Discussant Clifford Hudis, MD, Chief of Breast Medicine Service at Memorial Sloan Kettering Cancer Center, New York, highlighted neratinib's benefits while also advocating caution in interpreting the results due to incomplete data, the serious side effect of diarrhea, and the potentially g
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- Expert Point of View: Clifford Hudis, MD, Shanu Mo...
- APF530 Superior to Ondansetron in Preventing Chemo...
- Expert Point of View: Clifford Hudis, MD
- Genomics Now Driving Treatment of Waldenström's Ma...
- Antoni Ribas, MD, PhD, Receives NCI Outstanding In...
- Changing the Outlook for Chronic Lymphocytic Leukemia
- Third Annual JADPRO Live at APSHO Conference Attra...
- Genomic Test Identifies Patients With Prostate Can...
- Preston Robert Tisch Brain Tumor Center at Duke Re...
- Hypofractionated Radiotherapy Makes Inroads as Pri...
- Expert Point of View: David Beyer, MD
- Study Lowers the Age Bar for Radiation in Children...
- Expert Point of View: Anita Mahajan, MD
- Kara Kelly, MD, Will Head Joint Pediatric Hematolo...
- Howard Hochster, MD, Named President-Elect of ISGIO
- Evidence Mounts for Less-Intense Chemoradiation Th...
- Olympus EZDilate Multi-Stage Endoscopic Esophageal...
- Stridor: a rare presentation of oesophageal malign...
- A lump on the nose
- Dellen and corneal perforation after bilateral pte...
- POEMS syndrome: complex factors contributing to a ...
- Serratia marcescens osteomyelitis in Cushing's dis...
- Spontaneous sternal fracture due to multiple myelo...
- Bilateral central toxic keratopathy after laser in...
- Septic cavernous sinus thrombosis with infectious ...
- Gliosarcoma with neuroaxis metastases
- A cerebral abscess at first internist glance
- Bug on the back: vertebral osteomyelitis secondary...
- Systemic lupus erythaematosus presenting as sponta...
- Penetrating neck injury from a screwdriver: can th...
- The Function and Roles of ADAMTS-7 in Inflammatory...
- News & Announcements
- Are we misusing fiber posts? Guest editorial
- Validity of smartphone pedometer applications
- Validation of parent-reported physical activity an...
- Validation of the Postgraduate Hospital Educationa...
- Surgical management of vascular anomalies in child...
- GT825 5MP Polarizing Digital Microscope
- GT805 5MP USB Digital Microscope
- Fitness in Youth Can Pay Off Decades Later: Study
- After Concussion Symptoms Fade, Slowed Blood Flow ...
- Empliciti Approved for Multiple Myeloma
- 3-D video simulates severe bleeding for combat med...
- 3-D video simulates severe bleeding for combat med...
- Researchers Grow Retinal Nerve Cells in the Lab
- The Correlation of the Tinnitus Handicap Inventory...
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- Are crib bumpers safe?
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Νοε 30
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Ετικέτες
Δευτέρα 30 Νοεμβρίου 2015
Expert Point of View: Clifford Hudis, MD, Shanu Modi, MD, and Richard Gelber, PhD
APF530 Superior to Ondansetron in Preventing Chemotherapy-Induced Nausea or Vomiting
As part of a three-drug regimen, APF530 (extended-release formulation of granisetron) has become the first 5-HT3 (5-hydroxytryptamine) receptor antagonist to demonstrate superiority over the standard of care for delayed nausea and vomiting after highly emetogenic chemotherapy. Accor
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Expert Point of View: Clifford Hudis, MD
Discussant Clifford Hudis, MD, Chief, Breast Medicine Service at Memorial Sloan Kettering Cancer Center, New York, highlighted the obvious clinical advantages of APF530 over the current standard of care. "If this drug were simply the same in price and availability, why wouldn't y
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Genomics Now Driving Treatment of Waldenström's Macroglobulinemia
The treatment of Waldenström's macroglobulinemia has been greatly impacted by an understanding of its genomics, according to Steven P. Treon, MD, PhD, of Dana-Farber/Brigham and Women's Cancer Center and Massachusetts General Hospital Cancer Center, Boston. Dr. Treon brought listeners up t
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Antoni Ribas, MD, PhD, Receives NCI Outstanding Investigator Award
UCLA Jonsson Comprehensive Cancer Center member Antoni Ribas, MD, PhD, has received a National Cancer Institute (NCI) Outstanding Investigator Award of $4.2 million in recognition of his research conducted in the development of new immunotherapies that utilize the human body's own natural
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Changing the Outlook for Chronic Lymphocytic Leukemia
Small-molecule inhibitors, especially ibrutinib (Imbruvica) and idelalisib (Zydelig), have greatly changed the outlook for patients with chronic lymphocytic leukemia. William G. Wierda, MD, PhD, Professor and Center Medical Director in the Department of Leukemia at The University of Texas
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Third Annual JADPRO Live at APSHO Conference Attracts Over 700 Advanced Practitioners in Hematology-Oncology
Over 700 nurse practitioners, physician assistants, pharmacists, clinical nurse specialists, and other oncology health-care professionals were convened in Phoenix, Arizona, earlier this month to participate in JADPRO Live at APSHO (Advanced Practitioner Society in Hematology and Oncology), the t
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Genomic Test Identifies Patients With Prostate Cancer in Need of Intensified Salvage Therapy
Prostate cancer has been slow to catch up with breast cancer in terms of using biomarkers, but a new study represents progress in this regard. A genomic classifier called Decipher® provides important information that can be used to make treatment decisions for men with prostate cancer and a risin
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Preston Robert Tisch Brain Tumor Center at Duke Receives $7 Million Outstanding Investigator Award
