Significant Difference In Incidence Rate Research Articles

Long Term Incidence Rate of Glaucoma after Pars Plana Vitrectomy

Purpose: To evaluate the incidence rate of postoperative glaucoma after pars plana vitrectomy (PPV) and to compare incidence rate of glaucoma between phakic and pseudophakic eyes. Methods: Retrospective chart review of patients who underwent PPV between January 2007 and May 2014. The outcome measure was the presence or absence of postoperative glaucoma, defined as definitive loss of neuro-retinal rim defect on fundus exam or showing glaucomatous change on a visual field test that warranted maintenance of ocular hypotensive therapy. Results: There were 333 patients average age 57.09 ± 13.43 included this study. Patients were followed for an average of 56.23 ± 10.85 months. There was no significant difference in mean intra ocular pressure (IOP) between the vitretomized eyes with unoperative eyes, except in mean IOP at one day postoperatively (p = 0.012). In unoperative eyes, 10 of 315 (3.1%) were newly diagnosed as postoperative glaucoma. For the vitrectomized eyes, 69 of the 351 (19.6%) were newly diagnosed as postoperative glaucoma. There was a significant difference in incidence rate of glaucoma between the two groups (p < 0.001, chi-square test). There was a significantly higher IOP in glaucoma eyes compared with normal eyes (p < 0.001, Repeated Measures Analysis of variance [RM-ANOVA]). A possible risk factor for the development of glaucoma after PPV was cataract surgery (p = 0.0497, chi-square test). Conclusions: The incidence of glaucoma in patients with PPV is higher than in normal eyes. The incidence seems to increase particularly in those who have a pesudophakic eye. Patients who underwent PPV, especially in the pseudophakic state, need to have their IOP monitored carefully and managed properly by an ophthalmologist. J Korean Ophthalmol Soc 2016;57(1):80-85

Heritability of Health and Aging Limitations on Personally Desired Activities.

The aim of this study is to estimate heritability of incident limitations on personally desired activities within the eighth decade of life. We measured self-rated ability to perform ten personally desired activities in 1606 male veteran twin pairs at baseline and four years later. At follow-up, 33% of the cohort reported more limitations in desired activities. Among twins who completed both assessments, there were no statistically significant differences in incidence rates of limitations as a function of zygosity. Sensitivity tests showed the same for change scores; and that, if cognitive impairment or death are deemed to belong among limitations of desired activities, zygosity contributed 10% to new limitations at follow-up. Maintaining personally desired activities over four years in the eighth decade is not subject to substantial genetic influence. However, if death and cognitive impairment are added to incident limitations, then genetics plays a modest role. In all cases, unique environment is the predominant influence.

Treatment outcomes of concurrent chemoradiotherapy for locally advanced sinonasal squamous cell carcinoma: A single-institution study

Conclusions: CCRT is a potential treatment option for locally advanced sinonasal SCC in terms of organ preservation. Objectives: Concurrent chemoradiotherapy (CCRT) is increasingly used for patients with advanced head and neck cancer to preserve organ function and improve survival. In the present study, treatment outcomes were compared between surgery and post-operative radiotherapy (PORT) and CCRT in patients with locally advanced sinonasal squamous cell carcinoma (SCC). Methods: The records of 30 patients with non-metastatic stage III and IV sinonasal SCC were retrospectively reviewed. Fifteen patients were treated with CCRT and 15 patients underwent PORT. Results: The locoregional recurrence-free, distant metastasis-free, disease-free, disease-specific, and overall survival rates did not differ between PORT and CCRT groups. In addition, there were no significant differences in incidence rates of acute and chronic toxicities between the two groups.

