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Sample records for 2-year recurrence interval

  1. New Madrid seismic zone recurrence intervals

    SciTech Connect

    Schweig, E.S. Center for Earthquake Research and Information, Memphis, TN ); Ellis, M.A. )

    1993-03-01

    Frequency-magnitude relations in the New Madrid seismic zone suggest that great earthquakes should occur every 700--1,200 yrs, implying relatively high strain rates. These estimates are supported by some geological and GPS results. Recurrence intervals of this order should have produced about 50 km of strike-slip offset since Miocene time. No subsurface evidence for such large displacements is known within the seismic zone. Moreover, the irregular fault pattern forming a compressive step that one sees today is not compatible with large displacements. There are at least three possible interpretations of the observations of short recurrence intervals and high strain rates, but apparently youthful fault geometry and lack of major post-Miocene deformation. One is that the seismological and geodetic evidence are misleading. A second possibility is that activity in the region is cyclic. That is, the geological and geodetic observations that suggest relatively short recurrence intervals reflect a time of high, but geologically temporary, pore-fluid pressure. Zoback and Zoback have suggested such a model for intraplate seismicity in general. Alternatively, the New Madrid seismic zone is geologically young feature that has been active for only the last few tens of thousands of years. In support of this, observe an irregular fault geometry associated with a unstable compressive step, a series of en echelon and discontinuous lineaments that may define the position of a youthful linking fault, and the general absence of significant post-Eocene faulting or topography.

  2. Modelling volatility recurrence intervals in the Chinese commodity futures market

    NASA Astrophysics Data System (ADS)

    Zhou, Weijie; Wang, Zhengxin; Guo, Haiming

    2016-09-01

    The law of extreme event occurrence attracts much research. The volatility recurrence intervals of Chinese commodity futures market prices are studied: the results show that the probability distributions of the scaled volatility recurrence intervals have a uniform scaling curve for different thresholds q. So we can deduce the probability distribution of extreme events from normal events. The tail of a scaling curve can be well fitted by a Weibull form, which is significance-tested by KS measures. Both short-term and long-term memories are present in the recurrence intervals with different thresholds q, which denotes that the recurrence intervals can be predicted. In addition, similar to volatility, volatility recurrence intervals also have clustering features. Through Monte Carlo simulation, we artificially synthesise ARMA, GARCH-class sequences similar to the original data, and find out the reason behind the clustering. The larger the parameter d of the FIGARCH model, the stronger the clustering effect is. Finally, we use the Fractionally Integrated Autoregressive Conditional Duration model (FIACD) to analyse the recurrence interval characteristics. The results indicated that the FIACD model may provide a method to analyse volatility recurrence intervals.

  3. Landslide occurrences and recurrence intervals of heavy rainfalls in Japan

    NASA Astrophysics Data System (ADS)

    Saito, H.; Uchida, T.; Matsuyama, H.; Korup, O.

    2015-12-01

    Dealing with predicted increases in extreme weather conditions due to climate change requires robust knowledge about controls on rainfall-triggered landslides. This study developed the probable rainfall database from weather radar data, and analyzed the potential correlation between the landslide magnitude-frequency and the recurrence interval of the heavy rainfall across Japan. We analyzed 4,744 rainfall-induced landslides (Saito et al., 2014, Geology), 1 to 72 h rainfalls, and soil water index (SWI). We then estimated recurrence intervals for these rainfall parameters using a Gumbel distribution with jackknife fitting. Results showed that the recurrence intervals of rainfall events which caused landslides (<10^3 m^3) were less than 10 yr across Japan. The recurrence intervals increased with increases in landslide volumes. With regard to the landslides larger than 10^5 m^3, recurrence intervals of the rainfall events were more than 100 yr. These results suggest that recurrence intervals of heavy rainfalls are important for assessing regional landslide hazard in Japan.

  4. Timing and recurrence interval of Himalayan landslides

    NASA Astrophysics Data System (ADS)

    Pachauri, A. K.

    2009-04-01

    Himalayan landsldies have been occurring since the 55 million years ever since the Hinmlayan mountains came into being. The fact is that Himalayas are rising even today at the rate of a few cm per year as supported by the Indian Plate mtion measured by GPS. The recurrence of landsldies has not beeen documented even for well known landsldies and therefore the Border Road Organisation and Public Works departments of India are unable to realise the value of the data as the records are scanty and not formalised. There is a need to establish a data bank for landslides and debris flows as well as landslide related disasters in himalayas so that moelling for recurrence can be done. Some intersting examples of the landslides after the Chamoli earthquake are good examples of landsldies that occurred after several weeks of the earthquake at Chamoli as studied by the author. The present paper proposes the need for the analyses and a program that can be chalked out to prognasticate landslide occurrence.

  5. Recurrence Interval and Event Age Data for Type A Faults

    USGS Publications Warehouse

    Dawson, Timothy E.; Weldon, Ray J.; Biasi, Glenn P.

    2008-01-01

    This appendix summarizes available recurrence interval, event age, and timing of most recent event data for Type A faults considered in the Earthquake Rate Model 2 (ERM 2) and used in the ERM 2 Appendix C analysis as well as Appendix N (time-dependent probabilities). These data have been compiled into an Excel workbook named Appendix B A-fault event ages_recurrence_V5.0 (herein referred to as the Appendix B workbook). For convenience, the Appendix B workbook is attached to the end of this document as a series of tables. The tables within the Appendix B workbook include site locations, event ages, and recurrence data, and in some cases, the interval of time between earthquakes is also reported. The Appendix B workbook is organized as individual worksheets, with each worksheet named by fault and paleoseismic site. Each worksheet contains the site location in latitude and longitude, as well as information on event ages, and a summary of recurrence data. Because the data has been compiled from different sources with different presentation styles, descriptions of the contents of each worksheet within the Appendix B spreadsheet are summarized.

  6. A case of cervical metastases in a patient with preexisting cervical disc replacement and fusion after 2-year symptom-free interval: when do we need interdisciplinary diagnostics?

    PubMed

    Melloh, Markus; Barz, Thomas

    2012-08-01

    Recurrent cervical symptoms frequently occur after cervical disc replacement and fusion. To date, no algorithm for the diagnostic assessment of these symptoms has been established. We present a case report and review of the literature to illustrate the need for interdisciplinary diagnostics in recurrent cervicobrachialgia without pathological cervical imaging. The hospital chart, medical history, physical examination, and imaging of a single patient were reviewed. A 53-year-old man with preexisting cervical disc replacement and fusion presented with a new episode of cervicobrachialgia after a 2-year symptom-free interval. Cervical magnetic resonance imaging (MRI) showed no pathological findings. Six months later the patient reported increasing symptoms including numbness and weakness of the right arm. Repeated cervical MRI and thoracic computed tomography revealed cervical metastases with intraspinal tumor growth and an underlying extensive small cell bronchial carcinoma. In recurrent cervicobrachialgia, without pathological cervical imaging, interdisciplinary diagnostics are needed. Basic diagnostic tests may assist to exclude severe non-vertebrogenic pathologies.

  7. The recurrence interval of great earthquakes along the Sagami trough

    NASA Astrophysics Data System (ADS)

    Ando, M.

    2003-12-01

    Along the Sagami trough, an oblique subuduction zone between the Philippine Sea and North American plates, great earthquakes occurred in 1923 (M7.9) and1703 (M8.6), about 50 km southwest of the Tokyo. Both events generated strong ground motions and tsunamis. Strong ground motions equivalent to seismic intensities 6 to 7 in JMA scale and 10 to 12 in MM scale struck over southern Kanto. The two earthquakes are similar more or less in the extent of the damage and the crustal deformation, possibly occurring very near each other. The extent of the damage and the crustal deformation on the southern area was greater in the 1703 event, whose tsunami reached and damaged the coast of the Kii peninsula, 300 to 400 km away from the source. The source region of the 1703 earthquake, therefore, is considered to have extended towards the ocean and much larger than that of the 1923 event. Several studies of uplift coastal terraces suggest the events like the 1703 one have occurred possibly every 1,000-2,000 years, while those like the 1923 Kanto earthquake more frequently without leaving geomorphic evidence on the terraces. Before 1703, a possible candidate for a subduction event is the M7.0-7.5 1257 or M7.0 1293 earthquake that caused serious damage to southern Kanto region. However, no other earthquakes have been found in historical documents. Historically, the Kanto area was not well civilized until 13th century and earthquakes are not well documented. In addition most historical documents recorded between 14th and 16th centuries were lost during the age of civil wars. If an average recurrence interval is 200 years, at least 4 to 5 events should have occurred before 1703,since the 9th century when the first earthquake was reported in this area. The incomplete earthquake history may contain at least two recurrence intervals, 200 and 400 years. However, the 400 year interval can be shortened by inserting additional earthquakes. For the purposes of hazard mitigation and study of

  8. Restricted Consonant Inventories of 2-Year-Old Finnish Children with a History of Recurrent Acute Otitis Media

    ERIC Educational Resources Information Center

    Haapala, Sini; Niemitalo-Haapola, Elina; Raappana, Antti; Kujala, Tiia; Kujala, Teija; Jansson-Verkasalo, Eira

    2015-01-01

    Many children experience recurrent acute otitis media (RAOM) in early childhood. In a previous study, 2-year-old children with RAOM were shown to have immature neural patterns for speech sound discrimination. The present study further investigated the consonant inventories of these same children using natural speech samples. The results showed…

  9. Association of the recurrence and canceration rate of vocal leukoplakia with interleukin-10 promoter variants over a 2-year period.

    PubMed

    Zhou, Jian; Zhang, Duo; Zhou, Liang; Yang, Yue; Liu, Fei; Tao, Lei; Lu, Li-Ming

    2016-11-01

    Conclusion This study indicates that IL-10 promoter polymorphism variants, smoking, and alcohol consumption increase the risk of recurrence and canceration in vocal leukoplakia. Objective This prospective, clinical trial was performed to evaluate the association of interleukin (IL)-10 promoter polymorphism variants and canceration and recurrence rates in vocal leukoplakia (a pre-cancerous laryngeal carcinoma lesion) over a 2-year period. Participants and method Sixty-one post-operative patients with vocal leukoplakia were enrolled in this prospective, observational study and genotyped for the IL-10 promoter gene (IL-10-1082 A/G, -819 T/C and -592 A/C) using pyrosequencing, and responded to a 2-year follow-up survey. Recurrence and canceration rates were used to evaluate the association between the genotype variants and the clinical outcome. Results There was an increased canceration rate in the variant genotype group compared to that in the normal genotype group in the 2-year follow-up period (18.4% vs 0%, p-value = 0.038). Compared with the non-smoker group, the smoker group had a higher recurrence rate of vocal leukoplakia (29.3% vs 5%, p-value =0.044). Likewise, the recurrence rate in the alcohol consumption group was also higher (30.6% vs 8%, p-value =0.034). The percentage of cancerization in the alcohol consumption group was significantly higher than that in the non-alcohol consumption group (19.4% vs 0%, p-value =0.035).

  10. A case of cervical metastases in a patient with preexisting cervical disc replacement and fusion after 2-year symptom-free interval: when do we need interdisciplinary diagnostics?

    PubMed Central

    Melloh, Markus; Barz, Thomas

    2012-01-01

    Recurrent cervical symptoms frequently occur after cervical disc replacement and fusion. To date, no algorithm for the diagnostic assessment of these symptoms has been established. We present a case report and review of the literature to illustrate the need for interdisciplinary diagnostics in recurrent cervicobrachialgia without pathological cervical imaging. The hospital chart, medical history, physical examination, and imaging of a single patient were reviewed. A 53-year-old man with preexisting cervical disc replacement and fusion presented with a new episode of cervicobrachialgia after a 2-year symptom-free interval. Cervical magnetic resonance imaging (MRI) showed no pathological findings. Six months later the patient reported increasing symptoms including numbness and weakness of the right arm. Repeated cervical MRI and thoracic computed tomography revealed cervical metastases with intraspinal tumor growth and an underlying extensive small cell bronchial carcinoma. In recurrent cervicobrachialgia, without pathological cervical imaging, interdisciplinary diagnostics are needed. Basic diagnostic tests may assist to exclude severe non-vertebrogenic pathologies. PMID:23526906

  11. Cocaine-induced vasculitis with cutaneous manifestation: A recurrent episode after 2 years

    PubMed Central

    Swe, Thein; Pervil-Ulysse, Mona; Baqui, AAM A.

    2016-01-01

    Cocaine is a popular recreational drug in the United States, and up to 70% of the seized cocaine contains levamisole which is an antihelminthic that can cause cutaneous vasculitis with necrosis and positive antineutrophil cytoplasmic antibodies (ANCAs). Here, we report a unique case of recurrent cocaine-induced vasculitis in a patient who smokes cocaine for more than 20 years. A 38-year-old woman complained of painful erythematous rash in her right arm and right thigh which appeared some hours after smoking cocaine. Physical examination revealed tender, erythematous base, retiform purpura with necrosis and bullae. Serological test showed high atypical perinuclear ANCA titer of 1:320 and antimyeloperoxidase antibody level of 20.4 U/mL. Cocaine-induced vasculitis should be one of the differential diagnoses in cocaine abusers who present with painful rash and areas of necrosis. Early diagnosis is important since it is an emerging public health concern. PMID:28217616

  12. Psychosocial outcomes in patients with recurrent major depressive disorder during 2 years of maintenance treatment with venlafaxine extended release

    PubMed Central

    Trivedi, Madhukar H.; Dunner, David L.; Kornstein, Susan G.; Thase, Michael E.; Zajecka, John M.; Rothschild, Anthony J.; Friedman, Edward S.; Shelton, Richard C.; Keller, Martin B.; Kocsis, James H.; Gelenberg, Alan

    2013-01-01

    Background Psychosocial outcomes from the Prevention of Recurrent Episodes of Depression with Venlafaxine ER for Two Years (PREVENT) study were evaluated. Methods Adult outpatients with recurrent major depressive disorder (MDD) and response or remission following 6-month continuation treatment with venlafaxine extended release (ER) were randomized to receive venlafaxine ER or placebo for 1 year. Patients without recurrence on venlafaxine ER during year 1 were randomized to venlafaxine ER or placebo for year 2. Psychosocial functioning was assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire—Short Form (Q-LES-Q), Life EnjoymentScale—Short Version (LES-S), Social Adjustment Scale—Self-Report (SAS-SR) total and individual factors, Short Form Health Survey (SF-36) (vitality, social functioning, and role function-emotional items), and Longitudinal Interval Follow-up Evaluation (LIFE). Results At year 1 end, better overall psychosocial functioning was seen among patients randomly assigned to venlafaxine ER (n=129) vs placebo (n=129), with significant differences at end point on SF-36 role function-emotional, Q-LES-Q, and SAS-SR total, and work, house work, social/leisure, and extended-family factor scores (p≤0.05). At year 2 end, significant differences favored venlafaxine ER (n=43) vs placebo (n=40)on SF-36 vitality and rolefunction-emotional, Q-LES-Q, LES-S, LIFE, and SAS-SR total, social/leisure, and extended-family factor scores (p≤0.05). Limitations Patients with chronic MDD or treatment resistance were excluded and long-term specialist care was a financial incentive for treatment compliance. Discontinuation-related adverse events may have compromised the integrity of the treatment blind. Conclusions For patients with recurrent MDD, 2 years’ maintenance therapy with venlafaxine ER may improve psychosocial functioning vs placebo. PMID:20510459

  13. Variations in rupture process with recurrence interval in a repeated small earthquake

    USGS Publications Warehouse

    Vidale, J.E.; Ellsworth, W.L.; Cole, A.; Marone, C.

    1994-01-01

    In theory and in laboratory experiments, friction on sliding surfaces such as rock, glass and metal increases with time since the previous episode of slip. This time dependence is a central pillar of the friction laws widely used to model earthquake phenomena. On natural faults, other properties, such as rupture velocity, porosity and fluid pressure, may also vary with the recurrence interval. Eighteen repetitions of the same small earthquake, separated by intervals ranging from a few days to several years, allow us to test these laboratory predictions in situ. The events with the longest time since the previous earthquake tend to have about 15% larger seismic moment than those with the shortest intervals, although this trend is weak. In addition, the rupture durations of the events with the longest recurrence intervals are more than a factor of two shorter than for the events with the shortest intervals. Both decreased duration and increased friction are consistent with progressive fault healing during the time of stationary contact.In theory and in laboratory experiments, friction on sliding surfaces such as rock, glass and metal increases with time since the previous episode of slip. This time dependence is a central pillar of the friction laws widely used to model earthquake phenomena. On natural faults, other properties, such as rupture velocity, porosity and fluid pressure, may also vary with the recurrence interval. Eighteen repetitions of the same small earthquake, separated by intervals ranging from a few days to several years, allow us to test these laboratory predictions in situ. The events with the longest time since the previous earthquake tend to have about 15% larger seismic moment than those with the shortest intervals, although this trend is weak. In addition, the rupture durations of the events with the longest recurrence intervals are more than a factor of two shorter than for the events with the shortest intervals. Both decreased duration and

  14. Scaling of intraplate earthquake recurrence interval with fault length and implications for seismic hazard assessment

    NASA Astrophysics Data System (ADS)

    Marrett, Randall

    1994-12-01

    Consensus indicates that faults follow power-law scaling, although significant uncertainty remains about the values of important parameters. Combining these scaling relationships with power-law scaling relationships for earthquakes suggests that intraplate earthquake recurrence interval scales with fault length. Regional scaling data may be locally calibrated to yield a site-specific seismic hazard assessment tool. Scaling data from small faults (those that do not span the seismogenic layer) suggest that recurrence interval varies as a negative power of fault length. Due to uncertainties regarding the recently recognized changes in scaling for large earthquakes, it is unclear whether recurrence interval varies as a negative or positive power of fault length for large fauts (those that span the seismogenic layer). This question is of critical importance for seismic hazard assessment.

  15. Estimation of Flood Discharges at Selected Recurrence Intervals for Streams in New Hampshire

    USGS Publications Warehouse

    Olson, Scott A.

    2009-01-01

    This report provides estimates of flood discharges at selected recurrence intervals for streamgages in and adjacent to New Hampshire and equations for estimating flood discharges at recurrence intervals of 2-, 5-, 10-, 25-, 50-, 100-, and 500-years for ungaged, unregulated, rural streams in New Hampshire. The equations were developed using generalized least-squares regression. Flood-frequency and drainage-basin characteristics from 117 streamgages were used in developing the equations. The drainage-basin characteristics used as explanatory variables in the regression equations include drainage area, mean April precipitation, percentage of wetland area, and main channel slope. The average standard error of prediction for estimating the 2-, 5-, 10-, 25-, 50-, 100-, and 500-year recurrence interval flood discharges with these equations are 30.0, 30.8, 32.0, 34.2, 36.0, 38.1, and 43.4 percent, respectively. Flood discharges at selected recurrence intervals for selected streamgages were computed following the guidelines in Bulletin 17B of the U.S. Interagency Advisory Committee on Water Data. To determine the flood-discharge exceedence probabilities at streamgages in New Hampshire, a new generalized skew coefficient map covering the State was developed. The standard error of the data on new map is 0.298. To improve estimates of flood discharges at selected recurrence intervals for 20 streamgages with short-term records (10 to 15 years), record extension using the two-station comparison technique was applied. The two-station comparison method uses data from a streamgage with long-term record to adjust the frequency characteristics at a streamgage with a short-term record. A technique for adjusting a flood-discharge frequency curve computed from a streamgage record with results from the regression equations is described in this report. Also, a technique is described for estimating flood discharge at a selected recurrence interval for an ungaged site upstream or downstream

  16. Regression Equations for Estimating Flood Flows at Selected Recurrence Intervals for Ungaged Streams in Pennsylvania

    USGS Publications Warehouse

    Roland, Mark A.; Stuckey, Marla H.

    2008-01-01

    Regression equations were developed for estimating flood flows at selected recurrence intervals for ungaged streams in Pennsylvania with drainage areas less than 2,000 square miles. These equations were developed utilizing peak-flow data from 322 streamflow-gaging stations within Pennsylvania and surrounding states. All stations used in the development of the equations had 10 or more years of record and included active and discontinued continuous-record as well as crest-stage partial-record stations. The state was divided into four regions, and regional regression equations were developed to estimate the 2-, 5-, 10-, 50-, 100-, and 500-year recurrence-interval flood flows. The equations were developed by means of a regression analysis that utilized basin characteristics and flow data associated with the stations. Significant explanatory variables at the 95-percent confidence level for one or more regression equations included the following basin characteristics: drainage area; mean basin elevation; and the percentages of carbonate bedrock, urban area, and storage within a basin. The regression equations can be used to predict the magnitude of flood flows for specified recurrence intervals for most streams in the state; however, they are not valid for streams with drainage areas generally greater than 2,000 square miles or with substantial regulation, diversion, or mining activity within the basin. Estimates of flood-flow magnitude and frequency for streamflow-gaging stations substantially affected by upstream regulation are also presented.

  17. Recurrence intervals for great earthquakes of the past 3,500 years at northeastern Willapa Bay, Washington

    USGS Publications Warehouse

    Atwater, Brian F.; Hemphill-Haley, Eileen

    1997-01-01

    Seven great earthquakes, or earthquake series, probably ruptured the southern Washington part of the Cascadia subduction zone in the past 3,500 years. Each earthquake was probably of magnitude 8 or larger. The earthquakes define six recurrence intervals that average about 500 years. The longest interval, about 700-1300 years, was followed by two of the shortest, which together lasted less than 800 years. Another long interval, 600-1000 years, ended with an earthquake 300 years ago.

  18. Stress Accumulation on Longmenshan Fault and Recurrence Interval of Wenchuan Earthquake Based on Visco-elasticity

    NASA Astrophysics Data System (ADS)

    Liu, C.; Zhu, B.; Shi, Y.

    2010-12-01

    Wenchuan earthquake (Ms 8.0) occurred on a section of the Longmenshan fault where slow strain had accumulated. The stress change during this accumulation period is computed through 3-D finite-element modeling assuming visco-elasticity rheology and using the GPS data to quantify the boundary conditions. We calculate the stress accumulation in the lithosphere of the Longmenshan fault area, the co-seismic stress change and the post-seismic stress relaxation to estimate the Wenchuan earthquake recurrence interval. It is shown that the Eastern movement of Tibet Plateau resulting from the India-Asia collision is obstructed in the Longmenshan fault area by the strong Sichuan Basin. The soft materials of the middle and lower crust of Tibet Plateau accumulate at the contact of the basin resulting in stress concentration. Two factors are controlling this stress concentration. The first is the sharp reduction of the Moho thickness at the Longmenshan fault as one moves from the Tibetan Plateau to the Sichuan Basin. The second factor is the large difference in the viscosity of the middle and the lower crust between the Tibetan Plateau and the Sichuan Basin. During the inter-seismic period, stress increases almost linearly in time in the brittle upper crust of the Longmenshan fault, and the stress rate is larger at greater depths in the upper crust. The maximum stress accumulation of 21.6 MPa, with a steady rate of 0.0036MPa/y at the bottom of the upper crust, is reached after 6000 years. However, stress increases exponentially in the ductile middle and lower crust and in the upper lithospheric mantle. The spatial distribution of the stress after these 6000 years is as follows. The normal stress decreases, but the shear stress increases from Southwest to Northeast in the upper crust on the Longmenshan fault. This stress distribution explains the motion of the fault in thrust in the SW and in strike-slip motion in the NE. The recurrence interval of Wenchuan earthquake is

  19. Estimating the magnitude of annual peak discharges with recurrence intervals between 1.1 and 3.0 years for rural, unregulated streams in West Virginia

    USGS Publications Warehouse

    Wiley, Jeffrey B.; Atkins, John T.; Newell, Dawn A.

    2002-01-01

    Multiple and simple least-squares regression models for the log10-transformed 1.5- and 2-year recurrence intervals of peak discharges with independent variables describing the basin characteristics (log10-transformed and untransformed) for 236 streamflow-gaging stations were evaluated, and the regression residuals were plotted as areal distributions that defined three regions in West Virginia designated as East, North, and South. Regional equations for the 1.1-, 1.2-, 1.3-, 1.4-, 1.5-, 1.6-, 1.7-, 1.8-, 1.9-, 2.0-, 2.5-, and 3-year recurrence intervals of peak discharges were determined by generalized least-squares regression. Log10-transformed drainage area was the most significant independent variable for all regions. Equations developed in this study are applicable only to rural, unregulated streams within the boundaries of West Virginia. The accuracies of estimating equations are quantified by measuring the average prediction error (from 27.4 to 52.4 percent) and equivalent years of record (from 1.1 to 3.4 years).

  20. Spatiotemporal variations of interplate slip rates in northeast Japan inverted from recurrence intervals of repeating earthquakes

    NASA Astrophysics Data System (ADS)

    Nomura, Shunichi; Ogata, Yosihiko; Uchida, Naoki; Matsu'ura, Mitsuhiro

    2017-01-01

    Repeating earthquakes, the sequence of stress accumulation and release at isolated small asperities on a plate interface, can be regarded as a renewal process in statistics. From such a point of view, we modelled a sequence of repeating earthquakes and developed an objective Bayesian method to estimate the space-time distribution of interplate slip rates from the recurrence intervals of repeating earthquakes. The space-time distribution of slip rates is represented by the superposition of tri-cubic B-splines. The knots of B-splines in time are unequally allocated for representing co-seismic abrupt and post-seismic rapid changes in slip rates. In addition, to avoid overfitting, smoothness constraints are imposed and their optimal weights are determined by Akaike's Bayesian Information Criterion. We applied this method to the complete data set of repeating earthquakes in northeast Japan for about 18 yr before the 2011 Tohoku-oki earthquake, and revealed spatiotemporal variations of interplate slip rates off the Hokkaido-Tohoku region, where the 1994 Sanriku-oki (M7.6), 2003 Tokachi-oki (M8.0), 2004 Kushiro-oki (M7.1), and 2008 Ibaraki-oki (M7.0) earthquakes occurred. First, we confirmed the reciprocal correlation between the spatial distribution of average slip rates for a seismically calm period (1996-2000) and that of average slip-deficit rates, which has been estimated from GPS array data. Then, we examined the temporal variations of slip rates associated with the large interplate earthquakes in detail.

  1. Estimating the magnitude of peak flows for streams in Kentucky for selected recurrence intervals

    USGS Publications Warehouse

    Hodgkins, Glenn A.; Martin, Gary R.

    2003-01-01

    This report gives estimates of, and presents techniques for estimating, the magnitude of peak flows for streams in Kentucky for recurrence intervals of 2, 5, 10, 25, 50, 100, 200, and 500 years. A flowchart in this report guides the user to the appropriate estimates and (or) estimating techniques for a site on a specific stream. Estimates of peak flows are given for 222 U.S. Geological Survey streamflow-gaging stations in Kentucky. In the development of the peak-flow estimates at gaging stations, a new generalized skew coefficient was calculated for the State. This single statewide value of 0.011 (with a standard error of prediction of 0.520) is more appropriate for Kentucky than the national skew isoline map in Bulletin 17B of the Interagency Advisory Committee on Water Data. Regression equations are presented for estimating the peak flows on ungaged, unregulated streams in rural drainage basins. The equations were developed by use of generalized-least-squares regression procedures at 187 U.S. Geological Survey gaging stations in Kentucky and 51 stations in surrounding States. Kentucky was divided into seven flood regions. Total drainage area is used in the final regression equations as the sole explanatory variable, except in Regions 1 and 4 where main-channel slope also was used. The smallest average standard errors of prediction were in Region 3 (from -13.1 to +15.0 percent) and the largest average standard errors of prediction were in Region 5 (from -37.6 to +60.3 percent). One section of this report describes techniques for estimating peak flows for ungaged sites on gaged, unregulated streams in rural drainage basins. Another section references two previous U.S. Geological Survey reports for peak-flow estimates on ungaged, unregulated, urban streams. Estimating peak flows at ungaged sites on regulated streams is beyond the scope of this report, because peak flows on regulated streams are dependent upon variable human activities.

  2. Spatiotemporal variations of interplate slip rates in northeast Japan inverted from recurrence intervals of repeating earthquakes

    NASA Astrophysics Data System (ADS)

    Nomura, Shunichi; Ogata, Yosihiko; Uchida, Naoki; Matsu'ura, Mitsuhiro

    2016-10-01

    Repeating earthquakes, the sequence of stress accumulation and release at isolated small asperities on a plate interface, can be regarded as a renewal process in statistics. From such a point of view, we modeled a sequence of repeating earthquakes and developed an objective Bayesian method to estimate the space-time distribution of interplate slip rates from the recurrence intervals of repeating earthquakes. The space-time distribution of slip rates is represented by the superposition of tri-cubic B-splines. The knots of B-splines in time are unequally allocated for representing coseismic abrupt and postseismic rapid changes in slip rates. In addition, to avoid overfitting, smoothness constraints are imposed and their optimal weights are determined by Akaike's Bayesian Information Criterion (ABIC). We applied this method to the complete data set of repeating earthquakes in northeast Japan for about 18 years before the 2011 Tohoku-oki earthquake, and revealed spatiotemporal variations of interplate slip rates off the Hokkaido-Tohoku region, where the 1994 Sanriku-oki (M7.6), 2003 Tokachi-oki (M8.0), 2004 Kushiro-oki (M7.1), and 2008 Ibaraki-oki (M7.0) earthquakes occurred. First, we confirmed the reciprocal correlation between the spatial distribution of average slip rates for a seismically calm period (1996-2000) and that of average slip-deficit rates, which has been estimated from GPS array data. Then, we examined the temporal variations of slip rates associated with the large interplate earthquakes in detail.

  3. Millennium recurrence interval of morphogenic earthquakes on the Qingchuan fault, northeastern segment of the Longmen Shan Thrust Belt, China

    NASA Astrophysics Data System (ADS)

    Lin, Aiming; Yan, Bing; Rao, Gang

    2016-04-01

    The 2008 M w 7.9 Wenchuan produced a ˜285-300-km-long coseismic surface rupture zone, including a 60-km-long segment along the Qingchuan fault, the northeastern segment of the Longmen Shan Thrust Belt (LSTB), Sichuan Basin, central China. Field investigations, trench excavations, and radiocarbon dating results reveal that (i) the Qingchuan fault is currently active as a seismogenic fault, along which four morphogenic earthquakes including the 2008 Wenchuan earthquake occurred in the past ca. 3500 years, suggesting an average millennium recurrence interval of morphogenic earthquakes in the late Holocene; (ii) the most recent event prior to the 2008 Wenchuan earthquake took place in the period between AD 1400 and AD 1100; (iii) the penultimate paleoseismic event occurred in the period around 2000 years BP in the Han Dynasty (206 BC-AD 220); (iv) the third paleoseismic event occurred in the period between 900 and 1800 BC; and (v) at least three seismic faulting events occurred in the early Holocene. The present results are comparable with those inferred in the central and southwestern segments of the LSTB within which the Wenchuan magnitude earthquakes occurred in a millennium recurrence interval, that are in contrast with previous estimates of 2000-10,000 years for the recurrence interval of morphogenic earthquakes within the LSTB and thereby necessitating substantial modifications to existing seismic hazard models for the densely populated region at the Sichuan region.

  4. Interval Between Hysterectomy and Start of Radiation Treatment Is Predictive of Recurrence in Patients With Endometrial Carcinoma

    SciTech Connect

    Cattaneo, Richard; Hanna, Rabbie K.; Jacobsen, Gordon; Elshaikh, Mohamed A.

    2014-03-15

    Purpose: Adjuvant radiation therapy (RT) has been shown to improve local control in patients with endometrial carcinoma. We analyzed the impact of the time interval between hysterectomy and RT initiation in patients with endometrial carcinoma. Methods and Materials: In this institutional review board-approved study, we identified 308 patients with endometrial carcinoma who received adjuvant RT after hysterectomy. All patients had undergone hysterectomy, oophorectomy, and pelvic and para-aortic lymph node evaluation from 1988 to 2010. Patients' demographics, pathologic features, and treatments were compared. The time interval between hysterectomy and the start of RT was calculated. The effects of time interval on recurrence-free (RFS), disease-specific (DSS), and overall survival (OS) were calculated. Following univariate analysis, multivariate modeling was performed. Results: The median age and follow-up for the study cohort was 65 years and 72 months, respectively. Eighty-five percent of the patients had endometrioid carcinoma. RT was delivered with high-dose-rate brachytherapy alone (29%), pelvic RT alone (20%), or both (51%). Median time interval to start RT was 42 days (range, 21-130 days). A total of 269 patients (74%) started their RT <9 weeks after undergoing hysterectomy (group 1) and 26% started ≥9 weeks after surgery (group 2). There were a total of 43 recurrences. Tumor recurrence was significantly associated with treatment delay of ≥9 weeks, with 5-year RFS of 90% for group 1 compared to only 39% for group 2 (P<.001). On multivariate analysis, RT delay of ≥9 weeks (P<.001), presence of lymphovascular space involvement (P=.001), and higher International Federation of Gynecology and Obstetrics grade (P=.012) were independent predictors of recurrence. In addition, RT delay of ≥9 weeks was an independent significant predictor for worse DSS and OS (P=.001 and P=.01, respectively). Conclusions: Delay in administering adjuvant RT after hysterectomy was

  5. Possible Long-term SSEs in the Tokai Area, Central Japan, After 1981: Size, Duration, and Recurrence Interval

    NASA Astrophysics Data System (ADS)

    Ochi, T.

    2014-12-01

    The long-term slow slip event (LSSE) in the Tokai area, central Japan, from mid-2000 to mid-2005 [Suito and Ozawa (2009)], had continued five years, which was much longer than other LSSEs around the world [e.g. Schwartz and Rokosky (2007)]. After the termination of the SSE in 2005, no obvious long-term SSE was detected and that makes difficult to discuss a recurrence interval of the events. In order to reveal whether the event repeats or not, and if it repeats, to clarify the interval and a temporal and spatial change of the coupling and the LSSE, I analyzed a leveling data from 1981 to 1999 -- before the era of GNSS -- and deduced spatial patterns of the vertical crustal deformation rate.The deduced rates show two sorts of spatial patterns and the patterns appear alternately. One of them resembles the pattern during the LSSE between 2000 and 2005. Summing up the results and accounting for the estimation errors, it is clear that there are at least three events in the last thirty years; 2000-2005 (already and well known event), 1987-1990, and around 1983. The 2000-2005 event is the biggest and longest one, while 1983 event is the smallest and shortest one in the three events. It suggests that the duration of the event is longer, the interval to the next event becomes longer, and that there are some relationships between the size, duration time, and the recurrence interval of the events. These features are very unique for the Tokai LSSEs compared with those in the other regions such as the Bungo Channel and Cascadia.

  6. Interaction of the San Jacinto and San Andreas Fault Zones, Southern California: Triggered Earthquake Migration and Coupled Recurrence Intervals

    NASA Astrophysics Data System (ADS)

    Sanders, Christopher O.

    1993-05-01

    Two lines of evidence suggest that large earthquakes that occur on either the San Jacinto fault zone (SJFZ) or the San Andreas fault zone (SAFZ) may be triggered by large earthquakes that occur on the other. First, the great 1857 Fort Tejon earthquake in the SAFZ seems to have triggered a progressive sequence of earthquakes in the SJFZ. These earthquakes occurred at times and locations that are consistent with triggering by a strain pulse that propagated southeastward at a rate of 1.7 kilometers per year along the SJFZ after the 1857 earthquake. Second, the similarity in average recurrence intervals in the SJFZ (about 150 years) and in the Mojave segment of the SAFZ (132 years) suggests that large earthquakes in the northern SJFZ may stimulate the relatively frequent major earthquakes on the Mojave segment. Analysis of historic earthquake occurrence in the SJFZ suggests little likelihood of extended quiescence between earthquake sequences.

  7. Interaction of the san jacinto and san andreas fault zones, southern california: triggered earthquake migration and coupled recurrence intervals.

    PubMed

    Sanders, C O

    1993-05-14

    Two lines of evidence suggest that large earthquakes that occur on either the San Jacinto fault zone (SJFZ) or the San Andreas fault zone (SAFZ) may be triggered by large earthquakes that occur on the other. First, the great 1857 Fort Tejon earthquake in the SAFZ seems to have triggered a progressive sequence of earthquakes in the SJFZ. These earthquakes occurred at times and locations that are consistent with triggering by a strain pulse that propagated southeastward at a rate of 1.7 kilometers per year along the SJFZ after the 1857 earthquake. Second, the similarity in average recurrence intervals in the SJFZ (about 150 years) and in the Mojave segment of the SAFZ (132 years) suggests that large earthquakes in the northern SJFZ may stimulate the relatively frequent major earthquakes on the Mojave segment. Analysis of historic earthquake occurrence in the SJFZ suggests little likelihood of extended quiescence between earthquake sequences.

  8. Slip Rates, Recurrence Intervals and Earthquake Event Magnitudes for the southern Black Mountains Fault Zone, southern Death Valley, California

    NASA Astrophysics Data System (ADS)

    Fronterhouse Sohn, M.; Knott, J. R.; Bowman, D. D.

    2005-12-01

    The normal-oblique Black Mountain Fault zone (BMFZ) is part of the Death Valley fault system. Strong ground-motion generated by earthquakes on the BMFZ poses a serious threat to the Las Vegas, NV area (pop. ~1,428,690), the Death Valley National Park (max. pop. ~20,000) and Pahrump, NV (pop. 30,000). Fault scarps offset Holocene alluvial-fan deposits along most of the 80-km length of the BMFZ. However, slip rates, recurrence intervals, and event magnitudes for the BMFZ are poorly constrained due to a lack of age control. Also, Holocene scarp heights along the BMFZ range from <1 m to >6 m suggesting that geomorphic sections have different earthquake histories. Along the southernmost section, the BMFZ steps basinward preserving three post-late Pleistocene fault scarps. Surveys completed with a total station theodolite show scarp heights of 5.5, 5.0 and 2 meters offsetting the late Pleistocene, early to middle Holocene, to middle-late Holocene surfaces, respectively. Regression plots of vertical offset versus maximum scarp angle suggest event ages of <10 - 2 ka with a post-late Pleistocene slip rate of 0.1mm/yr to 0.3 mm/yr and recurrence of <3300 years/event. Regression equations for the estimated geomorphically constrained rupture length of the southernmost section and surveyed event displacements provides estimated moment magnitudes (Mw) between 6.6 and 7.3 for the BMFZ.

  9. Regression modeling with recurrent events and time-dependent interval-censored marker data.

    PubMed

    Chen, Eric Bingshu; Cook, Richard J

    2003-09-01

    In life history studies involving patients with chronic diseases it is often of interest to study the relationship between a marker process and a more clinically relevant response process. This interest may arise from a desire to gain a better understanding of the underlying pathophysiology, a need to evaluate the utility of the marker as a potential surrogate outcome, or a plan to conduct inferences based on joint models. We consider data from a trial of breast cancer patients with bone metastases. In this setting, the marker process is a point process which records the onset times and cumulative number of bone lesions which reflects the extent of metastatic bone involvement The response is also a point process, which records the times patients experience skeletal complications resulting from these bone lesions. Interest lies in assessing how the development of new bone lesions affects the incidence of skeletal complications. By considering the marker as an internal time-dependent covariate in the point process model for skeletal complications we develop and apply methods which allow one to express the association via regression. A complicating feature of this study is that new bone lesions are only detected upon periodic radiographic examination, which makes the marker processes subject to interval-censoring. A modified EM algorithm is used to deal with this incomplete data problem.

  10. Estimation of recurrence interval of large earthquakes on the central Longmen Shan fault zone based on seismic moment accumulation/release model.

    PubMed

    Ren, Junjie; Zhang, Shimin

    2013-01-01

    Recurrence interval of large earthquake on an active fault zone is an important parameter in assessing seismic hazard. The 2008 Wenchuan earthquake (Mw 7.9) occurred on the central Longmen Shan fault zone and ruptured the Yingxiu-Beichuan fault (YBF) and the Guanxian-Jiangyou fault (GJF). However, there is a considerable discrepancy among recurrence intervals of large earthquake in preseismic and postseismic estimates based on slip rate and paleoseismologic results. Post-seismic trenches showed that the central Longmen Shan fault zone probably undertakes an event similar to the 2008 quake, suggesting a characteristic earthquake model. In this paper, we use the published seismogenic model of the 2008 earthquake based on Global Positioning System (GPS) and Interferometric Synthetic Aperture Radar (InSAR) data and construct a characteristic seismic moment accumulation/release model to estimate recurrence interval of large earthquakes on the central Longmen Shan fault zone. Our results show that the seismogenic zone accommodates a moment rate of (2.7 ± 0.3) × 10¹⁷ N m/yr, and a recurrence interval of 3900 ± 400 yrs is necessary for accumulation of strain energy equivalent to the 2008 earthquake. This study provides a preferred interval estimation of large earthquakes for seismic hazard analysis in the Longmen Shan region.

  11. Estimation of Recurrence Interval of Large Earthquakes on the Central Longmen Shan Fault Zone Based on Seismic Moment Accumulation/Release Model

    PubMed Central

    Zhang, Shimin

    2013-01-01

    Recurrence interval of large earthquake on an active fault zone is an important parameter in assessing seismic hazard. The 2008 Wenchuan earthquake (Mw 7.9) occurred on the central Longmen Shan fault zone and ruptured the Yingxiu-Beichuan fault (YBF) and the Guanxian-Jiangyou fault (GJF). However, there is a considerable discrepancy among recurrence intervals of large earthquake in preseismic and postseismic estimates based on slip rate and paleoseismologic results. Post-seismic trenches showed that the central Longmen Shan fault zone probably undertakes an event similar to the 2008 quake, suggesting a characteristic earthquake model. In this paper, we use the published seismogenic model of the 2008 earthquake based on Global Positioning System (GPS) and Interferometric Synthetic Aperture Radar (InSAR) data and construct a characteristic seismic moment accumulation/release model to estimate recurrence interval of large earthquakes on the central Longmen Shan fault zone. Our results show that the seismogenic zone accommodates a moment rate of (2.7 ± 0.3) × 1017 N m/yr, and a recurrence interval of 3900 ± 400 yrs is necessary for accumulation of strain energy equivalent to the 2008 earthquake. This study provides a preferred interval estimation of large earthquakes for seismic hazard analysis in the Longmen Shan region. PMID:23878524

  12. Regression equations for estimating flood flows for the 2-, 10-, 25-, 50-, 100-, and 500-Year recurrence intervals in Connecticut

    USGS Publications Warehouse

    Ahearn, Elizabeth A.

    2004-01-01

    Multiple linear-regression equations were developed to estimate the magnitudes of floods in Connecticut for recurrence intervals ranging from 2 to 500 years. The equations can be used for nonurban, unregulated stream sites in Connecticut with drainage areas ranging from about 2 to 715 square miles. Flood-frequency data and hydrologic characteristics from 70 streamflow-gaging stations and the upstream drainage basins were used to develop the equations. The hydrologic characteristics?drainage area, mean basin elevation, and 24-hour rainfall?are used in the equations to estimate the magnitude of floods. Average standard errors of prediction for the equations are 31.8, 32.7, 34.4, 35.9, 37.6 and 45.0 percent for the 2-, 10-, 25-, 50-, 100-, and 500-year recurrence intervals, respectively. Simplified equations using only one hydrologic characteristic?drainage area?also were developed. The regression analysis is based on generalized least-squares regression techniques. Observed flows (log-Pearson Type III analysis of the annual maximum flows) from five streamflow-gaging stations in urban basins in Connecticut were compared to flows estimated from national three-parameter and seven-parameter urban regression equations. The comparison shows that the three- and seven- parameter equations used in conjunction with the new statewide equations generally provide reasonable estimates of flood flows for urban sites in Connecticut, although a national urban flood-frequency study indicated that the three-parameter equations significantly underestimated flood flows in many regions of the country. Verification of the accuracy of the three-parameter or seven-parameter national regression equations using new data from Connecticut stations was beyond the scope of this study. A technique for calculating flood flows at streamflow-gaging stations using a weighted average also is described. Two estimates of flood flows?one estimate based on the log-Pearson Type III analyses of the annual

  13. Recurrence intervals and rainfall intensity-duration thresholds for extensive shallow landslide occurrence in granitic mountains of Japan

    NASA Astrophysics Data System (ADS)

    Saito, Hitoshi; Murakami, Wataru; Daimaru, Hiromu

    2014-05-01

    Heavy rainfalls are major triggers of shallow landslides in Japan. Establishing rainfall thresholds is important for assessing future landslide occurrences. This study examined recurrence intervals of heavy rainfall and rainfall intensity-duration (I-D) thresholds for shallow landslide occurrence at two granitic mountains that have different climatic conditions and topography in Japan. Mt. Ichifusa, located in southwestern Japan, has mean annual precipitation of more than 3,000 mm. Shallow landslides have occurred frequently since the 1960s after clear-cutting was conducted on the mountain. The Abukuma Mountains in northeastern Japan, experience mean annual precipitation of about 1,500 mm. Extensive rainfall-induced shallow landslides occurred there in 1971. We interpreted the orthorectified aerial photographs from the 1950s. This study calculated the mean rainfall intensity (I, mm/h) and duration (D, h) of all rainfall events from the 1950s at Mt. Ichifusa, and from the 1970s in the Abukuma Mountains. Rainfall events were separated by the absence of rainfall for 24 h. We then examined the I-D thresholds of extreme rainfall events for extensive shallow landslide occurrences in each period of aerial photographs. We used a quantile-regression method and assumed that the threshold curve is a power law I = α × D ^ β, where α and β are constants, to determine the I-D threshold. Finally, we estimated recurrence intervals for rainfall thresholds using a Gumbel distribution. Results for Mt. Ichifusa show that few shallow landslides occurred at the beginning of clear-cutting, and that shallow landslides occurred frequently after clear-cutting, such as during periods of 1976-1980, 1980-1985, and 1990-1995. The I-D thresholds after the clear-cutting declined to one-third of those at the beginning of clear-cutting. These thresholds roughly correspond to return periods of longer than 10 yr and shorter than 1 yr, respectively, before and after clear-cutting. In the Abukuma

  14. Estimation of drought and flood recurrence interval from historical discharge data: a case study utilising the power law distribution

    NASA Astrophysics Data System (ADS)

    Eadie, Chris; Favis-Mortlock, David

    2010-05-01

    The choice of which statistical distribution to fit to historical discharge data is critical when attempting to predict the most extreme flows. It has been shown that depending upon the distribution selected, the calculated return periods can vary dramatically. Cunnane (1985) discussed the factors affecting the choice of distribution for river flow series data, and was able to show that small differences in the Extreme Value Type 1 (Gumbel), Type 2, and Type 3 can lead to large differences in the predicted return period. Indeed this divergence increases as the return period becomes larger: a finding which has obvious implications for fluvial management. Despite this, in many studies which fit a frequency-magnitude distribution to fluvial discharge data, the choice of distribution appears driven by regional convention, or even by some other apparently arbitrary factor. Benson (1968) analysed data for ten US stations, and compared the fit using the log-normal, gamma, Gumbel, log-Gumbel, Hazen and log-Pearson type 3 distributions. On the basis of this study alone, the standard approach to flow frequency estimation in the USA became the fitting of a log-Pearson type 3 (LP3) distribution (US Water Resources Council, 1982). While several other countries have adopted a similar approach, usage of the LP3 distribution is not geographically universal. Hydrologists in the United Kingdom conventionally utilise a fitted generalised logistic distribution for flow frequency estimation (Robson and Reed, 1999) while Chinese hydrologists utilise the log-normal distribution (Singh, 2002). Choice of fitted distribution is obviously crucial, since selecting one distribution rather than another will change the estimated probabilities of future droughts and floods, particularly the largest and rarest events. Malamud et al. (1996) showed that a flood of equivalent size to that experienced on the Mississippi in 1993 has a recurrence interval on the order of 100 years when a power

  15. Time series and recurrence interval models to predict the vulnerability of streams to episodic acidification in Shenandoah National Park, Virginia

    USGS Publications Warehouse

    Deviney, F.A.; Rice, Karen C.; Hornberger, G.M.

    2006-01-01

    Acid rain affects headwater streams by temporarily reducing the acid-neutralizing capacity (ANC) of the water, a process termed episodic acidification. The increase in acidic components in stream water can have deleterious effects on the aquatic biota. Although acidic deposition is uniform across Shenandoah National Park (SNP) in north central Virginia, the stream water quality response during rain events varies substantially. This response is a function of the catchment's underlying geology and topography. Geologic and topographic data for SNP's 231 catchments are readily available; however, long-term measurements (tens of years) of ANC and accompanying discharge are not and would be prohibitively expensive to collect. Transfer function time series models were developed to predict hourly ANC from discharge for five SNP catchments with long-term water-quality and discharge records. Hourly ANC predictions over short time periods (≤1 week) were averaged, and distributions of the recurrence intervals of annual water-year minimum ANC values were model-simulated for periods of 6, 24, 72, and 168 hours. The distributions were extrapolated to the rest of the SNP catchments on the basis of catchment geology and topography. On the basis of the models, large numbers of SNP streams have 6- to 168-hour periods of low-ANC values, which may stress resident fish populations. Smaller catchments are more vulnerable to episodic acidification than larger catchments underlain by the same bedrock. Catchments with similar topography and size are more vulnerable if underlain by less basaltic/carbonate bedrock. Many catchments are predicted to have successive years of low-ANC values potentially sufficient to extirpate some species.

  16. Surface rupture of the 1950 Assam earthquake: active faults and recurrence interval along the Eastern Himalayan Syntaxis

    NASA Astrophysics Data System (ADS)

    Coudurier Curveur, Aurelie; Kali, Elise; Tapponnier, Paul; Karakaş, Çaǧıl; Ildefonso, Sorvigenaleon; van der Woerd, Jerome; Baruah, Saurabh; Choudhury, Swapnamita; Okal, Emile; Banerjee, Paramesh

    2016-04-01

    The great Assam earthquake (08/15/1950, Mw.8.7) shook border regions between northeastern Indian, Tibet, and China for several minutes, triggering large landslides and numerous aftershocks over a wide area in the Abor and Mishmi Hills. Using morpho-tectonic field observations and high-resolution satellite images analysis we show that the earthquake produced a >200 km-long surface rupture along the Eastern Himalayan Syntaxis. It ruptured both the Main Himalayan Frontal Thrust (MFT) and the Mishmi Thrust (MST) all the way to the surface, producing clear tectonic scarps cutting Quaternary alluvial terrace risers at high angle. We analyse the geometry, height, shape, and slopes of these scarps with high-resolution topographic profiles levelled using Total Station and kinematic GPS, to document 1950 co-seismic and older cumulative surface uplifts. The co-seismic vertical throws differ between the two thrusts from ≈ 7 m and ≈ 3 m, along the MST and MFT, respectively. We stack series of parallel topographic profiles extracted from high-resolution data (eg. ALOS and Pleiades) to document the morphology of uplifted Quaternary alluvial terraces in order to identify past earthquakes. Our results show occurrence of 2 and 6 past earthquakes, along the MST and the MFT, respectively. We combine these results with radiocarbon and cosmogenic dating to assess the ages of these uplifted surfaces and constrain uplift rates of 3 ± 1 mm/yr on both thrusts and a recurrence interval of 1500 ± 300 yr between large events along the Eastern Himalayan Syntaxis. We discuss the possibility that our results suggest characteristic slip along both thrusts through Quaternary time scale.

  17. The source model and recurrence interval of Genroku-type Kanto earthquakes estimated from paleo-shoreline data

    NASA Astrophysics Data System (ADS)

    Sato, Toshinori; Higuchi, Harutaka; Miyauchi, Takahiro; Endo, Kaori; Tsumura, Noriko; Ito, Tanio; Noda, Akemi; Matsu'ura, Mitsuhiro

    2016-02-01

    In the southern Kanto region of Japan, where the Philippine Sea plate is descending at the Sagami trough, two different types of large interplate earthquakes have occurred repeatedly. The 1923 (Taisho) and 1703 (Genroku) Kanto earthquakes characterize the first and second types, respectively. A reliable source model has been obtained for the 1923 event from seismological and geodetical data, but not for the 1703 event because we have only historical records and paleo-shoreline data about it. We developed an inversion method to estimate fault slip distribution of interplate repeating earthquakes from paleo-shoreline data on the idea of crustal deformation cycles associated with subduction-zone earthquakes. By applying the inversion method to the present heights of the Genroku and Holocene marine terraces developed along the coasts of the southern Boso and Miura peninsulas, we estimated the fault slip distribution of the 1703 Genroku earthquake as follows. The source region extends along the Sagami trough from the Miura peninsula to the offing of the southern Boso peninsula, which covers the southern two thirds of the source region of the 1923 Kanto earthquake. The coseismic slip takes the maximum of 20 m at the southern tip of the Boso peninsula, and the moment magnitude (Mw) is calculated as 8.2. From the interseismic slip-deficit rates at the plate interface obtained by GPS data inversion, assuming that the total slip deficit is compensated by coseismic slip, we can roughly estimate the average recurrence interval as 350 years for large interplate events of any type and 1400 years for the Genroku-type events.

  18. Time Interval From Breast-Conserving Surgery to Breast Irradiation in Early Stage Node-Negative Breast Cancer: 17-Year Follow-Up Results and Patterns of Recurrence

    SciTech Connect

    Vujovic, Olga; Yu, Edward; Cherian, Anil; Dar, A. Rashid; Stitt, Larry; Perera, Francisco

    2015-02-01

    Purpose: A retrospectivechart review was conducted to determine whether the time interval from breast-conserving surgery to breast irradiation (surgery-radiation therapy interval) in early stage node-negative breast cancer had any detrimental effects on recurrence rates. Methods and Materials: There were 566 patients with T1 to T3, N0 breast cancer treated with breast-conserving surgery and breast irradiation and without adjuvant systemic treatment between 1985 and 1992. The surgery-to-radiation therapy intervals used for analysis were 0 to 8 weeks (201 patients), >8 to 12 weeks (233 patients), >12 to 16 weeks (91 patients), and >16 weeks (41 patients). Kaplan-Meier estimates of time to local recurrence, disease-free survival, distant disease-free survival, cause-specific survival, and overall survival rates were calculated. Results: Median follow-up was 17.4 years. Patients in all 4 time intervals were similar in terms of characteristics and pathologic features. There were no statistically significant differences among the 4 time groups in local recurrence (P=.67) or disease-free survival (P=.82). The local recurrence rates at 5, 10, and 15 years were 4.9%, 11.5%, and 15.0%, respectively. The distant disease relapse rates at 5, 10, and 15 years were 10.6%, 15.4%, and 18.5%, respectively. The disease-free failure rates at 5, 10, and 15 years were 20%, 32.3%, and 39.8%, respectively. Cause-specific survival rates at 5, 10, and 15 years were 92%, 84.6%, and 79.8%, respectively. The overall survival rates at 5, 10, and 15 years were 89.3%, 79.2%, and 66.9%, respectively. Conclusions: Surgery-radiation therapy intervals up to 16 weeks from breast-conserving surgery are not associated with any increased risk of recurrence in early stage node-negative breast cancer. There is a steady local recurrence rate of 1% per year with adjuvant radiation alone.

  19. Estimated Magnitudes and Recurrence Intervals of Peak Flows on the Mousam and Little Ossipee Rivers for the Flood of April 2007 in Southern Maine

    USGS Publications Warehouse

    Hodgkins, Glenn A.; Stewart, Gregory J.; Cohn, Timothy A.; Dudley, Robert W.

    2007-01-01

    Large amounts of rain fell on southern Maine from the afternoon of April 15, 2007, to the afternoon of April 16, 2007, causing substantial damage to houses, roads, and culverts. This report provides an estimate of the peak flows on two rivers in southern Maine--the Mousam River and the Little Ossipee River--because of their severe flooding. The April 2007 estimated peak flow of 9,230 ft3/s at the Mousam River near West Kennebunk had a recurrence interval between 100 and 500 years; 95-percent confidence limits for this flow ranged from 25 years to greater than 500 years. The April 2007 estimated peak flow of 8,220 ft3/s at the Little Ossipee River near South Limington had a recurrence interval between 100 and 500 years; 95-percent confidence limits for this flow ranged from 50 years to greater than 500 years.

  20. Impact of Time Interval between Trauma Onset and Burr Hole Surgery on Recurrence of Late Subacute or Chronic Subdural Hematoma

    PubMed Central

    Kim, Dae-in; Kim, Jae-hoon; Kang, Hee-in; Moon, Byung-gwan; Kim, Joo-seung

    2016-01-01

    Objective Although subdural hematoma (SDH) is commonly treatable by burr hole surgery in the late subacute or chronic stage, there is no clear consensus regarding appropriate management and exact predictive factors for postoperative recurrence also remain unclear. The aim of this study was to evaluate risk factors associated with recurrence of SDH that requires burr hole surgery in the late subacute or chronic stage. We also identified the appropriate timing of surgery for reducing the recurrence. Methods We retrospectively reviewed 274 patients with SDH in the late subacute or chronic stage treated with burr hole surgery in our hospital between January 2007 and December 2014. Excluding patients with acute intracranial complications or unknown time of trauma onset left 216 patients included in the study. Results Of 216 patients with SDH in the late subacute or chronic stage, recurrence was observed in 36 patients (16.7%). The timing of the operation in patients with late subacute stage (15–28 days) resulted in a significant decrease in recurrence (RR, 0.33; 95% CI, 0.17–0.65; p=0.001) compared to chronic stage (>28 days). Otherwise, no significant risk factors were associated with recurrences including comorbidities and surgical details. Conclusion The results indicated that time from trauma onset to burr hole surgery may be important for decreasing the risk of recurrence. Therefore, unless patients can be treated conservatively without surgery, prompt surgical management is recommended in patients diagnosed as having late subacute or chronic subdural hematoma treatable by burr hole surgery, even when neurological deficits are unclear. PMID:27651869

  1. Paleoearthquakes and large earthquakes recurrence interval along Yingxiu-Beichuan fault of the Longmenshan Fault Zone, Sichuan, China

    NASA Astrophysics Data System (ADS)

    Ran, Y.; Xu, X.; Chen, W.; Chen, L.; Dong, S.; Wang, H.

    2009-12-01

    former event occurred between 3.3±0.3kaBP and 1112aBP. We find a grey-black sand clay unit that may be a barrier lake depositon in the trench excavated on the T2 at Guixi Town. Above the sand clay unit, the upper strata deform with a vertical displacement of 2.2m, however the vertical deformation is 3.5m on the lower strata, which shows that two seismic events occurred after deposition of a barrier lake. If formation of a barrier lake supposed to be generated from another earlier seismic event, there would be three events revealed in the trench. The trunk in the barrier lake unit was yielded ages of 8726~8738aBP, three seismic events occurred after this age. We conclude that there are three events revealed in trenches along the Yingxiu-Beichuan Fault, the earliest event occurred after 5730aBP, and the one before the Wenchuan earthquake occurred at about 2600aBP. The average recurrence interval of events is 2800±200a.

  2. Preliminary Results on Earthquake Recurrence Intervals, Rupture Segmentation, and Potential Earthquake Moment Magnitudes along the Tahoe-Sierra Frontal Fault Zone, Lake Tahoe, California

    NASA Astrophysics Data System (ADS)

    Howle, J.; Bawden, G. W.; Schweickert, R. A.; Hunter, L. E.; Rose, R.

    2012-12-01

    Utilizing high-resolution bare-earth LiDAR topography, field observations, and earlier results of Howle et al. (2012), we estimate latest Pleistocene/Holocene earthquake-recurrence intervals, propose scenarios for earthquake-rupture segmentation, and estimate potential earthquake moment magnitudes for the Tahoe-Sierra frontal fault zone (TSFFZ), west of Lake Tahoe, California. We have developed a new technique to estimate the vertical separation for the most recent and the previous ground-rupturing earthquakes at five sites along the Echo Peak and Mt. Tallac segments of the TSFFZ. At these sites are fault scarps with two bevels separated by an inflection point (compound fault scarps), indicating that the cumulative vertical separation (VS) across the scarp resulted from two events. This technique, modified from the modeling methods of Howle et al. (2012), uses the far-field plunge of the best-fit footwall vector and the fault-scarp morphology from high-resolution LiDAR profiles to estimate the per-event VS. From this data, we conclude that the adjacent and overlapping Echo Peak and Mt. Tallac segments have ruptured coseismically twice during the Holocene. The right-stepping, en echelon range-front segments of the TSFFZ show progressively greater VS rates and shorter earthquake-recurrence intervals from southeast to northwest. Our preliminary estimates suggest latest Pleistocene/ Holocene earthquake-recurrence intervals of 4.8±0.9x103 years for a coseismic rupture of the Echo Peak and Mt. Tallac segments, located at the southeastern end of the TSFFZ. For the Rubicon Peak segment, northwest of the Echo Peak and Mt. Tallac segments, our preliminary estimate of the maximum earthquake-recurrence interval is 2.8±1.0x103 years, based on data from two sites. The correspondence between high VS rates and short recurrence intervals suggests that earthquake sequences along the TSFFZ may initiate in the northwest part of the zone and then occur to the southeast with a lower

  3. Design of delay-dependent state estimator for discrete-time recurrent neural networks with interval discrete and infinite-distributed time-varying delays.

    PubMed

    Liao, Chin-Wen; Lu, Chien-Yu

    2011-06-01

    The state estimation problem for discrete-time recurrent neural networks with both interval discrete and infinite-distributed time-varying delays is studied in this paper, where interval discrete time-varying delay is in a given range. The activation functions are assumed to be globally Lipschitz continuous. A delay-dependent condition for the existence of state estimators is proposed based on new bounding techniques. Via solutions to certain linear matrix inequalities, general full-order state estimators are designed that ensure globally asymptotic stability. The significant feature is that no inequality is needed for seeking upper bounds for the inner product between two vectors, which can reduce the conservatism of the criterion by employing the new bounding techniques. Two illustrative examples are given to demonstrate the effectiveness and applicability of the proposed approach.

  4. Assessing the efficacy of 2 years of maintenance treatment with venlafaxine extended release 75–225 mg/day in patients with recurrent major depression: a secondary analysis of data from the PREVENT study

    PubMed Central

    Kornstein, Susan G.; Kocsis, James H.; Ahmed, Saeeduddin; Thase, Michael; Friedman, Edward S.; Dunlop, Boadie W.; Yan, Bing; Pedersen, Ron; Ninan, Philip T.; Li, Thomas; Keller, Martin

    2013-01-01

    The objective of this study was to evaluate the long-term efficacy of venlafaxine extended release (ER) ≤225 mg/ day in patients with recurrent major depressive disorder (MDD). In this double-blind trial, outpatients with recurrent MDD (N=1096) were randomized to 10 weeks of acute-phase treatment with venlafaxine ER (75–300 mg/ day) or fluoxetine (20–60 mg/day) followed by a 6-month continuation phase and two consecutive 12-month maintenance phases. At the start of each maintenance period, venlafaxine ER responders were randomized to double-blind venlafaxine ER or placebo. In this analysis, data from responders to acute and continuation treatment were analyzed during the combined maintenance phases while receiving venlafaxine ER ≤225 mg/day. Failure to maintain response was defined as an increase in maintenance dose to 300 mg/day or recurrence. Differences were calculated using Kaplan–Meier methods and compared using log-rank tests. Continuation-phase responders (n =114) receiving venlafaxine ER ≤225 mg/ day comprised the analysis population (venlafaxine ER: n= 55; placebo: n= 59). The estimated probability for remaining well across 24 months of maintenance treatment was 67% for venlafaxine ER and 41% for placebo (P = 0.007). Venlafaxine ER effectively maintained response at doses ≤225 mg/day for up to 2.5 years in patients with recurrent MDD. The findings are consistent with those of the full data set. PMID:18854724

  5. Developmental milestones record - 2 years

    MedlinePlus

    Growth milestones for children - 2 years; Normal childhood growth milestones - 2 years; Childhood growth milestones - 2 years ... a cause for concern if not seen by 2 years.) Can run with better coordination . (May still ...

  6. Comparative Efficacy and Durability of Continuation Phase Cognitive Therapy for Preventing Recurrent Depression: Design of a Double-Blinded, Fluoxetine- and Pill-Placebo–Controlled, Randomized Trial with 2-Year Follow-up

    PubMed Central

    Thase, Michael E.

    2010-01-01

    Background Major depressive disorder (MDD) is highly prevalent and associated with disability and chronicity. Although cognitive therapy (CT) is an effective short-term treatment for MDD, a significant proportion of responders subsequently suffer relapses or recurrences. Purpose This design prospectively evaluates: 1) a method to discriminate CT-treated responders at lower versus higher risk for relapse; and 2) the subsequent durability of 8-month continuation phase therapies in randomized higher risk responders followed for an additional 24-months. The primary prediction is: after protocol treatments are stopped, higher risk patients randomly assigned to continuation phase CT (C-CT) will have a lower risk of relapse/recurrence than those randomized to fluoxetine (FLX). Methods Outpatients, aged 18 to 70 years, with recurrent MDD received 12–14 weeks of CT provided by 15 experienced therapists from two sites. Responders (i.e., no MDD and 17-item Hamilton Rating Scale for Depression ≤ 12) were stratified into higher and lower risk groups based on stability of remission during the last 6 weeks of CT. The lower risk group entered follow-up for 32 months; the higher risk group was randomized to 8 months of continuation phase therapy with either C-CT or clinical management plus either double-blinded FLX or pill placebo. Following the continuation phase, higher risk patients were followed by blinded evaluators for 24 months. Results The trial began in 2000. Enrollment is complete (N=523). The follow-up continues. Conclusions The trial evaluates the preventive effects and durability of acute and continuation phase treatments in the largest known sample of CT responders collected worldwide. PMID:20451668

  7. The application of Ground Penetrating Radar analysis to investigate the impact and recovery of coastal dunes and the recurrence interval of overwash events

    NASA Astrophysics Data System (ADS)

    Switzer, A.; Gouramanis, C.; Bristow, C. S.; Jankaew, K.; Rubin, C. M.; Pham, D. T.; Ildefonso, S. R.; Lee, Y. S.

    2013-12-01

    The common techniques for investigating the impact, recovery and recurrence interval in coastal systems are point source augering or pitting and/or excavations. These techniques are time and cost intensive. Ground Penetrating Radar (GPR) presents a rapid, non-invasive, spatially-continuous technique for identifying subsurface stratigraphy. Although GPR facies are not diagnostic of a particular sedimentary characteristic, when combined with satellite imagery, they provide an avenue for reconstructing the impact and the post event recovery, or to help constrain the spatial extent of sandy deposits in the subsurface. Here, we present results from two GPR survey campaigns at Phra Thong Island, Thailand. The first campaign targeted the large scale recovery of the coast following the 2004 Indian ocean tsunami using 200 MHz antennae and the second campaign focused on a thin-bed approach aimed at imaging thin (<15 cm) sandy tsunami deposits and their associated structures using high-frequency 500 and 1000 MHz GPR antennae complemented by auger cores. The tsunami impact and recovery was reconciled by three 100 MHz GPR profiles and quasi-yearly satellite imagery. The GPR revealed the depth and extent of tsunami scour along with the sedimentary history of post tsunami coastal aggradation and recovery. The second GPR campaign captured several distinct palaeotsunami deposits as discreet thin sand layers preserved within a swale. The base of the swale and the contacts between the sandy and muddy layers are clearly imaged, although these reflectors are less consistent across the profile, suggesting that the contacts between thin sand and mud units can be accurately imaged provided the units are thicker than ca. 10cm. Our investigations show that GPR can be used to rapidly and non-invasively assess post event recovery and to image sandy washover events in muddy swales that are the result of tsunamis or storms.

  8. Stratigraphic variations of lacustrine sediment gravity flow deposits and their recurrence intervals in the Middle Pleistocene Miyajima Formation, northeastern Japan: an implication for paleoenvironmental analysis

    NASA Astrophysics Data System (ADS)

    Sasaki, Hana; Onishi, Yuri; Ishihara, Yoshiro

    2016-04-01

    Lacustrine sediment gravity flow deposits have been proposed as archives for flood and earthquake events. Holocene lacustrine deposits are especially valuable because they can be correlated with historical records and other detailed paleoenvironmental indices. When sediment gravity flow deposits are intercalated in varved deposits, they can potentially be used for high resolution reconstruction of recurrence intervals of events in addition to environmental changes. The Shiobara Group in the Shiobara Basin, Tochigi Prefecture, northeastern Japan, consists of the upper Miyajima Formation and the lower Kamishiobara Formation. The Miyajima Formation includes varved deposits distributed at the center of the basin. These units are interpreted as lake floor deposits of the Paleo-Shiobara Caldera Lake. The varved deposits of the Miyajima Formation consist of cyclic repetitions of light-colored seasonal sub-layers mainly composed of diatoms (Stephanodiscus niagarae) and dark-colored seasonal sub-layers mainly composed of river inflow deposits. For this study, we measured lacustrine deposits of the Miyajima Formation and analyzed stratigraphic variation of varved deposits. Stratigraphic units of approximately 4 m in total thickness were studied, which included 416 events of sediment -gravity flow deposition over ca. 700 years. Sedimentary facies of the lacustrine sediment gravity flow deposits: The sediment gravity flow deposits can be classified by their erosional and internal features: whether they have an erosional base, whether they are graded, and whether they have rip-up clasts. Because high density currents were suggested from above features, most of the deposits are interpreted as the result of hyperpycnal flow. Also, the features suggest that the sediment gravity flow deposits originated from rivers around the lake. Stratigraphic variation of varved deposits: Average thicknesses of varves decrease from the lower and middle portions of the section to the upper part

  9. A new approach for river flood extent delineation in rural and urban areas combining RADARSAT-2 imagery and flood recurrence interval data

    NASA Astrophysics Data System (ADS)

    Tanguy, Marion; Bernier, Monique; Chokmani, Karem

    2015-04-01

    the many efforts recently done toward the improvements of the accuracy of the processing algorithms for flood detection in urban areas with high resolution SAR imagery, these algorithms still encounter difficulties to detect urban flooded pixels with precision. The difficulties do not seem to be only ascribable to the choice of SAR image processing methods, but can also be imputed to the limitations of the SAR imaging technique itself in urban areas. We propose a fully automatic and effective approach for near-real time delineation of urban and rural flooded areas, which combines the capacity of SAR imagery to detect open water areas, and explicit hydrodynamic characteristics of the region affected by the flood, expressed through flood recurrence interval data. This innovative approach has been tested with RADARSAT-2 Fine and Ultrafine Mode images acquired during the 2011 Richelieu River flooding, in Canada. It proved successful in accurately delineating flooding in urban and rural areas, with a RMSE inferior to 2 pixels.

  10. Latent rheumatic heart disease: outcomes 2 years after echocardiographic detection.

    PubMed

    Beaton, Andrea; Okello, Emmy; Aliku, Twalib; Lubega, Sulaiman; Lwabi, Peter; Mondo, Charles; McCarter, Robert; Sable, Craig

    2014-10-01

    Screening with portable echocardiography has uncovered a large burden of latent rheumatic heart disease (RHD) among asymptomatic children in endemic regions, the significance of which remains unclear. This study aimed to determine the 2-year outcomes for children with latent RHD diagnosed by echocardiographic screening. Children identified with latent RHD enrolled in a biannual follow-up program. Risk factors for disease persistence and progression were examined. Of 62 children, 51 (82 %) with latent RHD had a median follow-up period of 25 months. Of these 51 children, 17 (33.3 %) reported an interval sore throat or symptoms consistent with acute rheumatic fever (ARF). Of 43 children initially classified as having borderline RHD, 21 (49 %) remained stable, 18 (42 %) improved (to no RHD) and 4 (10 %) worsened to definite RHD. Of the 8 children initially classified as having definite RHD, 6 (75 %) remained stable, and 2 (25 %) improved to borderline RHD. Two children had confirmed episodes of recurrent ARF, one of which represented the sole case of clinical worsening. The risk factors for disease persistence or progression included younger age (p = 0.05), higher antistreptolysin O titers at diagnosis (p = 0.05), and more morphologic valve abnormalities (p = 0.01). After 2 years, most of the children had a benign course, with 91 % remaining stable or showing improvement. Education may improve recognition of streptococcal sore throat. Longer-term follow-up evaluation, however, is warranted to confirm disease progression and risk factor profile. This could help tailor screening protocols for those at highest risk.