The Preston Robert Tisch Brain Tumor Center at Duke has received nearly $7 million in funding under the National Cancer Institute's (NCI) Outstanding Investigator Award program for work on two novel immunotherapy approaches to treat brain tumors. The award recognizes the work of principal investi
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Hypofractionated Radiotherapy Makes Inroads as Primary Treatment of Prostate Cancer
Several studies presented at the 2015 ASTRO Annual Meeting explored the use of hypofractionation (delivering higher doses of radiation in fewer fractions) in the treatment of patients with prostate cancer. These studies found comparable outcomes in terms of efficacy and adverse events. Although a
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Expert Point of View: David Beyer, MD
In an interview with The ASCO Post, incoming ASTRO President David Beyer, MD, provided his perspective on the use of hypofractionation in prostate cancer. Dr. Beyer is Medical Director of the Cancer Centers of Northern Arizona in Sedona. "Fractionation has been an important
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Study Lowers the Age Bar for Radiation in Children With Ependymoma
The good news is that children as young as 1 year old with the aggressive brain tumor ependymoma can be treated safely and effectively with immediate postoperative radiation therapy, according to the results of a trial presented at the 2015 ASTRO Annual Meeting.1 "Ependymoma is
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Expert Point of View: Anita Mahajan, MD
This study pushes the envelope of how to use our therapies to give the most benefit to patients we otherwise wouldn't be treating: in this case, children under the age of 3. This age group has historically been a 'no man's land.' Now we see we can treat children as young as 1 year," said Anita
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Kara Kelly, MD, Will Head Joint Pediatric Hematology/Oncology Program at Roswell Park and Three Other Buffalo Institutions
Kara Kelly, MD, has been appointed as the new leader of the joint program in pediatric hematology/oncology, a partnership of Women & Children's Hospital of Buffalo (WCHOB), Roswell Park Cancer Institute (RPCI), UBMD Pediatrics, and the Universi
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Howard Hochster, MD, Named President-Elect of ISGIO
The International Society of Gastrointestinal Oncology (ISGIO) has named Howard Hochster, MD, as President-Elect. Dr. Hochster, Professor of Medical Oncology; Associate Director for Clinical Sciences at Yale Cancer Center; and Director of the Gastr
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Evidence Mounts for Less-Intense Chemoradiation Therapy for Low-Risk Oropharyngeal Cancer
A new study shows that deintensification of chemoradiation therapy translates to excellent pathologic complete response rates in low-risk human papillomavirus (HPV)-associated oropharyngeal cancer.1 Patient-reported outcomes showed that side ef
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Olympus EZDilate Multi-Stage Endoscopic Esophageal Balloon Dilator Unveiled in U.S.
Olympus is releasing the newly FDA cleared EZDilate multi-stage endoscopic balloon dilator, a device designed predominantly to be used for esophageal dilations. The balloon is compact during the delivery stage and the soft distal tip of the device should allow for easy access through difficult strictures.
It features fast inflation and deflation times and an easy to see center marker to help speed procedures along. The inflation can be controlled up to a half millimeter accuracy. The company claims the resulting dilations match the intended size more consistently than competing products.
Some more details from the product page:
EZDilate comes in both fixed-wire and wire-guided versions. The fixed-wire balloons are indicated for use in the esophagus and the wire-guided balloons are indicated for use in the esophagus, pylorus, papilla and colon.
EZDilate can offer inflation diameters from 6.0 mm to 20.0 mm while each EZDilate balloon inflates to three distinct diameters.
The EZDilate is compatible with any 60cc inflation device, but may be purchased with the Olympus MAJ-1740 syringe style inflation device.
Product page: EZDilate Endoscopic Balloon Dilator…
The post Olympus EZDilate Multi-Stage Endoscopic Esophageal Balloon Dilator Unveiled in U.S. appeared first on Medgadget.
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Stridor: a rare presentation of oesophageal malignancy
A middle-aged ex-smoker, with a history of curative surgery for oesophageal squamous cell carcinoma 7 years earlier, presented to the casualty department at Mater Dei Hospital with stridor and a 2-week history of progressively worsening dyspnoea. A thoracic CT scan showed the presence of a posterior mediastinal mass involving the upper half of the stomach and posterior wall of the trachea. Histology of an exophytic ulcerating lesion at 25 cm of the oesophagus was that of squamous cell carcinoma. Bronchoscopy performed to ascertain the cause of the stridor showed the trachea to be 70% occluded. The patient showed symptomatic improvement with radiotherapy and intravenous dexamethasone; however, he passed away a few weeks later due to respiratory failure secondary to tracheal occlusion.
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A lump on the nose
Description
A young woman presented with prominence of the dorsum of her nose since childhood. She had become increasingly self-conscious of her appearance but was otherwise fit and well. She denied symptoms of nasal obstruction, epistaxis or discharge but described an intermittent ache related to the lump. There was no history of seizures, meningitis or cerebral abscess. Examination revealed a firm midline dorsal hump (figures 1 and 2). The rest of the examination was normal.
Figure 1
Preoperative clinical photography demonstrates prominent nasal dorsum.
Figure 2
Anterolateral view.
Nasal surgery was delayed into adulthood as not to impede nasal development. At the age of 19 years she underwent open septorhinoplasty for correction of what was thought to be a congenital osseocartilagenous deformity. A skin-coloured, fibrous mass of adipose tissue, skeletal muscle and nerve fibres was...
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Dellen and corneal perforation after bilateral pterygium excision in a patient with no risk factors
Corneal perforation associated with dellen is a rare but serious complication of a primary pterygium excision. In this case report, we describe a 60-year-old man who underwent a corneal perforation in the centre of corneal dellen in his right eye and corneal dellen in his left eye after the surgical treatment of a bilateral pterygium with a bare sclera technique without adjunctive therapy. He was successfully treated with lamellar keratoplasty in his right eye and a conservative approach in his left eye, consisting of the use of artificial tears, antibiotic ointment and a patch. The clinical evidence from this brief interventional case report indicates that topical lubricants are proper therapy for corneal dellen. However, if corneal perforation is observed, lamellar keratoplasty is a good option.
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POEMS syndrome: complex factors contributing to a delayed diagnosis
POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein and skin changes) syndrome is a rare paraneoplastic syndrome due to an underlying plasma cell disorder. The chronically evolving nature of this syndrome and diverse clinical manifestations make it a challenging diagnosis, especially in the early stages of the disease. We present a case that illustrates well how these confounding factors can delay recognition of the disorder. We describe the presentation of some of the classical symptoms, and discuss how investigations can be optimised in order to fit together the clinical picture. Recent advances in the understanding of nerve conduction studies and electromyography in POEMS may help improve the early identification of this disease. This is of great importance, as early recognition and the initiation of appropriate treatment can reduce morbidity and mortality in POEMS.
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Serratia marcescens osteomyelitis in Cushing's disease
We report a case of a 46-year-old man with fever, hypotension and arthralgias of the ankles and knees after brain surgery for a pituitary tumour causing Cushing's disease. Blood and urine cultures isolated Serratia marcescens; antibiotic susceptibility testing showed sensitivity to piperacillin-tazobactan and ciprofloxacin. Articular MRI showed inflammation and necrosis of both knees and ankles, and left hip and right elbow (compatible with osteomyelitis). Culture of an ankle abscess on the ankle joint was positive for Serratia marcescens. Bone scintigraphy confirmed osteomyelitic lesions. Medical treatment included antibiotics and strong opioid therapy for 14 weeks. The patient was discharged clinically improved maintaining ciprofloxacin for 24 additional weeks based on clinical and analytic recovery.
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Spontaneous sternal fracture due to multiple myeloma requiring extensive surgical repair
Spontaneous sternal fracture is a well-known complication of multiple myeloma due to osteolytic bone lesions. The possibility of a multiple myeloma should be thoroughly investigated in patients presenting with a spontaneous sternal fracture. This work up should go beyond protein electrophoresis alone as a monoclonal paraprotein is not always present. In some cases, the myeloma plasma cell clone produces only the free light chain ( or ) or may even be non-secretory. The underlying plasma cell dyscrasia is treated with chemotherapy and, if needed, local radiotherapy. However, for patients with a fracture causing persistent pain and physical discomfort, internal fixation may be additionally required. We present a case of a patient who presented with a displaced pathological sternal fracture. She was treated with chemotherapy, radiotherapy and an open reduction and internal fixation with a Locking Compression Plate (LCP). This technique offers a feasible option for rigid fixation of pathological fractures.
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Bilateral central toxic keratopathy after laser in situ keratomileusis
One week after LASIK, our patient presented with bilateral haloes and reduced vision. Examination revealed the typical central toxic keratopathy triad: corneal thinning, hyperopic shift and a reduction in best corrected visual acuity to 6/12, which, after commencing high-dose topical steroids, improved 6 months later to 6/6.
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Septic cavernous sinus thrombosis with infectious arteritis of the internal carotid artery
Description
Septic cavernous sinus thrombosis (CST) is thrombophlebitis in the cavernous sinus. It is an unusual complication of paranasal sinusitis, otitis media and, less often, pharyngitis and dental infection, affecting the anatomic structures running in the cavernous sinus.1–3 Ophthalmoplaegia may be the presenting symptom of cavernous sinus thrombosis. Impaired extraocular muscle motility is seen, usually starting with a lateral gaze.3 Contrary to nervous system structures, however, the internal carotid artery (ICA) is rarely involved.
A 53-year-old woman without contributory medical history was admitted to our hospital with a high fever, left-sided headache and swelling of the left eye. Two days before admission, she developed hot flash-like symptoms and severe headache. Painful eye swelling developed on the left side 2 days later, and she visited our hospital. On physical examination, her temperature was 40.5 °C, pulse was 86 bpm and blood pressure was...
