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Future Strategies (future + strategy)
Selected AbstractsCurrent Status and Future Strategies for Development of Transgenic Plants in ChinaJOURNAL OF INTEGRATIVE PLANT BIOLOGY, Issue 9 2007De-Ping Wang Abstract In this review, the author summarized the current status, challenges, and strategies in China in the development of transgenic plants and its commercialization. Based on sets of successful examples and data achieved from execution of the National Special Project for Transgenic Plant Research and Commercialization in the last five years, the priorities and key directions were put forward for the future development of transgenic plants in China. [source] Cancer cachexia syndrome in head and neck cancer patients: Part I. Diagnosis, impact on quality of life and survival, and treatmentHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2007Marion Couch MD Abstract Background Cancer cachexia is a debilitating, wasting condition that affects many cancer patients, including those with head and neck cancer. The overall incidence of cancer cachexia is quite high for some types of cancer, and cachexia will be the main cause of death for more than 20% of all cancer patients. This syndrome uniquely challenges patients with head and neck cancer. This article outlines the diagnosis of cancer cachexia, reviews its impact on patient quality of life (QOL) and survival, and updates the reader on potential therapies that may suppress it. Methods A comprehensive literature search was performed using PubMed of the National Library of Medicine, which includes more than 15 million citations back to the 1950s. The Cochrane Library and Google search engine were used as well. Results This syndrome differs significantly from starvation, and thus accurate and timely diagnosis is essential. Nutritional therapy alone is insufficient. Current management strategies include corticosteroids and megesterol acetate, in conjunction with nutritional therapy. Future strategies may include nutraceuticals, omega-3 fatty acids, inflammatory antagonists, and other targeted treatments. Conclusions Because cancer cachexia differs significantly from starvation, nutritional supplementation must be used in conjunction with other anti-cachexia agents to reverse the chronic systemic inflammatory state and the effects of circulating tumor-derived factors seen in cachexia. Careful identification of patients at risk and those suffering from this syndrome will lead to better outcomes and treatments. Ultimately, more research is needed to better treat this devastating condition. © 2007 Wiley Periodicals, Inc. Head Neck, 2007 [source] Hepatitis B viral load predicts survival of HCC patients undergoing systemic chemotherapy,HEPATOLOGY, Issue 6 2007Winnie Yeo HCC is a common cause of morbidity and mortality. For patients who are not candidates for curative surgery, systemic chemotherapy is one of the standard treatments. In parts of China and the Far East, over 80% of HCC patients have chronic HBV infection. In this study, we aimed to assess the relationship between pre-chemotherapy HBV viral load and the survival of HCC patients. HBV infection status was determined prior to chemotherapy in 188 patients, 170 of whom had evidence of HBV chronic infection/exposure (160 hepatitis B surface antigen [HBsAg]-positive, 10 HBsAg-negative/hepatitis B core antibody,positive). Of these, 125 had pretreatment HBV DNA levels determined via real-time PCR. Virological data were analyzed using conventional clinical variables to identify factors that influenced survival. Multivariate analysis revealed that high total bilirubin (P = 0.0016; hazard ratio = 1.040 per 1 ,M increase; 95% CI 1.015,1.065), HCV infection (P = 0.0095; hazard ratio = 6.955; 95% CI 1.606,30.129), and high HBV DNA level (P = 0.0217; hazard ratio = 1.650; 95% CI 1.076,2.531) affected survival significantly. Exploratory analysis revealed that high levels of pretreatment HBV DNA had a significantly higher incidence of severe hepatitis during chemotherapy. Conclusion: For HCC patients with HBV chronic infection/exposure, a high viral load prior to treatment is an adverse factor for survival and may be associated with a higher incidence of severe hepatitis during chemotherapy. Future strategies to improve the prognosis of HCC patients undergoing chemotherapy should consider supportive therapy that incorporates antiviral therapies to reduce HBV viral load. (HEPATOLOGY 2007;45:1382,1389.) [source] Endogenous TNF, Lowers Maximum Peak Bone Mass and Inhibits Osteoblastic Smad Activation Through