Academic literature on the topic 'Consecutive cases'
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Journal articles on the topic "Consecutive cases"
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Obed, S. A., J. B. Wilson, and T. E. Elkins. "Eclampsia: 134 consecutive cases." International Journal of Gynecology & Obstetrics 45, no. 2 (1994): 97–103. http://dx.doi.org/10.1016/0020-7292(94)90115-5.
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Jamal, Adil, Mohammad S. Abomelha, and Ketab El-Otaibi. "Male Infertility: 155 Consecutive Cases." Annals of Saudi Medicine 10, no. 1 (1990): 45–50. http://dx.doi.org/10.5144/0256-4947.1990.45.
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Miao, Y., Z. Xu, Z. Qian, et al. "1010 consecutive cases of pancreaticoduodenectomy." Pancreatology 13, no. 2 (2013): e54-e55. http://dx.doi.org/10.1016/j.pan.2012.12.245.
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Jiang, Kuirong, Zekuan Xu, Zhuyin Qian, et al. "1010 Consecutive cases of pancreaticoduodenectomy." Pancreatology 13, no. 3 (2013): S12—S13. http://dx.doi.org/10.1016/j.pan.2013.04.036.
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Croquelois, Alexandre, and Julien Bogousslavsky. "Stroke Aphasia: 1,500 Consecutive Cases." Cerebrovascular Diseases 31, no. 4 (2011): 392–99. http://dx.doi.org/10.1159/000323217.
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Jory, W. J. "Radial keratotomy: 500 consecutive cases." Eye 3, no. 6 (1989): 663–71. http://dx.doi.org/10.1038/eye.1989.102.
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Wand, Martin, Jacob A. Clark, and David A. Hill. "Nd:YAG Laser Iridectomies: 100 Consecutive Cases." Ophthalmic Surgery, Lasers and Imaging Retina 19, no. 6 (1988): 399–402. http://dx.doi.org/10.3928/1542-8877-19880601-05.
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Fındık, Deniz, Aylin Hasanefendioğlu Bayrak, and Doğan Gönüllü. "Mesenteric Venous Thrombosis: Three Consecutive Cases." Kafkas Journal of Medical Sciences 10, no. 2 (2020): 157–60. http://dx.doi.org/10.5505/kjms.2020.37801.
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Delbridge, Leigh W., Seamus J. Dolan, Tran Thi Hop, Thomas S. Reeve, Bruce G. Robinson, and Margaret R. Wilkinson. "Minimally invasive parathyroidectomy: 50 consecutive cases." Medical Journal of Australia 172, no. 9 (2000): 418–22. http://dx.doi.org/10.5694/j.1326-5377.2000.tb124036.x.
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Asayama, Keiko, Hiroshi Ishikawa, and Hiromasa Tsuda. "Internuclear Ophthalmoplegia: 180 Consecutive Japanese Cases." Neuro-Ophthalmology 32, no. 6 (2008): 289–90. http://dx.doi.org/10.1080/01658100802504259.
Full textDissertations / Theses on the topic "Consecutive cases"
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Hofer, Amanda. "Causes and circumstances of neonatal deaths in 108 consecutive cases over a 10-year period at the children's hospital of Lucerne, Switzerland /." [S.l.] : [s.n.], 2009. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.
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Saager, Cristoph Peter. "Isthmic spondylolisthesis : an analysis of the clinical and radiological presentation in relation to intraoperative findings and surgical results in 72 consecutive cases /." Bern, 1992. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.
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Remolina, Medina Carlos Emilio. "Tratamento cirúrgico das afecções traqueais : análise de 256 casos consecutivos." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2010. http://hdl.handle.net/10183/60812.
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Introdução: Traqueoplastia é o procedimento de eleição para o tratamento definitivo das estenoses, malácia, fistula traqueoesofágica e tumores da via aérea central. Objetivo: Avaliar os resultados do tratamento cirúrgico (traqueoplastia) das afecções traqueais efetuadas em uma instituição em um período de dezenove anos. Métodos: Estudo de coorte histórica com intervenção, fundamentado em dados de prontuário médico hospitalar e de acompanhamento ambulatorial. Resultados: Entre Janeiro de 1990 e Junho de 2009, 256 pacientes foram submetidos à traqueoplastia. Tinham idade media de 42 anos, e 63,0% eram do sexo masculino. As indicações para a cirurgia foram: 64,8% estenose posinflamatoria, 10,2% re-estenoses, 7,4% fístula traqueo-esofágica, 6,3% ressecção de tumor traqueal, 5,5% tratamento de traqueomalacia, e 2,7% trauma traqueal. A principal abordagem foi por cervicotomia, em 95,6% dos casos. Efetuaram-se ressecção subglótica em 49,0% das vezes, anastomose traqueo-traqueal em 41,0%, correção de colapso com reforço (Marlex) 3,9%, enxerto condral (Cotton) 3,5% e sutura primária em 1,5%. Em 29,2% dos casos ocorreram complicações precoces, como deiscência 10,5%, infecção da ferida operatória 9,0%, infecção respiratória 5,9%. A principal complicação tardia foi a re-estenose, com freqüência 14,5%. A presença de diabete mostrou-se significativamente relacionada com complicações pós-operatorias (p = 0,03), e o uso corticosteróides esteve associado com risco para oocorrência de maus resultados nesses doentes (p = 0,01). A mortalidade operatória (30 dias) foi de 2,0%. Conclusões: O manejo cirúrgico das afecções traqueais é tarefa complexa, mas aceitável, com significativa morbi-mortalidade, mas com resultados satisfatórios.<br>Backgraund: Tracheoplasty is the procedure of election for the definitive treatment of stenosis, malacia, tracheoesophagic fistula and upper airway tumors. Objective: To analyze results of the surgical management of tracheal diseases in one single institution during nineteen years. Metods: Historical cohort study, through data collected from hospitalized patient and outpatient records. Results: Between January 1990 and June 2009, 256 patients were undergone to tracheoplasty. The average age was 42 years, and 63.0% were male. The indication for surgery was: 64.8% pos-inflamatory estenosis, 10.2% re-estenosis, 7.4% tracheoesophagic fistula, 6,3% tracheal tumor ressection, 5,5% treatment of tracheomalacy and 2,7% tracheal trauma. The main access was cervicotomy in 95.6%. It was performed subglotic ressection with crico-tracheal or thyroid-tracheal anastomosis in 49.0% of the cases, tracheo-tracheal anastomosis in 41.0%, tracheomalacy surgical treatment with prothesis of polipropileno in 3,9%, cartilage graft (Cotton) in 3,5% and primary suture in 1,5%. Early complications occurred in 29.2% of the times: deiscencia 10.5%, operatory site infection 9.0%, and respiratory infection 5.9%. The principal late complication was re-estenosis, in 14.5% of the cases. Diabetes was associated with postoperative complications (p=0.03), and corticosteroid use was associated to poor results (p=0.01). The surgical mortality (30 days) was 2.0%. Conclusions: The surgical treatment of tracheal diseases is an aceptable complex task, with significant morbid-mortality risk, but with satisfatory results.
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Almeida, Jaime. "Kinematic Evolution of aTranscurrent Fault Propagating Through Consecutive Volcanic Cones:a Case of Rheology and Separation." Thesis, Uppsala universitet, Institutionen för geovetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-303929.
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The main objective of this work is to test the effect of two conical-shaped positive topographic obstacleson propagation of a discrete basement dextral strike-slip or transcurrent fault. A set of sandbox analogue (physical) models was constructed, in which two consecutive sand cones were placed progressivelycloser to each other. Key structural and strain parameters, such axial strain ratios and angular strain, aswell as the width and direction of the basins which formed during deformation were measured and analyzed. This procedure was then repeated with a basal decoupling layer of PDMS beneath each cone,to test the influence of this layer on the deformation.The results show that, for models without a basal decoupling layer, the distance between the two cones governs the end-stage deformation patterns of the topographic obstacles. The proximity of the topographic obstacles causes an increase of their deformation, i.e., results in higher axial strain ratios and angular strain. This effect is particularly noticeable in the first obstacle, which is affected by a strong clockwise rotation. The basal ductile which partly decouples the basement fault from the cover units nullifies the previous effect (the increase in deformation caused by proximity) and, when present, localizes the deformation by not only producing narrower pull-apart basins within the obstacles but alsoby increasing their rotation.<br>O objectivo deste trabalho foi o de estabelecer os efeitos de uma única falha de desligamento direito emdois obstáculos cónicos consecutivos, de relevo positivo. Adicionalmente, procura-se estabelecer o efeito que uma camada basal dúctil poderá ter na deformação dos obstáculos.Como tal, uma série de modelos análogos foram efetuados onde dois cones de areia consecutivosforam colocados sistematicamente mais próximos um do outro. Durante estas experiências, parâmetros chave de natureza estrutural e de strain foram medidos, tais como os rácios de strain axial e angular,bem como a direção e largura das bacias formadas. Este procedimento foi repetido com uma camadabasal de silicone (PDMS) colocada por baixo dos obstáculos. Os resultados mostram que, para modelos sem a camada de silicone basal, a distância de separação dos cones tem uma influência muito forte no produto final da deformação nos cones. A proximidade dos obstáculos causa um aumento da deformação (ex. valores mais elevados de strain angular e strain axial) em ambos os obstáculos. Este efeito é particularmente visível no primeiro obstáculo, sendo este afetado por uma rotação no sentido dos ponteiros do relógio mais elevada que o segundo.Por fim, verifica-se que a presença da camada basal dúctil nulifica o efeito anterior e, quando presente, focaliza a deformação, não só criando bacias de pull-apart mais estreitas mas tambémcausando uma maior rotação nos obstáculos.
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Esposito, Papa Francesca <1993>. "Ruolo, compito e strategie dell’interprete consecutivo. Il case study della conferenza di Su Tong all’Università Ca’ Foscari." Master's Degree Thesis, Università Ca' Foscari Venezia, 2019. http://hdl.handle.net/10579/16204.
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L'argomento di questa tesi è un caso di studio in interpretazione consecutiva (CI). L’obiettivo principale è l'analisi dei problemi e delle strategie emerse durante un processo di interpretazione dal cinese all’italiano. Al fine di dimostrare il ruolo e l'importanza dell'interprete, questa tesi è stata suddivisa in tre capitoli.
Il primo capitolo descrive le origini dell'interpretazione, la sua evoluzione nel corso della storia e la sua classificazione secondo le diverse tipologie e i contesti d'utilizzo. Oggetto principale è l’interpretazione consecutiva (IC) in tutte le sue fasi: ascolto e comprensione del messaggio, memoria, presa di appunti e riformulazione dello stesso messaggio nella lingua d’arrivo. Notevole attenzione è stata dedicata alle nuove forme d’interpretazione. Il capitolo si conclude con un breve excursus riguardo gli Interpreting Studies e l’Interpreting Research.
Il secondo capitolo si concentra sulla professione dell’interprete. Si affronta il tema della conferenza come evento comunicativo e il ruolo che l’interprete assume al suo interno. Viene affrontata la disciplina del public speaking, in quanto gli interpreti devono essere in grado di esprimersi in modo chiaro e con una velocità adeguata; devono essere pronti, sicuri di sé e, cosa non meno importante, devono mantenere un buon contatto visivo con il pubblico.
Il terzo capitolo, infine, si addentra nell’analisi vera e propria del ruolo dell’interprete e di tutte le strategie che egli mette in pratica durante un’interpretazione consecutiva. Per dimostrare ciò, ci si è serviti della conferenza tenutasi a Ca’ Foscari in occasione della visita dello scrittore Su Tong. L’analisi si divide in due parti: nella prima parte viene analizzata la figura dell’interprete in campo lavorativo; la seconda parte, invece, analizza tutte le tecniche che l’interprete utilizza. Segue, infine, un commento ai dati emersi dall’analisi.
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Lima, Breno José Santiago Bezerra de. "Anestesia para aneurismectomia de aorta abdominal infra-renal: experiência com 104 casos consecutivos no HCFMRP-USP." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/17/17142/tde-09062011-155916/.
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Introdução. A morbi-mortalidade durante e após anestesia para aneurismectomia de aorta abdominal é alta, pois esta doença acomete pacientes após a sétima década de vida e que possuem várias doenças concomitantes. Objetivos. Analisar e discutir as condutas anestésicas utilizadas nos períodos pré e intra-operatório no Serviço de Anestesiologia do HCFMRP-USP. Casuística e Método. Foram analisados os prontuários de 104 pacientes submetidos à aneurismectomia de aorta no tocante às condutas utilizadas pelos anestesiologistas para a condução destes casos. Resultados. Apenas um paciente possuía menos de 40 anos de idade, 76,80% estavam na sétima ou oitava década de vida e 88,46% eram do sexo masculino. A hipertensão arterial acometeu 70,19% dos pacientes e 26,92% possuíam coronariopatia. Pacientes com obesidade foram a minoria (26,92%). O ecocardiograma pré-operatório demonstrou que a grande maioria dos pacientes apresentava função ventricular normal. A cirurgia foi realizada em regime de urgência em 7,69% dos casos. A anestesia geral exclusiva foi realizada em 17 pacientes e associada com a peridural em 57 pacientes, com a raquianestesia em 11 e com a raqui-peri combinadas em 19. O tempo cirúrgico variou de 120 a 510 minutos enquanto que o tempo de clampeamento aórtico variou de 30 a 165 minutos. Houve um óbito no período intra-operatório e a causa foi choque hipovolêmico e 10 óbitos até o vigésimo dia pós-operatório. Sessenta e seis pacientes receberam concentrado de papa de hemácias durante o período intra-operatório, mas só em 43,27% desses casos a indicação esteve suportada por exame laboratorial. Oitenta pacientes foram extubados ainda na sala de cirurgia, enquanto que os demais (23) permaneceram intubados no período pós-operatório e 19 necessitaram de suporte ventilatório que teve tempo que variou de 3 a 96 horas com média de 42,31 horas. Apenas quatro pacientes fizeram pós-operatório imediato no Centro de Terapia Intensiva enquanto que os demais permaneceram na Sala de Recuperação Pós-Anestésica. Conclusão. Não existe um protocolo único para a realização de anestesia para aneurismectomia de aorta no HCFMRP-USP e a técnica anestésica utilizada não influenciou o morbi-mortalidade.<br>Introduction. The morbidity and mortality during and after anesthesia for aneurysmectomy of the abdominal aorta are high since this disease affects patients after the seventh decade of life who have several concomitant diseases. Objectives. To analyze and discuss the anesthetic conducts used during the preoperative and intra-operative periods at the Service of Anesthesiology of HCFMRP-USP. Cases and Method. The medical records of 104 patients submitted to aneurysmectomy of the aorta were analyzed regarding the conducts used by the anesthesiologists for the management of these cases. Results. Only one patient was less than 40 years old, 76.80% were in he seventh or eighth decade of life, and 88.46% were male. Arterial hypertension was present in 70.19% of the patients and 26.92% had coronary artery disease. Obese patients were a minority (26.92%). The preoperative echocardiogram demonstrated that most patients had normal ventricular function. Surgery was performed on an emergency basis in 7.69% of cases. Seventeen patients received exclusive general anesthesia, while general anesthesia was associated with peridural anesthesia in 57, with rachi-anesthesia in 11 and with combined rachi-peridural anesthesia in 19. Surgical time ranged from 120 to 510 minutes and time of aortic clamping ranged from 30 to 165 minutes. One death occurred intra-operatively due to hypovolemic shock and 10 patients died up to the 20th postoperative day. Sixty-six patients received a red blood cell concentrate intra-operatively, but this indication was supported by a laboratory exam in only 43.27% of these cases. Eighty patients were extubated while still in the operating room while the remaining 23 continued to be intubated during the postoperative period and 19 required ventilatory support lasting 3 to 96 hours (mean duration: 42.31 hours). Only four patients spent the immediate postoperative period in the Intensive Care Unit, while the remaining ones stayed in the Post-Anesthesia Recovery Room. Conclusion. There is no single protocol for the application of anesthesia for aneurysmectomy of the aorta at HCFMRP-USP and the anesthetic technique used did not influence morbidity-mortality.
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Guzer, Osman Cenk. "Greek Foreign Policy : The Case Study of Greco-Turkish Relations under the two consecutive Kostas Simitis Premierships (1996-2000) and (2000-2004)." Thesis, Linköping University, Department of Management and Economics, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-4555.
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<p>The relations between Greece and Turkey have developed at an unprecedented level in recent years. Behind this development lay certain factors notably the Simitis Governments’ strategy of redefining the parameters of Greek national interests in foreign policy and the Turkish Governments’ subsequent positive responses to this favorable atmosphere. It is thus possible to use the term ‘détente’ to refer to the period which dates back to 1996, the rise of Simitis to the Greek premiership. Some observers on Greco-Turkish Relations tend to trace the origins of Greco-Turkish détente to the devastating 17 August earthquake in Turkey. Some others try to find the origin of détente in the 1999 Helsinki Summit where Turkey was offered the candidacy status for the EU membership. This thesis proposes an alternative approach by defending the view that the rise of Simitis to the prime ministry itself heralded the chain of events which would later pave the road to the relaxation of Greco-Turkish Relations.</p><p>This thesis is a modest attempt to understand the anatomy of Simitis Leadership and its reflections on Greco-Turkish Relations. On the basis of certain turning points in a chronological fashion, it will uncover the background of an eight-year ruling term with its ups and downs. There is an irony in Greco-Turkish Relations: Outbreak of crises between the two neighbors led both the Greek and the Turkish political actors to re-examine their attitude in the following phase of their relationship. In the Simitis Era, the tensions created opportunities for building up networks of cooperation initiatives to a certain extent. I also argue here that spillover logic in Greco-Turkish Relations has started working- albeit cautiously- and that this spirit could be sustainable if managed by both sides wisely. Continuation of the Greco-Turkish détente even after the governmental change in Athens in April 2004 demonstrates that the Simitis Leadership has determined a new framework for Greco- Turkish Relations. This framework has been set through pushing Turkey to the future EU membership orientation and setting mechanisms of reward/punishment (or carrot/stick) policy on Turkey’s route to Brussels through the EU.</p>
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Arumí, Ribas Marta. "Incidència d'una acció pedagògica dirigida a l'autoregulació. Dos estudis de cas a l'aula d'iniciació a l'aprenentatge de la interpretació consecutiva." Doctoral thesis, Universitat Pompeu Fabra, 2006. http://hdl.handle.net/10803/7583.
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L´objectiu d´aquesta tesi és analitzar com s´integra una acció pedagògica a l'aula d'interpretació consecutiva. Aquesta acció pedagògica es basa en un enfocament socioconstructivista i pretén fomentar els processos autoreguladors en l´aprenentatge. Es concreta en la incorporació d'una bateria de pautes metacognitives dissenyades específicament per a desenvolupar les habilitats que requereix l'aprenentatge de la interpretació consecutiva. El nostre centre d´interès és l'estudi del pas de l´heteroregulació a l´autoregulació mitjançant la incorporació de les pautes metacognitives, enteses com a instruments de mediació. <br/>Conceptualment, la recerca pren com a principals referents teòrics l'autonomia de l'aprenent i la relació d´aquest àmbit amb la teoria sociocultural i amb els processos d'autoregulació. Pel que fa a la metodologia, seguim els pressupòsits de la recerca etnogràfica i els de l'aproximació ecològica de la recerca. <br/>Un dels reptes importants d'aquest tipus de recerca és el de trobar un model d'anàlisi que serveixi de base per a l'estudi de les dades resultants de la reflexió metacognitiva. Per fer-ho, ens hem aproximat a l´anàlisi del discurs. Un cop segmentades les dades, per a l'anàlisi interpretativa hem tingut en compte, entre altres, els aspectes següents: <br/>a) la relació que s'estableix entre els enunciats a través dels marcadors i els connectors del discurs <br/>b) la localització temporal<br/>c) la modalització i la polifonia de veus en el discurs. <br/>Entre els resultats obtinguts, destaca que els instruments ´diari de l´aprenent- i ´pauta metacognitiva- esdevenen formes vàlides per a verbalitzar la reflexió metacognitiva. I també que l´autoregulació de l'aprenentatge es desenvolupa en un procés de reflexió, cíclic i dinàmic. En aquest procés es fan evidents diversos graus o nivells. Identificar-los ajuda a integrar i a treballar el component metacognitiu a l´aula. I ha de permetre elaborar un programa d´aprendre a aprendre enfocat a l'ensenyament de la interpretació consecutiva. Un programa que respecti els microprocessos relacionats amb els nivells de consciència identificats i que, a la vegada, esdevingui útil per a propòsits didàctics.<br>El objetivo de esta tesis es analizar cómo se integra en el aula de interpretación consecutiva una acción pedagógica basada en un enfoque socioconstructivista y que pretende fomentar los procesos autoreguladores en el aprendizaje. Esa acción se concreta en la incorporación de una batería de pautas metacognitivas diseñadas específicamente para desarrollar las habilidades que requiere el aprendizaje de la interpretación consecutiva. Nuestro interés se centra en el paso de la heteroregulación a la autorregulación mediante la citada incorporación de pautas metacognitivas entendidas como instrumentos de mediación. <br/>Conceptualmente, la investigación adopta como principales referentes teóricos la autonomía del aprendiz en su relación con la teoría sociocultural y con los procesos de autorregulación. En cuanto a la metodología, seguimos los presupuestos de la investigación etnográfica y los de la aproximación ecológica a la investigación. <br/>Uno de los retos fundamentales de ese tipo de investigación consiste en hallar un modelo de análisis que sirva de base para el estudio que permita estudiar los datos resultantes de la reflexión metacognitiva. A tal fin partimos del análisis del discurso, procediendo de modo que, una vez segmentados los datos, se lleva a cabo una interpretación de los mismos definida según los siguientes criterios:<br/>a) la relación que se establece entre los enunciados recurriendo a los marcadores y conectores discursivos<br/>b) la localización temporal<br/>c) la modalización y la polifonía de voces en el discurso.<br/>Entre los resultados más destacados del presente trabajo cabe citar, por una parte, que los instrumentos 'diario del aprendiz' y 'pauta metacognitiva' resultan fórmulas válidas para verbalizar la reflexión metacognitiva. Por otra parte, hay que referirse al hecho de que la autorregulación del aprendizaje se desarrolla en un proceso de reflexión cíclico y dinámico en el que se dan distintos grados o niveles, la identificación de los cuales permite integrar y trabajar el componente metacognitivo en el aula. Ello, por su parte, debe posibilitar la elaboración de un programa de ´aprender a aprender- aplicado a la didáctica de la interpretación consecutiva y que se ajuste a los microprocesos relacionados con los niveles de conciencia metacognitiva identificados.<br>The purpose of this research is to analyse how a teaching action is integrated into the consecutive interpreting classroom. This teaching action is based on a socio-constructivist approach and attempts to encourage self-regulation processes in learning. The action takes the form of a battery of metacognitive guides designed specifically for developing the skills required for learning consecutive interpreting.<br/>Our focus of interest is the study of the move from hetero-regulation to self-regulation through the incorporation of instruments of mediation - the metacognitive guides - designed to develop the skills required for learning consecutive interpreting. <br/>Conceptually, the research takes as its main theoretical references learner autonomy and the relationship of this field with socio-cultural theory and the processes of self-regulation. As for methodology, we follow the criteria of ethnographic and ecologial approach to research. <br/>One of the important challenges of this kind of research is finding a model of analysis that serves as a basis for studying the data resulting from metacognitive reflection. To do this, we have used a discourse analysis approach. Once the data has been segmented, for the interpretive analysis we have taken into account the following aspects, among others: <br/>a) the relationship between the sentences through the markers and connectors; <br/>b) the location in time; <br/>c) the modalization and the polyphony of voices in the speech. <br/>Among the main results obtained, the mediation instruments, ´learner´s diary- and ´metacognitive guide-, prove to be valid forms for verbalizing metacognitive reflection. Also, that self-regulation of learning is developed in a cyclical and dynamic reflection process. In this process, different degrees or levels become clear. Identifying them helps to integrate and work with the metacognitive element in the classroom. And it should make it possible to draw up a learning-to-learn program focused on teaching consecutive interpreting: a program that respects the micro-processes related to the levels of consciousness identified and which, at the same time, should prove useful for teaching purposes.
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Gracia, Alegria Isidro Angel. "Estudio observacional, descriptivo y retrospectivo de una cohorte de 102 casos consecutivos de sarcoma sinovial tratados en la Unidad de Cirugía Ortopédica Oncológica del Servicio de Cirugía Ortopédica y Traumatología del Hospital de Sant Pau entre los años 1983 y 2016 (35 años)." Doctoral thesis, Universitat Autònoma de Barcelona, 2021. http://hdl.handle.net/10803/672581.
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Introducció
La història del sarcoma sinovial, com per la majoria dels tumors malignes de parts toves, és complexa: conceptes, terminologia, criteris i eines han canviat radicalment el diagnòstic al llarg del temps. El problema es encara més gran si tenim en compte la baixa freqüència de tumors musculoesquelètics.
El Servei de Cirurgia Ortopèdica i Traumatologia (COT) de l’Hospital de la Santa Creu i Sant Pau de Barcelona disposa d’una Unitat de Cirurgia Ortopèdica oncològica especialitzada en el diagnòstic i tractament de tumors musculoesquelètics funcionant des del punt de vista científic i assistencial des de l’any 1985.