Comparison of two types of digestive tract reconstruction after total gastrectomy in patients with gastric carcinoma

To evaluate the influence of two different types of digestive tract reconstruction on the life quality, nutritional status and tolerance to adjuvant chemotherapy after total gastrectomy in patients with gastric carcinoma. The clinical data of a total of 107 patients treated in our department from January 2005 to december 2008 were analyzed retrospectively. Among them, 49 patients underwent digestive tract reconstruction with functional jejunal interposition (FJI group) and 58 patients underwent Roux en-Y jejunal P-type anastomosis (PR group) after total gastrectomy. 79 of 107 (73.8%) patients received postoperative adjuvant chemotherapy with XELOX regimen. The digestive complications and tolerance to chemotherapy were assessed respectively. Neither severe complications nor surgery-related or chemotherapy-related death were observed among the 107 patients. There were statistical differences in the incidence rate of emaciation, dumping syndrome and retention syndrome between the FJI and PR groups (P < 0.05), but no significant statistical difference in incidence rate of reflux esophagitis (P > 0.05). 28 of 40 (70.0%) patients in the FJI group completed all six cycles of chemotherapy, while 12 (30.0%) patients interrupted the treatment due to chemotherapy-related toxicity. 39 patients in the PR group received chemotherapy, 19 (48.7%) of them completed 6 cycles of chemotherapy but 20 (51.3%) patients interrupted. There was a significant difference in the incidence rate of grade III/IV chemotherapeutic toxicity and completion rate of chemotherapy (P < 0.05). Both functional jejunal interposition and Roux-Y operation are reasonable and safe procedures of digestive tract reconstruction. The incidence rates of emaciation, dumping syndrome and retention syndrome are lower in the patients with FJI, showing a better tolerance to adjuvant chemotherapy than Roux en-Y jejunal p type anastomosis.

MP3-10 REDUCTION OF ENLARGED PROSTATE DECREASES THE INCIDENCE OF INGUINAL HERNIA

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2015MP3-10 REDUCTION OF ENLARGED PROSTATE DECREASES THE INCIDENCE OF INGUINAL HERNIA Yu-Hua Fan, Hsiao-Jen Chung, Eric Huang, Alex Lin, and Kuang-Kuo Chen Yu-Hua FanYu-Hua Fan More articles by this author , Hsiao-Jen ChungHsiao-Jen Chung More articles by this author , Eric HuangEric Huang More articles by this author , Alex LinAlex Lin More articles by this author , and Kuang-Kuo ChenKuang-Kuo Chen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.113AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients with benign prostatic obstruction may need to strain to void and this effort over time may have a direct impact on the abdominal wall contributing to the development of inguinal hernia (IH). Furthermore, the published data showed that patients with IH present higher intensity of lower urinary tract symptoms. It is interesting to know whether transurethral prostatectomy for benign prostatic hyperplasia (BPH) could reduce the incidence of IH. METHODS We recruited male patients who were newly diagnosed with BPH and aged 50 years or older from a urology dataset including 3,431,366 individuals selected from the National Health Insurance Research Database for the year 2006 to 2010. According to treatment strategies, patients were assigned to one of the following categories: transurethral resection of prostate (TURP), alpha-1 blockers only, 5alpha-reductase inhibitors ± alpha-1 blockers. All subjects were followed up to the end of 2010 or the development of IH. Patients were excluded if they had prostatic cancer, constipation, chronic obstructive pulmonary disease, or IH developed within 6 months of diagnosis of BPH. The age-adjusted cox time-dependent model was used to calculate the risk of IH between different treatment groups. RESULTS We identified 171965 incident male patients with newly diagnosed BPH. Of the BPH patients, 8294 (4.82 %) underwent TURP (TURP group), 151753 (88.25%) received alpha-1 blockers only (AB group), 11918 (6.93%) received 5alpha-reductase inhibitors plus alpha-1 blockers or not (5ARI group). The incidences of IH in different treatment group were as follows: 93 (1.12%) in TURP group, 2334 (1.54%) in AB group, 147 (1.23%) in 5ARI group. Both the incidences of IH in TURP and 5ARI group were significantly lower than that in AB group (both P < 0.001). There was no difference in incidence rates of IH between TURP and 5ARI group. We further subdivided the TURP group into two subgroups according the weight of resected specimens and these were < 15 gm and >=15 gm. There was no difference in incidence rates of IH between the two subgroups of TURP. No matter what the weight of the resected specimens, no significant differences in incidence rates of IH were noted between TURP and 5ARI group. However, both subgroups of TURP group have significantly lower incidence rates of IH than AB group (both P < 0.001). CONCLUSIONS Prostate size-reducing treatments, including TURP and 5ARI, could significantly reduce the incidence of inguinal hernia in BPH patients compared with alpha-1 blockers. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e22 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yu-Hua Fan More articles by this author Hsiao-Jen Chung More articles by this author Eric Huang More articles by this author Alex Lin More articles by this author Kuang-Kuo Chen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Effect of cetuximab chemotherapy on operation resection rate of wild type k-ras gene in liver metastasis of colorectal cancer