NF-,B,,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 5 2007Yan Li Abstract Endogenous TNF, prevents the attainment of maximum achievable peak bone mass in vivo. In vitro, TNF, suppresses BMP-2, and TGF,-mediated Smad activation through induction of NF-,B. Consistently, pharmacological suppression of NF-,B augments osteoblast differentiation and mineralization in vitro. Introduction: Osteoporosis is a major health threat. Traditional therapeutic strategies have centered on anti-catabolic drugs that block bone resorption. Recently focus has shifted to anabolic agents that actively rebuild lost bone mass. Future strategies may involve elevating peak bone mass to delay osteoporosis development. Recent in vitro studies show that TNF, represses osteoblast differentiation and mineralization; however, the mechanisms are poorly understood and the impact of basal TNF, concentrations on the acquisition of peak bone mass in vivo is unknown. Materials and Methods: We examined peak BMD, bone volume, and bone turnover makers in mice deficient in TNF, or its receptors. We further examined the effect of TNF, on Smad-induced signaling by TGF, and BMP-2 in vitro using a Smad responsive reporter. The effect of TNF,-induced NF-,B signaling on Smad signaling and on in vitro osteoblast mineralization was examined using specific NF-,B inhibitors and activators, and effects of TNF,-induced NF-,B signaling on BMP-2,induced Runx2 mRNA were examined using RT-PCR. Results: Mice null for TNF, or its p55 receptor had significantly increased peak bone mass, resulting exclusively from elevated bone formation. In vitro, TNF, potently suppressed Smad signaling induced by TGF, and BMP-2, downregulated BMP-2,mediated Runx2 expression, and inhibited mineralization of osteoblasts. These effects were mimicked by overexpression of NF-,B and prevented by pharmacological NF-,B suppression. Conclusions: Our data suggest that TNF, and NF-,B antagonists may represent novel anabolic agents for the maximization of peak basal bone mass and/or the amelioration of pathological bone loss. [source] Representative marketing-oriented study on implants in the Austrian population.CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2003Abstract: The number of dental implants inserted annually worldwide has been estimated to come close to a million. But the level of information available to patients about realistic, evidence-based treatment options by implants is often enough more than fragmentary, and what is disseminated by the media and the industry does not always reflect evidence-based empirical data. This survey of 1000 adults presented with 18 questions was designed to shed light on several points. These were (1) level of subjective patient information, (2) sources of information and prejudices, (3) future demand for implant treatment and target groups for patient information campaigns, and (4) potential misinformation, information deficits, discrepancies of information and how these come about. Of those questioned, 20% said unprompted that implants were a possibility to replace missing teeth. When prompted, 72% said that they knew about dental implants. Most of those questioned felt poorly informed about the options for replacing missing teeth and many knew less about implants than about other alternatives. The dentist was said to be the desired source of information, but 77% of those questioned reported that their dentists did not practice implant dentistry. More than 79% of those questioned did not know whether their dentist worked with implants. Forty-four percent thought that implants should only be placed by specially trained doctors. Sixty-one percent were of the opinion that dentists who provide implant dentistry were better qualified than their nonimplanting colleagues. Half of those questioned attributed implant failures to allergies and incompatibilities, the other half to poor medical care. Only 29% incriminated poor oral hygiene as a cause of implant failure. Future strategies should be geared to more professional public relations and patient information. Internationally operating qualified implant institutions could contribute much to balance discrepant information. Résumé Le nombre d'implants dentaires insérés annuellement dans le monde se chiffrerait à environ un million. Mais le niveau d'information disponible du patient en ce qui concerne les options de traitement basées sur l'évidence est souvent fragmentaire, et l'information dispensée par les média et l'industrie ne reflète pas toujours ces options. Cette enquête réalisée sur mille adultes ayant reçu un questionnaire de 