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European Centers (european + center)
Selected AbstractsThree-dimensional variational assimilation of Special Sensor Microwave/Imager data into a mesoscale weather-prediction model: A case studyTHE QUARTERLY JOURNAL OF THE ROYAL METEOROLOGICAL SOCIETY, Issue 626 2007C. Faccani Abstract Assimilation of data from the Special Sensor Microwave/Imager (SSM/I) is performed in order to improve the forecast of a heavy-precipitation case (IOP2b, 20,21 September 1999) of the Mesoscale Alpine Programme 1999. The three-dimensional variational data assimilation technique of the MM5 model is used. Either brightness temperatures or precipitable water and surface wind speed are assimilated. The sensitivity of the model to SSM/I data is also tested by selectively excluding SSM/I frequencies and changing the size of the thinning box. All the experiments are performed using the European Center for Medium range Weather Forecasting (ECMWF) analysis on pressure level. The new initial conditions show considerable underestimation of the surface wind component V, and, even more, of the surface water vapour mixing ratio. This last error is partially corrected by assimilation of precipitable water alone, although these data produce a large increase in the mean error of the other surface variables (U, V and T). However, the forecast with this new set of initial conditions shows a good agreement (high correlation coefficient) with the rain gauge observations for the 1 h accumulated precipitation 3 h after the initial time. With a doubled box size, there is low sensitivity to the density of the observations used. In this case, the effect of the SSM/I data is slight, and the rainfall pattern produced is comparable to that obtained without any data assimilation. The model performance is also degraded if the 22 GHz brightness temperatures are removed from the assimilated measurements: the correlation coefficient for the precipitation is lower than in the case where all the frequencies are assimilated, and it decreases over time. In general, the use of precipitable water and surface wind speed affects the early stages (3 h) of the rainfall forecast, reducing the model spin-up. Brightness temperatures affect the forecast at a longer range (10 h). Copyright © 2007 Royal Meteorological Society [source] Incidence, risk factors, and survival of hepatocellular carcinoma in primary biliary cirrhosis: Comparative analysis from two centers,HEPATOLOGY, Issue 4 2009Anna Cavazza The limited information and divergent results on the prevalence, incidence, and risk factors for hepatocellular carcinoma (HCC) in patients with primary biliary cirrhosis (PBC) may be due to the low prevalence of the disease and geographical and environmental differences. Therefore, we analyzed the incidence, prevalence, survival, and risk factors for HCC in patients with PBC from two European centers (389 from Barcelona, Spain, and 327 from Padova, Italy) followed up for 9.3 ± 6.5 years. Gender, age, smoking habit, alcohol consumption, presence of hepatitis B surface antigen (HBsAg) or hepatitis C virus antibodies (anti-HCV), and advanced histological stage (III-IV) were evaluated as risk factors for tumor development. Twenty-four patients (13 from Barcelona and 11 from Padova) developed HCC. The prevalence of HCC was similar in Barcelona (3.34%) and Padova (3.36%). The incidence was 0.35 and 0.37 per 100 patient-years, respectively. Male gender, age >52 years, smoking habit, alcohol >40 g/day, HBsAg, and anti-HCV were not associated with HCC. Advanced histological stage was the only factor associated with the development of HCC (odds ratio [OR]: 5.80, 95% confidence interval [CI]: 2.34-14.38, P < 0.001). When analyzing the two series separately, male gender was associated with higher likelihood of HCC in Padova (OR: 8.09, 95% CI: 1.93-33.8, P < 0.01). The median survival after the diagnosis of HCC was 36 months. Conclusion: The prevalence and incidence of HCC is similar in Spain and Italy and the advanced histological stage is the only risk factor associated with the development of HCC in PBC. The slight disparities observed between the two series might be explained by patient features on diagnosis of liver disease. (HEPATOLOGY 2009.) [source] Independent predictors of contralateral metachronous upper urinary tract transitional cell carcinoma after nephroureterectomy: Multi-institutional dataset from three European centersINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2009Giacomo Novara Objectives: To identify the variables predictive of contralateral metachronous upper urinary tract transitional cell carcinoma (UUT-TCC) after nephroureterectomy (NFU) for non-metastatic UUT-TCC. Methods: Clinical and pathological data of 234 patients who had undergone NFU for UUT-TCC from 1989 to 2005 in three European urological centers were retrospectively collected and analyzed. Results: The median follow-up duration for the whole cohort was 34 months. Contralateral metachronous UUT-TCC was detected in 14 patients (6%). Three patients were treated by NFU, while seven patients underwent ureterectomy and reimplantation and four patients were treated by endoscopic resection plus bacillus Calmette,Guérin instillations within the UUT through a nephrostomic tube. On univariate analysis, a prior history of bladder TCC before NFU was the only factor predictive of the occurrence of contralateral UUT-TCC. Specifically, the 5-year probabilities of being free from contralateral UUT-TCC were 96.6% for the patients with de novo UUT-TCC, and 91.1% and 55.3% for those having non-muscle-invasive and muscle invasive bladder TCC before the UUT cancer, respectively. All survival differences were statistically significant (no history of bladder TCC vs history of non-muscle-invasive bladder TCC, log rank P value 0.015; history of non-muscle-invasive bladder TCC vs history of muscle-invasive bladder TCC, log rank P value 0.035). Conclusions: In our multicenter dataset of patients who had undergone NFU for UUT-TCC, contralateral metachronous UUT-TCC occurred in 6% of the patients. A prior history of bladder TCC before NFU was the only variable predictive of UUT recurrence at univariate analysis. [source] Risk Factors for Vertebral Deformities in Men: Relationship to Number of Vertebral DeformitiesJOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2000A. A. Ismail Abstract Recent epidemiological studies suggest a similar overall prevalence of vertebral deformity in men to that in women, though the influence of increasing age on the prevalence of vertebral deformity is less marked in men. However, most affected men have only a single or two vertebral deformities, which may be unrelated to osteoporosis. The aim of this study was to examine the role of risk factors, previously demonstrated to be associated with vertebral osteoporosis in females, in men with single/dual deformities compared to those with multiple deformities. Age stratified random samples of men aged 50 years and over were recruited from population registers in 30 European centers as part of the European Vertebral Osteoporosis Study (EVOS). Subjects had a lateral spinal radiograph and the presence of vertebral deformity was determined using the McCloskey algorithm. Lifestyle and other risk factor data were obtained from an interviewer-administered questionnaire. In all 6937 men with a mean age of 64.4 (SD = 8.5) years were studied of whom 738 (10.6%) subjects had one or two deformities, and 109 (1.6%) subjects had three or more deformities. There was a marked increase in the prevalence of multiple vertebral deformities with increasing age, but only a modest effect of age on the prevalence of single deformities. Associations between various risk factors for osteoporosis and vertebral deformity were analyzed separately in men with single/dual vertebral deformity from those with three or more deformities using logistic regression. After adjustment for age, there were statistically significant associations between the following risk factors and multiple deformities: previous hip fracture (odds ratio [OR] 10.5), lack of regular physical activity (OR 2.9), low body mass (OR 2.5), and previous steroid use (OR 2.3). By contrast, there were only weak associations with these same variables in males with single/dual deformities and, apart from poor self-reported general health, all of the 95% confidence intervals spanned unity. There was no difference in the reporting of very heavy levels of physical activity under the age of 50 years between men with single/dual deformities and those with multiple deformities. In conclusion, men with multiple deformities showed a similar pattern of risk factor association to those seen in women with vertebral deformity, in contrast to men with single/dual deformities. (J Bone Miner Res 2000;15:278,283) [source] Liver transplantation for non,hepatocellular carcinoma malignancy: Indications, limitations, and analysis of the current literatureLIVER TRANSPLANTATION, Issue 8 2010Eric J. Grossman Orthotopic liver transplantation (OLT) is currently incorporated into the treatment regimens for specific nonhepatocellular malignancies. For patients suffering from early-stage, unresectable hilar cholangiocarcinoma (CCA), OLT preceded by neoadjuvant radiotherapy has the potential to readily achieve a tumor-free margin, accomplish a radical resection, and treat underlying primary sclerosing cholangitis when present. In highly selected stage I and II patients with CCA, the 5-year survival rate is 80%. As additional data are accrued, OLT with neoadjuvant chemoradiation may become a viable alternative to resection for patients with localized, node-negative hilar CCA. Hepatic