Search results for: contact lens-associated complications
Commenced in January 2007
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Edition: International
Paper Count: 2738

Search results for: contact lens-associated complications

2018 Evaluation of Role of Surgery in Management of Pediatric Germ Cell Tumors According to Risk Adapted Therapy Protocols

Authors: Ahmed Abdallatif

Abstract:

Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

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2017 Removal of Nickel Ions from Industrial Effluents by Batch and Column Experiments: A Comparison of Activated Carbon with Pinus Roxburgii Saw Dust

Authors: Sardar Khana, Zar Ali Khana

Abstract:

Rapid industrial development and urbanization contribute a lot to wastewater discharge. The wastewater enters into natural aquatic ecosystems from industrial activities and considers as one of the main sources of water pollution. Discharge of effluents loaded with heavy metals into the surrounding environment has become a key issue regarding human health risk, environment, and food chain contamination. Nickel causes fatigue, cancer, headache, heart problems, skin diseases (Nickel Itch), and respiratory disorders. Nickel compounds such as Nickel Sulfide and Nickel oxides in industrial environment, if inhaled, have an association with an increased risk of lung cancer. Therefore the removal of Nickel from effluents before discharge is necessary. Removal of Nickel by low-cost biosorbents is an efficient method. This study was aimed to investigate the efficiency of activated carbon and Pinusroxburgiisaw dust for the removal of Nickel from industrial effluents using commercial Activated Carbon, and raw P.roxburgii saw dust. Batch and column adsorption experiments were conducted for the removal of Nickel. The study conducted indicates that removal of Nickel greatly dependent on pH, contact time, Nickel concentration, and adsorbent dose. Maximum removal occurred at pH 9, contact time of 600 min, and adsorbent dose of 1 g/100 mL. The highest removal was 99.62% and 92.39% (pH based), 99.76% and 99.9% (dose based), 99.80% and 100% (agitation time), 92% and 72.40% (Ni Conc. based) for P.roxburgii saw dust and activated Carbon, respectively. Similarly, the Ni removal in column adsorption was 99.77% and 99.99% (bed height based), 99.80% and 99.99% (Concentration based), 99.98%, and 99.81% (flow rate based) during column studies for Nickel using P.Roxburgiisaw dust and activated carbon, respectively. Results were compared with Freundlich isotherm model, which showed “r2” values of 0.9424 (Activated carbon) and 0.979 (P.RoxburgiiSaw Dust). While Langmuir isotherm model values were 0.9285 (Activated carbon) and 0.9999 (P.RoxburgiiSaw Dust), the experimental results were fitted to both the models. But the results were in close agreement with Langmuir isotherm model.

Keywords: nickel removal, batch, and column, activated carbon, saw dust, plant uptake

Procedia PDF Downloads 126
2016 Management Problems in a Patient With Long-term Undiagnosed Permanent Hypoparathyroidism

Authors: Babarina Maria, Andropova Margarita

Abstract:

Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.

Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria

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2015 Wetting Features of Butterflies Morpho Peleides and Anti-icing Behavior

Authors: Burdin Louise, Brulez Anne-Catherine, Mazurcyk Radoslaw, Leclercq Jean-louis, Benayoun Stéphane

Abstract:

By using a biomimetic approach, an investigation was conducted to determine the connections between morphology and wetting. The interest is focused on the Morpho peleides butterfly. This butterfly is already well-known among researchers for its brilliant iridescent color and has inspired numerous innovations. The intricate structure of its wings is responsible for such color. However, this multiscale structure exhibits a multitude of other features, such as hydrophobicity. Given the limited research on the wetting properties of Morpho butterfly, a detailed analysis of its wetting behavior is proposed. Multiscale surface topographies of the Morpho peleides butterfly were analyzed using scanning electron microscope and atomic force microscopy. To understand the relationship between morphology and wettability, a goniometer was employed to measured static and dynamic contact angle. Since several studies have consistently demonstrated that superhydrophobic surfaces can effectively delay freezing, icing delay time the Morpho’s wings was also measured. The results revealed contact angles close to 136°, indicating a high degree of hydrophobicity. Moreover, sliding angles (SA) were measured in different directions, including along and against the rolling-outward direction. The findings suggest anisotropic wetting. Specifically, when the wing was tilted along the rolling outward direction (i.e., away from the insect’s body) SA was about 7°. While, when the wing was tilted against the rolling outward direction, SA was about 29°. This phenomenon is directly linked to the butterfly’s survival strategy. To investigate the exclusive morphological impact on anti-icing properties, PDMS replicas of the Morpho butterfly were obtained. When compared to flat PDMS and microscale textured PDMS, Morpho replications exhibited a longer freezing time. Therefore, this could be a source of inspiration for designing superhydrophobic surfaces with anti-icing applications or functional surfaces with controlled wettability.

Keywords: biomimetic, anisotropic wetting, anti-icing, multiscale roughness

Procedia PDF Downloads 53
2014 Seroprevalence of Hepatitis B and C among Healthcare Workers in Dutse Metropolis, Jigawa State, Nigeria

Authors: N. M. Sani, I. Bitrus, A. M. Sarki, N. S. Mujahid

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Hepatitis is one of the neglected infectious diseases in sub Saharan Africa, and most of the available data is based on blood donors. Health care workers (HCWs) often get infected as a result of their close contact with patients. A cross-sectional study was conducted to determine the prevalence of hepatitis B and C among this group of professionals with a view to improving the quality of care to their patients. Hepatitis B and C infections pose a major public health problem worldwide. While infection is highest in the developing world particularly Asia and sub-Saharan Africa, healthcare workers are at higher risk of acquiring blood-borne viral infections, particularly Hepatitis B and C which are mostly asymptomatic. This study was aimed at determining the prevalence of Hepatitis B and C infections and associated risk factors among health care workers in Dutse Metropolis, Jigawa State - Nigeria. A standard rapid immuno-chromatographic technique i.e. rapid ELISA was used to screen all sera for Hepatitis B surface antigen (HBsAg) and Hepatitis C viral antibody (HCVAb) respectively. Strips containing coated antibodies and antigens to HBV and HCV respectively were removed from the foil. Strips were labeled according to samples. Using a separate disposable pipette, 2 drops of the sample (plasma) were added into each test strip and allowed to run across the absorbent pad. Results were read after 15 minutes. The prevalence of HBV and HCV infection in 100 healthcare workers was determined by testing the plasma collected from the clients during their normal checkup using HBsAg and HCVAb test strips. Results were subjected to statistical analysis using chi-square test. The prevalence of HBV among HCWs was 19 out of 100 (19.0%) and that of HCV was 5 out of 100 (5.0%) where in both cases, higher prevalence was observed among female nurses. It was also observed that all HCV positive cases were recorded among nurses only. The study revealed that nurses are at greater risk of contracting HBV and HCV due to their frequent contact with patients. It is therefore recommended that effective vaccination and other infection control measures be encouraged among healthcare workers.