18 questions a été effectuée afin de mettre en évidence certains points. Ces derniers étaient 1) le niveau de l'information subjective du patient, 2) les sources d'information et préjudices, 3) la demande future pour le traitement implantaire et les groupes cibles pour les campagnes d'information des patients, 4) les mauvaises informations potentielles, les déficits d'information, les désaccords de l'information et les causes de ces derniers. De ces personnes questionnées, 20% ont répondu spontanément que les implants étaient un moyen de remplacer les dents manquantes. Lorsqu'ils étaient interrogés, 72% ont répondu connaître les implants dentaires. La plupart de ces personnes se sentaient cependant peu informées sur les options de remplacement des dents manquantes et beaucoup d'entre-elles possédaient très peu d'information sur les implants par rapport aux autres possibilités existantes. Le dentiste semblait être la source préférentielle d'information mais 77 % des personnes questionnées ont rapporté que leur dentiste ne plaçait pas d'implant. Plus de 79% ne savaient pas si leur dentiste pratiquait l'implantologie. Quarante-quatre pour cent étaient persuadés que les implants ne pouvaient être placés que par des spécialistes. Soixante et un pour cent pensaient que les dentistes pratiquant de la dentisterie implantaire étaient plus qualifiés que les autres collègues. La moitié attribuait les échecs implantaires aux allergies et aux incompatiblités, l'autre moitié aux mauvais soins médicaux. Seul 29% incriminaient la mauvaise hygiène buccale comme une cause d'échec implantaire. Des stratégies futures devraient être orientées vers davantage de relations publiques professionnelles et d'informations du patient. Des institutions d'implants internationales pourraient grandement contribuer à changer cette mauvaise information. Zusammenfassung Eine repräsentative marketing-orientierte Studie über Implantate in der Bevölkerung von Oesterreich. Teil I: Stand der Information, Informationsquellen und Bedürfnis bezüglich Patienteninformation Die Anzahl weltweit gesetzter Implantate pro Jahr wird auf fast eine Million geschätzt. Aber die den Patienten zur Verfügung stehende Information über realistische, auf Evidenz basierende Behandlungsmöglichkeiten mit Implantaten ist mehr als lückenhaft. Was durch die Medien und durch die Industrie verbreitet wird, wiederspiegelt nicht immer auf Evidenz basierende empirische Daten. Diese Untersuchung an 1000 Erwachsenen, welchen 18 Fragen gestellt wurden, wurde entwickelt, um Licht auf verschiedene Punkte zu werfen. Die Punkte betrafen (1) Stand der subjektiven Patienteninformation; (2) Informationsquellen und Vorurteile; (3) zukünftiger Bedarf an Implantatbehandlungen und Zielgruppen für Propaganda zur Patienteninformation; (4) potentielle Fehlinformation, Informationsdefizite, Diskrepanzen in der Information und wie diese zustande kommen. Von den gefragten Individuen sagten ohne Vorinformation 20%, dass Implantate eine Varainte für den Ersatz von fehlenden Zähnen darstellen. Mit Vorinformation sagten 72%, dass sie von dentalen Implantaten Kenntnis haben. Die meisten der Befragten fühlten sich über die Möglichkeiten bezüglich Ersatz fehlender Zähne schlecht informiert und viele wussten weniger über Implantate als über andere Behandlungsvarianten. Es wurde gesagt, der Zahnarzt sei die gewünschte Informationsquelle, aber 77% der Befragten berichteten, dass ihr Zahnarzt keine Behandlungen mit Implantaten anbietet. Mehr als 79% der Befragten wussten nicht, ob ihr Zahnarzt mit Implantaten arbeitet. Vierundvierzig Prozent dachten, dass Implantate nur durch speziell ausgebildete Aerzte gesetzt werden sollten. Einundsechzig Prozent waren der Meinung, dass Zahnärzte, welche Implantatbehandlungen anbieten, besser qualifiziert sind als ihre nicht-implantierenden Kollegen. Die Hälfte der Befragten führten Implantatmisserfolge auf Allergien und Unverträglichkeiten zurück, die andere Hälfte auf schlechte medizinische Nachsorge. Nur 29% bezeichneten eine schlechte Mundhygiene als Ursache für Implantatmisserfolge. Zukünftige Studien sollten Richtung professioneller Publikums- und Patienteninformation gesteuert werden. International tätige qualifizierte Implantatinstitutionen könnten beträchtlich zum Ausgleich von widersprüchlichen Informationen beitragen. Resumen El número de implantes dentales insertados anualmente en todo el mundo se ha estimado cercano al millón. Pero el nivel de información disponible para los pacientes acerca de opciones de tratamiento reales con implantes basados en la evidencia es frecuentemente mas bien fragmentaria