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Tanaka, Hirokazu, Kenji Fukushima, Pramod Kadaba Srinivasan, Kerstin Pawlowsky, Babette Koegel, Koichiro Hata, Yonson Ku, Shinji Uemoto e René H. Tolba. "Efficacy of the Novel Medical Adhesive, MAR-VIVO-107, in an Acute Porcine Liver Resection Model". Surgical Innovation 24, n.º 5 (17 de julho de 2017): 423–31. http://dx.doi.org/10.1177/1553350617720993.
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Background. Despite modern surgical techniques, insufficient hemostasis after liver trauma is still a major cause of morbidity and mortality after injury. Therefore, efficient hemostatic agents are indicated. In this study, we evaluated the hemostatic efficacy of a novel synthetic wound adhesive (MAR-VIVO-107) based on polyurethane/polyurea, compared with a widely used fibrin adhesive (Tisseel). Materials and Methods. Twelve German Landrace pigs were randomly assigned to 2 groups. The animals were operated under sterile conditions. A midline laparotomy was performed and the left liver lobe was isolated and resected, using a surgical scissor, in order to induce hepatic trauma. MAR-VIVO-107 or Tisseel was applied to the resected area. The animals were monitored for 60 minutes; thereafter, they were sacrificed under anesthesia. Blood and tissue samples were collected pre- and postresection for biochemical and hematological analyses. Results. MAR-VIVO-107 versus Tisseel (mean ± SD, P value)—postsurgical survival rate was 100% in both groups. Bleeding time was significantly higher in Tisseel compared with MAR-VIVO-107 (10.3 ± 5.0 vs 3.7 ± 1.5 minutes, P = .0124). In trend, blood loss was less in the MAR-VIVO-107 group (54.3 ± 34.9 vs 105.5 ± 65.8 g, P = .222). Aspartate transaminase levels were significantly lower in the MAR-VIVO-107 group when compared with the Tisseel group (39.0 ± 10.0 vs 72.4 ± 23.4 U/L, P = .0459). Conclusion. The efficacy of MAR-VIVO-107 and comparable performance to the gold standard fibrin have been shown under pre-clinical conditions. MAR-VIVO-107 permits hemorrhage control within seconds, even in wet environment.
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Tannock, G. A., S. M. Gillett, R. S. Gillett, R. D. Barry, M. J. Hensley, R. Herd, A. L. A. Reid e N. A. Saunders. "A study of intranasally administered interferon A (rIFN-α2A) for the seasonal prophylaxis of natural viral infections of the upper respiratory tract in healthy volunteers". Epidemiology and Infection 101, n.º 3 (dezembro de 1988): 611–21. http://dx.doi.org/10.1017/s0950268800029484.
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SUMMARYThe efficacy of interferon A (rIFN-α2A), an Escherichia coli-derived interferon, in the prophylaxis of acute upper respiratory tract infection, was evaluated in a community-based double-blind placebo-controlled study in the Australian winter of 1985. The trial population of 412 healthy volunteers (190 males and 222 females, aged 18–65 years) self-administered 1·5, 3·0 and 6·0 megaunits (MU) of interferon A per day or a placebo, intranasally for 28 days.The period of study coincided with an outbreak of H3N2 influenza A (detected in 35 of the 107 acute specimens) as well as substantial numbers of respiratory syncytial virus and adenovirus infections. Rhinoviruses were isolated from only three specimens. In many cases, subjects had laboratory and clinical evidence of having had more than one respiratory tract infection during the period of the study. Viruses were detected in 54 or 107 acute specimens (49%).No statistically significant differences were noted between the various treatment groups in the incidence of laboratory-proven viral infection (virus isolation and/or antibody response). Analysis of reported symptoms indicated that blood-tinged mucus and nasal stuffiness occurred more frequently with higher doses of interferon. There appeared to be no clinical benefit from the use of interferon A in the amelioration of symptoms.
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Sitasari, Novendawati Wahyu, Wara Rahmawati e Yuli Asmi Rozali. "REGULASI DIRI SISWA SEKOLAH KHUSUS OLAHRAGA RAGUNAN BINAAN PEMERINTAH PROVINSI DKI JAKARTA". MOTORIC 3, n.º 2 (16 de dezembro de 2019): 83–91. http://dx.doi.org/10.31090/m.v3i2.943.
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The purpose of this study was to find out how self-regulation of SKO Ragunan students. The population and sample from this study amounted to 222 SKO Ragunan Fostered DKI Jakarta Provincial Government consisting of 115 male students and 107 female students. This research belongs to the type of quantitative research that is descriptive in nature. Data is collected by distributing self-regulation questionnaires based on the theory of Omrod (2009). Data analysis is done by making a total score category of self-regulation. The results showed that students of SKO Ragunan Fostered by the DKI Provincial Government who had medium regulation were 86.5% more than those who had high regulation of 13.5%. Besides male students have more good regulation than female students. And students with team or team sports have higher regulations than students from individual sports
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Banaszczyk, Wojciech. "Rearrangement of series in nonnuclear spaces". Studia Mathematica 107, n.º 3 (1993): 213–22. http://dx.doi.org/10.4064/sm-107-3-213-222.
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Howard, Jean E. "Mariko Ichikawa. The Shakespearean Stage Space. Cambridge: Cambridge University Press, 2013. xiii + 222 pp. $95. ISBN: 978–1–107–02035–1." Renaissance Quarterly 66, n.º 4 (2013): 1514–15. http://dx.doi.org/10.1086/675204.
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Builes, Carlos Esteban, Andrea Arango e Wilton Mauricio Cano. "Frecuencia de sangrado en pacientes con enfermedades cardiovasculares anticoagulados con warfarina genérica vs. Coumadin". Acta Médica Colombiana 35, n.º 4 (24 de setembro de 2019): 175–78. http://dx.doi.org/10.36104/amc.2010.1526.
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* Trabajo ganador del premio al "Mejor trabajo de Residentes" otorgado por el XXI Congreso Colombiano de Medicina Interna. Cali, 14 al 17 de octubre de 2010
Objetivos: comparar la frecuencia de complicaciones hemorrágicas en pacientes mayores de dieciocho años con enfermedades cardiovasculares que se encuentren anticoagulados con warfarina genérica y en aquellos anticoagulados con Coumadin.
Metodología: se realizó un estudio de cohortes de tipo retrospectivo, se tomó una muestra total de 444 pacientes, 222 en terapia con warfarina genérica y 222 en terapia con Coumadin.
Resultados: en la muestra de 444 se conoció el género en 406 pacientes, 187 (46.1%) fueron mujeres y 219 (53.9%) hombres. Los diagnósticos más frecuentes por los cuales los pacientes se encontraban anticoagulados fueron reemplazo valvular 265 pacientes y fibrilación auricular 123 pacientes. De todos los pacientes presentaron alguna complicación 194. Al momento de la complicación se encontraban en tratamiento con warfarina genérica 152 pacientes (78.4%) y 42 pacientes se encontraban en tratamiento con Coumadin (21.6%). De los 194 pacientes que presentaron complicaciones, 114 (58.76%) presentaron algún episodio de sangrado. De ellos, presentaron sangrado mayor siete pacientes y sangrado menor 107 pacientes.. Después de la complicación cambiaron de medicamento 47 pacientes, de los cuales lo hicieron de warfarina genérica a Coumadin 39 pacientes, de los cuales mejoraron 94.9% y de Coumadin a warfarina genérica ocho pacientes, con mejoría sólo en 12.5%.
Conclusiones: la frecuencia de episodios de sangrado menor es significativamente mayor entre los pacientes anticoagulados con warfarina genérica que en los anticoagulados con Coumadin. Además en los pacientes que presentaron alguna complicación, se observó una mejoría significativa con el cambio de warfarina genérica a Coumadin
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Murtaza Hasnain, Muhammad Usman, Sheikh Ishaque Aamir, Hamza Irshad e Muhammad Akram. "Evaluation of clinical laboratory parameters in COVID-19 positive cases admitted in Islamabad from May to July 2021." Professional Medical Journal 29, n.º 12 (1 de dezembro de 2022): 1838–45. http://dx.doi.org/10.29309/tpmj/2022.29.12.7146.
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Objective: To assess the variation of laboratory parameters in COVID-19 positive patients with different genders and age groups and clarify the consequences of COVID-19 infection on different patients. Study Design: Prospective study. Setting: IHITC (Isolation Hospital & Infectious Treatment Center), Islamabad. Period: 20th May, 2021 to 25th July, 2021. Material & Methods: With 222 participants was conducted in 119 were COVID positive serve as Case and 103 were COVID negative considered as control. Blood samples were drawn from all participants of study to measure biochemical and hematological laboratory parameters with demographic characteristics. Mean ± standard deviation (SD) of different lab parameters analyzed by using IBM SPSS Statistics 20. Results: Total 222 participants were analyzed having 115 (50.7%) male and 107 (49.3%) female having mean age 60±13.8. No significant variation has been seen in ALP, total bilirubin, creatinine and uric acid having mean values with in normal range. In 119 positive patients, ALT (p=0.001) (t=2.031), urea (p=0.001) (t=7.590), Ferritin (p=0.001) (t=7.13), CRP (p=0.001) (t=9.90) and D-dimer (p=0.001) (t=5.962) were elevated and good predictor of poor prognosis of disease. Pathological impacts of COVID-19 were also represented by hematological parameters including WBC count (p=0.001) (t=7.126), Neutrophil to Lymphocyte Ratio (p=0.001) (t=9.042) and Lymphocyte count (p=0.001) (t=-12.707). Conclusion: According to this research, males and old age population is more susceptible to SARS-2. Our study suggests that laboratory biomarkers including ALT, Urea, Ferritin, CRP, D-dimer and WBC count are significantly associated with poor prognosis in Covid-19 patients.
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van de Nieuwenhof, H. P., I. A. M. van der Avoort, L. F. A. G. Massuger e J. A. de Hullu. "Letter to the Editor concerning “Topical imiquimod can reverse vulvar intraepithelial neoplasia: A randomized, double blinded study.” Gynecologic Oncology 107 (2007) 219–222". Gynecologic Oncology 109, n.º 3 (junho de 2008): 430–31. http://dx.doi.org/10.1016/j.ygyno.2008.01.020.
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Williams, Robin Edward Thomas, Claude Y. Angel, Ryad Bourkaib, Philippe Brenot, Philippe Commeau, Robert Kendall Fisher, Ralph Jackson et al. "Multicenter Safety and Efficacy Analysis of Assisted Closure after Antegrade Arterial Punctures Using the StarClose Device". Journal of Endovascular Therapy 14, n.º 4 (agosto de 2007): 498–505. http://dx.doi.org/10.1177/152660280701400410.
