Aim Of Such Treatment Research Articles

Computational modelling of the scoliotic spine: A literature review.

Scoliosis is a deformity of the spine that in severe cases requires surgical treatment. There is still disagreement among clinicians as to what the aim of such treatment is as well as the optimal surgical technique. Numerical models can aid clinical decision‐making by estimating the outcome of a given surgical intervention. This paper provided some background information on the modelling of the healthy spine and a review of the literature on scoliotic spine models, their validation, and their application. An overview of the methods and techniques used to construct scoliotic finite element and multibody models was given as well as the boundary conditions used in the simulations. The current limitations of the models were discussed as well as how such limitations are addressed in non‐scoliotic spine models. Finally, future directions for the numerical modelling of scoliosis were addressed.

Edukacja muzyczna w kształceniu nauczycieli wczesnej edukacji w kontekście systemu reprezentacji Jerome’a Brunera. Jej celowość oraz modyfikacja metodyki nauczania do pracy zdalnej

The article consists of two parts. The first presents the implications for training early childhood music education teachers which arise from the theory of developmental psychology concerning Jerome Bruner’s system of representations. The author strives to point out that their proper understanding appears to be essential to building a good teaching foundation for working with early childhood education students. With reference to the theory in question, the second part of the article discusses a modification of selected methods of conducting music education at the indicated stage of education in relation to the challenges connected with the necessity to work remotely. The author discusses examples of methodology in detail and suggests modifications. The aim of such treatment of the matter is to demonstrate that it is possible to retain the practical nature of educational efforts in spite of the unfavourable conditions that stem from the need to be isolated and work online.

Music Education in Training Early Childhood Education Teachers in the Context of Jerome Bruner’s System of Representations. Its Purpose and Teaching Methodology Modification for Remote Work

The article consists of two parts. The first presents the implications for training early childhood music education teachers which arise from the theory of developmental psychology concerning Jerome Bruner’s system of representations. The author strives to point out that their proper understanding appears to be essential to building a good teaching foundation for working with early childhood education students. With reference to the theory in question, the second part of the article discusses a modification of selected methods of conducting music education at the indicated stage of education in relation to the challenges connected with the necessity to work remotely. The author discusses examples of methodology in detail and suggests modifications. The aim of such treatment of the matter is to demonstrate that it is possible to retain the practical nature of educational efforts in spite of the unfavourable conditions that stem from the need to be isolated and work online.

Oncolytic Newcastle Disease Virus as Cutting Edge between Tumor and Host.

Oncolytic viruses (OVs) replicate selectively in tumor cells and exert anti-tumor cytotoxic activity. Among them, Newcastle Disease Virus (NDV), a bird RNA virus of the paramyxovirus family, appears outstanding. Its anti-tumor effect is based on: (i) oncolytic activity and (ii) immunostimulation. Together these activities facilitate the induction of post-oncolytic adaptive immunity. We will present milestones during the last 60 years of clinical evaluation of this virus. Two main strategies of clinical application were followed using the virus (i) as a virotherapeutic agent, which is applied systemically or (ii) as an immunostimulatory agent combined with tumor cells for vaccination of cancer patients. More recently, a third strategy evolved. It combines the strategies (i) and (ii) and includes also dendritic cells (DCs). The first step involves systemic application of NDV to condition the patient. The second step involves intradermal application of a special DC vaccine pulsed with viral oncolysate. This strategy, called NDV/DC, combines anti-cancer activity (oncolytic virotherapy) and immune-stimulatory properties (oncolytic immunotherapy) with the high potential of DCs (DC therapy) to prime naive T cells. The aim of such treatment is to first prepare the cancer-bearing host for immunocompetence and then to instruct the patient’s immune system with information about tumor-associated antigens (TAAs) of its own tumor together with danger signals derived from virus infection. This multimodal concept should optimize the generation of strong polyclonal T cell reactivity targeted against the patient’s TAAs and lead to the establishment of a long-lasting memory T cell repertoire.

Anal Cancer: Are We Making Progress?

Anal cancer is an uncommon malignancy. There have been some intriguing developments in the past 3 years, in terms of our understanding of the molecular biology and processes that lead to anal cancer. There have also been some notable successes in prevention, imaging and treatment. Nonsurgical treatment is highly effective. The primary aim of such treatment is to achieve loco-regional control with chemoradiation (CRT), and preserve anal function without a colostomy. Randomised phase III trials presented or published over the past 3 years have explored novel strategies of neoadjuvant chemotherapy, maintenance chemotherapy, radiotherapy dose escalation and replacement of mitomycln C (MMC) with cisplatin in CRT. All have failed to improve on the current standard of care; i.e. MMC/ 5 fluorouracil (5FU) chemoradiation. However, more conformal strategies such as intensity modulated radiotherapy (IMRT) appear feasible to deliver with reduced toxicity, and may offer an opportunity to dose-escalate both to gross tumour and areas of potential nodal spread. Preliminary outcome data suggest no loss of efficacy. We evaluate the relevant recent literature published over the past 2 years, and summarize interesting and important new findings, with the aim of bringing the reader up-to-date on anal cancer.

