamartoma, hemangiosarcoma, hemangioma, and cutaneous histiocytoma were the most common tumor types identified on the canine scrotum. Breed predispositions and mean age at diagnosis were identified for each tumor type and should be considered when planning surgical excision of a canine scrotal tumor. PMID:24381341

  9. Extraction protocols for orthodontic treatment: A retrospective study

    PubMed Central

    Thirunavukkarasu, Vaishnevi N.; Ramachandra, Srinivas Sulugodu; Dicksit, Daniel D.; Gundavarapu, Kalyan C.

    2016-01-01

    Background and Objectives: Various extraction protocols have been followed for successful orthodontic treatment. The purpose of this study was to evaluate the extraction protocols in patients who had previously undergone orthodontic treatment and also who had reported for continuing orthodontic treatment from other clinics. Materials and Methods: One hundred thirty eight patients who registered for orthodontic treatment at the Faculty of Dentistry were divided into 10 extraction protocols based on the Orthodontic treatment protocol given by Janson et al. and were evaluated for statistical significance. Results: The descriptive statistics of the study revealed a total of 40 (29%) patients in protocol 1, 43 (31.2%) in protocol 2, 18 (13%) in protocol 3, 16 (11.6%) in protocol 5, and 12 (8.7%) in Type 3 category of protocol 9. The Type 3 category in protocol 9 was statistically significant compared to other studies. Midline shift and collapse of the arch form were noticed in these individuals. Conclusion: Extraction of permanent teeth such as canine and lateral incisors without rational reasons could have devastating consequences on the entire occlusion. The percentage of cases wherein extraction of permanent teeth in the crowded region was adopted as a treatment option instead of orthodontic treatment is still prevalent in dental practice. The shortage of orthodontists in Malaysia, the long waiting period, and lack of subjective need for orthodontic treatment at an earlier age group were the reasons for the patient's to choose extraction of the mal-aligned teeth such as the maxillary canine or maxillary lateral incisors. PMID:27041899

  10. Annual change in spirometric parameters among patients affected in Bhopal gas disaster: A retrospective observational study

    PubMed Central

    De, Sajal

    2013-01-01

    Background: The involvement of respiratory system due to inhalation of methyl isocyanate (MIC) during Bhopal gas disaster was particularly severe. We retrospectively evaluated the annual changes in spirometric parameters among those who were affected in this disaster (exposed survivors) and had respiratory symptoms. Materials and Methods: Spirometry reports of exposed survivors that were carried out in our institution were retrospectively reviewed and we identified 252 subjects who had performed spirometry at least twice with interval of more than one year. The annual changes in spirometric indices of them were calculated. Results: The average age of study population was 55.7 years and 72% were male. Annual decline of FEV1 ≥ 40 ml/yr was observed among 48% exposed survivors. The mean annual decline of FEV1 among symptomatic exposed survivors with initial normal spirometry was 91 ml (95% CI: 52 ml to 130 ml) and this was more than the patients with initial obstructive pattern. Among fifty four patients with initial normal spirometry, ten patients (18.5%) developed obstructive and two patients (5%) developed restrictive lung function abnormalities during follow up spirometry. Conclusion: The exposed survivors with chronic respiratory symptoms had accelerated decline in lung function and they are at higher risk of developing obstructive lung function. PMID:23741089

  11. PDT-induced apoptosis in brain tissue in vivo: a retrospective study

    NASA Astrophysics Data System (ADS)

    Lilge, Lothar D.; Portnoy, Michelle; Wilson, Brian C.

    1999-07-01

    The apoptotic response of normal brain and intracranial VX2 tumor following photodynamic therapy mediated by five different photodynamic drugs, Photofrin, ALA, AlClPc, SnET2 and mTHPC, was evaluated in a preliminary retrospective analysis. Rabbit brain, with or without tumor, was treated by PDT with interstitial light delivery. Histological sections at 24 h post PDT were assessed by the TUNEL assay. Confocal fluorescence microscopy was used to determine the total apoptotic cell count and the spatial distribution of apoptotic bodies within the tissue. The data were confirmed qualitatively by light microscopy on adjacent H&E-stained sections. Light-only and drug-only controls produced background levels. The highest apoptotic count was seen with Photofrin. The counts in AlClPc-treated animals were not above the background level, while the other 3 photosensitizers gave intermediate levels. With some, but not all, drugs the spatial distribution of apoptotic bodies correlated well with the light fluence distribution. Apoptosis was seen outside the zone of frank coagulative necrosis. There was not apparent drug-dose dependency at the relatively high doses used here. The retrospective nature of this study did not allow optimization of the treatment parameters. Nevertheless, the findings have potentially significant implications, both for understanding the mechanisms of apoptosis in brain tissue and for improving the clinical use of PDT for treatment of patients with malignant brain tumors.

  12. Langerhans cell histiocytosis: retrospective evaluation of 123 patients at a single institution.

    PubMed

    Braier, J; Chantada, G; Rosso, D; Bernaldez, P; Amaral, D; Latella, A; Balancini, B; Masautis, A; Goldberg, J

    1999-01-01

    The aim of this study was to retrospectively evaluate clinical characteristics at diagnosis and outcome of patients with Langerhans cell histiocytosis (LCH). From October 1987 to March 1996, 133 patients with confirmed LCH were admitted to Hospital JP Garrahan in Buenos Aires (123 evaluable). Median age was 5 years (range 15 days to 18 years). Initial organ involvement included bone 114 patients, ear 34, skin 30, liver 18, lung 14, lymph nodes 14, spleen 12, diabetes insipidus 9, and bone marrow 2. Nineteen patients had organ dysfunction, pulmonary 14, hematological 14, and hepatic 12. Two groups were defined: Group A included patients with single system disease (uni- or multifocal) and group B multisystem (with or without organ dysfunction). In group A (n = 82), 24 patients were treated with chemotherapy (prednisone and vinblastine), 21 with surgery, 15 received radiotherapy, and 22 were only observed. Patients of group B (n = 41) were treated with chemotherapy consisting of prednisone and vinblastine, DALHX 83, or LCH1-based chemotherapy. At a median follow-up of 3 years (range 1 month-8 5/12 years) 93% of patients of group A and 39% of group B survive free of reactivation. In group B, 22% had a reactivation and 39% died of progressive disease. Sequelae were detected in 35 patients (28%), which included diabetes insipidus in 17, hearing loss in 13, bony sequelae in 11, sclerosing cholangitis in 6, and lung fibrosis with bullae in 6. Two patients had a subsequent malignant disease. A total of 17 (14%) patients died and 16 of them belonged to the group B: 13 died of progressive disease, 2 due to sclerosing cholangitis (with sepsis in one case and encephalitis in the other one), 1 with progressive disease and associated myelofibrosis, and 1 patient of group A with active disease and brain stem tumor. Patients who had organ dysfunction had a reactivation free survival of 32%. All these patients survived with sequelae. Logistic regression analysis showed that organ

  13. Testing sustainability by prospective and retrospective demographic analyses: evaluation for palm leaf harvest.

    PubMed

    Zuidema, Pieter A; De Kroon, Hans; Werger, Marinus J A

    2007-01-01

    Harvesting nontimber forest products (NTFPs) is a major economic activity in tropical forests. As many NTFPs are overexploited, sustainability analyses are required to set harvest guidelines. Here we introduce and apply a new approach to evaluating sustainability, which combines prospective (elasticity) and retrospective (Life Table Response Experiments [LTRE]) demographic analyses of matrix population models. We relate the elasticity of vital rates (representing their importance for population growth rate, lamda) to their contribution to harvest-induced change in lamda ("LTRE contribution"). When high-elasticity vital rates have a low LTRE contribution, exploitation is potentially sustainable as negative effects for population growth are buffered. If the reverse is found, there is little scope for sustainability because crucial vital rates are affected. Our approach is less sensitive to chance fluctuations than the commonly used sustainability criterion of lamda = 1.0, as it does not depend on the absolute value of lamda. We applied this analysis to Geonoma deversa, a clustered forest understory palm. We studied three experimentally defoliated and control populations in a Bolivian rainforest during two years. Cutting all leaves of large ramets did not change mortality but strongly affected growth and reproduction. In spite of severe changes in some vital rates, population growth rate was not significantly reduced after defoliation. A literature review revealed that six other understory palms species responded very similarly to defoliation. The combination of LTRE contributions and elasticity analyses showed that low-elasticity vital rates were mainly responsible for the defoliation-induced change in lamda for Geonoma deversa. For two other understory palms (Astrocaryum mexicanum and Chamaedorea radicalis) new demographic analyses yielded very similar results. For Geonoma, the LTRE contribution-elasticity relation strongly changed when we mimicked harvest damage

  14. Thyroid abnormalities in paediatric patients with vitiligo: retrospective study

    PubMed Central

    Borlu, Murat; Çınar, Salih Levent; Kesikoğlu, Ayten; Utaş, Serap

    2016-01-01

    Introduction The association between vitiligo and thyroid disease is not fully investigated especially in paediatric patients. Aim To determine the incidence of vitiligo and thyroid disorders in children. This is the first report from middle Anatolia and the second report from Turkey. Material and methods A retrospective chart review was performed to examine the presence of thyroid abnormalities in paediatric patients who had been admitted to the dermatology department with vitiligo. Results A total of 155 paediatric patients, including 80 (52%) male and 75 (48%) female patients were included. The mean age was 8.6 years. Non segmental vitiligo was the most common type of the disease in 140 (90%) reviewed patients, while segmental vitiligo appeared only in 15 (10%) patients. The mean onset of vitiligo was 5.6 ±0.9 years. A family history of vitiligo was found in 14 (9%) children. Thirty-four (22%) patients had thyroid function tests and/or thyroid autoantibody abnormality. All of these patients had non segmental vitiligo. It was statistically significant (p < 0.05) in types of vitiligo and thyroid disease parameters. Conclusions Our results show that it may be useful to screen thyroid in children with non segmental vitiligo. PMID:27512360

  15. A retrospective study of patient outcomes and satisfaction following pinnaplasty

    PubMed Central

    Hope, Nicholas; Smith, Caroline P; Cullen, Jim R; McCluney, Neil

    2016-01-01

    Introduction Up to 5% of all children have prominent ears. Psychological distress and bullying adversely affect these children and can cause significant social exclusion. In times of austerity, cosmetic procedures such as surgical correction of prominent ears are felt to be an unnecessary cost to the health service. Materials and methods A retrospective case note review of all patients undergoing pinnaplasty was undertaken. Postoperative outcomes were compared against the Royal College of Surgeons of England standards. The Glasgow Benefit Inventory, a validated post-intervention questionnaire, was then posted out to all patients. Results A total of 72 patients were identified. Average age at procedure was 13 years. Eleven patients were above the age of 19 years. Twenty-eight patients were male and forty-four female. Sixty-two cases underwent bilateral pinnaplasty. No patients developed hematoma, and there were no readmissions within 30 days of surgery. Twenty-nine patients responded to the questionnaire (40%), of whom 27 reported a positive impact on their psychosocial well-being with a mean score of 36. Conclusion Pinnaplasty offers patients an opportunity to alleviate the psychological distress of bullying and harassment secondary to the appearance of prominent ears. PMID:27307775

  16. Retrospective cohort study of anti-tumor necrosis factor agent use in a veteran population

    PubMed Central

    Madkour, Nermeen; Kazerooni, Rashid

    2014-01-01

    Introduction. Anti-tumor necrosis factor (TNF) agents are effective for several immunologic conditions (rheumatoid arthritis (RA), Crohn’s disease (CD), and psoriasis). The purpose of this study was to evaluate the efficacy and safety of anti-TNF agents via chart review. Methods. Single-site, retrospective cohort study that evaluated the efficacy and safety of anti-TNF agents in veterans initiated between 2010 and 2011. Primary aim evaluated response at 12 months post-index date. Secondary aims evaluated initial response prior to 12 months post-index date and infection events. Results. A majority of patients were prescribed anti-TNF agents for CD (27%) and RA (24%). Patients were initiated on etanercept (41%), adalimumab (40%), and infliximab (18%) between 2010 and 2011. No differences in patient demographics were reported. Response rates were high overall. Sixty-five percent of etanercept patients, 82% of adalimumab patients, and 59% of infliximab patients were either partial or full responders, respectively. Approximately 16%, 11%, and 12% of etanercept, adalimumab, and infliximab were non-responders, respectively. Infections between the groups were non-significant. Etanercept and adalimumab patients had higher but non-significant odds of being a responder relative to infliximab. Conclusions. Most patients initiated with anti-TNF agent were responders at 12 months follow-up for all indications in a veteran population. PMID:24883246

  17. Salivary gland necrosis in dogs: a retrospective study of 19 cases.

    PubMed

    Schroeder, H; Berry, W L

    1998-03-01

    Salivary gland necrosis has been described in dogs and is characterised by enlarged, hard, painful salivary glands, retching and vomiting or regurgitation. The cause has yet to be determined. A retrospective study of 19 dogs with the same clinical signs was undertaken for breed, age, gender, history and presenting signs, diagnostic evaluations and findings, treatment and outcome. An underlying association was identified in 16 of the 19 dogs. This included Spirocerca lupi infestation (seven dogs), megaoesophagus (three dogs) and oesophagitis, oesophageal diverticulum, giardiasis and suspected autoimmune sialadenitis. Almost all associated lesions involved the oesophagus. Where the associated disease was successfully treated, the salivary glands returned to normal and all clinical signs resolved. It is hypothesised that an afferent vagal reflex may be involved, and that the mechanism of disease is similar to the neural pathogenesis suggested for hypertrophic osteopathy; in this instance, the efferent targets are the salivary glands rather than the limbs. PMID:9551379

  18. Informed consent in dental malpractice claims. A retrospective study.

    PubMed

    Lopez-Nicolas, Manuel; Falcón, Maria; Perez-Carceles, Maria Dolores; Osuna, Eduardo; Luna, Aurelio

    2007-06-01

    With the introduction of informed consent in dental practice in Spain during the last ten years activity has been focused on avoiding complaints rather than on giving adequate information to the patient. However, in the eyes of many professionals the document by which patients accept the cost or estimated charge of treatment is the equivalent of informed consent. Although Spanish law permits verbal consent in some cases (low risk therapeutic activities), some dentists interpret this law in a very broad way. The aim of this paper was to study the fulfilment of informed consent in relation to professional malpractice claims presented to the College of Dentists of the province of Murcia, south east Spain (regional professional association) during the last twelve years (n=52). Evaluation of the complaints pointed to adequate professional behaviour in 14 cases and malpractice in 38 cases (in 29 of which the treatment applied was technically correct but with inadequate information provided during the process, while nine cases represented technical errors). The written document of informed consent was absent in 40 cases, although the verbal information supplied was considered adequate in 14 cases. When the document of informed consent was present (12 cases) it was considered unsuitable, although adequately complemented by oral information. PMID:17695737

  19. Retrospective evaluation of cotrimoxazole use as preventive therapy in people living with HIV/AIDS in Boru Meda Hospital

    PubMed Central

    2014-01-01

    Background Drug use evaluation is a performance improvement method that focuses on evaluating and improving drug use process to achieve optimal patient outcomes. Drug use evaluation helps in identifying, preventing or resolving actual and potential drug related problems. The objective of the study was to evaluate the use of cotrimoxazole as preventive therapy in people living with HIV/AIDS in Boru Meda Hospital, Northeast Ethiopia. Methods A retrospective drug use evaluation was conducted on patients’ medical history records based on a validated drug use evaluation criteria according to the national guideline. Medical history records of 248 patients were selected using systematic sampling method. Results The result showed that 49.6% of the patients were at WHO clinical stage III at the start of cotrimoxazole preventive therapy. In this study, the use of cotrimoxazole preventive therapy was consistent with the guideline in the rationale for indication (97.98%), dose (96.77%), and its use despite the presence of contraindications (91.93%). Problems regarding drug-drug interaction were identified in 49.59% of cases, and 20.97% of patients discontinued cotrimoxazole preventive therapy due to different reasons. Conclusions In most patients cotrimoxazole preventive therapy was consistent with the national guideline regarding the rationale for indication, dose, discontinuation and its use in the presence of contraindications. PMID:24507658

  20. Implementing enhanced recovery after bariatric surgery protocol: a retrospective study.

    PubMed

    Proczko, Monika; Kaska, Lukasz; Twardowski, Pawel; Stepaniak, Pieter

    2016-02-01

    While the demand for bariatric surgery is increasing, hospital capacity remains limited. The ERABS (Enhanced Recovery After Bariatric Surgery) protocol has been implemented in a number of bariatric centers. We retrospectively compared the operating room logistics and postoperative complications between pre-ERABS and ERABS periods in an academic hospital. The primary endpoint was the length of stay in hospital. The secondary endpoints were turnover times-the time required for preparing the operating room for the next case, induction time (from induction of anesthesia until a patient is ready for surgery), surgical time (duration of surgery), procedure time (duration of stay in the operating room), and the incidence of re-admissions, re-operations and complications during admission and within 30 days after surgery. Of a total of 374 patients, 228 and 146 received surgery following the pre-ERABS and ERABS protocols, respectively. The length of hospital stay was significantly shortened from 3.7 (95 % confidence interval [CI] 3.1-4.7) days to 2.1 (95 % CI 1.6-2.6) days (P < 0.001). Procedure (surgical) times were shortened by 15 (7) min and 12 (5) min for gastric bypass and gastric sleeve surgery, respectively (P < 0.001 for both), by introducing the ERABS protocol. Induction times were reduced from 15.2 (95 % CI 14.3-16.1) min to 12.5 (95 % CI 11.7-13.3) min (P < 0.001).Turnover times were shortened significantly from 38 (95 % CI 44-32) min to 11 (95 % CI 8-14) min. The incidence of re-operations, re-admissions and complications did not change. PMID:26499320

  1. Anthracycline- and trastuzumab-induced cardiotoxicity: a retrospective study.

    PubMed

    Hamirani, Yasmin; Fanous, Ibrahim; Kramer, Christopher M; Wong, Andrew; Salerno, Michael; Dillon, Patrick

    2016-07-01

    Some chemotherapeutic agents cause cardiotoxic effects including reduction in left ventricular ejection fraction (LVEF) and occasionally congestive heart failure. Anthracyclines and HER2 monoclonal antibodies are common offenders, but clinical practice data on LVEF changes, risk factors and acute recovery is lacking. We retrospectively examined the electronic medical record at an academic medical center for receipt of anthracyclines and/or trastuzumab from 2000 to 2013 in cancer patients. Patient characteristics and serial LVEF assessments were collected. Patients with and without LVEF decline were analyzed by univariate and multivariate analysis. A total of 549 patients were identified with anthracycline/trastuzumab use and 216 had multiple LVEF assessments. Only 27 of the 216 patients who had multiple LVEF assessments at multiple occasions suffered a clinically significant LVEF fall (12.5 %), and symptomatic CHF was rare (0.5 %). Compared to unaffected patients, those with a fall in LVEF were more likely to have hypertension, hyperlipidemia or coronary artery disease (CAD). Concomitant trastuzumab and anthracycline use was a risk factor (36 vs 9.5 % for anthracycline alone, p < 0.001). The median time from start of chemotherapy to reduced LVEF was 202 days (5-3008). On multivariate analysis, hypertension and use of trastuzumab remained independent predictors of LVEF fall. Acute recovery in LVEF was observed in 44 % of patients. LVEF changes from cancer therapies are frequent and hard to predict. Hypertension, hyperlipidemia and CAD are associated with LVEF decline. Acute recovery of LVEF is observed in those experiencing treatment-related cardiotoxicity. Attention to timely interruption of cardiotoxic chemo is recommended. PMID:27334792

  2. Mortality among shipyard Coast Guard workers: a retrospective cohort study

    PubMed Central

    Krstev, S; Stewart, P; Rusiecki, J; Blair, A

    2007-01-01

    Background The mortality experience of 4702 (4413 men and 289 women) civilian workers in a US Coast Guard shipyard was evaluated. Methods All workers employed at the shipyard between 1 January 1950 and 31 December 1964 were included in the study and were followed through 31 December 2001 for vital status. Detailed shipyard and lifetime work histories found in the shipyard personnel records and job descriptions were evaluated. Workers were classified as likely exposed to any potential hazardous substances. In addition, 20 job groups were created on likely similar exposures. Standardised mortality ratios (SMRs) were calculated based on the general population of the state and adjusted for age, calendar period, sex and race. Results The follow‐up was successful for 93.3% of the workers. Among all men employed in the shipyard, there was an excess of mortality from all causes of death (SMR 1.08; 95% CI 1.04 to 1.12), respiratory cancers (SMR 1.29; 95% CI 1.15 to 1.43), lung cancer (SMR 1.26; 95% CI 1.12 to 1.41), mesothelioma (SMR 5.07; 95% CI 1.85 to 11.03) and emphysema (SMR 1.44; 95% CI 1.01 to 1.99) and a decrease for cardiovascular diseases (OR 0.95; 95% CI 0.90 to 1.00), vascular lesions of the central nervous system (SMR 0.80; 95% CI 0.67 to 0.96), cirrhosis of the liver (SMR 0.38; 95% CI 0.25 to 0.57) and external causes of death (SMR 0.55; 95% CI 0.44 to 0.68). A similar pattern was observed for the men classified as exposed. No increasing trend of mortality was found with duration of employment in the shipyard, with the exception of mesothelioma (SMRs of 4.23 and 6.27 for <10 years and ⩾10 years, respectively). In occupations with at least three cases and with an SMR of ⩾1.3, the authors observed a significantly elevated mortality for lung cancer among machinists (SMR 1.60; 95% CI 1.08 to 2.29) and shipfitters, welders and cutters (SMR 1.34; 95% CI 1.07 to 1.65) and for oral and nasopharyngeal cancers among wood workers (SMR 6.20; 95% CI 2.27 to 13

  3. Retrospective Study of Serum Sclerostin Measurements in Bed Rest Subjects

    NASA Technical Reports Server (NTRS)

    Spatz, J. M.; Fields, E. E.; Yu, E. W.; Divieti, Pajevic P.; Bouxsein, M. L.; Sibonga, M. L.; Zwart, S. R.; Smith, S. M.

    2011-01-01

    Animal models and human studies suggest that osteocytes regulate the skeleton s response to mechanical unloading at the cellular level in part by an increase in sclerostin, an inhibitor of the anabolic Wnt pathway. However, few studies have reported changes in serum sclerostin in humans exposed to reduced mechanical loading. Thus, we determined changes in serum sclerostin and bone turnover markers in healthy adult men who participated in a controlled bed rest study. Seven healthy adult men (31 +/- 3 yrs old) underwent 90-day six-degree head down tilt bed rest at the University of Texas Medical Branch in Galveston's Institute for Translational Sciences - Clinical Research Center (ITS-CRC). Serum sclerostin, PTH, serum markers of bone turnover (bone specific alkaline phosphatase, RANKL/OPG, and osteocalcin), urinary calcium and phosphorus excretion, and 24 hour pooled urinary markers of bone resorption (NTX, DPD, PYD) were evaluated pre-bed rest (BL), bed rest day 28 (BR-28), bed rest day 60 (BR-60), and bed rest day 90 (BR-90). In addition, bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry (DXA) at BL, BR-60, and post bed rest day 5 (BR+5). Data are reported as mean +/- standard deviation. We used repeated measures ANOVA to compare baseline values to BR-28, BR-60, and BR-90. RESULTS Consistent with prior reports, BMD declined significantly (1-2% per month) at weight-bearing skeletal sites (spine, hip, femur neck, and calcaneus). Serum sclerostin levels were elevated above BL at BR-28 (+29% +/- 20%, p = 0.003), BR-60 (+42% +/- 31%, p < 0.001), and BR-90 (22% +/- 21%, p = 0.07). Serum PTH levels were reduced at BR-28 (-17% +/- 16%, p = 0.02), BR-60 (-24% +/- 14%, p = 0.03), and returned to baseline at BR-90 (-21% +/- 21%, p = 0.14). Serum bone turnover markers did not change, however urinary bone resorption markers and calcium were significantly elevated following bed rest (p < 0.01). CONCLUSION We observed an increase of serum sclerostin

  4. A retrospective study of single frozen-thawed blastocyst transfer

    PubMed Central

    Ryu, Eun Kyung; Song, Seung Hyun; Yoon, San Hyun; Lim, Kyung Sil; Lee, Won Don; Lim, Jin Ho

    2016-01-01

    Objective To study the clinical outcomes of single frozen-thawed blastocyst transfer cycles according to the hatching status of frozen-thawed blastocysts. Methods Frozen-thawed blastocysts were divided into three groups according to their hatching status as follows: less-than-expanded blastocyst (≤EdB), hatching blastocyst (HgB), and hatched blastocyst (HdB). The female age and infertility factors of each group were evaluated. The quality of the single frozen-thawed blastocyst was also graded as grade A, tightly packed inner cell mass (ICM) and many cells organized in the trophectoderm epithelium (TE); grade B, several and loose ICM and TE; and grade C, very few ICM and a few cells in the TE. The clinical pregnancy and implantation rate were compared between each group. The data were analyzed by either t-test or chi-square analysis. Results There were no statistically significant differences in average female ages, infertility factors, or the distribution of blastocyst grades A, B, and C in each group. There was no significant difference in the clinical pregnancy and implantation rate of each group according to their blastocyst grade. However, there was a significant difference in the clinical pregnancy and implantation rate between each group. In the HdB group, the clinical pregnancy and implantation rate were similar regardless of the blastocyst quality. Conclusion There was an effect on the clinical outcomes depending on whether the blastocyst hatched during single frozen-thawed blastocyst transfer. When performing single frozen-thawed blastocyst transfer, the hatching status of the frozen-thawed blastocyst may be a more important parameter for clinical outcomes than the quality of the frozen-thawed blastocyst. PMID:27358829

  5. Increased Acquired Cholesteatoma Risk in Patients with Osteoporosis: A Retrospective Cohort Study

    PubMed Central

    Wang, Tang-Chuan; Lin, Che-Chen; Lin, Chia-Der; Chung, Hsiung-Kwang; Wang, Ching-Yuang; Tsai, Ming-Hsui; Kao, Chia-Hung

    2015-01-01

    Objective Clinically, we found the increased incidence of acquired colesteatoma in the patients with osteoporosis. In this study, we used a retrospective cohort to examine this association and to investigate the possible mechanism. Methods We conducted a population-based retrospective cohort study by using the National Health Insurance Research Database (NHIRD). We identified an osteoporosis cohort comprising 37 124 patients newly diagnosed with osteoporosis aged 20 years or older. Patients in the comparison cohort had no history of osteoporosis and were frequency matched with the patients in the osteoporosis cohort according to sex, age, and index year. Results The acquired cholesteatoma incidence rates for the osteoporosis and comparison cohorts were 1.12 and 0.83 per 1000 person-years, respectively. After we adjusted for confounding factors, the osteoporosis cohort exhibited a 1.32-fold increased acquired cholesteatoma risk relative to the comparison cohort (hazard ratio [HR] = 1.32, 95% confidence interval [CI] = 1.11–1.57). In addition, patients with no history of otitis media (HR = 1.33, 95% CI = 1.11–1.59), cancer (HR = 1.34, 95% CI = 1.12–1.60), or COPD (HR = 1.26, 95% CI = 1.05–1.52) in the osteoporosis cohort exhibited an increased risk of subsequent acquired cholesteatoma relative to those in the comparison cohort. Conclusions Our cohort study indicated that patients with osteoporosis had a 1.31-fold increased acquired cholesteatoma risk relative to the comparison cohort. This risk was further increased in patients with comorbid otitis media. Hence, we recommend that otolaryngologists evaluate the condition of the middle ear of patients with osteoporosis. PMID:26171780

  6. Outcomes and Treatment of Lumbosacral Spinal Tuberculosis: A Retrospective Study of 53 Patients

    PubMed Central

    He, Maolin; Wang, Kun; Fowdur, Mitra; Wu, Yang

    2015-01-01

    Study Strategy A retrospective clinic study. Purpose To evaluate the efficacy of conservative and surgical treatment for lumbosacral tuberculosis. Methods This study retrospectively reviewed 53 patients with lumbosacral tuberculosis who were treated in our institution between January 2005 and January 2011. There were 29 males and 24 females with average ages of 37.53 ± 17.28 years (range 6–72 years). 11 patients were given only anti-TB drugs; the remainder underwent anterior debridement, interbody fusion with and without instrumentation, or one-stage anterior debridement combined with posterior instrumentation. Outcome data for these patients included neurologic status, lumbosacral angle, erythrocyte sedimentation rate value(ESR) and C-reactive protein value(CRP) were assessed before and after treatment. Results The mean lumbosacral angles were 23.00°± 2.90°in the conservatively treated patients and 22.36°± 3.92o in the surgically treated patients. At the final follow-up, this had improved to 24.10o ± 2.96°in the conservatively treated patients and 28.13° ± 1.93°in the surgically treated patients (all P < 0.05). There were statistically significant differences before and after treatment in terms of ESR and CRP (all P < 0.05). All patients achieved bone fusion. The mean follow-up period was 32.34 ± 8.13 months (range 18 to 55 months). The neurological deficit did not worsen in any of the patients. Conclusions It has been proven that conservative and surgical treatments are safe and effective and produce good clinical outcomes for patients with lumbosacral tuberculosis. The advantages of operation include thoroughness of debridement, decompression of the spinal cord, and adequate spinal stabilization. PMID:26121685

  7. A Retrospective Evaluation of the Utility of Capsule Endoscopy and Double-Balloon Endoscopy in Crohn's Disease

    PubMed Central

    Nakamura, Masanao; Hirooka, Yoshiki; Watanabe, Osamu; Yamamura, Takeshi; Funasaka, Kohei; Ohno, Eizaburo; Kawashima, Hiroki; Miyahara, Ryoji

    2016-01-01

    Background. Although the usefulness of capsule endoscopy (CE) and double-balloon endoscopy (DBE) for the evaluation of Crohn's disease (CD) is established, their capabilities in the differential diagnosis of small bowel stenosis have not been sufficiently addressed. The present study therefore aimed to retrospectively determine the types of patients for whom CE and DBE would confer the most benefit. Patients and Methods. We retrospectively reviewed data from 185 patients with established CD. A change of treatment based on CE or DBE results or successful DBE balloon dilation was defined as clinically useful indication. We then analyzed the factors significantly related to useful and poor indications. Results. CE results were assessed as useful indications in 28 (45%) of 62 patients. Multivariate analysis demonstrated that positive CRP and low IOIBD score are factors significantly related to a useful indication. DBE results were recognized as useful indications in 118 (77%) of 153 patients. Multivariate analysis indicated small bowel stenosis and abdominal pain as factors significantly associated with useful indications. All patients with a poor indication on CE had small bowel stenosis. Conclusions. CE was most useful for patients in clinical remission with positive CRP and without stenosis, whereas DBE was useful for patients with symptoms of stenosis. PMID:26843856

  8. [Retrospective Cytogenetic Dose Evaluation. II. Computer Data Processing in Persons Irradiated in Different Radiation Accidents].

    PubMed

    Nugis, V Yu; Khvostunov, I K; Goloub, E V; Kozlova, M G; Nadejinal, N M; Galstian, I A

    2015-01-01

    The method for retrospective dose assessment based on the analysis of cell distribution by the number of dicentrics and unstable aberrations using a special computer program was earlier developed based on the data about the persons irradiated as a result of the accident at the Chernobyl nuclear power plant. This method was applied for the same purpose for data processing of repeated cytogenetic studies of the patients exposed to γ-, γ-β- or γ-neutron radiation in various situations. As a whole, this group was followed up in more distant periods (17-50 years) after exposure than Chernobyl patients (up to 25 years). The use for retrospective dose assessment of the multiple regression equations obtained for the Chernobyl cohort showed that the equation, which includes computer recovered estimate of the dose and the time elapsed after irradiation, was generally unsatisfactory (r = 0.069 at p = 0.599). Similar equations with recovered estimate of the dose and frequency of abnormal chromosomes in a distant period or with all three parameters as variables gave better results (r = 0.686 at p = 0.000000001 and r = 0.542 at p = 0.000008, respectively). PMID:26863777

  9. Retrospective evaluation of CTV to PTV margins using CyberKnife in patients with thoracic tumors.

    PubMed

    Floriano, Alejandro; García, Rafael; Moreno, Ramon; Sánchez-Reyes, Alberto

    2014-01-01

    The objectives of this study were to estimate global uncertainty for patients with thoracic tumors treated in our center using the CyberKnife VSI after placement of fiducial markers and to compare our findings with the standard CTV to PTV margins used to date. Datasets for 16 patients (54 fractions) treated with the CyberKnife and the Synchrony Respiratory Tracking System were analyzed retrospectively based on CT planning, tracking information, and movement data generated and saved in the logs files by the system. For each patient, we analyzed all the main uncertainty sources and assigned a value. We also calculated an expanded global uncertainty to ensure a robust estimation of global uncertainty and to enable us to determine the position of 95% of the CTV points with a 95% confidence level during treatment. Based on our estimation of global uncertainty and compared with our general mar- gin criterion (5 mm in all three directions: superior/inferior [SI], anterior/posterior [AP], and lateral [LAT]), 100% were adequately covered in the LAT direction, as were 94% and 94% in the SI and AP directions. We retrospectively analyzed the main sources of uncertainty in the CyberKnife process patient by patient. This individualized approach enabled us to estimate margins for patients with thoracic tumors treated in our unit and compare the results with our standard 5 mm margin.  PMID:25493508

  10. An evaluation system for electronic retrospective analyses in radiation oncology: implemented exemplarily for pancreatic cancer

    NASA Astrophysics Data System (ADS)

    Kessel, Kerstin A.; Jäger, Andreas; Bohn, Christian; Habermehl, Daniel; Zhang, Lanlan; Engelmann, Uwe; Bougatf, Nina; Bendl, Rolf; Debus, Jürgen; Combs, Stephanie E.

    2013-03-01

    To date, conducting retrospective clinical analyses is rather difficult and time consuming. Especially in radiation oncology, handling voluminous datasets from various information systems and different documentation styles efficiently is crucial for patient care and research. With the example of patients with pancreatic cancer treated with radio-chemotherapy, we performed a therapy evaluation by using analysis tools connected with a documentation system. A total number of 783 patients have been documented into a professional, web-based documentation system. Information about radiation therapy, diagnostic images and dose distributions have been imported. For patients with disease progression after neoadjuvant chemoradiation, we designed and established an analysis workflow. After automatic registration of the radiation plans with the follow-up images, the recurrence volumes are segmented manually. Based on these volumes the DVH (dose-volume histogram) statistic is calculated, followed by the determination of the dose applied to the region of recurrence. All results are stored in the database and included in statistical calculations. The main goal of using an automatic evaluation system is to reduce time and effort conducting clinical analyses, especially with large patient groups. We showed a first approach and use of some existing tools, however manual interaction is still necessary. Further steps need to be taken to enhance automation. Already, it has become apparent that the benefits of digital data management and analysis lie in the central storage of data and reusability of the results. Therefore, we intend to adapt the evaluation system to other types of tumors in radiation oncology.

  11. Prevalence, pattern, etiology, and management of maxillofacial trauma in a developing country: a retrospective study

    PubMed Central

    Udhayakumar, Rajesh Kumar

    2016-01-01

    Objectives This retrospective study aims to evaluate the prevalence of maxillofacial trauma in a developing country, along with its pattern, etiology and management. Data for the present study were collected from the Department of Dentistry, ESIC Medical College and Post Graduate Institute of Medical Sciences and Research, Chennai in India. Materials and Methods The medical records of patients treated for maxillofacial injuries between May 2014 and November 2015 were retrospectively retrieved and analyzed for prevalence, pattern, etiology, and management of maxillofacial trauma. SPSS software version 16.0 was used for the data analysis. Results Maxillofacial fractures accounts for 93.3% of total injuries. The mean and standard deviation for the age of the patients were 35.0±11.8 years and with a minimum age of 5 years and maximum age of 75 years. Adults from 20 to 40 years age groups were more commonly involved, with a male to female ratio of 3:1. There was a statistically significantly higher proportion of males more commonly involved in accident and injuries (P <0.001). Conclusion The most common etiology of maxillofacial injury was road traffic accidents (RTA) followed by falls and assaults, the sports injuries seem to be very less. In RTA, motorized two-wheelers (MTW) were the most common cause of incidents. The majority of victims of RTA were young adult males between the ages of 20 to 40 years. The malar bone and maxilla were the most common sites of fracture, followed by the mandible. The right side of the zygomatic complex was the predominant side of MTW injury. The majority of the zygomatic complex fractures were treated by conservative management. Open reduction and internal fixation were performed for indicated fracture patients. PMID:27595083

  12. Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study)

    PubMed Central

    2011-01-01

    Background Median sternotomy infection and bony nonunion are two commonly described complications which occur in 0.4 - 5.1% of cardiac procedures. Although relatively infrequent, these complications can lead to significant morbidity and mortality. The aim of this retrospective study is to evaluate the initial experience of a transverse plate fixation system following wound complications associated with sternal dehiscence with or without infection following cardiac surgery. Methods A retrospective chart review of 40 consecutive patients who required sternal wound reconstruction post sternotomy was performed. Soft tissue debridement with removal of all compromised tissue was performed. Sternal debridement was carried using ronguers to healthy bleeding bone. All patients underwent sternal fixation using three rib plates combined with a single manubrial plate (Titanium Sternal Fixation System®, Synthes). Incisions were closed in a layered fashion with the pectoral muscles being advanced to the midline. Data were expressed as mean ± SD, Median (range) or number (%). Statistical analyses were made by using Excel 2003 for Windows (Microsoft, Redmond, WA, USA). Results There were 40 consecutive patients, 31 males and 9 females. Twenty two patients (55%) were diagnosed with sternal dehiscence alone and 18 patients (45%) with associated wound discharge. Thirty eight patients went on to heal their wounds. Two patients developed recurrent wound infection and required VAC therapy. Both were immunocompromised. Median post-op ICU stay was one day with the median hospital stay of 18 days after plating. Conclusion Sternal plating appears to be an effective option for the treatment of sternal wound dehiscence associated with sternal instability. Long-term follow-up and further larger studies are needed to address the indications, benefits and complications of sternal plating. PMID:21529357

  13. Unilateral proptosis in thyroid eye disease with subsequent contralateral involvement: retrospective follow-up study

    PubMed Central

    2013-01-01

    Background The purpose of this retrospective follow-up study is to evaluate the prevalence of patients with thyroid eye disease presenting with apparent unilateral proptosis and determine the occurrence of exophthalmos in contralateral non-proptotic eye over the time. Associated features with this event were evaluated. Methods A cohort of 655 consecutive patients affected by thyroid eye disease with a minimum follow-up of 10 years was reviewed. Exophthalmos was assessed by using both Hertel exophthalmometer and computed tomography (CT). The influence of age, gender, hormonal status and of different therapies such as corticosteroids, radiotherapy and surgical decompression on this disease progression was evaluated. Results A total of 89 patients (13.5%) (95% confidence interval [CI] 15%-10%) had clinical evidence of unilateral exophthalmos at the first visit. Among these, 13 patients (14%) (95% CI 22%-7%) developed subsequent contralateral exophthalmos. The increase of protrusion ranged from 2 to 7 mm (mean of 4.2). The time of onset varied from 6 months to 7 years (mean time: 29 months). Smoking status, young age and surgical decompression are significantly associated with development of contralateral proptosis (p< .05). Conclusions Asymmetric thyroid eye disease with the appearance of unilateral exophthalmos at the initial examination is a fairly frequent event, while subsequent contralateral proptosis occurs less commonly. However, physicians should be aware that young patients, particularly if smokers, undergoing orbital decompression in one eye may need further surgery on contralateral side over time. PMID:23721066

  14. Metastatic lesions: A diagnostic dilemma-retrospective study, Srinagar, Jammu and Kashmir, India

    PubMed Central

    Farooq, Summyia; Nadaf, Afreen; Beigh, Ambreen; Khuroo, Mehnaaz; Bhat, Nazia; Nazir, Naila

    2016-01-01

    Background: Renal clear cell carcinoma (RCC) accounts for about 3% of adult malignancies and about 90% of neoplasms of the kidney. It is most common in men aged 50 to 60 years old. RCC has different manifestations, including metastasis in uncommon sites and paraneoplastic syndromes. Aims: To evaluate the clinicopathological pattern of RCC. Materials and Methods: This study was conducted in the Department of Pathology, Government Medical College, Srinagar. It was a retrospective study done over a period of 5 years, November 2009 to November 2014. Results: The study was done to evaluate the clinicopathological pattern of 6 cases of RCC diagnosed at a tertiary care hospital. All patients were males, presenting with submandibular swellings without any other symptom. Radiological and histopathological examination proved the lesion as metastasis of renal cell carcinoma to the mandible. Conclusion: Being a rare presentation in the head and neck region, metastatic renal cell carcinoma needs to be considered in the differential diagnosis of submandibular swellings even in patients younger than 40 years. PMID:27601819

  15. Retrospective study on prognostic importance of serum procalcitonin and amino-terminal pro-brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    PubMed Central

    Mehta, Chitra; Dara, Babita; Mehta, Yatin; Tariq, Ali M.; Joby, George V.; Singh, Manish K.

    2016-01-01

    Background: Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643) and morbidity (P = 0.000, AUC = 0.763), comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045). Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study. PMID:27052066

  16. [Retrospective Cytogenetic Dose Evaluation. I. Chromosome Aberration Levels in Remote Periods after Acute External Exposure in Different Situations].

    PubMed

    Nugs, V Yu; Khvostunov, I K; Goloub, E V; Kozlova, M G; Nadejina, N M; Galstian, I A

    2015-01-01

    Cytogenetic analysis of peripheral blood lymphocyte cultures of 22 persons was performed in remote terms after acute external γ-, γ-β- or γ-neutron irradiation as a result of various accidents using the classical me- thod. The initial dose estimates were obtained using physical calculations, the method of measuring the EPR signal in tooth enamel, according to haematological and/or cytogenetic parameters. The purpose of this study was to obtain evidence about the state of the lymphocyte chromosome apparatus of people approxi- mately 17-50 years after an accidental radiation exposure. In general, elevated levels of chromosome aberra- tions were detected. An average correlation was observed between the atypical chromosome frequency and absorbed dose. It is proposed to use the obtained results in the future to explore the possibility of retrospective dose evaluation on the basis of a special computer program. PMID:26601536

  17. Retrospective Cohort Study of a Microelectronics and Business Machine Facility

    PubMed Central

    Silver, Sharon R.; Pinkerton, Lynne E.; Fleming, Donald A.; Jones, James H.; Allee, Steven; Luo, Lian; Bertke, Stephen J.

    2015-01-01

    Objectives We examined health outcomes among 34,494 workers employed at a microelectronics and business machine facility 1969–2001. Methods Standardized mortality ratio (SMR) and standardized incidence ratios were used to evaluate health outcomes in the cohort and Cox regression modeling to evaluate relations between scores for occupational exposures and outcomes of a priori interest. Results Just over 17% of the cohort (5,966 people) had died through 2009. All cause, all cancer, and many cause-specific SMRs showed statistically significant deficits. In hourly males, SMRs were significantly elevated for non-Hodgkin’s lymphoma and rectal cancer. Salaried males had excess testicular cancer incidence. Pleural cancer and mesothelioma excesses were observed in workers hired before 1969, but no available records substantiate use of asbestos in manufacturing processes. A positive, statistically significant relation was observed between exposure scores for tetrachloroethylene and nervous system diseases. Conclusions Few significant exposure–outcome relations were observed, but risks from occupational exposures cannot be ruled out due to data limitations and the relative youth of the cohort. PMID:24375784

  18. Posterior implants for distal extension removable prostheses: a retrospective study.

    PubMed

    Mitrani, Ricardo; Brudvik, James S; Phillips, Keith M

    2003-08-01

    Common complaints associated with the Kennedy Class I (bilateral free end) and Class II (unilateral free end) removable partial denture situations are lack of stability, minimal retention, and unesthetic retentive clasping. Some of the same complaints have been reported for implant overdentures with only anterior implants. Starting in 1995, 10 of these patients were treated at the University of Washington with posterior osseointegrated implants to provide stability and/or retention of the removable prostheses, eliminating the need for clasps when possible. This article describes implant alternatives and prosthesis designs and presents a follow-up clinical evaluation of at least 1 year consisting of patient satisfaction, radiographic examination, and soft tissue health. Two groups were evaluated. Group 1 included patients whose implants were used as vertical stops for mandibular distal extension prostheses. Care was taken to ensure that the implants were not loaded laterally by creating a single-point contact at the center of a modified healing abutment. In these cases, sufficient retention was available from the anterior teeth and/or implant abutments. Group 2 included patients whose implants required retention because of lack of adequate tooth abutments. In those cases, a resilient type of attachment was used, which allowed for a small divergence from the path of insertion. Results indicated consistent increased satisfaction in all patients, minimal component wear, no radiographic evidence of excessive bone loss, and stable peri-implant soft tissues. PMID:12956479

  19. Reproducibility of Brain Morphometry from Short-Term Repeat Clinical MRI Examinations: A Retrospective Study

    PubMed Central

    Liu, Hon-Man; Chen, Shan-Kai; Chen, Ya-Fang; Lee, Chung-Wei; Yeh, Lee-Ren

    2016-01-01

    Purpose To assess the inter session reproducibility of automatic segmented MRI-derived measures by FreeSurfer in a group of subjects with normal-appearing MR images. Materials and Methods After retrospectively reviewing a brain MRI database from our institute consisting of 14,758 adults, those subjects who had repeat scans and had no history of neurodegenerative disorders were selected for morphometry analysis using FreeSurfer. A total of 34 subjects were grouped by MRI scanner model. After automatic segmentation using FreeSurfer, label-wise comparison (involving area, thickness, and volume) was performed on all segmented results. An intraclass correlation coefficient was used to estimate the agreement between sessions. Wilcoxon signed rank test was used to assess the population mean rank differences across sessions. Mean-difference analysis was used to evaluate the difference intervals across scanners. Absolute percent difference was used to estimate the reproducibility errors across the MRI models. Kruskal-Wallis test was used to determine the across-scanner effect. Results The agreement in segmentation results for area, volume, and thickness measurements of all segmented anatomical labels was generally higher in Signa Excite and Verio models when compared with Sonata and TrioTim models. There were significant rank differences found across sessions in some labels of different measures. Smaller difference intervals in global volume measurements were noted on images acquired by Signa Excite and Verio models. For some brain regions, significant MRI model effects were observed on certain segmentation results. Conclusions Short-term scan-rescan reliability of automatic brain MRI morphometry is feasible in the clinical setting. However, since repeatability of software performance is contingent on the reproducibility of the scanner performance, the scanner performance must be calibrated before conducting such studies or before using such software for retrospective

  20. Clinical evaluation of 860 anterior and posterior lithium disilicate restorations: retrospective study with a mean follow-up of 3 years and a maximum observational period of 6 years.