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Purpose: To evaluate the safety and efficacy of the StarClose device for closure of antegrade punctures following infrainguinal endovascular interventions. Methods: A retrospective review was conducted of 221 consecutive patients treated with the StarClose device in a 12-month period at 5 centers (4 French and 1 British). Of these, 107 patients (69 men; median age 75 years, range 44–93) were from the UK cohort (111 closures), and 94 patients (75 men; median age 67 years, range 32–95) were from the French cohort (111 closures). Technical success, complication rates, demographic data, medical history, and procedural details were gathered for all patients. Residual bleeding and the requirement for additional manual compression were recorded when the device failed. Clinical evaluation was performed at discharge; color-coded duplex ultrasonography was done in a subset of French patients. Results: The overall technical success rate was 94.6% (210/222; 95% CI 3.1%–9.2%). The results were similar in the 2 cohorts: 95.5% (106/111; 95% CI 1.9%–10.1%) in the UK and 93.7% (104/111; 95% CI 3.1%–12.4%) in France. The 12 failures (5 UK and 7 France) were due to several mechanisms: device failure (n=5), obesity (n=1), groin scarring (n=2), and unexplained (n=4). In 2 failed cases, open surgical closure of the arteriotomy was performed because pressure hemostasis failed. Two pseudoaneurysms were observed: one after immediate failure was successfully treated by prolonged pressure; the other, after apparent success of the device, required surgical therapy. The incidence of serious vascular complication was 1.8% (4/222; 95% CI 0.7%–4.5%); 2 patients from each cohort. Conclusion: The StarClose device safely and effectively closes antegrade punctures after infrainguinal endovascular intervention, even in patients who would be considered to be at high risk for puncture-site bleeding. However, a randomized trial would be required to support any definitive recommendations.
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Čolović, Petar, Bojan Branovački e Dragana Zgonjanin Bosić. "VALIDATION OF ZYGOSITY ASSESSMENT BY A SELF-REPORT QUESTIONNAIRE IN A SAMPLE OF ADULT SERBIAN TWINS". Primenjena psihologija 11, n.º 4 (14 de janeiro de 2019): 419–32. http://dx.doi.org/10.19090/pp.2018.4.419-432.
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Validation of a twin zygosity-estimating questionnaire, The Questionnaire of Twins’ Physical Resemblance, created by Oniszczenko et al. and used in European and Serbian twin studies, was carried out on a sample of 222 pairs (176 monozygotic, 46 dizygotic) of adult twins (average age 24.6). Four discriminant functions, use of different sets of indicators (zygosity questionnaire items), were applied in order to obtain the most correct and accurate estimates of zygosity. The first function was a predefined function used in European twin studies, the following two functions contained sets of 18 and 24 freely estimated indicators respectively, while the last one utilized the items with most consistent contributions to zygosity prediction. The analytic procedure included cross-validation, whereby the sample was randomly split into two subsamples, comprising 107 and 115 twin pairs. The results pointed to successful (over 90% correct) identification of monozygotic twins, and sizeably lower correctness in identifying dizygotic twins. Overall correctness of estimation exceeded 90%, with the small set of best-performing indicators. The results encourage questionnaire estimation of zygosity, and raise the issue of improving the classification procedure in dizygotic twins.
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Velez-Roa, Sonia, Baktybek Kojonazarov, Agnieszka Ciarka, Pascal Godart, Robert Naeije, Virend K. Somers e Philippe van de Borne. "Dobutamine potentiates arterial chemoreflex sensitivity in healthy normal humans". American Journal of Physiology-Heart and Circulatory Physiology 285, n.º 3 (setembro de 2003): H1356—H1361. http://dx.doi.org/10.1152/ajpheart.01126.2002.
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β-Adrenergic agonists may increase chemosensitivity in humans. We tested the hypothesis that the β1-agonist dobutamine increases peripheral chemosensitivity in a double-blind placebo-controlled randomized and crossover study. In 15 healthy subjects, we examined the effects of dobutamine on breathing, hemodynamics, and sympathetic nerve activity (measured using microneurography) during normoxia, isocapnic hypoxia (10% O2), posthypoxic maximal voluntary end-expiratory apnea, hyperoxic hypercapnia, and cold pressor test (CPT). Dobutamine increased ventilation (7.5 ± 0.3 vs. 6.7 ± 0.2 l/min, P = 0.0004) during normoxia, markedly enhanced the ventilatory (16.1 ± 1.6 vs. 11.4 ± 0.7 l/min, P < 0.0001) and sympathetic (+403 ± 94 vs. +222 ± 5%, P < 0.03) responses at the fifth minute of isocapnic hypoxia, and enhanced the sympathetic response to the apnea performed after hypoxia (+501 ± 107% vs. +291 ± 38%, P < 0.05). No differences were observed between dobutamine and placebo on the responses to hyperoxic hypercapnia and CPT. Dobutamine increases ventilation during normoxia and potentiates the ventilatory and sympathetic responses to hypoxia in healthy subjects. Dobutamine does not affect the responses to hyperoxic hypercapnia and CPT. We conclude that dobutamine enhances peripheral chemosensitivity.
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Burivong, Wanaporn, Thanatorn Sricharoen, Apichart Thachang, Sunsiree Soodchuen, Panitpong Maroongroge e Vichit Leelasithorn. "Early Radiologic Diagnosis of Pulmonary Infection in Febrile Neutropenic Patients: A Comparison of Serial Chest Radiography and Single CT Chest". Radiology Research and Practice 2021 (18 de fevereiro de 2021): 1–7. http://dx.doi.org/10.1155/2021/8691363.
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Objective. The purpose of this study is to compare the early radiologic diagnosis of pulmonary infection between serial chest radiography (chest film) and single chest computed tomography (CT chest) in the first seven days of febrile neutropenia. Methods. This study included 78 patients with hematologic malignancies who developed 107 episodes of febrile neutropenia from January 2012 to October 2017 and had a chest film performed within the first seven days. Demographic and radiographic data were retrospectively reviewed. Three radiologists independently and blindly evaluated chest films and CT chests. The sensitivity, specificity, and correlation of chest film with absolute neutrophil count were carried out. Results. A total of 222 chest films were performed during this period and found thirty-nine episodes (36.4%) of radiographic active pulmonary infection. The diagnosis of clinical positive for pulmonary infection is 44.8% (48/107). Sensitivity, specificity, positive predictive value, and negative predictive value of serial chest film in the early radiologic diagnosis of pulmonary infection are 50%, 74%, 61%, and 64%, respectively. The false-positive rate was 14%, and the false-negative rate was 22%. For single CT chest examinations, twenty-six studies were assessed, and 42.3% was indicative of radiographic active pulmonary infection. Sensitivity, specificity, positive predictive value, and negative predictive value of CT chest in the early radiologic diagnosis of pulmonary infection are 91%, 40%, 53%, and 86%, respectively. The false-positive rate was 60%. The absolute neutrophil count was not useful for predicting radiographic active pulmonary infection. Conclusion. Serial chest film for early radiologic diagnosis of pulmonary infection within the first seven days of febrile neutropenia has lower sensitivity with higher specificity as compared to a single CT chest. Conversely, CT chest may not only have a higher sensitivity in determining early pulmonary infection but also has a higher rate of false-positives.
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Forsythe, Anna, Wei Zhang, Uwe Phillip Strauss, Marc Fellous, Maesumeh Korei e Karen Keating. "A systematic review and meta-analysis of neurotrophic tyrosine receptor kinase gene fusion frequencies in solid tumors". Therapeutic Advances in Medical Oncology 12 (janeiro de 2020): 175883592097561. http://dx.doi.org/10.1177/1758835920975613.
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Introduction: The research objective was to systematically review evidence on neurotrophic tyrosine receptor kinase ( NTRK) gene fusion frequency in solid tumors. Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review (SLR) was conducted of studies published from January 1987 to 2 January 2020. Selected studies were appraised for use in meta-analysis, with frequency reported as a point estimate with confidence intervals, to estimate NTRK gene fusion tumor incidence and prevalence. Results: The SLR identified 222 studies from North America ( n = 122), Europe ( n = 33), Asia ( n = 41), Brazil ( n = 5), Australia ( n = 2), and multi-continental ( n = 19) reporting NTRK gene fusion frequencies across 101 histologies. Studies were prospective ( n = 43) and retrospective ( n = 179). Testing methods involved DNA ( n = 93), RNA ( n = 72), combined DNA/RNA ( n = 48), protein [immunohistochemistry (IHC), n = 5], and unreported ( n = 5). Sample sizes ranged from 1 to 66,871. Of the 222 studies, 107 were suitable for meta-analysis. Highest NTRK gene fusion frequencies were reported in rare cancers: infantile/congenital fibrosarcoma (90.56%, 95% CI 67.42–100.00), secretory breast cancer (92.87%, 95% CI 72.62–100.00), and congenital mesoblastic nephroma (21.52%, 95% CI 13.06–32.20). Lower frequencies were reported in non-small cell lung cancer (0.17%, 95% CI 0.09–0.25), colorectal adenocarcinoma (0.26%, 95% CI 0.15–0.36), cutaneous melanoma (0.31%, 95% CI 0.07–0.55), and non-secretory breast carcinoma (0.60%, 95% CI 0.00–1.50). Reported frequency was ~0% for some cancers: mesothelioma, renal cell carcinoma, prostate cancer, and bone sarcoma. Estimated global overall NTRK gene fusion tumour incidence and 5-year prevalence in 2018 was 0.52 and 1.52 per 100,000 persons, respectively. Conclusion: This research confirms the rarity and varying frequency of NTRK gene fusion across tumor types. Limitations included relatively low historic NTRK gene fusion testing and reporting, limited study samples for some cancers, and suboptimal molecular testing methods. In this rapidly developing area, gold-standard testing methods and companion diagnostics are needed to capture all NTRK gene fusions.
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Barker, Juliet N., Andromachi Scaradavou, Cladd Stevens e Pablo Rubinstein. "The Dose-Match Interaction in Umbilical Cord Blood (UCB) Transplantation: An Analysis of the Impact of Cell Dose and HLA-Match on the Disease-Free Survival (DFS) of 989 Patients Transplanted with Single Units for Hematologic Malignancy." Blood 110, n.º 11 (16 de novembro de 2007): 333. http://dx.doi.org/10.1182/blood.v110.11.333.333.