  11. Social Development:: 2 Year Olds

    MedlinePlus

    ... Español Text Size Email Print Share Social Development: 2 Year Olds Page Content Article Body By nature, ... probably are acting the same way. At age two, children view the world almost exclusively through their ...

  12. Emotional Development: 2 Year Olds

    MedlinePlus

    ... Español Text Size Email Print Share Emotional Development: 2 Year Olds Page Content Article Body It’s so ... to follow the ups and downs of a two-year-old. One moment he’s beaming and friendly; ...

  13. Patterns and Timing of Recurrence After Temozolomide-Based Chemoradiation for Glioblastoma

    SciTech Connect

    Milano, Michael T.; Okunieff, Paul; Donatello, Rosemary S.; Mohile, Nimish A.; Sul, Joohee; Walter, Kevin A.; Korones, David N.

    2010-11-15

    Purpose: To determine recurrence patterns of glioblastoma treated with temozolomide-based chemoradiation. Methods: Pretreatment and serial posttreatment magnetic resonance imaging scans of 54 patients were retrospectively evaluated. Central recurrence (i.e., local progression) and the development of new (i.e., interval appearance of discrete enhancing lesion) in-field, marginal, and distant recurrences were assessed, with the pattern of recurrence of individual lesions defined relative to the 95% isodose line (D{sub 95}). Distant recurrences were defined as lesions completely outside D{sub 95}, marginal recurrences crossed D{sub 95}, and in-field recurrences were completely inside D{sub 95}. Results: At a median follow-up of 17 months, 39 of 54 (72%) patients developed recurrent glioblastoma. Among these 39 patients, central recurrence occurred in 80% (at a median of 7 months from diagnosis); new in-field recurrence developed in 33% (at a median of 14 months); marginal recurrences developed in 15% (at a median of 18 months); and distant recurrences developed in 20% (at a median of 11 months). The actuarial rates of central, new in-field, marginal, distant, and any new recurrences at 1-year were 46%, 15%, 3%, 14%, and 25% respectively, whereas at 2 years, the rates were 68%, 60%, 32%, 28%, and 66%, reflecting an increasing probability of new lesions developing at later time points. Ten patients developed subependymal recurrences, of whom 7 developed multiple subependymal lesions. Conclusions: Whereas central recurrence of glioblastoma treated with radiation and temozolomide predominates and persists over time, new in-field, marginal, and distant recurrences commonly develop, particularly at later time points in patients with longer survival.

  14. Recurrent recurrent gallstone ileus.

    PubMed

    Hussain, Z; Ahmed, M S; Alexander, D J; Miller, G V; Chintapatla, S

    2010-07-01

    We describe the second reported case of three consecutive episodes of gallstone ileus and ask the question whether recurrent gallstone ileus justifies definitive surgery to the fistula itself or can be safely managed by repeated enterotomies.

  15. Risk Factors for Recurrent Urinary Tract Infection and Renal Scarring

    PubMed Central

    Shaikh, Nader; Pohl, Hans; Gravens-Mueller, Lisa; Ivanova, Anastasia; Zaoutis, Lisa; Patel, Melissa; deBerardinis, Rachel; Parker, Allison; Bhatnagar, Sonika; Haralam, Mary Ann; Pope, Marcia; Kearney, Diana; Sprague, Bruce; Barrera, Raquel; Viteri, Bernarda; Egigueron, Martina; Shah, Neha; Hoberman, Alejandro

    2015-01-01

    OBJECTIVES: To identify risk factors for recurrent urinary tract infection (UTI) and renal scarring in children who have had 1 or 2 febrile or symptomatic UTIs and received no antimicrobial prophylaxis. METHODS: This 2-year, multisite prospective cohort study included 305 children aged 2 to 71 months with vesicoureteral reflux (VUR) receiving placebo in the RIVUR (Randomized Intervention for Vesicoureteral Reflux) study and 195 children with no VUR observed in the CUTIE (Careful Urinary Tract Infection Evaluation) study. Primary exposure was presence of VUR; secondary exposures included bladder and bowel dysfunction (BBD), age, and race. Outcomes were recurrent febrile or symptomatic urinary tract infection (F/SUTI) and renal scarring. RESULTS: Children with VUR had higher 2-year rates of recurrent F/SUTI (Kaplan-Meier estimate 25.4% compared with 17.3% for VUR and no VUR, respectively). Other factors associated with recurrent F/SUTI included presence of BBD at baseline (adjusted hazard ratio: 2.07 [95% confidence interval (CI): 1.09–3.93]) and presence of renal scarring on the baseline 99mTc-labeled dimercaptosuccinic acid scan (adjusted hazard ratio: 2.88 [95% CI: 1.22–6.80]). Children with BBD and any degree of VUR had the highest risk of recurrent F/SUTI (56%). At the end of the 2-year follow-up period, 8 (5.6%) children in the no VUR group and 24 (10.2%) in the VUR group had renal scars, but the difference was not statistically significant (adjusted odds ratio: 2.05 [95% CI: 0.86–4.87]). CONCLUSIONS: VUR and BBD are risk factors for recurrent UTI, especially when they appear in combination. Strategies for preventing recurrent UTI include antimicrobial prophylaxis and treatment of BBD. PMID:26055855

  16. Factors affecting tumor recurrence after curative surgery for NSCLC: impacts of lymphovascular invasion on early tumor recurrence

    PubMed Central

    Park, Chanyeong; Jang, Seung Hun; Lee, Jae Woong

    2014-01-01

    Background Although surgery is potentially curative treatment for non-small cell lung cancer (NSCLC), the risk of postoperative disease recurrence is still high. This study was conducted to assess the factors associated with postoperative tumor recurrence in patients who underwent curative surgery for NSCLC. Methods One hundred seventy-one patients who underwent curative surgery for NSCLC were included in this study. Clinicopathological factors of histologic type, pathologic TNM stage, T stage, N stage, lymphovascular invasion (LVI), perineural invasion (PNI), surgical procedure, adjuvant chemotherapy and adjuvant radiotherapy were investigated. Gender, age, and clinicopathologic factors were included in univariate and multivariate analyses using the Kaplan-Meier method and Cox proportional hazards model, respectively. Mann-Whitney U and Kruskal-Wallis tests were used to investigate the significance of differences in recurrence-free interval (RFI) according to clinicopathological factors. Results Median RFI was 20 months. Univariate and multivariate analyses for overall recurrence identified T stage, N stage, and LVI as significant factors (P=0.045, 0.044, and <0.001, respectively). Pathologic stage (P=0.005) was the only factor that was significantly associated with locoregional recurrence. T stage (P=0.040) and LVI (P<0.001) were significantly associated with distant recurrence. The difference in 2-year freedom from recurrence between LVI positive and negative groups was significant (14.9% vs. 44.6%, P<0.001). LVI was the only factor that was significantly associated with a shortened mean RFI (P<0.001). Conclusions LVI had a significant effect on both overall and distant recurrence rates as well as on early tumor recurrence after curative surgery for NSCLC. PMID:25364519

  17. [Incidence of lithiasic recurrence after a diuretic therapy, alone or combined with treatment by a thiazide diuretic or phosphorus].

    PubMed

    Ulmann, A; Sayegh, F; Clavel, J; Lacour, B

    1984-05-12

    The preventive affects on recurrent renal calcium stones of water diuresis alone or combined with drugs aimed at lowering urinary calcium were evaluated prospectively in 51 patients with calcium nephrolithiasis. Following clinical and metabolic examination, the patients were allocated at random to 3 treatment groups: water diuresis alone (group I, n = 19) or associated with hydrochlorothiazide 50 mg/day (group II, n = 19) or with a neutral phosphate preparation 1500 mg/day (group III, n = 13). Results were assessed on the number of recurrences; 24-h urinary calcium was measured at regular intervals. The mean follow-up (2 years; range 1-4 years) was the same in all 3 groups. A significant fall in recurrence rate as compared with pre-treatment values was observed in groups I and II. The recurrence rate was the same in both groups during treatment. However, less patients had recurrences in group I (1/19) than in group II (5/19). No significant fall in recurrence rate was observed in group III, owing to some patients in this group having frequent recurrences. The recurrence rate was unrelated to clinical findings and biochemical values ( oxaluria , calciuria) measured before treatment and to the urinary Ca/Cr ratio calculated during treatment. This study confirms that water diuresis is effective in preventing recurrent renal calcium stones and that diuretics of the thiazide group reduce the number of patients with recurrences.

  18. Interval Training

    MedlinePlus

    ... before trying any type of interval training. Recent studies suggest, however, that interval training can be used safely for short periods even in individuals with heart disease. Also keep the risk of overuse injury in mind. If you rush into a strenuous workout before ...

  19. Your Child's Development: 2 Years (24 Months)

    MedlinePlus

    ... 1- to 2-Year-Old Your Child’s Development: 2 Years (24 Months) KidsHealth > For Parents > Your Child’s Development: 2 Years (24 Months) Print A A A en español El desarrollo de su hijo: 2 años (24 meses) Tired of changing diapers? When ...

  20. Risk factors for recurrent Clostridium difficile infection in allogeneic hematopoietic cell transplant recipients.

    PubMed

    Mani, S; Rybicki, L; Jagadeesh, D; Mossad, S B

    2016-05-01

    Clostridium difficile infection (CDI) is one of the leading causes of hospital-acquired infections in recent times. Hematopoietic stem cell transplantation (HSCT) confers increased risk for CDI because of prolonged hospital stay, immunosuppression, the need to use broad-spectrum antibiotics and a complex interplay of preparative regimen and GvHD-induced gut mucosal damage. Our study evaluated risk factors (RF) for recurrent CDI in HSCT recipients given the ubiquity of traditional RF for CDI in this population. Of the 499 allogeneic HSCT recipients transplanted between 2005 and 2012, 61 (12%) developed CDI within 6 months before transplant or 2 years after transplant and were included in the analysis. Recurrent CDI occurred in 20 (33%) patients. One year incidence of CDI recurrence was 31%. Multivariable analyses identified the number of antecedent antibiotics other than those used to treat CDI as the only significant RF for recurrence (hazard ratio 1.96, 95% confidence interval 1.09-3.52, P=0.025). Most recurrences occurred within 6 months of the first CDI, and the recurrence of CDI was associated with a trend for increased risk of mortality. This prompts the need for further investigation into secondary prophylaxis to prevent recurrent CDI.

  1. Sulodexide for the Prevention of Recurrent Venous Thromboembolism

    PubMed Central

    Bignamini, Angelo A.; Davì, Giovanni; Palareti, Gualtiero; Matuška, Jiří; Holý, Martin; Pawlaczyk-Gabriel, Katarzyna; Džupina, Andrej; Sokurenko, German Y.; Didenko, Yury P.; Andrei, Laurentia D.; Lessiani, Gianfranco; Visonà, Adriana

    2015-01-01

    Background— Patients with a first episode of unprovoked venous thromboembolism have a high risk of recurrence after discontinuation of anticoagulant therapy. Extending anticoagulation reduces the risk of recurrence but is associated with increased bleeding. Sulodexide, a glycosaminoglycan, exerts antithrombotic and profibrinolytic actions with a low bleeding risk when administered orally, but its benefit for preventing recurrent venous thromboembolism is not well known. Methods and Results— In this multicenter, double-blind study, 615 patients with first-ever unprovoked venous thromboembolism who had completed 3 to 12 months of oral anticoagulant treatment were randomly assigned to sulodexide 500 lipasemic units twice daily or placebo for 2 years, in addition to elastic stockings. The primary efficacy outcome was recurrence of venous thromboembolism. Major or clinically relevant bleeding was the primary safety outcome. Venous thromboembolism recurred in 15 of the 307 patients who received sulodexide and in 30 of the 308 patients who received placebo (hazard ratio, 0.49; 95% confidence interval [CI], 0.27–0.92; P=0.02). The analysis in which lost to follow-up was assigned to failure yielded a risk ratio among treated versus control subjects of 0.54 (95% confidence interval, 0.35–0.85; P=0.009). No major bleeding episodes occurred; 2 patients in each treatment group had a clinically relevant bleeding episode. Adverse events were similar in the 2 groups. Conclusion— Sulodexide given after discontinuation of anticoagulant treatment reduced the risk of recurrence in patients with unprovoked venous thromboembolism, with no apparent increase of bleeding risk. Clinical Trial Registration— URL: https://www.clinicaltrialsregister.eu/. Identifier: EudraCT number 2009-016923-77. PMID:26408273

  2. Recurrent Fever in Children

    PubMed Central

    Torreggiani, Sofia; Filocamo, Giovanni; Esposito, Susanna

    2016-01-01

    Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time. PMID:27023528

  3. Recurrent Fever in Children.

    PubMed

    Torreggiani, Sofia; Filocamo, Giovanni; Esposito, Susanna

    2016-03-25

    Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time.

  4. Recurrent vulvovaginitis.

    PubMed

    Powell, Anna M; Nyirjesy, Paul

    2014-10-01

    Vulvovaginitis (VV) is one of the most commonly encountered problems by a gynecologist. Many women frequently self-treat with over-the-counter medications, and may present to their health-care provider after a treatment failure. Vulvovaginal candidiasis, bacterial vaginosis, and trichomoniasis may occur as discreet or recurrent episodes, and have been associated with significant treatment cost and morbidity. We present an update on diagnostic capabilities and treatment modalities that address recurrent and refractory episodes of VV.

  5. Meningioma recurrence

    PubMed Central

    Bencze, János; Varkoly, Gréta; Kouhsari, Mahan C; Klekner, Álmos

    2016-01-01

    Abstract Meningioma accounts for more than 30% of all intracranial tumours. It affects mainly the elderly above the age of 60, at a female:male ratio of 3:2. The prognosis is variable: it is usually favourable with no progression in tumour grade and no recurrence in WHO grade 1 tumours. However, a minority of tumours represent atypical (grade 2) or anaplastic (grade 3) meningiomas; this heterogeneity is also reflected in histopathological appearances. Irrespective of the grade, the size of the tumour and the localisation may have severe, sometimes lethal consequences. Following neurosurgical interventions to remove the tumour, recurrence and progression in WHO grade may occur. Our knowledge on predisposing histomorphological and molecular factors of recurrence is rather limited. These can be classified as I) demographic II) environmental, III) genetic and epigenetic IV) imaging, V) neuropathological, and VI) neurosurgical. In view of the complex background of tumour recurrence, the recognition of often subtle signs of increased risk of recurrence requires close collaboration of experts from several medical specialties. This multidisciplinary approach results in better therapy and fewer complications related to tumour recurrence. PMID:28352788

  6. Recurrent novae

    NASA Technical Reports Server (NTRS)

    Hack, Margherita; Selvelli, Pierluigi

    1993-01-01

    Recurrent novae seem to be a rather inhomogeneous group: T CrB is a binary with a M III companion; U Sco probably has a late dwarf as companion. Three are fast novae; two are slow novae. Some of them appear to have normal chemical composition; others may present He and CNO excess. Some present a mass-loss that is lower by two orders of magnitude than classical novae. However, our sample is too small for saying whether there are several classes of recurrent novae, which may be related to the various classes of classical novae, or whether the low mass-loss is a general property of the class or just a peculiarity of one member of the larger class of classical novae and recurrent novae.

  7. Pattern of local recurrence after conservative surgery and whole-breast irradiation

    SciTech Connect

    Freedman, Gary M. . E-mail: G_Freedman@FCCC.edu; Anderson, Penny R.; Hanlon, Alexandra L.; Eisenberg, Debra F.; Nicolaou, Nicos

    2005-04-01

    Purpose: Most recurrences in the breast after conservative surgery and whole-breast irradiation have been reported to occur within the same quadrant as the initial primary tumor. We analyzed the long-term risk of recurrence by area of the breast after whole-breast irradiation. Materials and Methods: In all, 1,990 women with Stage 0-II breast cancer were treated with conservative surgery and whole-breast irradiation from 1970-1998. Stage was ductal carcinoma in situ in 237, T1 in 1273, and T2 in 480 patients. Of 120 local recurrences, 71 were classified as true local (confined to the original quadrant) and 49 as elsewhere (involving outside the original quadrant). Kaplan-Meier methodology was used to calculate 5-year, 10-year, and 15-year rates of recurrence (95% confidence intervals in parentheses). The median follow-up is 80 months. Results: There was no apparent difference in the 15-year rate of true local vs. elsewhere recurrence, but the time to recurrence was different. The rate of true local recurrence was 2%, 5%, and 7% (5-9%) at 5, 10, and 15 years, respectively. The recurrences elsewhere in the breast were rare at 5 (1%) and 10 (2%) years, but increased to 6 (3-9%) at 15 years. This 15-year rate of elsewhere recurrence was half the rate of contralateral breast cancers of 13% (10-16%). Conclusions: Recurrence elsewhere in the breast is rare for the first 10 years, but by 15 years is nearly equal to true local recurrence even after whole-breast irradiation. The 15-year rate of elsewhere recurrence was half the rate of contralateral breast cancers. This may indicate a therapeutic effect of whole-breast radiation for other areas of the breast. Very long follow-up will be needed for partial breast irradiation with or without tamoxifen to show that the risk of elsewhere recurrence is not significantly different than after whole-breast irradiation.

  8. Intensity-Modulated Radiation Therapy in the Salvage of Locally Recurrent Nasopharyngeal Carcinoma

    SciTech Connect

    Qiu Sufang; Lin Shaojun; Tham, Ivan W.K.; Pan Jianji; Lu Jun; Lu, Jiade J.

    2012-06-01

    Purpose: Local recurrences of nasopharyngeal carcinoma (NPC) may be salvaged by reirradiation with conventional techniques, but with significant morbidity. Intensity-modulated radiation therapy (IMRT) may improve the therapeutic ratio by reducing doses to normal tissue. The aim of this study was to address the efficacy and toxicity profile of IMRT for a cohort of patients with locally recurrent NPC. Methods and Materials: Between August 2003 and June 2009, 70 patients with radiologic or pathologically proven locally recurrent NPC were treated with IMRT. The median time to recurrence was 30 months after the completion of conventional radiation to definitive dose. Fifty-seven percent of the tumors were classified asrT3-4. The minimum planned doses were 59.4 to 60 Gy in 1.8- to 2-Gy fractions per day to the gross disease with margins, with or without chemotherapy. Results: The median dose to the recurrent tumor was 70 Gy (range, 50-77.4 Gy). Sixty-five patients received the planned radiation therapy; 5 patients received between 50 and 60 Gy because of acute side effects. With a median follow-up time of 25 months, the rates of 2-year locoregional recurrence-free survival, disease-free survival, and overall survival were 65.8%, 65.8%, and 67.4%, respectively. Moderate to severe late toxicities were noted in 25 patients (35.7%). Eleven patients (15.7%) had posterior nasal space ulceration, 17 (24.3%) experienced cranial nerve palsies, 12 (17.1%) had trismus, and 12 (17.1%) experienced deafness. Extended disease-free interval (relative risk 2.049) and advanced T classification (relative risk 3.895) at presentation were adverse prognostic factors. Conclusion: Reirradiation with IMRT provides reasonable long-term control in patients with locally recurrent NPC.

  9. Neonates with extra-renal pelvis: the first 2 years.

    PubMed

    Katzir, Ze'ev; Witzling, Michaela; Nikolov, Gallina; Gvirtz, Gabriela; Arbel, Eliana; Kohelet, David; Boaz, Mona; Smetana, Shmuel; Lorberboym, Mordechai

    2005-06-01

    Extra-renal pelvis (ERpel) is a common ultrasonographic finding among neonates who have undergone recurrent ultrasound examinations for a better definition of prenatal renal pelvic dilatation. This study tries to determine whether or not ERpel has important prognostic implications. Seventy-nine neonates (17 female) were examined. All had a diagnosis of prenatal renal pelvis dilatation, which was shown by postnatal ultrasound to be ERpel. Sixty ERpel neonates were examined 1.5 months to 2.5 months after the ultrasound (US) diagnosis by both Tc-99m diethylene triamine penta-acetic acid (DPTA) dynamic renal scanning and (99m)Tc-pertechnetate direct cystography. Clinical assessment, urine cultures and renal ultrasound follow-up were maintained for 2 years. The proportion of urinary tract infections (UTIs) in patients with ERpel was compared with that of the total neonatal and infantile population with normal US scans in the region of our hospital. Associated minor congenital malformations were found in 12 of 79 neonates (15.2%). Four had a family history of ERpel. Among 60 neonates who underwent renal scanning, 36 (60%) were found to have urinary retention in the collecting system. Another nine (15%) had vesico-ureteral (VU) reflux, of which seven had urinary retention. Fifteen (25%) showed normal isotope imaging. Urinary tract infection was diagnosed in 16 ERpel neonates in whom only one exhibited VU reflux (grade 2). The incidence of neonatal UTI in the ERpel group was more than that of either neonatal or infantile UTI in those with normal US scans in the local population (20.2% vs 1.2% and 4.3%, respectively). Fifty-three infants completed a 2-year follow-up. Repeat renal ultrasonography indicated that one infant (1.8%) had developed bilateral hydronephrosis, 12 (22.6%) had unchanged findings, 18 (40%) showed an improvement (decrease of ERpel width or resolution in one side) and, in 22 (41.5%) infants, the condition had resolved. No clinical or kidney function

  10. Remote orbital recurrence of olfactory neuroblastoma (esthesioneuroblastoma).

    PubMed

    Breazzano, Mark P; Lewis, James S; Chambless, Lola B; Rohde, Sarah L; Sobel, Rachel K

    2017-03-31

    Olfactory neuroblastoma is a rare and often locally aggressive malignancy that invades the orbit via local destruction. It is known to recur in a delayed fashion, particularly to the neck lymph nodes. This is a case of a 65-year-old gentleman who presents with recurrence in the orbit and a neck lymph node 19 years after treatment for his initial disease. This report describes the longest known interval in orbital recurrence and should alert the monitoring physician that extreme delays in recurrence can occur.

  11. Complex partial status epilepticus: a recurrent problem.

    PubMed Central

    Cockerell, O C; Walker, M C; Sander, J W; Shorvon, S D

    1994-01-01

    Twenty patients with complex partial status epilepticus were identified retrospectively from a specialist neurology hospital. Seventeen patients experienced recurrent episodes of complex partial status epilepticus, often occurring at regular intervals, usually over many years, and while being treated with effective anti-epileptic drugs. No unifying cause for the recurrences, and no common epilepsy aetiologies, were identified. In spite of the frequency of recurrence and length of history, none of the patients showed any marked evidence of cognitive or neurological deterioration. Complex partial status epilepticus is more common than is generally recognised, should be differentiated from other forms of non-convulsive status, and is often difficult to treat. PMID:8021671

  12. Interval arithmetic in calculations

    NASA Astrophysics Data System (ADS)

    Bairbekova, Gaziza; Mazakov, Talgat; Djomartova, Sholpan; Nugmanova, Salima

    2016-10-01

    Interval arithmetic is the mathematical structure, which for real intervals defines operations analogous to ordinary arithmetic ones. This field of mathematics is also called interval analysis or interval calculations. The given math model is convenient for investigating various applied objects: the quantities, the approximate values of which are known; the quantities obtained during calculations, the values of which are not exact because of rounding errors; random quantities. As a whole, the idea of interval calculations is the use of intervals as basic data objects. In this paper, we considered the definition of interval mathematics, investigated its properties, proved a theorem, and showed the efficiency of the new interval arithmetic. Besides, we briefly reviewed the works devoted to interval analysis and observed basic tendencies of development of integral analysis and interval calculations.

  13. Possible Misinterpretation of Demarcated Solid Patterns of Radiation Fibrosis on CT Scans as Tumor Recurrence in Patients Receiving Hypofractionated Stereotactic Radiotherapy for Lung Cancer

    SciTech Connect

    Takeda, Atsuya; Kunieda, Etsuo Takeda, Toshiaki; Tanaka, Michio; Sanuki, Naoko; Fujii, Hirofumi; Shigematsu, Naoyuki; Kubo, Atsushi M.D.

    2008-03-15

    Purpose: To retrospectively analyze opacity changes near primary lung cancer tumors irradiated by using hypofractionated stereotactic radiotherapy (HSRT) to determine the presence or absence of tumor recurrence. Methods and Materials: After review-board approval for a retrospective study, we examined data from 50 patients treated with curative intent for proven or highly suspected localized peripheral-lung cancer and followed up for at least 12 months. All patients had received 50 Gy in five fractions (80% isodose) and were followed up monthly with chest X-ray until clinical and X-ray findings stabilized. Follow-up computed tomography scans were performed 1 and 3 months after HSRT and thereafter at 3-month intervals during the first 2 years. Results: Median follow-up was 30.4 months (range, 12.0-73.8 months). Abnormal opacities that were suspicious for recurrent tumor appeared in 20 patients at a median of 20.7 months (range, 5.9-61.4 months). Only 3 patients were finally found to have recurrence; 14 were recurrence free but were suspected to have fibrosis, and findings for the other 3 patients were considered equivocal because of a short follow-up period ({<=}6 months). Conclusion: Radiation fibrosis, which may occur 1 year or longer after completion of HSRT, is difficult to distinguish from tumor recurrence. Even when opacities increase on follow-up radiologic scans, recurrence cannot be diagnosed conclusively based on image findings; biopsy occasionally is warranted.

  14. Feeding Your 1- to 2-Year-Old

    MedlinePlus

    ... to 2-Year-Old Feeding Your 1- to 2-Year-Old KidsHealth > For Parents > Feeding Your 1- to 2-Year-Old Print A A A What's in ... español Alimentar a su hijo de 1 a 2 años de edad Toddlers this age are moving ...

  15. Growth and Your 1- to 2-Year-Old

    MedlinePlus

    ... 2-Year-Old Growth and Your 1- to 2-Year-Old KidsHealth > For Parents > Growth and Your 1- to 2-Year-Old Print A A A You're ... down. Your toddler may gain about 5 pounds (2.27 kg) and grow about 4 or 5 ...

  16. Recurrent groin hernia

    PubMed Central

    Cox, P. J.; Leach, R. D.; Ellis, Harold

    1981-01-01

    One hundred consecutive recurrences following repair of inguinal hernias have been studied; 62 were direct, 30 indirect, 7 pantaloon and one a femoral hernia. Half the indirect recurrences occurred within a year of repair and probably represented failure to detect a small indirect sac. Later indirect recurrences probably represented failure to repair the internal ring. Nine of the direct hernias were medial funicular recurrences and represented failure to anchor the darn medially. The rest of the direct recurrences were attributable to tissue insufficiency and could probably have been averted by larger tissue bites. Recurrences following inguinal herniorrhaphy remain an all too common problem but can be reduced by meticulous surgical technique. PMID:7339602

  17. Recurrent aphthous stomatitis.

    PubMed

    Chattopadhyay, Amit; Shetty, Kishore V

    2011-02-01

    Recurrent aphthous stomatitis is a common oral ulcerative disease, affecting 10% to 15% of the general US population. This article reviews the epidemiology and clinical presentations of recurrent aphthous stomatitis, including diagnosis and management.

  18. [Chronic recurrent multifocal osteomyelitis].

    PubMed

    Marrero Calvo, M; Merino Arribas, J; Rodrigo Palacios, J; Bartolomé Albistegui, M; Camino Fernández, A; Grande Sáez, C

    2001-02-01

    Chronic recurrent multifocal osteomyelitis is a rare disorder of unknown etiology, characterized by multiple bone lesions and a variable clinical course. We present a 10 year old boy with chronic recurrent multifocal osteomyelitis who improved after treatment with naproxen.

  19. Recurrent paediatric pinworm infection of the vagina as a potential reservoir for Enterobius vermicularis.

    PubMed

    Kashyap, B; Samantray, J C; Kumar, S; Jhamb, R; Singh, A K; Kaur, I R

    2014-09-01

    Enterobius vermicularis infection remains one of the most common parasitic infections, particularly prevalent in children. Enterobiasis, although not usually dangerous, may cause significant morbidity. Elimination of the parasite from a family or an institution often poses problems, either because of an incomplete cure or re-infection. While there have been limited reports of ectopic enterobiasis throughout the world, ours is probably one of the rarest reports of recurrent vaginal E. vermicularis infection in the absence of any gastrointestinal symptoms despite complete treatment. A 4-year-old girl presented with recurrent episodes of vulval itching on 3-4 occasions over 2 years. There was no pruritis ani nor urinary/gastrointestinal complaints. The vulva was inflamed with 4-5 living worms, 6-7 mm in length, emerging from the anterior vaginal fornix, but with no vaginal discharge. Direct microscopic examination of vaginal swabs revealed adult worms of Enterobius but no eggs. Repeated stool samples from the patient, parents and a sibling were negative. The patient was treated orally with 100 mg of mebendazole for 3 days followed by two more courses at 3-week intervals over a period of 3 months. Recurrent vaginal enterobiasis despite complete treatment and in the absence of any gastrointestinal involvement suggests that the vagina is a potential reservoir for E. vermicularis, which supports the theory of rare ectopic enterobiasis through the ascending pathway of the female genital tract.

  20. Solid predominant histologic subtype and early recurrence predict poor postrecurrence survival in patients with stage I lung adenocarcinoma

    PubMed Central

    Han, Baohui; Zhang, Jie; Zhao, Heng; Fang, Wentao; Luo, Qingquan; Yang, Jun; Yang, Yunhai; Zhu, Lei; Chen, Tianxiang; Cheng, Xinghua; Huang, Qingyuan; Wang, Yiyang; Zheng, Jiajie; Chen, Haiquan

    2017-01-01

    Introduction This study investigated the correlation between histologic predominant pattern and postrecurrence survival (PRS), and identified the clinicopathologic factors influencing PRS in patients with completely resected stage I lung adenocarcinoma. Methods A total of 136 stage I lung adenocarcinoma patients who experienced tumor recurrence after completely resection were included in this study. To analysis the association between histologic predominant pattern and PRS, invasive adenocarcinomas with mixed histologic components were divided into 2 groups: solid and nonsolid group (including lepidic, acinar, papillary, micropapillary) based on the histologic predominant pattern. PRS was analyzed to identify the prognostic predictors using the Kaplan-Meier approach and multivariable Cox models. Results For all stage I invasive adenocarcinoma patients, the majority of postsurgical recurrences occurred within 2 years. Patients with solid predominant histological pattern were associated with unfavorable PRS (HR, 2.40; 95%CI 1.13-5.08, p=.022). There was a significant difference for poor PRS for patients who diagnosed tumor recurrence shorter than 12 months after surgery (HR, 2.34; 95%CI 1.12-4.90, p=.024). Extrathoracic metastasis was associated with poor media PRS in univariable analysis (p =.011), however, there was no significant PRS difference in multivariable analysis (HR, 1.56; 95%CI 0.65-3.73, p=.322) compared with intrathoracic metastasis. Conclusions Solid predominant histologic subtype and recurrence free interval less than 12 months predict worse PRS in patients with stage I lung adenocarcinoma. PMID:27732964

  1. Musical intervals in speech.

    PubMed

    Ross, Deborah; Choi, Jonathan; Purves, Dale

    2007-06-05

    Throughout history and across cultures, humans have created music using pitch intervals that divide octaves into the 12 tones of the chromatic scale. Why these specific intervals in music are preferred, however, is not known. In the present study, we analyzed a database of individually spoken English vowel phones to examine the hypothesis that musical intervals arise from the relationships of the formants in speech spectra that determine the perceptions of distinct vowels. Expressed as ratios, the frequency relationships of the first two formants in vowel phones represent all 12 intervals of the chromatic scale. Were the formants to fall outside the ranges found in the human voice, their relationships would generate either a less complete or a more dilute representation of these specific intervals. These results imply that human preference for the intervals of the chromatic scale arises from experience with the way speech formants modulate laryngeal harmonics to create different phonemes.

  2. Programming with Intervals

    NASA Astrophysics Data System (ADS)

    Matsakis, Nicholas D.; Gross, Thomas R.

    Intervals are a new, higher-level primitive for parallel programming with which programmers directly construct the program schedule. Programs using intervals can be statically analyzed to ensure that they do not deadlock or contain data races. In this paper, we demonstrate the flexibility of intervals by showing how to use them to emulate common parallel control-flow constructs like barriers and signals, as well as higher-level patterns such as bounded-buffer producer-consumer. We have implemented intervals as a publicly available library for Java and Scala.

  3. Medical Care and Your 1- to 2-Year-Old

    MedlinePlus

    ... Year-Old Medical Care and Your 1- to 2-Year-Old KidsHealth > For Parents > Medical Care and Your 1- to 2-Year-Old A A A The toddler months ... Following simple instructions? Saying a few words? Combining two words by age 2? The doctor may ask ...

  4. Association between the use of surveillance PET/CT and the detection of potentially salvageable occult recurrences among patients with resected high-risk melanoma.

    PubMed

    Leon-Ferre, Roberto A; Kottschade, Lisa A; Block, Matthew S; McWilliams, Robert R; Dronca, Roxana S; Creagan, Edward T; Allred, Jacob B; Lowe, Val J; Markovic, Svetomir N

    2017-03-14

    The optimal surveillance for patients with resected high-risk melanoma is controversial. Select locoregional or oligometastatic recurrences can be cured with salvage resection. Data on the ability of PET/CT to detect such recurrences are sparse. We evaluated whether surveillance PET/CT in patients with resected stage III-IV melanoma led to detection of clinically occult recurrences amenable to curative-intent salvage treatment. We retrospectively identified 1429 melanoma patients who underwent PET/CT between January 2008 and October 2012 at Mayo Clinic (Rochester, Minnesota). A total of 1130 were excluded because of stage I-II, ocular or mucosal melanoma, incomplete resection, PET/CT not performed for surveillance or performed at a different institution, and records not available. A total of 299 patients were eligible. Overall, 162 (52%) patients developed recurrence [locoregional: 77 (48%), distant: 85 (52%)]. The first recurrence was clinically occult in 98 (60%) and clinically evident in 64 (40%). Clinically evident recurrences were more often superficial (skin, subcutaneous, or nodal) or in the brain, whereas clinically occult recurrences more often visceral. Overall, 90% of all recurrences were detected by 2.8 years. In all, 70% of patients with recurrence underwent curative-intent salvage treatment (locoregional: 94%, distant: 48%), with similar rates for clinically occult versus clinically evident recurrences (66 vs. 75%, P=0.240). Overall survival was superior among those who underwent curative-intent salvage treatment [5.9 vs. 1.2 years; hazard ratio=4.27, 95% confidence interval (CI)=2.68-6.80; P<0.001], despite 79% developing recurrence again. PET/CT had high sensitivity (88%, 95% CI=79.94-93.31%), specificity (90%, 95% CI=88.56-91.56%), and negative predictive value (99%, 95% CI=98.46-99.52%). However, the positive predictive value was only 37% (95% CI=31.32-43.68%). In patients with resected stage III-IV melanoma, surveillance PET/CT detected a large

  5. Interval estimations in metrology

    NASA Astrophysics Data System (ADS)

    Mana, G.; Palmisano, C.

    2014-06-01

    This paper investigates interval estimation for a measurand that is known to be positive. Both the Neyman and Bayesian procedures are considered and the difference between the two, not always perceived, is discussed in detail. A solution is proposed to a paradox originated by the frequentist assessment of the long-run success rate of Bayesian intervals.

  6. Direct interval volume visualization.

    PubMed

    Ament, Marco; Weiskopf, Daniel; Carr, Hamish

    2010-01-01

    We extend direct volume rendering with a unified model for generalized isosurfaces, also called interval volumes, allowing a wider spectrum of visual classification. We generalize the concept of scale-invariant opacity—typical for isosurface rendering—to semi-transparent interval volumes. Scale-invariant rendering is independent of physical space dimensions and therefore directly facilitates the analysis of data characteristics. Our model represents sharp isosurfaces as limits of interval volumes and combines them with features of direct volume rendering. Our objective is accurate rendering, guaranteeing that all isosurfaces and interval volumes are visualized in a crack-free way with correct spatial ordering. We achieve simultaneous direct and interval volume rendering by extending preintegration and explicit peak finding with data-driven splitting of ray integration and hybrid computation in physical and data domains. Our algorithm is suitable for efficient parallel processing for interactive applications as demonstrated by our CUDA implementation.

  7. Prevalence and Predictors of Malnutrition among Guatemalan Children at 2 Years of Age

    PubMed Central

    Gippetti, James; Wager, Stefan; Chavez, Alejandro; Wise, Paul H.

    2016-01-01

    Objective To identify the prevalence and predictors of malnutrition among 2-year old children in the Western Highlands of Guatemala. Methods Prospective cohort of 852 Guatemalan children in San Lucas Toliman, Guatemala followed from birth to age 2 from May 2008 to December 2013. Socio-demographic, anthropometric, and health data of children was collected at 2 month intervals. Results Among the 402 males and 450 females in the cohort, mean weight-for-age Z-score (WAZ) declined from -0.67 ± 1.01 at 1 year to -1.07 ± 0.87 at 2 years, while mean height-for-age Z-score (HAZ) declined from -1.88 ± 1.19 at 1 year to -2.37 ± 0.99 at 2 years. Using multiple linear regression modeling, number of children <5 years old, vomiting in the past week, fever in the past week, and WAZ at 1 year were significant predictors of WAZ at 2 years. Significant predictors of HAZ at 2 years included household size, number of children <5 years old, diarrhea in the past week, WAZ at 1 year, and HAZ at 1 year. Vomiting in the past week and WAZ at 1 year were significant predictors of weight-for-height z-score (WHZ) at 2 years. Conclusions Number of children <5 years old, symptoms such as vomiting or diarrhea in the previous week, and prior nutritional status were the most significant predictors of malnutrition in this cohort. Future research may focus on the application of models to develop predictive algorithms for mobile device technology, as well as the identification of other predictors of malnutrition that are not well characterized such as the interaction of environmental exposures with protein consumption and epigenetics. PMID:27806066

  8. 75 FR 77958 - Gravesite Reservation Survey (2 Year); Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Gravesite Reservation Survey (2 Year); Correction AGENCY: National Cemetery Administration, Department of Veterans Affairs. ACTION: Notice; correction. SUMMARY: The Department of Veterans Affairs...

  9. Laboratory constraints on models of earthquake recurrence

    NASA Astrophysics Data System (ADS)

    Beeler, N. M.; Tullis, Terry; Junger, Jenni; Kilgore, Brian; Goldsby, David

    2014-12-01

    In this study, rock friction "stick-slip" experiments are used to develop constraints on models of earthquake recurrence. Constant rate loading of bare rock surfaces in high-quality experiments produces stick-slip recurrence that is periodic at least to second order. When the loading rate is varied, recurrence is approximately inversely proportional to loading rate. These laboratory events initiate due to a slip-rate-dependent process that also determines the size of the stress drop and, as a consequence, stress drop varies weakly but systematically with loading rate. This is especially evident in experiments where the loading rate is changed by orders of magnitude, as is thought to be the loading condition of naturally occurring, small repeating earthquakes driven by afterslip, or low-frequency earthquakes loaded by episodic slip. The experimentally observed stress drops are well described by a logarithmic dependence on recurrence interval that can be cast as a nonlinear slip predictable model. The fault's rate dependence of strength is the key physical parameter. Additionally, even at constant loading rate the most reproducible laboratory recurrence is not exactly periodic, unlike existing friction recurrence models. We present example laboratory catalogs that document the variance and show that in large catalogs, even at constant loading rate, stress drop and recurrence covary systematically. The origin of this covariance is largely consistent with variability of the dependence of fault strength on slip rate. Laboratory catalogs show aspects of both slip and time predictability, and successive stress drops are strongly correlated indicating a "memory" of prior slip history that extends over at least one recurrence cycle.

  10. Treatment of chronic recurrent multifocal osteomyelitis with interferon gamma.

    PubMed

    Gallagher, K T; Roberts, R L; MacFarlane, J A; Stiehm, E R

    1997-09-01

    Chronic recurrent multifocal osteomyelitis is characterized by recurrent episodes of painful swollen lesions of the bone and overlying skin with radiographic changes and an elevated sedimentation rate. It resembles infectious osteomyelitis but with negative findings on bacterial culture and no response to antibiotics. We treated a 13-year-old girl with interferon gamma for 3 months. She had 11 episodes of chronic recurrent multifocal osteomyelitis in 2 1/2 years before therapy and has had none in the 15 months since therapy, an outcome suggesting a favorable therapeutic response.

  11. Geological and historical evidence of irregular recurrent earthquakes in Japan.

    PubMed

    Satake, Kenji

    2015-10-28

    Great (M∼8) earthquakes repeatedly occur along the subduction zones around Japan and cause fault slip of a few to several metres releasing strains accumulated from decades to centuries of plate motions. Assuming a simple 'characteristic earthquake' model that similar earthquakes repeat at regular intervals, probabilities of future earthquake occurrence have been calculated by a government committee. However, recent studies on past earthquakes including geological traces from giant (M∼9) earthquakes indicate a variety of size and recurrence interval of interplate earthquakes. Along the Kuril Trench off Hokkaido, limited historical records indicate that average recurrence interval of great earthquakes is approximately 100 years, but the tsunami deposits show that giant earthquakes occurred at a much longer interval of approximately 400 years. Along the Japan Trench off northern Honshu, recurrence of giant earthquakes similar to the 2011 Tohoku earthquake with an interval of approximately 600 years is inferred from historical records and tsunami deposits. Along the Sagami Trough near Tokyo, two types of Kanto earthquakes with recurrence interval of a few hundred years and a few thousand years had been recognized, but studies show that the recent three Kanto earthquakes had different source extents. Along the Nankai Trough off western Japan, recurrence of great earthquakes with an interval of approximately 100 years has been identified from historical literature, but tsunami deposits indicate that the sizes of the recurrent earthquakes are variable. Such variability makes it difficult to apply a simple 'characteristic earthquake' model for the long-term forecast, and several attempts such as use of geological data for the evaluation of future earthquake probabilities or the estimation of maximum earthquake size in each subduction zone are being conducted by government committees.

  12. Recurrent inguinal hernia.

    PubMed Central

    Postlethwait, R W

    1985-01-01

    An analysis of 584 operations for recurrent inguinal hernia was made in an attempt to determine the cause of the recurrence based on the anatomic findings. The recurrence was indirect in 300, direct in 241, and various other in 43 operations. The causes of the indirect recurrences appeared to be an unrecognized hernia, incomplete dissection or improper ligation of the sac, failure to narrow the cord, or inadequate reconstruction of the internal ring. No cause for the diffuse direct recurrences was apparent. Of the 241 hernias in Hesselbach's triangle, 144 were small localized defects, usually (112) just lateral to the symphysis. These were considered to be caused by the cutting action of a suture placed under tension. On the basis of these findings, suggestions are made for primary inguinal hernia operations. PMID:4073990

  13. Severe bronchiolitis in infants born very preterm and neurodevelopmental outcome at 2 years.

    PubMed

    Gouin, Marion; Nguyen, Sylvie; Savagner, Christophe; Troussier, Francoise; Gascouin, Géraldine; Rozé, Jean-Christophe; Flamant, Cyril

    2013-05-01

    Preterm infants are at greater risk of bronchopulmonary dysplasia, which is associated with neurodevelopmental impairment. These infants are also more likely to develop severe bronchiolitis, which can contribute to neurodevelopmental impairment. The aim of this study was to determine whether severe bronchiolitis in very preterm infants (born before 33 weeks of gestation) was associated with an increased risk of neurodevelopmental impairment at 2 years of age. We analyzed a population-based cohort of infants (the Loire Infant Follow-up Team cohort) born between 1 January 2003 and 31 December 2009. Severe bronchiolitis was defined as hospitalization due to bronchiolitis during the first year of life. Neurodevelopmental outcome was assessed at 2 years of corrected age. A total of 2,405 infants were included in this analysis and categorized based on neonatal respiratory status: 1,308 (54.4 %) received no respiratory assistance, 864(35.9 %) received oxygen for <28 days, and 167 (6.9 %) had mild and 66 (2.7) moderate or severe bronchopulmonary dysplasia. At 2 years, 502 children displayed non-optimal neurodevelopmental outcome (20.9 %). Moderate or severe bronchopulmonary dysplasia was significantly associated with non-optimal neurodevelopmental outcome at 2 years (adjusted odds ratios (OR) = 2.3 [95 % confidence interval (CI): 1.3-3.9], p = 0.003). In the first year, 318 infants acquired severe bronchiolitis (13.2 %), which was not associated with non-optimal neurodevelopmental outcome (adjusted OR = 1.0 [95 % CI: 0.8-1.4]; p = 0.88). In conclusion, respiratory status in the neonatal period was significantly associated with non-optimal neurodevelopmental outcome at 2 years, while severe bronchiolitis was not.

  14. Coping with Fear of Recurrence

    MedlinePlus

    ... With Fear of Recurrence Request Permissions Coping With Fear of Recurrence Approved by the Cancer.Net Editorial ... affects your life. Tips for coping with the fear of recurrence Living with uncertainty is never easy. ...

  15. Chronic granulomatous disease presenting as aseptic ascites in a 2-year-old child.

    PubMed

    Moreau, J F; Ozolek, John A; Lin, P Ling; Green, Todd D; Cassidy, Elaine A; Venkat, Veena L; Buchert, Andrew R

    2013-01-01

    Chronic granulomatous disease (CGD) is a rare inherited immunodeficiency syndrome that results from abnormal nicotinamide adenine dinucleotide phosphate (NADPH) oxidase function. This defect leads to recurrent catalase-positive bacterial and fungal infections as well as associated granuloma formation. We review the case of a 2-year-old boy who presented with ascites and fever of an unknown origin as manifestations of CGD. Cultures were negative for infection throughout his course, and CGD was suspected after identification of granulomas on peritoneal biopsy. Genetic testing revealed a novel mutation in the CYBB gene underlying his condition. This paper highlights the importance of considering CGD in the differential diagnosis of fever of unknown origin and ascites in children.

  16. Management of hereditary gingival fibromatosis: A 2 years follow-up case report

    PubMed Central

    Tripathi, Amitandra Kumar; Dete, Gopal; Saimbi, Charanjeet Singh; Kumar, Vivek

    2015-01-01

    Hereditary gingival fibromatosis (HGF) is a rare hereditary condition characterized by slow, progressive, nonhemorrhagic, fibrous enlargement of gingiva due to increase in sub-mucosal connective tissue component. This paper presents a case report of an 18-year-old female suffering from HGF with positive family history. Her 42-year-old mother also have enlargement of the gums. After through clinical examination of both the patients, routine blood investigation was advised. All the investigations were within normal physiological limits of both the patients. Surgical excision of enlarged gingival tissue was planned after meticulous scaling and root planing. Patients were recalled 1 week after surgery. Postoperative healing were good and desired crown lengthening was achieved with significant improvement in speech and masticatory problems in both the patients. There was no recurrence of the disease even after 2 years follow-up. PMID:26229281

  17. Management of hereditary gingival fibromatosis: A 2 years follow-up case report.

    PubMed

    Tripathi, Amitandra Kumar; Dete, Gopal; Saimbi, Charanjeet Singh; Kumar, Vivek

    2015-01-01

    Hereditary gingival fibromatosis (HGF) is a rare hereditary condition characterized by slow, progressive, nonhemorrhagic, fibrous enlargement of gingiva due to increase in sub-mucosal connective tissue component. This paper presents a case report of an 18-year-old female suffering from HGF with positive family history. Her 42-year-old mother also have enlargement of the gums. After through clinical examination of both the patients, routine blood investigation was advised. All the investigations were within normal physiological limits of both the patients. Surgical excision of enlarged gingival tissue was planned after meticulous scaling and root planing. Patients were recalled 1 week after surgery. Postoperative healing were good and desired crown lengthening was achieved with significant improvement in speech and masticatory problems in both the patients. There was no recurrence of the disease even after 2 years follow-up.

  18. Laparoscopic repair of recurrent groin hernias.

    PubMed

    Felix, E L; Michas, C; McKnight, R L

    1994-06-01

    Between November 1991 and May 1993, 54 recurrent groin hernias were laparoscopically repaired in 50 patients. Forty-eight were men and two were women. Forty-six recurrent hernias were unilateral and four bilateral. Twenty-five were direct, 19 indirect, 10 pantaloon, and two had a femoral component. In only 10 patients was the contralateral side normal. In 27 patients, the other side had been previously repaired, and in 13 they had a new contralateral hernia. A transabdominal preperitoneal technique was used to dissect and repair the entire floor in all patients. A single sheet of polypropylene mesh was used in the repair of the women patients, and a double-buttress technique with the first sheet slitted for the cord was used for the men. Patients were examined every 3 months for the first year and at 6-month intervals thereafter. Follow-up ranged from 1 to 18 months with a mean of 8 months. No patient was lost to follow-up, and no recurrence was observed. Patients returned to normal activity in an average of 1 week. Seroma, which resolved spontaneously, was the most common complication. The overall short-term results suggested that a laparoscopic mesh buttressed repair of recurrent groin hernias is technically feasible and can eliminate early rerecurrence of the hernia so commonly seen after repair of recurrent hernias.

  19. Predictors of Recurrent AKI.

    PubMed

    Siew, Edward D; Parr, Sharidan K; Abdel-Kader, Khaled; Eden, Svetlana K; Peterson, Josh F; Bansal, Nisha; Hung, Adriana M; Fly, James; Speroff, Ted; Ikizler, T Alp; Matheny, Michael E

    2016-04-01

    Recurrent AKI is common among patients after hospitalized AKI and is associated with progressive CKD. In this study, we identified clinical risk factors for recurrent AKI present during index AKI hospitalizations that occurred between 2003 and 2010 using a regional Veterans Administration database in the United States. AKI was defined as a 0.3 mg/dl or 50% increase from a baseline creatinine measure. The primary outcome was hospitalization with recurrent AKI within 12 months of discharge from the index hospitalization. Time to recurrent AKI was examined using Cox regression analysis, and sensitivity analyses were performed using a competing risk approach. Among 11,683 qualifying AKI hospitalizations, 2954 patients (25%) were hospitalized with recurrent AKI within 12 months of discharge. Median time to recurrent AKI within 12 months was 64 (interquartile range 19-167) days. In addition to known demographic and comorbid risk factors for AKI, patients with longer AKI duration and those whose discharge diagnosis at index AKI hospitalization included congestive heart failure (primary diagnosis), decompensated advanced liver disease, cancer with or without chemotherapy, acute coronary syndrome, or volume depletion, were at highest risk for being hospitalized with recurrent AKI. Risk factors identified were similar when a competing risk model for death was applied. In conclusion, several inpatient conditions associated with AKI may increase the risk for recurrent AKI. These findings should facilitate risk stratification, guide appropriate patient referral after AKI, and help generate potential risk reduction strategies. Efforts to identify modifiable factors to prevent recurrent AKI in these patients are warranted.

  20. Proton Therapy for Reirradiation of Progressive or Recurrent Chordoma

    SciTech Connect

    McDonald, Mark W.; Linton, Okechuckwu R.; Shah, Mitesh V.

    2013-12-01

    Purpose: To report the results in patients reirradiated with proton therapy for recurrent or progressive chordoma, with or without salvage surgery. Methods and Materials: A retrospective review of 16 consecutive patients treated from 2005 to 2012 was performed. All patients had received at least 1 prior course of radiation therapy to the same area, and all but 1 patient had at least 1 surgical resection for disease before receiving reirradiation. At the time of recurrence or progression, half of the patients underwent additional salvage surgery before receiving reirradiation. The median prior dose of radiation was 75.2 Gy (range, 40-79.2 Gy). Six patients had received prior proton therapy, and the remainder had received photon radiation. The median gross tumor volume at the time of reirradiation was 71 cm{sup 3} (range, 0-701 cm{sup 3}). Reirradiation occurred at a median interval of 37 months after prior radiation (range, 12-129 months), and the median dose of reirradiation was 75.6 Gy (relative biological effectiveness [RBE]) (range. 71.2-79.2 Gy [RBE]), given in standard daily fractionation (n=14) or hyperfractionation (n=2). Results: The median follow-up time was 23 months (range, 6-63 months); it was 26 months in patients alive at the last follow-up visit (range, 12-63 months). The 2-year estimate for local control was 85%, overall survival 80%, chordoma-specific survival 88%, and development of distant metastases 20%. Four patients have had local progression: 3 in-field and 1 marginal. Late toxicity included grade 3 bitemporal lobe radionecrosis in 1 patient that improved with hyperbaric oxygen, a grade 4 cerebrospinal fluid leak with meningitis in 1 patient, and a grade 4 ischemic brainstem stroke (out of radiation field) in 1 patient, with subsequent neurologic recovery. Conclusions: Full-dose proton reirradiation provided encouraging initial disease control and overall survival for patients with recurrent or progressive chordoma, although additional

  1. Exploring Faculty Retirement Issues in Public 2-Year Institutions

    ERIC Educational Resources Information Center

    Conley, Valerie Martin

    2005-01-01

    Much of the research on faculty retirement focuses exclusively on 4-year institutions. This study fills a gap by describing the age distribution of faculty in public 2-year institutions, the retirement plans of these faculty, and factors related to the retirement decision-making process using data from the 1999 National Study of Postsecondary…

  2. Repetitive Behaviours in Typically Developing 2-Year-Olds

    ERIC Educational Resources Information Center

    Leekam, Susan; Tandos, Jonathan; McConachie, Helen; Meins, Elizabeth; Parkinson, Kathryn; Wright, Charlotte; Turner, Michelle; Arnott, Bronia; Vittorini, Lucia; Le Couteur, Ann

    2007-01-01

    Background: Repetitive behaviours are an essential part of the diagnosis of autism but are also commonly seen in typically developing children. The current study investigated the frequency and factor structure of repetitive behaviours in a large community sample of 2-year-olds. Methods: A new measure, the Repetitive Behaviour Questionnaire (RBQ-2)…

  3. Childhood Bereavement: Psychopathology in the 2 Years Postparental Death

    ERIC Educational Resources Information Center

    Cerel, Julie; Fristad, Mary A.; Verducci, Joseph; Weller, Ronald A.; Weller, Elizabeth B.

    2006-01-01

    Objective: Although the death of a parent is one of the most significant stressors a child can experience, the psychiatric sequelae of parental death are not fully understood. Method: A total of 360 parent-bereaved children (ages 6-17) and their surviving parents were directly interviewed four times during the first 2 years following the death (at…

  4. Triadic Interaction among Newly Acquainted 2-Year-Olds

    ERIC Educational Resources Information Center

    Ishikawa, Fumiko; Hay, Dale F.

    2006-01-01

    Are children as young as 2 years old able to interact in groups of three? The study applied the family triad model first introduced by Parke, Power, and Gottman (1979) to the case of peer interaction. In Experiment 1, the model was refined for use in studies of peer interaction and applied to an existing dataset of 16 triads of newly acquainted…

  5. [Constrictive pericarditis in children under 2 years of age].

    PubMed

    Silva, Lia; Anjos, Rui; Martins, Fernando Maymone; Telo, Margarida

    2002-01-01

    Two cases of constrictive pericarditis, in children under 2 years of age, of non-tuberculosis aetiology, diagnosed from June 97 to May 98 are reported. This entity is rare in paediatrics and it may progress to severe condition. Surgical treatment has a low risk and is generally associated with good prognosis. Aetiology, clinic presentation, differential diagnosis with restrictive cardiomyopathy and treatment are discussed.

  6. Intensity Accents in French 2 Year Olds' Speech.

    ERIC Educational Resources Information Center

    Allen, George D.

    The acoustic features and functions of accentuation in French are discussed, and features of accentuation in the speech of French 2-year-olds are explored. The four major acoustic features used to signal accentual distinctions are fundamental frequency of voicing, duration of segments and syllables, intensity of segments and syllables, and…

  7. Late recurrence of a completely occluded large intracranial aneurysm treated with a Tubridge flow diverter.

    PubMed

    Zhang, Xiaoxi; Lv, Nan; Wang, Chi; Cao, Wei; Liu, Jianmin; Huang, Qinghai

    2017-02-01

    We report a rare case of recurrence of a large intracavernous aneurysm after angiography proved complete occlusion. The aneurysm was treated by a combination of a Tubridge flow diverter and coils, and balloon angioplasty, after flow diverter devices deployment for parent vessel stenosis. Six month angiographic follow-up demonstrated complete occlusion. Unfortunately, obvious aneurysm recurrence was confirmed on 2 year angiographic follow-up. The probable mechanism of recurrence was analyzed.

  8. Multiple nodal locoregional recurrence of pheochromocytoma

    PubMed Central

    Ramírez-Plaza, César Pablo; Cárdenas, Elena Margarita Sanchiz; Humanes, Rocío Soler

    2015-01-01

    Introduction Malignancy is present in 10% of pheochromocytomas (PCC) and is defined as local/vascular infiltration of surrounding tissues or the presence of chromaffin cells deposits in distant organs. The presence of isolated nodal recurrence is very rare and only 7 cases have been reported in the medical literature. Presentation of the case The case of a 32-y male with a symptomatic recurrence of a previously operated (2-years ago) PCC is presented. Radiological and functional imaging studies confirmed the presence of multiple nodules in the surgical site. A radical left nephrectomy with extensive lymphatic clearance in order to get an R0 resection was performed. The pathologist confirmed the diagnosis of massive locoregional nodal invasion. Discussion A detailed histological report and a thorough genetic study must be considered in every operated PCC in order to identify mutations and profiles of risk for malignancy. When recurrence or metastastic disease is suspected, imaging and functional exams are done in order to obtain a proper staging. Radical surgery for the metastatic disease is the only treatment that may provide prolonged survival. If an R0 resection is not possible, then a debulking surgery is a good option when the benefit/risk ratio is acceptable. Conclusion Isolated lymph nodal recurrence is very rare in malignant PCC, with only 7 cases previously published. The role of surgery is essential to get long-term survival because provides clinical and functional control of the disease. PMID:26117450

  9. Unusual underlying cause of recurrent vulval abscess

    PubMed Central

    Dutta, Debarati; Agur, Wael; Macleod, Calum

    2010-01-01

    An ex-intravenous drug user was admitted four times during a 2 year period from December 2006, with the same complaint of vulval abscess which required repeat incision and drainage procedures. In January 2009, a pelvic x-ray showed widening of the symphysis pubis, marginal irregularities, and severe erosive changes which were consistent with pubic osteomyelitis. She was treated with intravenous ciprofloxacin and clindamycin for 2 weeks and was discharged on oral antibiotics for 6 weeks. She recovered well and her condition has significantly improved with no recurrent infection so far. She is now being followed up every 4–6 weeks at the orthopaedics outpatient clinic. PMID:22461858

  10. Isolated humeral recurrence in endometrial carcinoma

    PubMed Central

    Devdas, Santosh Kumar; Digumarti, Leela; Digumarti, Raghunadharao; Patro, Kunha Charan; Nutakki, Ramakoteswararao

    2016-01-01

    Isolated skeletal metastasis in endometrial carcinoma at recurrence is very rare. We report a 52-year-old woman diagnosed to have FIGO Stage 1b, Grade 1 endometrioid adenocarcinoma, presenting with isolated distal humerus metastasis, 2 years after surgery and adjuvant radiotherapy for primary disease. Imaging, bone scintigraphy, and cytology confirmed the diagnosis of poorly differentiated metastatic adenocarcinoma. She was treated with local radiotherapy followed by six cycles of paclitaxel and carboplatin chemotherapy along with zoledronic acid, monthly. She is symptom-free after the treatment and at a first follow-up visit after 3 months. PMID:27688615

  11. Color-Object Interference in Young Children: A Stroop Effect in Children 31/2-61/2 Years Old

    ERIC Educational Resources Information Center

    Prevor, M.B.; Diamond, A.

    2005-01-01

    The Stroop color-word task cannot be administered to children who are unable to read. However, our color-object Stroop task can. One hundred and sixty-eight children of 31/2-61/2 years (50% female; 24 children at each 6-month interval) were shown line drawings of familiar objects in a color that was congruent (e.g., an orange carrot), incongruent…

  12. Recurrent wheezing in children

    PubMed Central

    Piazza, Michele; Piacentini, Giorgio

    2016-01-01

    Recurrent wheezing have a significant morbidity and it’s estimated that about one third of school-age children manifest the symptom during the first 5 years of life. Proper identification of children at risk of developing asthma at school age may predict long-term outcomes and improve treatment and preventive approach, but the possibility to identify these children at preschool age remains limited. For many years authors focused their studies to identify early children with recurrent wheezing at risk to develop asthma at school age. Different phenotypes have been proposed for a more precise characterization and a personalized plan of treatment. The main criticism concerns the inability to define stable phenotypes with the risk of overestimating or underestimating the characteristics of symptoms in these children. The aim of this review is to report the recent developments on the diagnosis and treatment of recurrent paediatric wheezing. PMID:26835404

  13. Recurrence of angular cheilitis.

    PubMed

    Ohman, S C; Jontell, M; Dahlen, G

    1988-08-01

    The incidence of recurrence of angular cheilitis following a successful antimicrobial treatment was studied in 48 patients. Clinical assessments including a microbial examination were carried out 8 months and 5 yr after termination of treatment. Eighty percent of the patients reported recurrence of their angular cheilitis on one or more occasions during the observation period. Patients with cutaneous disorders associated with dry skin or intraoral leukoplakia had an increased incidence of recrudescence. Neither the presence of denture stomatitis nor the type of microorganisms isolated from the original lesions of angular cheilitis, i.e. Candida albicans and/or Staphylococcus aureus, were associated with the number of recurrences. The present observations indicate that treatment of the majority of patients with angular cheilitis should be considered in a longer perspective than previously supposed, due to the short lasting therapeutic effects of the antimicrobial therapy.

  14. Risk of First and Recurrent Stroke in Childhood Cancer Survivors Treated With Cranial and Cervical Radiation Therapy

    SciTech Connect

    Mueller, Sabine; Sear, Katherine; Hills, Nancy K.; Chettout, Nassim; Afghani, Shervin; Gastelum, Erica; Haas-Kogan, Daphne; Fullerton, Heather J.

    2013-07-15

    Purpose: To assess, in a retrospective cohort study, rates and predictors of first and recurrent stroke in patients treated with cranial irradiation (CRT) and/or cervical irradiation at ≤18 years of age. Methods and Materials: We performed chart abstraction (n=383) and phone interviews (n=104) to measure first and recurrent stroke in 383 patients who received CRT and/or cervical radiation at a single institution between 1980 and 2009. Stroke was defined as a physician diagnosis and symptoms consistent with stroke. Incidence of first stroke was number of first strokes per person-years of observation after radiation. We used survival analysis techniques to determine cumulative incidence of first and recurrent stroke. Results: Among 325 subjects with sufficient follow-up data, we identified 19 first strokes (13 ischemic, 4 hemorrhagic, 2 unknown subtype) occurring at a median age of 24 years (interquartile range 17-33 years) in patients treated with CRT. Imaging was reviewed when available (n=13), and the stroke was confirmed in 12. Overall rate of first stroke was 625 (95% confidence interval [CI] 378-977) per 100,000 person-years. The cumulative incidence of first stroke was 2% (95% CI 0.01%-5.3%) at 5 years and 4% (95% CI 2.0%-8.4%) at 10 years after irradiation. With each 100-cGy increase in the radiation dose, the stroke hazard increased by 5% (hazard ratio 1.05; 95% CI 1.01-1.09; P=.02). We identified 6 recurrent strokes; 5 had available imaging that confirmed the stroke. Median time to recurrence was 15 months (interquartile range 6 months-3.2 years) after first stroke. The cumulative incidence of recurrent stroke was 38% (95% CI 17%-69%) at 5 years and 59% (95% CI 27%-92%) at 10 years after first stroke. Conclusion: Cranial irradiation puts childhood cancer survivors at high risk of both first and recurrent stroke. Stroke prevention strategies for these survivors are needed.

  15. Recurrent aphthous stomatitis.

    PubMed

    Akintoye, Sunday O; Greenberg, Martin S

    2014-04-01

    Recurrent aphthous stomatitis (RAS) is the most common ulcerative disease affecting the oral mucosa. RAS occurs mostly in healthy individuals and has an atypical clinical presentation in immunocompromised individuals. The etiology of RAS is still unknown, but several local, systemic, immunologic, genetic, allergic, nutritional, and microbial factors, as well as immunosuppressive drugs, have been proposed as causative agents. Clinical management of RAS using topical and systemic therapies is based on severity of symptoms and the frequency, size, and number of lesions. The goals of therapy are to decrease pain and ulcer size, promote healing, and decrease the frequency of recurrence.

  16. [Recurrent purulent bacterial meningoencephalitis].

    PubMed

    Janeczko, J; Pogorzelska, E; Lipowski, D; Przyjałkowski, W; Rzadkiewicz, E

    2001-01-01

    During the period of 25 years there were 55 patients treated in our Institute because of recurrent purulent bacterial meningoencephalitis(rpbme). This group consisted of 42 males (76%) and 13 (24%) females, the prevalent number (53%) of patients being under 21 years of age. The diagnosis of rpbme was based on the commonly accepted criteria and confirmed by the laboratory results of CSF examination. The cause of the recurrences was established considering the skull X-ray examination, CT and MRI. The evaluation of the clinical status was based on the Glasgow Coma Score (GCS). During the first hospitalisation, severe or critic clinical status was noted in 42 patients (76%) and moderate in 13 (24%). The subsequent recurrences were mostly moderate, rarely severe or mild. The number of recurrences varied from 1 to 9. During the first hospitalisation, the etiologic factor was detected in 39 patients (71%), i.e. Streptococcus pneumoniae in 28 (51%), Neisseria meningitidis in 8 (14%), Pseudomonas aeruginosa and Staphylococcus aureus in 2 and 1 patients respectively. In 37 patients (67%) rpbme developed following cranial trauma, in 18 cases (33%) with single or comminuted fractures of the anterior cranial fossa (in 4 cases accompanied by CSF nasal exsudate). In 4 it followed neurosurgical intervention, in 3 it accompanied recurrent purulent highmorities, in 1 case--after removal of the nasal polyps and subsequent CSF nasal exsudate, and in 1 patient with recurrent mastoiditis. In 6 cases (11%) the cause of the recurrences remained unelucidated. The clinical signs and symptoms, diagnostic difficulties and the causative treatment of rpbme are discussed. In the authors' opinion, surgical treatment of the communication between the CSF and the external environment prevents the recurrences and is the only successful way of treatment. Special attention is drawn to the great diagnostic value of CT and MRI. The use of other modern techniques, e.g. positron emission tomography (PET

  17. Serially recurrent osteoid osteoma.

    PubMed

    Sampath, Srihari C; Sampath, Srinath C; Rosenthal, Daniel I

    2015-06-01

    Osteoid osteoma is a relatively common, benign, painful tumor of bone. It is widely believed to run a course culminating in spontaneous regression. The tumor can usually be eliminated by excision or ablation, although it may recur locally. Although management has classically been surgical, thermocoagulation via percutaneously delivered radiofrequency energy has demonstrated excellent results, typically resulting in durable response following a single treatment. Here, we present an unusual case of serially recurrent pathologically proven pediatric osteoid osteoma, treated by radiofrequency ablation five times over the course of 11 years. Limitations of RF ablation of osteoid osteoma and possible factors predisposing to incomplete treatment or recurrence are discussed.

  18. Recurrent Aphthous Stomatitis

    PubMed Central

    Akintoye, Sunday O.; Greenberg, Martin S.

    2014-01-01

    Recurrent Aphthous Stomatitis (RAS) is the most common ulcerative disease affecting the oral mucosa. It occurs mostly in healthy individuals and has atypical clinical presentation in immunocompromised individuals. The etiology of RAS is still unknown, but several local, systemic, immunologic, genetic, allergic, nutritional, and microbial factors, as well as immunosuppressive drugs, have been proposed as causative agents. Clinical management of RAS is based on severity of symptoms, frequency, size and number of lesions using topical and systemic therapies. The goals of therapy are to decrease pain and ulcer size, promote healing and decrease frequency of recurrence. PMID:24655523

  19. Social competence at 2 years following child traumatic brain injury.

    PubMed

    Anderson, Vicki; Beauchamp, Miriam Helen; Yeates, Keith Owen; Crossley, Louise; Ryan, Nicholas Peter; Hearps, Stephen J C; Catroppa, Cathy

    2017-02-08

    Children with traumatic brain injury (TBI) are at risk of social impairment, but research is yet to document the trajectory of these skills post-injury and factors that may predict social problems. The study addressed these gaps in knowledge, reporting on findings from a prospective, longitudinal follow-up study which investigated social outcomes post injury and explored factors contributing to these outcomes at 2 years post-injury. The sample included 113 children, 74 with TBI and 39 typically developing (TD) controls. TBI participants were recruited on presentation to hospital. Parents rated pre-injury function at that time and all children underwent magnetic resonance imaging (MRI) scan. Participants were followed up at 2 years post-injury. Outcomes were social adjustment, social participation, social relationships, and social cognition. Predictors of social outcomes examined included brain lesion characteristics, child cognition (6 months post-TBI) and behavior and environmental factors (pre-injury and 2 years). Reduced social adjustment (p=.011) and social participation (p<.001) were evident in children with TBI compared to TD controls. Poor social adjustment was predicted by externalizing behaviour problems and younger age at injury. Reduced social participation was linked to internalizing behavior problems. Greater lesion volume, lower socioeconomic status and family burden contributed to poorer social relationships, while age at injury predicted social cognition. Within the TBI group, 23% of children exhibited social impairment: younger age at injury, greater pre-injury and current behavior problems and family dysfunction, poorer IQ, processing speed, and empathy were linked to impairment. Further follow-up is required to track social recovery and the influences of cognition, brain, and environment over time.

  20. Ballpoint pen ingestion in a 2-year-old child.

    PubMed

    Rameau, Anaïs; Anand, Sumeet M; Nguyen, Lily H

    2011-07-01

    A 2-year-old girl ingested a ballpoint pen, which was found on chest x-ray to have lodged in the lower esophagus and stomach. The pen, which measured nearly 15 cm in length, was removed via rigid esophagoscopy without complication. To the best of our knowledge, this is the longest nonflexible foreign body ingested by a young child ever reported in the English-language literature. We describe the presentation of this case and the current guidelines for safety as enumerated in the Small Parts Regulations established by the U.S. Consumer Product Safety Commission.

  1. Rationale for a 'Male Lumpectomy,' a Prostate Cancer Targeted Approach Using Cryoablation: Results in 21 Patients with at Least 2 Years of Follow-Up

    SciTech Connect

    Onik, Gary

    2008-01-15

    Background. Prostate cancer in men raises many of the same issues that breast cancer does in women. Complications of prostate cancer treatment, including impotence and incontinence, affect the self-image and psyche of a man no less than does the loss of a breast in a woman. We present a pilot study in which 21 patients were treated with a focal cryoablation procedure. Methods. Focal cryoablation was performed using biplane transrectal ultrasound if the tumor was confined to only one prostate lobe. Preoperative PSA values were recorded. Cryoablation was planned to encompass the area of known tumor. PSA values were obtained every 3 months for 2 years and every 6 months thereafter. Potency and continence status was obtained at the same intervals. Routine biopsy was obtained at 1 year. Results. Twenty-one patients had focal cryoablation. Follow-up ranged from 24 to 105 months with a mean of 50 months. Twenty of 21 (95%) patients have stable PSA values with no evidence for cancer, despite 10 patients being at medium to high risk for recurrence. All patients biopsied (n = 19) were negative for tumor. Potency was maintained in 17 of 21 patients (80%). No other complications, including incontinence or fistula formation, were noted. Conclusion. These preliminary results indicate a 'male lumpectomy,' in which the prostate tumor region itself is destroyed, appears to preserve potency in a majority of patients and limits other complications, without compromising cancer control. If these results are confirmed by further studies and long-term follow-up, this treatment approach could have a profound effect on prostate cancer management.

  2. Successful resection of metachronous para-aortic, Virchow lymph node and liver metastatic recurrence of rectal cancer.

