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Age Limit (age + limit)
Kinds of Age Limit Selected AbstractsAllogeneic bone marrow transplantation with reduced conditioning (RC-BMT)EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 2 2001Lars Vindeløv Abstract: Allogeneic bone marrow transplantation with conventional conditioning (CC-BMT) has the potential of curing various malignant and non-malignant diseases. The curative mechanisms encompass 1) stem cell support for myeloablative radio-chemotherapy, 2) the graft-versus-tumor (GVT) effect, 3) gene replacement for genetic diseases and 4) immunoablation for autoimmune diseases. CC-BMT is characterized by high intensity conditioning, the requirement of prolonged and expensive hospital treatment and a treatment related mortality (TRM) of 10,50% depending on diagnosis, disease stage, patient age and donor type. Recent preclinical and clinical progress has resulted in the emergence of new concepts and procedures that allow replacement of patient bone marrow and immune system with that of the donor by a transplant procedure with markedly reduced conditioning (RC-BMT). This type of transplant, sometimes referred to as mini-BMT, activates curative mechanisms 2,4, which for a number of diseases seems sufficient for cure. It avoids the severe organ toxicity of myeloablative radio-chemotherapy and the complications of profound neutropenia. Patients beyond the age limit of conventional BMT (50,60 yr) may therefore be candidates for this type of transplant as well as patients which because of other medical conditions or the type of disease for which the transplant is needed are poor candidates for CC-BMT. The procedure can be performed in an outpatient setting. The resulting cost reduction should contribute to making allogenic BMT more readily available. This review describes basic concepts and procedures involved in RC-BMT and summarizes preliminary results obtained with RC-BMT in different transplant centers. [source] The Effects of Mammographic Detection and Comorbidity on the Survival of Older Women with Breast CancerJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2002Carol P. McPherson MSW OBJECTIVES: To determine an upper age limit or quantifiable level of comorbidity that would render mammography screening ineffectual in decreasing mortality in women aged 65 and older. DESIGN: Retrospective cohort study. SETTING: Upper midwestern United States. PARTICIPANTS: Five thousand one hundred eighty-six predominantly Caucasian women aged 65 to 101 diagnosed with invasive breast cancer from 1986 through 1994. Data were obtained from The Upper Midwest Tumor Registry System, a regional consortium database in Minnesota, North Dakota, and South Dakota. MEASUREMENTS: Relative risks (RRs) of death were computed for patients with mammographically detected tumors, stratified by age and comorbidity. Survival analysis was performed, stratified by level of comorbidity and method of tumor detection. RESULTS: Patients with mammographically detected tumors and no comorbidity experienced significantly lower RRs of death in every age group (range P < .001 to P = .039). Women with mammographically detected tumors and mild to moderate comorbidity had RRs of death as follows: age 65 to 69 (RR = 0.32, 95% confidence interval (CI) = 0.15,0.69), age 70 to 74, (RR = 0.45, 95% CI = 0.22,0.91); age 75 to 79 (RR = 0.47, 95% CI = 0.25,0.88), age 80 and older (RR = 0.52, 95% CI = 0.33,0.80). Women with severe or multiple comorbidities experienced no improvement in survival with mammographically detected tumors. CONCLUSIONS: Mammographic detection of breast cancer may be associated with a significantly decreased risk of death for older women of all ages, even for women with mild to moderate levels of comorbidity, but for older women with severe or multiple comorbidities, mammography is not associated with improvement in overall survival. [source] Evolution of the Pan-African Wadi Haimur metamorphic sole, Eastern Desert, EgyptJOURNAL OF METAMORPHIC GEOLOGY, Issue 6 2000H. Abd El-Naby By comparison with the general features of metamorphic soles (e.g. vertical and lateral extension, metamorphic grade and diagnostic mineral parageneses, deformation and dominant rock types), it is inferred that the amphibolites, metagabbros and hornblendites of the Wadi Um Ghalaga,Wadi Haimur area in the southern part of the Eastern Desert of Egypt represent the metamorphic sole of the Wadi Haimur ophiolite belt. The overlying ultramafic rocks represent overthrusted mantle peridotite. Mineral compositions and thermobarometric studies indicate that the rocks of the metamorphic sole record metamorphic conditions typical of such an environment. The highest P,T conditions (c. 700 °C and 6.5,8.5 kbar) are preserved in clinopyroxene amphibolites and garnet amphibolites from the top of the metamorphic sole, which is exposed in the southern part of the study area. The massive amphibolites and metagabbros further north (Wadi Haimur) represent the basal parts of the sole and show the lowest P,T conditions (450,620 °C and 4.7,7.8 kbar). The sole is the product of dynamothermal metamorphism associated with the tectonic displacement