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Abstract Total nucleated cell (TNC) dose and HLA-match are both recognized determinants of engraftment, transplant-related mortality (TRM), and DFS after UCB transplantation (UCBT). However, how to “trade off” dose and match in unit selection is not well defined. Therefore, we analyzed the impact of pre-freeze TNC dose and HLA-match upon 3 year transplant outcomes after 3-6/6 HLA-A, B antigen, DRB1 allele matched UCBT provided by the NCBP. Patients were transplanted with myeloablative conditioning using single units for the treatment of acute (n = 768) or chronic (n = 156) leukemia or myelodysplasia (n = 65) between 1993–2005. The 989 patients with outcome data to date (91% of single unit grafts provided in this interval) had a median age of 9 years (range 0–62). Individually, decreasing TNC dose adversely affected engraftment, TRM, and DFS as previously shown, whereas increasing HLA-mismatch adversely impacted these outcomes as well as the incidence of severe acute graft-vs-host disease (aGVHD). For example, using recipients of 5/6 units as a reference, the relative risk (RR) for grades III-IV aGVHD for recipients of 6/6 units was 0.3 (p = 0.03); for 4/6 unit recipients was 1.6 (p = 0.003); and for 3/6 unit recipients was 2.1 (p = 0.002). An analysis of the 3 year DFS combining both pre-freeze TNC dose and HLA-match, using recipients of 5/6 matched 2.5–4.9 x 107/kg units as the reference, is shown. Match/ Dose N RR: Death or Relapse (95%CI) p 6/6: any dose 50 0.4 (0.2–0.7) 0.002 5/6: TNC 0.7–2.4 66 1.7 (1.2–2.4) 0.003 5/6: TNC 2.5–4.9 116 1.0 (Reference) - 5/6: TNC ≥ 5.0 141 0.9 (0.6–1.2) 0.5 4/6: TNC 0.7–2.4 132 1.8 (1.4–2.5) < 0.001 4/6: TNC 2.5–4.9 222 1.3 (0.95–1.7) 0.12 4/6: TNC ≥ 5.0 198 0.9 (0.7–1.3) 0.9 3/6: any dose 64 1.5 (1.0–2.1) 0.045 Notably, within the dose range transplanted to date, recipients of 6/6 units had a significantly superior DFS which was not explained by other variables such as age, disease risk, or transplant center. In contrast, recipients of 3/6 units had inferior DFS, also regardless of dose. Further, recipients of 5/6 units with a TNC 2.5–4.9 x 107/kg (mean 3.5) had a DFS that was similar to those receiving larger 4/6 units ≥ 5.0 x 107/kg (mean 5.9) but with a lower risk of severe aGVHD. Recipients of small (< 2.5 x 107/kg) units that were either 5/6 or 4/6 matched had significantly inferior outcome. This data has significant implications for the practice of unit selection for patients with hematologic malignancy. Most importantly, it suggests that the best transplant survival can be obtained by selecting a 6/6 HLA-matched unit, although the cell dose threshold for these units has not been established. If no 6/6 units are available, 5/6 units above a dose of 2.5 x 107/kg are superior to 4/6 units of any dose. In addition, small (< 2.5 x 107/kg) 5/6 or 4/6 units are inadequate as a single unit graft. Units that are 3/6 HLA-matched should also be avoided. Finally, this analysis suggests improved UCBT outcome will be dependent upon the ability to obtain units that are both of sufficient TNC dose and HLA-match requiring an increase in the global inventory of ethnically and racially diverse UCB units of high cell dose.
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Robson, Lynn. "Ruth Ahnert. The Rise of Prison Literature in the Sixteenth Century. Cambridge: Cambridge University Press, 2013. x + 222 pp. $90. ISBN: 978-1-107-04030-4." Renaissance Quarterly 67, n.º 3 (2014): 1103–5. http://dx.doi.org/10.1086/678885.
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Van Hyning, Victoria. "Ruth Ahnert, The Rise of Prison Literature in the Sixteenth Century, Cambridge: Cambridge University Press, 2013; pp. ix+222, £55, ISBN 978-1-107-04030-4". British Catholic History 32, n.º 4 (11 de setembro de 2015): 587–91. http://dx.doi.org/10.1017/bch.2015.22.
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Mansur, Dil Islam, Sunima Maskey, Pragya Shrestha, Anupama Shrestha, Kalpana Sharma e Avinay Yadav. "MEASUREMENT OF CEPHALIC AND FACIAL INDICES AMONG STUDENTS OF KUSMS". Journal of Chitwan Medical College 10, n.º 1 (14 de março de 2020): 31–35. http://dx.doi.org/10.54530/jcmc.129.
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Background: The description of the human face has been a major concern since long time. Individual identification is one such field where anthropometric parameters, especially cephalo-facial measurements, are an important tool in determining the various shapes of head and face. Hence the objective of the study was to determine the shapes of head and face.
Methods: The present study was a cross-sectional and observational type which consisted of 222 individuals (115 female and 107 male). It was conducted from January to June, 2019 after receiving ethical approval. The cephalic and facial indices were derived after measuring length and breadth of head and face. The collected data was entered in excel and analyzed with SPSS (22.0).
Results: The present study observed that the most common type of face was hyperleptoprosopic 168 (75.68%) followed by leptoprosopic 43 (19.37%), mesoprosopic 10 (4.50% female only) and euryprosopic 1 (0.93% male only). Similarly, the most common type of head was dolicocephalic 165 (74.33%), followed by mesocephalic 51 (22.97%), and brachycephalic 6 (2.70%).
Conclusions: This study concluded that the hyperleptoprosopic face was most common type and the least common type was euryprosopic face. The most common type of head was found to be dolicocephalic and the least common type was found to be brachycephalic.
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Mansur, Dil Islam, Sunima Maskey, Pragya Shrestha, Anupama Shrestha, Kalpana Sharma e Avinay Yadav. "Measurement of cephalic and facial indices among students of KUSMS". Journal of Chitwan Medical College 10, n.º 1 (15 de março de 2020): 31–35. http://dx.doi.org/10.3126/jcmc.v10i1.28067.
Texto completo da fonteResumo:
Background: The description of the human face has been a major concern since long time. Individual identification is one such field where anthropometric parameters, especially cephalo-facial measurements, are an important tool in determining the various shapes of head and face. Hence the objective of the study was to determine the shapes of head and face.
Methods: The present study was a cross-sectional and observational type which consisted of 222 individuals (115 female and 107 male). It was conducted from January to June, 2019 after receiving ethical approval. The cephalic and facial indices were derived after measuring length and breadth of head and face. The collected data was entered in excel and analyzed with SPSS (22.0).
Results: The present study observed that the most common type of face was hyperleptoprosopic 168 (75.68%) followed by leptoprosopic 43 (19.37%), mesoprosopic 10 (4.50% female only) and euryprosopic 1 (0.93% male only). Similarly, the most common type of head was dolicocephalic 165 (74.33%), followed by mesocephalic 51 (22.97%), and brachycephalic 6 (2.70%).
Conclusions: This study concluded that the hyperleptoprosopic face was most common type and the least common type was euryprosopic face. The most common type of head was found to be dolicocephalic and the least common type was found to be brachycephalic.
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Vukusic, Sandra, Patricia K. Coyle, Stephanie Jurgensen, Philippe Truffinet, Myriam Benamor, Salman Afsar, Annie Purvis, Elizabeth M. Poole e Christina Chambers. "Pregnancy outcomes in patients with multiple sclerosis treated with teriflunomide: Clinical study data and 5 years of post-marketing experience". Multiple Sclerosis Journal 26, n.º 7 (10 de abril de 2019): 829–36. http://dx.doi.org/10.1177/1352458519843055.
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Background: Teriflunomide is contraindicated in pregnancy. Some pregnancies have occurred despite guidance to use effective contraception. Objectives: To report outcomes of pregnancies occurring in teriflunomide clinical trials and the post-marketing setting. Methods: Outcomes are summarized for pregnancies in teriflunomide monotherapy clinical trials and the post-marketing setting (data cutoff: December 2017). Results: Of 437 confirmed teriflunomide-exposed pregnancies, 222 had known outcomes (70 from clinical trials; 152 from the post-marketing setting); 161 were reported prospectively and 61 retrospectively. There were 107 (48.2%) live births, 63 (28.4%) elective abortions, 47 (21.2%) spontaneous abortions, 3 (1.4%) ectopic pregnancies, 1 (0.5%) stillbirth, and 1 (0.5%) maternal death leading to fetal death. Four birth defects were reported among cases with known pregnancy outcome: ureteropyeloectasia (only defect considered major); congenital hydrocephalus; ventricular septal defect; and malformation of right foot valgus. A case of cystic hygroma was identified on antenatal ultrasound (pregnancy outcome unknown). One elective abortion followed prenatal diagnosis of fetal anomaly (blighted ovum). The risk of major birth defects in prospectively reported live birth/stillbirth outcomes was 3.6% (1/28) in clinical trials and 0.0% (0/51) in post-marketing reports. Conclusions: Outcomes were consistent with the general population. Current human data do not indicate a teratogenic signal in teriflunomide-exposed pregnancies.
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Choi, Byung Jo, Se Gyu Choi, Ohnchae Ryeon e Woojin Kwon. "A study of the analgesic efficacy of rectus sheath block in single-port total laparoscopic hysterectomy: a randomized controlled study". Journal of International Medical Research 50, n.º 10 (outubro de 2022): 030006052211330. http://dx.doi.org/10.1177/03000605221133061.
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Objective To investigate the postoperative analgesic effects of rectus sheath block (RSB) in combination with patient-controlled analgesia (PCA) compared with PCA alone after single-port total laparoscopic hysterectomy (TLH) Methods This randomized, single-blind study enrolled female patients that underwent single-port TLH. The patients were randomized to receive either fentanyl PCA (PCA group) or RSB with the same PCA. The primary outcomes were fentanyl consumption at 8 h postoperatively and visual analogue scale (VAS) pain scores, which represented the severity of postoperative pain. Results A total of 36 patients were enrolled in the study: 18 in the PCA group and 18 in the RSB group (two patients were excluded). The primary outcome of fentanyl consumption was significantly lower at 8 h postoperatively in the RSB group than in the PCA group (148 ± 61 µg versus 222 ± 107 µg, respectively). VAS scores were significantly lower at arrival in the post-anaesthesia care unit and at 30 min after arrival in the RSB group compared with the PCA group. There were no significant differences in the nausea/vomiting score and in additional analgesic consumption between the two groups. Conclusions RSB can be used as a multimodal approach for pain control in single-port TLH procedures. Clinical Research Information Service (no. KCT0001461).
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Beltran, Brady, Jianhong Lin, Lubomir Sokol, Ling Zhang, Tint Lwin, Jennifer Cultrera, Pilar Quinones et al. "Dysregulation of Micrornas Involved In HTLV-Associated Adult T-Cell Lymphoma". Blood 116, n.º 21 (19 de novembro de 2010): 3122. http://dx.doi.org/10.1182/blood.v116.21.3122.3122.