    PubMed

    Fabbri, Giacomo; Zarone, Fernando; Dellificorelli, Gianluca; Cannistraro, Giorgio; De Lorenzi, Marco; Mosca, Alberto; Sorrentino, Roberto

    2014-01-01

    This study aimed to assess the clinical performance of lithium disilicate restorations supported by natural teeth or implants. Eight hundred sixty lithium disilicate adhesive restorations, including crowns on natural teeth and implant abutments, veneers, and onlays, were made in 312 patients. Parafunctional patients were included, but subjects with uncontrolled periodontitis and gingival inflammation were excluded. Veneers up to 0.5 mm thick were luted with flowable composite resin or light curing cements, while dual-curing composite systems were used with veneers up to 0.8 mm thick. Onlays up to 2 mm in thickness were luted with flowable composite resins or dual-curing composite cements. Crowns up to 1 mm in thickness were cemented with self-adhesive or dual-curing resin cements. The observational period ranged from 12 to 72 months, with a mean follow-up of 3 years. The mechanical and esthetic outcomes of the restorations were evaluated according to the modified California Dental Association (CDA) criteria. Data were analyzed with descriptive statistics. Twenty-six mechanical complications were observed: 17 porcelain chippings, 5 fractures, and 4 losses of retention. Structural drawbacks occurred mainly in posterior segments, and monolithic restorations showed the lowest number of mechanical complications. The clinical ratings of the successful restorations, both monolithic and layered, were satisfactory according to the modified CDA criteria for color match, porcelain surface, and marginal integrity. The cumulative survival rates of lithium disilicate restorations ranged from 95.46% to 100%, while cumulative success rates ranged from 95.39% to 100%. All restorations recorded very high survival and success rates. The use of lithium disilicate restorations in fixed prosthodontics proved to be effective and reliable in the short- and medium-term. PMID:24600653

  1. The Air Force health study: an epidemiologic retrospective.

    PubMed

    Buffler, Patricia A; Ginevan, Michael E; Mandel, Jack S; Watkins, Deborah K

    2011-09-01

    In 1979, the U.S. Air Force announced that an epidemiologic study would be undertaken to determine whether the Air Force personnel involved in Operation Ranch Hand-the program responsible for herbicide spraying in Vietnam-had experienced adverse health effects as a result of that service. In January 1982 the Air Force Health Study (AFHS) protocol was approved and the 20 year matched cohort study consisting of independent mortality, morbidity and reproductive health components was initiated. This controversial study has been criticized regarding the study's potential scientific limitations as well as some of the administrative aspects of its conduct. Now, almost 30 years since the implementation of the AFHS and nearly a decade since the final follow up examinations, an appraisal of the study indicates that the results of the AFHS do not provide evidence of disease in the Ranch Hand veterans caused by their elevated levels of exposure to Agent Orange. PMID:21441038

  2. Retrospect and Prospect of Studies of Teacher Efficacy in China

    ERIC Educational Resources Information Center

    He, Ning; Miao, Danmin

    2006-01-01

    Teacher efficacy is a powerful variable in educational and psychological studies. And it aroused much attention and interest from Chinese scholars in the past decade, which led to an accumulation of documents in this field. Following an introduction of efficacy studies in the west, the article reviews the brief history of those in China,…

  3. Hanging Deaths: A Retrospective Study Regarding 260 Cases.

    PubMed

    Russo, Maria Cristina; Verzeletti, Andrea; Piras, Mauro; De Ferrari, Francesco

    2016-09-01

    Hanging is a form of asphyxia caused by external pressure on the upper airways deriving from a band tightened by the gravitational weight of the body. During a 33-year period from 1983 to 2015, there were 260 hanging deaths examined at the Brescia Institute of Forensic Medicine (Northern Italy), which represented approximately 40% of all the asphyxial deaths recorded during this period. Almost all of the cases were represented by suicidal events, 1 case was a homicide event and there also was a case of sexual asphyxia. Eighty-two percent of the victims were men; 18% were women. There was an increasing tendency in the ages between 20 and 60 years, and the highest number of cases was observed in the 41- to 50-year age group (23% of the cases). The most common place chosen by the victim was the home setting followed by isolated outdoor places. The most common ligature material was a rope. The pathological findings were evaluated in all cases. PMID:27281442

  4. Vestibuloplasty: a retrospective study on conventional and laser operation techniques

    NASA Astrophysics Data System (ADS)

    Neckel, Claus P.

    1999-05-01

    40 patients with edentulous maxillary jaws were referred to our private practice limited to maxillofacial surgery, due to atrophy of the alveolar ridge. Before prosthetic renewal of the upper removable prosthesis the restorative dentist requested a sufficient vestibule. After supraperiostal preparation, soft tissue advancement and fixation with absorbable sutures. The recipient site was covered with a free gingival graft. Group I was operated on traditionally using a scalpel. In group II incision and soft tissue preparation was performed using a diode laser. Wavelength: 810 nm; Continuous wave mode; 400 micron optic fiber; Output power 1.6 Watt. All operations were performed by one surgeon experienced in both operation techniques. Every patient was followed-up 1, 4, 8 weeks, 6 and 12 months. The vestibular height directly adjacent to the nasal cavity and 2cm distal to these first measuring locations were taken. Each patient was asked to evaluate their individual discomfort and postoperative pain level. Both groups showed no significant difference in vestibular height after 1, 4, 8 weeks, 6 months and 1 year. The postoperative height of 1.28 cm was reduced to 0.84 cm after 1 year. Furthermore both groups showed uneventful healing and take of the free gingival grafts. The assessment of the pain and discomfort level by the patients brought a significant difference between both groups in favor of the laser assisted operation technique.

  5. Women's Reported Health Behaviours before and during Pregnancy: A Retrospective Study

    ERIC Educational Resources Information Center

    Smedley, Jenna; Jancey, Jonine M.; Dhaliwal, Satvinder; Zhao, Yun; Monteiro, Sarojini M. D. R.; Howat, Peter

    2014-01-01

    Objective: This study aimed to determine women's reported health behaviours (physical activity, diet, weight management) before and during pregnancy, and to identify sources of health information. Design: Retrospective study incorporating quantitative (a self-completed survey) and qualitative (one-on-one interviews) methods. Methodology:…

  6. A Retrospective Study of Gay Gifted, Young Adult Males' Perceptions of Giftedness and Suicide

    ERIC Educational Resources Information Center

    Sedillo, Paul James

    2013-01-01

    This qualitative, retrospective study investigated suicidal ideation among 32 young adult men. Participants were asked to report their experiences as adolescents. The primary focus of the study was to discover how gay gifted adolescents dealt with issues of suicide and suicidal ideation. Participants were selected using a purposive sampling…

  7. Pronuclear morphology evaluation in in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) cycles: a retrospective clinical review

    PubMed Central

    2013-01-01

    Background The assessment of the embryo quality is crucial to maintain an high pregnancy rate and to reduce the risk of multiple pregnancy. The evaluation of the pronuclear and nucleolar characteristics of human zygote have been proposed as an indicator of embryo development and chromosomal complement. The aim of the current study was to assess the role of pronuclear morphology evaluation in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) cycles. Methods Retrospective clinical analysis on 755 non-elective transfers of only one embryo (ET). Embryo assessment was performed in days 1 and 2. Clinical and biological data were recorded and analyzed according to embryo and/or pronuclear morphology. Results Both pronuclear and embryo morphology were significantly related to clinical pregnancy and live-birth rates. No significant difference in clinical pregnancy and live-birth rates was detected when the pronuclear and embryo morphology assessments were combined. Embryo morphology and maternal age were the only independent predictors of favorable outcome by logistic regression analysis. Conclusions Pronuclear evaluation is effective to select the best zygotes if ET is performed at day 1, whereas it did not improve the clinical outcomes when combined with embryo morphology evaluation in day 2. PMID:23282023

  8. A retrospective cohort study among iron-steel workers in Anshan, China: exposure assessment.

    PubMed

    Hoshuyama, Tsutomu; Pan, Guowei; Tanaka, Chieko; Feng, Yiping; Yu, Lianzheng; Liu, Tiefu; Liu, Liming; Hanaoka, Tomoyuki; Takahashi, Ken

    2006-09-01

    Although adequate assessment of exposure is needed in epidemiological studies among foundry workers, previous studies are often lacking in this aspect. We conducted a retrospective cohort study of a Chinese iron and steel company with a 14-yr follow up during 1980-1993. Exposure assessment was performed for a single job, i.e., the current job for the active worker and the longest job for the retired or deceased worker as of the end of the follow-up, which was allocated as the surrogate of lifetime job and was applied to a job-exposure matrix. Of the 147,062 cohort members, 52,394 males (43%) and 5,291 females (21%) were exposed to any of 15 hazardous factors such as dust, silica, PAHs (polycyclic aromatic hydrocarbons), CO (carbon monoxide) and heat. In 2,104 randomly selected samples, the exposure assessment of exposed workers based on a single job was found to be 12-14% lower than the real situation. This study suggests that the exposure assessment is valuable in evaluating the health effects among the foundry workers, despite some limitations such as underestimation of exposure assessment and the lack of data regarding smoking and drinking habits. PMID:16981402

  9. Rapid prototyping modelling in oral and maxillofacial surgery: A two year retrospective study

    PubMed Central

    Stoor, Patricia; Mesimäki, Karri; Kontio, Risto K.

    2015-01-01

    Background The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. Material and Methods The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination – multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. Results In total 114 RP models were fabricated for 102 patients. The mean age of the patients at the time of the production of the model was 50.4 years. The indications for the modelling included malignant lesions (29%), secondary reconstruction (25%), prosthodontic treatment (22%), orthognathic surgery or asymmetry (13%), benign lesions (8%), and TMJ disorders (4%). MSCT examination was used in 92 and CBCT examination in 22 cases. Most of the models (75%) were conventional hard tissue models. Models with colored tumour or other structure(s) of interest were ordered in 24%. Two out of the 114 models were soft tissue models. Conclusions The main benefit of the models was in treatment planning and in connection with the production of pre-bent plates or custom made implants. The RP models both facilitate and improve treatment planning and intraoperative efficiency. Key words:Rapid prototyping, radiology, computed tomography, cone beam computed tomography. PMID:26644837

  10. Long-term outcome of epilepsy surgery: a retrospective study in a population of 379 cases.

    PubMed

    Yu, Shengkun; Lin, Zhiguo; Liu, Li; Pu, Song; Wang, Haiyang; Wang, Jiabin; Xie, Chuncheng; Yang, Changlin; Li, Meng; Shen, Hong

    2014-03-01

    We evaluated the long-term outcome of epilepsy surgery in drug-resistant epilepsy patients, and investigated preoperative factors associated with postoperative long-term surgical outcome. We performed a retrospective study of 379 patients who received epilepsy surgeries from 2000 to 2010. Patients had completed a minimum of 2-year and up to 12-year follow-up. Preoperative evaluations, surgical outcomes and clinical data of patients were collected and analyzed. We found that the epilepsy surgery was effective in drug-resistant patients and the long-term outcome of epilepsy surgery was satisfactory. The bipolar electro-coagulation could improve the surgical outcome when the epileptogenic focus was on the functional cortex. Results of the 2-year follow-up showed that preoperative seizure characteristics including the history of febrile seizure, seizure frequency, and location, quantity and range of seizure foci were significantly associated with the surgical outcome. The surgery procedure including the surgery type and the extent of resection also affected outcome. Abnormal head or hippocampus MRI, inconsistent results of preoperative investigations, seizure types, and pathology type might also be predictors of long-term surgical outcome. PMID:24461543

  11. TET2 mutations in secondary acute myeloid leukemias: a French retrospective study

    PubMed Central

    Kosmider, Olivier; Delabesse, Eric; Mas, Véronique Mansat-De; Cornillet-Lefebvre, Pascale; Blanchet, Odile; Delmer, Alain; Recher, Christian; Raynaud, Sophie; Bouscary, Didier; Viguié, Franck; Lacombe, Catherine; Bernard, Olivier A.; Ifrah, Norbert; Dreyfus, François; Fontenay, Michaëla

    2011-01-01

    Ten-eleven translocation 2 (TET2) mutations have been involved in myeloid malignancies. This retrospective study aims at evaluating the frequency and impact of TET2 mutations in 247 secondary acute myeloid leukemia cases referred to as myelodysplasia-related changes (n=201) or therapy-related (n=46) leukemias. Mutation of at least one copy of the TET2 gene was detected in 49 of 247 (19.8%) patients who presented with older age, higher hemoglobin level, higher neutrophil and monocyte counts, and lower platelet count. TET2 mutations were significantly less frequent in therapy-related (8.7%) than myelodysplasia-related changes (22.3%; P=0.035) leukemias and strongly associated with normal karyotype (P<0.001). TET2 mutations did not significantly associate with NPM1, FLT3-ITD or FLT3-D835, WT1, or N- or K-RAS mutations. Complete remission was achieved in 57% of evaluable patients who had received intensive chemotherapy. In this group, TET2 mutations did not influence the complete remission rate or overall survival. PMID:21508122

  12. The "New Social Studies"--Retrospect and Prospect

    ERIC Educational Resources Information Center

    Massialas, Byron G.

    2009-01-01

    When he looks back to the 1960s, the author feels sentimental about the New Social Studies movement that began very strong and then suddenly disintegrated. At the time of the genesis of the movement, there was a group of professionals, representing both the social sciences and education, who felt they had a vision of what was needed to revitalize…

  13. Group Therapy for Eating Disorders: A Retrospective Case Study

    ERIC Educational Resources Information Center

    Wanlass, Janine; Moreno, J. Kelly; Thomson, Hannah M.

    2005-01-01

    An increasing amount of research supports group therapy as an effective treatment option for eating disorders (Moreno, 1994). In an attempt to further delineate therapeutic factors associated with productive group work, this study represents an exploratory, descriptive analysis of client and therapist perspectives on group process and outcome.…

  14. The Reconceptualization of Curriculum Studies, 1987: A Personal Retrospective.

    ERIC Educational Resources Information Center

    Pinar, William F.

    1988-01-01

    Relates how historical developments initiated the curriculum reform movement, which caused curriculum studies to become vulnerable to reconceptualization. Traces the movement from Sputnik in 1957 through reconceptualists' opposition to the mainstream field in the 1970s. The opposition has now become the field itself, which is characterized by…

  15. Effluent guidelines, leather tanning, and pollution prevention: A retrospective study

    SciTech Connect

    1995-06-01

    This study was undertaken to learn: in what ways and for what reasons a specific industry in the past already was implementing pollution in order to comply with existing effuent guidelines and to what degree the effluent guidelines development document for that industry had already previously projected that outcome.

  16. Cross-national Retrospective Studies of Mathematics Olympians.

    ERIC Educational Resources Information Center

    Campbell, James Reed, Ed.

    1996-01-01

    The eight chapters of this theme issue use quantitative and qualitative methods to explore the nature and nurture of young participants in the mathematics Olympiad from five countries. Parallel studies are presented of winners from China, Taiwan, and the United States, along with descriptions of programs in Japan and Russia. (SLD)

  17. Suicide in India: a four year retrospective study.

    PubMed

    Mohanty, Sachidananda; Sahu, Geeta; Mohanty, Manoj Kumar; Patnaik, Manju

    2007-05-01

    Suicide is one of the ten leading causes of death in the world, accounting for more than a million deaths annually. The purpose of the study was to identify the risk groups. In the four-year period from January 2000 to December 2003, 588 suicide victims were autopsied. Information was obtained by interviewing the acquaintances of the victim, perusal of hospital records and the autopsy findings. All the cases were analyzed as to sex, age, and methods of suicide, seasonal variation, diurnal variation and other sociological aspects. The present study depicts a suicidal rate of 11.76 per 100,000 population. Males and females were almost equally the sufferers. The largest number of victims were found in the age group of 21-30 years. Hanging and poisoning constituted the two major modes of suicides (63%). Majority of the victims were mentally sound, married and were from rural background. Victims were mostly drawn from low socioeconomic status (48%). Less educated or illiterates were usually the victims. Suicidal note was detected in 5% of cases. Suicidal tendency and alcohol intake could not be encountered in most of the cases. Indoor incidence was almost double of the outdoor incidence, mostly seen in rainy season (43%) and occurred almost equally during day and night. Financial burden (37%) and marital disharmony (35%) were the principal reasons for the suicide. PMID:16914358

  18. Risk Factors for Death during Pulmonary Tuberculosis Treatment in Korea: A Multicenter Retrospective Cohort Study

    PubMed Central

    2014-01-01

    The data regarding risk factors for death during tuberculosis (TB) treatment are inconsistent, and few studies examined this issue in Korea. The purpose of this study was to evaluate baseline prognostic factors for death during treatment of adult patients with pulmonary TB in Korea. A multicenter retrospective cohort study of 2,481 patients who received TB treatment at eight hospitals from January 2009 to December 2010 was performed. Successful treatment included cure (1,129, 45.5%) and treatment completion (1,204, 48.5%) in 2,333 patients (94.0%). Unsuccessful treatment included death (85, 3.4%) and treatment failure (63, 2.5%) occurred in 148 patients (6.0%). In multivariate analysis, male sex, anemia, dyspnea, chronic heart disease, malignancy, and intensive care unit (ICU) admission were significant risk factors for death during TB treatment. Therefore, male sex, anemia, dyspnea, chronic heart disease, malignancy, and ICU admission could be baseline prognostic factors for death during treatment of adult patients with pulmonary TB in Korea. Graphical Abstract PMID:25246740

  19. Consistency Rates of Clinical Diagnosis and Histopathological Reports of Oral Lesions: A Retrospective Study

    PubMed Central

    Fattahi, Shirin; Vosoughhosseini, Sepideh; Moradzadeh Khiavi, Monir; Mostafazadeh, Samira; Gheisar, Azhdar

    2014-01-01

    Background and aims. A correct diagnosis is the most important step in the treatment of oral lesions and each oral lesion has specific clinical features that provide clinical diagnosis; however, some of these features are common among different lesions. In these situations, biopsy and histopathological examination are indicated. The aim of this study was to evaluate the relationship between clinical and histopathological diagnosis of patients referred to the Department of Oral Pathology, Tabriz Faculty of Dentistry, from 2009 to 2011. Materials and methods. In this retrospective study, individual data and clinical findings of 311 patients who had been referred to the Department of Oral Pathology during a three-year period were collected through questionnaires and compared with histopathological reports. Data were analyzed by using chi-squared and Fisher's tests. Results. In 80.7% of the cases the clinical diagnosis of the lesions was consistent with pathology reports. In 19.3% of the cases, the clinical diagnosis of the lesions was not confirmed histopathologically. The greatest consistency was observed for lichen planus (100%) and inflammatory fibrous hyperplasia (epulis fissuratum) (94.3%). Conclusion. Although great consistency rates were observed in this study between clinical diagnoses and pathology reports, there was also a significant disagreement with the literature, indicating that comprehensive clinical examination, high consistency with oral lesion features and effective cooperation between surgeons and pathologists are necessary. PMID:25093056

  20. Development of monoclonal gammopathy under biotherapy in psoriasis: a French multicenter retrospective study.

    PubMed

    Liegeon, Anne-Laure; Mahe, Emmanuel; Begon, Edouard; Poreaux, Claire; Barbaud, Annick; Esteve, Eric; Quiles-Tsimaratos, Nathalie; Avenel-Audran, Martine; Schoeffler, Amélie; Mery-Bossard, Laure; Pauwels, Christine; Girard, Céline; Maillard, Hervé; Barthelme, Dominique; Bernier, Claire; Chaby, Guillaume; Reguiai, Ziad; Nguyen-Thi, Phi Linh; Maccari, François; Schmutz, Jean-Luc

    2016-02-01

    Biotherapies or targeted therapies are fairly new treatments indicated for moderate to severe psoriasis. The side effects appear to be mainly infectious or cancerous. The role of biotherapies in the development of a pre-cancerous condition, monoclonal gammopathy of undetermined significance (MGUS), has recently been debated in the literature. To evaluate the incidence of MGUS in psoriasis patients treated with biotherapy. This study was a French multicenter retrospective study carried out through the French multicenter study group RESOPSO. Data on the results of serum protein electrophoreses performed before and within at least six months after the start of the biotherapy were collected. Demographic data, medical history, and psoriasis treatment history were specified. Four hundred and forty three patients were eligible for inclusion. Of these, three presented with monoclonal gammopathy for which the assessment was in favor of MGUS. The average treatment period was 19.7 months. Six patients presented with MGUS prior to the treatment. These patients' immunoglobulin levels remained stable, with an average remission of 24 months. Only psoriatic rheumatism appeared to be statistically linked to MGUS. The incidence and frequency of MGUS in psoriasis patients treated with biotherapy do not appear to increase relative to the general population. PMID:26878712

  1. Functional Outcome Following Arthroscopic ACL Reconstruction with Rigid Fix: A Retrospective Observational Study

    PubMed Central

    Shervegar, Satish; Nagaraj, Prashanth; Grover, Amit; DJ, Niranthara Ganesh; Ravoof, Abdul

    2015-01-01

    Background: No uniform consensus exists to decide type of fixation for arthroscopic anterior cruciate ligament reconstruction. Hypothsis: There is similar functional outcome after rigid fix compared to other methods of fixation which has been published. Study design: Retrospective observational study. Methods: A total of 50 patients underwent arthroscopic anterior cruciate ligament reconstruction with hamstring tendons using femoral Rigid fix cross-pin and interference screw tibial fixation. The evaluation methods were clinical examination, IKDC scores, Lysholm and pre injury and post reconstruction Tegner score. Patients were followed up from minimum of 6 months to 4 year seven months. Results: C In our study of sample size 50 we found that mean age of patients was 30.8 Years with male preponderance. Mean post operative IKDC and Lysholm score has been 75.6 and 84.4 respectively. Mean Tegner pre-injury score and post reconstruction score has been 5.4 and 4.26. Box plot comparison of pre injury and post operativeTegner score reveals a statistically significant difference with respect to paired t test P<0.001. Conclusions: Arthroscopic anterior cruciate ligament reconstruction with femoral rigid fix cross pins and tibial interference screws results in comparable short term to midterm functional results compared to other types of fixation PMID:26550591

  2. Collisions in space: A retrospective overview of ISAS studies

    NASA Astrophysics Data System (ADS)

    Uesugi, K.

    A chronological review of studies in ISAS concerning collisions in space is presented. The collision probability in space with artificial orbiting bodies was estimated, and a Space Traffic Control System was proposed, in 1971. The design of a space station for safety against collision hazards was discussed in 1972. A trajectory optimization technique for low-thrust multiple rendezvous mission in order ti sweep space debris around the earth was developed in 1977. In 1984, the collision probability was reestimated using space bedris data accumulated for more than a decade. Several experimental projects in ISAS, such as hypervelocity impact experiments using a railgun system, sampling and measuring of alumina particles in exhaust plume of solid-propellant propellant rocket motors, and a result of analysis on the behavior of such alumina particles in orbit are also introduced.

  3. A retrospective study of risk to siblings in abusing families.

    PubMed

    Hamilton-Giachritsis, Catherine E; Browne, Kevin D

    2005-12-01

    Relatively little research has considered the risk to siblings within maltreating families. The sample in the present study consisted of the 795 siblings from a cohort of 400 "index" children who had been referred to police child protection units in England for abuse and/or neglect. In 44% of families (valid cases), the index child was scapegoated, in 37% maltreatment was nonspecific to all siblings, and in 20% maltreatment was specifically directed at some but not all siblings. Scapegoated children were more likely to be older and to experience physical or sexual abuse, whereas younger children and index child referrals for neglect, emotional abuse, or mixed abuse were associated with risk to some or all siblings. Parental difficulties and family stressors increased the risk of maltreatment to all siblings. There was no evidence of increased risk to stepsiblings or children with difficulties, suggesting that the special victim model has limited application. PMID:16402877

  4. Outcome following physician supervised prehospital resuscitation: a retrospective study

    PubMed Central

    Mikkelsen, Søren; Krüger, Andreas J; Zwisler, Stine T; Brøchner, Anne C

    2015-01-01

    Background Prehospital care provided by specially trained, physician-based emergency services (P-EMS) is an integrated part of the emergency medical systems in many developed countries. To what extent P-EMS increases survival and favourable outcomes is still unclear. The aim of the study was thus to investigate ambulance runs initially assigned ‘life-saving missions’ with emphasis on long-term outcome in patients treated by the Mobile Emergency Care Unit (MECU) in Odense, Denmark Methods All MECU runs are registered in a database by the attending physician, stating, among other parameters, the treatment given, outcome of the treatment and the patient's diagnosis. Over a period of 80 months from May 1 2006 to December 31 2012, all missions in which the outcome of the treatment was registered as ‘life saving’ were scrutinised. Initial outcome, level of competence of the caretaker and diagnosis of each patient were manually established in each case in a combined audit of the prehospital database, the discharge summary of the MECU and the medical records from the hospital. Outcome parameters were final outcome, the aetiology of the life-threatening condition and the level of competences necessary to treat the patient. Results Of 25 647 patients treated by the MECU, 701 (2.7%) received prehospital ‘life saving treatment’. In 596 (2.3%) patients this treatment exceeded the competences of the attending emergency medical technician or paramedic. Of these patients, 225 (0.9%) were ultimately discharged to their own home. Conclusions The present study demonstrates that anaesthesiologist administrated prehospital therapy increases the level of treatment modalities leading to an increased survival in relation to a prehospital system consisting of emergency medical technicians and paramedics alone and thus supports the concept of applying specialists in anaesthesiology in the prehospital setting especially when treating patients with cardiac arrest, patients in

  5. Pigmented Villonodular Synovitis: A Retrospective Multicenter Study of 237 Cases

    PubMed Central

    Liang, Chang-xiang; Zeng, Jian-chun; Chen, Zhi-yuan; Xu, Qian; Qi, Rui-zhen; Chen, Yi-rong; Yu, Bin

    2015-01-01

    Purpose To review clinical characteristics of pigmented villonodular synovitis (PVNS) in China. Methods Electronic medical records (EMR) of four Chinese institutes were queried for patients with histologically proven PVNS between January 2005 and February 2014. Their data were collected including gender, age at diagnosis, clinical presentation, affected site, symptom duration, comorbidities, treatment strategy, recurrence and routine laboratories. Results A total of 237 patients with biopsy-proven PVNS were investigated. The gender ratio was 1.35 for a female predominance (101 males and 136 females). The average age was 36 years (range, 2 to 83 years). The median delay from initial clinical symptom to diagnosis was 18 months. Main affected areas were the knee (73.84%) and the hip (18.14%). Forty patients had a clear history of joint trauma. Six patients were concurrently diagnosed with PVNS and avascular necrosis (AVN). Five patients suffered from PVNS following implantation of orthopaedic devices including artificial prosthesis, plate and wire. One hundred and twenty-nine patients underwent arthroscopic synovectomy and 108 open synovectomy. Altogether 48 patients (26 males and 22 females) had recurrence of disease. The relapse rate was 24% (knee) and 6.98% (hip), 20.93% (open surgery) and 19.44% (arthroscopy), respectively. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) rate were elevated in 45.83% and 38.41% of the patients respectively. Conclusions To our knowledge, this study is the largest sample size of PVNS patients reported as well as the largest sample of PVNS with concurrent AVN reported to date. Our outcomes suggest that PVNS shows a female predominance, occurs mostly between 20–40 years and favors the knee and hip. Recurrence is frequent, particularly in the knee. Serum ESR and CRP may be elevated in some patients. Additionally, the present study supports the theory of an association between PVNS and orthopedic surgery, which is not

  6. A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men.

    PubMed

    Eaton, C B; Liu, Y L; Mittleman, M A; Miner, M; Glasser, D B; Rimm, E B

    2007-01-01

    Erectile dysfunction (ED) is associated with clinical atherosclerosis and several atherosclerotic risk factors including smoking, hypertension, dyslipidemia, diabetes mellitus, obesity and sedentary lifestyle. Clinical atherosclerosis is also associated with these same risk factors and with biomarkers of inflammation, thrombosis, endothelial cell activation. We evaluated the cross-sectional association between the degree of ED and levels of atherosclerotic biomarkers. A subcohort of 988 US male health professionals between the ages 46 and 81 years as part of an ongoing epidemiologic study had atherosclerotic biomarkers measured from blood collected in 1994-1995. These same men had in 2000, been retrospectively asked about erectile function in 1995 and in 2000. Biennial questionnaires since 1986 assessed medical conditions, medications, smoking, physical activity, body mass index, alcohol intake. The retrospective assessment of erectile function in 2000 for 1995 in these 988 men ranged from very good - 28.2%, good - 25.1%, fair - 19.2%, poor - 13.6%, to very poor - 13.9%. Men with poor to very poor erectile function compared to men with good and very good erectile function had 2.9 the odds of having elevated Factor VII levels (P=0.03), 1.9 times the odds of having elevated vascular cell adhesion molecule (P=0.13) and 2.0 times the odds of having elevated intracellular adhesion molecule (P=0.06) and 2.1 times the odds of having elevated total cholesterol/high-density lipoprotein ratio (P=0.02) comparing the top to bottom quintiles for each atherosclerotic biomarker after multivariate adjustment. Lipoprotein(a), homocysteine, interleukin-6 and tumor necrosis factor receptor, C-reactive protein and fibrinogen were not associated with the degree of erectile function after adjustment. We conclude that selected biomarkers for endothelial function, thrombosis and dyslipidemia but not inflammation are associated with the degree of ED in this cross-sectional analysis. Future

  7. Retrospective Study of Campylobacter Infection in a Zoological Collection▿

    PubMed Central

    Taema, Maged M.; Bull, James C.; Macgregor, Shaheed K.; Flach, Edmund J.; Boardman, Wayne S.; Routh, Andrew D.

    2008-01-01

    Little is known about the epidemiology of Campylobacter spp. in wild animal populations. However, zoological collections can provide valuable insights. Using records from the Zoological Society of London Whipsnade Zoo compiled between 1990 and 2003, the roles of a range of biotic and abiotic factors associated with the occurrence of campylobacteriosis were investigated. The occurrence of campylobacteriosis varied widely across host taxonomic orders. Furthermore, in mammals, a combination of changes in both rainfall and temperature in the week preceding the onset of gastroenteritis were associated with isolation of Campylobacter from feces. In birds, there was a weak negative correlation between mean weekly rainfall and isolation of Campylobacter from feces. Importantly, in birds we found that the mean weekly rainfall 3 to 4 weeks before symptoms of gastroenteritis appeared was the best predictor of Campylobacter infection. Campylobacter-related gastroenteritis cases with mixed concurrent infections were positively associated with the presence of parasites (helminths and protozoans) in mammals, while in birds Campylobacter was associated with other concurrent bacterial infections rather than with the presence of helminths and protozoans. This study suggests that climatic elements are important factors associated with Campylobacter-related gastroenteritis. Further investigations are required to improve our understanding of Campylobacter epidemiology in captive wild animal populations. PMID:18165368

  8. Chronic hepatitis: a retrospective study in 34 dogs.

    PubMed Central

    Fuentealba, C; Guest, S; Haywood, S; Horney, B

    1997-01-01

    The aims of this study were to characterize the histological changes observed in 34 accessioned cases of canine chronic hepatitis and to correlate these changes with the clinical pathological data. Cases of chronic hepatitis were subdivided into 6 categories: chronic active hepatitis (10/34), chronic persistent hepatitis (7/32), chronic cholestatic hepatitis (6/34), fibrosing hepatitis with cirrhosis (3/34), chronic cholangiohepatitis (3/34), and miscellaneous secondary hepatitis (5/34). Iron accumulation was a consistent finding in all livers examined. Although all cases of chronic hepatitis had elevated liver enzymes, no correlation was detected between biochemical parameters and the severity of morphologic changes. Similarly, no correlation was detected between rhodanine staining for copper and morphologic or biochemical indicators of cholestasis. However, presence of copper correlated well with reticulo-fibrosis (r = 0.8) and bile duct hyperplasia, suggesting that changes in the hemodynamics of the hepatic acini due to fibrosis could influence storage of copper. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. PMID:9187802

  9. Retrospective Study of the Hungarian National Transplant Team's Cardiorespiratory Capacity.

    PubMed

    Trájer, E; Bosnyák, E; Komka, Z S; Kováts, T; Protzner, A; Szmodis, M; Tóth, S Z; Udvardy, A; Tóth, M

    2015-01-01

    The low availability of donor organs requires long-term successful transplantation as an accepted therapy for patients with end-stage renal and liver diseases. The health benefits of regular physical activity are well known among healthy individuals as well as patients under rehabilitation programs. Our aim was to describe the cardiorespiratory capacity of the Hungarian National Transplant Team. Twenty-five kidney (n = 21) or liver (n = 4) transplant athletes participated in this study. Maximal cardiorespiratory capacity (VO2max) was measured on a treadmill with the use of gas analysis. After a resting pulmonary function test, subjects completed a vita maxima test until exhaustion. Aerobic capacity of transplant athletes was higher than the age- and sex-predicted cardiorespiratory fitness (VO2max, 109.9 ± 21.7% of the predicted values; P = .0101). Resting respiratory function indicators exceeded 80% of predicted age- and sex-matched normal values. There were positive correlations between VO2max and workload (r(2) = 0.40; P = .0463), metabolic equivalent (r(2) = 0.72; P < .0001), and oxygen pulse (r(2) = 0.30; P = .0039). However, age showed negative correlation with VO2max (r(2) = 0.32; P = .0031), and there was no significant correlation between graft age and maximal oxygen consumption (r(2) = 0.15; P = .4561). Although the small amount of participants can not represent the general kidney and liver transplant population, the excellent cardiorespiratory performance suggests that a normal level of physical capacity is available after transplantation and can be even higher with regular physical activity. This favorable physiologic background leads to a state that provides proper graft oxygenization, which is an important factor in long-term graft survival. PMID:26293020

  10. Microsporidia and Its Relation to Crohn's Disease. A Retrospective Study

    PubMed Central

    Andreu-Ballester, Juan C.; Garcia-Ballesteros, Carlos; Amigo, Victoria; Ballester, Ferran; Gil-Borrás, Rafael; Catalán-Serra, Ignacio; Magnet, Angela; Fenoy, Soledad; del Aguila, Carmen; Ferrando-Marco, Jose; Cuéllar, Carmen

    2013-01-01

    Background The cause of Crohn's Disease (CD) remains unknown. Recently a decrease in the global lymphocyte population in the peripheral blood of CD patients has been reported. This decrease was more evident in γδ T lymphocytes, especially γδ CD8+T subsets. Furthermore, a decrease of IL-7 was also observed in these patients. We propose the hypothesis that microsporidia, an obligate intracellular opportunistic parasite recently related to fungi, in CD patients can take advantage of the lymphocytes and IL-7 deficits to proliferate and to contribute to the pathophysiology of this disease. Methods and Findings In this case-control study, serum samples were collected from 36 CD patients and from 36 healthy individuals (controls), IgE and IgG anti-Encephalitozoon antibodies were determined by ELISA; and forty-four intestinal tissue samples were analyzed through real time Polymerase Chain Reaction (PCR), twenty CD patients, nine with others diseases and 15 healthy subjects. We observed that IgE anti-Encephalitozoon levels were significantly higher in patients with CD: 0.386(±0.256) vs control group, 0.201(±0.147), P<0.001. However, IgG anti-Encephalitozoon values were significantly lower in CD patients: 0.361(±0.256) vs control group, 0.876(±0.380), P<0.001. In the group of CD patients, 6/20 (30%) were positive by real time PCR for microsporidia and, all the patients of the control group were negative by real time PCR. Conclusions These results suggest that CD patients are a group at risk for microsporidiasis and, moreover that microsporidia may be involved as a possible etiologic factor of CD. PMID:23637975

  11. Treatment of Bone Defects in War Wounds: Retrospective Study

    PubMed Central

    Grubor, Predrag; Milicevic, Snjezana; Grubor, Milan; Meccariello, Luigi

    2015-01-01

    Introduction: Results of the treatment of open fractures primarily depend on the treatment of connected soft tissue injuries. Objective: The aim was to present the experience and methods gained during the treatment of diaphyseal bone defects as a consequence of gunshot fracture soft war trauma. Patients and Methods: The study consisted of 116 patients with the diaphyseal bone defect who were treated with the usage of primary and delayed autotransplantation of bones, transplants of the fibula and Ilizarov distraction osteogenesis. Results: The results of compensation of bone defect less than 4 cm and conducted by an early cortico-spongioplastics were as follows: good in 8 respondents (45%), satisfactory in 6 (34%) and poor in 4 respondents (21%). In cases of delayed cortico-spongioplastics, the above mentioned results were: good in 36 (41%) respondents, satisfactory in 24 (34%) and poor in 16 (25%) respondents. The results of compensation of bone defect greater than 4 cm with the usage of fibular transplant were as follows: good in 3 (38%) respondents, satisfactory in 3 (38%) and poor in 2 (24%), and with the usage of using the Ilizarov method, the results were as follows: good in 8 (57%) respondents, satisfactory in 3 (21.5%) and poor in 3(21.5%) respondents. Conclusion: The results showed that, in cases of compensation of bone defects less than 4 cm, the advantage is given to the primary spongioplastics over the delayed one. In cases of compensation of bone defects greater than 4 cm, the advantage is given to the Ilizarov distraction osteogenesis when compared to the fibular transplant. PMID:26543315

  12. Second Mesiobuccal Canal Treatment in a Predoctoral Dental Clinic: A Retrospective Clinical Study.

    PubMed

    Coelho, Marcelo Santos; Parker, Jeffrey M; Tawil, Peter Z

    2016-06-01

    The aim of this retrospective clinical study was to evaluate the location and treatment of second canals in mesiobuccal roots (MB2) of first and second maxillary molars in a predoctoral endodontic clinic by the graduating classes of 2008 to 2015. These results were compared to similar clinical studies. Included in the study were 368 root canal treatments performed by 310 third- and fourth-year dental students at one U.S. dental school. All cases were done under faculty supervision, and the students were instructed to use dental loupe magnification. Students' evaluation sheets were used to deteremine the total MB2 canals treated in first and second maxillary molars. The results showed that, overall, 72.55% of the teeth had an MB2 canal treated. The frequency was higher in first molars (75.91%) than in second molars (56.92%) (p<0.05). Third-year students were able to detect 39 MB2 canals in 57 maxillary molars (68.42%), while fourth-year students detected 228 MB2 canals in 311 teeth (73.31%) (p>0.05). Under proper supervision by experienced endodontists, these dental students were capable of treating MB2 canals in maxillary molars. The frequency of MB2 canals located and treated by dental students with the assistance of experienced professionals was higher in first than in second molars. No significant difference was found between third- and fourth-year students. The incidence of MB2 canals located and treated in this study was found to be similar to that in other clinical studies. PMID:27251355

  13. Alcohol Intoxication in Pediatric Age: Ten-year Retrospective Study

    PubMed Central

    Bitunjac, Kristina; Saraga, Marijan

    2009-01-01

    Aim To examine the changes in the number of children younger than 18 who were hospitalized due to alcohol intoxication at the Department of Pediatrics, University Hospital of Split, from November 1, 1997 to October 31, 2007. Methods Data on children hospitalized due to intoxication were retrieved from hospital medical records. Children were classified into 4 age groups: 0-5, 6-9, 10-13, and 14-18 years, and their sex and type of intoxication were recorded. For children with alcohol intoxication, data on time of intoxication, reason for drinking, presence of injuries or suspected suicide attempts, and possible presence of other drugs in the organism were collected. Results Out of 29 506 hospitalized children, 594 were hospitalized due to intoxications. Out of these, 239 (40.2%) were hospitalized due to intoxication by alcohol. More boys than girls were hospitalized (71.1%). The proportion of alcohol intoxication cases among all types of intoxication cases increased from 16.7% in 1997/98 to 66.3% in 2006/07. The proportion of patients hospitalized due to alcohol intoxication increased from 0.3% of all hospitalized children in the first year to 1.7% in the last year of the study (P = 0.015, z test for comparison of two proportions). Eighty two per cent of cases of alcohol intoxication were in the 14-18 age-group. The number of alcohol intoxication cases increased among girls from 1 case (6.3% of all intoxication cases among girls) in 1997/98 to 15 cases (45.5%) in 2006/07, while among boys it increased from 6 cases (23.1% of all intoxicated boys) in 1997/98 to 44 cases (78.6%) in 2006/07. Children usually drank outside their homes (79.4%) and mostly on weekends and holidays (73.2%). Conclusion The alarming increase in the number of hospitalizations due to alcohol intoxication in children, especially among girls and in the adolescent age group, represents a serious problem, which requires further attention and research. PMID:19399948

  14. Retrospective Study of Lithium Use for Institutionalized Mentally Retarded Individuals with Behavior Disorders.

    ERIC Educational Resources Information Center

    Langee, Harvey R.

    1990-01-01

    Severely and profoundly mentally retarded institutionalized residents (N=74) who received lithium carbonate for behavior disorders were followed in a 10-year retrospective study. Thirty-one subjects demonstrated a sustained major reduction or elimination of behavioral symptoms. Lithium responders were likely to be older and to present symptoms of…

  15. Validation of the CDA CAMBRA caries risk assessment--a six-year retrospective study.

    PubMed

    Doméjean, Sophie; White, Joel M; Featherstone, John D B

    2011-10-01

    The present manuscript presents the results of a six-year retrospective study validating caries risk assessment in a caries management by risk assessment program in a large predominantly adult patient population seeking dental care. CRA was successful in accurately identifying patients at high caries risk. Caries risk assessment in a CAMBRA program is a good clinical tool for everyday dental practice. PMID:22132582

  16. Reduced Requirements for Long-Term Institutional Care: Results of a Retrospective Study.

    ERIC Educational Resources Information Center

    Gurewitsch, Eleanor Chestnut

    1984-01-01

    Conducted a retrospective study of 102 Swiss seniors to determine nonmedical factors affecting substantial care days required prior to death. Protected senior housing and an independent and helpful personality seemed to contribute significantly to compression of morbidity and to reduced need for long-term institutional care. (JAC)

  17. Examining the Impact of School Climate on Student Achievement: A Retrospective Study

    ERIC Educational Resources Information Center

    Hendricks, Kendall H.

    2011-01-01

    The purpose of this study was to retrospectively examine the changes in principal-teacher relationships and school climate over time as witnessed by staff members in elementary level "Turn Around Schools" in Indiana and how these relationships impacted student achievement. School climate and subsequent principal-teacher relationships…

  18. Retrospective study maxillofacial fractures epidemiology and treatment plans in Southeast of Iran

    PubMed Central

    Samieirad, Sahand; Tohidi, Elahe; Shahidi-Payam, Akbar; Abedini, Ali

    2015-01-01

    Background The epidemiology of facial injuries varies in different countries and geographic zones. Population concentration, lifestyle, cultural background, and socioeconomic status can affect the prevalence of maxillofacial injuries. Therefore, in this study, we evaluated the maxillofacial fractures epidemiology and treatment plans in hospitalized patients (2012-2014) which would be useful for better policy making strategies. Material and Methods In this retrospective study, the medical records of 386 hospitalized patients were evaluated from the department of maxillofacial surgery at Bahonar Hospital of Kerman, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. For data analysis, ANOVA, t-test, Chi-square, and Fisher’s exact test were performed, using SPSS version 21. Results The majority of patients were male (76.5%). Most subjects were within the age range of 20-30 years. Fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the mandible (parasymphysis). There was a significant association between the type of treatment and age. In fact, the age group of 16-59 years under went open reduction internal fixation (ORIF) more than other age groups (P=0.02). Also, a significant association was observed between gender and the occurrence of fractures (P=0.01). Conclusions Considering the geographic and cultural indices of the evaluated population, it can be concluded that patients age and gender and trauma causes significantly affect the prevalence of maxillofacial traumas and fracture kinds and treatment plans. Key words:Epidemiology, treatment, facial injuries, face fractures, maxillofacial trauma, trauma. PMID:26116845

  19. Radiological Insertion of Denver Peritoneovenous Shunts for Malignant Refractory Ascites: A Retrospective Multicenter Study (JIVROSG-0809)

    SciTech Connect

    Sugawara, Shunsuke; Sone, Miyuki; Arai, Yasuaki; Sakamoto, Noriaki; Aramaki, Takeshi; Sato, Yozo; Inaba, Yoshitaka; Takeuchi, Yoshito; Ueno, Teruko; Matsueda, Kiyoshi; Moriguchi, Michihisa; Tsushima, Takahiro

    2011-10-15

    Purpose: Peritoneal venous shunts (PVSs) are widely used for palliating symptoms of refractory malignant ascites and are recognized as one of the practical methods. However, reliable clinical data are insufficient because most previous reports have been small studies from single centers. We conducted a retrospective, multicenter study to evaluate the safety and efficacy of radiologically placed PVSs in patients with malignant refractory ascites. Methods: A total of 133 patients with malignant ascites refractory to medical therapies were evaluated for patient characteristics, technical success, efficacy, survival times, adverse events, and changes in laboratory data. Results: PVSs were successfully placed in all patients and were effective (i.e., improvement of ascites symptoms lasting 7 days or more) in 110 (82.7%). The median duration of symptom palliation was 26 days and median survival time was 41 days. The most frequent adverse event was PVS dysfunction, which occurred in 60 (45.1%) patients, among whom function was recovered with an additional minimally invasive procedure in 9. Abnormalities in coagulation (subclinical disseminated intravascular coagulation) occurred in 37 (27.8%) patients, although only 7 (5.3%) developed clinical disseminated intravascular coagulation. Other major adverse events were gastrointestinal bleeding (9.8%), sepsis (3.8%), and acute heart failure (3.0%). PVS was least effective in patients with elevated serum creatinine, bloody ascites, or gynecologic tumor. Conclusions: Radiological PVS is a technically feasible and effective method for palliating the symptoms from refractory malignant ascites, but preoperative evaluation and monitoring the postprocedural complications are mandatory to preclude severe adverse events after PVS.

  20. Statin Therapy May not Effect NLR and MPV Levels in Patients With Hypercholesterolemia: A Retrospective Study.

    PubMed

    Gungoren, Fatih; Besli, Feyzullah; Caliskan, Serhat; Polat, Ufuk; Basar, Cengiz; Serdar, Osman Akin

    2016-07-01

    Statins may exert pleiotropic effects in coronary artery disease (CAD), diabetes mellitus, and familial hypercholesterolemia. We evaluated the effects of statins on the neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) in 261 consecutive patients with hypercholesterolemia having CAD or at high cardiovascular (CV) risk and 50 healthy participants who were retrospectively included in this study. Patients were treated with 10 to 80 mg atorvastatin or 10 to 40 mg rosuvastatin for 24 weeks according to baseline levels of cholesterol, triglycerides, and CV risk. Baseline NLR and MPV were significantly higher in patients with CAD or at high risk compared to the control group (1.89 [0.37-6.78]) vs 1.44 [0.75-2.41], P < .001 and 8.8 [6.27-18.6] vs 8.45 [6-11] fL, P = .038, respectively). The NLR, MPV, and lipid parameters were also compared in the patient group after statin treatment for 24 weeks. Lipid levels decreased but the NLR and MPV did not change significantly after the statin therapy. Further studies are needed to clarify the effect of statin therapy on NLR and MPV in patients with CAD or at high CV risk. PMID:26341259

  1. Imaging changes after breast reconstruction with fat grafting - Retrospective study of 90 breast cancer

    PubMed Central

    Noor, Lubna; Reeves, Helen Rosemarry; Kumar, Dileep; Alozairi, Ous; Bhaskar, Pudhupalayam

    2016-01-01

    Objective: To evaluate the breast imaging changes after fat grafting and its impact on cancer follow up. Methods: This is a retrospective observational study conducted on patients who underwent fat grafting for breast reconstruction. We reviewed mammographic and ultrasound images of patients. Fisher’s exact test was used to analyze results. The level of significance was set at P < 0.05. Results: A total of ninety patients with breast cancer had fat grafting. Fifty eight patients for defects following post mastectomy reconstruction and 32 for wide local excision defects. The mean follow up was 37.4 months. Benign lumps were identified in 23/90 cases (25 percent). Mammograms were reported as BI-RADS I in 21/32 cases (72 percent) and BI-RADS II in 8/32 cases (28 percent). BI-RADs III score was reported in two patients on further follow up imaging, both were re-classified as BI-RADS II after biopsy. A total of eight patients (8.9 percent) required biopsy. No local recurrences or new cancers were observed in any patients. Conclusion: Our study suggests radiological changes after fat grafting are almost always benign with no adverse outcome on cancer follow up. PMID:27022335

  2. [Bacterial meningitis in adults: a retrospective multicentric study in Tuscany (Italy)].

