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Sample records for 30-year retrospective analysis

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  2. Predictors of poor outcome after both column acetabular fractures: a 30-year retrospective cohort study

    PubMed Central

    2013-01-01

    Background and Purpose Acetabular fractures are often combined with associated injuries to the hip joint. Some of these associated injuries seem to be responsible for poor long-term results and these injuries seem to affect the outcome independent of the quality of the acetabular reduction. The aim of our study was to analyze the outcome of both column acetabular fractures and the influence of osseous cofactors such as initial fracture displacement, hip dislocation, femoral head lesions and injuries of the acetabular joint surface. Methods A retrospective cohort study in patients with both column acetabular fractures treated over a 30 year period was performed. Patients with a follow-up of more than two years were invited for a clinical and radiological examination. Displacement was analyzed on initial and postoperative radiographs. Contusion and impaction of the femoral head was grouped. Injuries of the acetabular joint surface consisting of impaction, contusion and comminution were recorded. The Merle d’Aubigné Score was documented and radiographs were analysed for arthritis (Helfet classification), femoral head avascular necrosis (Ficat/Arlet classification) and heterotopic ossifications (Brooker classification). Results 115 patients were included in the follow up examination. Anatomic reduction (malreduction ≤ 1mm) was associated with a significantly better clinical outcome than nonanatomical reduction (p = 0.001). Initial displacement of more than 10mm (p = 0.031) and initial intraarticular fragments (p = 0.041) were associated with worse outcome. Other associated injuries, such as the presence of a femoral head dislocation, femoral head injuries and injuries to the acetabular joint surface showed no significant difference in outcome individually, but in fractures with more than two associated local injuries the risk for joint degeneration was significant higher (p < 0.001) than in cases with less than two of them. In the subgroup of

  3. Revisiting Public School/University Partnerships for Formal Leadership Development: A Brief 30-Year Retrospective

    ERIC Educational Resources Information Center

    Thompson, David C.

    2016-01-01

    In this article, the Kansas State University Chair of the Department of Educational Leadership reviews the strong history of his department's university and public school partnerships and the impact these partnerships have had on leadership preparation programs. Almost 30 years ago, Kansas State University foresaw the power of partnerships with…

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

    ERIC Educational Resources Information Center

    Roeder, John L.

    2005-01-01

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  6. 30 Years Retrospective Review of Tuberculosis Cases in a Tuberculosis Dispensary in Bursa/Nilufer, Turkey (1985–2014): Changes of Epidemics*

    PubMed Central

    Pala, Kayıhan; Gerçek, Harika; Taş, Tuncay Aydin; Çakir, Rukiye; Özgüç, Sedef; Yildiz, Timur

    2016-01-01

    Objective The aim of this study is to describe the epidemiological and clinical aspects of patients who applied to the Bursa Nilufer Tuberculosis Dispensary by investigating the trends in epidemics over three decades. Method In this retrospective observational study, the records of all tuberculosis cases (1630 patients) treated in the last 30 years (1985–2014) at the Bursa Nilufer Tuberculosis Dispensary were examined and statistically analyzed. Results Males comprised 65.2% of the patients. The ages of the patients ranged from 1 to 87 years, and the mean age was 37.4 (95% CI: 36.6–38.2). Among the cases, 86.7% were new infections and 74.1% were pulmonary tuberculosis. In the last decade, the education level, the percentage of patients who had received a BCG vaccination, the proportion of women and active employees among them increased (p<0.05), while it decreased among men (p<0.05). Clinical symptoms accompanying TB such as weakness, anorexia, weight loss, and cough, decreased to a statistically significant degree (p<0.05). In the last decade, the mortality rate was 3.6% and increased compared with previous decades (p<0.05). Mortality was higher among patients who were elderly, male, did not have a BCG scar or had a chronic disease (p<0.05). Conclusion This study adds information about the change of TB epidemics in Turkey in the last 30 years. Further studies are needed to determine the risk factors associated with tuberculosis mortality and to evaluate the effectiveness control programs of this disease. PMID:27872739

  7. Cotton dust, endotoxin and cancer mortality among the Shanghai textile workers cohort: a 30-year analysis

    PubMed Central

    Fang, S C; Mehta, A J; Hang, J Q; Eisen, E A; Dai, H L; Zhang, H X; Su, L; Christiani, D C

    2013-01-01

    Background Although occupational exposure to cotton dust and endotoxin is associated with adverse respiratory health, associations with cancer are unclear. We investigated cancer mortality in relation to cotton dust and endotoxin exposure in the Shanghai textile workers cohort. Methods We followed 444 cotton textile and a reference group of 467 unexposed silk workers for 30 years (26 777 person-years). HRs for all cancers combined (with and without lung cancer) and gastrointestinal cancer were estimated in Cox regression models as functions of cotton textile work and categories of cumulative exposure (low, medium, high), after adjustment for covariates including pack-years smoked. Different lag years accounted for disease latency. Results Risks of mortality from gastrointestinal cancers and all cancers combined, with the exclusion of lung cancer, were increased in cotton workers relative to silk workers. When stratified by category of cumulative cotton exposure, in general, risks were greatest for 20-year lagged medium exposure (all cancers HR=2.7 (95% CI 1.4 to 5.2); cancer excluding lung cancer HR=3.4 (1.7–7.0); gastrointestinal cancer HR=4.1 (1.8–9.7)). With the exclusion of lung cancer, risks of cancer were more pronounced. When stratified by category of cumulative endotoxin exposure, consistent associations were not observed for all cancers combined. However, excluding lung cancer, medium endotoxin exposure was associated with all cancers and gastrointestinal cancer in almost all lag models. Conclusions Cotton dust may be associated with cancer mortality, especially gastrointestinal cancer, and endotoxin may play a causative role. Findings also indirectly support a protective effect of endotoxin on lung cancer. PMID:23828454

  8. Profile of adult acute cholinesterase inhibitors substances poisoning – a 30 years analysis

    PubMed Central

    Gazzi, Eugen N.; Jaba, Irina M.; Lionte, Catalina; Bologa, Cristina; Lupusoru, Catalina E.; Lupusoru, Raoul; Sorodoc, Laurentiu; Petris, Ovidiu

    2015-01-01

    Objectives The objective of this study was to assess the pattern and outcome of acute cholinesterase inhibitors substances (CIS) poisoning cases, in a cohort from a regional tertiary care hospital. Methods cases admitted in the Toxicology Clinic of “Sf. Spiridon” Emergency Clinic Hospital Iasi, Romania between 1983 and 2013 were studied. Results a total number of 606 patients were included. The reason for exposures was intentional in 70% of cases and the commonest route of poisoning was oral in 92.2%. The highest percent of cases was females (56.4), the age group 20–29 (25.4%) and the majority (66.7%) coming from rural areas, 28.2% being agricultural workers. 36.6% of cases were severe clinical forms. Overall mortality rates were 3.8%, more than half of the death patients (65.2%) had concomitant alcohol intake. It was a significant statistical association between decrease level of serum cholinesterase on admittance and severe forms (p 0.000) and between survival and deaths groups (p 0.000). The pattern of poisoning described by our retrospective study suggests that CIS poisoning are mainly preventable. The main effective goals for prevention are restriction in free accessibility to toxic pesticides, together with sustained efforts in education concerning the life-threatening danger of pesticide poisoning. PMID:28352706

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

    ERIC Educational Resources Information Center

    Kaminsky, James S.

    2006-01-01

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

  10. CGM Retrospective Data Analysis

    PubMed Central

    2016-01-01

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

  11. Carcinoma of the buccal mucosa: a 30-year analysis at the Medical Center of Louisiana at New Orleans.

    PubMed

    Govett, G S; Amedee, R G

    1997-06-01

    Carcinoma of the buccal mucosa is an uncommon malignancy of the oral cavity which is primarily squamous cell in histologic origin. This study represents the first investigation of this lesion in an indigent population. The purpose of this report is to review survival rates, modalities of treatment, and current management of the disease. A retrospective analysis is performed on all patients with this disease diagnosed and treated from 1965 to 1995. Of 28 patients, 75% were white, advanced stages of disease predominated, and no 5-year Stage IV survivors were recorded. Additional conclusions of this study revealed an overall 5-year determinate survival rate which was lower than other studies (25%), with a statistically significant white predominance of disease.

  12. CRREL, 30 Years Retrospective 1986-1991

    DTIC Science & Technology

    1990-01-01

    commercially. A patent was awarded to Charles J. Korhonen and Frederick C. Gernhard, for a Blister Pressure Relief Valve. This valve, now in commercial...Andrew Assur Michael A. Bilello W. Keith Boyd GilbertA. Currier Francis C. Gagnon Robert W. Gerdel Arnold R. Goerke B. Lyle Hansen James R... Frederick Crory receives Army Research & Development Award. 20 Rodney Poland receives Meritorious Civilian Service Award. 1979 CRREL receives U.S. Army

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Satterfield, Franklin R.; Finney, Bruce P.

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

  15. 77 FR 47572 - Retrospective Analysis of Existing Rules

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    ... COMMISSION 19 CFR Chapter II Retrospective Analysis of Existing Rules AGENCY: International Trade Commission... July 11, 2011, the Commission recently adopted its Plan for Retrospective Analysis of Existing Rules... submitted in connection with the Commission's Preliminary Plan for Retrospective Analysis of Existing...

  16. Retrospective analysis of pathologic nipple discharge.

    PubMed

    Yang, L; Wu, D; Fan, Z-M

    2015-02-13

    The cause of pathologic nipple discharge is mainly benign lesions, but there is still a possibility of malignancy. Pathologic nipple discharge may be the only or the first symptom of breast cancer. This study aimed to investigate the clinical factors associated with lesions in patients with pathologic nipple discharge using a retrospective analysis of clinical data in 207 cases. The univariate analysis showed that age >50 years, breast lumps, or breast calcifications were risk factors associated with breast cancer in nipple discharge patients (P < 0.05). Discharge characteristics, duration of disease, and identification of lesions had no clear clinical significance (P > 0.05). The multivariate analysis also showed that age >50 years, breast lumps, and breast calcifications were risk factors associated with breast cancer in nipple discharge patients (P < 0.05). Age, breast lumps, and breast calcifications had important clinical significance in identification of benign and malignant nipple discharge.

  17. Solid waste 30-year volume summary

    SciTech Connect

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

    1994-06-01

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

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

    ERIC Educational Resources Information Center

    Sorensen, Terri

    2000-01-01

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

  19. Cognitive Systems Engineering: The Next 30 Years

    NASA Technical Reports Server (NTRS)

    Feary, Michael

    2012-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2009-04-01

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

  3. [Pacemaker implantation in dogs: results of the last 30 years].

    PubMed

    François, L; Chetboul, V; Nicolle, A; Carlos, C; Borenstein, N; Pouchelon, J L

    2004-07-01

    Pacemaker implantation in veterinary practice is still not well known and remains uncommon. However, this technique is the only possible way to cure animals suffering from symptomatic bradycardia whose state does not improve with a medical treatment. In most cases, the use of pacemakers in veterinary medicine leads to the disappearance of the clinical and electrocardiographic signs. This retrospective study concerning the last 30 years draws up an evaluation of the improvements, advantages and drawbacks of this method. Moreover, this study allows the understanding of the evolution of pacemakers' use in veterinary cardiology.

  4. TARDEC 30-Year Strategy Value Stream Analysis

    DTIC Science & Technology

    2015-07-01

    integrating advanced components and state of the art reverse osmosis iv. Draft detailed specification and drawing package c. Payoff: i. Fills the...Robust, and Simple Pretreatment to Reverse Osmosis . Opportunities FY 16-19 o Procurement and evaluation of COTS and emerging:  Pretreatment

  5. Lessons from 30 Years of Flight Software

    NASA Technical Reports Server (NTRS)

    McComas, David C.

    2015-01-01

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

  6. MEDPREP--30 Years of Making a Difference.

    ERIC Educational Resources Information Center

    Jackson, Evelyn W.; McGlinn, Shirley; Rainey, Michael; Bardo, Harold R.

    2003-01-01

    Describes the Medical/Dental Education Preparatory Program (MEDPREP) of Southern Illinois University School of Medicine. Over the course of its 30-year history, 68 percent of students have been accepted to professional schools, with 92 percent being accepted to medical schools and attending 90 different medical schools in the country. Of those…

  7. Retrospective Analysis Of CO2 Laser Myringotomy

    NASA Astrophysics Data System (ADS)

    Lipman, Sidney P.; Guelcher, Robert T.

    1988-06-01

    A retrospective review of the author's series of 91 carbon dioxide (CO2) laser myringotomy cases performed between 1983 and 1986 is presented. Patients with chronic otitis media with effusion (COME) were selected on the basis of possible benefit from shorter ventilation time than tympanostomy tube insertion. The proceedings were performed on an outpatient basis with topical iontophoretic anesthesia, which offers significant cost savings and a lack of possible complications. The CO2 laser gives clean precise 0.8mm perforations which remain open for 2-4 weeks, this shorter ventilation time minimizing the period of water precautions and other side effects. The laser perforations heal well. With a success rate of 52 % reported, which could be increased with careful patient selection, we feel that the advantages of carbon dioxide laser myringotomy over myringotomy plus intubation outweight the risk of recurrent otitis media with effusion formation in those patients to whom this procedure is applicable.

  8. Retrospective analysis of seven breast tuberculosis cases

    PubMed Central

    Çakar, Beyhan; Çiledağ, Aydin

    2016-01-01

    The present study aimed to evaluate the demographic data, diagnostic methods, therapeutic regimens and duration of therapy in 7 breast tuberculosis (BTB) cases. The data of BTB cases treated between January 2006 and December 2013 were retrospectively evaluated, with a total of 648 tuberculosis (TB) cases recorded during the 8-year period. Among these cases, 296 patients (50%) suffered from pulmonary TB, 278 (43%) from non-pulmonary TB and 45 (7%) from PTB plus NPTB. In total, 7 BTB were diagnosed, which constituted 1.08% (7/648) of all TB cases and 2.51% (7/278) of all NPTB cases. The mean age of patients was 34±9.46 years, with no pregnant or lactating women. Bilateral breast involvement was detected in only 1 case, while all cases had a BCG scar, and obtained a mean tuberculin skin test (TST) result of 14.28±6.79 mm (range, 7–26 mm). The symptoms included presence of a mass, tenderness, pain, swelling and fluctuation in the breast, with or without discharging sinuses. In 1 case, history of contact with TB was found. All patients were newly-diagnosed BTB cases, with no other organ involvement. Upon histopathological examination of breast tissue, granulomatous inflammation with typical caseous necrosis was observed in 1 case, non-caseous necrosis inflammation was detected in 2 cases, granulomatous inflammation was observed in 3 cases, and mastitis and fat necrosis inflammation was observed in 1 case. Acid-fast bacilli (AFB) staining was positive in only 2 cases, and all patient were treated with anti-TB drugs with a successful outcome and no recurrence. In conclusion, BTB is a rare form of TB and the present retrospective study reported 7 cases of BTB along with the results of histopathological examination, microbiological examination and treatment. TB must be considered when there is presence of breast masses presenting with tenderness, pain, swelling and fluctuation, with or without discharging sinuses. PMID:27882115

  9. Retrospective Analysis of Women with Only Mastalgia

    PubMed Central

    Arslan, Mehmet; Küçükerdem, Halime Seda; Can, Hüseyin; Tarcan, Ercüment

    2016-01-01

    Objective Mastalgia is the most common symptom in women, who has gone under breast imaging. 70% of women face with mastalgia at least once in their lifetime. In our study, we aimed to investigate the examinations and the results of the females referred to our outpatient clinics with mastalgia and to determine the frequency of malignancy. Materials and Methods Files of all women patients referred to General Surgery Outpatient Clinics between 01.06.2014–31.05.2015 has been investigated retrospectively. Cases only with breast pain complaint (n=789) out of 2798 women has been included in the study. Women with lump in breast, nipple discharge, redness, breast retraction and pregnant and lactating women were excluded. Breast examination findings, ultrasonography (USG), mammography results, whether biopsies are done or not and diagnoses have been investigated retrospectively. Results Mean age was 42.97±12.36 (16–74) years. 59.7% (n=471) of the women had bilateral mastalgia and 91.1% (n=719) of the breast examinations were found to be normal. USG was required from 664 (84.2%) women and mammography was required from 448 (56.8%) women. Considering diagnoses; fibrocystic changes in 32.3% (n=201), ductal ectasia in 8.8% (n=55), fibroadenomas in 6.1% (n=38), reactive lymphoid hyperplasia in 1.1% (n=7) was observed. Only 1 (0.2%) woman was diagnosed with invasive ductal carcinoma. Conclusion According to researches, 0.5% of the women with mastalgia were diagnosed with breast cancer. In our study this rate was found as 0.2%. Women with only mastalgia without any abnormality in physical examination should be informed about dealing with pain. PMID:28331753

  10. A 30-Year Global Wave Hindcast

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  11. Test anxiety inventory: 30 years later.

    PubMed

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

    2012-11-01

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

  12. Gallstone ileus 30 years status postcholecystectomy.

    PubMed

    Zens, Tiffany; Liebl, R Scott

    2010-12-01

    Gallstone ileus is an uncommon cause of small bowel obstruction which occurs in patients with chronic cholecystitis and gallstones who develop a cholecystoenteric fistula. Although gallstone ileus is relatively rare, it has a substantial mortality rate due in part to patient comorbidities and delays in treatment. We describe the case of a 94-year-old woman who presented with nausea, vomiting, mild abdominal tenderness, leukocytosis, and a 2.5-cm obstruction in her small bowel. Even though this patient underwent a total cholecystectomy 30 years prior, a 2.5-cm gallstone was surgically removed from her ileum. This case illustrates the importance of including gallstone ileus in the differential diagnosis for patients who present with small bowel obstruction even decades postcholecystectomy.

  13. Acute respiratory distress syndrome: 30 years later.

    PubMed

    Lesur, O; Berthiaume, Y; Blaise, G; Damas, P; Deland, E; Guimond, J G; Michel, R P

    1999-01-01

    Acute respiratory distress syndrome (ARDS) was first described about 30 years ago. Modern definitions and statements have recently been proposed to describe ARDS accurately, but none is perfect. Diffuse alveolar damage is the basic pathological pattern most commonly observed in ARDS, and the term includes permeability edema. The alveolar epithelium of the alveolar-capillary barrier is clearly a key component requiring repair, given its multipotent functional activity. Lung inflammation and neutrophil accumulation are essential markers of disease in ARDS, and a wide variety of pro- and anti-inflammatory cytokines have been described in the alveolar fluid and blood of patients. These molecules still have to prove their value as diagnostic or prognostic biomarkers of ARDS. Supportive therapy in ARDS improved in the past decade; mechanical ventilation with lung protective strategies and patient positioning are gaining interest, but the indications for corticosteroids for ARDS are still debated. Nitric oxide may have a place in the treatment of one-third of patients. Novel approaches, such as surfactant replacement and liquid ventilation, may further improve supportive therapy. Innovative interventions may be on the horizon in treatments that help to resolve or modulate common pathways of ARDS, such as inflammation (eg, granulocyte-colony stimulating factor) or epithelial repair (eg, keratinocyte growth factor).

  14. Modern Era Retrospective-Analysis for Research and Applications

    NASA Technical Reports Server (NTRS)

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

    2009-01-01

    The Modern Era Retrospective-analysis for Research and Applications (MERRA) reanalyses has produced several years of data, on the way to a. completing the 1979-present modern satellite era. Here, we present a preliminary evaluation of those years currently available, including comparisons with the existing long reanalyses (ERA40, JPA25 and NCEP I and II) as well as with global data sets for the water and energy cycle. Time series shows that the MERRA budgets can change with some of the variations in observing systems. We will present all terms of the budgets in MERRA including the time rates of change and analysis increments (tendency due to the analysis of observations).

  15. Pediatric tinea faciei in southern Spain: a 30-year survey.

    PubMed

    del Boz, Javier; Crespo, Vicente; de Troya, Magdalena

    2012-01-01

    Tinea faciei (TF) is a common clinical form of tinea in children that is frequently misdiagnosed and treated with corticosteroids. No large case series of TF focusing on children have been published. The aim of this study was to analyze the main epidemiologic, clinical, and microbiologic features of TF in children over a period of 30 years and compare these features with those of other tineas. We undertook a retrospective study of 818 cases of tinea in children at a referral hospital in southern Spain, diagnosed between 1977 and 2006, concentrating for this study on TF. Of the 73 cases of TF diagnosed, 50.7% were in girls. Most children (46.6%) were 4 to 9 years old. At the time of diagnosis, 29.2% of the cases had been treated with topical steroids. The most frequently isolated dermatophyte was Trichophyton mentagrophytes, which was isolated significantly more frequently in TF than in the other tineas. Cases of TF in children were not extremely unusual, emphasizing that TF must be considered in children with inflammatory facial eruptions. This consideration and the more-frequent use of mycologic tests can help achieve the correct diagnosis, when present.

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

    PubMed

    Lurie, S; Boaz, M; Golan, A

    2013-11-01

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

  17. Brazilian nursing and professionalization at technical level: a retrospective analysis.

    PubMed

    Göttems, Leila Bernarda Donato; Alves, Elioenai Dornelles; de Sena, Roseni Rosangela

    2007-01-01

    This article presents a retrospective analysis of the Brazilian Nursing concerning the professionalization of workers at technical level. It also provides some indication about the trends of professional education. There is a clear indication of increased intellectual and conceptual accumulation in the four decades the professional education in nursing at technical level has been part of the public policy agenda. This experience serves as reference for the formulation of new actions directed to other professionals of technical level who deliver direct care to the population. The study shows that there was reformulation of the nursing professional qualification issue, including in the discussion the need to improve the quality of educational processes and extensive supply of continuous education to workers already inserted in the process, in order to keep the constant changes in the Brazilian Health system.

  18. [Fauna attacks in French Guiana: retrospective 4-year analysis].

    PubMed

    Mimeau, E; Chesneau, P

    2006-02-01

    The rich, diversified fauna of French Guiana has an infamous reputation for its aggressiveness. A retrospective analysis of the records the SAMU emergency service in Guiana showed that less than 1% of phone calls received between 1998 and 2001 involved fauna attacks. Most of these calls involved flying hymenoptera (36.9%), snakes (15.6 %), dogs (13.8%), and scorpions (9.8%). In 69 of 666 cases, the attack was severe enough to warrant dispatching a SMUR intensive mobile care unit. These cases involved poisonous snake bites (n=35), flying hymenoptera stings (n=24) and scorpion stings (n=5). Although this study presents numerous confounding factors, its findings indicate that the risk of fauna attacks in French Guiana may be overestimated.

  19. Fatal electrocution in adults--a 30-year study.

    PubMed

    Wick, Regula; Gilbert, John D; Simpson, Ellie; Byard, Roger W

    2006-04-01

    A retrospective study was undertaken of all cases of death in adults (>16 years) due to electrocution which were autopsied at Forensic Science SA, Adelaide, Australia, over a 30-year period from 1973 to 2002. A total of 96 cases were identified with 87 males (91%) (mean age=41.6 years; range 17 to 86 years) and nine females (9%) (mean age=49.2 years; range 20 to 76 years). Deaths were due to accidents in 66 cases (69%; M:F = 63:3), suicides in 28 cases (29%; M:F=24:4) and homicides in two cases (2%). Both homicide victims were females, with females accounting for only 5% of the accidents and 14% of suicides. The number of accidental deaths increased until the early 1990s and then declined, whereas suicidal electrocutions were only found in the last 20 years of the study. Most deaths (N = 80; 83%) were due to low voltage circuits (<1000 volts), with deaths due to high voltages occurring in 15 cases (16%). One death was due to lightning (1%). While suicides were evenly distributed throughout the year, most accidental deaths occurred in late spring and summer (N = 42; 64%) with the lowest number of accidental deaths occurring in winter and early spring. This report demonstrates a significantly higher rate of electrocution deaths among males, with a summer predominance of accidental deaths, most likely due to increased outdoor activities in better weather. The reduction in cases over the last decade of the study may be a reflection of the success of workplace and domestic safety campaigns. Female electrocution suicides and electrocution homicides were rare events.

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

    PubMed

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

    2015-10-01

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

  1. 77 FR 65645 - Retrospective Analysis of Existing Rules: Notice of Staff Memorandum

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-30

    ... revisions to the Commission's Natural Gas Pipeline regulations that may be appropriate to remove reporting..., which requested independent regulatory agencies issue plans for periodic retrospective analysis of...

  2. Spinal cord gliomas: A multi-institutional retrospective analysis

    SciTech Connect

    Abdel-Wahab, May . E-mail: mwahab@med.miami.edu; Etuk, Blessing; Palermo, James; Shirato, Hiroki; Kresl, John; Yapicier, Ozlem; Walker, Gail; Shaw, Edward; Lee, Charles; Curran, Walter; Thomas, Terry; Markoe, Arnold

    2006-03-15

    Purpose: To determine the impact of postoperative radiation therapy (POXRT) on outcome in spinal cord gliomas. Patients and Methods: Data from 242 patients were collected retrospectively from six institutions using a standardized data sheet. Pathology specimens, when available, were centrally reviewed. Results: A total of 183 patients were analyzed: 82 received surgery alone as initial treatment, whereas 101 had surgery and POXRT. Demographic, diagnostic, and treatment factors were analyzed for impact on progression-free (PFS) and overall survival (OS). PFS in ependymoma patients was 74%, 60%, and 35% at 5, 10, 15 years, respectively, and was significantly influenced by treatment type, race, age, tumor grade, and type of surgery on univariate analysis, with age being the only significant factor on multivariate analysis (MVA) (p = 0.01). OS of ependymoma patients was 91%, 84%, and 75% at 5, 10, and 15 years, respectively, and was significantly influenced by both complete resection (p = 0.04) and age (p = 0.03) on MVA. In astrocytomas, PFS was 42%, 29%, and 15% at 5, 10, and 15 years, and was significantly influenced by POXRT in low- and intermediate-grade tumors on MVA (p = 0.02). OS at 5, 10, and 15 years was 59%, 53%, and 32%, respectively, and was significantly influenced by grade on MVA (p < 0.01). Conclusion: Postoperative radiation therapy reduced disease progression in low- and moderate-grade astrocytomas. In ependymomas, complete resection significantly influenced OS.

  3. Retrospective Demographic Analysis of Patients Seeking Care at a Free University Chiropractic Clinic

    PubMed Central

    Stevens, Gerald; Campeanu, Michael; Sorrento, Andrew T.; Ryu, Jiwoon; Burke, Jeanmarie

    2016-01-01

    Objective The purpose of this study was to describe the demographics, presenting complaints, and health history of new patients seeking treatment at a free chiropractic clinic within a university health center. Methods A retrospective analysis of patient files from 2008 to 2009 was performed for a free student chiropractic clinic in the Buffalo, NY, area. Demographics, presenting complaints, and health history of new patients seeking treatment were recorded. Results There were 343 new chiropractic patient files. Most patients were between the ages of 18 and 30 years (n = 304, 88%) with an almost equal distribution of men (n = 163, 48%) and women (n = 180, 52%). The patients were mostly single (n = 300, 87%). Patients self-reported that their case histories excluded a current medical diagnosis (n = 261, 76%), previous history of disease (n = 216, 63%), allergies (n = 240, 70%), previous surgical procedures (n = 279, 81%), and medication use (n = 250, 73%). The frequencies of spinal complaints were as follows: lumbar spine, n = 176 (51%); cervical spine, n = 78 (23%); and thoracic spine, n = 44 (13%). Maintenance care, headaches, and spine-related upper and lower extremities complaints accounted for the other 13% of patients treated. Half were chronic (n = 172, 50%), and a third were acute (n=108, 31%). Patients averaged 6 chiropractic visits, with 88% having 11 visits or less. Conclusion This study found that new patients seeking care at a free student chiropractic clinic within a university health center in the Buffalo area mainly consisted of young single adults, with chronic lumbar spine complaints with few comorbidities. PMID:27069428

  4. Key elements on team achievement: a retrospective analysis.

    PubMed

    Taveira, Alvaro D

    2008-07-01

    This study is a historical reconstruction and in-depth scrutiny of one very successful team initiative within a Quality Improvement (QI) program in a municipal government organization. The identification of the essential concepts that contributed to the team's success and their integration into a local explanatory theory of team achievement is the final purpose of the study. The focus of this retrospective study is on the team process, with primary attention given to team members' perspectives and reflections on the project development. Data collection and analysis were conducted with methods drawn from the qualitative research tradition and from Quality Management. Main findings point to the importance of consistent management support, correct team composition with an emphasis on the team leader choice and demeanor, and to the central role of training in the group conduct. The negotiated approach to decision-making employed by the team, which reflected its organizational context, and the effort and mechanisms that allowed the group to reach equilibrium between internal and external interests proved critical for its ultimate achievement.

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

    PubMed

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

    2010-07-01

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

  6. The Retrospective Iterated Analysis Scheme for Nonlinear Chaotic Dynamics

    NASA Technical Reports Server (NTRS)

    Todling, Ricardo

    2002-01-01

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

  7. Retrospective Analysis of Inflight Exercise Loading and Physiological Outcomes

    NASA Technical Reports Server (NTRS)

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

    2014-01-01

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

  8. TRUS Biopsy Yield in Indian Population: A Retrospective Analysis

    PubMed Central

    Pawar, Prakash Wamanrao; Sawant, Ajit Somaji; Patil, Akshay Vijay; Narwade, Sayalee Suryabhan; Mundhe, Shankar Tanaji; Savalia, Abhishek Jaysukhbhai; Tamhankar, Ashwin Sunil

    2017-01-01

    Introduction The reported cancer detection rate of Trans-Rectal Ultrasonography (TRUS) biopsies (TRUS biopsy yield) has been around 30 percent in western countries. However it is much lower in Asian countries, including India. Hence a larger proportion of patients in India undergo unnecessary biopsies. Aims To find out the cancer detection rate of TRUS biopsy (TRUS biopsy yield) in contemporary Indian population. Also, to study the positive predictive values at different serum Prostate-Specific Antigen (PSA)/PSA Density (PSAD) cut off levels and suspicious Digital Rectal Examination (DRE) findings. Materials and Methods This retrospective study was carried out in a tertiary care institute. All symptomatic patients who underwent TRUS guided biopsy for indication of raised serum PSA level (>4 ng/ml) or suspicious DRE findings (nodule, irregularity, hard consistency, immobile rectal mucosa) from January 2012 to December 2014 were included. For serum PSA range (4-10) ng/ml, TRUS guided biopsy was done in patients with percent free/total PSA < 25. Statistical analysis used were Chi-square test, Mann-Whitney U-test, Spearman’s rank correlation analysis and Receiver-Operating Characteristic (ROC) curve. Results Out of the 235 patients included, 60 patients had malignancy (overall cancer detection rate= 25.53%). The cancer detection rate for PSA ranges of (4-10) and (10-20) ng/ml was as low as 5.95% and 13.16% respectively. Patients with malignant disease had significantly smaller prostate gland size than patients with benign disease (53.89 vs 63.06; p-value <0.05). On the other hand, cancer detection rate was 100% for PSA greater than 50ng/ml. The cancer detection rates were only upto 10% for PSA density ranges upto 0.25 ng/ml/cm3. The Area Under the Curve (AUC) for PSA and PSAD was 0.876 and 0.884 respectively. Only one patient (0.43%) had post-biopsy complication (acute bacterial prostatitis) requiring hospital admission. Conclusion The current serum PSA and PSAD cut

  9. Complications of Laparoscopic Cholecystectomy: Our Experience from a Retrospective Analysis

    PubMed Central

    Radunovic, Miodrag; Lazovic, Ranko; Popovic, Natasa; Magdelinic, Milorad; Bulajic, Milutin; Radunovic, Lenka; Vukovic, Marko; Radunovic, Miroslav

    2016-01-01

    AIM: The aim of this study was to evaluate the intraoperative and postoperative complications of laparoscopic cholecystectomy, as well as the frequency of conversions. MATERIAL AND METHODS: Medical records of 740 patients who had laparoscopic cholecystectomy were analysed retrospectively. We evaluated patients for the presence of potential risk factors that could predict the development of complications such as age, gender, body mass index, white blood cell count and C-reactive protein (CRP), gallbladder ultrasonographic findings, and pathohistological analysis of removed gallbladders. The correlation between these risk factors was also analysed. RESULTS: There were 97 (13.1%) intraoperative complications (IOC). Iatrogenic perforations of a gallbladder were the most common complication - 39 patients (5.27%). Among the postoperative complications (POC), the most common ones were bleeding from abdominal cavity 27 (3.64%), biliary duct leaks 14 (1.89%), and infection of the surgical wound 7 patients (0.94%). There were 29 conversions (3.91%). The presence of more than one complication was more common in males (OR = 2.95, CI 95%, 1.42-4.23, p < 0.001). An especially high incidence of complications was noted in patients with elevated white blood cell count (OR = 3.98, CI 95% 1.68-16.92, p < 0.01), and CRP (OR = 2.42, CI 95% 1.23-12.54, p < 0.01). The increased incidence of complications was noted in patients with ultrasonographic finding of gallbladder empyema and increased thickness of the gallbladder wall > 3 mm (OR = 4.63, CI 95% 1.56-17.33, p < 0.001), as well as in patients with acute cholecystitis that was confirmed by pathohistological analysis (OR = 1.75, CI 95% 2.39-16.46, p < 0.001). CONCLUSION: Adopting laparoscopic cholecystectomy as a new technique for treatment of cholelithiasis, introduced a new spectrum of complications. Major biliary and vascular complications are life threatening, while minor complications cause patient discomfort and prolongation of

  10. Retrospective Analysis of a Home Care Hospice Program.

    ERIC Educational Resources Information Center

    Brescia, Frank J.; And Others

    1985-01-01

    Presents a retrospective study of patients who died in a hospice home care program to examine quality of care and differences between patients who died at home and in the hospital. No prediction could be made of which patients could remain at home until death. (JAC)

  11. A retrospective pooled analysis assessing the effect of age on the immunogenicity of Havrix™ in healthy adults.

    PubMed

    Van Der Meeren, Olivier; Crasta, Priya; de Ridder, Marc

    2015-01-01

    Over recent decades, the global incidence of hepatitis A virus infection has been reduced by improvements in sanitation infrastructure and through immunization programs. The immunogenicity and field efficacy of the inactivated hepatitis A vaccine (Havrix™, GSK, Belgium) has been demonstrated in clinical trials, population-impact studies as well as in several outbreak settings. However, immunological data in older populations are limited, with only few studies assessing the immune response of this vaccine in adults aged ≥ 40 years. This retrospective pooled analysis of 4 2-dose primary vaccination studies compared the immunogenicity and safety of the inactivated hepatitis A vaccine in adults aged ≥ 40 years with subjects aged 20-30 years (control group; N = 80 in each group). Fifteen days after the first vaccine dose, 79.7% (95% CI: 68.8-88.2) and 92.3% (95% CI: 84.0-97.1) of subjects were seropositive in the ≥ 40 years and control groups, respectively; 97.5% (95% CI: 91.2-99.7) and 97.4% (95% CI: 91.0-99.7), respectively, were seropositive one month after the first dose. All subjects in both groups (95% CIs: 95.4-100 and 95.3-100, respectively) were seropositive one month after the second dose. Safety profiles were similar in both groups. In conclusion, the inactivated hepatitis A vaccine induced similar immune responses in adults aged ≥ 40 and 20-30 years one month after the first and second dose whereas younger subjects may demonstrate a higher seroconversion rate 15 days after the first dose.

  12. 30 years of finite-gap integration theory.

    PubMed

    Matveev, Vladimir B

    2008-03-28

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

  13. Endoscopic Septoplasty: A Retrospective Analysis of 415 Cases.

    PubMed

    Kulkarni, Shreeya V; Kulkarni, Vinay P; Burse, Kiran; Bharath, Manu; Bharadwaj, Chaitanya; Sancheti, Vandana

    2015-09-01

    Nasal obstruction is the most common complaint in nasal and sinus disease. Deviated nasal septum is a very frequently encountered and common cause. Surgical correction of a deviated septum- nasal septoplasty- is the definite treatment for septal deviation. Over the last 2 decades, the applications for endoscopy in the field of rhinology have evolved beyond functional endoscopic sinus surgery (FESS). Septoplasty which is among the three most commonly performed procedures in otolaryngology is particularly well suited to endoscopic application. Endoscopic septoplasty as a minimally invasive technique can limit the dissection and minimize trauma to the nasal septal flap under excellent visualization whose primary advantage is to decrease morbidity and post operative swelling in isolated septal deviation by limiting the excision to the area of deviation. This was a retrospective study, conducted in a tertiary care medical college hospital over a period of 5 years. The study group comprised 415 patients in and around Nashik District; who visited our tertiary health centre and were subjected to endoscopic septoplasty. Complete data records from 415 patients were available for statistical analysis. Maximum numbers of patients were in age group 20-39. The youngest patient was 7 years old and oldest was 75 years. Mean age was 32 years. The 7 years old was operated for DCR for congenital NLD block and septoplasty was adjunct procedure. Even the 75 years was operated for DCR. In the present study out of 415 cases, 256 (67.5 %) cases were male and 115 (32.5 %) cases were female. There is a male preponderance in the overall distribution of cases. In the present study of 415 patients, the most common operative procedure done was septoplasty in 260 (62.6 %), FESS with septoplasty in 38 (9.2 %) cases, septorhinopolasty in 41 (9.9 %) cases and DCR with septoplasty in 78 (18.3 %) cases. Endoscopic septoplasty facilitates good access to accomplish endoscopic DCR, FESS, and

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

    PubMed Central

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

    2016-01-01

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

  15. 7 CFR 625.12 - 30-year contracts.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false 30-year contracts. 625.12 Section 625.12 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF..., maintenance, and management of habitat and forest ecosystem functions and values. (b) For the duration of...

  16. 7 CFR 625.12 - 30-year contracts.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false 30-year contracts. 625.12 Section 625.12 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF..., maintenance, and management of habitat and forest ecosystem functions and values. (b) For the duration of...

  17. 7 CFR 625.12 - 30-year contracts.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false 30-year contracts. 625.12 Section 625.12 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF..., maintenance, and management of habitat and forest ecosystem functions and values. (b) For the duration of...

  18. [The past 30 years of Chinese Journal of Biotechnology].

    PubMed

    Jiang, Ning

    2015-06-01

    This review addresses the association of "Chinese Journal of Biotechnology" and the development of biotechnology in China in the past 30 years. Topics include relevant awards and industrialization, development of the biotechnology discipline, and well know scientists in biotechnology, as well as perspectives on the journal.

  19. 7 CFR 625.12 - 30-year contracts.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false 30-year contracts. 625.12 Section 625.12 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF..., maintenance, and management of habitat and forest ecosystem functions and values. (b) For the duration of...

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

    ERIC Educational Resources Information Center

    Aggleton, Peter; Yankah, Ekua; Crewe, Mary

    2011-01-01

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

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

    PubMed

    Macher, Abe M; Wolfe, Martin S

    2006-05-01

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

  2. Intracranial abscesses: Retrospective analysis of 32 patients and review of literature

    PubMed Central

    Udoh, David O.; Ibadin, Emmanuel; Udoh, Mojisola O.

    2016-01-01

    Background: Intracranial abscess collections, though uncommon, are dreaded complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Combining surgical evacuation with the appropriate antibiotic therapy is the effective treatment for intracranial abscesses. However, literature on surgical treatment is replete with several procedures which, on their own, may not Objectives: To determine the epidemiology and outcomes (of various treatment modalities) of intracranial abscesses in our institution, a major referral center for neurosurgical conditions in the midwestern region of Nigeria. Materials and Methods: This is a retrospective analysis of demographic data as well as indications, treatment modalities, and outcomes of various surgical procedures for evacuation of intracranial abscesses between September 2006 and December 2011. Results: We carried out 40 procedures in 32 (23 male and 9 female) patients with various intracranial abscesses. These represented approximately 5.6% of all operative neurosurgical procedures in our unit since inception. Most abscesses [16, i.e. 50%] occurred in the second decade. In the first decade, there were 7 (22%), and after the age of 30 years, there were 4 (12.5%). The most susceptible single year of life was infancy with 4 (12.5%) cases of intracranial abscesses. None of the infants had features of congenital heart disease. The predisposing factors were mostly otolaryngologic (9) or posttraumatic (6). Most abscesses (41%) were located in the frontal region, and intraparenchymal (i.e. intracerebral or intracerebellar) (50%) lesions were commoner than extradural, subdural, or intraventricular lesions. The commonest procedure performed (50%) was burr hole evacuation. Four patients (12.5% of cases) died. Prognosis appears to worsen with meningitis as the predisposing infection, ventriculitis, multiple abscesses especially in infants, and immunosuppression. Conclusion

  3. Demodex dermatitis: a retrospective analysis of clinical diagnosis and successful treatment with topical crotamiton.

    PubMed

    Bikowski, Joseph B; Del Rosso, James Q

    2009-01-01

    Given the reported common occurrence of Demodex dermatitis in the general population, Demodex dermatitis-considered as a separate condition from rosacea and seborrheic dermatitis-was evaluated in a retrospective case analysis.

  4. Retrospective on 30 years of nonimaging optics development for solar energy at the University of Chicago

    NASA Astrophysics Data System (ADS)

    O'Gallagher, Joseph J.

    2016-09-01

    As the field of nonimaging optics has developed over the last 50 years, among its many applications, the best known and recognized is probably in solar energy. In particular, the approach provides the formalism that allows the design of devices that approach the maximum physically attainable geometric concentration for a given set of optical tolerances. This means that it has the potential to revolutionize the design of solar concentrators. Much of the experimental development and early testing of these concepts was carried out at the University of Chicago by Roland Winston and his colleagues and students. In this presentation, some of many embodiments and variations of the basic Compound Parabolic Concentrator that were developed and tested over a thirty-year period at Chicago are reviewed. Practical and economic aspects of concentrator design for both thermal and photovoltaic applications are discussed. Examples covering the whole range of concentrator applications from simple low-concentration non-tracking designs to ultrahigh-concentration multistage configurations are covered.

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

    ERIC Educational Resources Information Center

    Thase, Michael E.

    2012-01-01

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

  6. 1995 solid waste 30-year container volume summary

    SciTech Connect

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

    1995-07-01

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

  7. Early Intervention and AAC: What a Difference 30 Years Makes.

    PubMed

    Romski, MaryAnn; Sevcik, Rose A; Barton-Hulsey, Andrea; Whitmore, Ani S

    2015-01-01

    This article provides an overview of early intervention and AAC over the 30-year period since the founding of the journal Augmentative and Alternative Communication in 1985. It discusses the global context for early intervention and addresses issues pertaining to young children from birth to 6 years of age. It provides a narrative review and synthesis of the evidence base in AAC and early intervention. Finally, it provides implications for practice and future research directions.

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

    PubMed

    Exworthy, Mark

    2008-01-01

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

  9. Retrospective analysis of phone queries to an epilepsy clinic hotline.

    PubMed

    Laforme, Anny; Jubinville, Suzie; Gravel, Micheline; Cossette, Patrick; Nguyen, Dang K

    2014-01-01

    We undertook a retrospective study of 5,189 telephone calls made between January 2004 and June 2011 through our adult epilepsy clinic hotline to a single epileptologist initially and two epileptologists from June 2010 onwards. The majority of calls were made by patients themselves (72%), followed by family members (16%) and health care providers (11%). Half of the calls originated from outside the city limits. Most were related to medication (25%), notification of seizures (23%), appointments or tests (12%), and side effects (9%). Half of the workload was generated by 10% of patients. The hotline service appears to respond to needs, with most calls requiring rapid intervention. It is desirable to develop novel approaches to address the needs of high-frequency callers.

  10. Sickle cell anemia from central India: a retrospective analysis.

    PubMed

    Jain, Dipty; Italia, Khushnooma; Sarathi, Vijaya; Ghoshand, Kanjaksha; Colah, Roshan

    2012-11-01

    Although sickle cell anemia in India is believed to have a mild clinical presentation, few studies report severe disease in many patients from central India. Hence, we have retrospectively studied 316 children with SCA who were followed up for a period of 5.8±5.7 years. There were 55.4 blood transfusions, 43.3 episodes of vaso-occlusive crises requiring hospitalization, and 108.9 hospitalizations per 100 person years. Ninety six (30%) patients had severe disease whereas 74 patients also fulfilled the criteria for hydroxyurea therapy. Significant proportion of children with sickle cell anemia from central India present with severe clinical presentation and require regular medical attention.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-02-15

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

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

    PubMed Central

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

    2015-01-01

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

  14. Retrospective analysis of vocal cord-to-suprasternal notch distance

    PubMed Central

    Kim, Hyerim; Chang, Jee-Eun; Ryu, Jung-Hee; Jung, Haesun; Min, Seong-Won; Lee, Jung-Man; Hwang, Jin-Young

    2017-01-01

    Abstract Endotracheal tube (ETT) positioning using the cuff ballottement test, which confirms that the inflated cuff is positioned at the suprasternal notch with squeezing or inflating a pilot balloon, has been reported to be a simple and reliable method of preventing endobronchial intubation. However, in patients with a short vocal cord-to-suprasternal notch, ETT placement using the cuff ballottement test can cause vocal cord injury. In the present study, we assessed the distance from a point 15 mm below the vocal cord to the suprasternal notch (VSD-15), the safe position for ETT cuff placement above the suprasternal notch, and investigated variables for predicting VSD-15. We retrospectively examined neck computed tomography in 427 adult patients and measured VSD-15 and the distance from the thyroid notch to the suprasternal notch (TSD). Patient height, weight, sex, and age were also recorded. In total, 47 patients (11.0%) showed a VSD-15 shorter than 45 mm. VSD-15 significantly correlated with TSD (r = 0.778, P < 0.001) and height (r = 0.312, P < 0.001), and inversely correlated with age (r = −0.321, P < 0.001). In multiple linear regression models, a formula was obtained for VSD-15 (VSD-15 [mm] = −6.220 + 0.744 × TSD [mm] + 0.092 × height [cm] − 0.065 × age [years], R2 = 0.621). The cuff ballottement test should be used cautiously in patients with a predicted short VSD-15. VSD-15 can be predicted from TSD, height, and age. PMID:28207550

  15. Tuberculosis of hip in children: A retrospective analysis

    PubMed Central

    Moon, Myung-Sang; Kim, Sung-Soo; Lee, Sung-Rak; Moon, Young-Wan; Moon, Jeong-Lim; Moon, Seog-In

    2012-01-01

    Background: Tuberculosis (TB) of hip constitutes nearly 15% of all cases of osteoarticular tuberculosis. We report a retrospective study carried out on 43 children with hip TB. Materials and Methods: Forty-three children of TB hip treated between 1971 and 2000 were analysed. Twenty-four children of the early series were treated with streptomycin (S), isoniazid (H) and PAS (Pa) for 18 months (3HPaS, 15 HPa), while 19 children in the later series were treated with isoniazid (H), rifampicin (R) and ethambutol (E) or pyrazinamide (Z) for 12 months [(12 RHE(Z)]. Five out of 18 children with radiologically normal appearing type hip TB were treated with chemotherapy alone and 38 children were subjected to surgery; simple synovectomy alone in 31 hips, joint debridement in six hips, and proximal femoral varisation osteotomy in one. After surgery hips were immobilized in cast for one to three months according to the severity of the disease and patients pain tolerance, and then were mobilized under leg traction in bed gradually till pain subsided completely. Results: TB of hip healed with minimum sequelae in all children. In 18 Type one hip TB, normal hip (synovial form) anatomy was maintained, and in 25 patients with advanced lesions some defect in the femoral head and acetabulum was noticed, though painless good hip motion was maintained. Excellent to good results were obtained in 31 children (73.1%), fair in eight (18.6%), and poor in four (9.3%). In four patients with poor results, there was some residual morphological defect in the hip. None developed ankylosis of hip. Conclusion: We achieved good outcome with minimum sequelae in this series. The management goal should be aimed not only to heal the disease but also to maintain a painless mobile hip and anatomical cephalocotyloid relationship until maturity, and retard the development of secondary osteoarthritis. PMID:22448058

  16. Cleft lip and palate surgery: 30 years follow-up

    PubMed Central

    Guerrero, Cesar A.

    2012-01-01

    Ten cleft lip and palate patients with complete unilateral (five patients) and bilateral (five patients) clefts were treated by a multidisciplinary team integrated by psychologists, surgeons, orthodontists, prosthodontists, pediatric dentists, and speech pathologists, to obtain ideal soft tissue and hard tissue continuity, facial symmetry, functional and esthetic dentitions, excellent nasal architecture, subtle, and hidden lip scars. No hypernasality and adequate social adaptation were found in the 30 years follow-up (20-30 years follow-up with an average of 25.5 years). The patients were treated in a pro-active fashion avoiding complications and related problems, executing the ideal surgical, dental, and speech therapy plan, based on a close follow-up over the entire period. Those patients treated at the right time required less surgeries and less salvaging maneuvers and presented complete dentitions with less dental prosthesis or dental implants and stable occlusions, than those who missed the ideal dental and surgical treatment opportunities. The focus of this article is the need of a close long-term follow-up to ensure an ideal patient's quality of life. PMID:23483117

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  18. Structural patterns in Swedish health policy: a 30-year perspective.

    PubMed

    Saltman, Richard B

    2015-04-01

    This perspective reviews key institutional and organizational patterns in Swedish health care over the last 30 years, probing the roots of several complicated policy questions that concern present-day Swedish decision-makers. It explores in particular the ongoing structural tension between stability, on the one hand, and the necessary levels of innovation and dynamism demanded by the current period of major clinical, technological, economic, social and supranational (EU) change. Where useful, the article compares Swedish developments with those in the other three European Nordic countries as well as other northern European health systems. Sweden's health sector evolution can provide valuable insight for other countries into the complexity involved in re-thinking tradeoffs between policies that emphasize stability as against those that encourage innovation in health sector governance and provision.

  19. Education and HIV/AIDS-30 years on.

    PubMed

    Aggleton, Peter; Yankah, Ekua; Crewe, Mary

    2011-12-01

    Education has long been identified as having a key role to play in reducing HIV-related risk and vulnerability, and in mitigating the impact of the epidemic on affected individuals and communities. This article reflects on progress over a 30-year period with respect to older and more emergent forms of education concerning HIV and AIDS: treatment education, education for HIV prevention, and education to encourage a positive and supportive community response. It points to a number of priorities for the future. These include analyzing more carefully different forms of HIV-related education, their consequences and effects, and identifying the specific effectivity of education in general and HIV-related education in particular in achieving positive outcomes. The potential of education to enable new ways of seeing, understanding, and hoping is stressed, as is the need to support education processes and systems that "think" faster than the epidemic.

  20. Massive transcranial parotid pleomorphic adenoma: recurrence after 30 years.

    PubMed

    Strub, Graham M; Georgolios, Alexandros; Graham, Robert S; Powers, Celeste N; Coelho, Daniel H

    2012-10-01

    Pleomorphic adenoma, also known as benign mixed tumor, is the most common tumor affecting the parotid gland and can reach massive size; however, intracranial invasion is rare. Recurrence of pleomorphic adenoma after excision is a well-known phenomenon and can present decades after resection of the primary tumor. Here we present the case of a 53-year-old man who presented to our clinic with ear fullness, otalgia, and hearing loss 30 years after undergoing total parotidectomy and external beam radiotherapy for pleomorphic adenoma. Magnetic resonance imaging revealed a massive transcranial tumor invading the mastoid cavity, the dura of the posterior fossa, the fallopian and semicircular canals, the jugular foramen, the lateral infratemporal fossa skull base, the sigmoid and transverse sinuses, and the superior parapharyngeal region. Gross examination and histopathological studies confirmed that the mass was a recurrent pleomorphic adenoma. Here we discuss the features of recurrent pleomorphic adenoma and review the current literature.

  1. What Has 30 Years of HIV Vaccine Research Taught Us?

    PubMed Central

    Esparza, José

    2013-01-01

    When HIV was discovered and established as the cause of AIDS in 1983–1984, many people believed that a vaccine would be rapidly developed. However, 30 years have passed and we are still struggling to develop an elusive vaccine. In trying to achieve that goal, different scientific paradigms have been explored. Although major progress has been made in understanding the scientific basis for HIV vaccine development, efficacy trials have been critical in moving the field forward. Major lessons learned are: the development of an HIV vaccine is an extremely difficult challenge; the temptation of just following the fashion should be avoided; clinical trials are critical, especially large-scale efficacy trials; HIV vaccine research will require long-term commitment; and sustainable collaborations are needed to accelerate the development of an HIV vaccine. Concrete actions must be implemented with the sense of urgency imposed by the severity of the AIDS epidemic. PMID:26344345

  2. [Acupuncture for aphasia: a retrospective analysis of clinical literature].