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Abstract Abstract 3122 Adult T-cell leukemia/lymphoma (ATL) is an aggressive, fatal malignancy of CD4+ T cells that is etiologically associated with infection by human T-cell leukemia virus-type. ATL has been classified into four main subtypes, indolent smoldering, chronic forms, acute and lymphomatous forms. Most individuals in the chronic stage of ATL eventually undergo progression to a highly aggressive acute stage. Compelling evidence supports a pivotal role for altered tumor suppressor genes involved in leukemogenesis and lymphomagenesis of ATL as well as progression of the disease from the chronic/smoldering to the acute/lymphomatous type. Further investigations are needed as to how the alteration of cell cycle regulatory genes are involved in the aberrant growth of HTLV-infected T cells. The emerging role of microRNAs in tumor development and viral infection has prompted investigations on the role of microRNA in ATL pathogenesis and progression. We therefore performed microRNA microarrays on 16 lymphomatous tissues of ATL patients and normal CD4 lymphocytes of 5 healthy donors. After normalization, we identified a set of aberrantly expressed miRNAs in ATL lymphoma samples when compared with control CD4 lymphocytes including 49 upregulated microRNAs and 89 downregulated microRNAs. MiR-150, miR-24, miR-221, miR-222, miR-142-5p, miR-92b, miR-93, miR-181a, miR-103, miR-107 stands out as highly elevated miRNAs in ATL samples while miR-30b, miR-34a, miR-20b, miR-196b, miR-361-5p, miR-520b/e are found downregulated in ATLL samples. Using gain-and-loss experimentations, we demonstrated miR-181a overexpression decreases, whereas miR-181a inhibition increases a proapoptotic protein, Bim, levels by directly targeting Bim. Furthermore computational analysis, and previous studies revealed that that miR-214, miR-22, miR-93 increased AKT activity by repressing PTEN expression, and miR-221/222 and miR-93 promoted cell proliferation through inhibition of CDKN1B (p27). Overall, this study demonstrated a distinct set of miRNAs that are known to be critical in cellular transformation, representing a novel molecular mechanism and potential therapeutic targets in ATL lymphoma. Disclosures: No relevant conflicts of interest to declare.
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Wszałek-Rożek, Katarzyna, Magdalena Lazarus, Renata Afranowicz-Cieślak, Joanna Gołębiewska, Anna Kuczyńska, Marta Jarosińska, Artur Eichmann e Ryszard Markowski. "Endangered flora of Gdańsk Pomerania – its distinctiveness and diversity". Biodiversity Research and Conservation 50, n.º 1 (1 de junho de 2018): 53–60. http://dx.doi.org/10.2478/biorc-2018-0007.
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Abstract Gdańsk Pomerania is a region characterized by unique physiographic features and diverse flora. This region, as many other areas, is subject to numerous accelerating transformations. The occurrence of numerous species on their range edges and on isolated stands, e.g. mountain and xerothermic grassland species, was an important criterion in the development of a regional red list of vascular plants of Gdańsk Pomerania (Markowski & Buliński 2004). On this list, 648 species of vascular plants, which constitute about 39% of the regional flora and 26% of all Polish flora, are considered to be endangered at various levels. In total, 47 species have been declared extinct in the aforementioned region (RE), 39 taxa are considered as critically endangered (CR) and 109 – as endangered (EN). Further 222 plant species are classified as vulnerable (moderately endangered) (VU), 124 have low risk categories (NT or LC) and there are 107 taxa of unknown threat, due to lack of sufficient information (DD). The aim of this work was to synthesize endangered components of Gdańsk Pomerania vascular plant flora for their better recognition and characterization. Among the species varying in threat degrees, the authors identified species protected by law and endangered in Poland as well as globally. In addition, the participation of species diagnostic of individual phytosociological units was verified. Also, the share of taxa representing various geographical elements was indicated.
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Hasan, Md Mehedi, Md Amran Gazi, Subhasish Das, Shah Mohammad Fahim, Farzana Hossaini, Md Ashraful Alam, Mustafa Mahfuz e Tahmeed Ahmed. "Association of lipocalin-2 and low-density lipoprotein receptor-related protein-1 (LRP1) with biomarkers of environmental enteric dysfunction (EED) among under 2 children in Bangladesh: results from a community-based intervention study". BMJ Paediatrics Open 5, n.º 1 (agosto de 2021): e001138. http://dx.doi.org/10.1136/bmjpo-2021-001138.
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BackgroundEnvironmental enteric dysfunction (EED) is thought to occur from persistent intestinal inflammation. Studies also revealed the association of lipocalin-2 (LCN2) and low-density lipoprotein receptor-related protein-1 (LRP1) with intestinal inflammation. Therefore, we intended to explore the relationship of LCN2 and LRP1 with gut inflammation and biomarkers of EED in Bangladeshi malnourished children.MethodsA total of 222 children (length-for-age z-score (LAZ) <-1) aged 12–18 months were enrolled in this study in a cross-sectional manner. Among the participants, 115 were stunted (LAZ <-2) and 107 were at risk of being stunted (LAZ −1 to −2) children. Plasma and faecal biomarkers were measured using ELISA. Spearman’s rank correlation was done to see the correlation among LCN2, LRP1 and biological biomarkers.ResultsLCN2 correlates positively with myeloperoxidase (r=0.19, p=0.005), neopterin (r=0.20, p=0.004), calprotectin (r=0.3, p=0.0001), Reg1B (r=0.20, p=0.003) and EED score (r=0.20, p=0.003). Whereas, LRP1 correlates negatively with myeloperoxidase (r = −0.18, p=0.006), neopterin (r = −0.30, p=0.0001), alpha-1-antitrypsin (r = −0.18, p=0.006), Reg1B (r=−0.2, p=0.003) and EED score (r = −0.29, p=0.0001).ConclusionsOur findings imply that LCN2 might be a promising biomarker to predict gut inflammation and EED. Whereas, increased level of LRP1 may contribute to alleviating intestinal inflammation.
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Paajanen, Paavo, Tiina-Talvikki Lehtimäki, Anne Fagerström e Hannu Paajanen. "Diagnostic Potential of Magnetic Resonance Imaging in Chronic Abdominal Pain". Digestive Surgery 37, n.º 3 (10 de setembro de 2019): 258–64. http://dx.doi.org/10.1159/000502797.
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Introduction: About half of the adult patients suffering from chronic abdominal pain may have no organ-related cause. Our purpose was to evaluate the additional information of magnetic resonance imaging (MRI) in diagnosing the underlying organic causes of such pain. Methods: We performed retrospective audit of 636 consecutive abdominal MRI in patients suffering from nonspecific abdominal pain (NSAP) during years 2014–2017. Medical history, clinical examination, endoscopy reports, and the results of MRI were compared in all patients. The hypothesis was that MRI increases markedly the diagnostic specificity of patients’ symptoms. Results: The mean age of patients was 66 ± 14 years and 60 percent were females. Duration of abdominal pain ranged from 1 month to 30 years (median 1.1 ± 4.0 years). Concurrently with abdominal MRI (n = 636), also ultrasound (n = 106, 17%), colonoscopy (n = 222, 35%), and gastroscopy (n = 217, 34%) were performed. Abdominal MRI revealed additional information in 161/636 (25%) of NSAP patients. Spinal and pelvic bone abnormalities (n = 107) and malignant tumors (n= 31) were the most significant organ-specific findings changing the treatment algorithm. Conclusions: When computerized tomography is not available in outpatient clinics, abdominal MRI increases markedly diagnostic specificity and alters the treatment in 1 of 4 patients suffering from NSAP. Abdominal MRI is therefore suggested for patients suffering from severe symptoms of NSAP.
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MILOVIDOV, V. D. "AGE OF DISRUPTION: THE FIRST 20 YEARS". Scientific Works of the Free Economic Society of Russia 222, n.º 2 (2020): 88–107. http://dx.doi.org/10.38197/2072-2060-2020-222-2-88-107.
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Beliy, Vladimir, e Roman Kunitsyn. "EVALUATION OF WAYS TO REDUCE VOLTAGE LOSSES IN RURAL POWER SUPPLY SYSTEMS". Vestnik Altajskogo gosudarstvennogo agrarnogo universiteta 222, n.º 4 (28 de abril de 2023): 107–13. http://dx.doi.org/10.53083/1996-4277-2023-222-4-107-113.
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Lavery, Jonathan. "THE PROTAGORAS - J.C. Shaw Plato's Anti-hedonism and the Protagoras. Pp. viii + 222. Cambridge: Cambridge University Press, 2015. Cased, £65, US$99. ISBN: 978-1-107-04665-8." Classical Review 66, n.º 2 (14 de abril de 2016): 355–58. http://dx.doi.org/10.1017/s0009840x16000639.
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Nelson, J. B., D. J. Sleep, J. D. Isaacson e M. A. Carducci. "Limitation of prostate-specific antigen doubling time as a predictor of outcome in hormone-naive prostate cancer". Journal of Clinical Oncology 24, n.º 18_suppl (20 de junho de 2006): 4566. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.4566.
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4566 Background: Prostate-specific antigen doubling time (PSADT) is used to monitor progression after primary therapy for prostate cancer. Increasingly in this population, PSADT is an efficacy measure in therapeutic trials, many of which are uncontrolled. Examination of PSADT response on placebo in a randomized controlled study may evaluate the utility of PSADT as an outcome measure in patients with hormone-naive prostate cancer. Methods: Patients with biochemical failure post radical prostatectomy were enrolled in a randomized, double-blind, placebo-controlled trial of atrasentan 10 mg. Eligibility criteria included baseline PSA between 0.4 ng/mL and 5 ng/mL with a PSADT ≤12 months based on two PSA values at least 2 weeks apart. On-treatment PSADT was compared between treatment groups in patients with at least 3 on-treatment PSA values collected every 12 weeks while on study drug. Categorical analysis comparing PSADT between groups was performed using Cochran-Mantel-Haenszel methodology. Mean change from baseline in PSA velocity (log PSA vs time) was analyzed using a one-way analysis of variance with treatment as the factor. Results: Of 222 patients enrolled, 209 had 3 PSA values on study: N=107 for placebo; N = 102 for atrasentan. Baseline PSA was lower for patients in the placebo arm than for those in the atrasentan arm (mean of 1.4 ng/mL [SE 0.1] vs 1.8 ng/mL [SE 0.1] P =.012). On-treatment PSADT was similar between treatment arms (P =.363); the proportion of patients whose PSADT was >1 year on study was 55% with placebo and 51% with atrasentan. More notably, PSADT lengthened on study for most patients in both arms (76/107, 71% for placebo and 68/102, 64% for atrasentan). PSA velocity was also protracted for patients in both treatment arms (placebo: slope = 1.47 at baseline to 0.96, P < .001; atrasentan: slope = 1.56 at baseline to 1.26, P =.017). Conclusions: The fact that over 70% of patients receiving placebo experienced lengthened PSADT suggests that, in the absence of a control arm, changes in PSADT from baseline are not a reliable measure of treatment effect in trials in early prostate cancer. PSADT data from trials in this population should be interpreted with caution. [Table: see text]
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D’Souza, Randall F., Jonathan S. T. Woodhead, Nina Zeng, Cherie Blenkiron, Troy L. Merry, David Cameron-Smith e Cameron J. Mitchell. "Circulatory exosomal miRNA following intense exercise is unrelated to muscle and plasma miRNA abundances". American Journal of Physiology-Endocrinology and Metabolism 315, n.º 4 (1 de outubro de 2018): E723—E733. http://dx.doi.org/10.1152/ajpendo.00138.2018.