    PubMed

    Ricciardi, L; Meini, M; Luchi, S; Scasso, A; Corbisiero, R; Mencarelli, M; Cellesi, C; Aquilini, D; Carbonai, S; Paladini, A; Bresci, S; Panunzi, I; Leoncini, F; Trezzi, M; Nencioni, C; Toti, M; Maccanti, O; Pardelli, R; Sani, S; Pippi, L; Esperti, F; Messeri, D; Dionisio, D; Pippi, F; Ble, C; Pienotti, P; Mazzotta, F

    2006-06-01

    The Infectious Diseases Unit of Lucca Hospital conducted a multicentric retrospective study to evaluate the epidemiological and clinical features of adult patients affected by bacterial meningitis attending all the Infectious Diseases Units of Tuscany (Italy) from July 1999 to June 2004. A specific questionnaire was sent to all the units to collect information about each case of bacterial meningitis occurring in patients older than sixteen. Patients with meningitis by Mycobacterium tuberculosis were excluded from the analysis. Nine out of 12 Infectious Diseases Units of Tuscany took part in the study and 197 cases were identified. Most cases of meningitis occurred during 2002 with a slight reduction in cases in subsequent years. Streptococcus pneumoniae and Neisseria meningitidis were the most frequently isolated pathogens with an increase in diagnosis from 1999 to 2004; in 23.8% of patients no pathogens were isolated, with a reduction in meningitis from unknown aetiology from 1999 to 2004. Most patients were treated with a combination of two antibiotics, and corticosteroid drugs were added to the therapy; in the group of patients treated with corticosteroid drugs invalidating complications occurred in 23% of cases and 5% of patients died. In all, 27 out of 197 subjects (13.7%) developed invalidating complications and 20 out of 197 patients (10.2%) died. PMID:16891852

  3. Pelvic floor physical therapy for lifelong vaginismus: a retrospective chart review and interview study.

    PubMed

    Reissing, Elke D; Armstrong, Heather L; Allen, Caroline

    2013-01-01

    Pelvic floor physical therapy is used in the treatment of sexual pain disorders; however, women with lifelong vaginismus have not yet been included in treatment studies or have not been differentiated from women with acquired vaginismus and/or dyspareunia. This retrospective chart review and interview study was intended to obtain initial information on physical therapy interventions, course, and outcome in women who have never been able to experience vaginal intercourse. The files of 53 women, consecutively treated at one physical therapy clinic, were included in the chart review; 13 of these women volunteered to be interviewed. The chart review revealed significant pelvic floor pathology and an average treatment course of 29 sessions. Internal manual techniques were found to be most effective, followed by patient education, dilatation exercises, and home exercises. Although participants were very satisfied with the physical therapy, some symptoms, such as pain, anxiety/fear, and pelvic floor tension remained and scores on the Female Sexual Distress Scale and Female Sexual Function Index indicated clinical levels of sexual distress and impaired sexual function after treatment. Although there appears to be no linear relation between symptom reduction and healthy sexual function, this initial information suggests that physical therapy may be a promising treatment option for some women with lifelong vaginismus and merits further evaluation. PMID:23470141

  4. Synchronous and Metachronous Breast Malignancies: A Cross-Sectional Retrospective Study and Review of the Literature

    PubMed Central

    Londero, Ambrogio P.; Bernardi, Sergio; Bertozzi, Serena; Angione, Vito; Gentile, Giuliana; Dri, Cinzia; Minucci, Antonio; Caponnetto, Filippo; Petri, Roberto

    2014-01-01

    Objective. There is increasing interest in patients with metachronous (MBC) and synchronous breast cancer (SBC). The objective of this study was to evaluate the occurrence and outcome of MBCs and SBCs. Methods. A retrospective study on women operated in our department for breast cancer between 2002 and 2005 was carried out. Patients were divided into three groups: women with MBC, SBC, and unilateral breast cancer (UBC). Moreover, we performed a meta-analysis of the English literature about multiple breast cancers between 2000 and 2011 taking into consideration their prevalence and overall survival (OS). Results. We identified 584 breast cancer patients: 16 women (3%) presented SBC and 40 MBC (7%, second cancer after 72-month follow-up IQR 40–145). Although the meta-analysis showed significant OS differences between MBC or SBC and UBC, we did not observe any significant OS difference among the three groups of our population. Anyway, we found a significant worse disease-free survival in MBC than UBC and a significant higher prevalence of radical surgery in MBC and SBC than UBC. Conclusions. Despite the low prevalence of MBC and SBC, the presence of a long time risk of MBC confirms the crucial role of ipsi- and contralateral mammographies in the postoperative follow-up. PMID:24877073

  5. Spectrum of autoimmune vesiculobullous diseases in Iran: a 13-year retrospective study

    PubMed Central

    Sobhan, Mohammadreza; Farshchian, Mahmood; Tamimi, Maryam

    2016-01-01

    Background Autoimmune bullous diseases (ABDs) represent a group of rare, acquired disorders characterized by overlapping features with involvement of the skin and mucous membranes, resistance to treatment, and potential lethality that comprise pemphigus, bullous pemphigoid (BP), epidermolysis bullosa, dermatitis herpetiformis, and linear immunoglobulin A bullous dermatosis. Aim The main aim of this study was to identify the epidemiologic characteristics and clinical courses of these common diseases in Hamadan, Iran. Few surveys have been carried out to demonstrate the whole spectrum of ABDs in the literature. Notably, in Hamadan we are the first. Materials and methods This 13-year retrospective study was designed to evaluate all of documented data obtained from hospitalized patients with ABDs at Farshchian Hospital from October 1999 to October 2012. We collected information on epidemiologic data, clinical aspects, histologic findings, and therapy prescribed. Data were analyzed using SPSS. Results Of 168 patients, 78% had pemphigus. The age of patients at presentation ranged from 1 month to 115 years, with a mean of 47.5±19.93 years. Mucosal or skin involvement of ABDs was statistically significant (P<0.001). The incidence of ABDs differed significantly based on anatomic location (P=0.003). We documented three deaths. Conclusion Compared to previous literature, our findings showed equal epidemiologic properties in Iran. Although pemphigus was the most common ABD followed by BP, it is expected that in line with the global trend, an increase in BP will be driven by population aging in Iran. PMID:26811692

  6. Hydrophilic polymer embolism and associated vasculopathy of the lung: prevalence in a retrospective autopsy study.

    PubMed

    Mehta, Rupal I; Mehta, Rashi I; Choi, Julia M; Mukherjee, Arnob; Castellani, Rudy J

    2015-02-01

    Hydrophilic polymers are commonly applied as surface coatings on vascular devices and have been shown to dissociate during endovascular use, causing hydrophilic polymer embolism (HPE). Adverse effects related to this phenomenon have been recognized and reported. The prevalence of this complication is unknown. We conducted a retrospective study to determine the prevalence of HPE among hospital autopsies over a 29-month period. Postmortem tissue was histologically evaluated for the presence, location(s) and extent of HPE. HPE findings were correlated with documented clinical and laboratory data and patient outcome. Of 136 hospital autopsies examined, 18 (13%) showed evidence of HPE involving the lungs (n = 18), heart (n = 1) or central nervous system (n = 1). Localized pulmonary HPE was seen in 12 patients (9%). Multifocal pulmonary HPE was found in 6 patients (4%) and was associated with clinical vasculitis (33%; P < .0001), suspected pulmonary ischemia (50%; P = .008), coagulopathy (67%; P = .002), and constitutional disease (83%; P = .01). Within affected lung, associated histopathologic changes included occlusive intravascular or perivascular inflammation (89%), intravascular fibrous response (56%), microthrombus formation (44%), vasculitis (28%), and/or pulmonary microinfarction (28%). Statistically significant differences in hospital days (P = .008) and number of vascular interventions (P = .01) were noted between affected and unaffected patients. We conclude that HPE is an underdiagnosed phenomenon with primary involvement of the lungs, where secondary vascular changes are common. Additional studies may be needed to clarify risks and to identify preventative strategies for this iatrogenic complication of catheterizations and "minimally invasive" endovascular techniques. PMID:25543660

  7. Prevalence and severity of antipsychotic related constipation in patients with schizophrenia: a retrospective descriptive study

    PubMed Central

    2011-01-01

    Background Antipsychotic are the cornerstone in the treatment of schizophrenia. They also have a number of side-effects. Constipation is thought to be common, and a potential serious side-effect, which has received little attention in recent literature. Method We performed a retrospective study in consecutively admitted patients, between 2007 and 2009 and treated with antipsychotic medication, linking different electronic patient data to evaluate the prevalence and severity of constipation in patients with schizophrenia under routine treatment conditions. Results Over a period of 22 months 36.3% of patients (99) received at least once a pharmacological treatment for constipation. On average medication for constipation was prescribed for 273 days. Severe cases (N = 50), non-responsive to initial treatment, got a plain x-ray of the abdomen. In 68.4% fecal impaction was found. Conclusion A high prevalence of constipation, often severe and needing medical interventions, was confirmed during the study period. Early detection, monitoring over treatment and early intervention of constipation could prevent serious consequences such as ileus. PMID:21385443

  8. Survival Rate of Short, Locking Taper Implants with a Plateau Design: A 5-Year Retrospective Study

    PubMed Central

    Demiralp, Kemal Özgür; Akbulut, Nihat; Kursun, Sebnem; Argun, Didem; Bagis, Nilsun; Orhan, Kaan

    2015-01-01

    Background. Short implants have become popular in the reconstruction of jaws, especially in cases with limited bone height. Shorter implants, those with locking tapers and plateau root shapes, tend to have longer survival times. We retrospectively investigated the cumulative survival rates of Bicon short implants (<8 mm) according to patient variables over a 5-year period. Materials and Methods. This study included 111 consecutively treated patients with 371 implants supporting fixed or removable prosthetics. Data were evaluated to acquire cumulative survival rates according to gender, age, tobacco use, surgical procedure, bone quality, and restoration type. Statistics were performed using chi-square, Mann-Whitney, and Kruskal Wallis H tests. Results. The survival rate was 97.3% with, on average, 22.8 months of follow-up. Patients older than 60 years had higher failure rate than the other age groups (P < 0.05). Placed region, age, and bone quality had adverse effects on survival rate in the <8 mm implant group with statistically significant difference (P < 0.05). Conclusions. Approximately 23-month follow-up data indicate that short implants with locking tapers and plateau-type roots have comparable survival rates as other types of dental implants. However, due to limitations of study, these issues remain to be further investigated in future randomized controlled clinical trials. PMID:25961004

  9. Drug use evaluation of cefepime in the first affiliated hospital of Bengbu medical college: a retrospective and prospective analysis

    PubMed Central

    2013-01-01

    Background Cefepime is a fourth generation cephalosporin antimicrobial. Its extended antimicrobial activity and infrequent tendency to engender resistance make it popular for the treatment of infections. However, proper use of cefepime has not been studied adequately. In this study, we used a retrospective cohort and a prospective cohort to evaluate the usage pattern, adverse effects and cost-effectiveness of cefepime by conducting a drug use evaluation (DUE) program in the First Affiliated Hospital of Bengbu Medical College, Anhui, China. Methods The DUE criteria for cefepime were established by applying literature review and expert consultation, an effective method to promote interventions that will improve patient outcomes and the cost-effectiveness of drug therapy. According to the criteria, we performed a cross-sectional retrospective (cycle A) study on 96 hospitalized patients who received cefepime treatment and a prospective (cycle B) study on 111 hospitalized patients with cefepime treatment intervention. After identifying problems with usage and completing a cefepime use evaluation for cycle A, 2 months of educational intervention among professionals were given and a more effective and rational system of cefepime use was set up. During the 2 months, the lectures were arranged and attendance of prescribers was required. Results The data from cycle A showed that the biggest problem was irrational prescription of cefepime; bacterial culture and drug sensitivity tests for cefepime were also not carried out. Following 2 months of educational intervention among professionals, the results for cycle B showed that the correct indication rate was 94.59%, compared with 84.38% in cycle A. Use of bacterial culture and sensitivity tests also improved, by 88.29% in cycle B compared with 65.22% in cycle A. Compared with cycle A, the significantly improved items (P < 0.05) in cycle B were blood examination, liver function monitoring, renal function monitoring, dose and

  10. Perioperative management of patients for osteo-odonto-kreatoprosthesis under general anaesthesia: A retrospective study.

    PubMed

    Garg, Rakesh; Khanna, Puneet; Sinha, Renu

    2011-05-01

    An osteo-odonto-keratoprosthesis (OOKP) procedure is indicated in patients with failed corneal transplant but having intact retina for visual improvement. We studied perioperative concerns of patients who underwent the staged OOKP procedure. This was a retrospective analysis of patients who underwent OOKP. The information regarding symptoms, associated comorbidities, perioperative events including anaesthetic management were collected. Eight patients (five females and three males) underwent the staged OOKP procedure. The median age was 18 years. The median weight was 45 kg. The median duration of loss of vision was 4 years. The aetiology of blindness included Stevens-Johnson's syndrome (SJS) (7) and chemical burn (1). Four patients had generalized skin problem due to SJS. All cases were managed under general anaesthesia, and airway management included nasotracheal intubation for stage I and orotracheal intubation for stage II. The median mallampati classification was I prior to OOKP stage I procedure while it changed to II at stage II procedure. Two patients required fibreoptic nasotracheal intubation. One patient had excessive oozing from the mucosal harvest site and was managed conservatively. In one patient, tooth harvesting was done twice as the first tooth was damaged during creating a hole in it. We conclude that OOKP requires multidisciplinary care. Anaesthesiologist should evaluate the airway carefully and disease-associated systemic involvements. The use of various drugs requires caution and steroid supplementation should be done. Airway difficulty should be anticipated, mandating thorough evaluation. Re-evaluation of airway is prudent as it may become difficult during the staged OOKP procedure. PMID:21808400

  11. Prevalence and Audiological Characteristics of Auditory Neuropathy Spectrum Disorder in Pediatric Population: A Retrospective Study.

    PubMed

    Vignesh, S S; Jaya, V; Muraleedharan, A

    2016-06-01

    Auditory neuropathy spectrum disorder (ANSD) is a type of hearing disorder which is challenging for assessment and rehabilitation. This disorder has been studied over a decade and prevalence of the disorder is variable. The study aimed at estimating the prevalence and audiological characteristics of ANSD in children. A retrospective study was conducted from the medical records of pediatric patients evaluated at Rajiv Gandhi Government General Hospital and Madras Medical College, Chennai to estimate the prevalence of ANSD. Medical records of 2,624 children evaluated during the period of November 2010 to October 2012 within the age range of 6 months to 12 years were analyzed. Out of 2,624 pediatric population assessed 217 (8.26 %) of them had unilateral or bilateral sensory neural hearing loss with varying degrees. Out of 217 children with sensory neural hearing loss 5.06 % (N = 11) had ANSD. Audiological characteristics varied among the group. Children with ANSD had varied degree of hearing thresholds from normal to profound hearing impairment. All of them had 'A' type tympanogram with absent stapedial reflexes. DPOAEs or TEOAEs were observed in 54 % of population with ANSD. All of them had abnormal auditory brainstem responses (ABR). Replicable cochlear microphonics was observed in 46 % of children with ANSD. These results indicate that ANSD is not a rare condition among children and we emphasize the use of objective tests like tympanometry, Stapedial Reflex test, otoacoustic emissions and ABR in routine hearing assessment procedure for all children to identify ANSD. PMID:27340636

  12. Perianesthetic Mortality in Domestic Animals: A Retrospective Study of Postmortem Lesions and Review of Autopsy Procedures.

    PubMed

    DeLay, J

    2016-09-01

    Autopsy of animals that die in the perianesthetic period allows identification of anesthetic and surgical complications as well as preexisting disease conditions that may have contributed to mortality. In most studies to date investigating perianesthetic mortality in animals, inclusion of autopsy data is very limited. This retrospective study evaluated autopsy findings in 221 cases of perianesthetic death submitted to a veterinary diagnostic laboratory from primary care and referral hospitals. Canine (n = 105; 48%) and feline (n = 90; 41%) cases predominated in the study, involving elective (71%) and emergency (19%) procedures. The clinical history provided to the pathologist was considered incomplete in 42 of 221 cases (19%), but this history was considered essential for evaluating the circumstances of perianesthetic death. Disease had been recognized clinically in 69 of 221 animals (31%). Death occurred in the premedication or sedation (n = 19; 9%), induction (n = 22; 11%), or maintenance (n = 73; 35%) phases or in the 24 hours postanesthesia (n = 93 animals; 45%). Lesions indicative of significant natural disease were present in 130 of 221 animals (59%), mainly involving the heart, upper respiratory tract, or lungs. Surgical or anesthesia-associated complications were identified in 10 of 221 cases (5%). No lesions were evident in 80 of 221 animals (36%), the majority of which were young, healthy, and undergoing elective surgical procedures. Lesions resulting from cardiopulmonary resuscitation were identified in 75 of 221 animals (34%). Investigation of perianesthetic death cases should be done with knowledge of prior clinical findings and antemortem surgical and medical procedures; the autopsy should particularly focus on the cardiovascular and respiratory system, including techniques to identify pneumothorax and venous air embolism. PMID:27371539

  13. The Prospective and Retrospective Memory Questionnaire: a population-based random sampling study.

    PubMed

    Piauilino, D C; Bueno, O F A; Tufik, S; Bittencourt, L R; Santos-Silva, R; Hachul, H; Gorenstein, C; Pompéia, S

    2010-05-01

    The Prospective and Retrospective Memory Questionnaire (PRMQ) has been shown to have acceptable reliability and factorial, predictive, and concurrent validity. However, the PRMQ has never been administered to a probability sample survey representative of all ages in adulthood, nor have previous studies controlled for factors that are known to influence metamemory, such as affective status. Here, the PRMQ was applied in a survey adopting a probabilistic three-stage cluster sample representative of the population of Sao Paulo, Brazil, according to gender, age (20-80 years), and economic status (n=1042). After excluding participants who had conditions that impair memory (depression, anxiety, used psychotropics, and/or had neurological/psychiatric disorders), in the remaining 664 individuals we (a) used confirmatory factor analyses to test competing models of the latent structure of the PRMQ, and (b) studied effects of gender, age, schooling, and economic status on prospective and retrospective memory complaints. The model with the best fit confirmed the same tripartite structure (general memory factor and two orthogonal prospective and retrospective memory factors) previously reported. Women complained more of general memory slips, especially those in the first 5 years after menopause, and there were more complaints of prospective than retrospective memory, except in participants with lower family income. PMID:20408038

  14. Gender differences in outcome of eating disorders: a retrospective cohort study.

    PubMed

    Støving, René Klinkby; Andries, Alin; Brixen, Kim; Bilenberg, Niels; Hørder, Kirsten

    2011-04-30

    Eating disorders (EDs) are uncommon in males. The majority of outcome studies on ED have not presented gender-specific results, mostly because of small study samples or exclusion of males. Furthermore, psychometric tools and outcome criteria used in ED have mainly been validated for females only. The objective of this study was to evaluate gender differences in weight restoration in different EDs. We studied the male representation and outcome in a large retrospective single centre cohort, the Funen Anorexia Nervosa Study (FANS). A total of 1015 patients were included in the study. A total of 356 (35%) patients were diagnosed with anorexia nervosa (AN), 298 (29%) with eating disorder not otherwise specified (EDNOS) and 361 (36%) with bulimia nervosa (BN). The male fractions in AN and EDNOS were similar, but significantly lower in BN. When remission was defined as body weight restoration to at least 85% of ideal body weight (IBW) and no self-reported binge or purgative behaviors in six months, the median time from onset to remission for patients with AN was significantly shorter for males: 7 years for females vs. 3 years for males. Among patients with a 5 years history of disease, remission rates in AN were 39% for females vs. 59% for males. The median time to remission for patients with EDNOS was similar to that of AN: 6 years for females vs. 3 years for males. In patients with EDNOS, 45% of the females remitted within 5 years vs. 77% of the males. With regard to body weight restoration and remission of purging behavior, this study suggests a better outcome for males than for females. PMID:20826003

  15. Incidental Dural Tears During Lumbar Spine Surgery: A Retrospective Case Study of 84 Degenerative Lumbar Spine Patients

    PubMed Central

    Anekstein, Yoram; Mirovsky, Yigal

    2014-01-01

    Study Design A retrospective case study. Purpose To retrospectively review all incidental dural tears (DTs) that occurred at a single institution, classify them anatomically and evaluate the clinical significance of each subgroup. Overview of Literature Dural tears are considered the most commonly encountered complication during lumbar spine surgery. In contrast to the high frequency of DTs, reports on the characteristic location and mechanism are sparse. Methods We retrospectively retrieved all cases of degenerative lumbar spine surgery performed over a 9-year period and classified all identified DTs according to two independent planes. The coronal plane was divided into lower, middle and upper surgical fields, and the sagittal plane into posterior, lateral and ventral occurring tears. Demographic and clinical variables were retrieved and analyzed to search for significant associations. Results From 2003 to 2011, 1,235 cases of degenerative lumbar spine conditions were treated surgically at our institution. In 84 operations (6.8%), an incidental DT was either identified intraoperatively or suspected retrospectively. The most commonly involved location was the lower surgical field (n=39, 46.4%; p=0.002), followed equally by the middle and upper fields (n=16, 19%). In the sagittal plane, the most commonly involved locations were those in close proximity to the nerve root (n=35, 41.6%), followed by the dorsal aspect of the dural sac (n=24, 28.6%). None of the variables recorded was found to be associated with a particular location. Conclusions In our series, incidental DTs were found to occur most commonly in the lower surgical field. We hypothesize that local anatomic feature, such as the lordotic and broadening lumbar dura, may play a role in the observed DT tendency to occur in the lower surgical field. In light of the high frequency and potentially substantial resulting morbidity of incidental DTs, a better characterization of its location and mechanism may

  16. Laparoscopic Cholecystectomy Performed by Residents: A Retrospective Study on 569 Patients

    PubMed Central

    Fontana, Stefano; Zetti, Giorgio; Cortese, Ferdinando

    2014-01-01

    Introduction. Aim of this study was to evaluate the safety of laparoscopic cholecystectomy performed by residents. Materials and Methods. We retrospectively reviewed 569 elective laparoscopic cholecystectomies. Results. Duration of surgery was 84 ± 39 min for residents versus  66 ± 47 min for staff surgeons, P < 0.001. Rate of conversion was 3.2% for residents versus 2.7% for staff surgeons, P = 0.7. There was no difference in the rates of intraoperative and postoperative complications for residents (1.2% and 3.2%) versus staff surgeons (1.5% and 3.1%), P = 0.7 and P = 0.9. Postoperative hospital stay was 3.3 ± 1.8 days for residents versus  3.4 ± 3.2 days for staff surgeons, P = 0.6. One death in patients operated by residents (1/246) and one in patients operated by staff surgeons (1/323) were found, P = 0.8. No difference in the time to return to normal daily activities between residents (11.3 ± 4.2 days) and staff surgeons (10.8 ± 5.6 days) was found, P = 0.2. Shorter duration of surgery when operating the senior residents (75 ± 31 minutes) than the junior residents (87 ± 27 minutes), P = 0.003. Conclusion. Laparoscopic cholecystectomy performed by residents is a safe procedure with results comparable to those of staff surgeons. PMID:25379566

  17. Tolerance and efficacy of sodium oxybate in childhood narcolepsy with cataplexy: a retrospective study.

    PubMed

    Lecendreux, Michel; Poli, Francesca; Oudiette, Delphine; Benazzouz, Fatima; Donjacour, Claire E H M; Franceschini, Christian; Finotti, Elena; Pizza, Fabio; Bruni, Oliviero; Plazzi, Giuseppe

    2012-05-01

    Narcolepsy with cataplexy is a sleep disorder characterized by excessive daytime sleepiness, irresistible sleep episodes, and sudden loss of muscle tone (cataplexy) mostly triggered by emotions. Narcolepsy with cataplexy is a disabling lifelong disorder frequently arising during childhood. Pediatric narcolepsy often results in severe learning and social impairment. Improving awareness about this condition increases early diagnosis and may allow patients to rapidly access adequate treatments, including pharmacotherapy and/or non-medication-based approaches. Even though children currently undergo pharmacotherapy, data about safety and efficacy in the pediatric population are scarce. Lacking international guidelines as well as drugs registered for childhood narcolepsy with cataplexy, physicians have no other alternative but to prescribe in an off-label manner medications identical to those recommended for adults. We retrospectively evaluated 27 children ranging from 6 to 16 years old, suffering from narcolepsy with cataplexy, who had been treated with off-label sodium oxybate and had been followed in a clinical setting. Throughout a semi-structured interview, we documented the good efficacy and tolerability of sodium oxybate in the majority of the patients. This study constitutes a preliminary step towards a further randomized controlled trial in childhood narcolepsy with cataplexy. PMID:22547897

  18. Timing of Caffeine Therapy and Neonatal Outcomes in Preterm Infants: A Retrospective Study

    PubMed Central

    Hand, Ivan; Zaghloul, Nahla; Barash, Lily; Parris, Rudolph; Aden, Ulrika; Li, Hsiu-Ling

    2016-01-01

    Background. Caffeine is widely used to treat apnea of prematurity. Here, we evaluated the efficacy of early caffeine (1-2 DOL) in decreasing the incidence of adverse neonatal outcomes. Methods. A retrospective cohort was used to compare the neonatal morbidity of 150 preterm neonates with gestational age ≤29 weeks. Infants were divided into 3 groups based on the initiation timing of caffeine therapy; (1) early caffeine (1-2 DOL), (2) late caffeine (3–7 DOL), and (3) very late caffeine (≥8 DOL). Results. The neonatal outcomes of early caffeine were comparable with those of the late caffeine group. Moreover, when comparing the neonatal morbidity of the very late caffeine group with that of the early caffeine group, multivariable logistic regression analyses were performed. We found that the timing of caffeine did not influence the risk of BPD (OR, 0.393; CI, 0.126–1.223; p = 0.107), but birthweight did (OR, 0.996; CI, 0.993–0.999; p = 0.018) in these infants. Conclusion. Neonatal outcomes of preterm infants were comparable whether caffeine was administered early or late in the first 7 DOL. The risk of BPD in infants receiving caffeine after 8 DOL was irrespective of delayed treatment with caffeine. Our results clearly demonstrate the need for further studies before caffeine prophylaxis can be universally recommended. PMID:27242907

  19. Endoscopic dacryocystorhinostomy with and without silicone intubation: 4 years retrospective study.

    PubMed

    Longari, F; Dehgani Mobaraki, P; Ricci, A L; Lapenna, R; Cagini, C; Ricci, G

    2016-08-01

    The objective of this study is to assess different outcomes between endoscopic dacryocystorhinostomy (En-DCR) with and without silicone intubation. We retrospectively analyzed 84 patients (89 procedures), suffering from chronic epiphora for primary acquired nasolacrimal duct obstruction, treated with En-DCR and divided into two groups depending on silicone stent intubation. The surgical outcomes were evaluated at 7 post-operative controls using Munk's score criteria. Functional success was defined as absence of epiphora, no further episodes of dacryocystitis, and a patent ostium after fluorescein irrigation. 45 En-DCR with stent and 44 En-DCR without stent were performed. Success rate after 18 months follow-up were, respectively, 82.2 % in the stent group and 88.6 % in the non-stent group (OR 0.59) with no statistical differences. The ostial size reduction has been reported in higher percentage in the stent group, mainly due to peristomal granuloma (OR 3.64), scar tissue formation (OR 2.25), and turbinoseptal synaechia (OR 1.76). The benefits of non-intubation are less patient discomfort, reduced surgical time and costs, simpler follow-up regimen and less intubation-associated complications. En-DCR without silicone stent intubation should be the first choice of procedure, stent intubation should be reserved in selected cases with poor local conditions pre and intra-operatively assessed. PMID:26732693

  20. Income Related Inequality of Health Care Access in Japan: A Retrospective Cohort Study

    PubMed Central

    Fujita, Misuzu; Hata, Akira

    2016-01-01

    The purpose of this retrospective cohort study was to analyze the association between income level and health care access in Japan. Data from a total of 222,259 subjects (age range, 0–74 years) who submitted National Health Insurance claims in Chiba City from April 2012 to March 2014 and who declared income for the tax period from January 1 to December 31, 2012 were integrated and analyzed. The generalized estimating equation, in which household was defined as a cluster, was used to evaluate the association between equivalent income and utilization and duration of hospitalization and outpatient care services. A significant positive linear association was observed between income level and outpatient visit rates among all age groups of both sexes; however, a significantly higher rate and longer period of hospitalization, and longer outpatient care, were observed among certain lower income subgroups. To control for decreased income due to hospitalization, subjects hospitalized during the previous year were excluded, and the data was then reanalyzed. Significant inverse associations remained in the hospitalization rate among 40–59-year-old men and 60–69-year-old women, and in duration of hospitalization among 40–59 and 60–69-year-olds of both sexes and 70–74-year-old women. These results suggest that low-income individuals in Japan have poorer access to outpatient care and more serious health conditions than their higher income counterparts. PMID:26978270

  1. The role of endoscopic ultrasound on the preoperative T staging of gastric cancer: A retrospective study.

    PubMed

    Han, Chaoqun; Lin, Rong; Shi, Huiying; Liu, Jun; Qian, Wei; Ding, Zhen; Hou, Xiaohua

    2016-09-01

    Endoscopic ultrasonography (EUS) is used for preoperative assessment of gastric cancer. However, recent studies suggested that EUS staging accuracy is lower than previously thought. We aimed to assess EUS efficacy and image characteristics in preoperative gastric cancer T staging.A retrospective review of clinical and imaging features of 232 gastric carcinoma patients who underwent preoperative EUS assessment of T stage was performed. Only cases with tumor-free resection margin status and no metastases were enrolled. Comparisons of preoperative EUS and postoperative histopathological stagings were also performed to identify vital EUS image features for evaluating gastric carcinoma.EUS accuracy for T staging was 64.2% (149/232) with the highest accuracy for T3 (75.0%). Enlarged lymph nodes, well differentiated histological type and Borrmann IV type were associated with diagnostic accuracy in predicting tumor invasion. Although no factors were associated with overstaging, circumferential lesions ≥1/2, signet ring cell adenocarcinoma, and Borrmann IV type had significantly higher risks of understaging. Gastric wall outer edge irregularity was also an indicator of serosal involvement with a sensitivity of 82.0%. The pancreas and colon were more frequent disease extension sites than previously predicted.Although EUS is likely the best and most accurate option that we have used to stage gastric cancer, the finding that factors including circumferential lesions, signet ring cell adenocarcinoma, and Borrmann IV type carcinoma were more frequently related to incorrect staging warrants attention. PMID:27603347

  2. Differential Diagnosis and Treatment of Isolated Pathologies of the Sphenoid Sinus: Retrospective Study of 46 Cases

    PubMed Central

    Marcolini, Thomas Ribeiro; Safraider, Maryane Cristine; Socher, Jan Alessandro; Lucena, Guilherme Olinto

    2015-01-01

    Introduction Isolated disease of the sphenoid is rare and has often been overlooked due to its remote location and difficult access. Objective A retrospective study of the main causes of isolated sphenoid sinus diseases with discussion of the most appropriate methods of diagnosis and treatment. Methods A total of 46 cases of isolated sphenoid disease treated between January 2008 and December 2013 were evaluated by objective ear, nose, and throat examination and video endoscopy, computed tomography of the paranasal sinuses, and, in some cases, magnetic resonance imaging. In each case, we decided between drug and/or endoscopic treatment. Results We identified 12 cases of isolated sphenoiditis (26.1%), 3 cases of fungal sphenoiditis (6.5%), 3 cases of sphenochoanal polyps (6.5%), 22 cases of mucocele (47.8%), 2 cases of cerebrospinal fluid leak (4.3%), and 1 case each of meningoencephalocele (2.1%), inverted papilloma (2.1%), fibrous dysplasia (2.1%), and squamous cell carcinoma (2.1%). Conclusion A prevalence of inflammatory and infectious diseases was found, and endoscopic surgery for the sphenoid sinus approach is effective in treating various diseases of the isolated sphenoid, whether complicated or not. PMID:25992167

  3. E-Bike Injuries: Experience from an Urban Emergency Department—A Retrospective Study from Switzerland

    PubMed Central

    Papoutsi, Sylvana; Martinolli, Luca; Braun, Christian Tasso; Exadaktylos, Aristomenis K.

    2014-01-01

    Background. Between 2005 and 2012, annual sales of E-bikes in Switzerland increased from 1,792 to 52,941. This continuous and rapid transition from human-powered bicycles to an electric bicycle technology may indicate the increasing demand for low-cost transportation technology in combination with a healthy lifestyle. Material and Methods. In the present study, from April 2012 to September 2013, we retrospectively analysed E-bike accidents treated in the Emergency Department of our hospital by focusing on the following parameters: age, gender, time, period, and cause of the accident, as well as injury and outcome. Results. Patients were predominantly male. The mean age of injured E-cyclists was 47.5 years. The main causes of injury were self-accident. Most injuries were to the head/neck. The mean ISS was 8.48. The outcome showed that 9 patients were treated as outpatients, 9 were inpatients, and 5 patients were kept in the Intensive Care Unit (ICU). Only six patients underwent surgery (S). Discussion. This is the first attempt to evaluate E-bike injuries in Switzerland in an acute hospital setting. Since there is increasing popular preference for E-bikes as means of transportation and injuries to the head or neck are prevalent among E-cyclists, the hazard should not to be underestimated. PMID:24778880

  4. Bathtub drowning: An 11-year retrospective study in the state of Maryland.

    PubMed

    Okuda, Takahisa; Wang, Zhuo; Lapan, Sheldon; Fowler, David R

    2015-08-01

    A bathtub drowning is one of the leading causes of death in a bathtub. The purpose of this study was to evaluate how reliable the drowning-related signs could be for identifying a bathtub drowning in the cases of death in the bathtub. Performing a retrospective review of 92 deaths in the bathtub in Maryland, 71.7 percent were the presence of bathtub drowning and 28.3 percent were the absence of bathtub drowning. Three leading contributory causes of death were cardiovascular disease, drug/alcohol-related death, and seizure disorder in both groups. There was a statistically significant difference between the groups in relation to a history of recovery from the water (95.5% and 38.4%, p<0.001), foam in the air way (33.3% and 15.4%, p<0.05), watery fluid in the sphenoid sinuses (81.8% and 11.5%, p<0.05), hyperinflated lungs (36.4% and 3.8%, p<0.01), and watery fluid in the stomach contents (40.9% and 3.8%, p<0.01). More than triple overlapped drowning-related signs could be beneficial for the diagnosis of a bathtub drowning. A comprehensive investigation incorporating a thorough scene investigation, gathering of the victim's medical and psychosocial history, and a meticulous full autopsy is necessary to elucidate both the cause and manner of death in these cases of death in the bathtub. PMID:26046678

  5. Early fetal reduction of dichorionic triplets to dichorionic twin or singleton pregnancies: a retrospective study.

    PubMed

    Lin, Haiyan; Wen, Ya; Li, Yu; Chen, Xiaoli; Yang, Dongzi; Zhang, Qingxue

    2016-05-01

    A retrospective study conducted in an academic reproductive medicine centre evaluated the feasibility and safety of early fetal reduction in dichorionic triplets to dichorionic twin or singleton pregnancies. Thirty-three dichorionic triplets that underwent early transvaginal fetal reduction mechanically between 2002 and 2013 were included, of which 21 patients underwent fetal reduction to dichorionic twins (Group A) and 12 patients underwent fetal reduction to a singleton pregnancy (Group B). A further 84 patients with trichorionic triplets reduced to twins were included as the control group (Group C). The main outcome measures were live birth and preterm labour rates. Both early and late spontaneous abortion rates, were similar in group A compared with groups B and C. Gestational age at delivery was significantly lower in group C versus group A (P = 0.02). The preterm labour rate in group A, which was comparable with that in group C, was greater than in group B, but not significantly. Neonatal birth weight, low birth weight rate and neonatal body height were similar among groups. Small for gestational age rates were comparable. Live birth rates were similar among the groups. Early transvaginal fetal reduction for dichorionic triplets to dichorionic twins may be feasible and safe. PMID:26997475

  6. 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

  7. E-bike injuries: experience from an urban emergency department-a retrospective study from Switzerland.

    PubMed

    Papoutsi, Sylvana; Martinolli, Luca; Braun, Christian Tasso; Exadaktylos, Aristomenis K

    2014-01-01

    Background. Between 2005 and 2012, annual sales of E-bikes in Switzerland increased from 1,792 to 52,941. This continuous and rapid transition from human-powered bicycles to an electric bicycle technology may indicate the increasing demand for low-cost transportation technology in combination with a healthy lifestyle. Material and Methods. In the present study, from April 2012 to September 2013, we retrospectively analysed E-bike accidents treated in the Emergency Department of our hospital by focusing on the following parameters: age, gender, time, period, and cause of the accident, as well as injury and outcome. Results. Patients were predominantly male. The mean age of injured E-cyclists was 47.5 years. The main causes of injury were self-accident. Most injuries were to the head/neck. The mean ISS was 8.48. The outcome showed that 9 patients were treated as outpatients, 9 were inpatients, and 5 patients were kept in the Intensive Care Unit (ICU). Only six patients underwent surgery (S). Discussion. This is the first attempt to evaluate E-bike injuries in Switzerland in an acute hospital setting. Since there is increasing popular preference for E-bikes as means of transportation and injuries to the head or neck are prevalent among E-cyclists, the hazard should not to be underestimated. PMID:24778880

  8. Carotid endarterectomy under regional analgesia:a retrospective study (1988-1999).

    PubMed

    Singh, S M; Rajmohan, T; Juneja, R; Mehta, Y; Trehan, N

    2001-01-01

    The procedure of carotid endarterectomy is more or less standardized. Controversies persist on many technical issues, one of which is general versus regional anaesthesia. We retrospectively evaluated the influence of regional analgesia on perioperative complications, the hospital stay and the perioperative mortality after carotid endarterectomy in 53 patients. All the patients in the study received deep cervical block regional anaesthesia (Winne's technique) for carotid endarterectomy. Indications for surgery included transient ischaemic haemodynamically significant stenosis. Shunt was used in 7 cases (13.2%). General anaesthesia was supplemented in 2 patients (3.8%). There was no perioperative mortality. Permanent non-fatal neurologic deficit occurred in 1 patient (1.9%) and temporary neurologic Deficit occurred in 1 patient (1.9%). The mean ICU stay was 1.85 (+/-0.82) days and the hospital stay was 5.2 (+/-1.14) days. On the basis of our data we believe that under regional anaesthesia carotid endarterectomy can be performed with acceptable complications and that regional anaesthetic technique is safe and well tolerated by the patients. PMID:17851155

  9. A retrospective cohort study of military deployment and postdeployment medical encounters for respiratory conditions.

    PubMed

    Abraham, Joseph H; Eick-Cost, Angie; Clark, Leslie L; Hu, Zheng; Baird, Coleen P; DeFraites, Robert; Tobler, Steven K; Richards, Erin E; Sharkey, Jessica M; Lipnick, Robert J; Ludwig, Sharon L

    2014-05-01

    Deployed military personnel are exposed to inhalational hazards that may increase their risk of chronic lung conditions. This evaluation assessed associations between Operation Iraqi Freedom (OIF) deployment and postdeployment medical encounters for respiratory symptoms and medical conditions. This retrospective cohort study was conducted among military personnel who, between January 2005 and June 2007, were deployed to either of two locations with burn pits in Iraq, or to either of two locations without burn pits in Kuwait. Incidence rate ratios (IRRs) were estimated using two nondeployed reference groups. Rates among personnel deployed to burn pit locations were also compared directly to those among personnel deployed to locations without burn pits. Significantly elevated rates of encounters for respiratory symptoms (IRR = 1.25; 95% confidence interval [CI]: 1.20-1.30) and asthma (IRR = 1.54; 95% CI: 1.33-1.78) were observed among the formerly deployed personnel relative to U.S.-stationed personnel. Personnel deployed to burn pit locations did not have significantly elevated rates for any of the outcomes relative to personnel deployed to locations without burn pits. These results are consistent with the hypothesis that OIF deployment is associated with subsequent risk of respiratory conditions. Elevated medical encounter rates were not uniquely associated with burn pits. PMID:24806499

  10. Female Pattern Hair Loss: A Retrospective Study in a Tertiary Referral Center

    PubMed Central

    Siah, Tee Wei; Muir-Green, Llorenia; Shapiro, Jerry

    2016-01-01

    Background: Female pattern hair loss (FPHL) is a very common problem in women. The underlying pathophysiology remains unclear, and there are no universally agreed treatment guidelines. Objective: We explored the clinical features, relevant medical and family history, laboratory evaluation, and treatment and compliance of 210 patients with FPHL. Methods: Data analysis from case notes was performed on 210 patients with a diagnosis of FPHL seen from January 2011 to December 2011. Results: The youngest individual was 8 years old and the oldest was 86 years old. Nearly, 85% of the patients had a family history of androgenetic alopecia. Hypothyroidism and hypertension are the most common medical problems. Telogen effluvium (TE) is the most common concurrent hair loss condition. Only 38% of the patients were found to have normal Vitamin D level, 71% had ferritin level above 30 μg/L, and 85% had normal zinc level at the first consultation. Fifty-nine percent of the patients failed to attend any follow-up appointments. Limitations: One of the limitations of this study is its retrospective nature. Moreover, the severity of FPHL in terms of Ludwig score was not routinely documented in the medical charts. Conclusion: History of TE, hypothyroidism and hypertension, and low serum Vitamin D is common in our patients with FPHL. PMID:27601857

  11. Third-Line Chemotherapy for Metastatic Urothelial Cancer: A Retrospective Observational Study.

    PubMed

    Di Lorenzo, Giuseppe; Buonerba, Carlo; Bellelli, Teresa; Romano, Concetta; Montanaro, Vittorino; Ferro, Matteo; Benincasa, Alfonso; Ribera, Dario; Lucarelli, Giuseppe; De Cobelli, Ottavio; Sonpavde, Guru; De Placido, Sabino

    2015-12-01

    The prognosis of locally advanced (T3/T4 or N1) and metastatic disease urothelial carcinoma is poor. In this retrospective study, we reviewed data about patients receiving third-line chemotherapy for metastatic disease, in view of the lack of data in this setting.We retrospectively analyzed medical records of patients with a pathologic diagnosis of urothelial carcinoma treated with systemic chemotherapy for metastatic disease at 4 participating Institutions between January, 2010, and January, 2015. Cox proportional hazards regression was used to evaluate the association of the chemotherapy agent used versus others with overall survival, adjusted for 5 externally validated prognostic factors in advanced urothelial carcinoma.Of 182 patients that received first-line chemotherapy/adjuvant chemotherapy as defined above, 116 patients (63.73%) received second-line salvage treatment. Fifty-two patients were finally included in this analysis, whereas 9 were excluded due to missing data. Third-line chemotherapy was based on cyclophosphamide, platinum, vinflunine, taxanes, and gemcitabine in 16, 12, 11, 10, and 3 patients, respectively. Median PFS (progression-free survival) and OS (overall survival) of the population were 13 (10-17) and 31 (28-36) weeks. Single-agent cyclophosphamide was associated with a PFS of 18 (13-22) and an OS of 38 (33-41) weeks, whereas platinum-based combinations were associated with a PFS of 5 weeks and an OS of 8 weeks. Multivariate analysis showed improved survival in patients treated with cyclophosphamide (hazard ratio (HR) = 0.42; 95% CI: 0.20-0.89; P = 0.025) and a worse survival in those treated with platinum-based regimens (HR: 4.37; 95% CI = 1.95-9.77; P < 0.01).We observed a significantly longer overall survival in patients receiving single-agent cyclophosphamide, with few grade 3 to 4 toxicities. Further studies should assess the efficacy of metronomic single-agent cyclophosphamide in advanced lines of treatment, as it may

  12. Third-Line Chemotherapy for Metastatic Urothelial Cancer: A Retrospective Observational Study

    PubMed Central

    Di Lorenzo, Giuseppe; Buonerba, Carlo; Bellelli, Teresa; Romano, Concetta; Montanaro, Vittorino; Ferro, Matteo; Benincasa, Alfonso; Ribera, Dario; Lucarelli, Giuseppe; De Cobelli, Ottavio; Sonpavde, Guru; De Placido, Sabino

    2015-01-01

    Abstract The prognosis of locally advanced (T3/T4 or N1) and metastatic disease urothelial carcinoma is poor. In this retrospective study, we reviewed data about patients receiving third-line chemotherapy for metastatic disease, in view of the lack of data in this setting. We retrospectively analyzed medical records of patients with a pathologic diagnosis of urothelial carcinoma treated with systemic chemotherapy for metastatic disease at 4 participating Institutions between January, 2010, and January, 2015. Cox proportional hazards regression was used to evaluate the association of the chemotherapy agent used versus others with overall survival, adjusted for 5 externally validated prognostic factors in advanced urothelial carcinoma. Of 182 patients that received first-line chemotherapy/adjuvant chemotherapy as defined above, 116 patients (63.73%) received second-line salvage treatment. Fifty-two patients were finally included in this analysis, whereas 9 were excluded due to missing data. Third-line chemotherapy was based on cyclophosphamide, platinum, vinflunine, taxanes, and gemcitabine in 16, 12, 11, 10, and 3 patients, respectively. Median PFS (progression-free survival) and OS (overall survival) of the population were 13 (10–17) and 31 (28–36) weeks. Single-agent cyclophosphamide was associated with a PFS of 18 (13–22) and an OS of 38 (33–41) weeks, whereas platinum-based combinations were associated with a PFS of 5 weeks and an OS of 8 weeks. Multivariate analysis showed improved survival in patients treated with cyclophosphamide (hazard ratio (HR) = 0.42; 95% CI: 0.20–0.89; P = 0.025) and a worse survival in those treated with platinum-based regimens (HR: 4.37; 95% CI = 1.95–9.77; P < 0.01). We observed a significantly longer overall survival in patients receiving single-agent cyclophosphamide, with few grade 3 to 4 toxicities. Further studies should assess the efficacy of metronomic single-agent cyclophosphamide in advanced lines

  13. Paradoxical immune reconstitution inflammatory syndrome associated with cryptococcal meningitis in China: a 5-year retrospective cohort study.