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Gliosarcoma with neuroaxis metastases
Gliosarcomas are rare tumours of the central nervous system, with a well-known capacity for metastasis. When they metastasise, the dissemination occurs more frequently via the haematogenous route to extraneural sites. Metastasis-spread through the cerebrospinal fluid is extremely rare. We present the case of a 58-year-old man who underwent a gross total resection of a lesion in the left temporal lobe. The histological findings revealed a gliosarcoma and the patient received radiotherapy followed by chemotherapy. Seven months after surgery, while the patient remained neurologically intact, brain and spinal cord MRI revealed tumour recurrence and neuroaxis metastases through the traffic routes of the cerebrospinal fluid. The patient died 8 months after the diagnosis. A PubMed search regarding metastatic gliosarcoma up to June 2015 was also carried out. To the best of our knowledge, this is the first case report of gliosarcoma metastases to the brain and spinal cord leptomeninges.
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A cerebral abscess at first internist glance
A 73-year-old man was transferred to the neurosurgery ward, with a presumptive diagnosis of cerebral abscess. The case was also discussed with the internists as internal medicine consultants. The neurosurgeons pointed out a right temporal lobe abscedated lesion on CT, but we noticed that the hypodense attenuation that usually surrounds the abscess wall (vasogenic oedema) extended to a broader, well-delimitated area, suggesting medium cerebral artery territory. The patient had left-sided hemiplegia with a confusional state and low-grade fever. Considering possible haematogenous dissemination, an echocardiography was performed, confirming mitral endocarditis. Blood cultures and aspirated pus isolated Escherichia coli. Investigating the patient's medical history, we learned he had been submitted to bladder catheterisation 7 weeks before for acute urinary retention due to benign prostatic hyperplasia, and empirically medicated for urinary tract infection. E. coli had also been isolated in a urine specimen at the time. The clinical history of the patient cancelled the pathogenesis of cerebral abscess.
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Bug on the back: vertebral osteomyelitis secondary to fluoroquinolone resistant Salmonella typhi in an immunocompetent patient
Although Salmonella osteomyelitis is commonly seen in immunocompromised patients, it may occasionally affect an immunocompetent host. Symptoms are usually non-specific, such as fever, abdominal or back pain; hence it should be considered in the differential diagnosis of patients with a history of travel to endemic regions. Fluoroquinolone resistance is rising and non-responsive patients should be treated with ampicillin, trimethoprim-sulfamethoxazole and ceftriaxone. We present a case of acute T8-T11 osteomyelitis with cord compression caused by a fluoroquinolone resistant strain of Salmonella typhi.
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Systemic lupus erythaematosus presenting as spontaneous splenic rupture
Systemic lupus erythaematosus (SLE) is known to involve the reticuloendothelial system, but spontaneous splenic rupture (SSR) in the context of the disease is a very rare complication. We observed a 61-year-old woman with an unremarkable previous medical history who presented with SSR and underwent an emergency splenectomy. The histopathological analysis of the specimen revealed signs of vasculitis. On review of symptoms with the patient, a history of oligoarthralgia, photosensitivity, xerostomia and Raynaud phenomenon was elicited. Laboratory investigations revealed lymphopaenia, mild proteinuria and positive antinuclear and anti-dsDNA antibodies. The patient was started on hydroxychloroquine and the disease has since remained silent. This article addresses the rare association between SLE and SSR.
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Penetrating neck injury from a screwdriver: can the No Zone approach be applied to Zone I injuries?
The newer approach to management of penetrating neck injuries (PNI) involves the No Zone approach: comprehensive physical examination combined with CT angiography for triage to effectively identify or exclude vascular and aerodigestive injury. This approach, however, has a low negative exploration rate; there is risk of missing occult injuries especially Zone I and III PNI. We report a case of a patient with PNI to Zone I of the neck who was haemodynamically stable at presentation; CT scan revealed complete occlusion of the common carotid artery. Immediate surgical exploration revealed an occult hypopharyngeal injury in addition to the arterial trauma, which was missed on the CT scan. Hence the No Zone approach needs cautious clinical application, especially in Zone I injuries.
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The Function and Roles of ADAMTS-7 in Inflammatory Diseases
The ADAMTS proteinases are a group of multidomain and secreted metalloproteinases containing the thrombospondin motifs. ADAMTS-7 is a member of ADAMTS family and plays a crucial role in the pathogenesis of arthritis. Overexpression of ADAMTS-7 gene promotes the breakdown of cartilage oligomeric matrix protein (COMP) matrix and accelerates the progression of both surgically induced osteoarthritis and collagen-induced arthritis. Moreover, ADAMTS-7 and tumor necrosis factor-α (TNF-α) form a positive feedback loop in osteoarthritis. More significantly, granulin-epithelin precursor, a growth factor has important roles in bone development and bone-associated diseases, disturbs the interaction between ADAMTS-7 and COMP, and prevents COMP degradation. This review is based on our results and provides an overview of current knowledge of ADAMTS-7, including its structure, function, gene regulation, and inflammatory diseases involvement.
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Are we misusing fiber posts? Guest editorial
Publication date: Available online 30 November 2015
Source:Dental Materials
Author(s): Pekka K. Vallittu
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Validity of smartphone pedometer applications
Background: Given the widespread use of smartphone pedometer applications and the relatively limited number of published validity tests, this study examined the validity of three popular commercial smartphone pedometer applications (i.e., Accupedo, Moves, and Runtastic Pedometer).ParticipantsConvenience samples of males and females were recruited for laboratory tests [n = 11; mean: aged 24.18 years (±3.06)] and a free-living test [n = 18; mean: aged 28.78 years (±9.52)]. Methods: Five conditions were assessed: (a) 20-step test, (b) 40-step stair climbing, (c) treadmill walking and running at different speeds, (d) driving, and (e) 3-day free-living. The Yamax SW-200 pedometer and observed step counts were used as criterion measures. Results: Analyses identified an unacceptable error percentage in all of the applications compared to the pedometer. Conclusions: Given the inaccuracy of these applications, caution is required in their promotion to the public for self-monitoring physical activity and in their use as tools for assessing physical activity in research trials.
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Validation of parent-reported physical activity and sedentary time by accelerometry in young children
Background: It is unknown if young children's parent-reported physical activity and sedentary time are correlated with direct measures. The study objectives were to compare parent-reported physical and sedentary activity versus directly measured accelerometer data in early childhood. Methods: From 2013 to 2014, 117 healthy children less than 6 years of age were recruited to wear Actical accelerometers for 7 days. Accelerometer data and questionnaires were available on 87 children (74 %). Average daily physical activity was defined as the sum of activity ≥100 counts per minute, and sedentary time as the sum of activity <100 counts per minute during waking hours. Parents reported daily physical activity (unstructured free play in and out of school, and organized activities) and selected sedentary behaviors (screen time, stroller time, time in motor vehicle). Spearman correlation coefficients and Bland–Altman plots were used to assess the validity of parent-reported measures compared to accelerometer data. Results: Total physical activity was significantly greater when measured by accelerometer than parent-report; the median difference was 131 min/day (p < 0.001). Parent-reported child physical activity was weak to moderately correlated with directly measured total physical activity (r = 0.39, 95 % CI 0.19, 0.56). The correlations between types of physical activity (unstructured free play in and outside of school/daycare, and organized structured activity) and accelerometer were r = 0.30 (95 % CI 0.09, 0.49); r = 0.42 (95 % CI 0.23, 0.58); r = 0.26 (95 % CI 0.05, 0.46), respectively. There was no correlation between parent-reported and accelerometer-measured total sedentary time in children (r = 0.10, 95 % CI −0.12, 0.33). When the results were stratified by age group (<18, 18–47, and 48–70 months of age) no statistically significant correlations were observed and some inverse associations were observed. Conclusions: The correlation between parent-report of young children's physical activity and accelerometer-measured activity was weak to moderate depending on type of activity and age group. Parent-report of children's sedentary time was not correlated with accelerometer-measured sedentary time. Additional validation studies are needed to determine if parent-reported measures of physical activity and sedentary time are valid among children less than 6 years of age and across these young age groups.
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Validation of the Postgraduate Hospital Educational Environment Measure (PHEEM) in a sample of 731 Greek residents
Background: The Greek version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was evaluated to determine its psychometric properties, i.e., validity, internal consistency, sensitivity and responsiveness to be used for measuring the learning environment in Greek hospitals. Methods: The PHEEM was administered to Greek hospital residents. Internal consistency was measured using Cronbach's alpha. Root Mean Square Error of Approximation (RMSEA) was used to evaluate the fit of Structural Equation Models. Content validity was addressed by the original study. Construct validity was tested using confirmatory (to test the set of underlying dimensions suggested by the original study) and exploratory (to explore the dimensions needed to explain the variability of the given answers) factor analysis using Varimax rotation. Convergent validity was calculated by Pearson's correlation coefficient regarding the participant's PHEEM score and participant's overall satisfaction score of the added item "Overall, I am very satisfied with my specialization in this post". Sensitivity was checked by comparing good versus poor aspects of the educational environment and by satisfied versus unsatisfied participants. Results: A total of 731 residents from 83 hospitals and 41 prefectures responded to the PHEEM. The original three-factor model didn't fit better compared to one factor model that is accounting for 32 % of the variance. Cronbach's α was 0.933 when assuming one-factor model. Using a three-factor model (autonomy, teaching, social support), Cronbach's α were 0.815 (expected 0.830), 0.908 (0.839), 0.734 (0.793), respectively. The three-factor model gave an RMSEA value of 0.074 (90 % confidence interval 0.071, 0.076), suggesting a fair fit. Pearson's correlation coefficient between total PHEEM and global satisfaction was 0.765. Mean question scores ranged from 19.0 (very poor) to 73.7 (very good), and mean participant scores from 5.5 (very unsatisfied) to 96.5 (very satisfied). Conclusions: The Greek version of PHEEM is a valid, reliable, and sensitive instrument measuring the educational environment among junior doctors in Greek hospitals and it can be used for evidence-based SWOT analysis and policy.
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Surgical management of vascular anomalies in children at a tertiary care hospital in a resource-limited setting: a Tanzanian experience with 134 patients
Background: Vascular anomalies pose major diagnostic and therapeutic challenges among pediatricians and pediatric surgeons practicing in resource limited countries. There is paucity of published data regarding this subject in Tanzania and Bugando Medical Centre in particular. This study describes our experiences on the challenges and outcome of surgical management of childhood vascular anomalies in our environment. Methods: Between January 2009 and December 2013, a prospective study on the surgical management of vascular anomalies was undertaken at Bugando Medical Centre. Results: A total of 134 patients (M; F = 1:2.5) were studied. The median age at presentation was 6 years. Of the 134 patients, 101 (75.4 %) were diagnosed as having vascular tumors and 33 (24.6 %) had vascular malformations. The head and the neck were the most frequent anatomical site recorded as having a tumor (56.7 % of patients). Out of 134 patients, 129 (96.3 %) underwent surgical treatment. Failure to respond to non-operative treatment (86.8 %), huge disfiguring/obstructing mass (4.7 %), infection (3.1 %), ulceration (3.1 %) and hemorrhage (2.3 %) were indications for surgical intervention. Tumor excision and primary wound closure was the most common type of surgical procedure performed in 80.6 % of patients. Surgical site infection was the most frequent complications accounting for 33.8 % of cases. Mortality rate was 1.5 %. Tumor excision and primary wound closure gave better outcome compared with other surgical options (p < 0.001). Outcome of injection sclerotherapy in 3 (3.7 %) children, serial ligation of feeder vessels employed in 2 (1.6 %), and conservative treatment in 5 (3.7 %), were poor and required conversion to surgical excision. Despite low mortality rate recorded in this study, but ugly scar, 14 (20.6 %) and limb deformity, 6 (8.8 %) were problems. The overall result of surgical treatment at the end of follow up period was excellent in 108 (87.1 %) patients. Conclusion: Surgical excision and primary wound closure gave good outcome which could be employed in complicated and vascular anomalies which failed to respond to other treatment in regions with limited resources.
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GT825 5MP Polarizing Digital Microscope
The GT825 5MP Polarizing Digital Microscope is a special purpose digital video camera combined with a high magnification lens and multiple ultra-bright LED's.
This innovative device streams TRUE 5.0 megapixel live video to a computer (30fps) with up to 180x native optical and 540x digital zoom enabling the user to view and record crystal clear microscopic images or videos.
Firefly microscopes are widely used in many of the most prestigious universities and corporations. Most common uses are for education, gemology, high tech repair, quality inspection, manufacturing, visual aids, and labs/ science.
With its many uses and applications, the GT825 5MP Polarizing Digital Microscope is a versatile easy to use tool and is easy to acquire at a very affordable price. Please contact us for more information.
For Technical Specifications Click Here
[See image gallery at fireflyglobal.com]Features
- TRUE 2.0 Megapixel resolution
- Easily captures microscopic pictures and videos
- Variable magnification up to 180x (optically) and 540x (digitally).
- Observes and records in real time (30 FPS)
- High quality multi-layered glass lenses
- Fully adjustable brightness with 8 ultra-bright LEDs
- Built-in snapshot button
- Rugged industrialized construction
Uses
- Quality Assurance
- Engineering Design Work
- Research
- BGA Inspection
What's Included
- Polarizing Digital Microscope
- FireflyPro Software CD
- USB Cable
- Velvet Carrying Case
- Calibration Tool
- User Manual on CD
Technical Details | |
---|---|
Sensor Resolution | True 5.0 Megapixels (2592 x 1944) |
Magnification | Native Optical: 10x – 180x Digital: 10x – 540x |
Lens Assembly | Dual Lenses 3-Layer Glass, 650nm cutoff |
Video | Format: MJPG Frame rate: 15-30 FPS |
Video/Image Properties | Color: Hue, Saturation Exposure: Brightness, Contrast Image: Sharpness, Gamma |
Video, Image Files | BMP, JPG, AVI |
Lighting | 8 Ultra-Bright LEDs Fully adjustable brightness |
Dimensions | 13cm x 3.6cm x 4cm |
Interface | USB 2.0 |
Software | Scalable Window, Zoom, Freeze, Resolution, Rotate, Flip Region of Interest (ROI) Automatic/Manual white balance |
Operating Systems | Windows 10, 8, 7 and Mac OS 10.4 or higher |
Warranty | 1 Year Limited Hardware Warranty |
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GT805 5MP USB Digital Microscope
The GT805 5MP USB Digital Microscope is a special purpose digital video camera combined with a high magnification lens and multiple ultra-bright LED's.
This innovative device streams TRUE 5.0 megapixel live video to a computer (30fps) with up to 230x native optical and 700x digital zoom enabling the user to view and record crystal clear microscopic images or videos.
Firefly microscopes are widely used in many of the most prestigious universities and corporations. Most common uses are for education, gemology, high tech repair, quality inspection, manufacturing, visual aids, and labs/ science.
With its many uses and applications, the GT805 5MP USB Digital Microscope is a versatile easy to use tool and is easy to acquire at a very affordable price. Please contact us for more information.
For Technical Specifications Click Here
[See image gallery at fireflyglobal.com]Features
- TRUE 2.0 Megapixel resolution
- Easily captures microscopic pictures and videos
- Variable magnification up to 700x (digitally) and up to 230x (optically).