Justificació Científica
Per tal de fer un estudi en aquesta etiologia de baixa freqüència com son els tumors musculoesquelètics, hem escollit el sarcoma sinovial com un dels subtipus de sarcoma de parts toves més representatiu i relativament freqüent per assolir la necessitat d’aconseguir estudiar una sèrie de casos suficients i durant un període de temps llarg per fer un anàlisi en profunditat i amb resultats reproduïbles. L’objectiu de l’estudi seria l’anàlisi retrospectiva (estudi observacional i descriptiu) dels casos de sarcoma sinovial registrats a la unitat de 1983 a 2016 (35 anys) i observar els avenços en el diagnòstic i el tractament en termes de disminució de la recurrència local i la millora de la supervivència global.
Disseny del estudi
Estudi observacional, descriptiu i retrospectiu d’una cohort de 102 casos consecutius de sarcoma sinovial tractats a la Unitat de Cirurgia Ortopèdica Oncològica del Servei de Cirurgia Ortopèdica i Traumatologia de l’Hospital de la Santa Creu i Sant Pau entre 1983 i 2016 (35 anys).
La mida global de la mostra serà de 102 casos de sarcoma sinovial diagnosticat i tractat per la Unitat considerant un nombre i potència suficient de casos per l’anàlisi.
Per al correcte tractament de les dades d’aquesta tesi, es realitzen les anàlisis estadístiques següents:
1.- Un estudi descriptiu en el qual incloem les variables contínues com a mitges i desviacions típiques, i les variables qualitatives com a freqüències i percentatges.
2.- Per als contrastos d’hipòtesi, després de confirmar la normalitat de la distribucions en variables numèriques utilitzant el Kolmogorov- Smirnoff, utilitzem test paramètrics ANOVA y T-Student. Per a les variables qualitatives utilitzem la prova de Pearson Chi-square, o la prova exacta de Fisher.
ClinicalTrials.gov sistema de registre i resultats de protocols (PRS) Data de llançament de recepció: 6 de febrer de 2019 ClinicalTrials.gov ID: NCT03833037
Resultats
Finalment, no hi ha diferències estadísticament significatives en la supervivència global i lliure de malalties d’ambdós grups: sarcomes sinovials diagnosticats i tractats en el període 1983-1999 i sarcomes sinovials diagnosticats i tractats en el període 2000-2016 (més recent).
Per tant, podem inferir que si s’ha millorat en la tècnica diagnòstica (per la millora de la ressonància magnètica i la inclusió de PET-TC), en la tècnica quirúrgica (inclosa la biòpsia) i en la reconstrucció quirúrgica, fets que es reflecteixen en una disminució de la taxa de recurrència local. No obstant això, els factors estudiats pel que fa a l’estudi anatomopatològic i els tractaments complementaris de quimioteràpia no reflecteixen la millora en la taxa de disseminació a distància i, per tant, no hi ha millora en la supervivència global i lliure de malaltia.
Conclusions
D’aquesta manera, per tant, en els pacients de l’estudi observacional s’evidencia que es demostra la hipòtesi H0 del treball de tesi:
“H0: En aquest estudi observacional i descriptiu sobre una sèrie històrica de 102 casos de sarcoma sinovial tractats per la mateixa unitat quirúrgica (Unitat de Cirurgia Oncològica Ortopèdica) entre 1983 i 2016 no mostra una millora en els resultats en condicions de supervivència lliures de malalties i supervivència global”.<br>Introducción
La historia del sarcoma sinovial, en cuanto a la mayoría de los tumores malignos de partes blandas (sarcomas), es compleja: conceptos, terminología, criterios y herramientas han cambiado radicalmente el diagnóstico con el tiempo. El problema es aún mayor si tenemos en cuenta la baja frecuencia de tumores musculoesqueléticos.
El Servicio de Cirugía Ortopédica y Traumatología (COT) del Hospital de la Santa Creu i Sant Pau de Barcelona cuenta con una Unidad de Cirugía Ortopédica Oncológica especializada en el diagnóstico y tratamiento de tumores musculoesqueléticos, que funciona desde el punto de vista científico y sanitario desde 1985.
Justificación científica
Para llevar a cabo un estudio en esta etiología de baja frecuencia como los tumores musculoesqueléticos malignos, hemos elegido el sarcoma sinovial como uno de los subtipos más representativos y relativamente comunes del sarcoma de partes blandas para conseguir cubrir la necesidad de estudiar una serie de casos suficientes y durante un largo período de tiempo para llevar a cabo un análisis en profundidad con resultados reproducibles. El objetivo del estudio sería el análisis retrospectivo (estudio observacional y descriptivo) de los casos de sarcoma sinovial registrados en la unidad de 1983 a 2016 (35 años) y observar los avances en el diagnóstico y tratamiento en términos de disminución de la recurrencia local y mejoría en la supervivencia global.
Diseño de estudio
Estudio observacional, descriptivo y retrospectivo de una cohorte de 102 casos consecutivos de sarcoma sinovial tratados en la Unidad de Cirugía Ortopédica oncológica del Departamento de Cirugía Ortopédica y Traumatología del Hospital de la Santa Creu i Sant Pau entre 1983 y 2016 (35 años). El tamaño total de la muestra será de 102 casos de sarcoma sinovial diagnosticado y tratado por la Unidad teniendo en cuenta un número y potencia suficiente de casos para el análisis.
Para el tratamiento correcto de los datos de esta tesis, realizamos los siguientes análisis estadísticos:
1.- Un estudio descriptivo en el que se incluyen variables continúas como medias y desviaciones típicas, y cualitativas como frecuencias y porcentajes.
2.- Para los contrastes de hipótesis, tras confirmar la normalidad de las distribuciones en variables numéricas utilizando Kolmogorov-Smirnoff, se prueban test paramétricos ANOVA y T-Student. Para las variables cualitativas usamos la prueba de Pearson Chi-cuadrado o la prueba exacta de Fisher.
ClinicalTrials.gov sistema de registro y resultados de protocolo (PRS) Fecha de lanzamiento recibida: 6 de febrero de 2019 ClinicalTrials.gov ID: NCT03833037
Resultados
Por último, no existen diferencias estadísticamente significativas en la supervivencia global y libre de enfermedades de ambos grupos: sarcomas sinoviales diagnosticados y tratados en el período 1983-1999 y sarcomas sinoviales diagnosticados y tratados en el período 2000-2016 (más recientemente).
Por lo tanto, podemos inferir que si se ha mejorado en la técnica diagnóstica (mejorando la RMN e incluyendo PET-CT), en la técnica quirúrgica (incluida la biopsia) y en la reconstrucción quirúrgica, hechos que se reflejan en una disminución en la tasa de recurrencia local. Sin embargo, los factores estudiados con respecto al estudio anatomopatológico y los tratamientos de quimioterapia complementarios no reflejan la mejora en la tasa de diseminación a distancia y, por lo tanto, no hay mejoría en la supervivencia global y libre de enfermedad.
Conclusiones
De esta manera, por lo tanto, en los pacientes del estudio observacional se evidencia que se demuestra la hipótesis H0 del trabajo de tesis:
“H0: En este estudio observacional y descriptivo sobre una serie histórica de 102 casos de sarcoma sinovial tratados por la misma unidad quirúrgica (Unidad de Cirugía Oncológica Ortopédica) entre 1983 y 2016 no muestra una mejora en los resultados en condiciones de supervivencia libres de enfermedad y supervivencia global.”<br>Introduction
The history of synovial sarcoma, in regard to most oncologic musculoskeletal malignancies (sarcomas), is complex: concepts, terminology, criteria, and tools have radically changed diagnosis over time. The problem is even greater when the low frequency of musculoskeletal tumors is taken into account.
The Department of Orthopaedic Surgery and Traumatology (COT) of the Hospital de la Santa Creu i Sant Pau in Barcelona has a Unit of Oncological Orthopedic Surgery specialized in the diagnosis and treatment of musculoskeletal tumors, which has been operating from a scientific and health point of view since 1985.
Scientific justification
To conduct a study in this low-frequency etiology such as musculoskeletal tumors, we have chosen synovial sarcoma as one of the most representative and relatively common subtypes of soft tissue sarcoma to achieve the need to study sufficient cases over a long period of time to conduct an in-depth analysis with reproducible results. The objective of the study would be retrospective analysis (observational and descriptive study) of synovial sarcoma cases recorded in the unit from1983 to 2016 (35 years) and to observe advances in diagnosis and treatment in terms of decreased local recurrence and improved overall survival.
