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At least 775 records · Page 43Linked to original sources
PubMed1998

A 10-year follow-up of the outcome of lumbar microdiscectomy.

STUDY DESIGN: A retrospective analysis of the outcome of lumbar microdiscectomy, with independent assessment of outcome. OBJECTIVES: To explore whether the initial positive outcome after microdiscectomy is maintained at long-term follow-up. SUMMARY OF BACKGROUND DATA: Previous reports on long-term outcome after lumbar disc surgery give conflicting messages about whether an initially positive surgical outcome is maintained throughout a 10-year period. This is partly due to differing methods and the failure to include initial outcome, thereby permitting assessment of possible deterioration in the quality of outcome. METHODS: This study presents the initial and long-term outcome after lumbar microdiscectomy, with an independent assessment of outcome. Eighty-eight consecutive patients undergoing lumbar microdiscectomy were identified. Assessment at 10 years after surgery was obtained in 79 (90%) of the cases. The initial outcome was assessed retrospectively by an independent observer at 6 months after surgery using the Macnab classification. The final outcome Macnab classification was completed by postal questionnaire by the patients themselves, who also completed a modified Roland-Morris disability questionnaire. RESULTS: A successful outcome at 6 months was achieved in 91% of the cases. At 10-year follow-up, this result declined slightly to an 83% success rate. However, there was no statistically significant difference between these outcome results. The long-term Macnab classification results correlated well with disability, as measured by the Roland-Morris score. Patient satisfaction with the results of microdiscectomy 10 years later was high. CONCLUSIONS: Lumbar microdiscectomy achieves a high level of initial success, and this positive outcome is maintained at a 10-year follow-up.

Adolescent↗
PubMed1993

Diverse activity of sc-RIP saporin 6 on primary and metastatic melanoma cells in vitro.

The inhibitory effect of saporin 6, a single-chain ribosome-inactivating protein (sc-RIP) purified from the seeds of Saponaria officinalis, on the proliferation of human primary (MeWo, WM 164, SK MEL 28, MEM), cloned (MEM A9, A12, A13) and metastatic (M14) melanoma cells has been tested by protein synthesis and colony formation assays in vitro. Results indicate a marked difference in the sensitivity of primary and metastatic cells to the action of saporin 6, the latter being significantly more affected, both in treated and in pretreated cultures, with a high and specific response evident after 24 h of treatment and progressively increasing up to 72 h of culture with the drug (IC50 = 0.82 microgram/ml). This effect, which was dose-dependent in exponentially growing cells, was partially reversed upon removal of the inhibitor from the culture medium. No inhibitory effect was evident in the MeWo primary cells at the highest saporin 6 concentration used: the p170 glycoprotein-mediated mechanism is not involved in such a resistance pathway.

Antineoplastic Agents, Phytogenic↗
PubMedDate not supplied

Extramedullary myeloid tumors in children: the limited value of local treatment.

PURPOSE: To determine the incidence of extramedullary tumors (EMT) in Saudi Arabian children with acute myeloid leukemia, the factors associated with these tumors and the impact of local treatment on local tumor control, complete remission and survival rates. PATIENTS AND METHODS: One hundred children, median age 6 years, who received their primary treatment for acute myeloid leukemia at King Faisal Specialist Hospital and Research Center, from 1983 to 1997 were studied. EMT at diagnosis occurred in 18 (18%) patients at 25 sites. Meningeal leukemia, hepatosplenomegaly, lymph node enlargement, gingival hypertrophy, and cutaneous infiltration were not included in the definition of EMT. With these exclusions, children with EMT were younger than those without EMT (median age, 3.5 v. 7.5 years) and were more likely to have meningeal leukemia at diagnosis (33% v. 10%). The t(8;21) translocation was associated with a 47% EMT incidence compared with 23% without the translocation. Local radiation treatment was given to 16 of 25 (64%) EMT sites. RESULTS: The overall 5-year survival rate for all patients was 28%, and this was not significantly influenced by the drug regimen used, meningeal leukemia at diagnosis, the presence of the (8;21) translocation, M4 and M5 morphology combined, or EMT at diagnosis. Significant differences were observed in the 5-year survival rates for patients who underwent allogeneic bone marrow transplantation (52%; N = 37) and those who attained complete remission (CR) but did not undergo transplantation (21%; N = 44) and those who did not achieve complete remission with initial therapy (5%; N = 19). Systemic and local EMT CR was achieved in 17 of 18 patients with EMT, including 12 patients who underwent radiation treatment and 5 of 6 of those who did not. Isolated relapse was not seen at an EMT site and was not noted at any later stage of the disease. CONCLUSIONS: Permanent local control at sites of EMT was achieved in all patients who attained a bone marrow CR, whether or not the site was irradiated. Local radiation treatment of an EMT site did not appear to contribute to overall CR and survival rates. The use of radiation treatment should be conservative and limited to patients in whom there is a real and immediate threat to vision or renal function or when the spinal cord is compromised.

