Influence of ultra-low dose Aprotinin on thoracic surgical operations: a prospective randomized trial

<p>Abstract</p> <p>Background</p> <p>The blood saving effect of aprotinin has been well documented in cardiac surgery. In thoracic surgery, very few recent studies, using rather high doses of aprotinin, have shown a similar result. In a randomized prospective trial, we have tested the influence of aprotinin using an ultra-low dose drug regime.</p> <p>Methods</p> <p>Fifty-nine patients, mean age 58 ± 13.25 years (mean ± SD) undergoing general thoracic procedures were randomized into placebo (Group A) and treatment group (Group B). The group B (n = 29) received 500.000 IU of aprotinin after induction to anesthesia and a repeat dose immediately after chest closure. A detailed protocol with several laboratory parameters was recorded. Patients were transfused when perioperative Ht was less than 26%.</p> <p>Results</p> <p>The two groups were similar in terms of age, gender, diagnosis, pathology, co-morbidity and operations performed. The mean drainage of the first and second postoperative day in group B was significantly reduced (412.6 ± 199.2 vs. 764.3 ± 213.9 ml, p < 0.000, and 248.3 ± 178.5 vs. 455.0 ± 274.6, p < 0.001). Similarly, the need for fresh frozen plasma transfusion was lower in group B, p < 0.035. Both the operation time and the hospital stay were also less for group B but without reaching statistical significance (84.6 ± 35.2 vs 101.2 ± 52.45 min. and 5.8 ± 1.6 vs 7.2 ± 3.6 days respectively, p < 0.064). The overall transfusion rate did not differ significantly. No side effects of aprotinin were noted.</p> <p>Conclusion</p> <p>The perioperative ultra-low dose aprotinin administration was associated with a reduction of total blood losses and blood product requirements. We therefore consider the use of aprotinin safe and effective in major thoracic surgery.</p

Factors associated with intentions to adhere to colorectal cancer screening follow-up exams

BACKGROUND: To increase adherence rate to recommendations for follow-up after abnormal colorectal cancer (CRC) screening results, factors that inhibit and facilitate follow-up must be identified. The purpose of this study was to identify the factors associated with intention to adhere to CRC screening follow-up exams. METHODS: During a 4-week period in October 2003, this survey was conducted with 426 subjects participating in a community-based CRC screening program in Nagano, Japan. Study measures included intention to adhere to recommendation for clinical follow-up in the event of an abnormal fecal occult blood test (FOBT) result, perceived susceptibility and severity of CRC, perceived benefits and barriers related to undergoing follow-up examination, social support, knowledge of CRC risk factors, health status, previous CRC screening, personality and social demographic characteristics. Univariate and multivariate logistic regression analyses on intention to adhere to recommendations for follow-up were performed. RESULTS: Among the 288 individuals analyzed, approximately 74.7% indicated that they would definitely adhere to recommendations for follow-up. After controlling for age, gender, marital status, education, economic status, trait anxiety, bowel symptoms, family history of CRC, and previous screening FOBT, analyses revealed that lower levels of perceived barriers, higher levers of perceived benefits and knowledge of CRC risk factors were significantly associated with high intention respectively. CONCLUSION: The results of this study suggest that future interventions should focus on reducing modifiable barriers by clarifying misperceptions about follow-up, promoting the acceptance of complete diagnostic evaluations, addressing psychological distress, and making follow-up testing more convenient and accessible. Moreover, educating the public regarding the risk factors of CRC and increasing understanding of the benefits of follow-up is also important

The National Cancer Institute’s Community Networks Program Initiative to Reduce Cancer Health Disparities: Outcomes and Lessons Learned

We describe reach, partnerships, products, benefits, and lessons learned of the 25 Community Network Programs (CNPs) that applied community-based participatory research (CBPR) to reduce cancer health disparities

Punitive restoration and restorative justice.

Criminal justice policy faces the twin challenges of improving our crime reduction efforts while increasing public confidence. These challenges are exacerbated by the fact that at least some measures popular with the public are counterproductive to greater crime reduction. How to achieve greater crime reduction without sacrificing public confidence? While restorative justice approaches offer a promising alternative to traditional sentencing with the potential to achieve these goals, they suffer from several serious obstacles, not least their relatively limited applicability, flexibility, and public support. Punitive restoration is a new and distinctive idea about restorative justice modeled on an important principle of stakeholding, which states that those who have a stake in penal outcomes should have a say about them. Punitive restoration is restorative insofar as it aims to achieve the restoration of rights infringed or threatened by criminal offences. Punitive restoration is punitive insofar as the available options for this agreement are more punitive than found in most restorative justice approaches, such as the option of some form of hard treatment. Punitive restoration sheds new light on how we may meet the twin challenges of improving our efforts to reduce reoffending without sacrificing public confidence, demonstrating how restorative practices can be embedded deeper within the criminal justice system

Measurement of the Ratio of b Quark Production Cross Sections in Antiproton-Proton Collisions at 630 GeV and 1800 GeV

We report a measurement of the ratio of the bottom quark production cross section in antiproton-proton collisions at 630 GeV to 1800 GeV using bottom quarks with transverse momenta greater than 10.75 GeV identified through their semileptonic decays and long lifetimes. The measured ratio sigma(630)/sigma(1800) = 0.171 +/- .024 +/- .012 is in good agreement with next-to-leading order (NLO) quantum chromodynamics (QCD)

Microsoft Word - ponencia.doc

This paper draws on an ongoing study of comparative penology that is being undertaken by Michael Cavadino and myself in collaboration with colleagues from a wide range of countries representing Western Europe (England and Wales, France, Germany, Italy, The Netherlands, Sweden and Finland), the non-European English-speaking world (USA, Australia and New Zealand), an advanced industrialised but non-Western state (Japan) and the fascinating but rather special case of South Africa. At a theoretical level, the approach we have adopted is based on an analytical framework as we have previously developed for our book on the English Penal System (Cavadino and Dignan, 2002), which we call radical pluralism. We have tried to show how the radical pluralist framework applies to the realm of penality with the aid of a diagram (see Radical pluralism conceives of society as containing a plurality of interest groups, such as business organisations, trade unions, and political parties, which contend to have power exerted in their favour. These interest groups include economic classes, but are not restricted to them, since race, nationality and gender relations are also critical to any adequate social analysis. The state mediates this contest between the various interest groups, but does not do so in an impartial manner since it is inherently biased towards groups which already possess wealth, established power and status. However, the relationship between the state and the various interest groups is likely to vary from one country to another. The social world in which all this contending and mediating activity takes place has both material and ideological aspects to it, and these components interact with one another reciprocally [refer to diagram]. And the way they interact is likely to have important consequences in the realm of penality. Naturally, however, the precise nature of the relationship between political, economic and cultural factors -and also the interplay between them -is likely to vary within different kinds of societies. General hypothesis 2 2 So, generalising somewhat, we might expect that societies that resemble one another in terms of their economies, politics and cultures would also broadly resemble each other in terms of their penality, though it might be wise to expect some surprises and anomalies. In order to put this hypothesis to the test we have developed profiles of four different types of &apos;late&apos; capitalist societies that we have derived from the work of Esping-Andersen (1990) and others. These are depicted in the form of a typology that is set out in Trying to trace the origins, history and continuing development of &apos;youth justice&apos; systems is not an easy task. So, in order to try to simplify matters I will make reference to a second typology that is set out i

Penal Systems: A Comparative Approach

Penal Systems: A Comparative Approach is a comprehensive and original introduction to the comparative study of punishment. