Local recurrence in giant cell tumor of bone: Comparative study of two methods of surgical approach

Background: Most experts accept the use of curettage, phenol, and cement as the best treatment to prevent recurrence of giant-cell tumors. The purpose of this investigation was to analyze the effect of cement as a filling material and compare it with bone graft and the effect of high-speed burr in local recurrence of giant cell tumor after curettage. Methods: We retrospectively reviewed 168 consecutive patients diagnosed with giant cell tumor at the three most common sites (distal femur, proximal tibia, and distal radius) to determine the pattern of local tumor recurrence. Only patients who had intralesional excision of primary tumor by curettage without a surgical adjuvant were included. Results: A total of 168 patients with primary giant cell tumor were treated with curettage. The female to male ratio was 1.4: 1 and the mean age was 34 years (range: 17-68 years). The minimum follow-up was 24 months and the median follow up was 75 months. The knee region was involved in 135 (80.4) patients. There were 10 (5.9), 130 (77.4) and 28 (16.7) patients in Campanacci grade I, II and III, respectively. Tumor surgery was supplemented with high speed burring in 88 (52.4), bone cement in 82 (48.8) and bone grafting, either autograft or allograft in 86 (51.2) patients. The recurrence rates were 18.2 and 37.5 for curettage with or without high speed burring, respectively. For 46 (27) recurrent lesions treated by curettage, the recurrence rate was 35. The nature of the filling material used did not show any significant impact on the outcome of recurrence rate. Conclusions: Despite the high rates of recurrence after treatment of giant-cell tumor with curettage, the results of the present study suggested that the high-speed burr is effective in reducing the rate of recurrence. The risk of local recurrence after curettage with a high-speed burr and reconstruction with bone graft is similar to that observed after using cement. It is likely that the adequacy of the removal of the tumor rather than the use of adjuvant modalities is what determines the risk of recurrence

Research ethics training of trainers: Developing capacity of Bolivian health science and civil society leaders

Program/Project Purpose: The University of San Andres, Faculty of Medicine in La Paz, Bolivia in collaboration with Touro University California, Public Health Program was awarded a NIH Research Ethics Planning Grant in June, 2013 to develop strategies and processes for implementation of a comprehensive national research ethics program for Bolivia. Although the importance of scientific research based on ethical principles is highlighted in the Bolivian constitution and national health legislation, few Bolivian academics, researchers and health professionals have received formal training in the principles and practices of research ethics. A principle aim of the Planning Grant is to develop and implement a Research Ethics Train the Trainers (TOT) course with the goal of training faculty for future implementation of a national research ethics program. Structure/Method/Design: A Project Directors Committee representing public health science universities from four participating Bolivian Departments/States (La Paz; Santa Cruz, Cochabamba & Chuquisaca) was formed to oversee all project activities including implementation of a three day in-person TOT followed by a 10 week online training. Training modules utilized materials developed by Bolivian academics and scientists and international research ethics programs at PAHO (Pan American Health Organization) and CITI (Collaborative Institutional Training Initiative), University of Miami. TOT University and civil society representatives were selected from each participating Department/State for a total of 26 participants. Upon completion of the training, participants were asked to implement educational research ethics activities in their local communities and institutions. Outcomes & Evaluation: A pre-test/post-test study design was used to assess change in participant knowledge related to research ethics principles and practices. The mean score improved from 73% correct at baseline and 84% at course completion. Participants completed a course evaluation after the in-person and virtual components of the course. Participants highlighted the most useful topics in the course as respect for persons and human rights, principles of bioethics, informed consent and the function of research ethics committees. The most positive aspects of the in-person component of the course were the high level of participation, group work, communication and debate among participants representing different academic disciplines and social sectors. Eighty percent of participants completed the course with five dropping out during the virtual component. Most students reported that the instructions for using the virtual platform were clear and they received sufficient support from the Course Coordinator, however, most stated that some of the teachers provided insufficient academic support. Going Forward: Integrating the group interaction strengths of the in-person TOT component with the flexibility of the virtual component recommends using a mixed methods approach while providing additional training to teachers related to virtual teaching methodologies. Funding: NIH/FIC, International Research Ethics Education and Curriculum Development Award (R25)