    PubMed

    Tan, Jie; Zhang, Hong; Han, Guodong; Ai, Kun; Deng, Shifeng

    2016-04-01

    With the Meta-analysis method, the clinical efficacy of acupuncture and other regular methods for aphasia was evaluated, and the acupoints selection for aphasia was explored. The acupuncture literature of clinical randomized control trials for aphasia published in CNKI, WANFANG, VIP and CBM database was searched; the statistical analysis of clinical efficacy of acupuncture and other regular methods for aphasia was performed by using software Revman 5. 2 provided by Cochrane library. A file of Microsoft Excel was established to perform the analysis of acupoints selection based on frequency analysis method, so as to summarize the characteristics and rules. Totally 385 articles were searched, and 37 articles those met the inclusive criteria was included, involving 1,260 patients in the acupuncture group and 1 238 patients in the control group. The Meta-analysis results showed OR = 3.82, 95% Cl [3.01, 4.85]; rhombus was located on the right side and the funnel plot was nearly symmetry, indicating the treatment effect of the acupuncture group for aphasia was superior to the control group (Z = 11.04, P < 0.000 01). The frequency-analysis results showed that the frequency of acupoints from top to bottom was Lian-quan (CV 23), Tongli (HT 5), Yamen (GV 15), Jinjin (EX-HN 12), Yuye (EX-HN 13), Baihui (GV 20), Yuyan II, Yuyan I and Yuyan III. The frequency of meridians from top to bottom was the governor vessel, extra channels, conception vessel, heart meridian and large intestine meridian. It is concluded that the clinical efficacy of acupuncture combined with speech rehabilitation training and medication treatment for aphasia is superior to that of speech rehabilitation training and medication treatment alone. The clinical treatment for aphasia focuses on its local effect; the main acupoints are in the head and face, and the meridians are governor vessel, extra channels and conception vessel.

  3. Forensic age estimation of living individuals: a retrospective analysis.

    PubMed

    Santoro, Valeria; De Donno, Antonio; Marrone, Maricla; Campobasso, Carlo Pietro; Introna, Francesco

    2009-12-15

    In recent years, skeletal age determination has become increasingly important in criminal investigations for determining the age of living individuals. To increase diagnostic accuracy, a physical examination, an X-ray examination of the left hand, as well as a dental examination including the determination of the dental status and an X-ray of the dentition should always be performed. In this work, the authors analyze a sample of 52 illegal immigrants who came under their observation in the period from May 1989 to September 2007. A statistical analysis of the results of dental and skeletal age estimations was performed as well as an analysis between the reported and assessed ages. The results showed a significant difference between reported age and assessed biological age (p<0.001); however, no statistical difference was shown between skeletal and assessed dental age (p=0.431).

  4. Dysnatremias and Survival in Adult Burn Patients: A Retrospective Analysis

    DTIC Science & Technology

    2013-01-11

    hyponatre- mia occurred in 6.8% (n = 134) with mortality rates of 33.5 and 13.8%, respectively. Patients without a dysnatremia had Received: July 14...A multiple logistic regression analysis was performed to ana - lyze the relationship between independent variables of age, gen- der, %TBSA, %FT...15] . Of the 194 patients with hypernatre- mia , only 6 had concurrent head trauma for which an elevated sodium level was recommended by neurosur

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

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

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

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

    PubMed

    Rushton, A R

    2013-01-01

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

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-07

    ... Intellectual Property and Director of the United States Patent and Trademark Office. BILLING CODE 3510-16-P ... United States Patent and Trademark Office 37 CFR Chapter I Preliminary Plan for Retrospective Analysis of Existing Rules AGENCY: United States Patent and Trademark Office, Commerce. ACTION: Request for...

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

    ERIC Educational Resources Information Center

    Nguyen, Duyen T.; Fussell, Susan R.

    2015-01-01

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

  9. Retrospective analysis of outcomes from two intensive comprehensive aphasia programs.

    PubMed

    Persad, Carol; Wozniak, Linda; Kostopoulos, Ellina

    2013-01-01

    Positive outcomes from intensive therapy for individuals with aphasia have been reported in the literature. Little is known about the characteristics of individuals who attend intensive comprehensive aphasia programs (ICAPs) and what factors may predict who makes clinically significant changes when attending such programs. Demographic data on participants from 6 ICAPs showed that individuals who attend these programs spanned the entire age range (from adolescence to late adulthood), but they generally tended to be middle-aged and predominantly male. Analysis of outcome data from 2 of these ICAPs found that age and gender were not significant predictors of improved outcome on measures of language ability or functional communication. However, time post onset was related to clinical improvement in functional communication as measured by the Communication Activities of Daily Living, second edition (CADL-2). In addition, for one sample, initial severity of aphasia was related to outcome on the Western Aphasia Battery-Revised, such that individuals with more severe aphasia tended to show greater recovery compared to those with mild aphasia. Initial severity of aphasia also was highly correlated with changes in CADL-2 scores. These results suggest that adults of all ages with aphasia in either the acute or chronic phase of recovery can continue to show positive improvements in language ability and functional communication with intensive treatment.

  10. Mutational Profile of Metastatic Breast Cancers: A Retrospective Analysis

    PubMed Central

    Pedrero, Marion; Campone, Mario; Soria, Jean-Charles; Massard, Christophe; Lévy, Christelle; Arnedos, Monica; Lacroix-Triki, Magali; Garrabey, Julie; Boursin, Yannick; Deloger, Marc; Commo, Frédéric; Scott, Véronique; Kamal, Maud; Diéras, Véronique; Gonçalves, Anthony; Romieu, Gilles; Vanlemmens, Laurence; Mouret Reynier, Marie-Ange; Théry, Jean-Christophe; Le Du, Fanny; Guiu, Séverine; Dalenc, Florence; Bonnefoi, Hervé; Jimenez, Marta; Le Tourneau, Christophe; André, Fabrice

    2016-01-01

    Background Major advances have been achieved in the characterization of early breast cancer (eBC) genomic profiles. Metastatic breast cancer (mBC) is associated with poor outcomes, yet limited information is available on the genomic profile of this disease. This study aims to decipher mutational profiles of mBC using next-generation sequencing. Methods and Findings Whole-exome sequencing was performed on 216 tumor–blood pairs from mBC patients who underwent a biopsy in the context of the SAFIR01, SAFIR02, SHIVA, or Molecular Screening for Cancer Treatment Optimization (MOSCATO) prospective trials. Mutational profiles from 772 primary breast tumors from The Cancer Genome Atlas (TCGA) were used as a reference for comparing primary and mBC mutational profiles. Twelve genes (TP53, PIK3CA, GATA3, ESR1, MAP3K1, CDH1, AKT1, MAP2K4, RB1, PTEN, CBFB, and CDKN2A) were identified as significantly mutated in mBC (false discovery rate [FDR] < 0.1). Eight genes (ESR1, FSIP2, FRAS1, OSBPL3, EDC4, PALB2, IGFN1, and AGRN) were more frequently mutated in mBC as compared to eBC (FDR < 0.01). ESR1 was identified both as a driver and as a metastatic gene (n = 22, odds ratio = 29, 95% CI [9–155], p = 1.2e-12) and also presented with focal amplification (n = 9) for a total of 31 mBCs with either ESR1 mutation or amplification, including 27 hormone receptor positive (HR+) and HER2 negative (HER2−) mBCs (19%). HR+/HER2− mBC presented a high prevalence of mutations on genes located on the mechanistic target of rapamycin (mTOR) pathway (TSC1 and TSC2) as compared to HR+/HER2− eBC (respectively 6% and 0.7%, p = 0.0004). Other actionable genes were more frequently mutated in HR+ mBC, including ERBB4 (n = 8), NOTCH3 (n = 7), and ALK (n = 7). Analysis of mutational signatures revealed a significant increase in APOBEC-mediated mutagenesis in HR+/HER2− metastatic tumors as compared to primary TCGA samples (p < 2e-16). The main limitations of this study include the absence of bone

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

    NASA Technical Reports Server (NTRS)

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

    2008-01-01

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

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

    PubMed Central

    Fisher-Wellman, Kelsey; Bloomer, Richard J

    2009-01-01

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

  13. Changes in schoolgirls' body measurements during a 30 year period.

    PubMed

    Kaarma, Helje; Kasmel, Jaan; Koskel, Säde; Tiit, Ene-Margit

    2003-01-01

    Two data-sets containing the anthropometric measurements of Estonian schoolgirls aged 7-18 were analysed, one (set A) from the late sixties, size 1627 and the other (set K) from the late nineties, size 1546. In all data sets 8 measurements--three height, three breadth measures, chest circumference and mass--were measured using the same methodology, as well as BMI was calculated. The means of all the characteristics in age groups (size 100-150 individuals) were calculated and growth curves of means were approximated using polynomial least squares approximation. The maximal velocity points were found and the growth intensities in different body build groups were compared. It was proved that the usage of cross-sectional data for estimating growth curves is suitable for estimating the velocity of acceleration in different age groups. We found that the height of Estonian girls has increased during the last 30 years by about 4-5%, the breadth measurements--by about 1-2%, chest circumference up to 8% and BMI has decreased by 3-5%. The changes are quite modest in pre-puberty, most significant for girls aged 12-16 and smaller again for girls aged 17 and more. The maximal growth velocity has shifted for all characteristics to the earlier time. Comparison of different body build groups showed that the small girls of the sixties are quite similar to small girls in the nineties, but the differences are greater in the case of large and pycnomorphic girls.

  14. Retrospective Analysis of Demographic and Clinical Factors Associated with Etiology of Febrile Respiratory Illness Among US Military Basic Trainees

    DTIC Science & Technology

    2014-12-05

    Naval Health Research Center Retrospective Analysis of Demographic and Clinical Factors Associated with Etiology of Febrile Respiratory Illness...1471-2334/14/576RESEARCH ARTICLE Open AccessRetrospective analysis of demographic and clinical factors associated with etiology of febrile respiratory ...Patrick Blair1Abstract Background: Basic trainees in the US military have historically been vulnerable to respiratory infections. Adenovirus and

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

    NASA Technical Reports Server (NTRS)

    daSilva, Arlindo

    2009-01-01

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

  16. Modern Era Retrospective-analysis for Research and Applications (MERRA) Data and Services at the GES DISC

    NASA Astrophysics Data System (ADS)

    Berrick, S. W.; Ostrenga, D.; Shen, S.

    2008-12-01

    The Modern Era Retrospective-analysis for Research and Applications (MERRA) dataset is a NASA 30 year (1979 - 2007) reanalysis using the Goddard Earth Observing System Data Assimilation System, Version 5 (GEOS-5). The project, run out of NASA's Global Modeling and Assimilation Office at Goddard Space Flight Center, provides the science and application communities with a state-of-the-art global analysis with emphasis on improved estimates of the hydrological cycle over a broad range of weather and climate time scales. MERRA products are generated as a long-term synthesis that places the NASA EOS suite of observations in a climate context. The MERRA analysis is performed at a horizontal resolution of 2/3 x 1/2 degrees and at 72 levels, extended 0.01 hPa. Hourly, two-dimensional diagnostic fields are at the native horizontal resolution. Other products are available on a coarser horizontal grid with resolutions of 1.25 x 1.25 and 1.0 x 1.25 degrees. Daily and monthly MERRA products (with others to follow later) are archived and distributed by the Goddard Earth Sciences Data and Information Services Center (GES DISC) through its Modeling DISC Web (MDISC) portal. Multiple data access methods and services are available for MERRA data through MDISC: (1) Mirador offers a quick, comprehensive search of MERRA and all GES DISC archived data holdings, allowing searches on keywords, location names or latitude/longitude box, and date/time, with responses within a few seconds. (2) Giovanni is a GES DISC developed Web application that provides data visualization and analysis online. Giovanni features popular visualizations such as latitude- longitude maps, animations, cross sections, profiles, time series, etc. and some basic statistical analysis functions such as scatter plots and correlation coefficient maps. Users are able to download results in several different formats, including Google Earth. (3) On-the-fly parameter subsetting of data within a spatial/temporal window is

  17. Synthesising 30 Years of Mathematical Modelling of Echinococcus Transmission

    PubMed Central

    Atkinson, Jo-An M.; Williams, Gail M.; Yakob, Laith; Clements, Archie C. A.; Barnes, Tamsin S.; McManus, Donald P.; Yang, Yu Rong; Gray, Darren J.

    2013-01-01

    Background Echinococcosis is a complex zoonosis that has domestic and sylvatic lifecycles, and a range of different intermediate and definitive host species. The complexities of its transmission and the sparse evidence on the effectiveness of control strategies in diverse settings provide significant challenges for the design of effective public health policy against this disease. Mathematical modelling is a useful tool for simulating control packages under locally specific transmission conditions to inform optimal timing and frequency of phased interventions for cost-effective control of echinococcosis. The aims of this review of 30 years of Echinococcus modelling were to discern the epidemiological mechanisms underpinning models of Echinococcus granulosus and E. multilocularis transmission and to establish the need to include a human transmission component in such models. Methodology/Principal Findings A search was conducted of all relevant articles published up until July 2012, identified from the PubMED, Web of Knowledge and Medline databases and review of bibliographies of selected papers. Papers eligible for inclusion were those describing the design of a new model, or modification of an existing mathematical model of E. granulosus or E. multilocularis transmission. A total of 13 eligible papers were identified, five of which described mathematical models of E. granulosus and eight that described E. multilocularis transmission. These models varied primarily on the basis of six key mechanisms that all have the capacity to modulate model dynamics, qualitatively affecting projections. These are: 1) the inclusion of a ‘latent’ class and/or time delay from host exposure to infectiousness; 2) an age structure for animal hosts; 3) the presence of density-dependent constraints; 4) accounting for seasonality; 5) stochastic parameters; and 6) inclusion of spatial and risk structures. Conclusions/Significance This review discusses the conditions under which these

  18. TORUS2015: The AGN unification scheme after 30 years

    NASA Astrophysics Data System (ADS)

    Gandhi, P.; Hoenig, S. F.

    2015-09-01

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

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

    PubMed Central

    Denef, C

    2008-01-01

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

  20. A clinical analysis of brain metastasis in gynecologic cancer: a retrospective multi-institute analysis.

    PubMed

    Kim, Young Zoon; Kwon, Jae Hyun; Lim, Soyi

    2015-01-01

    This study analyzes the clinical characteristics of the brain metastasis (BM) of gynecologic cancer based on the type of cancer. In addition, the study examines the factors influencing the survival. Total 61 BM patients of gynecologic cancer were analyzed retrospectively from January 2000 to December 2012 in terms of clinical and radiological characteristics by using medical and radiological records from three university hospitals. There were 19 (31.1%) uterine cancers, 32 (52.5%) ovarian cancers, and 10 (16.4%) cervical cancers. The mean interval to BM was 25.4 months (21.6 months in ovarian cancer, 27.8 months in uterine cancer, and 33.1 months in cervical cancer). The mean survival from BM was 16.7 months (14.1 months in ovarian cancer, 23.3 months in uterine cancer, and 8.8 months in cervical cancer). According to a multivariate analysis of factors influencing survival, type of primary cancer, Karnofsky performance score, status of primary cancer, recursive partitioning analysis class, and treatment modality, particularly combined therapies, were significantly related to the overall survival. These results suggest that, in addition to traditional prognostic factors in BM, multiple treatment methods such as neurosurgery and combined chemoradiotherapy may play an important role in prolonging the survival for BM patients of gynecologic cancer.

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

    PubMed

    Binz, Tina M; Baumgartner, Markus R

    2016-01-06

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

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

    SciTech Connect

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

    2015-07-01

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

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

    PubMed

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

    2015-06-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  5. Blastomycosis in children and adolescents: a 30-year experience from Manitoba.

    PubMed

    Fanella, Sergio; Skinner, Stuart; Trepman, Elly; Embil, John M

    2011-08-01

    Blastomyces dermatitidis, a thermally dimorphic fungus endemic to areas of North America, causes a granulomatous infection which may affect any organ system. Since limited clinical data exist about pediatric blastomycosis, we conducted a retrospective review of medical records of pediatric patients with a laboratory-confirmed diagnosis of blastomycosis treated during a 30-year period at a tertiary care center. Thirty-four pediatric patients with blastomycosis were identified (20 [59%] male), with a mean age at diagnosis of 10 ± 5 years. Two patients were immunocompromised. Pulmonary disease was noted in 27 (79%) patients, and extrapulmonary disease was found in 13 (38%) patients (concurrent pulmonary and extrapulmonary disease, six patients), including five cases of central nervous system (CNS) disease. Delay in diagnosis was greater with extrapulmonary or central nervous system infections as compared with pulmonary blastomycosis. All patients received antifungal chemotherapy, with 19 (56%) patients receiving amphotericin B as initial therapy for 27.5 ± 17 days. Five patients required treatment in the intensive care unit. One patient died of non-Hodgkins lymphoma. Blastomycosis may occur in healthy children, including very young infants. Due to the frequency of extra-pulmonary disease, diagnosis may be difficult and frequently delayed, especially in cases of CNS infection.

  6. Treatment of postoperative lower extremity wounds using human fibroblast-derived dermis: a retrospective analysis.

    PubMed

    Carlson, Russell M; Smith, Nicholas C; Dux, Katherine; Stuck, Rodney M

    2014-04-01

    Human fibroblast-derived dermis skin substitute is a well-studied treatment for diabetic foot ulcers; however, no case series currently exist for its use in healing postoperative wounds of the lower extremity. A retrospective analysis was conducted on 32 lower extremity postoperative wounds treated weekly with human fibroblast-derived dermis skin substitute. Postoperative wounds were defined as a wound resulting from an open partial foot amputation, surgical wound dehiscence, or nonhealing surgical wound of the lower extremity. Wound surface area was calculated at 4 and 12 weeks or until wound closure if prior to 12 weeks. Postoperative wounds treated with weekly applications showed mean improvement in surface area reduction of 63.6% at 4 weeks and 96.1% at 12 weeks. More than 56% of all wounds healed prior to the 12-week endpoint. Additionally, only one adverse event was noted in this group. This retrospective review supports the use of human fibroblast-derived dermis skin substitute in the treatment of postoperative lower extremity wounds. This advanced wound care therapy aids in decreased total healing time and increased rate of healing for not only diabetic foot wounds but also postoperative wounds of the lower extremity, as demonstrated by this retrospective review.

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

    PubMed Central

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

    2016-01-01

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

  8. Clinical Analysis of Ectopic Pregnancies in a Tertiary Care Centre in Southern India: A Six-Year Retrospective Study

    PubMed Central

    Daniel, Mary; Solomon, Preethy

    2016-01-01

    Introduction Ectopic Pregnancy (EP) is a life-threatening emergency commonly encountered by medical practitioners where diagnosis can often be missed. Any woman in the reproductive age group, presenting with lower abdominal pain or vaginal bleeding must raise the suspicion of an ectopic pregnancy to prevent mortality and morbidity. Aim To review all cases of EP and determine the incidence of EP. To study the high risk factors and know the types of clinical presentation, methods of diagnosis, outcome and complications. Materials and Methods This was a retrospective cohort study, conducted at a tertiary care medical teaching hospital in Pondicherry, India. Medical records of all women with an EP between 2009 and 2015 were retrieved. Demographic data, parity, risk factors, clinical features, mode of management and need for blood transfusion was noted. Main outcome measures studied were the incidence of EP, risk factors, mortality and morbidity in these women. Statistical Analysis Data was entered in Microsoft Excel spreadsheet and analysed using SPSS software version 19.0. For categorical variables, data was compiled as frequency and percent. For continuous variables, data was calculated as mean ± SD. Results Seventy-two EP were diagnosed during the six-year period with an incidence of 9.1/1000 pregnancies. Majority of women were aged 21-30years (51.39%), 27.8% women were nulliparous. The most common risk factors were previous abortion (36.1%) and pelvic surgery (37.50%). Fifteen cases (20.8%) were diagnosed in women who had tubectomy. The classic triad of lower abdominal pain, amenorrhoea and vaginal bleeding was seen in 29(40.3%) cases. Ultrasonography was required to arrive at a diagnosis in 28(38.9%) cases. Urine pregnancy test was positive in 100% of cases. Majority (94.4%) were tubal ectopic pregnancies. Medical management with methotrexate alone benefitted 10(13.89%) of patients while another four required surgery for failed medical management. More than half

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

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

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

  10. Examining the Factors That Influence Students' Science Learning Processes and Their Learning Outcomes: 30 Years of Conceptual Change Research

    ERIC Educational Resources Information Center

    Lin, Jing-Wen; Yen, Miao-Hsuan; Liang, Jia-Chi; Chiu, Mei-Hung; Guo, Chorng-Jee

    2016-01-01

    This study used content analysis to examine the most studied conceptual change factors that influence students' science learning processes and their learning outcomes. The reviewed research included empirical studies published since Posner et al. proposed their conceptual change model 30 years ago (from 1982 to 2011). One hundred sixteen SSCI…

  11. The Equal Pay Act: The First 30 Years.

    ERIC Educational Resources Information Center

    Crampton, Suzanne M.; Hodge, John W.; Mishra, Jitendra M.

    1997-01-01

    Analysis by decade of the effects of the Equal Pay Act of 1963 shows that women's earnings relative to men's increased by 10 cents from 1960-1990. Black and Hispanic women's earnings lagged further behind. More education and experience did not help women narrow the gap. (SK)

  12. Primary neuroendocrine breast carcinomas: a retrospective analysis and review of literature

    PubMed Central

    Yang, Xin; Cao, Youde; Chen, Chen; Liu, Lin; Wang, Cheng; Liu, Shengchun

    2017-01-01

    Background Primary neuroendocrine breast carcinomas (NEBCs) are a rare type of breast carcinomas that lack comprehensive recognition, including the clinicopathological features, therapeutic strategies, and prognostic significance. The aim of this retrospective analysis is to present and analyze our own data of primary NEBCs. Materials and methods We retrospectively reviewed the medical records from 2005 to 2015 in The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China to obtain a cohort of breast carcinoma patients who were confirmed to have primary NEBC by histopathology. The detailed clinical data along with histopathology, treatment, and follow-up aspects were gathered for analysis. Results This retrospective analysis included 19 patients with a histopathological diagnosis of primary NEBC from 2005 to 2015. Their mean age was 59.2 years (ranging from 17 to 82 years). The majority of patients (15/19) focused on stages I and II. Of the 15 patients, 14 were positive for estrogen receptor, and 11 were positive for progesterone receptor. For neuroendocrine markers, the expression rates were 8/19, 14/18, 12/14, and 2/6 for chromogranin A, synaptophysin, neuron-specific enolase, and CD56, respectively. All operable patients except the one stage M1 underwent a surgery and 4/18 had axillary lymph node metastasis. Chemotherapy was performed in 12/19, and endocrine therapy in 8/10. With a median follow-up of 59.2 months, only 2 cases progressed after postoperative systemic therapy. Conclusion The understanding of NEBC is limited due to its rarity. More evidence should be provided to enhance the understanding of NEBC, especially for diagnosis, treatment, and prognosis. PMID:28176908

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

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

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

  14. Unidata: 30 Years of FOSS for the Geosciences

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  15. Sample size in psychological research over the past 30 years.

    PubMed

    Marszalek, Jacob M; Barber, Carolyn; Kohlhart, Julie; Holmes, Cooper B

    2011-04-01

    The American Psychological Association (APA) Task Force on Statistical Inference was formed in 1996 in response to a growing body of research demonstrating methodological issues that threatened the credibility of psychological research, and made recommendations to address them. One issue was the small, even dramatically inadequate, size of samples used in studies published by leading journals. The present study assessed the progress made since the Task Force's final report in 1999. Sample sizes reported in four leading APA journals in 1955, 1977, 1995, and 2006 were compared using nonparametric statistics, while data from the last two waves were fit to a hierarchical generalized linear growth model for more in-depth analysis. Overall, results indicate that the recommendations for increasing sample sizes have not been integrated in core psychological research, although results slightly vary by field. This and other implications are discussed in the context of current methodological critique and practice.

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

    NASA Technical Reports Server (NTRS)

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

    2008-01-01

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

  17. A Community Runs Through It: 30 Years of Collaboration in ...

    EPA Pesticide Factsheets

    When participants in the 2016 St Louis River Summit identified their roles and described their interactions with the estuary on the 50-year timeline, they were illustrating the community that built and is now implementing the Remedial Action Plan. From its inception, the Great Lakes Water Quality Agreement required that AOCs be collaborations between technical experts on remediation and restoration and the concerned public. Together, experts and the public form the community that runs through each AOC. Without such a community there is no way to gauge the success of BUI removal or AOC delisting in terms of associated social and health benefits. Community interactions are necessary in all stages of the journey to delisting to foster agreements, resolve conflicts, and to mobilize resources necessary to solve pressing environmental challenges. A social network analysis of the timeline responses was used to describe interactions of the community that runs through the SLRE. Self-identified managers and scientists were less likely than citizens and educators to form social networks. When social networks were present they typically included recreation as a major node. This suggests that while interactions among community members and the resource were diverse and widely distributed, a segment of the community remained professionally cloistered. These people clearly make important contributions to the science or management of the estuary, but constrain their further int

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

    PubMed

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

    2016-05-01

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

  19. Retrospective Analysis of the Benefits and Impacts of U.S. Renewable Portfolio Standards

    SciTech Connect

    Wiser, Ryan; Barbose, Galen; Heeter, Jenny; Mai, Trieu; Bird, Lori; Bolinger, Mark; Carpenter, Alberta; Heath, Garvin; Keyser, David; Macknick, Jordan; Mills, Andrew; Millstein, Dev

    2016-01-06

    This analysis is the first-ever comprehensive assessment of the benefits and impacts of state renewable portfolio standards (RPSs). This joint National Renewable Energy Laboratory-Lawrence Berkeley National Laboratory project provides a retrospective analysis of RPS program benefits and impacts, including greenhouse gas emissions reductions, air pollution emission reductions, water use reductions, gross jobs and economic development impacts, wholesale electricity price reduction impacts, and natural gas price reduction impacts. Wherever possible, benefits and impacts are quantified in monetary terms. The paper will inform state policymakers, RPS program administrators, industry, and others about the costs and benefits of state RPS programs. In particular, the work seeks to inform decision-making surrounding ongoing legislative proposals to scale back, freeze, or expand existing RPS programs, as well as future discussions about increasing RPS targets or otherwise increasing renewable energy associated with Clean Power Plan compliance or other emission-reduction goals.

  20. 30-year International Pediatric Craniofacial Surgery Partnership: Evolution from the “Third World” Forward

    PubMed Central

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

    2016-01-01

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

  1. Thrombophilia diagnosis: a retrospective analysis of a single-center experience.

    PubMed

    Spychalska-Zwolińska, Marta; Zwoliński, Tomasz; Mieczkowski, Artur; Budzyński, Jacek

    2015-09-01

    It is estimated that 30-50% of patients suffering from deep vein thrombosis (DVT) could be diagnosed with congenital or acquired thrombophilia. Its diagnosis, however, rarely changes the clinical management, but is associated with significant costs and negative psychological and social aspects. The aim of this study was to perform a retrospective analysis of the causes and clinical consequences of diagnostics for thrombophilia. A retrospective review of the medical records of 5600 patients was performed, 62 of whom had, at the time, been diagnosed for thrombophilia because of a thromboembolic event. A review of the current literature on the validity of diagnostic tests for hypercoagulability in certain clinical conditions was also performed. The most common reason for thrombophilia testing was episodes of lower limb DVT (56%). The most frequently diagnosed abnormalities were the heterozygous form of the V Leiden gene (18%), protein S deficiency (11%), and the anti cardiolipin antibody IgG (11%). In 45% of the patients, laboratory results did not confirm the presence of any congenital thrombophilia. After receiving the results, 11% of the respondents completed oral anticoagulation therapy after 3 months, and 28% of patients qualified for indefinite use of oral anticoagulant therapy. In most of the cases examined, the diagnosis of thrombophilia did not significantly affect the treatment. A common aberration identified in patients with a history of thromboembolic incidents was the coexistence of risk factors for atherosclerosis.

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

    PubMed Central

    Abed, Firas M.

    2016-01-01

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

  3. Suicidal hanging in Kuwait: retrospective analysis of cases from 2010 to 2012.

    PubMed

    Abd-Elwahab Hassan, Dalia; Ghaleb, Sherein S; Kotb, Heba; Agamy, Mervat; Kharoshah, Magdy

    2013-11-01

    Suicide is an important health hazard worldwide. We retrospectively analyzed the autopsy records of the Institute of Forensic Medicine between 2010 and 2012 to document the characteristics of fatalities resulting from hanging in Kuwait. Upon analysis of death scene investigation and autopsy reports together with the information gathered from the police, the cases of hanging fatalities of suicidal origin were selected. A retrospective study was carried out on 118 suicidal hanging cases autopsied at Forensic Medicine Center in Kuwait (from 2010 to 2012). Of these cases, 86 (73%) were males and 32 females (27%). There was an increasing trend of hanging among ages between 21 and 50 years (87.3%) and the third decade had the highest number of victims (about 43%) between all age groups. Local Kuwaiti nationals comprised a small proportion of cases (7 persons, 5.9%), while the others were foreigners working in Kuwait with an Indian precedence (54 persons, 54.8%), followed by other 12 different nationalities representing 39.3% of the cases. In conclusion, there was a decreasing trend of suicide by hanging in Kuwait from 44 cases in 2010 to 25 cases in 2012.

  4. Cervical necrotizing fasciitis: descriptive, retrospective analysis of 59 cases treated at a single center.

    PubMed

    Elander, Johanna; Nekludov, Michael; Larsson, Agneta; Nordlander, Britt; Eksborg, Staffan; Hydman, Jonas

    2016-12-01

    To provide retrospective, descriptive information on patients with cervical necrotizing fasciitis treated at a single center during the years 1998-2014, and to evaluate the outcome of a newly introduced treatment strategy. Retrospective analysis of clinical data obtained from medical records. Mortality, pre-morbidity, severity of illness, primary site of infection, type of bacteria, time parameters. The observed 3-month mortality was 6/59 (10 %). The most common initial foci of the infection were pharyngeal, dental or hypopharyngeal. The most common pathogen was Streptococcus milleri bacteria within the Streptococcus anginosus group (66 % of the cases). Using a combined treatment with early surgical debridement combined with hyperbaric oxygen treatment, it is possible to reduce the mortality rate among patients suffering from cervical necrotizing fasciitis, compared to the expected mortality rate and to previous historical reports. Data indicated that early onset of hyperbaric oxygen treatment may have a positive impact on survival rate, but no identifiable factor was found to prognosticate outcome.

  5. Interim Solar Radiation Data Manual: 30-Year Statistics from the National Solar Radiation Data Base

    SciTech Connect

    Not Available

    1992-11-01

    The 30-year (1961-1990) statistics contained in this document have been derived from the National Solar Radiation Data Base (NSRDB) produced by the National Renewable Energy Laboratory (NREL). They outline solar radiation sources, as well as 30-year monthly and annual means of 5 solar radiation elements (three surface and two extraterrestrial) and 12 meteorological elements for 239 locations.

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

    SciTech Connect

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

    2005-04-15

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

  7. Validation of a 30+ year soil moisture record from multi-satellite observations

    NASA Astrophysics Data System (ADS)

    de Jeu, R.; Dorigo, W.; Wagner, W.; Chung, D.; Parinussa, R.; van der Werf, G.; Liu, Y.; Mittelbach, H.; Hirschi, M.

    2012-12-01

    As part of the ESA Climate Change Initiative soil moisture project a 30+ year consistent soil moisture dataset is currently in development by harmonizing retrievals from both passive and active microwave satellite observations. The harmonization of these datasets incorporates the advantage of both microwave techniques and spans the entire period from 1978 onwards. A statistical methodology based on scaling, ranking and blending was developed to address differences in sensor specifications to create one consistent dataset. A soil moisture dataset provided by a land surface model (GLDAS-1-Noah) was used to scale the different satellite-based products to the same range. The blending of the active and passive datasets was based on their respective performance, which is closely related to vegetation cover. While this approach imposes the absolute values of the land surface model dataset to the final product, it preserves the relative dynamics (e.g., seasonality, inter-annual variations) and trends of the original satellite derived retrievals. Different validation methods were performed to quantify the skill of the various soil moisture datasets at different temporal and spatial scales. In situ data from the International Soil Moisture Network (ISMN) were used to calculate the local correlation (both Pearson and Spearman) and Root Mean Square Difference between ground observations and the satellite retrievals for different climate regimes. In addition a triple collocation analysis was applied on the passive and active satellite products in order to analyze the error structures at a global scale for the different sensors. Furthermore, indirect proxies like tree ring width data were used to study the consistency of the inter-annual variability within the 30+ year dataset. The combination of these techniques revealed a strong dynamical behavior in data quality in both time and space. In the future this additional information on error dynamics could be used to further

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

    PubMed

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

    2016-10-01

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

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

    SciTech Connect

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

    2006-06-08

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

  10. A retrospective analysis of recommendations for workplace accommodations for persons with mobility and sensory limitations.

    PubMed

    Sabata, Dory; Williams, Michael D; Milchus, Karen; Baker, Paul M A; Sanford, Jon A

    2008-01-01

    Many studies of workplace accommodations have primarily focused on a particular disability or functional limitation. The need exists for a broad-based study of the types and frequency of accommodations recommended for a variety of functional limitations, including multiple limitations. The researchers conducted a retrospective analysis of 266 persons who received vocational rehabilitation assessment to determine the frequency and types of recommended workplace accommodations. Computer systems/components and special tools/furnishings were the most frequently reported types of recommendations, regardless of functional limitation, whereas adaptive strategies were least likely to be suggested. In general, most job accommodation recommendations targeted the individual work space and were intended to assist in the completion of specific job tasks. Findings indicate that recommendations for workplace accommodations were surprisingly similar across all functional limitation groups.

  11. Airway Management in Patients with Tracheal Compression Undergoing Thyroidectomy: A Retrospective Analysis

    PubMed Central

    Sajid, Binu; Rekha, K.

    2017-01-01

    Background: Airway management in large and retrosternal goiters with tracheal compression is often fraught with challenges and is a source of apprehension among anesthesiologists globally. Aims: In this study we attempt to delineate the preferred techniques of airway management of such cases in our institution and also to assess whether airway management was unnecessarily complicated. Setting and Design: Retrospective analysis. Materials and Methods: A retrospective review was conducted of thyroidectomies performed in our institution over a three year period from January 2013. Clinical, radiological, pathological, anesthetic and surgical data were obtained from hospital case records. Statistical Analysis: Qualitative data is represented as frequencies and percentages and quantitative data as mean and standard deviation. Results: Of 1861 thyroidectomies tracheal compression were present in 50 patients with minimum tracheal diameter ranging from 4-12mm (mean 7.84); with majority(95%) having a benign pathology. Critical tracheal compression (≤5 mm) was observed in four patients. Conventional intravenous induction and intubation under muscle relaxant was performed in majority (64%) of these patients. The rest of the cases (n=18) were intubated while preserving spontaneous ventilation after induction. Primary technique of airway management was reported successful in all cases with no instances of difficult ventilation or intubation. Postoperative morbidity in few cases resulted from hematoma (n=1), recurrent laryngeal nerve palsy (n=1), tracheomalacia (n=1) and pulmonary complications (n=2). Conclusion: Airway management in patients with tracheal compression due to benign goiter is quite straightforward and can be managed in the conventional manner with little or no complications. PMID:28298767

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

    ERIC Educational Resources Information Center

    Tian-Ping, Yang

    2012-01-01

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

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

    PubMed

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

    2011-01-01

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

  14. Donepezil and life expectancy in Alzheimer’s disease: A retrospective analysis in the Tajiri Project

    PubMed Central

    2014-01-01

    Background Cholinesterase inhibitors (ChEIs) such as donepezil have the effect of delaying progression of Alzheimer’s disease (AD), but their effect on life expectancy is unclear. We analyzed the influence of donepezil on life expectancy after onset of AD, together with the effects of antipsychotic drugs and residency in a nursing home. Methods All outpatients at the Tajiri Clinic from 1999–2012 with available medical records and death certificates were included in a retrospective analysis. The entry criteria were a dementia diagnosis based on DSM-IV criteria and diagnosis of AD using NINCDS-ADRDA criteria; medical treatment for more than 3 months; and follow up until less than 1 year before death. Results We identified 390 subjects with medical records and death certificates, of whom 275 had a diagnosis of dementia that met the entry criteria. Of 100 patients diagnosed with AD, 52 had taken donepezil and 48 patients had not received the drug due to treatment prior to the introduction of donepezil in 1999 in Japan. The lifetime expectancies after onset were 7.9 years in the donepezil group and 5.3 years in the non-donepezil group. There was a significant drug effect with a significant covariate effect of nursing home residency. Other covariates did not reach a significant level. Conclusions Although this report has the limitation of all retrospective analyses: the lack of randomization, we found a positive effect of donepezil on lifetime expectancy after onset of AD. This may be due to a decreased mortality rate caused by reduction of concomitant diseases such as pneumonia. The similar life expectancies in patients taking donepezil at home and those not taking donepezil in a nursing home indicated a positive health economic effect of the drug. PMID:24720852

  15. Survival after squamous cell and basal cell carcinoma of the skin: A retrospective cohort analysis.

    PubMed

    Rees, Judy R; Zens, M Scot; Celaya, Maria O; Riddle, Bruce L; Karagas, Margaret R; Peacock, Janet L

    2015-08-15

    A retrospective cohort analysis of survival after keratinocyte cancer (KC) was conducted using data from a large, population-based case-control study of KC in New Hampshire. The original study collected detailed information during personal interviews between 1993 and 2002 from individuals with squamous (SCC) and basal (BCC) cell carcinoma, and controls identified through the Department of Transportation, frequency-matched on age and sex. Participants without a history of non-skin cancer at enrolment were followed as a retrospective cohort to assess survival after either SCC or BCC, or a reference date for controls. Through 2009, cancers were identified from the New Hampshire State Cancer Registry and self-report; death information was obtained from state death certificate files and the National Death Index. There were significant differences in survival between those with SCC, BCC and controls (p = 0.040), with significantly greater risk of mortality after SCC compared to controls (adjusted hazard ratio [HR] 1.25; 95% confidence interval 1.01-1.54). Mortality after BCC was not significantly altered (HR 0.96; 95% CI 0.77-1.19). The excess mortality after SCC persisted after adjustment for numerous personal risk factors including time-varying non-skin cancer occurrence, age, sex and smoking. Survival from the date of the intervening cancer, however, did not vary (HR for SCC 0.98; 95% CI 0.70-1.38). Mortality also remained elevated when individuals with subsequent melanoma were excluded (HR for SCC 1.30; 95% CI 1.05-1.61). Increased mortality after SCC cannot be explained by the occurrence of intervening cancers, but may reflect a more general predisposition to life threatening illness that merits further investigation.

  16. Prognostic factors of palatal mucoepidermoid carcinoma: a retrospective analysis based on a double-center study.

    PubMed

    Xu, Wenguang; Wang, Yufeng; Qi, Xiaofeng; Xie, Junqi; Wei, Zheng; Yin, Xiteng; Wang, Zhiyong; Meng, Jian; Han, Wei

    2017-03-06

    Mucoepidermoid carcinoma (MEC) of the palate is a common malignancy of minor salivary glands. This study was designed to identify the prognostic factors for MEC of the palate. The medical records of patients diagnosed with MEC of the palate who visited the Department of Oral and Maxillofacial Surgery at Nanjing Stomatological Hospital and the Department of Stomatology at Central Hospital of Xuzhou were retrospectively studied. The prognostic factors were determined using a Cox proportional hazards model. Furthermore, the expression of cancer stem cell (CSC) markers CD44, CD133, Nanog and Sox2 were detected in neoplastic samples of these patients by immunohistochemistry. As a result, both univariate analysis and multivariate analysis proved a high histological grade and an advanced tumor stage as negative prognostic factors for overall survival. By immunohistochemistry staining and survival analysis, a combination of CD44/CD133/SOX2 was found to have the strongest prognostic value for palatal MEC patients. In conclusion, the proposed nomogram which include histological grade and tumor stage along with cancer stem cell markers provides a more accurate long-term prediction for palatal MEC patients.

  17. Prognostic factors of palatal mucoepidermoid carcinoma: a retrospective analysis based on a double-center study

    PubMed Central

    Xu, Wenguang; Wang, Yufeng; Qi, Xiaofeng; Xie, Junqi; Wei, Zheng; Yin, Xiteng; Wang, Zhiyong; Meng, Jian; Han, Wei

    2017-01-01

    Mucoepidermoid carcinoma (MEC) of the palate is a common malignancy of minor salivary glands. This study was designed to identify the prognostic factors for MEC of the palate. The medical records of patients diagnosed with MEC of the palate who visited the Department of Oral and Maxillofacial Surgery at Nanjing Stomatological Hospital and the Department of Stomatology at Central Hospital of Xuzhou were retrospectively studied. The prognostic factors were determined using a Cox proportional hazards model. Furthermore, the expression of cancer stem cell (CSC) markers CD44, CD133, Nanog and Sox2 were detected in neoplastic samples of these patients by immunohistochemistry. As a result, both univariate analysis and multivariate analysis proved a high histological grade and an advanced tumor stage as negative prognostic factors for overall survival. By immunohistochemistry staining and survival analysis, a combination of CD44/CD133/SOX2 was found to have the strongest prognostic value for palatal MEC patients. In conclusion, the proposed nomogram which include histological grade and tumor stage along with cancer stem cell markers provides a more accurate long-term prediction for palatal MEC patients. PMID:28262804

  18. Retrospective incremental cost analysis of a hospital-based COPD Disease Management Programme in Sweden.

    PubMed

    Tunsäter, Alf; Moutakis, Mikael; Borg, Sixten; Persson, Ulf; Strömberg, Leif; Nielsen, Anders Lassen

    2007-05-01

    This paper reports on a retrospective analysis of hospital-based healthcare costs associated with the management of chronic obstructive pulmonary disease (COPD). During the second half of 2001, Simrishamn Hospital, Sweden, implemented a structured Disease Management Programme (DMP) for COPD and a total of 784 patients with COPD, enrolled in the DMP, were included in the analysis. The goal was to reduce the number of clinical events, such as severe exacerbations by early intervention, aggressive drug treatment, specialists easy available for advice, improved support for smoking cessation, increased number of scheduled follow-ups and closer tracking of high-risk COPD patients. The hospital administrative system provided data on resource consumption, such as outpatient care, inpatient care and drugs and unit cost, used in the economic analysis. The total cost of COPD drugs doubled (from euro 14,133 to euro 30,855 per year) as did the total number of outpatient visits (from 580 to 996 visits per year). The number of hospitalizations for acute COPD exacerbations and COPD with acute lower respiratory infection decreased from 67 to 25 per year. Total COPD-related healthcare costs decreased. The results presented here support the hypothesis that a COPD DMP can offer substantial overall direct cost savings.

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

    PubMed

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

    2015-01-01

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

  20. Retrospective Questions or a Diary Method? A Two-Level Multitrait-Multimethod Analysis

    ERIC Educational Resources Information Center

    Hox, Joop J.; Kleiboer, Annet M.

    2007-01-01

    This study describes a comparison between retrospective questions and daily diaries inquiring about positive and negative support in spousal interactions. The design was a multitrait-multimethod matrix with trait factors of positive and negative support, and method factors of retrospective questions and daily asked questions. Five questions were…

  1. Retrospective Analysis of the Blood Component Utilization in a University Hospital of Maximum Medical Care

    PubMed Central

    Geißler, R. Georg; Franz, Dominik; Buddendick, Hubert; Krakowitzky, Petra; Bunzemeier, Holger; Roeder, Norbert; Van Aken, Hugo; Kessler, Torsten; Berdel, Wolfgang; Sibrowski, Walter; Schlenke, Peter

    2012-01-01

    Background Demographic data illustrate clearly that people in highly developed countries get older, and the elderly need more blood transfusions than younger patients. Additionally, special extensive therapies result in an increased consumption of blood components. Beyond that the aging of the population reduces the total number of preferably young and healthy blood donors. Therefore, Patient Blood Management will become more and more important in order to secure an increasing blood supply under fair-minded conditions. Methods At the University Hospital of Münster (UKM) a comprehensive retrospective analysis of the utilization of all conventional blood components was performed including all medical and surgical disciplines. In parallel, a new medical reporting system was installed to provide a monthly analysis of the transfusional treatments in the whole infirmary, in every department, and in special blood-consuming cases of interest, as well. Results The study refers to all UKM in-patient cases from 2009 to 2011. It clearly demonstrates that older patients (>60 years, 35.2–35.7% of all cases, but 49.4–52.6% of all cases with red blood cell (RBC) transfusions, 36.4–41. 6% of all cases with platelet (PTL, apheresis only) transfusions, 45.2–48.0% of all cases with fresh frozen plasma (FFP) transfusions) need more blood products than younger patients. Male patients (54.4–63.9% of all cases with transfusions) are more susceptible to blood transfusions than female patients (36.1–45.6% of all cases with transfusions). Most blood components are used in cardiac, visceral, and orthopedic surgery (49.3–55.9% of all RBC units, 45.8–61.0% of all FFP units). When regarding medical disciplines, most transfusions are administered to hematologic and oncologic patients (12.9–17.7% of all RBC units, 9.2–12.0% of all FFP units). The consumption of PTL in this special patient cohort (40.6–50.9% of all PTL units) is more pronounced than in all other surgical or

  2. Moebius syndrome. Case report was a 30-year follow-up.

    PubMed

    Morello, D C; Converse, J M

    1977-09-01

    Moebius syndrome is uncommon, as reported in the literature. A patient with Moebius syndrome is reported, showing a 30-year follow-up after initial surgical treatment by bilateral partial transfers of the Masseter muscles.

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

    NASA Technical Reports Server (NTRS)

    Bosilovich, Michael G.; Chen, Junye

    2009-01-01

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

  4. Perioperative changes in oxygen saturation after ambulatory laparoscopic cholecystectomy: a retrospective analysis.

    PubMed

    Seneca, Michael; Zapp, Mark; Seneca, Martha

    2013-08-01

    In the ambulatory surgical setting, patients may present with grossly abnormal oxygen saturation (Spo2) readings that, along with other disease pathology, make referral to an inpatient facility a straightforward decision. Patients presenting with unexplained slightly abnormal Spo2 readings might make evaluation as an appropriate candidate for the ambulatory setting more problematic. Little guidance is provided for these scenarios in current consensus documents, and minimal data exist regarding preoperative baseline Spo2 readings as a predictor for postoperative Spo2 readings after undergoing general anesthesia and surgery in the ambulatory care setting. A retrospective analysis was performed of all laparoscopic cholecystectomies performed at a freestanding ambulatory surgery center during 2011 (n = 56). Multiple linear regression analysis was performed to establish predictors for variability in baseline Spo2. Wilcoxon tests were used to compare preoperative baseline Spo2 readings with readings taken at discharge. Increased patient age was the only statistically significant predictor of lower baseline Spo2 levels, although no statistically significant decrease in Spo2 was found at discharge in patients above 60 years old. Males, patients who smoke, and patients whose body mass index exceeded 30 kg/m2 all demonstrated statistically significant decreases in Spo2 values at discharge home (Z = -1.947, -1.807, -1.75, P < .05).

  5. Arterial ischemic stroke and hemorrhagic stroke in Chinese children: a retrospective analysis.

    PubMed

    Xie, Ling-Ling; Jiang, Li

    2014-02-01

    To study the characteristics of pediatric arterial ischemic stroke (AIS) and hemorrhagic stroke (HS) in southwest of China, and analyze the etiology and risk factor. This study retrospectively reviewed the records of all patients in both department of neurology and department of neurosurgery in Children's hospital of Chongqing medical university from January 2003 to March 2011, and patients were eligible for analysis if they had been diagnosed with AIS or HS. And SPSS 17.0 software was used for statistical analysis. The χ(2) test was used to exam relationships between stroke types and sex, age, and that between neuroradiological images and sex. 119 Boys (70.4%) and 50 girls (29.6%) were included. In these cases, HS accounted for the majority of the cases (n=109, 64.1%), and vitamin K deficiency was a major etiology in 65 out of 109 HS (59.6%), most of which occurred in breastfeeding infants (87.7%) and those who received no vitamin K after birth. AIS accounted for 35.3% of the cases, and minor head injury associated stroke (40.0%) was more common than vasculopathy associated stroke (16.6%) and other kinds of stroke. HS in children is more common than AIS. Vitamin K deficiency was a major etiology in these young infants who experienced HS, and many cases of AIS were associated with minor head injury.

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

    NASA Astrophysics Data System (ADS)

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

    2015-10-01

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

  7. Retrospective analysis of diversity and species composition of marine macroalgae of Hainan Island (China)

    NASA Astrophysics Data System (ADS)

    Titlyanov, Eduard A.; Titlyanova, Tamara V.; Xia, Bangmei; Bartsch, Inka

    2016-09-01

    Retrospective analysis of diversity and species composition of marine macroalgae of Hainan Island in the period 1933-1992 is presented in this paper. There are two extensive sample collection periods of benthic macroalgae: the early collection (EC) covers a period between the early 1930s and the 1980s before considerable urbanization and reef degradation took place and a late collection (LC) was performed in 1990/1992 during a phase of rapid urbanization. Analysis of data also including an earlier published inventory of green algae covering the same collection sites (Titlyanov et al. 2011a) revealed that the marine flora of the island comprises 426 taxa in total, with 59% red algae, 18% brown algae and 23% green algae. In total 59 species of red algae, 11 species of brown algae and 37 species of green algae sampled during the LC are new records for Hainan Island. Considerable floristic changes between EC and LC became evident. In the LC there were significantly more filamentous, tubular or fine blade-like, and often epiphytic, green and red algae with a high surface-to-volume ratio. Additionally a reduction of green, brown and red algal species with larger fleshy or foliose thalli and a low surface-to-volume ratio was observed. It is assumed that the changes reflect the degradation of the coral reef ecosystem around Hainan, which was damaged by human activities especially in the 1950s-1970s.

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

    NASA Technical Reports Server (NTRS)

    Schubert, Siegfried

    2008-01-01

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

  9. Clinical outcomes of antimicrobial lock solutions used in a treatment modality: a retrospective case series analysis

    PubMed Central

    Bookstaver, P Brandon; Gerrald, Katherine R; Moran, Robert R

    2010-01-01

    Background Antimicrobial lock therapy (ALT) may be considered as adjunctive therapy in the treatment of catheter-related bloodstream infections (CRBSI) when catheter removal is not a favorable option. Objective To evaluate the outcomes associated with ALT as adjunctive treatment of CRBSI. Methods This was a 24-month retrospective case series analysis evaluating patients treated for more than 24 hours with ALT. The primary outcome was blood culture sterilization for 30 days posttherapy. The impact of ALT duration and time to initiation on central venous catheter (CVC) salvage were evaluated. Logistic regression modeled the association between ALT and sterilization rates, with a prespecified level of significance (α) of 0.1. Results Twenty-six cases were included in data analysis. Patients included ranged from 5 months to 82 years of age; 77% of patients were receiving total parenteral nutrition or chemotherapy. The majority of patients received vancomycin, daptomycin, or gentamicin combined with heparin in a lock solution. Blood culture sterilization was achieved in 69.2% of cases, and sterilization plus CVC retention was achieved in 11 cases (42.3%). Longer durations of ALT (≥9 days) were significantly correlated with blood culture sterilization (odds ratio = 1.367, P = 0.077). Conclusion ALT used as an adjunct to systemic therapy for adequate duration in CRBSI can achieve CVC sterilization and retainment without subsequent infectious complications. PMID:22291495

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

    NASA Astrophysics Data System (ADS)

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

    2014-07-01

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

  11. [Retrospective Analysis of Diabetics with Regard to Treatment Duration and Costs].

    PubMed

    Pscherer, S; Nüssler, A; Bahrs, C; Reumann, M; Ihle, C; Stöckle, U; Ehnert, S; Freude, T; Ochs, B G; Flesch, I; Ziegler, P

    2017-02-01

    Background: The increasing incidence of diabetes mellitus is also reflected in the patient population of a trauma and orthopaedic centre. Diabetics also exhibit more comorbidities than non-diabetics. In addition to surgical problems in these patients, hospitalisation is often accompanied by complications, which can prolong treatment and increase costs. The aim of this retrospective study is to analyse hospitalisation of diabetics compared to non-diabetics, as well as differences in treatment costs, depending on associated age and comorbidities. Patients/Material and Methods: 17,185 patients were treated at a transregional trauma and orthopaedic centre and were included in this retrospective analysis between 2012 and 2015. Comorbidities and hospitalisation of diabetics and non-diabetics were recorded. All costs charged by DRG were evaluated to calculate the cost per day and per patient, on the basis of the specific case rate. In this calculation, patient-related case rates were divided by the average residence time and the means of the calculated daily rates were calculated. Inclusion criteria were treatment within the various departments and a minimum hospitalisation of one day. Statistical analysis was performed with the SPSS program (version 22.0, SPSS Inc., Chicago, USA). Results: In comparison to non-diabetics (ND), diabetics (D) exhibited significantly more comorbidities, including: obesity, arterial hypertension, coronary heart disease, myocardial infarction (in the history), peripheral arterial disease, chronic kidney disease and hyperlipidaemia. Pneumonia in hospital was considerably commoner in diabetics (2.45 % [D] vs. 1.02 % [ND], p < 0.001). Time in hospital was significantly longer in diabetics (endoprosthetics 13.52 days [D] vs. 12.54 days [ND], p < 0.001; septic surgery 18.62 days [D] vs. 16.31 days [ND], p = 0.007; traumatology 9.82 days [D] vs. 7.07 days [ND], p < 0.001). For patients aged under 60 years, time in hospital was

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

    PubMed Central

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

    2014-01-01

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

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

    SciTech Connect

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

    2014-01-01

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

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

    SciTech Connect

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

    2011-05-01

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

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

    SciTech Connect

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

    2010-07-01

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

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

    PubMed

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

    2014-01-01

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

  17. A retrospective analysis of the role of proton pump inhibitors in colorectal cancer disease survival

    PubMed Central

    Graham, C.; Orr, C.; Bricks, C.S.; Hopman, W.M.; Hammad, N.; Ramjeesingh, R.

    2016-01-01

    Background Proton pump inhibitors (ppis) are a commonly used medication. A limited number of studies have identified a weak-to-moderate association between ppi use and colorectal cancer (crc) risk, but none to date have identified an effect of ppi use on crc survival. We therefore postulated that an association between ppi use and crc survival might potentially exist. Methods We performed a retrospective chart review of 1304 crc patients diagnosed from January 2005 to December 2011 and treated at the Cancer Centre of Southeastern Ontario. Kaplan–Meier analysis and Cox proportional hazards regression models were used to evaluate overall survival (os). Results We identified 117 patients (9.0%) who were taking ppis at the time of oncology consult. Those taking a ppi were also more often taking asa or statins (or both) and had a statistically significantly increased rate of cardiac disease. No identifiable difference in tumour characteristics was evident in the two groups, including tumour location, differentiation, lymph node status, and stage. Univariate analysis identified a statistically nonsignificant difference in survival, with those taking a ppi experiencing lesser 1-year (82.1% vs. 86.7%, p = 0.161), 2-year (70.1% vs. 76.8%, p = 0.111), and 5-year os (55.2% vs. 62.9%, p = 0.165). When controlling for patient demographics and tumour characteristics, multivariate Cox regression analysis identified a statistically significant effect of ppi in our patient population (hazard ratio: 1.343; 95% confidence interval: 1.011 to 1.785; p = 0.042). Conclusions Our results suggest a potential adverse effect of ppi use on os in crc patients. These results need further evaluation in prospective analyses. PMID:28050148

  18. Improved outcomes of renal transplantation from cardiac death donors: a 30-year single center experience.

    PubMed

    Tojimbara, T; Fuchinoue, S; Iwadoh, K; Koyama, I; Sannomiya, A; Kato, Y; Nanmoku, K; Kai, K; Nakajima, I; Toma, H; Teraoka, S

    2007-03-01

    Outcomes of renal transplantation from donation after cardiac death (DCD) donors over 30 years were analyzed. Between 1975 and 2004, 256 renal transplantations from DCD donors were performed. The recipients were divided into four groups according to a time period as follows: 1975-1979 (Group 1; n = 18), 1980-1989 (Group 2; n = 81), 1990-1999 (Group 3; n = 84) and 2000-2004 (Group 4; n = 73). Of the 256 transplanted kidneys from DCD donors, 38 (15%) functioned immediately after transplantation. The incidence of delayed graft function (DGF) was 72%. Warm ischemic time and total ischemic time were 7.4 +/- 9.4 min and 11.9 +/- 5.6 h, respectively. The overall graft survival rates at 1, 5 and 10 years were 80%, 72% and 53%, respectively. Graft survival rates in each group have continually improved over time (5-year graft survival; 23% vs. 64% vs. 74% vs. 91%, respectively). However, there was no significant difference in graft survival rates between the groups of patients who survived with a functioning graft for more than 1 year. A multivariate Cox regression analysis showed acute rejection and donor age to be independently associated with graft outcome. DCD donors are a valuable source of kidneys for transplantation with promising long-term outcomes.

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

    PubMed

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Zachariah, Mathew; Hoffman, Arlene

    1985-12-01

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

  1. Donor Deferral Characteristics for Plateletpheresis at a Tertiary Care Center in India- A Retrospective Analysis

    PubMed Central

    Pujani, Mukta; Jyotsna, P Lalita; Pahuja, Sangeeta; Pathak, Chintamani; Jain, Manjula

    2014-01-01

    Background: The demand for plateletpheresis is increasing day by day due to its many merits over random donor platelets. However, in our country, there is a dearth of apheresis donors due to greater devotion and time required for the procedure and lack of awareness. Aim: The aim of the present study is to analyse the reasons for deferral of apheresis donors at a tertiary care center. Materials and Methods: This retrospective analysis was conducted to study the causes, frequency and the type of plateletpheresis donor deferral at regional blood transfusion center, Lady Hardinge Medical College and associated Shrimati Sucheta Kriplani Hospital and Kalawati Saran Childrens’ Hospital. The study was undertaken over a period of two years (from January 2010 to December 2011. Results: Out of a total of 343 donors screened, 87 donors were deferred, the overall deferral rate being 25.36%. The most frequent cause of deferral was a low platelet count accounting for 43.5% of all the causes followed by a low hemoglobin level (27.05%). Among the donors deferred for anaemia, 15 out of 23 (65.2%) had hemoglobin in the range of 11.5-12.4gm%, representing 17.2% of all deferrals. Conclusion: Based on these findings and the scarcity of apheresis donors in our country, we are of the opinion that the selection criteria for plateletpheresis donors should be revised to accommodate more donors and reduce deferral rate without compromising on the health of the donors. PMID:25177566

  2. Direct visual internal urethrotomy for isolated, post-urethroplasty strictures: a retrospective analysis

    PubMed Central

    Brown, Elizabeth Timbrook; Mock, Stephen; Dmochowski, Roger; Reynolds, W. Stuart; Milam, Douglas; Kaufman, Melissa R.

    2016-01-01

    Background: Urethroplasty is often successful for the treatment of male urethral stricture disease, but limited data exists on recurrence management. Our goal was to evaluate direct visual internal urethrotomy (DVIU) as a treatment option for isolated, recurrent strictures after urethroplasty. Methods: We retrospectively identified male patients who underwent urethroplasty from 1999 to 2013 and developed an isolated, recurrent stricture at the urethroplasty site treated with DVIU. Success was defined as lack of symptomatology and no subsequent intervention. Comparative analysis identified characteristics and stricture properties associated with success. Results: A total of 436 urethroplasties were performed in 401 patients at our institution between 1999 and 2013. Stricture recurrence was noted in 64 (16%) patients. Of these, 47 (73%) underwent a DVIU. A total of 37 patients met inclusion criteria and underwent 50 DVIU procedures at the urethroplasty site. A single DVIU was successful in 13 of 37 patients (35%). A total of 4 of 6 patients required a second DVIU (67%). Overall, 17 of 43 (40%) of the total DVIUs were successful after urethroplasty. Success did not differ by age, stricture length or location, surgical technique, radiation history, prior urethroplasty or DVIU, time to failure, or etiology. Conclusions: Post-urethroplasty DVIU for isolated, recurrent strictures may be offered as a minimally invasive treatment option. Approximately 40% of patients were spared further intervention. PMID:28203286

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

    USGS Publications Warehouse

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

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. Pediatric unilateral below-elbow amputees: retrospective analysis of 34 patients given multiple prosthetic options.

    PubMed

    Crandall, Robin C; Tomhave, Wendy

    2002-01-01

    Thirty-four unilateral below-elbow amputees from the Shriners Hospitals for Children/Twin Cities were retrospectively analyzed in long-term follow-up. All of these patients were provided with a variety of prosthetic options, including a "passive" cosmetic upper extremity device. Most of the patients were also fitted with conventional prostheses using a body-powered voluntary closing terminal device (97%) as well as myoelectric prostheses (82%). These patients were considered consistent prosthetic users by the clinic team. The average follow-up was 14 years, with many of the patients being followed up throughout their entire childhood. All patients were sent questionnaires, and the authors carried out patient interviews and chart review. Final analysis indicated that 15 patients (44%) selected a simple cosmetic "passive hand" as their prosthesis of choice. In long-term follow-up 14 patients (41%) continued as multiple users. Fourteen patients (41%) selected the conventional prosthesis using a voluntary closing terminal device as the prosthesis of choice. Only five patients (15%) selected the myoelectric device as their primary prosthesis. The authors conclude that successful unilateral pediatric amputees may choose multiple prostheses on the basis of function and that frequently the most functional prosthesis selected in the long term is the simplest in design. The authors believe strongly that unilateral pediatric amputees should be offered a variety of prosthetic options to help with normal activities of daily living.

  6. Chronic lymphocytic leukaemia with 17p deletion: a retrospective analysis of prognostic factors and therapy results.

    PubMed

    Delgado, Julio; Espinet, Blanca; Oliveira, Ana C; Abrisqueta, Pau; de la Serna, Javier; Collado, Rosa; Loscertales, Javier; Lopez, Montserrat; Hernandez-Rivas, Jose A; Ferra, Christelle; Ramirez, Angel; Roncero, Josep M; Lopez, Cristina; Aventin, Anna; Puiggros, Anna; Abella, Eugenia; Carbonell, Felix; Costa, Dolors; Carrio, Anna; Gonzalez, Marcos

    2012-04-01

    Patients with chronic lymphocytic leukaemia (CLL) whose tumour cells harbour a 17p deletion (17p-) are universally considered to have a poor prognosis. The deletion can be detected at diagnosis or during the evolution of the disease, particularly in patients who have received chemotherapy. We sought to evaluate the natural history of patients with 17p- CLL, identify predictive factors within this prognostic subgroup, and evaluate the results of different therapeutic approaches. Data from 294 patients with 17p- CLL followed up at 20 different institutions was retrospectively collected and analysed. Median age was 68 (range 27-98) years at the time of fluorescence in situ hybridization analysis. After 17p- documentation, 52% received treatment, achieving an overall response rate of 50%. Median overall survival was 41 months, and was significantly shorter in patients with elevated beta(2)-microglobulin concentration (P < 0·001), B symptoms (P = 0·016), higher percentage of cells with deletion (P < 0·001), and acquired deletions (P = 0·012). These findings suggest that patients with 17p- CLL have a variable prognosis that can be refined using simple clinical and laboratory features, including 17p- clone size, beta2-microglobulin concentration, presence of B symptoms and type of deletion (de novo versus acquired).

  7. Expectant management of vestibular schwannoma: a retrospective multivariate analysis of tumor growth and outcome.

    PubMed

    Hughes, Mark; Skilbeck, Christopher; Saeed, Shakeel; Bradford, Robert

    2011-09-01

    We conducted a retrospective observational study to assess the consequences of conservative management of vestibular schwannoma (VS). Data were collected from tertiary neuro-otological referral units in United Kingdom. The study included 59 patients who were managed conservatively with radiological diagnosis of VS. The main outcome measures were growth rate and rate of failure of conservative management. Multivariate analysis sought correlation between tumor growth and (i) demographic features, (ii) tumor characteristics. The mean tumor growth was 0.66 mm/y. 11 patients (19%) required intervention. Mean time to intervention was 37 months with two notable late "failures" occurring at 75 and 84 months. Tumors extending into the cerebellopontine angle (CPA) grew significantly faster than intracanalicular tumors (p = 0.0045). No association was found between growth rate and age, sex, tumor laterality, facial nerve function, and grade of hearing loss. Conservative management is acceptable for a subset of patients. Tumors extending into the CPA at diagnosis grow significantly faster than intracanalicular tumors. No growth within 5 years of surveillance does not guarantee a continued indolent growth pattern; surveillance must therefore continue.

  8. High risk of urinary tract infections in post-operative gynaecology patients: a retrospective case analysis.

    PubMed

    Crosby-Nwaobi, R R; Faithfull, S

    2011-11-01

    This study was undertaken to determine the incidence and risk factors related to the occurrence of urinary tract infections (UTIs), post surgery, in women being treated for a gynaecological cancer. A retrospective case analysis of 215 women was conducted using data collected via case review with domains covering known risk factors for the occurrence of urinary infections. Bacteriuria was defined as greater than 10(5) colony-forming units per millilitre. A total of 30.7% of women had a UTI post-operatively. Among these, 75.7% infections were Escherichia coli. Having a catheter in situ for ≤3 days was found to be slightly significant in the formation of a UTI post-operatively (U= 3878, P < 0.05). Having a catheter in situ for ≥7 days was found to be highly significant (χ(2) (1) = 6.602, P < 0.01), with an odds ratio of 2.44. A positive correlation was found between the duration of the catheter in situ and type of UTI (τ= .251, P < 0.01). Although urinary catheterisation is known to be related to hospital-acquired infection, a shorter duration of catheterisation may reduce the risk of possible infection post surgery. Oncology teams need to be more aware of this risk, identify women more likely to be catheterised for longer and use preventative strategies for managing infection, such as silver nitrite-lined catheters.

  9. Serum 25-Hydroxy Vitamin D and Survival in Advanced Colorectal Cancer: A Retrospective Analysis

    PubMed Central

    Wesa, Kathleen M.; Segal, Neil H.; Cronin, Angel M.; Sjoberg, Daniel D.; Jacobs, Gria N.; Coleton, Marci I.; Fleisher, Martin; Dnistrian, Ann M.; Saltz, Leonard B.; Cassileth, Barrie R.

    2015-01-01

    Background Higher serum 25-hydroxy vitamin D [25(OH)D] levels are associated with decreased colorectal cancer (CRC) incidence. In this retrospective study of stage IV CRC patients, we evaluate whether 25(OH)D levels at diagnosis correlate with survival. Methods Stored sera from carcinoembryonic antigen (CEA) measurements obtained between February 2005 and March 2006 were screened. The first 250 patients with CEA ±30 days of stage IV CRC diagnosis were included. Serum 25(OH)D levels were determined and categorized as adequate ≥30 ng/mL, or deficient <30 ng/mL. Multivariable Cox regression models controlling for albumin and Eastern Cooperative Oncology Group performance status were used to investigate whether higher 25(OH)D levels were associated with prolonged survival. Results A total of 207 patients (83%) were vitamin D-deficient (median, 21 ng/mL), with deficiencies significantly more likely among non-Hispanic black patients (P=0.009). Higher levels were associated with prolonged survival in categorical variable analysis: adequate vs deficient, hazard ratio 0.61, 95% CI 0.38–0.98, P=0.041. Conclusions A majority of newly diagnosed stage IV CRC patients are vitamin D-deficient. Our data suggest that higher 25(OH)D levels are associated with better overall survival. Clinical trials to determine whether aggressive vitamin D repletion would improve outcomes for vitamin D-deficient CRC patients are warranted. PMID:25646565

  10. Compliance with periodontal maintenance at the University of Pittsburgh: Retrospective analysis of 315 cases.

    PubMed

    Famili, Pouran; Short, Elizabeth

    2010-01-01

    Maintenance care is the most important part of periodontal treatment because maintenance - adherence to the schedule of recall dental appointments after treatment - is believed to be the key in preventing the recurrence of periodontal disease. This article is a retrospective analysis of 315 cases from the Department of Periodontics and Preventive Dentistry at the University of Pittsburgh to determine compliance with periodontal maintenance schedules over a two-year period. Following the completion of periodontal surgical treatment, patients were placed on a regimen of maintenance care that included recalls every three months, professional prophylaxis by the hygiene faculty, and repeated instructions in home self-care. Medical records and patient charts of 315 subjects were selected randomly and reviewed in terms of the patient's attending the scheduled recall visit. It was hypothesized that female subjects would show better compliance with the maintenance care regimen than male subjects, as suggested in the literature. Among the 315 subjects, 112 (54 women and 58 men) followed the recommended recall schedule; 30% ultimately returned for the three-month prophylaxis recall visit after the initial periodontal surgical appointment, and thus were considered to have complied with the suggested maintenance program. The investigators failed to reject the stated hypothesis that women would display better compliance than men (p = 0.3).

  11. Retrospective analysis of selected predictors of mortality within a veterinary intensive care unit.

    PubMed

    Simpson, Kerry E; McCann, Theresa M; Bommer, Nicholas X; Pereira, Yolanda Martinez; Corston, Claire; Reed, Nicola; Gunn-Moore, Danièlle A

    2007-10-01

    The records of 204 cats entering the intensive care unit (ICU) at the University of Edinburgh Small Animal Hospital between December 2002 and October 2006 were retrospectively analysed. Of these, 37 cats over 12 months of age had a systolic blood pressure recorded on entry into the ICU, and this group comprised our study population. Of these 37 cats, 36 had both heart rate and respiratory rate recorded on entry into the ICU, whilst 24 of these cats also had body temperature recorded. The relationship between (i) survival to discharge and (ii) survival until 21 days after admission to the ICU was analysed using univariate generalised linear models with binomial errors. The robustness of any significant relationship was assessed using multivariate analysis methods. In addition, receiver operator curves (ROC) were generated for any of the significant predictors of mortality and from these curves the threshold values, optimal sensitivity and specificity were calculated. Using these values survival curves were generated for any significant prognostic indexes. A decreased blood pressure at the time of admission to the ICU was found to be a significant negative predictor of survival until discharge from the hospital. Overall, a systolic blood pressure of 124 mmHg or higher at the time of admission to the ICU has a sensitivity of 47.8% and a specificity of 85.7% for predicting that a cat will survive until discharge from the hospital.

  12. Evaluation of accuracy and applicability of protein models: retrospective analysis of biological and biomedical predictions.

    PubMed

    Khan, Sofia; Vihinen, Mauno

    2009-01-01

    In order to study protein function and activity structural data is required. Since experimental structures are available for just a small fraction of all known protein sequences, computational methods such as protein modelling can provide useful information. Over the last few decades we have predicted, with homology modelling methods, the structures for numerous proteins. In this study we assess the structural quality and validity of the biological and medical interpretations and predictions made based on the models. All the models had correct scaffolding and were ranked at least as correct or good by numerical evaluators even though the sequence identity with the template was as low as 8%. The biological explanations made based on models were well in line with experimental structures and other experimental studies. Retrospective analysis of homology models indicates the power of protein modelling when made carefully from sequence alignment to model building and refinement. Modelling can be applied to studying and predicting different kinds of biological phenomena and according to our results it can be done so with success.

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

    PubMed

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

    2015-03-01

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

  14. The use of oral cyclosporin to treat feline dermatoses: a retrospective analysis of 23 cases.

    PubMed

    Vercelli, A; Raviri, G; Cornegliani, L

    2006-06-01

    Limited information is available regarding the use of cyclosporin A (CsA) for the treatment of feline dermatoses. The aim of this retrospective study was therefore to describe the efficacy of CsA for the therapy of eosinophilic granuloma (EG), eosinophilic plaque, indolent ulcer, linear granulomas, idiopathic pruritus and stomatitis. A computer search for feline dermatological cases treated with CsA between 1999 and 2004 was performed. Based on history, clinical signs and laboratory diagnostic tests, it was then possible to divide cases into three groups and to select 23 cats. Seven cats had one or more of the following conditions: EG, eosinophilic plaque, indolent ulcer and/or linear granuloma (group A); eight cats had idiopathic pruritus (group B) and eight cats had plasmacytic stomatitis (group C). Doses ranged from 5.8 to 13.3 mg kg(-1) oral CsA. All cats were monitored, with complete serum blood analysis and physical examination, monthly for a minimum of 6 months. Response to therapy was scored (severity of lesions and pruritus) with a 0-10 visual analogue scale at each visit (day 0, day, 30, day 60, day 90). All cats in groups A and B were cured and were maintained on alternate day therapy. In group C, 4/8 patients went into remission, while remaining cats have a fair to good improvement. Routine haematological and biochemical examination failed to reveal abnormalities related to CsA administration.

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

    PubMed Central

    Kaplan, Richard; Steinberg, Marilyn; Doucette, Joanne

    2006-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-12-01

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

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

    SciTech Connect

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

    1985-03-01

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

  19. Liver resection for benign hepatic lesions: A retrospective analysis of 827 consecutive cases

    PubMed Central

    Feng, Zhi-Qiang; Huang, Zhi-Qiang; Xu, Li-Ning; Liu, Rong; Zhang, Ai-Qun; Huang, Xiao-Qiang; Zhang, Wen-Zhi; Dong, Jia-Hong

    2008-01-01

    AIM: To analyze the operative and perioperative factors associated with hepatectomy of benign hepatic lesions. METHODS: A total of 827 condecutive cases of benign hepatic lesion undergoing hepatectomy from January 1986 to December 2005 in the Chinese PLA General Hospital were investigated retrospectively according to their medical documentation. RESULTS: The effect of operative and perioperative factors on the outcome of patients were analyzed. Of the 827 cases undergoing hepatectomy for more than 3 liver segments accounted for 22.1%, 316 (38.21%) required transfusion of blood products during operation. The average operating time was 220.59 ± 109.13 min, the average hospital stay after operation was 13.55 ± 9.38 d. Child-Pugh A accounted for 98.13%. The postoperative complication rate was 13.54% and the in-hospital mortality rate was 0.24%. Multivariate analysis showed that operating time (P = 0.004, OR = 1.003) and albumin value (P = 0.040, OR = 0.938) were the independent predictors of morbidity and indicated that operating time, blood transfusion, complication rate, and LOS had a trend to decrease. CONCLUSION: Hepatectomy for benign hepatic lesions can be performed safely with a low morbidity and mortality, provided that it is carried out with optimized perioperative management and an innovative surgical technique. PMID:19084942

  20. Therapy for treatment-refractory chronic hepatitis C virus genotype 1b infection: A retrospective analysis

    PubMed Central

    Cindoruk, Mehmet; Karakan, Tarkan; Unal, Selahattin

    2005-01-01

    Background: The most effective current therapy for hepatitis C virus (HCV) infection is the combination of pegylated interferon (peg-IFN) plus ribavirin (RBV). Objective: The aim of this retrospective analysis was to determine the rateof response to this therapy, and the factors affecting outcome, in patients with treatment-refractory chronic HCV genotype l b. Methods: The records of patients with chronic HCV infection and HCV geno-type1b who failed (nonresponse or relapse) previous treatment with standard interferon (IFN) + RSV were retrospectively analyzed for demographic data, virologic load, liver histology, biochemistry, treatment-related adverse effects (AEs), and the effects of dose reduction during treatment with peg-IFN + RBV for 48 weeks. Early virologic response (EVR) was defined as ≥2-log (copies/mL) decrease from baseline in serum HCV RNA concentration or the absence of detectable serum HCV RNA at treatment week 12. End-of-treatment response (ETR) was defined as the absence of detectable serum HCV RNA at treatment week 48. Sustained virologic response (SVR) was defined as the absence of detectable serum HCV RNA 24 weeks after treatment was discontinued. Factors affecting treatment outcome were determined using correlation analyses. Results: Data from the files of 17 patients (12 men, 5 women; mean [SD] age, 48 [2] years) were analyzed. EVR was achieved in 7 patients; however, viral breakthrough occurred in 2 of these patients during the treatment period, and 5 of these patients discontinued treatment because of severe treatment-related AEs (depression [1 patient] and neutropenia [4]). Seven patients achieved ETR, but HCV infection relapsed during the follow-up period. Three (18%) patients achieved SVR. Data concerning previous patterns of response to IFN + RBV therapy were available in 10 patients. Of these, 3 of 6 patients who had experienced relapse with the previous treatment achieved SVR with peg-IFN + RBV; neither of the 2 patients with

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

    NASA Technical Reports Server (NTRS)

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

    2015-01-01

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

  2. Using MERRA, AMIP II, CMIP5 Outputs to Assess Actual and Potential Building Climate Zone Change and Variability From the Last 30 Years Through 2100

    NASA Astrophysics Data System (ADS)

    Stackhouse, P. W.; Westberg, D. J.; Hoell, J. M., Jr.; Chandler, W.; Zhang, T.

    2014-12-01

    In the US, residential and commercial building infrastructure combined consumes about 40% of total energy usage and emits about 39% of total CO2emission (DOE/EIA "Annual Energy Outlook 2013"). Thus, increasing the energy efficiency of buildings is paramount to reducing energy costs and emissions. Building codes, as used by local and state enforcement entities are typically tied to the dominant climate within an enforcement jurisdiction classified according to various climate zones. These climates zones are based upon a 30-year average of local surface observations and are developed by DOE and ASHRAE (formerly known as the American Society of Hearting, Refrigeration and Air-Conditioning Engineers). A significant shortcoming of the methodology used in constructing such maps is the use of surface observations (located mainly near airports) that are unequally distributed and frequently have periods of missing data that need to be filled by various approximation schemes. This paper demonstrates the usefulness of using NASA's Modern Era Retrospective-analysis for Research and Applications (MERRA) atmospheric data assimilation to derive the ASHRAE climate zone maps and then using MERRA to define the last 30 years of variability in climate zones. These results show that there is a statistically significant increase in the area covered by warmer climate zones and some tendency for a reduction of area in colder climate zones that require longer time series to confirm. Using the uncertainties of the basic surface temperature and precipitation parameters from MERRA as determined by comparison to surface measurements, we first compare patterns and variability of ASHRAE climate zones from MERRA relative to present day climate model runs from AMIP simulations to establish baseline sensitivity. Based upon these results, we assess the variability of the ASHRAE climate zones according to CMIP runs through 2100 using an ensemble analysis that classifies model output changes by

  3. Retrospective analysis of etiology and comorbid diseases associated with Ludwig's Angina

    PubMed Central

    Botha, Andrew; Jacobs, Fred; Postma, Corne

    2015-01-01

    Introduction: Ludwig's angina (LA) still presents regularly at our tertiary academic hospital. Various etiologies and comorbid diseases are documented worldwide, but the South African population has not been studied. Aim: To establish whether LA cases presenting to the department are different from international reports regarding etiology and comorbidities. Settings and Design: Retrospective analysis of patients presenting with LA to a tertiary hospital. Materials and Methods: 93 patients were included over a 5-year period. Archived files were analyzed for data including age, gender, comorbid diseases, etiology, airway management, and season on admission. Statistical Analysis: Descriptive statistics with the inclusion of frequency distributions. Results: 93 patients were included; 65 (69.9%) male and 28 (30.1%) female; age - minimum 20 years, maximum 75 years, mean 40.366. Etiology: 68 (73.1%) odontogenic, 13 (14%) nonodontogenic, and 12 (12.9%) unknown cause. Comorbid diseases: 21 (22.6%) diabetes mellitus (DM), 19 (20.4%) hypertension, and 18 (19.4%) human immunodeficiency virus (HIV). Airway management: 61 (65.6%) tracheostomy and 32 (34.4%) nonsurgical. Complications: 11 (11.8%) deaths, 8 (8.60%) descending mediastinitis, and 7 (7.53%) necrotizing fasciitis. Seasonal occurrence: 30 (32.3%) spring, 24 (25.8%) winter, 22 (23.7%) summer, and 17 (18.3%) autumn. Conclusion: A 2.32:1 ratio male: female presentation mirrors previous statistics. DM patients had increased risks of complications, which resulted in multiple deaths. HIV patients showed increased risks for complications with more intense, longer hospital stays, but lower percentages of deaths compared to patients with DM and complications who died. There was no statistically significant finding regarding seasonal tendency. PMID:26981465

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

    PubMed Central

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

    2016-01-01

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

  5. Posaconazole after previous antifungal therapy with voriconazole for therapy of invasive aspergillus disease, a retrospective analysis.

    PubMed

    Heinz, Werner J; Egerer, Gerlinde; Lellek, Heinrich; Boehme, Angelika; Greiner, Jochen

    2013-05-01

    Invasive aspergillosis is an important cause of morbidity and mortality in haematological patients. Current guidelines recommend voriconazole as first-line therapy. A change in class of antifungal agent is generally recommended for salvage therapy. The focus of this analysis was to assess if posaconazole is suitable for salvage therapy following voriconazole treatment. This was a retrospective investigation on patients with sequential antifungal therapy of posaconazole after voriconazole identified at four German hospitals. Response rates at 30 and 60 days following start of posaconazole application and toxicity of azoles by comparing liver enzymes and cholestasis parameters were evaluated. Data were analysed by descriptive statistics. Overall, the success rate was 72.2% [15 of 36 patients showed complete response (41.7%), 11 patients partial response (30.6%) at any time point], eight patients failed treatment and two were not evaluable. Mean laboratory values increased during voriconazole and decreased during posaconazole treatment: aspartate aminotransferase (increase: 31.9 U l(-1) vs. decrease: 19.6 U l(-1) ), alanine aminotransferase (32.4 U l(-1) vs. 19.8 U l(-1) ), gamma-glutamyl transferase (124.2 U l(-1) vs. 152.3 U l(-1) ) and alkaline phosphatase (71.5 U l(-1) vs. 40.3 U l(-1) ) respectively. No patient discontinued posaconazole therapy due to an adverse event. In this analysis posaconazole was a safe and effective antifungal salvage therapy in patients with prior administration of another triazole.

  6. Angioleiomyomas in the head and neck: A retrospective clinical and immunohistochemical analysis

    PubMed Central

    LIU, YING; LI, BO; LI, LONGJIANG; LIU, YANBIN; WANG, CHENXING; ZHA, LAGABAIYILA

    2014-01-01

    Angioleiomyoma is a benign soft-tissue tumor originating from vascular smooth muscle, and is rare in the head and neck. The present study retrospectively examined a cohort of patients with head and neck angioleiomyoma treated at the West China Hospital of Stomatology, and also subjected archived tissues to modern immunohistochemical analysis. In total, 21 patients were treated for angioleiomyoma between 1978 and 2012 at the West China Hospital of Stomatology, Sichuan University (Chengdu, Sichuan, China). Medical records were examined and paraffin block sections were cut and stained with hematoxylin and eosin, Masson’s trichrome stain and Van Gieson stain, prior to being subjected to immunohistochemical analysis to re-evaluate and confirm the diagnoses. Angioleiomyomas were found to account for only 0.18% of the benign head and neck tumors in the patients presenting to the hospital over the past 34 years. The diagnosis was more common in males (male:female ratio, 1.625:1) and the mean age at diagnosis was 42.5 years. The most common sites were the buccal mucosa, parotid gland and palate. More than half of the tumors (61.9%) were >2 cm in diameter. Five tumors presented with pain and/or tenderness. The histological subtype was reported as solid in five cases, venous in six, cavernous in nine and venous-cavernous in one. Three tumors exhibited nerve neurofibrils. All tumors were excised with no subsequent recurrence. Cytological and imaging examinations were not useful for pre-operative diagnosis. Angioleiomyoma is a benign tumor that causes limited morbidity. Surgical excision is the only effective treatment and recurrence is rare. The present study revealed that nerves were present in a small proportion (14.3%) of tumors. It was hypothesized that the compression of nerves accompanying numerous blood vessels in the tumor may cause pain, particularly in venous- and cavernous-type angioleiomyomas. PMID:24959254

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2014-07-01

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

  12. Classifying degenerative joint disease by the RDC/TMD and by panoramic imaging: a retrospective analysis.

    PubMed

    Winocur, E; Reiter, S; Krichmer, M; Kaffe, I

    2010-03-01

    The purposes of the study were to evaluate the utility of diagnosing degenerative joint disease (DJD) by the clinical finding of coarse crepitus alone, without supporting imaging studies, as defined by the RDC/TMD, and to evaluate the contribution of panoramic radiography as an aid in the diagnosis of DJD. A retrospective analysis of 372 consecutive patients with TMD was conducted. Their panoramic radiographs were evaluated for the extent of their contribution to the final diagnosis. Panoramic radiography was of no diagnostic value in 94.4% of the cases when the group was considered as a whole. When patients diagnosed with DJD were considered separately, panoramic radiography was completely sufficient for reaching the final diagnosis in 20.0% of the cases. In almost 90% of these patients, however, the clinical examination did not support the diagnosis of DJD (no coarse crepitus was found). This raises some doubts about the effectiveness of the clinical examination according to the RDC/TMD and about the utility of panoramic radiography in the definitive diagnosis of DJD, because both techniques have low accuracy (11.1% and 20%, respectively). The present study supports the current recommendations that panoramic radiography should not be ordered routinely to assess DJD, but still it is first choice when any dental problem is suspected. Further additional imaging (computerized tomography, magnetic resonance imaging) should be considered only if there is reason to expect that the findings might affect diagnosis and management. This study adds to recent criticisms of the clinical validity of the RDC/TMD, with regard to DJD.

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2015-06-01

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

  16. Dural ossification associated with ossification of ligamentum flavum in the thoracic spine: a retrospective analysis

    PubMed Central

    Li, Bo; Qiu, Guixing; Guo, Shigong; Li, Wenjing; Li, Ye; Peng, Huiming; Wang, Chu; Zhao, Yu

    2016-01-01

    Objectives To investigate the incidence, distribution and radiological characteristics of dural ossification (DO) associated with ossification of ligamentum flavum (OLF) in the thoracic spine. Design A retrospective radiographical analysis. Setting This study was conducted at a single institution in China. Participants 53 patients with OLF who underwent posterior decompression surgery between January 2011 and July 2015 in a single institution were enrolled in this study. The decompression segments were grouped according to imaging evaluation and intraoperative evidences. Outcome measures The demographic distribution, radiological data and detailed surgical records were collected. First, preoperative CT images of decompressed segments were evaluated to identify imaging signs of DO. The ‘tram tack sign’ (TTS), ‘comma sign’ and ‘bridge sign’ were considered as characteristic imaging findings of DO in OLF. 4 kinds of confusing signs (false TTS) were identified and excluded. Then detailed surgical records were reviewed to finally identify segments with DO. Results The incidence of DO in patients with OLF was 43.4%. The incidence of DO in OLF segments was 21.5%. OLF was more common in the lower thoracic spine, and more than half (53.8%) of the DO was located in T9-T12. TTS was the most common sign, but it might be misdiagnosed. After excluding 4 kinds of false TTS, the sensitivity and specificity of imaging diagnosis were 94.23% and 94.21%, respectively. Conclusions DO was relatively common in thoracic OLF, especially in T9-T12. TTS might be misdiagnosed. After excluding 4 kinds of false TTS, the accuracy of imaging diagnosis was relatively high. PMID:27998902

  17. Predictive Factors for Second-Line Therapy in Metastatic Renal Cell Carcinoma: A Retrospective Analysis

    PubMed Central

    Ivanyi, Philipp; Hornig, Mareike; Grünwald, Viktor

    2017-01-01

    Currently, about 50% of patients with metastatic renal cell carcinoma (mRCC) receive a second-line therapy. Therefore, the choice at each subsequent treatment line remains an important issue. In this retrospective study, we sought to identify pretreatment clinical parameters that could predict the likelihood of a patient receiving a second-line therapy. One hundred and sixty-one mRCC patients who received targeted therapy were evaluated. Descriptive statistics, Kaplan–Meier overall survival (OS), Cox regression, and binary logistic regression models were used for data analysis. Second-line therapy was given to 105 patients (65%). Patients with grade 1 tumor received second-line therapy more frequently than those with grade 2/3 tumors (P = 0.03). Only tumor grade was significantly different between patients receiving, or not receiving, second-line treatment. Median OS was significantly superior in patients receiving second-line therapy (32 versus 14 months; P = 0.007; hazard ratio [HR], 1.75; P = 0.008), patients with grade 1 tumors (130 versus 29 months in G2/3 tumors; HR, 3.85; P = 0.009), and in patients without early tumor progression (41 versus 11 months; HR, 5.04; 95% confidence interval [CI], 3.06–8.31; P < 0.001). In binary logistic regression, we identified early progression to be significantly associated with a higher probability of not receiving a second-line therapy (HR, 2.50; 95% CI, 1.01–6.21; P = 0.048). This study hypothesizes that pretreatment grade and early progression are predictive parameters for the selection of patients for second-line therapy.

  18. Retrospective analysis showing the water method increased adenoma detection rate — a hypothesis generating observation

    PubMed Central

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

    2011-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  20. A retrospective analysis of endoscopic treatment outcomes in patients with postoperative bile leakage

    PubMed Central

    Sayar, Suleyman; Olmez, Sehmus; Avcioglu, Ufuk; Tenlik, Ilyas; Saritas, Bunyamin; Ozdil, Kamil; Altiparmak, Emin; Ozaslan, Ersan

    2016-01-01

    OBJECTIVE: Bile leakage, while rare, can be a complication seen after cholecystectomy. It may also occur after hepatic or biliary surgical procedures. Etiology may be underlying pathology or surgical complication. Endoscopic retrograde cholangiopancreatography (ERCP) can play major role in diagnosis and treatment of bile leakage. Present study was a retrospective analysis of outcomes of ERCP procedure in patients with bile leakage. METHODS: Patients who underwent ERCP for bile leakage after surgery between 2008 and 2012 were included in the study. Etiology, clinical and radiological characteristics, and endoscopic treatment outcomes were recorded and analyzed. RESULTS: Total of 31 patients (10 male, 21 female) were included in the study. ERCP was performed for bile leakage after cholecystectomy in 20 patients, after hydatid cyst operation in 10 patients, and after hepatic resection in 1 patient. Clinical signs and symptoms of bile leakage included abdominal pain, bile drainage from percutaneous drain, peritonitis, jaundice, and bilioma. Twelve (60%) patients were treated with endoscopic sphincterotomy (ES) and nasobiliary drainage (NBD) catheter, 7 patients (35%) were treated with ES and biliary stent (BS), and 1 patient (5%) was treated with ES alone. Treatment efficiency was 100% in bile leakage cases after cholecystectomy. Ten (32%) cases of hydatid cyst surgery had subsequent cystobiliary fistula. Of these patients, 7 were treated with ES and NBD, 2 were treated with ES and BS, and 1 patient (8%) with ES alone. Treatment was successful in 90% of these cases. CONCLUSION: ERCP is an effective method to diagnose and treat bile leakage. Endoscopic treatment of postoperative bile leakage should be individualized based on etiological and other factors, such as accompanying fistula. PMID:28058396

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

    PubMed Central

    Coupland, Robin

    1999-01-01

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

  2. Retrospective and Prospective Decomposition Analysis of Chinese Manufacturing Energy Use, 1995-2020

    SciTech Connect

    Hasanbeigi, Ali; Price, Lynn; Fino-Chen, Cecilia; Lu, Hongyou; Ke, Jing

    2013-01-15

    In 2010, China was responsible for nearly 20 percent of global energy use and 25 percent of energy-related carbon dioxide (CO2) emissions. Unlike most countries, China’s energy consumption pattern is unique because the industrial sector dominates the country’s total energy consumption, accounting for about 70 percent of energy use and 72 percent of CO2 emissions in 2010. For this reason, the development path of China’s industrial sector will greatly affect future energy demand and dynamics of not only China, but the entire world. A number of analyses of historical trends have been conducted, but careful projections of the key factors affecting China’s industry sector energy use over the next decade are scarce. This study analyzes industrial energy use and the economic structure of the Chinese manufacturing sector in detail. First, the study analyzes the energy use of and output from 18 industry sub-sectors. Then, retrospective (1995-2010) and prospective (2010-2020) decomposition analyses are conducted for these industrial sectors in order to show how different factors (production growth, structural change, and energy intensity change) influenced industrial energy use trends in China over the last 15 years and how they will do so over the next 10 years. The results of this study will allow policy makers to quantitatively compare the level of structural change in the past and in the years to come and adjust their policies if needed to move towards the target of less energy-intensive industries. The scenario analysis shows the structural change achieved through different paths and helps to understand the consequences of supporting or limiting the growth of certain manufacturing subsectors from the point of view of energy use and structural change. The results point out the industries that have the largest influence in such structural change

  3. Appropriateness of antibiotic treatment in intravenous drug users, a retrospective analysis

    PubMed Central

    Mertz, Dominik; Viktorin, Nina; Wolbers, Marcel; Laifer, Gerd; Leimenstoll, Bernd; Fluckiger, Ursula; Battegay, Manuel

    2008-01-01

    Background Infectious disease is often the reason for intravenous drug users being seen in a clinical setting. The objective of this study was to evaluate the appropriateness of treatment and outcomes for this patient population in a hospital setting. Methods Retrospective study of all intravenous drug users hospitalized for treatment of infectious diseases and seen by infectious diseases specialists 1/2001–12/2006 at a university hospital. Treatment was administered according to guidelines when possible or to alternative treatment program in case of patients for whom adherence to standard protocols was not possible. Outcomes were defined with respect to appropriateness of treatment, hospital readmission, relapse and mortality rates. For statistical analysis adjustment for multiple hospitalizations of individual patients was made by using a generalized estimating equation. Results The total number of hospitalizations for infectious diseases was 344 among 216 intravenous drug users. Skin and soft tissue infections (n = 129, 37.5% of hospitalizations), pneumonia (n = 75, 21.8%) and endocarditis (n = 54, 15.7%) were most prevalent. Multiple infections were present in 25%. Treatment was according to standard guidelines for 78.5%, according to an alternative recommended program for 11.3%, and not according to guidelines or by the infectious diseases specialist advice for 10.2% of hospitalizations. Psychiatric disorders had a significant negative impact on compliance (compliance problems in 19.8% of hospitalizations) in multiple logistic regression analysis (OR = 2.4, CI 1.1–5.1, p = 0.03). The overall readmission rate and relapse rate within 30 days was 13.7% and 3.8%, respectively. Both non-compliant patient behavior (OR = 3.7, CI 1.3–10.8, p = 0.02) and non-adherence to treatment guidelines (OR = 3.3, CI 1.1–9.7, p = 0.03) were associated with a significant increase in the relapse rate in univariate analysis. In 590 person-years of follow-up, 24.6% of the

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

    NASA Astrophysics Data System (ADS)

    Pena Cabra, Ivonne A.

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

  5. Behaviour of the low degree terms of the Earth gravity field over the last 30 years

    NASA Astrophysics Data System (ADS)

    Biancale, R.; Lemoine, J.-M.; Reinquin, F.; Deleflie, F.; Ramillien, G.; Gégout, P.

    2012-04-01

    The GRACE mission has revealed since 2002 the recent evolution of the Earth's gravity field with a resolution down to 400 km, equivalent to degree and order 50 in spherical harmonics. Precise orbit computation for altimetric satellites can obviously gain by applying these variations, which are classically given, as in recent EIGEN models, as drifts and periodic terms (yearly and semi-yearly). However extrapolating these variations to pre-GRACE periods, mainly the drifts, can be problematic for orbit computation performances on former altimetric satellites. One option is to analyse older satellite data, in particular SLR data on geodetic satellites, in order to assess the very low degree variations of the gravity field and compare it to the GRACE determination. This can be done over the last 30 years, using for instance the Lageos and Lageos-2, Starlette and Stella satellites. The spherical harmonic degrees that can be accessed in this way are degrees 2 to 4. Additional information on degree 2 can be derived from the analysis of the Earth orientation parameters, pole coordinates and length of day (LOD), which have been observed over a long period with great accuracy by astrometric, satellite geodetic and extra-galactic means. Once corrected for atmospheric and oceanic load and velocity variations, the pole coordinates will principally bring information on the C(2,1) and S(2,1) coefficients, while the LOD will principally be connected with the C(2,0). Combining these two approaches allows a better observation of the temporal evolution of the gravity field over a long time span and a more realistic modelling of it for the precise orbit computation of past altimeter missions.

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

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

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

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

    ERIC Educational Resources Information Center

    Kirk, Liz

    2012-01-01

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

  9. 7 CFR 1467.8 - Compensation for easements and 30-year contracts.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Henderson, Davetta A.

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    ERIC Educational Resources Information Center

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

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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

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

    PubMed

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

    2010-03-01

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

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

    ERIC Educational Resources Information Center

    Torrance, E. Paul

    2004-01-01

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

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

    ERIC Educational Resources Information Center

    Lahtinen, Ulla; Rintala, Pauli; Malin, Antero

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Loftus, Elizabeth F.

    2005-01-01

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

  18. Family Boundary Ambiguity: A 30-Year Review of Theory, Research, and Measurement

    ERIC Educational Resources Information Center

    Carroll, Jason S.; Olson, Chad D.; Buckmiller, Nicolle

    2007-01-01

    Since its introduction 30 years ago, family boundary ambiguity (BA) has been a widely used construct in family stress research and clinical intervention. In this article, we present a comprehensive and interdisciplinary review of published research studies that have used BA as a primary variable. Our review identified 37 studies investigating BA…

  19. 76 FR 81462 - Preliminary Plan for Retrospective Analysis of Existing Rules

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-28

    ... engage in such retrospective review in order to identify unnecessary or unduly burdensome regulations that may be hindering job creation and economic development. The Commission seeks input from the public... promoting innovation and job growth. In furtherance of these objectives, the Commission seeks comment on...

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  1. Chronic kidney disease progression: a retrospective analysis of 3-year adherence to a low protein diet.

    PubMed

    Rizzetto, Felipe; Leal, Viviane de Oliveira; Bastos, Leonardo Soares; Fouque, Denis; Mafra, Denise

    2017-11-01

    The potential benefits and dangers of dietary protein restriction in chronic kidney disease (CKD) are still controversial. Thus, the aim of this study is to evaluate the effect of low protein diet (LPD) on the renal function in nondialysis CKD patients. A retrospective study was conducted from 321 nondialysis CKD patient's medical files (65.1 ± 12.7 yrs, 58.2% men). These patients received individualized dietary protein prescription (0.6-0.8 g protein/kg/day). Protein intake was evaluated by food diary and 24 h-food recall. Adherence to the LPD was considered when patients intake from 90 to 110% of the prescribed amount of protein. The patients were divided into 4 groups: (G1) adherent diabetes mellitus (DM) patients (n = 83); (G2) non-adherent DM patients (n = 106); (G3) adherent non-DM patients (n = 75); (G4) non-adherent non-DM patients (n = 57). Renal function was assessed by estimated glomerular filtration rate (eGFR). Both groups of patients (DM and non-DM) that adhered to the LPD showed significant improvement in eGFR (G1: 38.7 ± 13.2 mL/min to 51.1 ± 17.0 mL/min (p < 0.001); G3: 35.1 ± 16.8 mL/min to 46.8 ± 21.4 mL/min (p < 0.001)). In adherent patients, no differences in albumin and BMI were observed at the end of follow up. In non-adherent patients, eGFR significantly decreased in DM group (G2: 44.2 ± 18.5 mL/min to 38.2 ± 15.8 mL/min (p = 0.003)). According to multivariate analysis, annual changes in eGFR were not independent associated with age, gender, BMI, lipid profile, bicarbonate or smoking status. In summary, adherence to low protein diet could be able to improve serum creatinine and eGFR, well-known markers of renal function. However, prospective studies are needed to control confounders which affect renal function and CKD progression.

  2. A Retrospective Analysis of Pressure Ulcer Incidence and Modified Braden Scale Score Risk Classifications.

    PubMed

    Chen, Hong-Lin; Cao, Ying-Juan; Wang, Jing; Huai, Bao-Sha

    2015-09-01

    The Braden Scale is the most widely used pressure ulcer risk assessment in the world, but the currently used 5 risk classification groups do not accurately discriminate among their risk categories. To optimize risk classification based on Braden Scale scores, a retrospective analysis of all consecutively admitted patients in an acute care facility who were at risk for pressure ulcer development was performed between January 2013 and December 2013. Predicted pressure ulcer incidence first was calculated by logistic regression model based on original Braden score. Risk classification then was modified based on the predicted pressure ulcer incidence and compared between different risk categories in the modified (3-group) classification and the traditional (5-group) classification using chi-square test. Two thousand, six hundred, twenty-five (2,625) patients (mean age 59.8 ± 16.5, range 1 month to 98 years, 1,601 of whom were men) were included in the study; 81 patients (3.1%) developed a pressure ulcer. The predicted pressure ulcer incidence ranged from 0.1% to 49.7%. When the predicted pressure ulcer incidence was greater than 10.0% (high risk), the corresponding Braden scores were less than 11; when the predicted incidence ranged from 1.0% to 10.0% (moderate risk), the corresponding Braden scores ranged from 12 to 16; and when the predicted incidence was less than 1.0% (mild risk), the corresponding Braden scores were greater than 17. In the modified classification, observed pressure ulcer incidence was significantly different between each of the 3 risk categories (P less than 0.05). However, in the traditional classification, the observed incidence was not significantly different between the high-risk category and moderate-risk category (P less than 0.05) and between the mild-risk category and no-risk category (P less than 0.05). If future studies confirm the validity of these findings, pressure ulcer prevention protocols of care based on Braden Scale scores can

  3. Performance curves of medical researchers during their career: analysis of scientific production from a retrospective cohort

    PubMed Central

    Duclos, Antoine; Herquelot, Eléonore; Polazzi, Stéphanie; Malbezin, Muriel; Claris, Olivier

    2017-01-01

    Objectives To establish the pattern of change in individual scientific production over the career of medical researchers. Design Retrospective cohort based on prospectively collected data in a hospital information system. Setting Multicentre university hospital in France. Participants Two distinct populations of 1835 researchers (full professors vs non-academic physicians) having produced 44 723 publications between 1995 and 2014. Main outcome measures Annual number of publications referenced in Medline/PubMed with a sensitivity analysis based on publications as first/last author and in high impact journals. The individual volume of publications was modelled by age using generalised estimating equations adjusted for birth cohort, biomedical discipline and academic position of researchers. Results Averaged over the whole career, the annual number of publications was 5.28 (95% CI 4.90 to 5.69) among professors compared to 0.82 (95% CI 0.76 to 0.89) among non-academic physicians (p<0.0001). The performance curve of professors evolved in three successive phases, including an initiation phase with a sharp increase in scientific production between 25 and 35 years (adjusted incidence rate ratio 102.20, 95% CI 60.99 to 171.30), a maturation phase with a slower increase from 35 to 50 years (2.10, 95% CI 1.75 to 2.51) until a stabilisation phase with constant production followed by a potential decline at the end of career (0.90, 95% CI 0.77 to 1.06). The non-academic physicians experienced a slower pace of learning curve at the beginning of their careers (42.38, 95% CI 25.37 to 70.81) followed by a smaller increase in the annual number of publications (1.29, 95% CI 1.11 to 1.51). Conclusions Compared to full professors, non-academic physicians had a poor capacity to publish, indicating a low productivity when medical doctors have limited time or little interest in undertaking research. This finding highlights the potential for rethinking the missions of medical doctors

  4. Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis.

    PubMed

    Sun, Eric C; Dixit, Anjali; Humphreys, Keith; Darnall, Beth D; Baker, Laurence C; Mackey, Sean

    2017-03-14

    Objectives To identify trends in concurrent use of a benzodiazepine and an opioid and to identify the impact of these trends on admissions to hospital and emergency room visits for opioid overdose.Design Retrospective analysis of claims data, 2001-13.Setting Administrative health claims database.Participants 315 428 privately insured people aged 18-64 who were continuously enrolled in a health plan with medical and pharmacy benefits during the study period and who also filled at least one prescription for an opioid.Interventions Concurrent benzodiazepine/opioid use, defined as an overlap of at least one day in the time periods covered by prescriptions for each drug. Main outcome measures Annual percentage of opioid users with concurrent benzodiazepine use; annual incidence of visits to emergency room and inpatient admissions for opioid overdose.Results 9% of opioid users also used a benzodiazepine in 2001, increasing to 17% in 2013 (80% relative increase). This increase was driven mainly by increases among intermittent, as opposed to chronic, opioid users. Compared with opioid users who did not use benzodiazepines, concurrent use of both drugs was associated with an increased risk of an emergency room visit or inpatient admission for opioid overdose (adjusted odds ratio 2.14, 95% confidence interval 2.05 to 2.24; P<0.001) among all opioid users. The adjusted odds ratio for an emergency room visit or inpatient admission for opioid overdose was 1.42 (1.33 to 1.51; P<0.001) for intermittent opioid users and 1.81 (1.67 to 1.96; P<0.001) chronic opioid users. If this association is causal, elimination of concurrent benzodiazepine/opioid use could reduce the risk of emergency room visits related to opioid use and inpatient admissions for opioid overdose by an estimated 15% (95% confidence interval 14 to 16).Conclusions From 2001 to 2013, concurrent benzodiazepine/opioid use sharply increased in a large sample of privately insured patients in the US and

  5. Efficacy of bevacizumab therapy for unresectable malignant glioma: A retrospective analysis

    PubMed Central

    Yonezawa, Hajime; Hirano, Hirofumi; Uchida, Hiroyuki; Habu, Mika; Hanaya, Ryosuke; Oyoshi, Tatsuki; Sadamura, Yuko; Hanada, Tomoko; Tokimura, Hiroshi; Moinuddin, Fm; Arita, Kazunori

    2017-01-01

    Bevacizumab (BEV), an inhibitor of vascular endothelial growth factor A, has been used for primary and recurrent malignant gliomas in Japan since June, 2013. Previous randomized controlled studies demonstrated that BEV prolonged the progression-free survival, but not the overall survival (OS) of patients with newly diagnosed glioblastoma. The aim of the present study was to elucidate the effect of BEV on the OS of patients with unresectable malignant gliomas. Of the 440 cases of malignant glioma initially treated in our institute between 2000 and 2015, 88 were not suitable for maximal resection due to patient age, physical condition, tumor location and extent, or the patient's wishes. Based on the biopsy results, the pathological diagnosis was glioblastoma, anaplastic astrocytoma and anaplastic oligodendroglioma in 60, 19 and 9 patients, respectively. Kaplan-Meier and log-rank analyses were performed to investigate the effect of BEV on OS. OS was longer in the BEV group (n=24) compared with that in the non-BEV group [n=64; median survival time (MST), 566 vs. 243 days, respectively; hazard ratio (HR)=0.413; 95% confidence interval (CI): 0.216–0.787; P=0.003]. In the 41 patients who received temozolomide (TMZ) and radiotherapy and the 31 patients with glioblastoma who received TMZ and radiotherapy, OS was longer in the BEV group compared with that in the non-BEV group (MST, 568 vs. 334 days, HR=0.404, 95% CI: 0.175–0.933, P=0.016; and MST, 566 vs. 160 days, HR=0.253, 95% CI: 0.099–0.646, P=0.001, respectively). In the Cox hazard model analysis of 41 patients who underwent TMZ-based chemoradiotherapy after biopsy, the use of BEV was the strongest independent beneficial factor associated with prolonged OS (HR=0.101; P=0.0002). Our retrospective survey suggested that BEV prolongs the OS of patients with unresectable malignant gliomas. However, these results must be verified by a well-designed prospective randomized controlled trial. PMID:28123740

  6. Changes in malaria indices between 1999 and 2007 in The Gambia: a retrospective analysis

    PubMed Central

    Ceesay, Serign J; Casals-Pascual, Climent; Erskine, Jamie; Anya, Samuel E; Duah, Nancy O; Fulford, Anthony JC; Sesay, Sanie SS; Abubakar, Ismaela; Dunyo, Samuel; Sey, Omar; Palmer, Ayo; Fofana, Malang; Corrah, Tumani; Bojang, Kalifa A; Whittle, Hilton C; Greenwood, Brian M; Conway, David J

    2008-01-01

    Summary Background Malaria is a major cause of morbidity and mortality in Africa. International effort and funding for control has been stepped up, with substantial increases from 2003 in the delivery of malaria interventions to pregnant women and children younger than 5 years in The Gambia. We investigated the changes in malaria indices in this country, and the causes and public-health significance of these changes. Methods We undertook a retrospective analysis of original records to establish numbers and proportions of malaria inpatients, deaths, and blood-slide examinations at one hospital over 9 years (January, 1999–December, 2007), and at four health facilities in three different administrative regions over 7 years (January, 2001–December, 2007). We obtained additional data from single sites for haemoglobin concentrations in paediatric admissions and for age distribution of malaria admissions. Findings From 2003 to 2007, at four sites with complete slide examination records, the proportions of malaria-positive slides decreased by 82% (3397/10861 in 2003 to 337/6142 in 2007), 85% (137/1259 to 6/368), 73% (3664/16932 to 666/11333), and 50% (1206/3304 to 336/1853). At three sites with complete admission records, the proportions of malaria admissions fell by 74% (435/2530 to 69/1531), 69% (797/2824 to 89/1032), and 27% (2204/4056 to 496/1251). Proportions of deaths attributed to malaria in two hospitals decreased by 100% (seven of 115 in 2003 to none of 117 in 2007) and 90% (22/122 in 2003 to one of 58 in 2007). Since 2004, mean haemoglobin concentrations for all-cause admissions increased by 12 g/L (85 g/L in 2000–04 to 97 g/L in 2005–07), and mean age of paediatric malaria admissions increased from 3·9 years (95% CI 3·7–4·0) to 5·6 years (5·0–6·2). Interpretation A large proportion of the malaria burden has been alleviated in The Gambia. Our results encourage consideration of a policy to eliminate malaria as a public-health problem, while

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

    PubMed Central

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

    2016-01-01

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

  8. Health hazards and medical treatment of volunteers aged 18-30 years working in international social projects of non-governmental organizations (NGO).

    PubMed

    Küpper, T; Rieke, B; Neppach, K; Morrison, A; Martin, J

    2014-01-01

    The specific health risk profile and diversity of treatments sought by young volunteers participating in international social projects should differ from those of their older colleagues. In the absence of any data to identify whether this was correct, a retrospective analysis was performed using a standardized questionnaire. Questions included what diseases occurred, and details of the frequency and types of treatment sought during their stay - (e.g. self-treatment, medical/dental intervention, or local healer). The 153 participants were aged 18-30 years and worked in a non-governmental organization for >6 months. The participants were: 53% female, mean age 20 years, and mean duration of stay was 11.2 months. Their NGO placement abroad was in Latin America 65.4%, 14.4% in Africa, and 9.8% in Asia. 83% of the young volunteers had received some advice regarding travel medicine before their departure. However, they suffered from more injuries compared to private travellers, and febrile infections were more common when compared to older studies. 21.2% suffered from dental problems and 50% of them sought medical treatment. This study highlights a previously unreported higher risk profile of specific health problems occurring in young NGO volunteers, including some potentially life-threatening diagnoses that differed from their older colleagues and normal travellers. It is recommended that young volunteers should receive age specific, comprehensive pre-departure training in health and safety, first aid, and management of common health problems. A medical check-up upon returning home should be mandatory. The provision of a basic first aid kit to each volunteer before departure is also recommended.

  9. Lower incidence of plasma cell neoplasm is maintained in migrant Chinese to British Columbia: findings from a 30-year survey.

    PubMed

    Chan, Vicky; Song, Kevin; Mang, Oscar; Ip, Dennis K M; Au, Wing Y

    2011-12-01

    The etiology of plasma cell myeloma (PCM) is largely unknown. Its incidence varies widely in different ethnic groups. Migrant study may help determine the relative contributions of genetic versus environmental factors to PCM pathogenesis. We performed a retrospective review of the computerized records of all patients diagnosed with PCM between 1975 and 2004 in British Columbia (BC), and identified patients of Chinese ethnicity. This was compared with PCM incidence in Hong Kong (HK) Chinese. Age distributions of HK, BC and BC Chinese populations were obtained from the census departments to calculate world age-standardized rates (WASRs). The WASR of PCM over the 30-year period in BC Chinese was 1.64/100 000 person-years (95% confidence interval [CI] 1.37-1.93). This was similar to the WASR observed in HK (1.78, 95% CI 1.73-1.83), with a standardized incidence ratio (SIR) of 0.91 (95% CI 0.74-1.10). The rate was much lower than that in the BC non-Chinese background population (WASR 3.59, 95% CI 3.50-3.68; SIR 0.46, 95% CI 0.38-0.56). The lower rates in BC Chinese were maintained across all years, both genders and in all age groups above 45 years. Our observations suggest a strong genetic component as the cause of differences in the ethnic predisposition to PCM.

  10. Outcomes for adult scoliosis patients receiving chiropractic rehabilitation: a 24-month retrospective analysis

    PubMed Central

    Morningstar, Mark W.

    2011-01-01

    Objectives The purpose of this study was to retrospectively report the results of patients who completed an exercise-based chiropractic program and its potential to alter the natural progression of adult scoliosis at 24 months after the clinic portion of treatment was concluded. Methods A retrospective chart review was conducted at 2 spine clinics in Michigan, USA. Each clinic uses the same chiropractic rehabilitation program to treat patients with adult scoliosis. Multidimensional patient outcomes included radiographic, respiratory, disability, and pain parameters. Outcomes were measured at baseline, at end of active treatment, and at long-term follow-up. Results A total of 28 patients fit the inclusion criteria for the study. The average beginning primary Cobb angle was 44° ± 6°. Patients received the same chiropractic rehabilitation program for approximately 6 months. At the end of active treatment, improvements were recorded in Cobb angle, pain scores, spirometry, and disability rating. All radiographic findings were maintained at 24-month follow-up. Conclusion This report is among the first to demonstrate sustained radiographic, self-rated, and physiologic benefits after treatment ceased. After completion of a multimodal chiropractic rehabilitation treatment, a retrospective cohort of 28 adult scoliosis patients reported improvements in pain, Cobb angle, and disability immediately following the conclusion of treatment and 24 months later. PMID:22014907

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

    PubMed

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

    2016-05-01

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

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

    USGS Publications Warehouse

    Field, Edward H.; Milner, Kevin R.; ,

    2008-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  15. 30-year lidar observations of the stratospheric aerosol layer state over Tomsk (Western Siberia, Russia)

    NASA Astrophysics Data System (ADS)

    Zuev, Vladimir V.; Burlakov, Vladimir D.; Nevzorov, Aleksei V.; Pravdin, Vladimir L.; Savelieva, Ekaterina S.; Gerasimov, Vladislav V.

    2017-02-01

    There are only four lidar stations in the world which have almost continuously performed observations of the stratospheric aerosol layer (SAL) state over the last 30 years. The longest time series of the SAL lidar measurements have been accumulated at the Mauna Loa Observatory (Hawaii) since 1973, the NASA Langley Research Center (Hampton, Virginia) since 1974, and Garmisch-Partenkirchen (Germany) since 1976. The fourth lidar station we present started to perform routine observations of the SAL parameters in Tomsk (56.48° N, 85.05° E, Western Siberia, Russia) in 1986. In this paper, we mainly focus on and discuss the stratospheric background period from 2000 to 2005 and the causes of the SAL perturbations over Tomsk in the 2006-2015 period. During the last decade, volcanic aerosol plumes from tropical Mt. Manam, Soufrière Hills, Rabaul, Merapi, Nabro, and Kelut and extratropical (northern) Mt. Okmok, Kasatochi, Redoubt, Sarychev Peak, Eyjafjallajökull, and Grímsvötn were detected in the stratosphere over Tomsk. When it was possible, we used the NOAA HYSPLIT trajectory model to assign aerosol layers observed over Tomsk to the corresponding volcanic eruptions. The trajectory analysis highlighted some surprising results. For example, in the cases of the Okmok, Kasatochi, and Eyjafjallajökull eruptions, the HYSPLIT air mass backward trajectories, started from altitudes of aerosol layers detected over Tomsk with a lidar, passed over these volcanoes on their eruption days at altitudes higher than the maximum plume altitudes given by the Smithsonian Institution Global Volcanism Program. An explanation of these facts is suggested. The role of both tropical and northern volcanic eruptions in volcanogenic aerosol loading of the midlatitude stratosphere is also discussed. In addition to volcanoes, we considered other possible causes of the SAL perturbations over Tomsk, i.e., the polar stratospheric cloud (PSC) events and smoke plumes from strong forest fires. At least

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

    PubMed Central

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

    2004-01-01

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

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

    SciTech Connect

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

    2012-07-15

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

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

    USGS Publications Warehouse

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

    2011-01-01

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

  19. Endovascular repair of inflammatory abdominal aneurysm: a retrospective analysis of CT follow-up.

    PubMed

    Hechelhammer, Lukas; Wildermuth, Simon; Lachat, Mario L; Pfammatter, Thomas

    2005-05-01

    Retrospective radiologic and clinical midterm follow-up is reported for 10 patients with inflammatory abdominal aortic aneurysm (IAAA) after endovascular aortic aneurysm repair (EVAR). At a mean follow-up of 33 months, regression of the thickness of the perianeurysmal fibrosis (PAF) and decrease of aneurysmal sac diameter was observed in nine patients. Four EVAR-associated complications were observed: periinterventional dissection of femoral artery (n = 1), blue toe syndrome (n = 1), and stent-graft disconnection (n = 2). EVAR is the less invasive method of aneurysm exclusion in patients with IAAA with a comparable evolution of the PAF as reported after open repair.

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

    NASA Astrophysics Data System (ADS)

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

    2014-04-01

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

  1. Medullary thyroid carcinoma: a 30-year experience at one institution in Korea

    PubMed Central

    Lee, Cho Rok; Lee, Sohee; Son, Haiyoung; Ban, Eunjeong; Kang, Sang-Wook; Lee, Jandee; Nam, Kee-Hyun; Chung, Woong Youn; Park, Cheong Soo

    2016-01-01

    Purpose The objective of this study was to review the clinical outcome and prognosis of patients with sporadic and hereditary medullary thyroid cancer (MTC) who were treated at a single tertiary hospital in Korea. Methods We retrospectively reviewed the case files of 85 patients treated from August 1982 to February 2012. Results In all, 65 patients (76.5%) had sporadic MTC and 20 patients (23.5%) had hereditary MTC. Patients in the sporadic group were older than in the hereditary group (P < 0.001). However, the hereditary group had more tumor multiplicity (P < 0.001) and bilaterality (P < 0.001). Neither survival rate was significantly different between the sporadic and hereditary groups (P = 0.775 and P = 0.866). By multivariate analysis, distant metastasis was a significant prognostic factor for overall and progression-free survival. Conclusion In general, patients with MTC have favorable outcomes. Distant metastasis appears to be the strongest predictor of overall and progression-free survival. PMID:27904849

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

    PubMed

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

    2015-01-01

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

  3. Pregnancy outcomes after exposure to tocilizumab: A retrospective analysis of 61 patients in Japan

    PubMed Central

    Nakajima, Ken; Watanabe, Omi; Mochizuki, Mayumi; Nakasone, Ayako; Ishizuka, Nobuhiko; Murashima, Atsuko

    2016-01-01

    Abstract Objectives: To assess the effects of tocilizumab on pregnancy outcomes in Japanese patients with rheumatic disease. Methods: Data from Chugai’s tocilizumab safety database (April 2005 to October 2014) were retrospectively analyzed to identify pregnancy outcomes in patients exposed to tocilizumab. Results: Data were available for 61 pregnancies exposed to tocilizumab, and outcomes were reported for 50 of those pregnancies. In 36 births, no congenital anomalies were identified; however, six neonatal abnormalities were reported: five cases of low birth weight (<2500 g) and one case of neonatal asphyxia. Of 36 births, tocilizumab was resumed during lactation in two patients, with no subsequent adverse events reported in newborns. The spontaneous abortion rate was 18.0% (9 of 50 pregnancies), which is comparable to the rate in the general population. The five terminated pregnancies included one case of caudal regression syndrome. Conclusions: The present retrospective study of 61 pregnancies exposed to tocilizumab at conception indicated no increased rates of spontaneous abortion or congenital abnormalities in patients with rheumatic disease. However, further study is necessary to confirm the benefit-risk profile of tocilizumab treatment during pregnancy. PMID:26873562

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

    SciTech Connect

    Georgievskiy, Vladimir

    2007-07-01

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

  5. SU-E-T-679: Retrospective Analysis of the Sensitivity of Planar Dose Measurements To Gamma Analysis Criteria

    SciTech Connect

    Elguindi, S; Ezzell, G; Gagneur, J

    2015-06-15

    Purpose: IMRT QA using planar dose measurements is still a widely used method for checking the accuracy of treatment plans. A pass/fail judgment is made using gamma analysis based on a single endpoint. Using more stringent criteria is a way to increase the sensitivity to planning and delivery errors. Before such implementation, it is necessary to understand how the sensitivity to different gamma criteria settings affects gamma passing rates (GPR). Methods: 752 IMRT QA measurements were re-analyzed with varying distance to agreement (DTA) and dose difference (DD) percentages using a Matlab program. Other quantifying information such as the mean dose difference in the treatment target (defined as points that are greater than 80% of maximal dose) were stored in a relational database for retrospective analysis. Results: The average and standard deviation of GPR (%) fell from 99.84 ± (0.43) to 89.61 ± (6.08) when restricting DD from 5 − 1% respectively, as compared to a drop from 99.15 ± (1.19) to 95.00 ± (4.43), when restricting the DTA from 5 − 1 mm respectively. The mean dose difference (%) in the treatment target between measured and calculated dose was −1.96 ± (0. 83), −0.09 ± (0.98), and 1.44 ± (0. 86) for each of our institution’s three matched linear accelerators (LINAC 1, 2, and 3 respectively). For plans that are approximately 2.7 sigma below the mean GPR, an average of 78.4% of those plans were measured on LINAC 1 or 3, while only 48% of the total plans were run on those machines. Conclusion: The data demonstrates that when restricting gamma criterion, such as the DD, the greatest indicator of reduced GPR in our institution is which matched LINAC the plan was measured on. While small, these differences manifest themselves to levels comparable to other treatment related differences and possibly confound the gamma analysis.

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

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

    The Modern Era Retrospective-analysis for Research and Applications (MERRA) reanalyses has completed 27 years of data) soon to be caught up to present. Here) we present an evaluation of those years currently available) including comparisons with the existing long reanalyses (ERA40) JRA25 and NCEP I and II) as well as with global data sets for the water and energy cycle. Time series shows that the MERRA budgets can change with some of the variations in observing systems, but that the magnitude of energy imbalance in the system is improved with more observations. We will present all terms of the budgets in MERRA including the time rates of change and analysis increments (tendency due to the analysis of observations).

  7. Incorporating Colour Information for Computer-Aided Diagnosis of Melanoma from Dermoscopy Images: A Retrospective Survey and Critical Analysis

    PubMed Central

    Drew, Mark S.

    2016-01-01

    Cutaneous melanoma is the most life-threatening form of skin cancer. Although advanced melanoma is often considered as incurable, if detected and excised early, the prognosis is promising. Today, clinicians use computer vision in an increasing number of applications to aid early detection of melanoma through dermatological image analysis (dermoscopy images, in particular). Colour assessment is essential for the clinical diagnosis of skin cancers. Due to this diagnostic importance, many studies have either focused on or employed colour features as a constituent part of their skin lesion analysis systems. These studies range from using low-level colour features, such as simple statistical measures of colours occurring in the lesion, to availing themselves of high-level semantic features such as the presence of blue-white veil, globules, or colour variegation in the lesion. This paper provides a retrospective survey and critical analysis of contributions in this research direction. PMID:28096807

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

    PubMed Central

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

    2007-01-01

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

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

    PubMed

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

    2016-04-15

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

  10. [The Brill-Zinsser disease still occurs in Croatia: retrospective analysis of 25 hospitalized patients].

    PubMed

    Turcinov, Drago; Kuzman, Ilija; Puljiz, Ivan

    2002-10-01

    The article presents epidemiological, clinical, laboratory and therapeutic characteristics of Brill-Zinsser disease (BZD). A total of 25 cases of BZD were retrospectively analyzed during the period from January 1, 1980 through December 31, 2000, and etiology was confirmed by rickettsial complement-fixation test (CFT). The majority of cases 15 (60%) quoted history of primary attack of epidemic typhus during or after the World War II. During the course of the disease in our patients different organic systems were involved. Aseptic meningitis was verified in 21 (84%) patients, rash in 17 (68%), liver lesion in 14 (56%), pneumonitis in 7 (28%), myopericarditis in 7 (28%) and 5 (20%) had renal lesion. Not a single clinical symptom or finding of disease has a diagnostic particularity. However, long term fever, headache, rash and aseptic meningitis, or information of infestation with lice in childhood, or a history of epidemic typhus should arouse a suspicion of this disease, which still occurs in Croatia.

  11. The Ponseti technique and improved ankle dorsiflexion in children with relapsed clubfoot: a retrospective data analysis.

    PubMed

    Marquez, Erika; Pacey, Verity; Chivers, Alison; Gibbons, Paul; Gray, Kelly

    2017-03-01

    This study quantifies the change in passive ankle range of motion following modified Ponseti casting in children with relapsed idiopathic clubfoot. Fifty-three cases (feet) were retrospectively reviewed, with 6-month follow-up data available for 72% of participants. The median improvement in dorsiflexion was 15° (95% confidence interval: 12.5°-17.5°, P≤0.05), with 85% achieving dorsiflexion≥10°. At the 6-month follow-up, dorsiflexion remained significantly improved and 12 feet (32%) presented with subsequent relapse. Nine were referred for further casting and three were recommended for extra-articular surgery. Repeat modified Ponseti management clinically and statistically improves passive ankle dorsiflexion in relapsed idiopathic clubfoot.

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

    PubMed Central

    Newcomer, Benjamin W.; Chamorro, Manuel F.

    2016-01-01

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

  13. [A retrospective study analysis of urinary hippuric acid levels in occupational toxicology exams].

    PubMed

    Gonzalez, Kelly Cristina; Sagebin, Fernando Rodrigues; Oliveira, Paola Garcia; Glock, Luiz; Thiesen, Flavia Valladão

    2010-06-01

    Hippuric acid is the primary metabolite of toluene, a solvent widely used in industrial processes with considerable toxic effects, a fact which justifies regularly monitoring individuals with occupational exposure to this solvent. This work aims at evaluating urinary hippuric acid levels found in workers subject to biological monitoring. A retrospective study was carried out with data referring from 2002 to 2005, in which exams results and employment status were analyzed (periodic, post-employment, and pre-employment exams). Results indicate a significant reduction in hippuric acid levels for 2005. Periodic exams presented higher results than pre-employment and post-employment exams. No significant difference was found in individuals grouped according to their status in each of the established intervals, their reference numbers, and maximum biological levels allowed. Hippuric acid levels detected indicate low risk of toluene exposure for the population under evaluation, probably due to a growing concern with the deployment of measures regarding occupational hygiene.

  14. A Retrospective Analysis of the Benefits and Impacts of U.S. Renewable Portfolio Standards

    SciTech Connect

    Wiser, Ryan; Barbose, Galen; Heeter, Jenny; Mai, Trieu; Bird, Lori; Bolinger, Mark; Carpenter, Alberta; Heath, Garvin; Keyser, David; Macknick, Jordan; Mills, Andrew; Millstein, Dev

    2016-01-01

    This is the second in a series of reports exploring the costs, benefits, and other impacts of state renewable portfolio standards (RPS), both retrospectively and prospectively. This report focuses on the benefits and impacts of all state RPS programs, in aggregate, for the year 2013 (the most-recent year for which the requisite data were available). Relying on a well-vetted set of methods, the study evaluates a number of important benefits and impacts in both physical and monetary terms, where possible, and characterizes key uncertainties. The prior study in this series focused on historical RPS compliance costs, and future work will evaluate costs, benefits, and other impacts of RPS policies prospectively.

  15. AT-09BEVACIZUMAB AND GLIOBASTOMA OF THE ELDERLY: A SINGLE-CENTER RETROSPECTIVE ANALYSIS

    PubMed Central

    Barrascout, Eduardo; Lamuraglia, Michele; Gervais, Claire; Tiako, Manuela; Gaillard, Stephan; Aldea, Sorin; Mabro, May; Gachet, Julie; Theodore, Christine

    2014-01-01

    PURPOSE: The primary objective of this study was to determine any difference in progression free survival (PFS), overall survival (OS), clinical benefit and tolerability between elderly and non-elderly patients receiving bevacizumab at recurrence for glioblastoma in a single center. PATIENTS AND METHODS: We retrospectively analyzed 32 patients with recurrent glioblastoma receiving bevacizumab (10 mg/kg every 14 days) between January 2011 and December 2013 in second line. Bevacizumab was introduced for all patients at recurrence after a treatment of first line by temozolomide. A cohort of 14 patients was older than 70 years against 18 patients were under 70 years. RESULTS: No statistically significant difference was detected in terms of PFS and OS. PFS was 2.8 months for elderly patients against 2.9 for non-elderly patients (p >0.5). OS from recurrence in elderly and non-elderly patients was respectively 4.3 and 5.5 months (p >0,5). Clinical improvement in neurological symptoms was observed in 3 of 14 elderly patients (21.1%) and 11 of 18 young patients (61.1%). A more important improvement in performance status was observed in young patients. Regarding toxicity, 3 of the 14 elderly patients experienced grade II or III hypertension. In younger patients, 5 adverse events have been observed (2 proteinuria, 1 hypertension, 1 hemorrhage and 1 anal abscess). CONCLUSION: Despite small number of patients in this retrospective study, the efficacy and safety of bevacizumab in recurrent glioblastoma appears similar in elderly and non-elderly patients. However, clinical benefit seemed to be less important in elderly patients. A prospective multicentric study integrating geriatric assessment tools and quality of life would be interesting in this patient's population.

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

    PubMed Central

    Ononiwu, Charles N

    2015-01-01

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

  17. Retrospective analysis of double-strand break rejoining data collected using warm-lysis PFGE protocols.

    PubMed

    Ratnayake, R K; Semenenko, V A; Stewart, R D

    2005-06-01

    Sample preparation procedures for the pulsed-field gel electrophoresis (PFGE) assay usually involve a lysis step at temperatures as high as 50 degrees C. During this warm-lysis procedure, multiply damaged sites containing heat-labile sites (HLS) can be converted into double-strand breaks (DSB). Once formed, these DSB cannot be distinguished from the DSB formed directly by ionizing radiation. This paper develops a method to correct DSB estimates for the effects of HLS in warm-lysis protocols. A first-order repair model is used to predict the number of HLS available for conversion into DSB as a function of the time available for repair before initiating warm-lysis. A mathematical expression is derived to separate prompt DSB from those formed through the artefactual conversion of HLS into DSB. The proposed formalism only requires the specification of two adjustable parameters, both of which can be estimated from measured data. Estimates of prompt DSB yields obtained by correcting warm-lysis data are in good agreement with estimates obtained using cold-lysis protocols, which do not include the effect of HLS. The retrospective analyses of two published datasets suggest that corrections for HLS have a substantial impact on DSB yields within the first 20-30 min after irradiation. Bi-exponential fits to the DSB data for Chinese hamster ovary cells suggest that corrections for HLS reduce the half-time for fast DSB rejoining by about 15%, whereas the half-time for the slow DSB rejoining only decreases by 4%. The total DSB yield and the fraction of fast-rejoining DSB decrease by 24 and 38%, respectively, when the correction is applied. The proposed formalism can be used to characterize trends and uncertainties in DSB rejoining kinetics associated with the artefactual conversion of HLS into DSB. The retrospective application of the methodology to warm-lysis data enhances their relevance and usefulness for studies of DSB rejoining kinetics.

  18. Citicoline for acute ischemic stroke in Mexican hospitals: a retrospective postmarketing analysis.

    PubMed

    Leon-Jimenez, C; Chiquete, E; Cantu, C; Miramontes-Saldana, M J; Andrade-Ramos, M A; Ruiz-Sandoval, J L

    2010-06-01

    Some neuroprotective agents have shown benefits in animal models, but disappointing results in humans. Citicoline is used in several countries as coadjuvant treatment in acute ischemic stroke (AIS) patients; however, there are no retrospective postmarketing surveillances on the experience of citicoline in Mexico. The aim of this study was to evaluate the correlation between citicoline exposure and functional outcome at discharge and at 30 and 90 days post-stroke, in a retrospective case-control design on systematic descriptive databases from three referral hospitals. Clinical records of 173 consecutively registered patients were analyzed, 86 of whom were treated with citicoline within the first 48 h after AIS and the remaining 87 were untreated, randomly selected controls matched for age (+/- 5 years), gender and NIHSS (+/- 1 point) at hospital admission. Pretreatment conditions were similar between groups. Compared with controls, exposure to citicoline was associated with a significantly lower 30-day mean and median modified Rankin score (in both, P < 0.05). After paired multivariate analyses (controlled for NIHSS, age, gender, hospital arrival in < 24 h, thrombolysis and comorbidities) citicoline was independently associated with a lower 90-day mortality risk (P = 0.047) and with fewer in-hospital complications (mainly infections and sepsis, P = 0.001). In this observational study, citicoline use was associated with a better functional status and lower rates of short-term mortality, possibly due to fewer in-hospital systemic complications. The putative benefits should be interpreted as clinical associations, since this is not a randomized, controlled clinical trial.

  19. Necrotising pneumonia and bronchiectasis in a previously healthy 30-year-old man

    PubMed Central

    Blauvelt, David G; Castellanos, Angela; Stern, Theodore A; Puig, Alberto

    2015-01-01

    We present a case of a previously healthy 30-year-old man who presented with a necrotising pneumonia and bronchiectasis. His infectious workup revealed a Staphylococcus aureus pneumonia. Since bronchiectasis and necrotising pneumonia are unusual findings in an otherwise healthy person, further investigation was pursued. His workup revealed non-classic cystic fibrosis (CF) and allergic bronchopulmonary aspergillosis (ABPA). This case discusses the differential diagnosis of bronchiectasis, the diagnosis and treatment of ABPA, and the role of CF mutations in the pathogenesis of ABPA. PMID:25608981

  20. 30 years of Physics Education Research at the University of Washington

    NASA Astrophysics Data System (ADS)

    Shaffer, Peter S.

    2017-01-01

    Over the past 30 years, members of the UW Physics Education Group have examined student learning in courses serving a wide range of populations. Most of the focus has been on elementary, middle, and high school teachers and students in introductory university physics courses, but more recently, the effort has expanded to include physics majors in upper-division courses on quantum mechanics and electrodynamics. In general, the group has taken a practical approach that focuses on identifying instructional strategies that are effective at promoting conceptual understanding and student reasoning ability. Examples will be drawn from across these courses to illustrate common themes and connections.

  1. Maternal dioxin exposure and pregnancy outcomes over 30 years of follow-up in Seveso.

    PubMed

    Wesselink, Amelia; Warner, Marcella; Samuels, Steven; Parigi, Aliza; Brambilla, Paolo; Mocarelli, Paolo; Eskenazi, Brenda

    2014-02-01

    Animal evidence suggests an association between exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and adverse pregnancy outcomes. Epidemiologic studies report inconsistent results, but are limited by narrow range of exposure, small sample size, and lack of a biologic measure of highest lifetime exposure. On July 10, 1976, a chemical explosion in Seveso, Italy resulted in the highest known residential exposure to TCDD. In 1996, we initiated the Seveso Women's Health Study (SWHS), a retrospective cohort of TCDD exposure and reproductive health. Individual-level TCDD was measured in serum collected soon after the explosion. After 20years of follow-up, we found no association between maternal TCDD in 1976 serum or estimated at pregnancy and spontaneous abortion (SAB), fetal growth, or gestational length. Here, we present an updated analysis of TCDD exposure and adverse pregnancy outcomes from a subsequent follow-up of the SWHS cohort in 2008-2009. SWHS women had 1211 post-explosion pregnancies through the 2008-2009 follow-up. We found no association between TCDD estimated at pregnancy and SAB, fetal growth, or gestational length. However, we found a non-significant inverse association between maternal 1976 serum TCDD and birthweight (adjusted β=-22.8, 95% CI: -80.1, 34.6). The association was stronger among first post-explosion births, but remained non-significant (adjusted β=-47.7, 95% CI: -107.3, 11.9). SWHS is the first study to be able to consider two potentially relevant measures of TCDD exposure: highest lifetime dose and in utero. Our results, although non-significant, suggest that highest dose may be more relevant in epidemiologic studies of TCDD and pregnancy outcomes.

  2. Trends in Stratospheric Water Vapor over Boulder, Colorado: Revelations of the 30-year Boulder Record

    NASA Astrophysics Data System (ADS)

    Hurst, D. F.; Oltmans, S. J.; Voemel, H.; Rosenlof, K. H.; Davis, S. M.; Ray, E. A.; Hall, E.; Jordan, A.

    2010-12-01

    The NOAA frost point hygrometer (FPH) has made in situ, balloon-borne measurements of stratospheric water vapor over Boulder, Colorado, since 1980. The 30-year data record is divided into four periods of multiple-year water vapor trends, including two that span the well-examined but unattributed 1980-2000 period of stratospheric water vapor growth. Trends are determined for five 2-km stratospheric layers (16-26 km) utilizing weighted, piecewise regression analyses. Over the entire 30-year span stratospheric water vapor increased by an average of 1.0 ± 0.2 ppmv (27 ± 6%) with significant shorter-term variations along the way, including an abrupt decrease starting in mid-2000 followed by a significant increase starting in mid-2005. Water vapor growth during some of the trend periods strengthens with altitude, revealing contributions from at least one mechanism that strengthens with altitude, such as methane oxidation. However, though atmospheric methane abundance increased considerably during 1980-2010, additional methane oxidation in the NH midlatitude stratosphere below 26 km can account for at most 25% of the net stratospheric water vapor increase over the last three decades. Moving averages of water vapor mixing ratios over Boulder, Colorado, averaged in 2-km altitude layers. The averaging window was ±1 yr and the averaging threshold was a minimum of 12 data points. Black markers with colored vertical bars define the four trend periods for each altitude layer.

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

    NASA Technical Reports Server (NTRS)

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

    2003-01-01

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

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

    PubMed

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

    2015-05-01

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

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

    PubMed

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

    2015-09-01

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

  6. Screening for microcytemia in Italy: analysis of data collected in the past 30 years.

    PubMed Central

    Silvestroni, E; Bianco, I

    1975-01-01

    Extensive population surveys begun in Italy in 1943 revealed a high incidence of mycrocytemia. Health authorities established a national organization to combat microcytemia which financed and directed activities throughout Italy from 1955 to 1971. The work performed by the microcytemia centers in screening and prophylaxis is described. The results of a screening program underway since 1967 involving 46,559 students of the University of Rome are presented in detail. A preliminary survey of 256 families revealed that the incidence of subsequent births after the births of a child affected by Cooley's anemia was generally low. Results obtained to date are encouraging and justify more extensive programs for the prevention and treatment of microcytemia. PMID:1124764

  7. Cervical cancer incidence trends in Canada: a 30-year population-based analysis.

    PubMed

    Mosavi-Jarrahi, Alireza; Kliewer, Erich V

    2013-07-01

    Objectifs : Utiliser les données les plus récentes pour offrir une mise à jour quant à la tendance pour ce qui est de l’incidence du cancer du col utérin au Canada au cours de la période de 30 ans s’étalant de 1978 à 2009. Méthodes : Les cas enregistrés de cancer du col utérin et les taux correspondants en personnes-années pour la population canadienne ont été récupérés auprès d’un dépôt de données en ligne du Centre International de Recherche sur le Cancer, ainsi qu’auprès de Statistique Canada, pour la période 1978 - 2009. Les taux annuels standardisés en fonction de l’âge ont été estimés pour l’ensemble des données et, de façon distincte, pour chacune des provinces. Les âges des cas ont été agrégés en trois groupes : 25 - 39 ans, 40 - 59 ans et 60 - 75 ans. Une analyse de régression Joinpoint a été utilisée pour décrire la tendance d’un groupe d’âge et d’une province à l’autre. Résultats : Entre 1978 et 2006, au Canada, le taux de cancer du col utérin corrigé en fonction de l’âge est passé de 20,05 à 12,66 par 100 000 femmes; après 2006, le taux a connu une hausse. Des baisses plus importantes ont été constatées au sein des groupes plus âgés. La modification annuelle moyenne en pourcentage (MAMP) était de −1,1 % (IC à 95 %, −1,1 % - 0,09 %), de −1,8 % (IC à 95 %, −2,5 % - −1,2 %) et de −2,6 % (IC à 95 %, −3,9 % - −1,4 %) pour les groupes d’âge de 25 à 39 ans, de 40 à 60 ans et de 60 à 75 ans, respectivement. La MAMP variait d’une province à l’autre, allant de −0,22 % (IC à 95 %, −1,4 % - 0,9 %) en Saskatchewan à −3,02 % (IC à 95 %, −4,5 % - −1,5 %) à Terre-Neuve-et-Labrador. En Ontario, l’incidence du cancer du col utérin a connu une hausse annuelle entre 2006 et 2009. En Colombie-Britannique, la tendance comptait une modification de pente significative en 1984. Conclusion : L’incidence du cancer du col utérin a connu une baisse, au Canada et dans toutes les provinces, entre 1978 et 2009. Cette baisse a été plus accentuée chez les femmes plus âgées.

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

    SciTech Connect

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

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2009-04-01

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

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

    PubMed Central

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

    2012-01-01

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

  11. Pesticide poisoning cases in Ankara and nearby cities in Turkey: an 11-year retrospective analysis.

    PubMed

    Kır, M Ziya; Öztürk, Gülfer; Gürler, Mukaddes; Karaarslan, Bekir; Erden, Gönül; Karapirli, Mustafa; Akyol, Ömer

    2013-05-01

    Since they are available in open markets and pharmacies, pesticides have been widely used all over the country. (Un)intentional poisoning with these compounds is one of the most common causes of chemical poisoning, especially in rural agricultural areas. Pesticide poisonings reported by various countries showed that it is a worldwide health problem with 250,000-370,000 associated deaths each year. In this study, medico-legal deaths between the years 2001 and 2011 in Ankara and nearby cities in Turkey were investigated retrospectively. The autopsies were partly carried out by Ankara Branch of Council of Forensic Medicine. Data were collected from reports of the Morgue Department whose toxicological analyses were performed in the Chemistry Department. The data revealed that 70 cases out of 10,720 autopsied ones had been attributed to fatal pesticide poisoning. The age range was 1-80 years (mean ± SD, 41.33 ± 17.42 years). Most of the cases (60%) were reported from Ankara. Insecticides were the most common (94%) cause of fatal pesticide poisonings, most of them (63%) being organophosphate insecticides. The percentages of pesticide-induced deaths are quite high in our society and should therefore not be underestimated. Accordingly, intensive efforts to reduce occupational and intentional pesticide poisonings are urgently needed in Ankara and nearby cities.

  12. Clinic-Based Retrospective Analysis of Psychopharmacology for Behavior in Fragile X Syndrome

    PubMed Central

    Berry-Kravis, Elizabeth; Sumis, Allison; Hervey, Crystal; Mathur, Shaguna

    2012-01-01

    Fragile X syndrome (FXS) is associated with behavior that limits functioning, including distractibility, hyperactivity, impulsivity, hyperarousal, anxiety, mood dysregulation, and aggression. Medication response and side effect data were reviewed retrospectively for 257 patients (age 14 ± 11 years, range 4–60 years, 203 M, 54 F) attending an FXS clinic. Treatment success rates were defined as the percentage of positive response in the form of documented clinical report of improvement in the behavior(s) being targeted over at least a 6-month period on the medication, without side effects requiring medication discontinuance, while failures were defined as discontinuance of medication due to lack of clinical effectiveness or side effects. Success rate for treatment of targeted behaviors with trials of individual medications was 55% for stimulants, 53% for antidepressants, 62% for alpha2-agonists, and 54% for antipsychotics. With sequential trials of different medications in the same class, success rate improved to 73–77%. Side effect-related failures were highest for antipsychotics. Systematic psychopharmacologic intervention targeted to behavioral symptoms appears helpful in the majority of patients with FXS. PMID:22899942

  13. Analysis of Mtwo rotary instrument separation during endodontic therapy: a retrospective clinical study.

    PubMed

    Wang, Nan-Nan; Ge, Jiu-Yu; Xie, Si-Jing; Chen, Ge; Zhu, Min

    2014-11-01

    To analyze the incidence of instrument separation (IS) and the factors influencing it, when associated with Mtwo rotary system (VDW, Munich, Germany) during endodontic therapy. A retrospective study involving a total of 24,108 root canals (11,036 endodontic treated teeth) was conducted at Nanjing Stomatology Hospital between January 2011 and March 2013. The information included were tooth type, root canal curvature, number of fractured instruments, length of the separated fragments, and the distance from broken tip to apex. The incidence of IS was observed to be 2.2 % according to the number of teeth and 1.0 % according to the number of root canals. Many of the separated fragments were 2-4 mm in length and the mean length was 3.07 ± 1.46 mm, and 78.4 % of fractures occurred in the apex. The mean length of separated fragments in severely curved canals was maximum, while ultra-severe curved canals was observed to be minimum. Mtwo instruments demonstrated an extremely low fracture rate during endodontic therapy. Molar teeth (especially lower molars) and the degree of canal curvature had a significant effect on the incidence of IS.

  14. The Role of Obesity in Sepsis Outcome among Critically Ill Patients: A Retrospective Cohort Analysis.

    PubMed

    Papadimitriou-Olivgeris, Matthaios; Aretha, Diamanto; Zotou, Anastasia; Koutsileou, Kyriaki; Zbouki, Aikaterini; Lefkaditi, Aikaterini; Sklavou, Christina; Marangos, Markos; Fligou, Fotini

    2016-01-01

    Background. The objective of this study was to assess the correlation between sepsis, obesity, and mortality of patients admitted to an Intensive Care Unit (ICU). Subjects and Methods. Data of all patients admitted to the ICU of a tertiary hospital during a 28-month period were retrospectively analyzed and included in the study. Results. Of 834 patients included, 163 (19.5%) were obese, while 25 (3.0%) were morbidly obese. Number of comorbidities (P < 0.001), bloodstream infection (P  0.033), and carbapenemase-producing Klebsiella pneumoniae colonization during ICU stay (P  0.005) were significantly associated with obesity, while nonobese patients suffered more frequently from spontaneous intracranial hemorrhage (P  0.038). Total ICU mortality was 22.5%. Increased mortality among obese ICU patients was observed. Sepsis was the main condition of admission for which obese patients had statistically lower survival than normal weight subjects (76.3% versus 43.7%; P  0.001). Mortality of septic patients upon admission was independently associated with SOFA score upon ICU admission (P  0.003), obesity (P  0.014), pneumonia (P  0.038), and development of septic shock (P  0.015). Conclusions. Our study revealed that sepsis upon ICU admission is adversely influenced by obesity but further studies are needed in order to assess the role of obesity in sepsis outcome.

  15. Safety of pancreatic resection in the elderly: a retrospective analysis of 556 patients

    PubMed Central

    Ansari, Daniel; Aronsson, Linus; Fredriksson, Joakim; Andersson, Bodil; Andersson, Roland

    2016-01-01

    Background The safety of pancreatic resection for elderly patients is still controversial. We examined the postoperative morbidity and mortality in patients aged 75 years or more undergoing pancreatic resection. Methods Patients undergoing pancreatic resection were studied retrospectively and the outcomes were compared between patients aged <75 and ≥75 years. Results Of the 556 patients enrolled, 78 (14%) were ≥75 years old. Elderly patients had significantly more co-morbidities, especially cardiovascular pathology (P=0.005). Also, elderly patients had significantly lower body mass index prior to surgery (P=0.005). There were no significant differences in terms of surgical procedures and tumor types between age groups. The incidence of postoperative pancreatic fistula grade A was significantly lower in the elderly group (P=0.022), but no significant differences were noted in the overall morbidity or the incidence of postpancreatectomy hemorrhage, delayed gastric emptying, bile leakage, cardiac complications, pulmonary complications or septic complications. The 30-day mortality rate was similar between groups (0.8% vs. 1.3%; P=0.532). Conclusion Pancreatic resection is a safe option for selected elderly patients. Our study confirms that age alone should not preclude potentially curative surgical therapy. PMID:27065736

  16. A Retrospective Analysis of Ventriculoperitoneal Shunt Revision Cases of a Single Institute

    PubMed Central

    Park, Man-Kyu; Kim, Myungsoo; Park, Ki-Su; Park, Seong-Hyun; Hwang, Jeong-Hyun

    2015-01-01

    Objective Ventriculoperitoneal (VP) shunt complication is a major obstacle in the management of hydrocephalus. To study the differences of VP shunt complications between children and adults, we analyzed shunt revision surgery performed at our hospital during the past 10 years. Methods Patients who had undergone shunt revision surgery from January 2001 to December 2010 were evaluated retrospectively by chart review about age distribution, etiology of hydrocephalus, and causes of revision. Patients were grouped into below and above 20 years old. Results Among 528 cases of VP shunt surgery performed in our hospital over 10 years, 146 (27.7%) were revision surgery. Infection and obstruction were the most common causes of revision. Fifty-one patients were operated on within 1 month after original VP shunt surgery. Thirty-six of 46 infection cases were operated before 6 months after the initial VP shunt. Incidence of shunt catheter fracture was higher in younger patients compared to older. Two of 8 fractured catheters in the younger group were due to calcification and degradation of shunt catheters with fibrous adhesion to surrounding tissue. Conclusion The complications of VP shunts were different between children and adults. The incidence of shunt catheter fracture was higher in younger patients. Degradation of shunt catheter associated with surrounding tissue calcification could be one of the reasons of the difference in facture rates. PMID:26113963

  17. A Retrospective Analysis of the Growth Pattern in Patients with Salt-wasting 21-Hydroxylase Deficiency

    PubMed Central

    Kawano, Atsuko; Kohno, Hitoshi; Miyako, Kenichi

    2014-01-01

    Abstract The objective of this study was to investigate the growth pattern of children with the salt-wasting form of congenital adrenal hyperplasia caused by 21-hydroxylase deficiency (21-OHD). We reviewed the medical records of 13 patients in whom salt-wasting 21-OHD was diagnosed during the first 2 mo of life at our hospital from 1980 through 2008. Six reached adult height. Growth patterns, bone age, biochemical data, and the hydrocortisone dose at each growth stage were analyzed retrospectively. The mean adult height was 155.1 ± 6.5 cm (mean ± SD) in females and 158.1 ± 7.1 cm in males. Although length at birth was normal or longer than the national mean in almost all patients, the mean height SD score of both boys and girls decreased to below 0 SD during infancy. Subsequently, both boys and girls transiently showed growth acceleration and reached their peak growth velocity at 3–10 yr of age. In conclusion, in addition to suppression of growth during infancy, there was inappropriate growth acceleration during childhood. Especially from 3 mo to 3 yr of age, decreasing the hydrocortisone dose in patients who exhibit slower growth may lead to satisfactory height outcomes. Also, strict adjustment of the hydrocortisone dose to avoid accelerated growth from childhood to adolescence might improve adult height outcomes of patients with 21-OHD. PMID:24790384

  18. Sarcoidosis with involvement of the paranasal sinuses - a retrospective analysis of 12 biopsy-proven cases

    PubMed Central

    2013-01-01

    Background Extrapulmonary involvement by sarcoidosis is observed in about 30–40% of patients with sarcoidosis. Little is known about the frequency and clinical characteristics of sinonasal sarcoidosis. Methods We retrospectively analyzed 12 cases of biopsy-proven sinonasal sarcoidosis. Patients were identified from a patient population of 1360 patients with sarcoidosis at the Outpatient Clinic for Sarcoidosis and Rare Lung Diseases at LungClinic Grosshansdorf, a tertiary care hospital for respiratory medicine. Results The most frequent signs and symptoms were nasal polyps (4 cases), epistaxis (3 cases), nasal crusts (8 cases) and anosmia (5 cases). Pulmonary sarcoidosis of the patients was staged as stage I (n = 1) and stage II (n = 11) on chest radiographs. Spirometry was normal in 11 patients. 7 patients had a diffusion capacity of the lung for carbon monoxide of less than 90% of predicted. Other organs were affected in 8 patients. All patients received systemic corticosteroid treatment and most patients received topical steroids. 5 patients received steroid sparing agents. Repeated sinus surgery had to be performed in 4 patients. Conclusions Sinonasal involvement is a rare disease manifestation of sarcoidosis with a frequency slightly lower than 1% in our patient population. The clinical course of sinonasal sarcoidosis can be complicated by relapse despite systemic immunosuppressive treatment and repeated sinus surgery. PMID:24070015

  19. Severe seafood poisoning in French Polynesia: a retrospective analysis of 129 medical files.

    PubMed

    Gatti, C; Oelher, E; Legrand, A M

    2008-04-01

    We present a retrospective study of 129 medical files concerning seafood poisonings (SFPs) registered at the central hospital of Tahiti (French Polynesia) between 1999 and 2005. Even if during that period most of the described cases (96%) concerned the ichtyosarcotoxism ciguatera, it is interesting to note that we also registered three other SFPs: tetrodotoxism, carchatoxism and lyngbyatoxism due to the consumption of tetraodon/diodon species, sharks or sea turtles, respectively. In ciguatera, cardiovascular symptoms were the primary criteria of severity with bradycardia and hypotension observed at 75% and 43%, respectively. Neurological manifestations (such as cerebellar syndrome, language troubles, diplopia or polyradiculoneuritis), trouble and/or loss of consciousness and dyspnoea were secondary criteria of severity. Body temperature was reported under 36.5 degrees C in 48 of 80 documented files. This observation, which has not previously been described in humans, may be related to possible central effects of the ingested toxin. The last remark concerns two extremely severe cases of ciguatera fish poisoning in which physicians had suspected an inflammatory neuropathy called the Guillain-Barré syndrome (GBS). Even if it is premature to conclude any correlation between the intoxication and the appearance of GBS, it is interesting to note that in both pathologies, morphological disturbances of nerve fibres have been reported.

  20. The specialising or sampling debate: a retrospective analysis of adolescent sports participation in the UK.

    PubMed

    Bridge, Matthew W; Toms, Martin R

    2013-01-01

    Whether young people should specialise in one competitive sport at an early age, or pursue a wider range of sports during adolescence is a topic of some debate (Baker, Cobley, & Fraser-Thomas, 2009) and is fundamental within sports policy and coaching practice. The purpose of this retrospective recall study was to identify whether early specialisation or sporting diversification (sampling) throughout childhood and adolescence can influence performance levels prior to adulthood. An online questionnaire was used to collect the sport participation histories of 1006 UK sports people, which were then compared with the developmental framework provided by the Developmental Model of Sport Participation (DMSP, Côté & Fraser-Thomas, 2007). A significant association between the number of sports participated in at the ages of 11, 13, and 15 and the standard of competition between 16 and 18 years was found. Individuals who competed in three sports aged 11, 13, and 15 were significantly more likely to compete at a national compared with club standard between the ages of 16 and 18 than those who practised only one sport. The findings reported here provide some empirical support for the sampling performance pathway DMSP model in a UK context.

  1. Association between serum vitamin D levels and gastric cancer: A retrospective chart analysis

    PubMed Central

    Vyas, Neil; Companioni, Rafael Ching; Tiba, Melik; Alkhawam, Hassan; Catalano, Carmine; Sogomonian, Robert; Baum, Joel; Walfish, Aaron

    2016-01-01

    AIM To determine whether there is an increased risk of gastric adenocarcinoma associated with vitamin D deficiency (VDd). METHODS A retrospective case control study was performed of all patients diagnosed with gastric adenocarcinoma between 2005 and 2015. After we excluded the patients without a documented vitamin D level, 49 patients were included in our study. RESULTS The average age of patients with gastric adenocarcinoma and documented vitamin D level was 64 years old (95%CI: 27-86) and average vitamin D level was 20.8 mg/dL (95%CI: 4-44). Compared to a matched control group, the prevalence of VDd/insufficiency in patients with gastric adenocarcinoma was significantly higher than normal vitamin D levels (83.7% vs 16.3%). Forty-one patients (83.7%) with adenocarcinoma showed VDd/insufficiency compared to 18 (37%) patients with normal vitamin D level without gastric cancer (OR: 8.8, 95%CI: 5-22, P value < 0.0001). The average age of males with gastric adenocarcinoma diagnosis was 60 years old vs 68 years old for females (P = 0.01). Stage II gastric adenocarcinoma was the most prevalent in our study (37%). CONCLUSION We reported a positive relationship between VDd and gastric adenocarcinoma, that is to say, patients with decreased VDd levels have an increased propensity for gastric adenocarcinoma. PMID:27672427

  2. Immunogenetic marrow donor search for 1012 patients: a retrospective analysis of strategies, outcome and costs.

    PubMed

    Ottinger, H; Grosse-Wilde, M; Schmitz, A; Grosse-Wilde, H

    1994-01-01

    To analyse strategies, outcome and costs of immunogenetic marrow donor search 1012 patients were enrolled in a retrospective single centre study covering the period from January 1990 to December 1992. An HLA-compatible donor was identified for 562 of the patients (55.4%). Core family donor search (CFDS) provided a donor for 39%, extended family donor search (EFDS) for 6.4% and unrelated marrow donor search (UMDS) for 10% of the patients. During the period analysed, UMDS success rate increased from 13.3% to 47.8%, while mean search length decreased from 7.2 to 4.8 months. The percentage of donors from German registries rose from 5% in 1990 to 50% in 1993. Search length was dependent on patient's HLA phenotype frequency, but even for patients with frequencies as low as < 1:3 000 000 a donor was found in 5 of 24 cases. The mean costs (DM) per donor identified by CFDS, EFDS and UMDS were 2921, 19 172 and 24 036, respectively. Thus, CFDS is the utmost effective type of search. In view of the clinical outcome of BMT, EFDS remains a meaningful strategy and should not be replaced by UMDS despite its increasing success rate.