Acute Disease↗
PubMed2006

Influence of dynamic compression on directional hearing in the horizontal plane.

OBJECTIVE: The purpose of this study was to assess the influence of dynamic compression on directional hearing in the frontal horizontal plane. DESIGN: Compression schemes with various compression ratios and attack times were created by using a digital signal processor. The influence of compression on isolated interaural level differences (ILDs) and interaural time differences (ITDs) was examined in discrimination experiments. The combination of ILDs and ITDs was investigated with measurements of localization based on head-related transfer functions. Five normal listeners and seven hearing-impaired subjects participated in the study. RESULTS: Dynamic compression revealed substantial effects on discrimination of ILDs but not on ITDs. With higher compression ratios and shorter attack times, just-noticeable differences for ILDs increased. Lateralization via head-related transfer functions was predominantly affected by compression in the higher frequency range because for lower frequencies, interaural time cues dominate over interaural level cues. The effect of compression was similar for normal and hearing-impaired listeners, but the latter performed worse on almost all tasks, especially with ITD discrimination at 4000 Hz. CONCLUSIONS: The influence of compression ratio and attack time could be shown for ILDs, but the effect was rather small, at least for the low compression ratios commonly used in hearing aids. The influence further decreased when attack time was prolonged. The dramatic impairment of the discrimination of ITDs with the hearing-impaired subjects in the high-frequency range suggests that they primarily rely on ILD cues.

Acoustic Stimulation↗
PubMed2003

Extubation failure in pediatric intensive care: a multiple-center study of risk factors and outcomes.

OBJECTIVE: To determine a contemporary failed extubation rate, risk factors, and consequences of extubation failure in pediatric intensive care units (PICUs). Three hypotheses were investigated: a) Extubation failure is in part disease specific; b) preexisting respiratory conditions predispose to extubation failure; and c) admission acuity scoring does not affect extubation failure. DESIGN: Twelve-month prospective, observational, clinical study. SETTING: Sixteen diverse PICUs in the United States. PATIENTS: Patients were 2,794 patients from the newborn period to 18 yrs of age experiencing a planned extubation trial. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A descriptive statistical analysis was performed, and outcome differences of the failed extubation population were determined. The extubation failure rate was 6.2% (174 of 2,794; 95% confidence interval, 5.3-7.1). Patient features associated with extubation failure (p <.05) included age < or =24 months; dysgenetic condition; syndromic condition; chronic respiratory disorder; chronic neurologic condition; medical or surgical airway condition; chronic noninvasive positive pressure ventilation; the need to replace the endotracheal tube on admission to the PICU; and the use of racemic epinephrine, steroids, helium-oxygen therapy (heliox), or noninvasive positive pressure ventilation within 24 hrs of extubation. Patients failing extubation had longer pre-extubation intubation time (failed, 148.7 hrs, SD +/- 207.8 vs. success, 107.9 hrs, SD +/- 171.3; p <.001), longer PICU length of stay (17.5 days, SD +/- 15.6 vs. 7.6 days, SD +/- 11.1; p <.001), and a higher mortality rate than patients not failing extubation (4.0% vs. 0.8%; p <.001). Failure was found to be in part disease specific, and preexisting respiratory conditions were found to predispose to failure whereas admission acuity did not. CONCLUSION: A variety of patient features are associated with an increase in extubation failure rate, and serious outcome consequences characterize the extubation failure population in PICUs.