- Observes and records in real time (30 FPS)
- High quality multi-layered glass lenses
- Fully adjustable brightness with 8 ultra-bright LEDs
- Built-in snapshot button
- Rugged industrialized construction
Uses
- Lab / Science
- High tech repair
- Gemology
- Quality inspection
- Biology
- Education
What's Included
- Microscope
- FireflyPro Software CD
- Stand
- USB Cable
- Velvet Carrying Case
- Calibration Tool
- User Manual on CD
Technical Details | |
---|---|
Sensor Resolution | True 5.0 Megapixels (2592 x 1944) |
Magnification | Native Optical: 10x – 180x Digital: 10x – 540x |
Lens Assembly | Dual Lenses 3-Layer Glass, 650nm cutoff |
Video | Format: MJPG Frame rate: 15-30 FPS |
Video/Image Properties | Color: Hue, Saturation Exposure: Brightness, Contrast Image: Sharpness, Gamma |
Video, Image Files | BMP, JPG, AVI |
Lighting | 8 Ultra-Bright LEDs Fully adjustable brightness |
Dimensions | 13cm x 3.6cm x 4cm |
Interface | USB 2.0 |
Software | Scalable Window, Zoom, Freeze, Resolution, Rotate, Flip Region of Interest (ROI) Automatic/Manual white balance |
Operating Systems | Windows 10, 8, 7 and Mac OS 10.4 or higher |
Warranty | 1 Year Limited Hardware Warranty |
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Fitness in Youth Can Pay Off Decades Later: Study
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After Concussion Symptoms Fade, Slowed Blood Flow in Brain May Persist
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Empliciti Approved for Multiple Myeloma
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3-D video simulates severe bleeding for combat medics' training
Fluid dynamics principles used to calculate and model highly realistic anatomy and bleeding from a shrapnel wound
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3-D video simulates severe bleeding for combat medics' training
Fluid dynamics principles used to calculate and model highly realistic anatomy and bleeding from a shrapnel wound
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Researchers Grow Retinal Nerve Cells in the Lab
Johns Hopkins researchers have developed a method to efficiently turn human stem cells into retinal ganglion cells, the type of nerve cells located within the retina that transmit visual signals from the eye to the brain.
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The Correlation of the Tinnitus Handicap Inventory with Depression and Anxiety in Veterans with Tinnitus
Objective. The mechanisms of tinnitus are known to alter neuronal circuits in the brainstem and cortex, which are common to several comorbid conditions. This study examines the relationship between tinnitus and anxiety/depression. Subjects and Methods. Ninety-one male veterans with subjective tinnitus were enrolled in a Veterans Affairs Tinnitus Clinic. The Tinnitus Handicap Inventory (THI) was used to assess tinnitus severity. ICD-9 codes for anxiety/depression were used to determine their prevalence. Pure tone averages (PTA) were used to assess hearing status. Results. Descriptive analyses revealed that 79.1% of the 91 tinnitus sufferers had a diagnosis of anxiety, 59.3% had depression, and 58.2% suffered from both anxiety/depression. Patients with anxiety had elevated total THI scores as compared to patients without anxiety (). Patients with anxiety or depression had significantly increased Functional and Emotional THI scores, but not Catastrophic THI score. Significant positive correlations were illustrated between the degree of tinnitus and anxiety/depression (). There were no differences in PTA among groups. Conclusions. A majority of patients with tinnitus exhibited anxiety and depression. These patients suffered more severe tinnitus than did patients without anxiety and depression. The data support the need for multidisciplinary intervention of veterans with tinnitus.
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Effects of Sacrificing Tensor Tympani Muscle Tendon When Manubrium of Malleus Is Foreshortened in Type I Tympanoplasty
The current study aims at observing effects of sacrificing the tensor tympani tendon when manubrium of malleus is foreshortened or retracted on graft uptake, hearing improvement, and occurrence of complications if any during type I tympanoplasty surgery for central perforations. 42 patients were included in group A where the tensor tendon was sectioned and 42 patients were included in group B where the tensor tympani tendon was retained and kept intact. Graft uptake rates are very good in both groups but hearing improvement was found significantly better in group A than group B. No unusual or undesired complications were seen in any of the cases. Sectioning of tensor tympani tendon is safe and effective procedure in cases where manubrium is foreshortened.
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Are crib bumpers safe?
True confession: I used a crib bumper with my first child– I even made it myself to match my nursery decor. I got rid of it when I found out the real risk of infant death associated with crib bumpers, but then I had a new problem. There is a time around 7-9 months when babies get their feet or legs stuck between the slats of the crib and can't get themselves unstuck. My baby would keep getting her feet stuck, then cry until I got them unstuck. What's a parent to do? Use a crib bumper and risk suffocation or sudden infant death syndrome (SIDS), or let baby get stuck and cry?
How dangerous are crib bumpers, anyway? Although uncommon, infant deaths attributed to the presence of a traditional (non-breathable) crib bumper do occur. A total of 77 deaths attributed to crib bumpers were found in a recent review of U.S. databases. Pediatricians from St. Louis Children's Hospital and Washington University School of Medicine contributed to this study. The details for this study are published in the Journal of Pediatrics. I will summarize their findings:
- According to the Consumer Products Safety Commission database, between 1985 and 2012, crib bumpers were attributed to 48 suffocations in the United States. 67% of these deaths were caused by a bumper alone, and 33% by wedgings between a bumper and another object such as a blanket, pillow or toy.
- The number of CPSC-reported deaths was compared with those from the National Center for the Review and Prevention of Child Deaths, 2008-2011; the latter reported substantially more deaths than CPSC, increasing the total to 77 deaths.
- An additional 146 infants sustained injuries from the bumpers, including choking on the bumper ties or nearly suffocating.
The American Academy of Pediatrics recommended against the use of crib bumpers in a 2012 statement on safe sleep environments for infants.
Are crib bumpers associated with sudden infant death syndrome (SIDS)? Technically, SIDS is not the same thing as infant suffocation, although sometimes it is difficult to differentiate between true SIDS and suffocation. We know that SIDS is more common when soft objects are in cribs, such as pillows, blankets and bumpers. A leading theory is that SIDS is caused by an infant re-breathing exhaled air with low oxygen content and their brain not recognizing the sensation of suffocation due to receptors in their brainstem that are not fully developed. Another theory is that SIDS may be caused by toxic gasses/volatile organic compound (VOCs) that escape from crib mattresses and bumpers manufactured with chemical flame retardants, vinyl, polyurethane foam and products associated with PVC (hyperlink). Although we don't know for sure what causes SIDS, both of these theories suggest that some cases of SIDS may be due to crib bumpers.
But now, finally, several companies are making breathable crib bumpers, so baby's feet won't get stuck and everyone can sleep well knowing that baby can breath. And yes, they come in all the colors and designs to match your nursery decorating scheme. Breathable crib bumpers have not been around long enough for us to really understand their safety. But theoretically they should reduce the risk of suffocation. Another option to prevent feet from getting stuck is to use a sleep sack. This keeps baby warm but makes it harder for her to move in the crib. To date, sleep sacks seem to be very safe and may even prevent deaths from SIDS.
Are you having trouble getting your infant to go to sleep? Here are some tried-and-true tricks to help your both sleep well. Considering melatonin for sleep? Read this first.
The post Are crib bumpers safe? appeared first on ChildrensMD.
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Structure-dependent tone sandhi in real and nonce disyllables in Shanghai Wu
Publication date: January 2016
Source:Journal of Phonetics, Volume 54
Author(s): Jie Zhang, Yuanliang Meng
Disyllabic sequences in Shanghai Wu undergo different types of tone sandhi depending on their structure: phonological words (e.g., modifier–nouns) spread the initial tone across the disyllable, while phrases (e.g., non-lexicalized verb–nouns) maintain the final tone and level the contour of the nonfinal tone. We investigated the productivity of the two tone sandhi types through 48 speakers' productions of real and nonce disyllables. Our results show that (a) the word-level tone sandhi in Shanghai indeed involves tone spreading, while the phrase-level sandhi is better interpreted as phonetic contour reduction, (b) the spreading sandhi generally applies productively to nonce words, but there are some differences in tone production between real and nonce words that are attributable to both categorical non-application and gradient application of the sandhi in nonce words, and (c) the structure dependency of Shanghai tone sandhi is also productive, as the speakers produced qualitatively different f0 patterns in modifier–noun nonce words and verb–noun nonce phrases. These results indicate that in order to arrive at a full picture of tone sandhi patterning, experimental data that shed light on the generalizations that speakers make from the speech input are necessary.
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Sensitivity and variability of Presage dosimeter formulations in sheet form with application to SBRT and SRS QA
To measure sensitivity and stability of the Presage dosimeter in sheet form for various chemical concentrations over a range of clinical photon energies and examine its use for stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery(SRS) QA.
Presage polymerdosimeters were formulated to investigate and optimize their sensitivity and stability. The dosimeter is composed of clear polyurethane base, leucomalachite green (LMG) reporting dye, and bromoform radical initiator in 0.9–1.0 mm thick sheets. The chemicals are mixed together for 2 min, cast in an aluminum mold, and left to cure at 60 psi for a minimum of two days. Dosimeter response was characterized at energies Co-60, 6 MV, 10 MV flattening-filter free, 15 MV, 50 kVp (mean 19.2 keV), and Ir-192. The dosimeters were scanned by a Microtek Scanmaker i800 at 300 dpi, 216 bit depth per color channel. Red component images were analyzed with ImageJ and rit. SBRT QA was done with gamma analysis tolerances of 2% and 2 mm DTA.
The sensitivity of the Presage dosimeter increased with increasing concentration of bromoform. Addition of tin catalyst decreased curing time and had negligible effect on sensitivity. LMG concentration should be at least as high as the bromoform, with ideal concentration being 2% wt. Gamma Knife SRS QA measurements of relative output and profile widths were within 2% of manufacturer's values validated at commissioning, except the 4 mm collimator relative output which was within 3%. The gamma pass rate of Presage with SBRT was 73.7%, compared to 93.1% for EBT2 Gafchromic film.
The Presage dosimeter in sheet form was capable of detecting radiation over all tested photon energies and chemical concentrations. The best sensitivity and photostability of the dosimeter were achieved with 2.5% wt. LMG and 8.2% wt. bromoform. Scanner used should not emit any UV radiation as it will expose the dosimeter, as with the Epson 10000 XL scanner. Presage dosimeter in this form was sensitive enough for use in SRS and SBRT QA. The lower gamma pass rate for Presage compared to Gafchromic film can be attributed to the simple equipment used in the fabrication process, which limited the dosimeter's sensitivity uniformity by agglomeration of air bubbles in the material, nonuniform concentration of chemicals throughout the material, and thickness variations. This demands improvements in mixing tools and molds.
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