Studio design
Observational, descriptive, and retrospective study of a cohort of 102 consecutive cases of synovial sarcoma treated in the Oncology Orthopedic Surgery Unit of the Department of Orthopaedic Surgery and Traumatology of St. Pau’s Hospital between 1983 and 2016 (35 years).
The total sample size will be 102 cases of synovial sarcoma diagnosed and treated by the Unit, taking into account enough cases for a sufficiently powered analysis.
For the correct processing of the data in this thesis, we carry out the following statistical analyses:
1.- A descriptive study in which continuous variables such as averages and typical deviations, and qualitative such as frequencies and percentages are included.
2.- For hypothesis contrasts, after confirming the normality of distributions in numerical variables using Kolmogorov-Smirnoff, parametric ANOVA and T-Student for quliatitive variables we use the Pearson Chi-square test or Fisher’s exact test.
ClinicalTrials.gov Protocol Registration and Results System (PRS) Release Date Received: February 6, 2019 ClinicalTrials.gov ID: NCT03833037
Results
Finally, there are no statistically significant differences in overall and disease-free survival of both groups: synovial sarcomas diagnosed and treated in the period 1983-1999 and synovial sarcomas diagnosed and treated in the period 2000-2016 (more recently).
Therefore, we can infer that the diagnostic technique (improving MRI and including PET-CT), surgical technique (including biopsy) and surgical reconstruction have been improved, facts that are reflected in a decrease in the rate of local recurrence. However, the factors studied with respect to anatomopathological study and complementary chemotherapy treatments do not reflect the improvement in the rate of remote dissemination and, therefore, there is no improvement in overall and disease-free survival.
Conclusions
In this way, therefore, in the patients of the observational study it is clear that the H0 hypothesis of this thesis is shown:
“H0: In this observational and descriptive study on a historical series of 102 cases of synovial sarcoma treated by the same surgical unit (Orthopedic Oncological Surgery Unit) between 1983 and 2016 shows no improvement in results under disease-free survival conditions and overall survival.”<br>Universitat Autònoma de Barcelona. Programa de Doctorat en Cirurgia i Ciències Morfològiques
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Pai, Huei-Ling, and 白惠齡. "A Quantitative Study on Discourse Analysis to Consecutive Interpretation Learning－A Case Study." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/3gw7fg.
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碩士<br>長榮大學<br>翻譯研究所<br>96<br>The process of consecutive interpretation includes to hearing, comprehending and analyzing, note-taking, organizing and interpreting. To handle these tasks within a short time seems too demanding for beginner students. Their unbalanced effort allocation during the process often makes CI a difficult task for them to accomplish. This study aims to discuss the efficacy of three methods in discourse analysis applied in CI course. Eleven first-year graduate students in the Department of Translation and Interpretation Studies were asked to take the pre-test and post-test before and after the discourse analysis of five informative speeches, including context analysis, situational analysis, and cultural analysis. Students were also requested to complete a questionnaire and an in-depth interview.
According to the research results, it can be concluded that the three methods in discourse analysis applied had positive influence on their performances. Content analysis helped students with anticipation and organization of their sentences. Situational analysis assisted them in grasping the tone and style of the speaker while cultural analysis helped them in understanding and getting familiar with cultural differences. Furthermore, the subjects agreed that background knowledge was an essential element for them to understand the speeches. Thus, it is suggested that the effective application of discourse analysis to consecutive interpretation along with proper background knowledge training can help beginning learners of interpretation to perform better and feel less stressed.
Books on the topic "Consecutive cases"
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Martini, Mareike. Deutsch-kubanische Arbeitsbesprechungen: Eine gesprächsanalytische Studie zu gedolmetschter Kommunikation in internationalen Hochschulkooperationen. Stauffenburg, 2008.
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Kirk, Esben, and Sven Ancher Kvorning. Hypometabolism: A Clinical Study of 308 Consecutive Cases. Elsevier Science & Technology Books, 2013.
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Pathology of Nephritis As Illustrated by Thirty-Two Consecutive Cases. Creative Media Partners, LLC, 2023.
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Anderson, McCall. On the Treatment of Diseases of the Skin: With an Analysis of Eleven Thousand Consecutive Cases. HardPress, 2020.
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Anderson, McCall 1836-1908, and Royal College of Physicians of Edinburgh. On the Treatment of Diseases of the Skin: With an Analysis of Eleven Thousand Consecutive Cases. Creative Media Partners, LLC, 2021.
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Hardpress. Affections of the Throat and Larynx, the Classification, Description, and Statistics of 150 Consecutive Cases Occurring in the Throat Department of St. Mary's Hospital. HardPress, 2020.
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Joel E. (Joel Ernest) B. Goldthwait. Treatment of Lateral Curvature of the Spine: With Appendix Giving an Analysis of 1000 Consecutive Cases Treated by Posture and Exercise Exclusively, Without Mechanical Supports. Creative Media Partners, LLC, 2023.
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Joel E. (Joel Ernest) B. 18 Goldthwait and Roth Bernard. Treatment of Lateral Curvature of the Spine: With Appendix Giving an Analysis of 1000 Consecutive Cases Treated by Posture and Exercise Exclusively, Without Mechanical Supports. Creative Media Partners, LLC, 2018.
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Joel E. (Joel Ernest) B. Goldthwait. Treatment of Lateral Curvature of the Spine: With Appendix Giving an Analysis of 1000 Consecutive Cases Treated by Posture and Exercise Exclusively, Without Mechanical Supports. Creative Media Partners, LLC, 2021.
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Bernard, Roth, and Joel E (Joel Ernest) B 18 Goldthwait. The Treatment of Lateral Curvature of the Spine: With Appendix Giving an Analysis of 1000 Consecutive Cases Treated by Posture and Exercise Exclusively, Without Mechanical Supports. Franklin Classics Trade Press, 2018.
Find full textBook chapters on the topic "Consecutive cases"
1
Sedel, Laurent, Agnes Raould, Frederic Zadegan, Didier Hannouche, and Remy Nizard. "An Abnormal Liner Fracture about 4 Consecutive Cases." In Key Engineering Materials. Trans Tech Publications Ltd., 2007. http://dx.doi.org/10.4028/0-87849-422-7.1219.
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Kelly, Scott, and Dimitri T. Azar. "Late-Onset Consecutive Hyperopia Following Decentered Myopic PRK." In Difficult and Complicated Cases in Refractive Surgery. Springer Berlin Heidelberg, 2014. http://dx.doi.org/10.1007/978-3-642-55238-0_72.
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Delepine, N., G. Delepine, P. Hernigou, M. Hassan, and J. C. Desbois. "Bone Union of Allografts and Chemotherapy Considerations About 55 Consecutive Cases." In Bone Transplantation. Springer Berlin Heidelberg, 1989. http://dx.doi.org/10.1007/978-3-642-83571-1_74.
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Moriyama, T., M. Kurosaki, and T. Shiwaku. "Early Surgery for Ruptured Aneurysms of the Posterior Circulation — 60 Consecutive Cases." In New Trends in Management of Cerebro-Vascular Malformations. Springer Vienna, 1994. http://dx.doi.org/10.1007/978-3-7091-9330-3_43.
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Bloch, G., P. Menu, J. P. Cachera, et al. "Subvalvular Aortic Stenosis: Anatomic Features and Surgical Treatment of 61 Consecutive Cases." In Pediatric Cardiology. Springer New York, 1986. http://dx.doi.org/10.1007/978-1-4613-8598-1_159.
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García-Bach, M., L. López, F. Isamat, and E. Ferrer. "Lumbar Microdiscectomy: Analysis of 100 Consecutive Cases. Its Pitfalls and Final Results." In Proceedings of the 8th European Congress of Neurosurgery, Barcelona, September 6–11, 1987. Springer Vienna, 1988. http://dx.doi.org/10.1007/978-3-7091-8978-8_10.
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Franzini, A., A. Allegranza, A. Melcarne, C. Giorgi, S. Ferraresi, and G. Broggi. "Serial Stereotactic Biopsy of Brain Stem Expanding Lesions. Considerations on 45 Consecutive Cases." In Proceedings of the 8th European Congress of Neurosurgery Barcelona, September 6–11, 1987. Springer Vienna, 1988. http://dx.doi.org/10.1007/978-3-7091-8975-7_34.
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Yamaguchi, T., K. Minematsu, J. Choki, T. Miyashita, and T. Omae. "Recurrent Cerebral Embolism and Factors Related to Early Recurrence - Analysis of 186 Consecutive Cases." In Central Nervous System Control of the Heart. Springer US, 1986. http://dx.doi.org/10.1007/978-1-4613-2327-3_22.