involvement from neuroendocrine tumors can be treated with OLT when metastases are unresectable or for palliation of medically uncontrollable symptoms. Five-year survival rates as high as 90% have been reported, and the Ki67 labeling index can be used to predict outcomes after OLT. Hepatic epithelioid hemangioendothelioma is a rare tumor of vascular origin. The data from single-institution series are limited, but compiled reviews have reported 1- and 10-year survival rates of 96% and 72%, respectively. Hepatoblastoma is the most common primary hepatic malignancy in children. There exist subtle differences in the timing of chemotherapy between US and European centers; however, the long-term survival rate after transplantation ranges from 66% to 77%. Fibrolamellar hepatocellular carcinoma is a distinct liver malignancy best treated by surgical resection. However, there is an increasing amount of data supporting OLT when resection is contraindicated. In the treatment of either primary or metastatic hepatic sarcomas, unacceptable survival and recurrence rates currently prohibit the use of OLT. Liver Transpl 16:930-942, 2010. © 2010 AASLD. [source] Evolution of liver transplantation in Europe: Report of the European Liver Transplant RegistryLIVER TRANSPLANTATION, Issue 12 2003René Adam MD The European Liver Transplant Registry (ELTR) currently allows for the analysis of 44,286 liver transplantations (LTs) performed on 39,196 patients in a 13-year period. After an exponential increase, the number of LTs is plateauing due to a lack of organs. To cope with this, alternatives to cadaveric LT, such as split LT, domino LT, or living-related LT (LRLT) are being used increasingly. They now account for 11% of all procedures. One of the most important findings in the evolution of LT is the considerable improvement of results along time with, for the mean time, a one-year survival of 83%, all indications confounded. The improvement is particularly significant for cancers. This improvement is mainly represented by hepatocellular carcinoma, with a gain of 17% for 5-year survival rate from 1990 to 2000. Increasingly, older donors are used to augment the donor pool and older recipients are transplanted due to improved results and a better selection of patients. More than two thirds of deaths and three quarters of retransplantations occurred within the first year of transplantation. Retransplantation is associated with much less optimal results than first LT. One of the prominent features of recent years is the development of LRLT. LRLT is now performed by almost half of the European centers. As with split LT or domino LT, LRLT aims to provide more patients to be transplanted. Special attention is paid to reducing the risk for the donor, which is now estimated to be 0.5% mortality and 21% postoperative morbidity. [source] Spinal Cord Stimulation for the Treatment of Chronic Pain in Patients with Lumbar Spinal StenosisNEUROMODULATION, Issue 4 2010Amedeo Costantini MD Objective:, Chronic back and leg pain associated with lumbar spinal stenosis (LSS) is common in the elderly. Surgical decompression is usually performed when conservative treatments fail. We present an evaluation of the long-term outcome of patients suffering from symptomatic LSS treated with spinal cord stimulation (SCS). Materials and Methods:, Data were collected prospectively in three independent registries in three European centers. Pooled data were analyzed retrospectively. Changes in pain intensity, functional status, and analgesic medication were compared at baseline and at the last available follow-up. Demographic data as well as details regarding the implantation procedure and any adverse events were systematically recorded. Results:, Data were recorded in 69 patients with a mean follow-up period of 27 months. All patients showed clinically and statistically significant improvement in pain relief, the visual analog scale decreasing from 7.4 ± 2.3 to 2.8 ± 2.4 (p < 0.05). The use of analgesic medication decreased and the functional status improved. Conclusion:, Spinal cord stimulation seems to be effective in the treatment of patients suffering from chronic pain associated with LSS. Being less invasive and reversible, SCS should be considered before surgical decompression, particularly in patients with increased risks associated with back surgery. [source] Patient-controlled Analgesia in Intrathecal Therapy for Chronic Pain: Safety and Effective Operation of the Model 8831 Personal Therapy Manager with a Pre-implanted SynchroMed Infusion SystemNEUROMODULATION, Issue 3 2003Jan Maeyaert Abstract The Model 8831 Personal Therapy Manager (PTM) offers a patient-controlled analgesia (PCA) option for the SynchroMed Infusion System (Medtronic Inc., Minneapolis, MN). The safety and effective operation of the PTM activator was evaluated in 45 patients in five European centers