y lo que se disemina por los medios y la industria no siempre refleja los datos empíricos basados en la evidencia. Esta encuesta de 1000 adultos que presentaba 18 preguntas fue diseñada para dar luz en determinados puntos. Estos fueron (1) nivel subjetivo de información de los pacientes; (2) fuentes de información y prejuicios; (3) demanda futura para tratamiento de implantes y grupos diana para campañas de información; (4) desinformación potencial, déficit de información, discrepancias de información y como se generan. De aquellos a los que se preguntó, 20% dijeron espontáneamente que los implantes eran una posibilidad para reemplazar dientes ausentes. Cuando se les preguntó, 72% dijeron que sabían acerca de los implantes dentales. La mayoría de los encuestados se sentían pobremente informados acerca de las opciones para reemplazar dientes ausentes y muchos sabían menos acerca de los implantes que sobre otras alternativas. Se dijo que el dentista era la fuente de información mas deseada, pero 77% de los encuestados manifestó que sus dentistas no practicaban implantología. Mas del 79% de los encuestados no sabían si su dentista trabajaba con implantes. El 44% pensaba que los implantes debían ponerse solamente por doctores especialmente entrenados. El 61% eran de la opinión de que los dentistas que realizaban odontología de implantes estaban mejor cualificados que sus colegas que no lo hacían. La mitad de los encuestados atribuían los fracasos de los implantes a alergias e incompatibilidades, la otra mitad a pobres cuidados médicos. Solo el 29% incriminó a la pobre higiene oral como causa de fracaso de los implantes. La futura estrategia debe ser encaminada a unas relaciones públicas más profesionales y a más información del paciente. Las instituciones de implantes cualificadas que operan internacionalmente podrían contribuir a equilibrar la información discrepante. [source] Persistent, recurrent, and acquired infection of the root canal system post-treatmentENDODONTIC TOPICS, Issue 1 2003Markus Haapasalo Apical periodontitis is an inflammatory process in the periradicular tissues caused by microorganisms in the necrotic root canal. Accordingly, to achieve healing of apical periodontitis, the main goal of the treatment must be elimination of the infection and prevention of re-infection. As shown by recent epidemiological studies in several countries around the world, post-treatment endodontic disease is a far too common finding. To understand the reasons for survival of resistant bacteria in the filled root canal, it is important to know in detail the interaction between treatment procedures and the root canal flora in primary apical periodontitis. Therefore, in the first half of this review, the focus is placed on control of infection in primary apical periodontitis. This is followed by a detailed description of the resistant root canal microflora and a discussion about the present and future strategies to eliminate even the most resistant microbes in post-treatment disease. [source] Sturgeon aquaculture in China: status of current difficulties as well as future strategies based on 2002,2006/2007 surveys in eleven provincesJOURNAL OF APPLIED ICHTHYOLOGY, Issue 6 2009By R. Li Summary A nationwide survey in July and August 2007 employed a representative sample of Chinese sturgeon farms from 2002,2006/2007, including data from previous surveys and official statistics dating back to 1998, showing that the development of China's sturgeon aquaculture has progressed steadily in the past few years. Acipenser baerii and Amur hybrids (Acipenser schrenckii × Huso dauricus) have become the dominant cultured species, accounting for 80% of total production. Production centers moved from the southeastern coast towards the midwestern inland provinces, where cold freshwater resources are available in abundance. The paper presents production trends as well as the price structure for commercial fish/meat and juveniles in the various provinces and also considers import and export data for products, fertilized eggs and fingerlings. Results show that: (i) production of juveniles in hatcheries has risen only slightly during the survey period; (ii) the number of larvae obtained from the wild gradually declines each year; (iii) the price for commercial fish/meat drastically declined between 1998 to 2002, but remained stable from 2002 to 2007; and (iv) total production from the 83 surveyed farms was almost stable from 2002 to 2007. Major problems influencing sustainable development of sturgeon aquaculture were identified, including: (i) insufficient domestic supply of