Patients' Expectations before and Satisfaction after Ultrasound Guided Foam Sclerotherapy for Varicose Veins

AbstractObjectivesUltrasound guided foam sclerotherapy (UGFS) is a minimally invasive treatment for varicose veins (VV) whose clinical and cost-effectiveness remains incompletely defined. The aim of the current study was to examine patients' expectations before and satisfaction after UGFS for VV in terms of relief of lower limb symptoms, improvement in appearance, and beneficial effect on life-style.MethodsA consecutive series of 351 patients (464 limbs) undergoing UGFS for VV completed questionnaires one week prior to and six months after treatment.ResultsPre and post-treatment response rates were 80%; 60% returned both questionnaires. Virtually all patients were expecting improvement in lower limb symptoms; these were exceeded in a third. Most patients expected cosmetic improvement and these were largely met. Two-thirds of patients expected significant life-style (clothes, work, social) benefits and outcomes were slightly less than expected. A quarter expected improvement in their interpersonal relationships. This benefit was greater than expected occurring in one-third of patients. Overall, a quarter of patients had their expectations exceeded and 10% (appearance and relationships) to 25% (clothing, work and social and leisure activities) were left with unmet expectations.DiscussionWhen specifically asked most patients admit to having a wide range of expectations in relation to their VV treatment, many of them probably unanticipated by the clinician. However, present data indicate that UGFS is usually able to meet, and often exceeds, these physical and psychosocial needs and expectations. UGFS is, therefore, a highly effective treatment for VV from the patients' perspective

Splitting of the Dipole and Spin-Dipole Resonances

Cross sections for the 90,92,94Zr(p,n) reactions were measured at energies of 79.2 and 119.4 MeV. A phenomenological model was developed to describe the variation with bombarding energy of the position of the L=1 peak observed in these and other (p,n) reactions. The model yields the splitting between the giant dipole and giant spin dipole resonances. Values of these splittings are obtained for isotopes of Zr and Sn and for 208Pb.Comment: 14 pages, 4 figure

Impedance adaptation for optimal robot–environment interaction

In this paper, impedance adaptation is investigated for robots interacting with unknown environments. Impedance control is employed for the physical interaction between robots and environments, subject to unknown and uncertain environments dynamics. The unknown environments are described as linear systems with unknown dynamics, based on which the desired impedance model is obtained. A cost function that measures the tracking error and interaction force is defined, and the critical impedance parameters are found to minimize it. Without requiring the information of the environments dynamics, the proposed impedance adaptation is feasible in a large number of applications where robots physically interact with unknown environments. The validity of the proposed method is verified through simulation studies

Review: The Newsletter of the Literary Managers and Dramaturgs of the Americas, volume 16, issue 1

Contents include: Editors\u27 Note; Kirk Watson\u27s List for Making a Cool City; Remembering the Collaboration Project: Texts for an Untitled Bird Play; Mix Tape: A Collaboration; An Untitled Piece; Untitled Baseball Play; Elliott Hayes Remarks 2005; A Newbie at LMDA Conference \u2705, reconstructed journal entries with mostly unforced bildungsroman narrative structure; What\u27s So Great About New Plays? A position paper on the focus on new plays in the field of dramaturgy with three responses; New Plays in Canada, What\u27s So Great About New Plays--A Thought or Seven; Thoughts on New Plays from an Elliott Hayes Award Acceptance Speech. Issue editors: D.J. Hopkins, Shelley Orr, Madeleine Oldhamhttps://soundideas.pugetsound.edu/lmdareview/1032/thumbnail.jp

Circulating pancreatic polypeptide concentrations predict visceral and liver fat content

CONTEXT AND OBJECTIVE: No current biomarker can reliably predict visceral and liver fat content, both of which are risk factors for cardiovascular disease. Vagal tone has been suggested to influence regional fat deposition. Pancreatic polypeptide (PP) is secreted from the endocrine pancreas under vagal control. We investigated the utility of PP in predicting visceral and liver fat. PATIENTS AND METHODS: Fasting plasma PP concentrations were measured in 104 overweight and obese subjects (46 men and 58 women). In the same subjects, total and regional adipose tissue, including total visceral adipose tissue (VAT) and total subcutaneous adipose tissue (TSAT), were measured using whole-body magnetic resonance imaging. Intrahepatocellular lipid content (IHCL) was quantified by proton magnetic resonance spectroscopy. RESULTS: Fasting plasma PP concentrations positively and significantly correlated with both VAT (r = 0.57, P < .001) and IHCL (r = 0.51, P < .001), but not with TSAT (r = 0.02, P = .88). Fasting PP concentrations independently predicted VAT after controlling for age and sex. Fasting PP concentrations independently predicted IHCL after controlling for age, sex, body mass index (BMI), waist-to-hip ratio, homeostatic model assessment 2-insulin resistance, (HOMA2-IR) and serum concentrations of triglyceride (TG), total cholesterol (TC), and alanine aminotransferase (ALT). Fasting PP concentrations were associated with serum ALT, TG, TC, low- and high-density lipoprotein cholesterol, and blood pressure (P < .05). These associations were mediated by IHCL and/or VAT. Fasting PP and HOMA2-IR were independently significantly associated with hepatic steatosis (P < .01). CONCLUSIONS: Pancreatic polypeptide is a novel predictor of visceral and liver fat content, and thus a potential biomarker for cardiovascular risk stratification and targeted treatment of patients with ectopic fat deposition

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Bonded orthodontic retainers:Clinical survival, adhesion and material aspects

Orthodontic retainers are used at the end of an orthodontic treatment to retain the achieved tooth position. Without a phase of retention, there is a tendency for the teeth to relapse towards their initial position after treatment. The aetiology of relapse is not fully understood but relates to a number of factors that involves periodontal and occlusal aspects, possibly soft tissue pressures and physiological growth. Retention, which refers to the fixation of the achieved orthodontic result, can be accomplished using removable or fixed retainers. Due to the advances in adhesive technologies, the use of fixed retainers bonded to lingual or palatal surfaces of the incisors has been widely used. Debonding of these retainers is however one of the most frequently reported failure types in orthodontics and has a multifactorial cause. This thesis was conducted in an attempt to identify some of the possible debonding factors causing these failures. Therefore, failures were analyzed in clinical retrospect as well as bond strenght comparison of different retainer types and materials. Comparison of the fatigue resistance, debonding force, and failure type of different retainer materials in vitro was conducted as well as a prospective evaluation of the survival of multi-stranded stainless steel bonded retainers using different resin composite types. At last the evaluation of anterior tooth movement with and without bonded retainers under incremental loading conditions using 3D reconstruction was done. Debonding of these retainers remains unsolved and multicausal, yet aspects such as age, gender, operator, resin composite type could be disclosed