Keywords: prevalence, hepatitis, viruses, healthcare workers, infection

Procedia PDF Downloads 357
2013 Electro-Discharge Drilling in Residual Stress Measurement of Annealed St.37 Steel

Authors: H. Gholami, M. Jalali Azizpour

Abstract:

For materials such as hard coating whose stresses state are difficult to obtain by a widely used method called high-speed hole-drilling method (ASTM Standard E837). It is important to develop a non contact method. This process itself imposes an additional stresses. The through thickness residual stress of st37 steel using elector-discharge was investigated. The strain gage and dynamic strain indicator used in all cases was FRS-2-11 rosette type and TML 221, respectively. The average residual stress in depth of 320 µm was -6.47 MPa.

Keywords: HVOF, residual stress, thermal spray, WC-Co

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2012 Outcomes of Pregnancy in Women with TPO Positive Status after Appropriate Dose Adjustments of Thyroxin: A Prospective Cohort Study

Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

Abstract:

This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: TPO antibody, subclinical hypothyroidism, anti nuclear antibody, thyroxin

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2011 A Mathematical Model for Studying Landing Dynamics of a Typical Lunar Soft Lander

Authors: Johns Paul, Santhosh J. Nalluveettil, P. Purushothaman, M. Premdas

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Lunar landing is one of the most critical phases of lunar mission. The lander is provided with a soft landing system to prevent structural damage of lunar module by absorbing the landing shock and also assure stability during landing. Presently available software are not capable to simulate the rigid body dynamics coupled with contact simulation and elastic/plastic deformation analysis. Hence a separate mathematical model has been generated for studying the dynamics of a typical lunar soft lander. Parameters used in the analysis includes lunar surface slope, coefficient of friction, initial touchdown velocity (vertical and horizontal), mass and moment of inertia of lander, crushing force due to energy absorbing material in the legs, number of legs and geometry of lander. The mathematical model is capable to simulate plastic and elastic deformation of honey comb, frictional force between landing leg and lunar soil, surface contact simulation, lunar gravitational force, rigid body dynamics and linkage dynamics of inverted tripod landing gear. The non linear differential equations generated for studying the dynamics of lunar lander is solved by numerical method. Matlab programme has been used as a computer tool for solving the numerical equations. The position of each kinematic joint is defined by mathematical equations for the generation of equation of motion. All hinged locations are defined by position vectors with respect to body fixed coordinate. The vehicle rigid body rotations and motions about body coordinate are only due to the external forces and moments arise from footpad reaction force due to impact, footpad frictional force and weight of vehicle. All these force are mathematically simulated for the generation of equation of motion. The validation of mathematical model is done by two different phases. First phase is the validation of plastic deformation of crushable elements by employing conservation of energy principle. The second phase is the validation of rigid body dynamics of model by simulating a lander model in ADAMS software after replacing the crushable elements to elastic spring element. Simulation of plastic deformation along with rigid body dynamics and contact force cannot be modeled in ADAMS. Hence plastic element of primary strut is replaced with a spring element and analysis is carried out in ADAMS software. The same analysis is also carried out using the mathematical model where the simulation of honeycomb crushing is replaced by elastic spring deformation and compared the results with ADAMS analysis. The rotational motion of linkages and 6 degree of freedom motion of lunar Lander about its CG can be validated by ADAMS software by replacing crushing element to spring element. The model is also validated by the drop test results of 4 leg lunar lander. This paper presents the details of mathematical model generated and its validation.

Keywords: honeycomb, landing leg tripod, lunar lander, primary link, secondary link

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2010 Clinically-Based Improvement Project Focused on Reducing Risks Associated with Diabetes Insipidus, Syndrome of Inappropriate ADH, and Cerebral Salt Wasting in Paediatric Post-Neurosurgical and Traumatic Brain Injury Patients

Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

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Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

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2009 Recovery of Draw Solution in Forward Osmosis by Direct Contact Membrane Distillation

Authors: Su-Thing Ho, Shiao-Shing Chen, Hung-Te Hsu, Saikat Sinha Ray

Abstract:

Forward osmosis (FO) is an emerging technology for direct and indirect potable water reuse application. However, successful implementation of FO is still hindered by the lack of draw solution recovery with high efficiency. Membrane distillation (MD) is a thermal separation process by using hydrophobic microporous membrane that is kept in sandwich mode between warm feed stream and cold permeate stream. Typically, temperature difference is the driving force of MD which attributed by the partial vapor pressure difference across the membrane. In this study, the direct contact membrane distillation (DCMD) system was used to recover diluted draw solution of FO. Na3PO4 at pH 9 and EDTA-2Na at pH 8 were used as the feed solution for MD since it produces high water flux and minimized salt leakage in FO process. At high pH, trivalent and tetravalent ions are much easier to remain at draw solution side in FO process. The result demonstrated that PTFE with pore size of 1 μm could achieve the highest water flux (12.02 L/m2h), followed by PTFE 0.45 μm (10.05 L/m2h), PTFE 0.1 μm (7.38 L/m2h) and then PP (7.17 L/m2h) while using 0.1 M Na3PO4 draw solute. The concentration of phosphate and conductivity in the PTFE (0.45 μm) permeate were low as 1.05 mg/L and 2.89 μm/cm respectively. Although PTFE with the pore size of 1 μm could obtain the highest water flux, but the concentration of phosphate in permeate was higher than other kinds of MD membranes. This study indicated that four kinds of MD membranes performed well and PTFE with the pore size of 0.45 μm was the best among tested membranes to achieve high water flux and high rejection of phosphate (99.99%) in recovery of diluted draw solution. Besides that, the results demonstrate that it can obtain high water flux and high rejection of phosphate when operated with cross flow velocity of 0.103 m/s with Tfeed of 60 ℃ and Tdistillate of 20 ℃. In addition to that, the result shows that Na3PO4 is more suitable for recovery than EDTA-2Na. Besides that, while recovering the diluted Na3PO4, it can obtain the high purity of permeate water. The overall performance indicates that, the utilization of DCMD is a promising technology to recover the diluted draw solution for FO process.

Keywords: membrane distillation, forward osmosis, draw solution, recovery

Procedia PDF Downloads 181
2008 Surgical Management of Cystic Lesions in the Sellar and Suprasellar Region

Authors: Hakim Derradji, Abdelkader Yahi, Abdelmalek Sabrou, Nacer Tabet

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Introduction: Cystic lesions located in the sellar and suprasellar region cause a diagnostic and therapeutic problem, given their location and their impact on neighboring structures. The patient's symptomatology varies from a simple headache to serious visual and endocrine disorders, involving the functional prognosis, sometimes even the vital prognosis. Surgery in this region remains a therapeutic challenge, and several surgical techniques have been described and used. Material and Methods: We treated 15 patients during the period from 2015 to 2022, whose clinical, biological, radiological, and therapeutic characteristics will be presented in detail in this work, and in whom the surgical technique differs from one case to another. Conclusion: We will discuss in this work the different techniques used to treat these lesions and the different objectives to be achieved for each case, as well as the complications and our conduct to be taken per and post-operative.

Keywords: cystic lesions, adenomas, sellar and suprasellar region, neuroendoscopy

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2007 Risking Injury: Exploring the Relationship between Risk Propensity and Injuries among an Australian Rules Football Team

Authors: Sarah A. Harris, Fleur L. McIntyre, Paola T. Chivers, Benjamin G. Piggott, Fiona H. Farringdon

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Australian Rules Football (ARF) is an invasion based, contact field sport with over one million participants. The contact nature of the game increases exposure to all injuries, including head trauma. Evidence suggests that both concussion and sub-concussive traumas such as head knocks may damage the brain, in particular the prefrontal cortex. The prefrontal cortex may not reach full maturity until a person is in their early twenties with males taking longer to mature than females. Repeated trauma to the pre-frontal cortex during maturation may lead to negative social, cognitive and emotional effects. It is also during this period that males exhibit high levels of risk taking behaviours. Risk propensity and the incidence of injury is an unexplored area of research. Little research has considered if the level of player’s (especially younger players) risk propensity in everyday life places them at an increased risk of injury. Hence the current study, investigated if a relationship exists between risk propensity and self-reported injuries including diagnosed concussion and head knocks, among male ARF players aged 18 to 31 years. Method: The study was conducted over 22 weeks with one West Australian Football League (WAFL) club during the 2015 competition. Pre-season risk propensity was measured using the 7-item self-report Risk Propensity Scale. Possible scores ranged from 9 to 63, with higher scores indicating higher risk propensity. Players reported their self-perceived injuries (concussion, head knocks, upper body and lower body injuries) fortnightly using the WAFL Injury Report Survey (WIRS). A unique ID code was used to ensure player anonymity, which also enabled linkage of survey responses and injury data tracking over the season. A General Linear Model (GLM) was used to analyse whether there was a relationship between risk propensity score and total number of injuries for each injury type. Results: Seventy one players (N=71) with an age range of 18.40 to 30.48 years and a mean age of 21.92 years (±2.96 years) participated in the study. Player’s mean risk propensity score was 32.73, SD ±8.38. Four hundred and ninety five (495) injuries were reported. The most frequently reported injury was head knocks representing 39.19% of total reported injuries. The GLM identified a significant relationship between risk propensity and head knocks (F=4.17, p=.046). No other injury types were significantly related to risk propensity. Discussion: A positive relationship between risk propensity and head trauma in contact sports (specifically WAFL) was discovered. Assessing player’s risk propensity therefore, may identify those more at risk of head injuries. Potentially leading to greater monitoring and education of these players throughout the season, regarding self-identification of head knocks and symptoms that may indicate trauma to the brain. This is important because many players involved in WAFL are in their late teens or early 20’s hence, may be at greater risk of negative outcomes if they experience repeated head trauma. Continued education and research into the risks associated with head injuries has the potential to improve player well-being.

Keywords: football, head injuries, injury identification, risk

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2006 The Effect of Age on the Outcome of Teenage Pregnancy in Nigeria: A Demographic Study

Authors: Chinelo Igwenagu

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Teenage childbearing in developing countries has been a thing of great concern as it has often led to a number of socioeconomic problems both to the society and to the families affected. The outcome of teenage pregnancy has been generally associated with higher rates of maternal morbidity and mortality, greater risks for delivery complications, low-birth weight infants and child mortality. As a result of teenagers’ physiological and social immaturity and their lack of adequate prenatal care, health risks associated with their pregnancies and childbearing are more pronounced than those of older women. Therefore this study has examined the relationship between the age of teenagers and the outcome of teenage pregnancy. Based on this study, the result of the analysis shows that both teenagers and older mothers suffer similarly during child bearing. Hence improve medical care is paramount in all the situations.

Keywords: childbearing, mortality, Nigeria, pregnancy, prematurity, teenagers

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2005 Chemical Aging of High-Density Polyethylene (HDPE-100) in Interaction with Aggressive Environment

Authors: Berkas Khaoula, Chaoui Kamel

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Polyethylene (PE) pipes are one of the best options for water and gas transmission networks. The main reason for such a choice is its high-quality performance in service conditions over long periods of time. PE pipes are installed in contact with different soils having various chemical compositions with confirmed aggressiveness. As a result, PE pipe surfaces undergo unwanted oxidation reactions. Usually, the polymer mixture is designed to include some additives, such as anti-oxidants, to inhibit or reduce the degradation effects. Some other additives are intended to increase resistance to the ESC phenomenon associated with polymers (ESC: Environmental Stress Cracking). This situation occurs in contact with aggressive external environments following different contaminations of soil, groundwater and transported fluids. In addition, bacterial activity and other physical or chemical media, such as temperature and humidity, can play an enhancing role. These conditions contribute to modifying the PE pipe structure and degrade its properties during exposure. In this work, the effect of distilled water, sodium hypochlorite (bleach), diluted sulfuric acid (H2SO4) and toluene-methanol (TM) mixture are studied when extruded PE samples are exposed to those environments for given periods. The chosen exposure periods are 7, 14 and 28 days at room temperature and in sealed glass containers. Post-exposure observations and ISO impact tests are presented as a function of time and chemical medium. Water effects are observed to be limited in explaining such use in real applications, whereas the changes in TM and acidic media are very significant. For the TM medium, the polymer toughness increased drastically (from 15.95 kJ/m² up to 32.01 kJ/m²), while sulfuric acid showed a steady augmentation over time. This situation may correspond to a hardening phenomenon of PE increasing its brittleness and its ability for structural degradation because of localized oxidation reactions and changes in crystallinity.

Keywords: polyethylene, toluene-methanol mixture, environmental stress cracking, degradation, impact resistance

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2004 A Development of Practice Guidelines for Surgical Safety Management to Reduce Undesirable Incidents from Surgical Services in the Operating Room of Songkhla Hospital, Thailand

Authors: Thitima Plejai

Abstract:

The practice in the operating room has been continually performed according to standards of services; however, undesirable incidents from surgical services are found such as surgical complications in the operating room. This participation action research aimed to develop practice guidelines for surgical safety management to reduce undesirable incidents from surgical services in the operating room of Songkhla Hospital. The target population was all 84 members of the multidisciplinary team who were involved in surgical services in the operating room consisting of 28 surgeons from five branches of surgery, 27 anesthetists and nurse anesthetists, and 29 surgical nurses. The data were collected through in-depth interviews, and non-participatory observations. The research instrument was tested by three experts, and the steps of the development consisted of four cycles, each consisting of assessment, planning, practice, practice reflection, and improvement until every step is practicable. The data were validated through triangulation research method, analyzed through content analysis and statistical analysis with number and percentage. The results of the development of practice guidelines surgical safety management to reduce undesirable incidents from surgical services could be concluded as follows. 1) The multidisciplinary team in surgery participated in the needs assessment for development of practice guidelines for surgical patient safety, and agreed on adapting the WHO Surgical Safety Checklists for use. 2) The WHO Surgical Safety Checklists was implemented, and meetings were held for the multidisciplinary team in surgery and the organizational risk committee to improve the practice guidelines to make them more practicable. 3) The multidisciplinary team consisting of surgeons from five branches of surgery, anesthetists, nurse anesthetists, surgical nurses, and the organizational risk committee announced policy on safety for surgical patients; the organizational risk committee designated the Surgical Safety Checklist as an instrument for surgical patient safety. The results of the safety management found that the surgical team members who could follow 100 percent of the guidelines were: professional nurses who checked patient identity and information before taking the patient to the operating room and kept complete records of data on the patients; surgical nurses who checked readiness of the patient before surgery; nurse anesthetists who assessed readiness before administering anesthetic drugs, and confirmed correctness of the patient; and circulating perioperative nurses who gave confirmation to the surgical team after completion of the surgery. The rates of undesirable incidents (surgical complications rates) before and after the implementation of the surgical safety management were 1.60 percent and 0.66 percent, respectively. The satisfaction of the surgery-related teams towards the use of the guidelines was 89 percent. The practice guidelines for surgical safety management to reduce undesirable incidents were taken as guidelines for surgical safety that the multidisciplinary team involved in the surgical process implemented correctly and in the same direction and clearly reduced undesirable incidents in surgical patients.

Keywords: practice guidelines, surgical safety management, reduce undesirable incidents, operating Room

Procedia PDF Downloads 293
2003 The Fragility of Sense: The Twofold Temporality of Embodiment and Its Role for Depression

Authors: Laura Bickel

Abstract:

This paper aims to investigate to what extent Merleau-Ponty’s philosophy of body memory serves as a viable resource for the enactive approach to cognitive science and its first-person experience-based research on ‘recurrent depressive disorder’ coded F33 in ICD-10. In pursuit of this goal, the analysis begins by revisiting the neuroreductive paradigm. This paradigm serves biological psychiatry to explain the condition of vital contact in terms of underlying neurophysiological mechanisms. It is demonstrated that the neuroreductive model cannot sufficiently account for the depressed person’s episodical withdrawal in causal terms. The analysis of the irregular loss of vital resonance requires integrating the body as the subject of experience and its phenomenological time. Then, it is shown that the enactive approach to depression as disordered sense-making is a promising alternative. The enactive model of perception implies that living beings do not register pre-existing meaning ‘out there’ but unfold ‘sense’ in their action-oriented response to the world. For the enactive approach, Husserl’s passive synthesis of inner time consciousness is fundamental for what becomes perceptually present for action. It seems intuitive to bring together the enactive approach to depression with the long-standing view in phenomenological psychopathology that explains the loss of vital contact by appealing to the disruption of the temporal structure of consciousness. However, this paper argues that the disruption of the temporal structure is not justified conceptually. Instead, one may integrate Merleau-Ponty’s concept of the past as the unconscious into the enactive approach to depression. From this perspective, the living being’s experiential and biological past inserts itself in the form of habit and bodily skills and ensures action-oriented responses to the environment. Finally, it is concluded that the depressed person’s withdrawal indicates the impairment of this application process. The person suffering from F33 cannot actualize sedimented meaning to respond to the valences and tasks of a given situation.

Keywords: depression, enactivism, neuroreductionsim, phenomenology, temporality

Procedia PDF Downloads 126
2002 Lateral Retroperitoneal Transpsoas Approach: A Practical Minimal Invasive Surgery Option for Treating Pyogenic Spondylitis of the Lumbar Vertebra

Authors: Sundaresan Soundararajan, Chor Ngee Tan

Abstract:

Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

Procedia PDF Downloads 175
2001 Sero-Prevalence of Hepatitis B Surface Antigen and Associated Factors among Pregnant Mothers Attending Antenatal Care Service, Mekelle, Ethiopia: Evidence from Institutional Based Quantitative Cross-Sectional Study

Authors: Semaw A., Awet H., Yohannes M.