of ultramafic rocks. Heat was derived mainly from the hot overlying mantle peridotites, and an inverted P,T gradient was caused by dynamic shearing during ophiolite emplacement. Sm/Nd dating of whole-rock,metamorphic mineral pairs yields similar ages of c. 630 Ma for clinopyroxene and hornblende, which is interpreted as a lower age limit for ophiolite formation and an upper age limit for metamorphism. A younger Sm/Nd age for a garnet-bearing rock (c. 590 Ma) is interpreted as reflecting a meaningful cooling age close to the metamorphic peak. Hornblende K/Ar ages in the range 570,550 Ma may reflect thermal events during late orogenic granite magmatism. [source] Tails of the unexpected: palatal medial edge epithelium is no more specialized than other embryonic epitheliumORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 1 2007NL Brown Structured Abstract Authors ,, Brown NL, Sandy JR Objective ,, To determine whether palatal medial edge epithelium (MEE) is specialized in its ability to disappear compared with other embryonic, non-palatal, epithelium. Subjects ,, Embryonic tissues harvested from CD1 mice. Methods ,, Organs were cultured in 2 ml of DMEM/F12 supplemented with 300 ,g/ml l-glutamine and 1% penicillin/streptomycin. Organs were cultured under various conditions including opposing other organs and opposing an inert material for a period of 6 days. Tissues were then processed for histological examination. Results ,, MEE of shelves opposing nothing persisted, whereas MEE of shelves contacting another shelf disappeared. When a tail was placed against a palatal shelf the MEE disappeared, as did the epithelium from the tail, resulting in fusion between the shelf and tail. Furthermore, when palatal shelves were placed against an inert material the MEE disappeared, suggesting pressure alone is a sufficient stimulus to initiate disappearance of the MEE, and that the interaction between the two palatal shelves is not a prerequisite for the disappearance of MEE. Moreover, when two embryonic tails were cultured in close apposition they fused, as did paired limbs. Non-palatal epithelia also disappeared after contact with inert materials. Epithelial disappearance began within 24 h of contact, but there was an age limit. Conclusion ,, These findings suggest that embryonic epithelium from non-specific sites around the body has the ability to disappear with mechanical contact resulting in fusion of tissues. MEE may not be as specialized as once thought. [source] Use of nonsteroidal anti-inflammatory drugs in infants.PEDIATRIC ANESTHESIA, Issue 5 2007A survey of members of the Association of Paediatric Anaesthetists of Great Britain, Ireland Summary Background:, Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used as perioperative analgesics. Many are currently used off label. Diclofenac is currently licensed for use in children over 1 year of age for the treatment of juvenile rheumatoid arthritis, while ibuprofen is licensed for use in children weighing over 7 kg. The dose and interval in children is currently extrapolated from adult studies, as the pharmacokinetic (PK) and pharmacodynamic (PD) data are lacking in infants. Methods:, A postal questionnaire was sent to members of the Association of Paediatric Anaesthetist of Great Britain and Ireland seeking to clarify members' prescribing patterns of NSAIDs, especially in infants. Information regarding the choice of NSAIDS, route of administration, lower age limit, dose interval, dose and practice in two specific perioperative contexts (adenotonsillectomy and open heart surgery) was sought. Results:, The response rate was 80%. NSAIDs are used by 86% of responders in infants. Diclofenac is most commonly used intraoperatively (78%); while ibuprofen (73%) was used more frequently postoperatively. NSAIDs are used by 21% of respondents in ICU. Commonest routes of administration were oral (81%) and rectal (80%), rarely intravenously (9%). The commonest dose for diclofena is 1 mg·kg,1 (59%); the dosing schedule employed being 8 hourly in 53% of cases. NSAIDs are used by 57% of responders as part of their analgesic regime for adenotonsillectomies. Conclusion:, Members of the Association of Paediatric Anaesthetists of Great Britain and Ireland commonly prescribe NSAIDs in infants. This is despite the dearth of PK and PD data in this age group. [source] Case Report: Combined Pancreas and En Bloc Kidney Transplantation Using a Bladder Patch Technique From Very Small Pediatric DonorsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2010J. Sageshima Very small pediatric donors are underutilized for pancreas and kidney transplantation for the fear of inadequate islet mass and higher incidence of technical complications, and the lower age limit for such donors is not well defined. We present here two cases of combined pancreas and en bloc kidney transplantation from very small pediatric donors (14 and 18 months old) to adult type 1 diabetic and uremic patients. The conventional surgical procedure for simultaneous pancreas and kidney transplantation with systemic venous and bladder exocrine drainage was successfully applied to very small organs. For both, we utilized the recently