Adolescent↗
PubMed2006

A study of disruptive behavior disorders in Puerto Rican youth: I. Background, design, and survey methods.

OBJECTIVE: This is the first of two related articles on a study carried out between 2000 and 2003 designed to assess the prevalence, associated comorbidities, and correlates of disruptive behavior disorders in two populations of Puerto Rican children: one in the Standard Metropolitan Areas of San Juan and Caguas in Puerto Rico, and the other in the south Bronx in New York City. METHOD: This article provides the study's background, design, and methodology. Probability samples of children ages 5 to 13 years were drawn at the two sites (n = 2,491). Subjects and their primary caretakers were interviewed using the Diagnostic Interview Schedule for Children-IV and a wide array of risk factor measures. The samples were weighted to correct for differences in the probability of selection resulting from sample design and to adjust for differences from the 2000 U.S. Census in the age/gender distribution. RESULTS: The samples are representative of the populations of Puerto Rican children in the south Bronx and in the Standard Metropolitan Areas in Puerto Rico. Of the 2,940 children identified as eligible for the study, 2,491 participated for an overall compliance rate of 85%. CONCLUSIONS: The study results, to be described in an accompanying report, are generalizable to the two target populations.

Adolescent↗
PubMed2006

A case of Turner syndrome associated with acute myeloid leukemia (M2).

A 9-year-old girl was diagnosed as acute myeloid leukemia-M2 according to the French-American-British classification. In addition, a diagnosis of Turner syndrome (TS) was made, on the basis of the presence of the chromosomal abnormality, ovarian failure, and abnormal physical features. In particular, children with Down syndrome have increased risk of developing acute myeloblastic leukemia especially M7. On the other hand, cases of myeloid leukemia that are complicated with TS are extremely rare. This is the first report of TS with acute myeloid leukemia of M2 subtype and t (8; 21) in children.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2005

Management of HIV-1 infection with a combination of nevirapine, stavudine, and lamivudine: a preliminary report on the Nigerian antiretroviral program.

OBJECTIVE: To evaluate treatment outcome in the first 12 months among HIV-positive patients managed with a combination of nevirapine + stavudine + lamivudine under the current national antiretroviral (ARV) program in Nigeria. DESIGN: This was a prospective observational, cohort study on 50 ARV-naive patients who met the inclusion criteria for the program and had given informed consent. All patients were in stage 2 or stage 3 periods of infection based on World Health Organization clinical classification. The patients were treated with the generic brands of ARVs and treatment consisted of oral nevirapine (Nevimal, Cipla, Mumbai, India), 200 mg daily, lamivudine (Lamivir, Cipla), 150 mg twice daily, and stavudine (Stavir, Cipla), 40 mg twice daily. Prior to initiation of treatment, the clinical history and baseline data for each patient were documented. The levels of plasma HIV-1 RNA, CD4 cell counts, frequency of opportunistic infections, and estimated body mass index were recorded at baseline and subsequently at intervals during treatment. Data obtained at the various sampling times for each parameter were compared against their baseline values. RESULTS: Data on the plasma HIV-1 RNA levels indicated that between baseline and week 24, the median viral load of the patients decreased by 1.79 log(10) copies/mL. Equally between baseline and week 48 the median CD4 cell counts increased by 186 x 10(6) cells/L, the frequency of opportunistic infections decreased by 82%, the median body mass index increased by 4.8 kg/m(2), and 36% experienced side effects, which were minor and transient. The most prevalent side effect recorded was skin rash associated with nevirapine. Good adherence to this triple regimen was recorded in >85% of the patients. CONCLUSIONS: The overall results within the 12-month treatment period indicated an effective suppression of viral replication, the reconstitution of the immune system, and improvement of the physical well-being of the study population. Though there may be differences in global distribution of the infecting HIV-1 subtypes, the clinical and biologic results of this study compared favorably to those documented in cohorts treated with branded and generic ARV drugs in some developed and developing countries. The cumulative data in this study further confirmed that the correct use of generic brands of ARVs is a feasible option in HIV care and support programs in resource-poor countries.

Academies and Institutes↗
PubMed2007

A case of Langerhans cell histiocytosis presented with pneumothorax.