Objective To explore the clinical effect and safety of cetuximab plus mFOLFOX6 first- line treatment in k- ras wild type patients with liver metastasis from colorectal cancer. Methods 40 k- ras wild- type colorectal cancer patients with liver metastasis diagnosed by histological detection in our hospital were chosen.20 patients in the observation group were treated with cetuximab plus mFOLFOX6.20 patients in the control group were only given mFOLFOX6. To observe the effect and safety of the two groups. Results RR,operation excision rate and R0 removal rate of observation group(60%,45%,35%)were significantly higher than those of the control group(30%,15%,10%),the differences were statistically significant(χ2= 3.95,4.36,4.28,P 0.05).In the observation group,there were 2 cases with rash,2 cases of leukopenia,1 case with nausea and vomiting,the incidence rate of adverse reaction was 25%(5/20);In the control group,there were 2 cases with leukopenia,1 case with nausea and vomiting,there was no rash and paronychia,the incidence rate of adverse reaction was 15%(3/20),there was no significant difference in incidence rate of adverse reaction between the two groups(P> 0.05). Conclusion Cetuximab combined with FOLFOX6 can improve the performance clinical remission rate and lesion resection rate of k-ras wild type patients with liver metastases from colorectal cancer, and has high safety, which is worthy of clinical application. Key words: Colorectal neoplasms; k-ras gene; Cetuximab

Clinical observation of one-stage resection of left colon cancer with acute obstruction

Objective To explore the effect of surgical management of left colon cancer with acute obstruction. Methods A retrospective analysis was made on the clinical data of 85 cases with acute obstructive colorectal carcinoma treated by one-stage resection. Among the 85 cases, there were 48 cases of left colon obstruction(treatment group), and the control group included 37 cases of right colon cancer. To compare the occurrence of postoperative complications. Results 20 cases had postoperative complication in the treatment group, among which,2 cases had anastomosis fistula,4 cases of pulmonary infection,5 cases of abdominal abscess,6 cases of incision infection and 3 cases of intestinal adhesion. In control group, there were 15 cases had complication, among which,1 case had anastomosis fistula,3 cases of pulmonary infection,3 cases of abdominal abscess,5 cases of incision infection and 3 cases of intestinal adhesion. There was no significant difference in incidence rate of complication between two groups(P> 0.05). Conclusion One stage resection in the treatment of left colon cancer with acute obstruction is safe and feasible. Key words: Colonic neoplasms; Intestinal Obstruction; Anastomosis, Surgical

Comparison of the efficacy of duloxetine and gabapentin in the treatment of diabetic peripheral neuritis

Objective To compare the efficacy and safety of duloxetine and gabapentin in the treatment of diabetic peripheral neuritis .Methods 135 patients with diabetic peripheral neuritis were divided into the observation group（71 cases） and the control group （64 cases） according to random number table method ,and all patients received hypoglycemic therapy based on diabetes treatment principle .Furthermore,the observation group received oral duloxe-tine,while the control group was given oral gabapentin .The pain scores of all patients were evaluated using visual ana-log scale（VAS） and medical outcomes study （SF-36）,and the adverse reactions were recorded during treatment . Results （1） Compared with before treatment ,both VAS scores and SF-36 scores in observation group and control group declined significantly at the end of 1st,2nd,4th week after treatment（all P〈0.05）,while there were no statis-tically significant differences in VAS scores and SF-36 scores between the two groups at the same time point （ all P〉0.05）.（2）The incidence rates of dry mouth ,drowsiness,fatigue and dizziness in observation group were significantly lower than those in control group （18.31% vs.34.38%,4.23% vs.26.56%,0.00% vs.23.44%,0.00% vs. 15.63%,χ2 =4.059,13.308,4.059,4.059,all P〈0.05）,while there were no statistically significant differences in incidence rates of nausea ,diarrhea and flustered between the two groups （all P〈0.05）.Conclusion The duloxetine and gabapentin in the treatment of diabetic peripheral neuritis have similar efficacy , but the duloxetine has better security. Key words: Diabetic neuropathies; Peripheral nervous system diseases ; Duloxetine ; Gabapentin

Incidence of type 1 diabetes mellitus in 0 to 14-yr-old children in Croatia--2004 to 2012 study.