    PubMed

    Takeshita, Nobuyoshi; Fukunaga, Toru; Kimura, Masayuki; Sugamoto, Yuji; Tasaki, Kentaro; Hoshino, Isamu; Ota, Takumi; Maruyama, Tetsuro; Tamachi, Tomohide; Hosokawa, Takashi; Asai, Yo; Matsubara, Hisahiro

    2015-11-28

    continue capecitabine administration with extension of interval period and dose reduction. After 2 years and 2 mo from starting capecitabine plus bevacizumab regimen, Virchow lymph nodes had slowly grown up to 17 mm. Because no recurrence had been detected besides Virchow lymph nodes for this follow up period, considering the side effects and quality of life, surgical resection was selected. We performed left supraclavicular lymph node dissection. Histological examination revealed moderately differentiated adenocarcinoma as a metastatic rectal cancer. After the fourth operation, the patient selected follow up without chemotherapy. Now we follow up her without recurrence and keep her quality of life high.

  3. On Solving Linear Recurrences

    ERIC Educational Resources Information Center

    Dobbs, David E.

    2013-01-01

    A direct method is given for solving first-order linear recurrences with constant coefficients. The limiting value of that solution is studied as "n to infinity." This classroom note could serve as enrichment material for the typical introductory course on discrete mathematics that follows a calculus course.

  4. Recurrent gallstone ileus.

    PubMed

    Hayes, Nicolas; Saha, Sanjoy

    2012-11-01

    Mechanical small bowel obstructions caused by gallstones account for 1% to 3% of cases. In these patients, 80% to 90% of residual gallstones in these patients will pass through a remaining fistula without consequence. Recurrent gallstone ileus has been reported in 5% of patients. We report the case of a woman, aged 72 years, who presented with mechanical small bowel obstruction caused by gallstone ileus. After successful surgical therapy for gallstone ileus, the patient's symptoms recurred, and she was diagnosed with recurrent gallstone ileus requiring a repeat operation. While management of gallstone ileus can be achieved through a single-stage operation including enterolithotomy and cholecystectomy with repair of biliary-enteric fistula or by enterolithotomy alone, the literature supports enterolithotomy alone as the treatment of choice for gallstone ileus due to decreased mortality and morbidity. However, the latter approach does not obviate potential recurrence. We present this case of recurrent gallstone ileus to elucidate and review the pathogenesis, presentation, diagnosis, and consensus recommendations regarding management of this disorder.

  5. Lung Cancer Indicators Recurrence

    Cancer.gov

    This study describes prognostic factors for lung cancer spread and recurrence, as well as subsequent risk of death from the disease. The investigators observed that regardless of cancer stage, grade, or type of lung cancer, patients in the study were more

  6. A selective IgA deficiency in a boy who presented recurrent parotitis

    PubMed Central

    Patıroglu, T.; Duman, L.

    2014-01-01

    Recurrent parotitis is a non-obstructive, non-suppurative inflammatory disease which is characterized by unilateral or bilateral parotid gland swelling attacks. It is also known as juvenile recurrent parotitis. Although the etiology is unknown, congenital malformations of the ductus, genetic predisposition, infections, allergies, autoimmune diseases, and some immune deficiencies are blamed. Here, we present a case report of recurrent parotitis with selective immunoglobulin A deficiency in a six-year-old boy. The patient was presented to us with a new episode of swelling of left parotid region. In the last 2 years, the patient suffered from recurrent parotitis which lasted for approximately 5 days in ten individual episodes. PMID:24883201

  7. Stereotactic Body Radiation Therapy in Recurrent Hepatocellular Carcinoma

    SciTech Connect

    Huang, Wen-Yen; Jen, Yee-Min; Lee, Meei-Shyuan; Chang, Li-Ping; Chen, Chang-Ming; Ko, Kai-Hsiung; Lin, Kuen-Tze; Lin, Jang-Chun; Chao, Hsing-Lung; Lin, Chun-Shu; Su, Yu-Fu; Fan, Chao-Yueh; Chang, Yao-Wen

    2012-10-01

    Purpose: To examine the safety and efficacy of Cyberknife stereotactic body radiation therapy (SBRT) and its effect on survival in patients of recurrent hepatocellular carcinoma (HCC). Methods and Materials: This was a matched-pair study. From January 2008 to December 2009, 36 patients with 42 lesions of unresectable recurrent HCC were treated with SBRT. The median prescribed dose was 37 Gy (range, 25 to 48 Gy) in 4-5 fractions over 4-5 consecutive working days. Another 138 patients in the historical control group given other or no treatments were selected for matched analyses. Results: The median follow-up time was 14 months for all patients and 20 months for those alive. The 1- and 2-year in-field failure-free rates were 87.6% and 75.1%, respectively. Out-field intrahepatic recurrence was the main cause of failure. The 2-year overall survival (OS) rate was 64.0%, and median time to progression was 8.0 months. In the multivariable analysis of all 174 patients, SBRT (yes vs. no), tumor size ({<=}4 cm vs. >4 cm), recurrent stage (stage IIIB/IV vs. I) and Child-Pugh classification (A vs. B/C) were independent prognostic factors for OS. Matched-pair analysis revealed that patients undergoing SBRT had better OS (2-year OS of 72.6% vs. 42.1%, respectively, p = 0.013). Acute toxicities were mild and tolerable. Conclusion: SBRT is a safe and efficacious modality and appears to be well-tolerated at the dose fractionation we have used, and its use correlates with improved survival in this cohort of patients with recurrent unresectable HCC. Out-field recurrence is the major cause of failure. Further studies of combinations of SBRT and systemic therapies may be reasonable.

  8. Rhythmicity, Recurrence, and Recovery of Flagellar Beating

    NASA Astrophysics Data System (ADS)

    Wan, Kirsty Y.; Goldstein, Raymond E.

    2014-12-01

    The eukaryotic flagellum beats with apparently unfailing periodicity, yet responds rapidly to stimuli. Like the human heartbeat, flagellar oscillations are now known to be noisy. Using the alga C. reinhardtii, we explore three aspects of nonuniform flagellar beating. We report the existence of rhythmicity, waveform noise peaking at transitions between power and recovery strokes, and fluctuations of interbeat intervals that are correlated and even recurrent, with memory extending to hundreds of beats. These features are altered qualitatively by physiological perturbations. Further, we quantify the recovery of periodic breaststroke beating from transient hydrodynamic forcing. These results will help constrain microscopic theories on the origins and regulation of flagellar beating.

  9. Recurrence of gestational diabetes mellitus: rates and risk factors from initial GDM and one abnormal GTT value.

    PubMed

    Nohira, Tomoyoshi; Kim, Seiichi; Nakai, Hiromi; Okabe, Kazuhiro; Nohira, Tomoo; Yoneyama, Kuniyoshi

    2006-01-01

    The recurrence rate of GDM among women in Japan who had GDM or one abnormal value on 75 g oral glucose tolerance test (OAV) during an initial pregnancy is unclear. We therefore sought to determine the recurrence rate and risk factors of recurrent GDM by evaluating 32 patients with GDM and 37 with OAV in their index pregnancies. Medical records and chemical data were compared between patients with and without GDM in their subsequent pregnancies. The recurrence rate from index GDM and OAV were 65.6% and 40.5%. Age, BMI before pregnancy, an increased weight gain between pregnancies and a short interval between pregnancies were risk factors for recurrence from the initial GDM. An increased weight gain between pregnancies and a short interval between pregnancies were risk factors of development to GDM from the initial OAV. We concluded that the control of weight gain and interval between pregnancies could be important to reduce GDM recurrence.

  10. A phonological system at 2 years after cochlear implantation

    PubMed Central

    CHIN, STEVEN B.; PISONI, DAVID B.

    2011-01-01

    This report is a description of a developing phonological system as manifested in the productions of a prelingually deafened child approximately 2 years after fitting with a Nucleus 22-Channel Multi-Electrode Cochlear Implant. A probe list consisting of 23 proper nouns familiar to the child was used to elicit samples of her speech; stimulus materials consisted of photographs of those persons (friends and family members) whose names were included in the probe list. Analysis of the child's productions addressed the composition of the phonetic inventory of consonants and vowels and the presence of syllable structure and other phonotactic constraints. Results indicated a rich inventory of speech sound segments (among both consonants and vowels) and a lack of stringent constraints on syllable structure and consonants permitted in specified word positions. A further comparative analysis of correspondences with the ambient language showed a number of patterns that are also common in the speech of children with normal hearing. PMID:22091697

  11. Langerhans cell histiocytosis in children under 2 years of age.

    PubMed

    Rivera-Luna, R; Alter-Molchadsky, N; Cardenas-Cardos, R; Martínez-Guerra, G

    1996-05-01

    This is a retrospective study of 55 children under the age of 2 years diagnosed with Langerhans cell histiocytosis (LCH). They were classified according to age and organ function and dysfunction following Lahey's criteria. The studied population was divided into four groups by age of diagnosis (0-6, 7-12, 13-18, and 19-24 months). Statistical analysis showed no significant difference in outcome between age groups, although the population under 6 months had a 81.3% fatality rate. The presence of organ dysfunction was a major cause of death in all age groups, being statistically significant in outcome (P > 0.005) compared with patients without organ dysfunction. The presence of thrombocytopenia and/or respiratory dysfunction was also highly associated with a fatal outcome. In the surviving population, no second malignancies have been reported. The late secondary effects of therapy include endocrine, orofacial, and osseous pathologies.

  12. Laser treatment of recurrent herpes labialis: a literature review.

    PubMed

    de Paula Eduardo, Carlos; Aranha, Ana Cecilia Corrêa; Simões, Alyne; Bello-Silva, Marina Stella; Ramalho, Karen Muller; Esteves-Oliveira, Marcella; de Freitas, Patrícia Moreira; Marotti, Juliana; Tunér, Jan

    2014-07-01

    Recurrent herpes labialis is a worldwide life-long oral health problem that remains unsolved. It affects approximately one third of the world population and causes frequent pain and discomfort episodes, as well as social restriction due to its compromise of esthetic features. In addition, the available antiviral drugs have not been successful in completely eliminating the virus and its recurrence. Currently, different kinds of laser treatment and different protocols have been proposed for the management of recurrent herpes labialis. Therefore, the aim of the present article was to review the literature regarding the effects of laser irradiation on recurrent herpes labialis and to identify the indications and most successful clinical protocols. The literature was searched with the aim of identifying the effects on healing time, pain relief, duration of viral shedding, viral inactivation, and interval of recurrence. According to the literature, none of the laser treatment modalities is able to completely eliminate the virus and its recurrence. However, laser phototherapy appears to strongly decrease pain and the interval of recurrences without causing any side effects. Photodynamic therapy can be helpful in reducing viral titer in the vesicle phase, and high-power lasers may be useful to drain vesicles. The main advantages of the laser treatment appear to be the absence of side effects and drug interactions, which are especially helpful for older and immunocompromised patients. Although these results indicate a potential beneficial use for lasers in the management of recurrent herpes labialis, they are based on limited published clinical trials and case reports. The literature still lacks double-blind controlled clinical trials verifying these effects and such trials should be the focus of future research.

  13. Risk Factors for Stone Recurrence after Percutaneous Nephrolithotomy

    NASA Astrophysics Data System (ADS)

    Krambeck, Amy E.; Rangel, Laureano J.; LeRoy, Andrew J.; Patterson, David E.; Gettman, Matthew T.

    2008-09-01

    Recent studies have demonstrated more than 30% of percutaneous nephrolithotomy (PCNL) patients will experience a stone recurrence over a 20 year period. The goal of our study was to identify risk factors for stone recurrence after PCNL. Chart review identified 754 patients treated with PCNL for urolithiasis from March of 1983 to July 1984 at our institution. Of this cohort, 87 patients continued to receive medical care at our clinic and had been evaluated within the last 5 years. Of the 87 patients, 80 had recent radiographic imaging. Average follow-up was 19.2 years and 32 (40.0%) experienced at least 1 stone recurrence. There was no difference in preoperative BMI (p = 0.453) or change in BMI (p = 0.964) between patients that did and did not have a stone recurrence. Renal stone location (p = 0.605) and stone size (p = 0.238) were not predictive of recurrence. Patients with calcium oxalate monohydrate stones were less likely to recur (38.7% vs. 41.6%, p = 0.004) and those with calcium oxalate dihydrate (COD) were more likely to recur (31.1% vs. 19.6%, p = 0.006) compared to other compositions. Diabetes mellitus was not associated with recurrent stones (p = 0.810). Those patients with residual stones or fragments <3 mm were more likely to recur and to recur earlier than patients rendered entirely stone free at time of PCNL (p = 0.015). Stone recurrences were associated with the late development of renal insufficiency (25% vs. 2.1%, p = 0.002). In conclusion, stone composition, as well as the presence of residual fragments was associated with recurrent symptomatic stone events after PCNL. Recurrent stone events were significantly associated with the risk of developing renal insufficiency, further stressing the need for complete stone clearance at time of PCNL.

  14. Long-Term Outcome of a Hepatocellular Carcinoma 71/2 Years After Surgery and Repeated Radiofrequency Ablation: Case Report and Review of the Literature

    SciTech Connect

    Thanos, L. Mylona, S.; Nikita, A.; Ptohis, N.; Kelekis, D.A.

    2007-04-15

    An interesting case is presented of a 78-year-old patient with cirrhosis who was managed with combined treatment (surgery and radiofrequency (RF) ablation) for hepatocellular carcinoma (HCC) and has survived for 71/2 years. Elevation of the {alpha}-FP (alpha-fetoprotein) levels was noted 2 years after surgery. CT demonstrated two lesions: one central at the remaining right liver lobe, and the other at the excision site. Biopsy of the lesions confirmed the diagnosis of HCC for both of them. RF ablation of these two lesions was performed in one session with technical success. Four and a half years after the first RF ablation a new recurrence was demonstrated at the CT follow-up control. RF ablation was again applied successfully. The imaging findings and the therapeutic percutaneous management of this patient along with the natural course of HCC and its recurrence are discussed, and the literature concerning risk factors is reviewed.

  15. Interval hypoxic training.

    PubMed

    Bernardi, L

    2001-01-01

    Interval hypoxic training (IHT) is a technique developed in the former Soviet Union, that consists of repeated exposures to 5-7 minutes of steady or progressive hypoxia, interrupted by equal periods of recovery. It has been proposed for training in sports, to acclimatize to high altitude, and to treat a variety of clinical conditions, spanning from coronary heart disease to Cesarean delivery. Some of these results may originate by the different effects of continuous vs. intermittent hypoxia (IH), which can be obtained by manipulating the repetition rate, the duration and the intensity of the hypoxic stimulus. The present article will attempt to examine some of the effects of IH, and, whenever possible, compare them to those of typical IHT. IH can modify oxygen transport and energy utilization, alter respiratory and blood pressure control mechanisms, induce permanent modifications in the cardiovascular system. IHT increases the hypoxic ventilatory response, increase red blood cell count and increase aerobic capacity. Some of these effects might be potentially beneficial in specific physiologic or pathologic conditions. At this stage, this technique appears interesting for its possible applications, but still largely to be explored for its mechanisms, potentials and limitations.

  16. Chronic recurrent multifocal osteomyelitis.

    PubMed

    Jurik, Anne Grethe

    2004-09-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a clinical entity distinct from bacterial osteomyelitis. It occurs mainly in children and adolescents and is characterized by a prolonged, fluctuating course with recurrent episodes of pain occurring over several years. CRMO is often multifocal and most often seen in tubular bones, the clavicle, and less frequently the spine and pelvic bones; other locations are rare. The radiographic appearance suggests subacute or chronic osteomyelitis. Histopathological and laboratory findings are nonspecific and bacterial culture is usually negative. CRMO is often diagnosed by exclusion of the two main differential diagnoses--bacterial infections and tumor--by assessing for a characteristic course and the findings by conventional radiography, if necessary supplemented by scintigraphy and/or magnetic resonance imaging (MRI). The MRI appearance of CRMO lesions in tubular bones and the spine is often rather characteristic and support the diagnosis. It is important to diagnose CRMO to avoid unnecessary diagnostic procedures and initiate an appropriate therapy.

  17. Chronic recurrent multifocal osteomyelitis.

    PubMed

    Costa-Reis, Patrícia; Sullivan, Kathleen E

    2013-08-01

    Chronic recurrent multifocal osteomyelitis is a rare auto-inflammatory condition that primarily affects children and adolescents. It presents with recurrent episodes of pain related to the presence of foci of sterile bone inflammation. The long bones of the lower extremities are more frequently affected and the spine can also be involved. Imaging studies, including whole-body magnetic resonance, are important for diagnosis and detection of asymptomatic lesions. Bone biopsies may be necessary to exclude other diseases, including malignancy and infections. Non-steroidal anti-inflammatory drugs cause relief of symptoms in the majority of cases. Bisphosphonates and TNF-α blockers are alternatives for patients who do not respond or who have spinal involvement.

  18. Treatment of recurrent concussion.

    PubMed

    McCrory, Paul

    2002-02-01

    The management of an athlete with recurrent concussions, whether persistently symptomatic or not, remains anecdotal. Currently, there are no evidence-based guidelines upon which a team physician can advise the athlete. All doctors involved in athlete care need to be aware of the potential for medicolegal problems if athletes are inappropriately returned to sport prematurely or, in the case of professional athletes, held out of sport or retired on the basis of nonscientific recommendations. This paper discusses such issues.

  19. Chronic recurrent multifocal osteomyelitis.

    PubMed

    Wedman, Jan; van Weissenbruch, Ranny

    2005-01-01

    We report what is, to our best knowledge, the first case of chronic recurrent multifocal osteomyelitis (CRMO) in which the frontal and sphenoid bones were involved. Characterized by a prolonged and fluctuating course of osteomyelitis at different sites, CRMO is self-limited, although sequelae can occur. The diagnosis is one of exclusion. It is important to publish cases like this, because the recognition of CRMO can prevent aggressive surgical and medical treatment.

  20. [Chronic recurrent multifocal osteomyelitis].

    PubMed

    Király, Balázs; Feith, Sándor; Barta, Miklós; Oroszlán, György

    2003-12-21

    The chronic recurrent multifocal osteomyelitis has been reported very rarely in the literature. However, its significance must be emphasized, because it is a spontaneously healing, benign disease, as compared to the classical forms of osteomyelitis. It leaves behind almost no residual symptoms, and many operations, long antimicrobial therapy may be avoided by diagnosing it. In this case report the authors provide the review of the disease through the history of a 9-year-old boy.

  1. Injury risk factors in junior tennis players: a prospective 2-year study.

    PubMed

    Hjelm, N; Werner, S; Renstrom, P

    2012-02-01

    The aim was to investigate injury risk factors in junior tennis players. Fifty-five players, 35 boys and 20 girls, answered a questionnaire about training habits, time of exposure, previous injuries and equipment factors. A battery of clinical tests and functional performance tests were also carried out. All tennis-related injuries that occurred during a 2-year period were identified and recorded. An injury was defined as an injury if it was impossible to participate in regular tennis training or playing matches during at least one occasion, a time loss injury. Potential injury risk factors were tested in a forward stepwise logistic regression model for injury. Thirty-nine players sustained totally 100 new and recurrent injuries. Injuries to the lower extremity were the most common ones (51%) followed by the upper extremity (24%) and the trunk (24%). Injured players performed more singles per week (P<0.0001) and played more tennis hours per year (P=0.016) than the uninjured players. Playing tennis more than 6 h/week was found to be a risk factor for back pain. A previous injury regardless of location was identified as an injury risk factor, and a previous injury to the back was a risk factor for back pain.

  2. Myeloablative chemotherapy for recurrent aggressive oligodendroglioma.

    PubMed Central

    Cairncross, G.; Swinnen, L.; Bayer, R.; Rosenfeld, S.; Salzman, D.; Paleologos, N.; Kaminer, L.; Forsyth, P.; Stewart, D.; Peterson, K.; Hu, W.; Macdonald, D.; Ramsay, D.; Smith, A.

    2000-01-01

    The objective of this study was to ascertain the duration of tumor control and the toxicities of dose-intense myeloablative chemotherapy for patients with recurrent oligodendrogliomas. Patients with previously irradiated oligodendrogliomas, either pure or mixed, that were contrast enhancing, measurable, and behaving aggressively at recurrence were eligible for this study. Only complete responders or major partial responders (75 % reduction in tumor size) to induction chemotherapy--either intensive-dose procarbazine, lomustine, and vincristine or cisplatin plus etoposide-could receive high-dose thiotepa (300 mg/m2/day for 3 days) followed by hematopoietic reconstitution using either bone marrow or peripheral blood stem cells. Thirty-eight patients began induction chemotherapy and 20 (10 men, 10 women; median age 46 years; median Karnofsky score 80) received high-dose thiotepa. For the high-dose group, the median event-free, progression-free, and overall survival times from recurrence were 17, 20, and 49 months, respectively. Tumor control in excess of 2 years was observed in 6 patients (30%). Four patients (20%) are alive and tumor free 27 to 77 months (median, 42 months) from the start of induction therapy; however, fatal treatment-related toxicities also occurred in 4 patients (20%). Three patients died as a result of a progressive encephalopathy which, in 2 instances, was accompanied by a wasting syndrome; 1 patient died as a consequence of an intracerebral (intratumoral) hemorrhage. Fatal toxicities occurred in patients with pretreatment Karnofsky scores of 60 or 70. High-dose thiotepa to consolidate response was a disappointing treatment strategy for patients with recurrent aggressive oligodendroglial neoplasms, although several patients had durable responses. Moreover, as prescribed, high-dose thiotepa had significant toxic effects in previously irradiated patients, especially those with poorer performance status. PMID:11303620

  3. New geoscience teachers division for 2-year colleges

    NASA Astrophysics Data System (ADS)

    Krumm, Debra; Granshaw, Frank

    2011-11-01

    The role of 2-year colleges (2YCs) in geoscience education is growing as the number of students enrolled in Earth and space science courses increases and as these institutions—which include community colleges and junior colleges—provide more students majoring in geoscience at public universities. In recognition of the increasing role of 2YCs in geoscience education, the National Association of Geoscience Teachers (NAGT) recently created a Geo2YC division for faculty, administrators, graduate students, and other geoscience professionals who share a professional interest in geoscience education at 2YCs. The mission of the new division, which is NAGT's first national division, is to serve as a forum for exchanging curricular ideas, concerns, and resources; establish a network of geoscience educators at 2YCs and other institutions with shared interests; sponsor NAGT 2YC activities and make recommendations to the NAGT Council in support of 2YC geoscience education; support and coordinate research on 2YC geoscience education; and advocate for 2YC geoscience education within NAGT and with other organizations.

  4. Tacrolimus ointment: utilization patterns in children under age 2 years.

    PubMed

    Housman, Tamara Salam; Norton, Amy B; Feldman, Steven R; Fleischer, Alan B; Simpson, Eric L; Hanifin, Jon M; Antaya, Richard J

    2004-07-15

    Atopic dermatitis (AD) is a common eczematous skin condition; as many as 10-17 percent of all children are affected, and 35-60 percent of affected patients manifest symptoms manifest during the first year of life. Treatment principles for AD in young children involve conservative measures such as avoidance of hot water and environmental irritants, combined with liberal use of emollients after bathing. Low potency topical corticosteroids (TCS) are the current standard of therapy for AD in young children, reserving mid- and high-potency TCS for severe disease. However, complications of long-term use of TCS include skin atrophy, stria formation, telangiectasia, hypopigmentation, secondary infections, steroid acne, allergic contact dermatitis, and miliaria. The pediatric population is also at increased risk for systemic absorption because of their high ratio of skin surface to body mass. Systemic absorption may result in hypothalamic-pituitary-adrenal axis suppression and ultimately growth retardation. Although most topical and systemic corticosteroids are not approved by the Food and Drug Administration for use in children less than 2 years of age, conservative treatment often fails in this age group and frequently patients are treated with TCS, antibiotics, and antihistamines.

  5. Cost and Schedule Analytical Techniques Development: Option 2 Year

    NASA Technical Reports Server (NTRS)

    1997-01-01

    This Final Report summarizes the activities performed by Science Applications International Corporation (SAIC) for the Option 2 Year from December 1, 1996 through November 30, 1997. The Final Report is in compliance with Paragraph 5 of Section F of the contract. This CSATD contract provides products and deliverable in the form of models, data bases, methodologies, studies and analyses for the NASA Marshall Space Flight Center's (MSFC) Engineering Cost Office (PPO3) the Program Plans and Requirements Officer (PP02), and other user organizations. Detailed Monthly Progress reports were submitted to MSFC in accordance with the contract's Statement of Work, Section TV "Reporting and Documentation". These reports spelled out each month's specific work accomplishments, deliverables submitted, major meetings held, and other pertinent information. This Final Report will summarize these activities at higher level. During this contract Option Year, SAIC expended 29,830 man-hours in tile performance of tasks called out in the Statement of Work and reported oil in this yearly Final Report. This represents approximately 16 full-time EPs. Included are the basis Huntsville-based team, plus SAIC specialists in San Diego, Ames Research Center, Chicago, and Colorado Springs performing specific tasks for which they are uniquely qualified.

  6. Laparoscopic repair of recurrent hernias.

    PubMed

    Felix, E L; Michas, C A; McKnight, R L

    1995-02-01

    The purpose of this study was to evaluate the results of a laparoscopic approach to recurrent inguinal hernia repair which dissected the entire inguinal floor and repaired all potential areas of recurrence without producing tension. Both a transabdominal preperitoneal and a totally extraperitoneal laparoscopic approach were utilized. Ninety recurrent hernias were repaired in 81 patients. The patients had 26 indirect, 36 direct, and 26 pantaloon recurrent hernias of which eight had a femoral component. In all but one patient the primary operations were open anterior repairs. The median follow-up was 14 months, ranging from 1 to 28 months. Patients returned to normal activities in an average of 1 week. The only recurrence observed was in the one patient whose primary repair was laparoscopic. When the entire inguinal floor of the recurrent hernia was redissected and buttressed with mesh, early recurrence was eliminated and recovery was shortened.

  7. The causes of recurrent geomagnetic storms

    NASA Technical Reports Server (NTRS)

    Burlaga, L. F.; Lepping, R. P.

    1976-01-01

    The causes of recurrent geomagnetic activity were studied by analyzing interplanetary magnetic field and plasma data from earth-orbiting spacecraft in the interval from November 1973 to February 1974. This interval included the start of two long sequences of geomagnetic activity and two corresponding corotating interplanetary streams. In general, the geomagnetic activity was related to an electric field which was due to two factors: (1) the ordered, mesoscale pattern of the stream itself, and (2) random, smaller-scale fluctuations in the southward component of the interplanetary magnetic field Bz. The geomagnetic activity in each recurrent sequence consisted of two successive stages. The first stage was usually the most intense, and it occurred during the passage of the interaction region at the front of a stream. These large amplitudes of Bz were primarily produced in the interplanetary medium by compression of ambient fluctuations as the stream steepened in transit to 1 A.U. The second stage of geomagnetic activity immediately following the first was associated with the highest speeds in the stream.

  8. Minimax confidence intervals in geomagnetism

    NASA Technical Reports Server (NTRS)

    Stark, Philip B.

    1992-01-01

    The present paper uses theory of Donoho (1989) to find lower bounds on the lengths of optimally short fixed-length confidence intervals (minimax confidence intervals) for Gauss coefficients of the field of degree 1-12 using the heat flow constraint. The bounds on optimal minimax intervals are about 40 percent shorter than Backus' intervals: no procedure for producing fixed-length confidence intervals, linear or nonlinear, can give intervals shorter than about 60 percent the length of Backus' in this problem. While both methods rigorously account for the fact that core field models are infinite-dimensional, the application of the techniques to the geomagnetic problem involves approximations and counterfactual assumptions about the data errors, and so these results are likely to be extremely optimistic estimates of the actual uncertainty in Gauss coefficients.

  9. Multiscale recurrence quantification analysis of order recurrence plots

    NASA Astrophysics Data System (ADS)

    Xu, Mengjia; Shang, Pengjian; Lin, Aijing

    2017-03-01

    In this paper, we propose a new method of multiscale recurrence quantification analysis (MSRQA) to analyze the structure of order recurrence plots. The MSRQA is based on order patterns over a range of time scales. Compared with conventional recurrence quantification analysis (RQA), the MSRQA can show richer and more recognizable information on the local characteristics of diverse systems which successfully describes their recurrence properties. Both synthetic series and stock market indexes exhibit their properties of recurrence at large time scales that quite differ from those at a single time scale. Some systems present more accurate recurrence patterns under large time scales. It demonstrates that the new approach is effective for distinguishing three similar stock market systems and showing some inherent differences.

  10. Recurrent brachial plexus neuropathy.

    PubMed

    Bradley, W G; Madrid, R; Thrush, D C; Campbell, M J

    1975-09-01

    The clinical, electrophysiological and pathological changes in 3 patients with recurrent attacks of non-traumatic brachial plexus neuropathy have been described. Two had recurrent attacks and a dominant family history of similar attacks, together with evidence of lesser degrees of nerve involvement outside the brachial plexus. In one patient the attacks were moderately painful, while in the other there was little or no pain. Only one showed undue slowing of motor nerve conduction during ischaemia, but in both cases the sural nerves had the changes of tomaculous neuropathy, with many sausage-shaped swellings of the myelin sheaths, and extensive segmental demyelination and remyelination. The third patient had two attacks of acute brachial plexus neuropathy which were both extremely painful. The clinical features were compatible with a diagnosis of neuralgic amuotrophy. In the second attack, there was vagus nerve involvement and the sural nerve showed evidence of healed extensive segmental demyelination. The various syndromes presenting with acute non-traumatic brachial plexus neuropathy are reviewed, and a tentative nonsological classification advanced. Most patients fall into the category of acute, painful paralysis with amyotrophy, with no family history and no evidence of lesions outside the brachial plexus. It is suggested that the term "neuralgic amyotrophy" be restricted to this group. Patients with features outside this clinical picture probably suffer from other disease entities presenting with brachial plexus neuropathy. The familial cases constitute one or more aetioliogical subgroups, differing from neuralgic amyotrophy in the frequency of recurrences, the relative freedom from pain in the attacks, the frequency of nerve lesions outside the brachial plexus, and of hypotelorism. Individual attacks of acute brachial plexus neuropathy, however, may be identical in patients with the different diseases, and further pathological and biochemical studies are

  11. Randomized Controlled Trial of Forward-Planned Intensity Modulated Radiotherapy for Early Breast Cancer: Interim Results at 2 Years

    SciTech Connect

    Barnett, Gillian C.; Wilkinson, Jennifer S.; Moody, Anne M.; Wilson, Charles B.; Twyman, Nicola; Wishart, Gordon C.; Burnet, Neil G.; Coles, Charlotte E.

    2012-02-01

    Purpose: This single-center randomized trial was designed to investigate whether intensity-modulated radiotherapy (IMRT) reduces late toxicity in patients with early-stage breast cancer. Methods and Materials: The standard tangential plans of 1,145 nonselected patients were analyzed. The patients with inhomogeneous plans were randomized to a simple method of forward-planned IMRT or standard radiotherapy (RT). The primary endpoint was serial photographic assessment of breast shrinkage. Results: At 2 years, no significant difference was found in the development of any photographically assessed breast shrinkage between the patients randomized to the interventional or control group (odds ratio, 1.51; 95% confidence interval, 0.83-1.58; p = .41). The patients in the control group were more likely to develop telangiectasia than those in the IMRT group (odds ratio, 1.68; 95% confidence interval 1.13-2.40; p = .009). Poor baseline surgical cosmesis resulted in poor overall cosmesis at 2 years after RT. In patients who had good surgical cosmesis, those randomized to IMRT were less likely to deteriorate to a moderate or poor overall cosmesis than those in the control group (odds ratio, 0.63; 95% confidence interval, 0.39-1.03, p = .061). Conclusions: IMRT can lead to a significant reduction in telangiectasia at comparatively early follow-up of only 2 years after RT completion. An important component of breast induration and shrinkage will actually result from the surgery and not from the RT. Surgical cosmesis is an important determinant of overall cosmesis and could partially mask the longer term benefits of IMRT at this early stage.

  12. Recurrent tarsal tunnel syndrome.

    PubMed

    Gould, John S

    2014-09-01

    Recurrence of tarsal tunnel syndrome after surgery may be due to inadequate release, lack of understanding or appreciation of the actual anatomy involved, variations in the anatomy of the nerve(s), failure to execute the release properly, bleeding with subsequent scarring, damage to the nerve and branches, persistent hypersensitivity of the nerves, and preexisting intrinsic damage to the nerve. Approaches include more thorough release, use of barrier materials to decrease adherence of the nerve to surrounding tissues to avoid traction neuritis, excisions of neuromas using conduits, and consideration of nerve stimulators and systemic medications to deal with persistent neural pain.

  13. Recurrent respiratory papillomatosis.

    PubMed

    Venkatesan, Naren N; Pine, Harold S; Underbrink, Michael P

    2012-06-01

    Recurrent respiratory papillomatosis (RRP) is a rare, benign disease with no known cure. RRP is caused by infection of the upper aerodigestive tract with the human papillomavirus (HPV). Passage through the birth canal is thought to be the initial transmission event, but infection may occur in utero. HPV vaccines have helped to provide protection from cervical cancer; however, their role in the prevention of RRP is undetermined. Clinical presentation of initial symptoms of RRP may be subtle. RRP course varies, and current management focuses on surgical debulking of papillomatous lesions with or without concurrent adjuvant therapy.

  14. Recurrent acute pancreatitis.

    PubMed

    Khurana, Vishal; Ganguly, Ishita

    2014-09-28

    Recurrent acute pancreatitis (RAP) is commonly encountered, but less commonly understood clinical entity, especially idiopathic RAP, with propensity to lead to repeated attacks and may be chronic pancreatitis if attacks continue to recur. A great number of studies have been published on acute pancreatitis, but few have focused on RAP. Analysing the results of clinical studies focusing specifically on RAP is problematic in view due to lack of standard definitions, randomised clinical trials, standard evaluation protocol used and less post intervention follow-up duration. With the availability of newer investigation modalities less number of etiologies will remains undiagnosed. This review particularly is focused on the present knowledge in understanding of RAP.

  15. Parent-reported appetite of a child and the child's weight status over a 2-year period in Korean children.

    PubMed

    Lee, Kayoung; Song, Yun-Mi

    2007-04-01

    This study sought to examine the association between the parent-reported appetite of a child and the child's weight status after 2 years. The design was a 2-year prospective study. A total of 531 Korean children aged 11 to 12 years were followed up for change in weight status (persistent overweight, persistent nonoverweight, recently overweight, recently nonoverweight) between 2001 and 2003 after the measurement of their appetite (low, moderate, and high) using a questionnaire administered to their parents in 2001. Weight status of each child was determined based on the criteria of body mass index (BMI) recommended by the International Obesity Task Force reference. The statistical analyses performed were multiple logistic regression analysis with adjustment for parental factors (parents' weight and height, education level, and income) and the child's characteristics (baseline BMI, physical activity, and television viewing). Main outcome measures were child's mean BMI and weight status, and the proportions of overweight children at the baseline and at the end of the follow-up were greater among those children whose parents reported that they had high appetites (P<0.001). Compared with the children with a low appetite, the odds ratio for overweight at the end of follow-up was 3.7 (95% confidence interval 1.2 to 11.7) in children with a high appetite. Subgroup analysis of overweight children at baseline showed that the risk of being persistently overweight over the 2-year follow-up was 5.5 times (95% confidence interval 1.1 to 27.5) higher in children with a high appetite than in those with a low appetite. There was a strong association between the parent-reported appetite of a child and being overweight after 2 years. Identifying children with higher appetites and targeting them for lifestyle modification may provide an effective way of reducing the incidence of childhood overweight.

  16. Temporal binding of interval markers

    PubMed Central

    Derichs, Christina; Zimmermann, Eckart

    2016-01-01

    How we estimate the passage of time is an unsolved mystery in neuroscience. Illusions of subjective time provide an experimental access to this question. Here we show that time compression and expansion of visually marked intervals result from a binding of temporal interval markers. Interval markers whose onset signals were artificially weakened by briefly flashing a whole-field mask were bound in time towards markers with a strong onset signal. We explain temporal compression as the consequence of summing response distributions of weak and strong onset signals. Crucially, temporal binding occurred irrespective of the temporal order of weak and strong onset markers, thus ruling out processing latencies as an explanation for changes in interval duration judgments. If both interval markers were presented together with a mask or the mask was shown in the temporal interval center, no compression occurred. In a sequence of two intervals, masking the middle marker led to time compression for the first and time expansion for the second interval. All these results are consistent with a model view of temporal binding that serves a functional role by reducing uncertainty in the final estimate of interval duration. PMID:27958311

  17. Effect Sizes, Confidence Intervals, and Confidence Intervals for Effect Sizes

    ERIC Educational Resources Information Center

    Thompson, Bruce

    2007-01-01

    The present article provides a primer on (a) effect sizes, (b) confidence intervals, and (c) confidence intervals for effect sizes. Additionally, various admonitions for reformed statistical practice are presented. For example, a very important implication of the realization that there are dozens of effect size statistics is that "authors must…

  18. Autologous serum and plasma skin test to predict 2-year outcome in chronic spontaneous urticaria

    PubMed Central

    Sangasapaviliya, Atik

    2016-01-01

    Background Autologous serum skin test (ASST) and autologous plasma skin test (APST) are simple methods to diagnose autoimmune chronic urticaria. However, the association data of ASST or APST with disease severity and long-term outcome are still unclear. Objective The results of ASST and APST might be used to predict urticaria symptom severity and long-term outcomes among chronic spontaneous urticaria (CSU) patients. Methods We evaluated the prevalence of reactive ASST and APST in 128 CSU patients. The patients were characterized by 4 groups: negative, ASST positive, APST positive, and both ASST and APST positive. We observed remission rate among the CSU patients during 2 years. Results Forty-four of 128 CSU patients (34%) had negative autologous skin test. The CSU patients with positive ASST, positive APST, and both positive ASST and APST were 47 (37%), 6 (5%), and 31 (24%), respectively. No significant difference was found between the groups according to urticaria severity score (USS) and dermatology life quality index (DLQI). Mean wheal diameter of ASST showed positive correlation with DLQI. Also, mean wheal diameter of APST showed positive correlation with USS and DLQI. Both the positive ASST and APST groups had a high proportion of 4-fold dose of H1-antihistamine than the positive ASST (p = 0.03) and negative groups (p = 0.0009). The rate of remission over 2 years in the negative, positive ASST, positive APST, and both positive ASST and APST groups were 81.1%, 62.3%, 60%, and 46.1%, respectively. The urticaria remission rate in patients in the negative group was significantly higher compared with both positive ASST and APST groups (odds ratio, 5.0; 95% confidence interval, 1.61–15.44; p = 0.006). Conclusion ASST and APST results could predict remission rates among patients with CSU. Our results suggested investigating ASST and APST among CSU patients before starting treatment. PMID:27803883

  19. [Chronic recurrent parotitis].

    PubMed

    Zenk, J; Koch, M; Klintworth, N; Iro, H

    2010-03-01

    Chronic recurrent parotitis is a non-obstructive disease with episodes of mostly painful swelling of the gland. It is categorized into a juvenile and an adult form, even without clear information on its actual origin. As to the etiology of the juvenile form, genetic factors and duct malformations as well as bacterial infections are discussed. Very rarely a complete lymphatic transformation of the gland might take place. Juvenile chronic recurrent parotitis is self-limiting in about 90% of all cases, as patients grow up. The diagnosis is based on patient history and clinical findings. Sonography is the imaging method of choice. Sialendoscopy shows a typical whitish pattern of the ducts in juvenile disease. Strictures or stenoses are typical for the adult form. The therapy of choice is gland massage and sialagogues, in addition to the administration of antibiotics. In more severe cases sialendoscopy together with rinsing of the ducts and instillation of cortisone are indicated. Total parotidectomy remains the last choice and is rarely necessary.

  20. Higher Tetanus Toxoid Immunity 2 Years After PsA-TT Introduction in Mali

    PubMed Central

    Basta, Nicole E.; Borrow, Ray; Berthe, Abdoulaye; Onwuchekwa, Uma; Dembélé, Awa Traoré Eps; Almond, Rachael; Frankland, Sarah; Patel, Sima; Wood, Daniel; Nascimento, Maria; Manigart, Olivier; Trotter, Caroline L.; Greenwood, Brian; Sow, Samba O.

    2015-01-01

    Background. In 2010, mass vaccination with a then-new meningococcal A polysaccharide–tetanus toxoid protein conjugate vaccine (PsA-TT, or MenAfriVac) was undertaken in 1- to 29-year-olds in Bamako, Mali. Whether vaccination with PsA-TT effectively boosts tetanus immunity in a population with heterogeneous baseline tetanus immunity is not known. We assessed the impact of PsA-TT on tetanus toxoid (TT) immunity by quantifying age- and sex-specific immunity prior to and 2 years after introduction. Methods. Using a household-based, age-stratified design, we randomly selected participants for a prevaccination serological survey in 2010 and a postvaccination survey in 2012. TT immunoglobulin G (IgG) antibodies were quantified and geometric mean concentrations (GMCs) pre- and postvaccination among all age groups targeted for vaccination were compared. The probability of TT IgG levels ≥0.1 IU/mL (indicating short-term protection) and ≥1.0 IU/mL (indicating long-term protection) by age and sex was determined using logistic regression models. Results. Analysis of 793 prevaccination and 800 postvaccination sera indicated that while GMCs were low pre–PsA-TT, significantly higher GMCs in all age–sex strata were observed 2 years after PsA-TT introduction. The percentage with short-term immunity increased from 57.1% to 88.4% (31.3-point increase; 95% confidence interval [CI], 26.6–36.0;, P < .0001) and with long-term immunity increased from 20.0% to 58.5% (38.5-point increase; 95% CI, 33.7–43.3; P < .0001) pre- and postvaccination. Conclusions. Significantly higher TT immunity was observed among vaccine-targeted age groups up to 2 years after Mali's PsA-TT mass vaccination campaign. Our results, combined with evidence from clinical trials, strongly suggest that conjugate vaccines containing TT such as PsA-TT should be considered bivalent vaccines because of their ability to boost tetanus immunity. PMID:26553691

  1. Comparison of 2-year clinical outcomes between diabetic versus nondiabetic patients with acute myocardial infarction after 1-month stabilization

    PubMed Central

    Hur, Seung-Ho; Won, Ki-Bum; Kim, In-Cheol; Bae, Jang-Ho; Choi, Dong-Ju; Ahn, Young-Keun; Park, Jong-Seon; Kim, Hyo-Soo; Choi, Rak-Kyeong; Choi, Donghoon; Kim, Joon-Hong; Han, Kyoo-Rok; Park, Hun-Sik; Choi, So-Yeon; Yoon, Jung-Han; Gwon, Hyeon-Cheol; Rha, Seung-Woon; Jang, Wooyeong; Bae, Jang-Whan; Hwang, Kyung-Kuk; Lim, Do-Sun; Jung, Kyung-Tae; Oh, Seok-Kyu; Lee, Jae-Hwan; Shin, Eun-Seok; Kim, Kee-Sik

    2016-01-01

    Abstract This study assessed the 2-year clinical outcomes of patients with diabetes mellitus (DM) after acute myocardial infarction (AMI) in a cohort of the DIAMOND (DIabetic Acute Myocardial infarctiON Disease) registry. Clinical outcomes were compared between 1088 diabetic AMI patients in the DIAMOND registry after stabilization of MI and 1088 nondiabetic AMI patients from the KORMI (Korean AMI) registry after 1 : 1 propensity score matching using traditional cardiovascular risk factors. Stabilized patients were defined as patients who did not have any clinical events within 1 month after AMI. Primary outcomes were the 2-year rate of major adverse cardiac events (MACEs), a composite of all-cause death, recurrent MI (re-MI), and target vessel revascularization (TVR). Matched comparisons revealed that diabetic patients exhibited significantly lower left ventricular ejection fraction (LVEF) and estimated glomerular filtration rate and smaller stent size. Diabetic patients exhibited significantly higher 2-year rates of MACE (8.0% vs 3.7%), all-cause death (3.9% vs 1.4%), re-MI (2.8% vs 1.2%), and TVR (3.5% vs 1.3%) than nondiabetic patients (all P < 0.01), and higher cumulative rates in Kaplan–Meier analyses of MACE, all-cause death, and TVR (all P < 0.05). A multivariate Cox regression analysis revealed that chronic kidney disease, LVEF < 35%, and long stent were independent predictors of MACE, and large stent diameter and the use of drug-eluting stents were protective factors against MACE. The 2-year MACE rate beyond 1 month after AMI was significantly higher in DM patients than non-DM patients, and this rate was associated with higher comorbidities, coronary lesions, and procedural characteristics in DM. PMID:27336875

  2. Recurrence theorems: A unified account

    SciTech Connect

    Wallace, David

    2015-02-15

    I discuss classical and quantum recurrence theorems in a unified manner, treating both as generalisations of the fact that a system with a finite state space only has so many places to go. Along the way, I prove versions of the recurrence theorem applicable to dynamics on linear and metric spaces and make some comments about applications of the classical recurrence theorem in the foundations of statistical mechanics.

  3. Automatic Error Analysis Using Intervals

    ERIC Educational Resources Information Center

    Rothwell, E. J.; Cloud, M. J.

    2012-01-01

    A technique for automatic error analysis using interval mathematics is introduced. A comparison to standard error propagation methods shows that in cases involving complicated formulas, the interval approach gives comparable error estimates with much less effort. Several examples are considered, and numerical errors are computed using the INTLAB…

  4. Children's Discrimination of Melodic Intervals.

    ERIC Educational Resources Information Center

    Schellenberg, E. Glenn; Trehub, Sandra E.

    1996-01-01

    Adults and children listened to tone sequences and were required to detect changes either from intervals with simple frequency ratios to intervals with complex ratios or vice versa. Adults performed better on changes from simple to complex ratios than on the reverse changes. Similar performance was observed for 6-year olds who had never taken…

  5. Interval Recognition in Minimal Context.

    ERIC Educational Resources Information Center

    Shatzkin, Merton

    1984-01-01

    Music majors were asked to identify interval when it was either preceded or followed by a tone moving in the same direction. Difficulties in interval recognition in context appear to be an effect not just of placement within the context or of tonality, but of particular combinations of these aspects. (RM)

  6. Teaching Confidence Intervals Using Simulation

    ERIC Educational Resources Information Center

    Hagtvedt, Reidar; Jones, Gregory Todd; Jones, Kari

    2008-01-01

    Confidence intervals are difficult to teach, in part because most students appear to believe they understand how to interpret them intuitively. They rarely do. To help them abandon their misconception and achieve understanding, we have developed a simulation tool that encourages experimentation with multiple confidence intervals derived from the…

  7. Explorations in Statistics: Confidence Intervals

    ERIC Educational Resources Information Center

    Curran-Everett, Douglas

    2009-01-01

    Learning about statistics is a lot like learning about science: the learning is more meaningful if you can actively explore. This third installment of "Explorations in Statistics" investigates confidence intervals. A confidence interval is a range that we expect, with some level of confidence, to include the true value of a population parameter…

  8. Comprehensive Locoregional Treatment and Systemic Therapy for Postmastectomy Isolated Locoregional Recurrence

    SciTech Connect

    Kuo, S.-H.; Huang, C.-S.; Kuo, W.-H.; Cheng, A.-L.; Chang, K.-J.; Chia-Hsien Cheng, Jason

    2008-12-01

    Purpose: To assess the impact of comprehensive locoregional therapy and systemic therapy on disease control and survival for postmastectomy patients with isolated locoregional recurrence (ILRR). Methods and Materials: A total of 115 postmastectomy breast cancer patients treated for ILRR were included. Of the patients, 98 underwent comprehensive locoregional treatment (local tumor excision plus postoperative radiotherapy), and 17 received definitive radiotherapy alone. Involved-field radiotherapy was given to 69 patients, whereas entire-field radiotherapy (both involved-field and elective-field, involving the chest wall and regional lymphatics) was given to 46 patients. Systemic therapy consisting of hormone therapy, chemotherapy, or both was given to 69% of patients. Results: Patients treated with comprehensive locoregional treatment had a significantly better 5-year invasive disease-free survival (IDFS) and overall survival (OS) after ILRR than patients treated with definitive radiotherapy alone (IDFS rate, 51% vs. 16%, p = 0.006; OS rate, 62% vs. 37%, p = 0.017). Patients with the most comprehensive locoregional treatment (recurrent tumor excision and entire-field radiotherapy) and systemic therapy had a significantly better 5-year IDFS and OS than patients given either treatment or neither treatment (IDFS rate, 52% vs. 39%, p = 0.011; OS rate, 63% vs. 50%, p = 0.026). Multivariate analysis revealed that positive axillary lymph nodes, Grade III tumor, negative estrogen and progesterone receptor status at primary diagnosis, disease-free interval of less than 2 years, and less comprehensive locoregional treatment were significantly associated with worse IDFS and OS. Conclusions: Use of comprehensive locoregional therapy and systemic therapy can achieve good survival outcome in a substantial proportion of postmastectomy patients with ILRR.

  9. VARIABLE TIME-INTERVAL GENERATOR

    DOEpatents

    Gross, J.E.

    1959-10-31

    This patent relates to a pulse generator and more particularly to a time interval generator wherein the time interval between pulses is precisely determined. The variable time generator comprises two oscillators with one having a variable frequency output and the other a fixed frequency output. A frequency divider is connected to the variable oscillator for dividing its frequency by a selected factor and a counter is used for counting the periods of the fixed oscillator occurring during a cycle of the divided frequency of the variable oscillator. This defines the period of the variable oscillator in terms of that of the fixed oscillator. A circuit is provided for selecting as a time interval a predetermined number of periods of the variable oscillator. The output of the generator consists of a first pulse produced by a trigger circuit at the start of the time interval and a second pulse marking the end of the time interval produced by the same trigger circuit.

  10. Abemaciclib in Children With DIPG or Recurrent/Refractory Solid Tumors

    ClinicalTrials.gov

    2017-02-10

    Diffuse Intrinsic Pontine Glioma; Brain Tumor, Recurrent; Solid Tumor, Recurrent; Neuroblastoma, Recurrent, Refractory; Ewing Sarcoma, Recurrent, Refractory; Rhabdomyosarcoma, Recurrent, Refractory; Osteosarcoma, Recurrent, Refractory; Rhabdoid Tumor, Recurrent, Refractory

  11. Body weight loss as an indicator of breast cancer recurrence.

    PubMed

    Marinho, L A; Rettori, O; Vieira-Matos, A N

    2001-01-01

    Body weight loss (BWL), a major prognostic factor in breast cancer, was included as a parameter to be monitored in the recent breast cancer surveillance guidelines of the American Society of Clinical Oncology. The aim of this work was prospectively to evaluate BWL as an indicator of breast cancer recurrence. Body weight was measured every 2 months for 10.4+/-3.7 (SD) months in 109 disease-free breast cancer patients in stage II node-positive and stage III disease. The correlation between unexplained BWL and recurrence was studied. Attempts were made to define the limits in weight variations among disease-free patients beyond which recurrence could be suspected. Unexplained BWL was observed in 16/19 (84%) patients developing recurrence, versus 9/90 (10%) patients remaining disease-free. There was a significant (p < 0.001) correlation between BWL and recurrence. BWL anticipated the diagnosis of recurrence by 6 (range 4-12) months. Based on the average percentage weight variation +/- 2 SD (95% confidence interval) of the disease-free group, the limits for BWL beyond which recurrence could be suspected were a 5.8% decrease in the last 6 months, 3.6% in the last 2 months or 3.0% of the patient's mean weight. However, because of the large variation in the amplitude of individual weight oscillations among disease-free patients (from < 0.5% to > 5.9% of the mean weight), individual limits derived from the patient's own body weight curve seemed more reliable. The results suggest that unexplained BWL is a valuable indicator of incipient breast cancer recurrence. Careful monitoring of body weight in breast cancer patients during follow-up is encouraged.

  12. Recurrence plots revisited

    NASA Astrophysics Data System (ADS)

    Casdagli, M. C.

    1997-09-01

    We show that recurrence plots (RPs) give detailed characterizations of time series generated by dynamical systems driven by slowly varying external forces. For deterministic systems we show that RPs of the time series can be used to reconstruct the RP of the driving force if it varies sufficiently slowly. If the driving force is one-dimensional, its functional form can then be inferred up to an invertible coordinate transformation. The same results hold for stochastic systems if the RP of the time series is suitably averaged and transformed. These results are used to investigate the nonlinear prediction of time series generated by dynamical systems driven by slowly varying external forces. We also consider the problem of detecting a small change in the driving force, and propose a surrogate data technique for assessing statistical significance. Numerically simulated time series and a time series of respiration rates recorded from a subject with sleep apnea are used as illustrative examples.

  13. Recurrent vulvovaginal candidiasis.

    PubMed

    Sobel, Jack D

    2016-01-01

    Recurrent vulvovaginal candidiasis (RVVC) is a common cause of significant morbidity in women in all strata of society affecting millions of women worldwide. Previously, RVVC occurrence was limited by onset of menopause but the widespread use of hormone replacement therapy has extended the at-risk period. Candida albicans remains the dominant species responsible for RVVC, however optimal management of RVVC requires species determination and effective treatment measures are best if species-specific. Considerable progress has been made in understanding risk factors that determine susceptibility to RVVC, particularly genetic factors, as well as new insights into normal vaginal defense immune mechanisms and their aberrations in RVVC. While effective control of RVVC is achievable with the use of fluconazole maintenance suppressive therapy, cure of RVVC remains elusive especially in this era of fluconazole drug resistance. Vaccine development remains a critical challenge and need.

  14. Urethral recurrence after cystectomy: current preventative measures, diagnosis and management.

    PubMed

    Chan, Yvonne; Fisher, Patrick; Tilki, Derya; Evans, Christopher P

    2016-04-01

    To summarise the current literature on the diagnosis and management of urethral recurrence (UR) after radical cystectomy (RC), as UR after RC is rare but associated with high mortality. With the recently increased use of orthotopic bladder substitution and the questionable benefit of prophylactic urethrectomy, identification of patients at high risk of UR, management of the remnant urethra, and treatment of UR become critical questions. A review of the PubMed database from 1980 to 2014 was performed to identify studies evaluating recurrent urothelial cancer of the urethra after RC. The search terms used included 'urethral recurrence', 'cystectomy' or 'cystoprostatectomy'. Selected studies provided information on the type of urinary diversion performed, the incidence of UR, and the time to UR. Incidence of UR after RC ranges from 1% to 8% with most recurrences occurring within the first 2 years after surgery. Increased risk of UR is associated with involvement of the prostate, tumour multifocality, bladder neck involvement, and cutaneous diversion. The median overall survival after UR ranges from 6 to 54 months and the 5-year disease-specific survival after UR is reported to be between zero and 83%. UR remains a relatively rare event. Current literature suggests that urethral wash cytology may be useful in patients with intermediate- to high-risk of recurrence to enable early detection of non-invasive disease, which may be amenable to conservative therapy before urethrectomy.

  15. Does Local Recurrence of Prostate Cancer After Radiation Therapy Occur at the Site of Primary Tumor? Results of a Longitudinal MRI and MRSI Study

    SciTech Connect

    Arrayeh, Elnasif; Westphalen, Antonio C.; Kurhanewicz, John; Roach, Mack; Jung, Adam J.; Carroll, Peter R.; Coakley, Fergus V.

    2012-04-01

    Purpose: To determine if local recurrence of prostate cancer after radiation therapy occurs at the same site as the primary tumor before treatment, using longitudinal magnetic resonance (MR) imaging and MR spectroscopic imaging to assess dominant tumor location. Methods and Materials: This retrospective study was HIPAA compliant and approved by our Committee on Human Research. We identified all patients in our institutional prostate cancer database (1996 onward) who underwent endorectal MR imaging and MR spectroscopic imaging before radiotherapy for biopsy-proven prostate cancer and again at least 2 years after radiotherapy (n = 124). Two radiologists recorded the presence, location, and size of unequivocal dominant tumor on pre- and postradiotherapy scans. Recurrent tumor was considered to be at the same location as the baseline tumor if at least 50% of the tumor location overlapped. Clinical and biopsy data were collected from all patients. Results: Nine patients had unequivocal dominant tumor on both pre- and postradiotherapy imaging, with mean pre- and postradiotherapy dominant tumor diameters of 1.8 cm (range, 1-2.2) and 1.9 cm (range, 1.4-2.6), respectively. The median follow-up interval was 7.3 years (range, 2.7-10.8). Dominant recurrent tumor was at the same location as dominant baseline tumor in 8 of 9 patients (89%). Conclusions: Local recurrence of prostate cancer after radiation usually occurs at the same site as the dominant primary tumor at baseline, suggesting supplementary focal therapy aimed at enhancing local tumor control would be a rational addition to management.

  16. A Validation Study of Administrative Claims Data to Measure Ovarian Cancer Recurrence and Secondary Debulking Surgery

    PubMed Central

    Livaudais-Toman, Jennifer; Egorova, Natalia; Franco, Rebeca; Prasad-Hayes, Monica; Howell, Elizabeth A.; Wisnivesky, Juan; Bickell, Nina A.

    2016-01-01

    Objective: Administrative claims data offer an alternative to chart abstraction to assess ovarian cancer recurrence, treatment and outcomes. Such analyses have been hindered by lack of valid recurrence and treatment algorithms. In this study, we sought to develop claims-based algorithms to identify ovarian cancer recurrence and secondary debulking surgery, and to validate them against the gold-standard of chart abstraction. Methods: We conducted chart validation studies; 2 recurrence algorithms and 1 secondary surgery among 94 ovarian cancer patients treated at one hospital between 2003–2009. A new recurrence algorithm was based on treatment timing (≥6 months after primary treatment) and a previously validated algorithm was based on secondary malignancy codes. A secondary debulking surgery algorithm was based on surgical billing codes. Results: The new recurrence algorithm had: sensitivity=100% (95% confidence interval [CI]=87%-=100%), specificity=89% (95%CI=78%–95%), kappa=84% (SE=10%) while the secondary-malignancy-=code recurrence algorithm had: sensitivity=84% (95%CI=66%–94%), specificity=44% (95%CI=31%-=57%), kappa=23% (SE=8%). The secondary surgery algorithm had: sensitivity=77% (95%CI=50%–92%), = specificity= 92% (95%CI=83%–97%), kappa=66% (SE=10%).= Conclusions: A recurrence algorithm based on treatment timing accurately identified ovarian cancer =recurrence. If validated in other populations, such an algorithm can provide a tool to compare effectiveness of recurrent ovarian cancer treatments. PMID:27891525

  17. Clinical and echocardiographic analysis of patients suffering from recurrent takotsubo cardiomyopathy

    PubMed Central

    El-Battrawy, Ibrahim; Ansari, Uzair; Behnes, Michael; Hillenbrand, Dennis; Schramm, Katja; Haghi, Darius; Hoffmann, Ursula; Papavassiliu, Theano; Elmas, Elif; Fastner, Christian; Becher, Tobias; Baumann, Stefan; Dösch, Christina; Heggemann, Felix; Kuschyk, Jürgen; Borggrefe, Martin; Akin, Ibrahim

    2016-01-01

    Background Recurrence of takotsubo cardiomyopathy (TTC) is a well-known complication. However, current literature lists only a few isolated cases. We aimed to determine the incidence and clinical significance of recurrent TTC. Methods & Results Our institutional database constituted a collective of 114 patients diagnosed with TTC since 2003. Close follow-up of these patients revealed a recurrence of TTC in seven of these (6.1%). The time interval between the index event and its recurrence varied between six months and six years. Arterial hypertension was more revealed in the recurrence group of TTC compared to non-recurrence group, (P = 0.02). Chronic obstructive pulmonary disease and/or asthma was more diagnosed in the recurrence group, (P = 0.04). Clinical events like right ventricular involvement, TTC related complications such as life-threatening arrhythmias, pulmonary congestion and in hospital death were observed more frequently in the recurrent episode. Over a mean follow-up of one year the mortality rate was similar in both groups. Conclusions Recurrence of TTC within six years after index event is not an uncommon phenomenon. In the event of right ventricular involvement in the relapse phase, it might be associated with a higher complication rate. TTC recurrence should be the first differential diagnosis in patients with a past history of TTC. PMID:28133464

  18. Treatment of juvenile recurrent parotitis.

    PubMed

    Katz, Philippe; Hartl, Dana M; Guerre, Agnès

    2009-12-01

    Juvenile recurrent parotitis (JRP) can be a debilitating illness in children. Knowing how to recognize and diagnose it for early treatment avoids recurrences that could lead to significant destruction of the glandular parenchyma. This article discusses the various therapeutic modalities proposed in the literature (medical treatment or sialendoscopy) and describes the authors' treatment of choice of combining antibiotics and iodinated oil sialography.

  19. Recurrent Bell's palsy in pregnancy.

    PubMed

    Deshpande, A D

    1990-09-01

    A case of recurrent Bell's palsy occurring in two successive pregnancies in a 37-year-old woman is presented. The causes of facial nerve paralysis of the lower motor neurone type are discussed. The rate of recurrence of Bell's palsy during pregnancy is unknown. Treatment with corticosteroids of Bell's palsy during pregnancy poses the threat of possible side effects on the fetus.

  20. Recurrent Aphthous Stomatitis: A Review

    PubMed Central

    Saleh, Dahlia; Miller, Richard A.

    2017-01-01

    Aphthous stomatitis is a painful and often recurrent inflammatory process of the oral mucosa that can appear secondary to various well-defined disease processes. Idiopathic recurrent aphthous stomatitis is referred to as recurrent aphthous stomatitis. The differential diagnosis for recurrent aphthous ulcerations is extensive and ranges from idiopathic benign causes to inherited fever syndromes, to connective tissue disease, or even inflammatory bowel diseases. A thorough history and review of systems can assist the clinician in determining whether it is related to a systemic inflammatory process or truly idiopathic. Management of aphthous stomatitis is challenging. For recurrent aphthous stomatitis or recalcitrant aphthous stomatitis from underlying disease, first-line treatment consists of topical medications with use of systemic medications as necessary. Herein, the authors discuss the differential diagnosis and treatment ladder of aphthous stomatitis as described in the literature. PMID:28360966

  1. Recurrent Aphthous Stomatitis: A Review.

    PubMed

    Edgar, Natalie Rose; Saleh, Dahlia; Miller, Richard A

    2017-03-01

    Aphthous stomatitis is a painful and often recurrent inflammatory process of the oral mucosa that can appear secondary to various well-defined disease processes. Idiopathic recurrent aphthous stomatitis is referred to as recurrent aphthous stomatitis. The differential diagnosis for recurrent aphthous ulcerations is extensive and ranges from idiopathic benign causes to inherited fever syndromes, to connective tissue disease, or even inflammatory bowel diseases. A thorough history and review of systems can assist the clinician in determining whether it is related to a systemic inflammatory process or truly idiopathic. Management of aphthous stomatitis is challenging. For recurrent aphthous stomatitis or recalcitrant aphthous stomatitis from underlying disease, first-line treatment consists of topical medications with use of systemic medications as necessary. Herein, the authors discuss the differential diagnosis and treatment ladder of aphthous stomatitis as described in the literature.

  2. Recurrence rate after discontinuation of long-term mebendazole therapy in alveolar echinococcosis (preliminary results).

    PubMed

    Ammann, R W; Hirsbrunner, R; Cotting, J; Steiger, U; Jacquier, P; Eckert, J

    1990-11-01

    The recurrence rate was investigated in 19 patients with non-resectable alveolar echinococcosis after discontinuation of a long-term therapy with mebendazole (average treatment 4.3 years). A control group consisted of 14 patients who underwent radical surgery and finished a course of prophylactic postoperative mebendazole treatment of 2 years. In the controls, no recurrence was observed after a post-therapy period averaging 3.5 years. In contrast, recurrence occurred in 7/19 patients (37%) with non-resectable alveolar echinococcosis an average of 1.6 years after discontinuation of the long-term mebendazole therapy. The absence of clinically detectable recurrence in the remaining 12 patients seems to be due either to spontaneous inactivation of alveolar echinococcosis preceding chemotherapy or too short post-therapy surveillance. The patients with recurrence responded favorably to reintroduction of chemotherapy. The data indicate that mebendazole therapy is parasitostatic rather than parasiticidal.

  3. TIME-INTERVAL MEASURING DEVICE

    DOEpatents

    Gross, J.E.

    1958-04-15

    An electronic device for measuring the time interval between two control pulses is presented. The device incorporates part of a previous approach for time measurement, in that pulses from a constant-frequency oscillator are counted during the interval between the control pulses. To reduce the possible error in counting caused by the operation of the counter gating circuit at various points in the pulse cycle, the described device provides means for successively delaying the pulses for a fraction of the pulse period so that a final delay of one period is obtained and means for counting the pulses before and after each stage of delay during the time interval whereby a plurality of totals is obtained which may be averaged and multplied by the pulse period to obtain an accurate time- Interval measurement.

  4. Frequency and impact of recurrent traumatic brain injury in a population-based sample.

    PubMed

    Theadom, Alice; Parmar, Priya; Jones, Kelly; Barker-Collo, Suzanne; Starkey, Nicola J; McPherson, Kathryn M; Ameratunga, Shanthi; Feigin, Valery L

    2015-05-15

    The aim of this study was to determine the frequency, mechanism(s), and impact of recurrent traumatic brain injury (TBI) over a 1-year period. Population-based TBI incidence and 1-year outcomes study with embedded case-control analysis. All participants (adults and children) who experienced a recurrent TBI (more than one) in the 12 months after an index injury and matched controls who sustained one TBI within the same period were enrolled in a population-based TBI incidence and outcomes study. Details of all recurrent TBIs sustained within 12 months of the initial index injury were recorded. Each recurrent TBI case was matched to a case sustaining one TBI based on age (±2 years), gender, and index TBI severity. Cognitive ability, disability, and postconcussion symptoms (PCS) were assessed 1 year after the index injury. Overall, 9.9% (n=72) of TBI cases experienced at least one recurrent TBI within the year after initial index injury. Males, people <35 years of age, and those who had experienced a TBI before their index injury were at highest risk of recurrent TBI. Recurrent TBI cases reported significantly increased PCS at 1 year, compared to the matched controls (n=72) sustaining one TBI. There was no difference in overall cognitive ability and disability between the two groups. People experiencing recurrent TBIs are more likely to experience increased frequency and severity of PCS. Greater public awareness of the potential effects of recurrent brain injury is needed.

  5. Re-irradiation for locally recurrent refractory breast cancer

    PubMed Central

    Merino, Tomas; Tran, William T.; Czarnota, Gregory J.

    2015-01-01

    Purpose To report an analysis of treatment outcomes of a cohort of patients re-irradiated for locally recurrent refractory breast cancer (LRRBC) Patients and Methods Between 2008 and 2013, 47 women (mean age = 60 years) were re-irradiated for LRRBC. Outcomes were measured using Kaplan-Meier log rank to compare curves and Cox regression for multivariate analysis. Outcomes included overall survival (OS), time to re-treatment, survival without systemic progression, and survival without local recurrence. Results Fifty-six instances of re-irradiation were completed and analyzed. The mean cumulative 2 Gy equivalent dose (EQD2) to the whole breast and tumour cavity (α/β = 3) was 99.8 Gy and 109.1 Gy, respectively. Most patients initially had significant symptoms before RT due to local recurrence. The median time to re-treatment and to systemic failure was 41 and 50 months, respectively. Median follow-up for OS was 17 months and OS was 0.73 (SE = 0.07) at 1 year and 0.67 (SE = 0.07) at 2 years. Local control was 0.62 (SE = 0.07) and 0.5 (0.08) at 1 and 2 years, respectively. Acute radiation dermatitis was G1-2, G3 and G4 in 45, 4 and 1 cases, respectively. One patient presented with necrosis. The most common long term toxicity was G3 fibrosis (n = 4) and telangiectatic changes (n = 3). Multivariable analysis indicated that skin involvement (Hazard Ratio = 6.6 (1.4-31), p = 0.016) and time to local recurrence <2yr (HR 3.1 (1.04-9.7) p = 0.042) predicted local recurrence. Conclusion High dose re-irradiation is feasible for locally RRBC. This approach can have a significant benefit in this very high-risk group. PMID:26459388

  6. Rhythmicity, recurrence, and recovery of flagellar beating

    NASA Astrophysics Data System (ADS)

    Wan, Kirsty; Goldstein, Raymond

    2015-03-01

    The eukaryotic flagellum beats with apparently unfailing periodicity, yet responds rapidly to stimuli. Like the human heartbeat, flagellar oscillations are now known to be noisy. Using the unicellular alga Chlamydomonas reinhardtii, we explore three aspects of nonuniform flagellar beating. We report the existence of rhythmicity, waveform noise peaking at transitions between power and recovery strokes, and fluctuations of interbeat intervals that are correlated and even recurrent, with memory extending to hundreds of beats. These features are altered qualitatively by physiological perturbations. Further, we quantify the recovery of periodic breaststroke beating from transient hydrodynamic forcing. These results will help constrain microscopic theories on the origins and regulation of flagellar beating. Financial support is acknowledged from the EPSRC, ERC Advanced Investigator Grant No. 247333, and a Senior Investigator Award from the Wellcome Trust.

  7. OTC Cough and Cold Products: Not for Infants and Children Under 2 Years of Age

    MedlinePlus

    ... Cold Products: Not For Infants and Children Under 2 Years of Age Share Tweet Linkedin Pin it ... and cold products for infants and children under 2 years of age? A. FDA strongly recommends that ...

  8. Recurrence plots and recurrence quantification analysis of human motion data

    NASA Astrophysics Data System (ADS)

    Josiński, Henryk; Michalczuk, Agnieszka; Świtoński, Adam; Szczesna, Agnieszka; Wojciechowski, Konrad

    2016-06-01

    The authors present exemplary application of recurrence plots, cross recurrence plots and recurrence quantification analysis for the purpose of exploration of experimental time series describing selected aspects of human motion. Time series were extracted from treadmill gait sequences which were recorded in the Human Motion Laboratory (HML) of the Polish-Japanese Academy of Information Technology in Bytom, Poland by means of the Vicon system. Analysis was focused on the time series representing movements of hip, knee, ankle and wrist joints in the sagittal plane.

  9. Chromatin changes predict recurrence after radical prostatectomy

    PubMed Central

    Hveem, Tarjei S; Kleppe, Andreas; Vlatkovic, Ljiljana; Ersvær, Elin; Wæhre, Håkon; Nielsen, Birgitte; Kjær, Marte Avranden; Pradhan, Manohar; Syvertsen, Rolf Anders; Nesheim, John Arne; Liestøl, Knut; Albregtsen, Fritz; Danielsen, Håvard E

    2016-01-01

    Background: Pathological evaluations give the best prognostic markers for prostate cancer patients after radical prostatectomy, but the observer variance is substantial. These risk assessments should be supported and supplemented by objective methods for identifying patients at increased risk of recurrence. Markers of epigenetic aberrations have shown promising results in several cancer types and can be assessed by automatic analysis of chromatin organisation in tumour cell nuclei. Methods: A consecutive series of 317 prostate cancer patients treated with radical prostatectomy at a national hospital between 1987 and 2005 were followed for a median of 10 years (interquartile range, 7–14). On average three tumour block samples from each patient were included to account for tumour heterogeneity. We developed a novel marker, termed Nucleotyping, based on automatic assessment of disordered chromatin organisation, and validated its ability to predict recurrence after radical prostatectomy. Results: Nucleotyping predicted recurrence with a hazard ratio (HR) of 3.3 (95% confidence interval (CI), 2.1–5.1). With adjustment for clinical and pathological characteristics, the HR was 2.5 (95% CI, 1.5–4.1). An updated stratification into three risk groups significantly improved the concordance with patient outcome compared with a state-of-the-art risk-stratification tool (P<0.001). The prognostic impact was most evident for the patients who were high-risk by clinical and pathological characteristics and for patients with Gleason score 7. Conclusion: A novel assessment of epigenetic aberrations was capable of improving risk stratification after radical prostatectomy. PMID:27124335

  10. Intraoperative radiation therapy in recurrent ovarian cancer

    SciTech Connect

    Yap, O.W. Stephanie . E-mail: stbeast@stanford.edu; Kapp, Daniel S.; Teng, Nelson N.H.; Husain, Amreen

    2005-11-15

    Purpose: To evaluate disease outcomes and complications in patients with recurrent ovarian cancer treated with cytoreductive surgery and intraoperative radiation therapy (IORT). Methods and Materials: A retrospective study of 24 consecutive patients with ovarian carcinoma who underwent secondary cytoreduction and intraoperative radiation therapy at our institution between 1994 and 2002 was conducted. After optimal cytoreductive surgery, IORT was delivered with orthovoltage X-rays (200 kVp) using individually sized and beveled cone applications. Outcomes measures were local control of disease, progression-free interval, overall survival, and treatment-related complications. Results: Of these 24 patients, 22 were available for follow-up analysis. Additional treatment at the time of and after IORT included whole abdominopelvic radiation, 9; pelvic or locoregional radiation, 5; chemotherapy, 6; and no adjuvant treatment, 2. IORT doses ranged from 9-14 Gy (median, 12 Gy). The anatomic sites treated were pelvis (sidewalls, vaginal cuff, presacral area, anterior pubis), para-aortic and paracaval lymph node beds, inguinal region, or porta hepatitis. At a median follow-up of 24 months, 5 patients remain free of disease, whereas 17 patients have recurred, of whom 4 are alive with disease and 13 died from disease. Five patients recurred within the radiation fields for a locoregional relapse rate of 32% and 12 patients recurred at distant sites with a median time to recurrence of 13.7 months. Five-year overall survival was 22% with a median survival of 26 months from time of IORT. Nine patients (41%) experienced Grade 3 toxicities from their treatments. Conclusion: In carefully selected patients with locally recurrent ovarian cancer, combined IORT and tumor reductive surgery is reasonably tolerated and may contribute to achieving local control and disease palliation.

