Laminectomy versus interlaminar approach for Lumbar disc herniation

Background: Low back pain is the most common health problem in men and women between the ages of 20 and 50 years. The lumbar disc prolapse has a major role in this condition. Treatment is either conservative or surgical. The most common surgical interventions are either laminectomy or interlaminar approach. Objective: To determine which is the best surgical approach for the patient according to his/her type of disc herniation. Patients and methods: A comparative clinical study conducted in the Neurosciences Hospital, Baghdad, Iraq from January 2016 to January 2018. In this paper we evaluated the clinical outcome following both approaches Results: We studied sixty cases; thirty-four patients had interlaminar approach for lumbar discectomy while twenty-six patients had laminectomy with discectomy. Conclusion: Both methods can manage different types of lumbar disc prolapse, apart from far-lateral disc which favors laminectomy approach

Development of Mountain Climate Generator and Snowpack model for Erosion Predictions in the Western United States using WEPP, Reserach Completion Report for Phase II

Executive Summary: This report summarizes work conducted during the funding period (July 1 through September 30, 1990) of a Cooperative Agreement between the United States Forest Service (USFS) and the Utah Water Research Laboratory (UWRL), Utah State University. The purpose of the agreement is to develop a Western Mountain Climate Generator (MCLIGEN) similar in function to the existing Climate Generator (CLIGEN), which is part of the Water Erosion Prediction Project (WEPP) procedure. Also, we are developing a Western U.S. snowpack simulation model for inclusion in WEPP. In the Western U.S., few meteorological observations exist in high elecation areas where Forest Service properties are located. Therefore, a procedure for estimating climatological variables in mountainous areas is needed to apply WEPP in these regions. A physically-based approach, using an expanded and improved orographic precipitation model, is being utilized. It will use radiosonde data and also lighning data to simualte convective storms. Climatological sequences thus estimated at ungaged locatiosn will be represented using stochastic models, similar to the approach used in the existing CLIGEN, and their parameters will be available to users through maps. By using these stochastic models, WEPP usters can synthsize climate sequences for input to WEPP. During the reporting period we have implemented the the Rhea orographic precipitation model and begun preliminary model testing in two regions. Also, we have begun formulation of model modifications for handling convective events. Various snowplack and meteorological data sets have been acquired and others have been ordered. Some of these have been applied in ititial applications of several snowpack models which have been recorded in a modeular form. Work has commenced on the statistical analysis of western climate sequences, including the preliminary assessment of the alternative stochastic model structures. Additional review of literature has been commenced for establishing desing storms and design hydrographs for events of various return periods in mountainous regions. Accomplishments are summarized in three parts: 1) climatological process models, 2) snowpack simulation models, and 3) stochastic models of climatological variablse and parameter regionalization. A chapter of the report is devoted to each of these three parts

Development of Mountain Climate Generator and Snowpack model for Erosion Predictions in the Western United States Using WEPP, Progress Report No. 1

Executive Summary: This report summarizes work conducted during the initial funding period (November 1, 1989 through June 30, 1990) of a Cooperative Agreement between the United States Forest Service (USFS) and the Utah Water Research Laboratory (UWRL), Utah State University. The purpose of the agreement is to develop a procedure for incorporating western mountain climate into the existing Climate Generator (CLIGEN), which is part of the Water Erosion Prediction Project (WEPP) procedure. In the Western U.S., few meteorological observations exist in high elevation areas where Forest Service properties are located. Therefore, a procedure for estimating climatological variables in mountainous areas is needed to apply WEPP in these regions. A physically-based approach, an expanded and improved orographic precipitation model, is proposed in this report. It will use radiosonde data and also lightning data to simulate convective storms. Climatological sequences thus estimated at ungaged locations will be represented using stochastic models, similar to the approach used in the existing CLIGEN, and their parameters will be available to users through maps. By using these stochastic models, WEPP users can synthesize climate sequences for input to WEPP. Several alternative approaches to developing the Mountain Climate Generator (MCLIGEN) have been formulated and evaluated. These options vary in their spatial resolution. Some will provide synthetic climate inputs whereas others will provide synthetic sequences of water delivery to the ground surface or overland flow delivery. The latter will reduce the user\u27s responsibility for judging adequate snowpack or hydrological simulations, but will enormously increase the effort required for parameterization during the developmental phase. Based on our evaluation, we recommend that Option 2 for generating fine scale climate sequences be adopted. This option appears to satisfy the WEPP spatial resolution requirements of the USFS and requires a reasonable level of developmental effort. We also recommend that Option 3 be available to the users. We recomment that under this option snowpack initial conditions at a specified date be available based on a return period or exceedance probability. Under this option discontinuous simulation periods could be considered. The data, models, and parameters needed to implement the recommended approach can be divided into three parts: 1) climatological process models, 2) a snowpack imulation model, and 3) stochastic models of climatological variables and parameter regionalization. A chapter of the report is devoted to each of these three parts. Each chapter includes a literature review and a description of the proposed methodology and work plan for its development. We further recommend that a comprehensive plan for data collection for validation of the entire WEPP methodology applied to the mountainous Western U.S. be developed. Also, we propose that UWRL take the lead in settin gup a user group for orographic precipitation modelers

