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Selected AbstractsEmergence of Electronic Home Monitoring in Chronic Heart Failure: Rationale, Feasibility, and Early Results With the HomMed SentryÔ-ObserverÔ SystemCONGESTIVE HEART FAILURE, Issue 3 2000Mandeep R. Mehra MD Electronic home monitoring for chronic heart failure is emerging as an available option to add to our armamentarium as a vital part of the multidisciplinary care process. This investigation describes the early clinical results of a multicenter study which suggests that important trends in medical resource utilization may be attained by the use of this modality. [source] Systematic review: the role of self-expanding plastic stents for benign oesophageal stricturesALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 12 2010A. REPICI Aliment Pharmacol Ther,31, 1268,1275 Summary Background, Treatment of refractory or recurrent benign oesophageal strictures is demanding and surgery may be the only available option. The role of self-expanding plastic stents (SEPS) in the treatment of these strictures is still controversial because of the conflicting results of various studies. Aim, To analyse with regard to SEPS: technical and clinical success, factors associated with outcome, and safety. Methods, Pooled-data analysis of a systematic review of the literature. Clinical success was defined as no need for further endoscopic or surgical treatment after SEPS removal. Results, Data of 10 studies with 130 treated patients were included. SEPS insertion was technically successful in 128 of 130 patients (98%, 95% CI = 96,100%). Clinical success was achieved in 68 patients (52%, 95% CI = 44,61%) and this was found to be lower in those with a cervical localization of the stricture (33% vs. 54%; P < 0.05). Early (<4 weeks) migration of the stent was reported in 19 (24%, 95% CI = 14,32%) cases, while post-insertion endoscopic re-intervention was required in 25 (21%, 95% CI = 14,28%). Major clinical complications occurred in 12 patients (9%, 95% CI = 4,14%), resulting in death of one (0.8%) patient. Conclusions, Our pooled-data analysis showed a favourable risk/benefit ratio when SEPS are applied in patients with recurrent or refractory benign oesophageal strictures. This supports the use of SEPS before referring patients to surgery, and they are a valuable alternative to repeat endoscopic dilation. [source] A survey of pregnant women's attitude towards breech delivery and external cephalic versionAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2000Tak Yeung Leung SUMMARY A structured interview survey was carried out in 150 women who came for their first antenatal visit in a university hospital in Hong Kong between June and July 1998. Their opinions and perceptions of fetal and maternal safeties on different modes of delivery for both cephalic and breech presentation, and external cephalic version (ECV) were surveyed. Their decisions on the management of term breech-presenting pregnancy were examined. Most women (92%) preferred vaginal delivery to Caesarean delivery (CS) in case of cephalic presentation, mainly because it was a natural way of parturition. They perceived that vaginal delivery was safer than CS for both mothers and babies, but the reverse was true for breech presentation. About 82% chose ECV as the first choice of managing breech presentation, mainly because a successful version allowed a natural way of delivery. Only 2% of women considered ECV ineffective, and 13.3% and 18.7% considered it not safe for mothers and fetuses respectively. Therefore, ECV should be an available option in all obstetric units. Adequate counselling and explanation would improve the acceptance of ECV. [source] 3465: Medical cancer therapy of lacrimal gland tumoursACTA OPHTHALMOLOGICA, Issue 2010C LE TOURNEAU Purpose The most common malignant epithelial cancer of the lacrimal gland is the adenoid cystic carcinoma (ACC). Despite a slow growth, ACCs are ultimately associated with a poor outcome. Methods Given the rarity of this disease, there are actually no conclusive recommendations for optimal therapy of this tumor. Results Surgery and postoperative radiation therapy is commonly used in the initial local treatment of ACC of the lacrimal gland. In high-risk recurrence patients, concomitant platinum-based chemoradiation should be discussed in an attempt to enhance radiosensitivity. While encouraging responses were reported with intraarterial neoadjuvant chemotherapy, this strategy was associated with substantial toxicity and should not be recommended outside of clinical trials. In the metastatic setting, systemic therapy is the only available option if no surgery and/or radiation is feasible. Although some tumour shrinkage has been reported with intravenous chemotherapy, only dismal objective response rates were achieved. Most active drugs remain anthracyclines and platinum compounds. Drug combinations do not seem to add much