The incidence of type 1 diabetes mellitus (T1DM) among children and adolescents increased during the last 50 yr. The T1DM incidence in Croatia was 8.87/100.000/yr over 1995-2003, with an annual increase of 9%, which placed Croatia among countries with moderate risk for T1DM. To investigate incidence rates and trends of T1DM from 2004 to 2012 in 0 to 14-yr-old Croatian children, and to compare the results with previous studies in Croatia and other European countries. T1DM crude incidence rates are estimated for the entire group and three subgroups: 0-4, 5-9, and 10-14 yr. Standardized incidence is calculated using the method of direct standardization according to World Health Organization (WHO) standard world population. The incidence rates by gender, age groups, seasonality, and calendar year, and their interactions were analyzed using Poisson regression model. A total of 1066 cases were ascertained over 2004-2012. The standardized incidence was 17.23/100.000/yr (95% CI: 16.19-18.26), with no significant differences in incidence rates or trends between boys and girls. Statistically significant annual increase of 5.87% (p < 0.001) was found for the whole group, and for the subgroups 5-9 yr (6.82%; p < 0.001) and 10-14 yr (7.47%; p < 0.001). In the youngest subgroup (0-4 yr), annual increase was lower (2.43%; p = 0338) and not statistically significant. The incidence of childhood T1DM is increasing in Croatia, thus placing Croatia among countries with high risk for T1DM. The annual increment of 5.87% is considerably lower than 9.0% reported earlier, but still higher than the European average (3.9%). The increase in incidence ceased in youngest children.

The Epidemiology of Medial Collateral Ligament Sprains in Young Athletes

Background: A medial collateral ligament (MCL) knee sprain is a prevalent injury in athletic populations that may result in significant time lost to injury. Remarkably little is known of the epidemiology of this injury. Purpose: To define the incidence of MCL tears and to determine the demographic and athletic risk factors. Study Design: Descriptive epidemiological study. Methods: A longitudinal cohort study was performed to examine the epidemiology of isolated MCL sprains at the United States Military Academy (USMA) between 2005 and 2009. Charts and radiographic studies were reviewed by an independent orthopaedic surgeon to identify all new isolated MCL sprains resulting in time lost to sport and activity that occurred within the study period. Incidence rates (IRs) with 95% confidence intervals (CIs) were calculated per 1000 person-years at risk and by sex, sport, and level of competition. The IR per 1000 athlete-exposures (AEs) was also determined. Incidence rate ratios (IRRs) and respective 95% CIs were calculated between male and female students, intercollegiate and intramural athletes, and male and female intercollegiate athletes involved in selected sports. Chi-square and Poisson regression analyses were used to examine the relationship between the variables of interest and the incidence of MCL sprains, with statistical significance set at P < .05. Results: A total of 128 cadets sustained isolated MCL injuries during 17,606 student person-years from 2005 to 2009. This resulted in an IR of approximately 7.3 per 1000 person-years. Of the 128 injuries, 114 were in male athletes (89%) and 14 were in female athletes (11%). Male cadets had a 44% higher IR than did female cadets (7.60 vs 5.36, respectively), although this was not significant (P = .212). Of 5820 at-risk intercollegiate athletes, 59 (53 male, 6 female) sustained an isolated MCL sprain during 528,523 (407,475 male, 121,048 female) AEs for an overall IR of 10.14 per 1000 person-years and 0.11 per 1000 AEs. The IRR of MCL sprains of men compared with women involved in intercollegiate athletics was 2.87 (95% CI, 1.24-8.18) per 1000 person-years and 2.62 (95% CI, 1.13-7.47) per 1000 AEs. Of 21,805 at-risk intramural athletes, with quarterly participation, 16 (all male) sustained isolated MCL injuries during 225,683 AEs for an overall IR of 0.07 per 1000 AEs. The IRs of MCL injuries of intercollegiate and intramural athletes did not differ significantly. In intercollegiate sports, wrestling (0.57), judo (0.36), hockey (0.34), and rugby (men’s, 0.22; women’s, 0.23) had the highest IRs per 1000 AEs. When examining men’s intercollegiate athletics, the IRRs of wrestling (13.41; 95% CI, 1.80-595.27) and hockey (8.12; 95% CI, 0.91-384.16) were significantly higher compared with that of lacrosse. Among women’s intercollegiate sports as well as intramural sports, there were no significant differences in IRs. A median of 16 days was lost to injury, with 2407 total days lost for all injuries. Grade 1 MCL injuries lost a median of 13.5 days, while higher grade injuries lost a median of 29 days. Conclusion: Medial collateral ligament injuries are relatively common in athletic cohorts. The most injurious sports are contact sports such as wrestling, hockey, judo, and rugby. Male athletes are at a greater risk than female athletes. Intercollegiate athletes are at a greater risk than intramural athletes. The average amount of time lost per injury was 23.2 days, with greater time lost with higher grade sprains than grade 1 sprains.

Live attenuated seasonal and pandemic influenza vaccine in school-age children: A randomized controlled trial

BackgroundThe novel influenza A(H1N1pdm09) virus emerged in North America in early 2009 and rapidly spread worldwide. In this study we report the efficacy of the live attenuated monovalent H1N1pdm09 vaccine and 2009–10 seasonal influenza vaccine in a randomized double-blind placebo-controlled trial. MethodsWe enrolled 703 children aged 7–11. Each child was randomly allocated in the ratio 3:2 to receive one dose of live attenuated monovalent H1N1pdm09 vaccine or saline placebo between November 2009 and January 2010, followed after 3–10 weeks by independent random allocation to one dose of live attenuated trivalent 2009–10 seasonal influenza vaccine or saline placebo in the same ratio. Children were followed up through September 2010 with biweekly telephone calls and symptom diaries. Seasonal and pandemic influenza infections were confirmed by virologic testing of nose and throat swabs collected during acute respiratory illnesses. ResultsOverall, 30 children had confirmed influenza including 3 (0.43%) H1N1pdm09, 10 (1.4%) seasonal A(H3N2), and 17 (2.4%) influenza B. There were no significant differences in incidence rates of H1N1pdm09 or A(H3N2) between the four study arms, but receipt of the seasonal influenza vaccine was associated with a significant reduction in risk of influenza B (p<0.01). Vaccine efficacy against confirmed H1N1pdm09 infection associated with receipt of the monovalent H1N1pdm09 vaccine was 65% (95% confidence interval, CI: −281%, 97%). Vaccine efficacies against confirmed seasonal influenza A(H3N2) and B infection associated with receipt of the seasonal influenza vaccine were 31% (95% CI: −138%, 80%) and 96% (95% CI: 67%, 99%) respectively. ConclusionsVaccine efficacy was consistent with other studies of the monovalent H1N1pdm09 vaccine and seasonal influenza vaccines. Our study was underpowered to provide precise estimates of vaccine efficacy due to low incidence of influenza A viruses during the study period.

Investigation of Factors Contributing to Childhood Soft-Tissue Injuries in the Face

Abstract The purpose of this study was to retrospectively investigate the contributing factors in facial soft tissue injuries among children. A record-based analysis was carried out on 126 patients with facial lacerations who visited I hospital in the dept of plastic surgery from April 2010 to May 2011. Through all age group showed a significant difference in incidence rate for male and female.(p<.05). Overall, 49% of injuries occurred outdoors and the most frequent cause of injury was slip-down (42%), followed by being struck (40%). In general, the frequency of injuries peaked summer(30.2%) and increased between 12pm and 4pm. 105 patients (83.3%) arrived at the emergency room within an hour.The forehead(26%) was the most commonly injured area. The depth of soft tissue injuries was mostly subcutaneous(54%), and 1~2cm was the length of injury with the highest incidence(46%). Most children (40%) needed local anesthesia and only 4 children (1.53%) suffered associated fractures. Facial injuries require special attention because of their potential threat in inducing permanent scar or disfigurement. For the safety of children, the preventive measures to reduce facial soft tissue injuries must be improved.