Phase 1B, randomized, double-blind, dose-escalation trial of CPG 10101 in patients with chronic hepatitis C virus

n/

Att leva med kronisk hjärtsvikt : En litteraturöversikt

Bakgrund: Kronisk hjärtsvikt är en folkhälsosjukdom som påverkar ca 2% av Sveriges befolkning. Sjukdomen orsakar fysiska symtom som dyspné och ödem i lungor samt extremiteter, vilket kan påverka patienter fysiskt, socialt och psykiskt.Syfte: Syftet med studien var att kartlägga befintlig kunskap om patienters upplevelser av kronisk hjärtsvikt. Metod: Studien genomfördes som en litteraturöversikt och analyserades med Fribergs (2022a) fyrstegsmodell. Studien baserades på kvalitativa artiklar som har inhämtats genom sökningar i Cinahl och PubMed. Resultat: Elva artiklar valdes ut för analys. Efter analysen skapades fyra kategorier med sex underkategorier som beskriver olika avseenden av patienternas upplevelser. Fynden som presenteras beskriver den fysiska, sociala och psykiska påverkan som patienterna upplever. Fynden visar även på utmaningarna som uppstår när patienterna anpassar sig till sin sjukdom. Slutsats: Kronisk hjärtsvikt påverkar patienter på olika sätt. Patienterna upplever både fysiska, sociala och psykiska begränsningar. För sjuksköterskan innebär det en utmaning att hjälpa patienten på ett holistiskt och personcentrerat sätt. Ett behov av vidare forskning kan finnas för att kunna kartlägga upplevelserna för specifika populationer

INTERLEUKIN-1β LEVELS IN THE HUMAN GINGIVAL SULCUS: RATES AND FACTORS AFFECTING ITS LEVELS IN HEALTHY SUBJECTS

Background and objective:  Gingival crevicular fluid (GCF) affords a exceptional window for investigation of periodontal condition as the levels of inflammatory mediators, which consequences owing to the increased local destruction of connective tissue structural elements. This study aimed to explore the interleukin 1β (IL-1β)) levels in the human gingival sulcus in healthy normal people; and the effect of host factors as age , gender, type of tooth used in pro-inflammatory biomarkers. Methods: Eighty seven patients, 54 (62.1%) female and 33 (37.9%) male (aged 12–34 years; mean 19.58±4.4 years), participated in this study. Each subject underwent a session on professional oral hygiene and received oral hygiene instructions. Gingival crevicular fluid (GCF) sampling was conducted (baseline). GCF was collected from the Central incisor, the Lateral incisor, the Canine, the First premolar and the second premolar in this study.  Results: In total, the mean±SD of central incisor IL-1β was 32.16±4.83 pg/ml, with a mode equal to 28.01 pg/mL, the median was 32.71 pg/mL, and ranged from 20.98 to 41.25 pg/ml with the 75% interquartile range (IQR) equal to 35.94 pg/ml. For males the mean±SD of central incisor IL-1β was 31.6±5.51 pg/ml VS 32.5±4.4 pg/ml of females. For the lateral incisor, canine, first premolar, second premolar: Conclusion: This study provides the upper limit of normal values ​​for interleukin 1β (IL-1β) levels for subjects aged 12–34 years in the GCF. These upper limits of normal values ​​will guide dentists in Yemen when they consider the diagnosis of periodontal disease, as well as its role during orthodontic tooth movement where they play important role in osteocyte activities (e.g, osteoclasts and osteoblasts), and will provide useful baseline data for future studies of interventions against periodontal disease, and teeth movement by orthodontics appliances, in Yemen.                           Peer Review History: Received: 1 September 2022; Revised: 11 October; Accepted: 6 November, Available online: 15 November 2022 Academic Editor: Dr. Emmanuel O. Olorunsola, Department of Pharmaceutics & Pharmaceutical Technology, University of Uyo, Nigeria, [email protected] Received file:                             Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Rima Benatoui,Laboratory of Applied Neuroendocrinology, Department of Biology, Faculty of Science, Badji Mokhtar University Annaba, Algeria.  [email protected] Dr. Gulam Mohammed Husain,, National Research Institute of Unani Medicine for Skin Disorders, Hyderabad, India, [email protected] Similar Articles:   THE EFFECT OF NANOSILVER AND CHLORHEXIDINE MOUTHWASH ON ANAEROBIC PERIODONTAL PATHOGENS COUNT