Abstract:

Background: Hepatitis B Virus (HBV) is a major global public health problem. Individuals living in Sub-Sahara Africa have 60% lifetime risk of acquiring HBV infection. Evidences showed that 80-90% of those born from infected mothers developed chronic HBV. Perinatal HBV transmission is a major determinant of HBV carrier status, its chronic squeal and maintains HBV transmission across generations. Method: Institution based cross-sectional study was conducted among 406 pregnant mothers attending Antenatal clinics at Mekelle and Ayder referral hospital from January 30 to April 1/2014. Epidata version 3.1 was used for data entry and SPSS version 21 statistical software was used for data cleaning, management and finally determine associated factors of hepatitis B surface antigen adjusting important confounders using multivariable logistic regression analysis at 5% level of significance. Result: The overall prevalence of hepatitis B surface antigen among pregnant women was 33 (8.1%). The socio-demographic characteristic of the study population showed that there is high positivity among secondary school 189 (46.6%). In the multivariable logistic regression analysis, history of a contact with individuals who had history of hepatitis B infection or jaundice and lifetime number of multiple sexual partners were found to be significantly associated with HBsAg positivity at AOR = 3.73 95%C.I (1.373-10.182) and AOR = 2.57 95%C.I (1.173-5.654), respectively. Moreover, Human Immunodeficiency Virus (HIV) and HBV confection rate was found 3.6%. Conclusion: This study has shown that HBV prevalence in pregnant women is highly prevalent (8.1%) in the study area. Contact with individuals who had a history of hepatitis or have jaundice and report of multiple lifetime sexual partnership were associated with hepatitis B infection. Education about HBV transmission and prevention as well as screening all pregnant mothers shall be sought to reduce the serious public health crisis of HBV.

Keywords: HBsAg, hepatitis B, pregnant women, prevalence

Procedia PDF Downloads 337
2000 Super-Hydrophilic TFC Membrane with High Stability in Oil

Authors: M. Obaid, Nasser A. M. Barakat, Fadali O.A

Abstract:

Low stability in oil media and the hydrophobicity problems of the ploysulfone electrospun membranes could be overcome in the present study. Synthesis of super-hydrophilic and highly stable in oil polysulfone electrospun nanofiber membrane was achieved by electrospinning of polysulfone solution containing NaOH salt followed by activation of the dried electrospun membrane by deposition of polyamide layer on the surface using m-phenylenediamine and 1,3,5-benzenetricarbonyl chloride. The introduced membrane has super-hydrophilicity characteristic (contact angle=3o), excellent stability in oil media and distinct performance in oil-water separation process.

Keywords: electrospinning, oil-degradability, membrane, nanofibers

Procedia PDF Downloads 476
1999 Cognitive Models of Health Marketing Communication in the Digital Era: Psychological Factors, Challenges, and Implications

Authors: Panas Gerasimos, Kotidou Varvara, Halkiopoulos Constantinos, Gkintoni Evgenia

Abstract:

As a result of growing technology and briefing by the internet, users resort to the internet and subsequently to the opinion of an expert. In many cases, they take control of their health in their hand and make a decision without the contribution of a doctor. According to that, this essay intends to analyze the confidence of searching health issues on the internet. For the fulfillment of this study, there has been a survey among doctors in order to find out the reasons a patient uses the internet about their health problems and the consequences that health information could lead by searching on the internet, as well. Specifically, the results regarding the research of the users demonstrate: a) the majority of users make use of the internet about health issues once or twice a month, b) individuals that possess chronic disease make health search on the internet more frequently, c) the most important topics that the majority of users usually search are pathological, dietary issues and the search of issues that are associated with doctors and hospitals. However, it observed that topic search varies depending on the users’ age, d) the most common sources of information concern the direct contact with doctors, as there is a huge preference from the majority of users over the use of the electronic form for their briefing and e) it has been observed that there is large lack of knowledge about e-health services. From the doctor's point of view, the following conclusions occur: a) almost all doctors use the internet as their main source of information, b) the internet has great influence over doctors’ relationship with the patients, c) in many cases a patient first makes a visit to the internet and then to the doctor, d) the internet significantly has a psychological impact on patients in order to for them to reach a decision, e) the most important reason users choose the internet instead of the health professional is economic, f) the negative consequence that emerges is inaccurate information, g) and the positive consequences are about the possibility of online contact with the doctor and contributes to the easy comprehension of the doctor, as well. Generally, it’s observed from both sides that the use of the internet in health issues is intense, which declares that the new means the doctors have at their disposal, produce the conditions for radical changes in the way of providing services and in the doctor-patient relationship.

Keywords: cognitive models, health marketing, e-health, psychological factors, digital marketing, e-health services

Procedia PDF Downloads 202
1998 Paralysis from an Ear Infection: A Severe Case of Otitis Externa Leading to Acute Complete Cervical Cord Syndrome

Authors: Rachael Collins, George Lafford

Abstract:

We report a case of a generally fit and a well 54-year-old gentleman who presented with a two-day history of worsening left-sided otorrhea, headache, neck stiffness, vomiting and pyrexia on the background of a seven-week history of OE. His condition progressed dramatically as he developed symptoms consistent with acute complete cervical cord syndrome with radiological evidence of skull base osteomyelitis, parapharyngeal, retropharyngeal and paravertebral abscesses and sigmoid sinus thrombus. Ultimately he made a significant, although not complete, recovery. This case is unique in demonstrating how OE can develop into a potentially life-threatening condition. It emphasizes the importance of early diagnosis and treatment of OE, the recognition of ‘red flag’ symptoms and highlights the importance of a multi-disciplinary team (MDT) approach when managing complex complications of OE.