larvae and the ban for commercial use of A. sinensis; (ii) disorganized hybridization; (iii) the potential threat to the genetics of natural stocks in the Yangtze River; (iv) diseases originating from environmental pollution and poor-quality fish feed; (v) limited domestic markets; (vi) low volume of sturgeon export due to lack of intensive processing; and (vii) lack of organizational structure in the industry. [source] Characterization of antimicrobial susceptibility and virulence genes of Salmonella serovars collected at a commercial turkey processing plantJOURNAL OF APPLIED MICROBIOLOGY, Issue 1 2008C.W. Nde Abstract Aims:, To determine the antimicrobial susceptibility profiles, distribution of class 1 integrons, virulence genes and genes encoding resistance to tetracycline (tetA, tetC, tetD and tetE) and streptomycin (strA, strB and aadA1) in Salmonella recovered from turkeys. Methods and Results:, The antimicrobial susceptibility of 80 isolates was determined using National Antimicrobial Resistance Monitoring System. The distribution of resistance genes, class 1 integrons and virulence genes was determined using PCR. Resistances to tetracycline (76·3%) and streptomycin (40%) were common. Sixty-two (77·5%) isolates displayed resistance against one or more antimicrobials and 33 were multi-drug resistant. tetA was detected in 72·5% of the isolates, while tetC, tetD and tetE were not detected. The strA and strB genes were detected in 73·8% of the isolates. Two isolates possessed class 1 integrons of 1 kb in size, containing the aadA1 gene conferring resistance to streptomycin and spectinomycin. Fourteen of the virulence genes were detected in over 80% of the isolates. Conclusions:, This study shows that continuous use of tetracycline and streptomycin in poultry production selects for resistant strains. The Salmonella isolates recovered possess significant ability to cause human illness. Significance and Impact of the Study:, Information from this study can be employed in guiding future strategies for the use of antimicrobials in poultry production. [source] Helicobacter pylori as a class I carcinogen: Physiopathology and management strategiesJOURNAL OF CELLULAR BIOCHEMISTRY, Issue 2 2007Paraskevi Vogiatzi Abstract The gram-negative bacterium Helicobacter pylori is known as a persistent colonizer of the human stomach, and probably less known is that it is also involved in extraintestinal diseases. Public awareness of its contribution in the development of gastric cancer is less than 15 years old. The efficacy of the current therapies based on antibiotics against H. pylori has been limited by difficulties such as antibiotic resistance and recurrence. As a consequence, the development of promising vaccines was prompted as the best preventive measure. Unfortunately, so far vaccines failed the transition from animal models to human trials. This keynote presentation is to provide a bird's eye view of H. pylori -related gastric diseases, including gastric cancer, with a synthesis of the molecular mechanisms involved, and an exhaustive presentation and discussion of the current therapeutic guidelines and future strategies for prevention or therapy. J. Cell. Biochem. 102: 264,273, 2007. © 2007 Wiley-Liss, Inc. [source] Intestinal metaplasia: A premalignant lesion involved in gastric carcinogenesisJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2 2009Rita A Busuttil Abstract Despite a plateau in incidence, gastric cancer remains a significant problem globally. The majority of gastric cancer is associated with histologically recognizable premalignant stages as first described by Pelayo Correa in the mid-1970s. The mortality from gastric cancer remains high especially in Western countries where, arguably, the index of suspicion of gastric cancer in patients presenting with upper abdominal symptoms is lower than in high prevalence countries. What is the evidence that intestinal metaplasia (IM) is a premalignant condition? What should the clinician know about IM and the relative risks of progression to gastric cancer? Finally, what are the current and future strategies that may help stratify patients into high risk and low risk for the development of gastric cancer? This review focuses on gastric IM and outlines some of the literature that discusses it as a premalignant condition. It also reviews the issue of surveillance of patients with IM in order to attempt to reduce the significant mortality of gastric cancer by detection of earlier stages of disease which are eminently treatable. [source] Potential and future strategies for radiotherapy in hepatocellular