    PubMed

    Yan, S; Chen, L; Wu, W; Li, Z; Fu, Z; Zhang, H; Xue, J; Hu, Y; Mou, J; Fu, C

    2015-04-01

    We performed a retrospective cohort study of hospitalised cryptococcal meningitis (CM) patients at a single centre to evaluate the clinical epidemiological features of paradoxical cryptococcal-related immune reconstitution inflammatory syndrome (CM-IRIS) in a setting in China. A total of 154 AIDS patients with CM were involved, and 17.5% experienced IRIS at a median of 27 days after initiation of antiretroviral therapy (ART). Overall, 3 deaths were directly attributed to IRIS. The occurrences of CM-IRIS were independently associated with the pre-ART CD4+count, pre-C-reactive protein level, and the timing of ART initiation. PMID:25658526

  14. Treatment of rabbit cheyletiellosis with selamectin or ivermectin: a retrospective case study

    PubMed Central

    Mellgren, Marianne; Bergvall, Kerstin

    2008-01-01

    Background A retrospective study of rabbits treated against cheyletiellosis was performed to evaluate the efficacy and safety of selamectin or ivermectin in clinical practice. Methods Medical records from 53 rabbits with microscopically confirmed Cheyletiella infestation were collected from two small animal clinics. The rabbits were divided into three groups, based on treatment protocols. Group 1 included 11 rabbits treated with ivermectin injections at 200–476 μg kg-1 subcutaneously 2–3 times, with a mean interval of 11 days. In Group 2, 27 rabbits were treated with a combination of subcutaneous ivermectin injections (range 618–2185 μgkg-1) and oral ivermectin (range 616–2732 μgkg-1) administered by the owners, 3–6 times at 10 days interval. The last group (Group 3) included 15 rabbits treated with selamectin spot-on applications of 6.2–20,0 mgkg-1, 1–3 times with an interval of 2–4 weeks. Follow-up time was 4 months–4.5 years. Results Rabbits in remission were 9/11 (81,8%), 14/27 (51,9%) and 12/15 (80,8%) in groups 1, 2 and 3, respectively. Conclusion All treatment protocols seemed to be sufficiently effective and safe for practice use. Though very high doses were used in Group 2 (ivermectin injections followed by oral administration), the protocol seemed less efficacious compared to ivermectin injections (Group 1) and selamectin spot on (Group 3), respectively, although not statistically significant. Controlled prospective studies including larger groups are needed to further evaluate efficacy of the treatment protocols. PMID:18171479

  15. There is no age limit for methadone: a retrospective cohort study

    PubMed Central

    2011-01-01

    Background Data from the US indicates that methadone-maintained populations are aging, with an increase of patients aged 50 or older. Data from European methadone populations is sparse. This retrospective cohort study sought to evaluate the age trends and related developments in the methadone population of Basel-City, Switzerland. Methods The study included methadone patients between April 1, 1995 and March 31, 2003. Anonymized data was taken from the methadone register of Basel-City. For analysis of age distributions, patient samples were split into four age categories from '20-29 years' to '50 years and over'. Cross-sectional comparisons were performed using patient samples of 1996 and 2003. Results Analysis showed a significant increase in older patients between 1996 and 2003 (p < 0.001). During that period, the percentage of patients aged 50 and over rose almost tenfold, while the proportion of patients aged under 30 dropped significantly from 52.8% to 12.3%. The average methadone dose (p < 0.001) and the 1-year retention rate (p < 0.001) also increased significantly. Conclusions Findings point to clear trends in aging of methadone patients in Basel-City which are comparable, although less pronounced, to developments among US methadone populations. Many unanswered questions on medical, psychosocial and health economic consequences remain as the needs of older patients have not yet been evaluated extensively. However, older methadone patients, just as any other patients, should be accorded treatment appropriate to their medical condition and needs. Particular attention should be paid to adequate solutions for persons in need of care. PMID:21592331

  16. Blunt Cardiac Injury in the Severely Injured – A Retrospective Multicentre Study

    PubMed Central

    Hanschen, Marc; Kanz, Karl-Georg; Kirchhoff, Chlodwig; Khalil, Philipe N.; Wierer, Matthias; van Griensven, Martijn; Laugwitz, Karl-Ludwig; Biberthaler, Peter; Lefering, Rolf; Huber-Wagner, Stefan

    2015-01-01

    Background Blunt cardiac injury is a rare trauma entity. Here, we sought to evaluate the relevance and prognostic significance of blunt cardiac injury in severely injured patients. Methods In a retrospective multicentre study, using data collected from 47,580 patients enrolled to TraumaRegister DGU (1993-2009), characteristics of trauma, prehospital / hospital trauma management, and outcome analysis were correlated to the severity of blunt cardiac injury. The severity of cardiac injury was assessed according to the abbreviated injury score (AIS score 1-6), the revised injury severity score (RISC) allowed comparison of expected outcome with injury severity-dependent outcome. N = 1.090 had blunt cardiac trauma (AIS 1-6) (2.3% of patients). Results Predictors of blunt cardiac injury could be identified. Sternal fractures indicate a high risk of the presence of blunt cardiac injury (AIS 0 [control]: 3.0%; AIS 1: 19.3%; AIS 2-6: 19.1%). The overall mortality rate was 13.9%, minor cardiac injury (AIS 1) and severe cardiac injury (AIS 2-6) are associated with higher rates. Severe blunt cardiac injury (AIS 4 and AIS 5-6) is associated with a higher mortality (OR 2.79 and 4.89, respectively) as compared to the predicted average mortality (OR 2.49) of the study collective. Conclusion Multiple injured patients with blunt cardiac trauma are at high risk to be underestimated. Careful evaluation of trauma patients is able to predict the presence of blunt cardiac injury. The severity of blunt cardiac injury needs to be stratified according to the AIS score, as the patients’ outcome is dependent on the severity of cardiac injury. PMID:26136126

  17. Retrospective study of recession of four horizontal rectus muscle in periodic alternating nystagmus

    PubMed Central

    Mimura, Osamu; Ishikawa, Hiroto; Kimura, Naoki; Kimura, Akiko; Borlongan, Cesar V

    2014-01-01

    Purpose Periodic alternating nystagmus (PAN) is a spontaneous horizontal nystagmus observed in disorders of the central nervous system. Patients with congenital PAN complain of oscillating vision at high rates. Medication is the first-choice treatment for PAN; however, clinicians still seek better therapy. The aim of this study was to evaluate outcomes of recession of four horizontal rectus muscle (R-FHR) in patients with congenital PAN. Patients and methods This study reports a retrospective case series of ten patients (seven males and three females; mean age 24.4±10.9) with congenital PAN who underwent R-FHR between 2007 and 2012, which was performed by the same surgeon at the Hyogo College of Medicine. Patients were evaluated for complications, recession amount, deviation angle, eye movements including a nystagmus amplitude, and visual acuity during pre- and post-operative periods. Results Pre-operatively, patients complained of oscillating vision, abnormal head posture, esotropia, and congenital superior oblique palsy. Post-operatively, changes from the previous observations of nystagmus amplitudes and abnormal head posture demonstrated a complete reversal in all patients. In addition, visual acuity determined with a Snellen chart improved in two patients. However, esotropia occurred in three patients who underwent additional strabismus surgery 2 days after R-FHR. R-FHR was particularly effective in eight patients who pre-operatively had periodic oscillating vision with a regular pattern of periodic nystagmus. Conclusion We demonstrated that ten patients with congenital PAN had improved vision following R-FHR, indicating that R-FHR was an effective procedure, especially in patients suffering PAN with periodic oscillating vision. PMID:25525330

  18. Management of neglected lateral condyle fractures of humerus in children: A retrospective study

    PubMed Central

    Agarwal, Anil; Qureshi, Nadeem Akhtar; Gupta, Neeraj; Verma, Indreshwar; Pandey, Devreshi Kumar

    2012-01-01

    Background: Late presentation of humeral lateral condylar fracture in children is a surgical dilemma. Osteosynthesis of the fracture fragment or correction of elbow deformity with osteotomies and ulnar nerve transposition or sometimes both procedures combined is a controversial topic. We retrospectively evaluated open reduction and fixation cases in late presentation of lateral humeral condyle fracture in pediatric cases with regards to union and functional results. Materials and Methods: Twenty two pediatric (≤12 years) patients with fractures of lateral condyle presenting 4 weeks or more post injury between the study period of 2006 and 2010 were included. Multiple K-wires / with or without screws along with bone grafting were used. At final evaluation, union (radiologically) and elbow function (Liverpool Elbow Score, LES) was assessed. Results: There were 19 boys and 3 girls. Followup averaged 33 months. Pain (n=9), swelling (n=6), restriction of elbow motion (n=6), prominence of lateral condylar region (n=4), valgus deformity (n=4) were the main presenting symptoms. Ulnar nerve function was normal in all patients. There were nine Milch type I and 13 type II fractures. Union occurred in 20 cases. One case had malunion and in another case there was resorption of condyle following postoperative infection and avascular necrosis. Prominent lateral condyles (4/12), fish tail appearance (n=7), premature epiphyseal closure (n=2) were other observations. LES averaged 8.12 (range, 6.66-9.54) at final followup. Conclusions: There is high rate of union and satisfactory elbow function in late presenting lateral condyle fractures in children following osteosynthesis attempt. Our study showed poor correlation between patient's age, duration of late presentation or Milch type I or II and final elbow function as determined by LES. PMID:23325975

  19. Feline mediastinal lymphoma: a retrospective study of signalment, retroviral status, response to chemotherapy and prognostic indicators.

    PubMed

    Fabrizio, Francesca; Calam, Amy E; Dobson, Jane M; Middleton, Stephanie A; Murphy, Sue; Taylor, Samantha S; Schwartz, Anita; Stell, Anneliese J

    2014-08-01

    Historically, feline mediastinal lymphoma has been associated with young age, positive feline leukaemia virus (FeLV) status, Siamese breed and short survival times. Recent studies following widespread FeLV vaccination in the UK are lacking. The aim of this retrospective multi-institutional study was to re-evaluate the signalment, retroviral status, response to chemotherapy, survival and prognostic indicators in feline mediastinal lymphoma cases in the post-vaccination era. Records of cats with clinical signs associated with a mediastinal mass and cytologically/histologically confirmed lymphoma were reviewed from five UK referral centres (1998-2010). Treatment response, survival and prognostic indicators were assessed in treated cats with follow-up data. Fifty-five cases were reviewed. The median age was 3 years (range, 0.5-12 years); 12 cats (21.8%) were Siamese; and the male to female ratio was 3.2:1.0. Five cats were FeLV-positive and two were feline immunodeficiency-positive. Chemotherapy response and survival was evaluated in 38 cats. Overall response was 94.7%; complete (CR) and partial response (PR) rates did not differ significantly between protocols: COP (cyclophosphamide, vincristine, prednisone) (n = 26, CR 61.5%, PR 34.0%); Madison-Wisconsin (MW) (n = 12, CR 66.7%, PR 25.0%). Overall median survival was 373 days (range, 20-2015 days) (COP 484 days [range, 20-980 days]; MW 211 days [range, 24-2015 days] [P = 0.892]). Cats achieving CR survived longer (980 days vs 42 days for PR; P = 0.032). Age, breed, sex, location (mediastinal vs mediastinal plus other sites), retroviral status and glucocorticoid pretreatment did not affect response or survival. Feline mediastinal lymphoma cases frequently responded to chemotherapy with durable survival times, particularly in cats achieving CR. The prevalence of FeLV-antigenaemic cats was low; males and young Siamese cats appeared to be over-represented. PMID:24366846

  20. Retrospective evaluation of exposure index (EI) values from plain radiographs reveals important considerations for quality improvement

    SciTech Connect

    Mothiram, Ursula; Brennan, Patrick C; Robinson, John; Lewis, Sarah J; Moran, Bernadette

    2013-12-15

    Following X-ray exposure, radiographers receive immediate feedback on detector exposure in the form of the exposure index (EI). To identify whether radiographers are meeting manufacturer-recommended EI (MREI) ranges for routine chest, abdomen and pelvis X-ray examinations under a variety of conditions and to examine factors affecting the EI. Data on 5000 adult X-ray examinations including the following variables were collected: examination parameters, EI values, patient gender, date of birth, date and time of examination, grid usage and the presence of implant or prosthesis. Descriptive statistics were used to summarize each data set and the Mann–Whitney U test was used to determine significant differences, with P < 0.05 indicating significance for all tests. Most examinations demonstrated EI values that were outside the MREI ranges, with significantly higher median EI values recorded for female patient radiographs than those for male patients for all manufacturers, indicating higher detector exposures for all units except for Philips digital radiography (DR), where increased EI values indicate lower exposure (P = 0.01). Median EI values for out of hours radiography were also significantly higher compared with normal working hours for all technologies (P ≤ 0.02). Significantly higher median EI values were demonstrated for Philips DR chest X-rays without as compared to those with the employment of a grid (P = 0.03), while significantly lower median EI values were recorded for Carestream Health computed radiography (CR) chest X-rays when an implant or prosthesis was present (P = 0.02). Non-adherence to MREIs has been demonstrated with EI value discrepancies being dependent on patient gender, time/day of exposure, grid usage and the presence of an implant or prosthesis. Retrospective evaluation of EI databases is a valuable tool to assess the need of quality improvement in routine DR.

  1. Retrospective evaluation of exposure index (EI) values from plain radiographs reveals important considerations for quality improvement

    PubMed Central

    Mothiram, Ursula; Brennan, Patrick C; Robinson, John; Lewis, Sarah J; Moran, Bernadette

    2013-01-01

    Introduction Following X-ray exposure, radiographers receive immediate feedback on detector exposure in the form of the exposure index (EI). Purpose To identify whether radiographers are meeting manufacturer-recommended EI (MREI) ranges for routine chest, abdomen and pelvis X-ray examinations under a variety of conditions and to examine factors affecting the EI. Methods Data on 5000 adult X-ray examinations including the following variables were collected: examination parameters, EI values, patient gender, date of birth, date and time of examination, grid usage and the presence of implant or prosthesis. Descriptive statistics were used to summarize each data set and the Mann–Whitney U test was used to determine significant differences, with P < 0.05 indicating significance for all tests. Results Most examinations demonstrated EI values that were outside the MREI ranges, with significantly higher median EI values recorded for female patient radiographs than those for male patients for all manufacturers, indicating higher detector exposures for all units except for Philips digital radiography (DR), where increased EI values indicate lower exposure (P = 0.01). Median EI values for out of hours radiography were also significantly higher compared with normal working hours for all technologies (P ≤ 0.02). Significantly higher median EI values were demonstrated for Philips DR chest X-rays without as compared to those with the employment of a grid (P = 0.03), while significantly lower median EI values were recorded for Carestream Health computed radiography (CR) chest X-rays when an implant or prosthesis was present (P = 0.02). Conclusions Non-adherence to MREIs has been demonstrated with EI value discrepancies being dependent on patient gender, time/day of exposure, grid usage and the presence of an implant or prosthesis. Retrospective evaluation of EI databases is a valuable tool to assess the need of quality improvement in routine DR. PMID:26229619

  2. Risk of Nephrotic Syndrome following Enteroviral Infection in Children: A Nationwide Retrospective Cohort Study

    PubMed Central

    Lin, Jiun-Nong; Lin, Cheng-Li; Yang, Chi-Hui; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Kao, Chia-Hung

    2016-01-01

    Purpose Nephrotic syndrome is a common chronic illness encountered during childhood. Infections have been identified as a cause of nephrotic syndrome. The aim of this study was to evaluate the association between enteroviral infection and nephrotic syndrome. Methods A nationwide retrospective cohort study was conducted by analyzing data from the National Health Insurance Research Database in Taiwan. Children aged <18 years with enteroviral infection were enrolled. Non-enterovirus-infected children were randomly selected as the comparison cohort. The primary endpoint was the occurrence of nephrotic syndrome. Methods This study included 280,087 enterovirus-infected children and 280,085 non-enterovirus-infected children. The mean age of the enterovirus-infected children was 2.38 years, and 53.7% of these children were boys. The overall incidence densities of nephrotic syndrome for enterovirus- and non-enterovirus-infected children were 2.65 and 2.21 per 10,000 person-years, respectively. The enterovirus-infected cohort had a higher cumulative incidence of nephrotic syndrome than did the non-enterovirus-infected cohort (log-rank test, p = 0.01). Multivariable analyses revealed that children with enteroviral infection were significantly associated with an increased risk of nephrotic syndrome compared with those without enteroviral infection (adjusted hazard ratio, 1.20; 95% confidence interval, 1.04–1.39; p = 0.01), particularly in children infected with coxsackievirus. Subgroup analyses revealed that enterovirus-infected girls, children of blue-collar workers, and children without allergies had a higher risk of nephrotic syndrome than did children in the non-enterovirus-infected cohort. Conclusion This study revealed a significant association between enteroviral infection and nephrotic syndrome. Additional studies elucidating the role and pathogenesis of enterovirus in nephrotic syndrome are warranted. PMID:27508414

  3. Frontolateral Approach Applied to Sellar Region Lesions: A Retrospective Study in 79 Patients

    PubMed Central

    Liu, Hao-Cheng; Wu, Zhen; Wang, Liang; Xiao, Xin-Ru; Li, Da; Jia, Wang; Zhang, Li-Wei; Zhang, Jun-Ting

    2016-01-01

    Background: Various surgical approaches for the removal of sellar region lesions have previously been described. This study aimed to evaluate the reliability and safety of the frontolateral approach (FLA) to remove sellar region lesions. Methods: We presented a retrospective study of 79 patients with sellar region lesions who were admitted and operated by the FLA approach from August 2011 to August 2015 in Department of Neurosurgery of Beijing Tian Tan Hospital. We classified FLA into three types, compared the FLA types to the areas of lesion invasion, and analyzed operation bleeding volume, gross total resection (GTR) rate, visual outcome, and mortality. Results: Seventy-nine patients were followed up from 2.9 to 50.3 months with a mean follow-up of 20.5 months. There were 42 cases of meningiomas, 25 cases of craniopharyngiomas, and 12 cases of pituitary adenomas. The mean follow-up Karnofsky Performance Scale was 90.4. GTR was achieved in 75 patients (94.9%). Two patients (2.5%) had tumor recurrence. No patients died perioperatively or during short-term follow-up. Three patients (3.8%) with craniopharyngioma died 10, 12, and 23 months, respectively, after surgery. The operative bleeding volume of this study was no more than that of the other approaches in the sellar region (P = 0.783). In this study, 35 patients (44.3%) had visual improvement after surgery, 38 patients (48.1%) remained unchanged, and three patients’ visual outcome (3.8%) worsened. Conclusions: FLA was an effective approach in the treatment of sellar region lesions with good preservation of visual function. FLA classification enabled tailored craniotomies for each patient according to the anatomic site of tumor invasion. This study found that FLA had similar outcomes to other surgical approaches of sellar region lesions. PMID:27364792

  4. 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

  5. Preschool children's vision screening in New Zealand: a retrospective evaluation of referral accuracy

    PubMed Central

    Langeslag-Smith, Miriam A; Vandal, Alain C; Briane, Vincent; Thompson, Benjamin; Anstice, Nicola S

    2015-01-01

    Objectives To assess the accuracy of preschool vision screening in a large, ethnically diverse, urban population in South Auckland, New Zealand. Design Retrospective longitudinal study. Methods B4 School Check vision screening records (n=5572) were compared with hospital eye department data for children referred from screening due to impaired acuity in one or both eyes who attended a referral appointment (n=556). False positive screens were identified by comparing screening data from the eyes that failed screening with hospital data. Estimation of false negative screening rates relied on data from eyes that passed screening. Data were analysed using logistic regression modelling accounting for the high correlation between results for the two eyes of each child. Primary outcome measure Positive predictive value of the preschool vision screening programme. Results Screening produced high numbers of false positive referrals, resulting in poor positive predictive value (PPV=31%, 95% CI 26% to 38%). High estimated negative predictive value (NPV=92%, 95% CI 88% to 95%) suggested most children with a vision disorder were identified at screening. Relaxing the referral criteria for acuity from worse than 6/9 to worse than 6/12 improved PPV without adversely affecting NPV. Conclusions The B4 School Check generated numerous false positive referrals and consequently had a low PPV. There is scope for reducing costs by altering the visual acuity criterion for referral. PMID:26614622

  6. Off-label use of TNF-alpha inhibitors in a dermatological university department: retrospective evaluation of 118 patients.

    PubMed

    Sand, Freja Lærke; Thomsen, Simon Francis

    2015-01-01

    Tumor necrosis factor-alpha (TNF)-alpha inhibitors are licensed for patients with severe refractory psoriasis and psoriatic arthritis. However, TNF-alpha inhibitors have also been used off-label for various recalcitrant mucocutaneous diseases. This study aimed to evaluate the efficacy and safety of TNF-alpha inhibitors used for off-label dermatological indications. We retrospectively evaluated patient records of 118 patients treated off-label with TNF-alpha inhibitors in a dermatological university department. Patients presented with severe aphthous stomatitis/genital aphthous lesions (26), chronic urticaria (25), hidradenitis suppurativa (29), acne conglobata (11), dissecting cellulitis of the scalp (two), orofacial granulomatosis (four), sarcoidosis (four), granuloma annulare (two), granulomatous rosacea (one), granuloma faciale (one), subcorneal pustulosis (one), pyoderma gangrenosum (four), Sweet's syndrome (four), Well's syndrome (one), benign familial pemphigus (one), lichen planus (one), and folliculitis decalvans (one). A significant number of these patients went into remission during therapy with TNF-alpha inhibitors. A total of 11 patients (9%) experienced severe adverse effects during therapy. Off-label therapy with TNF-alpha inhibitors may be considered for selected patients with severe recalcitrant mucocutaneous diseases. The risk of severe adverse effects signals that a thorough benefit-risk assessment should be performed before initiating off-label treatment with TNF-alpha inhibitors for these conditions. PMID:25731720

  7. Healthcare resource implications of hypoglycemia-related hospital admissions and inpatient hypoglycemia: retrospective record-linked cohort studies in England

    PubMed Central

    McEwan, Philip; Larsen Thorsted, Brian; Wolden, Michael; Jacobsen, Judith; Evans, Marc

    2015-01-01

    Objective Using a retrospective cohort study, the mean length of hospital stay (LoS) and total per-patient expenditure for hypoglycemia requiring admission to hospital were estimated. In a separate matched retrospective cohort study, the effect of inpatient hypoglycemia on LoS, expenditure, and risk of all-cause mortality while admitted was investigated. Methods The cohorts consisted of patients aged ≥18 years with a diagnosis of type 1 or 2 diabetes between January 1, 2002 and October 30, 2012 in the Clinical Practice Research Datalink database, who had initiated insulin treatment and had a recording of hypoglycemia in the same period. In the matched retrospective cohort study, exposed patients (who experienced hypoglycemia in hospital) were case-matched with patients who did not experience hypoglycemia during admission (unexposed). Generalized linear regression was used to estimate LoS. Risk of all-cause mortality was evaluated via logistic regression. Results In the retrospective cohort study (1131 patients), mean LoS was 5.46 (95% CI 4.62 to 6.45) days for type 1 diabetes, and 5.04 (95% CI 4.46 to 5.71) days for type 2 diabetes. Mean cost per admission was £1034 (95% CI £855 to £1253). In the matched retrospective cohort study (1079 pairs of patients), exposed patients had a mean LoS of 11.91 days (95% CI 10.96 to 12.94 days) versus 4.80 (95% CI 4.41 to 5.23) for unexposed patients, p<0.0001. Exposed patients had a higher mortality risk compared with unexposed patients (OR 1.439 (95% CI 1.060to 1.952), p=0.0195). Total average per-patient cost for exposed patients was GBP (£)2235, 40% (p<0.0001) higher than total average admission cost in unexposed patients. Conclusions Hypoglycemia has a significant negative impact on patient outcomes, healthcare resource use, and expenditure. PMID:25815204

  8. 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

  9. Fracture patterns in the maxillofacial region: a four-year retrospective study

    PubMed Central

    2015-01-01

    Objectives The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures. PMID:26734557

  10. Spa therapy for elderly: a retrospective study of 239 older patients with osteoarthritis

    NASA Astrophysics Data System (ADS)

    Karagülle, Mine; Kardeş, Sinan; Dişçi, Rian; Gürdal, Hatice; Karagülle, Müfit Zeki

    2016-01-01

    Very few studies tested the effectiveness of spa therapy in older patients with osteoarthritis. Therefore, we aimed to evaluate the short-term effects of spa therapy in patients aged 65 years and older with generalized, knee, hip, and cervical and lumbar spine osteoarthritis. In an observational retrospective study design at the Medical Ecology and Hydroclimatology Department of Istanbul Medical Faculty, we analyzed the records of 239 patients aged over 65 years with the diagnosis of all types of osteoarthritis who were prescribed a spa therapy course in some spa resorts in Turkey between 7 March 2002 and 31 December 2012. They travelled to a spa resort where they stayed at a thermal spa hotel and followed the usual therapy packages for 2 weeks. Patients were assessed by an experienced physician within a week before the spa journey and within a week after the completion of the spa therapy. Compared with baseline in whole sample, statistically significant improvements were observed in pain (visual analog scale, VAS), patient and physician global assessments (VAS), Health Assessment Questionnaire disability index (HAQ-DI), Lequesne algofunctional index (LAFI) for knee, Western Ontario and McMaster Universities index (WOMAC), Waddell disability index (WDI), and Neck Pain and Disability Scale (NPAD). According to Outcome Measures in Rheumatology—Osteoarthritis Research Society International (OMERACT-OARSI) Set of Responder Criteria, responder rate were 63.8 % (51/80) in generalized, 52 % (13/25) in knee, 50 % (2/4) in hip, 66.7 % (8/12) in lumbar, and 100 % (6/6) in cervical osteoarthritis subgroups. Spa therapy improved pain and physical functional status in older patients with osteoarthritis, especially generalized osteoarthritis and multiple joint osteoarthritis with involvement of knee. This improvement was clinically important in majority of the patients. To confirm the results of this preliminary study, there is a need of a randomized controlled clinical study

  11. Treatment of tibial eminence fractures with arthroscopic suture fixation technique: a retrospective study

    PubMed Central

    Yuan, Yanhao; Huang, Xiaohan; Zhang, Yanjie; Wang, Zhanchao

    2015-01-01

    Aims: The present study aims to investigate the clinical outcomes of arthroscopic suture fixation in treating tibial eminence fracture with a retrospective study design of two years’ follow-up. Methods: A total of 33 patients with imaging evidence of tibial eminence avulsion fractures who underwent arthroscopic surgery between 2008 and 2012 were included in this study. The inclusion criteria for the study were a displaced tibial eminence avulsion fracture and anterior knee instability of grade II or higher inskeletally mature patients. These patients were treated with arthroscopic suture fixation and followed with a mean period of 24 months. Anteroposterior and lateral radiographs were obtained 3 months postoperatively to assess fracture healing. At 24 months after surgery, all patients were evaluated by an independent orthopaedic professor with clinical examination like anteroposterior laxity (Lachman-Noulis and anterior drawer tests) and Rolimeter knee tester (Aircast, Vista, CA). Knee range of motion was evaluated actively and passively with a goniometer. Knee function was evaluated by the Lysholm and International Knee Documentation Committee (IKDC) scores. Knee radiographs in standing anteroposterior, standing lateral, and Merchant views were examined for alignment, joint space narrowing, and degenerative knee changes. Results: No major complication like infection, deep venous thrombosis, or neurovascular deficit happened peri-operatively. At the final follow-up, there were no symptoms of instability and no clinical signs of ACL deficiency. Radiographs showed that all fractures healed 3 months post-operative, but at the last follow-up, there was one person with degenerative changes like joint space narrowing in radiographs. Anterior translation of the tibia was 0.47 mm on average (0 to 2.5 mm) compared with the uninjured side. Range-of-motion measurement showed a mean extension deficit of 1.5° (0° to 5°) and a mean flexion deficit of 2.7° (0° to 10

  12. Survival Predictors for Severe ARDS Patients Treated with Extracorporeal Membrane Oxygenation: A Retrospective Study in China

    PubMed Central

    Liu, Xiaoqing; Xu, Yonghao; Zhang, Rong; Huang, Yongbo; He, Weiqun; Sang, Ling; Chen, Sibei; Nong, Lingbo; Li, Xi; Mao, Pu

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) is increasingly being applied as life support for acute respiratory distress syndrome (ARDS) patients. However, the outcomes of this procedure have not yet been characterized in severe ARDS patients. The aim of this study was to evaluate the outcomes of severe ARDS patients supported with ECMO and to identify potential predictors of mortality in these patients. A total of 38 severe ARDS patients (aged 51.39±13.27 years, 32 males) who were treated with ECMO in the specialized medical intensive care unit of Guangzhou Institute of Respiratory Diseases from July 2009 to December 2014 were retrospectively reviewed. The clinical data of the patients on the day before ECMO initiation, on the first day of ECMO treatment and on the day of ECMO removal were collected and analyzed. All patients were treated with veno-venous ECMO after a median mechanical ventilation duration of 6.4±7.6 days. Among the 20 patients (52.6%) who were successfully weaned from ECMO, 16 patients (42.1%) survived to hospital discharge. Of the identified pre-ECMO factors, advanced age, a long duration of ventilation before ECMO, a higher Acute Physiology and Chronic Health Evaluation II (APACHE II) score, underlying lung disease, and pulmonary barotrauma prior to ECMO were associated with unsuccessful weaning from ECMO. Furthermore, multiple logistic regression analysis indicated that both barotrauma pre-ECMO and underlying lung disease were independent predictors of hospital mortality. In conclusion, for severe ARDS patients treated with ECMO, barotrauma prior to ECMO and underlying lung disease may be major predictors of ARDS prognosis based on multivariate analysis. PMID:27336170

  13. Maxillofacial trauma in Tamil Nadu children and adolescents: A retrospective study

    PubMed Central

    Arvind, Ramraj Jayabalan; Narendar, Ramesh; Kumar, Palanisamy Dinesh; Venkataraman, Sivasubramaniam; Gokulanathan, Subramanium

    2013-01-01

    Aim: The aim of this retrospective study is to describe the incidence, aetiology, complexity and surgical indications of maxillofacial injuries in children and adolescents population of Tamil Nadu state of india during period of 4 years. Materials and Methods: A retrospective review was conducted among 500 children and adolescents patients of age group 6 years to 16 years suffered or suffering with maxillofacial and skull fractures presenting to ten Level I trauma centers over a 4 year period.The data collected for this study included age, gender, etiology, associated maxillofacial trauma, anatomic site of fracture and treatment. Results and Conclusion: In our study the most common cause of trauma was traffic 35%, followed by falls 24% and sports 22%. Mandible was commenest bone prone to fracture, followed by maxilla and nasal bone. Mandible fractures accounted for 72% of all maxillofacial fractures. PMID:23946572

  14. Four dimensional magnetic resonance imaging with retrospective k-space reordering: A feasibility study

    SciTech Connect

    Liu, Yilin; Yin, Fang-Fang; Cai, Jing; Chen, Nan-kuei; Chu, Mei-Lan

    2015-02-15

    Purpose: Current four dimensional magnetic resonance imaging (4D-MRI) techniques lack sufficient temporal/spatial resolution and consistent tumor contrast. To overcome these limitations, this study presents the development and initial evaluation of a new strategy for 4D-MRI which is based on retrospective k-space reordering. Methods: We simulated a k-space reordered 4D-MRI on a 4D digital extended cardiac-torso (XCAT) human phantom. A 2D echo planar imaging MRI sequence [frame rate (F) = 0.448 Hz; image resolution (R) = 256 × 256; number of k-space segments (N{sub KS}) = 4] with sequential image acquisition mode was assumed for the simulation. Image quality of the simulated “4D-MRI” acquired from the XCAT phantom was qualitatively evaluated, and tumor motion trajectories were compared to input signals. In particular, mean absolute amplitude differences (D) and cross correlation coefficients (CC) were calculated. Furthermore, to evaluate the data sufficient condition for the new 4D-MRI technique, a comprehensive simulation study was performed using 30 cancer patients’ respiratory profiles to study the relationships between data completeness (C{sub p}) and a number of impacting factors: the number of repeated scans (N{sub R}), number of slices (N{sub S}), number of respiratory phase bins (N{sub P}), N{sub KS}, F, R, and initial respiratory phase at image acquisition (P{sub 0}). As a proof-of-concept, we implemented the proposed k-space reordering 4D-MRI technique on a T2-weighted fast spin echo MR sequence and tested it on a healthy volunteer. Results: The simulated 4D-MRI acquired from the XCAT phantom matched closely to the original XCAT images. Tumor motion trajectories measured from the simulated 4D-MRI matched well with input signals (D = 0.83 and 0.83 mm, and CC = 0.998 and 0.992 in superior–inferior and anterior–posterior directions, respectively). The relationship between C{sub p} and N{sub R} was found best represented by an exponential function

  15. TIPS Evaluation Project Retrospective Study: Wave 1 and 2.

    ERIC Educational Resources Information Center

    Hubbard, Susan M.; Mulvey, Kevin P.

    2003-01-01

    Measured substance abuse treatment professionals' knowledge, attitudes, and practices regarding the Treatment Improvement Protocol (TIP) series and the 28 TIPs. Results for 3,267 respondents in wave 1 and 1,028 in wave 2 indicate that almost half of all professionals were aware of the TIPs. Attitudes toward TIPs were positive, but professionals…

  16. A Retrospective, Observational Study of the Adequacy of Elective Loop Stoma Diversion.

    PubMed

    Shah, Puja; Mauro, David; Friel, Charles; Hedrick, Traci

    2016-05-01

    Diverting stomas are employed for various clinical indications and easier to revert than end stomas. General, plastic, and colorectal surgeons continue to debate whether a diverting loop stoma adequately diverts stool, preventing spillage into the distal limb, which does not receive stool. A retrospective, descriptive study was conducted involving all patients who underwent loop ostomy surgery (colostomy or ileostomy) - defined by current procedural terminology (CPT) codes 44187, 44188, 44153, and 44155-44158 - between April 1, 2002 and October 12, 2010. The purpose of the study was to determine if a diverting loop stoma is completely diverting with no efflux into the distal limb by examining the rate of distal limb contamination. Two surgeons identified patients at the University of Virginia who had loop ostomy surgery and subsequently underwent computed tomography (CT) scan with oral contrast for clinical suspicion of abnormal pathology. A radiologist reviewed these images to evaluate the presence or absence of oral contrast in the ostomy distal limb. Distal progression of oral contrast was deemed adequate if oral contrast was visualized within the ostomy bag or if contrast was intraluminal distal to the loop ostomy. The loop ostomy was considered diverting if oral contrast was only visualized in the ostomy bag with no oral contrast distally. Of the 202 eligible patients, 26 (13%) underwent 41 postoperative CT scans of the abdomen/pelvis. Four (4) were excluded due to inadequate exam or confounding contrast (rectal contrast, contrast retention from preoperative scan). Of the remaining 22 patients with 35 CT scans (median age 54 [range 26-82] years, 10 men, 18 Caucasian, 18 having elective surgery), no patient (0%) had evidence of distal contrast. In this and other studies, loop stomas were found to provide adequate diversion without spillage into the nonfunctional limb for the vast majority of patients and should strongly be considered as the procedure of choice

  17. Minimally invasive endoscopic treatment for lumbar infectious spondylitis: a retrospective study in a tertiary referral center

    PubMed Central

    2014-01-01

    Background Spinal infections remain a challenge for clinicians because of their variable presentation and complicated course. Common management approaches include conservative administration of antibiotics or aggressive surgical debridement. The purpose of this study was to evaluate the efficacy of percutaneous endoscopic debridement with dilute betadine solution irrigation (PEDI) for treating patients with lumbar infectious spondylitis. Methods From January 2005 to July 2010, a total of 32 patients undergoing PEDI were retrospectively enrolled in this study. The surgical indications of the enrolled patients included single-level infectious spondylodiscitis, postoperative infectious spondylodiscitis, advanced infection with epidural abscess, psoas muscle abscess, pre-vertebral or para-vertebral abscess, multilevel infectious spondylitis, and recurrent infection after anterior debridement and fusion. Clinical outcomes were assessed by careful physical examination, Macnab criteria, regular serologic testing, and imaging studies to determine whether continued antibiotics treatment or surgical intervention was required. Results Causative bacteria were identified in 28 (87.5%) of 32 biopsy specimens. Appropriate parenteral antibiotics for the predominant pathogen isolated from infected tissue biopsy cultures were prescribed to patients. Twenty-seven (84.4%) patients reported satisfactory relief of their back pain after PEDI. Twenty-six (81.3%) patients recovered uneventfully after PEDI and sequential antibiotic therapy. No surgery-related major complications were found, except 3 patients with transient paresthesia in the affected lumbar segment. Conclusions PEDI was successful in obtaining a bacteriologic diagnosis, relieving the patient’s symptoms, and assisting in the eradication of lumbar infectious spondylitis. This procedure could be an effective alternative for patients who have a poor response to conservative treatment before a major open surgery. PMID:24669940

  18. Effect of ethnicity on erythropoietin therapy response for hemodialysis patients: a retrospective study.

    PubMed

    Al-Khalaf, Bader; Al-Khalaf, Nour; Mustafa, Seham

    2013-10-01

    Anemia is a common feature in chronic kidney disease patients due to deficiency of erythropoietin (EPO). Diseased kidneys are unable to produce EPO, which enhances red blood cell production from the bone marrow. Recombinant human EPO in hemodialysis patients was introduced with perfect outcomes as a hormonal substitutive treatment. Some ethnic minority groups have high prevalence of anemia associated with chronic kidney diseases. The aim of this study is to evaluate the differences between African Caribbeans and Caucasians' EPO therapy response with regard to hemoglobin (Hb), some factors affecting it and some comorbid conditions. A retrospective study for 6 months of 100 patients on hemodialysis was conducted on two ethnic minorities groups; 46 patients were African Caribbean and 54 patients were Caucasian, who received EPO therapy at once or three times weekly dose at the Hanbury Dialysis Unit of Royal London Hospital. There were three types of EPO therapy used: Aranesp, Mircera and Neorecormon. Forty-six patients were African Caribbean and 54 patients were Caucasian. There were 63.4% of patients treated by Aranesp while 13% were given Mircera; 22.8% of the sample used Neorecorman. It was shown that the chosen comorbid conditions had higher percentage in the African Caribbeans than in Caucasians. Diabetic and/or hypertensive patients are almost double the patient numbers. In addition, sickle cell anemia is only present in African Caribbeans. There were 43.5% of African Caribbeans and 81.1% of Caucasians who met the standards of Hb level. There was no significant difference between African Caribbeans and Caucasians regarding parathyroid hormone, c-reactive protein, B12, mean corpuscular volume, ferritin, and folate. In this study, there was a significant difference in the Hb levels between African Caribbean and Caucasian groups. Sixty percent of African Caribbeans had mean Hb less than normal levels. However, they received lower EPO dose than Caucasians. As a

  19. Risk indicators related to peri-implant disease: an observational retrospective cohort study

    PubMed Central

    2016-01-01

    Purpose The aim of the present study was to retrospectively investigate the influence of potential risk indicators on the development of peri-implant disease. Methods Overall, 103 patients referred for implant treatment from 2000 to 2012 were randomly enrolled. The study sample consisted of 421 conventional-length (>6 mm) non-turned titanium implants that were evaluated clinically and radiographically according to pre-established clinical and patient-related parameters by a single investigator. A non-parametric Mann-Whitney U test or Kruskal-Wallis rank test and a logistic regression model were used for the statistical analysis of the recorded data at the implant level. Results The diagnosis of peri-implant mucositis and peri-implantitis was made for 173 (41.1%) and 19 (4.5%) implants, respectively. Age (≥65 years), patient adherence (professional hygiene recalls <2/year) and the presence of plaque were associated with higher peri-implant probing-depth values and bleeding-on-probing scores. The logistic regression analysis indicated that age (P=0.001), patient adherence (P=0.03), the absence of keratinized tissue (P=0.03), implants placed in pristine bone (P=0.04), and the presence of peri-implant soft-tissue recession (P=0.000) were strongly associated with the event of peri-implantitis. Conclusions Within the limitations of this study, patients aged ≥65 years and non-adherent subjects were more prone to develop peri-implant disease. Therefore, early diagnosis and a systematic maintenance-care program are essential for maintaining peri-implant tissue health, especially in older patients. PMID:27588216

  20. [Lens luxation in dogs: a retrospective study of 134 dogs (2000-2011)].

    PubMed

    Betschart; Hässig; Spiess

    2014-03-01

    This retrospective study evaluated cases of lens luxation in dogs that were documented at the University of Zurich Veterinary Teaching Hospital between 2000 and 2011. A total 134 dogs were included in the study. This population of dogs with lens luxation represents 0.41 % of all dogs presented to the Zurich Veterinary Teaching Hospital (32'523) and 3.02 % of all dogs presented to the ophthalmology service during the same time period. The 134 dogs represented over 40 different breeds, including mixed breeds. 63 of the dogs were male, 71 were female. The 134 dogs were divided in primary lens luxation (86 of the 134 dogs, 64 %) and secondary lens luxation (48 dogs, 36 %). The most frequent causes for secondary lens luxation were glaucoma (58 %), cataract (19 %) and trauma (17 %). This study shows the predisposition for primary lens luxations in terrier breeds, Chinese Crested dogs, Pinscher and Spitz. In contrast, Siberian Huskies, Basset Hounds, Bearded Collies, Cairn Terriers, mixed breed dogs, Bolonka Zwetna, Boston Terriers, Borzoi, Doberman, Eurasian, Leonberg, Luzerner Niederlaufhund and Weimaraner suffered significantly more often from secondary lens luxation. There was no sex predilection for primary or secondary lens luxation. Dogs with primary lens luxation were on average 7.39 ± 3.02 years old, which is significantly younger than the dogs with secondary lens luxation (9.12 ± 3.38 years). Dogs with primary lens luxation showed a significantly higher rate of a bilateral development than those with secondary lens luxation (85.5 % of the dogs with primary lens luxation and only 14.5 % of the dogs with secondary lens luxation showed it in both their eyes). PMID:24568806

  1. Clinical Outcomes of Conservative Treatment and Arthroscopic Repair of Rotator Cuff Tears: A Retrospective Observational Study

    PubMed Central

    Lee, Woo Hyung; Do, Hyun Kyung; Lee, Joong Hoon; Kim, Bo Ram; Noh, Jee Hyun; Choi, Soo Hyun; Chung, Sun Gun; Lee, Shi-Uk; Choi, Ji Eun; Kim, Seihee; Kim, Min Jee

    2016-01-01

    Objective To compare the clinical outcomes following conservative treatment and arthroscopic repair in patients with a rotator cuff tear. Methods In this retrospective study, patients aged >50 years with a symptomatic rotator cuff tear were reviewed. The rotator cuff tendons were evaluated using ultrasonography, shoulder magnetic resonance imaging or MR arthrography, and the patients with either a high-grade partial-thickness or small-to-medium-sized (≤3 cm) full-thickness tear were included in this study. The primary outcome measures were a pain assessment score and range of motion (ROM) at 1-year follow-up. The secondary outcomes were the rate of tear progression or retear along with the rate of symptom aggravation after the treatments. Results A total of 357 patients were enrolled, including 183 patients that received conservative treatment and 174 patients who received an arthroscopic repair. The pain assessment score (p<0.001) and the ROM in forward flexion (p<0.001) were significantly improved in both groups. The ROM in internal rotation did not significantly change after conservative treatment and arthroscopic repair. The pain assessment score and ROM were not significantly different between the two groups. Retear was observed in 9.6% of patients who had an arthroscopic repair and tear progression was found in 6.7% of those who underwent conservative treatment. The proportion of aggravation for pain and ROM did not significantly differ between the two groups. Conclusion The effectiveness of conservative treatment is not inferior to arthroscopic repair for patients >50 years old with a less than medium-sized rotator cuff tear in a 1-year follow-up period. Further study is warranted to find the optimal combination of conservative treatment for a symptomatic rotator cuff tear. PMID:27152275

  2. A retrospective study of bitches with pyometra, medically treated with aglepristone.

    PubMed

    Ros, Linnea; Holst, Bodil Ström; Hagman, Ragnvi

    2014-12-01

    Pyometra is a common and life-threatening disease of intact bitches caused by hormonal influence of the uterus in combination with bacterial infection. The treatment of choice is ovariohysterectomy, but several purely medical options are available. Common drugs used for medical treatment in combination with antimicrobials are progesterone receptor blockers, prostaglandins, and dopamine agonists. The aim of this study was to evaluate long-term recovery and fertility after treatment with the progesterone receptor blocker aglepristone in bitches with pyometra. Data from 28 bitches with pyometra, admitted to the University Animal Hospital, Swedish University of Agricultural Sciences, during a 9-year period, were studied retrospectively and followed up by telephone interviews with the owners. The bitches had been treated with aglepristone at a dose of 10 mg/kg on a median of four occasions. All bitches had also been treated with antimicrobial drugs for a mean duration of 23 days, the most frequently used being enrofloxacin. Escherichia coli were the most commonly isolated bacteria from cranial vagina. The outcome was assessed for up to 6 years after treatment. The success rate, determined as restored clinically healthy status, was 75% (21/28 bitches), and the recurrence rate of disease was 48% (10/21 bitches). The mean time until recurrence was 10.5 months after the end of treatment. After treatment, 69% (9/13) of the mated bitches produced puppies. Of the seven bitches that did not have a successful treatment, six were ovariohysterectomized and one was euthanized. In conclusion, medical treatment with aglepristone in combination with antimicrobial therapy was successful in 75% of the bitches studied and the recurrence rate was 48%. PMID:25234791

  3. Epidemiological data of 290 pemphigus vulgaris patients: a 29-year retrospective study.

    PubMed

    Baum, Sharon; Astman, Nadav; Berco, Efraim; Solomon, Michal; Trau, Henri; Barzilai, Aviv

    2016-08-01

    Pemphigus vulgaris (PV), an autoimmune blistering disease involving the skin and mucosa, is traditionally considered to be prevalent among Jews, particularly those of Ashkenazi origin. Israel, where the Ashkenazi and non-Ashkenazi Jewish population live alongside a large Arab minority, is a particularly interesting place for epidemiological studies of PV. To characterise the epidemiological and clinical parameters of PV patients from a single tertiary medical centre in Israel. Data was retrieved retrospectively from the medical records of newly diagnosed PV patients referred to the Sheba Medical Center between 1980 and 2009. A total of 290 PV patients were diagnosed during the study period. The mean age at diagnosis was 49.7 years (range: 10-92 years) and a female predominance was identified (1.54:1; p<0.001). Among the Jewish patients, the ratio of Ashkenazi to non-Ashkenazi was 1.23:1, which was not statistically significant in comparison to the ratio of the general Jewish population in Israel (p = 0.289). We describe the comorbidities found among the patients. Disease severity at diagnosis was not found to be related to the epidemiological parameters examined. Studies from different countries reveal variations in the clinical and epidemiological characteristics of the disease. The epidemiology of PV in Israel, a Middle-Eastern country with a Western lifestyle and a diverse ethnic population, shows some characteristics that represent an "admixture" between European and Middle-Eastern or Asian countries. The associated comorbidities of PV emphasize the need for dermatologists to keep a high index of suspicion and actively evaluate patients to determine their presence. PMID:27300747

  4. Adverse Outcomes after Major Surgery in Patients with Pressure Ulcer: A Nationwide Population-Based Retrospective Cohort Study

    PubMed Central

    Chou, Chia-Lun; Lee, Woan-Ruoh; Yeh, Chun-Chieh; Shih, Chun-Chuan

    2015-01-01

    Background Postoperative adverse outcomes in patients with pressure ulcer are not completely understood. This study evaluated the association between preoperative pressure ulcer and adverse events after major surgeries. Methods Using reimbursement claims from Taiwan’s National Health Insurance Research Database, we conducted a nationwide retrospective cohort study of 17391 patients with preoperative pressure ulcer receiving major surgery in 2008-2010. With a propensity score matching procedure, 17391 surgical patients without pressure ulcer were selected for comparison. Eight major surgical postoperative complications and 30-day postoperative mortality were evaluated among patients with pressure ulcer of varying severity. Results Patients with preoperative pressure ulcer had significantly higher risk than controls for postoperative adverse outcomes, including septicemia, pneumonia, stroke, urinary tract infection, and acute renal failure. Surgical patients with pressure ulcer had approximately 1.83-fold risk (95% confidence interval 1.54-2.18) of 30-day postoperative mortality compared with control group. The most significant postoperative mortality was found in those with serious pressure ulcer, such as pressure ulcer with local infection, cellulitis, wound or treatment by change dressing, hospitalized care, debridement or antibiotics. Prolonged hospital or intensive care unit stay and increased medical expenditures were also associated with preoperative pressure ulcer. Conclusion This nationwide propensity score-matched retrospective cohort study showed increased postoperative complications and mortality in patients with preoperative pressure ulcer. Our findings suggest the urgency of preventing and managing preoperative pressure ulcer by a multidisciplinary medical team for this specific population. PMID:26000606

  5. A RETROSPECTIVE STUDY OF CAUSES OF SKIN LESIONS IN WILD TURKEYS (MELEAGRIS GALLOPAVO) IN THE EASTERN USA, 1975-2013.

    PubMed

    Elsmo, Elizabeth J; Allison, Andrew B; Brown, Justin D

    2016-07-01

    Skin lesions of Wild Turkeys ( Meleagris gallopavo ) are a common cause of concern to wildlife biologists and the general public and are a frequent reason for submission to diagnostic laboratories. The purpose of this retrospective study is to evaluate the causes, occurrence, and epidemiologic patterns of skin lesions in Wild Turkeys in the eastern US. Skin lesions were diagnosed in 30% (n=199) of the 660 Wild Turkey samples submitted to the Southeastern Cooperative Wildlife Disease Study diagnostic service from 1975 to 2013. Avian pox was the most frequent cause of skin lesions (66%, n=131), followed by bacterial dermatitis (22%, n=44), ectoparasitism-related dermatitis (3%, n=6), fungal dermatitis (2.5%, n=5), and neoplasia (2.0%, n=4). Although the gross appearance of skin lesions is often insufficient to determine the etiology, the anatomic distribution of lesions and temporal occurrence of certain diseases may offer insights into likely causes. Cases with lesions involving or restricted to the head and neck were much more likely to be caused by avian pox than other etiologies. Similarly, lesions restricted to the feet were more likely to be of bacterial origin. Skin lesions observed in the fall and winter were more likely to be caused by avian pox, whereas bacterial dermatitis was more frequently observed in the spring and summer. This retrospective study provides a summary of the causes of skin lesions in Wild Turkeys and serves as a useful reference to diagnosticians and biologists when evaluating Wild Turkeys with skin lesions. PMID:27195689

  6. 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

  7. Effects of Emergency Cervical Cerclage on Pregnancy Outcome: A Retrospective Study of 158 Cases

    PubMed Central

    Zhu, Li-Qiong; Chen, Hui; Chen, Li-Bin; Liu, Ying-Lin; Tan, Jian-Ping; Wang, Yun-Hui; Zhang, Rui; Zhang, Jian-Ping

    2015-01-01

    The aim of this study was to evaluate the effectiveness and safety of emergency cervical cerclage in women with advanced cervical dilatation and bulging of fetal membranes. The study included 158 women who underwent emergency cervical cerclage because of cervix dilatation and protruding membranes in mid-trimester at Sun Yat-sen Memorial Hospital of Sun Yat-sen University. Pregnancy outcomes and pregnancy outcome related to clinical features were analyzed retrospectively. Analysis revealed that the placement of emergency cerclage led to the delivery of live infants with a success rate of 82.28%. The mean interval between cerclage and delivery was 52.16.±26.62 days, with a mean gestation at delivery of 30.3±4.7 weeks and a mean birth weight of 1934.69±570.37 g. No severe maternal complications such as maternal death, hematosepsis, and hysterorrhexis occurred after the operation. Two women (1.25%) had laceration of the cervix, 1 woman (0.61%) suffered pulmonary edema, and 2 women (1.25%) developed deep vein thrombosis (DVT). There were significant correlations between the pregnancy outcome and risk factors, including any presenting symptoms, cervical dilatation, postoperative white blood cell count, and C-reactive protein (CRP) value. No significant difference was found in women with good vs. poor outcome in terms of maternal age and obstetric histories. Emergency cervical cerclage is effective in prolonging pregnancy and improving neonatal outcome in women with cervical incompetence. It should be considered a viable option for women with a dilated cervix in mid-trimester. PMID:25975832

  8. Development of a Novel Scoring System for Predicting the Risk of Colorectal Neoplasia: A Retrospective Study

    PubMed Central

    2016-01-01

    Objective The purpose of this study was to develop a novel scoring system to screen subjects who have a high risk for colorectal neoplasia. Study Design and Setting We retrospectively analyzed 1061 subjects undergoing total colonoscopy (TCS) for the first time at Gihoku Kosei Hospital. The characteristics and habits of the subjects were analyzed using a multivariate logistic regression analysis. The risk score was established according to each odds ratio of the individual risk factors, and the correlations between the sum of the risk scores and the prevalence of colorectal neoplasia for each individual were evaluated. Results Age 45–59 (risk score: 2 points) and ≥60 (3 points), male gender (1 point), and habitual alcohol consumption ≥21g daily (1 point) were extracted as the significant risk factors for colorectal neoplasia. When the risk groups were determined by summing up these risk scores, the prevalence rates of colorectal neoplasia were 8.8% for the low risk group (0–2 points), 30.5% for the low-moderate risk group (3 points), 39.1% for the high-moderate risk group (4 points), and 57.6% for the high risk group (5 points). In comparison with the low risk group, the odds ratio of the low-moderate risk, the high-moderate risk, and the high risk groups were 4.6, 6.7, and 14.1 folds, respectively. Conclusion Our scoring system, which linearly correlates with the prevalence rate of colorectal neoplasia, may be an effective tool for screening the subjects who have a high risk for colorectal neoplasia. These subjects, therefore, should be recommended to undergo TCS. PMID:27284907

  9. Effects of emergency cervical cerclage on pregnancy outcome: a retrospective study of 158 cases.

    PubMed

    Zhu, Li-Qiong; Chen, Hui; Chen, Li-Bin; Liu, Ying-Lin; Tian, Jian-Ping; Wang, Yun-Hui; Zhang, Rui; Zhang, Jian-Ping

    2015-01-01

    The aim of this study was to evaluate the effectiveness and safety of emergency cervical cerclage in women with advanced cervical dilatation and bulging of fetal membranes. The study included 158 women who underwent emergency cervical cerclage because of cervix dilatation and protruding membranes in mid-trimester at Sun Yat-sen Memorial Hospital of Sun Yat-sen University. Pregnancy outcomes and pregnancy outcome related to clinical features were analyzed retrospectively. Analysis revealed that the placement of emergency cerclage led to the delivery of live infants with a success rate of 82.28%. The mean interval between cerclage and delivery was 52.16.±26.62 days, with a mean gestation at delivery of 30.3±4.7 weeks and a mean birth weight of 1934.69±570.37 g. No severe maternal complications such as maternal death, hematosepsis, and hysterorrhexis occurred after the operation. Two women (1.25%) had laceration of the cervix, 1 woman (0.61%) suffered pulmonary edema, and 2 women (1.25%) developed deep vein thrombosis (DVT). There were significant correlations between the pregnancy outcome and risk factors, including any presenting symptoms, cervical dilatation, postoperative white blood cell count, and C-reactive protein (CRP) value. No significant difference was found in women with good vs. poor outcome in terms of maternal age and obstetric histories. Emergency cervical cerclage is effective in prolonging pregnancy and improving neonatal outcome in women with cervical incompetence. It should be considered a viable option for women with a dilated cervix in mid-trimester. PMID:25975832

  10. A Retrospective Study of 51 Cases of Abdominal Problems in the Calf: Etiology, Diagnosis and Prognosis

    PubMed Central

    Naylor, Jonathan M.; Bailey, Jerry V.