  3. A retrospective clinicopathological study on oral lichen planus and malignant transformation: Analysis of 518 cases

    PubMed Central

    Shen, Zheng Y.; Zhu, Lai K.; Feng, Jin Q.; Tang, Guo Y.; Zhou, Zeng T.

    2012-01-01

    Objective: To investigate the epidemiological and clinical characteristics of a relatively large cohort of patients with oral lichen planus (OLP) from eastern China. Study design: A total of 518 patients with histologically confirmed OLP in a long-term follow-up period (6 months-21.5 years) were retrospectively reviewed in our clinic. Results: Of the 518 patients, 353 females and 165 males were identified. The average age at diagnosis was 46.3 years (range 9-81 years) with the buccal mucosa being the most common site (87.8%). At initial presentation, white lichen and red lichen was seen in 52.3% and 47.7% patients, respectively. Of these, 5 (0.96%) patients previously diagnosed clinically and histopathologically as OLP developed oral cancer. All of them were the females with no a history of smoking or alcohol use. Conclusions: Clinical features of eastern Chinese OLP patients were elucidated. Notably, approximately 1% of OLP developed into cancer, which provides further evidence of potentially malignant nature of OLP. Key words:Oral lichen planus, clinical features, malignant transformation, oral cancer. PMID:22549677

  4. Cancer of unknown primary (CUP) of the head and neck: retrospective analysis of 81 patients.

    PubMed

    Al Kadah, Basel; Papaspyrou, Giorgos; Linxweiler, Maximilian; Schick, Bernhard; Rübe, Christian; Büchler, Benjamin Simeon; Niewald, Marcus

    2017-03-17

    The treatment of patients with cervical lymph node metastases without detectable primary tumor remains an important challenge, until today, no standard therapy is available. The present study investigated the multimodal treatment of patients with head and neck CUP syndrome (HNCUP) and their follow-up retrospectively. 81 patients with cervical lymph node metastases without a primary tumor were treated at the Departments of Otorhinolaryngology as well as Radiotherapy and Radiation Oncology at the University of Saarland in Homburg, Germany in the period between 1991 and 2013. All patients received routine work-up consisting of CUP panendoscopy and imaging. Neck dissection was then performed in 77% of the patients. The most common histology was squamous cell carcinoma (80%). Ten percent of the patients had distant metastases. All patients underwent primary or adjuvant radiation therapy, or simultaneous radiochemotherapy. After a median follow-up of 3.5 years, the 5-year survival rate was 30%. There was a local recurrence that was known in 20/63 patients (31%) and distant metastases were documented in 19/61 M0 patients (31%). Higher grade late toxicity (grade 3-4) was observed in 12% of patients. Neck dissection and radiation therapy remains an integral part of HNCUP therapy, while the use of chemotherapy could be considered in selected cases. Prospective multicenter randomized trials would be necessary to identify the best target volume and to clarify the role of chemotherapy.

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

    PubMed Central

    Legesse, Deresse; Haji, Yusuf; Abreha, Solomon

    2015-01-01

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

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

    PubMed

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

    2006-09-01

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

  7. The Role of Obesity in Sepsis Outcome among Critically Ill Patients: A Retrospective Cohort Analysis

    PubMed Central

    Papadimitriou-Olivgeris, Matthaios; Zotou, Anastasia; Koutsileou, Kyriaki; Zbouki, Aikaterini; Lefkaditi, Aikaterini; Sklavou, Christina; Marangos, Markos; Fligou, Fotini

    2016-01-01

    Background. The objective of this study was to assess the correlation between sepsis, obesity, and mortality of patients admitted to an Intensive Care Unit (ICU). Subjects and Methods. Data of all patients admitted to the ICU of a tertiary hospital during a 28-month period were retrospectively analyzed and included in the study. Results. Of 834 patients included, 163 (19.5%) were obese, while 25 (3.0%) were morbidly obese. Number of comorbidities (P < 0.001), bloodstream infection (P  0.033), and carbapenemase-producing Klebsiella pneumoniae colonization during ICU stay (P  0.005) were significantly associated with obesity, while nonobese patients suffered more frequently from spontaneous intracranial hemorrhage (P  0.038). Total ICU mortality was 22.5%. Increased mortality among obese ICU patients was observed. Sepsis was the main condition of admission for which obese patients had statistically lower survival than normal weight subjects (76.3% versus 43.7%; P  0.001). Mortality of septic patients upon admission was independently associated with SOFA score upon ICU admission (P  0.003), obesity (P  0.014), pneumonia (P  0.038), and development of septic shock (P  0.015). Conclusions. Our study revealed that sepsis upon ICU admission is adversely influenced by obesity but further studies are needed in order to assess the role of obesity in sepsis outcome. PMID:27777948

  8. Endoscopic Removal of Ingested Dentures and Dental Instruments: A Retrospective Analysis

    PubMed Central

    Takahashi, Kazuya; Tominaga, Kentaro; Nishigaki, Yuki; Sato, Hiroki; Ikarashi, Satoshi; Hayashi, Kazunao; Yamamoto, Takashi; Honda, Yutaka; Hashimoto, Satoru; Kamimura, Kenya; Takeuchi, Manabu; Yokoyama, Junji; Sato, Yuichi; Kobayashi, Masaaki; Terai, Shuji

    2016-01-01

    Background. Dentures and dental instruments are frequently encountered ingested foreign bodies. The aim of the present study was to assess the safety and efficacy of endoscopically removing ingested dental objects. Methods. Twenty-nine consecutive patients with 29 dental objects who were treated at the Niigata University Medical and Dental Hospital from August 2009 to December 2015 were retrospectively reviewed. Characteristics of the patients and the ingested dental objects, the clinical features and findings of radiological imaging tests, and outcomes of endoscopic removal were analyzed. Results. Patients' mean age was 62.9 ± 21.0 years. The ingested dental objects included 23 dentures (13 crowns, 4 bridges, 4 partial dentures, and 2 other dentures) and 6 dental instruments. Twenty-seven upper gastrointestinal endoscopies and 2 colonoscopies were performed, and their success rates were 92.6% and 100%, respectively. There were 2 cases of removal failure; one case involved an impacted partial denture in the cervical esophagus, and this case required surgical removal. Conclusions. Endoscopic removal of ingested dentures and dental instruments is associated with a favorable success rate and acceptable complications. The immediate intervention and appropriate selection of devices are essential for managing ingested dental objects. PMID:27738426

  9. Retrospective analysis of Salmonella isolates recovered from animal feed in Great Britain.

    PubMed

    Papadopoulou, C; Carrique-Mas, J J; Davies, R H; Sayers, A R

    2009-12-05

    To examine feed contamination rates with Salmonella, the diversity of serovars and the antimicrobial resistance of isolates from animal feedingstuffs in Great Britain, and to compare Salmonella strains found in animal feed and in livestock, data collected under voluntary and statutory Salmonella surveillance during the period 1987 to 2006 were analysed retrospectively. The feed contamination rate decreased from 3.8 per cent in 1993 to 1.1 per cent in 2006. A total of 263 Salmonella serovars were recovered: S Mbandaka (11.2 per cent), S Tennessee (10.4 per cent), S Senftenberg (8.4 per cent), S Agona (6.4 per cent), S Montevideo (6.4 per cent) and S Ohio (3.1 per cent) were the most prevalent. S Typhimurium was recovered at a proportion of 1.6 per cent from raw ingredients and 2.4 per cent from finished feed, while S Enteritidis was recovered at a proportion of 0.5 per cent from raw ingredients and 0.6 per cent from finished feed; 14.1 per cent of the isolates were resistant to at least one antimicrobial, and 1.9 per cent were multiresistant. There was no evidence of a statistical association (P<0.05) between the top 10 serovars recovered from feed and from livestock.

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

    SciTech Connect

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

    2008-01-01

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

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

    PubMed

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

    2015-02-01

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

  12. [Geriatric emergencies versus adult emergencies: retrospective analysis of medical emergencies at a general hospital].

    PubMed

    Rodríguez Artalejo, F; González Montalvo, J I; Sanz Segovia, F; Jaramillo Gómez, E; Banegas Banegas, J R; Rodríguez Mañas, L; Carbonell Collar, A

    1989-10-14

    The aim of the study was to evaluate the process of the attention to emergencies in patients older than 65 years and to compare it with the same process in adult patients. To this end, 965 clinical records of medical emergencies from the Hospital Central de la Cruz Roja in Madrid were retrospectively evaluated, and data were obtained regarding age, the cause for consultation, the investigations performed and their yield, the administration of drug therapy, the major diagnosis at the time of discharge from the service and the clinical course. It was found that all evaluated diagnostic investigations were carried out with equal or higher frequency in patients older than 65 years and that their mean clinical effectiveness was also higher. In addition, it was found that the patients older than 65 years were more commonly admitted to the hospital through the emergency service than the rest of the population. It was concluded, therefore, that the process of attention to emergencies has differential characteristics in the elderly population, and that if the number and proportion of old people increase as it will presumably happen during the two next decades, the cost of attention to emergencies and the number of emergency hospital admissions will also increase.

  13. Bronchoscopic Diagnosis and Treatment of Primary Tracheobronchial Amyloidosis: A Retrospective Analysis from China

    PubMed Central

    He, Bixiu; Wang, Ge; He, Baimei

    2017-01-01

    Objective. To assess the value of bronchoscopy in the diagnosis and treatment of primary tracheobronchial amyloidosis (TBA), in order to reduce misdiagnosis rates and improve prognosis. Methods. Clinical data of 107 patients with TBA reported from 1981 to 2015 in China were retrospectively analyzed for clinical features, bronchoscopic manifestations, pathologies, treatments, and outcomes. Results. 105 of 107 TBA patients were pathologically confirmed by bronchoscopy. Main bronchoscopic manifestations of TBA were single or multiple nodules and masses within tracheobronchial lumens; local or diffuse luminal stenosis and obstruction; luminal wall thickening and rigidity; rough or uneven inner luminal walls; congestion and edema of mucosa, which was friable and prone to bleeding upon touch; and so forth. 53 patients were treated with bronchoscopic interventions, like Nd-YAG laser, high-frequency electrotome cautery, freezing, resection, clamping, argon plasma coagulation (APC), microwaving, stent implantation, drug spraying, and other treatments. 51 patients improved, 1 patient worsened, and 1 died. Conclusion. Bronchoscopic biopsy is the primary means of diagnosing TBA. A variety of bronchoscopic interventions have good short-term effects on TBA. Bronchoscopy has important value in the diagnosis, severity assessment, treatment, efficacy evaluation, and prognosis of TBA. PMID:28197412

  14. A retrospective analysis of the clinicopathological characteristics of large cell carcinoma of the lung

    PubMed Central

    LIANG, RUI; CHEN, TIAN-XING; WANG, ZHI-QIANG; JIN, KE-WEI; ZHANG, LIAN-YU; YAN, QING-NA; ZHANG, HUI-HUA; WANG, WAN-PU

    2015-01-01

    The aim of the present study was to analyze and summarize the clinicopathological characteristics of large-cell lung carcinoma (LCLC) of the lung, in order to improve the definite diagnosis rate of LCLC. Clinicopathological data of 174 patients with LCLC, confirmed pathologically, were retrospectively reviewed. The 174 cases of LCLC accounted for 5.7% of the total lung cancer cases during the corresponding time period at the Affiliated Cancer Hospital of Tianjin Medical University (Tianjin, China), among which there were 131 males and 43 females with an average age of 61.4 years. The postoperative pathological diagnosis of the 174 cases showed 80 cases of classic LCLC, 64 cases of large cell neuroendocrine carcinoma (LCNEC), six cases of combined LCNEC, 19 cases of basaloid carcinoma, three cases of clear cell carcinoma and two cases of lymphoepithelioma-like carcinoma. Of the total 174 LCLC cases, 96 patients exhibited lymph node metastasis. LCLC is a highly aggressive malignancy with a high tendency of invasion and metastasis, although the incidence rate is low. A definite diagnosis of LCLC primarily relies on the pathological diagnosis. Each subtype of LCLC has its own pathomorphological and immunohistochemical characteristics. PMID:25452802

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

    PubMed Central

    Menghi, Enrico; Marcocci, Francesco; Bianchini, David

    2016-01-01

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

  16. Diabetic kidney disease patients on hemodialysis: a retrospective survival analysis across different socioeconomic groups

    PubMed Central

    Vijayan, Madhusudan; Radhakrishnan, Saranya; Mathew, Milly; Sampathkumar, Krishnaswamy; Mancha, Nevin Philip

    2016-01-01

    Background Diabetic kidney disease is the leading cause of stage 5 chronic kidney disease (CKD) in India. Renal replacement therapy (RRT) is accessible to very few patients because of socioeconomic deprivation. We studied the effect of diabetes and socioeconomic status on the outcome of patients on maintenance hemodialysis (MHD). Methods We retrospectively analyzed the outcome of 897 patients (629 males/268 females; mean age ± standard deviation 48.69 ± 14.27 years) initiated on MHD from 2003 to 2009 at five dialysis centers in south India. There were 335 type 2 diabetic patients and 562 non-diabetic patients. Group 1 comprised the self-paying patients (518 patients) and Group 2 included the TANKER Foundation charity dialysis patients (379 patients). We compared the 5-year survival rates of Group 1 versus Group 2 and also those of diabetic versus non-diabetic patients, using the Kaplan–Meier survival estimator. Results Of the 897 patients, 166 patients survived, 350 died, 234 were lost to follow-up, 137 had renal transplantation and 10 patients were transferred to peritoneal dialysis. The 5-year survival rates after censoring were 20.7 and 38.2% for diabetic and non-diabetic patients, respectively (P < 0.001). The survival rate of diabetic patients was significantly lower, compared with non-diabetic patients, in Group 2 (P < 0.001), but not significantly lower in Group 1 (P = 0.226). Conclusions Diabetic patients have poor survival rates on MHD, especially those from poor socioeconomic groups. Due to scarce RRT facilities and poor survival rates of diabetic patients, prevention, early detection and management of diabetic CKD patients should be the way to go forward. PMID:27994864

  17. Anterior Chamber Depth and Refractive Change in Late Postoperative Capsular Bag Distension Syndrome: A Retrospective Analysis

    PubMed Central

    Yang, Min Kyu; Wee, Won Ryang; Kwon, Ji-Won; Han, Young Keun

    2015-01-01

    Purpose To assess the characteristic findings and effects of laser capsulotomy in patients with late postoperative capsular bag distension syndrome (CBDS). Methods Twenty patients diagnosed with late postoperative CBDS between July 2010 and August 2013 were retrospectively reviewed. Before and 1 week after capsulotomy, changes in the anterior chamber depth (ACD) were assessed using ultrasound biomicroscopy. Changes in the refractive status and uncorrected visual acuity (UCVA) were also measured 1 week and 1 month after capsulotomy. For patients who received bilateral cataract surgery, preoperative ACD and axial length measured by IOLMaster were compared between the two eyes. Results Twenty-two eyes from 20 patients who had undergone laser capsulotomy showed a mean UCVA improvement of 0.27 ± 0.24 logMAR (range, 0.00–0.90). ACD was increased by an average of +0.04 mm (95% confidence interval, +0.01 to +0.06 mm, p = 0.034), equivalent to predicted refractive change of +0.10 D. The discrepancy between actual (+1.33 D) and predicted refractive change after capsulotomy suggests that refractive change may not be generated from IOL displacement in late postoperative CBDS. Preoperative ACD was deeper in the eye with late postoperative CBDS in all bilaterally pseudophakic patients (mean, 3.68 mm vs. 3.44 mm in the fellow eye, p = 0.068). Conclusions Late postoperative CBDS showed refractive changes that were resolved successfully after laser capsulotomy. The convex lens effects of opalescent material in the distended capsular bag may play a major role in myopic shift. A larger preoperative ACD is possibly associated with the development of late postoperative CBDS. PMID:25910003

  18. Outcomes of long-term testosterone replacement in older hypogonadal males: a retrospective analysis.

    PubMed

    Hajjar, R R; Kaiser, F E; Morley, J E

    1997-11-01

    To determine the complications, toxicities, and compliance of long term testosterone replacement in hypogonadal males, we retrospectively assessed 45 elderly hypogonadal men receiving testosterone replacement therapy and 27 hypogonadal men taking testosterone. Hypogonadism was defined as a bioavailable testosterone serum concentration of 72 ng/dL or less. Both groups received baseline physical examinations and blood tests. The testosterone-treated group received 200 mg testosterone enanthate or cypionate im every 2 weeks, and follow-up examinations and blood samplings were performed every 3 months. The control group had a single follow-up blood test and physical examination. There was no significant difference in the initial blood tests in the two groups. At 2 yr follow-up, only the hematocrit showed a statistically significant increase in the testosterone-treated group compared to the control group (P < 0.001). A decrease in the urea nitrogen to creatinine ratio and an increase in the prostate-specific antigen concentration was not statistically significant. Eleven (24%) of the testosterone-treated subjects developed polycythemia sufficient to require phlebotomy or the temporary withholding of testosterone, one third of which occurred less than 1 yr after starting testosterone treatment. There was no significant difference in the incidence of new illness in the two groups during the 2-yr follow-up. Although self-assessment of libido was dramatically improved in the testosterone-treated group (P < 0.0001), approximately one third of the subjects discontinued therapy. In conclusion, testosterone replacement therapy appears to be well tolerated by over 84% of the subjects. Long term testosterone replacement to date appears to be a safe and effective means of treating hypogonadal elderly males, provided that frequent follow-up blood tests and examinations are performed.

  19. Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study.

    PubMed

    Wu, Jian-nong; Gan, Tie-er; Zhu, Yue-xian; Cao, Jun-min; Ji, Cong-hua; Wu, Yi-hua; Lv, Bin

    2015-01-01

    In many traditional Chinese medicine (TCM) hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality. A retrospective surveillance study was performed to examine the epidemiology and microbiology of nBSIs in a TCM hospital from 2009 to 2011. A total of 482 patients with nBSIs were included in the study period. The incidence rate was 5.7/1000 admissions. Escherichia coli (25.5%) was the most common Gram-negative and coagulase-negative staphylococcus (CoNS) (14.1%) was the most common Gram-positive organism isolated. One-third of the E. coli and Klebsiella pneumoniae isolated from the nBSIs were the third-generation cephalosporin-resistant. Half of the Acinetobacter species isolates were resistant to imipenem. Of all the CoNS isolates, 90.7% were resistant to methicillin. Carbapenems and glycopeptide were the most frequently used for nBSI therapy. Only about one-third of patients (157/482) received appropriate empirical therapy. Septic shock, hemodialysis, Pitt bacteremia score >4, urinary tract infection, and appropriate empirical therapy were most strongly associated with 28-d mortality. The incidence of nBSIs was low in the TCM hospital but the proportion of nBSIs due to antibiotic-resistant organisms was high. A high Pitt bacteremia score was one of the most important risk factors for mortality in nBSIs. Therefore, the implementation of appropriate empirical therapy is crucial to improve the clinical outcome of nBSIs.

  20. Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction

    PubMed Central

    Esteves, Luiz Adriano; Joaquim, Andrei Fernandes; Tedeschi, Helder

    2016-01-01

    ABSTRACT Objective To evaluate the correlation between the treatment, the characteristics of the lesions and the clinical outcome of patients with traumatic injuries to the craniocervical junction. Methods This was a retrospective study of patients treated conservatively or surgically between 2010 and 2013 with complete data sets. Results We analyzed 37 patients, 73% were men with mean age of 41.7 years. Of these, 32% were submitted to initial surgical treatment and 68% received conservative treatment. Seven (29%) underwent surgery subsequently. In the surgical group, there were seven cases of odontoid type II fractures, two cases of fracture of posterior elements of the axis, one case of C1-C2 dislocation with associated fractured C2, one case of occipitocervical dislocation, and one case of combined C1 and C2 fractures, and facet dislocation. Only one patient had neurological déficit that improved after treatment. Two surgical complications were seen: a liquoric fistula and one surgical wound infection (reaproached). In the group treated conservatively, odontoid fractures (eight cases) and fractures of the posterior elements of C2 (five cases) were more frequent. In two cases, in addition to the injuries of the craniocervical junction, there were fractures in other segments of the spine. None of the patients who underwent conservative treatment presented neurological deterioration. Conclusion Although injuries of craniocervical junction are relatively rare, they usually involve fractures of the odontoid and the posterior elements of the axis. Our results recommend early surgical treatment for type II odontoid fractures and ligament injuries, the conservative treatment for other injuries. PMID:28076601

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  4. Decreased Ovarian Reserve Predicts Inexplicability of Recurrent Miscarriage? A Retrospective Analysis

    PubMed Central

    Ott, Johannes

    2016-01-01

    Objective To evaluate anti-Mullerian hormone, basal follicle stimulating hormone, luteinizing hormone, estradiol, and female age in women with recurrent miscarriage and to compare women with explained and idiopathic recurrent miscarriage. Design Retrospective cohort study. Setting University hospital, tertiary care center. Patients Women with recurrent miscarriage (78 explained, 66 idiopathic). Intervention(s) None. Main Outcome Measures(s) Anti-Mullerian hormone, basal follicle stimulating hormone, luteinizing hormone, estradiol, and age. Results Anti-Mullerian hormone and estradiol were significantly lower in women with idiopathic recurrent miscarriage (median 1.2 ng/ml, IQR 0.6–2.1, and median 36.5 pg/ml, IQR 25.8–47.3, respectively) than in women with explained recurrent miscarriage (median 2.0 ng/ml, IQR 1.1–2.7, and median 42.5 pg/ml, IQR 32.8–59.8, respectively; p<0.05). Optimized cut-off values for the prediction of idiopathic recurrent miscarriage were <39.5 pg/ml for estradiol (sensitivity: 63.3%, 95% CI: 50.9–75.1; specificity: 56.4%, 95% CI: 44.7–67.6) and <1.90 ng/ml for anti-Mullerian hormone (sensitivity: 72.7%, 95% CI: 60.4–83.0; specificity: 52.6%, 95% CI: 40.9–64.0). Conclusion Idiopathic recurrent miscarriage was associated with lower basal estradiol and anti-Mullerian hormone levels compared to explained recurrent miscarriage. PMID:27627119

  5. Wide spetcrum mutational analysis of metastatic renal cell cancer: a retrospective next generation sequencing approach.

    PubMed

    Fiorentino, Michelangelo; Gruppioni, Elisa; Massari, Francesco; Giunchi, Francesca; Altimari, Annalisa; Ciccarese, Chiara; Bimbatti, Davide; Scarpa, Aldo; Iacovelli, Roberto; Porta, Camillo; Virinder, Sarhadi; Tortora, Giampaolo; Artibani, Walter; Schiavina, Riccardo; Ardizzoni, Andrea; Brunelli, Matteo; Knuutila, Sakari; Martignoni, Guido

    2017-01-31

    Renal cell cancer (RCC) is characterized by histological and molecular heterogeneity that may account for variable response to targeted therapies. We evaluated retrospectively with a next generation sequencing (NGS) approach using a pre-designed cancer panel the mutation burden of 32 lesions from 22 metastatic RCC patients treated with at least one tyrosine kinase or mTOR inhibitor. We identified mutations in the VHL, PTEN, JAK3, MET, ERBB4, APC, CDKN2A, FGFR3, EGFR, RB1, TP53 genes. Somatic alterations were correlated with response to therapy. Most mutations hit VHL1 (31,8%) followed by PTEN (13,6%), JAK3, FGFR and TP53 (9% each). Eight (36%) patients were wild-type at least for the genes included in the panel.A genotype concordance between primary RCC and its secondary lesion was found in 3/6 cases. Patients were treated with Sorafenib, Sunitinib and Temsirolimus with partial responses in 4 (18,2%) and disease stabilization in 7 (31,8%). Among the 4 partial responders, 1 (25%) was wild-type and 3 (75%) harbored different VHL1 variants. Among the 7 patients with disease stabilization 2 (29%) were wild-type, 2 (29%) PTEN mutated, and single patients (14% each) displayed mutations in VHL1, JAK3 and APC/CDKN2A. Among the 11 non-responders 7 (64%) were wild-type, 2 (18%) were p53 mutated and 2 (18%) VHL1 mutated.No significant associations were found among RCC histotype, mutation variants and response to therapies. In the absence of predictive biomarkers for metastatic RCC treatment, a NGS approach may address single patients to basket clinical trials according to actionable molecular specific alterations.

  6. Percutaneous endoscopic gastrostomy (PEG) using a novel large-caliber introducer technique kit: a retrospective analysis

    PubMed Central

    Toh Yoon, Ezekiel Wong; Yoneda, Kaori; Nakamura, Shinya; Nishihara, Kazuki

    2016-01-01

    Background and study aims: Percutaneous endoscopic gastrostomy (PEG) using the introducer technique is not only useful in patients with upper digestive tract stenosis but has been shown to reduce peristomal infection. In this study, we evaluated the safety and utility of a novel large-caliber introducer PEG kit (using 20 Fr size tube) compared with a push kit of similar size. Patients and methods: One hundred and thirty-six patients who received PEG at our hospital between January 2014 and December 2015 were retrospectively analyzed. Baseline characteristics, laboratory biomarkers, hemodynamic changes, postoperative adverse events and clinical outcomes with both kits were compared. Results: The new introducer PEG kit was used in 61 patients while the remaining 75 patients received tube placement using a push technique PEG kit. Except for the prevalence of dementia, which was lower in the introducer PEG kit group, baseline characteristics were similar in both groups. Tube placements were 100 % successful with both PEG kits and there were no significant differences in the change of postoperative hemodynamic or laboratory biomarkers. The Introducer PEG kit group experienced fewer incidence of feeding-related aspiration pneumonia (8.2 % vs. 24 %, P = 0.02), lower peristomal infection scores (1.2 vs. 1.6, P < 0.01), shorter postoperative length of stay (16 days vs. 23.7 days, P = 0.01) and fewer deaths at day 60 (3.3 % vs. 16 %, P = 0.02). Conclusions: Gastrostomy using the new large-caliber introducer PEG kit is safe and produced non-inferior (with some favourable) results when compared to the push technique using similar size tubes. PMID:27652307

  7. A retrospective analysis of survival and prognostic factors of male breast cancer from a single center

    PubMed Central

    2014-01-01

    Background Less than 1% of all breast cancer cases are found in men, who reportedly have inferior outcomes compared with matched women patients. Ethnic differences may also affect their prognosis. Here, we investigated overall survival (OS) and major prognostic factors for male breast cancer (MBC) in a cohort of Egyptian patients. Methods We retrospectively analyzed OS in a cohort of 69 male patients with MBC who were surgically treated at the Mansoura Cancer Center, Egypt between 2000 and 2007. We registered demographic data, age, height, weight and body mass index, tumor size, histology, number of infiltrated axillary lymph nodes, hormone receptor (HR) status and metastatic presence, and TNM staging. Patients’ OS was the primary endpoint. Patients received treatment to the medical standards at the time of their diagnosis. Results In the 69 patients who met the inclusion criteria and had complete stored patient data, tumors ranged from T1c to T3. We could gather cancer-related survival data from only 56 patients. The collective 5-year survival in this cohort was 46.4%. Only five patients had distant metastasis at diagnosis, but they showed a null percent 5-year survival, whereas those with no lymph node infiltration showed a 100% 5-year survival. Lymph node status and tumor grading were the only prognostic factors that significantly affected OS. Conclusions Lymph node status and tumor grade are the most important prognostic factors for overall survival of MBC in Egyptian male patients; whereas even remarkably low HR expression in MBC did not significantly affect OS. Further research is needed to understand the factors that affect this disease. PMID:24673740

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

    PubMed Central

    Dimri, Deepak; Thapliyal, Swati; Thawani, Vijay

    2016-01-01

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

  9. A Retrospective Analysis of 334 Cases of Hemoptysis Treated by Bronchial Artery Embolization

    PubMed Central

    Bhalla, Ashu; Kandasamy, Devasenathipathy; Veedu, Prasad; Mohan, Anant; Gamanagatti, Shivanand

    2015-01-01

    Objectives To analyze the safety and efficacy of bronchial artery embolization (BAE) in the management of hemoptysis. Methods We conducted a retrospective study of 334 patients who had undergone BAE for hemoptysis from January 2007 to July 2013. Our study included 255 (76.3%) males and 79 (23.7%) females with an age range from five to 81 years old. All relevant arteries were evaluated but only those arteries that showed hypertrophy and significant blush were targeted. Polyvinyl alcohol (PVA) was used in all patients and gel foam was used in combination with PVA where there was significant shunting. Results Mild hemoptysis was seen in 70 patients, moderate in 195 patients, and severe in 69 patients. On imaging, right side disease was seen in 101 patients, left side involvement in 59 patients, and bilateral involvement in 174 patients. Post-tubercular changes were the predominant pathology seen in 248 patients. Among 334 patients (386 procedures), 42 patients underwent the procedure twice and five patients underwent the procedure thrice. A total of 485 arteries were attempted of which 440 arteries were successfully embolized. Right intercosto-bronchial was the most common culprit artery present in 157 patients, followed by common bronchial (n=97), left bronchial (n=55), and right bronchial (n=45). We embolized a maximum of four arteries in one session. Immediate complications such as dissection and rupture occurred in only nine sessions (2.3%). Twenty-five procedures (6.5%) were repeated within two months, which were due to technical or clinical failure and 27 procedures (7%) were repeated after two months. Conclusions BAE is a safe and effective procedure with a negligible complication rate. Our approach of targeting hypertrophied arteries was effective. PMID:25960838

  10. Experience of Laparoscopic Cholecystectomy Under Thoracic Epidural Anaesthesia: Retrospective Analysis of 96 Patients

    PubMed Central

    Bilgi, Murat; Alshair, Esin Erkan; Göksu, Hüseyin; Sevim, Osman

    2015-01-01

    Objective Although the traditional anaesthesia method for laparoscopic cholecystectomy has been general anaesthesia, regional anaesthesia techniques are also successfully used today. In this paper, we aimed to report our experiences with thoracic epidural anaesthesia, including complications, postoperative analgesia, technical difficulties and side effects. Methods Between December 2009 and November 2012, 90 patients undergoing laparoscopic cholecystectomy were retrospectively analysed. Demographic data, American Society of Anesthesiologists (ASA) scores, comorbidities, duration of operations, medications and doses used for sedation were reviewed. Results The gender distribution of patients were recorded as 15 males (15%) and 81 females (85%). The patients had an average age of 46.74±13.28, an average height of 162.50±5.57 cm and a mean weight of 73.57±12.48 kg. ASA classifications were distributed as follows: ASA I: 63 (65%) patients, ASA II 28 (29%) patients and ASA III: 5 patients. We recorded 3 patients with chronic obstructive pulmonary disease (COPD), 14 patients with diabetes mellitus (DM) and 22 patients with hypertension who got their diagnosis in the perioperative visit. During the operation, three patients had bradycardia (heart rate 50 min−1), and atropine was applied. Ephedrine and fluid resuscitation had been applied to 3 patients for the treatment of intraoperative hypotension. Midazolam, ketamine hydrochloride and propofol were administered to patients for sedation during the operations. Thoracic epidural anaesthesia was performed at the level of T7 -9 intervertebral space with the patients in the sitting position. Patients were given oxygen by a face mask at a rate of 3–4 L min−1. The pneumoperitoneum was created by giving carbon dioxide at the standard pressure of 12 mmHg into the abdominal cavity in all patients. If needed, postoperative analgesia was provided by epidural local anaesthetic administration. Conclusion Thoracic epidural

  11. Retrospective analysis of prognostic factors in dengue infected patients with intracranial bleed

    PubMed Central

    Gautam, Sachidanand; Meena, Rajesh K.; Meena, Shyam C.; Gautam, Bhawana

    2016-01-01

    Background: Dengue is one of the most common mosquito-transmitted arboviral disease of tropical and a few subtropical areas in the world. It is estimated that approximately 100 million cases occur per year and approximately 2.5 billion people are at risk of developing dengue infection. Hemorrhagic complications causing encephalopathy are quite rare but fatal consequences of this deadly disease. This study was conducted to discuss the prognostic factors in the management of intracranial hemorrhage in dengue infected patients. Methods: This retrospective study was conducted in the neurosurgery department of our tertiary healthcare centre. Duration of the study was 1 year, and 18 patients who presented with intracranial bleed and required neurosurgical care were included in this study. All patients had deranged coagulation profile and were thrombocytopenic. All the patients were given platelet concentrates for correction of thrombocytopenia. Eight of these patients had deterioration in their neurological status, and 6 of them underwent surgery. Results: Out of 18 patients, 12 (66.66%) were managed conservatively, including one case of cervical extradural hemorrhage. Five patients who were conservatively managed died because they had deep-seated bleed and rapid deterioration. The remaining 7 patients who were managed conservatively improved well with few residual deficits. Six (33.33%) patients who underwent surgery had excellent outcome with one case of mortality. Conclusion: Very high index of suspicion is required in dengue infected patients for neurological complications, especially during the convalescence period. Special attention should be given to those patients who have altered sensorium, and should not be misinterpreted as fever delirium or toxic encephalopathy. It requires immediate attention and further neurological investigation (including thorough clinical examination). Timely diagnosis using a computed tomography scan and early neurosurgical intervention

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

    PubMed Central

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

    2016-01-01

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

  13. Analysis of 1,545 Fractures of Facial Region—A Retrospective Study

    PubMed Central

    Gaddipati, Rajasekhar; Ramisetti, Sudhir; Vura, Nandagopal; Reddy, K. Rajiv; Nalamolu, Bhargav

    2015-01-01

    Incidence and etiology of facial fractures vary from region to region due to various constituents. This study was carried to evaluate the patterns and distribution of fractures in the facial region among different age groups of patients in both males and females caused due to various etiologies. This is a retrospective epidemiological study, which was performed on patients with fractures in the maxillofacial region during a period of 2005 to 2013 at Mamata Dental College and Hospital, Khammam, India. A total of 1,015 patients with 1,545 fractures were referred for treatment to department of oral and maxillofacial injuries surgery, of Mamata Dental College and Hospital, with a mean age of 31.19. The ratio of males (859):females (156) is 5.5:1. Injuries caused by motorbike injuries (34.9%) are highest. The highest frequency of fractures caused by various reasons is seen more in third decade (39%). Mandible (43.81%) is the most common fracture site in the face. Among soft tissue injuries most commonly seen are lacerations (43%). This study differentiates the etiological factors causing facial trauma in several age groups. Results of this study suggest outcomes indicate that more reliance on individual transport on motor vehicles has increased the frequency of facial bone fractures. Regardless of age, motor vehicle accidents were high in all age groups except the first decade of life and above 60 years of age when traffic accidents dominated. Thus effectiveness of current preventive measures is to be assessed, followed by instituting new guidelines for prevention and inflexible traffic rules shall be levied. More epidemiological surveys can, if encouraged to measure the frequency of fractures, better the world. PMID:26576235

  14. Retrospective growth kinetics and radiosensitivity analysis of various human xenograft models

    PubMed Central

    Lee, Ji Young; Kim, Eun Ho; Chung, Namhyun

    2016-01-01

    The purpose of this study was to delineate the various factors that affect the growth characteristics of human cancer xenografts in nude mice and to reveal the relationship between the growth characteristics and radiosensitivity. We retrospectively analyzed 390 xenografts comprising nine different human cancer lines grown in nude mice used in our institute between 2009 and 2015. Tumor growth rate (TGR) was calculated using exponential growth equations. The relationship between the TGR of xenografts and the proliferation of the cells in vitro was examined. Additionally, we examined the correlations between the surviving fractions of cells after 2 Gy irradiation in vitro and the response of the xenograft to radiation. The TGR of xenografts was positively related to the proliferation of the cells in vitro (rP=0.9714, p<0.0001), whereas it was independent of the histological type of the xenografts. Radiation-induced suppression of the growth rate (T/C%) of xenografts was positively related to the radiosensitivity of the cells in vitro (SF2; rP=0.8684, p=0.0284) and TGR (rP=0.7623, p=0.0780). The proliferation of human cancer cells in vitro and the growth rate of xenografts were positively related. The radiosensitivity of cancer cells, as judged from the SF2 values in vitro, and the radiation-induced suppression of xenograft growth were positively related. In conclusion, the growth rate of human xenografts was independent of histological type and origin of the cancer cells, and was positively related to the proliferation of the cancer cells in vitro. PMID:28053611

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

    PubMed Central

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

    2016-01-01

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

  16. A case of lupus vulgaris with rare localization diagnosed 30 years after onset.

    PubMed

    Laudańska, H; Reduta, T; Zalewski, G; Chodynicka, B

    2011-01-01

    Cutaneous tuberculosis (tuberculosis cutis) is one of the extrapulmonary forms of tuberculosis, which may affect the skin only or co-exist with tuberculosis of other organs, particularly the lungs. We describe a case of lupus vulgaris in a 72-year-old male patient with a single lesion localized on his lower extremity, developing for 30 years before correct diagnosis and previously treated with topical steroids. Bacillus infection in other organs was not detected. Diagnosis of tuberculosis was made based on personal history, clinical picture, hypersensitivity to tuberculin, histopathology and polymerase chain reaction. A multidrug therapy with rifampicin, isoniazid and pyrazinamide resulted in regression of the lesion. The common lack of knowledge about the clinical picture of cutaneous tuberculosis causes its late diagnosis and treatment.

  17. End of Life Operations for LEO and GEO Satellites: 30 Years of Continuous Improvement

    NASA Astrophysics Data System (ADS)

    Fremeaux, Claire; Moussi, Aurelie; Vintenat, Lionel; Moulin, Michel

    2013-08-01

    CNES is celebrating in 2013 its 40th year of satellites operations with nearly 40 satellites cared for from Symphony 1 (1973) to Pleiades 1B (2012). Half of them reached its end of mission. Although they were not designed for it, CNES imagined, prepared and executed end-of life operations for geostationary and low earth orbit satellites, in accordance with its strong involvement at international level in favour of space activity sustainability and space debris mitigation. With increasing experience, efficiency and completeness of operations have strongly improved: optimization of resources, precise orbit and eccentricity management, collision risk concern, controlled fluidic and electric passivation, concern for degraded or emergency cases… This paper presents the evolution and improvement of end of life operations handled by CNES for 30 years, with a highlight on the last evolutions in the whole process since the French Space Act came into force.

  18. 30-Year Satellite Record Reveals Accelerated Arctic Sea Ice Loss, Antarctic Sea Ice Trend Reversal

    NASA Technical Reports Server (NTRS)

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

    2003-01-01

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

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

    PubMed Central

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

    1966-01-01

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

  20. Rigid bronchoscopic management of acute respiratory failure in a 30-year-old woman

    PubMed Central

    Madan, Karan; Dhungana, Ashesh; Madan, Neha Kawatra; Mohan, Anant; Hadda, Vijay; Garg, Rakesh; Jain, Deepali; Guleria, Randeep

    2016-01-01

    A 30-year-old woman presented with a history of progressive shortness of breath, cough, and hoarseness. Stridor was audible on examination. Chest X-ray showed normal lung fields and contrast-enhanced computed tomography thorax showed lower tracheal occlusion with endoluminal growth. Diagnostic flexible bronchoscopy demonstrated multiple whitish glistening nodules over both vocal cords and lower tracheal occlusion by whitish nodular growth. In view of critical central airway obstruction, rigid bronchoscopy and excision of the lower tracheal growth were performed. Histopathological examination of the excised specimen demonstrated features of squamous papillomas. A diagnosis of respiratory papillomatosis was established. On follow-up surveillance bronchoscopy, there was a gradual spontaneous regression of the residual lesions, and the patient remains currently asymptomatic 1 year since the procedure. PMID:27891001

  1. Recurrent diplopia over a 30-year period: natural history of a Lewis and Sumner syndrome.

    PubMed

    Lefaucheur, Romain; Bouwyn, Jean Paul; Wallon, David; Bedat-Millet, Anne-Laure; Ahtoy, Patrick; Perot, Guillaume; Hannequin, Didier; Maltête, David

    2012-06-01

    We described the case of a patient with recurrent episodes of isolated diplopia over the last 30 years. On her last event, neurological examination revealed not only a right third and sixth cranial nerves involvement, but also a right peripheral facial palsy and a motor weakness on the left ulnar territory. Electrophysiological nerves motor conduction study revealed a conduction block on the left ulnar nerve and a less severe on the right ulnar nerve. Asymmetrical upper limb sensorimotor weakness combined with conduction block and cranial nerves palsy led to a diagnosis of Lewis and Sumner syndrome (LSS). This case is unusual by the presentation of the disease and is, to our knowledge the longer natural disease course of LSS reported. Moreover, it suggests that the recurrent diplopia variant may represent a separate entity with a good prognosis even in absence of invasive treatment.

  2. Natural products as sources of new drugs over the 30 years from 1981 to 2010.

    PubMed

    Newman, David J; Cragg, Gordon M

    2012-03-23

    This review is an updated and expanded version of the three prior reviews that were published in this journal in 1997, 2003, and 2007. In the case of all approved therapeutic agents, the time frame has been extended to cover the 30 years from January 1, 1981, to December 31, 2010, for all diseases worldwide, and from 1950 (earliest so far identified) to December 2010 for all approved antitumor drugs worldwide. We have continued to utilize our secondary subdivision of a "natural product mimic" or "NM" to join the original primary divisions and have added a new designation, "natural product botanical" or "NB", to cover those botanical "defined mixtures" that have now been recognized as drug entities by the FDA and similar organizations. From the data presented, the utility of natural products as sources of novel structures, but not necessarily the final drug entity, is still alive and well. Thus, in the area of cancer, over the time frame from around the 1940s to date, of the 175 small molecules, 131, or 74.8%, are other than "S" (synthetic), with 85, or 48.6%, actually being either natural products or directly derived therefrom. In other areas, the influence of natural product structures is quite marked, with, as expected from prior information, the anti-infective area being dependent on natural products and their structures. Although combinatorial chemistry techniques have succeeded as methods of optimizing structures and have been used very successfully in the optimization of many recently approved agents, we are able to identify only one de novo combinatorial compound approved as a drug in this 30-year time frame. We wish to draw the attention of readers to the rapidly evolving recognition that a significant number of natural product drugs/leads are actually produced by microbes and/or microbial interactions with the "host from whence it was isolated", and therefore we consider that this area of natural product research should be expanded significantly.

  3. Immunity of patients surviving 20 to 30 years after allogeneic or syngeneic bone marrow transplantation.

    PubMed

    Storek, J; Joseph, A; Espino, G; Dawson, M A; Douek, D C; Sullivan, K M; Flowers, M E; Martin, P; Mathioudakis, G; Nash, R A; Storb, R; Appelbaum, F R; Maloney, D G

    2001-12-15

    The duration of immunodeficiency following marrow transplantation is not known. Questionnaires were used to study the infection rates in 72 patients surviving 20 to 30 years after marrow grafting. Furthermore, in 33 of the 72 patients and in 16 donors (siblings who originally donated the marrow) leukocyte subsets were assessed by flow cytometry. T-cell receptor excision circles (TRECs), markers of T cells generated de novo, were quantitated by real-time polymerase chain reaction. Immunoglobulin G(2) (IgG(2)) and antigen-specific IgG levels were determined by enzyme-linked immunosorbent assay. Infections diagnosed more than [corrected] 15 years after transplantation occurred rarely. The average rate was 0.07 infections per patient-year (one infection every 14 years), excluding respiratory tract infections, gastroenteritis, lip sores, and hepatitis C. The counts of circulating monocytes, natural killer cells, B cells, CD4 T cells, and CD8 T cells in the patients were not lower than in the donors. The counts of TREC(+) CD4 T cells in transplant recipients younger than age 18 years (at the time of transplantation) were not different from the counts in their donors. In contrast, the counts of TREC(+) CD4 T cells were lower in transplant recipients age 18 years or older, even in those with no history of clinical extensive chronic graft-versus-host disease, compared with their donors. The levels of total IgG(2) and specific IgG against Haemophilus influenzae and Streptococcus pneumoniae were similar in patients and donors. Overall, the immunity of patients surviving 20 to 30 years after transplantation is normal or near normal. Patients who received transplants in adulthood have a clinically insignificant deficiency of de novo-generated CD4 T cells, suggesting that in these patients the posttransplantation thymic insufficiency may not be fully reversible.

  4. VIP Data Explorer: A Tool for Exploring 30 years of Vegetation Index and Phenology Observations

    NASA Astrophysics Data System (ADS)

    Barreto-munoz, A.; Didan, K.; Rivera-Camacho, J.; Yitayew, M.; Miura, T.; Tsend-Ayush, J.

    2011-12-01

    Continuous acquisition of global satellite imagery over the years has contributed to the creation of long term data records from AVHRR, MODIS, TM, SPOT-VGT and other sensors. These records account for 30+ years, as these archives grow, they become invaluable tools for environmental, resources management, and climate studies dealing with trends and changes from local, regional to global scale. In this project, the Vegetation Index and Phenology Lab (VIPLab) is processing 30 years of daily global surface reflectance data into an Earth Science Data Record of Vegetation Index and Phenology metrics. Data from AVHRR (N07,N09,N11 and N14) and MODIS (AQUA and TERRA collection 5) for the periods 1981-1999 and 2000-2010, at CMG resolution were processed into one seamless and sensor independent data record using various filtering, continuity and gap filling techniques (Tsend-Ayush et al., AGU 2011, Rivera-Camacho et al, AGU 2011). An interactive online tool (VIP Data Explorer) was developed to support the visualization, qualitative and quantitative exploration, distribution, and documentation of these records using a simple web 2.0 interface. The VIP Data explorer (http://vip.arizona.edu/viplab_data_explorer) can display any combination of multi temporal and multi source data, enable the quickly exploration and cross comparison of the various levels of processing of this data. It uses the Google Earth (GE) model and was developed using the GE API for images rendering, manipulation and geolocation. These ESDRs records can be quickly animated in this environment and explored for visual trends and anomalies detection. Additionally the tool enables extracting and visualizing any land pixel time series while showing the different levels of processing it went through. User can explore this ESDR database within this data explorer GUI environment, and any desired data can be placed into a dynamic "cart" to be ordered and downloaded later. More functionalities are planned and will be

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

    Rademaker, Marius

    2013-08-01

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

  7. Psychiatric liaison consultations of patients without psychiatric illness in a general hospital in Germany: a retrospective analysis.

    PubMed

    Fißler, Maria; Quante, Arnim

    2015-11-01

    The aim of the study was to explore the utilization of consultation-liaison psychiatric (CLP) service among nonpsychiatric patients in a general hospital. A retrospective analysis was conducted on all patients seen by the CLP in 2013. In 66 (5.9 %) of these 1112 consultations, no psychiatric diagnosis could be identified. These cases were analyzed by department of referral, assumed psychiatric symptoms, consensus with the symptoms found by the CLP, and recommended procedures. Assumed depressive symptoms, suicidal ideations and "difficult" behavior were the predominant reasons for CLP referrals. As the results suggest, CLP service was mostly "overprovided" because of uncertainty about the working areas of psychiatrists or overestimation of the severity of symptoms. These findings emphasize the importance to develop more precise guidelines for CLP services and that it could be worth striving for a more profound psychiatric training for nonpsychiatric physicians to achieve an optimal treatment for patients.

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

    PubMed Central

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

    2015-01-01

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

  9. Rifampicin and isoniazid plasma concentrations in relation to adverse reactions in tuberculosis patients: a retrospective analysis

    PubMed Central

    Aït Moussa, L.; El Bouazzi, O.; Serragui, S.; Soussi Tanani, D.; Soulaymani, A.; Soulaymani, R.

    2016-01-01

    Objective: High concentrations of antituberculosis (anti-TB) drugs can be associated with many adverse drug reactions (ADRs). The objective of this study was to examine the plasma concentrations of rifampicin (RMP) and isoniazid (INH) in patients with and without ADRs. Methods: Concentration monitoring data of patients treated with anti-TB drugs were retrospectively analyzed from 2009 to 2011. RMP and INH plasma concentrations were measured 2 and 3 h after drug administration respectively using high-performance liquid chromatography. Results: A total of 54 out of 120 patients have experienced ADRs to anti-TB drugs. The median concentrations [interquartile range (IQR)] obtained in patients with and without ADRs were 6.7 mg/l (3.7–9.9) and 5.6 mg/l (2.9–8.6) (p = 0.56) for RMP and 4.3 mg/l (2.3–5.3) and 3.1 mg/l (1.7–4.8) (p = 0.04) for INH, respectively. Related median doses (IQR) were 8.7 mg/kg (8.0–10.0) and 8.6 mg/kg (6.5–9.9) (p = 0.42) for RMP and 4.8 mg/kg (4.3–5.0) and 4.0 mg/kg (2.8–5) (p < 0.01) for INH, respectively. Concentrations above the expected range in patients with and without ADRs were not reached for RMP, but were 76% and 65% for INH, respectively. Correlation between concentrations and doses has not been established for RMP or INH. In addition, high INH concentrations showed no association with sex, age, liver injury or renal or diabetes. Conclusions: High INH concentrations were common in patients with and without ADRs whereas RMP concentrations were low or within the normal range in most patients. Further studies are required to assess the association between high INH concentrations and the occurrence of ADRs. PMID:27904742

  10. Spinal cord stimulation: a 20-year retrospective analysis in 260 patients.

    PubMed

    Reig, Enrique; Abejón, David

    2009-07-01

    Introduction. Spinal cord stimulation (SCS) is used clinically by many pain physicians and neurosurgeons alike without regard to their own outcome data. Methods. We reviewed our 20-year experience retrospectively of patients receiving SCS implants and analyzed our data by pain type and group. Results. We present 260 patients, 140 men and 120 women. The most frequent type of pain in our series was neuropathic pain in 44.25% and the most frequent diagnosis was peripheral vascular disease (PVD) with 98 cases. The second was failed back surgery syndrome (FBSS) with 65 cases and the third was complex regional pain syndrome type I (CRPS I), with 40 cases. In CRPS group, the mean visual analog scale (VAS) of this group was 77.89 ± 13.38. In total, 5% had no pain relief, 40% had poor pain relief, 47.5% had good pain relief, and 7.5% had excellent pain relief. In FBSS group, the mean VAS was 79.62 ± 11.69 mm. A total of 13.80% had no pain relief at all, 35.39% had poor pain relief, 50.76% had good pain relief, and there were no patients in this group who had complete pain relief. A total of 98 patients, 78 men and 20 women, were diagnosed with PVD. The mean VAS of this group was 69.75 ± 14.36 mm. A total of 11.22% had poor pain relief, 87.75% had good pain relief. One patient had complete pain relief and all patients in this group perceived at least some improvement in their symptoms. The rate of complications was close to 28% in our overall sample. Conclusions. In conclusion, we demonstrated the utility over time of this type of treatment is comparable with other series of efficacy of SCS. The analgesic efficacy was close to 65% in the overall group. The therapy was not free of complications. The preponderance of our patients was patients with the diagnosis of PVD and our results in this group of patients were excellent. These excellent results of more than 90% improvement suggest to us that SCS be considered as a first-line approach to the

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

    PubMed Central

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

    2016-01-01

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

  12. Retrospective analysis of the relationship between infantile seborrheic dermatitis and atopic dermatitis.

    PubMed

    Alexopoulos, Alex; Kakourou, Talia; Orfanou, Irene; Xaidara, Athina; Chrousos, George

    2014-01-01

    A growing number of dermatologists dispute the existence of infantile seborrheic dermatitis (ISD) as an independent clinical entity. Therefore the aim of the present study was to estimate the epidemiologic features of ISD in a defined population of Greek children, assess its course, and identify associations, if any, with other common dermatoses of childhood. Children from the region of Athens who were examined and diagnosed with typical clinical features of ISD between 1997 and 2011 were included in the study. The relevant data were collected retrospectively from their medical records using a standardized form. Eighty-seven children were enrolled (50 boys, 37 girls; mean age 3.1 mos at the time of ISD diagnosis). The main body areas affected were the scalp and face for the majority of the children (78/87), whereas the trunk and limbs were less frequently involved (9/87). In all cases, erythema and scaling of affected patients were mild to moderate. Forty-nine of the 87 children were followed up over a period of 5 years. Thirty children in this group developed features of atopic dermatitis (AD) at a later stage, according to the UK diagnostic criteria of AD, and 23 of these children were diagnosed with AD, at an average time interval of 6.4 months from ISD onset, and seven presented with clinical features of AD at the time of ISD diagnosis. The remaining 19 children in the follow-up group progressed without developing any other chronic skin disease, and all recovered within 6 months of its onset. Thirty-eight had no further follow-up after their initial ISD diagnosis. In spite of the lack of information on the disease course for the last group, assuming they all recovered, the prevalence of AD (34.4%) in our ISD sample was significantly higher than the prevalence of AD (10.7%) in the general population for the same age group, as shown in a previous study performed in the municipality of Athens (p < 0.001). A significant number of children were found to develop AD

  13. Comparison of different surgical options in the treatment of pilonidal disease: retrospective analysis of 175 patients.