Ovarian carcinoma associated with pregnancy: A clinicopathologic analysis of 23 cases and review of the literature

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to analyze and describe cases of ovarian cancer in pregnant women treated at our center and to review the literature concerned, and to discuss the rationale for therapy.</p> <p>Methods</p> <p>Twenty-Three patients of ovarian malignancies during pregnancy were treated at Vali- Asr Hospital between 1991 and 2002. Data on treatment and follow-up were evaluated.</p> <p>Results</p> <p>The incidence of ovarian carcinoma associated with pregnancy in our series was 0.083/1000 deliveries. Eleven (47.8%) were found with ovarian malignant germ cell tumors, five (21.7%) with low malignant potential tumors, four (17.4%) with invasive epithelial tumors, and three (13%) with sex cord stromal tumors. Seventeen (73.9%) of the patients were diagnosed in stage I and had complete remission. Five of the six in advanced stage died. The mean follow-up was 36.3 months. The prognosis was significantly related with stage and histological type (<it>P </it>< 0.05). Sixteen healthy live babies were recorded in this group, and two premature newborn died of respiratory distress syndrome. Chemotherapy was administered to 44% of the patients, in two cases during pregnancy. Overall survival at 5 years was 61%. In most of case conservative surgical treatment could be performed with adequate staging and debulking.</p> <p>Conclusion</p> <p>Early finding of ascitis by ultrasound and persistent large ovarian mass during pregnancy may be related to malignancy and advanced stage. Pregnant women in advanced stage of ovarian cancer seem to have poor prognosis.</p

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Optimalni neizraziti reglutor tipa 2 za sustave za grijanje, ventilaciju i klimatizaciju

In this paper a novel Optimal Type-2 Fuzzy Proportional-Integral-Derivative Controller (OT2FPIDC) is designed for controlling the air supply pressure of Heating, Ventilation and Air-Conditioning (HVAC) system. The parameters of input and output membership functions, and PID controller coefficients are optimized simultaneously by random inertia weight Particle Swarm Optimization (RNW-PSO). Simulation results show the superiority of the proposed controller than similar non-optimal fuzzy controller.U radu je predložena nova upravljačka shema optimalnog neizrazitog PID regulatora tipa 2 za upravljanje sustavima za grijajne, ventilaciju i klimatizaciju. Predložena je shema zasnovana na neizrazitom regulatoru (FLC) učestalo korištenom za upravljajne nelinearnim procesima. Kako bi se premostio problem neizrazitih regulatora, neodstatak metode dizajnirajna, parametri ulazno-izlaznih funkcija pripadanja, kao i parametri PID regulatora se optimiraju metodom roja čestica sa slučajnim parametrima inercije (RNW-PSO). Simulacijski rezultati pokazuju izvedivost predloženog pristupa

Effects of Salinity on Growth and Physiological Characteristics of Two Tomato Cultivars (Super Strain–B and Red Clud) in Hydroponic Conditions

Salinity is one of the greatest factors that limit the producion of horticultural crops in many parts of the world, especially in arid and semi-arid areas. Tomato (Lycopersicon esculentum L.) is an annual herbacious plant whose annual global production is over 80 million tons. In areas with warm and dry climate which are suitable for the production of tomatoes, salt is considered a major problem. This research was done in order to study the salinity effects on growth and physiological characteristics of tomato plant cultivars Super strain–B and Red clud. Firstly, seeds were planted in metal trays filled with sand in the greenhouse environment with sufficient moisture, and then seedlings in two leaf stages were transplanted to hydroponics’ medium with a Johnson nutritional solution. After establishment, the five levels of salinity treatments including, zero (control), 40, 80, 120 and 160 mM of Nacl were applied in three replications. The results showed that salt stress significantly reduces shoot and root dry weight, number of leaves, leaf area, leaf chlorophyll content, and stress index (Fv/Fm) of both cultivars. Specific leaf area (SLA) in both cultivars decreased due to salinity treatment however, this reduction was not significant in Red clud cultivar. Salinity also significantly increased the amount of proline in shoots in both cultivars. The results were suggestive of the relative resistance of tomato plant cultivar Red clud in comparison with Super strain-B to salinity conditions