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Tillo, Omar, Alberto Di Giuseppe, and Federico Giovagnoli. "Expansion Vibrating Lipofilling (EVL) in Buttocks Body Contouring: A Review of 50 Consecutive Cases." In Fat Transfer in Plastic Surgery. Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-10881-5_46.
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Bader, Peter, Franco Locatelli, and Christina Peters. "Paediatric Acute Lymphoblastic Leukaemia (ALL)." In The EBMT/EHA CAR-T Cell Handbook. Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-94353-0_10.
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AbstractAcute lymphoblastic leukaemia (ALL) is the most frequent malignant disease in childhood and adolescence, with an annual incidence of approximately 3–4 cases per 100,000 children under 15 years of age. Multimodal chemotherapy forms the base of current ALL treatment. Based on excellent national and international collaboration in consecutive prospective, randomized clinical trials, the prognosis of childhood ALL has significantly improved over time. Currently, up to 90% of all paediatric patients with ALL will survive.
Conference papers on the topic "Consecutive cases"
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Germerdonk, Klaus, Timothy Marston, and Andreas Pfanger. "Inspection Data Management Challenge and Basis of Efficient Risk Management." In CORROSION 1999. NACE International, 1999. https://doi.org/10.5006/c1999-99535.
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Abstract New generation inspection tools are able to accurately detect and size every anomaly which may cause a risk for the safe operation of the pipeline. Pipetronix' experience is that many pipeline inspections with intelligent tools reveal a vast number of anomalies, especially in older pipelines. In many cases, only a few of these are actually serious and affect the integrity of the pipeline at the moment. Immediate remedial action is generally focused on the limited number of most severe defects. Consecutive inline inspections allow an indication of any corrosion growth along the pipeline. The corrosion rate can be predicted depending on the detecting and sizing capabilities of the respective inspection tool. The results can be used to calculate the predicted remaining wall thickness or defect depth along the line for a given period of time. Defect assessment criteria are applicable to the predicted defect geometry. Very often, defect geometry information from consecutive inspections are not available for all defects. The reasons for that may be different reporting levels, limited number of reported defects, problematic inspection data or defects close to or below the specification limits of the respective tool, especially if data are collected from different inspection tool types. Furthermore, new corrosion defects may have been initiated in between the consecutive inspections. All these effects have to be dealt with in the data analysis procedure applied. In order to utilize the intelligent tool information as a basis for a risk management system, an appropriate tool which allows to handle the full amount of data and to integrate this with other relevant data is required. Pipetronix will present an inspection data management tool, with modules for defect monitoring and corrosion prediction. Other modules for GIS-integration, external inspection results, cathodic protection readings etc. will also be highlighted.
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Macak, J., P. Sajdl, P. Kucera, and R. Novotny. "In-Situ Study of High Temperature Aqueous Corrosion by Electrochemical Techniques." In CORROSION 2005. NACE International, 2005. https://doi.org/10.5006/c2005-05336.
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Abstract The aim of the presented paper is to describe high-temperature in-situ electrochemical measurements performed at the conditions of PWR′s (Pressurised Water Reactor) secondary cycle. Original electrode system was designed to allow consecutive electrochemical impedance and electrochemical noise measurements. All measurements were performed on austenitic 08CH18N10T steel (corresponding to UNS S32100), which is the standard material of steam generator tubes of VVER440 and VVER1000 nuclear power stations. A proper choice of an equivalent circuit for impedance spectra analysis is discussed. Impedance and noise corrosion data are confronted. It is shown that neglecting of diffusion impedance can in certain cases lead to a significant underestimation of corrosion rate. Corrosion data resulting from electrochemical measurements are compared with an integral corrosion rate estimated from the measurement of an oxide layer thickness.
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Ginsburg, M., K. R. Brenner, W. A. Bulman, P. Stanifer, and J. Sonett. "Evaluation of the Paralyzed Diaphragm: Review of 30 Consecutive Cases." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a3263.
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Chaskes, Mark, Swar Vimawala, Gurston Nyquist, et al. "Sellar Reconstruction with Surgicel Onlay: A Review of 61 Consecutive Cases." In 29th Annual Meeting North American Skull Base Society. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1679652.
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Younus, Iyan, Georgiana Dobri, Rohan Ramakrishna, and Theodore H. Schwartz. "Readmission after Endoscopic Transsphenoidal Pituitary Surgery: Analysis of 584 Consecutive Cases." In 30th Annual Meeting North American Skull Base Society. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1702298.
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Maldonado, F., F. Hawkins, and JH Ryu. "Medical and Surgical Management of Chylothorax, a Review of 74 Consecutive Cases." In American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California. American Thoracic Society, 2009. http://dx.doi.org/10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a4481.
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Bajwa, A., S. Bawek, S. Bajwa, and A. Rathore. "76 Consecutive Cases of Robotic-Assisted Navigational Bronchoscopy at a Single Center." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a4820.
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Younus, Iyan, Rafael Uribe-Cardenas, Peter Morgenstern, et al. "1,000 Consecutive Endonasal Endoscopic Skull Base Cases: How Long is the Learning Curve?" In 30th Annual Meeting North American Skull Base Society. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1702315.
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Hamy, A., S. Giacchetti, C. de Bazelaire, et al. "Nonpalpable Breast Lesions in a Breast Care Unit: Prospective Analysis on 2708 Consecutive Cases." In Abstracts: Thirty-Second Annual CTRC‐AACR San Antonio Breast Cancer Symposium‐‐ Dec 10‐13, 2009; San Antonio, TX. American Association for Cancer Research, 2009. http://dx.doi.org/10.1158/0008-5472.sabcs-09-6020.
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Jensen, Martin Glümer, Henrik Jacobsen, Michael Lyhne Gaihede, and Jørn Rosborg. "SUBANNULAR VENTILATION TUBES IN TREATMENT OF CHRONIC TUBAL DYSFUNCTION – RESULTS IN 85 CONSECUTIVE CASES." In Proceedings of the 4th International Symposium. WORLD SCIENTIFIC, 2007. http://dx.doi.org/10.1142/9789812708694_0006.
Full textReports on the topic "Consecutive cases"
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Gong, Xuan, Zhou Chen, Kui Yang, et al. Endoscopic Transsphenoidal Surgery for Infra-Diaphragmatic Craniopharyngiomas: Impact of Diaphragm Sellae Competence on Hypothalamic Injury. International Journal of Surgery, 2024. http://dx.doi.org/10.60122/j.ijs.2024.20.03.
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Objective: Investigate the impact of diaphragm sellae competence on surgical outcomes and risk factors for postoperative hypothalamic injury (HI) in patients undergoing endoscopic transsphenoidal surgery (ETS) for infra-diaphragmatic craniopharyngiomas (ICs). Methods: A retrospective analysis of 54 consecutive patients (2016-2023) with ICs treated by ETS was conducted. All tumors originated from the sellar region inferior to the diaphragm sellae and were classified into two subtypes in terms of diaphragm sellae competence: IC with competent diaphragm sellae (IC-CDS) and IC with incompetent diaphragm sellae (IC-IDS). Clinical features, intraoperative findings, and follow-up data were compared between subtypes. Postoperative HI was assessed using a magnetic resonance imaging-based scoring system. Results: Fifty-four patients (29 males, 25 females) were included in this study, with 12 (22.2%) under 18 years old. Overall, 35 cases were IC-CDS, while 19 were IC-IDS. Compared with IC-CDS, patients with IC-IDS tended to have hormone hypofunction before surgery (p = 0.03). Tumor volume in IC-IDS group (9.0 ± 8.6 cm3) was also higher than that in IC-CDS group (3.3 ±3.4 cm, p = 0.011). Thirty-seven patients underwent standard endoscopic transsphenoidal approach (SEA) and 17 underwent an extended endoscopic transsphenoidal approach (EEA). Gross total resection (GTR) was achieved in 50 cases (92.6%). Postoperative CSF leak was observed in four patients (7.4%). Permanent diabetes insipidus (DI) occurred in 13 patients (27.7%), six in IC-CDS and seven in IC-IDS. Postoperative HI occurred in 38.9% of patients. Univariate analysis revealed that large tumor size (p = 0.014), prior hypopituitarism (p = 0.048) and IC-IDS (p < 0.001) were significantly associated with postoperative HI. Multivariate analysis revealed that IC- IDS was the sole predictor of postoperative HI. Conclusion: To our knowledge, this is the largest case series in the literature to describe IC resected by endoscopic surgery in a single institution. Classification based on diaphragm sellae competence highlights distinct clinical features and surgical outcomes between IC-CDS and IC-IDS subtypes. Notably, IC-IDS is an independent risk factor for postoperative HI. Preoperative identification of subtype can guide surgical strategy and potentially minimize complications.