    PubMed

    Ersoy, Omer Faik; Karaca, Serdar; Kayaoglu, Huseyin Ayhan; Ozkan, Namik; Celik, Alper; Ozum, Turkay

    2007-02-01

    Pilonidal sinus disease is a benign disorder with an unidentified etiology and is observed mainly in young adults. It is an important health problem because it causes work loss. Although various nonsurgical treatment options have been tried up to date, there is a consensus on surgical intervention to treat the disease today. The optimal surgical method should be simple, associated with short hospital stay and low recurrence rates. In this study, patients who have undergone different surgical treatment methods due to pilonidal disease were retrospectively analyzed. The medical records of 175 patients who were operated on between 2002 and 2005 at the General Surgery Departments of Gaziosmanpasa University Medical School and Bartin State Hospital for pilonidal disease were reviewed for treatment option, postoperative complications, hospitalization time, work-off periods, and recurrence rates. The patients consisted of 150 (85.3%) males with a mean age of 26.47 +/- 7.78 years. Marsupialization was applied to 82 (46.9%), unroofing to 20 (14.7%), primary closure to 29 (16.6%), and Limberg flap to 44 (25.1%) patients. The longest hospitalization period of 3.61 +/- 1.08 days was observed in the Limberg flap group. The longest return to work period (20.12 +/- 5.1 days) was observed in the marsupialization group. Both differences were significant. The highest complication rate was observed among the primary closure group (31%) followed by the patients treated by Limberg flap technique (15.8%). In the primary closure group, infection was detected in five (17.2%) and wound dehiscence in four (13.8%) individuals. The highest complication rates (31.03%) and recurrences (13.8%) were observed in the primary closure group. Various operative methods utilized in the treatment of pilonidal disease are associated with a number of advantages and disadvantages. Postoperative complication rates of unroofing and marsupialization are low, but require long wound care. In our study, we did

  14. RETROSPECTIVE ANALYSIS OF ORTHODONTIC TREATMENT OUTCOMES AND ITS RELATION TO POSTRETENTION STABILITY*

    PubMed Central

    de Freitas, Karina Maria Salvatore; de Freitas, Marcos Roberto; Janson, Guilherme; Pinzan, Arnaldo; Henriques, José Fernando Castanha

    2006-01-01

    Objective: The present study was designed to retrospectively evaluate Class I malocclusion cases treated with extraction of the four first premolars, aiming to establish the relationship between the quality of orthodontic treatment outcomes and the long-term occlusal stability. Material and methods: The sample comprised 94 patients of both genders, presenting Class I malocclusion, treated with extractions of the four first premolars and Edgewise mechanics. All the patients selected were whites, being 50 males and 44 females. The mean pretreatment age was 13.46 years (s.d. 1.8). The mean treatment time was 2.09 years (s.d. 0.58), the mean retention time was 1.63 years (s.d. 0.73) and the mean time of postretention evaluation was 5.31 years (s.d. 1.61). The dental casts were measured at pretreatment (T1), posttreatment (T2) and postretention (T3), by the PAR index and by the Little irregularity index, and the correction due to treatment (T1-2) and the change at the postretention period (T3-2) were calculated. The descriptive statistics was performed and the Pearson correlation coefficient was applied for the PAR and the Little indices in the total sample, among the times evaluated. Results: The mean PAR reduction due to treatment was 78.54%, and 66.6%, at the postretention stage related to pretreatment stage. Significant correlations were found for the PAR index at the times evaluated, except between T1 and T2 and between T1-2 and T3. In other words, the higher the treatment correction (T1-2), the lower the posttreatment PAR index (PAR T2) will be, and the higher will be the PAR change at the postretention period (PAR T3-2). Also, the higher the posttreatment PAR score (PAR T2), the higher will be the postretention PAR score (PAR T3). Conclusion: It was concluded that the quality of orthodontic treatment outcomes is not related to the long-term occlusal stability. PMID:19089052

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

    PubMed

    Hokkanen, Laura; Launes, Jyrki; Michelsson, Katarina

    2014-01-01

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

  16. Neuropathological and genetic correlates of survival and dementia onset in synucleinopathies: a retrospective analysis

    PubMed Central

    Irwin, David J.; Grossman, Murray; Weintraub, Daniel; Hurtig, Howard I.; Duda, John E.; Xie, Sharon X.; Lee, Edward B.; Van Deerlin, Vivianna M.; Lopez, Oscar L.; Kofler, Julia K.; Nelson, Peter T.; Jicha, Gregory A.; Woltjer, Randy; Quinn, Joseph F.; Kaye, Jeffery; Leverenz, James B; Tsuang, Debby; Longfellow, Katelan; Yearout, Dora; Kukull, Walter; Keene, C. Dirk; Montine, Thomas J.; Zabetian, Cyrus P.; Trojanowski, John Q.

    2016-01-01

    Background There exists great heterogeneity in patient survival and the time interval between motor symptom and dementia onset (MDI) across Lewy body spectrum disorders (LBSD). The goal of this study is to identify genetic and pathological findings that have the strongest association with these features of clinical heterogeneity in LBSD. Methods In this retrospective study, we examined symptom onset, and genetic and neuropathological data from a cohort of LBSD patients with autopsy-confirmed α-synucleinopathy (as of Oct 1, 2015) recruited from 5 clinical research centres in 5 cities in the USA. Using histopathology techniques and markers, we assessed the burden of tau neurofibrillary tangles, neuritic plaques, α-synuclein inclusions, and other pathologic changes in cortical regions using averaged ordinal scores and genotyped cases for variants associated with LBSD. We evaluated the time interval from onset of motor symptoms to dementia (MDI) and overall survival in groups with varying levels of co-morbid Alzheimer’s disease pathology (AD) according to current National Institute on Aging–Alzheimer’s Association neuropathological criteria and used multivariate regression to control for age at death and gender. Findings This study included 213 patients who had been followed to autopsy and met inclusion criteria of clinical LBSD with autopsy-confirmed α-synculeinopathy. Patient groups were characterized by no (n=49,23%), low-level (n=56,26%), intermediate-level (n=45,21%) or high-level (n=63,30%) AD neuropathology. Across groups of increasing levels of AD neuropathology, there were higher cerebral α-synuclein scores, shorter MDI, and shorter disease duration (p<0·0001 all). Multivariate regression found independent negative associations of cerebral tau score with MDI (β= −4·0, 95% CI −5·5 to −2·6; p<0·0001) (R2=0·22, p<0·0001) and with survival (β=−2·0, 95% CI −3·2 to −0·8; p<0·0001) (R2=0·15, p<0·0001) in models including age at

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

    PubMed Central

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

    2016-01-01

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

  18. Retrospective comparison of the effectiveness of various treatment modalities of extragastric MALT lymphoma: a single-center analysis.

    PubMed

    Wöhrer, Stefan; Kiesewetter, Barbara; Fischbach, Julia; Müllauer, Leonhard; Troch, Marlene; Lukas, Julius; Mayerhoefer, Marius E; Raderer, Markus

    2014-08-01

    We have performed a retrospective analysis of all patients with extragastric mucosa-associated lymphoid tissue (MALT) lymphoma treated at our institution to compare the efficacy of first-line therapeutic modalities including surgery, radiation, systemic therapy, and antibiotics. One hundred eighty-five patients with extragastric MALT lymphoma with a median age of 63 (interquartile range (IQR) 50-74) years and a median follow-up time of 49 (IQR 18-103) months were retrospectively analyzed. Time to progression and time to next therapy were used as surrogate endpoints for efficacy. Patients having either surgery (100 %), chemo/immunotherapy (85.5 %), or radiation (80 %) had significantly (p = 0.01) higher response rates than patients treated with antibiotics (33.3 %). Patients who were irradiated had significantly more progressive disease, but also the longest follow-up time. Stage, elevated LDH, anemia, elevated beta-2 microglobulin, plasmacytic differentiation, monoclonal gammopathy, or autoimmune disease did not influence the rate of disease progression nor did complete remission or partial remission from initial therapy influence time to and rate of progression. There was no significant difference in the median time to progression (p = 0.141), but the estimated time to progression (p = 0.023) as well as the estimated time to next therapy (p = 0.021) was significantly different among the various cohorts favoring surgery, chemo/immunotherapy, and radiation. Our results suggest extragastric MALT lymphoma as a potential systemic disease irrespective of initial stage. Radiation, surgery, and chemo/immunotherapy seem to be equally effective in achieving remissions and prolonged progression free survivals, but a curative potential is questionable. Localized MALT lymphomas affecting the thyroid gland or the lungs have excellent long-term progression-free survivals with surgical treatment only.

  19. DIAGNOSTIC IMAGING IN A DIRECT-ACCESS SPORTS PHYSICAL THERAPY CLINIC: A 2-YEAR RETROSPECTIVE PRACTICE ANALYSIS

    PubMed Central

    Dedekam, Erik A.; Johnson, Michael R.; Dembowski, Scott C.; Westrick, Richard B.; Goss, Donald L.

    2016-01-01

    Background While advanced diagnostic imaging is a large contributor to the growth in health care costs, direct-access to physical therapy is associated with decreased rates of diagnostic imaging. No study has systematically evaluated with evidence-based criteria the appropriateness of advanced diagnostic imaging, including magnetic resonance imaging (MRI), when ordered by physical therapists. The primary purpose of this study was to describe the appropriateness of magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA) exams ordered by physical therapists in a direct-access sports physical therapy clinic. Study Design Retrospective observational study of practice. Hypothesis Greater than 80% of advanced diagnostic imaging orders would have an American College of Radiology (ACR) Appropriateness Criteria rating of greater than 6, indicating an imaging order that is usually appropriate. Methods A 2-year retrospective analysis identified 108 MRI/MRA examination orders from four physical therapists. A board-certified radiologist determined the appropriateness of each order based on ACR appropriateness criteria. The principal investigator and co-investigator radiologist assessed agreement between the clinical diagnosis and MRI/surgical findings. Results Knee (31%) and shoulder (25%) injuries were the most common. Overall, 55% of injuries were acute. The mean ACR rating was 7.7; scores from six to nine have been considered appropriate orders and higher ratings are better. The percentage of orders complying with ACR appropriateness criteria was 83.2%. Physical therapist's clinical diagnosis was confirmed by MRI/MRA findings in 64.8% of cases and was confirmed by surgical findings in 90% of cases. Conclusions Physical therapists providing musculoskeletal primary care in a direct-access sports physical therapy clinic appropriately ordered advanced diagnostic imaging in over 80% of cases. Future research should prospectively compare physical therapist

  20. Heparin-induced thrombocytopenia (HIT II) in liver transplant recipients: a retrospective multivariate analysis of prognostic factors.

    PubMed

    Hüser, Norbert; Aßfalg, Volker; Reim, Daniel; Novotny, Alexander; Thorban, Stefan; Cheng, Zhangjun; Kornberg, Arno; Friess, Helmut; Büchler, Peter; Matevossian, Edouard

    2012-07-01

    We investigated the prevalence of HIT II in liver transplant recipients and analysed associated factors. In recipients with clinically suspected HIT II in the 4Ts pretest clinical scoring system HIPA-assay was performed. Next, 37 clinical variables were analysed retrospectively for their association with HIT II. Factors significantly correlated to our findings in univariate analysis were included in a multivariate model and binary logistic regression analysis. Among 46 recipients 21 patients were suspicious in the 4Ts pretest and 14 of them (30.4%) were diagnosed HIT-antibody positive. Patient's age (P = 0.001), postoperative dialysis (P = 0.028), and postoperative hospital stay (P = 0.035) were significantly associated with development of HIT-antibodies in univariate analysis. Postoperative dialysis and postoperative hospital stay turned out as epiphenomena of patient's age, the only independent predictor (P = 0.021). Using multiple χ(2) -testing, a cut-off could be calculated, assigning patients younger than 59 years to a low risk group and patients of 59 years and older to a high risk group. High incidence of peri-operative HIT II seroconversion in liver transplant recipients is not associated with factors known to induce thrombocyte activation, like blood products or cell-saver. Only patients' age was identified as independent predictor.

  1. Natural Products as Sources of New Drugs over the 30 Years from 1981 to 2010†

    PubMed Central

    Newman, David J.; Cragg, Gordon M.

    2013-01-01

    This review is an updated and expanded version of the three prior reviews that were published in this journal in 1997, 2003 and 2007. In the case of all approved therapeutic agents, the time frame has been extended to cover the 30 years from January 1st 1981 to December 31st 2010 for all diseases world-wide, and from 1950 (earliest so far identified) to December 2010 for all approved antitumor drugs world-wide. We have continued to utilize our secondary subdivision of a “natural product mimic” or “NM” to join the original primary divisions, and have added a new designation “natural product botanical” or “NB” to cover those botanical “defined mixtures” that have now been recognized as drug entities by the FDA and similar organizations. From the data presented, the utility of natural products as sources of novel structures, but not necessarily the final drug entity, is still alive and well. Thus, in the area of cancer, over the time frame from around the 1940s to date, of the 175 small molecules, 131 or 74.8% are other than “S” (synthetic), with 85 or 48.6% actually being either natural products or directly derived there from. In other areas, the influence of natural product structures is quite marked with, as expected from prior information, the anti-infective area being dependent on natural products and their structures. Although combinatorial chemistry techniques have succeeded as methods of optimizing structures, and have been used very successfully in the optimization of many recently approved agents, we are only able to identify only one de novo combinatorial compound approved as a drug in this 30-year time frame. We wish to draw the attention of readers to the rapidly evolving recognition that a significant number of natural product drugs/leads are actually produced by microbes and/or microbial interactions with the “host from whence it was isolated”, and therefore we consider that this area of natural product research should be

  2. Factors driving mortality and growth at treeline: a 30-year experiment of 92 000 conifers.

    PubMed

    Barbeito, Ignacio; Dawes, Melissa A; Rixen, Christian; Senn, Josef; Bebi, Peter

    2012-02-01

    Understanding the interplay between environmental factors contributing to treeline formation and how these factors influence different life stages remains a major research challenge. We used an afforestation experiment including 92 000 trees to investigate the spatial and temporal dynamics of tree mortality and growth at treeline in the Swiss Alps. Seedlings of three high-elevation conifer species (Larix decidua, Pinus mugo ssp. uncinata, and Pinus cembra) were systematically planted along an altitudinal gradient at and above the current treeline (2075 to 2230 m above sea level [a.s.l.]) in 1975 and closely monitored during the following 30 years. We used decision-tree models and generalized additive models to identify patterns in mortality and growth along gradients in elevation, snow duration, wind speed, and solar radiation, and to quantify interactions between the different variables. For all three species, snowmelt date was always the most important environmental factor influencing mortality, and elevation was always the most important factor for growth over the entire period studied. Individuals of all species survived at the highest point of the afforestation for more than 30 years, although mortality was greater above 2160 m a.s.l., 50-100 m above the current treeline. Optimal conditions for height growth differed from those for survival in all three species: early snowmelt (ca. day of year 125-140 [where day 1 is 1 January]) yielded lowest mortality rates, but relatively later snowmelt (ca. day 145-150) yielded highest growth rates. Although snowmelt and elevation were important throughout all life stages of the trees, the importance of radiation decreased over time and that of wind speed increased. Our findings provide experimental evidence that tree survival and height growth require different environmental conditions and that even small changes in the duration of snow cover, in addition to changes in temperature, can strongly impact tree survival and

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

    ERIC Educational Resources Information Center

    Calma, Angelito; Davies, Martin

    2015-01-01

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

  4. A retrospective appreciation of Willard Day's contributions to radical behaviorism and the analysis of verbal behavior

    PubMed Central

    Moore, Jay

    1991-01-01

    Willard Day's contributions to radical behaviorism are grouped under three headings: (a) an emphasis on the distinction between radical and methodological behaviorism; (b) an emphasis on the interpretation, rather than the prediction and control, of behavior; and (c) an emphasis on the analysis of verbal behavior as a natural, ongoing phenomenon. The paper suggests that the contributions above are listed in ascending order of significance. PMID:22477632

  5. Chornobyl 30 years later: Radiation, pregnancies, and developmental anomalies in Rivne, Ukraine.

    PubMed

    Wertelecki, Wladimir; Chambers, Christina D; Yevtushok, Lyubov; Zymak-Zakutnya, Natalya; Sosyniuk, Zoriana; Lapchenko, Serhiy; Ievtushok, Bogdana; Akhmedzhanova, Diana; Komov, Oleksandr

    2017-01-01

    In the 30 years since the Chornobyl nuclear power plant disaster, there is evidence of persistent levels of incorporated ionizing radiation in adults, children and pregnant women in the surrounding area. Measured levels of Cesium-137 vary by region, and may be influenced by dietary and water sources as well as proximity to nuclear power plants. Since 2000, comprehensive, population-based birth defects monitoring has been performed in selected regions of Ukraine to evaluate trends and to generate hypotheses regarding potential causes of unexplained variations in defect rates. Significantly higher rates of microcephaly, neural tube defects, and microphthalmia have been identified in selected regions of Ukraine collectively known as Polissia compared to adjacent regions collectively termed non-Polissia, and these significantly higher rates were evident particularly in the years 2000-2009. The Polissia regions have also demonstrated higher mean whole body counts of Cesium-137 compared to values in individuals residing in other non-Polissia regions. The potential causal relationship between persistent ionizing radiation pollution and selected congenital anomaly rates supports the need for a more thorough, targeted investigation of the sources of persistent ionizing radiation and the biological plausibility of a potential teratogenic effect.

  6. [Spatiotemporal variation of soil pH in Guangdong Province of China in past 30 years].

    PubMed

    Guo, Zhi-Xing; Wang, Jing; Chai, Min; Chen, Ze-Peng; Zhan, Zhen-Shou; Zheng, Wu-Ping; Wei, Xiu-Guo

    2011-02-01

    Based on the 1980s' soil inventory data and the 2002-2007 soil pH data of Guangdong Province, the spatiotemporal variation of soil pH in the Province in past 30 years was studied. In the study period, the spatial distribution pattern of soil pH in the Province had less change (mainly acidic), except that in Pearl River Delta and parts of Qingyuan and Shaoguan (weak alkaline). The overall variation of soil pH was represented as acidification, with the average pH value changed from 5.70 to 5.44. Among the soil types in the Province, alluvial soil had an increased pH, lateritic red soil, paddy soil, and red soil had a large decrement of pH value, and lime soil was most obvious in the decrease of pH value and its area percentage. The soil acidification was mainly induced by soil characteristics, some natural factors such as acid rain, and human factors such as unreasonable fertilization and urbanization. In addition, industrialization and mining increased the soil pH in some areas.

  7. [Repeat bypass surgery for intracranial hemorrhage 30 years after indirect bypass for moyamoya disease].

    PubMed

    Hori, Satoshi; Kashiwazaki, Daina; Akioka, Naoki; Hamada, Hideo; Kuwayama, Naoya; Kuroda, Satoshi

    2014-04-01

    A 39-year-old man had been diagnosed with moyamoya disease and underwent a bilateral encephalo-duro-arterio-synangiosis(EDAS)intervention at the age of 9 years. During the 30 years after his bilateral EDAS, he experienced no cerebrovascular events. However, at age 39, he suddenly presented with mild consciousness disturbance and vomiting and was transferred to a local hospital. Brain CT showed an intracerebral hemorrhage associated with ventricular hematoma. He was referred to our hospital for further investigation and treatment. Cerebral angiography showed faint collaterals through the site of the bilateral EDAS and development of basal moyamoya vessels. SPECT showed decreased cerebral blood flow(CBF)and cerebrovascular reactivity(CVR)in the right frontal lobe. We diagnosed him with delayed cerebral hemorrhage due to delayed rupturing of fragile moyamoya vessels after indirect bypass. The patient underwent a repeat bypass surgery(STA-MCA anastomosis and encephalo-duro-myo-arterio-pericranial synangiosis;EDMAPS)on the right side. He showed improvement in cerebral hemodynamics after surgery, and has since remained free from cerebrovascular events. Hemorrhagic events occurring a very long time after indirect bypass surgery in pediatric-onset moyamoya disease are rare. In such cases, a lifelong follow-up strategy may be necessary. Repeat bypass surgery may be a powerful tool to prevent such hemorrhagic events.

  8. No association between mean telomere length and life stress observed in a 30 year birth cohort.

    PubMed

    Jodczyk, Sarah; Fergusson, David M; Horwood, L John; Pearson, John F; Kennedy, Martin A

    2014-01-01

    Telomeres are specialised structures that cap the ends of chromosomes. They shorten with each cell division and have been proposed as a marker of cellular aging. Previous studies suggest that early life stressors increase the rate of telomere shortening with potential impact on disease states and mortality later in life. This study examined the associations between telomere length and exposure to a number of stressors that arise during development from the antenatal/perinatal period through to young adulthood. Participants were from the Christchurch Health and Development Study (CHDS), a New Zealand longitudinal birth cohort which has followed participants from birth until age 30. Telomere length was obtained on DNA from peripheral blood samples collected from consenting participants (n = 677) at age 28-30, using a quantitative PCR assay. These data were assessed for associations with 26 measures of life course adversity or stress which occurred prior to 25 years of age. No associations were found between telomere length measured at age 28-30 years and life course adversity or stress for specific measures and for the summary risk scores for each developmental domain. The correlations were very small ranging from -0.06 to 0.06 with a median of 0.01, and none were statistically significant. Our results in this well-studied birth cohort do not support prior reports of such associations, and underscore the need for more extensive replication of proposed links between stress and telomere biology in larger cohorts with appropriate phenotypic data.

  9. Paraganglioma, neuroblastoma, and a SDHB mutation: Resolution of a 30-year-old mystery.

    PubMed

    Schimke, R Neil; Collins, Debra L; Stolle, Catherine A

    2010-06-01

    Familial paraganglioma/pheochromocytoma (PGL/PCC) is genetically heterogenous with mutations in three of the four subunits of the heterotetrameric mitochondrial complex II enzyme succinate dehydrogenase (SDH) being causally responsible for the majority of cases. In addition to PGL/PCC an array of non-paraganglial tumors have been described in affected individuals. We present a 30-year follow-up on the family of a deceased patient who synchronously developed malignant neuroblastoma (NBL), PCC, and renal cell carcinoma (RCC). Other family members with late onset disease have come to our attention, and molecular study revealed a mutation in the SDHB gene. Despite the embryologic relationship, NBL has been seen in only two previous patients with familial PGL/PCC, both with deletions of the SDHB gene. Review of the literature suggests the lack of a reported association between NBL and familial PGL/PCC may be an ascertainment bias. We further suggest that study of the SDH genes in NBL survivors who develop secondary solid tumors, particularly RCC, may correct this bias, and provide for more effective and comprehensive tumor screening in this patient population.

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

    PubMed

    Young, James D

    2016-06-15

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

  11. Development of the psychotherapy supervisor: review of and reflections on 30 years of theory and research.

    PubMed

    Watkins, C Edward

    2012-01-01

    The psychotherapy supervisor's development (i.e., the unfolding process of growth in being and becoming a supervisor) has long been considered a substantive issue in clinical supervision. Theory and clinical wisdom suggest that supervisors' level of development can have a significant and far-reaching impact on the supervision experience, potentially affecting supervisory alliance formation, in-session conceptualization and strategy utilization, and even the outcomes experienced by both supervisees and patients. Consensus seems to be that there is a critical need for empirical study of psychotherapy supervisor development. But with a generation of theory and research on psychotherapy supervisor development behind us, what do we know (or not know); where does this area of inquiry stand today, and what do we need to know about supervisor development going forward? In this paper, I attempt to address those questions. I examine the last 30-year period (approximately) of supervisor development theory, measurement, and quantitative and qualitative study; provide a contemporary status report of sorts on this subject; and identify some important matters for research and practical consideration. Despite a generation of inquiry, the psychotherapy supervisor still remains the largely unknown party in the supervision experience. But that long-standing reality can be changed, some possibilities for doing so are presented, and the promise of supervisor development study is seen to be an ever-inviting hope that awaits realization.

  12. Towards the development of a 30 year record of remotely sensed vegetation optical depth

    NASA Astrophysics Data System (ADS)

    de Jeu, Richard A. M.; Holmes, Thomas R. H.; van der Werf, Guido

    2009-09-01

    The framework for the development of a 30 year global record of remotely sensed vegetation optical depth is presented. The vegetation data set is derived from passive microwave observations and spans the period from November 1978 through the end of 2008. Different satellite sensor observations (i.e. Nimbus-7 SMMR, DMSP SSM/I, TRMM TMI, and AQUA AMSR-E). are used in a radiative transfer model to derive vegetation optical depth. Vegetation optical depth can directly be related to vegetation water content and is a function of biomass. The retrieval model is described and the quality of the retrieved vegetation optical depth is discussed. The new dataset will be merged into one consistent global product for the entire period of data record. To explore the potential to use this new product for long term vegetation modeling, the product was compared to total biomass from the biogeochemical model CASA. The results indicate that the vegetation optical depth can be an important contribution to the derivation of biophysical properties like biomass. It can also increase the reliability of optical sensor derived vegetation indices, because the microwave vegetation optical depth can be derived under cloudy conditions. This unique feature could create the possibility to improve the temporal resolution of other biophysical data products. The entire vegetation density dataset will be made available for download by the general science community and could give a significant contribution in climate research.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

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

    PubMed

    Karkee, R; Jha, N

    2010-01-01

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

  15. 30 Years of APS Congressional Fellows: Looking Back and Looking Forward

    NASA Astrophysics Data System (ADS)

    2003-04-01

    In 1973 AAAS launched a Congressional Fellows Program, and APS was one of three founding participants. Since then, APS has funded one or two Fellows annually to work with a Congressional Committee or on the personal staff of a Member of Congress. These fellows individually and collectively have had and continue to have a large impact in Washington. Six Fellows from different periods of the 30-year program, including a current Member of Congress, will present their views and assessments of the Fellowship program. They will address how it affected them, what it has done for the country and how APS should plan for the future. There will be ample time for questions and discussion. Panelists: Ben Cooper, Association of Oil Pipe Lines (Fellow, 1973-74) Rush Holt, Member, House of Representatives (Fellow, 1982-83) Jane Alexander, Office of Naval Research (Fellow, 1986-87) Duncan Moore, University of Rochester (Fellow, 1993-94) Peter Rooney, House Committee on Science (Fellow, 1997-98) Sherri Stephan, Senate Committee on Government Affairs (Fellow, 2000-01)

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

    NASA Astrophysics Data System (ADS)

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

    2009-01-01

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

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

    USGS Publications Warehouse

    Xu, J. P.

    2011-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Chandler, Jim; Micheletti, Natan; Lane, Stuart

    2015-04-01

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

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

    PubMed Central

    Duan, Jianping; Li, Lun; Fang, Yongjie

    2015-01-01

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

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

    SciTech Connect

    Meier, Alan

    2014-08-11

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

  1. International Standards for Properties and Performance of Advanced Ceramics - 30 years of Excellence

    NASA Technical Reports Server (NTRS)

    Jenkins, Michael G.; Salem, Jonathan A.; Helfinstine, John; Quinn, George D.; Gonczy, Stephen T.

    2016-01-01

    Mechanical and physical properties/performance of brittle bodies (e.g., advanced ceramics and glasses) can be difficult to measure correctly unless the proper techniques are used. For three decades, ASTM Committee C28 on Advanced Ceramics, has developed numerous full-consensus standards (e.g., test methods, practices, guides, terminology) to measure various properties and performance of a monolithic and composite ceramics and coatings that, in some cases, may be applicable to glasses. These standards give the "what, how, how not, why, why not, etc." for many mechanical, physical, thermal, properties and performance of advanced ceramics. Use of these standards provides accurate, reliable, repeatable and complete data. Involvement in ASTM Committee C28 has included users, producers, researchers, designers, academicians, etc. who write, continually update, and validate through round robin test programmes, more than 45 standards in the 30 years since the Committee's inception in 1986. Included in this poster is a pictogram of the ASTM Committee C28 standards and how to obtain them either as i) individual copies with full details or ii) a complete collection in one volume. A listing of other ASTM committees of interest is included. In addition, some examples of the tangible benefits of standards for advanced ceramics are employed to demonstrate their practical application.

  2. Recidivism Patterns Among Two Types of Juvenile Homicide Offenders: A 30-Year Follow-Up Study.

    PubMed

    Khachatryan, Norair; Heide, Kathleen M; Hummel, Erich V

    2016-07-01

    Although juvenile homicide has been a matter of concern in the United States since the 1980s, prior research has not addressed long-term recidivism patterns for convicted juvenile murderers. Furthermore, a prominent juvenile homicide typology had not previously been tested with U.S. offenders. The present study examined whether juvenile offenders who killed or attempted to kill during the commission of a crime differed from those who killed due to some type of conflict on pre-incarceration, incarceration, and post-incarceration variables. These offenders were sentenced to adult prison in the early 1980s. Follow-up data spanned 30 years. The results indicated that approximately 88% of released offenders have been rearrested. Analyses of pre-incarceration variables revealed that crime-oriented offenders were significantly more likely to commit the homicide offense using accomplices than conflict-oriented offenders, and the latter were significantly more likely to use a firearm during the homicide incident. The circumstances of the homicide, however, were not significantly related to any other pre-incarceration variables, release from prison, number of post-release arrests, and number of post-release violent offenses. The implications of the findings, their comparability to previous follow-up research on this typology, and avenues for future research are discussed.

  3. A 30 year old man with an acute presentation of a cerebellopontine angle lesion.

    PubMed

    McLaughlin, Nancy; Berthelet, France; Bojanowski, Michel W

    2013-03-01

    Schwannomas are slow-growing tumors with symptoms manifesting progressively. We report the case of a patient who manifested a sudden loss of consciousness as clinical presentation of an intracranial schwannoma with no acute hemorrhage or hydrocephalus. A 30-year-old male presented comatose and posturing. Cerebral CT revealed an extra-axial lesion with a heterogeneous enhancement and a cystic component located on the right cerebellopontine angle (CPA), displacing the brain stem. No acute hemorrhage or hydrocephalus was documented. Through a retrosigmoid suboccipital craniotomy, an extended subtotal tumor resection was performed. The patient experienced no functional hearing impairment and resumed his daily-life activities 3 months after surgery. Histopathological examination was compatible with a benign schwannoma. An exuberant lymphoplasmacytic infiltrate was found in many areas, signing the presence of an unusual inflammatory reaction with adjacent important intratumoral edema. We propose that the exuberant inflammatory infiltrate and the associated intratumoral edema acted as determining elements in the increase of mass effect and sudden clinical deterioration.

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

    Strøm, Agnete

    2009-11-01

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

  6. How are qualitative methods used in diabetes research? A 30-year systematic review.

    PubMed

    Hennink, Monique M; Kaiser, Bonnie N; Sekar, Swathi; Griswold, Emily P; Ali, Mohammed K

    2017-02-01

    We aimed to describe how qualitative methods are used in global research on diabetes and identify opportunities whereby qualitative methods could further benefit our understanding of the human experience of diabetes and interventions to address it. We conducted a systematic review of National Library of Medicine, EMBASE, and Web of Science electronic databases to identify original research articles that used qualitative methods to study diabetes between 1980 and 2011. We identified 554 eligible articles and categorised these by geographic region, year of publication, study population, study design, research question, qualitative data collection methods, and journal type. Results show low use of qualitative methods in diabetes research over the past 30 years. The majority of articles (75%) reported using substantive qualitative research, while mixed-methods research has remained underutilised. Eighty-five per cent of articles reported studies conducted in North America or Europe, with few studies in developing countries. Most articles reported recruiting clinic-based populations (58%). Over half (54%) of research questions focused on patient experience and 24% on diabetes management. Qualitative methods can provide important insights about socio-cultural aspects of disease to improve disease management. However, they remain underutilised for understanding the diabetes experience, especially in Africa and Asia and amongst non-clinic populations.

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

    PubMed Central

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

    2016-01-01

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

  8. 30 Years on Selected Issues in the Prevention of HIV among Persons Who Inject Drugs

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-09-13

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

  10. Exploration of Pedestrian Head Injuries—Collision Parameter Relationships through a Combination of Retrospective Analysis and Finite Element Method

    PubMed Central

    Liu, Wenjun; Su, Sen; Qiu, Jinlong; Zhang, Yongyong; Yin, Zhiyong

    2016-01-01

    There are a very limited number of reports concerning the relationship between pedestrian head injuries and collision parameters through a combination of statistical analysis methods and finite element method (FEM). This study aims to explore the characteristics of pedestrian head injuries in car–pedestrian collisions at different parameters by using the two means above. A retrospective analysis of pedestrian head injuries was performed based on detailed investigation data of 61 car–pedestrian collision cases. The head damage assessment parameters (head injury criterion (HIC), peak stress on the skull, maximal principal strain for the brain) in car–pedestrian simulation experiments with four contact angles and three impact velocities were obtained by FEM. The characteristics of the pedestrian head injuries were discussed by comparing and analyzing the statistical analysis results and finite element analysis results. The statistical analysis results demonstrated a significant difference in skull fractures, contusion and laceration of brain and head injuries on the abbreviated injury scale (AIS)3+ was found at different velocities (p < 0.05) and angles (p < 0.05). The simulation results showed that, in pedestrian head-to-hood impacts, the values of head damage assessment parameters increased with impact velocities. At the same velocity, these values from the impact on the pedestrian’s back were successively greater than on the front or the side. Furthermore, head injury reconstruction and prediction results of two selected cases were consistent with the real injuries. Overall, it was further spelled out that, for shorter stature pedestrians, increased head impact velocity results in greater head injury severity in car–pedestrian collision, especially in pedestrian head-to-hood impacts. Under a back impact, the head has also been found to be at greater damage risk for shorter stature pedestrians, which may have implications on automotive design and

  11. A Retrospective Perinatal Data Analysis of Immigrant and German Women from Representative Birth Cohorts at the Virchow Hospital, Berlin

    PubMed Central

    Armbrust, R.; von Rennenberg, R.; David, M.

    2016-01-01

    Introduction: The aim of this study was to define and characterise differences in the level of obstetric care provided to immigrant and German women. Materials and Methods: An analysis of the Virchow Hospitalʼs birth registers was conducted for the years 1974, 1984 and 1994. The study population of 5445 patients was grouped according to ancestry/family origin on the basis of a name analysis, and subsequently also according to parity (primiparous or multiparous). On name analysis 2741 women were defined as German, 1598 were grouped as women of Turkish origin and 810 as immigrants of other origin. χ2 tests and Fisherʼs exact test were used for significance testing (significance level p < 0.05), and a logistic regression analysis was performed. Results: Rates of caesarean section, episiotomy, higher grade perineal tears and severe postpartum haemorrhage did not differ between the groups. There were however significant differences in the use of uterine stimulants, analgesics in labour and both local and regional anaesthesia, with women of Turkish origin and other immigrants receiving anaesthesia less, but oxytocin more often. Rooming-in was more common among German primipara and multipara from 1984 onwards. Discussion: This retrospective analysis of three historical birth cohorts showed significant differences in perinatal care between German and immigrant women, presumably reflecting deficits in care. It seems remarkable that this trend has not changed over a time span of three decades despite a continuous increase in immigration and acculturation. A “research paradox”, however, remains: Despite these increasing rates, there are no current or older, prospective or systematic studies of obstetric care in immigrants. PMID:27904165

  12. Exploration of Pedestrian Head Injuries-Collision Parameter Relationships through a Combination of Retrospective Analysis and Finite Element Method.

    PubMed

    Liu, Wenjun; Su, Sen; Qiu, Jinlong; Zhang, Yongyong; Yin, Zhiyong

    2016-12-16

    There are a very limited number of reports concerning the relationship between pedestrian head injuries and collision parameters through a combination of statistical analysis methods and finite element method (FEM). This study aims to explore the characteristics of pedestrian head injuries in car-pedestrian collisions at different parameters by using the two means above. A retrospective analysis of pedestrian head injuries was performed based on detailed investigation data of 61 car-pedestrian collision cases. The head damage assessment parameters (head injury criterion (HIC), peak stress on the skull, maximal principal strain for the brain) in car-pedestrian simulation experiments with four contact angles and three impact velocities were obtained by FEM. The characteristics of the pedestrian head injuries were discussed by comparing and analyzing the statistical analysis results and finite element analysis results. The statistical analysis results demonstrated a significant difference in skull fractures, contusion and laceration of brain and head injuries on the abbreviated injury scale (AIS)3+ was found at different velocities (p < 0.05) and angles (p < 0.05). The simulation results showed that, in pedestrian head-to-hood impacts, the values of head damage assessment parameters increased with impact velocities. At the same velocity, these values from the impact on the pedestrian's back were successively greater than on the front or the side. Furthermore, head injury reconstruction and prediction results of two selected cases were consistent with the real injuries. Overall, it was further spelled out that, for shorter stature pedestrians, increased head impact velocity results in greater head injury severity in car-pedestrian collision, especially in pedestrian head-to-hood impacts. Under a back impact, the head has also been found to be at greater damage risk for shorter stature pedestrians, which may have implications on automotive design and pedestrian

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

    PubMed Central

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

    2015-01-01

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

  14. Retrospective analysis of hepatitis C infected patients treated through an integrated care model

    PubMed Central

    Levin, James M; Dabirshahsahebi, Shabnam; Bauer, Mindy; Huckins, Eric

    2016-01-01

    AIM To determine if our health system’s integrated model reflects sustained virologic response (SVR) outcomes similar to those in clinical trial data, maximizes adherence, and averts drug interactions. METHODS Subjects with chronic hepatitis C had their medical records reviewed from November 1st, 2014 through March 1st, 2016. Patients eligible for treatment were entered into an integrated care model therapy algorithm. The primary outcome was SVR12 based on intention to treat (ITT) analysis. Inclusion criteria consisted of both treatment naïve and experienced patients over the age of 18 who were at least twelve weeks post-therapy completion with any genotype (GT) or METAVIR score. Secondary outcomes included adherence, adverse events, and number of drug interaction interventions. RESULTS At the time of analysis, 133 patients had reached twelve weeks post therapy with ITT. In the ITT analysis 70 patients were GT 1a, 26 GT 1b, 23 could not be differentiated between GT 1a or 1b, 8 GT 2, 4 GT 3, and 2 patients with multiple genotypes. The ITT treatment regimens consisted of 97 sofosbuvir (SOF)/ledipasvir (LDV), 8 SOF/LDV and ribavirin (RBV), 7 SOF and Simeprevir (SMV), 6 3D and RBV, 1 3D, 11 SOF and RBV, and 1 SOF, peg interferon alpha, and RBV. The overall SVR12 rate was 93% in the ITT analysis with a total of 6 patients relapsing. In patients with cirrhosis, 89% obtained SVR12. All 33 patients who were previous treatment failures achieved SVR12. Drug-drug interactions were identified in 56.4% of our patient population, 69 of which required interventions made by the pharmacist. The most common side effects were fatigue (41.4%), headache (28.6%), nausea (18.1%), and diarrhea (8.3%). No serious adverse effects were reported. CONCLUSION Dean Health System’s integrated care model successfully managed patients being treated for hepatitis C virus (HCV). The integrated care model demonstrates high SVR rates amongst patients with different levels of fibrosis, genotypes

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

    PubMed

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

    2012-12-01

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

  16. Severe haematoperitoneum caused by ovarian bleeding after transvaginal oocyte retrieval: a retrospective analysis and systematic literature review.

    PubMed

    Nouri, Kazem; Walch, Katharina; Promberger, Regina; Kurz, Christine; Tempfer, Clemens B; Ott, Johannes

    2014-12-01

    A case series of haematoperitoneum caused by ovarian bleeding after transvaginal oocyte retrieval (TVOR) is presented and all published cases summarized. In a retrospective case series, four patients with ovarian bleeding after TVOR were included. In addition, a pooled analysis of all published cases (n = 32) who underwent surgical intervention for severe haematoperitoneum caused by ovarian bleeding after TVOR was carried out. Main outcome measures were incidence, risk factors, course and intraoperative findings. In the pooled analysis, the incidence was 0.08%. The first sign of haematoperitoneum was evident in 33.3% within the first postoperative hour, and, cumulatively, in 93.3% within 24 h. The median time between TVOR and surgical intervention was 10 h. In four patients, the ovary could not be preserved, which was associated with a longer time interval between TVOR and the onset of symptoms (median 18 h versus 2.5 h; P = 0.004) as well as between TVOR and surgical intervention (median 21.5 h versus 8.5 h; 0.004). In conclusion, severe haematoperitoneum occurs in 0.08% after TVOR. Late-onset bleeding is common. A longer time interval between TVOR and surgical intervention might put a patient at risk of ovariectomy.

  17. Second allogeneic transplantation for relapse of malignant disease: retrospective analysis of outcome and predictive factors by the EBMT.

    PubMed

    Ruutu, T; de Wreede, L C; van Biezen, A; Brand, R; Mohty, M; Dreger, P; Duarte, R; Peters, C; Garderet, L; Schönland, S; Gratwohl, A; Niederwieser, D; de Witte, T; Kröger, N

    2015-12-01

    In patients treated with allogeneic stem cell transplantation (SCT) for malignant disease who suffer from a relapse after the transplantation, the role of second allogeneic SCT is often uncertain. In a retrospective analysis, 2632 second allogeneic transplantations carried out for a relapse after the first transplantation were analyzed to define indications and identify predictive factors. Fifteen percent of the patients remained relapse-free until 5 years after the second SCT. Patients with CML had a better survival than patients with other diseases. In a multivariate analysis, factors associated with better survival were low disease burden, longer remission duration after the first transplantation, longer interval between the transplantations, younger age, absence of grade II-IV acute GvHD or chronic GvHD after the first transplantation, and later year of transplantation. The European Society for Blood and Marrow Transplantation risk score predicted the outcome. Using the same donor as in the first transplantation vs another donor had no predictive value for survival. Sibling donor was a favorable predictive factor. In conclusion, second allogeneic SCT offers a reasonable option especially for young patients with a long remission after the first transplantation and a low disease burden. The present findings do not support the usefulness of changing the donor for the second transplantation.

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

    PubMed Central

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

    2015-01-01

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

  19. Familial Papillary Thyroid Carcinoma (FPTC): a Retrospective Analysis in a Sample of the Bulgarian Population for a 10-Year Period.

    PubMed

    Vidinov, Kalin; Nikolova, Dragomira

    2017-03-01

    In recent years, there are numerous reports indicating the presence of familial papillary carcinoma. Unfortunately, no genetic defect can be linked directly to the disease. In this study, we set the goal to make a retrospective analysis of the cases with papillary carcinoma in the Department of Endocrine Surgery for the past 10 years, to compare the characteristics of sporadic and familial forms of the disease and to find families with hereditary papillary carcinoma. The study included 810 patients treated for thyroid cancer in the Department of Endocrine Surgery, USBALE "Acad. Iv. Penchev" Hospital, between January 1, 2006 and December 31, 2015. We used chi square test to determine statistical significant difference. The data analysis and interpretation was performed on SPSS 20.0. Both groups had similar demographic distribution. We found that 587 patients have sporadic papillary carcinoma, while 147 have a relative with thyroid pathology in the first degree of kinship. In 8 patients, there was a blood relative with thyroid cancer. When we compared the two groups, we found statistically significant difference only in tumor size. There was no significant difference in aggressiveness of the thyroid cancer (multifocality and lymph node metastasis). When analyzing the results, we identified 147 patients with a family history of thyroid disease (20%). In 8 patients (5.44%), we found at least one relative with papillary thyroid carcinoma. However, our study does not demonstrate any difference in the aggressiveness of familial and sporadic papillary thyroid carcinoma.

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

    PubMed

    Speroni, Elisabetta; Poggi, Susanna; Vinaccia, Vincenza

    2013-10-01

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

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

    PubMed

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

    2016-05-01

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

  2. MRSA-retrospective analysis of an outbreak in the burn centre Aachen.

    PubMed

    Fuchs, Paul Ch; Kopp, Jürgen; Häfner, Helga; Kleiner, Ullrich; Pallua, Norbert

    2002-09-01

    The growing interest in methicillin-resistant Staphylococcus aureus (MRSA) has been caused by its increased appearance in hospital and community populations. In our burn centre, an outbreak of MRSA was noticed during an 8-month period. We were able to isolate MRSA in eight patients. DNA analysis by pulsed-field gel electrophoresis (PFGE) demonstrated the development of five different strains during this period. Only two patients developed an infection caused by MRSA colonisation. The infections were proven by positive blood culture or catheter colonisation. One patient developed a clinical vancomycin-resistant sepsis which was treated successfully with the additional application of Quinupristin/Dalfopristin. THIS ANALYSIS SHOWS THAT: (1) the development of MRSA in a burn unit is often created in a single patient by long-term antibiotic therapy and not a result of cross-infection, (2) manifest MRSA infection seldom occurs even in colonised burn patients, and (3) a clinically vancomycin-resistant MRSA infection in burn patients can be treated sufficiently with Quinupristin/Dalfopristin.

  3. A retrospective economic analysis of the Ontario red fox oral rabies vaccination programme.

    PubMed

    Shwiff, S A; Nunan, C P; Kirkpatrick, K N; Shwiff, S S

    2011-05-01

    Ontario initiated a red fox (Vulpes vulpes) oral rabies vaccination (ORV) programme in 1989. This study utilized a benefit-cost analysis to determine if this ORV programme was economically worthwhile. Between 1979 and 1989, prior to ORV baiting, the average annual human post-exposure treatments, positive red fox rabies diagnostic tests and indemnity payments for livestock lost to rabies were 2248, 1861 and $246,809, respectively. After baiting, from 1990 to 2000, a 35%, 66% and 41% decrease in post-exposure treatments, animal rabies tests and indemnity payments was observed, respectively. These reductions were viewed as benefits of the ORV programme, whereas total costs were those associated with ORV baiting. Multiple techniques were used to estimate four different benefit streams and the total estimated benefits ranged from $35,486,316 to $98,413,217. The annual mean ORV programme cost was $6,447,720, with total programme costs of $77,372,637. The average benefit-cost ratios over the analysis period were .49, 1.06, 1.27 and 1.36, indicating overall programme efficiency in three of the four conservative scenarios.

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

    PubMed

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

    2016-01-01

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

  5. The association between frequent alcohol drinking and opioid consumption after abdominal surgery: A retrospective analysis

    PubMed Central

    Tsai, Hsin-I; Cheng, Chih-Wen; Lin, Ta-Wei; Chen, Chien-Chuan; Lin, Chia-Shiang

    2017-01-01

    Aims It is perceived that patients with a history of frequent alcohol consumption require more opioids for postoperative pain control and experience less postoperative nausea and vomiting than patients without such a history. However, there is scarce evidence supporting this notion. The aim of this study was to assess association between frequent alcohol consumption and opioid requirement for postoperative pain control and occurrence of postoperative nausea and vomiting. Methods The medical records for 4143 patients using intravenous patient-control analgesia with opioids after abdominal surgery between January 2010 and September 2013 were obtained, and associations were sought between the cumulative opioid consumption (in intravenous morphine equivalence) per body weight (mg/kg) in the first 2 days after abdominal operation and several demographic and clinical variables by multiple regression analysis. The association between the occurrence of postoperative nausea and vomiting and several demographic and clinical variables was also sought by multiple logistic regression analysis. Results Frequent alcohol drinking, among other previously reported factors, was associated with increased opioid consumption for postoperative pain control (p < 0.001). The estimate effect of frequent alcohol drinking was 0.117 mg/kg. Frequent alcohol drinking was also associated with decreased risks of postoperative nausea (odds ratio = 0.59, p = 0.003) and vomiting (odds ratio = 0.49, p = 0.026). Conclusions Frequent alcohol drinking was associated with increased opioid consumption for postoperative pain control and decreased risks of postoperative nausea and vomiting after abdominal surgery. PMID:28301483

  6. Evolution of the Urban Heat Island of the city of Bologna (Italy) in the last 30 years

    NASA Astrophysics Data System (ADS)

    Ventura, Francesca; Gaspari, Nicola; Piana, Stefano; Rossi Pisa, Paola

    2010-05-01

    The Urban Heat Island (UHI) phenomenon is the air temperature difference between the urban area and the surrounding agricultural area of a city, due to the anthropic activities and different surfaces typical of the town. This phenomenon has been documented for many cities with different population, topography and climate (Chandler, 1962 and Oke, 1982 among the first), and has been quantified in many areas (see as an example for Italy Agnese et al, 2008). Many causes contribute to the UHI, such as different heat capacities of vegetated surfaces as compared to buildings and paving materials; different absorption due to canopy geometry; anthropogenic heat sources and so on. (for example see Camilloni and Barros, 1997) What is not so easy to find in literature is the study of the evolution of this phenomenon with time. UHI could be improved by changes in the town behaviour (increase in car traffic or winter-heating/summer-cooling), reduced by the enlargement of the suburb area, arriving to include the rural meteorological stations, or mitigated by the general growth of air temperature due to global warming. In this work, results from the analysis of two 30 years time series air temperature data are presented. The first data set comes from an agrometeorological station sited in the Botanical garden of the University of Bologna, in the centre of the town (44° 30' 05"N, 11° 21' 18" E). The second agrometeorological station is sited in the experimental farm of the University of Bologna in Cadriano (44° 33' 03" N, 11° 24' 36" E), 9 km from the first and outside of the town boundaries. Both data series range from 1978 to 2007 and are measured by mechanical thermoigrometers. Detailed information about instruments and data treatment are available in Matzneller et al. (2009). Results show an increasing trend in both stations for air maximum (Tmax) and minimum (Tmin) temperatures, more evident in the rural data. The mean UHI is of about 1.3 ± 0.7 °C as an average on the 30

  7. Analysis and organization of protein sequence data: a retrospective spanning four decades.

    PubMed

    Barker, W C; Hunt, L T

    1997-07-01

    Protein sequence data are as useful and valuable today as was envisioned by pioneering sequencers and by the organizers of the first sequence database. Sequence analysis was first the province of specialists who developed search, comparison, and tree-building methods. Microcomputers, communication satellites, and the Internet have made these methods accessible to any scientist. The rapid increase in the data has driven a succession of changes in how databases are compiled, distributed, and accessed. Large public databases have become international collaborations. Although they need to develop still more efficient ways to accumulate, organize, annotate, and standardize huge amounts of data, inadequate support is available for such efforts. Thus there will be greater reliance on direct input from the scientific community. The World Wide Web is essential but not sufficient for integrated access to related databases.

  8. Retrospective analysis of exploratory laparotomies in 192 Andalusian horses and 276 horses of other breeds.

    PubMed

    Muñoz, E; Argüelles, D; Areste, L; Miguel, L San; Prades, M

    2008-03-08

    The medical records of 468 horses that underwent 490 exploratory laparotomies for the correction of gastrointestinal diseases were reviewed to search for differences between Andalusian horses and other breeds. The seasonal distribution of surgical colics and their outcome and complications were also investigated. Bivariant analysis was used to compare the horses' age, gender and breed with the type of surgery, the bowel affected and the type of colic, and all these variables were compared in relation to euthanasia during surgery, complications, short-term survival and seasonal distribution. A total of 405 horses survived the surgery and 329 were discharged from the hospital. Horses less than one year old had better short-term survival than older horses. Andalusian horses suffered more inguinal hernias than the other breeds and were more prone to suffer laminitis as a complication. Colic surgery and inguinal hernias were also more common in the summer.