carcinomaLIVER INTERNATIONAL, Issue 2 2009Daniel M. Aebersold No abstract is available for this article. [source] Vaccination as a Therapeutic Approach to Alzheimer's DiseaseMOUNT SINAI JOURNAL OF MEDICINE: A JOURNAL OF PERSONALIZED AND TRANSLATIONAL MEDICINE, Issue 1 2010Thomas Wisniewski MD Abstract Alzheimer's disease is the most common cause of dementia worldwide. Alzheimer's disease is a member of a broad range of neurodegenerative diseases characterized pathologically by the conformational change of a normal protein into a pathological conformer with a high ,-sheet content that renders it neurotoxic. In the case of Alzheimer's disease, the normal soluble amyloid , peptide is converted into oligomeric/fibrillar amyloid ,. The oligomeric forms of amyloid , have been hypothesized to be the most toxic, whereas fibrillar amyloid , becomes deposited as amyloid plaques and congophilic angiopathy, which both serve as neuropathological markers of the disease. In addition, the accumulation of abnormally phosphorylated tau as soluble toxic oligomers and as neurofibrillary tangles is a critical part of the pathology. Numerous therapeutic interventions are under investigation to prevent and treat Alzheimer's disease. Among the most exciting and advanced of these approaches is vaccination. Immunomodulation is being tried for a range of neurodegenerative disorders, with great success being reported in most model animal trials; however, the much more limited human data have shown more modest clinical success so far, with encephalitis occurring in a minority of patients treated with active immunization. The immunomodulatory approaches for neurodegenerative diseases involve targeting a self-protein, albeit in an abnormal conformation; hence, effective enhanced clearance of the disease-associated conformer has to be balanced with the potential risk of stimulating excessive toxic inflammation within the central nervous system. The design of future immunomodulatory approaches that are more focused is dependent on addressing a number of questions, including when is the best time to start immunization, what are the most appropriate targets for vaccination, and is amyloid central to the pathogenesis of Alzheimer's disease or is it critical to target tau-related pathology also. In this review, we discuss the past experience with vaccination for Alzheimer's disease and the development of possible future strategies that target both amyloid ,,related and tau-related pathologies. Mt Sinai J Med 77:17&–31, 2010. © 2010 Mount Sinai School of Medicine [source] Emergency Department Patient Flow: The Influence of Hospital Census Variables on Emergency Department Length of StayACADEMIC EMERGENCY MEDICINE, Issue 7 2009Ray Lucas MD Abstract Objectives:, The objective was to evaluate the association between hospital census variables and emergency department (ED) length of stay (LOS). This may give insights into future strategies to relieve ED crowding. Methods:, This multicenter cohort study captured ED LOS and disposition for all ED patients in five hospitals during five 1-week study periods. A stepwise multiple regression analysis was used to examine associations between ED LOS and various hospital census parameters. Results:, Data were analyzed on 27,325 patients on 161 study days. A significant positive relationship was demonstrated between median ED LOS and intensive care unit (ICU) census, cardiac telemetry census, and the percentage of ED patients admitted each day. There was no relationship in this cohort between ED LOS and ED volume, total hospital occupancy rate, or the number of scheduled cardiac or surgical procedures. Conclusions:, In multiple hospital settings, ED LOS is correlated with the number of admissions and census of the higher acuity nursing units, more so than the number of ED patients each day, particularly in larger hospitals with busier EDs. Streamlining ED admissions and improving availability of inpatient critical care beds may reduce ED LOS. [source] A family business: Women, children and smallholder sugar cane farming in FijiASIA PACIFIC VIEWPOINT, Issue 2 2003Sue Carswell Abstract: This paper highlights the contribution of women and children to the sugar industry in Fiji by examining the importance of family labour in the historical development of the smallholder system and describing the present situation for the study participants. It is based on ethnographic fieldwork conducted during 1996,97, on the island of Vanua Levu in the northern region of Fiji. The twenty smallholder households in the study comprised both Fijian and Fiji Indian