  11. New geological perspectives on earthquake recurrence models

    SciTech Connect

    Schwartz, D.P.

    1997-02-01

    In most areas of the world the record of historical seismicity is too short or uncertain to accurately characterize the future distribution of earthquakes of different sizes in time and space. Most faults have not ruptured once, let alone repeatedly. Ultimately, the ability to correctly forecast the magnitude, location, and probability of future earthquakes depends on how well one can quantify the past behavior of earthquake sources. Paleoseismological trenching of active faults, historical surface ruptures, liquefaction features, and shaking-induced ground deformation structures provides fundamental information on the past behavior of earthquake sources. These studies quantify (a) the timing of individual past earthquakes and fault slip rates, which lead to estimates of recurrence intervals and the development of recurrence models and (b) the amount of displacement during individual events, which allows estimates of the sizes of past earthquakes on a fault. When timing and slip per event are combined with information on fault zone geometry and structure, models that define individual rupture segments can be developed. Paleoseismicity data, in the form of timing and size of past events, provide a window into the driving mechanism of the earthquake engine--the cycle of stress build-up and release.

  12. Intrinsic adaptation in autonomous recurrent neural networks.

    PubMed

    Marković, Dimitrije; Gros, Claudius

    2012-02-01

    A massively recurrent neural network responds on one side to input stimuli and is autonomously active, on the other side, in the absence of sensory inputs. Stimuli and information processing depend crucially on the quality of the autonomous-state dynamics of the ongoing neural activity. This default neural activity may be dynamically structured in time and space, showing regular, synchronized, bursting, or chaotic activity patterns. We study the influence of nonsynaptic plasticity on the default dynamical state of recurrent neural networks. The nonsynaptic adaption considered acts on intrinsic neural parameters, such as the threshold and the gain, and is driven by the optimization of the information entropy. We observe, in the presence of the intrinsic adaptation processes, three distinct and globally attracting dynamical regimes: a regular synchronized, an overall chaotic, and an intermittent bursting regime. The intermittent bursting regime is characterized by intervals of regular flows, which are quite insensitive to external stimuli, interceded by chaotic bursts that respond sensitively to input signals. We discuss these findings in the context of self-organized information processing and critical brain dynamics.

  13. Smoking Patterns, Attitudes and Motives: Unique Characteristics among 2-Year versus 4-Year College Students

    ERIC Educational Resources Information Center

    Berg, C. J.; An, L. C.; Thomas, J. L.; Lust, K. A.; Sanem, J. R.; Swan, D. W.; Ahluwalia, J. S.

    2011-01-01

    Given the previously documented higher rates of smoking among 2-year college students in comparison with 4-year university students, this study compares smoking patterns, attitudes and motives among 2-year and 4-year college students. Two thousand two hundred and sixty-five undergraduate students aged 18-25 years at a 2-year college and a 4-year…

  14. Recurrent uric acid stones.

    PubMed

    Kamel, K S; Cheema-Dhadli, S; Shafiee, M A; Davids, M R; Halperin, M L

    2005-01-01

    A 46-year-old female had a history of recurrent uric acid stone formation, but the reason why uric acid precipitated in her urine was not obvious, because the rate of urate excretion was not high, urine volume was not low, and the pH in her 24-h urine was not low enough. In his discussion of the case, Professor McCance provided new insights into the pathophysiology of uric acid stone formation. He illustrated that measuring the pH in a 24-h urine might obscure the fact that the urine pH was low enough to cause uric acid to precipitate during most of the day. Because he found a low rate of excretion of NH(4)(+) relative to that of sulphate anions, as well as a high rate of citrate excretion, he speculated that the low urine pH would be due to a more alkaline pH in proximal convoluted tubule cells. He went on to suspect that there was a problem in our understanding of the function of renal medullary NH(3) shunt pathway, and he suggested that its major function might be to ensure a urine pH close to 6.0 throughout the day, to minimize the likelihood of forming uric acid kidney stones.

  15. [Chronic recurrent multifocal osteomyelitis].

    PubMed

    Seidl, T; Maier, M; Refior, H J; Veihelmann, A

    2003-06-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a rare, inflammatory, skeletal disease of unknown origin, which mainly affects children and adolescents in terms of cleido-spondylo-metaphysal skeletal inflammation. Only 10% of the patients are older than 20 years. To date, only about 200 cases have been reported in the literature. In the course of the disease, the initial radiological signs are osteolysis followed by sclerosis and hyperostosis in the end stage. The histological investigations reveal chronic inflammatory infiltrates with lymphocytes and hyperostosis. Although the prognosis of CRMO, to our current understanding, is self limiting, serious complications have been reported such as pathological fractures and compression fractures of the spine. A recently recommended therapy scheme is based on the administration of azithromycin combined with calcitonin. We present the case of a 25 year old female patient who has suffered from CRMO for 1.5 years with the cervical spine and the manubrium sterni being affected. The current state of diagnosis, therapy, and prognostic outlook of this rare disease are discussed.

  16. Chronic recurrent multifocal osteomyelitis.

    PubMed

    Roderick, Marion R; Ramanan, Athimalaipet V

    2013-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disease occurring primarily in children and adolescents. Episodes of systemic inflammation occur due to immune dysregulation without autoantibodies, pathogens or antigen-specific T cells. CRMO is characterised by the insidious onset of pain with swelling and tenderness over the affected bones. Clavicular involvement was the classical description; however, the metaphyses and epiphyses of long bones are frequently affected. Lesions may occur in any bone, including vertebrae. Characteristic imaging includes bone oedema, lytic areas, periosteal reaction and soft tissue reaction. Biopsies from affected areas display polymorphonuclear leucocytes with osteoclasts and necrosis in the early stages. Subsequently, lymphocytes and plasma cells predominate followed by fibrosis and signs of reactive new bone forming around the inflammation. Diagnosis is facilitated by the use of STIR MRI scanning, potentially obviating the need for biopsy and unnecessary long-term antibiotics due to incorrect diagnosis. Treatment options include non-steroidal anti-inflammatory drugs and bisphosphonates. Biologics have been tried in resistant cases with promising initial results. Gene identification has not proved easy although research in this area continues. Early descriptions of the disease suggested a benign course; however, longer-term follow up shows that it can cause significant morbidity and longer-term disability. Although it has always been thought of as very rare, the prevalence is likely to be vastly underestimated due to poor recognition of the disease.

  17. [Chronic recurrent multifocal osteomyelitis].

    PubMed

    Schilling, F; Eckardt, A; Kessler, S

    2000-01-01

    The aim of this paper is to give a detailed description of the so-called "chronic recurrent multifocal osteomyelitis" (CRMO). The clinical, radiological and histopathological results of an analysis of 29 cases (15 children/adolescents and 14 adults) are presented and correlated to current data from the literature. We could delinate the following points: 1. CRMO is a systemic aseptic inflammation of the bone marrow (Osteitis), it can occur polytopically and association with pustulous dermatologic symptoms is possible. 2. It is not a rare disease 3. Osteomyelitis is probably "reactive" and a plasma-cell sclerotic process with ist own characteristic histologic three-phase course. 4. We could observe 5 specific types of localization which can be documented by X-ray or bone scan. 5. Accompanying arthritis os often present, especially "sympathetic coxitis". 6. The use of drugs in treatment of CRMO (i.e. azithromycin, calcitonin, and bisphosphonates) is discussed. In conclusion we want to point out, that 1. 99mTC bone scan should always be performed when there is suspicion for CRMO to reveal the pattern of affection, 2. the rheumatologist and dermatologist should be contacted, 3. operation is normally not necessary for treatment of the mostly self-limitin disease, and 4. the term "SAPHO syndrome" should be avoided, further differentiation of the diagnosis is necessary.

  18. [Recurrent urinary tract infections].

    PubMed

    Pigrau-Serrallach, Carlos

    2005-12-01

    Recurrent urinary tract infections (RUTI) are a frequent clinical problem in sexually active young women, pregnant or postmenopausal women and in patients with underlying urological abnormalities. The present chapter reviews RUTI based on their classification: relapses, which usually occur early (< 1 month), are caused by the same microorganism and are associated with underlying urological abnormalities, and reinfections, which usually occur later and are caused by a new distinct microorganism (or by the same microorganism usually located in the rectum or uroepithelial cells). The pathogenesis of RUTI is reviewed and the risk factors associated with RUTI in premenopausal women (usually related to sexual activity), postmenopausal women (in whom estrogen deficiency has a significant effect on the vaginal Lactobacillus flora), and in pregnant women are discussed. Likewise, an extensive review of the distinct therapeutic strategies to prevent RUTI is provided: self-treatment of cystitis, continuous antibiotic prophylaxis, postcoital antibiotic prophylaxis, topical vaginal estrogens, Lactobacillus, cranberry juice, intravesical administration of non-virulent E. coli strains and vaccines, among others. Several diagnostic-therapeutic algorithms are included. These algorithms are based on the type of urinary infection (relapse-reinfection), on the type of patient (young, postmenopausal, or pregnant women) and on the number of episodes of RUTI.

  19. Dissimilar Physiological and Perceptual Responses Between Sprint Interval Training and High-Intensity Interval Training.

    PubMed

    Wood, Kimberly M; Olive, Brittany; LaValle, Kaylyn; Thompson, Heather; Greer, Kevin; Astorino, Todd A

    2016-01-01

    High-intensity interval training (HIIT) and sprint interval training (SIT) elicit similar cardiovascular and metabolic adaptations vs. endurance training. No study, however, has investigated acute physiological changes during HIIT vs. SIT. This study compared acute changes in heart rate (HR), blood lactate concentration (BLa), oxygen uptake (VO2), affect, and rating of perceived exertion (RPE) during HIIT and SIT. Active adults (4 women and 8 men, age = 24.2 ± 6.2 years) initially performed a VO2max test to determine workload for both sessions on the cycle ergometer, whose order was randomized. Sprint interval training consisted of 8 bouts of 30 seconds of all-out cycling at 130% of maximum Watts (Wmax). High-intensity interval training consisted of eight 60-second bouts at 85% Wmax. Heart rate, VO2, BLa, affect, and RPE were continuously assessed throughout exercise. Repeated-measures analysis of variance revealed a significant difference between HIIT and SIT for VO2 (p < 0.001), HR (p < 0.001), RPE (p = 0.03), and BLa (p = 0.049). Conversely, there was no significant difference between regimens for affect (p = 0.12). Energy expenditure was significantly higher (p = 0.02) in HIIT (209.3 ± 40.3 kcal) vs. SIT (193.5 ± 39.6 kcal). During HIIT, subjects burned significantly more calories and reported lower perceived exertion than SIT. The higher VO2 and lower BLa in HIIT vs. SIT reflected dissimilar metabolic perturbation between regimens, which may elicit unique long-term adaptations. If an individual is seeking to burn slightly more calories, maintain a higher oxygen uptake, and perceive less exertion during exercise, HIIT is the recommended routine.

  20. Vulvovaginitis candidiasis recurrence during pregnancy.

    PubMed

    Fardiazar, Z; Ronaci, F; Torab, R; Goldust, M

    2012-04-15

    Vulvovaginitis is the most common gynecologic condition seen by practitioners rendering primary care to women. Vulvovaginitis Candidiasis (VVC) is the most common type of vaginitis and this study aimed at specifying VVC recurrence during pregnancy. In this prospective study, 150 pregnant women suffering from vaginal excretion, morsus and itching were studied. Initially, the patients were treated using clotrimazole local cream (5 g) for 7 successive days. After initial treatment, the patients were freely visited once a month until delivery considering vaginitis symptoms and VVC recurrence was examined during pregnancy. Mean age of the understudy mothers was 27.26 +/- 3.76. Mean of recurrence number was 0.17 +/- 0.48 during the first trimester. Mean of recurrence number was 0.92 +/- 0.76 during the second trimester. Mean of recurrence number was 2.16 +/- 0.63 during the third trimester. Statistically significant difference was between recurrences during three trimesters of pregnancy (p < 0.001). There is statistically significant difference between mean number of recurrences during three trimesters of pregnancy.

  1. Recurrence analysis methods for the classification of nonlinear systems

    NASA Astrophysics Data System (ADS)

    Graybill, Mark

    Recurrence is a common phenomenon in natural systems: A system enters and leaves a state, but after a given period of time, passes near that same state again. Many complex signals, such as weather cycles, heartbeats, or neuron firing patterns, all show recurrence. The recurrence plot (RP) displays all times j where a system returns near a state it has occupied at time i, giving rise to upward-sloping diagonal lines where a system follows a recurrent path, orthogonal lines when the system changes very slowly, or many disconnected points where a system's behavior is unpredictable. Investigation of the RP can then proceed through recurrence quantification analysis (RQA). Three new measures for RQA were developed: diagonality, quantifying diagonal lines, verticality, quantifying vertical lines, and periodicity quantifying the arrangement of recurrence points in periodic structures. These new measures were applied alongside classical recurrence measures to explore trends in random data, identify periodicity and chaotic behavior in the logistic map, estimate the dimensionality of the Lorenz attractor, and discriminate between persistent data signals. In collaboration with biologist Dr. Michael Harris, RQA methods were applied to the discrimination of two neuron types: serotonergic cells are believed to stimulate respiration, while nonserotonergic cells are implicated in respiratory inhibition. Typical discrimination methods compare mean and standard deviation of firing rates to a reference line, which correctly classifies serotonergic cells but incorrectly classifies many nonserotonergic cells. Voltage signals from such cells were converted into inter-spike intervals. Convergence required trials containing over 300 spikes for biological methods, and over 1000 for full investigation using RQA. Whether such cells can be discriminated from baseline firing patterns remains an open question.

  2. Contralateral recurrence of tumefactive demyelination

    PubMed Central

    Guranda, Mihail; Essig, Marco

    2015-01-01

    Tumefactive demyelination refers to large focal demyelinating lesions in the brain, which can be mistaken for malignancy. In some patients, these lesions are monophasic with a self-limited course; however, other patients demonstrate recurrent disease with new tumefactive or non-tumefactive lesions, and a subsequent diagnosis of relapsing-remitting multiple sclerosis is not uncommon. Owing to the limited data available in the literature, many questions about the patterns and prognostic significance of recurrent tumefactive lesions remain unanswered. The current case report involves a patient who recovered from tumefactive demyelination and presented two years later with a new recurrent tumefactive lesion in the contralateral brain. PMID:26427896

  3. [Recurrent aphthous stomatitis in Rheumatology].

    PubMed

    Riera Matute, Gabriel; Riera Alonso, Elena

    2011-01-01

    Recurrent aphthous stomatitis consists on recurring oral ulcers of unknown etiology. Oral ulcers may be different in number and size depending on the clinical presentation, which also determines the time needed for healing. Moreover, there are factors associated to outbreaks but not implicated in its etiopathogenesis. When oral aphthosis has a known etiology, it is not considered as recurrent aphthous stomatitis. The severity and the clinical presentation helps in the differential diagnosis. Treatment is symptomatic in recurrent aphthous stomatitis while, if there is an underlying systemic disease, the treatment of such disease is need in addition to topical treatment.

  4. High resolution time interval meter

    DOEpatents

    Martin, A.D.

    1986-05-09

    Method and apparatus are provided for measuring the time interval between two events to a higher resolution than reliability available from conventional circuits and component. An internal clock pulse is provided at a frequency compatible with conventional component operating frequencies for reliable operation. Lumped constant delay circuits are provided for generating outputs at delay intervals corresponding to the desired high resolution. An initiation START pulse is input to generate first high resolution data. A termination STOP pulse is input to generate second high resolution data. Internal counters count at the low frequency internal clock pulse rate between the START and STOP pulses. The first and second high resolution data are logically combined to directly provide high resolution data to one counter and correct the count in the low resolution counter to obtain a high resolution time interval measurement.

  5. Finding Nested Common Intervals Efficiently

    NASA Astrophysics Data System (ADS)

    Blin, Guillaume; Stoye, Jens

    In this paper, we study the problem of efficiently finding gene clusters formalized by nested common intervals between two genomes represented either as permutations or as sequences. Considering permutations, we give several algorithms whose running time depends on the size of the actual output rather than the output in the worst case. Indeed, we first provide a straightforward O(n 3) time algorithm for finding all nested common intervals. We reduce this complexity by providing an O(n 2) time algorithm computing an irredundant output. Finally, we show, by providing a third algorithm, that finding only the maximal nested common intervals can be done in linear time. Considering sequences, we provide solutions (modifications of previously defined algorithms and a new algorithm) for different variants of the problem, depending on the treatment one wants to apply to duplicated genes.

  6. Earthquake recurrence on the southern San Andreas modulated by fault-normal stress

    NASA Technical Reports Server (NTRS)

    Palmer, Randy; Weldon, Ray; Humphreys, Eugene; Saucier, Francois

    1995-01-01

    Earthquake recurrence data from the Pallett Creek and Wrightwood paleoseismic sites on the San Andreas fault appear to show temporal variations in repeat interval. We investigate the interaction between strike-slip faults and auxiliary reverse and normal faults as a physical mechanism capable of producing such variations. Under the assumption that fault strength is a function of fault-normal stress (e.g. Byerlee's Law), failure of an auxiliary fault modifies the strength of the strike-slip fault, thereby modulating the recurrence interval for earthquakes. In our finite element model, auxiliary faults are driven by stress accumulation near restraining and releasing bends of a strike-slip fault. Earthquakes occur when fault strength is exceeded and are incorporated as a stress drop which is dependent on fault-normal stress. The model is driven by a velocity boundary condition over many earthquake cycles. Resulting synthetic strike-slip earthquake recurrence data display temporal variations similar to observed paleoseismic data within time windows surrounding auxiliary fault failures. Our simple model supports the idea that interaction between a strike-slip fault and auxiliary reverse or normal faults can modulate the recurrence interval of events on the strike-slip fault, possibly producing short term variations in earthquake recurrence interval.

  7. Recurrence Quantification of Fractal Structures

    PubMed Central

    Webber, Charles L.

    2012-01-01

    By definition, fractal structures possess recurrent patterns. At different levels repeating patterns can be visualized at higher magnifications. The purpose of this chapter is threefold. First, general characteristics of dynamical systems are addressed from a theoretical mathematical perspective. Second, qualitative and quantitative recurrence analyses are reviewed in brief, but the reader is directed to other sources for explicit details. Third, example mathematical systems that generate strange attractors are explicitly defined, giving the reader the ability to reproduce the rich dynamics of continuous chaotic flows or discrete chaotic iterations. The challenge is then posited for the reader to study for themselves the recurrent structuring of these different dynamics. With a firm appreciation of the power of recurrence analysis, the reader will be prepared to turn their sights on real-world systems (physiological, psychological, mechanical, etc.). PMID:23060808

  8. Recurrent ameloblastoma of the mandible.

    PubMed

    Joshi, C P; Vyas, K C; Deedwania, S; Jain, S; Mangal, M M

    1999-10-01

    Ameloblastoma is an agressive locally recurring neoplasm of odentogenic epithelium. Here we describe a case of mandibular ameloblastoma with 12 yrs. history of local recurrences followed with history of excision twice (10 yrs. and 7 years back).

  9. Pathways to Breast Cancer Recurrence

    PubMed Central

    2013-01-01

    Breast cancer remains a deadly disease, even with all the recent technological advancements. Early intervention has made an impact, but an overwhelmingly large number of breast cancer patients still live under the fear of “recurrent” disease. Breast cancer recurrence is clinically a huge problem and one that is largely not well understood. Over the years, a number of factors have been studied with an overarching aim of being able to prognose recurrent disease. This paper attempts to provide an overview of our current knowledge of breast cancer recurrence and its associated challenges. Through a survey of the literature on cancer stem cells (CSCs), epithelial-mesenchymal transition (EMT), various signaling pathways such as Notch/Wnt/hedgehog, and microRNAs (miRNAs), we also examine the hypotheses that are currently under investigation for the prevention of breast cancer recurrence. PMID:23533807

  10. Adverse Events during 2 Years of Daily Wear of Silicone Hydrogels in Children

    PubMed Central

    Sankaridurg, Padmaja; Chen, Xiang; Naduvilath, Thomas; de la Jara, Percy Lazon; Lin, Zhi; Li, Li; Smith, Earl L.; Ge, Jian; Holden, Brien A.

    2015-01-01

    Purpose Type and incidence of adverse events and rate of discontinuations for 2 years of daily wear with silicone hydrogel contact lenses in Chinese children with myopia. Methods Two hundred forty children aged 7 to 14 years were enrolled in a prospective randomized clinical trial from November 2008 to April 2009. Children with myopia of up to −3.50 diopters (D) spherical equivalent with astigmatism less than or equal to −0.75 D were randomized to one commercial and three experimental lens designs of Lotrafilcon B silicone hydrogel lenses (four groups) used bilaterally on a daily wear, monthly replacement schedule. The main outcome measures were incidence per 100 patient-years (incidence, in percentage) of adverse events and rate of discontinuations. Results There were no events of microbial keratitis. Fifty-five adverse events (incidence, 14.2%) were seen. There were also 12 recurrent events. The type and incidence percentage were contact lens papillary conjunctivitis (16 events, 4.1%), superior epithelial arcuate lesions (SEALs, six events, 1.5%), corneal erosions (eight events, 2.1%), infiltrative keratitis (five events, 1.3%), asymptomatic infiltrative keratitis (seven events, 1.8%), and asymptomatic infiltrates (13 events, 3.42%). There were differences in the incidence of SEALs between groups (p = 0.023), with the incidence of SEALs being greater with one of the experimental designs. No event resulted in any vision loss. Seventy participants (29.2%) discontinued, with one-third (26 participants, 10.8%) occurring in the first month of lens wear. Discomfort and non–lens-related reasons such as safety concern and disinterest were frequently cited reasons for discontinuations. Conclusions Adverse events with daily wear of silicone hydrogels in children were mainly mechanical in nature, and significant infiltrative events were few. The large number of dropouts in the early days of lens wear and their reasons for discontinuation suggest that adaptation and

  11. Recurrent hypertensive intracerebral haemorrhages: what should we do when a new hemispheric ischaemic event strikes?

    PubMed

    Amin, Osama S M

    2012-12-20

    Hypertensive intracerebral haemorrhage is usually a once in a lifetime event and recurrences are rare. Most recurrences usually develop within 2 years of the first event and the majority usually target the basal ganglia and thalami. Failure of blood pressure control is the most important, potentially preventable, culprit behind the development of primary intracerebral haemorrhages. However, the occurrence of a recurrent bleed in patients with optimally controlled hypertension should always prompt the physician to think of a new co-operating factor. We report on a 60-year-old hypertensive woman who developed right-sided thalamic haemorrhage 5 days after sustaining a lacunar infarct of the left thalamus for which she had been prescribed a dual antiplatelet therapy: aspirin and clopidrogrel. She had a history of two bilateral sequential hypertensive deep cerebellar haemorrhages which were developed 2 years ago.

  12. Risk factors in Dupuytren's diathesis: is recurrence after surgery predictable?

    PubMed

    Degreef, Ilse; De Smet, Luc

    2011-02-01

    In order to investigate the prognostic value of possible risk factors for Dupuytren's diathesis, clinical parameters on disease presentation in an operated group of patients were compared with self-reported recurrence after a minimum 2 years follow-up. In order of significance, the following factors were found to be significantly correlated with disease recurrence : age of onset under 50 years (p = 0.01), bilateral disease (p = 0.01), Ledderhose disease (p = 0.01), first ray involvement (p = 0.02), multiple ray involvement (more than 2 digits, p = 0.02), ectopic fibromatosis (p = 0.02), family occurrence (p = 0.04) and male gender (p = 0.05). No correlation of self-reported disease recurrence was seen with diabetes, frozen shoulder syndrome or epilepsy. An insight in the significance of the influence of specific risk factors on recurrence rates, helps in creating a clearer representation of Dupuytren's diathesis. This will help the surgeon to more accurately inform the patient and possibly to reconsider and adjust the choice in treatment options.

  13. Interval to Testosterone Recovery After Hormonal Therapy for Prostate Cancer and Risk of Death

    SciTech Connect

    D'Amico, Anthony V. Chen, M.-H.; Renshaw, Andrew A.; Loffredo, Marian; Kantoff, Philip W.

    2009-09-01

    Purpose: To assess whether the risk of death is associated with the time to testosterone recovery (TTR) after radiotherapy (RT) and hormonal therapy (HT) for prostate cancer (PCa). Patients and Methods: Between 1995 and 2001, 206 men with localized, unfavorable-risk PCa were randomized to receive RT or RT plus 6 months of HT. A multivariate postrandomization Cox regression analysis was used to assess whether the TTR in years was associated with the risk of death after adjusting for the known prognostic factors, age, Adult Comorbidity Evaluation-27 score, and the use of HT for recurrence. Results: Of the 102 men randomized to receive RT and HT, 57 (56%) had a TTR of >2 years, and none of these men had died of PCa after a median follow-up of 7.6 years. As the TTR increased, the risk of death decreased significantly (adjusted hazard ratio, 0.60; 95% confidence interval, 0.43-0.84; p = .003). A significant interaction was noted between the TTR and the comorbidity score (p = .002). The survival estimates were similar (p = 0.17) across the TTR values in men with moderate to severe comorbidity; however, these estimates increased significantly (p < .001) with decreasing PCa-specific mortality (p = .006) as the TTR increased in men with no or minimal comorbidity. Conclusion: The results of our study have shown that a longer TTR after RT plus 6 months of HT for unfavorable-risk PCa is associated with a lower risk of death in men with no or minimal comorbidity.

  14. The Importance of Frozen Section-Controlled Excision in Recurrent Basal Cell Carcinoma of the Eyelids

    PubMed Central

    Şahan, Berna; Çiftçi, Ferda; Özkan, Ferda; Öztürk, Vildan

    2016-01-01

    Objectives: To show the importance of frozen section-controlled excision to avoid the re-recurrence of recurrent basal cell carcinoma (BCC) of the eyelids. Materials and Methods: Thirty-five cases who underwent eyelid tumor excision in different centers and were admitted to our clinic with recurrent eyelid tumors. Recurrent tumors were resected by excision 1-2 mm from the tumor’s visible margin and sent to pathology for frozen section examination. Eyelid reconstructions with flap and graft were performed after confirming that the surgical margins were negative. Results: Twenty-one (60%) of our patients were male and 14 (40%) were female. Median age of our group was 63.4±14.2 years. Excision and sending the excised material for frozen section control was performed once for 11 patients, twice for 12 patients, 3 times for 8 patients and 4 times for 4 patients to confirm that the surgical margins were clean. All pathology samples were reported as BCC. All patients had eyelid reconstruction with flap and graft. Recurrence was detected in 2 patients (5.7%) during 1 to 8 years (mean 4.3 years) of follow-up and those patients were reoperated; no recurrence was detected in the remaining 33 patients (94.3%). Conclusion: Frozen section control can provide low re-recurrence rate in patients with recurrent BCC of the eyelids. PMID:28050325

  15. High resolution time interval counter

    NASA Technical Reports Server (NTRS)

    Zhang, Victor S.; Davis, Dick D.; Lombardi, Michael A.

    1995-01-01

    In recent years, we have developed two types of high resolution, multi-channel time interval counters. In the NIST two-way time transfer MODEM application, the counter is designed for operating primarily in the interrupt-driven mode, with 3 start channels and 3 stop channels. The intended start and stop signals are 1 PPS, although other frequencies can also be applied to start and stop the count. The time interval counters used in the NIST Frequency Measurement and Analysis System are implemented with 7 start channels and 7 stop channels. Four of the 7 start channels are devoted to the frequencies of 1 MHz, 5 MHz or 10 MHz, while triggering signals to all other start and stop channels can range from 1 PPS to 100 kHz. Time interval interpolation plays a key role in achieving the high resolution time interval measurements for both counters. With a 10 MHz time base, both counters demonstrate a single-shot resolution of better than 40 ps, and a stability of better than 5 x 10(exp -12) (sigma(sub chi)(tau)) after self test of 1000 seconds). The maximum rate of time interval measurements (with no dead time) is 1.0 kHz for the counter used in the MODEM application and is 2.0 kHz for the counter used in the Frequency Measurement and Analysis System. The counters are implemented as plug-in units for an AT-compatible personal computer. This configuration provides an efficient way of using a computer not only to control and operate the counters, but also to store and process measured data.

  16. Salvage Re-Irradiation for Recurrent Head and Neck Cancer

    SciTech Connect

    Lee, Nancy . E-mail: Leen2@mskcc.org; Chan, Kelvin; Bekelman, Justin E.; Zhung, Joanne; Mechalakos, James; Narayana, Ashwatha; Wolden, Suzanne; Venkatraman, Ennapadam S.; Pfister, David; Kraus, Dennis; Shah, Jatin; Zelefsky, Michael J.

    2007-07-01

    Purpose: To present a retrospective review of treatment outcomes for recurrent head and neck (HN) cancer patients treated with re-irradiation (re-RT) at a single medical center. Methods and Materials: From July 1996-September 2005, 105 patients with recurrent HN cancer underwent re-RT at our institution. Sites included were: the neck (n = 21), nasopharynx (n 21), paranasal sinus (n = 18), oropharynx (n = 16), oral cavity (n = 9), larynx (n = 10), parotid (n = 6), and hypopharynx (n = 4). The median prior RT dose was 62 Gy. Seventy-five patients received chemotherapy with their re-RT (platinum-based in the majority of cases). The median re-RT dose was 59.4 Gy. In 74 (70%), re-RT utilized intensity-modulated radiation therapy (IMRT). Results: With a median follow-up of 35 months, 18 patients were alive with no evidence of disease. The 2-year loco-regional progression-free survival (LRPFS) and overall survival rates were 42% and 37%, respectively. Patients who underwent IMRT, compared to those who did not, had a better 2-year LRPF (52% vs. 20%, p < 0.001). On multivariate analysis, non-nasopharynx and non-IMRT were associated with an increased risk of loco-regional (LR) failure. Patients with LR progression-free disease had better 2-year overall survival vs. those with LR failure (56% vs. 21%, p < 0.001). Acute and late Grade 3-4 toxicities were reported in 23% and 15% of patients. Severe Grade 3-4 late complications were observed in 12 patients, with a median time to development of 6 months after re-RT. Conclusions: Based on our data, achieving LR control is crucial for improved overall survival in this patient population. The use of IMRT predicted better LR tumor control. Future aggressive efforts in maximizing tumor control in the recurrent setting, including dose escalation with IMRT and improved chemotherapy, are warranted.

  17. Seizure Outcomes and Predictors of Recurrent Post-Stroke Seizure: A Retrospective Observational Cohort Study

    PubMed Central

    Motoyama, Rie; Fukuma, Kazuki; Miyagi, Tetsuya; Nishimura, Kazutaka; Toyoda, Kazunori; Nagatsuka, Kazuyuki

    2015-01-01

    Background Seizure is a common complication after stroke (termed “post-stroke seizure,” PSS). Although many studies have assessed outcomes and risk factors of PSS, no reliable predictors are currently available to determine PSS recurrence. We compared baseline clinical characteristics and post-stroke treatment regimens between recurrent and non-recurrent PSS patients to identify factors predictive of recurrence. Methods Consecutive PSS patients admitted to our stroke center between January 2011 and July 2013 were monitored until February 2014 (median 357 days; IQR, 160–552) and retrospectively evaluated for baseline clinical characteristics and PSS recurrence. Cumulative recurrence rates at 90, 180, and 360 days post-stroke were estimated by Kaplan—Meier analysis. Independent predictors of recurrent PSS were identified by Cox proportional-hazards analysis. Results A total of 104 patients (71 men; mean age, 72.1 ± 11.2 years) were analyzed. PSS recurred in 31 patients (30%) during the follow-up. Factors significantly associated with PSS recurrence by log-rank analysis included previous PSS, valproic acid (VPA) monotherapy, polytherapy with antiepileptic drugs (AEDs), frontal cortical lesion, and higher modified Rankin Scale score at discharge (all p < 0.05). Independent predictors of recurrent PSS were age <74 years (HR 2.38, 95% CI 1.02–5.90), VPA monotherapy (HR 3.86, 95% CI 1.30–12.62), and convulsions on admission (HR 3.87, 95% CI 1.35–12.76). Conclusions Approximately one-third of PSS patients experienced seizure recurrence within one year. The predictors of recurrent PSS were younger age, presence of convulsions and VPA monotherapy. Our findings should be interpreted cautiously in countries where monotherapy with second-generation AEDs has been approved because this study was conducted while second-generation AEDs had not been officially approved for monotherapy in Japan. PMID:26309124

  18. Metastasis-Free Interval Is Closely Related to Tumor Characteristics and Has Prognostic Value in Breast Cancer Patients with Distant Relapse

    PubMed Central

    Kim, Hee Jun; Ahn, Sung Gwe; Lee, Hak Min; Park, Jong Tae; Han, Kyunghwa; Lee, Seung Ah

    2015-01-01

    Purpose We investigated the relationships between metastasis-free interval (MFI) and tumor characteristics, and assessed the prognostic value of MFI for survival after metastasis in patients with metastatic breast cancer. Furthermore, we compared MFI among the subtypes. Methods We identified 335 patients with postoperative tumor recurrence at distant site(s). All patients underwent curative resection and had a MFI of at least 6 months. MFI was categorized as short (<2 years), intermediate (≥2 years and <5 years), or long (≥5 years). Overall survival after metastasis (OSM) was estimated. Results Patients with a shorter MFI were younger, more likely to have initial metastasis to visceral organs, and had a larger tumor with a higher stage and grade as well as a higher rate of nodal involvement at initial diagnosis. Among 136 patients with known disease subtypes, shorter MFI was associated with the triple-negative subtype while longer MFI was associated with the hormone receptor-positive/human epidermal growth factor receptor 2 negative subtype. Mortality after metastasis declined sharply with increasing MFI up to approximately 2 years, and continued gradually declining between 2 and 5 years. An MFI longer than 5 years did not add any survival benefit. MFI was a significant prognostic factor for OSM independent of nodal status, stage, metastatic site, and hormone receptor status of the metastasized cancer. Conclusion MFI is closely related to biological characteristics of both primary tumors and their metastases, and has a prognostic value for survival after metastasis. We therefore suggest investigation into treatments targeting improvement of MFI as a potential novel strategy. PMID:26770244

  19. Association between inflammatory cytokines and the risk of post-stroke depression, and the effect of depression on outcomes of patients with ischemic stroke in a 2-year prospective study

    PubMed Central

    Jiao, Jian-Tong; Cheng, Chao; Ma, Ying-Jun; Huang, Jin; Dai, Min-Chao; Jiang, Chen; Wang, Cheng; Shao, Jun-Fei

    2016-01-01

    The association between inflammatory cytokines and the risk of post-stroke depression (PSD) remains unclear. The aim of the present study was to investigate this association and the effect of PSD on the outcomes of ischemic stroke patients. A total of 355 patients who had experienced ischemic stroke participated in inflammatory cytokine detection by ELISA, in addition to depression, quality of life (QOL) and body performance testing. Cox regression was used to evaluate the associations between PSD risk, inflammatory cytokines and the outcomes of patients. Measurement data was evaluated using Student's t test, and counted data was measured by χ2 test. The incidence of PSD during the 2-year follow-up was 23.1%. The risk of PSD elevated with increased interleukin (IL)-6 expression levels [hazard ratio (HR)=3.18; 95% confidence interval (CI), 1.37–7.36] following the adjustment of confounders. However, no significant associations were identified between PSD and other inflammatory cytokines. QOL and body performance in the depressed group were significantly worse compared with those in the non-depressed group. The risk of stroke recurrence in patients with depression increased two-fold compared with patients without depression (HR=2.020; 95% CI, 1.123–3.635; Ptrend=0.019). No significant associations between PSD and the risk of mortality (HR=1.497; 95% CI, 0.547–4.098) were observed. In conclusion, depression is prevalent in patients following ischemic stroke. IL-6 is positively associated with the risk of PSD, and may predict its development in patients following ischemic stroke. PSD correlates with outcomes of patients, and the effective management of PSD may improve the prognosis of patients. PMID:27588080

  20. Bezlotoxumab for Prevention of Recurrent Clostridium difficile Infection.

    PubMed

    Wilcox, Mark H; Gerding, Dale N; Poxton, Ian R; Kelly, Ciaran; Nathan, Richard; Birch, Thomas; Cornely, Oliver A; Rahav, Galia; Bouza, Emilio; Lee, Christine; Jenkin, Grant; Jensen, Werner; Kim, You-Sun; Yoshida, Junichi; Gabryelski, Lori; Pedley, Alison; Eves, Karen; Tipping, Robert; Guris, Dalya; Kartsonis, Nicholas; Dorr, Mary-Beth

    2017-01-26

    Background Clostridium difficile is the most common cause of infectious diarrhea in hospitalized patients. Recurrences are common after antibiotic therapy. Actoxumab and bezlotoxumab are human monoclonal antibodies against C. difficile toxins A and B, respectively. Methods We conducted two double-blind, randomized, placebo-controlled, phase 3 trials, MODIFY I and MODIFY II, involving 2655 adults receiving oral standard-of-care antibiotics for primary or recurrent C. difficile infection. Participants received an infusion of bezlotoxumab (10 mg per kilogram of body weight), actoxumab plus bezlotoxumab (10 mg per kilogram each), or placebo; actoxumab alone (10 mg per kilogram) was given in MODIFY I but discontinued after a planned interim analysis. The primary end point was recurrent infection (new episode after initial clinical cure) within 12 weeks after infusion in the modified intention-to-treat population. Results In both trials, the rate of recurrent C. difficile infection was significantly lower with bezlotoxumab alone than with placebo (MODIFY I: 17% [67 of 386] vs. 28% [109 of 395]; adjusted difference, -10.1 percentage points; 95% confidence interval [CI], -15.9 to -4.3; P<0.001; MODIFY II: 16% [62 of 395] vs. 26% [97 of 378]; adjusted difference, -9.9 percentage points; 95% CI, -15.5 to -4.3; P<0.001) and was significantly lower with actoxumab plus bezlotoxumab than with placebo (MODIFY I: 16% [61 of 383] vs. 28% [109 of 395]; adjusted difference, -11.6 percentage points; 95% CI, -17.4 to -5.9; P<0.001; MODIFY II: 15% [58 of 390] vs. 26% [97 of 378]; adjusted difference, -10.7 percentage points; 95% CI, -16.4 to -5.1; P<0.001). In prespecified subgroup analyses (combined data set), rates of recurrent infection were lower in both groups that received bezlotoxumab than in the placebo group in subpopulations at high risk for recurrent infection or for an adverse outcome. The rates of initial clinical cure were 80% with bezlotoxumab alone, 73% with actoxumab

  1. Recurrent episodes of injury in children: an Australian cohort study.

    PubMed

    Cameron, Cate M; Spinks, Anneliese B; Osborne, Jodie M; Davey, Tamzyn M; Sipe, Neil; McClure, Roderick J

    2016-08-19

    Objective The aim of the present study was to compare sociodemographic characteristics of children with single versus recurrent episodes of injury and provide contemporary evidence for Australian injury prevention policy development.Methods Participants were identified from the Environments for Healthy Living: Griffith Birth Cohort Study 2006-11 (n=2692). Demographic data were linked to the child's hospital emergency and admissions data from birth to December 2013. Data were dichotomised in two ways: (1) injured or non-injured; and (2) single or recurrent episodes of injury. Multivariate logistic regression was used for analysis.Results The adjusted model identified two factors significantly associated with recurrent episodes of injury in children aged <3 years. Children born to mothers <25 years were almost fourfold more likely to have recurrent episodes of injury compared with children of mothers aged ≥35 years (adjusted odds ratio (aOR)=3.68; 95% confidence interval (CI) 1.44-9.39) and, as a child's age at first injury increased, odds of experiencing recurrent episodes of injury decreased (aOR=0.97; 95% CI 0.94-0.99). No differences were found in sociodemographic characteristics of children aged 3-7 years with single versus recurrent episodes of injury (P>0.1).Conclusion National priorities should include targeted programs addressing the higher odds of recurrent episodes of injury experienced by children aged <3 years with younger mothers or those injured in the first 18 months of life.What is known about the topic? Children who experience recurrent episodes of injury are at greater risk of serious or irrecoverable harm, particularly when repeat trauma occurs in the early years of life.What does the paper add? The present study identifies key factors associated with recurrent episodes of injury in young Australian children. This is imperative to inform evidence-based national injury prevention policy development in line with the recent expiry of the National

  2. Differences in Physiological Responses to Interval Training in Cyclists With and Without Interval Training Experience

    PubMed Central

    Hebisz, Rafal; Borkowski, Jacek; Zatoń, Marek

    2016-01-01

    Abstract The aim of this study was to determine differences in glycolytic metabolite concentrations and work output in response to an all-out interval training session in 23 cyclists with at least 2 years of interval training experience (E) and those inexperienced (IE) in this form of training. The intervention involved subsequent sets of maximal intensity exercise on a cycle ergometer. Each set comprised four 30 s repetitions interspersed with 90 s recovery periods; sets were repeated when blood pH returned to 7.3. Measurements of post-exercise hydrogen (H+) and lactate ion (LA-) concentrations and work output were taken. The experienced cyclists performed significantly more sets of maximal efforts than the inexperienced athletes (5.8 ± 1.2 vs. 4.3 ± 0.9 sets, respectively). Work output decreased in each subsequent set in the IE group and only in the last set in the E group. Distribution of power output changed only in the E group; power decreased in the initial repetitions of set only to increase in the final repetitions. H+ concentration decreased in the third, penultimate, and last sets in the E group and in each subsequent set in the IE group. LA- decreased in the last set in both groups. In conclusion, the experienced cyclists were able to repeatedly induce elevated levels of lactic acidosis. Power output distribution changed with decreased acid–base imbalance. In this way, this group could compensate for a decreased anaerobic metabolism. The above factors allowed cyclists experienced in interval training to perform more sets of maximal exercise without a decrease in power output compared with inexperienced cyclists. PMID:28149346

  3. Differences in Physiological Responses to Interval Training in Cyclists With and Without Interval Training Experience.

    PubMed

    Hebisz, Rafal; Hebisz, Paulina; Borkowski, Jacek; Zatoń, Marek

    2016-04-01

    The aim of this study was to determine differences in glycolytic metabolite concentrations and work output in response to an all-out interval training session in 23 cyclists with at least 2 years of interval training experience (E) and those inexperienced (IE) in this form of training. The intervention involved subsequent sets of maximal intensity exercise on a cycle ergometer. Each set comprised four 30 s repetitions interspersed with 90 s recovery periods; sets were repeated when blood pH returned to 7.3. Measurements of post-exercise hydrogen (H+) and lactate ion (LA-) concentrations and work output were taken. The experienced cyclists performed significantly more sets of maximal efforts than the inexperienced athletes (5.8 ± 1.2 vs. 4.3 ± 0.9 sets, respectively). Work output decreased in each subsequent set in the IE group and only in the last set in the E group. Distribution of power output changed only in the E group; power decreased in the initial repetitions of set only to increase in the final repetitions. H+ concentration decreased in the third, penultimate, and last sets in the E group and in each subsequent set in the IE group. LA- decreased in the last set in both groups. In conclusion, the experienced cyclists were able to repeatedly induce elevated levels of lactic acidosis. Power output distribution changed with decreased acid-base imbalance. In this way, this group could compensate for a decreased anaerobic metabolism. The above factors allowed cyclists experienced in interval training to perform more sets of maximal exercise without a decrease in power output compared with inexperienced cyclists.

  4. Missed sclera buckle as a cause of recurrent conjunctivitis.

    PubMed

    Rostron, Egle; Abdelaziz, Lamis; Barbara, Ramez; Metcalfe, Timothy

    2012-09-07

    A 63-year-old woman was referred to the eye clinic with a 2-year history of unresolving right eye discomfort, irritation and recurrent conjunctivitis, managed by her general practitioner, where frequent use of topical antibiotics and ocular lubricants provided little and transient relief. The right eye was blind following a complicated retinal detachment surgery 30 years ago. Examination revealed an extruding silicone sponge scleral buckle from a previous retinal detachment surgery in the superior conjunctival fornix, under the right upper lid. This was subsequently surgically removed and her symptoms resolved.

  5. Chronic recurrent multifocal osteomyelitis causing spinal cord compression.

    PubMed

    Baulot, E; Bouillien, D; Giroux, E A; Grammont, P M

    1998-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a very rare condition of unknown etiology and most commonly occurs during childhood or adolescence. The purpose of this paper is to present a case of CRMO in a vertebral location with severe kyphosis, spinal cord compression, and neurological dysfunction requiring anterior decompression and fusion. After 12 weeks, the patient was physically able to return to school. At 2-year follow-up, neurological and functional outcomes are fair. Magnetic resonance imaging shows good restoration of the sagittal spine alignment despite residual mild kyphosis, and restoration of a normal sagittal diameter of the spinal canal.

  6. Computationally Efficient Marginal Models for Clustered Recurrent Event Data

    PubMed Central

    Liu, Dandan; Schaubel, Douglas E.; Kalbfleisch, John D.

    2012-01-01

    Summary Large observational databases derived from disease registries and retrospective cohort studies have proven very useful for the study of health services utilization. However, the use of large databases may introduce computational difficulties, particularly when the event of interest is recurrent. In such settings, grouping the recurrent event data into pre-specified intervals leads to a flexible event rate model and a data reduction which remedies the computational issues. We propose a possibly stratified marginal proportional rates model with a piecewise-constant baseline event rate for recurrent event data. Both the absence and the presence of a terminal event are considered. Large-sample distributions are derived for the proposed estimators. Simulation studies are conducted under various data configurations, including settings in which the model is misspecified. Guidelines for interval selection are provided and assessed using numerical studies. We then show that the proposed procedures can be carried out using standard statistical software (e.g., SAS, R). An application based on national hospitalization data for end stage renal disease patients is provided. PMID:21957989

  7. Clinical significance and predictive factors of early massive recurrence after radiofrequency ablation in patients with a single small hepatocellular carcinoma

    PubMed Central

    Cho, Ju-Yeon; Choi, Moon Seok; Lee, Gil Sun; Sohn, Won; Ahn, Jemma; Sinn, Dong-Hyun; Gwak, Geum-Youn; Paik, Yong-Han; Lee, Joon Hyeok; Koh, Kwang Cheol; Paik, Seung Woon

    2016-01-01

    Background/Aims Radiofrequency ablation (RFA) is one of the most frequently applied curative treatments in patients with a single small hepatocellular carcinoma (HCC). However, the clinical significance of and risk factors for early massive recurrence after RFA—a dreadful event limiting further curative treatment—have not been fully evaluated. Methods In total, 438 patients with a single HCC of size ≤3 cm who underwent percutaneous RFA as an initial treatment between 2006 and 2009 were included. Baseline patient characteristics, overall survival, predictive factors, and recurrence after RFA were evaluated. In addition, the incidence, impact on survival, and predictive factors of early massive recurrence, and initial recurrence beyond the Milan criteria within 2 years were also investigated. Results During the median follow-up of 68.4 months, recurrent HCC was confirmed in 302 (68.9%) patients, with early massive recurrence in 27 patients (6.2%). The 1-, 3-, and 5-year overall survival rates were 95.4%, 84.7%, and 81.8%, respectively, in patients with no recurrence, 99.6%, 86.4%, and 70.1% in patients with recurrence within the Milan criteria or late recurrence, and 92.6%, 46.5%, and 0.05% in patients with early massive recurrence. Multivariable analysis identified older age, Child-Pugh score B or C, and early massive recurrence as predictive of poor overall survival. A tumor size of ≥2 cm and tumor location adjacent to the colon were independent risk factors predictive of early massive recurrence. Conclusion Early massive recurrence is independently predictive of poor overall survival after RFA in patients with a single small HCC. Tumors sized ≥2 cm and located adjacent to the colon appear to be independent risk factors for early massive recurrence. PMID:28081587

  8. Treatment of recurrent vulvovaginal candidiasis.

    PubMed

    Ringdahl, E N

    2000-06-01

    Vulvovaginal candidiasis is considered recurrent when at least four specific episodes occur in one year or at least three episodes unrelated to antibiotic therapy occur within one year. Although greater than 50 percent of women more than 25 years of age develop vulvovaginal candidiasis at some time, fewer than 5 percent of these women experience recurrences. Clinical evaluation of recurrent episodes is essential. Patients who self-diagnose may miss other causes or concurrent infections. Known etiologies of recurrent vulvovaginal candidiasis include treatment-resistant Candida species other than Candida albicans, frequent antibiotic therapy, contraceptive use, compromise of the immune system, sexual activity and hyperglycemia. If microscopic examination of vaginal secretions in a potassium hydroxide preparation is negative but clinical suspicion is high, fungal cultures should be obtained. After the acute episode has been treated, subsequent prophylaxis (maintenance therapy) is important. Because many patients experience recurrences once prophylaxis is discontinued, long-term therapy may be warranted. Patients are more likely to comply when antifungal therapy is administered orally, but oral treatment carries a greater potential for systemic toxicity and drug interactions.

  9. RECURRENT NOVAE IN M31

    SciTech Connect

    Shafter, A. W.; Henze, M.; Rector, T. A.; Schweizer, F.; Hornoch, K.; Orio, M.; Pietsch, W.; Darnley, M. J.; Williams, S. C.; Bode, M. F.; Bryan, J.

    2015-02-01

    The reported positions of 964 suspected nova eruptions in M31 recorded through the end of calendar year 2013 have been compared in order to identify recurrent nova (RN) candidates. To pass the initial screen and qualify as a RN candidate, two or more eruptions were required to be coincident within 0.′1, although this criterion was relaxed to 0.′15 for novae discovered on early photographic patrols. A total of 118 eruptions from 51 potential RN systems satisfied the screening criterion. To determine what fraction of these novae are indeed recurrent, the original plates and published images of the relevant eruptions have been carefully compared. This procedure has resulted in the elimination of 27 of the 51 progenitor candidates (61 eruptions) from further consideration as RNe, with another 8 systems (17 eruptions) deemed unlikely to be recurrent. Of the remaining 16 systems, 12 candidates (32 eruptions) were judged to be RNe, with an additional 4 systems (8 eruptions) being possibly recurrent. It is estimated that ∼4% of the nova eruptions seen in M31 over the past century are associated with RNe. A Monte Carlo analysis shows that the discovery efficiency for RNe may be as low as 10% that for novae in general, suggesting that as many as one in three nova eruptions observed in M31 arise from progenitor systems having recurrence times ≲100 yr. For plausible system parameters, it appears unlikely that RNe can provide a significant channel for the production of Type Ia supernovae.

  10. Recurrent Novae in M31

    NASA Astrophysics Data System (ADS)

    Shafter, A. W.; Henze, M.; Rector, T. A.; Schweizer, F.; Hornoch, K.; Orio, M.; Pietsch, W.; Darnley, M. J.; Williams, S. C.; Bode, M. F.; Bryan, J.

    2015-02-01

    The reported positions of 964 suspected nova eruptions in M31 recorded through the end of calendar year 2013 have been compared in order to identify recurrent nova (RN) candidates. To pass the initial screen and qualify as a RN candidate, two or more eruptions were required to be coincident within 0.‧1, although this criterion was relaxed to 0.‧15 for novae discovered on early photographic patrols. A total of 118 eruptions from 51 potential RN systems satisfied the screening criterion. To determine what fraction of these novae are indeed recurrent, the original plates and published images of the relevant eruptions have been carefully compared. This procedure has resulted in the elimination of 27 of the 51 progenitor candidates (61 eruptions) from further consideration as RNe, with another 8 systems (17 eruptions) deemed unlikely to be recurrent. Of the remaining 16 systems, 12 candidates (32 eruptions) were judged to be RNe, with an additional 4 systems (8 eruptions) being possibly recurrent. It is estimated that ∼4% of the nova eruptions seen in M31 over the past century are associated with RNe. A Monte Carlo analysis shows that the discovery efficiency for RNe may be as low as 10% that for novae in general, suggesting that as many as one in three nova eruptions observed in M31 arise from progenitor systems having recurrence times ≲ 100 yr. For plausible system parameters, it appears unlikely that RNe can provide a significant channel for the production of Type Ia supernovae.

  11. Shortest recurrence periods of novae

    SciTech Connect

    Kato, Mariko; Saio, Hideyuki; Hachisu, Izumi; Nomoto, Ken'ichi

    2014-10-01

    Stimulated by the recent discovery of the 1 yr recurrence period nova M31N 2008-12a, we examined the shortest recurrence periods of hydrogen shell flashes on mass-accreting white dwarfs (WDs). We discuss the mechanism that yields a finite minimum recurrence period for a given WD mass. Calculating the unstable flashes for various WD masses and mass accretion rates, we identified a shortest recurrence period of about two months for a non-rotating 1.38 M {sub ☉} WD with a mass accretion rate of 3.6 × 10{sup –7} M {sub ☉} yr{sup –1}. A 1 yr recurrence period is realized for very massive (≳ 1.3 M {sub ☉}) WDs with very high accretion rates (≳ 1.5 × 10{sup –7} M {sub ☉} yr{sup –1}). We revised our stability limit of hydrogen shell burning, which will be useful for binary evolution calculations toward Type Ia supernovae.

  12. Comparison between visual clinical examination and the replica method for assessments of sealant retention over a 2-year period

    PubMed Central

    Hu, Xuan; Chen, Xi; Ye, Lu; Fan, Ming-Wen; Huysmans, Marie-Charlotte; Frencken, Jo E

    2014-01-01

    To compare the levels of agreement and the survival rates of sealant retention for different sealing materials over a 2-year period assessed using the visual clinical examination and replica methods, sealant retention data were obtained by visual clinical examination and from replicas of the same sealed tooth at baseline and at 0.5-, 1- and 2-year evaluation points in 407 children and were compared for agreement using kappa coefficients. Survival curves of retained sealants on occlusal surfaces were created using modified categorisation (fully retained sealants and those having all pits and fissures partly covered with the sealant material versus completely lost sealants that included pit and fissure systems that had ≥1 pit re-exposed) according to the Kaplan–Meier method. The kappa coefficient for the agreement between both assessment methods over the three evaluation time points combined was 0.38 (95% confidence interval (CI): 0.35–0.41). More sealant retention was observed from replicas than through visual clinical examination. Cumulative survival curves at the three evaluation times were not statistically significantly higher when assessed from replicas (P=0.47). Using the replica method, more retained sealant material was observed than through visual clinical examination during the 2-year period. This finding did not result in a difference in the survival rates of sealants assessed by the two assessment methods. When replicas cast in die stone are used for assessing sealant retention, the level of reliability of the data is higher than that of data obtained through the commonly used visual clinical examination, particularly if such assessments are conducted over time. PMID:24625469

  13. Depression in Women with Recurrent Miscarriages - an Exploratory Study.

    PubMed

    Carvalho, Ariel Cesar de; Silva, Michele Eugênio da; Matos, Bárbara Magueta; Bottino, Cassio Machado de Campos; Abrahão, Anelise Riedel; Cohrs, Frederico Molina; Bottino, Sara Mota Borges

    2016-12-01

    Objective To assess depression, domestic violence and the use of substances in women with recurrent miscarriages. Methods The Abuse Assessment Screen (AAS), the Edinburgh Postnatal Depression Scale (EPDS) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess violence, depression and the use of substances among women with recurrent miscarriages. The population corresponded to patients receiving prenatal care from June to August 2014. Multiple logistic regression was used to assess the multivariable relationship between depression and sociodemographic, psychosocial and medical characteristics (p < 0,10). Results The prevalence of depression was of 41.3% (95% confidence interval [CI] = 28.3-55.7%). One third of the pregnant women (32.6%) reported emotional or physical violence, and 13% were classified as abusing or addicted to tobacco according to ASSIST. History of psychiatric diseases was associated with depression (p = 0.005). Violence during life demonstrated a modest association (p = 0.073) with depression, as well as the number of miscarriages (p = 0.071). Conclusion Depression is a frequent disease among pregnant women with recurrent miscarriages. The results of this investigation suggest that a systematic assessment of depression and its associated conditions, such as domestic violence and the use of substances, should be part of the prenatal follow-up visits for women with recurrent miscarriages.

  14. Analysis of recurrent event data with incomplete observation gaps.

    PubMed

    Kim, Yang-Jin; Jhun, Myoungshic

    2008-03-30

    In analysis of recurrent event data, recurrent events are not completely experienced when the terminating event occurs before the end of a study. To make valid inference of recurrent events, several methods have been suggested for accommodating the terminating event (Statist. Med. 1997; 16:911-924; Biometrics 2000; 56:554-562). In this paper, our interest is to consider a particular situation, where intermittent dropouts result in observation gaps during which no recurrent events are observed. In this situation, risk status varies over time and the usual definition of risk variable is not applicable. In particular, we consider the case when information on the observation gap is incomplete, that is, the starting time of intermittent dropout is known but the terminating time is not available. This incomplete information is modeled in terms of an interval-censored mechanism. Our proposed method is applied to the study of the Young Traffic Offenders Program on conviction rates, wherein a certain proportion of subjects experienced suspensions with intermittent dropouts during the study.

  15. Initial Results of a Phase I Dose-Escalation Trial of Concurrent and Maintenance Erlotinib and Reirradiation for Recurrent and New Primary Head-and-Neck Cancer

    SciTech Connect

    Rusthoven, Kyle E.; Feigenberg, Steven J.; Raben, David; Kane, Madeleine; Song, John I.; Nicolaou, Nicos; Mehra, Ranee; Burtness, Barbara; Ridge, John; Swing, Robyn; Lango, Miriam; Cohen, Roger; Jimeno, Antonio; Chen Changhu

    2010-11-15

    Purpose: To present the first report of a Phase I trial evaluating concurrent and maintenance erlotinib and reirradiation in patients with recurrent or secondary primary head-and-neck cancer (HNC). Methods and Materials: Patients with recurrent or new primary HNC with an interval of at least 6 months since prior radiation were eligible. Patients were treated in 3 sequential cohorts: Cohort I, 100 mg of erlotinib daily with reirradiation at 61.6 Gy in 28 fractions; Cohort II, 150 mg of erlotinib with 61.6 Gy in 28 fractions; and Cohort III, 150 mg of erlotinib with 66 Gy in 30 fractions. Maintenance erlotinib started immediately after reirradiation at 150 mg daily and was continued for 2 years or until disease progression or dose-limiting toxicity. Dose-limiting toxicities were defined as any Grade 4 or 5 toxicity or a toxicity-related delay in radiation therapy of greater than 7 days. Results: Fourteen patients were accrued, 3 to Cohort I, 4 to Cohort II, and 7 to Cohort III. Thirteen patients were evaluable for toxicity. Median follow-up was 8.4 months overall and 15.1 months for surviving patients. One patient had a dose-limiting toxicity in Cohort III. This patient declined initial percutaneous endoscopic gastrostomy tube placement, was hospitalized with Grade 3 dysphagia and aspiration, and required a delay in radiation therapy of greater than 7 days. No Grade 4 acute toxicity was observed. Acute Grade 3 toxicity occurred in 9 of 13 patients. No erlotinib-related toxicity of Grade 3 or greater was observed during maintenance therapy. One patient had Grade 5 carotid hemorrhage 6 months after reirradiation, and another patient had Grade 3 osteoradionecrosis. Conclusions: Reirradiation (66 Gy in 2.2 Gy fractions) with concurrent and maintenance erlotinib (150 mg daily) for recurrent or new primary HNC is feasible.

  16. New constraints on slip-rates, recurrence intervals, and strain partitioning beneath Pyramid Lake, Nevada

    SciTech Connect

    Eisses, Amy

    2012-05-05

    A high-resolution CHIRP seismic survey of Pyramid Lake, Nevada, located within the northern Walker Lane Deformation Belt, was conducted in summer 2010. Seismic CHIRP data with submeter vertical accuracy, together with piston and gravity cores, were used to calculate Holocene vertical slip rates, relative earthquake timing, and produce the first complete fault map beneath the lake. More than 500 line-kilometers of CHIRP data imaged complex fault patterns throughout the basin. Fault architecture beneath Pyramid Lake highlights a polarity flip, where down-to-the west patterns of sedimentation near the dextral Pyramid Lake fault to the south give way to down-to-the-east geometries to the north within a mostly normal (i.e., Lake Range fault) and transtensional environment. The Lake Range fault predominantly controls extensional deformation within the northern two-thirds of the basin and exhibits varying degrees of asymmetric tilting and divergence due to along-strike segmentation. This observation is likely a combination of fault segments splaying onshore moving the focus of extension away from the lake coupled with some true along-strike differences in slip-rate. The combination of normal and oblique-slip faults in the northern basin gives Pyramid Lake its distinctive “fanning open to the north” tectonic geometry. The dense network of oblique-slip faults in the northwestern region of the lake, in contrast to the well-defined Lake Range fault, are short and discontinuous in nature, and possible represent a nascent shear zone. Preliminary vertical slip-rates measured across the Lake Range and other faults provide new estimates on the extension across the Pyramid Lake basin. A minimum vertical slip rate of ~1.0 mm/yr is estimated along the Lake Range fault, which yields a potential earthquake magnitude range between M6.4 and M7.0. A rapid influx of sediment was deposited shortly after the end of the Tioga glaciation somewhere between 12.5 ka to 9.5 ka and provides a punctuated short-term record of little to no slip on the Lake Range fault. In contrast, for the past 9,500 years, the basin has experienced a decrease in sedimentation rate, but an escalation in earthquake activity on the Lake Range fault, with the potential of 3 or 4 major earthquakes assuming a characteristic offset of 2.5 m per event. Regionally, our CHIRP investigation helps to reveal how strain is partitioned along the boundary between the eastern edge of the Walker Lane Deformation Belt and the northwest Great Basin proper.

  17. Reconciling short recurrence intervals with minor deformation in the new madrid seismic zone.

    PubMed

    Schweig, E S; Ellis, M A

    1994-05-27

    At least three great earthquakes occurred in the New Madrid seismic zone in 1811 and 1812. Estimates of present-day strain rates suggest that such events may have a repeat time of 1000 years or less. Paleoseismological data also indicate that earthquakes large enough to cause soil liquefaction have occurred several times in the past 5000 years. However, pervasive crustal deformation expected from such a high frequency of large earthquakes is not observed. This suggests that the seismic zone is a young feature, possibly as young as several tens of thousands of years old and no more than a few million years old.

  18. Reconciling short recurrence intervals with minor deformation in the New Madrid seismic zone

    USGS Publications Warehouse

    Schweig, E.S.; Ellis, M.A.

    1994-01-01

    At least three great earthquakes occurred in the New Madrid seismic zone in 1811 and 1812. Estimates of present-day strain rates suggest that such events may have a repeat time of 1000 years or less. Paleoseismological data also indicate that earthquakes large enough to cause soil liquefaction have occurred several times in the past 5000 years. However, pervasive crustal deformation expected from such a high frequency of large earthquakes is not observed. This suggests that the seismic zone is a young feature, possibly as young as several tens of thousands of years old and no more than a few million years old.At least three great earthquakes occurred in the New Madrid seismic zone in 1811 and 1812. Estimates of present-day strain rates suggest that such events may have a repeat time of 1000 years or less. Paleoseismological data also indicate that earthquakes large enough to cause soil liquefaction have occurred several times in the past 5000 years. However, pervasive crustal deformation expected from such a high frequency of large earthquakes is not observed. This suggests that the seismic zone is a young feature, possibly as young as several tens of thousands of years old and no more than a few million years old.

  19. Estimating the magnitude of peak flows at selected recurrence intervals for streams in Idaho

    USGS Publications Warehouse

    Berenbrock, Charles

    2002-01-01

    The region-of-influence method is not recommended for use in determining flood-frequency estimates for ungaged sites in Idaho because the results, overall, are less accurate and the calculations are more complex than those of regional regression equations. The regional regression equations were considered to be the primary method of estimating the magnitude and frequency of peak flows for ungaged sites in Idaho.

  20. Recurrence of Hyperprolactinemia after Withdrawal of Long-Term Cabergoline Therapy

    PubMed Central

    Kharlip, J.; Salvatori, R.; Yenokyan, G.; Wand, G. S.

    2009-01-01

    Context: Recurrence of hyperprolactinemia after cabergoline withdrawal ranges widely from 36 to 80%. The Pituitary Society recommends withdrawal of cabergoline in selected patients. Objective: Our aim was to evaluate recurrence of hyperprolactinemia in patients meeting The Pituitary Society guidelines. Design: Patients were followed from the date of discontinuation to either relapse of hyperprolactinemia or the day of last prolactin test. Setting: We conducted the study at an academic medical center. Patients: Forty-six patients meeting Pituitary Society criteria (normoprolactinemic and with tumor volume reduction after 2 or more years of treatment) participated in the study. Interventions: After withdrawal, if prolactin returned above reference range, another measurement was obtained within 1 month, symptoms were assessed by questionnaire, and magnetic resonance imaging was performed. Main Outcome Measures: We measured risk of and time to recurrence estimates as well as clinical predictors of recurrence. Results: Mean age of patients was 50 ± 13 yr, and 70% were women. Thirty-one patients had microprolactinomas, 11 had macroprolactinomas, and four had nontumoral hyperprolactinemia. The overall recurrence was 54%, and the estimated risk of recurrence by 18 months was 63%. The median time to recurrence was 3 months (range, 1–18 months), with 91% of recurrences occurring within 1 yr after discontinuation. Size of tumor remnant prior to withdrawal predicted recurrence [18% increase in risk for each millimeter (95% confidence interval, 3–35; P = 0.017)]. None of the tumors enlarged in the patients experiencing recurrence, and 28% had symptoms of hypogonadism. Conclusions: Cabergoline withdrawal is practical and safe in a subset of patients as defined by The Pituitary Society guidelines; however, the average risk of long-term recurrence in our study was over 60%. Close follow-up remains important, especially within the first year. PMID:19336508

  1. Oncolytic HSV-1716 in Treating Younger Patients With Refractory or Recurrent High Grade Glioma That Can Be Removed By Surgery

    ClinicalTrials.gov

    2016-05-26

    Recurrent Childhood Anaplastic Astrocytoma; Recurrent Childhood Anaplastic Oligoastrocytoma; Recurrent Childhood Anaplastic Oligodendroglioma; Recurrent Childhood Giant Cell Glioblastoma; Recurrent Childhood Glioblastoma; Recurrent Childhood Gliomatosis Cerebri; Recurrent Childhood Gliosarcoma

  2. Galactosemia presenting as recurrent sepsis.

    PubMed

    Rathi, Narendra; Rathi, Akanksha

    2011-12-01

    Galactosemia is a treatable metabolic disorder caused by the deficiency of enzyme galactose-1-phosphate uridyl transferase (GALT) and inherited as an autosomal recessive trait. A case of neonate manifesting with recurrent Escherichia coli sepsis is presented here which turned out to be a classic galactosemia. No other common presenting features were observed in this infant except cataract on slit lamp examination. To the best of our knowledge, there is no case of galactosemia reported in literature which presented with recurrent neonatal sepsis without hepatomegaly, hyperbilirubinemia, bleeding disorder, vomiting, diarrhea, failure to thrive, hypoglycemia, coagulopathy, hemolysis or renal tubular acidosis.

  3. An Event Restriction Interval Theory of Tense

    ERIC Educational Resources Information Center

    Beamer, Brandon Robert

    2012-01-01

    This dissertation presents a novel theory of tense and tense-like constructions. It is named after a key theoretical component of the theory, the event restriction interval. In Event Restriction Interval (ERI) Theory, sentences are semantically evaluated relative to an index which contains two key intervals, the evaluation interval and the event…

  4. Endometrial transcriptome in recurrent miscarriage and recurrent implantation failure.

    PubMed

    Huang, Jin; Qin, Hao; Yang, Yihua; Chen, Xiaoyan; Zhang, Jiamiao; Laird, Susan; Wang, Chi Chiu; Chan, Ting Fung; Li, Tin Chiu

    2017-03-10

    The endometrium becomes receptive to the embryo only in the mid-luteal phase, but not other stages of the menstrual cycle. Endometrial factors play an important role in implantation. Women with recurrent miscarriage and recurrent implantation failure have both been reported to have altered expression of receptivity markers during the window of implantation. We aimed to compare the gene expression profiles of the endometrium in the window of implantation among women with unexplained recurrent implantation failures (RIF) and unexplained recurrent miscarriages (RM) by RNA sequencing (RNA-Seq). In total 20 patients (9 RIF and 11 RM) were recruited. In addition 4 fertile subjects were included as reference. Endometrium samples were precisely timed on the 7th day after luteal hormone surge (LH+7). All the 24 samples were extracted for total RNA. The transcriptome was determined by RNA-Seq in first 14 RNA samples (5 RIF, 6 RM, and 3 fertile). Differentially expressed genes between RM and RIF were validated by quantitative real time PCR (qPCR) in all 24 RNA samples (9 RIF, 11 RM and 4 fertile). Complementary and coagulation cascades pathway was the significantly up-regulated in RIF while down-regulated in RM. Differentially expressed genes C3, C4, C4BP, DAF, DF and SERPING1 in complement and coagulation cascade pathway between RM and RIF were further validated by qPCR. This study identified differential molecular pathways in endometrium between RIF and RM, which potentially affect the implantation process.

  5. Chief Student Affairs Officers in 2-Year Colleges: Their Demographics and Educational Backgrounds

    ERIC Educational Resources Information Center

    Keim, Marybelle C.

    2008-01-01

    The purpose of this study was to determine demographics and educational backgrounds of chief student affairs officers (CSAOs) in public 2-year colleges. Using systematic sampling techniques, 300 2-year colleges were selected from the AACC Membership Directory for inclusion in the study. Each college's website was visited to determine the name of…

  6. Infantile Amnesia across the Years: A 2-Year Follow-Up of Children's Earliest Memories

    ERIC Educational Resources Information Center

    Peterson, Carole; Warren, Kelly L.; Short, Megan M.

    2011-01-01

    Although infantile amnesia has been investigated for many years in adults, only recently has it been investigated in children. This study was a 2-year follow-up and extension of an earlier study. Children (4-13 years old) were asked initially and 2 years later for their earliest 3 memories. At follow-up, their age at the time of these memories…

  7. The Role of 2-Year Colleges in the Improving Situation of Hispanic Postsecondary Education

    ERIC Educational Resources Information Center

    Gonzalez, Arturo; Hilmer, Michael J.