described bladder patch technique for ureteral reconstruction. One patient developed venous thrombosis (partial thrombosis of the splenic and mesenteric veins) and the other urine leak (from a midportion of the medial ureter without compromising the bladder patch) after the transplants; both were successfully managed and the patients demonstrated immediate and sustained pancreas and kidney graft functions for 12 and 2 months posttransplantation. These cases illustrate the feasibility of combined pancreas and en bloc kidney transplantation from very small pediatric donors using a bladder patch technique to avoid small ureteral anastomosis. [source] Children making faces: the effect of age and prompts on children's facial composites of unfamiliar facesAPPLIED COGNITIVE PSYCHOLOGY, Issue 4 2008Carina B. Paine The police do not usually ask child witnesses (under 10-years) to construct facial composites, as it is believed that they could not create images of sufficient accuracy. The main aim of the current experiment was to evaluate whether this age limit is a suitable threshold by comparing composites made by children of age 6-, 8- and 10-years and adults. Additionally, as children's lack of vocabulary to describe faces was considered a likely factor, a technique based on visual prompts was devised to obtain facial descriptions, and compared to construction based on verbal prompting. The experiment involved participants' construction of composites, which were subsequently evaluated subjectively (ranking and rating tasks) and objectively (matching task). Although adults' and older children's composites were, on average, more accurate than those of the younger children, the results demonstrated that children from the age of 6-years were able to produce facial composites of an unfamiliar face. Copyright © 2007 John Wiley & Sons, Ltd. [source] Outcome and prognostic factor analysis of 217 consecutive isolated limb perfusions with tumor necrosis factor-, and melphalan for limb-threatening soft tissue sarcomaCANCER, Issue 8 2006Dirk J. Grunhagen M.D. Abstract BACKGROUND Extensive and mutilating surgery is often required for locally advanced soft tissue sarcoma (STS) of the limb. As it has become apparent that amputation for STS does not improve survival rates, the interest in limb-preserving approaches has increased. Isolated limb perfusion (ILP) with tumor necrosis factor-, (TNF) and melphalan is successful in providing local tumor control and enables limb-preserving surgery in a majority of cases. A mature, large, single-institution experience with 217 consecutive ILPs for STS of the extremity is reported. METHODS At a prospectively maintained database at a tertiary referral center, 217 ILPs were performed from July 1991 to July 2003 in 197 patients with locally advanced STS of the extremity. ILPs were performed at mild hyperthermic conditions with 1,4 mg of TNF and 10,13 mg/L limb-volume melphalan (M) for leg and arm perfusions, respectively. RESULTS The overall response rate was 75%. Limb salvage was achieved in 87% of the perfused limbs. Median survival post-ILP was 57 months and prognostic factors for survival were Trojani grade of the tumor and ILP for single versus multiple STS. The procedure could be performed safely, with a perioperative mortality of 0.5% in all patients with no age limit (median age, 54 yrs; range, 12,91). Systemic and locoregional toxicity were modest and easily manageable. CONCLUSION TNF+M-based ILP can provide limb salvage in a significant percentage of patients with locally advanced STS and has therefore gained a permanent place in the multimodality treatment of STS. Cancer 2006. © 2006 American Cancer Society. [source] Parent-proxy report of their children's health-related quality of life: an analysis of 13 878 parents' reliability and validity across age subgroups using the PedsQL 4.0 Generic Core ScalesCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2007Richard Reading Parent-proxy report of their children's health-related quality of life: an analysis of 13 878 parents' reliability and validity across age subgroups using the PedsQL 4.0 Generic Core Scales . VarniJ. W., LimbersC. A. & BurwinkleT. M. ( 2007 ) Health and Quality of Life Outcomes , 5 , 2 . DOI:10.1186/1477-7525-5-2. Background, Health-related quality of life (HRQOL) measurement has emerged as an important health outcome in clinical trials, clinical practice improvement strategies, and healthcare services research and evaluation. While paediatric patient self-report should be considered the standard for measuring perceived HRQOL, there are circumstances when children are too young, too cognitively impaired, too ill or fatigued to complete an HRQOL instrument, and reliable and valid parent-proxy report instruments are needed in such cases. Further, it is typically parents' perceptions of their children's HRQOL that influences healthcare utilization. Data from the PedsQL DatabaseSM were utilized to test the reliability and validity of parent-proxy report at the individual age subgroup level for ages 2,16 years as recommended by recent Food and Drug Administration (FDA) guidelines. Methods, The sample analysed represents parent-proxy