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Thongprasom, Kobkan, Pornpan Youngnak, and Vilaiwan Aneksuk. Hematological abnormalities in oral lichen planus, recurrent aphthous ulceration and stomatis or glossitis. Chulalongkorn University, 1998. https://doi.org/10.58837/chula.res.1998.12.
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Objective. The aim of this study was to analyse the hematologic status if Thai patients with oral lichen planus (OLP), recurrent aphthous ulceration (RAU) and stomatitis or glossitis (ST/GT). Study design. Sixty one patients were examined consecutively for hematological abnormalities including serum folate, red cell folate and serum vitamin B[subscribe12] levels. The patient were divide into 3 major groups with OLP(22), RAU(19) and ST/GT(20). Result. Low red cell folate and low serum with red cell folate were found in patients with OLP (11/22) , RAU(11/99) and ST/GT(8/20). However, there was no statistically significant difference in folate deficiencies among these groups (P.0.05). Low serum vitamin B[subscribe12] levels were found in only 5 of 61 cases. Gastrointestinal disorders were found in 15 of all these groups. Treatment in patients with deficiencies showed good response in approximately 46.3% of the cases. Conclusion. Investigations for folate and vitamin B[subscribe12] levels are recommended in patients with refractory oral lesions for the benefit of treatment.
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Boisclair, Yves R., and Arieh Gertler. Development and Use of Leptin Receptor Antagonists to Increase Appetite and Adaptive Metabolism in Ruminants. United States Department of Agriculture, 2012. http://dx.doi.org/10.32747/2012.7697120.bard.
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Objectives The original project had 2 major objectives: (1) To determine the effects of centrally administered leptin antagonist on appetite and adaptive metabolism in the sheep; (2) To develop and prepare second-generation leptin antagonists combining high binding affinity and prolonged in vivo half-life. Background Periods of suboptimal nutrition or exaggerated metabolic activity demands lead to a state of chronic energy insufficiency. Ruminants remain productive for a surprisingly long period of time under these circumstances by evoking adaptations sparing available energy and nutrients. The mechanism driving these adaptations in ruminant remains unknown, but could involve a reduction in plasma leptin, a hormone acting predominantly in the brain. In laboratory animals, reduced leptin signaling promotes survival during nutritional insufficiency by triggering energy sparing adaptations such as reduced thyroid hormone production and insulin resistance. Our overall hypothesis is that similar adaptations are triggered by reduced leptin signaling in the brain of ruminants. Testing of this hypothesis in ruminants has not been possible due to inability to block the actions of endogenous leptin and access to ruminant models where leptin antagonistic therapy is feasible and effective. Major achievements and conclusions The Israeli team had previously mutated 3 residues in ovine leptin, with no effect on receptor binding. This mutant was renamed ovine leptin antagonist (OLA) because it cannot activate signaling and therefore antagonizes the ability of wild type leptin to activate its receptor. To transform OLA into an effective in vivo antagonist, the Israeli made 2 important technical advances. First, it incorporated an additional mutation into OLA, increasing its binding affinity and thus transforming it into a super ovine leptin antagonist (SOLA). Second, the Israeli team developed a method whereby polyethylene glycol is covalently attached to SOLA (PEG-SOLA) with the goal of extending its half-life in vivo. The US team used OLA and PEG-SOLA in 2 separate animal models. First, OLA was chronically administered directly into the brain of mature sheep via a cannula implanted into the 3rdcerebroventricule. Unexpectedly, OLA had no effect of voluntary feed intake or various indicators of peripheral insulin action but reduced the plasma concentration of thyroid hormones. Second, the US team tested the effect of peripheral PEG-SOLA administration in an energy sensitive, rapidly growing lamb model. PEG-SOLA was administered for 14 consecutive days after birth or for 5 consecutive days before sacrifice on day 40 of life. Plasma PEG-SOLA had a half-life of over 16 h and circulated in 225- to 288-fold excess over endogenous leptin. PEG-SOLA administration reduced plasma thyroid hormones and resulted in a higher fat content in the carcass at slaughter, but had no effects on feed intake, body weight, plasma glucose or insulin. These results show that the team succeeded in developing a leptin antagonist with a long in vivo half-life. Moreover, in vivo results show that reduced leptin signaling promotes energy sparing in ruminants by repressing thyroid hormone production. Scientific and agricultural implications The physiological role of leptin in ruminants has been difficult to resolve because peripheral administration of wild type leptin causes little effects. Our work with leptin antagonists show for the first time in ruminants that reduced leptin signaling induces energy sparing mechanisms involving thyroid hormone production with little effect on peripheral insulin action. Additional work is needed to develop even more potent leptin antagonists, to establish optimal administration protocols and to narrow down phases of the ruminant life cycle when their use will improve productivity.
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Just, Richard E., Eithan Hochman, and Sinaia Netanyahu. Problems and Prospects in the Political Economy of Trans-Boundary Water Issues. United States Department of Agriculture, 2000. http://dx.doi.org/10.32747/2000.7573997.bard.
Full textAbstract:
The objective of this research was to develop and apply a conceptual framework for evaluating the potential of trans-boundary bargaining with respect to water resource sharing. The research accomplished this objective by developing a framework for trans-boundary bargaining, identifying opportunities for application, and illustrating the potential benefits that can be gained thereby. Specifically, we have accomplished the following: - Developed a framework to measure the potential for improving economic efficiency considering issues of political feasibility and sustainability that are crucial in trans-boundary cooperation. - Used both cooperative and non-cooperative game theory to assess feasible coalitions among the parties involved and to model potential bargaining procedures. - Identified empirically alternative schemes of cooperation that both improve upon the economic efficiency of present water usage and appease all of the cooperating parties. - Estimated the potential short-run and long-run affects of water reallocation on the agricultural sector and used this information to understand potential strategies taken by the countries in bargaining processes. - Performed case studies in Israeli-Jordanian relations, the relationship of Israel to the Palestinian Authority, and cooperation on the Chesapeake Bay. - Published or have in process publication of a series of refereed journal articles. - Published a book which first develops the theoretical framework, then presents research results relating to the case studies, and finally draws implications for water cooperation issues generally. Background to the Topic The increase in water scarcity and decline in water quality that has resulted from increased agricultural, industrial, and urban demands raises questions regarding profitability of the agricultural sector under its present structure. The lack of efficient management has been underscored recently by consecutive years of drought in Israel and increased needs to clean up the Chesapeake Bay. Since agriculture in the Middle East (Chesapeake Bay) is both the main water user (polluter) and the low-value user (polluter), a reallocation of water use (pollution rights) away from agriculture is likely with further industrial and urban growth. Furthermore, the trans-boundary nature of water resources in the case of the Middle East and the Chesapeake Bay contributes to increased conflicts over the use of the resources and therefore requires a political economic approach. Major Conclusions, Solutions, Achievements and Implications Using game theory tools, we critically identify obstacles to cooperation. We identify potential gains from coordination on trans-boundary water policies and projects. We identify the conditions under which partial (versus grand) coalitions dominate in solving water quality disputes among riparian countries. We identify conditions under which linking water issues to unrelated disputes achieves gains in trans-boundary negotiations. We show that gains are likely only when unrelated issues satisfy certain characteristics. We find conditions for efficient water markets under price-determined and quantity-determined markets. We find water recycling and adoption of new technologies such as desalination can be part of the solution for alleviating water shortages locally and regionally but that timing is likely to be different than anticipated. These results have been disseminated through a wide variety of publications and oral presentations as well as through interaction with policymakers in both countries.
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Monetary Policy Report - January 2022. Banco de la República, 2022. http://dx.doi.org/10.32468/inf-pol-mont-eng.tr1-2022.