    2006-01-01

    During the past two decades 2-year colleges have become an increasingly important part of the American higher education system, especially for Hispanics who are disproportionately likely to start their careers in 2-year colleges. Given that today's economy rewards college attendance more than every before [Bound & Johnson (1992). "The…

  8. Monte Carlo Method for Determining Earthquake Recurrence Parameters from Short Paleoseismic Catalogs: Example Calculations for California

    USGS Publications Warehouse

    Parsons, Tom

    2008-01-01

    Paleoearthquake observations often lack enough events at a given site to directly define a probability density function (PDF) for earthquake recurrence. Sites with fewer than 10-15 intervals do not provide enough information to reliably determine the shape of the PDF using standard maximum-likelihood techniques [e.g., Ellsworth et al., 1999]. In this paper I present a method that attempts to fit wide ranges of distribution parameters to short paleoseismic series. From repeated Monte Carlo draws, it becomes possible to quantitatively estimate most likely recurrence PDF parameters, and a ranked distribution of parameters is returned that can be used to assess uncertainties in hazard calculations. In tests on short synthetic earthquake series, the method gives results that cluster around the mean of the input distribution, whereas maximum likelihood methods return the sample means [e.g., NIST/SEMATECH, 2006]. For short series (fewer than 10 intervals), sample means tend to reflect the median of an asymmetric recurrence distribution, possibly leading to an overestimate of the hazard should they be used in probability calculations. Therefore a Monte Carlo approach may be useful for assessing recurrence from limited paleoearthquake records. Further, the degree of functional dependence among parameters like mean recurrence interval and coefficient of variation can be established. The method is described for use with time-independent and time-dependent PDF?s, and results from 19 paleoseismic sequences on strike-slip faults throughout the state of California are given.

  9. Monte Carlo method for determining earthquake recurrence parameters from short paleoseismic catalogs: Example calculations for California

    USGS Publications Warehouse

    Parsons, T.

    2008-01-01

    Paleoearthquake observations often lack enough events at a given site to directly define a probability density function (PDF) for earthquake recurrence. Sites with fewer than 10-15 intervals do not provide enough information to reliably determine the shape of the PDF using standard maximum-likelihood techniques (e.g., Ellsworth et al., 1999). In this paper I present a method that attempts to fit wide ranges of distribution parameters to short paleoseismic series. From repeated Monte Carlo draws, it becomes possible to quantitatively estimate most likely recurrence PDF parameters, and a ranked distribution of parameters is returned that can be used to assess uncertainties in hazard calculations. In tests on short synthetic earthquake series, the method gives results that cluster around the mean of the input distribution, whereas maximum likelihood methods return the sample means (e.g., NIST/SEMATECH, 2006). For short series (fewer than 10 intervals), sample means tend to reflect the median of an asymmetric recurrence distribution, possibly leading to an overestimate of the hazard should they be used in probability calculations. Therefore a Monte Carlo approach may be useful for assessing recurrence from limited paleoearthquake records. Further, the degree of functional dependence among parameters like mean recurrence interval and coefficient of variation can be established. The method is described for use with time-independent and time-dependent PDFs, and results from 19 paleoseismic sequences on strike-slip faults throughout the state of California are given.

  10. Lapatinib in Treating Young Patients With Recurrent or Refractory Central Nervous System Tumors

    ClinicalTrials.gov

    2014-05-07

    Recurrent Childhood Anaplastic Astrocytoma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Ependymoma; Recurrent Childhood Giant Cell Glioblastoma; Recurrent Childhood Glioblastoma; Recurrent Childhood Gliosarcoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood Oligodendroglioma

  11. Impact of Multidrug Resistance on Tuberculosis Recurrence and Long-Term Outcome in China

    PubMed Central

    Sun, Yanni; Harley, David; Vally, Hassan; Sleigh, Adrian

    2017-01-01

    Little is known about the impact of drug resistance on recurrence in TB. We conducted a cohort study to measure the impact of multi-drug resistance (MDR) on TB recurrence over nine years in Henan Province China. We reviewed medical records and conducted field interviews of 100 MDR and 150 non-MDR TB patients who were treated between 2001 and 2002. We compared long-term recurrence rates, risk factors, and outcomes in 2010 for 234 individuals who could be followed up. About one third (29.5%, 69/234) suffered recurrence after completion of treatment. The overall recurrence rate was 35/1,000 patient-years (PY), with a much higher rate (65/1,000 PY) among MDR-TB patients. MDR (HR: 2.75; CI: 1.58–4.79) and patient annual household income less than 10,000 Yuan (HR: 2.05; CI 1.11–3.80) were associated with recurrence. The mean time for recurrence among MDR-TB patients was 5.7 years, compared to 7.2 years among non-MDR-TB patients. Among the recurrence group members, 61.3% died, and 18.8% had failed treatments. We believe that the high TB recurrence rate after 9 years suggests that a high cure rate cannot accurately predict long-term outcome. We recommend that TB surveillance and control should be strengthened with a focus on MDR-TB and directly observed treatment, to reduce TB recurrence and transmission of MDR-TB. PMID:28118372

  12. A Brownian model for recurrent earthquakes

    USGS Publications Warehouse

    Matthews, M.V.; Ellsworth, W.L.; Reasenberg, P.A.

    2002-01-01

    We construct a probability model for rupture times on a recurrent earthquake source. Adding Brownian perturbations to steady tectonic loading produces a stochastic load-state process. Rupture is assumed to occur when this process reaches a critical-failure threshold. An earthquake relaxes the load state to a characteristic ground level and begins a new failure cycle. The load-state process is a Brownian relaxation oscillator. Intervals between events have a Brownian passage-time distribution that may serve as a temporal model for time-dependent, long-term seismic forecasting. This distribution has the following noteworthy properties: (1) the probability of immediate rerupture is zero; (2) the hazard rate increases steadily from zero at t = 0 to a finite maximum near the mean recurrence time and then decreases asymptotically to a quasi-stationary level, in which the conditional probability of an event becomes time independent; and (3) the quasi-stationary failure rate is greater than, equal to, or less than the mean failure rate because the coefficient of variation is less than, equal to, or greater than 1/???2 ??? 0.707. In addition, the model provides expressions for the hazard rate and probability of rupture on faults for which only a bound can be placed on the time of the last rupture. The Brownian relaxation oscillator provides a connection between observable event times and a formal state variable that reflects the macromechanics of stress and strain accumulation. Analysis of this process reveals that the quasi-stationary distance to failure has a gamma distribution, and residual life has a related exponential distribution. It also enables calculation of "interaction" effects due to external perturbations to the state, such as stress-transfer effects from earthquakes outside the target source. The influence of interaction effects on recurrence times is transient and strongly dependent on when in the loading cycle step pertubations occur. Transient effects may

  13. Outburst of the recurrent nova V745 Sco

    NASA Astrophysics Data System (ADS)

    Waagen, Elizabeth O.

    2014-02-01

    The outburst of the recurrent nova V745 Sco (Nova Sco 1937) by Rod Stubbings (Tetoora Road, VIC, Australia) at visual magnitude 9.0 on 2014 February 6.694 UT is reported. This recurrent nova is fading quickly. Follow-up observations of all types (visual, CCD, DSLR) are strongly encouraged, as is spectroscopy; fast time-series of this nova may be useful to detect possible flaring activity as was observed during the outburst of U Scorpii in 2010. Coincident time-series by multiple observers would be most useful for such a study, with a V-filter being preferred. Observations reported to the AAVSO International Database show V745 Sco at visual mag. 10.2 on 2014 Feb. 07.85833 UT (A. Pearce, Nedlands, W. Australia). Finder charts with sequence may be created using the AAVSO Variable Star Plotter (http://www.aavso.org/vsp). Observations should be submitted to the AAVSO International Database. Previous outbursts occurred in 1937 and 1989. The 1937 outburst was detected in 1958 (in decline at magnitude 11.0 on 1937 May 11.1 UT; outburst had occurred within the previous 19 days) by Lukas Plaut on plates taken by Hendrik van Gent at the Leiden Observatory; the object was announced as Nova Sco 1937 and later assigned the GCVS name V745 Sco. The 1989 outburst was detected on 1989 August 1.55 UT by Mati Morel (MMAT, Thornton, NSW, Australia) at visual magnitude 10.4 and in decline. Dr. Bradley Schaefer (Louisiana State University) reports (2010ApJS..187..275S) in his comprehensive analysis of the 10 known galactic recurrent novae (including V745 Sco) that the median interval between recurrent novae outbursts is 24 years. The interval since the 1989 outburst of V745 Sco is 24.10 years. See the Alert Notice for additional visual and multicolor photometry and for more details.

  14. Modeling disease progression of camellia twig blight using a recurrent event model.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To improve control of camellia twig blight (CTB) using sanitation methods, a more complete epidemiologic understanding of this disease is necessary. Three CTB disease stages were modeled using recurrent event analysis. Wound inoculated stems were observed at regular intervals for appearance of dise...

  15. Detection and prognostic value of recurrent exportin 1 mutations in tumor and cell-free circulating DNA of patients with classical Hodgkin lymphoma.

    PubMed

    Camus, Vincent; Stamatoullas, Aspasia; Mareschal, Sylvain; Viailly, Pierre-Julien; Sarafan-Vasseur, Nasrin; Bohers, Elodie; Dubois, Sydney; Picquenot, Jean Michel; Ruminy, Philippe; Maingonnat, Catherine; Bertrand, Philippe; Cornic, Marie; Tallon-Simon, Valérie; Becker, Stéphanie; Veresezan, Liana; Frebourg, Thierry; Vera, Pierre; Bastard, Christian; Tilly, Hervé; Jardin, Fabrice

    2016-09-01

    Classical Hodgkin lymphoma is one of the most common lymphomas and shares clinical and genetic features with primary mediastinal B-cell lymphoma. In this retrospective study, we analyzed the recurrent hotspot mutation of the exportin 1 (XPO1, p.E571K) gene, previously identified in primary mediastinal B-cell lymphoma, in biopsies and plasma circulating cell-free DNA from patients with classical Hodgkin lymphoma using a highly sensitive digital PCR technique. A total of 94 patients were included in the present study. This widely expressed XPO1 E571K mutation is present in one quarter of classical Hodgkin lymphoma patients (24.2%). Mutated and wild-type classical Hodgkin lymphomas were similar regarding the main clinical features. Patients with a detectable XPO1 mutation at the end of treatment displayed a tendency toward shorter progression-free survival, as compared to patients with undetectable mutation in plasma cell-free DNA (2-year progression-free survival: 57.1%, 95% confidence interval: 30.1-100% versus 2-year progression-free survival: 90.5%, 95% confidence interval: 78.8-100%, respectively, P=0.0601). To conclude, the detection of the XPO1 E571K mutation in biopsy and plasma cell-free DNA by digital PCR may be used as a novel biomarker in classical Hodgkin lymphoma for both diagnosis and minimal residual disease, and pinpoints a crucial role of XPO1 in classical Hodgkin lymphoma pathogenesis. The detection of somatic mutation in the plasma cell-free DNA of patients represents a major technological advance in the context of liquid biopsies and noninvasive management of classical Hodgkin lymphoma.

  16. [Radiodiagnosis of recurrences of lymphogranulomatosis].

    PubMed

    Mendeleev, I M; Miasnikov, A A; Balashov, A T; Polezhaev, Iu N

    1988-01-01

    The authors discuss the role and place of chest x-ray tomography, scintigraphy with 67Ga-citrate, ultrasonic investigation, angiography, angioscintigraphy, computed tomography, scintigraphy of the liver and bones in the diagnosis of recurrences of Hodgkin's disease and in control of a progress of disease. Indications for a successive use of one or the other method have been defined.

  17. Recurrent aphthous stomatitis: a review.

    PubMed

    Chavan, Mahesh; Jain, Hansa; Diwan, Nikhil; Khedkar, Shivaji; Shete, Anagha; Durkar, Sachin

    2012-09-01

    Recurrent aphthous stomatitis (RAS) is a common clinical condition producing painful ulcerations in oral cavity. The diagnosis of RAS is based on well-defined clinical characteristics but the precise etiology and pathogenesis of RAS remain unclear. The present article provides a detailed review of the current concepts and knowledge of the etiology, pathogenesis, and management of RAS.

  18. Recurrent Processing during Object Recognition

    PubMed Central

    O’Reilly, Randall C.; Wyatte, Dean; Herd, Seth; Mingus, Brian; Jilk, David J.

    2013-01-01

    How does the brain learn to recognize objects visually, and perform this difficult feat robustly in the face of many sources of ambiguity and variability? We present a computational model based on the biology of the relevant visual pathways that learns to reliably recognize 100 different object categories in the face of naturally occurring variability in location, rotation, size, and lighting. The model exhibits robustness to highly ambiguous, partially occluded inputs. Both the unified, biologically plausible learning mechanism and the robustness to occlusion derive from the role that recurrent connectivity and recurrent processing mechanisms play in the model. Furthermore, this interaction of recurrent connectivity and learning predicts that high-level visual representations should be shaped by error signals from nearby, associated brain areas over the course of visual learning. Consistent with this prediction, we show how semantic knowledge about object categories changes the nature of their learned visual representations, as well as how this representational shift supports the mapping between perceptual and conceptual knowledge. Altogether, these findings support the potential importance of ongoing recurrent processing throughout the brain’s visual system and suggest ways in which object recognition can be understood in terms of interactions within and between processes over time. PMID:23554596

  19. Recurrent Education. A Resource Guide.

    ERIC Educational Resources Information Center

    Rochte, Newton C.

    To assist both practitioner and reader to find answers to questions on the theory and practice of recurrent education, this resource guide compiles 715 abstracts of relevant articles, books, and monographs, from many countries. Descriptors and identifiers, used in computer searches to identify the materials, are arranged alphabetically in the…

  20. Onychomycosis: Strategies to Minimize Recurrence.

    PubMed

    Gupta, Aditya K; Elewski, Boni E; Rosen, Ted; Caldwell, Bryan; Pariser, David M; Kircik, Leon H; Bhatia, Neal; Tosti, Antonella

    2016-03-01

    Recurrence (relapse or re-infection) in onychomycosis is common, occurring in 10% to 53% of patients. However, data on prevalence is limited as few clinical studies follow patients beyond 12 months. It has been suggested that recurrence after continuous terbinafine treatment may be less common than with intermittent or continuous itraconazole therapy, probably due to the fungicidal activity of terbinafine, although these differences tended not to be significant. Relapse rates also increase with time, peaking at month 36. Although a number of factors have been suggested to play a role in recurrence, only the co-existence of diabetes has been shown to have a significant impact. Data with topical therapy is sparse; a small study showed amorolfine prophylaxis may delay recurrence. High concentrations of efinaconazole have been reported in the nail two weeks' post-treatment suggesting twice monthly prophylaxis with topical treatments may be a realistic option, and may be an important consideration in diabetic patients with onychomycosis. Data suggest that prophylaxis may need to be continued for up to three years for optimal effect. Treating tinea pedis and any immediate family members is also critical. Other preventative strategies include avoiding communal areas where infection can spread (such as swimming pools), and decontaminating footwear.

  1. Strong Seasonality and Interannual Recurrence in Marine Myovirus Communities

    PubMed Central

    Chow, C.-E. T.; Johannessen, T.; Fuhrman, J. A.; Thingstad, T. F.; Sandaa, R. A.

    2013-01-01

    The temporal community dynamics and persistence of different viral types in the marine environment are still mostly obscure. Polymorphism of the major capsid protein gene, g23, was used to investigate the community composition dynamics of T4-like myoviruses in a North Atlantic fjord for a period of 2 years. A total of 160 unique operational taxonomic units (OTUs) were identified by terminal restriction fragment length polymorphism (TRFLP) of the gene g23. Three major community profiles were identified (winter-spring, summer, and autumn), which resulted in a clear seasonal succession pattern. These seasonal transitions were recurrent over the 2 years and significantly correlated with progression of seawater temperature, Synechococcus abundance, and turbidity. The appearance of the autumn viral communities was concomitant with the occurrence of prominent Synechococcus blooms. As a whole, we found a highly dynamic T4-like viral community with strong seasonality and recurrence patterns. These communities were unexpectedly dominated by a group of persistently abundant viruses. PMID:23913432

  2. [Thoracoscopic treatment of recurrent pneumothorax].

    PubMed

    Suter, M; Berner, M; Vandoni, R; Cuttat, J F

    1994-04-01

    Spontaneous pneumothorax (PNO) is usually due to rupture of a small subpleural bleb into the pleural cavity and affects mainly young men. After simple drainage, recurrence occurs in about 50% of cases. The risk of recurrence increases after each new PNO. Secondary PNO complicates an underlying pulmonary disease, especially chronic obstructive pulmonary disease with emphysema. A new form of secondary PNO has emerged in the recent years in AIDS patients with pneumocystis carinii pneumonia. We have shifted to a thoracoscopic therapy of PNO since May 1991. 25 PNO in 24 patients (1 bilateral) have been treated since that time up to April 1993. 19 PNO were primary, whereas 6 were secondary, included 3 iatrogenic PNO. Resection of the leaking parenchymal area was performed in 20 patients, and parietal partial pleurectomy was done in 20 cases. In the remaining cases, fibrin glue was applied on the lesion and in 3 cases, chemical pleurodesis was attempted using silver nitrate or talc. 1 AIDS patient died of ARDS. 3 patients had recurrent PNO and had thoracotomy without complication. 21 patients did well. Partial PNO recurred in one of them 4 months later, and was treated by simple needle aspiration. Thoracoscopy is a useful method to treat recurrent or persistent spontaneous PNO. After only 25 cases, our success rate in primary PNO is 90%. There should be a learning curve. On the basis of our experience, we believe that recognition of the lesion and its resection as well as apical parietal pleurectomy are necessary to obtain good results and a low recurrence rate.

  3. High resolution time interval counter

    DOEpatents

    Condreva, K.J.

    1994-07-26

    A high resolution counter circuit measures the time interval between the occurrence of an initial and a subsequent electrical pulse to two nanoseconds resolution using an eight megahertz clock. The circuit includes a main counter for receiving electrical pulses and generating a binary word--a measure of the number of eight megahertz clock pulses occurring between the signals. A pair of first and second pulse stretchers receive the signal and generate a pair of output signals whose widths are approximately sixty-four times the time between the receipt of the signals by the respective pulse stretchers and the receipt by the respective pulse stretchers of a second subsequent clock pulse. Output signals are thereafter supplied to a pair of start and stop counters operable to generate a pair of binary output words representative of the measure of the width of the pulses to a resolution of two nanoseconds. Errors associated with the pulse stretchers are corrected by providing calibration data to both stretcher circuits, and recording start and stop counter values. Stretched initial and subsequent signals are combined with autocalibration data and supplied to an arithmetic logic unit to determine the time interval in nanoseconds between the pair of electrical pulses being measured. 3 figs.

  4. High resolution time interval counter

    DOEpatents

    Condreva, Kenneth J.

    1994-01-01

    A high resolution counter circuit measures the time interval between the occurrence of an initial and a subsequent electrical pulse to two nanoseconds resolution using an eight megahertz clock. The circuit includes a main counter for receiving electrical pulses and generating a binary word--a measure of the number of eight megahertz clock pulses occurring between the signals. A pair of first and second pulse stretchers receive the signal and generate a pair of output signals whose widths are approximately sixty-four times the time between the receipt of the signals by the respective pulse stretchers and the receipt by the respective pulse stretchers of a second subsequent clock pulse. Output signals are thereafter supplied to a pair of start and stop counters operable to generate a pair of binary output words representative of the measure of the width of the pulses to a resolution of two nanoseconds. Errors associated with the pulse stretchers are corrected by providing calibration data to both stretcher circuits, and recording start and stop counter values. Stretched initial and subsequent signals are combined with autocalibration data and supplied to an arithmetic logic unit to determine the time interval in nanoseconds between the pair of electrical pulses being measured.

  5. The Effects of Inhaled Steroids on Recurrent Wheeze After Acute Bronchiolitis

    PubMed Central

    Green, Patricia; Aronoff, Stephen C.

    2015-01-01

    Background. Acute bronchiolitis infection during infancy is associated with an increased risk of asthma later in life. The objective of this study was to determine if inhaled steroids are effective in preventing the development of recurrent wheeze or asthma following acute bronchiolitis. Methods. Multiple databases and bibliographies of selected references were searched. Inclusion required (a) a randomized controlled trial of inhaled steroids and control group, (b) at least 2 weeks duration of therapy started during the acute phase of disease, and (c) identification of the rate of recurrent wheeze or asthma at least 6 months after therapy. Results. Of 1410 studies reviewed, 8 reports were included in this meta-analysis (748 patients). The overall odds ratio for developing recurrent wheeze or asthma with treatment versus without treatment was 1.02 (95% confidence interval = 0.58-1.81). Conclusions. A course of inhaled steroids after acute bronchiolitis is not effective in preventing recurrent wheeze or asthma. PMID:27335972

  6. Management of Recurrent Trigeminal Neuralgia Associated with Petroclival Meningioma

    PubMed Central

    Bir, Shyamal C.; Maiti, Tanmoy Kumar; Bollam, Papireddy; Nanda, Anil

    2015-01-01

    Objective Petroclival meningioma (PM) presents with trigeminal neuralgia (TN) in < 5% of cases. Neurosurgeons often face the dilemma of formulating a treatment protocol when TN recurs. In this study, we sought to set up a protocol in patients with PM who had a recurrent TN. Materials and Methods We performed a retrospective review of 57 patients with PM. Of the 57 patients, only 7 patients presented with TN, and six patients experienced recurrent TN. The study population was evaluated clinically and radiographically after treatment. Results Overall improvement of pain control after various treatments was 67%, and tumor control was 100%. The pain-free period was 2 years for the Gamma Knife radiosurgery (GKRS) group and 4 years for the resection group when treated as a primary treatment (p = 0.034). Of the six patients, four patients had Barrow Neurosurgical Institute (BNI) score I (no TN, no medication), and two patients had BNI score III (some pain controlled with medication). The Karnofsky performance scale score was significantly improved after treatment compared with the pretreated status (78 versus 88; p = 0.044). Conclusion Microsurgical resection is superior to GKRS in achieving and maintaining pain-free status in patients with recurrent trigeminal pain associated with PM. PMID:26949588

  7. Eosinophilic cystitis with recurrent urinary retention: case report

    PubMed Central

    Park, Hongzoo

    2017-01-01

    Eosinophilic cystitis is a rare inflammatory disease of the bladder whose origin, pathogenesis, and treatment are unknown. Frequency, dysuria, and hematuria are frequent symptoms. Here, we report a rare occurrence of recurrent urinary retention and repetitive catheterization. A 67-year-old male presented with acute urinary retention and intermittent gross hematuria of 2 weeks duration. Urethral catheterization followed by a trial without catheter, was successful. Complete blood count showed presence of eosinophils (eosinophilia) and computed tomography of kidneys, ureter and bladder with contrast showed thickened bladder wall and small prostate. Cystoscopy revealed an erythematous lesion over the anterior wall. The rest of the mucosa was normal. Transurethral biopsies of the lesion were performed and histologic examination showed features of eosinophilic cystitis. Despite multiple medication regimens containing corticosteroids and antihistamines, he presented with recurrent urinary retention, approximately once every month. After 6 months, he was started on bethanechol, which led to no catheterization for up to 2 years. To the best of our knowledge, this is the first report on the successful use of bethanechol as a treatment for eosinophilic cystitis with recurrent urinary retention. PMID:28357204

  8. Recurrent pyometra and xanthogranulomatous salpingitis: A rare pathologic association in a postmenopausal lady.

    PubMed

    Gami, Neha; Mundhra, Rajlaxmi; Guleria, Kiran; Arora, Vinod Kumar; Garg, Shipra

    2014-07-01

    Xanthogranulomatous inflammation is a rare, non-neoplastic variant of chronic inflammation. Of the 15 reported cases of Xanthogranulomatous endometritis, majority (60%) were accompanied by endometrial carcinoma. We herein report a case of a postmenopausal woman presenting with recurrent pyometra who was suspected to be case of cervical tuberculosis and treated for the same. Inspite of antitubercular therapy, she had cervical stenosis and developed recurrent pyometra over the next 2 years requiring repeated drainage. She then underwent hysterectomy and was found to have co-existent Xanthogranulomatous salpingitis (XGS) on histopathological examination. Xanthogranulomatous inflammation is a rare pathological diagnosis that gynecologists need to be aware of while managing such patients.

  9. Recurrent pyometra and xanthogranulomatous salpingitis: A rare pathologic association in a postmenopausal lady

    PubMed Central

    Gami, Neha; Mundhra, Rajlaxmi; Guleria, Kiran; Arora, Vinod Kumar; Garg, Shipra

    2014-01-01

    Xanthogranulomatous inflammation is a rare, non-neoplastic variant of chronic inflammation. Of the 15 reported cases of Xanthogranulomatous endometritis, majority (60%) were accompanied by endometrial carcinoma. We herein report a case of a postmenopausal woman presenting with recurrent pyometra who was suspected to be case of cervical tuberculosis and treated for the same. Inspite of antitubercular therapy, she had cervical stenosis and developed recurrent pyometra over the next 2 years requiring repeated drainage. She then underwent hysterectomy and was found to have co-existent Xanthogranulomatous salpingitis (XGS) on histopathological examination. Xanthogranulomatous inflammation is a rare pathological diagnosis that gynecologists need to be aware of while managing such patients. PMID:25317003

  10. [Evaluation of serum IgG sub-classes in children with recurrent respiratory infections].

    PubMed

    Mancini, S; Iacovoni, R; Fierimonte, V; Di Gilio, P; Spaini, A; Pichi, A

    1996-03-01

    Serum IgG sub-classes levels were measured by radial immunodiffusion with policlonal antibodies in 26 children aged 2 years to 8 years, affected with respiratory recurrent infections. These subjects were controlled and compared with normal children values for age groups. In 10 patients a deficit of IgG sub-classes levels was found, in 7 patients an increase level for IgG1 was detected. These data must be taken in account defining IgG-sub-classes deficiencies in children with respiratory recurrent infection.

  11. Hydralazine Induced Lupus Syndrome Presenting with Recurrent Pericardial Effusion and a Negative Antinuclear Antibody

    PubMed Central

    Iyer, Praneet; Zijoo, Ritika

    2017-01-01

    Drug induced lupus erythematosus (DIL or DILE) is an autoimmune disorder caused by chronic use of certain drugs. We report a unique case of hydralazine induced lupus syndrome (HILS) with a negative antinuclear antibody in a female patient who was on hydralazine for a period of 1.5–2 years and developed recurrent pericardial effusion as a result of it. Initially her condition was managed with a pericardial window. The recurrence of a massive pericardial effusion necessitated a right hemipericardiectomy. After hydralazine was stopped, she never had any further episodes of pericardial effusion or tamponade. PMID:28194293

  12. Orders on Intervals Over Partially Ordered Sets: Extending Allen's Algebra and Interval Graph Results

    SciTech Connect

    Zapata, Francisco; Kreinovich, Vladik; Joslyn, Cliff A.; Hogan, Emilie A.

    2013-08-01

    To make a decision, we need to compare the values of quantities. In many practical situations, we know the values with interval uncertainty. In such situations, we need to compare intervals. Allen’s algebra describes all possible relations between intervals on the real line, and ordering relations between such intervals are well studied. In this paper, we extend this description to intervals in an arbitrary partially ordered set (poset). In particular, we explicitly describe ordering relations between intervals that generalize relation between points. As auxiliary results, we provide a logical interpretation of the relation between intervals, and extend the results about interval graphs to intervals over posets.

  13. Correlation of matrix metalloproteinase-2 and -9 expression with recurrences in primary spontaneous pneumothorax patients

    PubMed Central

    Chiu, Wen-Chin; Lee, Yi-Chen; Su, Yu-Han; Chai, Chee-Yin; Hu, Stephen Chu-Sung

    2016-01-01

    Background Primary spontaneous pneumothorax (PSP) is a common benign disorder. However, unpredictable recurrence is a major concern for most patients. The aim of the present study was to assess the role of matrix metalloproteinase-2 (MMP-2) and MMP-9 in alveolar macrophages of patients with PSP and its relationship with recurrence. Methods Ninety-two patients who received needlescopic video-assisted thoracoscopic surgery (NVATS) wedge resection of lung with identifiable blebs for PSP were enrolled for the study. Immunohistochemistry was performed to evaluate the expression of MMP-2 and MMP-9 in lung tissues of patients with PSP. The result was correlated with clinicopathological variables and recurrence rates by the chi-square test. The value of MMP-2 and MMP-9 for overall recurrence was evaluated by univariate and multivariable Cox regression analyses. Results The MMP-2 and MMP-9 staining was predominantly observed in alveolar macrophages of patients with PSP. We found that MMP-2 (recurrence: P<0.001; smoking status: P=0.029) and MMP-9 (recurrence: P=0.001; smoking status: P=0.045) expression in PSP, especially male patients, was significantly correlated with recurrence and smoking status. In the multivariate analyses, MMP-2 [hazard ratio (HR) =2.83; 95% confidence interval (CI): 1.37–5.85, P=0.005) and MMP-9 (HR =2.25; 95% CI: 1.19–4.24, P=0.013) were statistically significant risk factors for overall recurrence in PSP patients. Conclusions High expression levels of MMP-2 and MMP-9 showed a positive correlation with recurrence in PSP patients. Further studies are required to test whether inhibition of MMP-2 and MMP-9 expression renders a promising approach for reducing the risk of PSP recurrence in the future. PMID:28149562

  14. Relationship Between Topoisomerase 2A RNA Expression and Recurrence after Adjuvant Chemotherapy for Breast Cancer

    PubMed Central

    Sparano, Joseph A.; Goldstein, Lori J.; Childs, Barrett H.; Shak, Steven; Brassard, Diana; Badve, Sunil; Baehner, Frederick L.; Bugarini, Roberto; Rowley, Steve; Perez, Edith; Shulman, Lawrence N.; Martino, Silvana; Davidson, Nancy E.; Sledge, George W.; Gray, Robert

    2009-01-01

    Purpose To perform an exploratory analysis of the relationship between gene expression and recurrence in operable hormone receptor (HR)-positive, HER2-normal breast cancer patients treated with adjuvant doxorubicin-containing chemotherapy. Experimental Design RNA was extracted from archived tumor samples derived from 378 patients with stage I–III HR-positive, HER2-normal breast cancer and analyzed by RT-PCR for a panel of 374 genes, including the 21 gene Recurrence Score (RS). Patients were randomized to receive adjuvant doxorubicin plus cyclophosphamide or docetaxel in trial E2197, with no difference in recurrence seen in the treatment arms. All available recurrent cases were selected plus a non-recurrent cohort. Cox proportional hazard models were used to identify relationships between gene expression and recurrence. Results TOP2A expression exhibited the strongest association with increased recurrence risk (p=0.01), and was significantly associated with recurrence (p=0.008) in a multivariate analysis adjusted for clinicopathological features. Elevated TOP2A expression above the median was associated with a 2.6-fold increase (95% confidence intervals [CI], 1.3, 5.2 p=0.008) in risk of recurrence if the RS was less than 18, and a 2.0-fold increase (95% CI, 1.2, 3.2, p=0.003) if there was an intermediate RS of 18–30. Conclusions In patients with HR-positive, HER2-normal breast cancer, a population known to have a low incidence of TOP2A gene alterations thought to be predictive of anthracycline benefit, there is a range of TOP2A RNA expression that is strongly associated with recurrence after adjuvant anthracyclines which provides information complementary to RS, indicating that it merits further evaluation as a prognostic and predictive marker. PMID:19996222

  15. Recurrent facial urticaria following herpes simplex labialis.

    PubMed

    Zawar, Vijay; Godse, Kiran

    2012-03-01

    We describe recurrent acute right-sided facial urticaria associated with herpes labialis infection in a middle-aged female patient. Antiviral medications and antihistamines not only successfully cleared the herpes infection and urticaria but also prevented further recurrences.

  16. Pigeons' Choices between Fixed-Interval and Random-Interval Schedules: Utility of Variability?

    ERIC Educational Resources Information Center

    Andrzejewski, Matthew E.; Cardinal, Claudia D.; Field, Douglas P.; Flannery, Barbara A.; Johnson, Michael; Bailey, Kathleen; Hineline, Philip N.

    2005-01-01

    Pigeons' choosing between fixed-interval and random-interval schedules of reinforcement was investigated in three experiments using a discrete-trial procedure. In all three experiments, the random-interval schedule was generated by sampling a probability distribution at an interval (and in multiples of the interval) equal to that of the…

  17. Recurrent MRSA skin infections in atopic dermatitis.

    PubMed

    Ong, Peck Y

    2014-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of recurrent skin and soft tissue infections. For patients with atopic dermatitis, recurrent skin infections with MRSA often lead to eczema exacerbation. There currently is no standard practice in the prevention of recurrent MRSA soft tissue infections in the general and the atopic dermatitis populations. The current article reviews recent data on S aureus decolonization treatments for the prevention of recurrent MRSA soft tissue infections in the community setting.

  18. Clinical Score Predicting Long-Term Survival after Repeat Resection for Recurrent Adrenocortical Carcinoma

    PubMed Central

    Tran, Thuy B; Maithel, Shishir K; Pawlik, Timothy M; Wang, Tracy S; Hatzaras, Ioannis; Phay, John E; Fields, Ryan C; Weber, Sharon M; Sicklick, Jason K; Yopp, Adam C; Duh, Quan-Yang; Solorzano, Carmen C; Votanopoulos, Konstantinos I; Poultsides, George A

    2017-01-01

    BACKGROUND Adrenocortical carcinoma (ACC) is an aggressive malignancy typically resistant to chemotherapy and radiation. Surgery, even in the setting of locally recurrent or metastatic disease, remains the only potentially curative option. However, the subset of patients who will benefit from repeat resection in this setting remains ill defined. The objective of this study was to propose a prognostic clinical score that facilitates selection of patients for repeat resection of recurrent ACC. STUDY DESIGN Patients who underwent curative-intent repeat resection for recurrent ACC at 1 of 13 academic medical centers participating in the US ACC Study Group were identified. End points included morbidity, mortality, and overall survival. RESULTS Fifty-six patients underwent repeat curative-intent resection for recurrent ACC (representing 21% of 265 patients who underwent resection for primary ACC) from 1997 to 2014. Median age was 52 years. Sites of resected recurrence included locoregional only (54%), lung only (14%), liver only (12%), combined locoregional and lung (4%), combined liver and lung (4%), and other distant sites (12%). Thirty-day morbidity and mortality rates were 40% and 5.4%, respectively. Cox regression analysis revealed that the presence of multifocal recurrence, disease-free interval <12 months, and extrapulmonary distant metastases were independent predictors of poor survival. A clinical score consisting of 1-point each for the 3 variables demonstrated good discrimination in predicting survival after repeat resection (5-year: 72% for 0 points, 32% for 1 point, 0% for 2 or 3 points; p = 0.0006, area under the curve = 0.78). CONCLUSIONS Long-term survival after repeat resection for recurrent ACC is feasible when 2 of the following factors are present: solitary tumor, disease-free interval >12 months, and locoregional or pulmonary recurrence. PMID:27618748

  19. A prospective evaluation of obesometric parameters associated with renal stone recurrence

    PubMed Central

    Bos, Derek; Dason, Shawn; Matsumoto, Edward; Pinthus, Jehonathan; Allard, Christopher

    2016-01-01

    Introduction: Our aim was to evaluate whether obesometric serum hormones and body fat distribution are associated with renal stone recurrence. Methods: We conducted a prospective cohort study of participants undergoing renal stone (RS) intervention at a single institution from November 2009–June 2010 and followed them for a median 62 months. Obesometric parameters were measured at baseline, including body mass index (BMI), fasting serum leptin and adiponectin, and proportion of visceral adipose tissue (%VAT) averaged from three fixed axial computed tomography (CT) slices. The primary study outcome was stone recurrence. Results: A total of 110 participants were enrolled. Elevated %VAT was associated RS recurrence; participants with %VAT in the highest quartile had a five-year stone-free rate of 47.1% compared to 72.2% among other participants (p=0.004). Adjusting for gender, elevated %VAT was independently predictive of renal stone recurrence among initial stone formers (n=74; hazard ratio [HR] 4.53, 95% confidence interval [CI] 1.08–19.02), but not among recurrent stone formers (n=19; HR 0.51, 95% CI 0.054–4.72). Other obesometric factors, including leptin, adiponectin, and BMI, were not significantly predictive of recurrence. Conclusions: We report a novel association between an elevated %VAT and stone recurrence. These findings may inform patient counselling and followup regimens. The metabolic basis for these findings requires further investigation. PMID:27878041

  20. Treatment of a Circadian Rhythm Disturbance in a 2-Year-Old Blind Child.

    ERIC Educational Resources Information Center

    Mindell, J. A.; And Others

    1996-01-01

    The use of sleep scheduling and a daytime routine for the treatment of circadian rhythm disorder was found helpful in decreasing a blind 2-year old's nighttime wake periods and daytime sleepiness. (DB)

  1. 14 CFR 121.427 - Recurrent training.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Recurrent training. 121.427 Section 121.427..., FLAG, AND SUPPLEMENTAL OPERATIONS Training Program § 121.427 Recurrent training. (a) Recurrent training must ensure that each crew member or dispatcher is adequately trained and currently proficient...

  2. 14 CFR 91.1107 - Recurrent training.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Recurrent training. 91.1107 Section 91.1107... Management § 91.1107 Recurrent training. (a) Each program manager must ensure that each crewmember receives recurrent training and is adequately trained and currently proficient for the type aircraft and...

  3. 14 CFR 135.351 - Recurrent training.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Recurrent training. 135.351 Section 135.351... AND ON DEMAND OPERATIONS AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Training § 135.351 Recurrent training. (a) Each certificate holder must ensure that each crewmember receives recurrent...

  4. A perspective on recurrent vertigo.

    PubMed

    Gacek, Richard R

    2013-01-01

    The recurrent nature of the 3 most common vestibulopathies suggests a recurrent cause. Histopathology in temporal bones from patients with these syndromes - vestibular neuronitis (VN, n = 7), Ménière's disease (MD, n = 8) and benign paroxysmal positional vertigo (BPPV, n = 5) - shows focal degeneration of vestibular nerve axons and degenerated nearby facial nerve meatal ganglion cells. Transmission electron microscopic confirmation of intracytoplasmic viral particles in surgically excised vestibular nerves from patients with VN and MD support a viral etiology in these vestibulopathies. Antiviral treatment of these syndromes in a series of 211 patients with a 3- to 8-year follow-up resulted in complete control of vertigo in VN (88%), MD (90%) and BPPV (60%).

  5. Chronic recurrent multifocal osteomyelitis (CRMO).

    PubMed

    Schuster, T; Bielek, J; Dietz, H G; Belohradsky, B H

    1996-02-01

    Pathogenesis of CRMO still remains unknown. Characteristic, but not pathognomonic for this syndrome are clinical course (age, sex, chronic recurrent, intermittent course), radiological findings (metaphyseal lesions), histology (chronic osteomyelitis without colliquation) and microbiological results (lack of pathogen, infectious agents). Favorable, self-limited long-term prognosis of CRMO has been assumed. Antibiotics provide no improvement. Course, severity and recurrency can be influenced positively by antiphlogistic substances, although this has not yet been proved. Whether surgical intervention beyond biopsies might cause improvement on the follow-up is unknown. Our experience (4 cases), and the literature demonstrate great clinical importance that unusual types of osteomyelitis (OM) can be within the differential diagnosis of multifocal osteolytic changes.

  6. Recurrent airway obstruction: a review.

    PubMed

    Pirie, R S

    2014-05-01

    Recurrent airway obstruction is a widely recognised airway disorder, characterised by hypersensitivity-mediated neutrophilic airway inflammation and lower airway obstruction in a subpopulation of horses when exposed to suboptimal environments high in airborne organic dust. Over the past decade, numerous studies have further advanced our understanding of different aspects of the disease. These include clarification of the important inhaled airborne agents responsible for disease induction, improving our understanding of the underlying genetic basis of disease susceptibility and unveiling the fundamental immunological mechanisms leading to establishment of the classic disease phenotype. This review, as well as giving a clinical overview of recurrent airway obstruction, summarises much of the work in these areas that have culminated in a more thorough understanding of this debilitating disease.

  7. Factors associated with early recurrence after curative surgery for gastric cancer

    PubMed Central

    Kang, Wei-Ming; Meng, Qing-Bin; Yu, Jian-Chun; Ma, Zhi-Qiang; Li, Zhi-Tian

    2015-01-01

    AIM: To characterize patterns of gastric cancer recurrence and patient survival and to identify predictors of early recurrence after surgery. METHODS: Clinicopathological data for 417 consecutive patients who underwent curative resection for gastric cancer were retrospectively analyzed. Tumor and node status was reclassified according to the 7th edition of the American Joint Committee on Cancer tumor-node-metastasis classification for carcinoma of the stomach. Survival data came from both the patients’ follow-up records and telephone follow-ups. Recurrent gastric cancer was diagnosed based on clinical imaging, gastroscopy with biopsy, and/or cytological examination of ascites, or intraoperative findings in patients who underwent reoperation. Predictors of early recurrence were compared in patients with pT1 and pT2-4a stage tumors. Pearson’s χ2 test and Fisher’s exact test were used to compare differences between categorical variables. Survival curves were constructed using the Kaplan-Meier method and compared via the log-rank test. Variables identified as potentially important for early recurrence using univariate analysis were determined by multivariate logistic regression analysis. RESULTS: Of 417 gastric cancer patients, 80 (19.2%) were diagnosed with early gastric cancer and the remaining 337 (80.8%) were diagnosed with locally advanced gastric cancer. After a median follow-up period of 56 mo, 194 patients (46.5%) experienced recurrence. The mean time from curative surgery to recurrence in these 194 patients was 24 ± 18 mo (range, 1-84 mo). Additionally, of these 194 patients, 129 (66.5%) experienced recurrence within 2 years after surgery. There was no significant difference in recurrence patterns between early and late recurrence (P < 0.05 each). For pT1 stage gastric cancer, tumor size (P = 0.011) and pN stage (P = 0.048) were associated with early recurrence of gastric tumors. Patient age, pT stage, pN stage, Lauren histotype, lymphovascular

  8. Spatiotemporal recurrences of sandpile avalanches

    NASA Astrophysics Data System (ADS)

    Tarun, Anjali B.; Paguirigan, Antonino A.; Batac, Rene C.

    2015-10-01

    We study the space and time properties of avalanches in a continuous sandpile model by constructing a temporally directed network linking together the recurrent avalanche events based on their spatial separation. We use two different criteria for network construction: a later event is connected to a previous one if it is either nearest or farthest from it among all the later events. With this, we observe scale-free regimes emerge as characterized by the following power-law exponents: (a) α = 1.7 for the avalanche size distributions; (b) βF = 2.1 in the in-degree distribution of farthest recurrences; (c) δ = 1 for the separation distances; and (d) γ = 1 for the temporal separations of recurrences. Our results agree with earlier observations that describe the sandpile avalanches as repulsive events, i.e. the next avalanche is more likely to be physically separated from an earlier one. These observations, which are not captured by usual interoccurrence statistics and by random connection mechanisms, suggest an underlying spatiotemporal organization in the sandpile that makes it useful for modeling real-world systems.

  9. Min and Max Extreme Interval Values

    ERIC Educational Resources Information Center

    Jance, Marsha L.; Thomopoulos, Nick T.

    2011-01-01

    The paper shows how to find the min and max extreme interval values for the exponential and triangular distributions from the min and max uniform extreme interval values. Tables are provided to show the min and max extreme interval values for the uniform, exponential, and triangular distributions for different probabilities and observation sizes.

  10. Familiarity-Frequency Ratings of Melodic Intervals

    ERIC Educational Resources Information Center

    Jeffries, Thomas B.

    1972-01-01

    Objective of this study was to determine subjects' reliability in rating randomly played ascending and descending melodic intervals within the octave on the basis of their familiarity with each type of interval and the frequency of their having experienced each type of interval in music. (Author/CB)

  11. Prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2-year results

    SciTech Connect

    Packer, R.J.; Sutton, L.N.; Atkins, T.E.; Radcliffe, J.; Bunin, G.R.; D'Angio, G.; Siegel, K.R.; Schut, L. )

    1989-05-01

    As survival rates have risen for children with malignant primary brain tumors, so has the concern that many survivors have significant permanent cognitive deficits. Cranial irradiation (CRT) has been implicated as the major cause for cognitive dysfunction. To clarify the etiology, incidence, and severity of intellectual compromise in children with brain tumors after CRT, a prospective study was undertaken comparing the neuropsychological outcome in 18 consecutive children with malignant brain tumors treated with CRT to outcome in 14 children harboring brain tumors in similar sites in the nervous system who had not received CRT. Children with cortical or subcortical brain tumors were not eligible for study. Neuropsychological testing was performed after surgery prior to radiotherapy, after radiotherapy, and at 1- and 2-year intervals thereafter. Children who had received CRT had a mean full-scale intelligence quotient (FSIQ) of 105 at diagnosis which fell to 91 by Year 2. Similar declines were noted in their performance intelligence quotient (IQ) and verbal IQ. After CRT, patients demonstrated a statistically significant decline from baseline in FSIQ (p less than 0.02) and verbal IQ (p less than 0.04). Children who had not received CRT did not demonstrate a fall in any cognitive parameter over time. The decline between baseline testing and testing performed at Year 2 in patients who had CRT was inversely correlated with age (p less than 0.02), as younger children demonstrated the greatest loss of intelligence. Children less than 7 years of age at diagnosis had a mean decline in FSIQ of 25 points 2 years posttreatment. No other clinical parameter correlated with the overall IQ or decline in IQ. After CRT, children demonstrated a wide range of dysfunction including deficits in fine motor, visual-motor, and visual-spatial skills and memory difficulties.

  12. Effect of exacerbations on quality of life in patients with chronic obstructive pulmonary disease: a 2 year follow up study

    PubMed Central

    Miravitlles, M; Ferrer, M; Pont, A; Zalacain, R; Alvarez-Sala, J; Masa, F; Verea, H; Murio, C; Ros, F; Vidal, R

    2004-01-01

    Background: A study was undertaken to evaluate exacerbations and their impact on the health related quality of life (HRQL) of patients with chronic obstructive pulmonary disease (COPD). Methods: A 2 year follow up study was performed in 336 patients with COPD of mean (SD) age 66 (8.2) years and mean (SD) forced expiratory volume in 1 second (FEV1) 33 (8)% predicted. Spirometric tests, questions regarding exacerbations of COPD, and HRQL measurements (St George's Respiratory Questionnaire (SGRQ) and SF-12 Health Survey) were conducted at 6 month intervals. Results: A total of 1015 exacerbations were recorded, and 103 (30.7%) patients required at least one hospital admission during the study. After adjustment for baseline characteristics and season of assessment, frequent exacerbations had a negative effect on HRQL in patients with moderate COPD (FEV1 35–50% predicted); the change in SGRQ total score of moderate patients with ⩾3 exacerbations was almost two points per year greater (worse) than those with <3 exacerbations during the follow up (p = 0.042). For patients with severe COPD (FEV1 <35% predicted) exacerbations had no effect on HRQL. The change in SGRQ total score of patients admitted to hospital was almost 2 points per year greater (worse) than patients not admitted, but this effect failed to show statistical significance in any severity group. There was a significant and independent seasonal effect on HRQL since SGRQ total scores were, on average, 3 points better in measurements performed in spring/summer than in those measured in the winter (p<0.001). Conclusions: Frequent exacerbations significantly impair HRQL of patients with moderate COPD. A significant and independent effect of seasonality was also observed. PMID:15115864

  13. Ajmaline Challenge To Unmask Infrahisian Disease In Patients With Recurrent And Unexplained Syncope, Preserved Ejection Fraction, With Or Without Conduction Abnormalities On Surface ECG.

    PubMed

    Pentimalli, Francesco; Bacino, Luca; Ghione, Matteo; Giambattista, Siri; Gazzarata, Massimo; Bellotti, Paolo

    2016-01-01

    Background: Pharmacological challenge with class I antiarrhythmic drug is a recommended diagnostic test in patients with unexplained syncope only in the presence of bundle branch block, when non-invasive tests have failed to make the diagnosis. Its role in patients with minor or no conduction disturbances on 12-leads ECG has not been evaluated yet. It is also not clear which are the values of His-Ventricular interval to be considered diagnostic. We sought to evaluate the role of ajmaline challenge in unmasking the presence of an infrahisian disease in patients with recurrent and unexplained syncope, regardless of the existence of conduction disturbances on surface ECG. Materials And Methods: Patients with history of recurrent syncope, preserved EF and a negative first level workup were enrolled. Conduction disturbances on ECG were not considered as an exclusion criteria. During EPS, basal HV conduction was determined. In the presence of a HV >70 msec the study was interrupted and the patient was implanted with a pacemaker. If the HV was ≤ 70 msec, ajmaline was infused and HV was reassessed. The maximum value of HV was considered. A prolongation ≥ 100 msec was considered as diagnostic and indicative of conduction disease, and the patient underwent pacemaker implantation. Patients with an HV <100 msec were implanted with an ILR. Results: Sixteen consecutive patients were studied (age 76±5.2 years). Nine patients had conduction disturbances at baseline ECG (group ECG+). Among them, 5 had a basal diagnostic HV interval and 4 had a non-diagnostic HV interval. In the latter group, abnormal response to ajmaline was observed in 3 patients. In this group only one patient was implanted with an ILR, 8 patients were implanted with a pacemaker. Among the seven patients without conduction disturbances (group ECG-), no one had a diagnostic basal HV interval. After drug administration, 4 patients had a non-diagnostic response and were implanted with an ILR, while 3 patient

  14. A meta-analysis comparing long-term recurrences of toenail onychomycosis after successful treatment with terbinafine versus itraconazole.

    PubMed

    Yin, Zhiqiang; Xu, Jiali; Luo, Dan

    2012-12-01

    As the most frequently used systemic antifungal agents for onychomycosis, terbinafine and itraconazole have both proved to have the conditions of recurrence in various degrees during follow-up period after end of therapy; very little is known about their comparative recurrences after long-term follow-up. We conducted a meta-analysis of available trials to compare the long-term recurrences of toenail onychomycosis after successful treatment with terbinafine versus itraconazole. Meta-analysis was performed by the Review Manager version 5.0.25. Risk ratio and 95% confidence intervals were calculated by the fixed effect model. Five trials and total 251 eligible patients were included in this meta-analysis. The combined risk ratio of the meta-analysis comparing terbinafine with itraconazole for mycological recurrence rate was 0.44 (95% CI 0.29-0.66), which suggests that itraconazole therapy is more likely to produce mycological recurrence compared with terbinafine therapy.

  15. Laser photocoagulation around extra foveolar foci of toxoplasma retinochoroiditis: a way to decrease frequency of recurrence

    NASA Astrophysics Data System (ADS)

    Labalette, P.; Desmettre, Thomas; Mordon, Serge R.; Constantinides, G.

    1995-01-01

    Thirty four patients with retinochoroiditis initially treated with medical treatment and later treated with laser photocoagulation around the foci were retrospectively evaluated for the risk of recurrence of the eretinochoroiditis. We used a Kaplan-Meier representation to show the evolution of the number of patients without recurrence as a function of time and as the number of patients followed up decreases (rate of patients without recurrence at 1 year: 86 +/- 12.3% for 26 patients exposed; at 2 years: 75 +/- 16.4% for 20 patients exposed; at 3 years and at 4 years 70 +/- 17% for 17 patients exposed). The recurrence rates were compared to the data previously published in the literature. We failed to demonstrate the efficacy of laser photocoagulation on inactive retinochoroiditis for prevention of recurrence of ocular toxoplasmosis. However, the heterogeneity of our series, the great amount of patients lost to follow up, and the heterogeneity of the recurrence rates of the literature contribute to explain that result.

  16. Surgical Management of Recurrent Musculotendinous Hamstring Injury in Professional Athletes

    PubMed Central

    Sonnery-Cottet, Bertrand; Daggett, Matt; Gardon, Roland; Pupim, Barbara; Clechet, Julien; Thaunat, Mathieu

    2015-01-01

    Background: Hamstring injury is the most common muscular lesion in athletes. The conservative treatment is well described, and surgical management is often indicated for proximal tendinous avulsions. To our knowledge, no surgical treatment has been proposed for failure of conservative treatment in musculotendinous hamstring lesions. Purpose: To describe the surgical management of proximal and distal hamstring musculotendinous junction lesions in professional athletes after failure of conservative treatment. Study Design: Case series; Level of evidence, 4. Methods: A consecutive series of 10 professional athletes, including 4 soccer players, 4 rugby players, and 2 handball players, underwent surgical intervention between October 2010 and June 2014 for the treatment of recurrent musculotendinous hamstring injuries. All athletes had failed at least 3 months of conservative treatment for a recurrent musculotendinous hamstring injury. Surgical resection of the musculotendinous scar tissue was performed using a longitudinal muscular suture. Lower Extremity Functional Scale (LEFS) and Marx scores were obtained at the 3-month follow-up, and a final phone interview was completed to determine recurrence of hamstring injury and return to previous level of play. Results: The mean age at surgery was 25.2 years (range, 19-35 years). The musculotendinous hamstring lesions involved 8 semitendinosus and 2 biceps femoris, with 6 injuries located proximally and 4 distally. Conservative treatment lasted a mean 5.1 months (range, 3-9 months) after last recurrence, and the patients had an average of 2.7 (range, 2-5) separate incidents of injury recurrence before surgical intervention was decided upon. At the 3-month follow-up, all patients had Marx activity scores of 16 and LEFS scores of 80. All 10 patients returned to the same level of play at a mean 3.4 months (range, 2-5 months). At a mean follow-up of 28.7 months, none of the athletes had suffered a recurrence. No surgical

  17. Stress Reduction in Improving Quality of Life in Patients With Recurrent Gynecologic or Breast Cancer

    ClinicalTrials.gov

    2015-10-08

    Anxiety Disorder; Depression; Fatigue; Leydig Cell Tumor; Ovarian Sarcoma; Ovarian Stromal Cancer; Pain; Peritoneal Carcinomatosis; Pseudomyxoma Peritonei; Recurrent Breast Cancer; Recurrent Cervical Cancer; Recurrent Endometrial Carcinoma; Recurrent Fallopian Tube Cancer; Recurrent Gestational Trophoblastic Tumor; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Primary Peritoneal Cavity Cancer; Recurrent Uterine Sarcoma; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer

  18. Erlotinib and Temozolomide in Treating Young Patients With Recurrent or Refractory Solid Tumors

    ClinicalTrials.gov

    2013-06-04

    Previously Treated Childhood Rhabdomyosarcoma; Recurrent Childhood Brain Tumor; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Malignant Germ Cell Tumor; Recurrent Childhood Medulloblastoma; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Soft Tissue Sarcoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor; Recurrent Neuroblastoma; Recurrent Osteosarcoma

  19. Interpregnancy interval and obstetrical complications.

    PubMed

    Shachar, Bat Zion; Lyell, Deirdre J

    2012-09-01

    Obstetricians are often presented with questions regarding the optimal interpregnancy interval (IPI). Short IPI has been associated with adverse perinatal and maternal outcomes, ranging from preterm birth and low birth weight to neonatal and maternal morbidity and mortality. Long IPI has in turn been associated with increased risk for preeclampsia and labor dystocia. In this review, we discuss the data regarding these associations along with recent studies revealing associations of short IPI with birth defects, schizophrenia, and autism. The optimal IPI may vary for different subgroups. We discuss the consequences of short IPI in women with a prior cesarean section, in particular the increased risk for uterine rupture and the considerations regarding a trial of labor in this subgroup. We review studies examining the interaction between short IPI and advanced maternal age and discuss the risk-benefit assessment for these women. Finally, we turn our attention to women after a stillbirth or an abortion, who often desire to conceive again with minimal delay. We discuss studies speaking in favor of a shorter IPI in this group. The accumulated data allow for the reevaluation of current IPI recommendations and management guidelines for women in general and among subpopulations with special circumstances. In particular, we suggest lowering the current minimal IPI recommendation to only 18 months (vs 24 months according to the latest World Health Organization recommendations), with even shorter recommended minimal IPI for women of advanced age and those who conceive after a spontaneous or induced abortion.

  20. Quasi-periodic recurrence of large earthquakes on the southern San Andreas fault

    USGS Publications Warehouse

    Scharer, Katherine M.; Biasi, Glenn P.; Weldon, Ray J.; Fumal, Tom E.

    2010-01-01

    It has been 153 yr since the last large earthquake on the southern San Andreas fault (California, United States), but the average interseismic interval is only ~100 yr. If the recurrence of large earthquakes is periodic, rather than random or clustered, the length of this period is notable and would generally increase the risk estimated in probabilistic seismic hazard analyses. Unfortunately, robust characterization of a distribution describing earthquake recurrence on a single fault is limited by the brevity of most earthquake records. Here we use statistical tests on a 3000 yr combined record of 29 ground-rupturing earthquakes from Wrightwood, California. We show that earthquake recurrence there is more regular than expected from a Poisson distribution and is not clustered, leading us to conclude that recurrence is quasi-periodic. The observation of unimodal time dependence is persistent across an observationally based sensitivity analysis that critically examines alternative interpretations of the geologic record. The results support formal forecast efforts that use renewal models to estimate probabilities of future earthquakes on the southern San Andreas fault. Only four intervals (15%) from the record are longer than the present open interval, highlighting the current hazard posed by this fault.

  1. Remembering September 11th: the role of retention interval and rehearsal on flashbulb and event memory.

    PubMed

    Shapiro, Lauren R

    2006-02-01

    Retention interval and rehearsal effects on flashbulb and event memory for 11th September 2001 (9/11) were examined. In Experiment 1, college students were assessed three times (Groups 1 and 2) or once (Group 3) over 11 weeks. In Experiment 2, three new groups assessed initially at 23 weeks (Group 4), 1 year (Group 5), or 2 years (Group 6) were compared at 1 year and at 2 years with subsamples of those assessed previously. No effects of retention interval length or rehearsal were found for flashbulb memory, which contained details at each assessment. Event memory, but not consistency, was detrimentally affected by long retention intervals, but improved with rehearsal. Recall was higher for the reception event than for the main events. Also, consistency from 1 day to 11 weeks, but not 1 year to 2 years, was higher for flashbulb memory than for event memory. Event recall was enhanced when respondents conceived of their memory as vivid, frozen, and encompassing a longer period of time. Positive correlations were found for event memory with confidence in accuracy and with rehearsal through discussion at 2 years.

  2. Retrospective analysis of the overt proteinuria diabetic kidney disease in the treatment of modified Shenzhuo formula for 2 years

    PubMed Central

    Chen, Hongdong; Guo, Jing; Zhao, Xuemin; He, Xinhui; He, Zhongchen; Zhao, Linhua; Tong, Xiaolin

    2017-01-01

    Abstract The objective of the present study was to evaluate the 2-year effectiveness of modified Shenzhuo formula in the treatment of overt proteinuria diabetic kidney disease (DKD). Patients diagnosed with type 2 DKD in the clinical research database of Prof Xiaolin Tong (>20,000 data points) with >1-year follow-up were screened for this study. Patients’ demographic data, chief complaint, present illness, past history, allergic history, personal history, family history, test results, tongue images, pulse information, and prescription information at 1, 1.5, and 2 years of follow-up were analyzed. EpiData3.1 was used to establish the electronic database of this research and SPSS v20.0 (SPSS Inc, Chicago, IL) was used for performing statistical analyses. The patients’ common main symptoms of overt proteinuria DKD were weak breath and fatigue, numbness of limbs, insomnia, blurred vision, nocturia, edema, low backache, constipation, itchy skin ulcer, and chills. The average 24-hour urinary protein of patients treated with modified Shenzhuo formula was statistically significantly lower than baseline values at 1, 1.5, and 2 years (0.66 g, 95% confidence interval [CI] [−0.95, −0.41]; 1.00 g, 95% CI [−1.67, 0.38]; 1.11 g, 95% CI [−1.79, −0.57]). There are no statistically significant differences between the glomerular filtration rate at the baseline and that after modified Shenzhuo formula intervention. Statistically significant reductions in serum triglyceride and glycosylated hemoglobin values and systolic blood pressure also were recorded. Other indexes, including serum creatinine, blood urea nitrogen, diastolic blood pressure, cholesterol, high-density lipoprotein, and low-density lipoproteins, did not differ between baseline and post-treatment time points. Modified Shenzhuo formula could reduce 24-hour urinary protein excretion in patients with DKD. The formula maybe had the potential advantages on glomerular filtration rate, creatinine reciprocal

  3. Assessment of effectiveness of percutaneous adhesiolysis and caudal epidural injections in managing post lumbar surgery syndrome: 2-year follow-up of a randomized, controlled trial

    PubMed Central

    Manchikanti, Laxmaiah; Singh, Vijay; Cash, Kimberly A; Pampati, Vidyasagar

    2012-01-01

    Background The literature is replete with evaluations of failed surgery, illustrating a 9.5%–25% reoperation rate. Speculated causes of post lumbar surgery syndrome include epidural fibrosis, acquired stenosis, recurrent disc herniation, sacroiliac joint pain, and facet joint pain among other causes. Methods Patients (n = 120) were randomly assigned to two groups with a 2-year follow-up. Group I (control group, n = 60) received caudal epidural injections with catheterization up to S3 with local anesthetic (lidocaine 2%, 5 mL), nonparticulate betamethasone (6 mg, 1 mL), and 6 mL of 0.9% sodium chloride solution. Group II (intervention group, n = 60) received percutaneous adhesiolysis of the targeted area, with targeted delivery of lidocaine 2% (5 mL), 10% hypertonic sodium chloride solution (6 mL), and nonparticulate betamethasone (6 mg). The multiple outcome measures included the Numeric Rating Scale, the Oswestry Disability Index 2.0, employment status, and opioid intake with assessments at 3, 6, 12, 18, and 24 months posttreatment. Primary outcome was defined as 50% improvement in pain and Oswestry Disability Index scores. Results Significant improvement with at least 50% relief with pain and improvement in functional status was illustrated in 82% of patients at the 2-year follow-up in the intervention group compared to 5% in the control group receiving caudal epidural injections. The average number of procedures over a period of 2 years in Group II was 6.4 ± 2.35 with overall total relief of approximately 78 weeks out of 104 weeks. Conclusion The results of this study show significant improvement in 82% of patients over a period of 2 years with an average of six to seven procedures of 1-day percutaneous adhesiolysis in patients with failed back surgery syndrome. PMID:23293536

  4. Management of recurrent head and neck cancer: variables related to salvage surgery.

    PubMed

    Gañán, Laura; López, Montserrat; García, Jacinto; Esteller, Eduard; Quer, Miquel; León, Xavier

    2016-12-01

    After a local and/or regional recurrence of head and neck squamous cell carcinoma (HNSCC) not all patients are candidates to salvage treatment. The objective of this study was to identify the variables related to performance of salvage surgery with curative intent in these patients. We performed a retrospective study of 1088 HNSCC patients with a local and/or regional recurrence. According to a multivariate analysis, the variables related to performance of salvage surgery were the Karnofsky index, the location and extension of the primary tumor, the initial treatment, the disease-free interval between treatment of the initial tumor and diagnosis of the recurrence, and the year the recurrence was diagnosed. Considering salvage surgery as the dependent variable, the results of a recursive partitioning analysis defined four categories of patients in function of the category of local and regional extension of the initial tumor, the location of the primary tumor, the initial treatment and the disease-free interval between treatment of the initial tumor and diagnosis of the recurrence.

  5. Associations between weather conditions and clinical symptoms in patients with hip osteoarthritis: a 2-year cohort study.

    PubMed

    Dorleijn, Desirée M J; Luijsterburg, Pim A J; Burdorf, Alex; Rozendaal, Rianne M; Verhaar, Jan A N; Bos, Pieter K; Bierma-Zeinstra, Sita M A

    2014-04-01

    The goal of this study was to assess whether there is an association between ambient weather conditions and patients' clinical symptoms in patients with hip osteoarthritis (OA). The design was a cohort study with a 2-year follow-up and 3-monthly measurements and prospectively collected data on weather variables. The study population consisted of 222 primary care patients with hip OA. Weather variables included temperature, wind speed, total amount of sun hours, precipitation, barometric pressure, and relative humidity. The primary outcomes were severity of hip pain and hip disability as measured with the Western Ontario and McMasters University Osteoarthritis Index (WOMAC) pain and function subscales. Associations between hip pain and hip disability and the weather variables were assessed using crude and multivariate adjusted linear mixed-model analysis for repeated measurements. On the day of questionnaire completion, mean relative humidity was associated with WOMAC pain (estimate 0.1; 95% confidence interval=0.0-0.2; P=.02). Relative humidity contributed < or = 1% to the explained within-patient variance and between-patient variance of the WOMAC pain score. Mean barometric pressure was associated with WOMAC function (estimate 0.1; 95% confidence interval=0.0-0.1; P=.02). Barometric pressure contributed < or = 1% to the explained within-patient variance and between-patient variance of the WOMAC function score. The other weather variables were not associated with the WOMAC pain or function score. Our results support the general opinion of OA patients that barometric pressure and relative humidity influence perceived OA symptoms. However, the contribution of these weather variables (< or = 1%) to the severity of OA symptoms is not considered to be clinically relevant.

  6. The Effect of Eradication of Helicobacter pylori upon the Duodenal Ulcer Recurrence

    PubMed Central

    Kim, Na Young; Oh, Hyun Sook; Jung, Hyung Man; Wee, Sung Ho; Choi, Jeong Heui; Lee, Kye Heui

    1994-01-01

    Objectives To evaluate the effect of eradication of Helicobacter pylori(H.pylori) in the patients with duodenal ulcer(Du) upon the DU recurrence. Methods This study was performed for 190 patients with DU. Four different methods-microscopy of Gram stained mucosal smear, specific culture, biopsy urease test, histology of H&E staining-were taken for identifying colonization of H. pylori before treatment, and for finding the eradication of H. pylori 4 weeks after completion of therapy in each treatment group (cometidine, omeprazole, colloidal bismuth subcitrate(CBS), CBS and metronidazole double therapy, CBS. metronidazole and amoxicillin triple therapy). To detect DU recurrence, the gastroscopy was performed at 6, 12, 18, and 24 months after therapy. Results The eradication rate of the cimetidine group, the omeprazole group, and the CBS group were 0%, 7.7%, 0%, respectively, and that of the double therapy group and the triple therapy group were 44.4% and 89.3%, respectively. Seventy three patients who were followed up for 2 years were categorized into two groups according to the eradication of H. pylori. The recurrence rate was 3.2% both in 1 year and 2 years later in the former group-one consisting of 31 patients with H. pylori eradicated, while the recurrence rate was 57.1% in 1 year and 78.6% in 2 years later, in the latter group-the other of 42 patients with H. pylori not eradicated. Conclusion The eradication of H. pylori in patients with DU reduces the recurrence of DU. PMID:7865492

  7. A family of Nikishin systems with periodic recurrence coefficients

    SciTech Connect

    Delvaux, Steven; Lopez, Abey; Lopez, Guillermo L

    2013-01-31

    Suppose we have a Nikishin system of p measures with the kth generating measure of the Nikishin system supported on an interval {Delta}{sub k} subset of R with {Delta}{sub k} Intersection {Delta}{sub k+1} = Empty-Set for all k. It is well known that the corresponding staircase sequence of multiple orthogonal polynomials satisfies a (p+2)-term recurrence relation whose recurrence coefficients, under appropriate assumptions on the generating measures, have periodic limits of period p. (The limit values depend only on the positions of the intervals {Delta}{sub k}.) Taking these periodic limit values as the coefficients of a new (p+2)-term recurrence relation, we construct a canonical sequence of monic polynomials {l_brace}P{sub n}{r_brace}{sub n=0}{sup {infinity}}, the so-called Chebyshev-Nikishin polynomials. We show that the polynomials P{sub n} themselves form a sequence of multiple orthogonal polynomials with respect to some Nikishin system of measures, with the kth generating measure being absolutely continuous on {Delta}{sub k}. In this way we generalize a result of the third author and Rocha [22] for the case p=2. The proof uses the connection with block Toeplitz matrices, and with a certain Riemann surface of genus zero. We also obtain strong asymptotics and an exact Widom-type formula for functions of the second kind of the Nikishin system for {l_brace}P{sub n}{r_brace}{sub n=0}{sup {infinity}}. Bibliography: 27 titles.

  8. High-Dose-Rate Intraoperative Radiation Therapy for Recurrent Head-and-Neck Cancer

    SciTech Connect

    Perry, David J.; Chan, Kelvin; Wolden, Suzanne; Zelefsky, Michael J.; Chiu, Johnny; Cohen, Gilad; Zaider, Marco; Kraus, Dennis; Shah, Jatin; Lee, Nancy

    2010-03-15

    Purpose: To report the use of high-dose-rate intraoperative radiation therapy (HDR-IORT) for recurrent head-and-neck cancer (HNC) at a single institution. Methods and Materials: Between July 1998 and February 2007, 34 patients with recurrent HNC received 38 HDR-IORT treatments using a Harrison-Anderson-Mick applicator with Iridium-192. A single fraction (median, 15 Gy; range, 10-20 Gy) was delivered intraoperatively after surgical resection to the region considered at risk for close or positive margins. In all patients, the target region was previously treated with external beam radiation therapy (median dose, 63 Gy; range, 24-74 Gy). The 1- and 2-year estimates for in-field local progression-free survival (LPFS), locoregional progression-free survival (LRPFS), distant metastases-free survival (DMFS), and overall survival (OS) were calculated. Results: With a median follow-up for surviving patients of 23 months (range, 6-54 months), 8 patients (24%) are alive and without evidence of disease. The 1- and 2-year LPFS rates are 66% and 56%, respectively, with 13 (34%) in-field recurrences. The 1- and 2-year DMFS rates are 81% and 62%, respectively, with 10 patients (29%) developing distant failure. The 1- and 2-year OS rates are 73% and 55%, respectively, with a median time to OS of 24 months. Severe complications included cellulitis (5 patients), fistula or wound complications (3 patients), osteoradionecrosis (1 patient), and radiation-induced trigeminal neuralgia (1 patient). Conclusions: HDR-IORT has shown encouraging local control outcomes in patients with recurrent HNC with acceptable rates of treatment-related morbidity. Longer follow-up with a larger cohort of patients is needed to fully assess the benefit of this procedure.

  9. Paleoearthquake recurrence on the East Paradise fault zone, metropolitan Albuquerque, New Mexico

    USGS Publications Warehouse

    Personius, Stephen F.; Mahan, Shannon

    2000-01-01

    A fortuitous exposure of the East Paradise fault zone near Arroyo de las Calabacillas has helped us determine a post-middle Pleistocene history for a long-forgotten Quaternary fault in the City of Albuquerque, New Mexico. Mapping of two exposures of the fault zone allowed us to measure a total vertical offset of 2.75 m across middle Pleistocene fluvial and eolian deposits and to estimate individual surface-faulting events of about 1, 0.5, and 1.25 m. These measurements and several thermoluminescence ages allow us to calculate a long-term average slip rate of 0.01 ± 0.001 mm/yr and date two surface-faulting events to 208 ± 25 ka and 75 ± 7 ka. The youngest event probably occurred in the late Pleistocene, sometime after 75 ± 7 ka. These data yield a single recurrence interval of 133 ± 26 ka and an average recurrence interval of 90 ± 10 ka. However, recurrence intervals are highly variable because the two youngest events occurred in less than 75 ka. Offsets of 0.5-1.25 m and a fault length of 13-20 km indicate that surface-rupturing paleoearthquakes on the East Paradise fault zone had probable Ms or Mw magnitudes of 6.8-7.0. Although recurrence intervals are long on the East Paradise fault zone, these data are significant because they represent some of the first published slip rate, paleoearthquake magnitude, and recurrence information for any of the numerous Quaternary faults in the rapidly growing Albuquerque-Rio Rancho metropolitan area.

  10. Tuberculosis Recurrence after Completion Treatment in a European City: Reinfection or Relapse?

    PubMed Central

    Millet, Juan-Pablo; Shaw, Evelyn; Orcau, Àngels; Casals, Martí; Miró, Jose M.; Caylà, Joan A.