Pneumothorax (PTX) is an unusual complication of Langerhans cell histiocytosis (LCH) in childhood. Spontaneous PTX is rare in childhood, and it is very rare in infancy. There are no specific recommendations for the treatment of PTX from LCH described in the literature. We are presenting a 19-month-old boy, who suddenly developed left-sided PTX with infiltrations in both lungs. He presented with PTX and skin lesions. He had a prolonged cardiac arrest, and although resuscitation was successful he required continuing ventilatory support (intermittent positive-pressure ventilation). Because he suddenly developed right-sided PTX and died on the second day of the admission, his LCH diagnosis was made only postmortem. So, he did not receive chemotherapy. It is likely that intermittent positive-pressure ventilation during the operation induced the development of much more multiple lung bullae, which subsequently ruptured, and/or it facilitated the development of the right-sided PTX. The patients with PTX and skin lesions, including babies, most likely have LCH and specific chemotherapy should be started in emergency, even before the final diagnosis is achieved.

Fatal Outcome↗
PubMed2007

Serum leptin levels in patients with childhood immune thrombocytopenic purpura.

Acute immune thrombocytopenic purpura (ITP) induces thrombocytopenia by means of an autoimmune mechanism. Recent studies suggested that T helper immune response is responsible for the pathogenesis of chronic ITP. Despite several studies that were carried out, we do not have a clue as to what triggers the autoimmunity. Leptin is a 16-kd protein secreted from the adipose tissue. Leptin is structurally similar to interleukin (IL)-2, IL-6, and IL-15. The structural similarities between leptin receptor and hematopoietic cytokine receptors suggested that leptin could play a role in hematopoiesis and immune function. Recent studies suggested that leptin could play an important role in autoimmunity. We made a prospective analysis of a series of 39 newly diagnosed acute childhood ITP in a year period. Serum leptin levels were obtained after diagnosis and before treatment and all patients were followed up at least 6 months to designate acute or chronic event. We conclude that in childhood acute ITP, leptin did not play a role in the pathophysiology of the disease. Further investigations are needed to examine what triggers T cells and how the autoimmune disease became.

Acute Disease↗
PubMed2006

An iterated sequence in the genome of Banana bunchy top virus is essential for efficient replication.

Banana bunchy top virus (BBTV) has a multi-component genome of circular, single-stranded DNA. BBTV replicates via a rolling-circle mechanism, probably involving sequence-specific interaction of the replication initiation protein (Rep) with iterated sequences (iterons) within the viral genome. Three putative iterons (designated F1, F2 and R), with the sequence GGGAC, have been identified in the intergenic region of each BBTV component. To investigate their role in replication, each of the iterons was mutated, singularly and in tandem, in a BBTV DNA-N 1.1mer and the ability of these molecules to be replicated by the BBTV 'master' Rep was evaluated in banana cells using transient biolistic assays. All iteron mutants were replicated less efficiently than the native DNA-N. Mutation of the F1 and R iterons caused a 42 and 62 % reduction in DNA-N replication, respectively, whereas mutation of the F2 and combined F1F2 iteron virtually abolished DNA-N replication.

Base Sequence↗
PubMed2005

Applied K fertilizer use efficiency in pineapples grown on a tropical peat soil under residues removal.

In Malaysia, pineapples are grown on peat soils, but most K fertilizer recommendations do not take into account K loss through leaching. The objective of this study was to determine applied K use efficiency under a conventionally recommended fertilization regime in pineapple cultivation with residues removal. Results showed that K recovery from applied K fertilizer in pineapple cultivation on tropical peat soil was low, estimated at 28%. At a depth of 0-10 cm, there was a sharp decrease of soil total K, exchangeable K, and soil solution K days after planting (DAP) for plots with K fertilizer. This decline continued until the end of the study. Soil total, exchangeable, and solution K at the end of the study were generally lower than prior values before the study. There was no significant accumulation of K at depths of 10-25 and 25-45 cm. However, K concentrations throughout the study period were generally lower or equal to their initial status in the soil indicating leaching of the applied K and partly explained the low K recovery. Potassium losses through leaching in pineapple cultivation on tropical peat soils need to be considered in fertilizer recommendations for efficient recovery of applied K.

Agriculture↗