Keywords: ENT, neurology, otology, MDT

Procedia PDF Downloads 147
1997 An Original and Suitable Induction Method of Repeated Hypoxic Stress by Hydralazine to Investigate the Integrity of an in Vitro Contact Co-Culture Blood Brain Barrier Model

Authors: Morgane Chatard, Clémentine Puech, Nathalie Perek, Frédéric Roche

Abstract:

Several neurological disorders are linked to repeated hypoxia. The impact of such repeated hypoxic stress, on endothelial cells function of the blood-brain barrier (BBB) is little studied in the literature. Indeed, the study of hypoxic stress in cellular pathways is complex using hypoxia exposure because HIF 1α (factor induced by hypoxia) has a short half life. Our study presents an innovative induction method of repeated hypoxic stress, more reproducible, which allows us to study its impacts on an in vitro contact co-culture BBB model. Repeated hypoxic stress was induced by hydralazine (a mimetic agent of hypoxia pathway) during two hours and repeated during 24 hours. Then, BBB integrity was assessed by permeability measurements (transendothelial electrical resistance and membrane permeability), tight junction protein expressions (cell-ELISA and confocal microscopy) and by studying expression and activity of efflux transporters. First, this study showed that repeated hypoxic stress leads to a BBB’s dysfunction illustrated by a significant increase in permeability. This loss of membrane integrity was linked to a significant decrease of tight junctions’ protein expressions, facilitating a possible transfer of potential cytotoxic compounds in the brain. Secondly, we demonstrated that brain microvascular endothelial cells had set-up defence mechanism. These endothelial cells significantly increased the activity of their efflux transporters which was associated with a significant increase in their expression. In conclusion, repeated hypoxic stress lead to a loss of BBB integrity with a decrease of tight junction proteins. In contrast, endothelial cells increased the expression of their efflux transporters to fight against cytotoxic compounds brain crossing. Unfortunately, enhanced efflux activity could also lead to reducing pharmacological drugs delivering to the brain in such hypoxic conditions.

Keywords: BBB model, efflux transporters, repeated hypoxic stress, tigh junction proteins

Procedia PDF Downloads 290
1996 A Descriptive Study on Comparison of Maternal and Perinatal Outcome of Twin Pregnancies Conceived Spontaneously and by Assisted Conception Methods

Authors: Aishvarya Gupta, Keerthana Anand, Sasirekha Rengaraj, Latha Chathurvedula

Abstract:

Introduction: Advances in assisted reproductive technology and increase in the proportion of infertile couples have both contributed to the steep increase in the incidence of twin pregnancies in past decades. Maternal and perinatal complications are higher in twins than in singleton pregnancies. Studies comparing the maternal and perinatal outcomes of ART twin pregnancies versus spontaneously conceived twin pregnancies report heterogeneous results making it unclear whether the complications are due to twin gestation per se or because of assisted reproductive techniques. The present study aims to compare both maternal and perinatal outcomes in twin pregnancies which are spontaneously conceived and after assisted conception methods, so that targeted steps can be undertaken in order to improve maternal and perinatal outcome of twins. Objectives: To study perinatal and maternal outcome in twin pregnancies conceived spontaneously as well as with assisted methods and compare the outcomes between the two groups. Setting: Women delivering at JIPMER (tertiary care institute), Pondicherry. Population: 380 women with twin pregnancies who delivered in JIPMER between June 2015 and March 2017 were included in the study. Methods: The study population was divided into two cohorts – one conceived by spontaneous conception and other by assisted reproductive methods. Association of various maternal and perinatal outcomes with the method of conception was assessed using chi square test or Student's t test as appropriate. Multiple logistic regression analysis was done to assess the independent association of assisted conception with maternal outcomes after adjusting for age, parity and BMI. Multiple logistic regression analysis was done to assess the independent association of assisted conception with perinatal outcomes after adjusting for age, parity, BMI, chorionicity, gestational age at delivery and presence of hypertension or gestational diabetes in the mother. A p value of < 0.05 was considered as significant. Result: There was increased proportion of women with GDM (21% v/s 4.29%) and premature rupture of membranes (35% v/s 22.85%) in the assisted conception group and more anemic women in the spontaneous group (71.27% v/s 55.1%). However assisted conception per se increased the incidence of GDM among twin gestations (OR 3.39, 95% CI 1.34 – 8.61) and did not influence any of the other maternal outcomes. Among the perinatal outcomes, assisted conception per se increased the risk of having very preterm (<32 weeks) neonates (OR 3.013, 95% CI 1.432 – 6.337). The mean birth weight did not significantly differ between the two groups (p = 0.429). Though there were higher proportion of babies admitted to NICU in the assisted conception group (48.48% v/s 36.43%), assisted conception per se did not increase the risk of admission to NICU (OR 1.23, 95% CI 0.76 – 1.98). There was no significant difference in perinatal mortality rates between the two groups (p = 0.829). Conclusion: Assisted conception per se increases the risk of developing GDM in women with twin gestation and increases the risk of delivering very preterm babies. Hence measures should be taken to ensure appropriate screening methods for GDM and suitable neonatal care in such pregnancies.

Keywords: assisted conception, maternal outcomes, perinatal outcomes, twin gestation

Procedia PDF Downloads 207
1995 Acceleration Techniques of DEM Simulation for Dynamics of Particle Damping

Authors: Masato Saeki

Abstract:

Presented herein is a novel algorithms for calculating the damping performance of particle dampers. The particle damper is a passive vibration control technique and has many practical applications due to simple design. It consists of granular materials constrained to move between two ends in the cavity of a primary vibrating system. The damping effect results from the exchange of momentum during the impact of granular materials against the wall of the cavity. This damping has the advantage of being independent of the environment. Therefore, particle damping can be applied in extreme temperature environments, where most conventional dampers would fail. It was shown experimentally in many papers that the efficiency of the particle dampers is high in the case of resonant vibration. In order to use the particle dampers effectively, it is necessary to solve the equations of motion for each particle, considering the granularity. The discrete element method (DEM) has been found to be effective for revealing the dynamics of particle damping. In this method, individual particles are assumed as rigid body and interparticle collisions are modeled by mechanical elements as springs and dashpots. However, the computational cost is significant since the equation of motion for each particle must be solved at each time step. In order to improve the computational efficiency of the DEM, the new algorithms are needed. In this study, new algorithms are proposed for implementing the high performance DEM. On the assumption that behaviors of the granular particles in the each divided area of the damper container are the same, the contact force of the primary system with all particles can be considered to be equal to the product of the divided number of the damper area and the contact force of the primary system with granular materials per divided area. This convenience makes it possible to considerably reduce the calculation time. The validity of this calculation method was investigated and the calculated results were compared with the experimental ones. This paper also presents the results of experimental studies of the performance of particle dampers. It is shown that the particle radius affect the noise level. It is also shown that the particle size and the particle material influence the damper performance.