efficacy. More recently, non-cytotoxic molecularly targeted agents have emerged and demonstrated significant efficacy in several tumour types. These agents modulate specific targets thought to be essential for tumour proliferation and/or angiogenesis. c-KIT, PDGFR,, EGFR, and VEGFR are transmembrane receptors with oncogenic tyrosine kinase activity that are commonly overexpressed in ACC. The use of drugs triggering these targets has been disappointing so far. Conclusion The recent identification of a hallmark gene fusion transcript thought to activate critical targets involved in apoptosis, cell cycle control, cell growth and angiogenesis, heralds new treatment promise. [source] Graphical user interfaces in an engineering educational environmentCOMPUTER APPLICATIONS IN ENGINEERING EDUCATION, Issue 1 2005Christopher Depcik Abstract Graphical user interfaces (GUIs) are being increasingly used in the classroom to provide users of computer simulations with a friendly and visual approach to specifying all input parameters and increased configuration flexibility. In this study, the authors first describe a number of software and language options that are available to build GUIs. Subsequently, a comprehensive comparative assessment of possible alternatives is undertaken in the light of a benchmark educational program used in a course on computational fluid dynamics (CFD) at the University of Michigan. For the GUIs presented, their educational value with respect to flexible data entry and post-processing of results has been demonstrated. In addition, the authors offer recommendations for pros and cons of available options in terms of platform independence, ease of programming, facilitation of interaction with students, and flexibility. © 2005 Wiley Periodicals, Inc. Comput Appl Eng Educ 13: 48,59, 2005; Published online in Wiley InterScience (www.interscience.wiley.com); DOI 10.1002/cae.20029 [source] Nonoperative therapies for combined modality treatment of hepatocellular cancer: expert consensus statementHPB, Issue 5 2010Roderich E. Schwarz Abstract Although surgical resection and liver transplantation are the only treatment modalities that enable prolonged survival in patients with hepatocellular carcinoma (HCC), the majority of HCC patients presents with advanced disease and do not undergo resective or ablative therapy. Transarterial chemoembolization (TACE) is indicated in intermediate/advanced stage unresectable HCC even in the setting of portal vein involvement (excluding main portal vein). Sorafenib has been shown to improve survival of patients with advanced HCC in two controlled randomized trials. Yttrium 90 is a safe microembolization treatment that can be used as an alternative to TACE in patients with advanced liver only disease or in case of portal vein thrombosis. External beam radiation can be helpful to provide local control in selected unresectable HCC. These different treatment modalities may be combined in the treatment strategy of HCC and also used as a bridge to resection or liver transplantation. Patients should undergo formal multidisciplinary evaluation prior to initiating any such treatment in order to individualize the best available options. [source] Social Dialogue: A Potential "Highroad" to Policies Addressing Ageing in The EU Member StatesINTERNATIONAL SOCIAL SECURITY REVIEW, Issue 1 2006Hedva Sarfati The impact of demographic ageing on the sustainability of pensions has become the focus of heated debate in Europe, as governments try to reform their welfare systems. Among the most vocal opponents of the reforms are employers' organizations and managements, trade unions and individual workers. The article looks at the issues at stake and the relevance of social dialogue, despite difficulties, for reaching consensus among all stakeholders on acceptable labour market and pension reforms. These have to be comprehensive and free from ideological a priori assumptions. Specific examples of available options are mentioned, including Finland, Denmark, Spain and the United Kingdom. [source] World Commission on Dams: implications for food and irrigation1,IRRIGATION AND DRAINAGE, Issue 2 2001Chris Perry barrages; l'irrigation; securité d'alimentation Abstract The World Commission on Dams has now published its report. Insights into the workings and conclusions of the Commission were published in the last edition of this Journal. While the WCD report brings together a number of important existing and new recommendations on ameliorating the negative impacts of large dams, it pays inadequate attention to the impacts in the major area (food production and security) for which dams have been built. Consideration of data presented by the WCD would suggest a more positive impact, and a brief review of national and world trends in food production suggests that irrigation , of which large dams are an intrinsic and central component , has underlain if not dominated the vast improvement