Long‐term effects of daily hemodialysis on vascular access outcomes: A prospective controlled study

Daily hemodialysis has been associated with surrogate markers of improved survival among hemodialysis patients. A potential disadvantage of daily hemodialysis is that frequent vascular access cannulations may affect long-term vascular access patency. The study design was a 4-year, nonrandomized, contemporary control, prospective study of 77 subjects in either 3-h daily hemodialysis (six 3-h dialysis treatments weekly; n = 26) or conventional dialysis (three 4-h dialysis treatments weekly; n = 51). Outcomes of interest were vascular access procedures (fistulagram, thrombectomy and access revision). Total access procedures (fistulagram, thrombectomy and access revision) were 543.2 (95% confidence interval [CI]: 432.9, 673.0) per 1000 person-years in the conventional dialysis group vs. 400.8 (95% CI: 270.2, 572.4) per 1000 person-years in the daily hemodialysis dialysis group (incidence rate ratio = 0.74 with 95% CI: from 0.40 to 1.36, P = 0.33), after adjusting for age, gender, diabetes status, serum phosphorus, hemoglobin level and erythropoietin dose, there was no significant differences in incidence rate of total access procedures (P-value > 0.05). There was no difference in time to first access revision between the daily dialysis and the conventional dialysis groups after adjustment for covariates (hazard ratio = 0.99 95% CI: 0.42, 2.36, P = 0.96). Daily hemodialysis is not associated with increased vascular access complications, or increased vascular access failure rates.

Hiatus in Infant Acute Leukemia Incidence rates in Belarus: Adaptation-to-Low-Dose-Radiation Phenomenon?

Abstract 507The question of whether child acute leukemia (ChAL) incidence has changed as a result of Chernobyl is of great scientific and public interest. Our initial report (Nature, 1993) showed no increase in the incidence rates (IR) of ChAL in Belarus in the whole group of children (0–14 y.o.) 5 years (1986 – 1991) after accident. This data were confirmed in several European countries. As concerns infant’s AL (0–1 y.o.), Petridou et al. reported 2.6 times increase of AL in Greek infants, exposed in utero to Chernobyl radiation. No significant difference in IR was found among children aged 1 – 4 y.o. or older. All epidemiological data concerning separate analysis of infant (0–1 y.o.) ChL was concentrated on the first decade after Chernobyl and no any systematic data is available after 1996. Since 1979 the occurrence of leukemia has been documented accurately through the Registry of Blood diseases. The patients had to be inhabitants of Belarus and were grouped by age at diagnosis. AL diagnostic accuracy was confirmed by the international experts. Rates were standardized directly to the standard world population. We present the age-cohort-period analyses of IR trends of ChAL from 1979 to 2006 in Belarus. It comprised 1077 ChAL cases (0–4 y.o.). Number of cases and equivalent doses of whole body radiation exposure was tabulated by age at diagnosis and period of observation (seven pre-accident years, 1979–1985) and post-accident 7-year periods: 1986–1992, 1993–1999 and 2000–2006.During first 7 years after the accident (1986–1992) the IR of infant AL (0–1 y.o.) increased significantly – from 49 (IR=4.33) before Chernobyl to 67 cases (IR=6.36) in 1986–1992 (RR=1.47; p=0.04). Older age group (1–4 y.o.) did not show any increase in ChAL rates. Following 7-years period (1993–1999) revealed the statistically significant decrease of incidence of infant leukemia: from 49 (IR=4.33) before Chernobyl to 16 cases (IR=2.29) in 1993–1999 years (RR=0.53; p=0.024). Surprisingly, during the next 7 years (2000–2006) we found a further decrease of the incidence of infant leukemia with only 3 cases (IR=0.47) in 7 years. It is highly significant when compared with 49 cases (IR=4.33) before Chernobyl (p= 0.0000053, RR=0.11) and 67 cases (IR=6.36) appeared during first 7 years following Chernobyl accident (p < 0.0000001, RR=0.04). As concerns the older group (1–4 y.o.) we did not find any decrease of IR into the second (1993–1999) and third (2000–2006) 7-year periods.Actually we are working on the next time period (2007–2010) and new upgraded data will be presented.Long-term analysis of incidence of post-Chernobyl childhood acute leukemia permitted to discover the biphasic dynamics of infant's AL incidence rate. Significant increase into the first 7-year period followed by dramatic decrease between year +8 and year + 21. From radiological point of view it is relatively simpler to explain the increase into the first 7 years, because ionizing radiation is one of the few exposures for which the casual relationship with childhood leukemia has been established. Much more difficult to explain following after decrease in incidence rate of infant leukemia in Belarus. Can we speculate about the “adaptation-to-radiation” mechanisms? Over the past decades the growing body of data from cell cultures, experimental animals and humans suggests that low-dose ionizing radiation may have some beneficial (hormetic or adoptive) effect. Several epidemiological studies (India, China, Japan, USA) of a long-term low dose environmental irradiation are in favor of the hypothesis of radiation hormesis or adaptation. The carcinogenic effects of low dose radiation exposure may be restricted to children exposed in utero or in early infancy (0-12 months) during the first years after explosion. Following after dramatic decrease of IRs of infant leukemia might be explained by the developing of adaptive response to chronic low dose ionizing radiation exposure. The presented data may be one of the first clinical evidence concerning human ability of adaptation to long-term low dose radiation. Disclosures:No relevant conflicts of interest to declare.