ABO Incompatible Renal Transplantation without Augmented Immunosuppression or Antibody Removal - Report of 10 Cases

Introduction: Many centres now perform renal transplants from live donors into ABO blood group incompatible (ABOi) recipients. Treatment protocols are varied but include some or all of pre-transplant rituximab, splenectomy, IVIG, T-cell depleting antibody induction, and antibody removal. The aim of such treatment is to reduce recipient ABO antibody titres to ‘safe’ levels (typically a titre of 1:8 or less) on the day of transplant. Here we report 10 successful ABOi transplants in patients with a baseline titre of 1:8 or less, none of whom received antibody removal or augmented immunosuppression. Methods: Between 2006 and 2011 20 patients have received an ABOi live donor transplant at our centre. In 10 of these the baseline IgG and IgM ABO antibody titres (measured using DiaMed gel-cards) were consistently 1:8 or less (1:8 for 3 patients, 1:4 for 3 and 1:2 for 4). Five of these patients were blood group O, with two A1, two A2 and one group B donor. The other 5 recipients were group A, with two AB and three B donors. Results: All patients received basiliximab induction followed by tacrolimus, MMF and prednisolone maintenance immunosuppression. All patients had primary graft function. There have been no episodes of either biopsy-proven or clinically determined rejection. 8 patients have stable graft function with a mean serum creatinine (SCr) of 111μmol/L (range 86-140) after 21 months follow up (2-74). One patient required ureteric reimplantation after a period of obstruction, and now has a stable SCr of 198μmol/L at 2 years follow up. The tenth patient has impaired graft function with SCr of 185μmol/L in the setting of very substantial weight gain. Conclusions: ABOi live donor renal transplantation can safely be performed without antibody removal or enhanced immunosuppression in patients with a baseline antibody titre of 1:8 or less. We suggest that ABO antibody titres should be measured in all patients with an ABOi live donor. We also believe that ABO antibody titres may usefully be measured in ABO group O patients on deceased donor waiting lists. ABOi kidneys could be offered to those with low titres, something that may be of particular benefit to HLA sensitized group O patients.

A study to assess changes in myocardial perfusion after treatment with spinal cord stimulation and percutaneous myocardial laser revascularisation; data from a randomised trial

BackgroundSpinal cord stimulation (SCS) and percutaneous myocardial laser revascularisation (PMR) are treatment modalities used to treat refractory angina pectoris, with the major aim of such treatment being the relief of disabling symptoms. This study compared the change in myocardial perfusion following SCS and PMR treatment.MethodsSubjects with Canadian Cardiovascular Society class 3/4 angina and reversible perfusion defects as assessed by single-photon emission computed tomographic myocardial perfusion scintigraphy were randomised to SCS (34) or PMR (34). 28 subjects in each group underwent repeat myocardial perfusion imaging 12 months post intervention. Visual scoring of perfusion images was performed using a 20-segment model and a scale of 0 to 4.ResultsThe mean (standard deviation) baseline summed rest score (SRS) and stress scores (SSS) were 4.6 (5.7) and 13.6 (9.0) in the PMR group and 6.1 (7.4) and 16.8 (11.6) in the SCS group. At 12 months, SRS was 5.5 (6.0) and SSS 15.3 (11.3) in the PMR group and 6.9 (8.2) and 15.1 (10.9) in the SCS group. There was no significant difference between the two treatment groups adjusted for baseline (p = 1.0 for SRS, p = 0.29 for SSS).ConclusionThere was no significant difference in myocardial perfusion one year post treatment with SCS or PMR.

A Review of Catalytic Membrane Layers for Gas/Liquid Reactions

This paper summarises the main ideas of how to use membranes with built-in catalytic function for performing catalysed gas/liquid reactions. Mass transfer effects on catalyst performance and other decisive factors for the design of industrial gas/liquid and gas/liquid/solid reactors are briefly reviewed. Various concepts for applying catalytic membrane layers in multiphase reactors are introduced and the motivation behind their use is explained. What follows is an assessment of the present achievements in using such concepts for gas/liquid reactions. The results available in literature are critically evaluated, focussing mainly on the field of liquid-phase hydrogenations and oxidations, which constitute the major areas where catalytic membranes have been applied to date to gas/liquid systems. The aim of such treatment is to point out the targets, to elaborate on how far the whole field has developed and what challenges remain, rather than to cover a multitude of specific aspects of the many different studies reported in literature.

Existe-t-il des arguments pour instituer un traitement à visée étiologique dès la première poussée de sclérose en plaques ?