in food availability that occurred in the second half of the last century. With water in crisis in many countries, planners, policymakers and politicians will continue to face challenging decisions on the allocation of limited freshwater supplies, and demands to increase the level of water resources development. Some guidance from the WCD is helpful, and some is flawed. Most importantly, much is missing, and to be useful, guidance must reflect rational and balanced, expert and rigorous assessment of all the impacts of the available options. Copyright © 2001 John Wiley & Sons, Ltd. La Commission Globale des Barrages a maintenant publiée son rapport. Quelques apercus sur les méthodes et les conclusions de la commission ont été données dans la dernière edition de ce journal. Quant le rapport CGB a se rassemblé quelques recommendations nouveaux et actuels pour amèliorer les impacts négatifs des grands barrages, il n'y a pas d'attention suffisante donnés aux impacts sur les questions importantes (comme le production et la sécurité d'alimentation) pour qui les barrages ont étés construits. Penser aux donnés du CGB suggère un impact plus positif et un critique des tendances nationale et globale du production d'alimentation denote que l'irrigation (dont les grands barrages sont un composant central et intrinsèque) a soutienne si non dominée l'immense amélioration de la disponibililité d'alimentation dans la dernière partie du XXe siècle. Avec la crise actuèlle de l'eau en beaucoup de pays, les planificateurs, les dirigants de politique et les politiciens se continuent de faire face aux decisions difficile sur les questions d'allocation d'eau limitée et les demands pour une augmentation de développement des resources en eau. Quelques conseils du CGB sont util mais quelques uns sont en défaut. Les plus importantes problèmes sont que le rapport manque beaucoup de choses et que, pour être utile, les conseils doivent réfléchir les impactes de tous les choix dans une façon rationale et équilibrée avec une évaluation experte et rigoureuse. Copyright © 2001 John Wiley & Sons, Ltd. [source] Women's Decision Making About the Use of Hormonal and Nonhormonal Remedies for the Menopausal TransitionJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 6 2003Rosemary Theroux Objective: To critically review qualitative research on women's decision making about the use of hormonal and nonhormonal remedies for the menopausal transition. Data Sources: Computerized searches in CINAHL, MEDLINE, Medscape, and PsychINFO databases, using the keywords decision making, hormone therapy, herbal remedies, attitude toward hormone therapy, and qualitative research; and ancestral bibliographies. Study Selection: Articles from indexed journals from 1982 to 2001 in the English language relevant to the keywords were evaluated. Sixteen studies met inclusion criteria and were included in the analysis. Data Extraction: Study findings were organized into several categories and compared and contrasted across publications and categories. Data Synthesis: Half of the researchers described decision making as a weighing of benefits and risks. Women's considerations, beliefs, and values, as well as interaction with the environment, were primary influences on the process. Conclusions: Major gaps in care for midlife women were identified. Women need information about the process of menopause and the range of available options for menopause management. Nurses can play a major role in providing information, counseling, and developing decision aids. Women's values and beliefs, cultures, life contexts, and desire for involvement in the decision should guide interventions. [source] Successful ISCR-enhanced bioremediation of a TCE DNAPL source utilizing EHC® and KB-1®REMEDIATION, Issue 3 2010James G. D. Peale Remediation of chlorinated solvent DNAPL sites often meets with mixed results. This can be attributed to the diametrically opposed nature of the impacts, where the disparate dissolved-phase plume is more manageable than the localized, high-concentration source area. A wide range of technologies are available for downgradient plume management, but the relative mass of contaminants in a DNAPL source area generally requires treatment for such technologies to be effective over the long term. In many cases, the characteristics of DNAPL source zones (e.g., depth, soil heterogeneity, structural limitations) limit the available options. The following describes the successful full-scale implementation of in situ chemical reduction (ISCR) enhanced bioremediation of a TCE DNAPL source zone. In this demonstration, concentrations of TCE were rapidly reduced to below the maximum contaminant level (MCL) in less than six months following implementation. The results described herein suggest that ISCR-enhanced bioremediation is a viable remedial alternative for chlorinated solvent source zones. © 2010 Wiley Periodicals, Inc. [source] | |||||||||||||