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

    PubMed

    Leslie, Julian C

    2006-07-01

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

  10. Herbert Spencer's Contributions to Behavior Analysis: A Retrospective Review of Principles of Psychology

    PubMed Central

    Leslie, Julian C

    2006-01-01

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

  11. First maintenance therapy for COPD in the UK between 2009 and 2012: a retrospective database analysis

    PubMed Central

    Price, David; Miravitlles, Marc; Pavord, Ian; Thomas, Mike; Wedzicha, Jadwiga; Haughney, John; Bichel, Katsiaryna; West, Daniel

    2016-01-01

    Clinical guidelines recommend long-acting bronchodilators as first maintenance therapy for chronic obstructive pulmonary disease (COPD), with inhaled corticosteroids (ICS) reserved for patients with more severe disease and exacerbations. The aim of this analysis was to examine real-life prescribing of first maintenance therapy for COPD in the UK. Data were extracted from the UK Optimum Patient Care Research Database for patients with a first prescription for COPD maintenance therapy between 2009 and 2012 and a diagnosis of COPD at or before the date of the first prescription for COPD maintenance therapy. Routine clinical data including demographics, disease history and symptoms, comorbidities, therapy, hospitalisation rate and exacerbation rate were collected and used to characterise patients stratified by disease severity and Global Initiative for Chronic Obstructive Lung Disease (GOLD) group (A–D). The analysis population included 2,217 individuals (55.4% male, 45.2% smokers). Long-acting muscarinic antagonists (LAMA) as monotherapy were prescribed as first maintenance therapy for 40.2% of patients. ICS were prescribed as ICS/long-acting beta-agonists combination for 29.1% of patients or as monotherapy for 15.5%. ICS (alone or in combination) were prescribed to >40% of patients in each GOLD group. ICS-containing regimens were prescribed to patients with a history of pneumonia and comorbid conditions for whom the risks of ICS therapy may outweigh the benefits. The clinical reality of prescribing indicates that ICS are often prescribed outside current guideline recommendations for many patients newly diagnosed with COPD in the UK. Encouragingly, LAMAs are increasingly being prescribed as first maintenance therapy for these patients. PMID:27808096

  12. First maintenance therapy for COPD in the UK between 2009 and 2012: a retrospective database analysis.

    PubMed

    Price, David; Miravitlles, Marc; Pavord, Ian; Thomas, Mike; Wedzicha, Jadwiga; Haughney, John; Bichel, Katsiaryna; West, Daniel

    2016-11-03

    Clinical guidelines recommend long-acting bronchodilators as first maintenance therapy for chronic obstructive pulmonary disease (COPD), with inhaled corticosteroids (ICS) reserved for patients with more severe disease and exacerbations. The aim of this analysis was to examine real-life prescribing of first maintenance therapy for COPD in the UK. Data were extracted from the UK Optimum Patient Care Research Database for patients with a first prescription for COPD maintenance therapy between 2009 and 2012 and a diagnosis of COPD at or before the date of the first prescription for COPD maintenance therapy. Routine clinical data including demographics, disease history and symptoms, comorbidities, therapy, hospitalisation rate and exacerbation rate were collected and used to characterise patients stratified by disease severity and Global Initiative for Chronic Obstructive Lung Disease (GOLD) group (A-D). The analysis population included 2,217 individuals (55.4% male, 45.2% smokers). Long-acting muscarinic antagonists (LAMA) as monotherapy were prescribed as first maintenance therapy for 40.2% of patients. ICS were prescribed as ICS/long-acting beta-agonists combination for 29.1% of patients or as monotherapy for 15.5%. ICS (alone or in combination) were prescribed to >40% of patients in each GOLD group. ICS-containing regimens were prescribed to patients with a history of pneumonia and comorbid conditions for whom the risks of ICS therapy may outweigh the benefits. The clinical reality of prescribing indicates that ICS are often prescribed outside current guideline recommendations for many patients newly diagnosed with COPD in the UK. Encouragingly, LAMAs are increasingly being prescribed as first maintenance therapy for these patients.

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

    2010-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  16. Contrasting population trends of piscivorous seabirds in the Pribilof Islands: A 30-year perspective

    USGS Publications Warehouse

    Byrd, G.V.; Schmutz, J.A.; Renner, H.M.

    2008-01-01

    The Pribilof Islands provide nesting habitat for one of the largest concentrations of piscivorous seabirds in the North Pacific region. Pribilof breeding populations of black-legged and red-legged kittiwakes (Rissa tridactyla and Rissa brevirostris), and common and thick-billed murres (Uria aalge and Uria lomvia) are supported by a highly productive marine food web. Productivity and temperature in this area are influenced by winter sea ice that frequently reaches its maximum extent near the Pribilofs. Although St. George and St. Paul islands, the two largest of the Pribilof group, are situated only 60 km apart, St. George is within 25 km of the shelf break, but St. Paul is approximately 90 km away. In contrast, the local contribution of sea ice-edge productivity in the spring is frequently closer to St. Paul than to St. George. Central place foraging piscivorous seabirds nesting at St. Paul and St. George are likely differentially affected by the relative contributions of the shelf break and ice-edge environments based on juxtaposition. Within the past decade or so, sea ice in the Bering Sea has failed to reach the vicinity of the Pribilofs in some years, and predictions of warming in the future suggest the possibility that direct effects of the ice on the immediate Pribilof environment will be reduced. To evaluate the response of kittiwakes and murres on the two islands to conditions in their foraging environments, we examined population trends over the past 30 years based on data from the seabird monitoring program conducted by the Alaska Maritime National Wildlife Refuge and others. Spatial differences in trends have been more consistent than differences among species, with populations at St. Paul having more enduring declines than those at St. George. At St. George, black-legged kittiwakes and common murres have remained stable. Red-legged kittiwakes and thick-billed murres both declined, but began to rebound in the late 1980s, such that in 2005 population

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

    PubMed Central

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

    2015-01-01

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

  18. Retrospective analysis of canine gallbladder contents in biliary sludge and gallbladder mucoceles

    PubMed Central

    MIZUTANI, Shinya; TORISU, Shidow; KANEKO, Yasuyuki; YAMAMOTO, Shushi; FUJIMOTO, Shinsuke; ONG, Benedict Huai Ern; NAGANOBU, Kiyokazu

    2016-01-01

    The pathophysiology of canine gallbladder diseases, including biliary sludge, gallbladder mucoceles and gallstones, is poorly understood. This study aimed to evaluate the component of gallbladder contents and bacterial infection of the gallbladder in order to elucidate the pathophysiology of biliary sludge and gallbladder mucoceles. A total of 43 samples of canine gallbladder contents (biliary sludge, 21 and gallbladder mucoceles, 22) were subjected to component analysis by infrared spectroscopy, and the resultant infrared spectra were compared with that of swine mucin. Of the 43 samples, 41 were also evaluated by aerobic and anaerobic bacterial culture. The contents of 20 (95.2%) biliary sludge and 22 (100%) gallbladder mucocele samples exhibited similar infrared spectra as swine mucin. Although biliary sludge and gallbladder mucocele contents exhibited similar infrared spectra, one sample of biliary sludge (4.8%) was determined to be composed of proteins. The rate of bacterial infection of the gallbladder was 10.0% for biliary sludge and 14.3% for gallbladder mucoceles. Almost all of the identified bacterial species were intestinal flora. These results indicate that the principal components of gallbladder contents in both gallbladder mucoceles and biliary sludge are mucins and that both pathophysiologies exhibit low rates of bacterial infection of the gallbladder. Therefore, it is possible that gallbladder mucoceles and biliary sludge have the same pathophysiology, and, rather than being independent diseases, they could possibly represent a continuous disease. Thus, biliary sludge could be considered as the stage preceding the appearance of gallbladder mucoceles. PMID:27990011

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

    PubMed

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

    2016-06-01

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

  20. Changes in physical fitness and nutritional status of schoolchildren in a period of 30 years (1980-2010)

    PubMed Central

    Ferrari, Gerson Luis de Moraes; Matsudo, Victor Keihan Rodrigues; Fisberg, Mauro

    2015-01-01

    Objective: To analyze and compare the changes in physical fitness according to the nutritional status and gender of schoolchildren during a period of 30 years (1980-2010). Methods: Four cross-sectional evaluations were performed every 10 years in a period of 30 years from 1978 to 1980 (baseline), 1988-1990 (10 years), 1998-2000 (20 years) and 2008-2010 (30 years). The sample consisted of 1291 schoolchildren (188 in baseline, 307 in 10 years; 375 in 20 years; 421 in 30 years) of 10 and 11 years old. The variables assessed were: body weight (kg), height (cm), upper limb strength (ULS; kg), lower limb strength (LLS; cm), agility (seconds) and velocity (seconds). Schoolchildren were classified as normal weight and overweight according to World Health Organization reference of body mass index for age and gender. Comparisons among periods applied ANOVA followed by Bonferroni test, with a significance level set at of p<0.01. Variation between baseline and 30 years was assessed by the percentage delta. Seven different percentile values were presented for each variable. Results: In eutrophic boys and girls, mean values of ULS (−16.7%; −3.2%), agility (−1.5%; −1.6%) decreased significantly after 30 years (p<0.001). In the overweight boys and girls, only the average ULS (−15.5%; −12.5%) decreased significantly over time (p<0.001). After 30 years, the ULS percentile changed in boys. Conclusions: The decline in physical fitness was greater in schoolchildren with normal weight than in those with overweight. PMID:26298653

  1. Congenital lobar emphysema: 30-year case series in two university hospitals*

    PubMed Central

    Cataneo, Daniele Cristina; Rodrigues, Olavo Ribeiro; Hasimoto, Erica Nishida; Schmidt, Aurelino Fernandes; Cataneo, Antonio José Maria

    2013-01-01

    OBJECTIVE: To review the cases of patients with congenital lobar emphysema (CLE) submitted to surgical treatment at two university hospitals over a 30-year period. METHODS: We reviewed the medical records of children with CLE undergoing surgical treatment between 1979 and 2009 at the Botucatu School of Medicine Hospital das Clínicas or the Mogi das Cruzes University Hospital. We analyzed data regarding symptoms, physical examination, radiographic findings, diagnosis, surgical treatment, and postoperative follow-up. RESULTS: During the period studied, 20 children with CLE underwent surgery. The mean age at the time of surgery was 6.9 months (range, 9 days to 4 years). All of the cases presented with symptoms at birth or during the first months of life. In all cases, chest X-rays were useful in defining the diagnosis. In cases of moderate respiratory distress, chest CT facilitated the diagnosis. One patient with severe respiratory distress was misdiagnosed with hypertensive pneumothorax and underwent chest tube drainage. Only patients with moderate respiratory distress were submitted to bronchoscopy, which revealed no tracheobronchial abnormalities. The surgical approach was lateral muscle-sparing thoracotomy. The left upper and middle lobes were the most often affected, followed by the right upper lobe. Lobectomy was performed in 18 cases, whereas bilobectomy was performed in 2 (together with bronchogenic cyst resection in 1 of those). No postoperative complications were observed. Postoperative follow-up time was at least 24 months (mean, 60 months), and no late complications were observed. CONCLUSIONS: Although CLE is an uncommon, still neglected disease of uncertain etiology, the radiological diagnosis is easily made and surgical treatment is effective. PMID:24068262

  2. High methane emissions dominate annual greenhouse gas balances 30 years after bog rewetting

    NASA Astrophysics Data System (ADS)

    Vanselow-Algan, M.; Schmidt, S. R.; Greven, M.; Fiencke, C.; Kutzbach, L.; Pfeiffer, E.-M.

    2015-02-01

    Natural peatlands are important carbon sinks and sources of methane (CH4). In contrast, drained peatlands turn from a carbon sink to a carbon source and potentially emit nitrous oxide (N2O). Rewetting of peatlands thus implies climate change mitigation. However, data about the time span that is needed for the re-establishment of the carbon sink function by restoration is scarce. We therefore investigated the annual greenhouse gas (GHG) balances of three differently vegetated bog sites 30 years after rewetting. All three vegetation communities turned out to be sources of carbon dioxide (CO2) ranging between 0.6 ± 1.43 t CO2 ha-2 yr-1 (Sphagnum-dominated vegetation) and 3.09 ± 3.86 t CO2 ha-2 yr-1 (vegetation dominated by heath). While accounting for the different global warming potential (GWP) of the three greenhouse gases, the annual GHG balance was calculated. Emissions ranged between 25 and 53 t CO2-eq ha-1 yr-1 and were dominated by large emissions of CH4 (22 up to 51 t CO2-eq ha-1 yr-1), while highest rates were found at purple moor grass (Molinia caerulea) stands. These are to our knowledge the highest CH4 emissions so far reported for bog ecosystems in temperate Europe. As the restored area was subject to large fluctuations in water table, we conclude that the high CH4 emission rates were caused by a combination of both the temporal inundation of the easily decomposable plant litter of this grass species and the plant-mediated transport through its tissues. In addition, as a result of the land use history, the mixed soil material can serve as an explanation. With regards to the long time span passed since rewetting, we note that the initial increase in CH4 emissions due to rewetting as described in the literature is not limited to a short-term period.

  3. CT imaging, then and now: a 30-year review of the economics of computed tomography.

    PubMed

    Stockburger, Wayne T

    2004-01-01

    The first computed tomography (CT) scanner in the US was installed in June 1973 at the Mayo Clinic in Rochester, MN. By the end of 1974, 44 similar systems had been installed at medical facilities around the country. Less than 4 years after the introduction of CT imaging in the US, at least 400 CT systems had been installed. The practice of pneumoencephalography was eliminated. The use of nuclear medicine brain scans significantly diminished. At the time, CT imaging was limited to head studies, but with the introduction of contrast agents and full body CT systems the changes in the practice of medicine became even more significant. CT imaging was hailed by the US medical community as the greatest advance in radiology since the discovery of x-rays. But the rapid spread of CT systems, their frequency of use, and the associated increase in healthcare costs combined to draw the attention of decision-makers within the federal and state governments, specifically to establish policies regarding the acquisition and use of diagnostic technologies. Initially, CT imaging was limited to neurological applications, but in the 30 years since its inception, capabilities and applications have been expanded as a result of the advancements in technology and software development. While neurological disorders are still a common reason for CT imaging, many other medical disciplines (oncology, emergency medicine, orthopedics, etc.) have found CT imaging to be the definitive tool for diagnostic information. As such, the clinical demand for CT imaging has steadily increased. Economically, the development of CT imaging has been one of success, even in the face of governmental action to restrict its acquisition and utilization by healthcare facilities. CTimaging has increased the cost of healthcare, but in turn has added unquantifiable value to the practice of medicine in the US.

  4. Multiscale structure of the MJO revealed from 30-year satellite data

    NASA Astrophysics Data System (ADS)

    Kikuchi, K.; Kiladis, G. N.; Dias, J.; Nasuno, T.

    2015-12-01

    How the intangible convective envelope of the MJO is made up of organized deep convection has been of particular interest, because it is the key to understand the physics and dynamics of the MJO from the viewpoint of multiscale interactions. We explored the multiscale convective structure of the MJO using 30-year (1983.7-2013) high-resolution satellite date taking advantage of the spatio-temporal wavelet transform (STWT), which is able to localize the space-time spectral characteristics of cloudiness in both space and time. Namely, the multiscale structure of the MJO can be interpreted in terms of a sum of a variety of so-called convectively coupled equatorial waves (CCEWs). It is found that a range of CCEWs tend to be enhanced in the MJO convective envelope, whereas the types of CCEWs with characteristic space-time scales vary seasonally, geographically, and even from event to event. It is thus difficult to find a universal multiscale structure of the MJO, although there is a tendency for the MJO to prefer certain types of CCEWs including Kelvin waves and n=1 westward inertio-gravity (WIG) waves. Within the MJO convective envelope, those waves tend to be enhanced by as large as 100 % compared to the climatological values and Kelvin waves tend to have much slower phase speed of about 9 m s-1 or less (i.e., equivalent depth of ~8 m) as opposed to the climatological mean values (equivalent depths of 25-90 m) and n=1 WIG waves tend to have 2 day periodicity. Such strong modulation effect, however, is less pronounced over the Maritime continent. The historical database we created will be useful to place the convective systems of the MJO during the CINDY/DYNAMO and the future YMC field campaigns in the historical context.

  5. [Tubulo-villous rectal tumours. Results of surgical resection in relation to histotype (30 years' experience)].

    PubMed

    Carditello, Antonio; Milone, Antonino; Paparo, Domenica; Anastasi, Giuliana; Mollo, Francesco; Stilo, Francesco

    2004-01-01

    Adenomas of the rectum are frequently found during endoscopic examination. We report on our 30 years of experience with the treatment of tubulo-villous adenomas based on histotype. Between 1971 and 2001, 104 villous tumours of the rectum were treated surgically. The patients' average age was 65 years. These were sessile tumours in 69% of cases, pedunculated in 17.5% and flowing tumours in 13.5%. The mean tumour size was 3 cm. They were associated with colon cancer in 15% of cases and with polyadenoma in 10%. They were located in the rectum within 0 to 6 cm of the anal margin in half the cases. These tumours were treated by local excision in 74 cases and by wide excision in 30 cases. The malignant potential of the tumours was 30%, including 10% invasive malignancy. There were no surgical fatalities, but a 6% medical fatality rate was registered. There was a 20% complication rate related to the surgical technique. Twenty patients were lost to follow-up. Out of 84 villous tumours, monitored over a mean survival period of 6.5 years, there were 24 recurrences: 18 underwent endoscopic excision and in 6 cases a wide resection. The various tumour resection techniques and the operative indications of variable difficulty are presented. It would seem, at present, that total resection of the rectum with a colo-anal anastomosis is the best treatment for large flowing villous tumours occupying almost the entire rectum. Thorough preoperative examination and the mastering of various surgical procedures should allow the most suitable choice of treatment for each individual case.

  6. A 30-year history of earthquake crisis communication in California and lessons for the future

    NASA Astrophysics Data System (ADS)

    Jones, L.

    2015-12-01

    The first statement from the US Geological Survey to the California Office of Emergency Services quantifying the probability of a possible future earthquake was made in October 1985 about the probability (approximately 5%) that a M4.7 earthquake located directly beneath the Coronado Bay Bridge in San Diego would be a foreshock to a larger earthquake. In the next 30 years, publication of aftershock advisories have become routine and formal statements about the probability of a larger event have been developed in collaboration with the California Earthquake Prediction Evaluation Council (CEPEC) and sent to CalOES more than a dozen times. Most of these were subsequently released to the public. These communications have spanned a variety of approaches, with and without quantification of the probabilities, and using different ways to express the spatial extent and the magnitude distribution of possible future events. The USGS is re-examining its approach to aftershock probability statements and to operational earthquake forecasting with the goal of creating pre-vetted automated statements that can be released quickly after significant earthquakes. All of the previous formal advisories were written during the earthquake crisis. The time to create and release a statement became shorter with experience from the first public advisory (to the 1988 Lake Elsman earthquake) that was released 18 hours after the triggering event, but was never completed in less than 2 hours. As was done for the Parkfield experiment, the process will be reviewed by CEPEC and NEPEC (National Earthquake Prediction Evaluation Council) so the statements can be sent to the public automatically. This talk will review the advisories, the variations in wording and the public response and compare this with social science research about successful crisis communication, to create recommendations for future advisories

  7. [Dynamics of major forest vegetations in Tiantong National Forest Park during the last 30 years].

    PubMed

    Wu, Yang-Yang; Guo, Chun-Zi; Ni, Jian

    2014-06-01

    The study of vegetation succession and development is not only one of the hot spots of modern ecology, but also a key issue of the sustainable development of human society, especially under the circumstances of climate change and anthropogenic disturbance. A comparison of forest communities in the Tiantong National Forest Park (TNFP) in Zhejiang Province, eastern China from 1982 to 2012 was performed. Six forests in the park were investigated, including the typical evergreen broadleaved forest (EBLF, three sub-associations), evergreen and deciduous broad-leaved mixed forest (EDBLMF), evergreen conifer forest (ECF) and bamboo forest (BF). Data from two field investigations in 1982 and 2012, respectively, were used to analyze the changes of species composition, community structure and species diversity during the past 30 years. The spatial pattern and community structure of the forest vegetation in the TNFP did not obviously change. The spatial distribution of plant communities did not significantly shifted. The proportion of young trees and individuals in small diameters increased. The regeneration status of communities was healthy and the natural regeneration ability of communities was enhanced. The species diversity of the TNFP forests showed an increasing trend in the tree layer and a decreasing trend in the shrub and herb layers. Meanwhile, the evergreen component increased. Along with the changed climate, forest vegetation in the TNFP was developing towards the forward succession. Species diversity, especially the trees, increased with the increase of temperature. This demonstrated that, on one hand, forest vegetation in Tiantong had been well protected; on the other hand, there was a potential positive relationship between the EBLF succession and climate change.

  8. A survey of health care and disease in geriatric horses aged 30 years or older.

    PubMed

    Ireland, Joanne L; McGowan, Catherine M; Clegg, Peter D; Chandler, Keith J; Pinchbeck, Gina L

    2012-04-01

    This study reports on aspects of preventive health care and on the prevalence of disease in geriatric (≥30 years old) horses and ponies in North-West England and North Wales. Of 128 questionnaires mailed to horse owners, 87 useable responses were received and 69 horses were subject to veterinary examination. Of the animals examined, 16% were underweight with body condition scores (BCS)<2/5, and 10% were overweight (BCS>3/5). This contrasted with the owner responses that reported 23% of the animals surveyed to be underweight and only 3% to be overweight. When assessed at trot, 77% of the horses were lame on at least one limb, with 97% having a reduced range of motion in at least one joint. Only 16% of these animals were reported by owners to have been lame within the previous 12 months. Owner-reported changes to hair coat were significantly associated with hirsutism or abnormal moulting detected at clinical examination (39%). At least one ophthalmic lesion was identified in all of the horses and ponies examined and 17% of owners reported that their animal had experienced visual problems within the previous year. Although dental abnormalities were detected in all animals where an oral examination was performed, only 42% of owners reported that their horse suffered from a known dental disorder. In general, despite a high prevalence of disease detected in these geriatric animals and with the majority having multiple abnormalities at clinical examination, there was under-reporting/under-recognition of these health problems by owners.

  9. 30 years of upper air soundings on board of R/V POLARSTERN

    NASA Astrophysics Data System (ADS)

    Driemel, Amelie; Loose, Bernd; Grobe, Hannes; Sieger, Rainer; König-Langlo, Gert

    2016-06-01

    The research vessel and supply icebreaker POLARSTERN is the flagship of the Alfred-Wegener-Institut in Bremerhaven (Germany) and one of the infrastructural pillars of German Antarctic research. Since its commissioning in 1982, POLARSTERN has conducted 30 campaigns to Antarctica (157 legs, mostly austral summer), and 29 to the Arctic (94 legs, northern summer). Usually, POLARSTERN is more than 300 days per year in operation and crosses the Atlantic Ocean in a meridional section twice a year. The first radiosonde on POLARSTERN was released on the 29 December 1982, 2 days after POLARSTERN started on its maiden voyage to the Antarctic. And these daily soundings have continued up to the present. Due to the fact that POLARSTERN has reliably and regularly been providing upper air observations from data sparse regions (oceans and polar regions), the radiosonde data are of special value for researchers and weather forecast services alike. In the course of 30 years (29 December 1982 to 25 November 2012) a total of 12 378 radiosonde balloons were started on POLARSTERN. All radiosonde data can now be found at König-Langlo (2015, doi:10.1594/PANGAEA.810000). Each data set contains the directly measured parameters air temperature, relative humidity and air pressure, and the derived altitude, wind direction and wind speed. 432 data sets additionally contain ozone measurements.Although more sophisticated techniques (meteorological satellites, aircraft observation, remote-sensing systems, etc.) have nowadays become increasingly important, the high vertical resolution and quality of radiosonde data remains paramount for weather forecasts and modelling approaches.

  10. Alma-Ata 30 years on: revolutionary, relevant, and time to revitalise.

    PubMed

    Lawn, Joy E; Rohde, Jon; Rifkin, Susan; Were, Miriam; Paul, Vinod K; Chopra, Mickey

    2008-09-13

    In this paper, we revisit the revolutionary principles-equity, social justice, and health for all; community participation; health promotion; appropriate use of resources; and intersectoral action-raised by the 1978 Alma-Ata Declaration, a historic event for health and primary health care. Old health challenges remain and new priorities have emerged (eg, HIV/AIDS, chronic diseases, and mental health), ensuring that the tenets of Alma-Ata remain relevant. We examine 30 years of changes in global policy to identify the lessons learned that are of relevance today, particularly for accelerated scale-up of primary health-care services necessary to achieve the Millennium Development Goals, the modern iteration of the "health for all" goals. Health has moved from under-investment, to single disease focus, and now to increased funding and multiple new initiatives. For primary health care, the debate of the past two decades focused on selective (or vertical) versus comprehensive (horizontal) delivery, but is now shifting towards combining the strengths of both approaches in health systems. Debates of community versus facility-based health care are starting to shift towards building integrated health systems. Achievement of high and equitable coverage of integrated primary health-care services requires consistent political and financial commitment, incremental implementation based on local epidemiology, use of data to direct priorities and assess progress, especially at district level, and effective linkages with communities and non-health sectors. Community participation and intersectoral engagement seem to be the weakest strands in primary health care. Burgeoning task lists for primary health-care workers require long-term human resource planning and better training and supportive supervision. Essential drugs policies have made an important contribution to primary health care, but other appropriate technology lags behind. Revitalisng Alma-Ata and learning from three

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

    SciTech Connect

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

    2005-11-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2002-10-01

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

  13. [PEG tube placement in German geriatric wards - a retrospective data-base analysis].

    PubMed

    Wirth, R; Volkert, D; Bauer, J M; Schulz, R J; Borchelt, M; Fleischhauer, C; Steinhagen-Thiessen, E; Sieber, C C

    2007-02-01

    The placement of a percutaneous endoscopic gastrostomy (PEG) is a safe and widely accepted method of artificial enteral nutrition. In Germany, PEG placement is performed approximately 140,000 times a year, about 65% of them in elderly patients. Yet indications for PEG placement in the elderly, as well as the health and functional status of these patients are unexplored in Germany. To draw conclusions about the indication for PEG placement, the health status and the further development of patients undergoing PEG in acute geriatric wards, we performed an analysis of the 2004 annual data set of the German Gemidas database. The Gemidas database is an instrument of voluntary quality assurance, where the treatment data of patients in German geriatric hospital units are registered. Data of 40 acute geriatric hospital units with 27,775 patients and 393 PEG tube placements were analyzed. According to the database items, we received information about the incidence of PEG placement, nutrition-relevant treatment diagnosis, patients age, functional and mental status, length of hospital stay, where patients were admitted from and discharged to and the hospital mortality of geriatric patients with and without PEG placement. In 1.4% of all treatment cases, a PEG was inserted. PEG placement was mainly performed in patients with the treatment diagnosis stroke (65.1%) and dysphagia (64.1%). The functional status of patients with PEG tube placement was very poor, with an Barthel Index of 8.2 (+/- 14.6) points at admission. Due to the severity of the disease and in concordance with existing data the overall hospital mortality of patients undergoing PEG placement was 17.6%, which is higher than in patients without PEG placement (4.3%). In all 27 775 analyzed geriatric patients, a diagnosis related to malnutrition was coded in only 7.0%, although sufficient data show a prevalence of about 50% in elderly hospital patients.

  14. A Retrospective Analysis of Radiographic Jaw Findings in Young Women; Prevalence and Predictors

    PubMed Central

    El Khateeb, Sara M.; Abu-Hammad, Osama; Fadel, Hani; Dar-Odeh, Najla

    2017-01-01

    Aims and Objectives: To determine the prevalence and types of jaw pathologic findings as detected in panoramic radiographs of a sample of young women attending a teaching hospital in Al Madinah Al Munawarah, Saudi Arabia, and to determine the most important factors that predict the occurrence of jaw pathologic findings. Materials and Methods: The electronic clinical files of a representative sample of female patients who attended the outpatient dental clinics were retrieved. Patients were aged 18 to 25 years. Types of pathologic radiographic jaw findings and their prevalence were determined through screening of panoramic radiographs. Data were analyzed using the statistical analysis software [SPSS version 21 (IBM Corp.)]. Multiple linear regression was used to explore the significance of some types of dental lesions as predictor variables for the occurrence of jaw pathologic findings. Results: A total of 190 patients (mean age, 22.4 ± 2.46 years) were included in the study. Periapical lesions, retained roots, and alveolar bone loss were detected in 53.6%, 24.8%, and 17.4% of the participants, respectively. Other odontogenic abnormalities such as supernumerary and impacted teeth (6.4% and 33.7%, respectively) were also detected. Patients' age was found to be a good predictor for alveolar bone loss and number of periapical lesions (P ≤ 0.05). Conclusions: A high prevalence of periapical lesions, retained roots, and alveolar bone loss was found among a sample of young female dental attendees, as shown by their panoramic radiographs. Further studies are needed to explore potential risk factors for such a noticeable trend of poor oral health, and the needed strategies to counteract this trend. PMID:28316945

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

    PubMed

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

    2004-01-01

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

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

    PubMed Central

    2011-01-01

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

  17. Contraceptive confidence and timing of first birth in Moldova: an event history analysis of retrospective data

    PubMed Central

    Lyons-Amos, Mark; Padmadas, Sabu S; Durrant, Gabriele B

    2014-01-01

    Objectives To test the contraceptive confidence hypothesis in a modern context. The hypothesis is that women using effective or modern contraceptive methods have increased contraceptive confidence and hence a shorter interval between marriage and first birth than users of ineffective or traditional methods. We extend the hypothesis to incorporate the role of abortion, arguing that it acts as a substitute for contraception in the study context. Setting Moldova, a country in South-East Europe. Moldova exhibits high use of traditional contraceptive methods and abortion compared with other European countries. Participants Data are from a secondary analysis of the 2005 Moldovan Demographic and Health Survey, a nationally representative sample survey. 5377 unmarried women were selected. Primary and secondary outcome measures The outcome measure was the interval between marriage and first birth. This was modelled using a piecewise-constant hazard regression, with abortion and contraceptive method types as primary variables along with relevant sociodemographic controls. Results Women with high contraceptive confidence (modern method users) have a higher cumulative hazard of first birth 36 months following marriage (0.88 (0.87 to 0.89)) compared with women with low contraceptive confidence (traditional method users, cumulative hazard: 0.85 (0.84 to 0.85)). This is consistent with the contraceptive confidence hypothesis. There is a higher cumulative hazard of first birth among women with low (0.80 (0.79 to 0.80)) and moderate abortion propensities (0.76 (0.75 to 0.77)) than women with no abortion propensity (0.73 (0.72 to 0.74)) 24 months after marriage. Conclusions Effective contraceptive use tends to increase contraceptive confidence and is associated with a shorter interval between marriage and first birth. Increased use of abortion also tends to increase contraceptive confidence and shorten birth duration, although this effect is non-linear—women with a very high

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

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

    PubMed Central

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

    2015-01-01

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

  20. A retrospective analysis of oral cholera vaccine use, disease severity and deaths during an outbreak in South Sudan

    PubMed Central

    Bekolo, Cavin Epie; van Loenhout, Joris Adriaan Frank; Rodriguez-Llanes, Jose Manuel; Rumunu, John; Ramadan, Otim Patrick

    2016-01-01

    Abstract Objective To determine whether pre-emptive oral cholera vaccination reduces disease severity and mortality in people who develop cholera disease during an outbreak. Methods The study involved a retrospective analysis of demographic and clinical data from 41 cholera treatment facilities in South Sudan on patients who developed cholera disease between 23 April and 20 July 2014 during a large outbreak, a few months after a pre-emptive oral vaccination campaign. Patients who developed severe dehydration were regarded as having a severe cholera infection. Vaccinated and unvaccinated patients were compared and multivariate logistic regression analysis was used to identify factors associated with developing severe disease or death. Findings In total, 4115 cholera patients were treated at the 41 facilities: 1946 (47.3%) had severe disease and 62 (1.5%) deaths occurred. Multivariate analysis showed that patients who received two doses of oral cholera vaccine were 4.5-fold less likely to develop severe disease than unvaccinated patients (adjusted odds ratio, aOR: 0.22; 95% confidence interval, CI: 0.11–0.44). Moreover, those with severe cholera were significantly more likely to die than those without (aOR: 4.76; 95% CI: 2.33–9.77). Conclusion Pre-emptive vaccination with two doses of oral cholera vaccine was associated with a significant reduction in the likelihood of developing severe cholera disease during an outbreak in South Sudan. Moreover, severe disease was the strongest predictor of death. Two doses of oral cholera vaccine should be used in emergencies to reduce the disease burden. PMID:27708472

  1. [Medicolegal experiences in external post-mortem examinations before cremation--a retrospective analysis of the years 1998-2008].

    PubMed

    Eckstein, Philipp; Schyma, Christian; Madea, Burkhard

    2010-01-01

    The paper presents a retrospective analysis of 16,541 external post-mortem examinations carried out before cremation by the Institute of Forensic Medicine of the University of Bonn between 1998 and 2008 with regard to different variables (age, sex, place of death, cause of death etc.). In more than 50 % of cases, the individuals had died in a hospital followed by their apartment or a nursing home. The first post-mortem examination was mainly performed by hospital doctors followed by emergency doctors and office practitioners. As to the age distribution, the 6th to 8th decade of life was prevalent. In 99.8 %, a natural death was certified in the first external post-mortem and only in 0.2 % the manner of death was determined to be non-natural or unclear. In more than half of the cases, the non-natural deaths were determined by emergency doctors. Deaths wrongly classified in the first external post-mortem were mostly accidents and deaths associated with medical procedures. Although the second external examination before cremation is very useful in detecting previously overlooked signs of homicide, it is only of limited value in homicides with few external traces or for detecting underlying diseases and causes of death. In this respect, the second external examination before cremation can only check the plausibility of the cause of death given by the attending physician. The gold standard for a reliable certification of the manner and cause of death remains the autopsy.

  2. Comparative analysis of kinesiotherapy rehabilitation after hip arthroscopy, quantified by harris and vail hip scores: a retrospective study

    PubMed Central

    Saavedra, Melissa; Moraga, Ricardo; Diaz, Patricia; Camacho, Daniel; Mardones, Rodrigo

    2016-01-01

    Summary Background It has been proven that femoroacetabular impingement cases improve following arthroscopic surgery. However, rehabilitation has a major role in the patient’s recovery. The protocol used by our institution consists of an evidence-based guideline for the different phases of rehabilitation. Objective Describe and determine the effectiveness of our institution’s kinesiotherapy rehabilitation program during 2011–2016, comparing Harris and Vail Hip Scores scales (HHS and VHS, respectively) at the beginning of each treatment phase. Materials and methods This is an observational, descriptive, longitudinal and retrospective study which, from a total of 684 subjects who underwent surgery, and 103 subjects who followed our institution’s rehabilitation program, ultimately uses a sample of 48 subjects for analysis; these subjects were included because they completed the scales on the three occasions determined. Results Significant exact differences were found in: multivariate contrasts HHS (F=147.420; p=0.000); VHS (F=82,160; p=0,000). Mauchly’s sphericity test: HHS (W=0.722; p=0.001); VHS (W=0.830; p=0.014). The within-subject effect showed significant exact differences in: HHS (F=169.451; p=0.000); VHS (F=115.387; p=0.000). Conclusion Results showed significant exact differences p=0.00. In spite of its limitations, this study provides a guideline for a patient’s safe return to daily life activities. Level of evidence IV. PMID:28066749

  3. Efficacy of methotrexate/vinblastine/doxorubicin cisplatin combination in gemcitabine-pretreated patients with advanced urothelial cancer: a retrospective analysis

    PubMed Central

    Karadimou, Alexandra; Lianos, Evangelos; Pectasides, Dimitrios; Dimopoulos, Meletios A; Bamias, Aristotle

    2010-01-01

    Objective Second-line treatment options in advanced urothelial cancer are limited. We investigated the efficacy of a methotrexate/vinblastine/doxorubicin/cisplatin (MVAC) combination after failure of gemcitabine/platinum chemotherapy. Patients and methods Twenty-five patients with advanced urothelial cancer, who received second-line MVAC after first-line gemcitabine/cisplatin (n = 9) or gemcitabine/carboplatin (n = 16), were included in this retrospective analysis. Results Twenty-two patients (88%) relapsed within 6 months after first-line treatment. Following MVAC, there were 5 (20%) objective responses. Median follow-up was 20.2 months. Median progression-free survival (PFS) was 3.8 months (95% CI: 2.3–5.2), and median overall survival (OS) was 9 months (95% CI: 6.6–11.4). Eastern Cooperative Oncology Group performance status 0.1 versus 2 was associated with longer PFS (5 months versus 3.3 months, P = 0.049). Response or stabilization of disease during second-line chemotherapy predicted for a significantly longer PFS and OS (7.4 versus 3.5, P = 0.005; 15.5 versus 7, P = 0.046). Conclusions Second-line MVAC chemotherapy may result in prolonged survival in some patients with refractory disease. Further research in this field is necessary. PMID:24198628

  4. The threshold of hypothyroidism after radiation therapy for head and neck cancer: a retrospective analysis of 116 cases.

    PubMed

    Fujiwara, Masayuki; Kamikonya, Norihiko; Odawara, Soichi; Suzuki, Hitomi; Niwa, Yasue; Takada, Yasuhiro; Doi, Hiroshi; Terada, Tomonori; Uwa, Nobuhiro; Sagawa, Kosuke; Hirota, Shozo

    2015-05-01

    The purpose of the present study was to determine the risk factors for developing thyroid disorders based on a dose-volume histograms (DVHs) analysis. Data from a total of 116 consecutive patients undergoing 3D conformal radiation therapy for head and neck cancers was retrospectively evaluated. Radiation therapy was performed between April 2007 and December 2010. There were 108 males and 8 females included in the study. The median follow-up term was 24 months (range, 1-62 months). The thyroid function was evaluated by measuring thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels. The mean thyroid dose, and the volume of thyroid gland spared from doses ≥10, 20, 30 and 40 Gy (VS10, VS20, VS30 and VS40) were calculated for all patients. The thyroid dose and volume were calculated by the radiotherapy planning system (RTPS). The cumulative incidences of hypothyroidism were 21.1% and 36.4% at one year and two years, respectively, after the end of radiation therapy. In the DVH analyses, the patients who received a mean thyroid dose <30 Gy had a significantly lower incidence of hypothyroidism. The univariate analyses showed that the VS10, VS20, VS30 and VS40 were associated with the risk of hypothyroidism. Hypothyroidism was a relatively common type of late radiation-induced toxicity. A mean thyroid dose of 30 Gy may be a useful threshold for predicting the development of hypothyroidism after radiation therapy for head and neck cancers.

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

    PubMed

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

    2016-02-01

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

  6. Retrospective analysis of application of compressive sensing to 1H MR metabolic imaging of the human brain

    NASA Astrophysics Data System (ADS)

    Geethanath, Sairam; Baek, Hyeonman; Kodibagkar, Vikram D.

    2010-03-01

    Magnetic resonance spectroscopic imaging (MRSI) has been shown to provide valuable information about the biochemistry of the anatomy of interest and thus has been increasingly used in clinical research. However, the long acquisition time associated with multidimensional MRSI is a barrier for translation of this technology to the clinic. A novel approach using the application of compressive sensing, to reduce the acquisition time of MRSI is proposed. Reconstruction of data, simulated to be acquired through compressed sensing is implemented on a computer generated phantom simulating two metabolites of the human brain. The effect of Gaussian noise on this phantom is evaluated. A retrospective analysis of the application of such a reconstruction method for 1H MRSI of previously acquired in vitro brain phantom MRSI data is performed for the first time. On comparison of the reconstruction of the in vitro and computer generated phantoms from undersampled data to that performed from complete k-space; the errors in reconstruction was less than 1%. This indicates that our approach has a significant potential to reduce acquisition times for MRSI studies by 50% which could aid in MRSI being routinely used in the clinic.

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

    PubMed Central

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

    2016-01-01

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

  8. Analysis of seasonal changes in residual refraction 1-year after corneal laser refractive surgery: a retrospective study

    PubMed Central

    Luger, Michiel H.A.; Ewering, Tobias; Arba-Mosquera, Samuel

    2014-01-01

    Purpose To analyze the effect of seasonal changes in residual refraction 1-year after corneal refractive surgery using the SCHWIND AMARIS laser system. Methods 5740 consecutive treatments have been retrospectively reviewed. For all eyes, aspheric treatments were planned with the Custom Ablation Manager software and the ablations were performed with the SCHWIND AMARIS system (SCHWIND eye-tech-solutions). Seasonal outcomes were evaluated in terms of residual refraction stratified per treatment month, as well as stratified per year season. Student's T test comparing stratified values with global ones was used for the statistical analysis. Results Treatments performed in April, June, August, September, and October showed relative undercorrections of the spherical equivalent (SE) (−0.09D), whereas treatments performed in January, February, and March showed relative overcorrections of the SE (+0.13D). Similarly, treatments performed in spring and summer showed relative undercorrections of the SE (−0.04D), whereas treatments performed in winter showed relative overcorrections of the SE (+0.10D). Conclusions Seasonal differences in refractive outcomes were observed among a large scale population. The effect of these environmental variables on refractive outcomes warrants further evaluation. PMID:25000869

  9. A retrospective analysis of personality disorder presentations in a Canadian university-affiliated hospital’s emergency department

    PubMed Central

    Penfold, Sarah; Groll, Dianne; Mauer-Vakil, Dane; Pikard, Jennifer; Yang, Megan

    2016-01-01

    Background Individuals with personality disorders often have extensive involvement with healthcare services including frequent utilisation of emergency departments. Aims The aim of this study was to identify factors associated with emergency department presentations by individuals with personality disorders. Method A 12-month retrospective data analysis of all mental-health-related emergency department visits was performed. Age, gender, time and season of presentation, length of stay, mode of arrival and discharge arrangements for individuals with personality disorders were compared to individuals with other psychiatric diagnoses. Results There were 336 visits by individuals with personality disorders and 5290 visits by individuals with other psychiatric diagnoses. Individuals with personality disorders were significantly more likely to be female, young adults, brought in by police, arrive in the evening, discharged home and have a longer median length of stay. Conclusion Knowing what factors are associated with emergency department presentations by individuals with personality disorders can help ensure that appropriately trained support staff are available. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:27990295

  10. Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis.

    PubMed

    Passos, L N; Araújo Filho, O F; Andrade Junior, H F

    2000-01-01

    We conducted a retrospective analysis of Toxoplasma encephalitis patients from Instituto de Infectologia Emílio Ribas, the main AIDS hospital of São Paulo, Brazil, during two different stages of the HIV epidemics, in 1988 (38 patients) and 1991 (33 patients). There were AIDS-related demographic differences, but the clinical presentation and diagnostic efficiency were similar, usually based on tomography and clinical response to therapy, with a clear distinction from other CNS infections, based on clinical and laboratory findings. Specific serologic studies were performed less often in 1991, with a high frequency of therapy change. The direct acute death rate from Toxoplasma encephalitis was high during both periods, i.e. 8/38 in 1988 and 10/33 in 1991. The direct acute death rate for the patients from the two periods as a whole was 25.4% (18/71), related to the time of HIV infection, absence of fever and presence of meningeal irritation at presentation, blood leukocytes higher than 10,000/mm3 and blood lymphocytes lower than 350/mm3. Toxoplasma encephalitis is a preventable disease when adequate prophylactic therapy is used and is relatively easy to treat in diagnosed HIV patients. Unfortunately, this severe and deadly disorder is the HIV diagnostic disease in several patients, and our data support the need for careful management of these patients, especially in those countries with a high toxoplasmosis prevalence where AIDS is concurrent with economic and public health problems.

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

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

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

  12. Discharge, water temperature, and water quality of Warm Mineral Springs, Sarasota County, Florida: A retrospective analysis

    USGS Publications Warehouse

    Metz, Patricia A.

    2016-09-27

    characterized by a slight-green color, with varying water clarity, low dissolved oxygen (indicative of deep groundwater), and a hydrogen sulfide odor. Water-quality samples detected ammonium-nitrogen and nitrates, but at low concentrations. The drinking water standard for nitrate adopted by the U.S. Environmental Protection Agency is 10 milligrams per liter, measured as nitrogen. Water samples collected at spring vents by divers on April 29, 2015, had concentrations of 0.9 milligram per liter nitrate-nitrogen at vent A and 0.04–0.05 milligram per liter at vents B, C, and D. Typically, the water clarity is highest in the morning (about 30 feet Secchi depth) and often decreases throughout the day.Analysis of existing data provided some insight into the hydrologic processes affecting Warm Mineral Springs; however, data have been sparsely and discontinuously collected since the 1940s. Continuous monitoring of hydrologic characteristics such as discharge, water temperature, specific conductance, and water-quality indicators, such as nitrate and turbidity (water clarity), would be valuable for monitoring and development of models of spring discharge and water quality. In addition, water samples could be analyzed for isotopic tracers, such as strontium, and the results used to identify and quantify the sources of groundwater that discharge at Warm Mineral Springs. Groundwater flow/transport models could be used to evaluate the sensitivity of the quality and quantity of water flowing from Warm Mineral Springs to changes in climate, aquifer levels, and water use.

  13. High methane emissions dominated annual greenhouse gas balances 30 years after bog rewetting

    NASA Astrophysics Data System (ADS)

    Vanselow-Algan, M.; Schmidt, S. R.; Greven, M.; Fiencke, C.; Kutzbach, L.; Pfeiffer, E.-M.

    2015-07-01

    Natural peatlands are important carbon sinks and sources of methane (CH4). In contrast, drained peatlands turn from a carbon sink to a carbon source and potentially emit nitrous oxide (N2O). Rewetting of peatlands thus potentially implies climate change mitigation. However, data about the time span that is needed for the re-establishment of the carbon sink function by restoration are scarce. We therefore investigated the annual greenhouse gas (GHG) balances of three differently vegetated sites of a bog ecosystem 30 years after rewetting. All three vegetation communities turned out to be sources of carbon dioxide (CO2) ranging between 0.6 ± 1.43 t CO2 ha-2 yr-1 (Sphagnum-dominated vegetation) and 3.09 ± 3.86 t CO2 ha-2 yr-1 (vegetation dominated by heath). While accounting for the different global warming potential (GWP) of CO2, CH4 and N2O, the annual GHG balance was calculated. Emissions ranged between 25 and 53 t CO2-eq ha-1 yr-1 and were dominated by large emissions of CH4 (22-51 t CO2-eq ha-1 yr-1), with highest rates found at purple moor grass (Molinia caerulea) stands. These are to our knowledge the highest CH4 emissions so far reported for bog ecosystems in temperate Europe. As the restored area was subject to large fluctuations in the water table, we assume that the high CH4 emission rates were caused by a combination of both the temporal inundation of the easily decomposable plant litter of purple moor grass and the plant-mediated transport through its tissues. In addition, as a result of the land use history, mixed soil material due to peat extraction and refilling can serve as an explanation. With regards to the long time span passed since rewetting, we note that the initial increase in CH4 emissions due to rewetting as described in the literature is not inevitably limited to a short-term period.

  14. Contextual learning and context effects during infancy: 30 years of controversial research revisited.

    PubMed

    Revillo, D A; Cotella, E; Paglini, M G; Arias, C

    2015-09-01

    Over the last 30years a considerable number of reports have explored learning about context during infancy in both humans and rats. This research was stimulated by two different theoretical frameworks. The first, known as the neuromaturational model, postulates that learning and behavior are context-independent during early ontogeny, a hypothesis based on the idea that contextual learning is dependent on the hippocampal function, and that this brain structure does not reach full maturity until late in infancy. The second theoretical framework views infants not as immature organisms, but rather as perfectly matured ones, given that their behavioral and cognitive capacities allow them to adapt appropriately to the demands of their specific environment in accordance with their maturational level. This model predicts significant ontogenetic variations in learning and memory due to developmental differences in what is perceived and attended to during learning episodes, which can result in ontogenetic differences in contextual learning depending on the specific demands of the task. The present manuscript reviews those studies that have examined potential developmental differences in contextual learning and context effects in rats. The reviewed results show that, during infancy, context can exert a similar influence over learning and memory as that described for the adult rat. Moreover, in some cases, contextual learning and context effects were greater in infants than in adults. In contrast, under other experimental conditions, no evidence of contextual learning or context effects was observed. We analyzed the procedural factors of these studies with the aim of detecting those that favor or impede contextual learning during infancy, and we discussed whether existing empirical evidence supports the claim that the functionality of the hippocampus is a limiting factor for this type of learning during infancy. Finally, conclusions from human research into contextual learning

  15. Parkinson's disease progression at 30 years: a study of subthalamic deep brain-stimulated patients.

    PubMed

    Merola, Aristide; Zibetti, Maurizio; Angrisano, Serena; Rizzi, Laura; Ricchi, Valeria; Artusi, Carlo A; Lanotte, Michele; Rizzone, Mario G; Lopiano, Leonardo

    2011-07-01

    Clinical findings in Parkinson's disease suggest that most patients progressively develop disabling non-levodopa-responsive symptoms during the course of the disease. Nevertheless, several heterogeneous factors, such as clinical phenotype, age at onset and genetic aspects may influence the long-term clinical picture. In order to investigate the main features of long-term Parkinson's disease progression, we studied a cohort of 19 subjects treated with subthalamic nucleus deep brain stimulation after >20 years of disease, reporting clinical and neuropsychological data up to a mean of 30 years from disease onset. This group of patients was characterized by an early onset of disease, with a mean age of 38.63 years at Parkinson's disease onset, which was significantly lower than in the other long-term subthalamic nucleus deep brain stimulation follow-up cohorts reported in the literature. All subjects were regularly evaluated by a complete Unified Parkinson's Disease Rating Scale, a battery of neuropsychological tests and a clinical interview, intended to assess the rate of non-levodopa-responsive symptom progression. Clinical data were available for all patients at presurgical baseline and at 1, 3 and 5 years from the subthalamic nucleus deep brain stimulation surgical procedure, while follow-up data after >7 years were additionally reported in a subgroup of 14 patients. The clinical and neuropsychological performance progressively worsened during the course of follow-up; 64% of patients gradually developed falls, 86% dysphagia, 57% urinary incontinence and 43% dementia. A progressive worsening of motor symptoms was observed both in 'medication-ON' condition and in 'stimulation-ON' condition, with a parallel reduction in the synergistic effect of 'medication-ON/stimulation-ON' condition. Neuropsychological data also showed a gradual decline in the performances of all main cognitive domains, with an initial involvement of executive functions, followed by the impairment

  16. Pichia anomala J121: a 30-year overnight near success biopreservation story.

    PubMed

    Schnürer, Johan; Jonsson, Anders

    2011-01-01

    Thirty years ago, the ascomycetous yeast Pichia anomala strain J121 was isolated from moist wheat grain stored under conditions of restricted air access. Early observations indicated that an inverse relationship existed between mould and P. anomala colony forming units in grain. This yeast strain was later found to have strong antifungal properties in laboratory, pilot and farm studies with high-moisture wheat under malfunctioning airtight storage. P. anomala had the highest inhibitory activity of 60 yeast species evaluated against the mould Penicillium roqueforti. It also demonstrated strong inhibitory effects against certain Gram-negative bacteria. P. anomala J121 possesses a number of physiological characteristics, i.e. capacity to grow under low pH, low water activity and low oxygen tension and ability to use a wide range of carbon and nitrogen sources, enabling it to act as an efficient biopreservative agent. The biocontrol effect in grain was enhanced by addition of glucose, mainly through formation of the volatile antimicrobial ethyl acetate. Animal feeding trials with P. anomala J121 inoculated grains, fed to chickens and beef cattle, demonstrated that mould control observed in vitro in small scale laboratory experiments could be extended to large scale farm trials. In addition, no adverse effects on animal weight gain, feed conversion, health or behaviour were observed. We have now studied P. anomala J121 biology, ecology and grain preservation ability for 30 years. Over this period, more than 40 scientific publications and five PhD theses have been written on different aspects of this yeast strain, extending from fundamental research on metabolism, genetics and molecular biology, all the way to practical farm-scale level. In spite of the well documented biopreservative ability of the yeast, it has to date been very difficult to create the right constellation of technical, agricultural and biotechnical industries necessary to reach a commercial launch of a

  17. Long-Term Prognostic Analysis after Endoscopic Endonasal Surgery for Olfactory Neuroblastoma: A Retrospective Study of 13 Cases

    PubMed Central

    Zhang, Luyao; Zhu, Kang; Xia, Cui; Yan, Jing; Zhao, Wei; Wei, Junrong; Duan, Maoli; Zheng, Guoxi

    2016-01-01

    Objectives To summarize the characteristics and long–term outcomes of olfactory neuroblastoma through the analysis of 13 cases in single institution, with the assessment of treatment modality, prognostic factors. Method A retrospective study of thirteen cases diagnosed as olfactory neuroblastoma and underwent combined treatments during the period 2000–2010. Statistical analysis was performed to search for prognostic factors and compared different treatment modalities. Results 13 patients were enrolled in this study, including 8 male and 5 female, ranging from 15 to 69 (median 43) years old. One patient at stage A was only treated with endoscopic endonasal surgery (EES). Seven patients were treated with preoperative radiotherapy and EES, two with EES and postoperative radiotherapy, and the other three with combined radiotherapy and chemotherapy. The range of follow-up time varied from 23 to 116 months (median 65 months). The 5-year overall survival rate was 46.2% (6/13). To date, these thirteen patients have not suffered local recurrences while two patients had lymph node recurrences and one had distant metastasis in the bone marrow. In 13 patients, 61.5% were diagnosed as late T stage (T3/4), 69.2% late Kadish stage (C/D) and 53.8% were high Hyams grade (I/ II), which indicated poor prognosis. Related prognostic factors were the TNM stage (T stage P = 0.028, N stage P = 0.000, M stage P = 0.007), Kadish stage (P = 0.025) and treatment modality (P = 0.015). Conclusion Late stage of TNM and Kadish staging system indicated a poor prognosis. Combined treatment modality, including endoscopic endonasal surgery, achieved a better outcome than non-surgical approach. PMID:27806104

  18. A retrospective observational analysis to identify patient and treatment-related predictors of outcomes in a community mental health programme

    PubMed Central

    Green, Stuart A; Honeybourne, Emmi; Chalkley, Sylvia R; Price, Geraint; Bell, Derek; Green, John

    2015-01-01

    Objectives This study aims to identify patient and treatment factors that affect clinical outcomes of community psychological therapy through the development of a predictive model using historic data from 2 services in London. In addition, the study aims to assess the completeness of data collection, explore how treatment outcomes are discriminated using current criteria for classifying recovery, and assess the feasibility and need for undertaking a future larger population analysis. Design Observational, retrospective discriminant analysis. Setting 2 London community mental health services that provide psychological therapies for common mental disorders including anxiety and depression. Participants A total of 7388 patients attended the services between February 2009 and May 2012, of which 4393 (59%) completed therapy, or there was an agreement to end therapy, and were included in the study. Primary and secondary outcome measures Different combinations of the clinical outcome scores for anxiety Generalised Anxiety Disorder-7 and depression Patient Health Questionnaire-9 were used to construct different treatment outcomes. Results The predictive models were able to assign a positive or negative clinical outcome to each patient based on 5 independent pre-treatment variables, with an accuracy of 69.4% and 79.3%, respectively: initial severity of anxiety and depression, ethnicity, deprivation and gender. The number of sessions attended/missed were also important factors identified in recovery. Conclusions Predicting whether patients are likely to have a positive outcome following treatment at entry might allow suitable modification of scheduled treatment, possibly resulting in improvements in outcomes. The model also highlights factors not only associated with poorer outcomes but inextricably linked to prevalence of common mental disorders, emphasising the importance of social determinants not only in poor health but also poor recovery. PMID:25995234

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2014-01-01

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

  2. Empirical model for estimating dengue incidence using temperature, rainfall, and relative humidity: a 19-year retrospective analysis in East Delhi

    PubMed Central

    2016-01-01

    OBJECTIVES Aedes mosquitoes are responsible for transmitting the dengue virus. The mosquito lifecycle is known to be influenced by temperature, rainfall, and relative humidity. This retrospective study was planned to investigate whether climatic factors could be used to predict the occurrence of dengue in East Delhi. METHODS The number of monthly dengue cases reported over 19 years was obtained from the laboratory records of our institution. Monthly data of rainfall, temperature, and humidity collected from a local weather station were correlated with the number of monthly reported dengue cases. One-way analysis of variance was used to analyse whether the climatic parameters differed significantly among seasons. Four models were developed using negative binomial generalized linear model analysis. Monthly rainfall, temperature, humidity, were used as independent variables, and the number of dengue cases reported monthly was used as the dependent variable. The first model considered data from the same month, while the other three models involved incorporating data with a lag phase of 1, 2, and 3 months, respectively. RESULTS The greatest number of cases was reported during the post-monsoon period each year. Temperature, rainfall, and humidity varied significantly across the pre-monsoon, monsoon, and post-monsoon periods. The best correlation between these three climatic factors and dengue occurrence was at a time lag of 2 months. CONCLUSIONS This study found that temperature, rainfall, and relative humidity significantly affected dengue occurrence in East Delhi. This weather-based dengue empirical model can forecast potential outbreaks 2-month in advance, providing an early warning system for intensifying dengue control measures. PMID:27899025

  3. Apollo: A retrospective analysis

    NASA Technical Reports Server (NTRS)

    Launius, Roger D.