The arrival of immunomodulating treatments The pathology of multiple sclerosis (MS) took benefit from progresses of magnetic resonance-based and immunological studies, leading to the introduction of immunomodulatory agents and notably interferon beta (IFNbeta). The therapeutic impact of such treatments in the relapsing-remitting forms of the disease, and our improved knowledge on the natural history of the disease, raise the possibility of treating patients after the first demyelinating episode. This strategy may be more relevant in patients presenting poor prognostic criteria. Magnetic resonance imaging (MRI) data The clinical characteristics of the first episode do not help to predict the mean or long term progression. Magnetic resonance imaging has shown that the progression of the disease is partly infra-clinical. Other than data revealing demyelination involvement and inflammation, MRI has also provided arguments suggesting early axonal distress. In a patient, the presence of high lesion load at onset on weighted T2 sequences, of black holes and gadolinium enhancing lesions s on T1 sequences, or the presence of new lesions on MRI conducted a few Months later are all predictive factors of clinical progression and suggest that treatment should be initiated early. The interest of interferon beta Two clinical trials have shown that treatment with IFNbeta treatment after a first demyelinating event significantly decreased the risk of a second episode in the short term. The aim of such treatment would be to limit the irreversible axonal lesions, notably in the form of axonal sections often associated with inflammatory lesions. An early reduction in the inflammatory response could lead to a lesser number of axons and, consequently, reduced clinical disability.

An Overview of Therapeutic Interventions in Myocardial Infarction

The high risk of subsequent mortality and morbidity following the occurrence of a myocardial infarction (MI) underlies the importance of instituting effective preventive regimens as part of the overall management of these patients. The aim of such treatment is to prolong survival by preventing sudden and non-sudden death and further major cardiovascular events. Currently available data from randomised, controlled clinical trials in MI patients indicate that early treatment with thrombolytic agents [streptokinase, anisolyated plasminogen streptokinase activator complex (APSAC) or recombinant tissue-type plasminogen activator (rt-PA)] in the first few hours after onset of symptoms significantly reduces the short term mortality following MI, with follow-up studies at 1 year indicating that the early benefits persist long term. The optimum time for initiation of thrombolytic therapy is within 6 hours of onset, but treatment started between 7 and 24 hours after onset can also be beneficial. Similarly, there is good evidence that beta-blockers (e.g. propranolol, timolol, metoprolol, atenolol) and aspirin are effective in reducing both the mortality and reinfarction rate following MI. With beta-blockers, a policy of starting treatment early intravenously and continuing orally for 2 to 3 years seems likely to save more lives than either strategy alone; however, contraindications to beta-blockade reduce the number of patients eligible to receive this treatment. In the case of aspirin, the optimum dosage has yet to be determined, but on the basis of present evidence, it seems reasonable to start treatment early with doses of 160 to 325 mg daily and continue for a year or 2 after recovery. Other studies have shown that long term oral anticoagulant therapy is also effective in reducing the mortality and reinfarction rate after MI. Subcutaneous heparin therapy given for 10 days in patients with acute anterior MI reduces the frequency of left ventricular mural thrombosis, while intravenous heparin given for greater than or equal to 4 days improves coronary artery patency rates following administration of a thrombolytic agent. In a comparison with low dose aspirin, intravenous heparin proved more effective in maintaining coronary artery patency rates after rt-PA thrombolysis. There is also evidence that oral nitrates may reduce mortality in MI patients, especially in those with heart failure. However, current data on the use of antiarrhythmic drugs do not support the routine of these drugs following MI. Similarly, with lipid-lowering agents, the evidence that lowering cholesterol is beneficial in reducing mortality after MI is at present inconclusive. Further studies with these groups of drugs are awaited with interest.(ABSTRACT TRUNCATED AT 400 WORDS)

Intra-arterial Radionuclide Infusion as an Aid to Assess Chemotherapy Perfusion Patterns

Regional treatment of advanced head and neck cancer by intra-arterial infusion has been tried for several years. The aim of such treatment is to increase the concentration of the drug in the tumor area while decreasing systemic toxicity. The exact localization of the intra-arterial catheter is thereby the key to effective treatment. This report describes the results of radionuclide imaging as an aid to defining the perfusion pattern in comparison with vital dye injection and contrast angiography. It is concluded that radionuclide infusion imaging is the best method to monitor the localization of the catheter.

The Value of Serum Reactions in Radiotherapy of Cancer

During 1932, there have been published, among others, three papers which, while of special value to the radiologist, are of considerable interest to the general clinician. Webster1 in discussing the X-ray and radium treatment of operable and borderline cases of cancer of the breast, gives his own findings and those of others, which suggest that improved clinical results are obtained by combining radiation with operation, and concludes that greater success should be obtained, were it possible in selected cases to associate pre- and post-operative radiation in the scheme of surgical treatment. Adair2 compares the results of treatment of mammary carcinoma by operation, by radiation, and by a combination of both, and presents evidence that the best results followed the combined form of treatment, emphasis being laid upon the local devitalisation by radiation upon cancer cells, the ultimate aim of such treatment being to render the malignant growth innocuous by a process of reactive connective tissue fibrosis.