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MicroRNAs (miRNAs) regulate gene expression via transcript degradation and translational inhibition, and they may also function as long distance signaling molecules. Circulatory miRNAs are either protein-bound or packaged within vesicles (exosomes). Ten young men (24.6 ± 4.0 yr) underwent a single bout of high-intensity interval cycling exercise. Vastus lateralis biopsies and plasma were collected immediately before and after exercise, as well as 4 h following the exercise bout. Twenty-nine miRNAs previously reported to be regulated by acute exercise were assessed within muscle, venous plasma, and enriched circulatory exosomes via qRT-PCR. Of the 29 targeted miRNAs, 11 were altered in muscle, 8 in plasma, and 9 in the exosome fraction. Although changes in muscle and plasma expression were bidirectional, all regulated exosomal miRNAs increased following exercise. Three miRNAs were altered in all three sample pools (miR-1-3p, -16-5p, and -222-3p), three in both muscle and plasma (miR-21-5p, -134-3p, and -107), three in both muscle and exosomes (miR-23a-3p, -208a-3p, and -150-5p), and three in both plasma and exosomes (miR-486-5p, -126-3p, and -378a-5p). There was a marked discrepancy between the observed alterations between sample pools. A subset of exosomal miRNAs increased in abundance following exercise, suggesting an exercise-induced release of exosomes enriched in specific miRNAs. The uniqueness of the exosomal miRNA response suggests its relevance as a sample pool that needs to be further explored in better understanding biological functions.
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Evans, Dai Morgan. "The Roman Amphitheatre in Britain. By Tony Wilmott. 250mm. Pp 222, 29 col, 107 b&w ills, inc maps & plans. Stroud: Tempus, 2008. ISBN 9780752441238. £17.99 (pbk)." Antiquaries Journal 88 (setembro de 2008): 446–47. http://dx.doi.org/10.1017/s0003581500001670.
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Laksono, Ollivia Brylliant, Jusup Suprijanto e Ali Ridlo. "Kandungan Mikroplastik pada Sedimen di Perairan Bandengan Kabupaten Kendal". Journal of Marine Research 10, n.º 2 (10 de maio de 2021): 158–64. http://dx.doi.org/10.14710/jmr.v10i2.29032.
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Mikroplastik adalah plastik yang berukuran kurang dari 5 mm sehingga dapat ditrasnportasikan disedimen dan memiliki dampak pada lingkungan. Penelitian ini bertujuan mengetahui bentuk dan jumlah mikroplastik di sedimen Perairan Bandengan Kabupaten Kendal. Sampel sedimen diambil pada Bulan April dan Agustus 2019 secara purposive sampling menggunakan sediment grab pada 3 stasiun berbeda, yaitu stasiun 1 (berjarak ± 9 km dari muara ke laut lepas. Stasiun 2 (berjarak ± 3 km dari muara ke laut lepas dan stasiun 3 (Muara) pada kedalaman lapisan sedimen masing-masing stasiun 2 m. Sedimen sebanyak 25 g direndam dalam 100 ml larutan ZnCl2 (972 g ZnCl2 + 1000 ml akuades) selama 24 jam. Partikel mikroplastik yang mengambang diambil lalu direndam dalam larutan H2O2 30% 50 ml selama 24 jam, kemudian disaring dengan kertas whattman nomor 42 ukuran pori 2 μm dan diamati dengan mikroskop pada perbesaraan 10x10. Keberadaan mikroplastik di Perairan Bandengan Kabupaten Kendal diduga berasal dari industri disekitar perairan aktivitas nelayan serta kegiatan masyarakat dengan bentuk mikroplastik yang ditemukan yaitu fiber, fragmen, film dan pelet. Jumlah mikroplastik pada Bulan April di stasiun 1, 2 dan 3 berturut turut adalah 271, 142 dan 107 partikel, sedangkan pada Bulan Agustus di Stasiun 1, 2 dan 3 adalah 144, 178, dan 83 partikel. Bentuk mikroplastik yang dominan bervariasi di setiap stasiun pada kedua waktu pengamatan. Pada April, bentuk mikroplastik yang dominan adalah pelet (189 partikel), sedangkan pada Agustus, jumlah terbanyak adalah pelet (186 partikel). Warna yang paling banyak adalah hitam (222 partikel). Ukuran mikroplastik terkecil adalah pelet (1,14 µm) dan terpanjang adalah fiber (214,4 µm). Microplastics are plastics that are less than 5 mm in size so that they can be transported in sediment and have an impact on the environment. This study aims to determine the shape and amount of microplastics in the sediments of Bandengan waters in Kendal Regency. Sediment samples were taken in April and August 2019 by purposive sampling using sediment grabs at 3 different stations, namely station 1 (± 9 km from the estuary to the open sea. Station 2 (± 3 km from the estuary to the high seas) and station 3 (± 3 km from the estuary to the high seas). Estuary) at a depth of 2 m of sediment layer at each station. 25 g of sediment was immersed in 100 ml of ZnCl2 solution (972 g ZnCl2 + 1000 ml distilled water) for 24 hours. Floating microplastic particles were taken and then immersed in 30% 50 ml H2O2 solution for 24 hours, then filtered with Whattman paper number 42 with a pore size of 2 μm and observed with a microscope at a magnification of 10x10.The presence of microplastics in Bandengan waters, Kendal Regency is thought to have come from industries around the waters of fishing activities as well as community activities with microplastic forms found, namely fiber, fragments , films and pellets. The number of microplastics in April at stations 1, 2 and 3 were 271, 142 and 107 particles, respectively. Shows in August at Stations 1, 2 and 3 are 144, 178, and 83 particles. The dominant form of microplastic varied at each station at the two observation times. In April, the dominant form of microplastic was pellets (189 particles), while in August, the highest number was pellets (186 particles). The most common color was black (222 particles). The smallest microplastic size was pellets (1.14 µm) and the longest was fiber (214.4 µm).
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McTighe, Sheila. "Carl Goldstein. Print Culture in Early Modern France: Abraham Bosse and the Purposes of Print. Cambridge: Cambridge University Press, 2012. xvi + 222 pp. $99. ISBN: 978–1–107–01214–1." Renaissance Quarterly 65, n.º 4 (2012): 1283–84. http://dx.doi.org/10.1086/669420.
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West, M. L. "GREEK–MESOPOTAMIAN DIALOGUES - J. Haubold Greece and Mesopotamia. Dialogues in Literature. Pp. xii + 222, ill. Cambridge: Cambridge University Press, 2013. Cased, £55, US$95. ISBN: 978-1-107-01076-5." Classical Review 65, n.º 1 (7 de agosto de 2014): 5–6. http://dx.doi.org/10.1017/s0009840x14001668.
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Bomgardner, David L. "Yet more amphitheatres on the fringe - TONY WILMOTT, THE ROMAN AMPHITHEATRE IN BRITAIN (Tempus Publishing, Stroud2008). Pp. 222, figs. 107, 29 colour ills. ISBN 978 0 7524 4123 8. £17.99." Journal of Roman Archaeology 23 (2010): 639–42. http://dx.doi.org/10.1017/s1047759400002853.
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Montenegro, Fábio L. M., Rodney B. Smith, Inês V. Castro, Marcos R. Tavares, Anói C. Cordeiro e Alberto R. Ferraz. "Associação de carcinoma papilífero da tireóide e hiperparatireoidismo". Revista do Colégio Brasileiro de Cirurgiões 32, n.º 3 (junho de 2005): 115–19. http://dx.doi.org/10.1590/s0100-69912005000300003.
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OBJETIVO: A ocorrência de carcinoma papilífero da tireóide (CPT) em doentes com hiperparatireoidismo (HPT) suscita dúvidas quanto a ser apenas coincidência ou apresentar relação causal. O objetivo deste trabalho é verificar se a incidência de CPT em diferentes formas de HPT é semelhante entre si e à incidência de CPT em achados de necropsias, assim como em doentes submetidos à tireoidectomia na mesma região. MÉTODO: Os dados de 222 pacientes consecutivos tratados por HPT foram revistos e foi analisada a incidência de CPT. Os pacientes foram estratificados em HPT primário (107) e HPT secundário (115). Os laudos anatomopatológicos foram revistos, a incidência de CPT foi pesquisada e suas características nesses indivíduos foram estudadas. Esses dados foram comparados a dados encontrados em casos de necrópsia e em 89 casos de bócio compressivo/mergulhante. Empregou-se o teste exato de Fisher e o teste t não pareado. RESULTADOS: Os laudos foram passíveis de análise em 103 casos de HPT primário, com 10 pacientes com CPT (9,7%) e em 111 portadores de HPT secundário, com três CPT associados (2,7%). Houve diferença entre o HPT primário e HPT secundário (p=0,04). Essa diferença também foi significativa em relação aos 1% de CPT achados em necrópsia na região (p=0,0001). Não houve diferença com relação à incidência de 11,2% de CPT no grupo operado por compressão e também em relação às características dos tumores, apesar de haver 80% de multicentricidade no CPT de doentes com HPT primário. CONCLUSÕES: A ocorrência de CPT em HPT primário é maior que em HPT secundário e que em achados de necropsia.
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Neumann, Martin, Ebru Coskun, Ouidad Benlasfer, Sandra Heesch, Stefan Schwartz, Nicola Goekbuget, Dieter Hoelzer, Wolf-Karsten Hofmann, Eckhard Thiel e Claudia Baldus. "High Rate of FLT3 Mutations In Adult ETP-ALL." Blood 116, n.º 21 (19 de novembro de 2010): 1031. http://dx.doi.org/10.1182/blood.v116.21.1031.1031.