Keywords: particle damping, discrete element method (DEM), granular materials, numerical analysis, equivalent noise level

Procedia PDF Downloads 450
1994 The Use of Brachytherapy in the Treatment of Liver Metastases: A Systematic Review

Authors: Mateusz Bilski, Jakub Klas, Emilia Kowalczyk, Sylwia Koziej, Katarzyna Kulszo, Ludmiła Grzybowska- Szatkowska

Abstract:

Background: Liver metastases are a common complication of primary solid tumors and sig-nificantly reduce patient survival. In the era of increasing diagnosis of oligometastatic disease and oligoprogression, methods of local treatment of metastases, i.e. MDT, are becoming more important. Implementation of such treatment can be considered for liver metastases, which are a common complication of primary solid tumors and significantly reduce patient survival. To date, the mainstay of treatment for oligometastatic disease has been surgical resection, but not all patients qualify for the procedure. As an alternative to surgical resection, radiotherapy techniques have become available, including stereotactic body radiation therapy (SBRT) or high-dose interstitial brachytherapy (iBT). iBT is an invasive method that emits very high doses of radiation from the inside of the tumor to the outside. This technique provides better tumor coverage than SBRT while having little impact on surrounding healthy tissue and elim-inates some concerns involving respiratory motion. Methods: We conducted a systematic re-view of the scientific literature on the use of brachytherapy in the treatment of liver metasta-ses from 2018 - 2023 using PubMed and ResearchGate browsers according to PRISMA rules. Results: From 111 articles, 18 publications containing information on 729 patients with liver metastases were selected. iBT has been shown to provide high rates of tumor control. Among 14 patients with 54 unresectable RCC liver metastases, after iBT LTC was 92.6% during a median follow-up of 10.2 months, PFS was 3.4 months. In analysis of 167 patients after treatment with a single fractional dose of 15-25 Gy with brachytherapy at 6- and 12-month follow-up, LRFS rates of 88,4-88.7% and 70.7 - 71,5%, PFS of 78.1 and 53.8%, and OS of 92.3 - 96.7% and 76,3% - 79.6%, respectively, were achieved. No serious complications were observed in all patients. Distant intrahepatic progression occurred later in patients with unre-sectable liver metastases after brachytherapy (PFS: 19.80 months) than in HCC patients (PFS: 13.50 months). A significant difference in LRFS between CRC patients (84.1% vs. 50.6%) and other histologies (92.4% vs. 92.4%) was noted, suggesting a higher treatment dose is necessary for CRC patients. The average target dose for metastatic colorectal cancer was 40 - 60 Gy (compared to 100 - 250 Gy for HCC). To better assess sensitivity to therapy and pre-dict side effects, it has been suggested that humoral mediators be evaluated. It was also shown that baseline levels of TNF-α, MCP-1 and VEGF, as well as NGF and CX3CL corre-lated with both tumor volume and radiation-induced liver damage, one of the most serious complications of iBT, indicating their potential role as biomarkers of therapy outcome. Con-clusions: The use of brachytherapy methods in the treatment of liver metastases of various cancers appears to be an interesting and relatively safe therapeutic method alternative to sur-gery. An important challenge remains the selection of an appropriate brachytherapy method and radiation dose for the corresponding initial tumor type from which the metastasis origi-nated.

Keywords: liver metastases, brachytherapy, CT-HDRBT, iBT

Procedia PDF Downloads 110
1993 Reduction of the Cellular Infectivity of SARS-CoV-2 by a Mucoadhesive Nasal Spray

Authors: Adam M. Pitz, Gillian L. Phillipson, Jayant E. Khanolkar, Andrew M. Middleton

Abstract:

New emerging evidence suggests that the nose is the predominant route for entry of the SARS-CoV-2 virus into the host. A virucidal suspension test (conforming in principle to the European Standard EN14476) was conducted to determine whether a commercial liquid gel intranasal spray containing 1% of the mucoadhesive hydroxypropyl methylcellulose (HPMC) could inhibit the cellular infectivity of the SARS-CoV-2 coronavirus. Virus was added to the test product samples and to controls in a 1:8 ratio and mixed with one part bovine serum albumin as an interfering substance. The test samples were pre-equilibrated to 34 ± 2°C (representing the temperature of the nasopharynx) with the temperature maintained at 34 ± 2°C for virus contact times of 1, 5 and 10 minutes. Neutralized aliquots were inoculated onto host cells (Vero E6 cells, ATCC CRL-1586). The host cells were then incubated at 36 ± 2°C for a period of 7 days. The residual infectious virus in both test and controls was detected by viral-induced cytopathic effect. The 50% tissue culture infective dose per mL (TCID50/mL) was determined using the Spearman-Karber method with results reported as the reduction of the virus titer due to treatment with test product, expressed as log10. The controls confirmed the validity of the results with no cytotoxicity or viral interference observed in the neutralized test product samples. The HPMC formulation reduced SARS-CoV-2 titer, expressed as log10TCID50, by 2.30 ( ± 0.17), 2.60 ( ± 0.19), and 3.88 ( ± 0.19) with the respective contact times of 1, 5 and 10 minutes. The results demonstrate that this 1% HPMC gel formulation can reduce the cellular infectivity of the SARS-CoV-2 virus with an increasing viral inhibition observed with increasing exposure time. This 1% HMPC gel is well tolerated and can reside, when delivered via nasal spray, for up to one hour in the nasal cavity. We conclude that this intranasal gel spray with 1% HPMC repeat-dosed every few hours may offer an effective preventive or early intervention solution to limit the transmission and impact of the SARS-CoV-2 coronavirus.