Ability of Combinations of Cash Flow Components to Predict Financial Distress

The aim of this research is to provide a model that predicts company’s financial distress on the basis of the operational, investment and financing components of its cash flow statement. To prevent bankruptcy and its negative consequences that among them are abuse of creditors, investors, management and employees’ right, the prediction of financial distress and its probable consequence such as bankruptcy is essential. To serve this purpose, for the research 70 reliable firm-years and 70 distressed firm-years within the years 1995 to 2008 were selected from Tehran stock exchange. Considering the information that is reflected in the cash flow statement, the viability of financial distress prediction was examined . The result of chi-square test shows that there is significant difference in incidence rate of financial distress among the companies with different cash flow composition in one, two and three years before distress. In other words, the financial distress can be predicted on the basis of the contents and composition of the cash flow statement.

Epidemiology of injuries among elite pre-professional ballet students

BackgroundDancers destined for a career in professional ballet undergo intensive training from a young age and have a reportedly high risk of injury. The extent of this risk is currently...

Outcomes after incidental durotomy during first-time lumbar discectomy

Incidental durotomy is an infrequent but well-recognized complication during lumbar disc surgery. The effect of a durotomy on long-term outcomes is, however, controversial. The authors sought to examine whether the occurrence of durotomy during surgery impacts long-term clinical outcome. Spine Patient Outcomes Research Trial (SPORT) participants who had a confirmed diagnosis of intervertebral disc herniation and were undergoing standard first-time open discectomy were followed up at 6 weeks and at 3, 6, and 12 months after surgery and annually thereafter at 13 spine clinics in 11 US states. Patient data from this prospectively gathered database were reviewed. As of May 2009, the mean (± SD) duration of follow-up among all of the intervertebral disc herniation patients whose data were analyzed was 41.5 ± 14.5 months (41.4 months in those with no durotomy vs 40.2 months in those with durotomy, p < 0.68). The median duration of follow-up among all of these patients was 47 months (range 1-95 months). A total of 799 patients underwent first-time lumbar discectomy. There was an incidental durotomy in 25 (3.1%) of these cases. There were no significant differences between the durotomy and no-durotomy groups with respect to age, sex, race, body mass index, herniation level or type, or the prevalence of smoking, diabetes, or hypertension. When outcome differences between the groups were analyzed, the durotomy group was found to have significantly increased operative duration, operative blood loss, and length of inpatient stay. However, there were no significant differences in incidence rates for nerve root injury, postoperative mortality, additional surgeries, or SF-36 scores for Bodily Pain or Physical Function, or Oswestry Disability Index scores at 1, 2, 3, or 4 years. Incidental durotomy during first-time lumbar discectomy does not appear to impact long-term outcome in affected patients.