receiving intrathecal drug infusion for the treatment of chronic pain via a SynchroMed pump. The total volume of drug delivered intrathecally over a four-week follow-up period was calculated. Adverse events were recorded and pain levels were measured via the Visual Analog pain Scale (VAS), Brief Pain Inventory, and SF-12 Quality of Life scores. Patient satisfaction with the device and its instruction manual was also assessed by questionnaire. The expected and calculated intrathecal drug volumes (and therefore drug doses) were the same, demonstrating that the device worked as intended. There were no device-related serious adverse events. Overall, 96% of patients were satisfied with the activator. Patients appreciated being able to control their pain and considered the device and its instructions easy to use. The PTM was shown to be safe and functioning properly in the intrathecal treatment of pain. The successful addition of a PCA function to the SynchroMed system may create a new standard in intrathecal pain therapy. [source] The safety and efficacy of an extravascular, water-soluble sealant for vascular closure: Initial clinical results for MynxÔCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 5 2007D. Scheinert MD Abstract Objective: The purpose of this study was to evaluate the hemostatic efficacy and safety of the Mynx extravascular sealant for femoral artery closure. Background: The Mynx device is an extra-arterial vascular closure technology utilizing a water-soluble, porous, polyethylene glycol matrix that immediately seals the arteriotomy by rapidly absorbing subcutaneous fluids and expanding in the tissue tract and then, resorbs within 30 days. Methods: The Mynx study was a prospective, multicenter, single-arm clinical investigation conducted at five European centers. The safety and effectiveness of the Mynx device was evaluated in patients following diagnostic or interventional endovascular procedures performed through 5 Fr, 6 Fr, or 7 Fr introducer sheaths in the common femoral artery. The primary safety endpoint was the combined rate of major complications within 30 days (±7 days). The primary efficacy endpoints were time to hemostasis and time to ambulation. Results: Patient enrollment included 190 patients with 50% having undergone diagnostic catheterization and 50% interventional procedures with a mean activated clotting time of 221 sec. One (0.5%) major vascular complication (transfusion) occurred in one patient. No device-precipitated complications associated with serious clinical sequelae were reported. Mean (± standard deviation) times to hemostasis and ambulation were 1.3 ± 2.3 min and 2.6 ± 2.6 hr, respectively. There was no significant difference in median times to hemostasis between diagnostic and interventional patients (0.5 vs. 0.6 min). Conclusions: The initial experience with the extra-arterial Mynx closure technology supports hemostatic safety and efficacy in patients undergoing diagnostic and interventional catheterization procedures. © 2007 Wiley-Liss, Inc. [source] Activity of telithromycin and seven other agents against 1034 pediatric Streptococcus pneumoniae isolates from ten central and eastern European centersCLINICAL MICROBIOLOGY AND INFECTION, Issue 7 2003B. Bozdogan Objective, To test the activity of telithromycin against 1034 Streptococcus pneumoniae isolates from pediatric patients in ten centers from ten central and eastern European countries during 2000,2001, and to compare it with the activities of erythromycin A, azithromycin, clarithromycin, clindamycin, and quinupristin,dalfopristin. Methods, The minimum inhibitory concentrations (MICs) of telithromycin, erythromycin A, azithromycin, clarithromycin, clindamycin, levofloxacin, quinupristin,dalfopristin and penicillin G were tested by the agar dilution method with incubation in air, and mechanisms of resistance to macrolides and quinolones were investigated. Results, Strains were isolated from sputum, tracheal aspirates, ear, eye, blood, and cerebrospinal fluid. Among S. pneumoniae strains tested, 36% had raised penicillin G MICs (, 0.12 mg/L). Susceptibilities were as follows: telithromycin, quinupristin,dalfopristin and levofloxacin, , 99%; clindamycin, 83%; and erythromycin A, azithromycin and clarithromycin, 78%. Of 230 (22.3%) erythromycin A-resistant S. pneumoniae strains, 176 (79.6%) had erm(B), 38 (16.1%) had mef(A), and 10 (4.3%) had mutations in 23S ribosomal RNA or in ribosomal protein L4. The rates of drug-resistant S. pneumoniae are high in all centers except Kaunas, Riga, and Prague. Conclusion, Telithromycin had low MICs against all strains, irrespective of macrolide, azalide or clindamycin resistance. Ribosomal methylation was the most prevalent resistance mechanism among all resistant strains, except in Sofia, where the prevalence of the efflux mechanism was higher. [source] | ||||||||||