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Abstract Abstract 1031 Introduction: Mutations of FLT3 are recognized as important prognostic factor in acute myeloid leukemia (AML) with an impact on new therapeutic strategies. However, FLT3 mutations are rarely (1-3%) found in acute T-lymphoblastic leukemia (T-ALL). Recently, a new T-ALL subgroup defined by a specific gene expression profile and a characteristic immunophenotype (CD1a-, CD8-, CD5weak with expression of stem cell or myeloid markers) and with poor outcome has been described in pediatric T-ALL patients. This subgroup likely originates from early thymic progenitors (ETP) and has therefore been termed ETP-ALL. To unravel the molecular alterations of this distinct subgroup with myeloid characteristics, we studied adult ETP-ALL patients for FLT3 mutations. Moreover, we analyzed miRNA expression to explore their potential involvement in the specific gene expression signature observed in ETP-ALL. Patients and methods: We screened 1241 peripheral blood and bone marrow samples of T-ALL patients that were sent to the central diagnostic reference laboratory of the German Acute Lymphoblastic Leukemia Multicenter Study Group (GMALL). Of the immunophenotypically identified ETP-ALL patients (n=142), sufficient material was available in 70 cases. FLT3 mutations (ITD and TKD) were assessed using the FLT3 mutation assay (InVivoScribe Technologies, San Diego, USA). Expression of miRNAs was first screened by TaqMan low density arrays including 667 miRNAs in ETP-ALL (n=8) and compared to non-ETP T-ALL (n=6). Subsequently, expression of miR-221 and miR-222 was examined by real-time PCR in all 70 ETP-ALL. Results: In our cohort of 1241 T-ALL, 142 (11.4 %) patients showed an immunophenotype of an ETP-ALL, which is in the range of reported frequencies in pediatric patients. Among the 70 ETP-ALL samples analyzed, we identified 9 patients with a FLT3 D835 mutation and 15 patients with a FLT3 ITD. In total, 34 % (24 of the 70) patients carried a FLT3 mutation, which represents approximately 4 % of all T-ALL patients. In contrast, only one patient was identified with a FLT3 mutation within an arbitrarily selected control group of 107 T-ALL patients with a non-ETP immunophenotype. Interestingly, ETP-ALL with FLT3 mutations showed a distinct immunophentype compared to ETP-ALL with a wild type FLT3: ETP-ALL with FLT3 mutations had a higher rate of positivity for CD2 (88% vs. 30%, P<0.001), CD117 (83% vs. 28%, P<0.001), and CD13 (100 % vs. 37%, P<0.001). On the other hand, ETP-ALL with wild type FLT3 were characterized by a more frequent positivity of CD5 (54% vs. 4%, P<0.001) and CD33 (54% vs. 4%, P<0.001). Based on these findings a specific immunophenotype may be linked to FLT3 mutated ETP-ALL: in 73% (21/29) of patients with CD2/CD13 positivity a FLT3 mutation was present, compared to only 7% (3/41) of the remaining patients with ETP-ALL. In addition, we generated miRNA expression profiles in ETP-ALL and identified 7 miRNAs that were differentially expressed compared to non-ETP T-ALL. Among these miR-221 and miR-222, which were significantly overexpressed in ETP-ALL, are targeting genes characterizing the ETP-ALL phenotype (e.g. ETS1, KIT). Examination of miR-221 and miR-222 in 70 ETP-ALL revealed their particular overexpression in FLT3 mutated samples (miR-221 2.45-fold, P=0.012; miR-222: 2.05-fold, P=0.008) compared to ETP-ALL with wild type FLT3. Conclusion: We identified a yet unreported high frequency of FLT3 mutations in T-ALL, which are nearly exclusively found within the subgroup of ETP-ALL. In this group the rate is comparable high to the rate of FLT3 mutations in AML. Therefore, on the basis of established flow cytometry analysis we identified T-ALL patients that should be now prospectively and routinely screened for FLT3 mutations. Moreover, the distinct miRNA expression pattern may impact on the specific gene expression pattern of ETP-ALL. Thus, patients of this molecular distinct ETP-ALL entity may benefit from tyrosine kinase inhibitors in relapse situations or with presence of minimal residual disease as a bridging therapy to allogeneic stem cell transplantation. Disclosures: Baldus: Novartis: Research Funding.
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Tang, Jih-Luh, Ming Yao, Meng-Yao Lu, Bor-Sheng Ko, Shang-Yi Huang, Chi-Cheng Li, Chien-Ting Lin et al. "Quantitative Monitoring of EBV Viral Load in 222 Hematopoietic Stem Cell Transplant Patients: Risk Analysis and Development of EBV-Associated Post-Transplant Lymphoproliferative Diseases (PTLD)". Blood 118, n.º 21 (18 de novembro de 2011): 3018. http://dx.doi.org/10.1182/blood.v118.21.3018.3018.
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Abstract Abstract 3018 Background and Purposes Epstein-Barr virus (EBV)-associated PTLD is a life-threatening complication following hematopoietic stem cell transplantation (HSCT). Independent risk factors include use of ATG, acute GVHD, CMV antigenemia, T-depleted graft, and unrelated donor in our previous study. Quantitative real-time polymerase chain reaction (Q-PCR) was developed for early detection and intervention of EBV reactivation to prevent PTLD-related mortality. Patients and Methods Between Apr 2004 and Oct 2010, EBV viral load in plasma was monitored by Q-PCR in 222 HSCT patients (total 2945 samples) in NTUH. EBV reactivation was defined as > 500 copies/mL in two consecutive assays or > 10-fold elevation than baseline level. Results EBV reactivation occurred in 50 (22%) patients. The cumulated incidence of EBV reactivation was 28% at 1-year and 32% at 2-year. Median time to EBV reactivation was 40 days (ranges, 26–406) after SCT and median peak EBV-viral load, 10888 copies/ml (ranges, 948–3×107). The risk of EBV reactivation was significantly higher in patients receiving ATG (52% vs. 13%, p< 0.001), use of TBI (58% vs. 26%, p<0.001), mismatched donor (69% vs. 27%, p<0.001), CMV reactivation (44% vs. 19%, p<0.001) in univariate analysis. In multivariate analysis, independent risk factors include: ATG use (HR 5.44, p<0.001), TBI (HR 3.52, p<0.001), and Fludara-based conditioning (HR 3.16, P=0.01). PTLD developed in 8 patients (5%) who didn't monitor EBV viral load regularly, and two were dead. Conclusions Monitoring of EBV viral load is a sensitive and useful tool in the surveillance of EBV-reactivation. Frequent monitoring in high-risk patients is important to prevent occurrence of EBV-PTLD. Disclosures: No relevant conflicts of interest to declare.
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Bagmet, L. V. "Crop wild relatives of Karachay-Cherkessia: inventorying and conservation prospects". Proceedings on applied botany, genetics and breeding 182, n.º 2 (1 de julho de 2021): 9–17. http://dx.doi.org/10.30901/2227-8834-2021-2-9-17.
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Studying wild relatives of cultivated plants in each specific region is an essential component in assessing the state of national plant genetic resources. This is especially true for the regions of the Russian Caucasus, with its tremendous diversity of plant species. This paper presents the results of exploring crop wild relatives (CWR) in natural plant communities of the Karachay-Cherkess Republic. The author conducted an inventory of CWR and analysis of their species composition in Karachay-Cherkessia. The CWR list includes 516 species belonging to 134 genera of 36 families; in this list, 449 species from 107 genera of 33 families are native to this region. The Dzheguta floristic district is the richest in CWR species diversity (391 species). There are 350 and 346 species in the Arkhyz and Uchkulan districts, respectively, and 301 species in the Cherkessk district. Species were ranked according to their agricultural value and economic importance: the 1st rank was assigned to 149 plant species, 2nd rank to 17, 3rd rank to 32, 4th rank to 97, and 5th rank to 222 species. In the context of their economic use, the species for feed (158) and food (136) purposes dominated over those for medicinal (60), melliferous (54), ornamental (53), industrial (51), and revegetation (5) applications. The list of priority conservation species was compiled for CWR of Karachay-Cherkessia according to the criteria of rarity and vulnerability, based on the analysis of the CWR species distribution over the studied area and their assessment for useful economic and biological traits. A map showing localities of these species within the Republic is presented, and recommendations are given for their effective conservation.
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Yılmaz, Sercan, Halil Cagri Aybal, Hakan Özdemir, Eymen Gazel, Engin Kaya, Serdar Yalcin, Mehmet Yilmaz, Ali Yusuf Oner, Mehmet Yorubulut e Lutfi Tunc. "Single center results of magnetic resonance imaging ultrasound guided fusion prostate biopsy obtained patients". Yeni Üroloji Dergisi 16, n.º 16-2 (29 de junho de 2021): 140–47. http://dx.doi.org/10.33719/yud.2021;16-2-850577.
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Objective: We aimed to evaluate magnetic resonance imaging-ultrasound guided fusion prostate biopsy (MRI- US FPBx) results from a single center and to compare with current literature. Material and Methods: Between January 2016 and July 2019, MRI-US FPBx pathological and imaging results of 358 men were retrospectively analyzed. PI-RADS scores were determined as 3, 4 and 5 in 222 (62%), 107 (29.8%) and 29 (8.1%) patients, respectively. Totally 454 lesions were underwent MRI-US FPBx. 303 (66.7%) lesions were scored as PI-RADS 3, 120 (26.4%) lesions were scored as PI-RADS 4 and 31 (6.8%) lesions were scored as PI-RADS 5. 315 (69.3%) of lesions were in peripheral zone, 26 (5.7%) were in central zone, 111 (24.4%) were in transitional zone and 2 of them were in anterior fibromuscular stroma. Results: Overall prostate cancer detection rate was 36.3%. Concerning detection rates, MRI-US FPBx alone and transrectal ultrasonography guided prostate biopsy (TRUS-Bx) alone were 27.6% and 26.5%, respectively. Cancer detection rate only through MRI-US FPBx PIRADS-3 and PI-RADS 4&5 were 6.9% and 20.6%, respectively. Clinically significant prostate cancer (csPCa) rates were evaluated and csPCa to overall prostate cancer (PCa) rates for TRUS-Bx, MRI-US FPBx and combined techniques were 16.8%, 35.4% and 39.2%, respectively. Results of 11 patients were evaluated as benign. Conclusion: MRI-US FPBx significantly increases success rate of prostate biopsy procedure. Regarding current MRI technology, it is not appropriate to consider MRI-US FPBx as a stand-alone biopsy option without concomitant with TRUS-Bx. Keywords: prostate cancer; biopsy; MRI; fusion
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Shah, Maunank, Sonia Paradis, Joshua Betz, Natalie Beylis, Renu Bharadwaj, Tatiana Caceres, Eduardo Gotuzzo et al. "Multicenter Study of the Accuracy of the BD MAX Multidrug-resistant Tuberculosis Assay for Detection of Mycobacterium tuberculosis Complex and Mutations Associated With Resistance to Rifampin and Isoniazid". Clinical Infectious Diseases 71, n.º 5 (27 de setembro de 2019): 1161–67. http://dx.doi.org/10.1093/cid/ciz932.