Incidence of piscine parasites on the gills and gastrointestinal tract of clarias gariepinus (teugels) at bagauda fish farm, Kkano

The aim of this work is to investigate piscine parasites of gills and intestinal tract of Clarias gariepinus. Six hundred and forty five (645) specimens of specie were examined fortnightly for a period of one year from November, 2006 to October, 2007. One hundred and fourteen (114) and one hundred and ninety nine (199) were infested fish samples from gills and gastrointestinal tract respectively. Parasites recovered during the survey include two species from gills identified as Ergasilus sarsi ((24.60%) a crustacean (copepod), and one protozoan (myxosporean) named Henneguya sp (11.82%). However, parasites recovered from the GIT composed of four different specie of Cestodes (35.53%) comprising of Anomataenia sp, Bothriocephalus aegypticus, polyonchobothrium polypetri and polychobothrium sp, two species from nematodes (28.13%), with Procaamallinus laevionchus and unidentified specie. All these parasites were located in the intestinal lumen of the specie with the exception of Anomataenia and Procaamallinus species dominating the stomach region only. Females samples had higher incidence rate 235 (75.5%) than males 78 (24.9%), there was no significant difference (P>0.05) in infestation rate. Incidence of infestation among the three sized classes showed adults were mostly infested (69.03%) followed by sub adults (26.82%) with juveniles (4.2%) being the least parasitized. There was significant difference in incidence rate (P<0.05) among the three classes. Analysis of results indicated size influenced the degree of infestation rates in adults’ size. And the sex of host did not influence the incidence of the parasites.

Potentially inappropriate medication use in elderly Japanese patients

Background: Modified Beers criteria for elderly Japanese patients were developed in 2008 by consensus among 9 experts to reflect regional clinical practice and available medications in Japan. Since then, many physicians and pharmacists have expressed interest in obtaining more information about the criteria and alternative drug choices. Objective: This study examined the incidence, health care utilization, and costs associated with potentially inappropriate medications (PIMs) in elderly patients based on the modified Beers criteria. Methods: A retrospective, observational cohort study was conducted using health insurance claims data in Japan. The study population included elderly patients aged ≥65 years who had at least 2 pharmacy claims in separate months over a 1-year period (April 2006 through March 2007). Use of the PIMs was identified using the modified criteria, and 1-year incidence rates were calculated for the total study population and for subgroups stratified by age and sex. A logistic regression model was used to examine demographic and clinical characteristics associated with PIMs. Health care utilization rates and costs were also analyzed and compared between patients with and without PIMs using generalized linear models. All models included dummy variables indicating age category, female sex, hospitalization, polypharmacy, index month, and number of Elixhauser comorbidities to adjust for potential confounders. Results: Among 6628 elderly patients, 71.2% (4721/6628) were female and 62.9% (4167/6628) were aged 65 to 74 years; 43.6% (2889/6628) were prescribed at least one PIM. The most commonly used PIMs were histamine-2 blockers (20.5% [1356/6628]), benzodiazepines (11.4% [756/6628]), and anticholinergics and antihistamines (7.9% [526/6628]). No significant differences in incidence rates were observed based on age or sex. Inpatient service use, polypharmacy, and comorbidities of peptic ulcer, depression, and cardiac arrhythmias were significant predictors of PIM use while controlling for other factors. PIM users had significantly higher hospitalization risk (1.68-fold), more outpatient visit days (1.18-fold), and higher medical costs (33% increase) than did nonusers. Conclusions: In a group of elderly Japanese patients, 43.6% used at least one PIM over a 1-year period in this study. PIM use was associated with greater health care utilization rates and costs.

Adjunctive lithium treatment in the prevention of suicidal behaviour in depressive disorders: a randomised, placebo‐controlled, 1‐year trial

Evidence based on controlled studies is still limited for treatment strategies that prevent recurrence of suicide attempts. Findings from observational as well as meta-analytic studies strongly suggest that lithium may have suicide-protective properties. Patients with a recent suicide attempt in the context of an affective spectrum disorder (n = 167) were treated with either lithium or placebo during a 12-month period. Survival analysis showed no significant difference of suicidal acts between lithium and placebo-treated individuals (adjusted hazard ratio 0.517; 95% CI 0.18-1.43). However, post hoc analysis revealed that all completed suicides had occurred in the placebo group accounting for a significant difference in incidence rates (P = 0.049). Results indicate that lithium treatment might be effective in reducing the risk of completed suicide in adult patients with affective disorders. Our findings contribute to the growing body of evidence suggesting a specific antisuicidal effect of lithium.