    2013-01-01

    Background Tuberculosis (TB) recurrence can be due to reinfection or relapse. The contribution of each to TB incidence and the factors associated with recurrence are not well known. Effectiveness of TB control programs is assessed in part by recurrence rates. The aim of this study was to establish the recurrence rate of TB in Barcelona, the associated risk factors and the role of reinfection. Methods A population-based retrospective longitudinal study was performed in Barcelona, Spain. TB patients with positive culture results who completed treatment between Jan 1st, 2003 and Dec 31st, 2006 were followed-up until December 31st, 2009 by the TB Control Program. The incidence rate of recurrence was calculated per person-year of follow-up (py). Kaplan-Meier and Cox regression methods were used for the survival analysis by calculating the hazard ratio (HR) with 95% confidence intervals (CI). Results Of the 1,823 TB cases identified, 971 fulfilled the inclusion criteria and 13 (1.3%) had recurrent TB. The recurrence rate was 341 cases per 100,000 py, 13 times higher than the TB incidence of the general population. Likelihood of TB recurrence at the 1st, 3rd and 5th year of follow-up was 0.1%, 1.4% and 1.6%, respectively. Factors associated with recurrence were HIV infection (HR: 4.7, CI: 1.4–15.7), living in the inner city district (HR: 3.9, CI: 1.3–11.8) and history of TB treatment (HR: 5.2, CI: 1.7–16.2). Genotyping results of recurrent cases were available for 6 patients (3 reinfections and 3 relapses). Conclusion The rate of TB recurrence in Barcelona is low and most episodes occur within the first three years. Patients at higher risk of recurrence are co-infected with HIV, living in neighborhoods with high TB incidence or with a history of TB treatment. When available, genotyping results help determine whether the recurrence is due to reinfection or relapse. PMID:23776440

  11. Interferon alfa-2b in the management of recurrent conjunctival papillomatosis.

    PubMed

    Singh, Manpreet; Gautam, Natasha; Gupta, Adit; Kaur, Manpreet

    2016-10-01

    A 2-year-old boy presented with a recurrent strawberry-like reddish mass arising from the left caruncular region for 8 months. An incisional biopsy was performed elsewhere 2 months earlier, followed by an increase in size of mass, significant epiphora, and intermittent bleeding. On examination, exuberant exophytic gelatinous mass with multifocal origin was observed arising from inferior forniceal conjunctiva and caruncle. Clinical differential of multifocal conjunctival papilloma was kept, and topical interferon alfa-2b (INFα-2b) was started. No clinical reduction in mass or symptomatology was observed over 6 weeks. Excision biopsy with cryotherapy and subconjunctival injection of INFα-2b was performed over all foci. Conjunctival papilloma was confirmed on histopathology, and topical INFα-2b was continued in postoperative period for 3 months. At 14 months of follow-up, no recurrence, epiphora, or bleeding was noticed. We advocate a possible role of local INF therapy in managing and preventing recurrences of conjunctival papillomatosis.

  12. Recurrence of depressive disorders after interferon-induced depression.

    PubMed

    Chiu, W-C; Su, Y-P; Su, K-P; Chen, P-C

    2017-02-07

    Interferon alpha (IFN-α)-treated patients commonly develop depression during the therapy period. Although most IFN-α-induced depressive disorders achieve remission after IFN-α therapy, no studies have examined the long-term mood effects of IFN-α treatment. We conducted a 12-year population-based cohort study of hepatitis C virus (HCV)-infected patients who were older than 20 years and had received IFN-α therapy. The sample was obtained from the Taiwan National Health Insurance Research Database. The cohort included patients with and without IFN-α-induced depression, matched randomly by age, sex and depression history, at a ratio of 1:10. The follow-up started after the last administration of IFN-α and was designed to determine the incidence of recurrent depressive disorder after IFN-α therapy. A total of 156 subjects were identified as having IFN-α-induced depression and achieving full remission after IFN-α therapy. The overall incidence of recurrent depressive disorders among patients with and without IFN-α-induced depression was 56.8 (95% confidence interval (CI), 42.4-76.1) and 4.1 (95% CI, 2.9-5.8) cases, respectively, per 100 000 person-years, P<0.001. The adjusted hazard ratios for recurrent depressive disorder were 13.5 (95% CI, 9.9-18.3) in the IFN-α-treated cohort and 22.2 (95% CI, 11.2-44.2) in the matched cohort for IFN-α-induced depression patients after adjusting for age, sex, income, urbanization and comorbid diseases. IFN-α-induced depression was associated with a high risk of recurrent depression. It was not a transient disease and might be considered an episode of depressive disorder. Continuation therapy might be considered, and further research is needed.

  13. Anxiety and depression symptoms in recurrent painful renal lithiasis colic.

    PubMed

    Diniz, D H M P; Blay, S L; Schor, N

    2007-07-01

    Several studies have reported that symptoms of anxiety and depression are significantly associated with diseases characterized by painful crises. However, there is little information about the psychological aspects of recurrent painful episodes of renal stone disease. Our objective was to evaluate the association of symptoms of anxiety, depression and recurrent painful renal colic in a case-control study involving 64 subjects (32 cases/32 controls) matched for age and sex. Cases were outpatients with a confirmed diagnosis of nephrolithiasis as per their case history, physical examination, image examination and other laboratory exams. Patients had a history of at least two episodes within a 3-year period, and were currently in an intercrisis interval. The control group consisted of subjects seen at the Ophthalmology Outpatient Clinic of this University Hospital with only eye refraction symptoms, and no other associated disease. Symptoms of anxiety were evaluated by the State-Trait Anxiety Inventory and symptoms of depression by the Beck Depression Inventory. Statistically significant differences were observed between patients with nephrolithiasis and controls for anxiety state (P = 0.001), anxiety trait (P = 0.005) and symptoms of depression (odds ratio = 3.74; 95%CI = 1.31-10.62). The Beck Depression Inventory showed 34.5% of respondents with moderate and 6% with severe levels of depression. There was a significant linear correlation between symptoms of anxiety (P = 0.002) and depression (P < 0.001) and the number of recurrent colic episodes (anxiety-state: P = 0.016 and anxiety-trait: P < 0.001). These data suggest an association between recurrent renal colic and symptoms of both anxiety and depression.

  14. Detection of Recurrent Fluorescence Photons

    NASA Astrophysics Data System (ADS)

    Ebara, Yuta; Furukawa, Takeshi; Matsumoto, Jun; Tanuma, Hajime; Azuma, Toshiyuki; Shiromaru, Haruo; Hansen, Klavs

    2016-09-01

    We have detected visible photons emitted from the thermally populated electronic excited state, namely recurrent fluorescence (RF), of C6- stored in an electrostatic ion storage ring. Clear evidence is provided to distinguish RF from normal fluorescence, based on the temporal profile of detected photons synchronized with the revolution of C6- in the ring, for which the time scale is far longer than the lifetime of the intact photoexcited state. The relaxation (cooling) process via RF is likely to be commonplace for isolated molecular systems and crucial to the stabilization of molecules in interstellar environments.

  15. Recurrent hypoglycemia in a toddler.

    PubMed

    Cohen, Marissa; Zwiebel, Sean; Jeanmonod, Rebecca

    2015-12-01

    Idiopathic ketotic hypoglycemia is the most common cause of hypoglycemia in toddlers. This diagnosis should be considered in any hypoglycemic toddler with no prior history of abnormal growth who is developmentally normal when toxic ingestions and sepsis are inconsistent with the clinical picture. Diagnosis is important in preventing serious long-term sequelae and is made in the setting of hypoglycemia, ketonuria, and ketonemia. Therefore, checking urine and blood ketones is an essential part of the evaluation in any hypoglycemic toddler. We report the case of a 3-year-old girl with recurrent hypoglycemia secondary to idiopathic ketotic hypoglycemia.

  16. Intervals in evolutionary algorithms for global optimization

    SciTech Connect

    Patil, R.B.

    1995-05-01

    Optimization is of central concern to a number of disciplines. Interval Arithmetic methods for global optimization provide us with (guaranteed) verified results. These methods are mainly restricted to the classes of objective functions that are twice differentiable and use a simple strategy of eliminating a splitting larger regions of search space in the global optimization process. An efficient approach that combines the efficient strategy from Interval Global Optimization Methods and robustness of the Evolutionary Algorithms is proposed. In the proposed approach, search begins with randomly created interval vectors with interval widths equal to the whole domain. Before the beginning of the evolutionary process, fitness of these interval parameter vectors is defined by evaluating the objective function at the center of the initial interval vectors. In the subsequent evolutionary process the local optimization process returns an estimate of the bounds of the objective function over the interval vectors. Though these bounds may not be correct at the beginning due to large interval widths and complicated function properties, the process of reducing interval widths over time and a selection approach similar to simulated annealing helps in estimating reasonably correct bounds as the population evolves. The interval parameter vectors at these estimated bounds (local optima) are then subjected to crossover and mutation operators. This evolutionary process continues for predetermined number of generations in the search of the global optimum.

  17. Interpregnancy Interval and Risk of Autism Spectrum Disorders

    PubMed Central

    Yoshida, Cathleen; Gunderson, Erica P.; Dorward, Kaht; Croen, Lisa A.

    2015-01-01

    OBJECTIVE: To determine whether subsequent births after short and long interpregnancy intervals (IPIs) are associated with risk of autism spectrum disorder (ASD). METHOD: We assessed the association between IPI and ASD risk in a cohort of 45 261 children born at Kaiser Permanente Northern California (KPNC) between 2000 and 2009. Children with ASD were identified from International Classification of Diseases, Revision 9 diagnostic codes 299.0, 299.8, and 299.9 recorded in KPNC electronic medical records. IPI was defined as the time from the birth of the first child to the conception of the second child. Survival analysis and logistic regression models were used to evaluate the association between IPI and risk of ASD in second-born children. RESULTS: Children born after an IPI of <12 months or ≥72 months had a 2- to 3-fold increased ASD risk compared with children born after an interval of 36 to 47 months. Respective adjusted hazard ratios (95% confidence intervals) were as follows: <6 months, 3.0 (1.9–4.7); 6 to 8 months, 2.1 (1.4–3.3); 9 to 11 months, 1.9 (1.3–2.1); 12 to 23 months, 1.5 (1.1–2.1); and ≥72 months, 2.4 (1.5–3.7). The results are not explained by maternal BMI or change in BMI between pregnancies or by parental age, maternal antidepressant medication use, or unfavorable events occurring during the first or second pregnancy. CONCLUSIONS: Children born after interpregnancy intervals <2 years or >6 years may be at increased risk of ASD. The mechanism explaining this association is unknown, and more research is needed. PMID:26371204

  18. Persistence of a recurrent group of intestinal helminth species in a coyote population from southern Texas.

    PubMed

    Radomski, A A; Pence, D B

    1993-06-01

    The persistence and interrelationships of a recurrent group of intestinal helminth species in a coyote population from southern Texas were determined; data were collected at 4-yr intervals (1979, 1983, and 1987). The a priori expectation was that a defined recurrent group of helminth species persisted over time and that the respective helminth species were stable in terms of their abundances. The Fager index and subsequent recurrent group analysis indicated a small group of taxonomically unrelated recurring species of helminths that always demonstrated affinities with each other and occasionally with certain of the remaining species. Although there were differences across host subpopulations delineated by sex and age, temporal changes reflective of extrinsic environmental variables acting on certain helminth species appeared to have the greatest effect on recurrent group size and structure. Three of the 8 common intestinal helminth species (Ancylostoma caninum, Oncicola canis, and Alaria marcianae) occurred in all recurrent groups. Thus, there was temporal persistence of a small recurrent group of dominant helminth species that formed the basis of the intestinal helminth community in this coyote population.

  19. Capacitated max -Batching with Interval Graph Compatibilities

    NASA Astrophysics Data System (ADS)

    Nonner, Tim

    We consider the problem of partitioning interval graphs into cliques of bounded size. Each interval has a weight, and the weight of a clique is the maximum weight of any interval in the clique. This natural graph problem can be interpreted as a batch scheduling problem. Solving a long-standing open problem, we show NP-hardness, even if the bound on the clique sizes is constant. Moreover, we give a PTAS based on a novel dynamic programming technique for this case.

  20. Herpes zoster in a 2-year-old vaccinated against varicella.

    PubMed

    Ulman, Catherine A; Trevino, Julian J; Gandhi, Rishi K

    2014-01-15

    Herpes zoster is uncommon in the pediatric population. We report a case of herpes zoster in a 2-year-old boy who received the live attenuated varicella zoster virus vaccination at his 12-month pediatric visit. The child was treated with acyclovir and recovered without complications.

  1. AGU awarded grant to establish program on engaging 2-year-college students in research

    NASA Astrophysics Data System (ADS)

    Asher, Pranoti; Adamec, Bethany Holm

    2012-03-01

    Students at 2-year colleges are a critical part of the future Earth and space science workforce, and undergraduate research experiences provide a hook to retain and ultimately to graduate students in the field. AGU was awarded a planning grant by the U.S. National Science Foundation Directorate for Geosciences (Opportunities for Enhancing Diversity in the Geosciences award 1201578) to help launch a new initiative concerning these issues; education and public outreach staff are the principal investigators. This new initiative, titled Unique Research Experiences for Two-Year College Faculty and Students (URECAS), will begin with a planning workshop this summer (11-13 July). The workshop will bring together faculty from 2-year colleges, 4-year colleges and universities, and representatives from professional societies and federal organizations to learn more about how to support 2-year-college faculty and students engaged in Earth and space science research and to discuss the development of a program to strengthen the role of 2-year-college Earth and space science students in the future workforce

  2. Changing Network Support for Drinking: Network Support Project 2-Year Follow-up

    ERIC Educational Resources Information Center

    Litt, Mark D.; Kadden, Ronald M.; Kabela-Cormier, Elise; Petry, Nancy M.

    2009-01-01

    The Network Support Project was designed to determine whether a treatment could lead patients to change their social network from one that supports drinking to one that supports sobriety. This study reports 2-year posttreatment outcomes. Alcohol-dependent men and women (N = 210) were randomly assigned to 1 of 3 outpatient treatment conditions:…

  3. INSTRUMENTATION TECHNOLOGY, A SUGGESTED 2-YEAR POST HIGH SCHOOL CURRICULUM. TECHNICAL EDUCATIONAL PROGRAM SERIES, NUMBER 6.

    ERIC Educational Resources Information Center

    Office of Education (DHEW), Washington, DC.

    A 2-YEAR POST-SECONDARY CURRICULUM FOR TECHNICIANS IS PRESENTED. IT IS DESIGNED TO AID SCHOOL ADMINISTRATORS, SUPERVISORS, AND TEACHERS TO PLAN AND DEVELOP NEW PROGRAMS OR EVALUATE EXISTING PROGRAMS. IT WAS PREPARED PURSUANT TO A U.S. OFFICE OF EDUCATION CONTRACT BY THE INSTRUMENT SOCIETY OF AMERICA AFTER A NATIONAL SURVEY OF INSTRUMENTATION…

  4. Japanese Female Students' Perceptions of 2-Year Colleges as a Choice for Postsecondary Education

    ERIC Educational Resources Information Center

    Anzai, Shinobu; Paik, Chie Matsuzawa

    2012-01-01

    Two-year colleges have played an important role in providing postsecondary education for women in postwar Japan. More recently, a dwindling college-bound population in Japan has resulted in a drastic decrease in the number of and enrollment in 2-year colleges. This study explored the motivations and aspirations of 12 Japanese female students to…

  5. Weight and Weight-Related Behaviors among 2-Year College Students

    ERIC Educational Resources Information Center

    Nanney, Marilyn S.; Lytle, Leslie A.; Farbakhsh, Kian; Moe, Stacey G.; Linde, Jennifer A.; Gardner, Jolynn K.; Laska, Melissa N.

    2015-01-01

    Objectives and Participants: The purpose of this article is to describe weight indicators and weight-related behaviors of students enrolled in 2-year colleges, including sex differences. Methods: During Fall 2011 and Spring 2012, 441 students from 3 Minnesota community colleges enrolled in the Choosing Healthy Options in College Environments and…

  6. Robotically Assisted Gynecologic Surgery: 2-Year Experience in the French Foch Hospital

    PubMed Central

    Goetgheluck, Julie; Carbonnel, Marie; Ayoubi, Jean Marc

    2014-01-01

    Robotically assisted laparoscopic surgery has seen rapid expansion over the past few years and it constantly evolves with a progressive enlargement of its range of indications. In the present paper we would like to share our 2-year experience regarding the use of robotics in various laparoscopic procedures, including hysterectomy, myomectomy, adnexal surgery, and sacrocolpopexy. PMID:25593933

  7. 7 CFR 25.403. - Ongoing 2-year work plan requirement.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... commitments have been obtained; (iii) Technical assistance resources and other forms of support pledged by... COMMUNITIES Post-Designation Requirements § 25.403. Ongoing 2-year work plan requirement. (a) Each Empowerment Zone and Enterprise Community shall prepare and submit annually, work plans for the subsequent...

  8. 7 CFR 25.403. - Ongoing 2-year work plan requirement.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... commitments have been obtained; (iii) Technical assistance resources and other forms of support pledged by... COMMUNITIES Post-Designation Requirements § 25.403. Ongoing 2-year work plan requirement. (a) Each Empowerment Zone and Enterprise Community shall prepare and submit annually, work plans for the subsequent...

  9. Improving Social Competence through Emotion Knowledge in 2-Year-Old Children: A Pilot Study

    ERIC Educational Resources Information Center

    Giménez-Dasí, Marta; Fernández-Sánchez, Marta; Quintanilla, Laura

    2015-01-01

    Research Findings: The goal of this study was to determine the efficacy of an educational intervention program to improve emotion knowledge, emotion regulation, and social competence in 2-year-old Spanish children. This study makes two original contributions because there are no validated education programs for such young children and because it…

  10. Attitudes of College Students Enrolled in 2-Year Health Care Programs towards Online Learning

    ERIC Educational Resources Information Center

    Abdulla, Dalya

    2012-01-01

    Colleges offering 2-year diplomas to high-school graduates were among the forefront leaders in online learning however studies illustrating appropriate course construction for such student populations are scarce. Pharmacy Math (MATH16532) is a core course for students enrolled in the Practical Nursing (PN) and Pharmacy Technician (PT) programs at…

  11. Phonetic Modification of Vowel Space in Storybook Speech to Infants up to 2 Years of Age

    ERIC Educational Resources Information Center

    Burnham, Evamarie B.; Wieland, Elizabeth A.; Kondaurova, Maria V.; McAuley, J. Devin; Bergeson, Tonya R.; Dilley, Laura C.

    2015-01-01

    Purpose: A large body of literature has indicated vowel space area expansion in infant-directed (ID) speech compared with adult-directed (AD) speech, which may promote language acquisition. The current study tested whether this expansion occurs in storybook speech read to infants at various points during their first 2 years of life. Method: In 2…

  12. Persistence by 2-Year College Graduates to 4-Year Colleges and Universities.

    ERIC Educational Resources Information Center

    Dworkin, Stephen L.

    1996-01-01

    Presents findings from a study of the relationship between the characteristics of 3,762 Connecticut 2-year college students 25 or older and their persistence to 4-year colleges. Reports that students with higher perceptions of social and institutional support and those over 35 were more likely to persist to 4-year institutions. (10 citations) (AJL)

  13. Antecedents of Compliance in 2-Year-Olds From a High-Risk Sample.

    ERIC Educational Resources Information Center

    Erickson, Martha Farrell; Crichton, Leslie

    In order to identify antecedents of infant's compliance with mothers' directions on how to solve four tasks (graded in terms of stressfulness to the infant), 194 high-risk mothers and their 2-year-old children were observed on videotape and assessed with a six-point rating scale. Data collected prenatally and postnatally at 3, 6, 12 and 18 months…

  14. Prenatal Cocaine Exposure: A Comparison of 2-Year-Old Children in Parental and Nonparental Care

    ERIC Educational Resources Information Center

    Brown, Josephine V.; Bakeman, Roger; Coles, Claire D.; Platzman, Kathleen A.; Lynch, Mary Ellen

    2004-01-01

    Effects of prenatal cocaine exposure and parental versus nonparental care on outcome at 2 years of age were examined. The sample included 83 cocaine-exposed and 63 nonexposed children and their caregivers; 49 and 34 of the cocaine-exposed children experienced parental and nonparental care, respectively. Prenatal drug exposure was not related…

  15. Myopia Control with a Novel Peripheral Gradient Soft Lens and Orthokeratology: A 2-Year Clinical Trial

    PubMed Central

    Pauné, Jaime; Morales, Hari; Armengol, Jesús; Quevedo, Lluisa; Faria-Ribeiro, Miguel; González-Méijome, José M.

    2015-01-01

    Objective. To evaluate the degree of axial elongation with soft radial refractive gradient (SRRG) contact lenses, orthokeratology (OK), and single vision (SV) spectacle lenses (control) during a period of 1 year before treatment and 2 years after treatment. Methods. This was a prospective, longitudinal, nonrandomized study. The study groups consisted of 30, 29, and 41 children, respectively. The axial length (AL) was measured during 2 years after recruitment and lens fitting. Results. The baseline refractive sphere was correlated significantly (Spearman's Rho (ρ) correlation = 0.542; P < 0.0001) with the amount of myopia progression before baseline. After 2 years, the mean myopia progression values for the SRRG, OK, and SV groups were −0.56 ± 0.51, −0.32 ± 0.53, and −0.98 ± 0.58 diopter, respectively. The results represent reductions in myopic progression of 43% and 67% for the SRRG and OK groups, respectively, compared to the SV group. The AL increased 27% and 38% less in the SRRG and OK groups, respectively compared with the SV group at the 2-year visit (P < 0.05). Axial elongation was not significantly different between SRRG and OK (P = 0.430). Conclusion. The SRRG lens significantly decreased AL elongation compared to the SV control group. The SRRG lens was similarly effective to OK in preventing myopia progression in myopic children and adolescent. PMID:26605331

  16. Depressive and anxiety disorders: Associated with losing or gaining weight over 2 years?

    PubMed

    de Wit, Leonore M; van Straten, Annemieke; Lamers, Femke; Cuijpers, Pim; Penninx, Brenda W J H

    2015-06-30

    This longitudinal study examines to what extent different depressive and anxiety disorders and clinical characteristics are associated with subsequent weight change, while controlling for baseline weight, sociodemographics, health status, psychotropic medication use and (un)healthy lifestyle factors. Data are from a sample of 2447 respondents aged 18-65 years of the Netherlands Study of Depression and Anxiety (NESDA). Baseline depressive disorders and anxiety disorders were determined with the Composite International Diagnostic Interview (CIDI). Weight at baseline and after 2 years was measured and analyzed as continuous change score (mean change in weight 1kg) and in categories of significant weight loss (<1S.D. weight change equaling <4kg), weight maintenance and weight gain (>1S.D., >6kg). After full adjustment for covariates baseline comorbid anxiety and depressive disorder and baseline Major Depressive Disorder (MDD) were associated with significant 2-year weight gain. Both current and remitted MDD at baseline and a baseline dysthymia, but none of the anxiety disorders, were associated with significant weight loss. This longitudinal study confirms a U-curved link between depression and weight change over 2 years. Furthermore, a dose-response effect of depression severity on 2-year weight gain was found.

  17. Behavior Predictors of Language Development over 2 Years in Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Bopp, Karen D.; Mirenda, Pat; Zumbo, Bruno D.

    2009-01-01

    Purpose: This exploratory study examined predictive relationships between 5 types of behaviors and the trajectories of vocabulary and language development in young children with autism over 2 years. Method: Participants were 69 children with autism assessed using standardized measures prior to the initiation of early intervention (T1) and 6 months…

  18. Intermittent pancreatitis in a 2-year-old chihuahua mixed breed dog.

    PubMed

    Chan, Alice K Y

    2006-05-01

    A 2-year-old, female, Chihuahua mixed breed was presented on multiple occasions with vomiting and diarrhea. Diagnostic tests, including blood analyses and ultrasonography, established pancreatitis as the cause of gastrointestinal irritation. Hospitalization and supportive care, followed by maintenance of a prescription gastrointestinal diet, allowed management of the disease.

  19. Emotionally Focused Interventions for Couples with Chronically Ill Children: A 2-Year Follow-Up

    ERIC Educational Resources Information Center

    Cloutier, Paula F.; Manion, Ian G.; Walker, Jan Gordon; Johnson, Susan M.

    2002-01-01

    Couples with chronically ill children are particularly at risk for experiencing marital distress. The study presented here is a 2-year follow-up of a randomized control trial that assessed the efficacy of Emotionally Focused Therapy (EFT) in decreasing marital distress in a sample of couples with a chronically ill child. Thirteen couples with…

  20. How Are 2-Year US Colleges Addressing Student Alcohol Use and Related Problems?

    ERIC Educational Resources Information Center

    Lenk, Kathleen M.; Nelson, Toben F.; Erickson, Darin J.; Toomey, Traci L.

    2015-01-01

    A considerable amount of attention and research has been dedicated to addressing alcohol use and related problems among students at 4-year colleges; however, less attention has been given to alcohol-related issues among students at 2-year technical/community colleges. This article describes research that expands on a study by Chiauzzi and…

  1. Communication Apprehension: Levels of First-Generation College Students at 2-Year Institutions

    ERIC Educational Resources Information Center

    Francis, Trevor A.; Miller, Michael T.

    2008-01-01

    The study explored the oral communication apprehension (CA) levels of first-generation college students at a 2-year case study community institution. Overall and general-context CA were measured using the Personal Report of Communication Apprehension-24 (PRCA-24). The survey was sent by e-mail to 2,040 institutionally-identified first-generation…

  2. How Joint Attention Relates to Cooperation in 1- and 2-Year-Olds

    ERIC Educational Resources Information Center

    Wu, Zhen; Pan, Jingtong; Su, Yanjie; Gros-Louis, Julie

    2013-01-01

    Joint attention has been suggested to contribute to children's development of cooperation; however, few empirical studies have directly tested this hypothesis. Children aged 1 and 2 years participated in two joint action activities to assess their cooperation with an adult partner, who stopped participating at a specific moment during the tasks.…

  3. Slowly but Surely: Adverbs Support Verb Learning in 2-Year-Olds

    ERIC Educational Resources Information Center

    Syrett, Kristen; Arunachalam, Sudha; Waxman, Sandra R.

    2014-01-01

    To acquire the meanings of verbs, toddlers make use of the surrounding linguistic information. For example, 2-year-olds successfully acquire novel transitive verbs that appear in semantically rich frames containing content nouns ("The boy is gonna pilk a balloon"), but they have difficulty with pronominal frames ("He is gonna pilk…

  4. Common Aetiology for Diverse Language Skills in 4 1/2-Year-Old Twins

    ERIC Educational Resources Information Center

    Hayiou-Thomas, Marianna E.; Kovas, Yulia; Harlaar, Nicole; Plomin, Robert; Bishop, Dorothy V. M.; Dale, Philip S.

    2006-01-01

    Multivariate genetic analysis was used to examine the genetic and environmental aetiology of the interrelationships of diverse linguistic skills. This study used data from a large sample of 4 1/2-year-old twins who were tested on measures assessing articulation, phonology, grammar, vocabulary, and verbal memory. Phenotypic analysis suggested two…

  5. Upper limb movements and outcome in intrauterine-growth-retarded infants at 2 years.

    PubMed

    Zuk, Luba; Harel, Shaul; Leitner, Yael; Jaffa, Ariel; Fattal-Valevski, Aviva

    2008-11-01

    This study aims to examine the usefulness of spontaneous upper limb movements (ULM) as an early marker for predicting neurodevelopmental outcome in infants with intrauterine-growth retardation (IUGR). The assessment of general movements (GMs) during the first 20 weeks is an accepted method for early detection of brain dysfunction. During this period, spontaneous upper limb movements were examined in 32 infants with IUGR and 32 appropriate-for-gestational-age-matched controls. ULM (arms, forearms and hands) were scored as optimal or suboptimal by sequential videotape recordings in the writhing (term-2 weeks: score 0-5); early fidgety (9-11 weeks: score 0-6); and late fidgety (14-16 weeks: score 0-6) periods, and correlated with neurodevelopmental score at 2 years of age. The mean ULM score was lower in the IUGR infants than the controls (p<0.05) and in the IUGR group was lower in the infants with abnormal outcome (p<0.05). Significant correlations were found between ULM and 2-year neurodevelopmental scores in the IUGR group. The ULM during late-fidgety period was most predictive for 2-year neurodevelopmental score. No difference was found in the mean ULM score between the pre-term and term IUGR infants. We conclude that ULM score can serve as an early predictor for neurodevelopmental outcome at 2 years of age in infants with IUGR.

  6. Generacion 1.5: A Cultural Historical Agenda for Research at the 2-Year College

    ERIC Educational Resources Information Center

    Salas, Spencer; Portes, Pedro R.; D'Amico, Mark M.; Rios-Aguilar, Cecilia

    2011-01-01

    In this article, we employ a cultural historical theoretical framework to extend understandings of how widespread 2-year college placement policies concerning English remediation potentially locate and retain U.S.-educated Latino adolescents at the margins of higher education through well-intentioned yet deficit-driven postsecondary cultural…

  7. Coordination of Lip Muscle Activity by 2-Year-Old Children During Speech and Nonspeech Tasks

    PubMed Central

    Ruark, Jacki L.; Moore, Christopher A.

    2014-01-01

    This investigation was designed to quantify the coordinative organization of lip muscle activity of 2-year-old children during speech and nonspeech behaviors. Electromyographic (EMG) recordings of right upper and lower lip activity of seven 2-year-old children were obtained during productions of chewing, syllable repetition, lip protrusion, and speech (repeated two-word utterances) tasks. Task comparisons revealed that the coordinative organization of upper and lower lip activity is task specific; different coordinative strategies are employed for different tasks. Lip protrusion and syllable repetition tasks yielded strong coupling of upper and lower lip activity. Lip rounding (sentences containing the lip-rounding vowel /u/) and “nonlabial” speech tasks (sentences free of bilabials and lip-rounding vowels) resulted in low coupling of upper and lower lip activity. Moderate levels of coupling of upper and lower lip activity were evident for chewing and bilabial speech tasks (sentences loaded with bilabial plosion). This finding, that the coordinative elements of the perioral system of 2-year-olds are task specific, extends the results of previous studies of adults and children, where task-specific coordinative strategies were employed by the mandibular and perioral systems (Moore, 1993; Moore & Ruark, 1996; Moore, Smith, & Ringel, 1988; Wohlert & Goffman, 1994). The task-dependent coordination of the perioral system of 2-year-olds supports the notion that developing speech and earlier developing oromotor behaviors (i.e., sucking, chewing) are mediated by different control mechanisms. PMID:9430757

  8. The Prognosis of Acute Low Back Pain in Primary Care in the U.S. A 2-Year Prospective Cohort Study

    PubMed Central

    Mehling, Wolf E.; Gopisetty, Viranjini; Bartmess-LeVasseur, Elizabeth; Acree, Mike; Pressman, Alice; Goldberg, Harley; Hecht, Frederick M; Carey, Tim; Avins, Andrew L

    2011-01-01

    Study Design Prospective cohort study Objective to assess the prognosis of patients presenting with acute low back pain (LBP) in a primary care setting in the U.S. Summary of Background Data Practice guidelines for acute LBP based on return-to-work outcomes underestimate the development of chronic pain in the primary care setting. Due to differences in inclusion criteria, chronic pain definitions and national health systems, prognostic cohort studies have reported a wide range of results limiting interpretation and generalization. Current data from carefully designed prognostic studies of acute LBP are lacking for the U.S. primary care system. Methods Members of a large health service organization were enrolled after seeking medical care for acute LBP, with or without sciatica, of up to 30 days duration, with no prior episode in the past 12 months and no history of spine surgery. We conducted phone interviews at baseline, six months and two years. Based on receiver operating characteristic analyses, a combination of global perceived recovery with pain intensity was used as primary outcome for chronic pain. Recurrence and multiple secondary outcomes were assessed to allow for comparison with other studies. Results 605 patients had an average pain intensity of 5.6 (numeric rating scale 0–10) and disability of 15.8 (Roland Morris scale 0–24). Eight percent had declared sick leave between pain onset and baseline interview. 13% of 521 patients (86% follow-up) suffered from chronic pain at six months and 19% of 443 patients at 2 years. At six months, 54% had experienced at least one LBP recurrence, and 47% in the subsequent 18 months. Conclusion The prognosis of strictly-defined acute LBP, with or without sciatica, is less favorable than commonly stated in practice guidelines based on failure to return to work. Broad initiatives to develop new means for the primary and secondary prevention of recurrent and chronic LBP are urgently needed. PMID:22504516

  9. Volcanic Event Recurrence Rate Model (VERRM): Incorporating Radiometric Ages, Volcanic Stratigraphy and Paleomagnetic Data into a Monte Carlo Simulation to Estimate Uncertainty in Recurrence Rate through Time

    NASA Astrophysics Data System (ADS)

    Wilson, J. A.; Richardson, J. A.

    2015-12-01

    Traditional methods used to calculate recurrence rate of volcanism, such as linear regression, maximum likelihood and Weibull-Poisson distributions, are effective at estimating recurrence rate and confidence level, but these methods are unable to estimate uncertainty in recurrence rate through time. We propose a new model for estimating recurrence rate and uncertainty, Volcanic Event Recurrence Rate Model. VERRM is an algorithm that incorporates radiometric ages, volcanic stratigraphy and paleomagnetic data into a Monte Carlo simulation, generating acceptable ages for each event. Each model run is used to calculate recurrence rate using a moving average window. These rates are binned into discrete time intervals and plotted using the 5th, 50th and 95th percentiles. We present recurrence rates from Cima Volcanic Field (CA), Yucca Mountain (NV) and Arsia Mons (Mars). Results from Cima Volcanic Field illustrate how several K-Ar ages with large uncertainties obscure three well documented volcanic episodes. Yucca Mountain results are similar to published rates and illustrate the use of using the same radiometric age for multiple events in a spatially defined cluster. Arsia Mons results show a clear waxing/waning of volcanism through time. VERRM output may be used for a spatio-temporal model or to plot uncertainty in quantifiable parameters such as eruption volume or geochemistry. Alternatively, the algorithm may be reworked to constrain geomagnetic chrons. VERRM is implemented in Python 2.7 and takes advantage of NumPy, SciPy and matplotlib libraries for optimization and quality plotting presentation. A typical Monte Carlo simulation of 40 volcanic events takes a few minutes to couple hours to complete, depending on the bin size used to assign ages.

  10. RECURRENT ECTOPIC CRANIOPHARYNGIOMA IN THE SYLVIAN FISSURE THIRTY YEARS AFTER RESECTION THROUGH A PTERIONAL APPROACH: A CASE REPORT AND REVIEW OF THE LITERATURE

    PubMed Central

    CLARK, SHANNON W.; KENNING, TYLER J.; EVANS, JAMES J.

    2015-01-01

    ABSTRACT Local recurrence of craniopharyngiomas after apparently complete resection occurs frequently. Ectopic recurrence remote from the original site has been reported in 18 adult patients. The interval between the original diagnosis and the time of recurrence varies widely in these reports (1–26 years). We report a case of an ectopic recurrence in the sylvian fissure of an adamantinomatous type craniopharyngioma 34 years after the initial presentation and 30 years after the last surgical resection. In addition to this being the latest reported ectopic recurrence, the location of this new lesion in the sylvian fissure is fairly rare, having been reported in only three other cases. We also reviewed the English literature for reports of ectopic recurrent craniopharyngiomas in order to conduct an analysis of surveillance and treatment strategies. PMID:25797995

  11. [Traumatic recurrence of idiopathic spinal cord herniation].

    PubMed

    Lorente-Muñoz, Asís; Cortés-Franco, Severiano; Moles-Herbera, Jesús; Casado-Pellejero, Juan; Rivero-Celada, David; Alberdi-Viñas, Juan

    2013-01-01

    Idiopathic spinal cord herniation is a rare cause of thoracic myelopathy and its recurrence is even more infrequent. Cord herniation is through an anterior dural defect in thoracic spine with unknown causes. Symptomatic cases must be surgically treated to reduce the hernia and seal the defect to prevent recurrences. We report a patient presenting a Brown-Séquard syndrome secondary to a D5 spinal cord herniation treated successfully and its posterior traumatic recurrence.

  12. Recurrence of spinal schwannoma: Is it preventable?

    PubMed Central

    Senapati, Satya B.; Mishra, Sudhansu S.; Dhir, Manmath K.; Patnaik, Ashis; Panigrahi, Souvagya

    2016-01-01

    Spinal schwannomas account for about 25% of primary intradural spinal cord tumors in adult. The prognosis for spinal schwannomas is excellent in most cases. Complete resection is curative. However following subtotal removal, recurrence develops after several years. We describe a case of recurrent spinal schwannoma who had been operated twice before for same disease. The possible cause of recurrence and difficulties in reoperation are discussed. PMID:27695564

  13. Confidence Interval Procedures for Reliability Growth Analysis

    DTIC Science & Technology

    1977-06-01

    Plj2s tSAA - TECHNICAL RPORT NO. 197 CONFIDENCE INTERVAL PROCEDURES FOR RELIABILITY, GROWTH ANALYSIS LARRY H. CROW JUNE 1977 APPROVED FOR PUBLIC...dence Intervals for M(T). ¶-. fl [ ] 1 Siion IIS0III0N/AVAI Ale ITY ClOtS Next page is blank. So3 CONFIDENCE INTERVAL PROCIEDURIS• FOR RELTABILITY...and confidence interval procedures for the parameters B and P = X are presented in [l , [2], [4]. In the application of the Weibull process model to

  14. What operation for recurrent rectal prolapse after previous Delorme’s procedure? A practical reality

    PubMed Central

    Javed, Muhammad A; Afridi, Faryal G; Artioukh, Dmitri Y

    2016-01-01

    AIM: To report our experience with perineal repair (Delorme’s procedure) of rectal prolapse with particular focus on treatment of the recurrence. METHODS: Clinical records of 40 patients who underwent Delorme’s procedure between 2003 and 2014 were reviewed to obtain the following data: Gender; duration of symptoms, length of prolapse, operation time, ASA grade, length of post-operative stay, procedure-related complications, development and treatment of recurrent prolapse. Analysis of post-operative complications, rate and time of recurrence and factors influencing the choice of the procedure for recurrent disease was conducted. Continuous variables were expressed as the median with interquartile range (IQR). Statistical analysis was carried out using the Fisher exact test. RESULTS: Median age at the time of surgery was 76 years (IQR: 71-81.5) and there were 38 females and 2 males. The median duration of symptoms was 6 mo (IQR: 3.5-12) and majority of patients presented electively whereas four patients presented in the emergency department with irreducible rectal prolapse. The median length of prolapse was 5 cm (IQR: 5-7), median operative time was 100 min (IQR: 85-120) and median post-operative stay was 4 d (IQR: 3-6). Approximately 16% of the patients suffered minor complications such as - urinary retention, delayed defaecation and infected haematoma. One patient died constituting post-operative mortality of 2.5%. Median follow-up was 6.5 mo (IQR: 2.15-16). Overall recurrence rate was 28% (n = 12). Recurrence rate for patients undergoing an urgent Delorme’s procedure who presented as an emergency was higher (75.0%) compared to those treated electively (20.5%), P value 0.034. Median time interval from surgery to the development of recurrence was 16 mo (IQR: 5-30). There were three patients who developed an early recurrence, within two weeks of the initial procedure. The management of the recurrent prolapse was as follows: No further intervention (n = 1

  15. Mapping longitudinal development of local cortical gyrification in infants from birth to 2 years of age.

    PubMed

    Li, Gang; Wang, Li; Shi, Feng; Lyall, Amanda E; Lin, Weili; Gilmore, John H; Shen, Dinggang

    2014-03-19

    Human cortical folding is believed to correlate with cognitive functions. This likely correlation may have something to do with why abnormalities of cortical folding have been found in many neurodevelopmental disorders. However, little is known about how cortical gyrification, the cortical folding process, develops in the first 2 years of life, a period of dynamic and regionally heterogeneous cortex growth. In this article, we show how we developed a novel infant-specific method for mapping longitudinal development of local cortical gyrification in infants. By using this method, via 219 longitudinal 3T magnetic resonance imaging scans from 73 healthy infants, we systemically and quantitatively characterized for the first time the longitudinal cortical global gyrification index (GI) and local GI (LGI) development in the first 2 years of life. We found that the cortical GI had age-related and marked development, with 16.1% increase in the first year and 6.6% increase in the second year. We also found marked and regionally heterogeneous cortical LGI development in the first 2 years of life, with the high-growth regions located in the association cortex, whereas the low-growth regions located in sensorimotor, auditory, and visual cortices. Meanwhile, we also showed that LGI growth in most cortical regions was positively correlated with the brain volume growth, which is particularly significant in the prefrontal cortex in the first year. In addition, we observed gender differences in both cortical GIs and LGIs in the first 2 years, with the males having larger GIs than females at 2 years of age. This study provides valuable information on normal cortical folding development in infancy and early childhood.

  16. Cytokines as a predictor of clinical response following hip arthroscopy: minimum 2-year follow-up

    PubMed Central

    Shapiro, Lauren M.; Safran, Marc R.; Maloney, William J.; Goodman, Stuart B.; Huddleston, James I.; Bellino, Michael J.; Scuderi, Gaetano J.; Abrams, Geoffrey D.

    2016-01-01

    Hip arthroscopy in patients with osteoarthritis has been shown to have suboptimal outcomes. Elevated cytokine concentrations in hip synovial fluid have previously been shown to be associated with cartilage pathology. The purpose of this study was to determine whether a relationship exists between hip synovial fluid cytokine concentration and clinical outcomes at a minimum of 2 years following hip arthroscopy. Seventeen patients without radiographic evidence of osteoarthritis had synovial fluid aspirated at time of portal establishment during hip arthroscopy. Analytes included fibronectin–aggrecan complex as well as a multiplex cytokine array. Patients completed the modified Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index and the International Hip Outcomes Tool pre-operatively and at a minimum of 2 years following surgery. Pre and post-operative scores were compared with a paired t-test, and the association between cytokine values and clinical outcome scores was performed with Pearson’s correlation coefficient with an alpha value of 0.05 set as significant. Sixteen of seventeen patients completed 2-year follow-up questionnaires (94%). There was a significant increase in pre-operative to post-operative score for each clinical outcome measure. No statistically significant correlation was seen between any of the intra-operative cytokine values and either the 2-year follow-up scores or the change from pre-operative to final follow-up outcome values. No statistically significant associations were seen between hip synovial fluid cytokine concentrations and 2-year follow-up clinical outcome assessment scores for those undergoing hip arthroscopy. PMID:27583163

  17. Saliva in perimenopausal and early postmenopausal women. A 2-year follow-up study.

    PubMed

    Tarkkila, Laura; Furuholm, Jussi; Tiitinen, Aila; Meurman, Jukka H

    2012-06-01

    This study aims to investigate salivary flow and biochemical constituents of menopausal-age women with the hypothesis that women using hormone therapy (HT) might present better saliva values than non-users. Two hundred HT users and 200 non-users were selected at random from a cohort study of 3,173 peri- and postmenopausal women and invited to a 2-year clinical follow-up study. Clinical examination with saliva sampling was made at baseline and 2 years later. Salivary total protein, albumin, and immunoglobulin (Ig) concentrations were analyzed. Final material included 106 consistent HT users and 55 non-users. Backward logistic regression analysis was made to determine the risk factors for higher or lower than medium salivary protein values. No difference was seen in salivary flow rate, total protein, and IgA values between baseline and follow-up measurements or between the groups. Albumin, IgG, and IgM concentrations were significantly lower in the 2-year samples of the HT group when compared with baseline. IgA and IgM values were higher in the non-HT 2-year samples when compared with the corresponding HT samples. The only significant explanatory factor for higher than median salivary albumin concentration was the number of teeth both at baseline and 2 years later. HT possibly improved epithelial integrity since the concentrations of serum components albumin, IgG, and IgM decreased during the follow-up. HT as such does not seem to affect saliva, although it may modify it. The clinical relevance of these results needs to be assessed in future studies.

  18. Risk factors for cardiovascular disease during the first 2 years after renal transplantation.

    PubMed

    Laurés, A S; Gómez, E; Baltar, J; Alvarez-Grande, J

    2005-11-01

    The aim of the present study was to assess the role of cardiovascular risk factors in the occurrence of cardiovascular events among 100 consecutive renal transplant recipients during the first 2 years after transplantation. The following parameters were analyzed: (1) demographic data (gender, age, dialysis duration, preexistent diabetes, and pretransplantation events) as well as (2) basal 1-year, and 2-year posttransplantation data for events, body mass index, arterial hypertension, number of drugs for hypertension control, use of ACE or ARA II inhibitors, treatment with lipid- lowering drugs, de novo diabetes, anemia, immunosuppression with cyclosporine versus tacrolimus, and homocysteine, folic acid, serum creatinine, uric acid, PTH-i, and cholesterol total, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, and triglyceride levels. At the end of the second posttransplantation year, 14 patients versus 86 who did not experience a new cardiovascular event. Patients in the event group had more events pretransplantation and during the first posttransplantation year than those in the non event group (57.1% vs 17.4%; P = .003 and 78.6% vs 2.3%; P = .000, respectively). Furthermore, the former cohort of patients were older, had greater ventricular hypertrophy and had higher triglyceride and serum creatinine concentrations during the 2 years after transplantation. A multiple logistic regression analysis confirmed the relationship between events within 1 year of transplantation and serum creatinine level at the end of 2 years as well as the development of cardiovascular disease within 2 years. In conclusion, our data suggest the need for aggressive intervention during the first year to prevent the development of new cardiovascular events. Renoprotective strategies may also contribute to reduce the cardiovascular risk of renal transplant recipients.

  19. Diagnosing Juvenile Recurrent Parotitis. Case Reports.

    PubMed

    Schorr, Brittany; Mandel, Louis

    2016-01-01

    Diagnosis of juvenile recurrent parotitis is based upon clinical symptomatology, because no positive serologic signs have been identified. Objective confirmation is best obtained from sialographic or ultrasound studies.

  20. Palbociclib Isethionate in Treating Younger Patients With Recurrent, Progressive, or Refractory Central Nervous System Tumors

    ClinicalTrials.gov

    2016-10-19

    Childhood Choroid Plexus Tumor; Childhood Ependymoblastoma; Childhood Grade III Meningioma; Childhood High-grade Cerebellar Astrocytoma; Childhood High-grade Cerebral Astrocytoma; Childhood Medulloepithelioma; Recurrent Childhood Anaplastic Astrocytoma; Recurrent Childhood Anaplastic Oligoastrocytoma; Recurrent Childhood Anaplastic Oligodendroglioma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Giant Cell Glioblastoma; Recurrent Childhood Glioblastoma; Recurrent Childhood Gliomatosis Cerebri; Recurrent Childhood Gliosarcoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood Pineoblastoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor

  1. Partial breast irradiation as second conservative treatment for local breast cancer recurrence

    SciTech Connect

    Hannoun-Levi, Jean-Michel . E-mail: jean-michel.hannoun-levi@fccc.edu; Houvenaeghel, Gilles; Ellis, Steve; Teissier, Eric; Alzieu, Claude; Lallement, Michel; Cowen, Didier

    2004-12-01

    Purpose: Mastectomy is the treatment of reference for local relapse after breast cancer (BC). The aim of this study was to document the feasibility and the results of associating lumpectomy with partial breast irradiation by interstitial brachytherapy (IB) as local treatment for an isolated ipsilateral BC local recurrence (LR). Methods and materials: Between 1975 and 1996 at Marseille and Nice Cancer Institutes, 4026 patients received lumpectomy and radiotherapy (RT) (50-80 Gy) for a localized breast cancer of which 473 presented a LR. Among these patients, 69 (14.6%) received a second lumpectomy followed by IB, which delivered 30 Gy (Nice, n = 24) or 45-50 Gy (Marseille, n = 45) with 3 to 8 {sup 192}Ir wires in 1 or 2 planes on the 85% isodose. Results: Median age at LR was 58.2 years, median follow-up since primary BC was 10 years, and median follow-up after the second conservative treatment was 50.2 months (range, 2-139 months). Immediate tolerance was good in all cases. Grade 2 to 3 long-term complications (LTC) according to IB dose were 0%, 28%, and 32%, respectively, for 30 Gy, 45 to 46 Gy, and 50 Gy (p 0.01). Grade 2 to 3 LTC according to total dose were 4% and 30%, respectively, for total doses (initial RT plus IB) {<=} 100 Gy or >100 Gy (p = 0.008). Logistic regression showed that the only factor associated with Grade 2 to 3 complications was higher IB doses (p = 0.01). We noted 11 second LRs (LR2), 10 distant metastases (DM), and 5 specific deaths. LR2 occurred either in the tumor bed (50.8%) or close to the tumor bed (34.3%) or in another quadrant (14.9%). Kaplan-Meier 5-year freedom from (FF) LR2 (FFLR2), FFDM, and DFS were 77.4%, 86.7%, and 68.9%, respectively. Overall 5-year survival (OS) was 91.8%. Univariate analysis showed the following factors associated with a higher FFLR2: (1) number of wires used for IB (3-4 vs. 5-8 wires, p = 0.006), (2) IB doses (30-45 Gy vs. 46-60 Gy, p = 0.05), (3) number of planes (1 vs. 2, p = 0.05), (4) interval between

  2. Factors Predictive of Tumor Recurrence and Survival After Initial Complete Response of Esophageal Squamous Cell Carcinoma to Definitive Chemoradiotherapy

    SciTech Connect

    Ishihara, Ryu; Yamamoto, Sachiko; Iishi, Hiroyasu; Takeuchi, Yoji; Sugimoto, Naotoshi; Higashino, Koji; Uedo, Noriya; Tatsuta, Masaharu; Yano, Masahiko; Imai, Atsushi; Nishiyama, Kinji

    2010-01-15

    Purpose: To assess factors predictive of recurrent disease and survival after achieving initial complete response (CR) to chemoradiotherapy (CRT) for esophageal cancer. Methods and Materials: Patients who had clinical Stage I-IVA esophageal cancer and received definitive CRT between 2001 and 2007 were retrospectively analyzed. Results: Of 269 patients with esophageal cancer, 110 who achieved CR after definitive CRT were included in the analyses. Chemoradiotherapy mainly consisted of 2 cycles of cisplatin and fluorouracil with concurrent radiotherapy of 60 Gy in 30 fractions. We identified 28 recurrences and 28 deaths during follow-up. The cumulative 1- and 3-year recurrence rates were 18% and 32%, respectively. By univariate and multivariate analyses, tumor category (hazard ratio [HR] 6.6; 95% confidence interval [CI] 1.4-30.2; p = 0.015) was an independent risk factor for local recurrence, whereas age (HR 3.9; 95% CI 1.1-14.0; p = 0.034) and primary tumor location (HR 4.5; 95% CI 1.6-12.4; p = 0.004) were independent risk factors for regional lymph node or distant recurrences. The cumulative overall 1- and 3-year survival rates were 91% and 66%, respectively. As expected, recurrence was associated with poor survival (p = 0.019). By univariate and multivariate analyses, primary tumor location (HR 3.8; 95% CI 1.2-12.0; p = 0.024) and interval to recurrence (HR 4.3; 95% CI 1.3-14.4; p = 0.018) were independent factors predictive of survival after recurrence. Conclusion: Risk of recurrence after definitive CRT for esophageal cancer was associated with tumor category, age, and primary tumor location; this information may help in improved prognostication for these patients.

  3. Perceived outcomes and satisfaction of Saudi parents and their children following dental rehabilitation under general anesthesia: A 2-year follow-up

    PubMed Central

    El Batawi, Hisham Yehia; Panigrahi, Priyankar; Awad, Manal A.

    2014-01-01

    Purpose: To investigate the perceived clinical outcome and parents’ satisfaction after dental rehabilitation under general anesthesia over a follow-up period of 2 years. Materials and Methods: A prospective study of questionnaire data obtained from 352 pediatric patients before and after treatment of early childhood caries with full dental rehabilitation under general anesthesia. Questionnaires focused on oral symptoms, functional limitations, and emotional and social well-being before and after dental treatment. Cases were followed up for 2 years postoperatively. Results: A dramatic disappearance of symptoms was reported from parents’ perspective. There was a high satisfaction rate (99.14%) also among parents of the children included in the study. Conclusion: Children with early childhood caries do not necessarily express it verbally as pain. The disease has a lot of other expressions affecting children's behavior and habits, including the ability to sleep, thrive, and socialize. This study contributes to the existing literature that full dental rehabilitation under general anesthesia [dental general anesthesia (DGA)] has an immediate positive impact on the physical and social quality of life of children suffering from early childhood caries as well as on their families. Postoperative preventive care, early diagnosis, and treatment of recurrent caries are key factors to maintain postoperative outcome of DGA. PMID:25625072

  4. Moyamoya syndrome in childhood sickle cell disease: a predictive factor for recurrent cerebrovascular events.

    PubMed

    Dobson, Scott R; Holden, Kenton R; Nietert, Paul J; Cure, Joel K; Laver, Joseph H; Disco, Deborah; Abboud, Miguel R

    2002-05-01

    We conducted a retrospective study to determine whether the presence of moyamoya collaterals influenced the risk of recurrence of cerebrovascular events (CVEs: stroke or transient ischemic attack) in patients with sickle cell disease placed on chronic transfusions after a stroke. Forty-three patients with homozygous sickle cell anemia (HbSS) and 1 with HbSO(Arab) (16 females, 28 males) who had suffered strokes while under the age of 18 were studied. All patients had been on transfusions aimed at maintaining the sickle hemoglobin (HbS) level below 30%. They were followed for a mean of 6.6 years (2.2 to 20.4 years). The presence of collaterals was diagnosed based on either magnetic resonance angiography or conventional angiography. Eighteen (41%) of the 44 patients suffered recurrent CVEs. Nineteen (43%) (6 females, 13 males) patients had moyamoya collaterals. Eleven (58%) of these 19 experienced 21 total recurrent CVEs, including 4 strokes in 4 patients (21%). In comparison, 7 (28%) of 25 patients without moyamoya collaterals experienced 9 recurrent CVEs (P <.05) with only 1 recurrent stroke (4%). Moyamoya patients were also more likely to have 2 recurrent CVEs (42% vs 8%, P <.05) as well as poorer neuropsychological testing results. A proportional hazards regression analysis indicated that patients with moyamoya were more than twice as likely to incur a subsequent CVE (hazard ratio, 2.40; 95% confidence interval, 0.85, 6.75). We conclude that up to 41% of patients with sickle cell disease experience recurrent CVEs after an initial stroke despite chronic transfusions and that the risk of recurrence is significantly higher for those who have moyamoya collaterals.

  5. QT-Interval Duration and Mortality Rate

    PubMed Central

    Zhang, Yiyi; Post, Wendy S.; Dalal, Darshan; Blasco-Colmenares, Elena; Tomaselli, Gordon F.; Guallar, Eliseo

    2012-01-01

    Background Extreme prolongation or reduction of the QT interval predisposes patients to malignant ventricular arrhythmias and sudden cardiac death, but the association of variations in the QT interval within a reference range with mortality end points in the general population is unclear. Methods We included 7828 men and women from the Third National Health and Nutrition Examination Survey. Baseline QT interval was measured via standard 12-lead electrocardiographic readings. Mortality end points were assessed through December 31, 2006 (2291 deaths). Results After an average follow-up of 13.7 years, the association between QT interval and mortality end points was U-shaped. The multivariate-adjusted hazard ratios comparing participants at or above the 95th percentile of age-, sex-, race-, and R-R interval–corrected QT interval (≥439 milliseconds) with participants in the middle quintile (401 to <410 milliseconds) were 2.03 (95% confidence interval, 1.46-2.81) for total mortality, 2.55 (1.59-4.09) for mortality due to cardiovascular disease (CVD), 1.63 (0.96-2.75) for mortality due to coronary heart disease, and 1.65 (1.16-2.35) for non-CVD mortality. The corresponding hazard ratios comparing participants with a corrected QT interval below the fifth percentile (<377 milliseconds) with those in the middle quintile were 1.39 (95% confidence interval, 1.02-1.88) for total mortality, 1.35 (0.77-2.36) for CVD mortality, 1.02 (0.44-2.38) for coronary heart disease mortality, and 1.42 (0.97-2.08) for non-CVD mortality. Increased mortality also was observed with less extreme deviations of QT-interval duration. Similar, albeit weaker, associations also were observed with Bazett-corrected QT intervals. Conclusion Shortened and prolonged QT-interval durations, even within a reference range, are associated with increased mortality risk in the general population. PMID:22025428

  6. Telmisartan to Prevent Recurrent Stroke and Cardiovascular Events

    PubMed Central

    Yusuf, Salim; Diener, Hans-Christoph; Sacco, Ralph L.; Cotton, Daniel; Ôunpuu, Stephanie; Lawton, William A.; Palesch, Yuko; Martin, Reneé H.; Albers, Gregory W.; Bath, Philip; Bornstein, Natan; Chan, Bernard P.L.; Chen, Sien-Tsong; Cunha, Luis; Dahlöf, Björn; De Keyser, Jacques; Donnan, Geoffrey A.; Estol, Conrado; Gorelick, Philip; Gu, Vivian; Hermansson, Karin; Hilbrich, Lutz; Kaste, Markku; Lu, Chuanzhen; Machnig, Thomas; Pais, Prem; Roberts, Robin; Skvortsova, Veronika; Teal, Philip; Toni, Danilo; VanderMaelen, Cam; Voigt, Thor; Weber, Michael; Yoon, Byung-Woo

    2009-01-01

    BACKGROUND Prolonged lowering of blood pressure after a stroke reduces the risk of recurrent stroke. In addition, inhibition of the renin–angiotensin system in high-risk patients reduces the rate of subsequent cardiovascular events, including stroke. However, the effect of lowering of blood pressure with a renin–angiotensin system inhibitor soon after a stroke has not been clearly established. We evaluated the effects of therapy with an angiotensin-receptor blocker, telmisartan, initiated early after a stroke. METHODS In a multicenter trial involving 20,332 patients who recently had an ischemic stroke, we randomly assigned 10,146 to receive telmisartan (80 mg daily) and 10,186 to receive placebo. The primary outcome was recurrent stroke. Secondary outcomes were major cardiovascular events (death from cardiovascular causes, recurrent stroke, myocardial infarction, or new or worsening heart failure) and new-onset diabetes. RESULTS The median interval from stroke to randomization was 15 days. During a mean followup of 2.5 years, the mean blood pressure was 3.8/2.0 mm Hg lower in the telmisartan group than in the placebo group. A total of 880 patients (8.7%) in the telmisartan group and 934 patients (9.2%) in the placebo group had a subsequent stroke (hazard ratio in the telmisartan group, 0.95; 95% confidence interval [CI], 0.86 to 1.04; P = 0.23). Major cardiovascular events occurred in 1367 patients (13.5%) in the telmisartan group and 1463 patients (14.4%) in the placebo group (hazard ratio, 0.94; 95% CI, 0.87 to 1.01; P = 0.11). New-onset diabetes occurred in 1.7% of the telmisartan group and 2.1% of the placebo group (hazard ratio, 0.82; 95% CI, 0.65 to 1.04; P = 0.10). CONCLUSIONS Therapy with telmisartan initiated soon after an ischemic stroke and continued for 2.5 years did not significantly lower the rate of recurrent stroke, major cardiovascular events, or diabetes. (ClinicalTrials.gov number, NCT00153062.) PMID:18753639

  7. 9 CFR 71.18 - Individual identification of certain cattle 2 years of age or over for movement in interstate...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... cattle 2 years of age or over for movement in interstate commerce. 71.18 Section 71.18 Animals and Animal... certain cattle 2 years of age or over for movement in interstate commerce. (a) No cattle 2 years of age or...) of this chapter, shall be moved in interstate commerce other than in accordance with the...

  8. 9 CFR 71.18 - Individual identification of certain cattle 2 years of age or over for movement in interstate...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... cattle 2 years of age or over for movement in interstate commerce. 71.18 Section 71.18 Animals and Animal... certain cattle 2 years of age or over for movement in interstate commerce. (a) No cattle 2 years of age or over, except steers and spayed heifers and cattle of any age which are being moved interstate...

  9. 9 CFR 71.18 - Individual identification of certain cattle 2 years of age or over for movement in interstate...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... cattle 2 years of age or over for movement in interstate commerce. 71.18 Section 71.18 Animals and Animal... certain cattle 2 years of age or over for movement in interstate commerce. (a) No cattle 2 years of age or over, except steers and spayed heifers and cattle of any age which are being moved interstate...

  10. 9 CFR 71.18 - Individual identification of certain cattle 2 years of age or over for movement in interstate...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... cattle 2 years of age or over for movement in interstate commerce. 71.18 Section 71.18 Animals and Animal... certain cattle 2 years of age or over for movement in interstate commerce. (a) No cattle 2 years of age or over, except steers and spayed heifers and cattle of any age which are being moved interstate...

  11. Recurrent pregnancy loss and obesity.

    PubMed

    Sugiura-Ogasawara, Mayumi

    2015-05-01

    Recurrent pregnancy loss (RPL) was defined as two or more miscarriages. Antiphospholipid syndrome, uterine anomalies, and parental chromosomal abnormalities, particularly translocation and abnormal embryonic karyotype, are identifiable causes of RPL. Obesity may increase the risk of sporadic miscarriage in pregnancies conceived spontaneously. Obesity with body mass index (BMI)>30 kg/m2 is an independent risk factor for further miscarriage with odds ratio 1.7-3.5 in patients with early RPL. Obesity is associated with euploid miscarriage. Unexplained RPL with euploid embryo might be a common disease caused by both polymorphisms of multiple susceptibility genes and lifestyle factors such as women's age, obesity, and smoking. Patients with a history of RPL were found to have a higher risk of cardiovascular disease, celiac disease, gastric ulcer, gastritis, and atopic dermatitis. No study has examined the effect of weight loss on the prevention of further miscarriage in patients with RPL.

  12. Recurrent Excitation in Neocortical Circuits

    NASA Astrophysics Data System (ADS)

    Douglas, Rodney J.; Koch, Christof; Mahowald, Misha; Martin, Kevan A. C.; Suarez, Humbert H.

    1995-08-01

    The majority of synapses in the mammalian cortex originate from cortical neurons. Indeed, the largest input to cortical cells comes from neighboring excitatory cells. However, most models of cortical development and processing do not reflect the anatomy and physiology of feedback excitation and are restricted to serial feedforward excitation. This report describes how populations of neurons in cat visual cortex can use excitatory feedback, characterized as an effective "network conductance," to amplify their feedforward input signals and demonstrates how neuronal discharge can be kept proportional to stimulus strength despite strong, recurrent connections that threaten to cause runaway excitation. These principles are incorporated into models of cortical direction and orientation selectivity that emphasize the basic design principles of cortical architectures.

  13. Nonsurgical treatment of recurrent glioblastoma

    PubMed Central

    Gallego, O.

    2015-01-01

    Standard treatment for glioblastoma multiforme is surgery followed by radiotherapy and chemotherapy, generally with temozolomide. However, disease recurs in almost all patients. Diagnosis of progression is complex given the possibility of pseudoprogression. The Response Assessment in Neuro-Oncology criteria increase the sensitivity for detecting progression. Most patients will not be candidates for new surgery or re-irradiation, and anticancer drugs are the most common approach for second-line treatment, if the patient’s condition allows. Antiangiogenics, inhibitors of the epidermal growth factor receptor, nitrosoureas, and re-treatment with temozolomide have been studied in the second line, but a standard therapy has not yet been established. This review considers currently available medical treatment options for patients with glioblastoma recurrence. PMID:26300678

  14. RSV frequency in children below 2 years hospitalized for lower respiratory tract infections.

    PubMed

    Hacımustafaoğlu, Mustafa; Celebi, Solmaz; Bozdemir, Sefika Elmas; Ozgür, Taner; Ozcan, Ismail; Güray, Atilla; Cakır, Deniz

    2013-01-01

    Respiratory syncytial virus (RSV) is the most frequent agent of acute lower respiratory diseases and creates a significant burden of disease in children under 5 years all over the world. RSV causes severe lower respiratory tract infections (LRTI) that require hospitalization, especially in children ≤2 years. The aim of this study was to determine the incidence of RSV in children ≤2 years of age hospitalized for LRTI. Children ≤2 years of age hospitalized for one year for LRTI in the three largest hospitals of Bursa City Center, Turkey were evaluated. These three hospitals comprise 67.5% of all child beds in central Bursa, so this study allows us to evaluate the total disease burden and hospitalization incidence in central Bursa. Nasal swabs of the children were evaluated with RSV Respi- Strip (Coris Bioconcept Organization). A total of 671 children were hospitalized for LRTI, and 254 (37.9%) had at least one hospitalization that was positive for RSV. Of all patients with LRTI, 54.8% (368/671) were hospitalized for acute bronchiolitis, while 45.2% (303/671) were hospitalized for pneumonia. Of patients with acute bronchiolitis or pneumonia, 41% (151/368) and 34% (103/303) were RSV+, respectively. Of RSV+ hospitalized children, 59.5% (151/254) were diagnosed as acute bronchiolitis and 40.5% (103/254) as pneumonia. The annual incidences of hospitalization due to LRTI, acute bronchiolitis and pneumonia were 20.5/1000, 11.2/1000 and 9.3/1000, respectively, in children ≤2 years of age. The annual incidences of hospitalization due to RSV+ LRTI, acute bronchiolitis and pneumonia were found as 7.8/1000, 4.6/1000 and 3.2/1000, respectively, in children ≤2 years of age. More than one-third of all children hospitalized with LRTI (38.3%, n=257) were in the 0-3 months age group. Compared to other age groups, RSV positivity was highest in that age group for acute bronchiolitis (57%), pneumonia (39.5%) and also total children with LRTI (47.9%). RSV is a very important

  15. Modified Leclerc blocking procedure with miniplates and temporal fascial flap for recurrent temporomandibular joint dislocation.

    PubMed

    Ying, Binbin; Hu, Jing; Zhu, Songsong

    2013-05-01

    This study introduced the modified Leclerc blocking procedure with miniplate and temporal fascial flap for recurrent temporomandibular joint (TMJ) dislocation and evaluated its clinical effects. Seven patients were treated by the modified Leclerc blocking procedure with miniplate and temporal fascial flap. The postoperative follow-up period ranged from half a year to 2 years to access the maximal mouth opening, TMJ disorder symptoms (pain and sound), and incidence of recurrence. No recurrence was observed in all of the 7 patients postoperatively. The mean preoperative and postoperative MMOs were 49.7 mm and 40.1 mm, respectively. There were 3 patients who reported the alleviation of pain and/or sound postoperatively. Two older patients with long-term course of disease reported no improvement of the TMJ symptoms in terms of pain and sound postoperatively. Our results showed that the modified Leclerc blocking procedure with miniplates and temporal fascial flap provided a more stable support for the condylar movement with less recurrence, suggesting that this operation could be a good alternative for the treatment of recurrent TMJ dislocation.

  16. ACR Appropriateness Criteria®—Recurrent Rectal Cancer

    PubMed Central

    Suh, W. Warren; Herman, Joseph M.; Blackstock, A. William; Hong, Theodore S.; Poggi, Matthew M.; Rodriguez-Bigas, Miguel; Small, William; Thomas, Charles R.; Zook, Jennifer

    2012-01-01

    ABSTRACT The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions. These Criteria are reviewed every 2 years by a multidisciplinary expert panel. The development and review of these guidelines includes an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Local recurrence of rectal cancer can result in devastating symptoms for patients, including intractable pain and discharge. Prior treatment can limit subsequent treatment options. Preoperative 5-FU based chemoradiotherapy is the treatment of choice for patients with a local recurrence who did not receive adjuvant therapy after initial resection or who might have received chemotherapy alone. Chemoradiotherapy followed by evaluation for surgery is the preferred treatment for patients who have undergone previous radiotherapy after surgery. The inclusion of surgery has resulted in the best outcomes in a majority of studies. Palliative chemoradiotherapy is appropriate for patients who have received previous radiotherapy whose recurrent disease is considered inoperable. Radiotherapy can be delivered on a standard or hyperfractionated treatment schedule. Newer systemic treatments have improved response rates and given physicians more options for treating patients in this difficult situation. The use of induction chemotherapy prior to radiotherapy is an evolving treatment option. Specialized treatment modalities should be used at institutions with experience in these techniques and preferably in patients enrolled in clinical trials. PMID:22574231

  17. Preventing Relapse/Recurrence in Recurrent Depression With Cognitive Therapy: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Bockting, Claudi L. H.; Schene, Aart H.; Spinhoven, Philip; Koeter, Maarten W. J.; Wouters, Luuk F.; Huyser, Jochanan; Kamphuis, Jan H.

    2005-01-01

    This article reports on the outcome of a randomized controlled trial of cognitive group therapy (CT) to prevent relapse/recurrence in a group of high-risk patients diagnosed with recurrent depression. Recurrently depressed patients (N = 187) currently in remission following various types of treatment were randomized to treatment as usual,…

  18. Interval and Contour Processing in Autism

    ERIC Educational Resources Information Center

    Heaton, Pamela

    2005-01-01

    High functioning children with autism and age and intelligence matched controls participated in experiments testing perception of pitch intervals and musical contours. The finding from the interval study showed superior detection of pitch direction over small pitch distances in the autism group. On the test of contour discrimination no group…

  19. Interpretation of Confidence Interval Facing the Conflict

    ERIC Educational Resources Information Center

    Andrade, Luisa; Fernández, Felipe

    2016-01-01

    As literature has reported, it is usual that university students in statistics courses, and even statistics teachers, interpret the confidence level associated with a confidence interval as the probability that the parameter value will be between the lower and upper interval limits. To confront this misconception, class activities have been…

  20. SINGLE-INTERVAL GAS PERMEABILITY ESTIMATION

    EPA Science Inventory

    Single-interval, steady-steady-state gas permeability testing requires estimation of pressure at a screened interval which in turn requires measurement of friction factors as a function of mass flow rate. Friction factors can be obtained by injecting air through a length of pipe...

  1. Recurrence Rates and Risk Factors for Primary Giant Cell Tumors around the Knee: A Multicentre Retrospective Study in China

    PubMed Central

    Hu, Pan; Zhao, Liming; Zhang, Huilin; Yu, Xiuchun; Wang, Zhen; Ye, Zhaoming; Wu, Sujia; Guo, Shibing; Zhang, Guochuan; Wang, Jinghua; Ning, Xianjia; Hu, Yongcheng; Zhang, Yingze

    2016-01-01

    Giant cell tumors of the bone (GCTBs) are commonly diagnosed in Asian populations, usually around the knee. Herein, we aimed to determine the clinical characteristics, local recurrence rates, and relevant risk factors of primary GCTB around the knee. Univariate and multivariate survival analyses were used to identify the risk factors for local recurrence. Four hundred ten patients with primary GCTB around the knee, treated between March 2000 and June 2014, were recruited from 7 institutions in China. The overall local recurrence rate was 23.4%, but was higher in patients aged 20–39 years (28.5%; P = 0.039). The local recurrence rate was the highest in patients treated with intralesional curettage (53.4%), and the lowest in those treated with resection (4.9%). We found a higher risk of tumor recurrence in the proximal fibula compared to the distal femur (hazard ratio: 28.52, 95% confidence interval: 5.88–138.39; P < 0.0001), and in patients treated with curettage compared to those treated with resection (hazard ratio: 12.07, 95% confidence interval: 4.99–29.18; P < 0.0001). Thus, the tumor location must be considered when selecting the optimal surgical treatment approach to reduce the risk of local recurrence and preserve joint function, especially in young patients. PMID:27827384

  2. GPS constraints on M 7-8 earthquake recurrence times for the New Madrid seismic zone

    USGS Publications Warehouse

    Stuart, W.D.