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Macroeconomic summary Several factors contributed to an increase in projected inflation on the forecast horizon, keeping it above the target rate. These included inflation in December that surpassed expectations (5.62%), indexation to higher inflation rates for various baskets in the consumer price index (CPI), a significant real increase in the legal minimum wage, persistent external and domestic inflationary supply shocks, and heightened exchange rate pressures. The CPI for foods was affected by the persistence of external and domestic supply shocks and was the most significant contributor to unexpectedly high inflation in the fourth quarter. Price adjustments for fuels and certain utilities can explain the acceleration in inflation for regulated items, which was more significant than anticipated. Prices in the CPI for goods excluding food and regulated items also rose more than expected. This was partly due to a smaller effect on prices from the national government’s VAT-free day than anticipated by the technical staff and more persistent external pressures, including via peso depreciation. By contrast, the CPI for services excluding food and regulated items accelerated less than expected, partly reflecting strong competition in the communications sector. This was the only major CPI basket for which prices increased below the target inflation rate. The technical staff revised its inflation forecast upward in response to certain external shocks (prices, costs, and depreciation) and domestic shocks (e.g., on meat products) that were stronger and more persistent than anticipated in the previous report. Observed inflation and a real increase in the legal minimum wage also exceeded expectations, which would boost inflation by affecting price indexation, labor costs, and inflation expectations. The technical staff now expects year-end headline inflation of 4.3% in 2022 and 3.4% in 2023; core inflation is projected to be 4.5% and 3.6%, respectively. These forecasts consider the lapse of certain price relief measures associated with the COVID-19 health emergency, which would contribute to temporarily keeping inflation above the target on the forecast horizon. It is important to note that these estimates continue to contain a significant degree of uncertainty, mainly related to the development of external and domestic supply shocks and their ultimate effects on prices. Other contributing factors include high price volatility and measurement uncertainty related to the extension of Colombia’s health emergency and tax relief measures (such as the VAT-free days) associated with the Social Investment Law (Ley de Inversión Social). The as-yet uncertain magnitude of the effects of a recent real increase in the legal minimum wage (that was high by historical standards) and high observed and expected inflation, are additional factors weighing on the overall uncertainty of the estimates in this report. The size of excess productive capacity remaining in the economy and the degree to which it is closing are also uncertain, as the evolution of the pandemic continues to represent a significant forecast risk. margin, could be less dynamic than expected. And the normalization of monetary policy in the United States could come more quickly than projected in this report, which could negatively affect international financing costs. Finally, there remains a significant degree of uncertainty related to the duration of supply chocks and the degree to which macroeconomic and political conditions could negatively affect the recovery in investment. The technical staff revised its GDP growth projection for 2022 from 4.7% to 4.3% (Graph 1.3). This revision accounts for the likelihood that a larger portion of the recent positive dynamic in private consumption would be transitory than previously expected. This estimate also contemplates less dynamic investment behavior than forecast in the previous report amid less favorable financial conditions and a highly uncertain investment environment. Third-quarter GDP growth (12.9%), which was similar to projections from the October report, and the fourth-quarter growth forecast (8.7%) reflect a positive consumption trend, which has been revised upward. This dynamic has been driven by both public and private spending. Investment growth, meanwhile, has been weaker than forecast. Available fourth-quarter data suggest that consumption spending for the period would have exceeded estimates from October, thanks to three consecutive months that included VAT-free days, a relatively low COVID-19 caseload, and mobility indicators similar to their pre-pandemic levels. By contrast, the most recently available figures on new housing developments and machinery and equipment imports suggest that investment, while continuing to rise, is growing at a slower rate than anticipated in the previous report. The trade deficit is expected to have widened, as imports would have grown at a high level and outpaced exports. Given the above, the technical staff now expects fourth-quarter economic growth of 8.7%, with overall growth for 2021 of 9.9%. Several factors should continue to contribute to output recovery in 2022, though some of these may be less significant than previously forecast. International financial conditions are expected to be less favorable, though external demand should continue to recover and terms of trade continue to increase amid higher projected oil prices. Lower unemployment rates and subsequent positive effects on household income, despite increased inflation, would also boost output recovery, as would progress in the national vaccination campaign. The technical staff expects that the conditions that have favored recent high levels of consumption would be, in large part, transitory. Consumption spending is expected to grow at a slower rate in 2022. Gross fixed capital formation (GFCF) would continue to recover, approaching its pre-pandemic level, though at a slower rate than anticipated in the previous report. This would be due to lower observed GFCF levels and the potential impact of political and fiscal uncertainty. Meanwhile, the policy interest rate would be less expansionary as the process of monetary policy normalization continues. Given the above, growth in 2022 is forecast to decelerate to 4.3% (previously 4.7%). In 2023, that figure (3.1%) is projected to converge to levels closer to the potential growth rate. In this case, excess productive capacity would be expected to tighten at a similar rate as projected in the previous report. The trade deficit would tighten more than previously projected on the forecast horizon, due to expectations of an improved export dynamic and moderation in imports. The growth forecast for 2022 considers a low basis of comparison from the first half of 2021. However, there remain significant downside risks to this forecast. The current projection does not, for example, account for any additional effects on economic activity resulting from further waves of COVID-19. High private consumption levels, which have already surpassed pre-pandemic levels by a large margin, could be less dynamic than expected. And the normalization of monetary policy in the United States could come more quickly than projected in this report, which could negatively affect international financing costs. Finally, there remains a significant degree of uncertainty related to the duration of supply chocks and the degree to which macroeconomic and political conditions could negatively affect the recovery in investment. External demand for Colombian goods and services should continue to recover amid significant global inflation pressures, high oil prices, and less favorable international financial conditions than those estimated in October. Economic activity among Colombia’s major trade partners recovered in 2021 amid countries reopening and ample international liquidity. However, that growth has been somewhat restricted by global supply chain disruptions and new outbreaks of COVID-19. The technical staff has revised its growth forecast for Colombia’s main trade partners from 6.3% to 6.9% for 2021, and from 3.4% to 3.3% for 2022; trade partner economies are expected to grow 2.6% in 2023. Colombia’s annual terms of trade increased in 2021, largely on higher oil, coffee, and coal prices. This improvement came despite increased prices for goods and services imports. The expected oil price trajectory has been revised upward, partly to supply restrictions and lagging investment in the sector that would offset reduced growth forecasts in some major economies. Elevated freight and raw materials costs and supply chain disruptions continue to affect global goods production, and have led to increases in global prices. Coupled with the recovery in global demand, this has put upward pressure on external inflation. Several emerging market economies have continued to normalize monetary policy in this context. Meanwhile, in the United States, the Federal Reserve has anticipated an end to its asset buying program. U.S. inflation in December (7.0%) was again surprisingly high and market average inflation forecasts for 2022 have increased. The Fed is expected to increase its policy rate during the first quarter of 2022, with quarterly increases anticipated over the rest of the year. For its part, Colombia’s sovereign risk premium has increased and is forecast to remain on a higher path, to levels above the 15-year-average, on the forecast horizon. This would be partly due to the effects of a less expansionary monetary policy in the United States and the accumulation of macroeconomic imbalances in Colombia. Given the above, international financial conditions are projected to be less favorable than anticipated in the October report. The increase in Colombia’s external financing costs could be more significant if upward pressures on inflation in the United States persist and monetary policy is normalized more quickly than contemplated in this report. As detailed in Section 2.3, uncertainty surrounding international financial conditions continues to be unusually high. Along with other considerations, recent concerns over the potential effects of new COVID-19 variants, the persistence of global supply chain disruptions, energy crises in certain countries, growing geopolitical tensions, and a more significant deceleration in China are all factors underlying this uncertainty. The changing macroeconomic environment toward greater inflation and unanchoring risks on inflation expectations imply a reduction in the space available for monetary policy stimulus. Recovery in domestic demand and a reduction in excess productive capacity have come in line with the technical staff’s expectations from the October report. Some upside risks to inflation have materialized, while medium-term inflation expectations have increased and are above the 3% target. Monetary policy remains expansionary. Significant global inflationary pressures and the unexpected increase in the CPI in December point to more persistent effects from recent supply shocks. Core inflation is trending upward, but remains below the 3% target. Headline and core inflation projections have increased on the forecast horizon and are above the target rate through the end of 2023. Meanwhile, the expected dynamism of domestic demand would be in line with low levels of excess productive capacity. An accumulation of macroeconomic imbalances in Colombia and the increased likelihood of a faster normalization of monetary policy in the United States would put upward pressure on sovereign risk perceptions in a more persistent manner, with implications for the exchange rate and the natural rate of interest. Persistent disruptions to international supply chains, a high real increase in the legal minimum wage, and the indexation of various baskets in the CPI to higher inflation rates could affect price expectations and push inflation above the target more persistently. These factors suggest that the space to maintain monetary stimulus has continued to diminish, though monetary policy remains expansionary. 1.2 Monetary policy decision Banco de la República’s board of directors (BDBR) in its meetings in December 2021 and January 2022 voted to continue normalizing monetary policy. The BDBR voted by a majority in these two meetings to increase the benchmark interest rate by 50 and 100 basis points, respectively, bringing the policy rate to 4.0%.