Individual Basis (individual + basis)

Distribution by Scientific Domains

Selected Abstracts

Body distribution of trace elements in black-tailed gulls from Rishiri Island, Japan: Age-dependent accumulation and transfer to feathers and eggs

Tetsuro Agusa
Abstract Body distribution and maternal transfer of 18 trace elements (V, Cr, Mn, Co, Cu, Zn, Se, Rb, Sr, Mo, Ag, Cd, Sb, Cs, Ba, Hg, Tl, and Pb) to eggs were examined in black-tailed gulls (Larus crassirostris), which were culled in Rishiri Island, Hokkaido Prefecture, Japan. Manganese, Cu, Rb, Mo, and Cd showed the highest levels in liver and kidney, Ag, Sb, and Hg in feather, and V, Sr, and Pb in bone. Maternal transfer rates of trace elements ranged from 0.8% (Cd) to as much as 65% (Tl) of maternal body burden. Large amounts of Sr, Ba, and Tl were transferred to the eggs, though maternal transfer rates of V, Cd, Hg, and Pb were substantially low. It also was observed that Rb, Sr, Cd, Cs, and Ba hardly were excreted into feathers. Concentrations of Co in liver, Ba in liver and kidney, and Mo in liver increased significantly with age, whereas Se in bone and kidney, Hg in kidney, and Cr in feather decreased with age in the known-aged black-tailed gulls (2,20 years old). It also was suggested that feathers might be useful to estimate contamination status of trace elements in birds, especially for Hg on a population basis, although the utility is limited on an individual basis for the black-tailed gulls. To our knowledge, this is the first report on the maternal transfer rate of multielements and also on the usefulness of feathers to estimate contamination status of Hg in birds on a population basis. [source]

Evolution of striatal degeneration in McLeod syndrome

P. O. Valko
Background and purpose:, McLeod neuroacanthocytosis syndrome (MLS) is an X-linked multisystem disorder with CNS manifestations resembling Huntington disease. Neuroimaging studies revealed striatal atrophy with predominance of the caudate nucleus. Our previous cross-sectional MRI study showed an association of volume loss in the caudate nucleus and putamen with the disease duration. Methods:, In the present study, we examined three brothers with genetically confirmed diagnosis of MLS using an observer-independent and fully automated subcortical segmentation procedure to measure striatal volumes. Results:, In a cross-sectional comparison with 20 healthy age-matched control men, the volumes of the caudate nucleus of the three patients were significantly smaller as confirmed by z -score transformations. On an individual basis, volumes in the two more severely affected and older patients were smaller than in the less affected younger brother. Longitudinal MRI-based measurements over 7 years demonstrated a statistical trend towards significant decreased caudate volumes in McLeod patients. Conclusions:, Our findings indicate that structural MRI combined with fully automated computational morphometric analyses represents an objective and observer-independent imaging tool for the representation of progressive striatal degeneration in MLS and might be a valuable methodology for cross-sectional as well as longitudinally volumetric studies in other rare neurodegenerative diseases, even on individual patients. [source]

Radiation exposure and the justification of computed tomography scanning in an Australian hospital emergency department

M. Street
Abstract In an emergency department (ED), computed tomography (CT) is particularly beneficial in the investigation of high-speed trauma patients. With the advent of multidetector CT (MDCT) scanners, it is becoming faster and easier to conduct scans. In recent years, this has become evident with an increasing number of CT requests. Patients who have multiple CT scans during their hospital stay can receive radiation doses that have an increased theoretical risk of induction of cancer. It is essential that the clinical justification for each CT scan be considered on an individual basis and that due consideration is given to the radiation risk and possible diagnostic benefit. The current lack of a central State or Commonwealth data repository for medical images is a contributing factor to excessive radiation dosage to the population. The principles of justification and radiation risks are discussed in this study. [source]