Effect of 1-MCP on Storage and Shelflife of Strawberry Fruits (Fragaria xananassa Cv. Camarossa)

1-Methylecyelopropene (1-MCP) is a new material which prevents the ethylene from reacting in quite low concentration and is easily consumed and does not exert negative effects on the human health and the environments. Therefore the effect of using zero concentration (Control), 0.25, 0.5, 0.75 and 1 µL.L-1 of 1-MCP on the storage life (1°C) and shelf life (20°C) of the fruits under 90% humidity throuth the 27 and 3 days was studied respectivly. The study of storage life was done through the split plot in time within a complete randomized design and the shelflife within a complete randomized design both in 3 replications. The results of storage life experiment showed that the marketability, firmness, citric acid (TA) ,vitamin C and the the ratio of TSS/TA were protected desirable in 1-MCP treatment. Amount of appearance decay was significantly reduced.The pH of fruit extract and also the fewest anthocyanins in the treatment of 1 µL.L-1 of 1-MCP were seen. This observation depicts the positive and significant effect of 1-MCP over the reduction in the speed of physiochemical characteristics changes in the fruit tissue. The highest fruit color indices include brightness (L), color regions (a* and b*) and Chroma (C) were seen in 1 µL.L-1 treatment. Moreover, the result obtained from the study over the effect of 1-MCP on the shelf life of strawberries in 20°C showed that this substances relatively positive effect on the preservation of fruit and it seems that 1-MCP is able to keep the quality of fruits over longer periods of time in usual degrees of temperature

Effect of irrigation and nutrient on physical properties of safflower seeds

The effect of irrigation and nutrient treatments on physical properties of safflower seeds was investigated. Physical properties of safflower seeds were determined at a moisture content of 7% w.b. The parameters determined at different treatments were: size, geometric mean diameter, sphericity, surface area, mass, volume, bulk and true densities, porosity, and static and dynamic coefficient of friction. The results showed a better effect of the use of organic fertilizers in comparison with chemical ones. The results showed that nutrient and irrigation treatments had a significant effect on most of the physical properties of safflower seeds at p<0.01

Comparison of the Effect of 1-MCP and Low-Pressure Air on Shelflife of Strawberry Fruit (Fragaria ananassa cv. Camarossa)

Strawberry (Fragaria×ananassa) has tasteful, fragrant and nutritious fruits. But, because of delicate texture and high metabolic activities of the fruits at maturity, are very sensitive and easily decayed, and thus have short shelflife. Ethylene is one of the main causes of postharvest fruit losses, which could reduce the shelflife of strawberry. Therefore, an experiment was carried out to examine the effect of 1 µL/L 1-MCP treatment and low-pressure air pretreatment at 0.2 atm in 2 hours on apparent and physicochemical characteristics of strawberry fruit, cultivar Camarossa, during storage in cold store. The study was performed as split plots in time, based on complete randomized design with 3 replications. The results showed that the highest marketability (90%), fruit firmness (7.95 N), titrable organic acids (1.15 g/100 cc), vitamin C (78.13 mg/100 cc) and total soluble solids (10.48 %) and the lowest amount of apparent decay (13.3 %), acidity (3.63) and taste index (9.04) were obtained in 1-MCP and low-pressure air treatments, which shows the effect of treatments on reducing the rate of biochemical variations in fruit texture. Correlation coefficients between all treatments were significant (P≤0.01). Meanwhile, the positive effect of 1-MCP on appearance and studied physicochemical characteristics was more than low-pressure air pretreatment. Even, the combination of these two treatments had no significant difference with 1-MCp treatment alone. In general, this observation depicts the more positive and significant effect of 1-MCP treatment in delaying the maturity and improving the qualitative traits of strawberry fruits after being stored in cold storage