    1987-01-01

    A retrospective study of 51 calves less than two months of age showing signs of abdominal pain or presented because of abdominal distension was carried out to evaluate the relationship between etiological, diagnostic, and prognostic characteristics. We found that the age of the calf differed with the type of lesion present. Calves under eight days of age had a 73% incidence of lesions which required surgical therapy. Atresia of part of the intestinal tract was the most frequently diagnosed problem, In eight-day to two-month-old calves, medical causes of colic were more common; only 26% of cases had lesions that required surgical correction. Gaseous distension of the abomasum and intestine was the most frequent cause of colic in older calves. Other abdominal problems observed in this study included abomasal ulceration and abomasal torsion. Mortality was more common in calves with surgical problems. Of the 21 calves with surgical problems, 76% died compared with a 20% mortality rate in the 30 calves with medical problems. Because of the high incidence of surgical problems in young calves, mortality was 69% in calves under eight days of age and only 33% in older calves. The chance of recovery decreased with the severity of hypothermia and dehydration. Most calves (75%) which were recumbent at presentation died, whereas only 29% of calves which were alert and able to stand at presentation died. Hematological findings indicative of severe inflammation were poor prognostic signs. Heart rate and the apparent severity of abdominal pain were not useful prognostic indicators. PMID:17422908

  11. Hereditary hypophosphatemia in Norway: a retrospective population-based study of genotypes, phenotypes, and treatment complications

    PubMed Central

    Rafaelsen, Silje; Johansson, Stefan; Ræder, Helge; Bjerknes, Robert

    2015-01-01

    Objective Hereditary hypophosphatemias (HH) are rare monogenic conditions characterized by decreased renal tubular phosphate reabsorption. The aim of this study was to explore the prevalence, genotypes, phenotypic spectrum, treatment response, and complications of treatment in the Norwegian population of children with HH. Design Retrospective national cohort study. Methods Sanger sequencing and multiplex ligand-dependent probe amplification analysis of PHEX and Sanger sequencing of FGF23, DMP1, ENPP1KL, and FAM20C were performed to assess genotype in patients with HH with or without rickets in all pediatric hospital departments across Norway. Patients with hypercalcuria were screened for SLC34A3 mutations. In one family, exome sequencing was performed. Information from the patients' medical records was collected for the evaluation of phenotype. Results Twety-eight patients with HH (18 females and ten males) from 19 different families were identified. X-linked dominant hypophosphatemic rickets (XLHR) was confirmed in 21 children from 13 families. The total number of inhabitants in Norway aged 18 or below by 1st January 2010 was 1 109 156, giving an XLHR prevalence of ∼1 in 60 000 Norwegian children. FAM20C mutations were found in two brothers and SLC34A3 mutations in one patient. In XLHR, growth was compromised in spite of treatment with oral phosphate and active vitamin D compounds, with males tending to be more affected than females. Nephrocalcinosis tended to be slightly more common in patients starting treatment before 1 year of age, and was associated with higher average treatment doses of phosphate. However, none of these differences reached statistical significance. Conclusions We present the first national cohort of HH in children. The prevalence of XLHR seems to be lower in Norwegian children than reported earlier. PMID:26543054

  12. Large Retrospective Evaluation of the Effectiveness and Safety of Ceftaroline Fosamil Therapy

    PubMed Central

    Casapao, Anthony M.; Davis, Susan L.; Barr, Viktorija O.; Klinker, Kenneth P.; Goff, Debra A.; Barber, Katie E.; Kaye, Keith S.; Mynatt, Ryan P.; Molloy, Leah M.; Pogue, Jason M.

    2014-01-01

    Ceftaroline has been approved for acute bacterial skin infections and community-acquired bacterial pneumonia. Limited clinical experience exists for use outside these indications. The objective of this study was to describe the outcomes of patients treated with ceftaroline for various infections. Retrospective analyses of patients receiving ceftaroline ≥72 h from 2011 to 2013 were included. Clinical and microbiological outcomes were analyzed. Clinical success was defined as resolution of all signs and symptoms of infection with no further need for escalation while on ceftaroline treatment during hospitalization. A total of 527 patients received ceftaroline, and 67% were treated for off-label indications. Twenty-eight percent (148/527) of patients had bacteremia. Most patients (80%) were initiated on ceftaroline after receipt of another antimicrobial, with 48% citing disease progression as a reason for switching. The median duration of ceftaroline treatment was 6 days, with an interquartile range of 4 to 9 days. A total of 327 (62%) patients were culture positive, and the most prevalent pathogen was Staphylococcus aureus, with a frequency of 83% (271/327). Of these patients, 88.9% (241/271) were infected with methicillin-resistant S. aureus (MRSA). Clinically, 88% (426/484) achieved clinical success and hospital mortality was seen in 8% (40/527). While on ceftaroline, adverse events were experienced in 8% (41/527) of the patients and 9% (28/307) were readmitted within 30 days after discharge for the same infection. Patients treated with ceftaroline for both FDA-approved and off-label infections had favorable outcomes. Further research is necessary to further describe the role of ceftaroline in a variety of infections and its impact on patient outcomes. PMID:24550331

  13. Use of the Airtraq® device for airway management in the prehospital setting – a retrospective study

    PubMed Central

    2014-01-01

    Background Difficulties with prehospital intubations have encouraged the development of indirect laryngoscopy techniques, facilitating laryngeal visualization. Airtraq® is a relatively new single-use indirect laryngoscope. The Airtraq® has been evaluated in several prehospital mannequin intubation trials. However, prehospital clinical experience with the device is limited. Methods A retrospective medical chart review was performed for patients who underwent prehospital endotracheal intubation in the Stockholm County between January 2008 and December 2012. Both anaesthesiologists and nurse anaesthetists performed prehospital intubations during the study period. All Airtraq® intubations during this period were included in the analysis. The objective was to estimate the success rate of Airtraq® used in a prehospital setting. Results During the 5-year period (January 2008- December 2012), 2453 tracheal intubations were performed. Airtraq® was used in 28 cases (1%). The overall Airtraq® intubation success rate was 68%. Among patients with anticipated or unexpected difficult airway (23/28) the Airtraq® success rate was 61% (14/23). Among patients who underwent drug facilitated or rapid-sequence intubation protocols 4/5 (80%) were successfully intubated with Airtraq®. Conclusion In conclusion, this retrospective study showed a higher Airtraq® success rate than previous prospective prehospital trials. However, compared to other prehospital direct and indirect intubation methods the Airtraq success rate is low. Further clinical trials are necessary to evaluate the role of Airtraq® in the prehospital airway management. PMID:24484856

  14. Effects of maintenance lithium treatment on serum parathyroid hormone and calcium levels: a retrospective longitudinal naturalistic study

    PubMed Central

    Albert, Umberto; De Cori, David; Aguglia, Andrea; Barbaro, Francesca; Lanfranco, Fabio; Bogetto, Filippo; Maina, Giuseppe

    2015-01-01

    Objective The aim of this retrospective longitudinal naturalistic study was to evaluate the effects of maintenance lithium treatment on parathyroid hormone (PTH) and calcium levels. Methods A retrospective longitudinal naturalistic study design was used. Data were collected from the database of a tertiary psychiatric center covering the years 2010–2014. Included were bipolar patients who had never been exposed to lithium and had lithium started, and who had PTH, and total and ionized calcium levels available before and during lithium treatment. Paired t-tests were used to analyze changes in PTH and calcium levels. Linear regressions were performed, with mean lithium level and duration of lithium exposure as independent variables and change in PTH levels as dependent variable. Results A total 31 patients were included. The mean duration of lithium treatment was 18.6±11.4 months. PTH levels significantly increased during lithium treatment (+13.55±14.20 pg/mL); the rate of hyperparathyroidism was 12.9%. Neither total nor ionized calcium increased from baseline to follow-up; none of our patients developed hypercalcemia. Linear regressions analyses did not show an effect of duration of lithium exposure or mean lithium level on PTH levels. Conclusion Lithium-associated stimulation of parathyroid function is more common than assumed to date. Among parameters to be evaluated prior to lithium implementation, calcium and PTH should be added. PMID:26229473

  15. A Retrospective, Observational Study of Enteral Nutrition in Patients with Enteroatmospheric Fistulas.

    PubMed

    Reinisch, Alexander; Liese, Juliane; Woeste, Guido; Bechstein, Wolf; Habbe, Nils

    2016-07-01

    Enteroatmospheric fistulas (EAFs) represent a challenging problem in patients with an open abdomen (OA). A retrospective, descriptive study was conducted to evaluate the effects of enteral alimentation on wound status and management and nutrition. All patients with an EAF in an OA treated between October 2012 and December 2014 at a university hospital in Germany were included without criteria for exclusions. Demographic and morbidity-related data collected included age, gender, surgeries, OA grading, body mass index (BMI), serum albumin, and serum creatinin. Underlying diseases and time between the index operation and the formation of the OA and EAFs were analyzed in relation to the initiation of enteral nutrition (EN), which can aggravate and contaminate the OA due to intestinal secretions necessary for digestion. The OA was described in size and area of the fascia defect and classified according to the Björck Scale. The number and location of the fistulas and the duration of negative pressure wound therapy (NPWT) were documented. Outcome parameters included fistula volume, wound management (eg, dressing change frequency, need for wound revision), feeding tolerance, systemic impact of nutrition, nutrition status at discharge, and mortality. Data were analyzed using primary descriptive statistics. The Mann-Whitney test was used to evaluate changes in fistula volume and BMI; categorical data were compared using Fisher's exact test. A P value less than 0.05 was considered significant. Ten (10) patients (8 women, median age of participants 55.4 [range 44-71] years) were treated during the study time period. Seven (7) patients had the first fistula orifice in the upper jejunum (UJF); 8 had more than 1 fistula. EN was initiated with high caloric liquid nutrition and gradually increased to a 25 kcal/kg/day liquid or solid nutrition. All patients were provided NPWT at 75 mm Hg to 100 mm Hg. EN was not followed by a significant increase of median daily fistula volume

  16. Transfusion-related risk of secondary bacterial infections in sepsis patients: a retrospective cohort study.

    PubMed

    Juffermans, Nicole P; Prins, David J; Vlaar, Alexander P J; Nieuwland, Rienk; Binnekade, Jan M

    2011-04-01

    There is a need for insight into factors that contribute to late mortality of sepsis patients. Immunomodulatory effects have been ascribed to blood transfusion. This retrospective cohort study investigates the association between the development of nosocomial bacterial infection and transfusion of leukodepleted red blood cells (RBCs) or platelets (PLTs) in survivors of the initial phase of sepsis. Patients diagnosed with sepsis after admission to the intensive care unit of a tertiary referral hospital were included. Of 134 patients with sepsis, 67 received a blood transfusion (50%). A secondary infection developed in 19 patients (14%). A multiple logistic regression model revealed that the use of immunosuppressive medication with an odds ratio (OR) of 1.17 (95% confidence interval [CI], 1.04-1.31), but not Acute Physiology and Chronic Health Evaluation II score, malignancy, HIV infection, alcohol abuse, or diabetes mellitus, was a risk factor for nosocomial infection. In an adjusted model, the amount of transfused RBCs was associated with secondary infection with an OR of 1.18 (95% CI, 1.01-1.37). Storage time of RBCs was a relevant confounder of the effect of the amount of RBCs on infection, with an adjusted OR of 1.25 (95% CI, 1.04-1.51), P = 0.02. Also, the amount of transfused PLTs was associated with secondary infection, with an OR of 1.36 (95% CI, 1.05-1.78). In conclusion, transfusion of RBCs and PLTs is associated with the onset of secondary bacterial infection in sepsis patients. Storage time of RBCs influences this increased risk. These findings suggest that immunomodulatory effects of blood transfusion contribute to adverse outcome in the convalescent phase of sepsis. PMID:21192282

  17. A retrospective study on the role of diabetes and metformin in colorectal cancer disease survival

    PubMed Central

    Ramjeesingh, R.; Orr, C.; Bricks, C.S.; Hopman, W.M.; Hammad, N.

    2016-01-01

    Background Recent studies have suggested an effect of metformin on mortality for patients with both diabetes and colorectal cancer (crc). However, the literature is contradictory, with both positive and negative effects being identified. We set out to determine the effect of metformin with respect to prognosis in crc patients. Methods After a retrospective chart review of crc patients treated at the Cancer Centre of Southeastern Ontario, Kaplan–Meier analyses and Cox proportional hazards regression models were used to compare overall survival (os) in patients with and without diabetes. Results We identified 1304 crc patients treated at the centre. No significant differences between the diabetic and nondiabetic groups were observed with respect to tumour pathology, extent of metastatic disease, time or toxicity of chemotherapy, and the os rate (1-year os: 85.6% vs. 86.4%, p = 0.695; 2-year os: 73.6% vs. 77.0%, p = 0.265). In subgroup analysis, diabetic patients taking metformin survived significantly longer than their counterparts taking other diabetes treatments (os for the metformin group: 91% at 1 year; 80.5% at 2 years; os for the group taking other treatments, including diet control: 80.6% at 1 year, 67.4% at 2 years). Multivariate analysis suggests that patients with diabetes taking treatments other than metformin experience worse survival (p = 0.025). Conclusions Our results suggest that crc patients with diabetes, excluding those taking metformin, might have a worse crc prognosis. Taking metformin appears to have a positive association with prognosis. The protective nature of metformin needs further evaluation in prospective analyses. PMID:27122979

  18. Retrospective Study of Cryptococcal Meningitis With Elevated Minimum Inhibitory Concentration to Fluconazole in Immunocompromised Patients

    PubMed Central

    Nasri, Hashem; Kabbani, Sarah; Bou Alwan, Melhim; Wang, Yun F.; Rebolledo, Paulina A.; Kraft, Colleen S.; Nguyen, Minh L.; Anderson, Albert M.; Rouphael, Nadine

    2016-01-01

    Background. Mortality for cryptococcal meningitis remains significant, in spite of available treatment. Resistance to first-line maintenance therapy, particularly fluconazole, has been reported. Methods. A retrospective chart review was performed on immunocompromised patients with cryptococcal meningitis, who had susceptibility testing performed between January 2001 and December 2011, at 3 hospitals in Atlanta, Georgia. Results. A total of 35 immunocompromised patients with cryptococcal meningitis were identified, 13 (37.1%) of whom had an elevated minimum inhibitory concentration (MIC) to fluconazole (MIC ≥16 µg/mL). Eighty percent of patients were males with African American predominance, the median age was 37 years, and 80% of the patients were human immunodeficiency virus (HIV) positive. Subsequent recurrence of cryptococcal meningitis was more likely in HIV patients compared with solid organ transplant patients (P = .0366). Overall, there was a statistically significant increase in an elevated MIC to fluconazole in patients who had a history of prior azole use (odds ratio, 10.12; 95% confidence interval, 2.04–50.16). Patients with an elevated MIC to fluconazole and those with a high cerebrospinal fluid cryptococcal antigen load (≥1:512) were more likely to have central nervous system complications (P = .0358 and P = .023, respectively). Although no association was observed between an elevated MIC to fluconazole and mortality, those who received voriconazole or high-dose fluconazole (≥800 mg) for maintenance therapy were more likely to survive (P = .0288). Conclusions. Additional studies are required to further investigate the morbidity and mortality associated with an elevated MIC to fluconazole in cryptococcal meningitis, to determine when it is appropriate to perform susceptibility testing, and to evaluate its cost effectiveness. PMID:27419153

  19. Unexpected Histopathological Findings in Appendectomy Specimens: a Retrospective Study of 1627 Cases.

    PubMed

    Limaiem, Faten; Arfa, Nafaa; Marsaoui, Lobna; Bouraoui, Saadia; Lahmar, Ahlem; Mzabi, Sabeh

    2015-12-01

    Pathologic evaluation of the appendix after appendectomy is routine and can occasionally identify unexpected findings. The aim of the present study was to determine the incidence and type of pathologic diagnoses found in appendectomy specimens at our institution. The clinicopathological data of 1627 patients who underwent appendectomies for presumed acute appendicitis from January 2008 to October 2014 were reviewed retrospectively. There were 986 men and 641 women (sex ratio M/F = 1.5) aged between 16 months and 90 years (mean = 30 years). All patients underwent appendectomy (either open or laparoscopic). Histological examination of the surgical specimen showed acute inflammation of the appendix in 1455 cases (89.42 %), fibrosed appendix in 37 cases (2.27 %), and Enterobius vermicularis (n = 23). In 101 cases (6.2 %), the appendix was histologically normal. Incidental unexpected pathological diagnoses were noted in 57 appendectomy specimens. They included pinworm (n = 23), mucinous neoplasms (n = 12), neuroendocrine tumors (NET) (n = 8), adenocarcinoma (n = 2), granulomatous inflammation (n = 5), tuberculosis (n = 2), hyperplastic polyp (n = 1), tubular adenoma (n = 1), diverticulitis (n = 1), endometriosis (n = 1), and actinomycosis (n = 1). The routine histopathological examination of the appendix is of value for identifying unsuspected conditions requiring further postoperative management. Gross examination alone does not appear to be a good indicator of an unexpected finding on microscopic exam. It is recommended that in order to avoid misdiagnoses, all appendices should be histopathologically examined. PMID:27011552

  20. Breast reconstruction de novo by water-jet assisted autologous fat grafting – a retrospective study

    PubMed Central

    Hoppe, Delia Letizia; Ueberreiter, Klaus; Surlemont, Yves; Peltoniemi, Hilkka; Stabile, Marco; Kauhanen, Susanna

    2013-01-01

    Background: Autologous fat grafting has become a frequent, simple, reproducible and low-risk technique for revisional or partial breast reconstruction. The presented European multicenter study describes an optimized treatment and follow-up protocol for the de novo breast reconstruction after total mastectomy by lipotransfer alone. Methods: A retrospective European multicenter trial included 135 procedures on 28 (35 breasts) postmastectomy patients (mean 52.4 years). All women were treated with the water-jet assisted fat grafting method (BEAULI™) combined with additional procedures (NAC reconstruction, contralateral mastoplasty) and evaluated with at least 6 months follow-up (mean 2.6 years). Sonography or mammography, clinical examination, patient questionnaire (10-point Likert scale) and digital photographs were carried out. Results: On average the patients received 4 to 6 procedures each with a single volume of 159 ml (±61 ml) over 21 months (range 9 months to 2.5 years). In total 1,020 ml (±515 ml) fat were grafted till a complete breast reconstruction was achieved. Irradiated patients needed a significantly higher volume than non-irradiated (p<0.041). Main treatment complications were liponecrosis (2.59%), infection (0.74%) and granuloma (0.74%). Patient satisfaction was overall high to very high (96%) and confirmed the good aesthetic results (68%) and the natural softness, contour and shape of the reconstructed breast. Conclusions: A complete breast reconstruction with large volume fat grafting is alternatively possible to standard techniques in selected cases. It takes at least 4 to 6 lipotransfers in the course of 2 years. Patients with prior radiotherapy may require even up to 8 sessions over nearly 3 years of treatment. PMID:24403878

  1. Radiation-induced brachial plexopathy in patients with nasopharyngeal carcinoma: a retrospective study

    PubMed Central

    Fu, Ruying; Rong, Xiaoming; Wu, Rong; Cheng, Jinping; Huang, Xiaolong; Luo, Jinjun; Tang, Yamei

    2016-01-01

    Radiation-induced brachial plexopathy (RIBP) is one of the late complications in nasopharyngeal carcinoma (NPC) patients who received radiotherapy. We conducted a retrospective study to investigate its clinical characteristics and risk factors. Thirty-onepatients with RIBP after radiotherapy for NPC were enrolled. Clinical manifestations of RIBP, electrophysiologic data, magnetic resonance imaging (MRI), and the correlation between irradiation strategy and incidence of RIBP were evaluated. The mean latency at the onset of RIBP was 4.26 years. Of the symptoms, paraesthesia usually presented first (51.6%), followed by pain (22.6%) and weakness (22.6%). The major symptoms included paraesthesia (90.3%), pain (54.8%), weakness (48.4%), fasciculation (19.3%) and muscle atrophy (9.7%). Nerve conduction velocity (NCV) and electromyography (EMG) disclosed that pathological changes of brachial plexus involved predominantly in the upper and middle trunks in distribution. MRI of the brachial plexus showed hyper-intensity on T1, T2, post-contrast T1 and diffusion weighted whole body imaging with background body signal suppression (DWIBS) images in lower cervical nerves. Radiotherapy with Gross Tumor volume (GTVnd) and therapeutic dose (mean 66.8±2.8Gy) for patients with lower cervical lymph node metastasis was related to a significantly higher incidence of RIBP (P<0.001). Thus, RIBP is a severe and progressive complication of NPC after radiotherapy. The clinical symptoms are predominantly involved in upper and middle trunk of the brachial plexus in distribution. Lower cervical lymph node metastasis and corresponding radiotherapy might cause a significant increase of the RIBP incidence. PMID:26934119

  2. Hyperglycaemic index as a tool to assess glucose control: a retrospective study

    PubMed Central

    Vogelzang, Mathijs; van der Horst, Iwan CC; Nijsten, Maarten WN

    2004-01-01

    Introduction Critically ill patients may benefit from strict glucose control. An objective measure of hyperglycaemia for assessing glucose control in acutely ill patients should reflect the magnitude and duration of hyperglycaemia, should be independent of the number of measurements, and should not be falsely lowered by hypoglycaemic values. The time average of glucose values above the normal range meets these requirements. Methods A retrospective, single-centre study was performed at a 12-bed surgical intensive care unit. From 1990 through 2001 all patients over 15 years, staying at least 4 days, were included. Admission type, sex, age, Acute Physiology and Chronic Health Evaluation II score and outcome were recorded. The hyperglycaemic index (HGI) was defined as the area under the curve above the upper limit of normal (glucose level 6.0 mmol/l) divided by the total length of stay. HGI, admission glucose, mean morning glucose, mean glucose and maximal glucose were calculated for each patient. The relations between these measures and 30-day mortality were determined. Results In 1779 patients with a median stay in the intensive care unit of 10 days, the 30-day mortality was 17%. A total of 65,528 glucose values were analyzed. Median HGI was 0.9 mmol/l (interquartile range 0.3–2.1 mmol/l) in survivors versus 1.8 mmol/l (interquartile range 0.7–3.4 mmol/l) in nonsurvivors (P < 0.001). The area under the receiver operator characteristic curve was 0.64 for HGI, as compared with 0.61 and 0.62 for mean morning glucose and mean glucose. HGI was the only significant glucose measure in binary logistic regression. Conclusion HGI exhibited a better relation with outcome than other glucose indices. HGI is a useful measure of glucose control in critically ill patients. PMID:15153239

  3. Optic toxicity in radiation treatment of meningioma: a retrospective study in 213 patients.

    PubMed

    Farzin, Mostafa; Molls, Michael; Kampfer, Severin; Astner, Sabrina; Schneider, Ralf; Roth, Karin; Dobrei, Michaela; Combs, Stephanie; Straube, Christoph

    2016-05-01

    In this retrospective evaluation, we correlated radiation dose parameters with occurrence of optical radiation-induced toxicities. 213 meningioma patients received radiation between 2000 and 2013. Radiation dose and clinical data were extracted from planning systems and patients' files. The range of follow-up period was 2-159 months (median 75 months). Median age of patients was 60 years (range 23-86). There were 163 female and 50 male patients. In 140 cases, at least one of the neuro-optic structures (optic nerves and chiasm) was inside the irradiated target volumes. We found 15 dry eye (7 %) and 24 cataract (11.2 %) cases. Median dose to affected lachrymal glands was 1.47 Gy and median dose to affected lenses was 1.05 Gy. Age and blood cholesterol level in patients with cataract were significantly higher. Patients with dry eye were significantly older. Only two patients with visual problems attributable to radiation treatment were seen. They did not have any risk factors. Maximum and median delivered doses to neuro-optic structures were not higher than 57.30 and 54.60 Gy respectively. Low percentages of cases with radiation induced high grade optic toxicities show that modern treatment techniques and doses are safe. In very few patients with optic side effects, doses to organs at risk were higher than the defined constraint doses. This observation leads to the problem of additional risk factors coming into play. The role of risk factors and safety of higher radiation doses in high grade meningiomas should be investigated in more comprehensive studies. PMID:26852221

  4. Postoperative antibiotic prophylaxis in clean-contaminated head and neck oncologic surgery: a retrospective cohort study.

    PubMed

    Busch, C-J; Knecht, R; Münscher, A; Matern, J; Dalchow, C; Lörincz, B B

    2016-09-01

    Antibiotic prophylaxis is commonly used in head and neck oncologic surgery, due to the clean-contaminated nature of these procedures. There is a wide variety in the use of prophylactic antibiotics regarding the duration of application and the choice of agent. The purpose of this study was to determine whether short-term or long-term antibiotic prophylaxis has an impact on the development of head and neck surgical wound infection (SWI). Retrospective chart review was carried out in 418 clean-contaminated head and neck surgical oncology cases at our department. More than 50 variables including tumour type and stage, type of surgical treatment, co-morbidities, duration and choice of antibiotic prophylaxis, and the incidence of SWI were analysed. Following descriptive data analysis, Chi square test by Pearson and Fisher's exact test were used for statistical evaluation. Fifty-eight of the 418 patients (13.9 %) developed SWI. Patients with advanced disease and tracheotomy showed a significantly higher rate of SWI than those with early stage disease and without tracheotomy (p = 0.012 and p = 0.00017, respectively). However, there was no significant difference between the SWI rates in the short term and long term treatment groups (14.6 and 13.2 %, respectively; p = 0.689). Diabetes and body weight were not found to be risk factors for SWI. Long-term antibiotic prophylaxis was not associated with a decrease in SWI in the entire cohort of patients undergoing clean-contaminated major head and neck oncologic surgery. Our data confirmed the extent of surgery and tracheotomy as being risk factors for postoperative SWI. PMID:26683471

  5. Morbidity and Outcomes of Foreign Travelers in Zakynthos Island, Greece: A Retrospective Study

    PubMed Central

    Plessa, Eleni; Tansarli, Giannoula S.; Xanthopoulos, Dimitrios; Falagas, Matthew E.

    2014-01-01

    Background Although there is satisfactory recording of diseases affecting travelers visiting developing countries, little is known regarding morbidity of travelers when visiting developed countries. We sought to evaluate the morbidity of foreign travelers in Zakynthos, a popular Greek island attracting large number of foreign tourists every summer. Methods Data from foreign travelers that accommodated in Zakynthos and sought medical services from the private offices of Zante Medical Care from May 1 to October 30 2012 were retrospectively analyzed. Results Two thousand six hundred and eighty-eight patients were included in the study. The mean age (±SD) of the patients whom the age was recorded was 29.6 (±18.3) and 51.5% of them were from 18 to 40 years old. Disorders of the respiratory tract (32.7%), dermatologic conditions (21.1%), musculoskeletal injuries (16.4%), and gastrointestinal disorders (16.3%) were the four most prevalent clinical categories among patients. Ear disorder was the most common syndromic description (14.5%) among which 81.2% were ear infections; otitis externa and otitis media were diagnosed in 8.5% and 3.3% patients in total. The most common specific diagnosis was gastroenteritis (14.3%). Insect bite and sunburn were the most common diagnosis (6.5% and 3.8%, respectively) among patients with a dermatologic condition. Ear infection was the most common diagnosis in pediatric patients. Conclusion Disorders mainly of the upper respiratory tract were the predominant causes of illness among foreign travelers in Zakynthos. Traveler's diarrhea was the most common specific diagnosis but the prevalence within the total population was not very high. PMID:24728297

  6. Longitudinal and retrospective study has demonstrated morphometric variations in the fingerprints of elderly individuals.

    PubMed

    Silva, Lara Rosana Vieira; Mizokami, Leila Lopes; Vieira, Paola Rabello; Kuckelhaus, Selma Aparecida Souza

    2016-02-01

    Dermatoglyphics can be found in the thick skin of both hands and feet which make the identification process possible, however morphological changes throughout life can affect identification in elderly individuals. Considering that dermatoglyphics is an important biometric method, due to it being practical and inexpensive, this longitudinal and retrospective study was aimed to evaluate the morphological variations in fingerprints obtained from men and women (n=20) during their adult and elderly stages of life; the time between obtaining the two fingerprints was 33.5±9.4 years. For the morphometric analysis, an area of 1 cm(2) was selected to quantify the visible friction ridges, minutiae, interpapillary and white lines, and later side-by-side confrontation was used to determine the identity of the individuals. Our results showed a reduction of friction ridges, an increase in the number of white lines for the group (men and women) and a decrease in the number of interpapillary lines in the group of women. It also showed that the selection of compatible fingerprints by the automated AFIS/VRP system allowed the identification of 23 individuals (57.5%), but when the identification was made by the automated AFIS/VRP system, followed by the analysis of archived patterns to eliminate incompatible fingerprints, determination of the identity of 28 individuals (70.0%) was possible. The dermatoglyphics of the elderly suffered morphometric changes that prevented the identification of 30% of them, probably due to the aging process, and pointed to the importance of improving the methods of obtaining fingerprints to clarify issues related to the identification of the elderly. PMID:26734989

  7. Mechanical Ventilation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Observational Study

    PubMed Central

    Pesaro, Antonio Eduardo P.; Katz, Marcelo; Katz, Jason N.; Barbas, Carmen Sílvia Valente; Makdisse, Marcia R.; Correa, Alessandra G.; Franken, Marcelo; Pereira, Carolina; Serrano, Carlos V.; Lopes, Renato D.

    2016-01-01

    Purpose Patients with acute myocardial infarction (AMI) and respiratory impairment may be treated with either invasive or non-invasive mechanical ventilation (MV). However, there has been little testing of non-invasive MV in the setting of AMI. Our objective was to evaluate the incidence and associated clinical outcomes of patients with AMI who were treated with non-invasive or invasive MV. Methods This was a retrospective observational study in which consecutive patients with AMI (n = 1610) were enrolled. The association between exclusively non-invasive MV, invasive MV and outcomes was assessed by multivariable models. Results Mechanical ventilation was used in 293 patients (54% invasive and 46% exclusively non-invasive). In-hospital mortality rates for patients without MV, with exclusively non-invasive MV, and with invasive MV were 4.0%, 8.8%, and 39.5%, respectively (P<0.001). The median lengths of hospital stay were 6 (5.8–6.2), 13 (11.2–4.7), and 28 (18.0–37.9) days, respectively (P<0.001). Exclusively non-invasive MV was not associated with in-hospital death (adjusted HR = 0.90, 95% CI 0.40–1.99, P = 0.79). Invasive MV was strongly associated with a higher risk of in-hospital death (adjusted HR = 3.07, 95% CI 1.79–5.26, P<0.001). Conclusions In AMI setting, 18% of the patients required MV. Almost half of these patients were treated with exclusively non-invasive strategies with a favorable prognosis, while patients who needed to be treated invasively had a three-fold increase in the risk of death. Future prospective randomized trials are needed to compare the effectiveness of invasive and non-invasive MV for the initial approach of respiratory failure in AMI patients. PMID:26977804

  8. Comparison of Outcomes between Individuals with Pure and Mixed Lupus Nephritis: A Retrospective Study

    PubMed Central

    Ilori, Titilayo O.; Enofe, Nosayaba; Oommen, Anju; Cobb, Jason; Navarrete, Jose; Adedinsewo, Demilade A.; Oshikoya, Oluwatobiloba; Fevrier, Helene; Farris, Alton B.; Plantinga, Laura; Ojo, Akinlolu O.

    2016-01-01

    Introduction Lupus nephritis (LN) is a serious organ manifestation of systemic lupus erythematosus. Histologic overlap is relatively common in the six pathologic classes (I to VI) of LN. For example, mixed proliferative LN (MPLN) often includes features of classes III & V or classes IV & V combined. We performed a comparative evaluation of renal outcomes in patients with MPLN to patients with pure proliferative LN (PPLN) against pre-specified renal outcomes, and we also identified predictor of clinical outcomes among those with PPLN and MPLN. Hypothesis Individuals with MPLN will have worse short-term renal outcomes compared to those with PPLN. Methods We retrospectively reviewed 278 adult LN patients (≥18 years old) identified from an Emory University Hospital registry of native renal biopsies performed between January 2000 and December 2011. The final analytic sample consisted of individuals with a diagnosis of PPLN (n = 60) and MPLN (n = 96). We analyzed differences in clinical and laboratory characteristics at baseline. We also assessed associations between LN category and renal outcomes (complete remission and time to ESRD) with logistic and Cox proportional hazards models within two years of baseline. Results The study population was predominantly female (83.97%) and African American (71.8%) with a mean age of 33.4 years at baseline. Over a median follow up of 1.02 years, we did not find any statistically significant associations between MPLN and the development of ESRD or remission when compared to patients with PPLN (adjusted HR = 0.30, 95% CI = 0.07, 1.26). Conclusion There was no association between mixed or pure histopathologic features of LN at presentation and rate of complete or partial remission but higher baseline eGFR was associated with a lower probability of complete remission among patients with lupus nephritis. PMID:27304068

  9. Profiling postgraduate workplace-based assessment implementation in Ireland: a retrospective cohort study.

    PubMed

    Barrett, Aileen; Galvin, Rose; Steinert, Yvonne; Scherpbier, Albert; O'Shaughnessy, Ann; Walsh, Gillian; Horgan, Mary

    2016-01-01

    In 2010, workplace-based assessment (WBA) was formally integrated as a method of formative trainee assessment into 29 basic and higher specialist medical training (BST/HST) programmes in six postgraduate training bodies in Ireland. The aim of this study is to explore how WBA is being implemented and to examine if WBA is being used formatively as originally intended. A retrospective cohort study was conducted and approved by the institution's Research Ethics Committee. A profile of WBA requirements was obtained from 29 training programme curricula. A data extraction tool was developed to extract anonymous data, including written feedback and timing of assessments, from Year 1 and 2 trainee ePortfolios in 2012-2013. Data were independently quality assessed and compared to the reference standard number of assessments mandated annually where relevant. All 29 training programmes mandated the inclusion of at least one case-based discussion (max = 5; range 1-5). All except two non-clinical programmes (93 %) required at least two mini-Clinical Evaluation Exercise assessments per year and Direct Observation of Procedural Skills assessments were mandated in 27 training programmes over the course of the programme. WBA data were extracted from 50 % of randomly selected BST ePortfolios in four programmes (n = 142) and 70 % of HST ePortfolios (n = 115) in 21 programmes registered for 2012-2013. Four programmes did not have an eligible trainee for that academic year. In total, 1142 WBAs were analysed. A total of 164 trainees (63.8 %) had completed at least one WBA. The average number of WBAs completed by HST trainees was 7.75 (SD 5.8; 95 % CI 6.5-8.9; range 1-34). BST trainees completed an average of 6.1 assessments (SD 9.3; 95 % CI 4.01-8.19; range 1-76). Feedback-of varied length and quality-was provided on 44.9 % of assessments. The majority of WBAs were completed in the second half of the year. There is significant heterogeneity with respect to the frequency and

  10. A retrospective study on the quality of Haemophilus influenzae type b vaccines used in the UK between 1996 and 2004.

    PubMed

    Bolgiano, Barbara; Mawas, Fatme; Burkin, Karena; Crane, Dennis T; Saydam, Manolya; Rigsby, Peter; Corbel, Michael J

    2007-01-01

    Following the reduction in efficacy of Hib-TT vaccines in the primary immunization schedule observed in the UK between 1999 and 2003, batches of vaccine manufactured by two different companies were retrospectively examined by the National Institute for Biological Standards and Control. The study evaluated 41 batches of the Hib-TT vaccines manufactured between 1994 and 2003, assaying potency (total PRP saccharide content), integrity (% free saccharide), consistency (molecular sizing), and immunogenicity, as well as reviewing data previously obtained at the time of release. The study indicated the stability of the lyophilized final fill vaccines to extend well past their assigned shelf-lives, and found no trends in the endotoxin content, total saccharide or % free saccharide content. A trend towards slightly larger conjugates was observed over time in Hib-TT A, evidenced in both the manufacturer's data obtained at the time that samples were submitted for testing and in data obtained from the retrospective analysis. The study confirmed that that there had been no significant change in the quality of the Hib vaccines that could possibly account for the change reported in their protective efficacy in the UK. The study also demonstrated the value of independent testing of vaccines from the time of licensure and in the ongoing monitoring and re-examination of selected batches, as necessary, to assure their continuing quality, safety and consistency. PMID:17786035

  11. Clinical characteristics and prognosis of childhood rhabdomyosarcoma: a ten-year retrospective multicenter study

    PubMed Central

    Ma, Xiaoli; Huang, Dongsheng; Zhao, Weihong; Sun, Liming; Xiong, Hao; Zhang, Yi; Jin, Mei; Zhang, Dawei; Huang, Cheng; Wang, Huanmin; Zhang, Weiping; Sun, Ning; He, Lejian; Tang, Jingyan

    2015-01-01

    Purpose: Rhabdomyosarcoma (RMS) is the most frequent soft tissue sarcoma in children. We have retrospectively explored the treatment results of childhood RMS and identified prognostic factors in multicenter in China, in order to lay the foundation for further multicenter study. Methods: This retrospective study was carried out analyzing the medical records of 161 patients with the pathological diagnosis of RMS from January, 2001 to February, 2014 at 5 large cancer centers in China. The data was reviewed clinico-epidemiological factors. Age, gender, histology type, primary site, tumor size, intergroup rhabdomyosarcoma study (IRS) group and results of treatments were evaluated. Patients were followed up to Dec 31, 2014. Results: The median age of our patients was 51 months. 10.5% of our patients were infants. The genitourinary system was the most common primary site of tumor (43.5%). The proportion of primary site of head and neck except parameningeal, at 28.2% (42 cases), while the proportion of parameningeal region was 4.6% (7 cases). The histological findings were as follows: 130 cases (80.7%) with embryonal, 19 cases (11.9%) with alveolar and 5 cases (3.1%) with botryoid type. According to the classification system of the IRS group, 1 case (0.6%) was group I, 54 cases (33.5%) were group II, 46 cases (28.6%) were group III and 60 cases (37.3 %) were group IV. 149 patients were treated and followed-up regularly, Patients in Beijing children’s hospital (n=95) were enrolled in IRS-II/COG-D9803, D9802 protocols. while the other patients (n=54) started on treatment according to Chinese Anti-cancer Association protocol. There were median time of 51 months for following up, 60 occurred event. The ten-year event free survival rate was 53.4±5.1%, overall survival was 65.3±6.3%. The relations between outcome and age (0.046), primary site (0.022), pathologic subtype (0.013), tumor size (0.008) and IRS group (P=0.000) were associated significantly with event free survival

  12. A retrospective drug use evaluation of cabergoline for lactation inhibition at a tertiary care teaching hospital in Qatar

    PubMed Central

    AlSaad, Doua; ElSalem, Samah; Abdulrouf, Palli Valapila; Thomas, Binny; Alsaad, Tayseer; Ahmed, Afif; AlHail, Moza

    2016-01-01

    Background Breastfeeding is considered as gold standard for infant nutrition and should be interrupted only when a compelling indication exists. Certain medical conditions such as abortion, stillbirth, HIV infection, or infant galactosemia and certain medications such as chemotherapy necessitate lactation inhibition to protect the health of mother and infant. Drug use evaluation (DUE) studies are done to explore the current practice in a setting and help to identify areas in which further information and education may be needed by clinicians. Objective The aim of this study was to conduct a DUE of cabergoline to assess indications for lactation inhibition, dosage regimen, and its safety. Method A retrospective cross-sectional DUE study was conducted over a period of 4 months from September 1, 2013, till December 31, 2013, at the Women’s Hospital, Qatar. All cabergoline prescriptions written for lactation inhibition within 10 days of delivery or abortion were included in the study. A descriptive data analysis was undertaken. Results Of the 85 patients included, stillbirth (50.6%) was considered as the main reason for lactation inhibition, followed by abortion (27.1%) and neonatal death (12.9%). The remaining 9.4% of the patients had live baby, and the majority of them were prescribed cabergoline for lactation inhibition because their maternal medical conditions required the use of drugs with insufficient safety data (n=6). Seventy-four percent of patients received cabergoline at accurate time and dose. However, 14% of the patients had preexisting hypertensive disorder and 58.3% of them were diagnosed as uncontrolled hypertension. Conclusion The current DUE study found that cabergoline was mainly used to inhibit lactation for patients with stillbirth, abortion, and neonatal death. In mothers who use medications for other medical conditions, benefits and risks of breastfeeding should be carefully balanced before prescribing cabergoline. Current prescribing pattern

  13. Outcomes of Microendoscopic Discectomy and Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation: A Comparative Retrospective Study

    PubMed Central

    Sinkemani, Arjun; Hong, Xin; Gao, Zeng-Xin; Zhuang, Su-Yang; Jiang, Zan-Li; Zhang, Shao-Dong; Bao, Jun-Ping; Zhu, Lei; Zhang, Pei; Xie, Xin-Hui; Wang, Feng

    2015-01-01

    Study Design Retrospective, case control evaluation of 86 patients who underwent microendoscopic discectomy (MED) and percutaneous transforaminal endoscopic discectomy (PTED) for the treatment of lumbar disc herniation (LDH). Purpose To evaluate the safety and the outcomes of MED and PTED for the treatment of LDH. Overview of Literature MED and PTED are minimally invasive surgical techniques for lower back pain. Studies to date have shown that MED and PTED are safe and effective treatment modalities for LDH. Methods A retrospective study was performed in patients with LDH treated with MED (n=50) and transforaminal endoscopic discectomy (PTED; n=36) in our hospital. All patients were followed-up with self-evaluation questionnaires, Oswestry disability index (ODI), medical outcomes study 36-item short form health survey and MacNab criteria. All the patients in both groups were followed up to 12 months after the operation. Results ODI questionnaire responses were not statistically different between the MED and PTED groups (53.00 vs. 48.72) before treatment. Average scores and minimal disability after 5 days to 12 months of follow-up were 4.96 in the MED group and 3.61 in the PTED group. According to MacNab criteria, 92.0% of the MED group and 94.4% of the PTED group had excellent or good results with no significant difference. Conclusions There was no significant difference between MED and PTED outcomes. Further large-scale, randomized studies with long-term follow-up are needed. PMID:26713113

  14. Safety in the epilepsy monitoring unit: A retrospective study of 524 consecutive admissions.

    PubMed

    Fahoum, Firas; Omer, Nurit; Kipervasser, Svetlana; Bar-Adon, Tal; Neufeld, Miri

    2016-08-01

    The yield of monitoring patients at an epilepsy monitoring unit (EMU) depends on the recording of paroxysmal events in a timely fashion, however, increasing the risk of safety adverse events (AEs). We aimed to retrospectively study the frequency and risk factors for AE occurrences in all consecutive admissions to an adult EMU in a tertiary medical center. We also compared our findings with published data from other centers. Between January 2011 and June 2014, there were 524 consecutive admissions to the adult EMU at the Tel Aviv Sourasky Medical Center. Adverse events were recorded in 47 (9.0%) admissions. The most common AE was 4-hour seizure cluster (58.7% of AEs) and, in decreasing frequency, AEs related to antiepileptic drugs (AEDs, 11.1%), falls and traumatic injuries (9.5%), intravenous line complications (9.5%), electrode-related (4.8%), status epilepticus (SE, 3.2%), and cardiac (1.6%) and psychiatric (1.6%) complications. There were significantly more AEs among patients with a younger age at disease onset (p=0.005), a history of temporal lobe epilepsy (p=0.046), a history of focal seizures with altered consciousness (p=0.008), a history of SE (p=0.022), use of a vagal nerve stimulator (p=0.039), and intellectual disability (p=0.016) and when the indication for EMU monitoring was noninvasive or invasive presurgical evaluation (p=0.001). Adverse events occurred more frequently when patients had more events in the EMU (p=0.001) and among those administered carbamazepine (p=0.037), levetiracetam (p=0.004), clobazam (p=0.008), and sulthiame (p=0.016). Patients with a history of psychogenic nonepileptic seizures (PNESs) had significantly fewer AEs (p=0.013). Adverse events were not associated with the age, gender, duration of hospitalization or monitoring, AED withdrawal and renewal, seizure frequency by history, presence of major psychiatric comorbidities, abnormal neurological exam, or the presence of a lesion as on brain magnetic resonance imaging. In

  15. Tuberculosis After One Year of Combination Antiretroviral Therapy in Nigeria: A Retrospective Cohort Study

    PubMed Central

    Achenbach, Chad J.; Feinglass, Joe; Taiwo, Babafemi; Onu, Adamu; Pho, Mai T.; Agbaji, Oche; Kanki, Phyllis; Murphy, Robert L.