    2001-01-01

    Newman et al. (1999) estimate the time interval between the 1811-1812 earthquake sequence near New Madrid, Missouri and a future similar sequence to be at least 2,500 years, an interval significantly longer than other recently published estimates. To calculate the recurrence time, they assume that slip on a vertical half-plane at depth contributes to the current interseismic motion of GPS benchmarks. Compared to other plausible fault models, the half-plane model gives nearly the maximum rate of ground motion for the same interseismic slip rate. Alternative models with smaller interseismic fault slip area can satisfy the present GPS data by having higher slip rate and thus can have earthquake recurrence times much less than 2,500 years.

  3. Comparative Study of Different {beta}-Radiation Doses for Preventing Pterygium Recurrence

    SciTech Connect

    Yamada, Takayuki; Mochizuki, Hideki; Ue, Takahiro; Kiuchi, Yoshiaki; Takahashi, Yasuhiro; Oinaka, Matsuyoshi

    2011-12-01

    Purpose: To compare the pterygium recurrence rates after treatment with two different {beta}-radiation doses. Methods and Materials: A total of 84 patients with a mean age of 63.0 {+-} 10.3 years (men, 48 eyes, and women, 47 eyes) and initially treated with {beta}-radiation after pterygium excision were recruited. The mean follow-up period was 49.9 {+-} 51.3 months. The patients were assigned to two dose groups: a high-dose (40 Gy) or a low-dose (20 Gy) group. The statistical significance of differences in patient age, pterygium size, and interval between surgery and radiotherapy were analyzed in the 20-Gy group using the Cox proportional hazard model at p < .05. Results: The high- and low-dose groups included 28 and 67 eyes, respectively. Pterygia recurred in 11 eyes, all in the low-dose group. The interval between surgery and radiotherapy was not a significant predictor of recurrence. Smaller pterygia had a lower risk of recurrence than pterygia that had encroached the pupillary area (pterygium located within one-third of the corneal radius from the limbus, corrected hazard ratio [HR], 0.069; 95% confidence interval [CI], 0.006-0.766; p = .030; pterygium extending beyond one-third of the corneal radius, corrected HR, 0.188; 95% CI, 0.018-0.696; p = 0.019; and pterygium reaching the pupillary area, corrected HR, 0.184; 95% CI, 0.036-0.929; p = .040). Older age was marginally significant as a negative predictor of recurrence (HR, 0.943; 95% CI, 0.887-1.003; p = .061). No scleromalacia developed during the follow-up period. Conclusions: {beta}-Radiation at 40 Gy was more efficacious than at 20 Gy in preventing pterygium recurrence without scleromalacia development, particularly for large-size pterygia and those in young patients.

  4. Childcare arrangements and infant feeding practices by family structure and household income among US children aged 0 to 2 years.

    PubMed

    Kim, Juhee; Gallien, Tara L

    2016-07-01

    The primary objective of this study is to examine the disparities in childcare and infant feeding practices by family structure (single-mother vs. two-parent households) and whether household income level may modify the observed associations by family structure. The cross-sectional data analysis was conducted using a nationally representative sample of children aged 0 to 2 years enrolled in the 2007 National Survey of Children's Health. The analytic sample is children from single mothers (n = 1801, 16.0%) and children from two parents (n = 11 337, 84.0%). Children of single mothers used more non-parental childcare [adjusted odds ratios (AOR) = 2.67, 95% confidence intervals (CI) = 1.99-3.58], especially relative care and centre care, than children of two parents. Lower rates of any breastfeeding for 6 months (AOR = 0.57, 95% CI = 0.43-0.77) and ever breastfed (AOR = 0.66, 95% CI = 0.50-0.89) were reported among children of single mothers than those of two parents. The many observed differences in childcare arrangements and breastfeeding by family structure remained significant in both low- and high-income households. However, children of low-income single mothers had more last-minute changes of childcare arrangement (AOR = 2.34, 95% CI = 1.55-3.52) than children of low-income two-parent households and children of high-income single mothers had more early introduction of complementary foods (AOR = 1.92, 95% CI = 1.12-3.29) than children of high-income two-parent households. This study documented disparities in childcare arrangements and infant feeding practices by family structure, regardless of income level. These findings support the need to for comprehensive policies that address maternal employment leave, childcare support and workplace accommodations and support for breastfeeding for children 0 to 2 years, especially among single mothers, regardless of income.

  5. Biomathematics and Interval Analysis: A Prosperous Marriage

    NASA Astrophysics Data System (ADS)

    Markov, S. M.

    2010-11-01

    In this survey paper we focus our attention on dynamical bio-systems involving uncertainties and the use of interval methods for the modelling study of such systems. The kind of envisioned uncertain systems are those described by a dynamical model with parameters bounded in intervals. We point out to a fruitful symbiosis between dynamical modelling in biology and computational methods of interval analysis. Both fields are presently in the stage of rapid development and can benefit from each other. We point out on recent studies in the field of interval arithmetic from a new perspective—the midpoint-radius arithmetic which explores the properties of error bounds and approximate numbers. The midpoint-radius approach provides a bridge between interval methods and the "uncertain but bounded" approach used for model estimation and identification. We briefly discuss certain recently obtained algebraic properties of errors and approximate numbers.

  6. Oxaliplatin in Treating Young Patients With Recurrent Solid Tumors That Have Not Responded to Previous Treatment

    ClinicalTrials.gov

    2013-06-04

    Childhood Central Nervous System Germ Cell Tumor; Childhood Extragonadal Germ Cell Tumor; Childhood Hepatoblastoma; Childhood Hepatocellular Carcinoma; Childhood High-grade Cerebral Astrocytoma; Childhood Low-grade Cerebral Astrocytoma; Childhood Malignant Ovarian Germ Cell Tumor; Childhood Malignant Testicular Germ Cell Tumor; Childhood Teratoma; Recurrent Adrenocortical Carcinoma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Liver Cancer; Recurrent Childhood Malignant Germ Cell Tumor; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Soft Tissue Sarcoma; Recurrent Childhood Visual Pathway and Hypothalamic Glioma; Recurrent Colon Cancer; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Nasopharyngeal Cancer; Recurrent Neuroblastoma; Recurrent Osteosarcoma; Recurrent Rectal Cancer; Recurrent Renal Cell Cancer

  7. Improved interval estimation of comparative treatment effects

    NASA Astrophysics Data System (ADS)

    Van Krevelen, Ryne Christian

    Comparative experiments, in which subjects are randomized to one of two treatments, are performed often. There is no shortage of papers testing whether a treatment effect exists and providing confidence intervals for the magnitude of this effect. While it is well understood that the object and scope of inference for an experiment will depend on what assumptions are made, these entities are not always clearly presented. We have proposed one possible method, which is based on the ideas of Jerzy Neyman, that can be used for constructing confidence intervals in a comparative experiment. The resulting intervals, referred to as Neyman-type confidence intervals, can be applied in a wide range of cases. Special care is taken to note which assumptions are made and what object and scope of inference are being investigated. We have presented a notation that highlights which parts of a problem are being treated as random. This helps ensure the focus on the appropriate scope of inference. The Neyman-type confidence intervals are compared to possible alternatives in two different inference settings: one in which inference is made about the units in the sample and one in which inference is made about units in a fixed population. A third inference setting, one in which inference is made about a process distribution, is also discussed. It is stressed that certain assumptions underlying this third type of inference are unverifiable. When these assumptions are not met, the resulting confidence intervals may cover their intended target well below the desired rate. Through simulation, we demonstrate that the Neyman-type intervals have good coverage properties when inference is being made about a sample or a population. In some cases the alternative intervals are much wider than necessary on average. Therefore, we recommend that researchers consider using our Neyman-type confidence intervals when carrying out inference about a sample or a population as it may provide them with more

  8. Complete Response to Bicalutamide Withdrawal Prolonged for Almost 2 Years in Patients With Metastatic Prostate Cancer.

    PubMed

    Hongo, Hiroshi; Kosaka, Takeo; Oya, Mototsugu

    2014-09-01

    This is the first case report describing a complete response to bicalutamide withdrawal that lasted for almost 2 years in a patient with metastatic prostate cancer. An 80-year-old man who had prostate-specific antigen (PSA) level elevation (168.1 ng/mL) visited our hospital in February 2010. Bone scintigraphy showed pelvic metastases. We started hormonal therapy with leuprorelin and bicalutamide. The PSA concentration decreased to <0.1 ng/mL but started increasing again and reached 1.64 ng/mL in October 2012, at which time bicalutamide administration was discontinued. The PSA concentration decreased again and has remained below the limit of sensitivity for almost 2 years.

  9. Language experiences and vocabulary development in Dominican and Mexican infants across the first 2 years.

    PubMed

    Song, Lulu; Tamis-Lemonda, Catherine S; Yoshikawa, Hirokazu; Kahana-Kalman, Ronit; Wu, Irene

    2012-07-01

    We longitudinally investigated parental language context and infants' language experiences in relation to Dominican American and Mexican American infants' vocabularies. Mothers provided information on parental language context, comprising measures of parents' language background (i.e., childhood language) and current language use during interviews at infants' birth. Infants' language experiences were measured at ages 14 months and 2 years through mothers' reports of mothers' and fathers' engagement in English and Spanish literacy activities with infants and mothers' English and Spanish utterances during videotaped mother-infant interactions. Infants' vocabulary development at 14 months and 2 years was examined using standardized vocabulary checklists in English and Spanish. Both parental language context and infants' language experiences predicted infants' vocabularies in each language at both ages. Furthermore, language experiences mediated associations between parental language context and infants' vocabularies. However, the specific mediation mechanisms varied by language.

  10. Association of carotid atherosclerosis and recurrent cerebral infarction in the Chinese population: a meta-analysis

    PubMed Central

    Liu, Jianping; Zhu, Yun; Wu, Yuhuai; Liu, Yan; Teng, Zhaowei; Hao, Yinglu

    2017-01-01

    Stroke, when poor blood flow to the brain results in cell death, is the third leading cause of disability and mortality worldwide, and appears as an unequal distribution in the global population. The cumulative risk of recurrence varies greatly up to 10 years after the first stroke. Carotid atherosclerosis is a major risk factor for stroke. The aim of this study was to investigate and estimate the relationship between carotid atherosclerosis and risk of stroke recurrence in the Chinese population. We performed a systematic review and meta-analysis of randomized controlled trials published from 2000 to 2013, using the following databases: PubMed, Embase, Medline, Wanfang, and the China National Knowledge Infrastructure. The odds ratios with 95% confidence intervals were calculated to examine this strength. A total of 22 studies, including 3,912 patients, 2,506 first-ever cases, and 1,406 recurrent cases, were pooled in this meta-analysis. Our results showed that the frequency of carotid atherosclerosis is higher in recurrent cases than that in the first-ever controls (78.88% vs 59.38%), and the statistical analysis demonstrated significant positive association between carotid atherosclerosis and recurrent cerebral infarction (odds ratio: 2.87; 95% confidence interval: 2.42–3.37; P<0.00001) in a fixed-effect model. No significant heterogeneity was observed across all studies. In conclusion, our results showed that carotid atherosclerosis was associated with increased risk of recurrent stroke. However, further well-designed research with large sample sizes is still needed to identify the clear mechanism. PMID:28260898

  11. Electrophysiologic Testing: Predictive of Amiodarone Efficacy in Recurrent Sustained Ventricular Tachycardia?

    PubMed Central

    Mas, Ildefonso J.; Massumi, Ali; Harlan, Mary; Seger, John J.; Hall, Robert J.

    1987-01-01

    The role of programmed ventricular stimulation (PVS) was evaluated in 12 patients with recurrent sustained ventricular tachycardia (VT) who were treated with amiodarone as the sole antiarrhythmic agent. At control PVS, sustained VT was induced in 11 patients and nonsustained VT was induced in one patient, as compared with late PVS (mean, 8.6 weeks) when sustained VT was induced in six patients and nonsustained VT was induced in five. Amiodarone significantly prolonged the patients' RR, PR, QRS, and QTc intervals, VT cycle length, and right ventricular effective refractory period. During a mean follow-up of 16 ± 13.6 months, two patients had recurrent clinical VT. In the patients in whom amiodarone therapy failed (1) sustained VT was induced during late PVS, (2) VT cycle length and symptoms during late PVS and during recurrent clinical VT were similar, and (3) the QTc failed to be prolonged significantly (32.5 ± 1.6 ms in amiodarone failure vs. 84.1 ± 27.1 ms in amiodarone success, P<0.05). It is concluded that (1) amiodarone in high-risk patients is clinically effective (88.3%), (2) patients with noninducible VT or nonsustained VT during late PVS did not have recurrent clinical VT, (3) late PVS is probably predictive of electrophysiologic and hemodynamic consequences in patients with recurrent spontaneous VT, and (4) failure of the QTc interval to be prolonged substantially is probably predictive of clinical recurrence of VT. (Texas Heart Institute Journal 1987; 14:382-388) PMID:15227294

  12. Trials show delayed recurrence in ovarian cancer.

    PubMed

    Bender, Eric

    2013-06-01

    Phase I trials of 2 treatments for recurrent ovarian cancer-a 2-step immunotherapy treatment and an antibody-drug conjugate-demonstrated promising early results in delaying recurrence, in work presented at the American Association for Cancer Research Annual Meeting 2013.

  13. Recurrent takotsubo cardiomyopathy in a child.

    PubMed

    Srivastava, Nayan T; Parent, John J; Hurwitz, Roger A

    2016-02-01

    Takotsubo cardiomyopathy or transient apical ballooning syndrome very rarely presents in children. In all patients with takotsubo, it is estimated that only 3.5% will have recurrence. In this study, we describe a case of recurrent takotsubo cardiomyopathy in a child, likely triggered by status epilepticus.

  14. Recurrence Effects in the Parametric Spring Pendulum.

    ERIC Educational Resources Information Center

    Falk, Lars

    1978-01-01

    Gives a perturbation analysis to recurrence effects of the spring pendulum. The recurrence depends on two conservation laws which determine the motion in an intermediate region; oscillations outside this region are unstable and must return. Gives the relation to Fermi-Pasta-Ulam problem together with the explicit solution. (Author/GA)

  15. Ectopic recurrent craniopharyngioma of the frontal bone.

    PubMed

    Jakobs, Martin; Orakcioglu, Berk

    2012-09-01

    Ectopic recurrence of craniopharyngioma is a rare phenomenon after transcranial resection of the primary tumor. The authors present a case of ectopic recurrent adamantinomatous craniopharyngioma of the frontal bone resected 16 years after initial transcranial resection of the primary tumor. The lesion was first radiographically described 12 years after surgery and was adjacent to the osteosynthesis plate that had been implanted at the craniotomy site. The recurrent craniopharyngioma was totally resected via a lateral eyebrow approach. No infiltration of the meninges or the brain was detected. Only 50 cases of ectopic recurrent craniopharyngioma have been described to date, with the present case being the first one with recurrence located at the skull bone. So far 2 mechanisms have been described: contamination with tumor cells alongside the surgical tract and spreading via CSF and the subarachnoid space. The authors reviewed the literature, provided the largest collection of cases so far, and performed basic statistical analysis regarding ectopic recurrence. Pediatric and adult patients as well as male and female ones are affected equally by this phenomenon. The mean time of ectopic recurrence after initial surgery was 7.1 years. Ectopic recurrence, although rare, should always be considered in a patient with a newly diagnosed intracranial lesion who has undergone transcranial craniopharyngioma resection before.

  16. 28 CFR 51.14 - Recurrent practices.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Recurrent practices. 51.14 Section 51.14 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED General Provisions § 51.14 Recurrent practices. Where...

  17. Recurrence in Major Depression: A Conceptual Analysis

    ERIC Educational Resources Information Center

    Monroe, Scott M.; Harkness, Kate L.

    2011-01-01

    Theory and research on major depression have increasingly assumed a recurrent and chronic disease model. Yet not all people who become depressed suffer recurrences, suggesting that depression is also an acute, time-limited condition. However, few if any risk indicators are available to forecast which of the initially depressed will or will not…

  18. Predictors for critical care admission among children presenting to emergency department with recurrent wheezing

    PubMed Central

    Saini, Aman; Kaushik, Jaya Shankar; Arya, Vandana; Gathwala, Geeta

    2017-01-01

    Context: Children with recurrent wheezing contribute to a significant burden of inpatient hospital admission in developing countries. However, many patients could be managed at home following a short observation period in emergency unit. Aim: This study aimed to determine the predictors of critical care admission in a population of children aged 6 months to 2 years attending pediatric emergency department (ED) for recurrent wheezing. Setting and Design: This is a case–control study conducted in pediatric ED of a tertiary care center in North India. Patients and Methods: Demographic and clinical details were recorded for children aged 6 months to 2 years who presented to ED for “recurrent wheezing” within 48 h of onset of symptoms. Those who were admitted to critical care unit were considered cases and those who were discharged within 6 h of stay at short observation units of ED were considered controls. Statistical Analysis: Logistic regression model was used to determine which of the various demographic and clinical factors best predicted the need for critical care admission. Results: The cases (n = 58) had significantly higher number of emergency visits in the preceding 1 month (P = 0. 018), had more episodes of wheezing in the last 3 months (P = 0.025), had higher respiratory rate (P < 0.001), and had higher clinical severity score (P < 0.001) when compared to control (n = 58) group. Logistic regression model revealed incomplete immunization status of children (P = 0.005) to be a significant risk factor that determine the need for critical care admission. Conclusion: The present cross-sectional study with limited sample size revealed incomplete immunization status of children to be a significant risk factor that determined the need for critical care admission among children below 2 years of age presenting to ED with recurrent wheezing. PMID:28243009

  19. Memory B cell compartment constitution and susceptibility to recurrent lower respiratory tract infections in young children.

    PubMed

    Siebert, Johan N; L'huillier, Arnaud G; Grillet, Stéphane; Delhumeau, Cécile; Siegrist, Claire-Anne; Posfay-Barbe, Klara M

    2013-06-01

    A proportion of children have recurrent LRTIs, mostly as a result of Spn, which persist after 2 years of age. Here, we investigate, by flow cytofluorometry, the constitution of the memory B cell compartment in 90 healthy children and 49 children with recurrent LRTIs to determine if an increased susceptibility to recurrent LRTIs results from a delayed or abnormal ontogeny with poor antibody-mediated protection. Total IgA, IgM, IgG, and IgG subclasses were measured by nephelometry, as well as antipneumococcal antibodies by ELISA. Pneumococcal vaccination status was obtained. We show that the memory B cells increase between birth and 2 years of age (1.6% vs. 21.1%, P<0.001) without further significant increase noted per additional years (3-4 years old: 23.3%; 4-5 years old: 22.2%, P>0.40) to reach adult-like values (31.8±11.8%, P=0.08). Proportions of switched and IgM memory B cells were similar in children and adults. Comparatively, LRTI children had no delay in the constitution of their memory B cell compartment (2-3 years old: 26.9%; 3-4 years old: 18.2%; 4-5 years old: 26.8%, P>0.05). Their switched and IgM memory B cells were similar among age categories, and the distribution was overall similar to that of healthy controls. LRTI children had normal total and pneumococcal serotype-specific antibody values but showed a rapid waning of antipneumococcal antibody levels after vaccination. In summary, our results show that the memory B cell compartment is already similarly constituted at 2 years of age in healthy and LRTI children and thus, cannot explain the increased susceptibility to bacterial pneumonia. However, the waning of antibodies might predispose children to recurrent infections in the absence of revaccination.

  20. Giant epicardial cyst presenting as acute cardiac tamponade in a 2-year-old boy.

    PubMed

    Masuoka, Ayumu; Sakurai, Hayato; Shiraishi, Masahisa; Yoshiba, Shigeki; Katogi, Toshiyuki; Suzuki, Takaaki

    2015-09-01

    Cystic structures within the pericardial cavity are rare. They are divided into epicardial and pericardial variants. Pericardial and epicardial cysts rarely cause symptoms. This report describes a case of epicardial cyst with acute cardiac tamponade in a 2-year-old boy with no previous cardiac history who was transferred to our hospital because of hemodynamic instability. Emergency drainage of the pericardial effusion and complete excision of the cyst were performed through a median full sternotomy.

  1. Applied behaviour analysis and standard treatment in intellectual disability: 2-year outcomes.

    PubMed

    Hassiotis, Angela; Canagasabey, Anton; Robotham, Daniel; Marston, Louise; Romeo, Renee; King, Michael

    2011-06-01

    Applied behaviour analysis by a specialist team plus standard treatment for adults with intellectual disability displaying challenging behaviour was reported to be clinically and cost-effective after 6 months. In a 2-year follow-up of the same trial cohort, participants receiving the specialist intervention had significantly lower total and subdomain Aberrant Behavior Checklist scores than those receiving usual care alone. After adjustment for baseline covariates there was no significant difference in costs between the trial arms.

  2. Uric acid in relapsing-remitting multiple sclerosis: a 2-year longitudinal study.

    PubMed

    Moccia, Marcello; Lanzillo, Roberta; Costabile, Teresa; Russo, Cinzia; Carotenuto, Antonio; Sasso, Gabriella; Postiglione, Emanuela; De Luca Picione, Carla; Vastola, Michele; Maniscalco, Giorgia Teresa; Palladino, Raffaele; Brescia Morra, Vincenzo

    2015-01-01

    Uric acid (UA) is reduced in multiple sclerosis (MS), and possibly relates to MS outcomes, with lower UA levels in subjects experiencing a relapse or presenting higher disability scores. The present retrospective longitudinal study evaluated UA variations in MS, in relation to clinical relapses, disability progression, and cognitive functions. We included 141 subjects with relapsing-remitting MS (RRMS) and performed expanded disability status scale (EDSS), symbol digit modalities test (SDMT) and UA evaluation at baseline visit and after 2-year follow-up. Paired t test showed significantly lower UA levels after 2-year follow-up than at baseline (3.987 ± 1.135 and 4.167 ± 1.207 mg/dL, respectively) (p = 0.001). The difference in UA levels between 2-year follow-up and baseline related to EDSS sustained progression (p < 0.001; OR = 0.099), and presented a trend for clinical relapses at logistic regression (p = 0.211; OR = 0.711) and for the time to relapse at Cox regression (p = 0.236; HR = 0.792). Analysis of variance showed reduced baseline UA levels in subjects with impaired SDMT at baseline (p = 0.045; adjusted R(2) = 0.473) and after 2-year follow-up (p = 0.034; adjusted R(2) = 0.470). This is the first study showing a progressive reduction of UA levels during the course of RRMS, suggesting a progressive decrease of antioxidant reserves, in relation to relapse risk, disability progression and cognitive function.

  3. Filariasis presenting as a scrotal nodule in a 2 year old child: a case report.

    PubMed

    Yagain, Kiran; Mathew, Mary

    2011-02-01

    A two year old boy from southwestern village of India presented with a 2 cm × 1 cm size swelling in scrotum for 8 months. It was excised surgically and the histopathological examination revealed a gravid filarial worm. The occurrence of adult filarial worm in 2 year old boy signifies the endemicity and high larval load of insect vectors in western coast of south India.

  4. Local Recurrence After Uveal Melanoma Proton Beam Therapy: Recurrence Types and Prognostic Consequences

    SciTech Connect

    Caujolle, Jean-Pierre; Paoli, Vincent; Chamorey, Emmanuel; Maschi, Celia; Baillif, Stéphanie; Herault, Joël; Gastaud, Pierre; Hannoun-Levi, Jean Michel

    2013-04-01

    Purpose: To study the prognosis of the different types of uveal melanoma recurrences treated by proton beam therapy (PBT). Methods and Materials: This retrospective study analyzed 61 cases of uveal melanoma local recurrences on a total of 1102 patients treated by PBT between June 1991 and December 2010. Survival rates have been determined by using Kaplan-Meier curves. Prognostic factors have been evaluated by using log-rank test or Cox model. Results: Our local recurrence rate was 6.1% at 5 years. These recurrences were divided into 25 patients with marginal recurrences, 18 global recurrences, 12 distant recurrences, and 6 extrascleral extensions. Five factors have been identified as statistically significant risk factors of local recurrence in the univariate analysis: large tumoral diameter, small tumoral volume, low ratio of tumoral volume over eyeball volume, iris root involvement, and safety margin inferior to 1 mm. In the local recurrence-free population, the overall survival rate was 68.7% at 10 years and the specific survival rate was 83.6% at 10 years. In the local recurrence population, the overall survival rate was 43.1% at 10 years and the specific survival rate was 55% at 10 years. The multivariate analysis of death risk factors has shown a better prognosis for marginal recurrences. Conclusion: Survival rate of marginal recurrences is superior to that of the other recurrences. The type of recurrence is a clinical prognostic value to take into account. The influence of local recurrence retreatment by proton beam therapy should be evaluated by novel studies.

  5. Conservation treatment of the eye: Conformal proton reirradiation for recurrent uveal melanoma

    SciTech Connect

    Marucci, Laura; Lane, Anne M.; Li Wenjun; Egan, Kathleen M.; Gragoudas, Evangelos S.; Adams, Judy; Collier, John M.; Munzenrider, John E. . E-mail: jmunzenrider@partners.org

    2006-03-15

    Purpose: To evaluate the outcomes of a second course of proton beam radiation therapy (PBRT) in patients with recurrent uveal melanoma. Methods and Materials: Thirty-one patients received a second course of PBRT. The mean interval between the first and the second PBRT course was 50.2 months (range, 8-165 months). Most patients (87%) received 70 cobalt Gray equivalent (CGE) for both courses. Visual acuity was 20/200 or better in 30 patients initially and in 22 patients at the second treatment. The mean follow-up time after the second treatment was 50 months (range, 6-164 months). Results: At the time of the last follow-up, 20 patients were classified as having no evidence of disease, defined as tumor regression or an absence of tumor progression. Nine eyes (29%) were enucleated because of local recurrence (n = 5) or intractable pain (n = 4). The 5-year eye retention rate was 55% (95% confidence interval: 25.2-77.4). Six of the 22 patients who retained the eye (27%) had useful vision (20/200 or better). Conclusions A second course of PBRT for recurrent uveal melanoma to total doses between 118 and 140 CGE was associated with a relatively good probability of local control and a low enucleation rate. Although most patients lost vision, the majority were able to retain the reirradiated eye. Further evaluation is needed to assess metastasis-free survival of additional proton irradiation vs. enucleation after local recurrence.

  6. Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after Coloplast Titan prosthesis

    PubMed Central

    Pryor, Michael B; Carrion, Rafael; Wang, Run; Henry, Gerard

    2016-01-01

    A common complaint after inflatable penile prosthesis surgery is reduced penile length. We previously reported how using the Coloplast Titan inflatable penile prosthesis with aggressive new length measurement technique (NLMT) coupled with postoperative IPP rehabilitation of the implant for 1-year helped to improve patient satisfaction and erectile penile measurements. This is a 2 years follow-up of a prospective, three-center, study of 40 patients who underwent Titan prosthesis placement, with new length measurement technique for erectile dysfunction. Patient instructions were to inflate daily for 6 months and then inflate maximally for 1–2 h daily for 6–24 months. Fifteen penile measurements were taken before and immediately after surgery and at follow-up visits. Measurement changes were improved at 24 months as compared to immediately postoperative and at 12 months. 67.8% of subjects were satisfied with their length at 2 years, and 77% had perceived penile length that was longer (30.8%) or the same (46.2%) as prior to the surgery. 64.3% and 17.9% of subjects had increased and unchanged satisfaction, respectively, with penile length as compared to prior to penile implant surgery. All but one subject (96.5%) was satisfied with the overall function of his implant. This study suggests using the Coloplast Titan with aggressive cylinder sizing, and a postoperative penile rehabilitation inflation protocol can optimize patient satisfaction and erectile penile measurements at 2 years postimplant. PMID:26459782

  7. Antenatal renal pelvis dilatation: 2-year follow-up with DMSA scintigraphy.

    PubMed

    Lidefelt, Karl-Johan; Herthelius, Maria; Soeria-Atmadja, Sandra

    2009-03-01

    The aim of this study was to determine whether a postnatal ultrasound (US) can detect infants with antenatal renal pelvis dilatation (ARPD) who run a minimal risk of renal damage 2 years after birth. The study cohort consisted of 14,000 pregnant women who consecutively underwent routine US examinations during the second trimester. Subsequent examinations were performed on the basis of obstetrical indications. In total, 106 foetuses were diagnosed with ARPD > or =5 mm. Two postnatal US were performed on the newborns: on postpartum days 5-7 and during the third week of life. The findings were considered to be normal when the renal pelvis diameter (RPD) was < or = 7 mm and when there was no calyceal or ureteric dilatation or signs of renal dysplasia or other anomalies. Voiding cystourethrography (VCUG) was done at 6-8 weeks after birth. When the children reached 2 years of age, renal status was evaluated with DMSA scintigraphy or, if not possible, US. In 53 of the 103 children available for evaluation, the postnatal US findings were normal; 49 of the 53 children were also given a DMSA, and the results were normal in all cases. An US scan (all normal) only was performed in three children because the families refused a DMSA. One family refused any form of examination at the 2-year follow-up. Based on our results, we conclude that postnatal US can detect infants who do not require follow-up assessments of renal development.

  8. Strabismus at Age 2 Years in Children Born Before 28 Weeks’ Gestation: Antecedents and Correlates

    PubMed Central

    VanderVeen, Deborah K.; Allred, Elizabeth N.; Wallace, David K.; Leviton, Alan

    2015-01-01

    Children born very preterm are at greater risk of ophthalmic morbidities, including strabismus, than children born at term. We evaluated perinatal factors associated with strabismus at age 2 years in a large population of infants delivered before 28 weeks’ gestation. A total of 996 infants in the multicenter ELGAN (Extremely Low Gestational Age Newborn) study who had a retinal exam in infancy and a developmental assessment at 2 years corrected age are included. Their mothers were interviewed about the pregnancy, and both mother and newborn charts were reviewed. Certified examiners administered the Bayley Scales of Infant Development-II and performed an examination of ocular alignment. Time-oriented logistic regression risk models were created to evaluate the associations of characteristics and exposures with the development of strabismus. Overall, 14% (n = 141) of the children had strabismus at 2 years, and 80% of strabismic children had esotropia. Characteristics associated with strabismus were birth before 26 weeks’ gestation, severe fetal growth restriction, and maternal history of aspirin ingestion. Associated postnatal factors included a SNAP-II (Score for Neonatal Acute Physiology) illness severity value ≥30, brain ventriculomegaly, type I retinopathy of prematurity, and ventilator-dependent severe bronchopulmonary dysplasia. Strabismus in very preterm populations is associated with a number of antenatal and postnatal antecedents as well as clinical and imaging correlates indicative of brain damage in these children. Routine ophthalmologic assessments in the early years can allow appropriate and timely interventions. PMID:26350726

  9. Beneficial effects of chrysin and benzoflavone on virility in 2-year-old male rats.

    PubMed

    Dhawan, Kamaldeep; Kumar, Suresh; Sharma, Anupam

    2002-01-01

    This work describes the potential usefulness of bioflavonoids for countering the deleterious effects of aging on male sexuality in 2-year-old rats. A flavone chrysin from Passiflora caerulea Linn. and a benzoflavone moiety (BZF) recently isolated from Passiflora incarnata Linn. were administered to 2-year-old male rats for a period of 30 days. After cessation of these treatments, there was a significant improvement in overall sexual functions in the rats given bioflavonoids, compared with control rats. The rats receiving chrysin (1 mg/kg) and BZF (10 mg/kg) exhibited increased libido when they were allowed to interact with nonestrous female rats. Additionally, both treated groups had increased sperm count, greater fertilization potential, and greater litter size when they were allowed to interact with proven proestrous female rats of a similar strain. BZF was more potent than chrysin as an antiaromatase agent and exhibited better effects on the sexual system of the 2-year-old male rats. Plant flavonoids have great potential for clinical and therapeutic applications against the physiological and biochemical effects of aging.

  10. [Causes of local recurrence after curative surgery for rectal cancer].

    PubMed

    Hôhn, József; Varga, László; Baradnay, Gellért; Simonka, Zsolt; Géczi, Tibor; Nagy, Ferenc; Molnár, Tamás; Maráz, Anikó; Kahán, Zsuzsa; Balogh, Adám

    2003-01-01

    The rate of local recurrence (LR) has been 20-40% after resective surgery for rectal cancer by the traditional - Miles or Dixon - operative technics. The authors performed curative resection in 358 patients with rectal cancer in a 10 year period (01.01.1990 - 31.12.2000) in the Surgical Department of Szeged University. Since 01.01.1996 the authors changed this type of surgery for the Heald technics (total mesorectal excision - TME - with sharp dissection, using the UltraCision device) for the surgical treatment of middle or lower third rectal cancer. To compare the results of the two procedures, the authors analysed their material in two periods: Period I: 01.01.1991 - 31.12.1992: 62 patients operated on with the traditional operative technics; LR 15% within 2 years after surgery. Period II: 01.01.1997 - 31.12.1998: 78 patients operated on with the Heald technics (TME with sharp dissection); LR 6.4% within 2 years after surgery. Based on their results, the authors found that the modern operative technics by Heald, used in the second period of the study, was a relevant factor decreasing LR from 15% to 6.4%, while the gender, age of the patients, ratio of the abdominoperineal extirpation versus anterior resection (APRE/AR) and the free margin of more than 3 cm proved to be irrelevant.

  11. Evidence-based management of recurrent miscarriages

    PubMed Central

    Jeve, Yadava B.; Davies, William

    2014-01-01

    Recurrent miscarriages are postimplantation failures in natural conception; they are also termed as habitual abortions or recurrent pregnancy losses. Recurrent pregnancy loss is disheartening to the couple and to the treating clinician. There has been a wide range of research from aetiology to management of recurrent pregnancy loss. It is one of the most debated topic among clinicians and academics. The ideal management is unanswered. This review is aimed to produce an evidence-based guidance on clinical management of recurrent miscarriage. The review is structured to be clinically relevant. We have searched electronic databases (PubMed and Embase) using different key words. We have combined the searches and arranged them with the hierarchy of evidences. We have critically appraised the evidence to produce a concise answer for clinical practice. We have graded the evidence from level I to V on which these recommendations are based. PMID:25395740

  12. Recurrent well-differentiated thyroid carcinoma.

    PubMed

    Magarey, Matthew J R; Freeman, Jeremy L

    2013-07-01

    The incidence of Well-differentiated Thyroid Carcinoma (WDTC) has been increasing over the past several decades. Consequently, so has the incidence of recurrence, which ranges from 15% to 30%. Factors leading to increased risk of recurrence are well described. However, the impact of local and regional recurrence is not well understood, but distant recurrence dramatically reduces 10-year survival to 50%. Recurrent WDTC has several established options for treatment; Observation, Radioactive Iodine (RAI), Surgery and External Beam Radiotherapy (EBRT). Novel treatments such as radiofrequency ablation (RFA) and percutaneous ultrasound-guided ethanol injection (PUEI) are beginning to gain popularity and have promising early results. A review of the current literature, outcome measurements and a strategy for revision surgery within the central neck compartment are discussed within this manuscript.

  13. Does the interval of screening endoscopy affect survival in gastric cancer patients?

    PubMed Central

    Kim, Jieun; Kim, Su Mi; Ha, Man Ho; Seo, Jeong Eun; Choi, Min-Gew; Lee, Jun Ho; Sohn, Tae Sung; Kim, Sung; Jung, Sin-Ho; Bae, Jae Moon

    2016-01-01

    Abstract Gastric cancer remains the second most common cancer in Korea; however, its mortality has decreased due to earlier diagnosis. In Korea, screening endoscopy has been performed nationwide since 1999. The aim of this study was to elucidate the benefit of screening endoscopy on actual survival in gastric cancer patients and to determine the optimal interval of screening endoscopy. We analyzed 1651 patients diagnosed with gastric adenocarcinoma who underwent surgical treatment between June 2008 and December 2014. Patients were divided into 4 groups according to the interval of screening endoscopy prior to their gastric cancer diagnosis. (Group I = within 1 year, Group II = >1 but <2 years, Group III = more than 2 years, Group IV = no prior endoscopic examination). Patient demographics, clinicopathologic characteristics, and postoperative surgical outcomes including overall survival were compared. The 5-year gastric cancer-specific survival rates of groups I and II were significantly higher than groups III and IV (90.9% vs 85.4%, P = 0.002, respectively). Multivariate analysis showed that screening interval was an independent factor for the diagnosis of advanced gastric cancer. The risk of advanced gastric cancer decreased in group I (odds ratio: 0.515, 95% confidence interval [CI] 0.369–0.719; P < 0.001) and group II (odds ratio: 0.678, 95% CI 0.517–0.889, P = 0.005). Screening endoscopy was helpful in increasing the survival of gastric cancer patients. A 2-year endoscopic screening interval is suitable to detect early-stage gastric cancer. PMID:27930534

  14. Mycophenolate mofetil (MMF) does not slow the progression of subclinical atherosclerosis in SLE over 2 years.

    PubMed

    Kiani, Adnan N; Magder, Laurence S; Petri, Michelle

    2012-09-01

    Accelerated atherosclerosis is a major cause of mortality in SLE. Mycophenolate mofetil (MMF) has been shown to suppress growth factor-induced proliferation of vascular smooth muscle and endothelial cells in animal models. We hypothesized that MMF might modify the inflammatory component of atherosclerosis in SLE. We examined the effect of MMF on atherosclerosis as measured by changes in carotid intima-media thickness (IMT) or coronary artery calcium (CAC) over 2 years. CAC and carotid IMT were measured at baseline and 2 years later in a cohort of 187 patients with SLE. The cohort was 91% women, 59% Caucasian, and 35% African-American, with a mean age of 45 ± 11 years. Of these, 12.5% (n = 25) received MMF during follow-up. The daily dose ranged from 500 to 3,000 mg/day, and duration ranged from 84 days to the entire 2 years. We divided MMF users into three groups: low exposure (<1,500 mg average daily dose), high exposure (≥1,500 average daily dose), and any exposure of MMF (<1,500 or ≥1,500 average daily dose) for 2 years. The mean CAC increased in all four groups: no MMF: 1.17-1.28, low MMF: 1.02-1.13, high MMF: 1.44-1.61, and any MMF: 1.21-1.34 log-Agatston units. Compared to no MMF, there was no statistically different change between the three groups (p = 0.99, 0.87, and 0.91). Similarly, mean carotid IMT increased in all four groups: no MMF: 0.58-0.66, low MMF: 0.55-0.60, high MMF: 0.56-0.71, and any MMF: 0.56-0.66. We then adjusted for statin use, lupus nephritis, body mass index, systolic blood pressure, cholesterol, and age during the 2-year follow-up. The association between MMF exposure and change in CAC or carotid IMT was not statistically significant (p = 0.63 for CAC, and p = 0.085 for carotid IMT). There was no evidence that MMF slowed or decreased the progression of atherosclerosis as measured by carotid IMT or CAC. Because the number of patients taking MMF was only twenty-five, larger studies for longer time periods are needed to explore any

  15. Kineflex (Centurion) Lumbar Disc Prosthesis: Insertion Technique and 2-Year Clinical Results in 100 Patients

    PubMed Central

    Weinberg, Ian R.; Sliwa, Karen; Sweet, Barry MBE; de Villiers, Malan

    2007-01-01

    Background The Kineflex lumbar disc is a mechanical, unconstrained, re-centering disc prosthesis developed in South Africa. The first implantation took place in October 2002. We present a single-center, prospective, longitudinal study of the first 100 patients treated with the Kineflex lumbar disc. Our objective was to evaluate the insertion technique, clinical outcomes, and patient satisfaction at 2 years postimplantation in 100 consecutive patients with 132 (68 single- and 32 2-level) Kineflex lumbar disc replacements. Methods We determined the exact central placement of all disc implants in the coronal and midsagittal planes. We measured clinical outcome with the Oswestry disability index (ODI), our own questionnaire, and the time needed to return to work. All patients received radiological and clinical follow-up assessments for 2 years after the index procedure. Results Forty-three patients were female. The mean age of the patients at operation was 44.9 years (range, 23–63 years). Postoperative hospitalization averaged 2.8 days (range, 2 to 8 days). All patients who were employed before surgery returned to work 31 ± 16.8 days after the operation. Fifty-six percent of operated disc levels had intervertebral disc heights of less than 5 mm. A 2-year clinical outcome was available for 98 of the 100 patients (58 excellent, 30 good, 7 fair, 3 poor). The ODI score improved from 47.8 ± 16.0 preoperatively to 14.2 ± 14.0 (P < .01) at 2 years. At 2 years, 95% of disc implants were radiologically in the ideal position. The insertion technique, with a released prosthetic mechanism for final placement, allowed ideal placement in the sagittal plane in 98% of discs. The radiographic placement accuracy achieved was equal in patients with preoperative intervertebral disc height below and above 5 mm. Conclusions Good short-term clinical results were achieved with the Kineflex disc in a heterogeneous patient group with a high number of patients with advanced disc

  16. Sampling Theory and Confidence Intervals for Effect Sizes: Using ESCI To Illustrate "Bouncing"; Confidence Intervals.

    ERIC Educational Resources Information Center

    Du, Yunfei

    This paper discusses the impact of sampling error on the construction of confidence intervals around effect sizes. Sampling error affects the location and precision of confidence intervals. Meta-analytic resampling demonstrates that confidence intervals can haphazardly bounce around the true population parameter. Special software with graphical…

  17. Interval Estimates of Multivariate Effect Sizes: Coverage and Interval Width Estimates under Variance Heterogeneity and Nonnormality

    ERIC Educational Resources Information Center

    Hess, Melinda R.; Hogarty, Kristine Y.; Ferron, John M.; Kromrey, Jeffrey D.

    2007-01-01

    Monte Carlo methods were used to examine techniques for constructing confidence intervals around multivariate effect sizes. Using interval inversion and bootstrapping methods, confidence intervals were constructed around the standard estimate of Mahalanobis distance (D[superscript 2]), two bias-adjusted estimates of D[superscript 2], and Huberty's…

  18. The microanalysis of fixed-interval responding

    PubMed Central

    Gentry, G. David; Weiss, Bernard; Laties, Victor G.

    1983-01-01

    The fixed-interval schedule of reinforcement is one of the more widely studied schedules in the experimental analysis of behavior and is also a common baseline for behavior pharmacology. Despite many intensive studies, the controlling variables and the pattern of behavior engendered are not well understood. The present study examined the microstructure and superstructure of the behavior engendered by a fixed-interval 5- and a fixed-interval 15-minute schedule of food reinforcement in the pigeon. Analysis of performance typical of fixed-interval responding indicated that the scalloped pattern does not result from smooth acceleration in responding, but, rather, from renewed pausing early in the interval. Individual interresponse-time (IRT) analyses provided no evidence of acceleration. There was a strong indication of alternation in shorter-longer IRTs, but these shorter-longer IRTs did not occur at random, reflecting instead a sequential dependency in successive IRTs. Furthermore, early in the interval there was a high relative frequency of short IRTs. Such a pattern of early pauses and short IRTs does not suggest behavior typical of reinforced responding as exemplified by the pattern found near the end of the interval. Thus, behavior from clearly scalloped performance can be classified into three states: postreinforcement pause, interim behavior, and terminal behavior. PMID:16812324

  19. Microanalysis of fixed-interval responding

    SciTech Connect

    Gentry, G.D.; Weiss, B.; Laties, V.G.

    1983-03-01

    The fixed-interval schedule of reinforcement is one of the more widely studied schedules in the experimental analysis of behavior and is also a common baseline for behavior pharmacology. Despite many intensive studies, the controlling variables and the pattern of behavior engendered are not well understood. The present study examined the microstructure and superstructure of the behavior engendered by a fixed-interval 5- and a fixed-interval 15-minute schedule of food reinforcement in the pigeon. Analysis of performance typical of fixed-interval responding indicated that the scalloped pattern does not result from smooth acceleration in responding, but, rather, from renewed pausing early in the interval. Individual interresponse-time (IRT) analyses provided no evidence of acceleration. There was a strong indication of alternation is shorter-longer IRTs, but these shorter-longer IRTs did not occur at random, reflecting instead a sequential dependency in successive IRTs. Furthermore, early in the interval there was a high relative frequency of short IRTs. Such a pattern of early pauses and short IRTs does not suggest behavior typical of reinforced responding as exemplified by the pattern found near the end of the interval. Thus, behavior from clearly scalloped performance can be classified into three states: postreinforcement pause, interim behavior, and terminal behavior. 31 references, 11 figures, 4 tables.

  20. Fast transfer of crossmodal time interval training.

    PubMed

    Chen, Lihan; Zhou, Xiaolin

    2014-06-01

    Sub-second time perception is essential for many important sensory and perceptual tasks including speech perception, motion perception, motor coordination, and crossmodal interaction. This study investigates to what extent the ability to discriminate sub-second time intervals acquired in one sensory modality can be transferred to another modality. To this end, we used perceptual classification of visual Ternus display (Ternus in Psychol Forsch 7:81-136, 1926) to implicitly measure participants' interval perception in pre- and posttests and implemented an intra- or crossmodal sub-second interval discrimination training protocol in between the tests. The Ternus display elicited either an "element motion" or a "group motion" percept, depending on the inter-stimulus interval between the two visual frames. The training protocol required participants to explicitly compare the interval length between a pair of visual, auditory, or tactile stimuli with a standard interval or to implicitly perceive the length of visual, auditory, or tactile intervals by completing a non-temporal task (discrimination of auditory pitch or tactile intensity). Results showed that after fast explicit training of interval discrimination (about 15 min), participants improved their ability to categorize the visual apparent motion in Ternus displays, although the training benefits were mild for visual timing training. However, the benefits were absent for implicit interval training protocols. This finding suggests that the timing ability in one modality can be rapidly acquired and used to improve timing-related performance in another modality and that there may exist a central clock for sub-second temporal processing, although modality-specific perceptual properties may constrain the functioning of this clock.

  1. Time-predictable recurrence model for large earthquakes

    SciTech Connect

    Shimazaki, K.; Nakata, T.

    1980-04-01

    We present historical and geomorphological evidence of a regularity in earthquake recurrence at three different sites of plate convergence around the Japan arcs. The regularity shows that the larger an earthquake is, the longer is the following quiet period. In other words, the time interval between two successive large earthquakes is approximately proportional to the amount of coseismic displacement of the preceding earthquake and not of the following earthquake. The regularity enables us, in principle, to predict the approximate occurrence time of earthquakes. The data set includes 1) a historical document describing repeated measurements of water depth at Murotsu near the focal region of Nankaido earthquakes, 2) precise levelling and /sup 14/C dating of Holocene uplifted terraces in the southern boso peninsula facing the Sagami trough, and 3) similar geomorphological data on exposed Holocene coral reefs in Kikai Island along the Ryukyu arc.

  2. The Total Interval of a Graph.

    DTIC Science & Technology

    1988-01-01

    definitions for all of these clases . A Husimi tree is a graph for which every block is a clique. A cactus is a graph for which every edge is in at most one...proportion of graphs with n vertices that we can represent with q(n) intervals is at most n-2 and this approaches zero as n gets large . Hence the...representations will have relatively few intervals of small depth and relatively many intervals of large depth. It is nevertheless often useful to restrict

  3. Advanced Interval Management: A Benefit Analysis

    NASA Technical Reports Server (NTRS)

    Timer, Sebastian; Peters, Mark

    2016-01-01

    This document is the final report for the NASA Langley Research Center (LaRC)- sponsored task order 'Possible Benefits for Advanced Interval Management Operations.' Under this research project, Architecture Technology Corporation performed an analysis to determine the maximum potential benefit to be gained if specific Advanced Interval Management (AIM) operations were implemented in the National Airspace System (NAS). The motivation for this research is to guide NASA decision-making on which Interval Management (IM) applications offer the most potential benefit and warrant further research.

  4. Learned interval time facilitates associate memory retrieval

    PubMed Central

    van de Ven, Vincent; Kochs, Sarah; Smulders, Fren; De Weerd, Peter

    2017-01-01

    The extent to which time is represented in memory remains underinvestigated. We designed a time paired associate task (TPAT) in which participants implicitly learned cue–time–target associations between cue–target pairs and specific cue–target intervals. During subsequent memory testing, participants showed increased accuracy of identifying matching cue–target pairs if the time interval during testing matched the implicitly learned interval. A control experiment showed that participants had no explicit knowledge about the cue–time associations. We suggest that “elapsed time” can act as a temporal mnemonic associate that can facilitate retrieval of events associated in memory. PMID:28298554

  5. Palliative Treatment of Rectal Carcinoma Recurrence Using Radiofrequency Ablation

    SciTech Connect

    Mylona, Sophia Karagiannis, Georgios Patsoura, Sofia; Galani, Panagiota; Pomoni, Maria; Thanos, Loukas

    2012-08-15

    Purpose: To evaluate the safety and efficacy of CT-guided radiofrequency (RF) ablation for the palliative treatment of recurrent unresectable rectal tumors. Materials and Methods: Twenty-seven patients with locally recurrent rectal cancer were treated with computed tomography (CT)-guided RF ablation. Therapy was performed with the patient under conscious sedation with a seven- or a nine-array expandable RF electrode for 8-10 min at 80-110 Degree-Sign C and a power of 90-110 W. All patients went home under instructions the next day of the procedure. Brief Pain Inventory score was calculated before and after (1 day, 1 week, 1 month, 3 months, and 6 months) treatment. Results: Complete tumor necrosis rate was 77.8% (21 of a total 27 procedures) despite lesion location. BPI score was dramatically decreased after the procedure. The mean preprocedure BPI score was 6.59, which decreased to 3.15, 1.15, and 0.11 at postprocedure day 1, week 1, and month 1, respectively, after the procedure. This decrease was significant (p < 0.01 for the first day and p < 0.001 for the rest of the follow-up intervals (paired Student t test; n - 1 = 26) for all periods during follow-up. Six patients had partial tumor necrosis, and we were attempted to them with a second procedure. Although the necrosis area showed a radiographic increase, no complete necrosis was achieved (secondary success rate 65.6%). No immediate or delayed complications were observed. Conclusion: CT-guided RF ablation is a minimally invasive, safe, and highly effective technique for treatment of malignant rectal recurrence. The method is well tolerated by patients, and pain relief is quickly achieved.

  6. Dasatinib in Treating Patients With Recurrent or Persistent Ovarian, Fallopian Tube, Endometrial or Peritoneal Cancer

    ClinicalTrials.gov

    2017-04-05

    Endometrial Clear Cell Adenocarcinoma; Estrogen Receptor Negative; Ovarian Clear Cell Cystadenocarcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Recurrent Uterine Corpus Carcinoma

  7. Alisertib in Treating Young Patients With Recurrent or Refractory Solid Tumors or Leukemia

    ClinicalTrials.gov

    2016-07-20

    Hepatoblastoma; Previously Treated Childhood Rhabdomyosarcoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Kidney Neoplasm; Recurrent Childhood Malignant Germ Cell Tumor; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Soft Tissue Sarcoma; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Neuroblastoma; Recurrent Osteosarcoma

  8. Cabozantinib S-Malate in Treating Younger Patients With Recurrent or Refractory Solid Tumors

    ClinicalTrials.gov

    2017-03-20

    Childhood Solid Neoplasm; Childhood Thyroid Gland Medullary Carcinoma; Recurrent Childhood Central Nervous System Neoplasm; Recurrent Malignant Solid Neoplasm; Recurrent Melanoma; Recurrent Thyroid Gland Carcinoma

  9. Wrightwood and the earthquake cycle: What a long recurrence record tells us about how faults work

    USGS Publications Warehouse

    Weldon, R.; Scharer, K.; Fumal, T.; Biasi, G.

    2004-01-01

    The concept of the earthquake cycle is so well established that one often hears statements in the popular media like, "the Big One is overdue" and "the longer it waits, the bigger it will be." Surprisingly, data to critically test the variability in recurrence intervals, rupture displacements, and relationships between the two are almost nonexistent. To generate a long series of earthquake intervals and offsets, we have conducted paleoseismic investigations across the San Andreas fault near the town of Wrightwood, California, excavating 45 trenches over 18 years, and can now provide some answers to basic questions about recurrence behavior of large earthquakes. To date, we have characterized at least 30 prehistoric earthquakes in a 6000-yr-long record, complete for the past 1500 yr and for the interval 3000-1500 B.C. For the past 1500 yr, the mean recurrence interval is 105 yr (31-165 yr for individual intervals) and the mean slip is 3.2 m (0.7-7 m per event). The series is slightly more ordered than random and has a notable cluster of events, during which strain was released at 3 times the long-term average rate. Slip associated with an earthquake is not well predicted by the interval preceding it, and only the largest two earthquakes appear to affect the time interval to the next earthquake. Generally, short intervals tend to coincide with large displacements and long intervals with small displacements. The most significant correlation we find is that earthquakes are more frequent following periods of net strain accumulation spanning multiple seismic cycles. The extent of paleoearthquake ruptures may be inferred by correlating event ages between different sites along the San Andreas fault. Wrightwood and other nearby sites experience rupture that could be attributed to overlap of relatively independent segments that each behave in a more regular manner. However, the data are equally consistent with a model in which the irregular behavior seen at Wrightwood

  10. MDX-010 in Treating Patients With Recurrent or Refractory Lymphoma

    ClinicalTrials.gov

    2014-05-22

    Adult Grade III Lymphomatoid Granulomatosis; B-cell Chronic Lymphocytic Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenström Macroglobulinemia

  11. Loss of PTEN expression is associated with increased risk of recurrence after prostatectomy for clinically localized prostate cancer.

    PubMed

    Chaux, Alcides; Peskoe, Sarah B; Gonzalez-Roibon, Nilda; Schultz, Luciana; Albadine, Roula; Hicks, Jessica; De Marzo, Angelo M; Platz, Elizabeth A; Netto, George J

    2012-11-01

    PTEN (phosphatase and tensin homolog on chromosome 10) is one of the most frequently lost tumor suppressor genes in human cancers and it has been described in more than two-thirds of patients with advanced/aggressive prostate cancer. Previous studies suggest that, in prostate cancer, genomic PTEN loss is associated with tumor progression and poor prognosis. Thus, we evaluated whether immunohistochemical PTEN expression in prostate cancer glands was associated with higher risk of recurrence, using a nested case-control study that included 451 men who recurred and 451 men who did not recur with clinically localized prostate cancer treated by radical prostatectomy. Recurrence was defined as biochemical recurrence (serum prostate-specific antigen >0.2 ng/ml) or clinical recurrence (local recurrence, systemic metastases, or prostate cancer-related death). Cases and controls were matched on pathological T stage, Gleason score, race/ethnicity, and age at surgery. Odds ratios of recurrence and 95% confidence intervals were estimated using conditional logistic regression to account for the matching factors and to adjust for year of surgery, preoperative prostate-specific antigen concentrations, and status of surgical margins. Men who recurred had a higher proportion of PTEN negative expression (16 vs 11%, P=0.05) and PTEN loss (40 vs 31%, P=0.02) than controls. Men with markedly decreased PTEN staining had a higher risk of recurrence (odds ratio=1.67; 95% confidence intervals 1.09, 2.57; P=0.02) when compared with all other men. In summary, in patients with clinically localized prostate cancer treated by prostatectomy, decreased PTEN expression was associated with an increased risk of recurrence, independent of known clinicopathological factors.

  12. Prolonged clot lysis time increases the risk of a first but not recurrent venous thrombosis.

    PubMed

    Karasu, Alev; Baglin, Trevor P; Luddington, Roger; Baglin, Caroline A; van Hylckama Vlieg, Astrid

    2016-03-01

    The role of the fibrinolytic system in the development of venous thrombosis (VT) is unclear. We studied the risk of first and recurrent VT associated with reduced fibrinolysis, as measured by clot lysis time (CLT). We also studied the relationship between CLT and thrombin generation to determine if any relationship between CLT and VT was affected by thrombin generation. Analyses were performed in the Thrombophilia Hypercoagulability Environmental risk for Venous Thromboembolism Study, a two-centre population-based case-control study, including 579 patients and 338 controls, with patients followed from the event to determine incidence of recurrent VT. Hypofibrinolysis was associated with a 1·8-fold increased risk of a first VT [95% confidence interval (CI) 1·2-2·7]. Adjustment for sex, age, study location and Endogenous Thrombin Potential (ETP) did not change the result. The risk of VT was 2·9-fold increased when the 90th percentiles of prolonged CLT and high ETP were combined, with the highest risk for unprovoked first events (Odds Ratio = 4·2, 95% CI 1·3-13·5). In the follow-up study the Hazard Ratio for a recurrent VT associated with hypofibrinolysis was 1·5 (95% CI 0·9-2·6). A weak dose response effect was observed in relation to prolongation of CLT and recurrent VT. Although hypofibrinolysis constitutes a risk factor for a first VT, an association with recurrence is, at best, weak.

  13. Association Between Unprotected Ultraviolet Radiation Exposure and Recurrence of Ocular Herpes Simplex Virus

    PubMed Central

    Ludema, Christina; Cole, Stephen R.; Poole, Charles; Smith, Jennifer S.; Schoenbach, Victor J.; Wilhelmus, Kirk R.

    2014-01-01

    Studies have suggested that exposure to ultraviolet (UV) light may increase risk of herpes simplex virus (HSV) recurrence. Between 1993 and 1997, the Herpetic Eye Disease Study (HEDS) randomized 703 participants with ocular HSV to receipt of acyclovir or placebo for prevention of ocular HSV recurrence. Of these, 308 HEDS participants (48% female and 85% white; median age, 49 years) were included in a nested study of exposures thought to cause recurrence and were followed for up to 15 months. We matched weekly UV index values from the National Oceanic and Atmospheric Administration to each participant's study center and used marginal structural Cox models to account for time-varying psychological stress and contact lens use and selection bias from dropout. There were 44 recurrences of ocular HSV, yielding an incidence of 4.3 events per 1,000 person-weeks. Weighted hazard ratios comparing persons with ≥8 hours of time outdoors to those with less exposure were 0.84 (95% confidence interval (CI): 0.27, 2.63) and 3.10 (95% CI: 1.14, 8.48) for weeks with a UV index of <4 and ≥4, respectively (ratio of hazard ratios = 3.68, 95% CI: 0.43, 31.4). Though results were imprecise, when the UV index was higher (i.e., ≥4), spending 8 or more hours per week outdoors was associated with increased risk of ocular HSV recurrence. PMID:24142918

  14. Recurrent fires and environment shape the vegetation in Quercus suber L. woodlands and maquis.

    PubMed

    Schaffhauser, Alice; Curt, Thomas; Véla, Errol; Tatoni, Thierry

    2012-06-01

    The effects of fire recurrence on vegetation patterns in Quercus suber L. and Erica-Cistus communities in Mediterranean fire-prone ecosystems of south-eastern France were examined on stands belonging to 5 fire classes, corresponding to different numbers of fires (from 0 to 4) and time intervals between fires since 1959. A common pool of species was identified among the plots, which was typical of both open and closed maquis. Fire recurrence reduced the abundance of trees and herbs, whereas it increased the abundance of small shrubs. Richness differed significantly between the most contrasting classes of fire recurrence, with maximal values found in control plots and minimal values in plots that had burned recurrently and recently. Equitability indices did not vary significantly, in contrast to Shannon's diversity index which mostly correlated with richness. Forest ecosystems that have burnt once or twice in the last 50 years were resilient; that is to say they recovered a biomass and composition similar to that of the pre-fire state. However, after more than 3-4 fires, shrubland communities displayed lower species richness and diversity indices than unburned plots. The time since the last fire and the number of fires were the most explanatory fire variables, governing the structure of post-fire plant communities. However, environmental factors, such as slope or exposure, also made a significant contribution. Higher rates of fire recurrence can affect the persistence or expansion of shrublands in the future, as observed in other Mediterranean areas.

  15. [Annexins and recurrent pregnancy loss].

    PubMed

    Udry, Sebastián; Aranda, Federico; Latino, Omar; Larrañaga, Gabriela de

    2013-01-01

    Recurrent Pregnancy Loss (RPL) affects public health and directly compromises the quality of life of hundreds of women, with a detrimental effect on their physical and mental health. Approximately 50% of RPL are not associated to any of the currently known etiology and will be considered idiopathic. Recently, it has been demonstrated that the expression of annexin 5 (ANXA5), a protein found on the trophoblastic surface, plays a fundamental role in the development of pregnancy due to its immunomodulator and anticoagulant function at the placentary level. Some genetic haplotypes of ANXA5 are associated to alterations in the expression of this gene, such as haplotype M2 which is associated to a decrease in the expression of ANXA5. The presence of this haplotype is related to the following conditions occurring during pregnancy: RPL, foetal intrauterine growth restriction, low child weight at birth, preeclampsia and maternal pulmonary thromboembolism. This review describes the structure, function and genetic expression of ANXA5, as well as its possible implication in RPL.

  16. Urban legends: recurrent aphthous stomatitis.

    PubMed

    Baccaglini, L; Lalla, R V; Bruce, A J; Sartori-Valinotti, J C; Latortue, M C; Carrozzo, M; Rogers, R S

    2011-11-01

    Recurrent aphthous stomatitis (RAS) is the most common idiopathic intraoral ulcerative disease in the USA. Aphthae typically occur in apparently healthy individuals, although an association with certain systemic diseases has been reported. Despite the unclear etiopathogenesis, new drug trials are continuously conducted in an attempt to reduce pain and dysfunction. We investigated four controversial topics: (1) Is complex aphthosis a mild form of Behçet's disease (BD)? (2) Is periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome a distinct medical entity? (3) Is RAS associated with other systemic diseases [e.g., celiac disease (CD) and B12 deficiency]? (4) Are there any new RAS treatments? Results from extensive literature searches, including a systematic review of RAS trials, suggested the following: (1) Complex aphthosis is not a mild form of BD in North America or Western Europe; (2) Diagnostic criteria for PFAPA have low specificity and the characteristics of the oral ulcers warrant further studies; (3) Oral ulcers may be associated with CD; however, these ulcers may not be RAS; RAS is rarely associated with B12 deficiency; nevertheless, B12 treatment may be beneficial, via mechanisms that warrant further study; (4) Thirty-three controlled trials published in the past 6 years reported some effectiveness, although potential for bias was high.

  17. Recurrent gene mutations in CLL.

    PubMed

    Martínez-Trillos, Alejandra; Quesada, Víctor; Villamor, Neus; Puente, Xose S; López-Otín, Carlos; Campo, Elías

    2013-01-01

    Next-generation sequencing of whole genomes and exomes in chronic lymphocytic leukemia (CLL) has provided the first comprehensive view of somatic mutations in this disease. Subsequent studies have characterized the oncogenic pathways and clinical implications of a number of these mutations. The global number of somatic mutations per case is lower than those described in solid tumors but is in agreement with previous estimates of less than one mutation per megabase in hematological neoplasms. The number and pattern of somatic mutations differ in tumors with unmutated and mutated IGHV, extending at the genomic level the clinical differences observed in these two CLL subtypes. One of the striking conclusions of these studies has been the marked genetic heterogeneity of the disease, with a relatively large number of genes recurrently mutated at low frequency and only a few genes mutated in up to 10-15 % of the patients. The mutated genes tend to cluster in different pathways that include NOTCH1 signaling, RNA splicing and processing machinery, innate inflammatory response, Wnt signaling, and DNA damage and cell cycle control, among others. These results highlight the molecular heterogeneity of CLL and may provide new biomarkers and potential therapeutic targets for the diagnosis and management of the disease.

  18. Prospective Study of Plasmodium vivax Malaria Recurrence after Radical Treatment with a Chloroquine-Primaquine Standard Regimen in Turbo, Colombia

    PubMed Central

    Blair, Silvia; Akinyi Okoth, Sheila; Udhayakumar, Venkatachalam; Marcet, Paula L.; Escalante, Ananias A.; Alexander, Neal; Rojas, Carlos

    2016-01-01

    Plasmodium vivax recurrences help maintain malaria transmission. They are caused by recrudescence, reinfection, or relapse, which are not easily differentiated. A longitudinal observational study took place in Turbo municipality, Colombia. Participants with uncomplicated P. vivax infection received supervised treatment concomitantly with 25 mg/kg chloroquine and 0.25 mg/kg/day primaquine for 14 days. Incidence of recurrence was assessed over 180 days. Samples were genotyped, and origins of recurrences were established. A total of 134 participants were enrolled between February 2012 and July 2013, and 87 were followed for 180 days, during which 29 recurrences were detected. The cumulative incidence of first recurrence was 24.1% (21/87) (95% confidence interval [CI], 14.6 to 33.7%), and 86% (18/21) of these events occurred between days 51 and 110. High genetic diversity of P. vivax strains was found, and 12.5% (16/128) of the infections were polyclonal. Among detected recurrences, 93.1% (27/29) of strains were genotyped as genetically identical to the strain from the previous infection episode, and 65.5% (19/29) of infections were classified as relapses. Our results indicate that there is a high incidence of P. vivax malaria recurrence after treatment in Turbo municipality, Colombia, and that a large majority of these episodes are likely relapses from the previous infection. We attribute this to the primaquine regimen currently used in Colombia, which may be insufficient to eliminate hypnozoites. PMID:27185794

  19. Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial

    PubMed Central

    Huijbers, Marloes J.; Spinhoven, Philip; Spijker, Jan; Ruhé, Henricus G.; van Schaik, Digna J. F.; van Oppen, Patricia; Nolen, Willem A.; Ormel, Johan; Kuyken, Willem; van der Wilt, Gert Jan; Blom, Marc B. J.; Schene, Aart H.; Rogier, A.; Donders, T.; Speckens, Anne E. M.

    2016-01-01

    Background Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. Aims To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM. Method A multicentre randomised controlled non-inferiority trial (ClinicalTrials.gov: NCT00928980). Adults with recurrent depression in remission, using mADM for 6 months or longer (n = 249), were randomly allocated to either discontinue (n = 128) or continue (n = 121) mADM after MBCT. The primary outcome was depressive relapse/recurrence within 15 months. A confidence interval approach with a margin of 25% was used to test non-inferiority. Key secondary outcomes were time to relapse/recurrence and depression severity. Results The difference in relapse/recurrence rates exceeded the non-inferiority margin and time to relapse/recurrence was significantly shorter after discontinuation of mADM. There were only minor differences in depression severity. Conclusions Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT. PMID:26892847

  20. Efficient Computation Of Confidence Intervals Of Parameters

    NASA Technical Reports Server (NTRS)

    Murphy, Patrick C.

    1992-01-01

    Study focuses on obtaining efficient algorithm for estimation of confidence intervals of ML estimates. Four algorithms selected to solve associated constrained optimization problem. Hybrid algorithms, following search and gradient approaches, prove best.

  1. Application of Interval Analysis to Error Control.

    DTIC Science & Technology

    1976-09-01

    We give simple examples of ways in which interval arithmetic can be used to alert instabilities in computer algorithms , roundoff error accumulation, and even the effects of hardware inadequacies. This paper is primarily tutorial. (Author)

  2. Intact Interval Timing in Circadian CLOCK Mutants

    PubMed Central

    Cordes, Sara; Gallistel, C. R.

    2008-01-01

    While progress has been made in determining the molecular basis for the circadian clock, the mechanism by which mammalian brains time intervals measured in seconds to minutes remains a mystery. An obvious question is whether the interval timing mechanism shares molecular machinery with the circadian timing mechanism. In the current study, we trained circadian CLOCK +/− and −/− mutant male mice in a peak-interval procedure with 10 and 20-s criteria. The mutant mice were more active than their wild-type littermates, but there were no reliable deficits in the accuracy or precision of their timing as compared with wild-type littermates. This suggests that expression of the CLOCK protein is not necessary for normal interval timing. PMID:18602902

  3. A robust measure of food web intervality

    PubMed Central

    Stouffer, Daniel B.; Camacho, Juan; Amaral, Luís A. Nunes

    2006-01-01

    Intervality of a food web is related to the number of trophic dimensions characterizing the niches in a community. We introduce here a mathematically robust measure for food web intervality. It has previously been noted that empirical food webs are not strictly interval; however, upon comparison to suitable null hypotheses, we conclude that empirical food webs actually do exhibit a strong bias toward contiguity of prey, that is, toward intervality. Further, our results strongly suggest that empirically observed species and their diets can be mapped onto a single dimension. This finding validates a critical assumption in the recently proposed static niche model and provides guidance for ongoing efforts to develop dynamic models of ecosystems. PMID:17146055

  4. Inguinal hernia recurrence: Classification and approach

    PubMed Central

    Campanelli, Giampiero; Pettinari, Diego; Cavalli, Marta; Avesani, Ettore Contessini

    2006-01-01

    The authors reviewed the records of 2,468 operations of groin hernia in 2,350 patients, including 277 recurrent hernias updated to January 2005. The data obtained - evaluating technique, results and complications - were used to propose a simple anatomo-clinical classification into three types which could be used to plan the surgical strategy: Type R1: first recurrence ‘high,’ oblique external, reducible hernia with small (<2 cm) defect in non-obese patients, after pure tissue or mesh repairType R2: first recurrence ‘low,’ direct, reducible hernia with small (<2 cm) defect in non-obese patients, after pure tissue or mesh repairType R3: all the other recurrences - including femoral recurrences; recurrent groin hernia with big defect (inguinal eventration); multirecurrent hernias; nonreducible, linked with a controlateral primitive or recurrent hernia; and situations compromised from aggravating factors (for example obesity) or anyway not easily included in R1 or R2, after pure tissue or mesh repair. PMID:21187986

  5. Recurrent neural processing and somatosensory awareness.

    PubMed

    Auksztulewicz, Ryszard; Spitzer, Bernhard; Blankenburg, Felix

    2012-01-18

    The neural mechanisms of stimulus detection, despite extensive research, remain elusive. The recurrent processing hypothesis, a prominent theoretical account of perceptual awareness, states that, although stimuli might in principle evoke feedforward activity propagating through the visual cortex, stimuli that become consciously detected are further processed in feedforward-feedback loops established between cortical areas. To test this theory in the tactile modality, we applied dynamic causal modeling to electroencephalography (EEG) data acquired from humans in a somatosensory detection task. In the analysis of stimulation-induced event-related potentials (ERPs), we focused on model-based evidence for feedforward, feedback, and recurrent processing between primary and secondary somatosensory cortices. Bayesian model comparison revealed that, although early EEG components were well explained by both the feedforward and the recurrent models, the recurrent model outperformed the other models when later EEG segments were analyzed. Within the recurrent model, stimulus detection was characterized by a relatively early strength increase of the feedforward connection from primary to secondary somatosensory cortex (>80 ms). At longer latencies (>140 ms), also the feedback connection showed a detection-related strength increase. The modeling results on relative evidence between recurrent and feedforward model comparison support the hypothesis that the ERP responses from sensory areas arising after aware stimulus detection can be explained by increased recurrent processing within the somatosensory network in the later stages of stimulus processing.

  6. Tea and Recurrent Clostridium difficile Infection

    PubMed Central

    Starley, Brad; Galagan, Jack Carl; Yabes, Joseph Michael; Evans, Sara

    2016-01-01

    Background and Aims. Studies have shown effects of diet on gut microbiota. We aimed to identify foods associated with recurrent Clostridium difficile infection (CDI). Methods. In this cross-sectional survey, consecutive patients diagnosed with CDI were identified by electronic medical records. Colitis symptoms and positive Clostridium difficile assay were confirmed. Health-care onset-health-care facility associated CDI was excluded. Food surveys were mailed to 411 patients. Survey responses served as the primary outcome measure. Spearman's rank correlation identified risk factors for CDI recurrence. Results. Surveys were returned by 68 patients. Nineteen patients experienced CDI recurrence. Compared to patients without CDI recurrence, patients with CDI recurrence had more antibiotics prescribed preceding their infection (p = 0.003). Greater numbers of the latter also listed tea (p = 0.002), coffee (p = 0.013), and eggs (p = 0.013), on their 24-hour food recall. Logistic regression identified tea as the only food risk factor for CDI recurrence (adjusted OR: 5.71; 95% CI: 1.26–25.89). Conclusion. The present results indicate a possible association between tea and CDI recurrence. Additional studies are needed to characterize and confirm this association. PMID:27651790

  7. Opioids and Breast Cancer Recurrence: A Danish population-based cohort study

    PubMed Central

    Cronin-Fenton, D.P.; Heide-Jørgensen, U.; Ahern, T.P.; Lash, T.L.; Christiansen, P.M.; Ejlertsen, B.; Sjøgren, P.; Kehlet, H.; Sørensen, H.T.