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Abstract Background Tuberculosis (TB) control is hindered by absence of rapid tests to identify Mycobacterium tuberculosis (MTB) and detect isoniazid (INH) and rifampin (RIF) resistance. We evaluated the accuracy of the BD MAX multidrug-resistant (MDR)-TB assay (BD MAX) in South Africa, Uganda, India, and Peru. Methods Outpatient adults with signs/symptoms of pulmonary TB were prospectively enrolled. Sputum smear microscopy and BD MAX were performed on a single raw sputum, which was then processed for culture and phenotypic drug susceptibility testing (DST), BD MAX, and Xpert MTB/RIF (Xpert). Results 1053 participants with presumptive TB were enrolled (47% female; 32% with human immunodeficiency virus). In patients with confirmed TB, BD MAX sensitivity was 93% (262/282 [95% CI, 89–95%]); specificity was 97% (593/610 [96–98%]) among participants with negative cultures on raw sputa. BD MAX sensitivity was 100% (175/175 [98–100%]) for smear-positive samples (fluorescence microscopy), and 81% (87/107 [73–88%]) in smear-negative samples. Among participants with both BD MAX and Xpert, sensitivity was 91% (249/274 [87–94%]) for BD MAX and 90% (246/274 [86–93%]) for Xpert on processed sputa. Sensitivity and specificity for RIF resistance compared with phenotypic DST were 90% (9/10 [60–98%]) and 95% (211/222 [91–97%]), respectively. Sensitivity and specificity for detection of INH resistance were 82% (22/27 [63–92%]) and 100% (205/205 [98–100%]), respectively. Conclusions The BD MAX MDR-TB assay had high sensitivity and specificity for detection of MTB and RIF and INH drug resistance and may be an important tool for rapid detection of TB and MDR-TB globally.
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Li, Qingjie, Kevin T. Kline, Xiaoying S. Zhong, Haifeng Lian, Jun Peng e Don W. Powell. "Chronic Colitis Impairs Heart Function by Inducing Epigenetic Remodeling in the Adult Heart". Journal of Immunology 204, n.º 1_Supplement (1 de maio de 2020): 146.2. http://dx.doi.org/10.4049/jimmunol.204.supp.146.2.
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Abstract Background and Aims Inflammatory bowel disease (IBD) represents a spectrum of chronic inflammatory mediated conditions with known extraintestinal manifestations. The interplay between heart and gut in IBD has previously been noted, but the mechanisms remain elusive. The aim of this study was to identify epigenetic mechanisms by which chronic colitis impairs cardiac function. Methods To induce chronic colitis, dextran sodium sulfate (DSS, 5% in drinking water) was given to adult rats for 5 days followed by 9 days with normal drinking water for 4 cycles over 8 weeks. Transthoracic echocardiography (TTE) was performed to evaluate heart function. Results DSS-induced chronic colitis led to a significant decrease in left ventricular ejection fraction on TTE (68% vs 49%, P<0.05), increased left ventricular mass (107 vs 148, P<0.05), and increased B-type natriuretic protein (222 vs 487, P<0.05). Cardiac and circulating BDNF, as well as GSK-3β, BCL2 and pAKT(S133), was markedly decreased. BDNF was also decreased in colitis induced by trinitrobenzene sulfonic acid. MiRNA profiling showed a total of 52 miRNAs significantly increased in DSS colitis, 7 of which are predicted to target BDNF. RT-qPCR subsequently validated the increase of miR-1b, Let-7d, and miR-155-5p in the adult heart by colitis. Transient transfection demonstrated that miR-1b, Let-7d, and miR-155-5p suppress BDNF in H9c2 rat myoblasts. BDNF overexpression mitigated H2O2-induced oxidative damage n H9c2 cells. Cardiac-specific conditional knockout of BDNF enlarged the heart size and impaired cardiac function. Conclusions Chronic colitis suppresses cardiac BDNF by elevating miRNAs; this was accompanied by biochemical and TTE findings suggestive of heart failure.
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Merin, Uzi, Dani Gilad, Shamay Jacoby, Benny Keynan, Yochai Hefer, Yaniv Lavon e Gabriel Leitner. "Retrospective evaluation of udder recovery of cows with subclinical mastitis following treatment with acoustic pulse technology (APT) on commercial dairy farms and its economic impact". PLOS ONE 19, n.º 5 (31 de maio de 2024): e0303947. http://dx.doi.org/10.1371/journal.pone.0303947.
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Retrospective evaluation of udder recovery following treatment of the inflamed quarter with acoustic pulse technology (APT) of cows with subclinical mastitis was done on 4 Israeli commercial dairy farms. Here, we evaluated the APT treatment as a tool to manage subclinical mastitis and its economic consequences in commercial farms. Recovery of the infected glands following APT treatment was compared to the customary no-treatment (NT) for cows with subclinical mastitis. Over 2 years, 467 cows with subclinical mastitis were identified. Subclinical mastitis was defined by elevated somatic cell count (SCC; >1 × 106 cells/mL) in the monthly test-day milk sample; 222 cows were treated with APT and 245 cows were not treated and served as control. Differences between treatment groups in culling, milk quality, milk yield and bacterial elimination were analyzed. After treatment, cure from bacteria was calculated only for cows with pre-isolated bacteria. The percentage of sampled cows determined as cured (no bacterial finding) in the NT group was 32.7% (35/107) (30.9% Gram negative; 32.4% Gram positive) and in the APT-treated group, 83.9% (42/55) (89.4% Gram negative; 80.6% Gram positive). Culling rate due to mastitis was significantly lower (>90%) in the APT-treated vs. NT group. Recovery was 66.0% in the APT group compared to 11.5% in the NT group at 90 d post-treatment. Average milk volume per cow in the APT-treated group was 16.1% higher compared to NT cows. Based on the study, savings incurred by using APT to treat only subclinical cows per 100-cow herd can total $15,106/y, or $309 per treated subclinically infected cow.
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van der Horst, Pieter W. "Jewish Exegesis and Homeric Scholarship in Alexandria. By Maren R. Niehoff. Cambridge: Cambridge University Press, 2011. Pp. xiv, 222. Cloth with dust jacket. £50.00 / US$ 85.00. ISBN 978-1-107-00072-8." Journal for the Study of Judaism 43, n.º 1 (2012): 105–6. http://dx.doi.org/10.1163/157006312x618028.
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Storey, Armide, R. Michael Scott, Richard Robertson e Edward Smith. "Preoperative transdural collateral vessels in moyamoya as radiographic biomarkers of disease". Journal of Neurosurgery: Pediatrics 19, n.º 3 (março de 2017): 289–95. http://dx.doi.org/10.3171/2016.9.peds16161.
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OBJECTIVE The prevalence of angiographically evident preoperative transdural collateral vessels in moyamoya is not well documented. The authors hypothesized that transdural collaterals could be used as radiographic biomarkers of disease, and that their presence is associated with more advanced moyamoya arteriopathy at diagnosis, which is a harbinger of more frequent operative complications and a predictor of better long-term angiographic results following surgery. METHODS The study consists of a single-institution case series of patients with moyamoya who underwent pial synangiosis between 2005 and 2013. RESULTS Moyamoya was diagnosed in a total of 204 patients (n = 121 [59%] female, 83 [41%] male); the average age at surgery was 9.5 years (range 0.4–35 years). Radiographically, 154 (75%) had bilateral disease for a total of 308 affected hemispheres; 152 (75%) had radiographic stroke; and 190 (93%) had “ivy sign” on FLAIR MRI, indicating slow flow. Of the 358 hemispheres, 324 were treated operatively. On preoperative angiography, 107 patients (52%) had transdural collaterals in 176 affected hemispheres (49%). The Suzuki stage was higher in patients with collaterals (3.4 vs 3.0, p = 0.002). Of 324 treated hemispheres, 84 (26%) had collaterals within the surgical field. Complications included 12 strokes (3.7% stroke rate/hemisphere), with 5 (42%) directly attributable to interruption of transdural collaterals. On 1-year postoperative arteriograms available in 222 hemispheres, Matsushima grades trended better in patients with preoperative collaterals (1.5 vs 1.8 [A = 1, B = 2, C = 3]; p < 0.003). CONCLUSIONS Transdural collaterals are present in nearly half of all preoperative arteriograms in patients with moyamoya. These collaterals are more common in advanced disease, are associated with stroke as a perioperative complication, and may suggest increased capacity to produce surgical collaterals postoperatively. These data support the utility of preoperative arteriography.
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Sente, Marko, e Ruza Sente. "Annual report of the Municipal and Eye Hospital in Subotica for 1889". Medical review 55, n.º 5-6 (2002): 253–58. http://dx.doi.org/10.2298/mpns0206253s.
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Introduction The paper is the translation of the report of the Head physician of the Municipal Hospital in Subotica for 1889. It shows the number of patients, the number of checkups, the number of outpatients and inpatients, distribution by sex, age, place of residence, the frequency of patients by months and groups of diseases, the average length of treatment the number of cured, unsuccessfully treated and deceased patients, the most significant surgeries, the number of doctors employed and a detailed survey of groups of diseases. Annual report From January 1, to December 31, 1889 6.123 patients were treated, 5.141 outpatients and 982 inpatients; 24.644 visits, 69 patients on average, 2.884 men and 2.257 women; 662 under 1 year of age; 828 aged 1 to 5; 1.655 aged 5 to 20; 1.854 aged 20 to 80; 142 patients over 80 years of age. 4.260 patients were from Subotica and 881 from other parts of the country. 19.436 patient days were required, 19 3/4 on average. 747 patients were cured, condition improved in 132, 60 were unsuccessfully treated and 43 patients died. Cerebral and spinal cord diseases occurred in 73 outpatients and 38 patients (the same distribution outpatients + inpatients goes for all diseases, respectively); nervous system diseases 82+18; ear diseases 139+2; eye diseases 1706+220; nose diseases 12+0; respiratory tract diseases 478+95; circulatory system diseases 35+13; lymphatic system diseases 51+5; mouth and throat lumen diseases 207+9; coronary diseases and diseases of intestinal mucosa 711+18 genitourinary tract diseases 252+66; skin diseases 440+107; muscle, gland and tissue diseases 104+23; joint diseases 75+16; bone diseases 56+20; acute infectious diseases 344+43; chronic infectious disease 143+137; general nutritional disorders 222+43; poisonings 3+2; childbirths 8+6.
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Doyle, Laura A., Virginia L. Lockamy, Cheng Peng, Adam Dicker, Yan Yu, Robert Benjamin Den e Amy S. Harrison. "Process mapping and time study to improve efficiency of HDR prostate brachytherapy." Journal of Clinical Oncology 32, n.º 30_suppl (20 de outubro de 2014): 103. http://dx.doi.org/10.1200/jco.2014.32.30_suppl.103.