    2013-01-01

    Abstract Our objective was to determine tuberculosis (TB) incidence and evaluate TB risk in adults after one or more years of use of combination antiretroviral therapy (cART) through a retrospective cohort study in Jos, Nigeria. We studied a cohort of HIV-infected adults treated with ART for at least 1 year. Based on immunologic and virologic responses to ART, patients were categorized into four groups: CD4 T cell count ≥350 cells/mm3 and HIV-1 RNA level ≤400 copies/ml (group 1), CD4 T cell count ≥350 cells/mm3 and HIV-1 RNA level >400 copies/ml (group 2), CD4 T cell count <350 cells/mm3 and HIV-1 RNA level ≤400 copies/ml (group 3), and CD4 T cell count <350 cells/mm3 and HIV-1 RNA level >400 copies/ml (group 4). Time to incident TB for the four groups was analyzed using the Kaplan–Meier method. Cox regression models were used to evaluate predictors of incident TB. In this cohort of 5,093 HIV-infected adults, of which 68.4% were female, with a mean age 35.1 years (standard deviation 9.1 years), we observed 98 cases of incident TB during 4 years and 3 months of follow-up. The overall TB incidence rate was 8.7 cases/1,000 patient-years of follow-up. Adjusted hazards for incident TB were 2.11 (95% CI 0.97–4.61), 2.05 (95% CI 1.10–3.79), and 3.65 (95% CI 1.15–5.06) in group 2, 3, and 4 patients, respectively, compared to group 1. Tuberculosis incidence in patients on ART is driven by poor immunologic and/or virologic response. Optimization of HIV treatment should be prioritized to reduce the burden of TB in this high-risk population. PMID:23316724

  16. Tuberculosis after one year of combination antiretroviral therapy in Nigeria: a retrospective cohort study.

    PubMed

    Akanbi, Maxwell O; Achenbach, Chad J; Feinglass, Joe; Taiwo, Babafemi; Onu, Adamu; Pho, Mai T; Agbaji, Oche; Kanki, Phyllis; Murphy, Robert L

    2013-06-01

    Our objective was to determine tuberculosis (TB) incidence and evaluate TB risk in adults after one or more years of use of combination antiretroviral therapy (cART) through a retrospective cohort study in Jos, Nigeria. We studied a cohort of HIV-infected adults treated with ART for at least 1 year. Based on immunologic and virologic responses to ART, patients were categorized into four groups: CD4 T cell count ≥350 cells/mm(3) and HIV-1 RNA level ≤400 copies/ml (group 1), CD4 T cell count ≥350 cells/mm(3) and HIV-1 RNA level >400 copies/ml (group 2), CD4 T cell count <350 cells/mm(3) and HIV-1 RNA level ≤400 copies/ml (group 3), and CD4 T cell count <350 cells/mm(3) and HIV-1 RNA level >400 copies/ml (group 4). Time to incident TB for the four groups was analyzed using the Kaplan-Meier method. Cox regression models were used to evaluate predictors of incident TB. In this cohort of 5,093 HIV-infected adults, of which 68.4% were female, with a mean age 35.1 years (standard deviation 9.1 years), we observed 98 cases of incident TB during 4 years and 3 months of follow-up. The overall TB incidence rate was 8.7 cases/1,000 patient-years of follow-up. Adjusted hazards for incident TB were 2.11 (95% CI 0.97-4.61), 2.05 (95% CI 1.10-3.79), and 3.65 (95% CI 1.15-5.06) in group 2, 3, and 4 patients, respectively, compared to group 1. Tuberculosis incidence in patients on ART is driven by poor immunologic and/or virologic response. Optimization of HIV treatment should be prioritized to reduce the burden of TB in this high-risk population. PMID:23316724

  17. Early epileptic encephalopathies including West syndrome: a 3-year retrospective study from Klang Hospital, Malaysia.

    PubMed

    Thambyayah, M

    2001-11-01

    It is difficult to give a country report from Malaysia. A study done in 1999 reported the incidence of West Syndrome to be 3% among newly diagnosed cases of epilepsy. In this 3 year retrospective hospital-based study (1997-1999), the prevalence of early epileptic encephalopathy (EEE) and West Syndrome were 4.1 and 2.5% respectively. There is difficulty classifying EEE cases into distinct sub-groups of EIEE (early infantile epileptic encephalopathy), WS (West Syndrome) and SMEI (severe myoclonic epilepsy of infancy), using a combination of clinical features, EEG and CT/MRI findings. PMID:11701263

  18. Effectiveness of inhaler types for real-world asthma management: retrospective observational study using the GPRD

    PubMed Central

    Price, David; Haughney, John; Sims, Erika; Ali, Muzammil; von Ziegenweidt, Julie; Hillyer, Elizabeth V; Lee, Amanda J; Chisholm, Alison; Barnes, Neil

    2011-01-01

    Purpose: Results of randomized controlled trials may not predict effectiveness of inhaled corticosteroids (ICS) in real-world clinical practice, where inhaler technique and device characteristics can influence effectiveness. We compared asthma outcomes for ICS delivered via three different inhaler devices: pressurized metered-dose inhaler (pMDI), breath-actuated MDI (BAI), and dry powder inhaler (DPI). Patients and methods: This retrospective database study evaluated 1-year outcomes for primary care patients with asthma aged 5–60 years prescribed their first ICS (initiation population) by pMDI (n = 39,746), BAI (n = 9809), or DPI (n = 6792), or their first ICS dose increase (step-up population) by pMDI (n = 6245), BAI (n = 1388), or DPI (n = 1536). Co-primary outcome measures were composite proxy measures of asthma control (no hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory infection) and severe exacerbations (unscheduled hospital admission, emergency room attendance, or oral corticosteroids). Outcomes were adjusted for potential confounding factors identified during a baseline year. Results: In the initiation population, adjusted odds ratios (95% confidence intervals [CI]) for asthma control, as compared with pMDIs, were significantly better for BAIs (1.08 [1.02–1.14]) and DPIs (1.13 [1.06–1.21]), while adjusted exacerbation rate ratios (95% CI) were 1.00 (0.93–1.08) and 0.88 (0.81–0.95), respectively. In the step-up population, adjusted odds of asthma control were 1.21 (1.05–1.39) for BAIs and 1.13 (0.99–1.29) for DPIs; adjusted exacerbation rate ratios were 0.83 (0.71–0.98) for BAIs and 0.85 (0.74–0.98) for DPIs, compared with pMDIs. Conclusion: Inhaler device selection may have a bearing on clinical outcomes. Differences in real-world effectiveness among these devices require closer evaluation in well-designed prospective trials. PMID:21698214

  19. Skin substitutes based on allogenic fibroblasts or keratinocytes for chronic wounds not responding to conventional therapy: a retrospective observational study.

    PubMed

    Pajardi, Giorgio; Rapisarda, Vicenzo; Somalvico, Francesco; Scotti, Andrea; Russo, Giulia Lo; Ciancio, Francesco; Sgrò, Arturo; Nebuloni, Manuela; Allevi, Raffaele; Torre, Maria L; Trabucchi, Emilio; Marazzi, Mario

    2016-02-01

    Chronic wounds are an expression of underlying complex pathologies and have a high incidence. Skin substitutes may represent an alternative approach to treat chronic ulcers. The aim of this retrospective observational study was to evaluate the wound reduction using skin substitutes based on allogenic fibroblasts or keratinocytes in 30 patients not responding to conventional therapy. Wound bed was prepared, then keratinocytes on Laserskin(®) to treat superficial wounds or fibroblasts on Hyalograft 3D(R) to treat deep leg ulcers were applied, and finally wounds were treated with a secondary dressing composed of nanocrystalline silver. Once a week constructs were removed and new bioengineered products were applied, as well as nanocrystalline silver medication. In none of the cases under examination did any complications arise relating to the treatment. We also achieved a reduction in wound dimension and exudates, and an increase in wound bed score. Postoperative assessment shows a degree of healing that is statistically higher in the group treated with keratinocytes as compared with the fibroblast group. This retrospective study improves our understanding and defines the clinical indications for the various uses of the two types of skin substitutes. PMID:24517418

  20. Outcome of the Pediatric Patients with Portal Cavernoma: The Retrospective Study for 10 Years Focusing on Recurrent Variceal Bleeding

    PubMed Central

    Guo, Hongjie; Hao, Fabao; Guo, Chunbao; Yu, Yang

    2016-01-01

    Background. Portal cavernoma (PC) is the most critical condition with risk or variceal hemorrhage in pediatric patients. We retrospectively investigated the patients with PC focusing on the predictors for recurrent variceal bleeding. Methods. Between July 2003 and June 2013, we retrospectively enrolled all consecutive patients admitted to our department with a diagnosis of PC without abdominal malignancy or liver cirrhosis. The primary endpoint of this observational study was recurrent variceal bleeding. Independent predictors of recurrent variceal bleeding were identified using the logistic regression model. Results. A total of 157 patients were enrolled in the study. During the follow-up period, 24 patients exhibited onset of recurrent variceal bleeding. Acute variceal bleeding was subjected to conservative symptomatic treatment and emergency endoscopic sclerotherapy. Surgical procedure selection was based on the severity of vascular dilation and collateral circulation. Multivariate logistic regression analysis demonstrated that the presence of ascites, collateral circulation, and portal venous pressure were independent prognostic factors of recurrent variceal bleeding for patients with portal cavernoma. Conclusions. The presence of ascites, collateral circulation, and portal venous pressure evaluation are important and could predict the postsurgical recurrent variceal bleeding in patients with portal cavernoma. PMID:26949386

  1. Treatment Outcome and Associated Factors among Tuberculosis Patients in Debre Tabor, Northwestern Ethiopia: A Retrospective Study.

    PubMed

    Melese, Addisu; Zeleke, Balew; Ewnete, Biniam

    2016-01-01

    Background. Assessing the outcomes of tuberculosis (TB) treatment is an important indicator for evaluation of the effectiveness of tuberculosis control programs. In Ethiopia, directly observed treatment short course (DOTS) was included in the national tuberculosis control program as a strategy but little is known about its effectiveness in the study area. Therefore, this study was aimed at assessing the treatment outcomes of TB patients and associated factors in Debre Tabor, northwest Ethiopia. Methods. A retrospective study was conducted among TB patients for the period from May 2008 to April 2013 at Debre Tabor Health Center, northwest Ethiopia. Data were entered and analyzed using SPSS version 20.0. Descriptive statistics were used to generate frequency tables and figures. Logistic regressions were used to identify factors associated with treatment outcomes at P value ≤ 0.05. Results. Out of 339 patients (197 males and 142 females) registered for antituberculosis treatment in Debre Tabor Health Center, only 303 patients were included in the treatment outcome analysis and 87.1% had successful treatment outcome while 12.9% had unsuccessful treatment outcome. In the multivariate logistic regression analysis, the odds of successful treatment outcome were higher among patients ≥45 years of age (AOR = 3.807, 95% CI: 1.155-12.544) and lower among females (AOR = 0.347, 95% CI: 0.132-0.917), rural residents (AOR = 0.342, 95% CI: 0.118-0.986), and negative smear result at the second month of treatment (AOR = 0.056, 95% CI: 0.005-0.577) as compared to their counterparts. Conclusion. The treatment outcome of all forms of tuberculosis patients in Debre Tabor health center was satisfactory as expected from effective implementation of DOTS. Although the observed successful treatment outcome was in agreement with the national target, follow-up of patients during the course of treatment to trace the treatment outcomes of transferred-out patients and assessment of other

  2. Treatment Outcome and Associated Factors among Tuberculosis Patients in Debre Tabor, Northwestern Ethiopia: A Retrospective Study

    PubMed Central

    Zeleke, Balew; Ewnete, Biniam

    2016-01-01

    Background. Assessing the outcomes of tuberculosis (TB) treatment is an important indicator for evaluation of the effectiveness of tuberculosis control programs. In Ethiopia, directly observed treatment short course (DOTS) was included in the national tuberculosis control program as a strategy but little is known about its effectiveness in the study area. Therefore, this study was aimed at assessing the treatment outcomes of TB patients and associated factors in Debre Tabor, northwest Ethiopia. Methods. A retrospective study was conducted among TB patients for the period from May 2008 to April 2013 at Debre Tabor Health Center, northwest Ethiopia. Data were entered and analyzed using SPSS version 20.0. Descriptive statistics were used to generate frequency tables and figures. Logistic regressions were used to identify factors associated with treatment outcomes at P value ≤ 0.05. Results. Out of 339 patients (197 males and 142 females) registered for antituberculosis treatment in Debre Tabor Health Center, only 303 patients were included in the treatment outcome analysis and 87.1% had successful treatment outcome while 12.9% had unsuccessful treatment outcome. In the multivariate logistic regression analysis, the odds of successful treatment outcome were higher among patients ≥45 years of age (AOR = 3.807, 95% CI: 1.155–12.544) and lower among females (AOR = 0.347, 95% CI: 0.132–0.917), rural residents (AOR = 0.342, 95% CI: 0.118–0.986), and negative smear result at the second month of treatment (AOR = 0.056, 95% CI: 0.005–0.577) as compared to their counterparts. Conclusion. The treatment outcome of all forms of tuberculosis patients in Debre Tabor health center was satisfactory as expected from effective implementation of DOTS. Although the observed successful treatment outcome was in agreement with the national target, follow-up of patients during the course of treatment to trace the treatment outcomes of transferred-out patients and assessment of

  3. Two Years Retrospective Evaluation of Overdenture Retained by Symphyseal Single Implant Using Two Types of Attachments

    PubMed Central

    Ismail, Hussien Abdelfattah; Mahrous, Ahmed I; Banasr, Fahad H; Soliman, Tarek A; Baraka, Yasser

    2015-01-01

    Background: This study was aimed to evaluate complete mandibular overdentures retained by a symphyseal single implant using ball and magnet attachments in both clinical and radiographic evaluation. Materials and Methods: Ten dental press fit titanium implants were installed in the lower jaws of completely edentulous patients according to two-stage surgical protocol. For each patient, one implant was installed in the symphyseal midline region, and left submerged and unloaded for 4 months. The patients were then divided into two equal groups. The first group received mandibular overdentures retained by ball and socket attachment. The second group received mandibular overdentures retained by magnet attachment. Both groups were supplied with conventional maxillary complete dentures. All patients were evaluated immediately after denture insertion, 6 months, and 12 months and after 24 months of overdenture insertion. Results: The study showed insignificant difference regarding the clinical condition and the marginal bone height changes in both groups during the follow-up period. Conclusion: Single implant retained overdenture with ball and socket or magnetic attachments was easy in construction, required less home care to maintain gingival health and give satisfactory clinical results. PMID:26124591

  4. Recombinant human erythropoietin in very elderly patients with myelodysplastic syndromes: results from a retrospective study.

    PubMed

    Tatarelli, Caterina; Piccioni, Anna Lina; Maurillo, Luca; Naso, Virginia; Battistini, Roberta; D'Andrea, Mariella; Criscuolo, Marianna; Nobile, Carolina; Villivà, Nicoletta; Mancini, Stefano; Neri, Benedetta; Breccia, Massimo; Fenu, Susanna; Buccisano, Francesco; Voso, Maria Teresa; Latagliata, Roberto; Aloe Spiriti, Maria Antonietta

    2014-08-01

    Myelodysplastic syndromes (MDS) are common in elderly patients. Recombinant human erythro-poietin (rHuEPO) has been widely used to treat anemia in lower risk MDS patients, but few data are known about rHuEPO treatment in the very elderly patient group. In order to investigate the role of rHuEPO treatment in terms of response, overall survival (OS), and toxicity in a very elderly MDS patient group, 93 MDS patients treated with rHuEPO when aged ≥80 years were selected among MDS cases enrolled in a retrospective multicenter study by the cooperative group Gruppo Romano Mielodisplasie (GROM) from Jan 2002 to Dec 2010. At baseline, median age was 82.7 (range 80-99.1) with a median hemoglobin (Hb) level of 9 g/dl (range 6-10.8). The initial dose of rHuEPO was standard (epoetin alpha 40,000 IU/week or epoetin beta 30,000 IU/week) in 59 (63.4 %) patients or high in 34 (36.6 %) (epoetin alpha 80,000 IU/week) patients. We observed an erythroid response (ER) in 59 (63.4 %) patients. No thrombotic event was reported. Independent predictive factors for ER were low transfusion requirement before treatment (p = 0.004), ferritin <200 ng/ml (p = 0.017), Hb >8 g/dl (p = 0.034), and a high-dose rHuEPO treatment (p = 0.032). Median OS from rHuEPO start was 49.3 months (95 % CI 27.5-68.4) in responders versus 30.6 months (95 % CI 7.3-53.8) in resistant patients (p = 0.185). In conclusion, rHuEPO treatment is safe and effective also in the very elderly MDS patients. However, further larger studies are warranted to evaluate if EPO treatment could be worthwhile in terms of quality of life and cost-efficacy in very old patients. PMID:24647684

  5. Rates of prenatal screening across health care regions in Ontario, Canada: a retrospective cohort study

    PubMed Central

    Hayeems, Robin Z.; Campitelli, Michael; Ma, Xiaomu; Huang, Tianhua; Walker, Mark; Guttmann, Astrid

    2015-01-01

    Background It is recommended that all pregnant women be offered screening for Down syndrome and open neural tube defects, but emerging prenatal tests that are not publicly insured may compromise access. We evaluated screening rates for publicly insured screening tests across health care regions in the province of Ontario and determined whether maternal, provider or regional characteristics are associated with screening uptake. Methods We conducted a population-based retrospective cohort study involving pregnant women in Ontario who were at or beyond 16 weeks’ gestation in 2007–2009. We ascertained prenatal screening rates using linked health administrative and prenatal screening datasets. We examined maternal, provider and regional characteristics associated with screening uptake. Rate ratios (RRs) were estimated. Results Of the 264 737 women included in the study, 62.2% received prenatal screening; uptake varied considerably by region (range 27.8%–80.3%). A greater proportion of women initiated screening in the first rather than the second trimester (50.0% v. 12.2%). Factors associated with lower screening rates included living in a rural area versus an urban area (adjusted rate ratio 0.64, 95% confidence interval [CI] 0.63–0.66), receiving first-trimester care from a family physician or midwife versus an obstetrician (adjusted rate ratio 0.91, 95% CI 0.90–0.92, and 0.40, 95% CI 0.38–0.43, respectively) and being in a lower income quintile (adjusted RR for lowest v. highest 0.95, 95% CI 0.94–0.96). Being an immigrant or a refugee was associated with higher screening rates. Interpretation There were significant maternal, provider and regional differences in the uptake of prenatal screening across the province. With discrepancies expected to increase with the emergence of noninvasive prenatal tests paid for out of pocket by many women, policy efforts to reduce barriers to prenatal screening and optimize its availability are warranted. PMID:26389102

  6. Role of Lactobacillus Species in the Intermediate Vaginal Flora in Early Pregnancy: A Retrospective Cohort Study

    PubMed Central

    Farr, Alex; Kiss, Herbert; Hagmann, Michael; Machal, Susanne; Holzer, Iris; Kueronya, Verena; Husslein, Peter Wolf; Petricevic, Ljubomir

    2015-01-01

    Background Poor obstetrical outcomes are associated with imbalances in the vaginal flora. The present study evaluated the role of vaginal Lactobacillus species in women with intermediate vaginal flora with regard to obstetrical outcomes. Methods We retrospectively analysed data from all women with singleton pregnancies who had undergone routine screening for asymptomatic vaginal infections at our tertiary referral centre between 2005 and 2014. Vaginal smears were Gram-stained and classified according to the Nugent scoring system as normal flora (score 0–3), intermediate vaginal flora (4–6), or bacterial vaginosis (7–10). Only women with intermediate vaginal flora were investigated. Women with a Nugent score of 4 were categorised into those with and without Lactobacilli. Follow-up smears were obtained 4–6 weeks after the initial smears. Descriptive data analysis, the Welch’s t-test, the Fisher’s exact test, and multiple regression analysis with adjustment for confounders were performed. Gestational age at delivery and birth weight were the outcome measures. Results At antenatal screening, 529/8421 women presented with intermediate vaginal flora. Amongst these, 349/529 (66%) had a Nugent score of 4, 94/529 (17.8%) a Nugent score of 5, and 86/529 (16.2%) a Nugent score of 6. Amongst those with a Nugent score of 4, 232/349 (66.5%) women were in the Lactobacilli group and 117/349 (33.5%) in the Non-Lactobacilli group. The preterm delivery rate was significantly lower in the Lactobacilli than in the Non-Lactobacilli group (OR 0.34, CI 0.21–0.55; p<0.001). Mean birth weight was 2979 ± 842 g and 2388 ± 1155 g in the study groups, respectively (MD 564.12, CI 346.23–781.92; p<0.001). On follow-up smears, bacterial vaginosis rates were 9% in the Lactobacilli and 7.8% in the Non-Lactobacilli group. Conclusions The absence of vaginal Lactobacillus species and any bacterial colonisation increases the risks of preterm delivery and low birth weight in women with

  7. Retrospective cohort mortality study of workers at an aircraft maintenance facility. I. Epidemiological results.

    PubMed

    Spirtas, R; Stewart, P A; Lee, J S; Marano, D E; Forbes, C D; Grauman, D J; Pettigrew, H M; Blair, A; Hoover, R N; Cohen, J L

    1991-08-01

    A retrospective cohort study of 14,457 workers at an aircraft maintenance facility was undertaken to evaluate mortality associated with exposures in their workplace. The purpose was to determine whether working with solvents, particularly trichloroethylene, posed any excess risk of mortality. The study group consisted of all civilian employees who worked for at least one year at Hill Air Force Base, Utah, between 1 January 1952 and 31 December 1956. Work histories were obtained from records at the National Personnel Records Centre, St. Louis, Missouri, and the cohort was followed up for ascertainment of vital state until 31 December 1982. Observed deaths among white people were compared with the expected number of deaths, based on the Utah white population, and adjusted for age, sex, and calendar period. Significant deficits occurred for mortality from all causes (SMR 92, 95% confidence interval (95% CI) 90-95), all malignant neoplasms (SMR 90, 95% CI 83-97), ischaemic heart disease (SMR 93, 95% CI 88-98), non-malignant respiratory disease (SMR 87, 95% CI 76-98), and accidents (SMR 61, 95% CI 52-70). Mortality was raised for multiple myeloma (MM) in white women (SMR 236, 95% CI 87-514), non-Hodgkin's lymphoma (NHL) in white women (SMR 212, 95% CI 102-390), and cancer of the biliary passages and liver in white men dying after 1980 (SMR 358, 95% CI 116-836). Detailed analysis of the 6929 employees occupationally exposed to trichloroethylene, the most widely used solvent at the base during the 1950s and 1960s, did not show any significant or persuasive association between several measures of exposure to trichloroethylene and any excess of cancer. Women employed in departments in which fabric cleaning and parachute repair operations were performed had more deaths than expected from MM and NHL. The inconsistent mortality patterns by sex, multiple and overlapping exposures, and small numbers made it difficult to ascribe these excesses to any particular substance

  8. Prognostic Factors in Peptic Ulcer Perforations: A Retrospective 14-Year Study

    PubMed Central

    Unver, Mutlu; Fırat, Özgür; Ünalp, Ömer Vedat; Uğuz, Alper; Gümüş, Tufan; Sezer, Taylan Özgür; Öztürk, Şafak; Yoldaş, Tayfun; Ersin, Sinan; Güler, Adem

    2015-01-01

    Regarding the complications of peptic ulcer, a perforation remains the most important fatal complication. The aim of our retrospective study was to determine relations between postoperative morbidity and comorbid disease or perioperative risk factors in perforated peptic ulcer. In total, 239 patients who underwent emergency surgery for perforated peptic ulcer in Ege University General Surgery Department, between June 1999 and May 2013 were included in this study. The clinical data concerning the patient characteristics, operative methods, and complications were collected retrospectively. One hundred seventy-five of the 239 patients were male (73.2%) and 64 were female (26.8%). Mean American Society of Anesthesiologists (ASA) score was 1 in the patients without morbidity, but mean ASA score was 3 in the morbidity and mortality groups. Primary suture and omentoplasty was the selected procedure in 228 of the patients. Eleven patients underwent resection. In total, 105 patients (43.9%) had comorbidities. Thirty-seven patients (67.3%) in the morbidity group had comorbid diseases. Thirteen (92.9%) patients in the mortality group had comorbid diseases. Perforation as a complication of peptic ulcer disease still remains among the frequent indications of urgent abdominal surgery. Among the analyzed parameters, age, ASA score, and having comorbid disease were found to have an effect on both mortality and morbidity. The controversial subject in the present study is regarding the duration of symptoms. The duration of symptoms had no effect on mortality nor morbidity in our study. PMID:26011220

  9. A retrospective study of patients with mandibular fractures treated at a Swedish University Hospital 1999-2008

    PubMed Central

    Ramadhan, Anwar; Gavelin, Petter; Hirsch, Jan M.; Sand, Lars P.

    2014-01-01

    Background: Fracture of the mandible is one of the most common fractures of the maxillofacial skeleton. However, the etiology, gender, and age distribution vary between different regions and countries, and the purpose of this study was to evaluate the current trend of patients with mandibular fractures at the Department of Oral and Maxillofacial Surgery, in Uppsala, Sweden. Aim: The aim of this retrospective study was to analyze patients with mandibular fractures treated in the University Hospital of Uppsala (the county capital of Uppland) Sweden during a 10-year period (1999-2008). Materials and Methods: This study was designed as a retrospective study of patients admitted to the Department of Oral and Maxillofacial Surgery at Uppsala University Hospital, Sweden. The location of fractures was evaluated clinically by the surgeon and on the X-rays. We classified the data according to gender, age, etiology, day of the week, month of the year, fracture site, and method of treatment of the fractures. Results: Records were collected from patient charts from 266 patients. One hundred eighty-seven patients (70%) with mandibular fractures were of male gender, and 132 patients (50%) were aged 16-30 years. Interpersonal violence constituted the most common etiological factor for mandibular fractures (24%), followed by falls (23%). Forty-nine percentages of the patients were treated surgically, and 51% were treated conservatively. There was an increase of the annual incidence of fractures toward the end of the period, even though not statistically significant. Conclusions: Mandibular fractures occurred primarily among younger men between 16- and 30-year-old. Condyle fractures were the most common fracture site and 50% of the patients required surgery. Summer months and weekends were the most common time of mandibular fractures. PMID:25593868

  10. Diltiazem as augmentation therapy in patients with treatment-resistant bipolar disorder: a retrospective study.

    PubMed Central

    Silverstone, P H; Birkett, L

    2000-01-01

    OBJECTIVE: To examine the efficacy of a slow-release formulation of diltiazem as adjunctive therapy in patients with treatment-resistant bipolar disorder. DESIGN: Retrospective study. PATIENTS: Eight female patients with treatment-resistant bipolar disorder. INTERVENTIONS: Patients were administered diltiazem and monitored for a 6-month period before starting diltiazem and a 6-month period after starting the drug. OUTCOME MEASURES: All patients were seen at least monthly and usually every 2 weeks. The frequency and severity of both depressive and manic episodes were examined during the 6-month period after starting diltiazem, and compared with those during the 6-month period before diltiazem treatment. RESULTS: There was a statistically significant decrease in the frequency and severity of both manic and depressive episodes in these patients after they started treatment with diltiazem, compared with the period before they started treatment with diltiazem (p < 0.001). There was no evidence of side effects requiring patient withdrawal or of drug interactions. CONCLUSIONS: The results support previous suggestions that calcium-channel antagonists may be an effective adjunctive treatment in the management of bipolar disorder. Further controlled clinical studies are needed to confirm this small, open-label, retrospective study. PMID:10863888

  11. Retrospective evaluation of the clinical use of prothrombin complex concentrate for the reversal of anticoagulation with vitamin K antagonists.

    PubMed

    Cruz, Jennifer L; Moss, Mary C; Chen, Sheh-Li; Hansen, Kayla M; Amerine, Lindsey B

    2015-06-01

    Anticoagulation reversal is a time-sensitive intervention for the prevention of life-threatening hemorrhagic events occurring with bleeding or surgery. Recommendations for the most effective and well tolerated reversal agent in these settings remain controversial. Several clinical guidelines for the management of intracerebral hemorrhage support use of prothrombin complex concentrates (PCCs) for the rapid reversal of warfarin-associated coagulopathy despite limited clinical data. The purpose of this investigation was to evaluate the efficacy and safety of PCC for the rapid reversal of anticoagulation by vitamin K antagonists for life-threatening bleeding or emergent surgery and to assess adherence to a hospital-based protocol. A retrospective chart review was conducted of adult patients receiving PCC for the reversal of anticoagulation. Patients were assessed according to indication for anticoagulation reversal. The primary outcome measure was adequacy of international normalized ratio reversal. Other outcomes included cessation of bleeding, thrombotic complications, and adherence to an institutional-based guideline for the use of PCC. ICU and hospital length of stay and 30-day mortality was assessed. There were 70 patients included in this study. Mean international normalized ratio was reduced from 3.1 to 1.6 following administration of at least one dose of PCC. Cessation of bleeding occurred in 65.7% of patients. Clinical assessment was unclear in 18.6%. Thrombotic complications were observed in 7.1% of patients. The 30-day mortality rate was found to be 14.3%. These data demonstrate that PCC is a well tolerated and effective method for anticoagulation reversal associated with a relatively high 30-day survival rate. PMID:25688457

  12. A Retrospective Study of 1526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus

    PubMed Central

    Jin, Mei; Liang, Yong-Mei; Wang, Xiao-Fang; Guo, Bao-Jing; Zheng, Ke; Gu, Yan; Lyu, Zhen-Yu

    2015-01-01

    Background: Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China. Since then, several devices have been invented for occluding PDA. This study aimed to evaluate the technical feasibility, safety, and efficacy of transcatheter occlusion of PDA with different devices. Methods: One thousand five hundred and twenty-six patients (537 boys, 989 girls) with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure. We retrospectively analyzed data of these patients, including gender, age, weight, size and morphology of PDA, and devices used in transcatheter occlusion, outcomes, and postoperational complications. Results: Median age and median weight were 4.0 years (range: 0.3–52.0 years old) and 15.3 kg (range: 4.5–91.0 kg), respectively. Mean ductal diameter, aortic ductal diameter, ductal length, and pulmonary artery pressure were 3.50 ± 2.15 mm, 10.08 ± 2.46 mm, 7.49 ± 3.02 mm, and 30.21 ± 17.28 mmHg, respectively. Morphology of PDA assessed by descending aortogram was of type A in 1428 patients, type B in 6 patients, type C in 79 patients, type D in 4 patients, and type E in 9 patients according to the classification of Krichenko. Of all the 1526 patients, 1497 patients underwent transcatheter PDA closure, among which 1492 were successful. Devices used were Amplatzer duct occluder I (ADO I, 1280, 85.8%), Cook detachable coils (116, 7.8%), ADO II (ADO II, 68, 4.6%), muscular VSD occluder (12, 0.8%), and Amplatzer vascular plug (16, 1.0%). Conclusions: Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types. With transcatheter occlusion technique and devices developing, more patients with PDA can be treated with transcatheter closure both safely and efficiently. PMID:26315073

  13. Diplopia of pediatric orbital blowout fractures: a retrospective study of 83 patients classified by age groups.

    PubMed

    Su, Yun; Shen, Qin; Lin, Ming; Fan, Xianqun

    2015-01-01

    Orbital blowout fractures are relatively rare in patients under 18 years of age, but may lead to serious complications. We conducted this retrospective study to evaluate diplopia, clinical characteristics, and postoperative results in cases of orbital blowout fractures in the pediatric population. Eighty-three patients, all less than 18 years old, with orbital blowout fractures, were divided into 3 groups by age: 0 to 6 years old, 7 to 12 years old, and 13 to 18 years old. The cause of injury, fracture locations, diplopia grades, ocular motility restrictions, enophthalmos, and postoperative results were reviewed from their records. Chi-square tests, Fisher's exact analyses, analyses of variance, and logistic regressions were performed to determine characteristics associated with diplopia, and to identify factors related to residual diplopia in pediatric patients. The most common causes of injuries were traffic accidents in the 0 to 6 years old group, normal daily activities in the 7 to 12 years old group, and assaults in the 13 to 18 years old group. Floor fractures were the most common location in both the 0 to 6- and 7 to 12 years old groups, and medial-floor fractures were the most common location in the 13 to 18 years old group. The occurrence of preoperative diplopia was related to ocular motility restriction and enophthalmos, but not with the age group, the gender, the cause of injury, or the fracture locations. The time interval from injury to surgery was significant in the outcome of postoperative diplopia (P < 0.01). A statistical difference was also found in the recovery time from diplopia among the 3 age groups (P < 0.01). The characteristics of orbital blowout fracture varied among the different age groups. It was related to 2 factors, the cause of injury and fracture locations, which probably resulted from structural growth changes and differences in daily habits. Children had a slower recovery from orbital fractures, and the younger the

  14. Diplopia of Pediatric Orbital Blowout Fractures: A Retrospective Study of 83 Patients Classified by Age Groups

    PubMed Central

    Su, Yun; Shen, Qin; Lin, Ming; Fan, Xianqun

    2015-01-01

    Abstract Orbital blowout fractures are relatively rare in patients under 18 years of age, but may lead to serious complications. We conducted this retrospective study to evaluate diplopia, clinical characteristics, and postoperative results in cases of orbital blowout fractures in the pediatric population. Eighty-three patients, all less than 18 years old, with orbital blowout fractures, were divided into 3 groups by age: 0 to 6 years old, 7 to 12 years old, and 13 to 18 years old. The cause of injury, fracture locations, diplopia grades, ocular motility restrictions, enophthalmos, and postoperative results were reviewed from their records. Chi-square tests, Fisher's exact analyses, analyses of variance, and logistic regressions were performed to determine characteristics associated with diplopia, and to identify factors related to residual diplopia in pediatric patients. The most common causes of injuries were traffic accidents in the 0 to 6 years old group, normal daily activities in the 7 to 12 years old group, and assaults in the 13 to 18 years old group. Floor fractures were the most common location in both the 0 to 6- and 7 to 12 years old groups, and medial-floor fractures were the most common location in the 13 to 18 years old group. The occurrence of preoperative diplopia was related to ocular motility restriction and enophthalmos, but not with the age group, the gender, the cause of injury, or the fracture locations. The time interval from injury to surgery was significant in the outcome of postoperative diplopia (P < 0.01). A statistical difference was also found in the recovery time from diplopia among the 3 age groups (P < 0.01). The characteristics of orbital blowout fracture varied among the different age groups. It was related to 2 factors, the cause of injury and fracture locations, which probably resulted from structural growth changes and differences in daily habits. Children had a slower recovery from orbital fractures, and the younger

  15. Risk Factors for Acute Kidney Injury in Older Adults With Critical Illness: A Retrospective Cohort Study

    PubMed Central

    Kane-Gill, Sandra L.; Sileanu, Florentina E.; Murugan, Raghavan; Trietley, Gregory S.; Handler, Steven M.; Kellum, John A.

    2014-01-01

    Background Risk for acute kidney injury (AKI) in older adults has not been systematically evaluated. We sought to delineate the determinants of risk for AKI in older compared to younger adults. Study Design Retrospective analysis of patients hospitalized in July 2000–September 2008. Setting & Participants We identified all adult patients admitted to an intensive care unit (ICU) (n=45,655) in a large tertiary care university hospital system. We excluded patients receiving dialysis or kidney transplant prior to hospital admission, and patients with baseline creatinine ≥ 4 mg/dl, liver transplantation, indeterminate AKI status, or unknown age, leaving 39,938 patients. Predictor We collected data on multiple susceptibilities and exposures including age, sex, race, body mass, comorbid conditions, severity of illness, baseline kidney function, sepsis, and shock. Outcomes We defined AKI according to KDIGO (Kidney Disease: Improving Global Outcomes) criteria. We examined susceptibilities and exposures across age strata for impact on development of AKI. Measurements We calculated area under the receiver operating characteristic curve (AUC) for prediction of AKI across age groups. Results 25,230 patients (63.2%) were aged 55 years or older. Overall 25,120 patients (62.9%) developed AKI (69.2% aged 55 years or older). Examples of risk factors for AKI in the oldest age category (75 years or older) were drugs (vancomycin, aminoglycosides, nonsteroidal anti-inflammatories), history of hypertension (OR, 1.13; 95% CI, 1.02–1.25) and sepsis (OR, 2.12; 95% CI, 1.68–2.67). Fewer variables remained predictive of AKI as age increased and the model for older patients was less predictive (p<0.001). For the age categories 18–54, 55–64, 65–74, and 75 years or older, the AUCs were 0.744 (95% CI, 0.735–0.752), 0.714 (95% CI, 0.702–0.726), 0.706 (95% CI, 0.693–0.718), and 0.673 (95% CI, 0.661–0.685), respectively. Limitations Analysis may not apply to non-ICU patients

  16. Antibiotics against Pseudomonas aeruginosa for COPD exacerbation in ICU: a 10-year retrospective study

    PubMed Central

    Planquette, Benjamin; Péron, Julien; Dubuisson, Etienne; Roujansky, Ariane; Laurent, Virginie; Le Monnier, Alban; Legriel, Stephane; Ferre, Alexis; Bruneel, Fabrice; Chiles, Peter G; Bedos, Jean P

    2015-01-01

    Summary Chronic obstructive pulmonary disease (COPD) is a frequent source of hospitalization. Antibiotics are largely prescribed during COPD exacerbation. Our hypothesis is that large broad-spectrum antibiotics are more and more frequently prescribed. Our results confirm this trend and highlight that the increase in large broad-spectrum use in COPD exacerbation is largely unexplained. Background Acute COPD exacerbation (AECOPD) is frequently due to respiratory tract infection, and the benefit of antipseudomonal antibiotics (APA) is still debated. Health care–associated pneumonia (HCAP) was defined in 2005 and requires broad-spectrum antibiotherapy. The main objectives are to describe the antibiotic use for AECOPD in intensive care unit and to identify factors associated with APA use and AECOPD prognosis. Methods We conducted a monocentric, retrospective study on all AECOPDs in the intensive care unit treated by antibiotics for respiratory tract infection. Treatment failure (TF) was defined by death, secondary need for mechanical ventilation, or secondary systemic steroid treatment. A multivariate analysis was used to assess factors associated with APA prescription and TF. Results From January 2000 to December 2011, 111 patients were included. Mean age was 69 years (±12), mean forced expiratory volume 38% of theoretic value (±13). Thirty-five (31%) patients were intubated, and 52 (47%) were treated with noninvasive ventilation. From 107 patients, 8 (7%) cases of Pseudomonas aeruginosa were documented. APAs were prescribed in 21% of patients before 2006 versus 57% after (P=0.001). TF prevalence was 31%. Risk factors for P. aeruginosa in COPD and HCAP diagnosis did not influence APA, whereas the post-2006 period was independently associated with APA prescription (odds ratio 6.2; 95% confidence interval 1.9–20.3; P=0.0013). APA did not improve TF (odds ratio 1.09; 95% confidence interval 0.37–3.2). Conclusion HCAP guidelines were followed by an increase in APA

  17. Automated classification of radiology reports to facilitate retrospective study in radiology.

    PubMed

    Zhou, Yihua; Amundson, Per K; Yu, Fang; Kessler, Marcus M; Benzinger, Tammie L S; Wippold, Franz J

    2014-12-01

    Retrospective research is an import tool in radiology. Identifying imaging examinations appropriate for a given research question from the unstructured radiology reports is extremely useful, but labor-intensive. Using the machine learning text-mining methods implemented in LingPipe [1], we evaluated the performance of the dynamic language model (DLM) and the Naïve Bayesian (NB) classifiers in classifying radiology reports to facilitate identification of radiological examinations for research projects. The training dataset consisted of 14,325 sentences from 11,432 radiology reports randomly selected from a database of 5,104,594 reports in all disciplines of radiology. The training sentences were categorized manually into six categories (Positive, Differential, Post Treatment, Negative, Normal, and History). A 10-fold cross-validation [2] was used to evaluate the performance of the models, which were tested in classification of radiology reports for cases of sellar or suprasellar masses and colloid cysts. The average accuracies for the DLM and NB classifiers were 88.5% with 95% confidence interval (CI) of 1.9% and 85.9% with 95% CI of 2.0%, respectively. The DLM performed slightly better and was used to classify 1,397 radiology reports containing the keywords "sellar or suprasellar mass", or "colloid cyst". The DLM model produced an accuracy of 88.2% with 95% CI of 2.1% for 959 reports that contain "sellar or suprasellar mass" and an accuracy of 86.3% with 95% CI of 2.5% for 437 reports of "colloid cyst". We conclude that automated classification of radiology reports using machine learning techniques can effectively facilitate the identification of cases suitable for retrospective research. PMID:24874407

  18. A retrospective study on related factors affecting the survival rate of dental implants

    PubMed Central

    Kang, Jeong-Kyung; Lee, Ki; Lee, Yong-Sang; Park, Pil-Kyoo

    2011-01-01

    PURPOSE The aim of this retrospective study is to analyze the relationship between local factors and survival rate of dental implant which had been installed and restored in Seoul Veterans Hospital dental center for past 10 years. And when the relationship is found out, it could be helpful to predict the prognosis of dental implants. MATERIALS AND METHODS A retrospective study of patients receiving root-shaped screw-type dental implants placed from January 2000 to December 2009 was conducted. 6385 implants were placed in 3755 patients. The following data were collected from the dental records and radiographs: patient's age, gender, implant type and surface, length, diameter, location of implant placement, bone quality, prosthesis type. The correlations between these data and survival rate were analyzed. Statistical analysis was performed with the use of Kaplan-Meier analysis, Chi-square test and odds ratio. RESULTS In all, 6385 implants were placed in 3755 patients (3120 male, 635 female; mean age 65 ± 10.58 years). 108 implants failed and the cumulative survival rate was 96.33%. There were significant differences in age, implant type and surface, length, location and prosthesis type (P<.05). No significant differences were found in relation to the following factors: gender, diameter and bone quality (P>.05). CONCLUSION Related factors such as age, implant type, length, location and prosthesis type had a significant effect on the implant survival. PMID:22259704

  19. Cysts in Periradicular Region of Deciduous Molars in Mixed Dentition: Retrospective Study of Five Cases

    PubMed Central

    Chavan, Ankush; Wadde, Kavita; Dewalwar, Vishal

    2014-01-01

    ABSTRACT% The cyst in mixed dentition stage cause expansion of buccal cortex, displacement of teeth and may present as case of infection. The cyst in periradicular region of deciduous molar are of frequent occurrence. The differential diagnosis of this lesion is radicular cysts of deciduous molar: developmental or infammatory dentigerous cyst of corresponding unerupted premolar. After going through the available literature of radicular cyst of deciduous molars and dentigerous cysts of developing premolars in mixed dentition we studied the five cases of cyst in periradicular region of deciduous molars in mixed dentition retrospectively for the diagnostic dilemma of radicular cyst verses dentigerous cyst. In conclusion, we can set some criteria for the diagnosis which is particularly important for treatment and for conservation of developing premolar. How to cite this article: Manekar VS, Chavan A, Wadde K, Dewalwar V. Cysts in Periradicular Region of Deciduous Molars in Mixed Dentition: Retrospective Study of Five Cases. Int J Clin Pediatr Dent 2014;7(3):229-235. PMID:25709310

  20. Retrospective survey to evaluate the safety and efficacy of Japanese botulinum antitoxin therapy in Japan.

    PubMed

    Mottate, Keita; Yokote, Hiroyuki; Mori, Shigemi; Horita, Akira; Miyatsu, Yoshinobu; Torii, Yasushi; Kozaki, Shunji; Iwaki, Masaaki; Takahashi, Motohide; Ginnaga, Akihiro

    2016-02-01

    Japanese botulinum antitoxins have been used for more than 50 years; however, their safety and therapeutic efficacy are not clear. In order to analyze the available data on botulinum antitoxin therapy in Japan, we surveyed published reports about botulism cases in which botulinum antitoxins were used, and retrospectively analyzed the safety and efficacy of the therapy. A total of 134 patients administered botulinum antitoxins were identified from published reports. Two cases of side effects (1.5%) were detected after antitoxin administration, both not fatal. The fatality rate was 9.4%, and more than 70% of the patients showed improvement in their symptoms and better clinical conditions than those not treated with antitoxins. These data suggest that the therapy with Japanese antitoxins is safe and highly effective. PMID:26615088

  1. The effect of the lunar cycle on frequency of births: a retrospective observational study in Indian population.

    PubMed

    Bharati, Saswata; Sarkar, Malay; Haldar, Partha Sarathi; Jana, Swapan; Mandal, Subrata

    2012-01-01

    For ancient period moon has been held responsible for many biological activities. That way, lunar cycle, by activity of moon, has been held responsible for increase in number of child birth. In this retrospective, observational study, we examined a total of 9890 full-term spontaneous deliveries as well as non-elective cesarean sections that occurred throughout 12 lunar months (February 7 th , 2008-January 25 th , 2009) in a rural medical college to evaluate the influence of the lunar position on the distribution of deliveries among Indian population. Student's 't' test and ANOVA were used for statistical analysis where each delivery was considered as a single measure. We found no significant differences in the frequency of births during various phase of lunar cycle regardless of route of delivery. Our observations do not support the hypothesis of a relationship between lunar cycle and the frequency of obstetric deliveries. PMID:22910625

  2. Association between clinical features, treatment, and recurrence rate of adenoid cystic carcinoma of the palate: a 10-year retrospective study.