respondents who relied primarily on selling sugar cane for their cash income. How inequalities within the household in terms of allocation of labour and resources are legitimated is outlined. Resource distribution within the household in regards to two important issues for the sugar industry, land and trade liberalisation, are examined. In light of global trends in trade liberalisation and probable falls in sugar prices, future strategies for survival identified by Fijian and Fiji Indian smallholders are also discussed. The case study demonstrates that the sugar industry is still largely reliant on family labour and, particularly for low socio-economic smallholders, the unremunerated labour of family members makes an essential contribution to the production of sugar cane. [source] 4235: Vitreoretinal considerations in OOKPACTA OPHTHALMOLOGICA, Issue 2010E HUGHES Purpose To present the difficulties of managing vitreoretinal complications in patients with OOKP and open a discussion about future strategies to prevent and deal with these problems. Methods Retrospective review of cases. Results Vitreo-retinal complications occurred in 14 of 54 patients receiving OOKP surgery. These included vitreous hemorrhage (4 patients), rhegmatogenous retinal detachment (3 patients), endophthalmitis with retinal detachment (5 patients), endophthalmitis without retinal detachment (1 patient) and intraoperative choroidal hemorrhage (1 patient). Most cases of endophthalmitis presented late and may result from lamina resorption, leak and hypotony. The prognosis of retinal detachment in an eye with OOKP was poor with successful repair in 1 of 3 cases not related to endophthalmitis and 0 of 5 cases with endophthalmitis. Overall, pars plana vitrectomy was performed on 10 occasions (8 patients), of which 2 were endoscopic and 2 utilised a temporary keratoprosthesis. Conclusion There is a relatively high rate of posterior segment problems in OOKP patients and their management is challenging both in assessment (limited view and ultrasound amenability) and surgical approach. Surgical outcomes were poor for these complications. Other concepts in management, including endoscopic vitrectomy at stage I surgery should be considered, which will be discussed. [source] Diabetic macular oedema and visual loss: relationship to location, severity and durationACTA OPHTHALMOLOGICA, Issue 7 2009Thomas W. Gardner Abstract. Purpose:, To assess the relationship between visual acuity (VA) and diabetic macular oedema (DMO) in relation to the location of retinal thickening and the severity and duration of central macular thickening. Methods:, Data from 584 eyes in 340 placebo-treated patients in the 3-years-long Protein Kinase C Diabetic Retinopathy Study (PKC-DRS2) trial were used to investigate the relationship between VA and DMO. Eligible eyes had moderately severe to very severe non-proliferative diabetic retinopathy and VA of at least 45 letters on Early Treatment Diabetic Retinopathy Study (ETDRS) charts (Snellen equivalent = 20/125). Diabetic retinopathy and DMO status were assessed using stereo photographs. Results:, Nearly one third of study eyes had foveal centre-involving DMO at the start of the trial. Sustained moderate visual loss was found in 36 eyes, most commonly associated with DMO at the centre of the fovea in 73% of eyes. There was a strong relationship (p < 0.001) between foveal centre involvement with DMO and mean VA. Mean VA decreased with increasing retinal thickness at the centre (p < 0.001) and increasing duration of centre-involving DMO (p < 0.001). Conclusion:, This study documents the relationship between duration of DMO and progressive vision loss, and the key role of central foveal involvement in patients with diabetic retinopathy. These data will help to develop future strategies to prevent vision loss. [source] Therapeutic hypothermia for neonatal encephalopathy: a UK survey of opinion, practice and neuro-investigation at the end of 2007ACTA PAEDIATRICA, Issue 4 2009Andrew Kapetanakis Abstract Background: The 2007 Cochrane review of therapeutic hypothermia for neonatal encephalopathy (NE) indicates a significant reduction in adverse outcome. UK National Institute for Clinical Excellence guidelines are awaited. Objective: To benchmark current opinion and practice to inform future strategies for optimal knowledge transfer for therapeutic hypothermia. Methods: A web based questionnaire (30 sections related to opinion and practice of management of NE) sent to the clinical leads of Level I, II and III neonatal units throughout the UK in November/December 2007. Results: One