Sperm DNA integrity in cancer patients: the effect of disease and treatment

O. Ståhl
Summary As oncological treatment might impair the patients' fertility, male cancer patients are offered to cryopreserve semen prior to treatment. Impaired sperm DNA quality is associated with reduced fertility, and in case of assisted reproduction, sperm DNA integrity may have an impact on choice of method. Therefore, we have assessed sperm DNA integrity in cancer patients, comparing pre- and post-treatment quality. Sperm DNA integrity was investigated in cryopreserved semen from 121 cancer patients, the predominating diagnoses were germ cell cancer (GCC) and Hodgkin's lymphoma (HL). Post-treatment samples, with a median follow-up of 3 years, were analysed for 58 of the men, allowing a pre- and post-treatment analysis on an individual basis. Sperm DNA integrity was assessed using the Sperm Chromatin Structure Assay and expressed here as the DNA Fragmentation Index (DFI%). One hundred and thirty-seven fertile men served as controls. Before treatment, GCC (n = 84) and HL (n = 18) patients had higher DFI% than controls (n = 143) with a mean difference of 7.7 (95% CI 3.2,8.8) and 7.0 (95% CI 2,12), respectively. The same trend was observed for other cancer diagnoses, but without reaching statistical significance (mean difference 3.6, 95% CI ,1.2 to 8.4). No increase was seen in DFI% comparing pre- and post-treatment semen, regardless of treatment modality. A moderate elevation of DFI% was observed in cryopreserved semen from cancer patients. Oncological treatment, generally, did not induce any increase in DFI. These findings should be considered when discussing the utilization of pre-treatment cryopreserved semen vs. post-treatment fresh sperm in cancer patients undergoing assisted reproduction. [source]

A comparison of 60, 70, and 90 kDa stress protein expression in normal rat NRK-52 and human HK-2 kidney cell lines following in vitro exposure to arsenite and cadmium alone or in combination

Emily F. Madden
Abstract Arsenite and cadmium are two potent nephrotoxicants and common Superfund site elements. These elements are included among the stress protein inducers, but information regarding relationships between toxicity produced by combinations of these agents to the stress protein response is lacking. In this study, the immortalized cell lines normal rat kidney NRK-52E and human kidney HK-2 were exposed in vitro to arsenite (As3+), cadmium (Cd2+), or to equimolar As3+ plus Cd2+ mixture combinations for 3 and 5 h over a concentration range of 0.1,100 ,M. After a 12-h recovery period, cultured cells were then evaluated for expression of the 60, 70, and 90 kDa major stress protein families. Results indicated that expression of stress proteins varied depending on the species of kidney cells exposed, the exposure concentrations, and the length of exposure to each element on an individual basis and for combined mixtures. For the HK-2 kidney cell line, increased levels of the 70 kDa stress protein was observed for single and combined element exposures whereas there was no change or a decrease of stress proteins 60 and 90 kDa. Increased 70 kDa expression was observed for 10-,M doses of single elements and for a lower dose of 1 ,M of the As plus Cd mixture at 3- and 5-h exposures. NRK-52 kidney cells exposed to equivalent doses of As3+ and Cd2+ alone or in combination showed increased levels of all stress proteins 60, 70, and 90 kDa. This increase was seen for 10 ,M of the As plus Cd mixture at 3 h whereas for single element exposures, increased stress protein levels were generally observed for the 100-,M doses. At 5 h- exposure, 60 and 90 kDa levels increased for 10 ,M of Cd2+ and 60 kDa levels increased for 1 ,M of As3+. However, exposures to 10 ,M of the As plus Cd mixture decreased 60 kDa protein expression to control levels at 5 h. For both kidney cell lines, there was a decrease in the stress protein expression levels for all three stress protein families for 100-,M doses of the mixture combination for 3- and 5-h exposures. These data indicate a dose- and combination-related correlation between depression of the stress protein response and the onset of overt cellular toxicity and/or cell death. The threshold for these changes was cell line specific. © 2002 Wiley Periodicals, Inc. J Biochem Mol Toxicol 16:24,32, 2002; DOI 10.1002/jbt.10015 [source]

Living donor liver transplantation in high-risk vs. low-risk patients: Optimization using statistical models

François Durand
Living donors represent a recognized alternative for facilitating the access to transplantation in a period of organ shortage. However, which candidates should be preferentially considered for living-donor liver transplantation (LDLT) is debated. The aim of this study was to create statistical models to determine which strategies of selection for LDLT provide the most efficient contribution. The study included 331 patients listed for deceased-donor transplantation (DDLT) and 128 transplanted with living donors. Statistical models predicting the events following listing were created and combined in a multistate model allowing the testing of different strategies of selection for LDLT and to compare their results. Taking 3-yr survival after listing as the principal end-point, selecting the 20% patients at highest risk of death on the waiting list gave better results than selecting the 20% patients at lowest risk of death after LDLT (70% vs. 64%, respectively). These strategies resulted in waiting list mortality rates of 17% and 8%, respectively. One-year survival after LDLT was lower in high-risk patients (85%) than in low-risk patients (91%). However, the 1-yr survival benefit derived from LDLT was 75% in high-risk patients while it was nil in low-risk patients. In conclusion, LDLT is more effective for overcoming the consequences of organ shortage when performed in patients at high risk of death on the waiting list. On an individual basis, the sickest patients are those who derive the most important benefit from LDLT. This study provides incentives for considering LDLT in high-risk patients. Liver Transpl 12:231,239, 2006. © 2006 AASLD. [source]

C2 monitoring of cyclosporine in de novo liver transplant recipients: The clinician's perspective

Federico Villamil
Adjusting cyclosporine (CsA) dose based on blood concentration at 2 hours after dose (C2) has been shown in prospective clinical trials to reduce the risk of rejection compared with conventional trough monitoring. In addition, it provides equivalent efficacy to tacrolimus in liver transplant patients, with a favorable safety profile. Target C2 should be defined on an individual basis depending on adjunctive therapy and the level of exposure required. It appears less critical to achieve target C2 in the first few days after liver transplantation than was previously believed. Achieving target C2 exposure in the initial period after transplant requires that changes in the proportion of cyclosporine absorbed from the gut be taken into account to avoid risk of overexposure. In addition, if a starting dose of 10,15 mg/day is used, it is advisable to delay increasing the dose until a trend in C2 level indicates this to be necessary. Immediate dose reduction is required if C2 exceeds target range. In patients with low C2 values, cyclosporine concentration at a later time point should be measured to establish whether the patient is a poor absorber or a delayed absorber of C2, and dose adjustments should be undertaken accordingly. In conclusion, this more flexible approach to C2 monitoring allows the dose of cyclosporine to be individualized effectively for each patient, which results in significant efficacy benefits while minimizing the risk of toxicity. (Liver Transpl 2004;10:577,583.) [source]


William F. Perrin
Abstract We offer the first report for a cetacean of geographical variation in mating system based in morphology. Analysis of samples from 1,678 male spinner dolphins from the eastern Pacific revealed that testis + epididymis weight was greater (to 1,354 g) in the whitebelly form of the species than in the eastern form (to 843 g). Sexual dimorphism in dorsal-fin shape is greater in the eastern form. The difference in testis size was strongly linked with shape of the dorsal fin on an individual basis. Only a few eastern males (0.6%) reached testis + epididymis weight at which all epididymides contain sperm, while a much larger proportion of whitebelly spinners (15.2%) reached this level, suggesting that a smaller proportion of eastern spinner males may participate in reproductive activity. This, and the fact that increased dimorphism and decreased testis size are indicative of increased polygyny in a wide variety of other mammal species, leads to the conclusion that the mating system varies geographically in the species, with a gradient from a more polygynous mating system in the eastern form to a more open or polygynandrous mating system in the whitebelly form. Differences in ovulation rate in the two forms are consistent with this conclusion. [source]

A review of the effectiveness of aspartame in helping with weight control

A. De La Hunty
Summary, Strategies to reverse the upward trend in obesity rates need to focus on both reducing energy intake and increasing energy expenditure. The provision of low- or reduced-energy-dense foods is one way of helping people to reduce their energy intake and so enable weight maintenance or weight loss to occur. The use of intense sweeteners as a substitute for sucrose potentially offers one way of helping people to reduce the energy density of their diet without any loss of palatability. This report reviews the evidence for the effect of aspartame on weight loss, weight maintenance and energy intakes in adults and addresses the question of how much energy is compensated for and whether the use of aspartame-sweetened foods and drinks is an effective way to lose weight. All studies which examined the effect of substituting sugar with either aspartame alone or aspartame in combination with other intense sweeteners on energy intake or bodyweight were identified. Studies which were not randomised controlled trials in healthy adults and which did not measure energy intakes for at least 24 h (for those with energy intakes as an outcome measure) were excluded from the analysis. A minimum of 24-h energy intake data was set as the cut-off to ensure that the full extent of any compensatory effects was seen. A total of 16 studies were included in the analysis. Of these 16 studies, 15 had energy intake as an outcome measure. The studies which used soft drinks as the vehicle for aspartame used between 500 and about 2000 ml which is equivalent to about two to six cans or bottles of soft drinks every day. A significant reduction in energy intakes was seen with aspartame compared with all types of control except when aspartame was compared with non-sucrose controls such as water. The most relevant comparisons are the parallel design studies which compare the effects of aspartame with sucrose. These had an overall effect size of 0.4 standardised difference (SD). This corresponds to a mean reduction of about 10% of energy intake. At an average energy intake of 9.3 MJ/day (average of adult men and women aged 19,50 years) this is a deficit of 0.93 MJ/day (222 kcal/day or 1560 kcal/week), which would be predicted (using an energy value for obese tissue of 7500 kcal/kg) to result in a weight loss of around 0.2 kg/week with a confidence interval 50% either side of this estimate. Information on the extent of compensation was available for 12 of the 15 studies. The weighted average of these figures was 32%. Compensation is likely to vary with a number of factors such as the size of the caloric deficit, the type of food or drink manipulated, and timescale. An estimate of the amount of compensation with soft drinks was calculated from the four studies which used soft drinks only as the vehicle. A weighted average of these figures was 15.5%. A significant reduction in weight was seen. The combined effect figure of 0.2 SD is a conservative figure as it excludes comparisons where the controls gained weight because of their high-sucrose diet and the long-term follow-up data in which the aspartame groups regained less weight than the control group. An effect of 0.2 SD corresponds to about a 3% reduction in bodyweight (2.3 kg for an adult weighing 75 kg). Given the weighted average study length was 12 weeks, this gives an estimated rate of weight loss of around 0.2 kg/week for a 75-kg adult. The meta-analyses demonstrate that using foods and drinks sweetened with aspartame instead of sucrose results in a significant reduction in both energy intakes and bodyweight. Meta-analyses both of energy intake and of weight loss produced an estimated rate of weight loss of about 0.2 kg/week. This close agreement between the figure calculated from reductions in energy intake and actual measures of weight loss gives confidence that this is a true effect. The two meta-analyses used different sets of studies with widely differing designs and controls. Although this makes comparisons between them difficult, it suggests that the final figure of around 0.2 kg/week is robust and is applicable to the variety of ways aspartame-containing foods are used by consumers. This review has shown that using foods and drinks sweetened with aspartame instead of those sweetened with sucrose is an effective way to maintain and lose weight without reducing the palatability of the diet. The decrease in energy intakes and the rate of weight loss that can reasonably be achieved is low but meaningful and, on a population basis, more than sufficient to counteract the current average rate of weight gain of around 0.007 kg/week. On an individual basis, it provides a useful adjunct to other weight loss regimes. Some compensation for the substituted energy does occur but this is only about one-third of the energy replaced and is probably less when using soft drinks sweetened with aspartame. Nevertheless, these compensation values are derived from short-term studies. More data are needed over the longer term to determine whether a tolerance to the effects is acquired. To achieve the average rate of weight loss seen in these studies of 0.2 kg/week will require around a 220-kcal (0.93 MJ) deficit per day based on an energy value for obese tissue of 7500 kcal/kg. Assuming the higher rate of compensation (32%), this would require the substitution of around 330 kcal/day (1.4 MJ/day) from sucrose with aspartame (which is equivalent to around 88 g of sucrose). Using the lower estimated rate of compensation for soft drinks alone (15.5%) would require the substitution of about 260 kcal/day (1.1 MJ/day) from sucrose with aspartame. This is equivalent to 70 g of sucrose or about two cans of soft drinks every day. [source]

Effect of light filters on reading speed in normal and low vision due to age-related macular degeneration

Frank Eperjesi
Abstract Purpose:, To investigate the effects of light filters on reading speed in normal and low vision due to age-related macular degeneration (AMD). Methods:, Reading speed was determined for 12 subjects with normal vision and 12 subjects with non-exudative AMD using stationary lowercase nonsensical print in Times Roman font and four light filters; a yellow Corning Photochromic Filter (CPF) 450, a grey neural density (ND) filter, an individual filter obtained using the Intuitive Colorimeter® and a clear filter. Results:, There was no statistically significant light filter effect on reading speed for the normal subjects. The AMD group demonstrated a statistically significant 5% average improvement in reading speed with the CPF450 compared with the other filters although some AMD subjects had improvements of 10,15%. Conclusions:, Light filters obtained using the Intuitive Colorimeter® performed poorly when compared with the CPF450, ND and clear filters for both the study groups. For the AMD group, average reading speed was statistically greater with the CPF450 than the other filters, however it is questionable whether the improvement (5%) would be clinically significant. As some of the subjects with AMD had greater improvements with the CPF450 we advocate clinical assessment of light filters using existing protocols on an individual basis. [source]

Intradiscal High-Voltage, Long-Duration Pulsed Radiofrequency for Discogenic Pain: A Preliminary Report

PAIN MEDICINE, Issue 5 2006
Alexandre Teixeira MD
ABSTRACT Background., Intradiscal radiofrequency, with the electrode placed in the center of the nucleus pulposus, has been a controversial procedure in patients with discogenic pain. Possibly the effect has not been due to the production of heat, but to exposure to electric fields. Design., We have investigated the effect of high-voltage, long-duration intradiscal pulsed radiofrequency in patients with one-level discogenic low back pain, as confirmed by discography. Outcome Measure., The pain intensity score on a 0,10 numeric rating scale (NRS) was taken as outcome measure. Patients., Eight patients were reported. The mean duration of pain was 6.3 years (range 0.5,16, median 4). The mean NRS score was 7.75 (range 5,9). Disc height was reduced 60% in one patient and up to 30% in the others. Intervention., A 15-cm, 20-gauge needle with a 15-mm active tip was placed centrally in the disc. Pulsed radiofrequency was applied for 20 min at a setting of 2 × 20 ms/s and 60 V. Results., There was a very significant fall in the NRS scores over the first 3 months (P < 0.0001). On an individual basis, all patients had a fall of the NRS score of at least 4 points at the 3-month follow-up. A follow-up of 12.8 months (range 6,25, median 9) was available for five patients. All these patients are now pain free, except for one patient with an NRS score of 2. Conclusion., It is concluded that this method merits a controlled, prospective study. [source]

Establishment of a pharmacoepidemiological database in Germany: methodological potential, scientific value and practical limitations

Dipl., Iris Pigeot Dr rer.nat.
Abstract Purpose We present a new population-based pharmacoepidemiological (PE) database obtained from statutory health insurances (SHIs) that is able to generate signals, to monitor prescribed drugs and to describe drug utilisation. We discuss methodological features of the database and we assess to which degree this database reflects basic demographic characteristics and hospitalisation rates of the general population. Methods Files of three SHIs were linked with drug dispensation data from a pharmacies' electronic data processing centre on an individual basis using the unique subject identification number (ID) at a trusted third party centre. Plausibility checks and descriptive analyses were carried out. Results The database covers 3.6 million SHI-members, provides drug utilisation data and data on hospitalisations. SHI membership is fairly stable over time. Our data indicate marked differences in socio-demographic characteristics between SHIs. Hospital admission rates standardised for age vary between 0.164 and 0.229 per person year, which is in good agreement with official statistics (0.20). The age distribution shows good agreement for men and some underrepresentation for women above the age of 60 as compared to the general population. Conclusions Confounder information on medical conditions, concomitant medications and socio-demographic variables can be obtained from the database, while the assessment of confounders related to lifestyle requires supplementary data collection. The database allows for a population-based approach and reflects daily practice including off-label use of drugs. Independent recording of exposure and outcome data prevents reporting bias on medication or outcome. Legal conditions that allow continuous updating of the database need to be settled. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Attitudes to prenatal and preimplantation diagnosis in Saudi parents at genetic risk