    2015-01-01

    Background Opioids may alter immune function and thereby potentially affect cancer recurrence. We investigated the association between post-diagnosis opioid use and breast cancer recurrence. Methods We identified incident early-stage breast cancer patients, diagnosed 1996-2008 in Denmark, registered in the Danish Breast Cancer Cooperative Group Registry. Opioid prescriptions were ascertained from the Danish National Prescription Registry. Follow-up began on the date of breast cancer primary surgery and continued until breast cancer recurrence, death, emigration, ten years, or 31 July 2013, whichever occurred first. We used Cox regression models to compute hazard ratios (HRs) and 95% confidence intervals (95%CI) associating breast cancer recurrence with opioid prescription use overall, and by opioid type and strength, immunosuppressive effect, chronic use (>=6 months continuous exposure), and cumulative morphine-equivalent dose, adjusting for confounders. Results We identified 34,188 patients who together contributed 283,666 person-years of follow-up. There was no association between ever use of opioids and breast cancer recurrence (HRcrude=0.98, 95% CI=0.90 - 1.1, and HRadjusted=1.0, 95% CI=0.92 - 1.1), regardless of opioid type, strength, chronicity of use, and cumulative dose. Breast cancer recurrence rates were lower among users of strong but not weakly immunosuppressive opioids, possibly due to channeling bias among those with high competing risk as mortality was higher among users of this drug type. Conclusions This large prospective cohort study provided no clinically relevant evidence of an association between opioid prescriptions and breast cancer recurrence. Our findings are important to cancer survivorship, as opioids are frequently used to manage pain associated with comorbid conditions. PMID:26207518

  8. Diabetic Cardiovascular Autonomic Neuropathy Predicts Recurrent Cardiovascular Diseases in Patients with Type 2 Diabetes

    PubMed Central

    Cha, Seon-Ah; Yun, Jae-Seung; Lim, Tae-Seok; Min, Kyoungil; Song, Ki-Ho; Yoo, Ki-Dong; Park, Yong-Moon; Ahn, Yu-Bae

    2016-01-01

    Cardiovascular autonomic neuropathy (CAN) is a risk factor for cardiovascular disease (CVD) and mortality in patients with type 2 diabetes. This study evaluated the relationship between CAN and recurrent CVD in type 2 diabetes. A total of 206 patients with type 2 diabetes who had a history of CVD within 3 years of enrollment were consecutively recruited from January 2001 to December 2009 and followed-up until December 2015. Cardiovascular autonomic function tests were performed using the following heart rate variability parameters: expiration-to-inspiration ratio, response to Valsalva maneuver and standing. We estimated the recurrence of CVD events during the follow-up period. A total of 159 (77.2%) of the 206 patients enrolled completed the follow up, and 78 (49.1%) patients had recurrent episodes of CVD, with an incidence rate of 75.6 per 1,000 patient-years. The mean age and diabetes duration were 62.5 ± 8.7 and 9.2 ± 6.9 years, respectively. Patients who developed recurrent CVD also exhibited hypertension (P = 0.004), diabetic nephropathy (P = 0.012), higher mean systolic blood pressure (P = 0.006), urinary albumin excretion (P = 0.015), and mean triglyceride level (P = 0.035) than did patients without recurrent CVD. Multivariable Cox hazard regression analysis revealed that definite CAN was significantly associated with an increased risk of recurrent CVD (hazard ratio [HR] 3.03; 95% confidence interval [CI] 1.39−6.60; P = 0.005). Definite CAN was an independent predictor for recurrent CVD in patients with type 2 diabetes who had a known prior CVD event. PMID:27741306

  9. Reproductive steroid hormones and recurrence-free survival in women with a history of breast cancer.

    PubMed

    Rock, Cheryl L; Flatt, Shirley W; Laughlin, Gail A; Gold, Ellen B; Thomson, Cynthia A; Natarajan, Loki; Jones, Lovell A; Caan, Bette J; Stefanick, Marcia L; Hajek, Richard A; Al-Delaimy, Wael K; Stanczyk, Frank Z; Pierce, John P

    2008-03-01

    Epidemiologic studies fairly consistently show in postmenopausal women that reproductive steroid hormones contribute to primary breast cancer risk, and this association is strongly supported by experimental studies using laboratory animals and model systems. Evidence linking sex hormone concentrations with risk for recurrence in women diagnosed with breast cancer is limited; however, beneficial effects of antiestrogenic therapy on recurrence-free survival suggest that these hormones affect progression and risk for recurrence. This study examined whether baseline serum concentrations of estradiol, testosterone, and sex hormone binding globulin were associated with recurrence-free survival in a nested case-control cohort of women from a randomized diet trial (Women's Healthy Eating and Living Study) who were followed for >7 years after diagnosis. In 153 case-control pairs of perimenopausal and postmenopausal women in this analysis, total estradiol [hazard ratio (HR), 1.41 per unit increase in log concentration; 95% confidence interval (95% CI), 1.01-1.97], bioavailable estradiol (HR, 1.26; 95% CI, 1.03-1.53), and free estradiol (HR, 1.31; 95% CI, 1.03-1.65) concentrations were significantly associated with risk for recurrence. Recurred women had an average total estradiol concentration that was double that of nonrecurred women (22.7 versus 10.8 pg/mL; P = 0.05). Testosterone and sex hormone binding globulin concentrations did not differ between cases and controls and were not associated with risk for recurrence. Although genetic and metabolic factors likely modulate the relationship between circulating sex hormones and risk, results from this study provide evidence that higher serum estrogen concentration contributes to risk for recurrence in women diagnosed with early stage breast cancer.

  10. Management of low transsphincteric anal fistula with serial setons and interval muscle-cutting fistulotomy.

    PubMed

    Wang, Chen; Rosen, Lester

    2016-03-01

    This study evaluates low transsphincteric anal fistula managed by serial setons and interval fistulotomy, with attention to healing without recurrence and preservation of continence. Following Institutional Review Board approval, consecutive anal fistula operations performed by a single surgeon from January 1, 2009 to December 31, 2013 were retrospectively reviewed using electronic medical records and telephone interviews for patients lost to follow up. Of the 71 patients, 26 (37%) had low transsphincteric fistula (23 males and 3 females; mean age: 46 years), treated at our institution by seton placement followed by interval surgical muscle cutting and subsequent seton replacement or final fistulotomy. Of the 26 patients, 22 (85%) were initially referred due to previous failed treatment, with a 30.6 month mean duration of fistula prior to referral and a mean of 2.2 (range: 0 -6) prior anorectal surgeries. At a mean follow-up of 11.9 months, none of the 21 patients experienced recurrence or fecal incontinence. Serial seton with interval muscle-cutting sphincterotomy followed by complete fistulotomy is an effective treatment for the management of patients who are either initially seen for low transsphincteric fistula, or referred after failed anorectal surgery for that condition.

  11. Return volatility interval analysis of stock indexes during a financial crash

    NASA Astrophysics Data System (ADS)

    Li, Wei-Shen; Liaw, Sy-Sang

    2015-09-01

    We investigate the interval between return volatilities above a certain threshold q for 10 countries data sets during the 2008/2009 global financial crisis, and divide these data into several stages according to stock price tendencies: plunging stage (stage 1), fluctuating or rebounding stage (stage 2) and soaring stage (stage 3). For different thresholds q, the cumulative distribution function always satisfies a power law tail distribution. We find the absolute value of the power-law exponent is lowest in stage 1 for various types of markets, and increases monotonically from stage 1 to stage 3 in emerging markets. The fractal dimension properties of the return volatility interval series provide some surprising results. We find that developed markets have strong persistence and transform to weaker correlation in the plunging and soaring stages. In contrast, emerging markets fail to exhibit such a transformation, but rather show a constant-correlation behavior with the recurrence of extreme return volatility in corresponding stages during a crash. We believe this long-memory property found in recurrence-interval series, especially for developed markets, plays an important role in volatility clustering.

  12. The utility of gadoxetic acid-enhanced magnetic resonance imaging in the surveillance for postoperative recurrence of hepatocellular carcinoma

    PubMed Central

    Kim, Jung Hee; Min, Yang Won; Gwak, Geum-Youn; Paik, Yong Han; Choi, Moon Seok; Lee, Joon Hyoek; Koh, Kwang Cheol; Paik, Seung Woon

    2016-01-01

    Abstract This study aimed to investigate the utility of gadoxetic acid-enhanced magnetic resonance imaging (Gd-MRI) in surveillance for recurrent hepatocellular carcinoma (HCC) after hepatectomy. This retrospective study analyzed 147 patients who underwent surveillance with alternating multidetector computed tomography (MDCT) and Gd-MRI after hepatectomy for HCC. The patients were followed-up every 3 months during the first 2 years, and every 6 months thereafter. At each visit, MDCT was performed but once a year (every 12 months), Gd-MRI was performed instead of MDCT. Each HCC recurrence detection rate of MDCT and Gd-MRI was evaluated, and recurrent HCC characteristics were compared according to the detection test. A total of 63 patients had recurrent HCC. Among them, 9 were detected with Gd-MRI and 29 with MDCT. The baseline characteristics of patients with recurrent HCC showed no significant differences according to the detection test. The HCC recurrence detection rate of Gd-MRI and MDCT was 4.8% (9/180) and 4.3% (29/580), respectively, on the per test basis (P = 0.764). However, in the population with a follow-up period of ≥12 months, the detection rate of Gd-MRI and MDCT was 4.3% (7/150) and 1.5% (19/400), respectively (P = 0.035). Recurrent HCCs detected with Gd-MRI were smaller than those detected with MDCT (tumor size < 2 cm, 100% vs 65.5%, P = 0.040). Our data suggest that Gd-MRI has advantages in detecting recurrent HCC after hepatectomy. Surveillance with alternating MDCT and Gd-MRI may identify more recurrent HCC in an early stage than with MDCT alone in patients who received hepatectomy for HCC. PMID:28002336

  13. Interval and contour processing in autism.

    PubMed

    Heaton, Pamela

    2005-12-01

    High functioning children with autism and age and intelligence matched controls participated in experiments testing perception of pitch intervals and musical contours. The finding from the interval study showed superior detection of pitch direction over small pitch distances in the autism group. On the test of contour discrimination no group differences emerged. These findings confirm earlier studies showing facilitated pitch processing and a preserved ability to represent small-scale musical structures in autism.

  14. Periodicity In The Intervals Between Primes

    DTIC Science & Technology

    2015-07-02

    statistically strong periodicity is identified in the counting function giving the total number of intervals of a certain size. The nature of the periodic...positive intervals among the first n<=10^6 prime numbers as a probe of the global nature of the sequence of primes. A statistically strong periodicity is...Let x = x1, x2, . . . be an increasing sequence of real numbers which may be either finite or infinitely long. Throughout the following every bold

  15. Tantalum trabecular metal implants in anterior cervical corpectomy and fusion: 2-year prospective analysis.

    PubMed

    King, V; Swart, A; Winder, M J

    2016-10-01

    Anterior cervical decompression for two or more cervical spondylotic levels can be performed using either multiple anterior cervical discectomies and fusion or anterior cervical corpectomy and fusion (ACCF). A variety of options for ACCF implants exist but to our knowledge, there is no clinical data for the use of tantalum trabecular metal implants (TTMI) for ACCF. A retrospective review was performed of prospectively collected data for ten patients undergoing ACCF with TTMI between 2011 and 2012. Radiological outcome was assessed by measuring the change in cervical (C) lordosis (fusion Cobb and C2-C7 Cobb), graft subsidence (anterior/posterior, determined by the subsidence of anterior/posterior body height of fused segments; cranial/caudal, determined by the cranial/caudal plate-to-disc distances) and rate of fusion using lateral cervical X-rays of patients at 0, 6, 12 and 24months post-operatively. The Neck Disability Index (NDI) assessed clinical outcome pre-operatively and at 6, 12 and 24months post-operatively. Cervical lordosis (Cobb angle of fused segment) was 5.2° (± 4.2°) at 0months and 6.0° (± 5.7°) at 24months post-operatively. Graft subsidence was observed to occur at 6months post-operatively and continued throughout follow-up. Anterior, posterior and caudal subsidence occurred more in the first 12months post-operatively than in the following 12months (p<0.05). Average pre-operative NDI was 45%. Average NDIs were 18%, 13% and 10% at 6, 12 and 24months post-operatively, respectively. ACCF patients treated with TTMI demonstrated stable cervical lordosis over 2years of follow-up and 100% fusion rates after 2years. Measures of subsidence appeared to decrease with time. Patients experienced improved clinical outcomes over the 2-year period.

  16. Clinically Significant Behavior Problems among Young Children 2 Years after the Great East Japan Earthquake

    PubMed Central

    Fujiwara, Takeo; Yagi, Junko; Homma, Hiroaki; Mashiko, Hirobumi; Nagao, Keizo; Okuyama, Makiko

    2014-01-01

    Background On March 11, 2011, a massive undersea earthquake and tsunami struck East Japan. Few studies have investigated the impact of exposure to a natural disaster on preschool children. We investigated the association of trauma experiences during the Great East Japan Earthquake on clinically significant behavior problems among preschool children 2 years after the earthquake. Method Participants were children who were exposed to the 2011 disaster at preschool age (affected area, n = 178; unaffected area, n = 82). Data were collected from September 2012 to June 2013 (around 2 years after the earthquake), thus participants were aged 5 to 8 years when assessed. Severe trauma exposures related to the earthquake (e.g., loss of family members) were assessed by interview, and trauma events in the physical environment related to the earthquake (e.g. housing damage), and other trauma exposure before the earthquake, were assessed by questionnaire. Behavior problems were assessed by caregivers using the Child Behavior Checklist (CBCL), which encompasses internalizing, externalizing, and total problems. Children who exceeded clinical cut-off of the CBCL were defined as having clinically significant behavior problems. Results Rates of internalizing, externalizing, and total problems in the affected area were 27.7%, 21.2%, and 25.9%, respectively. The rate ratio suggests that children who lost distant relatives or friends were 2.36 times more likely to have internalizing behavior problems (47.6% vs. 20.2%, 95% CI: 1.10–5.07). Other trauma experiences before the earthquake also showed significant positive association with internalizing, externalizing, and total behavior problems, which were not observed in the unaffected area. Conclusions One in four children still had behavior problems even 2 years after the Great East Japan Earthquake. Children who had other trauma experiences before the earthquake were more likely to have behavior problems. These data will be

  17. Altered corpus callosum morphology associated with autism over the first 2 years of life.

    PubMed

    Wolff, Jason J; Gerig, Guido; Lewis, John D; Soda, Takahiro; Styner, Martin A; Vachet, Clement; Botteron, Kelly N; Elison, Jed T; Dager, Stephen R; Estes, Annette M; Hazlett, Heather C; Schultz, Robert T; Zwaigenbaum, Lonnie; Piven, Joseph

    2015-07-01

    Numerous brain imaging studies indicate that the corpus callosum is smaller in older children and adults with autism spectrum disorder. However, there are no published studies examining the morphological development of this connective pathway in infants at-risk for the disorder. Magnetic resonance imaging data were collected from 270 infants at high familial risk for autism spectrum disorder and 108 low-risk controls at 6, 12 and 24 months of age, with 83% of infants contributing two or more data points. Fifty-seven children met criteria for ASD based on clinical-best estimate diagnosis at age 2 years. Corpora callosa were measured for area, length and thickness by automated segmentation. We found significantly increased corpus callosum area and thickness in children with autism spectrum disorder starting at 6 months of age. These differences were particularly robust in the anterior corpus callosum at the 6 and 12 month time points. Regression analysis indicated that radial diffusivity in this region, measured by diffusion tensor imaging, inversely predicted thickness. Measures of area and thickness in the first year of life were correlated with repetitive behaviours at age 2 years. In contrast to work from older children and adults, our findings suggest that the corpus callosum may be larger in infants who go on to develop autism spectrum disorder. This result was apparent with or without adjustment for total brain volume. Although we did not see a significant interaction between group and age, cross-sectional data indicated that area and thickness differences diminish by age 2 years. Regression data incorporating diffusion tensor imaging suggest that microstructural properties of callosal white matter, which includes myelination and axon composition, may explain group differences in morphology.

  18. Preterm infant gut colonization in the neonatal ICU and complete restoration 2 years later.

    PubMed

    Moles, L; Gómez, M; Jiménez, E; Fernández, L; Bustos, G; Chaves, F; Cantón, R; Rodríguez, J M; Del Campo, R

    2015-10-01

    Preterm infants in a neonatal intensive care unit (NICU) are exposed to multidrug-resistant bacteria previously adapted to the hospital environment. The aim of the present study was to characterize the bacterial antibiotic-resistant high-risk lineages colonizing preterm infants during their NICU stay and their persistence in faeces after 2 years. A total of 26 preterm neonates were recruited between October 2009 and June 2010 and provided 144 faecal samples. Milk samples (86 mother's milk, 35 human donor milk and 15 formula milk) were collected at the same time as faecal samples. An additional faecal sample was recovered in 16 infants at the age of 2 years. Samples were plated onto different selective media, and one colony per morphology was selected. Isolates were identified by 16S rDNA nucleotide sequence and MALDI-TOF. Antibiotic susceptibility (agar dilution), genetic diversity (RAPD, PFGE and MLST) and virulence factors (only in enterococcal and staphylococcal isolates) were determined by PCR. A high proportion of antibiotic-resistant high-risk clones was detected in both faecal and milk samples during the NICU admittance. Almost all infants were colonized by Enterococcus faecalis ST64 and Enterococcus faecium ST18 clones, while a wider genetic diversity was observed for the Gram-negative isolates. Multidrug-resistant high-risk clones were not recovered from the faecal samples of the 2-year-olds. In conclusion, the gut of preterm infants admitted to the NICU might be initially colonized by antibiotic-resistant and virulent high-risk lineages, which are later replaced by antibiotic-susceptible community ones.

  19. Analysis of regression confidence intervals and Bayesian credible intervals for uncertainty quantification

    NASA Astrophysics Data System (ADS)

    Lu, Dan; Ye, Ming; Hill, Mary C.

    2012-09-01

    Confidence intervals based on classical regression theories augmented to include prior information and credible intervals based on Bayesian theories are conceptually different ways to quantify parametric and predictive uncertainties. Because both confidence and credible intervals are used in environmental modeling, we seek to understand their differences and similarities. This is of interest in part because calculating confidence intervals typically requires tens to thousands of model runs, while Bayesian credible intervals typically require tens of thousands to millions of model runs. Given multi-Gaussian distributed observation errors, our theoretical analysis shows that, for linear or linearized-nonlinear models, confidence and credible intervals are always numerically identical when consistent prior information is used. For nonlinear models, nonlinear confidence and credible intervals can be numerically identical if parameter confidence regions defined using the approximate likelihood method and parameter credible regions estimated using Markov chain Monte Carlo realizations are numerically identical and predictions are a smooth, monotonic function of the parameters. Both occur if intrinsic model nonlinearity is small. While the conditions of Gaussian errors and small intrinsic model nonlinearity are violated by many environmental models, heuristic tests using analytical and numerical models suggest that linear and nonlinear confidence intervals can be useful approximations of uncertainty even under significantly nonideal conditions. In the context of epistemic model error for a complex synthetic nonlinear groundwater problem, the linear and nonlinear confidence and credible intervals for individual models performed similarly enough to indicate that the computationally frugal confidence intervals can be useful in many circumstances. Experiences with these groundwater models are expected to be broadly applicable to many environmental models. We suggest that for

  20. Food production and nutrition for the crew during the first 2-year closure of Biosphere 2.

    PubMed

    Silverstone, S E

    1997-01-01

    Biosphere 2's finite natural resources: atmosphere, plants, water, and soil, and its unique increased rate of nutrient cycling, mandated a design for the agriculture that emphasized sustainability and high productivity. The results of the initial 2-year test of the agriculture system showed that it could provide a diet that was both nutritionally adequate and pleasing to the palate of the eight-member crew from September 1991 to September 1993. The agriculture design was developed from 1985 to 1991 at the Space Biospheres research greenhouses with consulting from the Institute of Ecotechnics (London) from its experiments in New Mexico, Australia, and France and the Environmental Research Laboratory (University of Arizona). During the 2-year mission this research was continued with the close collaboration of outside scientific consultants, particularly in the area of soil management and integrated pest management. The 2000-m2 cropping area provided approximately 81% of the overall nutritional needs of the crew. Initial results showed light to be the main limiting factor and the additional electric light was added after the first 2-year mission to increase the productivity for future experiments. The diet was primarily vegetarian supplemented with daily amounts of milk, and weekly meals of meat and eggs from the system's domestic goats, pigs, and chickens. Nontoxic methods of pest and disease control were used. The main pest problems were broad mite and root knot nematode. Inedible plant material, domestic animal wastes, and human waste water were successfully processed for nutrient return to the soil. Eighty-six varieties of crops were grown in Biosphere 2. Major staple crops included rice, sweet potato, beets, banana, and papaya. The African pygmy goats were the most productive of the domestic animals producing on average 1.14 kg of milk per day. The diet averaged 2200 calories, 73 g of protein, and 32 g of fat per person per day over the 2 years. The crew had a 10

  1. Xanthomatous posterior pyramid meningioma in a 2-year-old girl.

    PubMed

    Germanò, A; Galatioto, S; La Rosa, G; Caffo, M; Cardia, E

    1997-07-01

    Meningiomas are common lesions in adults but unusual in infancy and meningiomas located in the posterior cranial fossa are even more rare. Metaplastic changes of meningothelial meningiomas can lead to the rarely observed xanthomatous form. We describe the case of a posterior pyramid xanthomatous meningioma in a 2-year-old girl. After detailed neuroradiological evaluation, the histological diagnosis was confirmed with the aid of immunohistochemical evaluation. A critical case evaluation in the light of the more recent literature, the surgical strategy and technique, and an immunohistological hypothesis are reported.

  2. Predictors of progression in atherosclerosis over 2 years in systemic lupus erythematosus

    PubMed Central

    Kiani, Adnan N.; Post, Wendy S.; Magder, Laurence S.

    2011-01-01

    Objectives. Cardiovascular disease remains the major cause of death in SLE. We assessed the degree to which cardiovascular risk factors (CVRFs) and disease activity were associated with 2-year changes in measures of subclinical atherosclerosis. Methods. One hundred and eighty-seven SLE patients participating in a placebo-controlled trial of atorvastatin underwent multi-detector CT [for coronary artery calcium (CAC)] and carotid duplex [for carotid intima–media thickness (IMT) and carotid plaque] twice, 2 years apart. During the 2 years, patients were assessed every 3 months for CVRF. Both groups were combined for analysis, as atorvastatin did not differ from placebo in preventing progression of coronary calcium. We examined the correlation between these clinical measures and progression of CAC, IMT and plaque during the follow-up period. Results. In an analysis adjusting for age, gender and ethnicity, CAC progression was positively associated with total serum cholesterol measured over the 2-year period (P = 0.04) and smoking (P = 0.003). Carotid IMT progression was associated with systolic BP (P = 0.003), high-sensitivity CRP (hsCRP) (P = 0.013) and white blood cell (WBC) count (P = 0.029). Carotid plaque progression, defined as patients without carotid plaque at baseline with subsequent development of plaque at follow-up, was associated with systolic BP (P = 0.003), WBC count (P = 0.02), physician's global assessment (P = 0.05), blood lymphocyte count (P = 0.048), urine protein (P = 0.017) and duration of SLE (P = 0.019). Conclusion. Our data did not provide evidence of an association between measures of SLE disease activity (SLEDAI, anti-dsDNA, anti-phospholipid and treatment) and progression of subclinical atherosclerosis. Age and hypertension were associated with the progression of carotid IMT and plaque. Age, smoking and cholesterol were associated with progression of CAC. PMID:21875880

  3. Probability Distribution for Flowing Interval Spacing

    SciTech Connect

    S. Kuzio

    2004-09-22

    Fracture spacing is a key hydrologic parameter in analyses of matrix diffusion. Although the individual fractures that transmit flow in the saturated zone (SZ) cannot be identified directly, it is possible to determine the fractured zones that transmit flow from flow meter survey observations. The fractured zones that transmit flow as identified through borehole flow meter surveys have been defined in this report as flowing intervals. The flowing interval spacing is measured between the midpoints of each flowing interval. The determination of flowing interval spacing is important because the flowing interval spacing parameter is a key hydrologic parameter in SZ transport modeling, which impacts the extent of matrix diffusion in the SZ volcanic matrix. The output of this report is input to the ''Saturated Zone Flow and Transport Model Abstraction'' (BSC 2004 [DIRS 170042]). Specifically, the analysis of data and development of a data distribution reported herein is used to develop the uncertainty distribution for the flowing interval spacing parameter for the SZ transport abstraction model. Figure 1-1 shows the relationship of this report to other model reports that also pertain to flow and transport in the SZ. Figure 1-1 also shows the flow of key information among the SZ reports. It should be noted that Figure 1-1 does not contain a complete representation of the data and parameter inputs and outputs of all SZ reports, nor does it show inputs external to this suite of SZ reports. Use of the developed flowing interval spacing probability distribution is subject to the limitations of the assumptions discussed in Sections 5 and 6 of this analysis report. The number of fractures in a flowing interval is not known. Therefore, the flowing intervals are assumed to be composed of one flowing zone in the transport simulations. This analysis may overestimate the flowing interval spacing because the number of fractures that contribute to a flowing interval cannot be

  4. Successful ABO-incompatible living-related intestinal transplantation: a 2-year follow-up.

    PubMed

    Fan, D M; Zhao, Q C; Wang, W Z; Shi, H; Wang, M; Chen, D L; Zheng, J Y; Li, M B; Wu, G S

    2015-05-01

    ABO-incompatible intestinal transplantation has rarely been performed due to poor patient outcomes. Herein we present a case of successful ABO-incompatible intestinal transplantation with a 2-year follow-up. A 16-year-old female with a history of extensive bowel resection received an ABO-incompatible living donor bowel graft from her father (blood type AB graft into a type A recipient). Posttransplant immunosuppression consisted of an initial anti-CD20, plasmapheresis/intravenous immunoglobulin before transplantation, followed by an anti-thymocyte globulin (ATG) induction and splenectomy, and maintenance with tacrolimus and prednisone. Her postoperative course was remarkable for a single episode of rejection on day 14 which responded promptly to treatment with methyprednisolone and ATG. Three months after transplantation, the patient developed an abdominal abscess requiring open surgical drainage. No viral infections were encountered. Posttransplant anti-B antibody titers and anti-B7 donor-specific antibody levels remained low. At a 2-year follow-up, the patient showed a progressive weight gain of 5.0 kg. This case illustrates that ABO-incompatible living-related bowel transplantation is immunologically feasible and is associated with good outcomes for the recipient. The management of blood type antibodies and the use of adequate immunosuppression in the early period of the procedure may be the keys to the success of future cases.

  5. Contrastive voicing acquisition in 2-year-old children: Preliminary data

    NASA Astrophysics Data System (ADS)

    Hitchcock, Elaine R.; Koenig, Laura L.

    2004-05-01

    Earlier studies using voice-onset time (VOT) as the acoustic marker of contrastive voicing acquisition in English have differed widely in method and statistical procedures. Research in this area has shown three primary patterns of voicing acquisition for English stop consonants. One report indicates children demonstrate discrete voicing categories with adult-like VOT values as early as 2 years old. Other reports suggest a subperceptual distinction of the voicing contrast, followed by an exaggerated voicing contrast with evidence of more adult-like discrete categories by 3 years old. Still other reports suggest no distinction between the voicing categories until approximately 3 years. This work investigates voicing acquisition in three typically developing, English-speaking 2-year-old children. The subjects were recorded every 2 weeks for 4-6 months. Approximately 15-20 tokens were elicited for four target utterances containing initial /b p t d/. Frequency distribution, measures of central tendency, and skewness will be calculated for every recording session of each child. Discussion will focus on the development of contrastive VOT categories and their stability over time. These data will contribute to our understanding of laryngeal timing for English stop consonants in young children.

  6. The OAO heat pipes - 8 1/2 years of flight data

    NASA Technical Reports Server (NTRS)

    Harwell, W.; Mcintosh, R.

    1981-01-01

    Heat pipe performance data taken during the 8 1/2 years of flight of the OAO-C (Copernicus) spacecraft are presented. Three fixed conductance heat pipes (FCHP), each with different wicking concepts (axial groove, pedestal artery, and self-priming spiral artery), and one variable conductance heat pipe (VCHP) are onboard. Aluminum tubes (1/2 in. diameter) rolled into a 48 in. loop containing ultra high purity ammonia as the heat transfer fluid comprise all FCHP, whose purpose is to circumferentially isothermalize the central tube housing the telescope. The VCHP is a hot, non-wicked reservoir concept including a composite artery and methanol heat transfer fluid, and is used to maintain the temperature of the onboard processor. Flight thermal data analysis reveals that no degradation in performance occurred since launch and agrees well with pre-flight data; the onboard processor still shows an offset in control range of 4 F, and the pipes perform the same after 8 1/2 years in orbit.

  7. Phonetic Modification of Vowel Space in Storybook Speech to Infants up to 2 Years of Age

    PubMed Central

    Burnham, Evamarie B.; Wieland, Elizabeth A.; Kondaurova, Maria V.; McAuley, J. Devin; Bergeson, Tonya R.

    2015-01-01

    Purpose A large body of literature has indicated vowel space area expansion in infant-directed (ID) speech compared with adult-directed (AD) speech, which may promote language acquisition. The current study tested whether this expansion occurs in storybook speech read to infants at various points during their first 2 years of life. Method In 2 studies, mothers read a storybook containing target vowels in ID and AD speech conditions. Study 1 was longitudinal, with 11 mothers recorded when their infants were 3, 6, and 9 months old. Study 2 was cross-sectional, with 48 mothers recorded when their infants were 3, 9, 13, or 20 months old (n = 12 per group). The 1st and 2nd formants of vowels /i/, /ɑ/, and /u/ were measured, and vowel space area and dispersion were calculated. Results Across both studies, 1st and/or 2nd formant frequencies shifted systematically for /i/ and /u/ vowels in ID compared with AD speech. No difference in vowel space area or dispersion was found. Conclusions The results suggest that a variety of communication and situational factors may affect phonetic modifications in ID speech, but that vowel space characteristics in speech to infants stay consistent across the first 2 years of life. PMID:25659121

  8. Evaluation of laparoscopic skills: a 2-year follow-up during residency training

    PubMed Central

    Derossis, Anna M.; Antoniuk, Maureen; Fried, Gerald M.

    1999-01-01

    Objective To evaluate laparoscopic technical skill in surgical residents over a 2-year period. Design The laparoscopic technical skills of general surgical residents were evaluated using the MISTELS program. This provides an objective evaluation of laparoscopic skill, taking into account precision and speed. Setting Inanimate laparoscopic skills centre. Participants Ten general surgical residents (5 PGY1, 3 PGY2 and 2 PGY3 residents) who were required to complete 3 structured laparoscopic tasks. Outcome measures A composite score incorporating precision and timing was assigned to each task. The paired t-test was used to compare performance of each resident at the 2 levels of their residency training for each task. Linear regression analysis was used to correlate level of training and total score (sum of all tasks). Results Linear regression analysis demonstrated a highly significant correlation between level of training and total score (r = 0.82, p < 0.01). There was a significant increase in scores in the cutting and suturing task over the 2-year period (p < 0.01). Transferring skills did not improve significantly (p = 0.11). Conclusions Performance in the simulator improved over residency training and was correlated highly with postgraduate year. This simulator model is a valuable teaching tool for training and evaluation of basic laparoscopic tasks in laparoscopic surgery. PMID:10459330

  9. Comparison of wear and clinical performance between amalgam, composite and open sandwich restorations: 2-year results.

    PubMed

    Sachdeo, A; Gray, Gordon B; Sulieman, M A; Jagger, Daryll C

    2004-03-01

    There has been some disquiet over the use of mercury containing restorative materials. The most commonly used alternative is composite resin but this has the potential disadvantage associated with wear and marginal leakage, which in turn, has proven to result in secondary caries and sensitivity. To overcome the shortcomings of a directly placed composite restoration, the glass-ionomer/composite open sandwich technique was introduced followed by the subsequent introduction of compomer systems. The aims of this study were to evaluate the wear and clinical performance of a control group of amalgam restorations compared with that of a group of posterior composite resin restorations fillings and a group of compomer/composite open sandwich restorations placed by a single general dental practitioner. The duration of the study was 2 years. One hundred and thirty three (71.4%) patients were successfully recalled and the wear and clinical performance of each restoration after 6, 12 and 24 months was measured, indirectly. There was no statistically significant difference recorded between the groups at 6 months or 1 year (p > 0.05). However, at the end of the 2-year study, there was a significantly lower rate of wear recorded for the control amalgam restorations compared with other two groups (p = 0.033). There was no statistically significant difference in wear recorded between the two groups of tooth-coloured restorations (p > 0.05). With regards to clinical performance of the restorations, occlusal and proximal contacts in each group of restoration remained satisfactory throughout the study.

  10. Breastfeeding and complementary feeding of children up to 2 years of age.

    PubMed

    Brown, Kenneth H

    2007-01-01

    Appropriate breastfeeding and complementary feeding practices are fundamental to children's nutrition, health, and survival during the first 2 years of life. The World Health Organization recommends exclusive breastfeeding until 6 months of age and continued breastfeeding for at least 2 years, along with the timely introduction of adequate amounts of complementary foods of suitable nutritional and microbiological quality. The amounts of energy and micronutrients required from complementary foods have been estimated as the difference between the total physiological requirements of these food components and the amounts transferred to the child in breast milk. Recommendations for the energy density of complementary foods and their frequency of feeding have also been proposed. Intakes of several micronutrients, including iron, zinc, calcium, selected B vitamins and (in some settings) vitamin A, remain problematic because commonly available, low-cost foods contain inadequate amounts of these nutrients to provide the shortfall in breast milk. Alternative strategies to provide these nutrients include adding animal source foods to the diet, providing fortified, processed complementary foods, administering micronutrient supplements, or offering some combination of these approaches. Advantages, disadvantages, and possible risks of these different strategies are discussed.

  11. Genetic Considerations in Recurrent Pregnancy Loss

    PubMed Central

    Hyde, Kassie J.; Schust, Danny J.

    2015-01-01

    Human reproduction is remarkably inefficient; nearly 70% of human conceptions do not survive to live birth. Spontaneous fetal aneuploidy is the most common cause for spontaneous loss, particularly in the first trimester of pregnancy. Although losses owing to de novo fetal aneuploidy occur at similar frequencies among women with sporadic and recurrent losses, some couples with recurrent pregnancy loss have additional associated genetic factors and some have nongenetic etiologies. Genetic testing of the products of conception from couples experiencing two or more losses may aid in defining the underlying etiology and in counseling patients about prognosis in a subsequent pregnancy. Parental karyotyping of couples who have experienced recurrent pregnancy loss (RPL) will detect some couples with an increased likelihood of recurrent fetal aneuploidy; this may direct interventions. The utility of preimplantation genetic analysis in couples with RPL is unproven, but new approaches to this testing show great promise. PMID:25659378

  12. Genetics Home Reference: benign recurrent intrahepatic cholestasis

    MedlinePlus

    ... All Close All Description Benign recurrent intrahepatic cholestasis (BRIC) is characterized by episodes of liver dysfunction called ... a lack of appetite. A common feature of BRIC is the reduced absorption of fat in the ...

  13. [Recurrent intestinal ischemia due to factor VIII].

    PubMed

    Castellanos Monedero, Jesús Javier; Legaz Huidobro, María Luisa; Galindo Andugar, María Angeles; Rodríguez Pérez, Alvaro; Mantrana del Valle, José María

    2008-01-01

    Intestinal ischemia is difficult to diagnose and can be caused by several etiologic processes. We report the case of a female patient with recurrent bowel ischemia due to small vessel thrombosis, which is caused by factor VIII, a procoagulant factor.

  14. Benign recurrent VI nerve palsy in childhood.

    PubMed

    Bixenman, W W; von Noorden, G K

    1981-01-01

    The case of a child with six documented episodes of benign recurrent unilateral VI nerve palsy between the ages of 2 1/2 months and 3 years is presented. Despite the recognized self-limiting course of this disorder, its possible evolution into a comitant esotropia makes close follow-up mandatory. The practical aspects of management including maintenance occlusion therapy are stressed as well as the need for prompt surgical intervention once the acquired stabismus has become stabilized. The etiology of benign VI nerve palsy of childhood may have the same immunological basis as other cases of para-infectious neuropathy. This isolated postinfective cranial mononeuropathy easily blends into the continuum of neurological involvement seen with the Landry-Guillian-Barre syndrome. With recovery from the initial episode, the abducens nerve may have become predisposed to recurrent inflammatory episodes and recurrent loss of function. Most often these recurrences are triggered by febrile illnesses of childhood.

  15. Childhood recurrent pneumonia caused by endobronchial sutures

    PubMed Central

    Zan, Yiheng; Liu, Hanmin; Zhong, Lin; Qiu, Li; Tao, Qingfen; Chen, Lina

    2017-01-01

    Abstract Background: Recurrent pneumonia is defined as more than two episodes of pneumonia in one year or three or more episodes anytime in life. Common clinical scenarios leading to recurrent pneumonia include anatomical abnormalities of respiratory tract, immunodeficiency, congenital heart diseases, primary ciliary dyskinesia, etc. Case report: A school-aged girl suffered from 1-2 episodes of pneumonia each year after trachea connection and lung repair operation resulted from an accident of car crash. Bronchoscopy revealed the sutures twisted with granulation in the left main bronchus and the patient's symptoms relieved after removal of the sutures. Here we report for the first time that surgical suture was the cause of recurrent pneumonia. Conclusions: This case indicates that children with late and recurrent onset of pneumonia should undergo detailed evaluation including bronchoscopy. PMID:28121955

  16. Management of Urethral Recurrences: Urothelial and Nonurothelial.

    PubMed

    Zargar-Shoshtari, Kamran; Sexton, Wade J; Poch, Michael A

    2016-11-01

    This article discusses the diagnostic and therapeutic options in the management of urethral cancer recurrence in patients treated with urethral sparing cystectomy as well as those who had urethral preservation following primary urethral carcinoma.

  17. Desmoid-type fibromatosis-associated Gardner fibromas: prevalence and impact on local recurrence.

    PubMed

    Cates, Justin M M; Stricker, Thomas P; Sturgeon, Duveen; Coffin, Cheryl M

    2014-10-28

    Although Gardner fibroma is a precursor lesion of desmoid tumor, the prevalence and prognostic importance of Gardner fibroma associated with desmoid tumors has not been systematically studied in adults. From 129 patients with desmoid-type fibromatosis, 170 specimens were re-examined for the presence of an associated Gardner fibroma. Clinicopathologic features of Gardner fibroma-associated desmoid-type fibromatosis were compared to desmoid tumors without associated Gardner fibroma. Recurrence-free survival was compared using multivariate Cox proportional hazard regression to account for known confounding factors. Of 104 evaluable primary desmoid tumor resections, 25 (24%) had an associated Gardner fibroma. When previous incisional biopsies and resection specimens of locally recurrent desmoid tumors were also examined, the overall prevalence of associated Gardner fibroma was 37%. Desmoid tumors arising in high risk anatomic sites (extremities or deep soft tissues of the back and chest wall) were more often associated with Gardner fibroma than tumors at other sites. Median recurrence-free survival for patients with Gardner fibroma-associated desmoid-type fibromatosis was 3.2 years, whereas median survival for patients without associated Gardner fibroma was >25 years (hazard ratio 2.8; P = 0.001). Although the presence of Gardner fibroma had no impact on the recurrence rate of desmoid tumors arising at high risk anatomic sites, associated Gardner fibroma increased the risk of recurrence 4-fold for desmoid tumors at low risk anatomic sites. Associated Gardner fibroma is under-recognized in desmoid-type fibromatosis and increases the risk of local recurrence for a subgroup of patients.

  18. Multifocal recurrent periostitis. Report of two cases.

    PubMed

    Kozlowski, K; Anderson, R; Tink, A

    1981-11-01

    Two case reports of recurrent multifocal periostitis in two girls aged 15 and 6 are added to the eight cases already reported in the literature. The disease is characterized clinically by recurrent mesomelic swelling of the extremities and radiologically by periosteal thickening and sclerosis of underlying bone. Hyperglobulinaemia is the most constant biochemical finding. The bone biopsy shows no typical features. The possibility of a viral etiology is discussed.

  19. Risk of Recurrence in Laryngeal Cancer

    PubMed Central

    Sørum Falk, Ragnhild; Folkvard Evensen, Jan; Boysen, Morten; Brøndbo, Kjell

    2016-01-01

    A cohort study was undertaken to analyze the risk of recurrence among 1616 patients with primary squamous cell carcinoma of the larynx from 1983 to 2010 at a single, tertiary academic center in Oslo, Norway. The cohort was followed from the date of diagnosis to September 2011. Competing risk regression analysis assessed the association between various risk factors and the risk of recurrence, where death was considered a competing event. Recurrence was observed in 368 patients (23%) during the study period. The majority (71%) of recurrences involved the location of the primary tumor. The overall risk of recurrence during the first three years after initiating treatment was 20.5%. Increased risk of recurrence was observed in patients with supraglottic cancer, younger patients, those with T2–T3 tumors and in patients treated in the earlier part of the study period. Significant factors for recurrence in glottic carcinomas were age, treatment in the earlier part of the study and T-status, whereas age was a significant factor in supraglottic cancer. N-status appeared less significant. In conclusion, follow-up of laryngeal squamous cell carcinoma should place particular emphasis on the site of the primary tumor, younger patients, cases of supraglottic cancer and T2-T4 primary tumors, especially during the first three years after treatment. More studies are needed to assess the impact of surgical versus non-surgical treatment, and eventually the significance of recurrence, for disease-specific and overall survival in cases of advanced laryngeal squamous cell carcinoma. PMID:27716797

  20. Salvage HDR Brachytherapy for Recurrent Prostate Cancer After Previous Definitive Radiation Therapy: 5-Year Outcomes

    SciTech Connect

    Chen, Chien Peter; Weinberg, Vivian; Shinohara, Katsuto; Roach, Mack; Nash, Marc; Gottschalk, Alexander; Chang, Albert J.; Hsu, I-Chow

    2013-06-01

    Purpose: Evaluate efficacy and toxicity of salvage high-dose-rate brachytherapy (HDRB) for locally recurrent prostate cancer after definitive radiation therapy (RT). Methods and Materials: We retrospectively analyzed 52 consecutively accrued patients undergoing salvage HDRB between 1998 and 2009 for locally recurrent prostate cancer after previous definitive RT. After pathologic confirmation of locally recurrent disease, patients received 36 Gy in 6 fractions. Twenty-four patients received neoadjuvant hormonal therapy before salvage, and no patients received adjuvant hormonal therapy. Determination of biochemical failure after salvage HDRB was based on the Phoenix definition. Overall survival (OS) and bF distributions were calculated using the Kaplan-Meier method. Univariate analyses were performed to identify predictors of biochemical control. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities, based on Common Terminology Criteria for Adverse Events (version 4), were documented. Results: Median follow-up after salvage HDRB was 59.6 months. The 5-year OS estimate was 92% (95% confidence interval [CI]: 80%-97%) with median survival not yet reached. Five-year biochemical control after salvage was 51% (95% CI: 34%-66%). Median PSA nadir postsalvage was 0.1 (range: 0-7.2) reached at a median of 10.2 months after completing HDRB. As for complications, acute and late grade 3 GU toxicities were observed in only 2% and 2%, respectively. No grade 2 or higher acute GI events and 4% grade 2 GI late events were observed. On univariate analysis, disease-free interval after initial definitive RT (P=.07), percent of positive cores at the time of diagnosis (P=.08), interval from first recurrence to salvage HDRB (P=.09), and pre-HDRB prostate-specific antigen (P=.07) were each of borderline significance in predicting biochemical control after salvage HDRB. Conclusions: Prostate HDRB is an effective salvage modality with relatively few long-term toxicities. We

  1. Heterogeneous recurrence monitoring and control of nonlinear stochastic processes

    SciTech Connect

    Yang, Hui Chen, Yun

    2014-03-15

    Recurrence is one of the most common phenomena in natural and engineering systems. Process monitoring of dynamic transitions in nonlinear and nonstationary systems is more concerned with aperiodic recurrences and recurrence variations. However, little has been done to investigate the heterogeneous recurrence variations and link with the objectives of process monitoring and anomaly detection. Notably, nonlinear recurrence methodologies are based on homogeneous recurrences, which treat all recurrence states in the same way as black dots, and non-recurrence is white in recurrence plots. Heterogeneous recurrences are more concerned about the variations of recurrence states in terms of state properties (e.g., values and relative locations) and the evolving dynamics (e.g., sequential state transitions). This paper presents a novel approach of heterogeneous recurrence analysis that utilizes a new fractal representation to delineate heterogeneous recurrence states in multiple scales, including the recurrences of both single states and multi-state sequences. Further, we developed a new set of heterogeneous recurrence quantifiers that are extracted from fractal representation in the transformed space. To that end, we integrated multivariate statistical control charts with heterogeneous recurrence analysis to simultaneously monitor two or more related quantifiers. Experimental results on nonlinear stochastic processes show that the proposed approach not only captures heterogeneous recurrence patterns in the fractal representation but also effectively monitors the changes in the dynamics of a complex system.

  2. Spinal Recurrence From Intracranial Germinoma: Risk Factors and Treatment Outcome for Spinal Recurrence

    SciTech Connect

    Ogawa, Kazuhiko Yoshii, Yoshihiko; Shikama, Naoto; Nakamura, Katsumasa; Uno, Takashi; Onishi, Hiroshi; Itami, Jun; Shioyama, Yoshiyuki; Iraha, Shiro; Hyodo, Akio; Toita, Takafumi; Kakinohana, Yasumasa; Tamaki, Wakana; Ito, Hisao; Murayama, Sadayuki

    2008-12-01

    Purpose: To analyze retrospectively the risk factors of spinal recurrence in patients with intracranial germinoma and clinical outcomes of patients who developed spinal recurrence. Methods and Materials: Between 1980 and 2007, 165 patients with no evidence of spinal metastases at diagnosis were treated with cranial radiotherapy without spinal irradiation. The median follow-up in all 165 patients was 61.2 months (range, 1.2-260.1 months). Results: After the initial treatment, 15 patients (9.1%) developed spinal recurrences. Multivariate analysis revealed that large intracranial disease ({>=}4 cm) and multifocal intracranial disease were independent risk factors for spinal recurrence. Radiation field, total radiation dose, and the use of chemotherapy did not affect the occurrence of spinal recurrences. Of the 15 patients who experienced spinal recurrence, the 3-year actuarial overall survival and disease-free survival (DFS) rates from the beginning of salvage treatments were 65% and 57%, respectively. In the analysis, presence of intracranial recurrence and salvage treatment modality (radiotherapy with chemotherapy vs. radiotherapy alone) had a statistically significant impact on DFS. The 3-year DFS rate in patients with no intracranial recurrence and treated with both spinal radiotherapy and chemotherapy was 100%, whereas only 17% in patients with intracranial recurrence or treated with radiotherapy alone (p = 0.001). Conclusion: Large intracranial disease and multifocal intracranial disease were risk factors for spinal recurrence in patients with intracranial germinoma with no evidence of spinal metastases at diagnosis. For patients who developed spinal recurrence alone, salvage treatment combined with spinal radiotherapy and chemotherapy was effective in controlling the recurrent disease.

  3. Dupuytren contracture recurrence project: reaching consensus on a definition of recurrence.

    PubMed

    Felici, N; Marcoccio, I; Giunta, R; Haerle, M; Leclercq, C; Pajardi, G; Wilbrand, S; Georgescu, A V; Pess, G

    2014-12-01

    The aim of this study was to determine a definition of recurrence of Dupuytren disease that could be utilized for the comparison of the results independently from the treatment used. 24 hand surgeons from 17 countries met in an international consensus conference. The participants used the Delphi method to evaluate a series of statements: (1) the need for defining recurrence, (2) the concept of recurrence applied to the Tubiana staging system, (3) the concept of recurrence applied to each single treated joint, and (4) the concept of recurrence applied to the finger ray. For each item, the possible answer was given on a scale of 1-5: 1=maximum disagreement; 2=disagreement; 3=agreement; 4=strong agreement; 5=absolute agreement. There was consensus on disagreement if 1 and 2 comprised at least 66% of the recorded answers and consensus on agreement if 3, 4 and 5 comprised at least 66% of the recorded answers. If a threshold of 66% was not reached, the related statement was considered "not defined". A need for a definition of recurrence was established. The presence of nodules or cords without finger contracture was not considered an indication of recurrence. The Tubiana staging system was considered inappropriate for reporting recurrence. Recurrence was best determined by the measurement of a specific joint, rather than a total ray. Time 0 occurred between 6 weeks and 3 months. Recurrence was defined as a PED of more than 20° for at least one of treated joint, in the presence of a palpable cord, compared to the result obtained at time 0. This study determined the need for a standard definition of recurrence and reached consensus on that definition, which we should become the standard for the reporting of recurrence. If utilized in subsequent publications, this will allow surgeons to compare different techniques and make is easier to help patients make an informed choice.

  4. Post-transplantation hepatocellular carcinoma recurrence: Patterns and relation between vascularity and differentiation degree

    PubMed Central

    Pecchi, Annarita; Besutti, Giulia; De Santis, Mario; Del Giovane, Cinzia; Nosseir, Sofia; Tarantino, Giuseppe; Di Benedetto, Fabrizio; Torricelli, Pietro

    2015-01-01

    AIM: To evaluate the relationship between hepatocellular carcinoma (HCC) vascularity and grade; to describe patterns and vascular/histopathological variations of post-transplantation recurrence. METHODS: This retrospective study included 165 patients (143 men, 22 women; median age 56.8 years, range 28-70.4 years) transplanted for HCC who had a follow-up period longer than 2 mo. Pre-transplantation dynamic computed tomography or magnetic resonance examinations were retrospectively reviewed, classifying HCC imaging enhancement pattern into hypervascular and hypovascular based on presence of wash-in during arterial phase. All pathologic reports of the explanted livers were reviewed, collecting data about HCC differentiation degree. The association between imaging vascular pattern and pathological grade was estimated using the Fisher exact test. All follow-up clinical and imaging data were reviewed for evidence of recurrence. Recurrence rate was calculated and imaging features of recurrent tumor were collected, classifying early and late recurrences based on timing (< or ≥ 2 years after transplantation) and intrahepatic, extrahepatic and both intrahepatic and extrahepatic recurrences based on location. All intrahepatic recurrences were classified as hypervascular or hypovascular and the differentiation degree was collected where available. The presence of variations in imaging enhancement pattern and pathological grade between the primary tumor and the intrahepatic recurrence was evaluated and the association between imaging and histopatholgical variations was estimated by using the χ2 test. RESULTS: Of the 163 patients with imaging evidence of viable tumor, 156 (95.7%) had hypervascular and 7 (4.3%) hypovascular HCC. Among the 125 patients with evidence of viable tumor in the explanted liver, 19 (15.2%) had grade 1, 56 (44.8%) grade 2, 40 (32%) grade 3 and 4 (3.2%) grade 4 HCC, while the differentiation degree was not assessable for 6 patients (4.8%). A significant

  5. Recurrence relations for spin foam vertices

    NASA Astrophysics Data System (ADS)

    Bonzom, Valentin; Livine, Etera R.; Speziale, Simone

    2010-06-01

    We study recurrence relations for various Wigner 3nj-symbols and the non-topological 10j-symbol. For the 6j- and the 15j-symbols which correspond to basic amplitudes of 3d and 4d topological spin foam models, recurrence relations are obtained from the invariance under Pachner moves and can be interpreted as quantizations of the constraints of the underlying classical field theories. We also derive recurrences from the action of holonomy operators on spin network functionals, making a more precise link between the topological Pachner moves and the classical constraints. Interestingly, our recurrence relations apply to any SU(2) invariant symbol, depending on the cycles of the corresponding spin network graph. Another method is used for non-topological objects such as the 10j-symbol and pseudo-isosceles 6j-symbols. The recurrence relations are also interpreted in terms of elementary geometric properties. Finally, we discuss the extension of the recurrences to take into account boundary states which leads to equations similar to Ward identities for correlation functions in the Barrett-Crane model.

  6. Sunspot Time Series: Passive and Active Intervals

    NASA Astrophysics Data System (ADS)

    Zięba, S.; Nieckarz, Z.

    2014-07-01

    Solar activity slowly and irregularly decreases from the first spotless day (FSD) in the declining phase of the old sunspot cycle and systematically, but also in an irregular way, increases to the new cycle maximum after the last spotless day (LSD). The time interval between the first and the last spotless day can be called the passive interval (PI), while the time interval from the last spotless day to the first one after the new cycle maximum is the related active interval (AI). Minima of solar cycles are inside PIs, while maxima are inside AIs. In this article, we study the properties of passive and active intervals to determine the relation between them. We have found that some properties of PIs, and related AIs, differ significantly between two group of solar cycles; this has allowed us to classify Cycles 8 - 15 as passive cycles, and Cycles 17 - 23 as active ones. We conclude that the solar activity in the PI declining phase (a descending phase of the previous cycle) determines the strength of the approaching maximum in the case of active cycles, while the activity of the PI rising phase (a phase of the ongoing cycle early growth) determines the strength of passive cycles. This can have implications for solar dynamo models. Our approach indicates the important role of solar activity during the declining and the rising phases of the solar-cycle minimum.

  7. Evaluation of 2-year-old intrasplenic fetal liver tissue transplants in rats.

    PubMed

    Lupp, Amelie; Danz, Manfred; Müller, Dieter

    2003-01-01

    Liver cell transplantation into host organs like the spleen may possibly provide a temporary relief after extensive liver resection or severe liver disease or may enable treatment of an enzyme deficiency. With time, however, dedifferentiation or malignant transformation of the ectopically transplanted cells may be possible. Thus, in the present study syngenic fetal liver tissue suspensions were transplanted into the spleen of adult male rats and evaluated 2 years thereafter in comparison to orthotopic livers for histopathological changes and (as markers for preneoplastic transformation) for cytochrome P450 (P450) and glutathione S-transferase (GST) isoform expression. Because inducibility of P450 and GST isoforms may be changed in preneoplastic foci, prior to sacrifice animals were additionally treated either with beta-naphthoflavone, phenobarbital, dexamethasone, or the respective solvent. In the 2-year-old grafts more than 70% of the spleen mass was occupied by the transplant. The transplanted hepatocytes were arranged in cord-like structures. Also few bile ducts were present. Morphologically, no signs of malignancy were visible. With all rats, transplant recipients as well as controls, however, discrete nodular structures were seen in the livers. Due to age, both livers and transplants displayed only a low P450 2B1 and 3A2 and GST class alpha and mu isoform expression. No immunostaining for P450 1A1 was visible. At both sites, beta-naphthoflavone, phenobarbital, or dexamethasone treatment enhanced P450 1A1, P450 2B1 and 3A2, or P450 3A2 expression, respectively. No immunostaining for GST class pi isoforms was seen in the transplants. The livers of both transplant recipients and control rats, however, displayed GST pi-positive foci, corresponding to the nodular structures seen histomorphologically. Compared to the surrounding tissue, these foci also exhibited a more pronounced staining for GST class alpha and mu isoforms and a stronger inducibility of the P450 1A

  8. Racial Disparities in Allergic Outcomes in African Americans Emerge as Early as Age 2 Years

    PubMed Central

    Wegienka, Ganesa; Havstad, Suzanne; Joseph, Christine LM; Zoratti, Edward; Ownby, Dennis; Woodcroft, Kimberley; Johnson, Christine Cole

    2011-01-01

    BACKGROUND Racial disparities in allergic disease outcomes have been reported with African Americans suffering disproportionately compared to White individuals. OBJECTIVE Examine whether racial disparities are present as early as age 2 years in a racially diverse birth cohort in the Detroit metropolitan area. METHODS All children who were participants in a birth cohort study in the Detroit metropolitan area were invited for a standardized physician exam with skin prick testing and parental interview at age 2 years. Physicians made inquiries regarding wheezing and allergy symptoms and inspected for and graded any atopic dermatitis (AD). Skin testing was performed for Alternaria, cat, cockroach, dog, Dermatophagoides farinae (Der F), Short Ragweed, Timothy grass, egg, milk and peanut. Specific IgE was measured for these same allergens and total IgE was determined. RESULTS African American children (n=466) were more likely than White children (n=223) to have experienced any of the outcomes examined: at least 1 positive skin prick test from the panel of 10 allergens (21.7% versus 11.0%, p=0.001); at least one specific IgE ≥0.35 IU/mL (out of a panel of 10 allergens) (54.0% versus 42.9%, p=0.02); had AD (27.0% versus 13.5%, Chi-square p<0.001); and to ever have wheezed (44.9% versus 36.0%, p=0.03). African American children also tended to have higher total IgE (geometric means 23.4 IU/mL (95%CI 20.8, 27.6) versus 16.7 IU/mL (95%CI 13.6, 20.6 IU/mL), Wilcoxon Rank Sum p=0.004). With the exception of wheezing, the associations did not vary after adjusting for common social economic status variables (e.g.; household income), environmental variables (endotoxin; dog, cat and cockroach allergen in house dust) or variables that differed between the racial groups (e.g.; breastfeeding). After adjustment, the wheeze difference was ameliorated. CONCLUSIONS With disparities emerging as early as age 2 years, investigations into sources of the disparities should include the

  9. Collagenase injections for Dupuytren's disease: prospective cohort study assessing 2-year treatment effect durability

    PubMed Central

    Lauritzson, Anna; Atroshi, Isam

    2017-01-01

    Objectives To assess 2-year durability of joint contracture correction following collagenase injections for Dupuytren's disease. Design Prospective cohort study. Setting Orthopaedic Department in Sweden. Participants Patients with palpable Dupuytren's cord and active extension deficit (AED) ≥30° in the metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joint. A surgeon injected 0.80 mg collagenase into multiple cord parts and performed finger manipulation under local anaesthesia after 24–48 hours. A hand therapist measured joint contracture before and 5 weeks after injection in all treated patients. Of 57 consecutive patients (59 hands), 48 patients (50 hands) were examined by a hand therapist 24–35 months (mean 26) after injection. Five of the patients had received a second injection in the same finger within 6 months of the first injection. Outcome measures Primary outcome was proportion of treated joints with ≥20° worsening in AED from 5 weeks to 2 years. Results Between the 5-week and the 2-year measurements, AED had worsened by ≥20° in seven MCP and seven PIP joints (28% of the treated hands; all had received a single injection). Mean AED for the MCP joints was 54° before injection, 6° at 5 weeks and 9° at 2 years and for the PIP joints 30°, 13° and 16°, respectively. For joints with ≥10° contracture at baseline, mean (95 % CI) baseline to 2 years AED improvement was for MCP 49° (41–54) and for PIP 25° (17–32). No treatment-related adverse events were observed at the 2-year follow-up evaluation. Conclusions Two years after collagenase injections for Dupuytren's disease, improvement was maintained in 72% of the treated hands. Complete contracture correction was seen in more than 80% of the MCP but in less than half of the PIP joints. PMID:28298365

  10. Delta Reverse Polarity Shoulder Replacement: Single Surgeon Experience with a Minimum 2-Year Follow-up

    PubMed Central

    Eltayeb, Magid; Javaid, Mohammad Muddassir Mahmood

    2015-01-01

    Background The delta reverse shoulder replacement system was developed for the treatment of rotator cuff arthropathy so that the deltoid can substitute for the deficient rotator cuff. To evaluate the results of delta reverse shoulder replacement for functional improvement and complications in a consecutive series by a single surgeon over a period of six years with a minimum follow-up of 2 years. Methods The data were collected retrospectively from electronic theatre records. Over a period of 6 years (2006-2012), 46 cases that fulfilled the inclusion criteria were identified. There were 34 females and 12 males. The average age of patients was 76.2 years (range, 58 to 87 years). A single surgeon performed all procedures using the anterosuperior approach. The mean follow-up time was 49 months (range, 24 to 91 months). All cases had preoperative and postoperative Constant scores. We collected the data on indications, hospital stay, and change in the Constant score, complications, and reoperation rates. Results The main indication for surgery was rotator cuff arthropathy (52.2%), followed by massive rotator cuff tear (28.3%), osteoarthritis (8.7%), fractures (6.5%), and rheumatoid arthritis (4.3%). Also, 65.2% of the cases were referred by general practitioners, 26% of the cases were referred by other consultants, and 8.8% of the cases were already under the care of a shoulder surgeon. The average preoperative Constant score was 23.5 (range, 8 to 59). The average Constant score at the final follow-up was 56 (range, 22 to 83). On average, there was an improvement of 33 points in the Constant score. The improvement in the Constant score was significant (p < 0.001). We observed complications in four patients (8.6%). Three of four patients (6.5%) needed reoperation. The first complication was pulmonary embolism in the early postoperative period. The other complications included dissociation of the glenosphere from the metaglene, deltoid detachment, and stitch abscess

  11. Aspirin-induced recurrent urticaria and recurrent angioedema in non-atopic children.

    PubMed

    Botey, J; Ibero, M; Malet, A; Marin, A; Eseverri, J L

    1984-09-01

    Recurrent urticaria and recurrent angioedema are frequent adverse reactions in non-atopic patients who do not tolerate aspirin. Of 1,632 infants and children who visited our allergy department for the first time, nine children (0.55%), five males and four females, presented recurrent urticaria or recurrent angioedema after taking aspirin. No evidence of atopy was disclosed either by clinical history (personal and family), skin testing, eosinophil levels or total IgE. Aspirin intolerance was established by oral challenge. Only three of the nine patients reported aspirin intolerance in their histories.

  12. Rapid recurrent sialolithiasis: Altered stone composition and potential factors for recurrence.

    PubMed

    Trujillo, Oscar; Drusin, Madeleine A; Rahmati, Rahmatullah

    2016-10-18

    The objective of this report was to identify potential factors associated with recurrent sialolithiasis after surgical intervention. This is a report of a woman with recurrent submandibular sialolithiasis after surgical intervention. Several characteristics of this patient indicate that she may have been predisposed to recurrent stone formation. Patient and disease factors leading to recurrent salivary stone formation are not well known. Notwithstanding, there may be stone factors and intraoperative findings that aid in determining whether a patient is likely to be successfully treated with a gland-sparing approach. Laryngoscope, 2016.

  13. Repeat Brachytherapy for Patients With Residual or Recurrent Tumors of Oral Cavity

    SciTech Connect

    Yoshimura, Ryo-ichi; Shibuya, Hitoshi; Hayashi, Keiji; Nakagawa, Keiko; Toda, Kazuma; Watanabe, Hiroshi; Kaida, Atushi; Miura, Masahiko

    2012-07-15

    Purpose: To analyze data from patients receiving repeat brachytherapy (re-BT) for the treatment of residual or recurrent tumor in the oral cavity. Methods and Materials: Between January 2003 and December 2007, 62 patients who had undergone definitive BT as an initial treatment of oral cancer subsequently underwent re-BT for the treatment of residual or recurrent tumors at the diagnostic radiology and oncology department (Tokyo Medical and Dental University Hospital). Re-BT was performed 0.9-73 months (median, 5.7) after the initial BT. Au-198 grains were used as the re-BT source in all 62 patients, and an area of 0.8-6.3 cm{sup 2} (median, 3.1) was permanently irradiated with 60-110 Gy (median, 83) according to the system of Paterson-Parker. Results: The 2-year local control and overall survival rate was 53% and 66%, respectively, and local control significantly affected overall survival. Both local control and overall survival were affected by the initial tumor characteristics and the macroscopic appearance of the residual or recurrent tumor. Grade 3 or 4 complications were seen in 5 patients. The incidence of mandibular and mucosal complications was significantly related to a biologic effective dose of {alpha}/{beta} of 3 Gy to the surface of the gingiva and mucosa, respectively. Conclusion: Re-BT using Au-198 grains for the treatment of residual or recurrent tumor after definitive BT in the oral cavity is effective and well tolerated.

  14. Incidence and influence of hospitalization for recurrent syncope and its effect on short- and long-term all-cause and cardiovascular mortality.

    PubMed

    Ruwald, Martin H; Numé, Anna-Karin; Lamberts, Morten; Hansen, Carolina M; Hansen, Morten L; Vinther, Michael; Kober, Lars; Torp-Pedersen, Christian; Hansen, Jim; Gislason, Gunnar H

    2014-05-15

    Recurrence of syncope is a common event, but the influence of recurrent syncope on the risk of death has not previously been investigated on a large scale. We examined the prognostic impact of recurrent syncope in a nationwide cohort of patients with syncope. All patients (n = 70,819) hospitalized from 2001 to 2009 in Denmark with a first-time diagnosis of syncope aged from 15 to 90 years were identified from national registries. Recurrence of syncope was incorporated as a time-dependent variable in multivariable-adjusted Cox models on the outcomes of 30-day, 1-year, and long-term all-cause mortality and cardiovascular death. During a mean follow-up of 3.9 ± 2.6 years, a total of 11,621 patients (16.4%) had at least 1 hospitalization for recurrent syncope, with a median time to recurrence of 251 days (33 to 364). A total of 14,270 patients died, and 3,204 deaths were preceded by a hospitalization for recurrent syncope. The long-term risk of all-cause death was significantly associated with recurrent syncope (hazard ratio 2.64, 95% confidence interval 2.54 to 2.75) compared with those with no recurrence. On 1-year mortality, recurrent syncope was associated with a 3.2-fold increase in risk and on 30-day mortality associated with a threefold increase. The increased mortality risk was consistent over age groups 15 to 39, 40 to 59, and 60 to 89 years, and a similar pattern of increase in both long-term and short-term risk of cardiovascular death was evident. In conclusion, recurrent syncope is independently associated with all-cause and cardiovascular mortality across all age groups exhibiting a high prognostic influence. Increased awareness on high short- and long-term risk of adverse events in subjects with recurrent syncope is warranted for future risk stratification.

  15. Bilateral recurrent ocular surface squamous cell cancer associated with epidermodysplasia verruciformis

    PubMed Central

    Arora, Tarun; Sharma, Sourabh; Sharma, Namrata; Titiyal, Jeewan S

    2015-01-01

    A 17-year-old boy, presented with a 2-year history of bilateral, recurrent ocular surface mass. Dermatological evaluation revealed the presence of multiple hypopigmented macules over his body. Skin biopsy showed features typical of epidermodysplasia verruciformis. Topical mitomycin C (0.02%) was administered in both eyes for 6 weeks (three 1-week cycles over 6 weeks). While the mass in the left eye regressed, the mass in the right eye was excised under guidance of intraoperative frozen section. Triple-freeze thaw cryotherapy of the surrounding conjunctiva along with placement of amniotic membrane graft was performed. Postoperative mitomycin C (0.02%) was administered for another 6 weeks (three 1-week cycles over 6 weeks) in both eyes. At 4 years of follow-up, no recurrence has been noted. PMID:25636630

  16. Bilateral recurrent ocular surface squamous cell cancer associated with epidermodysplasia verruciformis.

    PubMed

    Arora, Tarun; Sharma, Sourabh; Sharma, Namrata; Titiyal, Jeewan S

    2015-01-30

    A 17-year-old boy, presented with a 2-year history of bilateral, recurrent ocular surface mass. Dermatological evaluation revealed the presence of multiple hypopigmented macules over his body. Skin biopsy showed features typical of epidermodysplasia verruciformis. Topical mitomycin C (0.02%) was administered in both eyes for 6 weeks (three 1-week cycles over 6 weeks). While the mass in the left eye regressed, the mass in the right eye was excised under guidance of intraoperative frozen section. Triple-freeze thaw cryotherapy of the surrounding conjunctiva along with placement of amniotic membrane graft was performed. Postoperative mitomycin C (0.02%) was administered for another 6 weeks (three 1-week cycles over 6 weeks) in both eyes. At 4 years of follow-up, no recurrence has been noted.

  17. Combination Therapy of Simeprevir and Sofosbuvir in Recurrent HCV Genotype 4 After Liver Retransplantation: Case Report

    PubMed Central

    Obed, Aiman; Jarrad, Anwar; Bashir, Abdalla; Moog, Gero

    2016-01-01

    Patient: Male, 50 Final Diagnosis: Recurrent hepatitis C Symptoms: — Medication: — Clinical Procedure: Anti hepatitis C therapy Specialty: Gastroenterology and Hepatology Objective: Unusual clinical course Background: The treatment of hepatitis C virus (HCV) infection is evolving rapidly. Many studies have been completed during the last 2 years, with more studies still in progress. The management of recurring HCV infection following liver organ transplantation remains very challenging, especially for HCV genotype 4 (GT-4). More research is needed in this area. Case Report: We report on a patient with a recurring HCV infection and fibrosing cholestatic hepatitis following liver retransplantation, who was successfully treated with a combination therapy of simeprevir and sofosbuvir without interferon/ribavirin. As far as we know, this is the first reported case of this kind. Conclusions: This information may be of importance and inform future management of patients with recurrent HCV infections following liver transplantation. PMID:27230979

  18. Intracardiac bronchogenic cyst in a 2-year-old Nigerian boy

    PubMed Central

    Ogunkunle, Oluwatoyin Oluwafunmilayo; Animashaun, Deola

    2012-01-01

    Primary cardiac tumours are rare in the paediatric age group. Bronchogenic cysts, although relatively rare, represent the most common cystic lesion of the mediastinum. Intracardiac bronchogenic cysts however, are extremely rare. The authors are unaware of any case previously reported in a Nigerian child and hence report the case of a 2-year-old boy for its rarity and interest. The boy was referred for evaluation of a cardiac murmur. Clinical, radiological and electrographic findings were suggestive of mild pulmonary stenosis or an atrial septal defect (ASD). 2-dimensional echocardiography however, revealed in addition to a small ASD, an intracardiac mass attached to the tricuspid valve. The mass was surgically removed and found on histology to be a bronchogenic cyst. Our experience highlights the importance of echocardiography in the evaluation of asymptomatic patients with cardiac murmurs, in whom a rare lesion might have otherwise been missed. PMID:22605814

  19. Weight and Weight-Related Behaviors Among 2-Year College Students

    PubMed Central

    Nanney, Marilyn S.; Lytle, Leslie A.; Farbakhsh, Kian; Moe, Stacey G.; Linde, Jennifer A.; Gardner, Jolynn K.; Laska, Melissa N.

    2015-01-01

    Objectives and Participants The purpose of this paper is to describe weight indicators and weight-related behaviors of students enrolled in 2-year colleges, including sex differences. Methods During Fall 2011 and Spring 2012, 441 students from 3 Minnesota community colleges enrolled in the Choosing Healthy Options in College Environments and Settings (CHOICES) Study and completed baseline assessments. Participants completed a baseline survey evaluating eating and activity patterns, sleep, and stress and measures of height, weight, waist circumference, and body fat. Results Participants were primarily female (68%), white (73%), with a mean age of 22.8 years and 66.2% reporting an annual income <$12,000. Almost half (47%) were overweight or obese. Young males appeared to engage the most in risky health behaviors and had higher levels of overweight or obesity, compared to young females. Conclusions Findings confirm the need for innovative interventions targeting this understudied and underserved young adult population. PMID:25692380

  20. Gesture and Symbolic Representation in Italian and English-Speaking Canadian 2-Year-Olds.

    PubMed

    Marentette, Paula; Pettenati, Paola; Bello, Arianna; Volterra, Virginia

    2016-05-01

    Analyses of elicited pantomime, primarily of English-speaking children, show that preschool-aged children are more likely to symbolically represent an object with gestures depicting an object's form rather than its function. In contrast, anecdotal reports of spontaneous gesture production in younger children suggest that children use multiple representational techniques. This study examined the spontaneous gestures of sixty-four 2-year-old Italian children and English-speaking Canadian children, primarily from middle-class Caucasian families. The Italian children produced twice as many gestures as Canadian children in a picture-naming task but produced a similar range of representational techniques. Two-year-olds were equally likely to produce gestures depicting function as form. These data suggest young children's communicative skills are supported by a symbolic capacity that reflects contextual communicative demands.