Keywords: hydroxypropyl methylcellulose, mucoadhesive nasal spray, respiratory viruses, SARS-CoV-2

Procedia PDF Downloads 137
1992 Touching Interaction: An NFC-RFID Combination

Authors: Eduardo Álvarez, Gerardo Quiroga, Jorge Orozco, Gabriel Chavira

Abstract:

AmI proposes a new way of thinking about computers, which follows the ideas of the Ubiquitous Computing vision of Mark Weiser. In these, there is what is known as a Disappearing Computer Initiative, with users immersed in intelligent environments. Hence, technologies need to be adapted so that they are capable of replacing the traditional inputs to the system by embedding these in every-day artifacts. In this work, we present an approach, which uses Radiofrequency Identification (RFID) and Near Field Communication (NFC) technologies. In the latter, a new form of interaction appears by contact. We compare both technologies by analyzing their requirements and advantages. In addition, we propose using a combination of RFID and NFC.

Keywords: touching interaction, ambient intelligence, ubiquitous computing, interaction, NFC and RFID

Procedia PDF Downloads 499
1991 The Analysis of Drill Bit Optimization by the Application of New Electric Impulse Technology in Shallow Water Absheron Peninsula

Authors: Ayshan Gurbanova

Abstract:

Despite based on the fact that drill bit which is the smallest part of bottom hole assembly costs only in between 10% and 15% of the total expenses made, they are the first equipment that is in contact with the formation itself. Hence, it is consequential to choose the appropriate type and dimension of drilling bit, which will prevent majority of problems by not demanding many tripping procedure. However, within the advance in technology, it is now seamless to be beneficial in the terms of many concepts such as subsequent time of operation, energy, expenditure, power and so forth. With the intention of applying the method to Azerbaijan, the field of Shallow Water Absheron Peninsula has been suggested, where the mainland has been located 15 km away from the wildcat wells, named as “NKX01”. It has the water depth of 22 m as indicated. In 2015 and 2016, the seismic survey analysis of 2D and 3D have been conducted in contract area as well as onshore shallow water depth locations. With the aim of indicating clear elucidation, soil stability, possible submersible dangerous scenarios, geohazards and bathymetry surveys have been carried out as well. Within the seismic analysis results, the exact location of exploration wells have been determined and along with this, the correct measurement decisions have been made to divide the land into three productive zones. In the term of the method, Electric Impulse Technology (EIT) is based on discharge energies of electricity within the corrosivity in rock. Take it simply, the highest value of voltages could be created in the less range of nano time, where it is sent to the rock through electrodes’ baring as demonstrated below. These electrodes- higher voltage powered and grounded are placed on the formation which could be obscured in liquid. With the design, it is more seamless to drill horizontal well based on the advantage of loose contact of formation. There is also no chance of worn ability as there are no combustion, mechanical power exist. In the case of energy, the usage of conventional drilling accounts for 1000 𝐽/𝑐𝑚3 , where this value accounts for between 100 and 200 𝐽/𝑐𝑚3 in EIT. Last but not the least, from the test analysis, it has been yielded that it achieves the value of ROP more than 2 𝑚/ℎ𝑟 throughout 15 days. Taking everything into consideration, it is such a fact that with the comparison of data analysis, this method is highly applicable to the fields of Azerbaijan.

Keywords: drilling, drill bit cost, efficiency, cost

Procedia PDF Downloads 70
1990 Microstructures of Si Surfaces Fabricated by Electrochemical Anodic Oxidation with Agarose Stamps

Authors: Hang Zhou, Limin Zhu

Abstract:

This paper investigates the fabrication of microstructures on Si surfaces by using electrochemical anodic oxidation with agarose stamps. The fabricating process is based on a selective anodic oxidation reaction that occurs in the contact area between a stamp and a Si substrate. The stamp which is soaked in electrolyte previously acts as a current flow channel. After forming the oxide patterns as an etching mask, a KOH aqueous is used for the wet etching of Si. A complicated microstructure array of 1 cm2 was fabricated by the method with high accuracy.

Keywords: microstructures, anodic oxidation, silicon, agarose stamps

Procedia PDF Downloads 300
1989 Relationship between the Development of Sepsis, Systemic Inflammatory Response Syndrome and Body Mass Index among Adult Trauma Patients at University Hospital in Cairo

Authors: Mohamed Hendawy Mousa, Warda Youssef Mohamed Morsy

Abstract:

Background: Sepsis is a major cause of mortality and morbidity in trauma patients. Body mass index as an indicator of nutritional status was reported as a predictor of injury pattern and complications among critically ill injured patients. Aim: The aim of this study is to investigate the relationship between body mass index and the development of sepsis, systemic inflammatory response syndrome among adult trauma patients at emergency hospital - Cairo University. Research design: Descriptive correlational research design was utilized in the current study. Research questions: Q1. What is the body mass index profile of adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, Q2. What is the frequency of systemic inflammatory response syndrome and sepsis among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, and Q3. What is the relationship between the development of sepsis, systemic inflammatory response syndrome and body mass index among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?. Sample: A purposive sample of 52 adult male and female trauma patients with revised trauma score 10 to 12. Setting: The Emergency Hospital affiliated to Cairo University. Tools: Four tools were utilized to collect data pertinent to the study: Socio demographic and medical data tool, Systemic inflammatory response syndrome assessment tool, Revised Trauma Score tool, and Sequential organ failure assessment tool. Results: The current study revealed that, (61.5 %) of the studied subjects had normal body mass index, (25 %) were overweight, and (13.5 %) were underweight. 84.6% of the studied subjects had systemic inflammatory response syndrome and 92.3% were suffering from mild sepsis. No significant statistical relationship was found between body mass index and occurrence of Systemic inflammatory response syndrome (2= 2.89 & P = 0.23). However, Sequential organ failure assessment scores were affected significantly by body mass index was found mean of initial and last Sequential organ failure assessment score for underweight, normal and obese where t= 7.24 at p = 0.000, t= 16.49 at p = 0.000 and t= 9.80 at p = 0.000 respectively. Conclusion: Underweight trauma patients showed significantly higher rate of developing sepsis as compared to patients with normal body weight and obese. Recommendations: based on finding of this study the following are recommended: replication of the study on a larger probability sample from different geographical locations in Egypt; Carrying out of further studies in order to assess the other risk factors influencing trauma outcome and incidence of its complications; Establishment of standardized guidelines for managing underweight traumatized patients with sepsis.

Keywords: body mass index, sepsis, systemic inflammatory response syndrome, adult trauma

Procedia PDF Downloads 244