hundred and twenty-five (out of 195) UK neonatal units responded (response rate 66%). Ten percent, 37.5% and 51.5% responses were from level I, II and III units respectively. Twenty eight percent of all units provided therapeutic hypothermia locally (52% of level III units), however 80% of responders would offer therapeutic hypothermia if there was the facility. Overall, 57% of responders considered therapeutic hypothermia effective or very effective , similar for all unit levels; 43% considered more data are required. Regional availability of therapeutic hypothermia exists in 55% of units and 41% of units offer transfer to a regional centre for therapeutic hypothermia. Conclusion: In the UK in 2007, access to therapeutic hypothermia was widespread although not universal. More than half of responders considered therapeutic hypothermia effective. Fifty-five percent of perinatal networks have the facility to offer therapeutic hypothermia. The involvement of national bodies may be necessary to ensure the adoption of therapeutic hypothermia according to defined protocols and standards; registration is important and will help ensure universal neurodevelopmental follow up. [source] Strategies for early prevention of asthmaCLINICAL & EXPERIMENTAL ALLERGY REVIEWS, Issue 2004Fernando Maria De Benedictis Summary Asthma is the most commonly diagnosed chronic disease in childhood. Pathogenesis of the disease has received much attention lately as the last few decades have seen such a global rise in prevalence. There is hope to reverse this trend in prevalence by developing new preventive strategies. Here, we summarize the recent evidence for the role of early life events such as prenatal factors, infections, pollution, allergen exposure, nutrition, and discuss the implications for future strategies for asthma prevention. [source] Attacking Poverty,a strategic dilemma for the World BankJOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 3 2001Michael Hubbard Attacking Poverty has attracted more than the usual interest in World Development Reports mainly because it reflects the dilemma in future strategy for the World Bank. Its basis in a widely welcomed consultation with the poor, its transparent process and new conceptual framework contrast with limited development of the new themes , equality, security, empowerment of the poor , and of issues to do with aid: resources and rights. Contributors to this special issue discuss the dilemma reflected in Attacking Poverty from a number of angles: critical self-awareness by World Bank, promoting equality, shifting from the Washington Consensus, limits to the Bank's role, and enabling collective action by the poor. Other contributions discuss how the analysis in Attacking Poverty should be strengthened: inclusion of urban poverty and urbanisation's role in political development, promoting informal means of reducing vulnerability, and investigation of the long term consequences of the HIV/AIDS pandemic. Priorities for the next poverty-focused World Development Report (2010?) should include a more disaggregated and complete view of who is poor, why and where, and analysis of progress in political development. The World Bank may be best able to contribute to political development by extending to the subnational and public services level its main achievement of recent decades: the gathering, analysis and dissemination of comparative development data, to help move the focus of politics towards improving services and living standards. Copyright © 2001 John Wiley & Sons, Ltd. [source] The demand for electricity in PakistanOPEC ENERGY REVIEW, Issue 1 2009Muhammad Arshad Khan This paper examines the patterns of electricity demand in Pakistan over the period 1970,2006 using autoregressive distributed lag technique to cointegration. Long run and short-run price and income elasticities are examined for the national level and for the three major consumer's categories,households, industry and agriculture. The overall results suggest that income and price elasticities possess expected signs at aggregate and disaggregate levels in the long run as well as in the short run. The error correction terms possess expected negative signs and are highly significant with reasonable magnitudes. Furthermore, the estimated long run and short-run electricity demand functions remains stable over the sample period. The results thus convey important information to the agents operating in the electricity market regarding the pricing policies and helps in planning the future strategy of electricity demand management. [source] | |||||||||||||||||||