report age data on 13 878 children ages 2,16 years from the PedsQL 4.0 Generic Core Scales DatabaseSM. Parents were recruited from general paediatric clinics, sub-specialty clinics and hospitals in which their children were being seen for well-child checks, mild acute illness or chronic illness care (n = 3,718, 26.8%), and from a State Children's Health Insurance Program in California (n = 10 160, 73.2%). Results, The percentage of missing item responses for the parent-proxy report sample as a whole was 2.1%, supporting feasibility. The majority of the parent-proxy report scales across the age subgroups exceeded the minimum internal consistency reliability standard of 0.70 required for group comparisons, while the total scale scores across the age subgroups approached or exceeded the reliability criterion of 0.90 recommended for analysing individual patient scale scores. Construct validity was demonstrated utilizing the known groups approach. For each PedsQL scale and summary score, across age subgroups, healthy children demonstrated a statistically significant difference in HRQOL (better HRQOL) than children with a known chronic health condition, with most effect sizes in the medium-to-large effect size range. Conclusion, The results demonstrate the feasibility, reliability and validity of parent-proxy report at the individual age subgroup for ages 2,16 years. These analyses are consistent with recent FDA guidelines which require instrument development and validation testing for children and adolescents within fairly narrow age groupings and which determine the lower age limit at which reliable and valid responses across age categories are achievable. Even as paediatric patient self-report is advocated, there remains a fundamental role for parent-proxy report in paediatric clinical trials and health services research. [source] Ar-Ar ages and thermal histories of enstatite meteoritesMETEORITICS & PLANETARY SCIENCE, Issue 5 2010Donald D. BOGARD In this study, we report 39Ar- 40Ar dating results for five EL chondrites: Khairpur, Pillistfer, Hvittis, Blithfield, and Forrest; five EH chondrites: Parsa, Saint Marks, Indarch, Bethune, and Reckling Peak 80259; three igneous-textured enstatite meteorites that represent impact melts on enstatite chondrite parent bodies: Zaklodzie, Queen Alexandra Range 97348, and Queen Alexandra Range 97289; and three aubrites, Norton County, Bishopville, and Cumberland Falls Several Ar-Ar age spectra show unusual 39Ar recoil effects, possibly the result of some of the K residing in unusual sulfide minerals, such as djerfisherite and rodderite, and other age spectra show 40Ar diffusion loss. Few additional Ar-Ar ages for enstatite meteorites are available in the literature. When all available Ar-Ar data on enstatite meteorites are considered, preferred ages of nine chondrites and one aubrite show a range of 4.50,4.54 Ga, whereas five other meteorites show only lower age limits over 4.35,4.46 Ga. Ar-Ar ages of several enstatite chondrites are as old or older as the oldest Ar-Ar ages of ordinary chondrites, which suggests that enstatite chondrites may have derived from somewhat smaller parent bodies, or were metamorphosed to lower temperatures compared to other chondrite types. Many enstatite meteorites are brecciated and/or shocked, and some of the younger Ar-Ar ages may record these impact events. Although impact heating of ordinary chondrites within the last 1 Ga is relatively common for ordinary chondrites, only Bethune gives any significant evidence for such a young event. [source] Registration and classification of adolescent and young adult cancer casesPEDIATRIC BLOOD & CANCER, Issue S5 2008Brad H. Pollock MPH Abstract Cancer registries are an important research resource that facilitate the study of etiology, tumor biology, patterns of delayed diagnosis and health planning needs. When outcome data are included, registries can track secular changes in survival related to improvements in early detection or treatment. The surveillance, epidemiology, and end results (SEER) registry has been used to identify major gaps in survival for older adolescent and young adult (AYA) patients compared with younger children and older adults. In order to determine the reasons for this gap, the complete registration and accurate classification of AYA malignancies is necessary. There are inconsistencies in defining the age limits for AYAs although the Adolescent and Young Adult Oncology Progress Review Group proposed a definition of ages 15 through 39 years. The central registration and classification issues for AYAs are case-finding, defining common data elements (CDE) collected across different registries and the diagnostic classification of these malignancies. Goals to achieve by 2010 include extending and validating current diagnostic classification schemes and expanding the CDE to support AYA oncology research, including the collection of tracking information to assess long-term outcomes. These efforts will advance preventive, etiologic, therapeutic, and health services-related research for this understudied age group. Pediatr Blood Cancer 2008:50:1090,1093. © 2008 Wiley-Liss, Inc. [source] | ||||||||||