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103 Background: New technologies and procedures have the potential to improve outcomes; however, initial implementation is often associated with a steep learning curve, decreased efficiency, and patient safety implications. Since process mapping, checklists and external benchmarks have been proven to be useful quality improvement (QI) tools in health care, we sought to use these QI tools in a novel setting to decrease new procedure times without sacrificing the quality of care. Methods: Implementation of a real-time, ultrasound based prostate high-dose-rate brachytherapy procedure involved a multidisciplinary team composed of approximately 6-8 team members and numerous complex tasks. To characterize time spent on various aspects of the procedure and improve efficiency, our team developed a detailed process map including checklists and team debriefings. A benchmark was created based on an experienced institution which has performed >100 procedures annually. Times for key events, such as induction of general anesthesia, acquisition of first image, catheter insertion and completion of planning were recorded during each case. The process map was analyzed based on clinical tasks and treatment planning tasks. Results: The expert institution completed a procedure in 65 minutes. Over the course of ten cases at our institution, total procedure time ranged from 222-107 minutes. Implementation of the process map resulted in a reduction of total time by 52% (51% for clinical tasks and 65% for planning). Process improvements included changes to room layout, availability of supplies and identification of parallel processes. Improvement in efficiency was done without compromising quality as defined by dosimetric parameters. Conclusions: The implementation of a new procedure benefits from the integration and utilization of a process map. We were able to reduce procedure time significantly, which resulted in decreased time under general anesthesia, reduced risk of deep vein thrombosis and improved overall patient safety.
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Bliss, Judith M., Lucy S. Kilburn, Robert E. Coleman, John F. Forbes, Alan S. Coates, Stephen E. Jones, Jacek Jassem et al. "Disease-Related Outcomes With Long-Term Follow-Up: An Updated Analysis of the Intergroup Exemestane Study". Journal of Clinical Oncology 30, n.º 7 (1 de março de 2012): 709–17. http://dx.doi.org/10.1200/jco.2010.33.7899.
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Purpose Intergroup Exemestane Study (IES), an investigator-led study in 4,724 postmenopausal patients with early-stage breast cancer has demonstrated clinically important benefits from switching adjuvant endocrine therapy after 2 to 3 years of tamoxifen to exemestane. Now, with longer follow-up, a large number of non–breast cancer–related events have been reported. Exploratory analyses describe breast cancer–free survival (BCFS) and explore incidence and patterns of the different competing events. Patients and Methods Patients who were disease-free after 2 to 3 years of adjuvant tamoxifen were randomly assigned to continue tamoxifen or switch to exemestane to complete 5 years of adjuvant endocrine therapy. At this planned analysis, the median follow-up was 91 months. Principal analysis focuses on 4,052 patients with estrogen receptor (ER) –positive and 547 with ER-unknown tumors. Results In all, 930 BCFS events have been reported (exemestane, 423; tamoxifen, 507), giving an unadjusted hazard ratio (HR) of 0.81 (95% CI, 0.71 to 0.92; P = .001) in favor of exemestane in the ER-positive/ER unknown group. Analysis partitioned at 2.5 years after random assignment showed that the on-treatment benefit of switching to exemestane (HR, 0.60; 95% CI, 0.48 to 0.75; P < .001) was not lost post-treatment, but that there was no additional gain once treatment had ceased (HR, 0.94; 95% CI, 0.80 to 1.10; P = .60). Improvement in overall survival was demonstrated, with 352 deaths in the exemestane group versus 405 deaths in the tamoxifen group (HR, 0.86; 95% CI, 0.75 to 0.99; P = .04). Of these, 222 were reported as intercurrent deaths (exemestane, 107; tamoxifen, 115). Conclusion The protective effect of switching to exemestane compared with continuing on tamoxifen on risk of relapse or death was maintained for at least 5 years post-treatment and was associated with a continuing beneficial impact on overall survival.
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Dascomb, Kristin, Karen Singson, Cherie Frame, Sharon Petersen, Isabel Pande e Dallin Peterson. "Nosocomial Rabies Encephalitis: Lessons Learned From Exposures in a Large Healthcare System". Infection Control & Hospital Epidemiology 41, S1 (outubro de 2020): s331—s332. http://dx.doi.org/10.1017/ice.2020.935.
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Background: In October 2018 a patient presented to hospital A’s emergency department (ED) for a work injury, arm spasms, and inability to drink liquids. He developed rapid neurologic decline and was transferred to hospital B for neurocritical care. He developed a fever, was intubated, and had an unrevealing infectious diseases (ID) consultation. He became comatose, had refractory seizures, and was transferred to hospital C. A second ID consultation revealed that he had many bats in his home, and his symptoms were consistent with rabies encephalitis. Antemortem specimens of serum, CSF, skin biopsy, and saliva were all positive for rabies virus PCR, and/or rabies serologies. Objective: We describe the response of a multihospital system to the exposure of employees across 3 facilities to rabies-infected body fluids. Methods: Three hospitals in 1 system (222 caregivers) cared for the index patient (hospital A, n = 8; hospital B, n = 107; hospital C, n = 107; 19 students and residents), as did 2 additional facilities outside the system. These included physicians (n = 21), registered nurses (n = 57), respiratory therapists (n = 29), imaging technicians (n = 24), phlebotomists (n = 12), laboratorians (n = 8) and others (n = 71). Infection prevention, employee health, and pharmacy leadership created a centralized team to ensure that all exposed caregivers were screened, and if exposed, were vaccinated. An electronic screening tool developed and administered by the Utah Department of Health via Research Electronic Data Capture (Redcap), rapidly assessed caregiver body fluid exposure risks (saliva, tears, neurologic tissue), and use of personal protective equipment in patient care. After completion, caregivers received notification that he or she (1) had no exposure (no further action), (2) had exposure and should report to employee health for vaccination, or (3) had unclear exposure and should contact the employee health department. Results: Caregivers feared that the tool underestimated exposure risk. Many caregivers (n = 48), repeated the assessment more than once, changing answers. The most common reasons cited were incomplete forms (n = 21), caregiver did not recall using personal protective equipment with contact with saliva (n = 8) or did not understand rabies transmission (n = 3). All vaccinations were initiated by 11 of 26 care givers, 18 days after initial deployment of the tool. All exposed caregivers completed the course. No caregivers developed symptoms of rabies encephalitis. Conclusions: An online tool can safely assess large healthcare exposure such as rabies. A team comprising infection preventionists, employee health representatives, pharmacists, and public health department representatives made the assessment of many geographically dispersed caregivers rapid and effective. Caregivers should employ the basic tenets of standard precautions in the daily care of patients to avoid unknown exposures to common bodily fluids.Funding: NoneDisclosures: None
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Fan, Xiaolong, Jing Cai, Chao Yan, Jian Zhao, Yishuo Guo, Chang Li, Kaspar R. Dällenbach et al. "Atmospheric gaseous hydrochloric and hydrobromic acid in urban Beijing, China: detection, source identification and potential atmospheric impacts". Atmospheric Chemistry and Physics 21, n.º 14 (29 de julho de 2021): 11437–52. http://dx.doi.org/10.5194/acp-21-11437-2021.
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Abstract. Gaseous hydrochloric (HCl) and hydrobromic acid (HBr) are vital halogen species that play essential roles in tropospheric physicochemical processes. Yet, the majority of the current studies on these halogen species were conducted in marine or coastal areas. Detection and source identification of HCl and HBr in inland urban areas remain scarce, thus limiting the full understanding of halogen chemistry and potential atmospheric impacts in the environments with limited influence from the marine sources. Here, both gaseous HCl and HBr were concurrently measured in urban Beijing, China, during winter and early spring of 2019. We observed significant HCl and HBr concentrations ranging from a minimum value at 1 × 108 molecules cm−3 (4 ppt) and 4 × 107 molecules cm−3 (1 ppt) up to 6 × 109 molecules cm−3 (222 ppt) and 1 × 109 molecules cm−3 (37 ppt), respectively. The HCl and HBr concentrations are enhanced along with the increase of atmospheric temperature, UVB and levels of gaseous HNO3. Based on the air mass analysis and high correlations of HCl and HBr with the burning indicators (HCN and HCNO), gaseous HCl and HBr are found to be related to anthropogenic burning aerosols. The gas–particle partitioning may also play a dominant role in the elevated daytime HCl and HBr. During the daytime, the reactions of HCl and HBr with OH radicals lead to significant production of atomic Cl and Br, up to 2 × 104 molecules cm−3 s−1 and 8 × 104 molecules cm−3 s−1, respectively. The production rate of atomic Br (via HBr + OH) is 2–3 times higher than that of atomic Cl (via HCl + OH), highlighting the potential importance of bromine chemistry in the urban area. On polluted days, the production rates of atomic Cl and Br are faster than those on clean days. Furthermore, our observations of elevated HCl and HBr may suggest an important recycling pathway of halogen species in inland megacities and may provide a plausible explanation for the widespread halogen chemistry, which could affect the atmospheric oxidation in China.
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Prothero, Larissa Stella, e Theresa Foster. "A survey-based evaluation of ambulance staff awareness of vitamin D and risk of deficiency in a UK ambulance service". British Paramedic Journal 6, n.º 2 (1 de setembro de 2021): 40–48. http://dx.doi.org/10.29045/14784726.2021.9.6.2.40.
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Background: Healthcare professions, shift-working and indoor-working are risk factors for vitamin D deficiency. The aim of this survey was to investigate ambulance staff awareness of vitamin D, and the risks associated with deficiency, to inform the need for appropriate well-being resources.Methods: A purpose-designed, 20-question survey was developed, based on a validated vitamin D questionnaire, to explore staff vitamin D knowledge and self-health in one UK ambulance service. Disseminated during June/July 2020, survey completion was voluntary, and responses obtained were analysed using descriptive and thematic approaches.Results: A total of 384 survey responses were received; 41% (n = 156) of respondents were male. Over half worked within emergency operational service delivery (57%; n = 219). Respondents were predominantly ‘White British’ (92%; n = 352). According to the Fitzpatrick Scale, most described themselves as having a ‘Medium, between white to moderate brown: sometimes mild burns, gradual tan’ complexion (47%; n = 182). The majority felt they got sufficient sunlight exposure when at home (66%; n = 253), but not at work (58%; n = 222). Almost one fifth (17%; n = 66) had received a diagnosis of vitamin D deficiency. Forty percent took vitamin D supplements: 12% (n = 45) as advised by a medical professional; 28% (n = 107) self-directed to prevent deficiency. The ability of respondents to recognise known factors that affect vitamin D production in the skin, good vitamin D food sources and individuals at risk of vitamin D deficiency were variable. Respondents commented on their lack of vitamin D awareness, vitamin supplementation, COVID-19, work arrangements and access to sunlight.Conclusions: Ambulance staff are at risk of vitamin D deficiency irrespective of their role: vitamin D awareness, access to sunlight and use of vitamin D supplements are variable. For affected individuals, the impact of vitamin D deficiency can be significant, requiring absence from work. The development of appropriate vitamin D and well-being resources appears to be warranted.