    PubMed

    Tabrizi, Reza; Aliabadi, Ehsan; Maleki, Mohammad Javad; Barouj, Mehrdad Dehghanpour

    2016-07-01

    Adenoid cystic carcinoma (ACC) is both invasive and clinically unpredictable, and our aim was to evaluate the factors that affect its recurrence in the palate. We retrospectively studied 38 patients who had ACC of the palate treated surgically, and the outcome measure was recurrence during the mean (SD) followup time of 55 (18) months. Age, sex, T-stage, bony involvement, duration of follow up, histological type, perineural invasion, and surgical margins were all recorded. Results showed no association between recurrence, and age or histopathological types. However, T-stage (p=0.001), sex (p=0.04), and bony and perineural involvement (p=0.01 in each case) were significantly associated with recurrent tumour. Close superior and posterior margins (< 2mm) were also associated with recurrence (p=0.001 in each case). Large tumours with bony and perineural involvement, together with close superior and posterior surgical margins, had a higher risk of recurrence. PMID:27094499

  3. A retrospective evaluation of the global decline of carnivores and ungulates.

    PubMed

    Di Marco, M; Boitani, L; Mallon, D; Hoffmann, M; Iacucci, A; Meijaard, E; Visconti, P; Schipper, J; Rondinini, C

    2014-08-01

    Assessing temporal changes in species extinction risk is necessary for measuring conservation success or failure and for directing conservation resources toward species or regions that would benefit most. Yet, there is no long-term picture of genuine change that allows one to associate species extinction risk trends with drivers of change or conservation actions. Through a review of 40 years of IUCN-related literature sources on species conservation status (e.g., action plans, red-data books), we assigned retrospective red-list categories to the world's carnivores and ungulates (2 groups with relatively long generation times) to examine how their extinction risk has changed since the 1970s. We then aggregated species' categories to calculate a global trend in their extinction risk over time. A decline in the conservation status of carnivores and ungulates was underway 40 years ago and has since accelerated. One quarter of all species (n = 498) moved one or more categories closer to extinction globally, while almost half of the species moved closer to extinction in Southeast Asia. The conservation status of some species improved (toward less threatened categories), but for each species that improved in status 8 deteriorated. The status of large-bodied species, particularly those above 100 kg (including many iconic taxa), deteriorated significantly more than small-bodied species (below 10 kg). The trends we found are likely related to geopolitical events (such as the collapse of Soviet Union), international regulations (such as CITES), shifting cultural values, and natural resource exploitation (e.g., in Southeast Asia). Retrospective assessments of global species extinction risk reduce the risk of a shifting baseline syndrome, which can affect decisions on the desirable conservation status of species. Such assessments can help conservationists identify which conservation policies and strategies are or are not helping safeguard biodiversity and thus can improve

  4. Multicenter retrospective evaluation of the validity of the Thoracolumbar Injury Classification and Severity Score system in children.

    PubMed

    Sellin, Jonathan N; Steele, William J; Simpson, Lauren; Huff, Wei X; Lane, Brandon C; Chern, Joshua J; Fulkerson, Daniel H; Sayama, Christina M; Jea, Andrew

    2016-08-01

    OBJECTIVE The Thoracolumbar Injury Classification and Severity Score (TLICS) system was developed to streamline injury assessment and guide surgical decision making. To the best of the authors' knowledge, external validation in the pediatric age group has not been undertaken prior to this report. METHODS This study evaluated the use of the TLICS in a large retrospective series of children and adolescents treated at 4 pediatric medical centers (Texas Children's Hospital, Children's Healthcare of Atlanta, Riley Children's Hospital, and Doernbecher Children's Hospital). A total of 147 patients treated for traumatic thoracic or lumbar spine trauma between February 1, 2002, and September 1, 2015, were included in this study. Clinical and radiographic data were evaluated. Injuries were classified using American Spinal Injury Association (ASIA) status, Denis classification, and TLICS. RESULTS A total of 102 patients (69%) were treated conservatively, and 45 patients (31%) were treated surgically. All patients but one in the conservative group were classified as ASIA E. In this group, 86/102 patients (84%) had Denis type compression injuries. The TLICS in the conservative group ranged from 1 to 10 (mean 1.6). Overall, 93% of patients matched TLICS conservative treatment recommendations (score ≤ 3). No patients crossed over to the surgical group in delayed fashion. In the surgical group, 26/45 (58%) were ASIA E, whereas 19/45 (42%) had neurological deficits (ASIA A, B, C, or D). One of 45 (2%) patients was classified with Denis type compression injuries; 25/45 (56%) were classified with Denis type burst injuries; 14/45 (31%) were classified with Denis type seat belt injuries; and 5/45 (11%) were classified with Denis type fracture-dislocation injuries. The TLICS ranged from 2 to 10 (mean 6.4). Eighty-two percent of patients matched TLICS surgical treatment recommendations (score ≥ 5). No patients crossed over to the conservative management group. Eight patients (8

  5. Reliability of an expert rating procedure for retrospective assessment of occupational exposures in community-based case-control studies.

    PubMed

    Siemiatycki, J; Fritschi, L; Nadon, L; Gérin, M

    1997-03-01

    The most daunting problem in community-based studies of occupational cancer is retrospective exposure assessment. To avoid the error involved in using job title as the exposure variable or self-report of exposure, our team developed an approach based on expert judgment applied to job descriptions obtained by interviewers. A population-based case-control study of cancer and occupation was carried out in Montreal between 1979 and 1986, and over 4,000 job histories were assessed by our team of experts. The job histories of these subjects were evaluated, by consensus, by a team of chemist/hygienists for evidence of exposure to a list of 294 workplace chemicals. In order to evaluate the reliability of this exposure assessment procedure, four years after the rating was completed, we selected 50 job histories at random and had two members of the expert team carry out the same type of coding, blind to the original ratings for these jobs. For 25 job histories, comprising 94 distinct jobs, the pair worked as a consensus panel; for the other 25, comprising 92 distinct jobs, they worked independently. Statistical comparisons were made between the new ratings and the old. Among those rated by consensus, the marginal distribution of exposure prevalence was almost identical between old and new. The weighted kappa for agreement was 0.80. Among items for which both ratings agreed that there had been exposure, there was good agreement on the frequency, concentration, and route of contact. When the two raters worked independently, the levels of agreement between them and between each of them and the original rating was good (kappas around 0.70), though not as high as when they worked together. It is concluded that high levels of reliability are attainable for retrospective exposure assessment by experts. PMID:9055950

  6. Clinical and Breed Characteristics of Idiopathic Head Tremor Syndrome in 291 Dogs: A Retrospective Study

    PubMed Central

    Shell, Linda G.; Berezowski, John; Rishniw, Mark; Nibblett, Belle M.; Kelly, Patrick

    2015-01-01

    Objective. To establish signalment and phenomenology of canine idiopathic head tremor syndrome (IHTS), an episodic head movement disorder of undetermined pathogenesis. Design. Retrospective case series. Animals. 291 dogs with IHTS diagnosed between 1999 and 2013. Procedures. Clinical information was obtained from an online community of veterinary information aggregation and exchange (Veterinary Information Network, 777 W Covell Boulevard, Davis, CA 95616) and conducted with their approval. Information on breed, sex, age of onset, tremor description, mentation during the event, effect of distractions and drugs, diagnostics, presence of other problems, and outcome was analyzed. Results. IHTS was found in 24 pure breeds. Bulldogs, Labrador Retrievers, Boxers, and Doberman Pinschers comprised 69%; mixed breeds comprised 17%. Average onset age was 29 months (range: 3 months to 12 years). First episode occurred before 48 months of age in 88%. Vertical (35%), horizontal (50%), and rotational (15%) movements were documented. Possible trigger events were found in 21%. Mentation was normal in 93%. Distractions abated the tremor in 87%. Most dogs did not respond to antiepileptic drugs. Conclusions and Clinical Relevance. This retrospective study documents IHTS in many breeds including Labrador Retrievers, Boxers, and mixed breeds. PMID:26064776

  7. Middle and Lower Face Soft Tissue Reconstruction: A 10-Year Retrospective Study.

    PubMed

    Wusiman, Patiguli; Tuerxun, Julaiti; Ling, Wang; Tuerdi, Maimaitituerxun; Maimaiti, Abudukelimujiang; Tao, Yao Zhi; Saimait, Adilijiang; Mijiti, Ainiwaer; Moming, Adili

    2016-09-01

    Retrospectively analyze the reconstruction methods and surgical outcomes of patients with middle and lower face soft tissue defects treated at our hospital over the past 10 years. 200 patients with middle and lower face soft tissue defects were surgically reconstructed at our hospital. Medical charts were retrospectively reviewed and analyzed to abstract the pertinent information. The lesion was mainly at the eyelid, lips, chin and nasal-cheek region. There were 41 (63.08 %) men and 24 (36.92 %) women. In our study, male to female ratio = 1.7:1. We used direct closure for night patients, local flap for 141 patients, free flap for 38 patients, combined flap for 12 patients involving extensive mid face and lower face defects. Most patients had their tumor resected and reconstructed in single stage procedure mostly with local advancement flap, and no flap failure was presented post-operatively. Middle and lower face soft tissue defects can be successfully treated with local flap in a single stage approach and step-by-step approach. PMID:27508131

  8. A retrospective study of peanut and tree nut allergy: Sensitization and correlations with clinical manifestations

    PubMed Central

    Yang, Lihua; Clements, Stacy

    2015-01-01

    Peanut (PN) and tree nut (TN) allergies are among the leading causes of fatal food-induced anaphylaxis and are increasing in prevalence, especially in children. Their cosensitization and concurrent clinical allergy have been understudied. This retrospective study investigated the correlation between PN and TN allergy, both in terms of in vitro sensitization (IVS) and clinical allergic manifestations. We conducted a retrospective medical record review at the Allergy Clinic at University Hospital of Brooklyn. Fourteen hundred six charts were reviewed, of which 76 (5.4%) had documented relevant clinical allergy: PN allergy but not TN allergy (n = 29) or TN allergy but not PN allergy (n = 11) or both (n = 30). Six patients with PN allergy but no TN exposure history were not included in the analysis. The majority of patients (67/76, 88.1%) had a concurrent history of asthma, rhinoconjunctivitis, or AD. Sensitivity of TN IVS predicting PN IVS was 38/39 (97%). Similarly, sensitivity of PN IVS predicting TN IVS was 38/42 (91%). Sensitivity of TN clinical allergy predicting PN allergy was 30/59 (51%). Sensitivity of PN clinical allergy predicting TN allergy was 30/41 (73%). The total number of organ systems involved in reported clinical reactions correlated with IVS to TN (p = 0.004) but not IVS to PN (p = 0.983). In summary, we found PN sensitization predicts TN sensitization in vitro, with lower predictability for clinical reactions. PMID:25860169

  9. Surgical management of corneal limbal dermoids: retrospective study of different techniques and use of Mitomycin C

    PubMed Central

    Lang, S J; Böhringer, D; Reinhard, T

    2014-01-01

    Purpose We retrospectively studied the efficacy and safety of different surgical approaches to treating pediatric limbal dermoids with regard to intra and postoperative complications. Methods The data of 12 consecutive patients (14 eyes), who underwent monocentric surgery of a limbal demoid in the past 9 years, were retrospectively analyzed for intra and postoperative complications. Group one consists of eleven eyes: seven eyes with a bare-sclera deep lamellar excision of the dermoid and four eyes with an additional amniotic membrane transplantation subsequent to excision. Group two consists of three eyes: two eyes treated with Mitomycin C 0.02% over 2 min following the excision, and one eye treated with Mitomycin C and amniotic membrane transplantation after removal of the dermoid. Follow-up ranged from 2 to 53 months (median 17 months). Results Intraoperative complications did not occur in any of the patients. Postoperatively, all patients showed corneal reepithelialization within a week. Limbal stem cell deficiency with a pseudopterygium developed in four eyes, one treated with bare-sclera excision and the others with amniotic membrane transplantation. One pseudopterygium had to be removed surgically because of visual acuity deterioration. Not a single eye treated with Mitomycin C developed a pseudopterygium. Conclusions The transplantation of amniotic membrane following removal of a limbal dermoid cannot prevent the occurrence of a pseudopterygium. However, the use of Mitomycin C seems to have a protective effect. PMID:24858530

  10. Myxomatous stromal changes and necrosis of bone marrow--a retrospective study of 3 years.

    PubMed

    Gupta, Nalini; Kumar, Vijay; Varma, Neelam; Garewal, Gurjeevan; Das, Reena; Ahluwalia, Jasmina; Dash, Sumitra

    2004-07-01

    Myxomatous stromal changes and bone marrow necrosis (BMN) are uncommon histologic findings. These changes have been found in various conditions like disseminated carcinomatosis, postchemotherapy cases, chronic infections, infiltrative disorders of the marrow etc. The present study is a retrospective study of 3 years (Jan, 1999 to Dec. 2001) from Deptt. Of Hematology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh (India). During this period, 3740 bone marrow samples were examined. Myxomatous stromal changes and bone marrow necrosis were noted in 0.43% (16/3740) and 0.45% (17/3740) samples respectively. In addition to common causes of myxomatous stromal changes and bone marrow necrosis as described in the literature, this study highlights the association of these conditions with some of the rarer entities like hyperoxalosis, leishmaniasis, parvovirus induced marrow aplasia and cryptococcal infection. There is paucity of such associations in the literature. PMID:16295422

  11. A retrospective study of clinical and mutational findings in 45 Danish families with ectodermal dysplasia.

    PubMed

    Tiedemann Svendsen, Mathias; Henningsen, Emil; Hertz, Jens Michael; Vestergaard Grejsen, Dorthe; Bygum, Anette

    2014-09-01

    Ectodermal dysplasias form a complex, nosologic group of diseases with defects in at least 2 ectodermal structures. A retrospective study of patients with ectodermal dysplasia seen at our department over a period of 19 years (1994-2013) was performed. The study population consisted of 67 patients covering 17 different diagnoses. Forty-five families were identified of which 26 were sporadic cases with no affected family members. In 27 tested families a disease-causing mutation was identified in 23 families. Eleven mutations were novel mutations. To our knowledge, we present the first large ectodermal dysplasia cohort focusing on clinical manifestations in combination with mutational analysis. We recommend a nationwide study to estimate the prevalence of the ectodermal dysplasia and to ensure relevant molecular genetic testing which may form the basis of a national ectodermal dysplasia database. PMID:24514865

  12. A retrospective perspective: evaluating population changes by repeating historic bird surveys

    USGS Publications Warehouse

    Igl, L.D.; Johnson, D.H.

    2005-01-01

    Acquiring an accurate picture of the changes in bird populations often involves a tradeoff between the time and effort required to complete the surveys and the number of years spent surveying the bird populations. An alternative approach to long-term monitoring efforts is to collect current data and contrast those with data collected earlier in a similar fashion on the same study site(s). To evaluate changes in bird populations, we repeated two extensive surveys, one in North Dakota (1967 vs. 1992-1993) and the other in the Platte River Valley of Nebraska (1979-1980 vs. 2001), where large areas of native vegetation had been converted to agriculture. We use these examples and others from the literature to illustrate the advantages and disadvantages of using historical data as a frame of reference for population changes.

  13. Postgraduate Study and Managers' Subsequent Work Experience: An Exploratory Evaluation

    ERIC Educational Resources Information Center

    Andrews, Jane; Harris, Margaret

    2009-01-01

    Drawing on an exploratory qualitative study, this article considers the link between business school teaching at graduate level and subsequent work behaviour and experiences of former students. It evaluates the student experience some time "after" graduation. The findings of the retrospective evaluation point to the value of classroom peer…

  14. Assessment of clinicopathologic features in patients with pituitary adenomas in Northeast of Iran: A 13-year retrospective study

    PubMed Central

    Anvari, Kazem; Kalantari, Mahmoud Reza; Samini, Fariborz; Shahidsales, Soodabeh; Seilanian-Toussi, Mehdi; Ghorbanpour, Zakiyeh

    2015-01-01

    Background: Intracranial lesions of the pituitary gland are common pituitary adenomas, accounting for 6-10% of all symptomatic intracranial tumors. In this retrospective study, the clinicopathologic features and survival rate of pituitary adenomas were evaluated. Methods: The present retrospective study was conducted on 83 patients with pituitary adenomas, referring to radiation oncology departments of Ghaem and Omid Hospitals, Mashhad, Iran, over a period of 13 years (1999-2012). Data obtained from clinical records including clinical features, type of surgery (if performed), treatment modality, overall survival rate, and progression-free survival rate were analyzed. Results: Eighty-three patients including 44 males (53%) and 39 females (47%) participated in this study. The median age was 40 years (age range: 10-69 years). Chiasm compression was reported in 62 patients (74.4%), and 45.78% of the subjects suffered from headaches. Functional and non-functional adenomas were reported in 44 (53.01%) and 39 (46.99%) patients, respectively. In cases with functional and non-functional adenomas, the disease was controlled in 95 and 84.5% of the subjects for 3 years, respectively. Furthermore, 1- and 3-year survival rates for functional adenoma were 84.6 and 23%, respectively; the corresponding values were 90.9 and 22.7% in non-functional adenomas, respectively. Conclusion: In this study, a significant correlation between headache severity and type of adenoma was observed. So, application of surgery and radiotherapy together could be a highly effective approach for treating functional adenomas, although it is less efficient for the non-functional type. PMID:26885336

  15. Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study

    PubMed Central

    Hu, Sung-Yuan; Hsieh, Ming-Shun; Lin, Meng-Yu; Hsu, Chiann-Yi; Lin, Tzu-Chieh; How, Chorng-Kuang; Wang, Chen-Yu; Tsai, Jeffrey Che-Hung; Wu, Yu-Hui; Chang, Yan-Zin

    2016-01-01

    Objectives To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition. Setting A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan. Participants Adult ED visits (aged ≥18 years) during 2009–2013, with or without receiving CT, were enrolled as the study participants. Main outcome measures For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay. Results In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013). Conclusions ED CT utilisation rates increased significantly during 2009–2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective. PMID:27279477

  16. Profile of deliberate self-harm patients presenting to Emergency Department: A retrospective study

    PubMed Central

    Jegaraj, Moses Kirubairaj Amos; Mitra, Shubhanker; Kumar, Sathish; Selva, Bagyalakshmi; Pushparaj, Manimaran; Yadav, Bijesh; Prabhakar, Abhilash Kundavaram Paul; Reginald, Alex

    2016-01-01

    Background: Deliberate self-harm (DSH) is a major under-recognized epidemic in the low- and middle-income countries. This is a large retrospective study form the Emergency Department (ED) of Tertiary Care Center of South India to describe the clinicodemographic features of DSH cases. Materials and Methods: This is a retrospective study conducted at ED of Christian Medical College, Vellore, India from January 01, 2011 to December 31, 2013. All cases of DSH were included in the study. The demographic details, mode of DSH and clinical outcome were extracted from the electronic medical record. Descriptive statistics are presented. Chi-square test was used to compare categorical variables. For all tests, a two-sided P ≤ 0.05 was considered statistically significant. Results: Total of 1228 patients were admitted to ED for DSH during the study period. Male and female occurred in equal ratio. More than half of the cases occurred among age group below 30 years. Consumption of pesticides (agricultural chemicals) was the single most common mode of DSH (46%), especially among men, followed by medication overdose (29.8%). Consumption of plant poison and tablet overdose was higher among women. Overall mortality due to DSH was low (1.5%) in our study. Conclusion: DSH is under-recognized major public health problem in low-middle income countries like India. Most cases occur among young and productive age group and in equal frequencies among men and women. Timely and the appropriate institution of treatment can decrease the morbidity and mortality due to DSH remarkably. PMID:27453847

  17. Is Endoscopy Really Necessary in My Case? A Four Year Retrospective Study

    PubMed Central

    Dinesh, HN; Kumar, CD Jagadish; Sachin, V; Basavaraju

    2015-01-01

    Introduction: About 40% of the general population report dyspepsia at some time in their life making it a fairly common disease. Uncomplicated dyspepsia refers to patients whose dyspepsia is not accompanied by alarm features or associated with NSAIDS usage. Aim: To assess the need for UGI Endoscopy and find out the patterns of different endoscopic presentations in patients presenting with uncomplicated dyspepsia. Materials and Methods: Our study conducted in KR Hospital, Mysore, Department of General Surgery is a retrospective endoscopic study of 1450 patients with uncomplicated dysepsia. Results: A significant 64% of the patients presenting with uncomplicated dyspepsia were found to have findings on endoscopy. The most common age range for positive endoscopic findings was 40-50 years in our hospital. Malignancy was diagnosed in 2.5% patients. Conclusion: We recommend upper GI endoscopy in patients presenting with uncomplicated dyspepsia for patients above 40 years of age in our hospital. PMID:26417553

  18. Prevalence and phenomenology of neonaticide in Switzerland 1980-2010: a retrospective study.

    PubMed

    Krüger, Paula

    2015-01-01

    For a child, the likelihood of being murdered is highest during the first year of life, and many such cases are neonaticides. Although several recent studies have examined neonaticide in different countries and cultures, there has been no in-depth analysis of Swiss cases, even though this country has special neonaticide legislation and four "baby hatches" have been opened to prevent such killings. The primary objective of this retrospective study was to analyze the prevalence and phenomenon of neonaticide in Switzerland. Using data from judicial files, 11 cases were identified in 15 German-speaking cantons between 1980 and 2010. The sample included two uncommon cases of nonmaternal neonaticide. The discussion addresses possible prevention strategies. PMID:25929137

  19. Tracheobronchial Mycosis in a Retrospective Case-Series Study of Five Status Asthmaticus Patients

    PubMed Central

    Mak, Garbo; Porter, Paul C.; Bandi, Venkata; Kheradmand, Farrah; Corry, David B.

    2013-01-01

    The aetiology of status asthmaticus (SA), a complication of severe asthma, is unknown. Fungal exposure, as measured by fungal atopy, is a major risk factor for developing asthma, but the relationship of fungi in SA per se has not previously been reported. In this five patient retrospective case series study, lower respiratory tract cultures were performed on bronchoalveolar lavage or tracheal aspirate fluid, comparing standard clinical laboratory cultures with a specialized technique in which respiratory mucus was removed prior to culture. We show mucolytic treatment allows increased detection of fungal growth, especially yeast, from the lower airways of all SA patients. We also demonstrate that the yeast Candida albicans inhalation readily induces asthma-like disease in mice. Our observations suggest, SA may represent a fungal infectious process, and supports additional prospective studies utilizing anti-fungal therapy to supplement conventional therapy, broad-spectrum antibiotics and high-dose glucocorticoids, which can promote fungal overgrowth. PMID:23280490

  20. The clinical spectrum of lichen sclerosus in male patients - a retrospective study.

    PubMed

    Kantere, Despina; Löwhagen, Gun-Britt; Alvengren, Gunilla; Månesköld, Anna; Gillstedt, Martin; Tunbäck, Petra

    2014-09-01

    Lichen sclerosus (LS) is a chronic dermatosis mainly localised to the anogenital area. The aim of this study was to investigate the clinical features of LS in adult men. A retrospective analysis of records from 771 patients diagnosed with LS was made and a questionnaire was sent to all patients. The results showed that the clinical spectrum was wide. Itch, tenderness and pain were frequently reported and more than half of the patients reported that LS had a negative impact on their sexual health. Phimosis was common and almost 1/3 of the patients were circumcised before or during the study period. Eight cases (1%) of penile squamous cell carcinoma were recorded. This emphasises the need for follow-up of male patients with LS. PMID:24549239

  1. GREATER KUDU (TRAGELAPHUS STREPSICEROS) MORTALITY IN EUROPEAN ZOOLOGICAL INSTITUTIONS: A RETROSPECTIVE STUDY.

    PubMed

    Leclerc, Antoine; Lamglait, Benjamin; Petit, Thierry; Roman, Yannick; Jebram, Joerg

    2016-06-01

    A questionnaire was sent to 39 European institutions holding greater kudus (Tragelaphus strepsiceros), in order to determine the causes of captive greater kudu mortality. All reported macroscopic lesions and histopathologic observations, as well as other information regarding individuals that died, were analyzed to determine the most affected body systems and causes of death. Overall response rate was 31%, and 131 individuals were included in the study. The most frequently affected body systems were the digestive system (47%), respiratory system (38%), musculoskeletal system (37%), and cardiovascular system (32%). Most frequent causes of death were infectious diseases (27%) and trauma/accidents (18%); the cause was undetermined in 28% of cases. Nutrition-related disorders were difficult to assess, but results highlight possible nutritional imbalances. This retrospective study represents the first overview of greater kudu mortality in a captive population. PMID:27468026

  2. Victims of gun shootings. A retrospective study of 36 spinal cord injured adolescents.

    PubMed

    Graham, P M; Weingarden, S I

    1989-11-01

    Interpersonal violence with a handgun is the primary cause of spinal cord injuries (SCI) among teenagers in the population served by the Southeastern Michigan Spinal Cord Injury System (SEMSCIS). As part of a community-wide effort to reduce the injury and death rate from acts of violence, SEMSCIS selected the victim, rather than the perpetrator or the sociocultural environment, as its segment of a prevention program. A retrospective study of demographic data, causal statements, medical information from the medical records of 36 injured adolescents, and telephone conversations with the victims identified "risk taking" as the pre-event behavior that had made them vulnerable to violence. This study led to the production of a powerful video, "Wasted Dreams," in which disabled teenagers tell their peers about their injury and how to avoid becoming a victim. PMID:2606753

  3. Comparison of Renal Amyloid and Hyaline Glomerulopathy in B6C3F1 Mice: An NTP Retrospective Study.

    PubMed

    Hoane, Jessica S; Johnson, Crystal L; Morrison, James P; Elmore, Susan A

    2016-07-01

    Due to potential misdiagnosis of hyaline glomerulopathy (HG) for amyloidosis, a retrospective study of B6C3F1 mice from the National Toxicology Program (NTP) archives was undertaken to determine whether HG had occurred in prior NTP studies and, if so, whether these 2 glomerular lesions could be routinely discriminated. Kidney slides from 7 amyloid-positive control mice, 2 HG-positive control mice, 3 normal or negative control mice, and 41 potential HG mice (with renal-only deposits previously diagnosed as amyloid) were evaluated using hematoxylin and eosin (H&E), periodic acid Schiff (PAS), Congo red (CR), and Masson's trichrome (MT) stains. Utilizing these techniques, HG was reliably distinguished from amyloidosis. All 41 potential HG mice had glomerular deposits histochemically inconsistent with amyloid; the deposits were PAS positive and CR negative. Four of the 41 mice were selected for transmission electron microscopy of the glomerular deposits; ultrastructurally, the deposits in these animals were consistent with HG and not amyloid. Our findings indicate that HG is a spontaneous lesion in B6C3F1 mice of low occurrence, is commonly misdiagnosed as amyloidosis, and is more likely than amyloid to cause glomerular deposits in mice without evidence of deposits in other tissues. Also, HG can be distinguished from amyloid on H&E evaluation; however, the distinction is improved with use of PAS or CR staining and/or ultraviolet evaluation. PMID:27000376

  4. Serum Liver Fibrosis Markers for Predicting the Presence of Gastroesophageal Varices in Liver Cirrhosis: A Retrospective Cross-Sectional Study

    PubMed Central

    Li, Hongyu; Chen, Jiang; Xia, Chunlian; Peng, Ying; Dai, Junna; Hou, Yue; Deng, Han; Li, Jing; Guo, Xiaozhong

    2015-01-01

    Background and Aims. A retrospective cross-sectional study was conducted to evaluate the role of hyaluronic acid (HA), laminin (LN), amino-terminal propeptide of type III procollagen (PIIINP), and collagen IV (CIV) in predicting the presence of gastroesophageal varices (GEVs) in patients with liver cirrhosis. Methods. We enrolled 118 patients with liver cirrhosis who underwent the tests for the four serum liver fibrosis markers and upper gastrointestinal endoscopy at the same admissions. The predictive values of the four serum liver fibrosis markers were evaluated by the areas under the receiving operator characteristics curves (AUROCs) with 95% confidence intervals (CIs). Results. The prevalence of GEVs was 88% (104/118). The AUROCs for HA, LN, PIIINP, and CIV levels in predicting the presence of GEVs were 0.553 (95% CI: 0.458 to 0.644, P = 0.5668), 0.490 (95% CI: 0.397 to 0.584, P = 0.9065), 0.622 (95% CI: 0.528 to 0.710, P = 0.1099), and 0.560 (95% CI: 0.466 to 0.652, P = 0.4909). The PIIINP level at a cut-off value of 31.25 had a sensitivity of 73.1% and a specificity of 57.1%. Conclusions. The present study did not recommend HA, LN, PIIINP, and CIV levels to evaluate the presence of GEVs in liver cirrhosis. PMID:26770190

  5. Retrospective evaluation of 5-fluorouracil-interferon-a aTreatment of advanced colorectal cancer patients.

    PubMed

    András, C; Csiki, Z; Gál, I; Takács, I; Antal, L; Szegedi, G

    2000-01-01

    The authors describe the retrospective analysis of treatment by 5-fluorouracil and interferon-a aof 34 patients with advanced colorectal cancer. An average of 4.6 treatment cycles (3 12) was applied. Complete remission was not observed; partial remission was observed in 8 patients; in 13 patients no change occurred and progression was detected in 14 cases. Remission rate was 22.8%, mean response time was 5.2 (3 12) months, mean progress-free survival 5.6 (0 22) months. Mean survival from the start of treatment was 11.9 (1 42) months and from the establishment of the diagnosis 26.1 (3 60) months. Severe life-threatening side-effects did not occur; other side-effects such as fever, nausea, diarrhea, leucopenia, and anemia responded to drugs. Treatment by 5-FU and interferon, in accordance with other authors findings, improved survival and well-being of patients but no breakthrough has been achieved. PMID:11033456

  6. Perioperative Chemotherapy in Gastroesophageal Cancer. A Retrospective Monocenter Evaluation of 42 Cases

    PubMed Central

    Brehler, Ann-Christin E.; Hartmann, Wolfgang; Wiebe, Stefanie; Kerkhoff, Andrea; Schliemann, Christoph; Palmes, Daniel; Senninger, Norbert; Lenze, Frank; Ullerich, Hansjoerg; Berdel, Wolfgang E.; Kessler, Torsten

    2015-01-01

    Background Perioperative chemotherapy increases the overall and progression-free survival of patients suffering from resectable adenocarcinomas of the lower esophagus, gastroesophageal junction and stomach (GEC). Comparing different chemotherapy regimens platin-based protocols with 5-fluorouracil (5-FU)/calcium folinate (CF) or oral fluoropyrimidines were favorable in terms of efficacy and side-effects. However, there is no consensus which regimen is the most efficacious. Methods 42 consecutive patients with resectable GEC (UICC II and III) were treated with 3 pre- and postoperative chemotherapy cycles each consisting of epirubicin, oxaliplatin and capecitabine (EOX). We analyzed the overall survival, progression-free survival and toxicity retrospectively in comparison to published data. Results The median overall survival in our cohort was 29 months and the progression-free survival was 17 months. The most frequent grade 3 and 4 toxicities during preoperative chemotherapy were diarrhea (16.7%), leukocytopenia (9.5%) and nausea (9.5%); overall 38.1% of our patients suffered from grade 3 or 4 toxicity. Surgery was carried out in 83% of our patients, 69% of those achieved R0 resection. Conclusion Comparing our data with the results of previously published randomized trials EOX is at least non-inferior with regard to overall survival, progression-free survival and toxicity. In conclusion, EOX is an appropriate perioperative therapy for patients with resectable GEC. PMID:25855972

  7. Reconstruction of Organ Dose for External Radiotherapy Patients in Retrospective Epidemiologic Studies

    PubMed Central

    Lee, Choonik; Jung, Jae Won; Pelletier, Christopher; Pyakuryal, Anil; Lamart, Stephanie; Kim, Jongoh; Lee, Choonsik

    2015-01-01

    Organ dose estimation for retrospective epidemiological studies of late effects in radiotherapy patients involves two challenges: radiological images to represent patient anatomy are not usually available for patient cohorts who were treated years ago, and efficient dose reconstruction methods for large-scale patient cohorts are not well established. In the current study, we developed methods to reconstruct organ doses for radiotherapy patients by using a series of computational human phantoms coupled with a commercial treatment planning system (TPS) and a radiotherapy-dedicated Monte Carlo transport code, and performed illustrative dose calculations. First, we developed methods to convert the anatomy and organ contours of the pediatric and adult hybrid computational phantom series to Digital Imaging and Communications in Medicine (DICOM)-image and DICOM-structure files, respectively. The resulting DICOM files were imported to a commercial TPS for simulating radiotherapy and dose calculation for in-field organs. The conversion process was validated by comparing electron densities relative to water and organ volumes between the hybrid phantoms and the DICOM files imported in TPS, which showed agreements within 0.1% and 2%, respectively. Second, we developed a procedure to transfer DICOM-RT files generated from the Eclipse system directly to a Monte Carlo transport code, X-ray Voxel Monte Carlo (XVMC) for more accurate dose calculations. Third, to illustrate the performance of the established methods, we simulated a whole brain treatment for the 10-year-old male phantom and a prostate treatment for the adult male phantom. Radiation doses to selected organs were calculated using the Eclipse and XVMC, and compared to each other. Organ average doses from the two methods matched within 7%, whereas maximum and minimum point doses differed up to 45%. The dosimetry methods and procedures established in this study will be useful for the reconstruction of organ dose to

  8. Reconstruction of organ dose for external radiotherapy patients in retrospective epidemiologic studies.

    PubMed

    Lee, Choonik; Jung, Jae Won; Pelletier, Christopher; Pyakuryal, Anil; Lamart, Stephanie; Kim, Jong Oh; Lee, Choonsik

    2015-03-21

    Organ dose estimation for retrospective epidemiological studies of late effects in radiotherapy patients involves two challenges: radiological images to represent patient anatomy are not usually available for patient cohorts who were treated years ago, and efficient dose reconstruction methods for large-scale patient cohorts are not well established. In the current study, we developed methods to reconstruct organ doses for radiotherapy patients by using a series of computational human phantoms coupled with a commercial treatment planning system (TPS) and a radiotherapy-dedicated Monte Carlo transport code, and performed illustrative dose calculations. First, we developed methods to convert the anatomy and organ contours of the pediatric and adult hybrid computational phantom series to Digital Imaging and Communications in Medicine (DICOM)-image and DICOM-structure files, respectively. The resulting DICOM files were imported to a commercial TPS for simulating radiotherapy and dose calculation for in-field organs. The conversion process was validated by comparing electron densities relative to water and organ volumes between the hybrid phantoms and the DICOM files imported in TPS, which showed agreements within 0.1 and 2%, respectively. Second, we developed a procedure to transfer DICOM-RT files generated from the TPS directly to a Monte Carlo transport code, x-ray Voxel Monte Carlo (XVMC) for more accurate dose calculations. Third, to illustrate the performance of the established methods, we simulated a whole brain treatment for the 10 year-old male phantom and a prostate treatment for the adult male phantom. Radiation doses to selected organs were calculated using the TPS and XVMC, and compared to each other. Organ average doses from the two methods matched within 7%, whereas maximum and minimum point doses differed up to 45%. The dosimetry methods and procedures established in this study will be useful for the reconstruction of organ dose to support

  9. Tunnelled haemodialysis catheter and haemodialysis outcomes: a retrospective cohort study in Zagreb, Croatia

    PubMed Central

    Pašara, Vedran; Maksimović, Bojana; Gunjača, Mihaela; Mihovilović, Karlo; Lončar, Andrea; Kudumija, Boris; Žabić, Igor; Knotek, Mladen

    2016-01-01

    Objectives Studies have reported that the tunnelled dialysis catheter (TDC) is associated with inferior haemodialysis (HD) patient survival, in comparison with arteriovenous fistula (AVF). Since many cofactors may also affect survival of HD patients, it is unclear whether the greater risk for survival arises from TDC per se, or from associated conditions. Therefore, the aim of this study was to determine, in a multivariate analysis, the long-term outcome of HD patients, with respect to vascular access (VA). Design Retrospective cohort study. Participants This retrospective cohort study included all 156 patients with a TDC admitted at University Hospital Merkur, from 2010 to 2012. The control group consisted of 97 patients dialysed via AVF. The groups were matched according to dialysis unit and time of VA placement. The site of choice for the placement of the TDC was the right jugular vein. Kaplan-Meier analysis with log-rank test was used to assess patient survival. Multivariate Cox regression analysis was used to determine independent variables associated with patient survival. Primary outcome measures Patient survival with respect to VA. Results The cumulative 1-year survival of patients who were dialysed exclusively via TDC was 86.4% and of those who were dialysed exclusively via AVF, survival was 97.1% (p=0.002). In multivariate Cox regression analysis, male sex and older age were independently negatively associated with the survival of HD patients, while shorter HD vintage before the creation of the observed VA, hypertensive renal disease and glomerulonephritis were positively associated with survival. TDC was an independent risk factor for survival of HD patients (HR 23.0, 95% CI 6.2 to 85.3). Conclusion TDC may be an independent negative risk factor for HD patient survival. PMID:27188801

  10. Reconstruction of organ dose for external radiotherapy patients in retrospective epidemiologic studies

    NASA Astrophysics Data System (ADS)

    Lee, Choonik; Jung, Jae Won; Pelletier, Christopher; Pyakuryal, Anil; Lamart, Stephanie; Kim, Jong Oh; Lee, Choonsik

    2015-03-01

    Organ dose estimation for retrospective epidemiological studies of late effects in radiotherapy patients involves two challenges: radiological images to represent patient anatomy are not usually available for patient cohorts who were treated years ago, and efficient dose reconstruction methods for large-scale patient cohorts are not well established. In the current study, we developed methods to reconstruct organ doses for radiotherapy patients by using a series of computational human phantoms coupled with a commercial treatment planning system (TPS) and a radiotherapy-dedicated Monte Carlo transport code, and performed illustrative dose calculations. First, we developed methods to convert the anatomy and organ contours of the pediatric and adult hybrid computational phantom series to Digital Imaging and Communications in Medicine (DICOM)-image and DICOM-structure files, respectively. The resulting DICOM files were imported to a commercial TPS for simulating radiotherapy and dose calculation for in-field organs. The conversion process was validated by comparing electron densities relative to water and organ volumes between the hybrid phantoms and the DICOM files imported in TPS, which showed agreements within 0.1 and 2%, respectively. Second, we developed a procedure to transfer DICOM-RT files generated from the TPS directly to a Monte Carlo transport code, x-ray Voxel Monte Carlo (XVMC) for more accurate dose calculations. Third, to illustrate the performance of the established methods, we simulated a whole brain treatment for the 10 year-old male phantom and a prostate treatment for the adult male phantom. Radiation doses to selected organs were calculated using the TPS and XVMC, and compared to each other. Organ average doses from the two methods matched within 7%, whereas maximum and minimum point doses differed up to 45%. The dosimetry methods and procedures established in this study will be useful for the reconstruction of organ dose to support

  11. Affective Antecedents of the Perceived Effectiveness of Antidrug Advertisements: An Analysis of Adolescents’ Momentary and Retrospective Evaluations

    PubMed Central

    Vohs, Kathleen D.; Luciana, Monica; Cuthbert, Bruce N.; MacDonald, Angus W.

    2013-01-01

    Perceived message effectiveness is often used as a diagnostic tool to determine whether a health message is likely to be successful or needs modification before use in an intervention. Yet, published research on the antecedents of perceived effectiveness is scarce and, consequently, little is known about why a message is perceived to be effective or ineffective. The present study’s aim was to identify and test the affective antecedents of perceived effectiveness of antidrug television messages in a sample of 190 adolescents in the 15–19 year age range. Factor-analytical tests of retrospective message evaluation items suggested two dimensions of perceived effectiveness, one that contained items such as convincingness whereas the other contained pleasantness items. Using retrospective data as well as real time valence and arousal ratings, we found that arousal underlies perceived convincingness and valence underlies perceived pleasantness. The results indicated activation of appetitive and defensive motivational systems, which suggests a clear motivational component to the concept of perceived message effectiveness. PMID:21499729

  12. Potential of Hybrid Computational Phantoms for Retrospective Heart Dosimetry After Breast Radiation Therapy: A Feasibility Study

    SciTech Connect

    Moignier, Alexandra; Derreumaux, Sylvie; Broggio, David; Beurrier, Julien; Chea, Michel; Boisserie, Gilbert; Franck, Didier; Aubert, Bernard; Mazeron, Jean-Jacques

    2013-02-01

    Purpose: Current retrospective cardiovascular dosimetry studies are based on a representative patient or simple mathematic phantoms. Here, a process of patient modeling was developed to personalize the anatomy of the thorax and to include a heart model with coronary arteries. Methods and Materials: The patient models were hybrid computational phantoms (HCPs) with an inserted detailed heart model. A computed tomography (CT) acquisition (pseudo-CT) was derived from HCP and imported into a treatment planning system where treatment conditions were reproduced. Six current patients were selected: 3 were modeled from their CT images (A patients) and the others were modelled from 2 orthogonal radiographs (B patients). The method performance and limitation were investigated by quantitative comparison between the initial CT and the pseudo-CT, namely, the morphology and the dose calculation were compared. For the B patients, a comparison with 2 kinds of representative patients was also conducted. Finally, dose assessment was focused on the whole coronary artery tree and the left anterior descending coronary. Results: When 3-dimensional anatomic information was available, the dose calculations performed on the initial CT and the pseudo-CT were in good agreement. For the B patients, comparison of doses derived from HCP and representative patients showed that the HCP doses were either better or equivalent. In the left breast radiation therapy context and for the studied cases, coronary mean doses were at least 5-fold higher than heart mean doses. Conclusions: For retrospective dose studies, it is suggested that HCP offers a better surrogate, in terms of dose accuracy, than representative patients. The use of a detailed heart model eliminates the problem of identifying the coronaries on the patient's CT.

  13. Statins are Associated with Reduced Use of Steroids in Inflammatory Bowel Disease: a Retrospective Cohort Study

    PubMed Central

    Crockett, Seth D.; Hansen, Richard A.; Stürmer, Til; Schectman, Robin; Darter, Jane; Sandler, Robert S.; Kappelman, Michael D.

    2011-01-01

    Introduction Statin medications have anti-inflammatory effects. We sought to determine whether statin use in persons with inflammatory bowel disease (IBD) was associated with reduced rates of steroid use or other markers of disease activity. Methods We performed a retrospective cohort study using administrative data. Statin users with IBD were compared to statin-unexposed IBD subjects. The primary outcome was an oral steroid prescription; secondary outcomes included anti-TNF initiation, hospitalization, or abdominal surgery. Cox proportional hazard models were used to estimate hazard ratios (HR) adjusted for potential confounders. Results The study cohort included 1,986 statin-exposed and 9,871 unexposed subjects. Statin use was associated with an 18% reduction in the rate of steroid initiation [HR 0.82 (95% CI 0.71, 0.94)]. A statistically significant result was seen with atorvastatin only [HR 0.76 (95% CI 0.60, 0.96)]. Statins were associated with a reduced rate of steroids in ulcerative colitis [HRs 0.75 (95% CI 0.62, 0.91)], but not in Crohn’s disease [HR 0.91 (95% CI 0.74, 1.12)]. Statin use was associated with reduced hazard of anti-TNF use [HR 0.72 (95% CI 0.46, 1.11)], abdominal surgery [HR 0.80 (95% CI 0.63, 1.02)], and hospitalization [HR 0.88 (95% CI 0.74, 1.05)], but these results did not reach statistical significance. Conclusion In this large retrospective cohort study, statin use amongst persons with IBD was associated with reduced use of oral steroids, particularly for UC. Prospective clinical trials are needed to confirm whether adjuvant treatment of IBD with statin drugs may spare immunosuppressant therapy or ameliorate flares. PMID:21826766

  14. Improved effectiveness and safety of flexible ureteroscopy for renal calculi (<2 cm): A retrospective study

    PubMed Central

    Chen, Shuqiu; Xu, Bin; Liu, Ning; Jiang, Hua; Zhang, Xiaowen; Yang, Yu; Liu, Jing; Sha, Guozhu; Zhu, Weidong; Chen, Ming

    2015-01-01

    Introduction: We discuss the efficacy and safety of flexible ureteroscopy for renal calculi with a burden of <2 cm, as well as the prevention and treatment of complications. Methods: A total of 108 renal calculi with flexible ureteroscopy and holmium laser treatment were retrospectively analyzed. The stone-free rate was evaluated. The effectiveness, safety, surgical technique, incidence of complications, and relevant treatments were analyzed. Results: All patients underwent only one lithotripsy procedure. The success rate of flexible ureteroscopy was 97.2% (105/108). Among the 105 cases, the total lithotripsy success rate was 97.1% (101/105). The total stone-free rate after 8 weeks post-operation was 94.3% (99/105), the stone-free rate of the lower calyx was 85.7% (30/35); it was 98.6% (69/70) in the middle–upper calyceal and renal pelvis. The incidence of complications was 12.9% (14/108). None of the patients had serious adverse outcomes. Conclusion: Flexible ureteroscopy represents an optimal treatment option for selected renal calculi with burden of <2 cm. The effectiveness and safety of flexible ureteroscopy can be further improved through reasonable preoperative evaluation and advances in surgical techniques, as well as a better understanding of the inducement and treatment of complications. PMID:26029294

  15. Treating drug dependence with the aid of ibogaine: a retrospective study.

    PubMed

    Schenberg, Eduardo Ekman; de Castro Comis, Maria Angélica; Chaves, Bruno Rasmussen; da Silveira, Dartiu Xavier

    2014-11-01

    Ibogaine is an alkaloid purported to be an effective drug dependence treatment. However, its efficacy has been hard to evaluate, partly because it is illegal in some countries. In such places, treatments are conducted in underground settings where fatalities have occurred. In Brazil ibogaine is unregulated and a combined approach of psychotherapy and ibogaine is being practiced to treat addiction. To evaluate the safety and efficacy of ibogaine, we conducted a retrospective analysis of data from 75 previous alcohol, cannabis, cocaine and crack users (72% poly-drug users). We observed no serious adverse reactions or fatalities, and found 61% of participants abstinent. Participants treated with ibogaine only once reported abstinence for a median of 5.5 months and those treated multiple times for a median of 8.4 months. This increase was statistically significant (p < 0.001), and both single or multiple treatments led to longer abstinence periods than before the first ibogaine session (p < 0.001). These results suggest that the use of ibogaine supervised by a physician and accompanied by psychotherapy can facilitate prolonged periods of abstinence, without the occurrence of fatalities or complications. These results suggest that ibogaine can be a safe and effective treatment for dependence on stimulant and other non-opiate drugs. PMID:25271214

  16. Nasopharyngeal Development in Patients with Cleft Lip and Palate: A Retrospective Case-Control Study

    PubMed Central

    Wermker, Kai; Jung, Susanne; Joos, Ulrich; Kleinheinz, Johannes

    2012-01-01

    Introduction. The aim of this paper was to evaluate cephalometrically the nasopharyngeal development of patients with complete unilateral cleft lip and palate. Influencing factors were evaluated and cleft to noncleft subjects were compared to each other. Material and Methods. The lateral cephalograms of 66 patients with complete cleft lip and palate were measured and compared retrospectively to the cephalograms of 123 healthy probands. Measurements were derived from a standardized analysis of 56 landmarks. Results. We observed significant differences between cleft and control group: the cleft patients showed amaxillary retroposition and a reduced maxillary length; the inclination of the maxilla was significantly more posterior and cranial; the anterior nasopharyngeal height was reduced; the nasopharyngeal growth followed a vertical tendency with reduced sagittal dimensions concerning hard and soft tissue. The velum length was reduced. In the cleft group, an accumulation of mandibular retrognathia and an anterior position of the hyoid were observed. Skeletal configuration and type of growth were predominantly vertical. Conclusions. Our data provides a fundamental radiological analysis of the nasopharyngeal development in cleft patients. It confirms the lateral cephalogram as a basic diagnostic device in the analysis of nasopharyngeal and skeletal growth in cleft patients. PMID:22523495

  17. A retrospective study of non-suppurative encephalitis in beef cattle from western Canada

    PubMed Central

    Sánchez, Sergio; Clark, Edward G.; Wobeser, Gary A.; Janzen, Eugene D.; Philibert, Hélène

    2013-01-01

    Non-suppurative encephalitis occurs sporadically in beef cattle in western Canada, leading to loss of animals. This retrospective study investigated the presence of viral, bacterial, and protozoal antigens or DNA in 37 western Canadian feedlot cattle with non-suppurative encephalitis for which a cause had not been identified. Cases were selected based on the age of the animal (> 7 months), and clinical history of recumbency and depression. The identification of rabies in 1 case stresses the importance of including this viral disease in the list of differential diagnoses. Because there was variation in the severity, distribution, and type of lesions, it is possible that there may be more than 1 cause, but failure to identify an infectious agent might also suggest that non-infectious agents could play a role. PMID:24293671

  18. [A retrospective study of animal poisoning reports to the Swiss Toxicological Information Centre (1997 - 2006)].