    1994-01-01

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

  4. Apollo: A Retrospective Analysis

    NASA Technical Reports Server (NTRS)

    Launius, Roger D.

    2004-01-01

    The program to land an American on the Moon and return safely to Earth in the 1960s has been called by some observers a defining event of the twentieth century. Pulitzer Prize-winning historian Arthur M. Schlesinger, Jr., even suggested that when Americans two centuries hence study the twentieth century, they will view the Apollo lunar landing as the critical event of the century. While that conclusion might be premature, there can be little doubt but that the flight of Apollo 11 in particular and the overall Apollo program in general was a high point in humanity s quest to explore the universe beyond Earth. Since the completion of Project Apollo more than twenty years ago there have been a plethora of books, studies, reports, and articles about its origin, execution, and meaning. At the time of the twenty-fifth anniversary of the first landing, it is appropriate to reflect on the effort and its place in U.S. and NASA history. This monograph has been written as a means to this end. It presents a short narrative account of Apollo from its origin through its assessment. That is followed by a mission by mission summary of the Apollo flights and concluded by a series of key documents relative to the program reproduced in facsimile. The intent of this monograph is to provide a basic history along with primary documents that may be useful to NASA personnel and others desiring information about Apollo.

  5. Effects of Miniscalpel-Needle Release on Chronic Neck Pain: A Retrospective Analysis with 12-Month Follow-Up

    PubMed Central

    Li, Shuming; Shen, Tong; Liang, Yongshan; Zhang, Ying; Bai, Bo

    2015-01-01

    Objective Chronic neck pain is a highly prevalent condition, and is often treated with non-steroidal anti-inflammatory drugs. Limited clinical studies with short-term follow-up have shown promising efficacy of acupuncture as well as miniscalpel-needle (MSN) release. In this retrospective study, we examined whether MSN release could produce long-lasting relief in patients with chronic neck pain. Methods We retrieved the medical records of all patients receiving weekly MSN release treatment for chronic neck pain at this institution during a period from May 2012 to December 2013. Only cases with the following information at prior to, and 1, 6, and 12 months after the treatment, were included in the analysis: neck disability index (NDI), numerical pain rating scale (NPRS), and active cervical range of motion (CROM). The primary analysis of interest is comparison of the 12-month measures with the baseline. Patients who took analgesic drugs or massage within 2 weeks prior to assessment were excluded from the analysis. For MSN release, tender points were identified manually by an experienced physician, and did not necessarily follow the traditional acupuncture system. MSN was inserted vertically (parallel to the spine) until breaking through resistance and patient reporting of distention, soreness or heaviness. The depth of the needling ranged from 10 to 50 mm. The release was carried out by moving the MSN up and down 3–5 times without rotation. Results A total of 559 cases (patients receiving weekly MSN release treatment for chronic neck pain) were screened. The number of cases with complete information (NDI, NPRS, and CROM at baseline, 1, 6 and 12 months after last treatment) was 180. After excluding the cases with analgesic treatment or massage within 2 weeks of assessment (n = 53), a total of 127 cases were included in data analysis. The number of MSN release session was 7 (range: 4–11). At 12 months after the treatment, both NPRS and NDI were significantly lower

  6. Pre-Hypertension among Young Adults (20–30 Years) in Coastal Villages of Udupi District in Southern India: An Alarming Scenario

    PubMed Central

    Kamath, Veena G.; Kulkarni, Muralidhar M.; Kamath, Asha; Shivalli, Siddharudha

    2016-01-01

    Introduction According to Joint National Committee-7 (JNC-7) guidelines, a systolic blood pressure (SBP) of 120 to 139 mm Hg and/or diastolic blood pressure (DBP) of 80 to 89 mm Hg is considered as pre-hypertension. Existing evidence suggest that the cardiovascular morbidities are increasing among pre-hypertensive individuals compared to normal. Objective To assess the magnitude and factors associated with pre-hypertension among young adults (20–30 years) in coastal villages of Udupi Taluk (an area of land with a city or town that serves as its administrative centre and usually a number of villages), Udupi District, Karnataka state, India. Design Community based cross sectional study Setting 6 (out of total 14) coastal villages of Udupi Taluk, Karnataka state, India. Sample 1,152 young adults (age group: 20–30 years) selected by stratified random sampling in 6 coastal villages of Udupi Taluk, Karnataka state, India Method A semi structured pre-tested questionnaire was used to elicit the details on socio-demographic variables, dietary habits, tobacco use, alcohol consumption, physical activity, family history of hypertension and stress levels. Anthropometric measurements and blood pressure were recorded according to standard protocols. Serum cholesterol was measured in a sub sample of the study population. Multivariate logistic regression was applied to identify the independent correlates of pre-hypertension among young adults (20–30 years). Main Outcome Measures Prevalence, Odds ratio (OR) and adjusted (adj) OR for pre-hypertension among young adults (20–30 years). Results The prevalence of pre-hypertension in the study population was 45.2% (95%CI: 42.4–48). Multivariate logistic regression analysis revealed that age group of 25–30 years (adj OR: 4.25, 95% CI: 2.99–6.05), white collared (adj OR: 2.29, 95% CI: 1.08–4.85) and skilled occupation (adj OR: 3.24, 95% CI: 1.64–6.42), students (adj OR: 2.46, 95% CI: 1.22–4.95), using refined cooking oil

  7. Terrestrial cosmogenic 3He: where are we 30 years after its discovery?

    NASA Astrophysics Data System (ADS)

    Blard, Pierre-Henri; Pik, Raphaël; Farley, Kenneth A.; Lavé, Jérôme; Marrocchi, Yves

    2016-04-01

    It is now 30 years since cosmogenic 3He has been detected for the first time in a terrestrial sample (Kurz, 1986). 3He is now a widely used geochemical tool in many fields of Earth sciences: volcanology, tectonics, paleoclimatology. 3He has the advantage to have a high "production rate" to "detection limit" ratio, allowing surfaces as young as hundred of years to be dated. Although its nuclear stability implies several limitations, it moreover represents a useful alternative to 10Be in mafic environments. This contribution is a review of the progresses that have been accomplished since this discovery, and discuss strategies to improve both the accuracy and the precision of this geochronometer. 1) Measurement of cosmogenic 3He Correction of magmatic 3He. To estimate the non-cosmogenic magmatic 3He, Kurz (1986) invented a two steps method involving crushing of phenocrysts (to analyze the isotopic ratio of the magmatic component), followed by a subsequent melting of the sample, to extract the remaining components, including the cosmogenic 3He: 3Hec = 3Hemelt -4Hemelt x (3He/4He)magmatic (1) Several studies suggested that the preliminary crushing may induce a loss of cosmogenic 3He (Hilton et al., 1993; Yokochi et al., 2005; Blard et al., 2006), implying an underestimate of the cosmogenic 3He measurement. However, subsequent work did not replicate these observations (Blard et al., 2008; Goerhing et al., 2010), suggesting an influence of the used apparatus. An isochron method (by directly melting several phenocrysts aliquots) is an alternative to avoid the preliminary crushing step (Blard and Pik, 2008). Atmospheric contamination. Protin et al. (in press) provides robust evidences for a large and irreversible contamination of atmospheric helium on silicate surfaces. This unexpected behavior may reconcile the contrasted observations about the amplitude of crushing loss. This undesirable atmospheric contamination is negligible if grain fractions smaller than 150 mm are

  8. 30 years later: Social Representations about AIDS and sexual practices of rural towns residents.

    PubMed

    Furtado, Francisca Marina de Souza Freire; Santos, José Anderson Galdino; Loredanna, Stedile; Araújo, Eunice; Saldanha, Ana Alayde Werba; Silva, Josevânia da

    2016-06-01

    In the 30 years of the AIDS pandemic in Brazil, it is recognized the HIV virus internalization of the phenomenon as a challenge to care and current health policies. In this sense, it aimed to verify sex practices and social representations that rural towns residents have about the disease. Attended by 789 people, men and women, between 18 and 90 years old, residents in 41 towns with fewer than 11,000 inhabitants in the state of Paraiba / Brazil. Data were collected by a questionnaire and the free association of words test. The results showed low concern about disease, perception of invulnerability to HIV infection and not using condoms during sexual intercourse, and confidence in the major reason related partner. Also showed endure derogatory and stereotypical representations, revealing that still persist in rural areas, beliefs and representations concerning the beginning of the epidemic. From these findings, it is possible to point out deficiencies in the care provided by the health services in these localities, which may result in increased vulnerability of this population to diseases, so there is the need to intensify information campaigns and intervention. The results reveal the existence of three different types of modes of learning health literacy skills in informal context: : i) learning that takes place in action, in achieving daily tasks; ii) learning processes that result from problem solving; iii) learning that occurs in an unplanned manner, resulting from accidental circumstances and, in some cases, devoid of intentionality. Nos 30 anos da pandemia da Aids no Brasil, reconhece-se o fenômeno da interiorização do vírus HIV como um desafio ao cuidado e às politicas de saúde atuais. Neste sentido, objetivou-se conhecer práticas sexuais e as representações sociais que residentes de cidades rurais têm acerca da doença. Participaram 789 pessoas, homens e mulheres, entre 18 e 90 anos de idade, residentes em 41 cidades com menos de 11.000 habitantes

  9. Treatment outcomes, quality of life, and impact of hemophilia on young adults (aged 18-30 years) with hemophilia.

    PubMed

    Witkop, Michelle; Guelcher, Christine; Forsyth, Angela; Hawk, Sarah; Curtis, Randall; Kelley, Laureen; Frick, Neil; Rice, Michelle; Rosu, Gabriela; Cooper, David L

    2015-12-01

    The Hemophilia Experiences, Results and Opportunities (HERO) initiative assessed psychosocial issues reported by people with moderate to severe hemophilia and was led by a multidisciplinary international advisory board. This analysis reports data from young adult respondents (aged 18-30 years), including both US and overall global (including US respondents) results, and investigates treatment outcomes, quality of life, and impacts of hemophilia on relationships. More young adults in HERO received prophylaxis than on-demand treatment, although a majority reported not using factor products exactly as prescribed, and 50% of global respondents and 26% of US respondents reported issues with access to factor replacement therapy in the previous 5 years. Many young adults with hemophilia reported comorbidities, including bone/skeletal arthritis, chronic pain, and viral infections, and nearly half of young adults reported anxiety/depression. Most reported pain interference with daily activities in the past 4 weeks, although a majority reported participating in lower-risk activities and approximately half in intermediate-risk activities. Most young adults were very or quite satisfied with the support of partners/spouses, family, and friends, although roughly one-third reported that hemophilia affected their ability to develop close relationships with a partner. A majority of young adults reported that hemophilia has had a negative impact on employment, and 62% of global respondents and 78% of US respondents were employed at least part-time. Together these data highlight the psychosocial issues experienced by young adults with hemophilia and suggest that increased focus on these issues may improve comprehensive care during the transition to adulthood.

  10. Treatment of osteolytic solitary painful osseous metastases with radiofrequency ablation or cryoablation: A retrospective study by propensity analysis

    PubMed Central

    ZUGARO, LUIGI; DI STASO, MARIO; GRAVINA, GIOVANNI LUCA; BONFILI, PIERLUIGI; GREGORI, LORENZO; FRANZESE, PIETRO; MARAMPON, FRANCESCO; TOMBOLINI, VINCENZO; DI CESARE, ERNESTO; MASCIOCCHI, CARLO

    2016-01-01

    The present study aimed to measure the improvement in pain relief and quality of life in patients with osteolytic solitary painful bone metastasis treated by cryoablation (CA) or radiofrequency ablation (RFA). Fifty patients with solitary osteolytic painful bone metastases were retrospectively studied and selected by propensity analysis. Twenty-five patients underwent CA and the remaining twenty-five underwent RFA. Pain relief, in terms of complete response (CR), the number of patients requiring analgesia and the changes in self-rated quality of life (QoL) were measured following the two treatments. Thirty-two percent of patients treated by CA experienced a CR at 12 weeks versus 20% of patients treated by RFA. The rate of CR increased significantly with respect to baseline only in the group treated by CA. In both groups there was a significant change in the partial response with respect to baseline (36% in the CA group vs. 44% in the RFA group). The recurrence rate in the CA and RFA groups was 12% and 8%, respectively. The reduction in narcotic medication requirements with respect to baseline was only significant in the group treated by CA. A significant improvement in self-rated QoL was observed in both groups. The present study seems to suggest that CA only significantly improves the rate of CR and decreases the requirement of narcotic medications. Both CA and RFA led to an improvement in the self-rated QoL of patients after the treatments. However, the results of the present study should be considered as preliminary and to serve as a framework around which future trials may be designed. PMID:26998106

  11. Clinical Malaria Transmission Trends and Its Association with Climatic Variables in Tubu Village, Botswana: A Retrospective Analysis

    PubMed Central

    Chimbari, Moses John; Ngwenya, Barbara Ntombi; Sartorius, Benn

    2016-01-01

    Good knowledge on the interactions between climatic variables and malaria can be very useful for predicting outbreaks and preparedness interventions. We investigated clinical malaria transmission patterns and its temporal relationship with climatic variables in Tubu village, Botswana. A 5-year retrospective time series data analysis was conducted to determine the transmission patterns of clinical malaria cases at Tubu Health Post and its relationship with rainfall, flood discharge, flood extent, mean minimum, maximum and average temperatures. Data was obtained from clinical records and respective institutions for the period July 2005 to June 2010, presented graphically and analysed using the Univariate ANOVA and Pearson cross-correlation coefficient tests. Peak malaria season occurred between October and May with the highest cumulative incidence of clinical malaria cases being recorded in February. Most of the cases were individuals aged >5 years. Associations between the incidence of clinical malaria cases and several factors were strong at lag periods of 1 month; rainfall (r = 0.417), mean minimum temperature (r = 0.537), mean average temperature (r = 0.493); and at lag period of 6 months for flood extent (r = 0.467) and zero month for flood discharge (r = 0.497). The effect of mean maximum temperature was strongest at 2-month lag period (r = 0.328). Although malaria transmission patterns varied from year to year the trends were similar to those observed in sub-Saharan Africa. Age group >5 years experienced the greatest burden of clinical malaria probably due to the effects of the national malaria elimination programme. Rainfall, flood discharge and extent, mean minimum and mean average temperatures showed some correlation with the incidence of clinical malaria cases. PMID:26983035

  12. Regression Rates Following the Treatment of Aggressive Posterior Retinopathy of Prematurity with Bevacizumab Versus Laser: 8-Year Retrospective Analysis.

    PubMed

    Nicoară, Simona D; Ștefănuţ, Anne C; Nascutzy, Constanta; Zaharie, Gabriela C; Toader, Laura E; Drugan, Tudor C

    2016-04-10

    BACKGROUND Retinopathy is a serious complication related to prematurity and a leading cause of childhood blindness. The aggressive posterior form of retinopathy of prematurity (APROP) has a worse anatomical and functional outcome following laser therapy, as compared with the classic form of the disease. The main outcome measures are the APROP regression rate, structural outcomes, and complications associated with intravitreal bevacizumab (IVB) versus laser photocoagulation in APROP. MATERIAL AND METHODS This is a retrospective case series that includes infants with APROP who received either IVB or laser photocoagulation and had a follow-up of at least 60 weeks (for the laser photocoagulation group) and 80 weeks (for the IVB group). In the first group, laser photocoagulation of the retina was carried out and in the second group, 1 bevacizumab injection was administered intravitreally. The following parameters were analyzed in each group: sex, gestational age, birth weight, postnatal age and postmenstrual age at treatment, APROP regression, sequelae, and complications. Statistical analysis was performed using Microsoft Excel and IBM SPSS (version 23.0). RESULTS The laser photocoagulation group consisted of 6 premature infants (12 eyes) and the IVB group consisted of 17 premature infants (34 eyes). Within the laser photocoagulation group, the evolution was favorable in 9 eyes (75%) and unfavorable in 3 eyes (25%). Within the IVB group, APROP regressed in 29 eyes (85.29%) and failed to regress in 5 eyes (14.71%). These differences are statistically significant, as proved by the McNemar test (P<0.001). CONCLUSIONS The IVB group had a statistically significant better outcome compared with the laser photocoagulation group, in APROP in our series.

  13. Angioplasty or Stenting in Adult Coarctation of the Aorta? A Retrospective Single Center Analysis Over a Decade

    SciTech Connect

    Macdonald, Sumaira Thomas, Steven M.; Cleveland, Trevor J.; Gaines, Peter A.

    2003-08-15

    For over 11 years, endovascular treatment by angioplasty (PTA) alone or stenting of adult coarctation at a single center was evaluated. We retrospectively reviewed 28 consecutive patients (31 interventions), median age 25 years, treated between 1991 and 2002, 20 of whom had native coarctation. Thirteen patients had PTA alone (16 procedures) (10 'kissing balloon' angioplasty comprising 12 interventions, and 3 single balloon angioplasty comprising 4 interventions) and 15 patients were stented(15 procedures), including 6 secondary and 9 primary stents. There were no procedural or 30-day complications. For the whole group, the median follow-up was 6.6 years (range 1-10 years). In the PTA group, median follow-up was 9 years (range 3-10) and in the stenting group it was 3 years (range 1-5). There were 9 restenoses in the PTA group (6 after 'kissing balloons' and 3 after single balloon) comprising 56% of the angioplasties (9/16 procedures). There was 1 restenosis in the stenting group diagnosed at computed tomography (CT). The patient was clinically well. For the whole group there were significant reductions in systolic blood pressure (BP) (p 0.0003), diastolic BP (p = 0.004) and number of drugs per patient (p = 0.045) at latest follow-up post-treatment. Five patients discontinued therapy.Analysis of the groups revealed that the reduction of systolic and diastolic BP and number of drugs did not reach statistical significance in the PTA group but were significant in the stent group. The endovascular management of adult coarctation is safe. Stents may be more effective than PTA alone but longer-term follow-up of stents is required.

  14. Yield of new versus reused endobronchial ultrasound-guided transbronchial needle aspiration needles: A retrospective analysis of 500 patients

    PubMed Central

    Dhooria, Sahajal; Sehgal, Inderpaul Singh; Gupta, Nalini; Ram, Babu; Aggarwal, Ashutosh Nath; Behera, Digambar; Agarwal, Ritesh

    2016-01-01

    Background: Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) requires a dedicated needle for aspiration of mediastinal lesions. There is no data on reuse of these needles. Methods: This is a retrospective study of patients who underwent EBUS-TBNA with either new or reused EBUS-TBNA needles. The needles were reused after thorough cleaning with filtered water and organic cleaning solution, disinfection with 2.4% glutaraldehyde solution followed by ethylene oxide sterilization. The yield of EBUS-TBNA was compared between the two groups. Results: A total of 500 EBUS-TBNA procedures (351 new, 149 reused needles) were performed. The baseline characteristics were different in the two groups with suspected granulomatous disorders (sarcoidosis or tuberculosis) being significantly more common in the new compared to the reused needle group. Similarly, the median, interquartile range number of lymph node stations sampled, and the total number of passes were significantly higher in the new versus the reused needle group. The diagnostic yield was significantly higher with new needle as compared to reused needle (65.2% vs. 53.7%, P = 0.02). On multivariate logistic regression analysis, clinical suspicion of granulomatous disorders (odds ratio 1.86 [95% confidence interval, 1.20-2.87], P = 0.005) was the only predictor of diagnostic yield, after adjusting for the type of needle (new or reused), total number of passes and the number of lymph node stations sampled. No case of mediastinitis was encountered in either group. Conclusions: The yield of EBUS-TBNA might be similar with single reuse of needles as compared to new needles. However, reuse of needle should be performed only when absolutely necessary. PMID:27578927

  15. Who Dies after ICU Discharge? Retrospective Analysis of Prognostic Factors for In-Hospital Mortality of ICU Survivors

    PubMed Central

    2017-01-01

    We investigated the causes of inpatient death after intensive care unit (ICU) discharge and determined predictors of in-hospital mortality in Korea. Using medical ICU registry data of Seoul National University Hospital, we performed a retrospective cohort study involving patients who were discharged alive from their first ICU admission with at least 24 hours of ICU length of stay (LOS). From January 2011 to August 2013, 723 patients were admitted to ICU and 383 patients were included. The estimated in-hospital mortality rate was 11.7% (45/383). The most common cause of death was respiratory failure (n = 25, 56%) followed by sepsis and cancer progression; the causes of hospital death and ICU admission were the same in 64% of all deaths; sudden unexpected deaths comprised about one-fifth of all deaths. In order to predict in-hospital mortality among ICU survivors, multivariate analysis identified presence of solid tumor (odds ratio [OR], 4.06; 95% confidence interval [CI], 2.01–8.2; P < 0.001), hematologic disease (OR, 4.75; 95% CI, 1.51–14.96; P = 0.013), Sequential Organ Failure Assessment (SOFA) score upon ICU admission (OR, 1.08; 95% CI, 0.99–1.17; P = 0.075), and hemoglobin (Hb) level (OR, 0.67; 95% CI, 0.52–0.86; P = 0.001) and platelet count (Plt) (OR, 0.99; 95% CI, 0.99–1.00; P = 0.033) upon ICU discharge as significant factors. In conclusion, a significant proportion of in-hospital mortality is predictable and those who die in hospital after ICU discharge tend to be severely-ill, with comorbidities of hematologic disease and solid tumor, and anemic and thrombocytopenic upon ICU discharge. PMID:28145659

  16. Clinical retrospective analysis of erlotinib in the treatment of elderly patients with advanced non-small cell lung cancer.

    PubMed

    Platania, Marco; Agustoni, Francesco; Formisano, Barbara; Vitali, Milena; Ducceschi, Monika; Pietrantonio, Filippo; Zilembo, Nicoletta; Gelsomino, Francesco; Pusceddu, Sara; Buzzoni, Roberto

    2011-09-01

    In order to evaluate the clinical efficacy and the safety profile of molecularly targeted therapies as a palliative approach in elderly populations affected by advanced thoracic neoplasms, we retrospectively studied, in terms of effectiveness and toxicities, a group of pretreated elderly metastatic non-small cell lung cancer (NSCLC) patients admitted to our institution and treated with erlotinib at standard daily/dose. Forty-three patients aged 70 years or older who had previously failed on chemotherapy or radiotherapy were treated with oral Eerlotinib (150 mg/d) until disease progression or unacceptable toxicity. Clinical data, pathological types, potential prognostic factors, efficacy and toxicity of erlotinib were included in this analysis. In our series we observed: objective responses in six patients (14%) and stable disease in 15 (35%). Skin rash was the most common side effect (67%). Grade 3-4 adverse events were observed in 16 cases (37%). The median overall survival and the median progression-free survival were 8.4 months (CI 95%: 0.7-43.6) and 3 months (CI 95%: 0.4-28.4), respectively. Patients with adenocarcinoma achieved the best disease control rate (p = 0.027), while not/former smokers showed a better response (p = 0.069). In our experience the use of erlotinib after chemotherapy failure in an unselected elderly population affected by NSCLC showed moderate efficacy and a moderate safety profile. However, erlotinib represents a valid option in this setting, but other factors such as biological information, comorbidities and concomitant medications need to be carefully take into consideration in this particular subset of cancer patients.

  17. Effect of type and transfer of conventional weapons on civilian injuries: retrospective analysis of prospective data from Red Cross hospitals

    PubMed Central

    Coupland, Robin M; Samnegaard, Hans O

    1999-01-01

    Objective To examine the link between different weapons used in modern wars and their potential to injury civilians. Design Retrospective analysis of prospectively collected data about hospital admissions. Setting Hospitals of the International Committee of the Red Cross. Subjects 18 877 people wounded by bullets, fragmentation munitions, or mines. Of these, 2012 had been admitted to the hospital in Kabul within six hours of injury. Main outcome measures Age and sex of wounded people according to cause of injury and whether they were civilians (women and girls, boys under 16 years old, or men of 50 or more). Results 18.7% of those injured by bullets, 34.1% of those injured by fragments, and 30.8% of those injured by mines were civilians. Of those admitted to the Red Cross hospital in Kabul within six hours of injury, 39.1% of those injured by bullets, 60.6% of those injured by fragments, and 55.0% of those injured by mines were civilians. Conclusions The proportion of civilians injured differs between weapon systems. The higher proportion injured by fragments and mines is explicable in terms of the military efficiency of weapons, the distance between user and victim, and the effect that the kind of weapon has on the psychology of the user. Key messagesDuring war, mines and fragmenting munitions (mortars, bombs, and shells) are more likely than bullets to injure civiliansCivilians in a city under siege are particularly at risk of being injured by weapons whose users are not able to see the victimThe inherent nature of weapons may be a factor in determining whether civilians are killed or injuredThere is a need for greater respect for the Fourth Geneva Convention and for greater controls on weapons being transferred to untrained and undisciplined forces PMID:10445921

  18. Representation of tropical storms in the northwestern pacific by the Modern-Era Retrospective analysis for research and applications

    NASA Astrophysics Data System (ADS)

    Lee, Myong-In; Schubert, Siegfried D.; Kim, Dongmin

    2011-05-01

    This study examines the tropical storms simulated in the Modern-Era Retrospective analysis for Research and Applications (MERRA) global atmospheric reanalysis for the recent 12 years (1998-2009), focusing on the tropical storm activity over the Northwestern Pacific. For validation, the International Best Track Archive for Climate Stewardship (IBTrACS) dataset is used as an observational counterpart. Climatological-mean features of the tropical storm genesis, tracks and their maximum intensity are the primary interests in this study. Regarding the genesis location of tropical storms, MERRA is reasonable in resolving major development regions over the South China Sea and the Northwestern Pacific close to the Philippines. The seasonal variation of the number of storms is also reproduced in a realistic way in MERRA, with peak values occurring from July to September. In addition, MERRA tends to reproduce the observed interannual variation of the number of tropical storms during the 12-years, though with a limited accuracy. The simulated paths toward higher latitudes are also reasonable in MERRA, where the reanalysis corresponds well with the observations in resolving frequent paths of westward moving storms and recurving storms toward the northeast. Regarding the intensity, MERRA captures the linear relationship between the minimum center pressure and the maximum wind speed near the surface at the maximum development. Some discrepancies from the observed features are found in the reanalysis, such as less frequent development of storms over the South China Sea and less frequent paths over this region. The reanalysis also does not attain the observed maximum intensity for the resolved tropical storms, particularly underestimating the center pressure. These deficiencies are likely related to limitations in the horizontal resolution and the parameterized physics of the data assimilation system.

  19. Suspected metaldehyde slug bait poisoning in dogs: a retrospective analysis of cases reported to the Veterinary Poisons Information Service.

    PubMed

    Bates, N S; Sutton, N M; Campbell, A

    2012-09-29

    A retrospective analysis of telephone enquiries to the Veterinary Poisons Information Service found 772 cases with follow-up concerning suspected metaldehyde slug bait ingestion in dogs between 1985 and 2010. Half the enquiries occurred in the summer months. The amount and strength of the slug bait ingested was rarely known. In 56, cases the quantity consumed was estimated and was on average 229.6 grams of bait. Clinical signs developed in 77.3 per cent of dogs; common signs were convulsions, hypersalivation, twitching, hyperaesthesia, tremor, vomiting, hyperthermia and ataxia. Only 4.6 per cent of dogs developed hepatic changes, and only one developed renal impairment. The average time to onset of signs was 2.9 hours post-ingestion, with 50.3 per cent of dogs developing effects within one hour. Increased muscle activity (twitching, convulsions) lasted on average 15.2 hours. Recovery time was reported in 61 cases and occurred on average at 39.3 hours. Common treatments were gut decontamination, anticonvulsants, anaesthetics and intravenous fluids. Of the dogs that were treated with sedatives, 45.8 per cent required more than one sedative or anaesthetic agent. Methocarbamol was rarely used, probably due to unavailability. The outcome was reported in 762 dogs; 21.7 per cent remained asymptomatic, 61.7 per cent recovered and 16 per cent of dogs died or were euthanased. Where known (only six cases), the fatal dose of bait ranged from 4.2 to 26.7 g/kg (average 11.8 g/kg).

  20. Dementia-specific risks of scabies: Retrospective epidemiologic analysis of an unveiled nosocomial outbreak in Japan from 1989–90

    PubMed Central

    Tsutsumi, Masae; Nishiura, Hiroshi; Kobayashi, Toshio

    2005-01-01

    Background Although senile dementia patients in long-term care facilities are at leading risk of scabies, the epidemiologic characteristics of this disease have yet to be fully clarified. This study documents the findings of a ward-scale nosocomial outbreak in western Japan from 1989–90, for which permission to publish was only recently obtained. Methods A retrospective epidemiologic study was performed to identify specific risk factors of scabies among patients with dementia. Analyses were based on a review of medical and nursing records. All inpatients in the affected ward at the time of the outbreak were included in the study. Observational and analytical approaches were employed to assess the findings. Results Twenty of 65 inpatients in the ward met the case definition of scabies. The outbreak lasted for almost 10 months and as a result, the spatial distribution of infections showed no localized patterns in the latter phase of the outbreak. The duration of illness significantly decreased after initiation of control measures (P = 0.0067). Movement without assistance (Odds Ratio [OR] = 11.3; 95% Confidence Interval [CI]: 2.9, 44.8) and moving beyond the room (but within the ward) (OR = 4.1; 95% CI: 1.4, 12.5) were significantly associated with infection, while types of room (Western or Japanese) and sleeping arrangement (on beds or futons laid directly on the floor) appeared not to be risk factors. Conclusion Univariate analysis demonstrated the importance of patients' behaviours during daily activities in controlling scabies among senile dementia patients. The findings also support previous evidence that catching scabies from fomites is far less common. Moreover, since cognitive disorders make it difficult for individuals to communicate and understand the implications of risky contacts as well as treatment method, and given the non-specific nature of individual contacts that are often unpredictable, real-time observations might help improve control practices

  1. A retrospective analysis of dermatoses in the perimenopausal population attending a tertiary care centre in South India

    PubMed Central

    Aboobacker, Shamma; Saritha, Mohanan; Karthikeyan, Kaliaperumal

    2015-01-01

    Introduction: Menopausal is a normal physiologic aging process in women characterized by decreasing estrogen levels. The skin is an organ dependant on hormones, estrogen being the most important in case of females, thereby influencing both the biology of skin and composition. Studies show that the systemic effects of estrogen deprivation occur years after attaining menopausal, however cutaneous features have been noticed earlier. The purpose of this study is to evaluate the common disorders occurring in perimenopausal women of Indian ethnicity. Materials and Methods: A retrospective observational study of outpatient records from Dermatology clinic between 2005 and 2012. All female patients between 45-55 years of age from an outpatient register that outlines the final diagnosis made by a qualified dermatologist after investigations. The data was entered according to the pattern of dermatoses and their seasonal variation and analyzed were included. Results: A total of 8,156 cases were found. After analysis of the many variables, the most common dermatoses in the perimenopausal population were eczematous disorders (23.6%), followed by urticaria (12.4%) and papulosquamous disorders (10.7%). Of the eczematous disorders, allergic and photosensitive disorders were found to be more frequent. Conclusion: The leading dermatoses being eczema and urticaria in the perimenopausal population probably accounts for a tendency of exaggerated response to external factors. The population studied in the current study might be of significance due to complete lack of treatment in the form of hormone replacement therapy (HRT), while routine sun exposure and cultural practices predominate. However, evaluation with respect to individual factors is beyond the scope of the current study and may be necessary to define a causal relationship. PMID:26538988

  2. Science Engagement and Literacy: A Retrospective Analysis for Indigenous and Non-Indigenous Students in Aotearoa New Zealand and Australia

    NASA Astrophysics Data System (ADS)

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

    2013-02-01

    Previous research has underlined the importance of school students' engagement in science (including students' attitudes, interests and self beliefs). Engagement in science is important as a correlate of scientific literacy and attainment, and as an educational outcome in its own right. Students positively engaged with science are more likely to pursue science related careers, and to support science related policies and initiatives. This retrospective, secondary analysis of PISA 2006 national data for Aotearoa New Zealand and Australia examines and compares the factors associated with science literacy and with science engagement for indigenous and non-indigenous 15 year old students. Using a four step hierarchical regression model, our secondary analyses showed consistent patterns of influence on engagement in science for both indigenous and non-indigenous students in Aotearoa and Australia. Variations in students' interest, enjoyment, personal and general valuing, self-efficacy, and self concept in science were most strongly associated with the extent to which students engaged in science activities outside of school. In contrast, socioeconomic status, time spent on science lessons and study, and the character of science teaching experienced by students in their schools were the factors most explanatory of variations in science literacy. Yet, the factors that explained variation in science literacy had only quite weak associations with the suite of variables comprising engagement in science. We discuss the implications of these findings for science educators and researchers interested in enhancing students' engagement with science, and committed to contributing positively to closing the persistent gap in educational outcomes between indigenous and non-indigenous peoples.

  3. Resting anal pressure, not outlet obstruction or transit, predicts healthcare utilization in chronic constipation: a retrospective cohort analysis

    PubMed Central

    Staller, Kyle; Barshop, Kenneth; Kuo, Braden; Ananthakrishnan, Ashwin N

    2015-01-01

    Background Chronic constipation is common and exerts a considerable burden on health-related quality of life and healthcare resource utilization. Anorectal manometry (ARM) and colonic transit testing have allowed classification of subtypes of constipation, raising promise of targeted treatments. There has been limited study of the correlation between physiological parameters and healthcare utilization. Methods All patients undergoing ARM and colonic transit testing for chronic constipation at two tertiary care centers from 2000 to 2014 were included in this retrospective study. Our primary outcomes included number of constipation-related and gastroenterology visits per year. Multivariate linear regression adjusting for confounders defined independent effect of measures of colonic and anorectal function on healthcare utilization. Key Results Our study included 612 patients with chronic constipation. More than 50% (n=333) of patients had outlet obstruction by means of balloon expulsion testing and 43.5% (n=266) had slow colonic transit. On unadjusted analysis, outlet obstruction (1.98 vs. 1.68), slow transit (2.40 vs 2.07) and high resting anal pressure (2.16 vs. 1.76) were all associated with greater constipation-related visits/year compared to patients without each of those parameters (P<0.05 for all). Outlet obstruction and high resting anal pressure were also associated with greater number of gastroenterology visits/year. After multivariate adjustment, high resting anal pressure was the only independent predictor of increased constipation-related visits/year (P=0.02) and gastroenterology visits/year (P=0.04). Conclusions and Inferences Among patients with chronic constipation, high resting anal pressure, rather than outlet obstruction or slow transit, predicts healthcare resource utilization. PMID:26172284

  4. Retrospective characterization of ontogenetic shifts in killer whale diets via δ13C and δ15N analysis of teeth

    USGS Publications Warehouse

    Newsome, Seth D.; Etnier, Michael A.; Monson, Daniel H.; Fogel, Marilyn L.

    2009-01-01

    Metabolically inert, accretionary structures such as the dentin growth layers in teeth provide a life history record of individual diet with near-annual resolution. We constructed ontogenetic δ13C and δ15N profiles by analyzing tooth dentin growth layers from 13 individual killer whales Orcinus orca collected in the eastern northeast Pacific Ocean between 1961 and 2003. The individuals sampled were 6 to 52 yr old, representing 2 ecotypes—resident and transient—collected across ~25° of latitude. The average isotopic values of transient individuals (n = 10) are consistent with a reliance on mammalian prey, while the average isotopic values of residents (n = 3) are consistent with piscivory. Regardless of ecotype, most individuals show a decrease in δ15N values of ~2.5‰ through the first 3 yr of life, roughly equivalent to a decrease of one trophic level. We interpret this as evidence of gradual weaning, after which, ontogenetic shifts in isotopic values are highly variable. A few individuals (n = 2) maintained relatively stable δ15N and δ13C values throughout the remainder of their lives, whereas δ15N values of most (n = 11) increased by ~1.5‰, suggestive of an ontogenetic increase in trophic level. Significant differences in mean δ13C and δ15N values among transients collected off California suggest that individuality in prey preferences may be prevalent within this ecotype. Our approach provides retrospective individual life history and dietary information that cannot be obtained through traditional field observations of free-ranging and elusive species such as killer whales, including unique historic ecological information that pre-dates modern studies. By providing insights into individual diet composition, stable isotope analysis of teeth and/or bones may be the only means of evaluating a number of hypothesized historical dietary shifts in killer whales of the northeast Pacific Ocean

  5. Retrospective characterization of ontogenetic shifts in killer whale diets via δ13C and δ15N analysis of teeth

    USGS Publications Warehouse

    Newsome, Seth D.; Etnier, Michael A.; Monson, Daniel H.; Fogel, Marilyn L.

    2009-01-01

    Metabolically inert, accretionary structures such as the dentin growth layers in teeth provide a life history record of individual diet with near-annual resolution. We constructed ontogenetic ??13C and ??15N profiles by analyzing tooth dentin growth layers from 13 individual killer whales Orcinus orca collected in the eastern northeast Pacific Ocean between 1961 and 2003. The individuals sampled were 6 to 52 yr old, representing 2 ecotypes-resident and transient - collected across ???25?? of latitude. The average isotopic values of transient individuals (n = 10) are consistent with a reliance on mammalian prey, while the average isotopic values of residents (n = 3) are consistent with piscivory. Regardless of ecotype, most individuals show a decrease in ??15N values of ???2.5% through the first 3 yr of life, roughly equivalent to a decrease of one trophic level. We interpret this as evidence of gradual weaning, after which, ontogenetic shifts in isotopic values are highly variable. A few individuals (n = 2) maintained relatively stable ??15N and ??13C values throughout the remainder of their lives, whereas ??15N values of most (n = 11) increased by ???1.5%, suggestive of an ontogenetic increase in trophic level. Significant differences in mean ??13C and ??15N values among transients collected off California suggest that individuality in prey preferences may be prevalent within this ecotype. Our approach provides retrospective individual life history and dietary information that cannot be obtained through traditional field observations of free-ranging and elusive species such as killer whales, including unique historic ecological information that pre-dates modern studies. By providing insights into individual diet composition, stable isotope analysis of teeth and/or bones may be the only means of evaluating a number of hypothesized historical dietary shifts in killer whales of the northeast Pacific Ocean. ?? Inter-Research 2009.

  6. Institutional, Retrospective Analysis of 777 Patients With Brain Metastases: Treatment Outcomes and Diagnosis-Specific Prognostic Factors

    SciTech Connect

    Antoni, Delphine; Clavier, Jean-Baptiste; Pop, Marius; Schumacher, Catherine; Lefebvre, François; Noël, Georges

    2013-07-15

    Purpose: To retrospectively evaluate the prognostic factors and survival of a series of 777 patients with brain metastases (BM) from a single institution. Methods and Materials: Patients were treated with surgery followed by whole-brain radiation therapy (WBRT) or with WBRT alone in 16.3% and 83.7% of the cases, respectively. The patients were RPA (recursive partitioning analysis) class I, II, and III in 11.2%, 69.6%, and 18.4% of the cases, respectively; RPA class II-a, II-b, and II-c in 8.3%, 24.8%, and 66.9% of the cases, respectively; and with GPA (graded prognostic assessment) scores of 0-1.0, 1.5-2.0, 2.5-3.0, and 3.5-4.0 in 35%, 27.5%, 18.2%, and 8.6% of the cases, respectively. Results: The median overall survival (OS) times according to RPA class I, II, and III were 20.1, 5.1, and 1.3 months, respectively (P<.0001); according to RPA class II-a, II-b, II-c: 9.1, 8.9, and 4.0 months, respectively (P<.0001); and according to GPA score 0-1.0, 1.5-2.0, 2.5-3.0, and 3.5-4.0: 2.5, 4.4, 9.0, and 19.1 months, respectively (P<.0001). By multivariate analysis, the favorable independent prognostic factors for survival were as follows: for gastrointestinal tumor, a high Karnofsky performance status (KPS) (P=.0003) and an absence of extracranial metastases (ECM) (P=.003); for kidney cancer, few BM (P=.002); for melanoma, few BM (P=.01), an absence of ECM (P=.002), and few ECM (P=.0002); for lung cancer, age (P=.007), a high KPS (P<.0001), an absence of ECM (P<.0001), few ECM and BM (P<.0001 and P=.0006, respectively), and control of the primary tumor (P=.004); and for breast cancer, age (P=.001), a high KPS (P=.007), control of the primary tumor (P=.05), and few ECM and BM (P=.01 and P=.0002, respectively). The triple-negative subtype was a significant unfavorable factor (P=.007). Conclusion: Prognostic factors varied by pathology. Our analysis confirms the strength of prognostic factors used to determine the GPA score, including the genetic subtype for breast cancer.

  7. A retrospective study of the chemical analysis cost for the remediation of Lower East Fork Poplar Creek, Oak Ridge, Tennessee

    SciTech Connect

    Klatt, L.N.

    1998-06-01

    A retrospective study of the remediation of Lower East Fork Poplar Creek (LEFPC) in Oak Ridge, Tennessee was completed. The study was conducted by reviewing the public Comprehensive Environmental Response, Compensation, and Liability Act record documents associated with the remediation of LEFPC and through discussions with the project staff involved or familiar with the project. The remediation took place in two phases. The first phase involved the excavation of about 5,560 yd{sup 3} of soil at the National Oceanic and Atmospheric Administration (NOAA) locations in 1996. The second phase involved the excavation of 39,200 yd{sup 3} at another NOAA location and at the Bruner location in 1997. For the entire project (remedial investigation through cleanup), a total of 7,708 samples (1 sample for each 5.8 yd{sup 3} of soil remediated) were analyzed for mercury. The project obtained special regulatory approval to use two methods for the determination of mercury in soils that are not part of the Resource Conservation and Recovery Act SW-846 methods manual. The mercury analysis cost was $678,000, which represents 9.6% of the cleanup cost. During the cleanup phase of the project, an on-site laboratory was used. The estimated cost savings that the on-site laboratory provided fall into two categories: direct reduction of costs associated with chemical analysis and sample shipment totaling approximately $38,000, which represents a 5.3% savings relative to the estimated cost of using an off-site laboratory, and savings in the amount of $890,000 (12.5% of the $7.1 M cleanup cost), associated with expediting execution of the cleanup work by providing rapid (< 3 hours) sample result turnaround time. The manner in which the analytical services were procured for the LEFPC project suggest that the development of new chemical analysis technology must address deployment, performance, regulatory, robustness, reliability, and business appropriateness factors if the technology is to be

  8. Using Conference Submission Data to Uncover Broad Trends in Language Teaching: A Case Study of One Conference over 30 Years

    ERIC Educational Resources Information Center

    Stapleton, Paul

    2013-01-01

    Submissions to conferences can provide rich material for analysing characteristics and trends within a conference's history and that of similar conferences, as well as the associated field at large. The present study uses data gathered over 30 years from a language teachers' conference in Japan (JALT National) to expound upon patterns related to…

  9. The Public Acceptance of Voluntary Childlessness in the Netherlands: From 20 to 90 Per Cent in 30 Years

    ERIC Educational Resources Information Center

    Noordhuizen, Suzanne; de Graaf, Paul; Sieben, Inge

    2010-01-01

    Within a relatively short period of 30 years, public acceptance of voluntary childlessness has increased enormously in the Netherlands. In this paper, we address two research questions, which we answer with data from 13 waves of the repeated cross-sectional survey Cultural Change in the Netherlands (CCN, 1965-1996). First, we investigate to what…

  10. Longitudinal Pathways between Maternal Mental Health in Infancy and Offspring Romantic Relationships in Adulthood: A 30-Year Prospective Study

    ERIC Educational Resources Information Center

    Slominski, Lisa; Sameroff, Arnold; Rosenblum, Katherine; Kasser, Tim

    2011-01-01

    Longitudinal pathways between maternal mental health in infancy and offspring romantic relationship outcomes in adulthood were examined using a 30-year prospective longitudinal study of 196 mothers and their children. Structural equation modeling revealed that maternal mental health at 30 months was related to offspring relationship status and…

  11. Platinum-based Chemotherapy in Primary Advanced Seminoma—a Retrospective Analysis: Treatment Results at the Northern Israel Oncology Center (1989–2010)

    PubMed Central

    Stein, Moshe E.; Drumea, Karen; Charas, Tomer; Gershuny, Anthony; Ben-Yosef, Rahamim

    2014-01-01

    Objective: Over the past 30 years, great strides have been made in the treatment of disseminated testicular tumors. Despite the low number of patients and the rarity of studies concerning primary advanced seminoma, the efficacy of chemotherapy is clear, mainly 3–4-cisplatin-based chemotherapy. Aiming to contribute to the understanding and implementation of proper chemotherapeutic management in advanced seminoma patients, we retrospectively summarized our experience with 26 patients who were referred for platinum-based chemotherapy, post-orchiectomy to the Northern Israel Oncology Center between 1989 and 2010. Response rate, side effects, and long-term outcome were investigated. Methods: Before chemotherapy, meticulous staging was done, including tumor markers (B-human chorionic gonadotropin (B-HCG), alpha-fetoprotein (AFP), and lactic dehydrogenase (LDH)), and abdominal and pelvic computerized tomography (CT) scans were carried out. Results: All 26 treated patients achieved complete remission, clinically and symptomatically, with normalization of their CT scans. At a median follow-up of 120 months (range, 24–268 months) all patients are alive, without evidence of recurrent disease. One patient whose disease recurred twice achieved a third complete remission following salvage treatment with high-dose chemotherapy and autologous peripheral stem cell transplantation. Another patient, who preferred surveillance, relapsed abdominally after 9 months but achieved long-standing complete remission with cisplatin-based chemotherapy. Both these patients are alive with no evidence of disease. Three patients recovered uneventfully from bleomycin-induced pneumonitis. Conclusions: Advanced seminoma is a highly curable disease using platinum-based chemotherapy. Our study confirms the efficacy and safety of cisplatin-based chemotherapy in the treatment of advanced seminoma. PMID:24498512

  12. [Carcinoma of unknown origin++ with latero-cervical metastasis. Diagnostic problems. Retrospective analysis of 110 cases of latero-cervical tumefaction].

    PubMed

    Santacroce, L; Luperto, P; Fiorella, M L; Losacco, T

    2000-01-01

    The cervical region, despite to its little extension, is very important by the surgical and anatomical point of view. This region, occupied by a lot of organs, sometimes is the site of metastasis from carcinomas located in various parts of the body. In some cases the origin site of cancer stays unknown. The aim of this paper is the retrospective analysis of 110 cases of latero cervical swellings and the related problems of differential diagnosis.

  13. Economic costs of automated and continuous ambulatory peritoneal dialysis in Taiwan: a combined survey and retrospective cohort analysis

    PubMed Central

    Tang, Chao-Hsiun; Wu, Yu-Ting; Huang, Siao-Yuan; Chen, Hsi-Hsien; Wu, Ming-Ju; Hsu, Bang-Gee; Tsai, Jer-Chia; Chen, Tso-Hsiao; Sue, Yuh-Mou

    2017-01-01

    Objectives Taiwan succeeded in raising the proportion of peritoneal dialysis (PD) usage after the National Health Insurance (NHI) payment scheme introduced financial incentives in 2005. This study aims to compare the economic costs between automated PD (APD) and continuous ambulatory PD (CAPD) modalities from a societal perspective. Design and setting A retrospective cohort of patients receiving PD from the NHI Research Database was identified during 2004–2011. The 1:1 propensity score matched 1749 APD patients and 1749 CAPD patients who were analysed on their NHI-financed medical costs and utilisation. A multicentre study by face-to-face interviews on 117 APD and 129 CAPD patients from five hospitals located in four regions of Taiwan was further carried out to collect data on their out-of-pocket payments, productivity losses and quality of life with EuroQol-5D-5L. Outcome measures The NHI-financed medical costs, out-of-pocket payments and productivity losses of APD and CAPD patients. Results The total NHI-financed medical costs per patient-year after 5 years of follow-up were significantly higher with APD than CAPD (US$23 005 vs US$19 237; p<0.01). In terms of dialysis-related costs, APD had higher costs resulting from the use of APD machines (US$795) and APD sets (US$2913). Significantly lower productivity losses were found with APD (US$2619) than CAPD (US$6443), but the out-of-pocket payments were not significantly different. The differences in NHI-financed medical costs and productivity losses between APD and CAPD remained robust in the bootstrap analysis. The total economic costs of APD (US$30 401) were similar to those of CAPD (US$29 939), even after bootstrap analysis (APD, US$28 399; CAPD, US$27 960). No discernable differences were found in the results of mortality and quality of life between the APD and CAPD patients. Conclusions APD had higher annual dialysis-related costs and lower annual productivity losses than CAPD, which made the

  14. Counselling in humanitarian settings: a retrospective analysis of 18 individual-focused non-specialised counselling programmes

    PubMed Central

    2013-01-01

    Background Médecins Sans Frontières (MSF) provides individual counselling interventions in medical humanitarian programmes in contexts affected by conflict and violence. Although mental health and psychosocial interventions are a common part of the humanitarian response, little is known about how