Association Between New Unconfirmed Bone Lesions and Outcomes in Men With Metastatic Castration-Resistant Prostate Cancer Treated With Enzalutamide: Secondary Analysis of the PREVAIL and AFFIRM Randomized Clinical Trials

IMPORTANCE For men with metastatic castration-resistant prostate cancer (mCRPC) whose condition is responding to enzalutamide, new unconfirmed bone lesions detected at posttreatment scinitigraphymay reflect an osteoblastic reaction that represents healing, known as pseudoprogression, which can lead to premature discontinuation of therapy. OBJECTIVE Todetermine the associationbetweennewunconfirmed lesionsdetectedona followup bone scintigram (bone scan) and outcomes in enzalutamide-treated men with mCRPC. DESIGN, SETTING, AND PARTICIPANTS This post hoc, retrospective secondary analysis of 1672 enzalutamide-treated men from 2 phase 3, randomized mCRPC studies (PREVAIL and AFFIRM) before or after treatment with docetaxel was conducted from April 12, 2018, to July 25, 2019. Participants were men from the enzalutamide groups of the 2 studies with a decrease in prostate-specific antigen level at any time or with stable disease or soft-tissue disease responding to treatment based onradiologic findings. INTERVENTION Enzalutamide, 160mg once daily. MAIN OUTCOMES AND MEASURES The clinical significance of new lesions detected on the first (early) or second (late) posttreatment bone scan, without an unfavorable change in prostate-specific antigen level or soft-tissue progression, was investigated. Associations of new unconfirmed lesions with radiographic progression-free survival, overall survival, decrease in prostate-specific antigen level, objective response in soft tissue, and quality of life were evaluated. RESULTS Among the 643 men (median age, 72 years [range, 43-93 years]) in PREVAIL, early and late unconfirmed lesionswere observed in 177 men (27.5%) with stable disease or disease responding to enzalutamide. Among the 404 men (median age, 70 years [range, 41-88 years]) in AFFIRM, early and late unconfirmed lesionswere observed in 73 men (18.1%) with stable disease or disease responding to enzalutamide. In PREVAIL, men with new unconfirmed lesions had median radiographic progression-free survival (hazard ratio [HR], 1.37 [95%CI, 0.81-2.30]; P = .23) and median overall survival (HR, 1.25 [95%CI, 0.85-1.83]) in the chemotherapy-naive setting similar to men those of men without such new lesions. In AFFIRM, the median overall survival (HR, 1.94 [95%CI, 1.10-3.44])was reduced among men with unconfirmed bone lesions, but the median radiographic progression-free survivalwas not reduced (HR, 1.21 [95%CI, 0.83-1.75]; P = .32). Quality of life over timewas similar regardless of the presence of new unconfirmed lesions detected on a follow-up bone scan in either setting. CONCLUSIONS AND RELEVANCE These results suggest that new unconfirmed lesions detected on follow-up bone scans may represent pseudoprogression in men with mCRPC and are indicative of a favorable treatment response to enzalutamide. The detection of new unconfirmed bone lesions in men with mCRPC that responded to treatment with enzalutamide after docetaxel appears to be associated with worse overall survival and may represent true progression, thus highlighting the need for improved functional bone metastasis imaging

Post Hoc Analysis of the Effect of Pegcetacoplan Treatment of Patients with Paroxysmal Nocturnal Hemoglobinuria and Baseline Hemoglobin Levels Greater Than 10 Grams per Deciliter

Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, potentially life-threatening hematologic disease characterized by various degrees of hemolysis, bone marrow failure, and thrombophilia. Pegcetacoplan (PEG), a C3 complement-inhibitor approved by the FDA for treatment of adults with PNH, has demonstrated improved hemoglobin (Hb) levels for PNH patients with screening Hb levels <10.5 g/dL and prior suboptimal response to eculizumab (ECU; C5-inhibitor) (Hillmen P, et al., N Engl J Med, 2021 384 (11):1028-1037) or complement-inhibitor naïve PNH patients (Wong RS, et al., Blood, 2020 136 [Supplement 1]). While these studies have demonstrated positive results for patients with lower baseline Hb levels, the efficacy and safety of PEG in PNH patients with baseline Hb ≥10.0 g/dL has not been evaluated