    PubMed

    Curti, R; Kupper, J; Kupferschmidt, H; Naegeli, H

    2009-06-01

    The purpose of this retrospective study was to analyse the etiology, frequency and outcome of toxicological cases recorded by the consultation service of the Swiss Toxicological Information Centre (STIC) hotline over a 10-year period, from 1997 to 2006. A detailed analysis of this database indicates that common human drugs not intended for use in animals, as well as pesticides and toxic plants represent the most prominent hazards involved in the reported cases of animal poisonings. The comparison with a previous survey from the years 1976 - 1985 revealed new toxic risks due to the accidental uptake of cannabis products, castor seeds or chocolate by dogs. In addition, there is a striking increase of serious poisonings with pyrethroids in cats. The follow-up reports delivered by veterinarians also reflect novel pharmacological and technological trends in the management of poisonings. PMID:19496046

  19. The Stateville penitentiary malaria experiments: a case study in retrospective ethical assessment.

    PubMed

    Miller, Franklin G

    2013-01-01

    During World War II, malaria research was conducted in prisons. A notable example was the experiments at Stateville Penitentiary in Illinois, in which prisoner-subjects were infected with malaria for the purpose of testing the safety and efficacy of novel anti-malaria drugs. Over time, commentators have shifted from viewing the malaria research at Stateville as a model of ethical clinical research to seeing the experiments as paradigmatic of abusive human experimentation. This essay undertakes a retrospective ethical assessment of the Stateville malaria research during the 1940s in light of basic ethical principles and the Nuremberg Code, as well as contemporary malaria research. In addition to its historical interest, this case study provides a rich context for addressing basic issues of research ethics, including the voluntariness of consent, the justification of risks, and the exploitation of vulnerable subjects. PMID:24769747

  20. A retrospective study of the profile of ESN children seen at the Child Psychiatric Clinic.

    PubMed

    Ko, S M; Oon, P K

    1989-04-01

    A retrospective study of 50 cases of educationally subnormal children seen at the Child Psychiatric Clinic was done. Almost half of the referrals were initiated by schools, the majority being picked up at Primary 1. Forty-six percent of fathers and sixty percent of mothers had no more than primary education. Eighty-two percent of fathers had unskilled or semi-skilled jobs. Besides being below average in academic performance in school, these children also showed some behavioural problems like restlessness, disobedience, bullying, quarrelling or fighting with other children. They tended to be solitary, unresponsive, inert or apathetic, and were not much liked by others. Although all the children were referred and registered for special education, only half the number of parents accepted the offer for their children. PMID:2609177

  1. Diagnosis of High-Grade Osteosarcoma by Radiology and Cytology: A Retrospective Study of 52 Cases

    PubMed Central

    Skoog, Lambert; Unni, Krishnan K.; Bertoni, Franco; Brosjö, Otte; Kreicbergs, Andris

    2004-01-01

    The diagnostic value of combined radiology and fine needle aspiration cytology (FNAC) was retrospectively assessed in a consecutive series of 52 patients with high-grade osteosarcoma. The series was divided into typical and atypical osteosarcomas according to radiological features and site. Thirty-two of 33 radiologically typical osteosarcoma cases were correctly diagnosed by cytology; one lesion was diagnosed as sarcoma NOS. Nineteen osteosarcoma cases were radiographically atypical. Six of these were diagnosed as osteosarcoma and another six as sarcoma NOS. In three cases another type of sarcoma was suggested. One case was falsely classified as benign. FNAC of three cases were non-diagnostic. Overall, the diagnostic difficulties pertained to the radiologically atypical cases. Notably, four of these also posed considerable difficulties in the histopathological assessment prompting external consultation. Our study suggests that open biopsy can be obviated in high-grade osteosarcomas exhibiting typical radiological features, i.e., in two-thirds. PMID:18521391

  2. Extranodal oral non-Hodgkin's lymphomas. A retrospective study of 40 cases in Argentina.

    PubMed

    Keszler, Alicia; Piloni, María J; Paparella, María L; Soler, Marcela de Dios; Ron, Patricia Cabrera; Narbaitz, Marina

    2008-01-01

    A retrospective study was conducted of extranodal oral Non-Hodgkin's Lymphomas diagnosed at the Surgical Pathology Laboratory of the School of Dentistry at Buenos Aires University, Argentina, between 1985 and 2004. The 40 cases found represent 0.2% of the oral biopsies diagnosed during that time and 4.6% of malignant neoplasias. Overall mean age of patients was 49.4 years, and frequency was greater in males. 80% affected soft tissues. Prevalent location was gingival, followed by palate. Intraosseous cases were more frequent in mandible (75%) than in upper maxilla. 100% of the cases were phenotype B, with a higher frequency of high-grade aggressiveness. The most common histological type was Diffuse Large Cell Lymphoma. 60% of the Plasmablastic Lymphomas in the series came from HIV+ patients. Evolution time prior to consultation was 1 to 3 months in 57.7% of the cases. PMID:18841745

  3. A Retrospective Study of Marjolin's Ulcer Over an Eleven Year Period

    PubMed Central

    Challa, Vasu Reddy; Deshmane, Vijayalakshmi; Ashwatha Reddy, Madhusudana Bommasandra

    2014-01-01

    Background: Marjolin's ulcer is a rare aggressive cutaneous malignancy occurring in previously occurred wounds. The most common aetiology is a burn wound involving extremities and squamous cell carcinoma is the most common variant. Materials and Methods: A retrospective analyses of medical records of patients treated in a single unit with a diagnosis of Marjolin's ulcer was performed. Results: During the study period, 14 patients were treated. Four patients had lymph node metastases and one had pulmonary metastases at the time of presentation. Seven patients underwent wide excision with reconstruction and seven underwent amputation or disarticulation because of advanced malignancy. During the follow up two patients developed local recurrence and one developed pulmonary metastases. Both the patients with pulmonary metastases had Marjolin's ulcer of trunk. Conclusion: Marjolin's ulcer occurs more commonly in the extremities. Distant metastases occur commonly in patients with ulcers on the of trunk. PMID:25538436

  4. The psychological impact of a catastrophic earthquake: a retrospective study 50 years after the event.

    PubMed

    Lazaratou, Helen; Paparrigopoulos, Thomas; Galanos, Gerassimos; Psarros, Constantinos; Dikeos, Dimitris; Soldatos, Constantin

    2008-04-01

    Aim of the present study was to retrospectively assess the impact of a catastrophic earthquake in a sample of 121 survivors, 50 years after the event. Mean age +/- SD of the responders was 72.2 +/- 6.1 years. The majority of the victims (78%) acknowledged a strong overall impact of the earthquake on their lives, and almost all of them had intense recollection of the event at its anniversary. The most frequent symptom during the 6 months after the earthquake was persistent remembering or "reliving" of the event; women had considerably more often recurrent dreams of the earthquake and distress than did men. Women and young adults at the time of the earthquake appear to be the most vulnerable groups regarding the psychological effects of the event. PMID:18414131

  5. [Fat embolism still exists. A retrospective study of 17 cases in a surgical intensive care unit].

    PubMed

    Gaertner, E; Simon, P; Pottecher, T

    1995-01-01

    Fat embolism is a severe complication in patients with femoral fractures. This retrospective study records 17 cases of post traumatic fat embolism diagnosed between 1979 and 1993 among 430 patients admitted for femoral fractures (incidence: 2.7%). These cases underline the high frequency of early hypovolaemia (10/17), of respiratory and cerebral disorders (15/17), all occurring during the first post trauma week. Three cases were observed in the postoperative period. Severity of fat embolism is proved by three deaths and a mean mechanical ventilation period of 13 days. With early osteosynthesis, incidence of fat embolism could be lowered to 0.2%. Prevention is based on osteosynthesis, avoidance of hypovolemia and of hypoalbuminemia. PMID:7671054

  6. A retrospective study of end-stage renal disease in captive polar bears (Ursus maritimus).

    PubMed

    LaDouceur, Elise E B; Davis, Barbara; Tseng, Flo

    2014-03-01

    This retrospective study summarizes 11 cases of end-stage renal disease (ESRD) in captive polar bears (Ursus maritimus) from eight zoologic institutions across the United States and Canada. Ten bears were female, one was male, and the mean age at the time of death was 24 yr old. The most common clinical signs were lethargy, inappetence, and polyuria-polydipsia. Biochemical findings included azotemia, anemia, hyperphosphatemia, and isosthenuria. Histologic examination commonly showed glomerulonephropathies and interstitial fibrosis. Based on submissions to a private diagnostic institution over a 16-yr period, ESRD was the most commonly diagnosed cause of death or euthanasia in captive polar bears in the United States, with an estimated prevalence of over 20%. Further research is needed to discern the etiology of this apparently common disease of captive polar bears. PMID:24712164

  7. [Ganglia of the hand and wrist--a retrospective study on the origination of recurrences].

    PubMed

    Schicke, S; Hoigne, D; Zwipp, H; Grünert, J

    2011-10-01

    This study examines retrospectively the impact of operative and perioperative factors on the recurrence rate of finger and wrist cysts.Out of a total of 237 recorded cyst operations in 201 patients, 46% were carried out for dorsal wrist ganglia, 38% for finger ganglia, and 16% for palmar wrist cysts. 133 (56%) patients answered on a mailed questionnaire. At an average of 2 years 79 of these 133 patients could be re-examined. Data concerning history, size of the cyst, location of the cyst, the hand surgical experience of the performing surgeon were taken from the charts. Statistical analysis were performed.There were 48 (36.1%; n=133) recurrences. Most (79.2%) occurred within the first year. A higher recurrence rate was observed in patients with a longer history, larger ganglia, and when patients were operated by less experienced surgeons. Recurrence rates did neither correlate with the ganglion location, the patient's age, and gender. PMID:21935849

  8. Survival time of endodontically treated teeth: a 7-year retrospective clinical study

    NASA Astrophysics Data System (ADS)

    Baldea, Bogdan; Canjau, Silvana; Popescu, Dragos; Tudor, Anca; Todea, Carmen

    2014-01-01

    The aim of this retrospective clinical study was to examine the survival time of endodontically treated teeth (ETT) and the factors that may influence the failure risk, over a period of up to 7 years. The files of 67 patients that received metal free post and core restorations using a standardized technique were analyzed. The survival probability was assessed using Kaplan-Meyer analysis and Log Rank (Matel-Cox). Cox regression was used to assess the risk of failure and to identify possible covariates. The average survival time of the ETT was 6.6 Years. The cumulative failure rate was 5.82% for all type of the restored endodontically treated teeth. The main failure type was encountered in the cervical area of the teeth, and due to the extensive hard tissue loss, the teeth were extracted.

  9. Is procalcitonin increased in cases of invasive amoebiasis? A retrospective, observational study.

    PubMed

    Recipon, Guillaume; Piver, Éric; Caille, Agnès; Le Pape, Patrice; Pihet, Marc; Pagès, Jean-Christophe; Chandenier, Jacques; Desoubeaux, Guillaume

    2015-12-01

    Procalcitonin (PCT) levels are commonly used for diagnostic guidance in routine bacterial infections. By contrast, little data are currently available regarding PCT in parasitic diseases, and its role in cases of invasive amoebiasis has not yet been described. For this purpose, 35 adult patients with a proven diagnosis of invasive or digestive amoebiasis were included in a 4-year study period. Serum PCT was retrospectively assessed. Results were analysed with regard to the usual inflammatory biomarkers, like C-reactive protein (CRP). PCT was significantly higher in patients with proven invasive amoebiasis than in digestive amoebiasis (mean value: 4.03 μg/L versus 0.07 μg/L, respectively; P < 0.001), but the SD was greater than with CRP, and the effect was less than that demonstrated in bacterial infections. By contrast, PCT was not shown to be elevated during digestive amoebiasis. PMID:26388549

  10. Clinical practice trends in cryosurgery: a retrospective study of cutaneous lesions

    PubMed Central

    Erkan, Ceren Dagar; Karaca, Semsettin

    2015-01-01

    Introduction Cryosurgery is an alternative treatment for many benign, premalignant, and malignant lesions of the skin. Aim To review the indications of cryosurgery for cutaneous lesions. Material and methods The retrospective study was based on the assessment of medical records of 1031 dermatology patients who had cryosurgery. Results One thousand two hundred and forty-four sessions of cryosurgery were applied to the total of 1031 patients. Of the 1031 patients, the most frequent indication for cryosurgery was common warts which were present in 535 (61.59%) patients, followed by anogenital warts in 119 (11.54%) patients, callosity in 81 (7.85%) patients, actinic keratosis in 77 (7.46%) patients, molluscum contagiosum in 35 (3.39%) patients, and other benign or malignant skin lesions. Conclusions Cryosurgery is still a valuable treatment of choice in various benign, premalignant, and malignant skin diseases but seems to be underused for indications other than viral warts. PMID:26015777

  11. Corticosteroid therapy in regressive autism: Preliminary findings from a retrospective study.

    PubMed

    Golla, Sailaja; Sweeney, John A

    2014-01-01

    Some children with autism spectrum disorders (ASD; 15% to 30% of patients) show a significant and persistent regression in speech and social function during early childhood. There are no established treatments for the regressive symptoms. However, there are some known causes of this type of regression, such as Rett syndrome and Landau-Kleffner syndrome (LKS). In LKS, steroids have been used as a treatment. Some evidence suggests an autoimmune contribution to the pathophysiology of autism (Chez MG, Guido-Estrada N: Immune therapy in autism: historical experience and future directions with immunomodulatory therapy. Neurotherapeutics 2010, 7:293-301, Wasilewska J, Kaczmarski M, Stasiak-Barmuta A, Tobolczyk J, Kowalewska E: Low serum IgA and increased expression of CD23 on B lymphocytes in peripheral blood in children with regressive autism aged 3-6 years old. Arch Med Sci 2012, 8:324-331, Stefanatos G: Changing perspectives on Landau-Kleffner syndrome. Clin Neuropsychol 2011, 25:963-988), raising the possibility that steroids might be a useful therapy for regression in ASD. A retrospective study published in BMC Neurology by Duffy et al. (Duffy, et al: Corticosteroid therapy in regressive autism: A retrospective study of effects on the Frequency Modulated Auditory Evoked Response (FMAER), language, and behavior. BMC Neurol 2014, 14:70) reviewed 20 steroid treated R-ASD (STAR) patients and 24 ASD control patients not treated with steroids (NSA). Improvements in clinical function and in a neurophysiological biomarker were seen in the steroid-treated children pre- to post-prednisolone treatment. This research provides a rationale for a randomized trial with steroid therapy to determine the longer term benefits and complications of steroids in this population. PMID:24884537

  12. Effect of therapeutic hypothermia on gas exchange and respiratory mechanics: a retrospective cohort study.

    PubMed

    Karnatovskaia, Lioudmila V; Festic, Emir; Freeman, William D; Lee, Augustine S

    2014-06-01

    Targeted temperature management (TTM) may improve respiratory mechanics and lung inflammation in acute respiratory distress syndrome (ARDS) based on animal and limited human studies. We aimed to assess the pulmonary effects of TTM in patients with respiratory failure following cardiac arrest. Retrospective review of consecutive cardiac arrest cases occurring out of hospital or within 24 hours of hospital admission (2002-2012). Those receiving TTM (n=44) were compared with those who did not (n=42), but required mechanical ventilation (MV) for at least 4 days following the arrest. There were no between-group differences in age, gender, body mass index, APACHE II, or fluid balance during the study period. The TTM group had lower ejection fraction, Glasgow Coma Score, and more frequent use of paralytics. Matched data analyses (change at day 4 compared with baseline of the individual subject) showed favorable, but not statistically significant trends in respiratory mechanics endpoints (airway pressure, compliance, tidal volume, and PaO2/FiO2) in the TTM group. The PaCO2 decreased significantly more in the TTM group, as compared with controls (-12 vs. -5 mmHg, p=0.02). For clinical outcomes, the TTM group consistently, although not significantly, did better in survival (59% vs. 43%) and hospital length of stay (12 vs. 15 days). The MV duration and Cerebral Performance Category score on discharge were significantly lower in the TTM group (7.3 vs. 10.7 days, p=0.04 and 3.2 vs. 4, p=0.01). This small retrospective cohort suggests that the effect of TTM ranges from equivalent to favorable, compared with controls, for the specific respiratory and clinical outcomes in patients with respiratory failure following cardiac arrest. PMID:24840620

  13. Exogenous lipid pneumonia: a retrospective multicentre study of 44 cases in France.

    PubMed

    Gondouin, A; Manzoni, P; Ranfaing, E; Brun, J; Cadranel, J; Sadoun, D; Cordier, J F; Depierre, A; Dalphin, J C

    1996-07-01

    A nationwide retrospective study of exogenous lipid pneumonia (ELP) was carried out to update the data on this disease, with emphasis on thoracic computed tomography (CT) scan and bronchoalveolar lavage (BAL) findings. The inclusion criteria were: 1) presence of abnormal imaging features compatible with the diagnosis of ELP; 2) presence of intrapulmonary lipids; and 3) exogenous origin of the lipid pneumonia. Forty four cases were included (20 males and 24 females; mean age 62 +/- 11 yrs), of which four were occupational (chronic inhalation of cutting mist or oily vapour in an industrial environment). Thirty of the 40 nonoccupational cases were related to aspiration of liquid paraffin used for the treatment of constipation. A condition possibly favouring oil aspiration or inhalation was present in 34 patients (77%), most commonly gastro-oesophageal reflux (n = 20) and neurological or psychiatric illness (n = 14). Fever (39%), weight loss (34%), cough (64%), dyspnoea (50%) and crepitations (45%) were the most frequent symptoms. BAL was performed in 39 cases: 23% had a lymphocytic alveolitis; 14% neutrophilic alveolitis; and 31% a mixed alveolitis (lymphocytic and neutrophilic). Alveolar consolidations (57%), ground glass opacities (39%), and alveolar nodules (23%) were the most common radiological abnormalities. The changes were bilateral (79%), predominant in the posterior and lower zones of the lobes concerned (74%), hypodense (71%), and spared the subpleural zones (52%). In 13 cases, hypodensity was retrospectively established on CT scan by the presence of a "positive angiogram". This sign may be of diagnostic value when the density measurement is either not possible or not reliable. In conclusion, this study provides an update of the clinical, biological and radiological profile of exogenous lipid pneumonia and, in particular, confirms the diagnostic benefit of computed tomography scan, which revealed bilateral and hypodense changes in a large majority of cases

  14. Volar Plate Fixation of Intra-Articular Distal Radius Fractures: A Retrospective Study

    PubMed Central

    Fok, Margaret W. M.; Klausmeyer, Melissa A.; Fernandez, Diego L.; Orbay, Jorge L.; Bergada, Alex Lluch

    2013-01-01

    Background Intra-articular fractures of the distal radius represent a therapeutic challenge as compared with the unstable extra-articular fractures. With the recent development of specifically designed internal fixation materials for the distal radius, treatment of these fractures by fragment-specific implants using two or more incisions has been advocated. Purpose The purpose of this study was to investigate the efficacy of a fixed-angle locking plate applied through a single volar approach in maintaining the radiographic alignment of unstable intra-articular fractures as well as to report the clinical outcomes. We only excluded those with massive comminution, as is discussed in greater detail in the text. Patients and Methods This is a multicentered, retrospective study involving three hospitals situated in Spain, Switzerland, and the United States. In the period between January 2000 and March 2006, 97 patients with 101 intra-articular distal radius fractures, including 13 volarly displaced and 88 dorsally angulated fractures were analyzed. Over 80% were C2/C3 fractures, based on the AO classification. 16 open fractures were noted. Results With an average follow-up of 28 months (range 24-70 months), the range of movement of the wrist was very satisfactory, and the mean grip strength was 81% of the opposite wrist. The Disabilities of the Arm, Shoulder, and Hand (DASH) score was 8. The complications rate was < 5%, including loss of reduction in two patients. All fractures healed by 3 months postinjury. Conclusions Irrespective of the direction and amount of initial displacement, a great majority of intra-articular fractures of the distal radius can be managed with a fixed-angle volar plate through a single volar approach. Level IV retrospective case series PMID:24436824

  15. Physical fitness and hematological changes during acclimatization to moderate altitude: a retrospective study.

    PubMed

    Brothers, Michael D; Wilber, Randall L; Byrnes, William C

    2007-01-01

    While high altitude adaptations have been studied extensively, limited research has examined moderate altitude (MA: 1500 to 3000 m) adaptations and their time course, despite the fact that millions of people sojourn to or reside at MA. We retrospectively examined long-term MA acclimatization by analyzing recurring physical fitness test results and hematological data among 2147 college-age male cadets previously residing at either sea level (SL) or MA and currently attending the U.S. Air Force Academy (USAFA), a unique, regimented, and well-controlled military university located at 2210 m. Significant (p < 0.01) differences were found in aerobic and anaerobic fitness test scores between former SL and MA subjects, with MA subjects scoring 27 points (8%) higher during a 1.5-mile aerobic fitness run and 18 points (6%) higher than SL subjects in the anaerobic fitness test for 2 yr. These differences may be partly explained by the hematological differences observed. Hemoglobin concentration ([Hb]) was significantly (p < 0.001) higher (6.3%; approximately 1 g/dL) in MA subjects prior to arrival at USAFA and acutely, but the difference between altitude conditions was gone at the next retrospective blood draw (+17 months). After 2.5 yr at USAFA, former SL residents had significantly (p < 0.001) higher [Hb] by +10%, or 1.5 g/dL versus prearrival values. This study suggests that significant hematological acclimatization occurs with MA exposure and requires greater than 7 months to reach stability. The altitude-induced erythropoiesis may explain in part the improvements in aerobic performance, but altitude-related anaerobic differences still remain after hematological acclimatization. PMID:17824822

  16. The Effect of Multiple Sequential Light Sources to Activate Aminolevulinic Acid in the Treatment of Actinic Keratoses: A Retrospective Study

    PubMed Central

    Goldman, Mitchel P.; Fabi, Sabrina G.; Guiha, Isabella

    2014-01-01

    There is a lack of research regarding the sequential use of multiple light sources for topical 5-aminolevulinic acid activation in photodynamic therapy for actinic keratosis. This study evaluated 5-aminolevulinic acid-photodynamic therapy for actinic keratosis using blue light combined with red light, pulsed dye laser, and/or intense pulsed light in a retrospective fashion. Field-directed 5-aminolevulinic acid-photodynamic therapy was performed with blue light only, blue light + pulsed dye laser, blue light + intense pulsed light, blue light + pulsed dye laser + intense pulsed light, or blue light + red light + pulsed dye laser + intense pulsed light for nonhyperkeratotic actinic keratoses of face, scalp, or upper trunk. Blue light + intense pulsed light + pulsed dye laser produced greater patient-reported improvement in actinic keratoses than blue light or blue light + intense pulsed light and greater subject-reported improvement in overall skin quality than blue light + intense pulsed light. The addition of red light led to no further benefit in either outcome measure. Photodynamic therapy with multiple, sequential laser and light sources led to greater patient-graded improvement in actinic keratoses than that with a single light source (blue light), without significant differences in post-treatment adverse events. However, the small, widely disparate number of patients between groups and follow-up times between patients, as well as retrospective assessments based on subjective patient recall, severely limit the significance of these findings. Nevertheless, the results raise interesting questions regarding the use of multiple light and laser sources for photodynamic therapy of actinic keratoses and warrant further research with a prospective, randomized, controlled study. PMID:25276272

  17. Efficacy of low-dose radiotherapy in painful gonarthritis: experiences from a retrospective East German bicenter study

    PubMed Central

    2013-01-01

    Purpose To evaluate the efficacy of low-dose radiotherapy in painful gonarthritis. Methods We assessed the medical records of 1037 patients with painful gonarthritis who had undergone low-dose radiotherapy between 1981 and 2008. The subjective patient perception of the response to irradiation as graded immediately or up to two months after the completion of a radiotherapy series was evaluated and correlated with age, gender, radiological grading and the duration of symptoms before radiotherapy. Moreover, we performed a mail survey to obtain additional long-term follow-up information and received one hundred and six evaluable questionnaires. Results We assessed 1659 series of radiotherapy in 1037 patients. In 79.3% of the cases the patients experienced a slight, marked or complete pain relief immediately or up to two months after the completion of radiotherapy. Gender, age and the duration of pain before radiotherapy did not have a significant influence on the response to irradiation. In contrast, severe signs of osteoarthritis were associated with more effective pain relief. In more than 50% of the patients who reported a positive response to irradiation a sustained period of symptomatic improvement was observed. Conclusions Our results confirm that low-dose radiotherapy is an effective treatment for painful osteoarthritis of the knee. In contrast to an earlier retrospective study, severe signs of osteoarthritis constituted a positive prognostic factor for the response to irradiation. A randomized trial is urgently required to compare radiotherapy with other treatment modalities. PMID:23369282

  18. Reproductive outcome after hysteroscopic septoplasty in patients with septate uterus - a retrospective cohort study and systematic review of the literature

    PubMed Central

    2010-01-01

    Background Septate uterus, one of the most common forms of congenital uterine malformations, negatively affects female reproductive health. Methods In a retrospective cohort study, we evaluated the reproductive outcome after hysteroscopic septoplasty in 64 women with septate uterus and primary or secondary infertility. We performed a systematic review of studies evaluating the reproductive outcome after hysteroscopic septoplasty. Results Sixty-four women underwent hysteroscopic septoplasty. In 2/64 (3%) women, intraoperative uterine perforation occurred. Complete follow-up was available for 49/64 (76%) patients. Mean follow-up time was 68.6 +/- 5.2 months. The overall pregnancy rate after hysteroscopic septoplasty was 69% (34/49). The overall life birth rate (LBR) was 49% (24/49). The mean time interval between surgery and the first life birth was 35.8 +/- 22.5 months. Including our own data, we identified 18 studies investigating the effect of septoplasty on reproductive outcome in 1501 women. A pooled analysis demonstrated that hysteroscopic septoplasty resulted in an overall pregnancy rate of 60% (892/1501) and a LBR of 45% (686/1501). The overall rate of intra- and postoperative complications was 1.7% (23/1324) and the overall rate of re-hysteroscopy was 6% (79/1324). Conclusions In women with septate uterus and a history of infertility, hysteroscopic septoplasty is a safe and effective procedure resulting in a pregnancy rate of 60% and a LBR of 45%. PMID:20492650

  19. 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).

  20. Treatment results and prognostic factors of pediatric neuroblastoma: a retrospective study

    PubMed Central

    2010-01-01

    Background We conducted a retrospective analysis to investigate treatment results and prognostic factors of pediatric neuroblastoma patients. Methods This retrospective study was carried out analyzing the medical records of patients with the pathological diagnosis of neuroblastoma seen at South Egypt Cancer Institute, Assiut University during the period from January 2001 and January 2010. After induction chemotherapy, response according to international neuoblastoma response criteria was assessed. Radiotherapy to patients with residual primary tumor was applied. Overall and event free survival (OAS and EFS) rates were estimated using Graphed prism program. The Log-rank test was used to examine differences in OAS and EFS rates. Cox-regression multivariate analysis was done to determine the independent prognostic factors affecting survival rates. Results Fifty three cases were analyzed. The median follow-up duration was 32 months and ranged from 2 to 84 months. The 3-year OAS and EFS rates were 39.4% and 29.3% respectively. Poor prognostic factors included age >1 year of age, N-MYC amplification, and high risk group. The majority of patients (68%) presented in high risk group, where treatment outcome was poor, as only 21% of patients survived for 3 year. Conclusion Multivariate analysis confirmed only the association between survival and risk group. However, in univariate analysis, local radiation therapy resulted in significant survival improvement. Therefore, radiotherapy should be given to patients with residual tumor evident after induction chemotherapy and surgery. Future attempts to improve OAS in high risk group patients with aggressive chemotherapy and bone marrow transplantation should be considered. PMID:21182799

  1. Mortality Risk amongst Nursing Home Residents Evacuated after the Fukushima Nuclear Accident: A Retrospective Cohort Study

    PubMed Central

    Nomura, Shuhei; Gilmour, Stuart; Tsubokura, Masaharu; Yoneoka, Daisuke; Sugimoto, Amina; Oikawa, Tomoyoshi; Kami, Masahiro; Shibuya, Kenji

    2013-01-01

    Background Safety of evacuation is of paramount importance in disaster planning for elderly people; however, little effort has been made to investigate evacuation-related mortality risks. After the Fukushima Daiichi Nuclear Plant accident we conducted a retrospective cohort survival survey of elderly evacuees. Methods A total of 715 residents admitted to five nursing homes in Minamisoma city, Fukushima Prefecture in the five years before 11th March 2011 joined this retrospective cohort study. Demographic and clinical characteristics were drawn from facility medical records. Evacuation histories were tracked until the end of 2011. The evacuation's impact on mortality was assessed using mortality incidence density and hazard ratios in Cox proportional hazards regression. Results Overall relative mortality risk before and after the earthquake was 2.68 (95% CI: 2.04–3.49). There was a substantial variation in mortality risks across the facilities ranging from 0.77 (95% CI: 0.34–1.76) to 2.88 (95% CI: 1.74–4.76). No meaningful influence of evacuation distance on mortality was observed although the first evacuation from the original facility caused significantly higher mortality than subsequent evacuations, with a hazard ratio of 1.94 (95% CI: 1.07–3.49). Conclusion High mortality, due to initial evacuation, suggests that evacuation of the elderly was not the best life-saving strategy for the Fukushima nuclear disaster. Careful consideration of the relative risks of radiation exposure and the risks and benefits of evacuation is essential. Facility-specific disaster response strategies, including in-site relief and care, may have a strong influence on survival. Where evacuation is necessary, careful planning and coordination with other nursing homes, evacuation sites and government disaster agencies is essential to reduce the risk of mortality. PMID:23555921

  2. Prognostic Criteria in Traumatic Knee Dislocations: A Retrospective Study of 42 Cases

    PubMed Central

    Pehlivanoğlu, Tuna; Balcı, Halil İbrahim; Chodza, Mehmet; Kılıçoğlu, Önder İsmet

    2014-01-01

    Objectives: Traumatic knee dislocation (TKD) is an orthopaedic emergency, which may include not only knee joint’s structures, but also neurovascular tissues. While such a major trauma can easily be expected to cause significant impairment in knee joint’s functions in long term, individual impact of these injured structures on the outcome needs to be clarified. This study questions the effect of injury type and the effect of the presence of neurovascular injuries on the functional outcome after TKD treatment in a level 3 trauma center. Methods: Between 1997 and 2013, 42 knee joints of 42 patients (mean age 34; range 18 – 80) were diagnosed with TKD and treated accordingly. Patients were reviewed after a mean period of 116 months (range 12 – 204), retrospectively. The type of knee injury was classified according to Schenck’s criteria, accompanying injuries and emergency and elective surgical interventions were recorded. Patients were evaluated radiographically and clinically on the follow-up examination. Clinical outcome parameters were KSS, Lysholm-Tegner, IKDC and SF-36 scores, grouping patients as either “good or excellent” or “poor or fair”. Cut-off values for this stratification was 70 points or higher for KSS, 80 or higher for Tegner-Lysholm and 70 for IKDC score. Effect of injury patterns on the clinical outcome was investigated using frequency tables and Chi-Square test for categorical data and Anova one-way analysis or Kruskal-Wallis test for numerical results. Results: According to Schenck’s classification, 6 knee joints (13.9%) were classified as KDI, 3 joints (6.9%) as KDII, 10 joints (23.2%) as KDIII, 19 joints (44.1%) as KDIV and 3 (6.9%) as KDV. An arterial injury was diagnosed in 11 cases (25.5%), fibular nerve injury in 12 cases (27.9%) and tibial nerve injury in 2 cases (4.6%). An external fixator was placed in 20 patients (46.5%) in the emergency setting. Vascular repair was performed in 6 patients, of which four (9.3%) also

  3. Can Total Thyroidectomy Be Safely Performed by Residents?: A Comparative Retrospective Multicenter Study.

    PubMed

    Gurrado, Angela; Bellantone, Rocco; Cavallaro, Giuseppe; Citton, Marilisa; Constantinides, Vasilis; Conzo, Giovanni; Di Meo, Giovanna; Docimo, Giovanni; Franco, Ilaria Fabiola; Iacobone, Maurizio; Lombardi, Celestino Pio; Materazzi, Gabriele; Minuto, Michele; Palazzo, Fausto; Pasculli, Alessandro; Raffaelli, Marco; Sebag, Frederic; Tolone, Salvatore; Miccoli, Paolo; Testini, Mario

    2016-04-01

    This retrospective comparative multicenter study aims to analyze the impact on patient outcomes of total thyroidectomy (TT) performed by resident surgeons (RS) with close supervision and assistance of attending surgeons (AS).All patients who underwent TT between 2009 and 2013 in 10 Units of endocrine surgery (8 in Italy, 1 in France, and 1 in UK) were evaluated. Demographic data, preoperative diagnosis, extension of goiter, type of surgical access, surgical approach, operative time, use and duration of drain, length of hospitalization, histology, and postoperative complications were recorded. Patients were divided into 3 groups: A, when treated by an AS assisted by an RS; B and C, when treated by a junior and a senior RS, respectively, assisted by an AS.The 8908 patients (mean age 51.1 ± 13.6 years), with 6602 (74.1%) females were enrolled. Group A counted 7092 (79.6%) patients, Group B 261 (2.9%) and Group C 1555 (17.5%). Operative time was significantly greater (P < 0.001) in B (101.3 ± 43.0 min) vs A (71.8 ± 27.6 min) and C (81.2 ± 29.9 min). Duration of drain was significantly lower (P < 0.001) in A (47.4 ± 13.2 h) vs C (56.4 ± 16.5 h), and in B (42.8 ± 14.9 h) vs A and C. Length of hospitalization was significantly longer (P < 0.001) in C (3.8 ± 1.8 days) vs B (2.4 ± 1.0 days) and A (2.6 ± 1.5 days). No mortality occurred. Overall postoperative morbidity was 22.3%: it was significantly higher in B vs A (29.5% vs 22.3%; odds ratio [OR] 1.46, 95% confidence interval [CI] 1.11-1.92, P = 0.006) and C (21.3%; OR 1.55, 95% CI 1.15-2.07, P = 0.003). No differences were found for recurrent laryngeal nerve palsy, hypoparathyroidism, hemorrhage, and wound infection. The adjusted ORs in multivariate analysis showed that overall morbidity remained significantly associated with Group B vs A (OR 1.48, 95% CI 1.12-1.96, P = 0.005) and vs C (OR 1.60, 95% CI 1.19-2.17, P = 0.002), while

  4. High-Dose-Rate Brachytherapy for Non-Small-Cell Lung Carcinoma: A Retrospective Study of 226 Patients

    SciTech Connect

    Aumont-le Guilcher, Maud; Prevost, Bernard; Sunyach, Marie Pierre; Peiffert, Didier; Maingon, Philippe; Thomas, Laurence; Williaume, Daniele; Begue, Mickael; Lerouge, Delphine; Campion, Loic; Mahe, Marc-Andre

    2011-03-15

    Purpose: To evaluate the efficacy and toxicity of high-dose-rate (HDR) brachytherapy in patients with inoperable endobronchial carcinoma. Methods and Materials: We retrospectively reviewed the records (April 1991-May 2004) of patients with non-small-cell carcinoma, with no extrabronchial spread on computed tomography scans, who underwent HDR brachytherapy because of contraindications to surgery and external beam radiation therapy. Kaplan-Meier survival curves were compared by the log-rank test. Prognostic factors were analyzed by multivariate analysis. Results: 226 patients (223 men, 3 women, mean age: 62.2 years (range, 40-84)) were included. Of those, 217 (97%) had squamous cell carcinoma (Tis/T1/T2/Tx: 60/153/9/4). Dose was prescribed at 1 cm from the radius (24-35 Gy in 4-6 fractions). Mean follow-up was 30.4 months (range, 9-116). Complete endoscopic response rate was 93.6% at 3 months. One hundred twenty-eight patients (56%) died of intercurrent disease (n = 45), local failure (n = 36), metastasis (n = 10), local failure and metastasis (n = 11), complications (n = 13), and other causes (n = 12). The 2-year and 5-year survival rates were, respectively, 57% and 29% (overall) (median, 28.6 months), 81% and 56% (cancer-specific), and 68% and 50% (local disease-free). Acute toxicity included pneumothorax (1.5%) and mucosal inflammation (10%). Late complications were hemoptysis (6.6% with 5% of fatalities), bronchitis (19.5%), and necrosis (3.5%). In multivariate analysis, a distal tumor location and the use of two catheters were associated with improved local disease-free survival (p = 0.003 and p = 0.007, respectively) and a distal tumor location with improved overall survival (p = 0.0001). Conclusions: This large retrospective study confirms that HDR brachytherapy is an efficient and safe treatment in patients with inoperable endobronchial carcinoma.

  5. Home Start Evaluation Study.

    ERIC Educational Resources Information Center

    High/Scope Educational Research Foundation, Ypsilanti, MI.

    Case studies of seven Home Start programs are given as the third section of an evaluation study. Communities involved are Huntsville, Alabama; Fairbanks, Alaska; Fort Defiance, Arizona; Dardanelle, Arkansas; Wichita, Kansas; Gloucester, Massachusetts; and Reno, Nevada. Although each study varies in format, each describes in detail the degree and…

  6. Anemia and Immunosuppressive Regimen in Renal Transplanted Patients: Single-Center Retrospective Study.

    PubMed

    Carta, P; Bigazzi, B; Buti, E; Antognoli, G; Di Maria, L; Caroti, L; Minetti, E E

    2016-03-01

    We compared retrospectively the level of hemoglobin and the percentage of patients with anemia among 59 kidney transplant recipients receiving everolimus, cyclosporine, and corticosteroids and 128 treated with cyclosporine, mycophenolic acid, and corticosteroids. We also compared age at the time of transplantation, sex and ferritine, serum creatinine, creatinine clearance, folic acid, cyanocobalamine levels, use od recombinant erythropoietin, mean corpuscolar volume at the last ambulatory control. Statistical analysis included Student t test, χ(2) test, and logistic regression. The analysis was performed using SPSS software. We observed no difference in terms of hemoglobin levels in patients treated with everolimus (12.9 ± 1.6 vs 12.7 ± 1.5 g/dL). Anemia (defined as hemoglobin <13 g/dL in men and <12 g/dL in women, or need to use erythropoietin) was found in 49% and 45% of patients in the 2 groups respectively (P = .6). The other parameters evaluated were similar except for the mean corpuscular volume, which was significantly lower in the everolimus group. In the multivariate analysis only serum creatinine and estimated glomerular filtration rate influenced the level of hemoglobin. We observed no differences in terms of development of anemia in renal transplanted patients treated with everolimus-based regimen. PMID:27109950

  7. Recent viral pathogen in acute gastroenteritis: a retrospective study at a tertiary hospital for 1 year

    PubMed Central

    Jin, Hye Il; Lee, Yoo Mi; Choi, You Jin

    2016-01-01

    Purpose Viral gastroenteritis among children is mainly caused by rotavirus, norovirus, astrovirus, or adenovirus strains. However, changing socioeconomic conditions and a rotavirus vaccination program may be affecting the prevalence of these viral infections. Therefore, we aimed to elucidate the season-specific trends in viral infections for facilitating prophylaxis and surveillance in our region. Methods We evaluated 345 pediatric patients (203 males, 142 females; age, 1 month to 16 years) who visited the CHA Bundang Medical Center because of gastroenteric symptoms between June 2014 and May 2015. The specimens were simultaneously tested for norovirus, rotavirus, astrovirus, and adenovirus via multiplex reverse transcription polymerase chain reaction. Clinical characteristics of patients were analyzed retrospectively. Results The most common virus was norovirus, followed by rotavirus, adenovirus, and astrovirus. Of all viral infections, 45.2% occurred mainly between 6 and 24 months of age; in particular, norovirus infection mostly occurred in all age groups except those below 6 months of age, when rotavirus was most prevalent. In addition, seasonal variation was observed, such as norovirus infection from December to February, rotavirus infection from February to April, and adenovirus infection from July to October. Conclusion Our results showed that the most common cause of acute pediatric viral gastroenteritis had changed from rotavirus to norovirus in our patients, because of effective rotaviral vaccination. We recommend the management of food and personal hygiene in accordance with age or seasons as well as active vaccination for preventing viral gastroenteritis. PMID:27186218

  8. Evidence based general practice: a retrospective study of interventions in one training practice.

    PubMed Central

    Gill, P.; Dowell, A. C.; Neal, R. D.; Smith, N.; Heywood, P.; Wilson, A. E.

    1996-01-01

    OBJECTIVES--To estimate the proportion of interventions in general practice that are based on evidence from clinical trials and to assess the appropriateness of such an evaluation. DESIGN--Retrospective review of case notes. SETTING--One suburban training general practice. SUBJECTS--122 consecutive doctor-patient consultations over two days. MAIN OUTCOME MEASURES--Proportions of interventions based on randomised controlled trials (from literature search with Medline, pharmaceutical databases, and standard textbooks), on convincing non-experimental evidence, and without substantial evidence. RESULTS--21 of the 122 consultations recorded were excluded due to insufficient data; 31 of the interventions were based on randomised controlled trial evidence and 51 based on convincing non-experimental evidence. Hence 82/101 (81%) of interventions were based on evidence meeting our criteria. CONCLUSIONS--Most interventions within general practice are based on evidence from clinical trials, but the methods used in such trials may not be the most appropriate to apply to this setting. PMID:8608291

  9. Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Surgery in the Sugammadex Era: A Retrospective Study.

    PubMed

    Oh, Chung-Sik; Rhee, Ka Young; Yoon, Tae-Gyoon; Woo, Nam-Sik; Hong, Seung Wan; Kim, Seong-Hyop

    2016-01-01

    Background. Residual neuromuscular block (NMB) after general anesthesia has been associated with pulmonary dysfunction and hypoxia, which are both associated with postoperative delirium (POD). We evaluated the effects of sugammadex on POD in elderly patients who underwent hip fracture surgery. Methods. Medical records of 174 consecutive patients who underwent hip fracture surgery with general anesthesia were reviewed retrospectively to compare the perioperative incidence of POD, pulmonary complications, time to extubation, incidence of hypoxia, and laboratory findings between patients treated with sugammadex and those treated with a conventional cholinesterase inhibitor. Results. The incidence of POD was not significantly different between the two groups (33.3% versus 36.5%, resp.; P = 0.750). Postoperative pulmonary complications and laboratory findings did not showed significant intergroup difference. However, time to extubation (6 ± 3 versus 8 ± 3 min; P < 0.001) and the frequency of postoperative hypoxia were significantly lower (23% versus 43%; P = 0.010) in the sugammadex group than in the conventional cholinesterase inhibitor group. Conclusion. Sugammadex did not reduce POD or pulmonary complications compared to conventional cholinesterase inhibitors, despite reducing time to extubation and postoperative hypoxia in elderly patients who underwent hip fracture surgery under general anesthesia. PMID:26998480

  10. Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Surgery in the Sugammadex Era: A Retrospective Study

    PubMed Central

    Oh, Chung-Sik; Rhee, Ka Young; Yoon, Tae-Gyoon; Woo, Nam-Sik; Hong, Seung Wan; Kim, Seong-Hyop

    2016-01-01

    Background. Residual neuromuscular block (NMB) after general anesthesia has been associated with pulmonary dysfunction and hypoxia, which are both associated with postoperative delirium (POD). We evaluated the effects of sugammadex on POD in elderly patients who underwent hip fracture surgery. Methods. Medical records of 174 consecutive patients who underwent hip fracture surgery with general anesthesia were reviewed retrospectively to compare the perioperative incidence of POD, pulmonary complications, time to extubation, incidence of hypoxia, and laboratory findings between patients treated with sugammadex and those treated with a conventional cholinesterase inhibitor. Results. The incidence of POD was not significantly different between the two groups (33.3% versus 36.5%, resp.; P = 0.750). Postoperative pulmonary complications and laboratory findings did not showed significant intergroup difference. However, time to extubation (6 ± 3 versus 8 ± 3 min; P < 0.001) and the frequency of postoperative hypoxia were significantly lower (23% versus 43%; P = 0.010) in the sugammadex group than in the conventional cholinesterase inhibitor group. Conclusion. Sugammadex did not reduce POD or pulmonary complications compared to conventional cholinesterase inhibitors, despite reducing time to extubation and postoperative hypoxia in elderly patients who underwent hip fracture surgery under general anesthesia. PMID:26998480

  11. Is rigorous retrospective harmonization possible? Application of the DataSHaPER approach across 53 large studies

    PubMed Central

    Fortier, Isabel; Doiron, Dany; Little, Julian; Ferretti, Vincent; L’Heureux, François; Stolk, Ronald P; Knoppers, Bartha M; Hudson, Thomas J; Burton, Paul R

    2011-01-01

    Background Proper understanding of the roles of, and interactions between genetic, lifestyle, environmental and psycho-social factors in determining the risk of development and/or progression of chronic diseases requires access to very large high-quality databases. Because of the financial, technical and time burdens related to developing and maintaining very large studies, the scientific community is increasingly synthesizing data from multiple studies to construct large databases. However, the data items collected by individual studies must be inferentially equivalent to be meaningfully synthesized. The DataSchema and Harmonization Platform for Epidemiological Research (DataSHaPER; http://www.datashaper.org) was developed to enable the rigorous assessment of the inferential equivalence, i.e. the potential for harmonization, of selected information from individual studies. Methods This article examines the value of using the DataSHaPER for retrospective harmonization of established studies. Using the DataSHaPER approach, the potential to generate 148 harmonized variables from the questionnaires and physical measures collected in 53 large population-based studies (6.9 million participants) was assessed. Variable and study characteristics that might influence the potential for data synthesis were also explored. Results Out of all assessment items evaluated (148 variables for each of the 53 studies), 38% could be harmonized. Certain characteristics of variables (i.e. relative importance, individual targeted, reference period) and of studies (i.e. observational units, data collection start date and mode of questionnaire administration) were associated with the potential for harmonization. For example, for variables deemed to be essential, 62% of assessment items paired could be harmonized. Conclusion The current article shows that the DataSHaPER provides an effective and flexible approach for the retrospective harmonization of information across studies. To implement

  12. A Retrospective Pretest-Posttest Evaluation of a One-Time Personal