Ayman Alsulaiman
Abstract Background Prenatal diagnosis (PND) is only available for severe abnormality in Saudi Arabia, and preimplantation genetic diagnosis (PGD) has been proposed as a valuable alternative. The acceptability of PGD is unexplored, and may ultimately determine the value of this technology in Saudi Arabia. This study reports attitudes towards PND and PGD of Saudi couples offered genetic counselling following the birth of a child with a single gene or chromosomal condition. Methods Thirty couples attending the King Faisal Specialist Hospital and Research Centre in Riyadh were interviewed using a semi-structured questionnaire. One couple had previous experience of PND and none had experience of PGD or IVF. Results Eight of the 30 couples (27%) would only accept PGD; four (13%) only PND; three (10%) either technology; the remainder would accept neither test, or were unsure. The main concerns of those who would accept neither technology were related to personal religious views. Specific concerns about PGD related to the IVF procedure, the risk of multiple pregnancies, the chance of mistakes and the chance of not getting pregnant. A high proportion of couples (six out of seven; 86%) who had a child with thalassaemia expressed interest in PGD, and all would be prepared to use technology to avoid having an affected child. Views were more mixed for the other conditions. Conclusion PGD is acceptable to many couples and for some, it represents a valuable alternative to PND. However, parents' concerns are complex, and the acceptability of different reproductive technologies must be established on an individual basis. Copyright © 2006 John Wiley & Sons, Ltd. [source]

An automatable screen for the rapid identification of proteins amenable to refolding

Nathan P. Cowieson Dr.
Abstract Insoluble expression of heterologous proteins in Escherichia coli is a major bottleneck of many structural genomics and high-throughput protein biochemistry projects. Many of these proteins may be amenable to refolding, but their identification is hampered by a lack of high-throughput methods. We have developed a matrix-assisted refolding approach in which correctly folded proteins are distinguished from misfolded proteins by their elution from affinity resin under non-denaturing conditions. Misfolded proteins remain adhered to the resin, presumably via hydrophobic interactions. The assay can be applied to insoluble proteins on an individual basis but is particularly well suited for high-throughput applications because it is rapid, automatable and has no rigorous sample preparation requirements. The efficacy of the screen is demonstrated on small-scale expression samples for 15,proteins. Refolding is then validated by large-scale expressions using SEC and circular dichroism. [source]

Cerebrospinal fluid sulfatide is decreased in subjects with incipient dementia

Xianlin Han PhD
We recently noted a profound decline in brain sulfatides (ST) in subjects who died with incipient dementia due to Alzheimer's disease. Herein, we measured ST levels in cerebrospinal fluid in cognitively normal elderly and in subjects with mild cognitive impairment due to incipient demenia of the Alzheimer type. There was a significant decrease in cerebrospinal fluid ST and in the ST to phosphatidylinositol ratio in MCI subjects. The ST to phosphatidylinositol ratio accurately differentiated very mildly impaired subjects from controls on an individual basis. The cerebrospinal fluid ST to phosphatidylinositol ratio may be a very useful biomarker for the earliest clinical stage of Alzheimer's disease. Ann Neurol 2003;54:115,119 [source]

The success of succession: a symposium commemorating the 50th anniversary of the Buell-Small Succession Study

M.L. Cadenasso
Motivation: The Buell-Small Succession Study (BSS) is the longest running study of post agricultural succession in North America. To honor this program, a symposium at the Ecological Society of America meetings was organized to explore the state of succession theory and its contribution to the field of ecology and its application to restoration. The BSS was originally motivated by two controversies in the literature during the 1950's. The first was between a community versus and individual basis of secondary succession. The second was the validity of the Initial Floristic Composition hypothesis. Location: Hutcheson Memorial Forest, Somerset, New Jersey, USA Methods: Vegetation composition and cover has been continuously quantified in permanent plots established in 10 old fields. Continued Research Motivation: The rich data set has documented population and community dynamics and the spatio-temporal controls and historical contingencies that influence those dynamics. The regulation of community dynamics continues to be a line of inquiry as does the application of results to restoration and understanding the dynamics of non-native species. Conclusions: Long term vegetation studies are uncommon in ecology yet they are uniquely valuable for understanding system dynamics , particularly if the studies capture periodic events or system shifts such as droughts and invasions by non-native species. Resilient long term studies, of which the BSS is an example, maintain methods and data structure while allowing motivating questions to evolve along side advancements in the theoretical and conceptual realms of the field. Succession continues to serve as a basic tenet of ecology which is demonstrated by the papers making up this special issue. [source]

The overactive bladder syndrome: treating patients on an individual basis

Linda Cardozo
First page of article [source]

The treatment of uveal melanoma with iodine plaque brachytherapy

Purpose To provide an overview of managing uveal melanoma (UM) with iodine brachytherapy (IBT). Methods Personal experience of the author in using IBT since 1990. Results IBT is an effective option for managing a UM of any size, although it is mostly used for medium-sized tumours, preference being given to ruthenium brachytherapy (RBT) when the tumour is <5-6 mm thick and to transscleral local resection when thickness is >6 mm, especially when vision is good. IBT is also a safe alternative to enucleation of large UM >10 mm in thickness if the patient is keen to preserve the eye and motivated to accept eventual complications. The plaque is positioned over the UM with a 1-2 mm safety margin when using a collimated/rimmed plaque. Because of stray radiation, a safety margin is not mandatory when the plaque is non-collimated/non-rimmed. Otherwise, surgical technique does not differ from RBT. An advantage of IBT is that the radioactive seeds are separate from the plaque, allowing economical use of plaques of many different sizes and shapes and individual positioning of the seeds in a conformal way. A disadvantage is a short half-life; the seeds need to be changed every 6 months. The dose the author uses is 80 Gy to tumour apex, which is reduced on an individual basis to 60-70 Gy when the UM is very thick. Local tumour control rate is 90% and, paradoxically, not worse for large UM as compared to smaller ones. There are no unequivocal safety distances for avoiding radiation cataract, maculopathy and optic neuropathy, which are more or less frequent depending on the size and location of the UM. Conclusion IBT achieves good local tumour control of UM of all sizes, but preservation of vision is decidedly less frequent than after RBT, which is always given preference. [source]

Clinical complications following thyroid fine-needle biopsy: a systematic review

Stergios A. Polyzos
Summary Thyroid fine-needle biopsy (FNB) is a simple, reliable, inexpensive and generally safe diagnostic procedure in the management of thyroid nodules. Post-FNB local pain and minor haematomas are the most common complications, while serious complications seem to be rare. Given that use of FNB minimizes unnecessary surgery and subsequent operative morbidity and mortality as well as the fact that the majority of FNB complications resolve spontaneously, the overall safety of FNB is not questioned. However, awareness of the potential complications and careful estimation of the risk-benefit ratio in an individual basis may further decrease the low morbidity of FNB. In this systematic review we tried to collect and summarize all reported clinical complications following diagnostic thyroid FNB, aiming to make physicians aware of possible complications and to provide preventive measures to avoid them. [source]

Self-concept and attributions about other women in women with a history of childhood sexual abuse

Susan J. McAlpine
Abstract Self-concept literature and literature on childhood sexual abuse (CSA) suggests that women with a history of CSA may have particular ways of perceiving themselves, which, as well as impacting upon relationships within their everyday lives, may also have implications for therapy; whether this is on an individual basis or within a group. This research investigated self-concept and attributions about other women using an adapted version of the self-concept sorting task. Three groups of women were compared: women with a history of CSA, women experiencing depressed mood but without a history of CSA and a healthy non-clinical comparison group of hospital staff. To some extent the current findings supported previous studies indicating that women attempting to cope with the consequences of a history of CSA have a negative self-concept. However, there was evidence to suggest that certain self-aspects are protective or protected. Similarly, there is some support for previous evidence of difficult relationships with mothers. Possible explanations for these findings were discussed and areas for future research suggested.,Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Massage: , Although women with a history of CSA and depression have a negative view of themselves in comparison to a non-clinical group, there is no qualitative difference between these two groups. , Nor do women with a history of CSA have a more negative view of other women in general than women who are depressed. , Therefore, being aware of the likelihood that an individual may preceive herself, but not other women negatively, a therapist may use therapy to actively increase awareness and address this issue. [source]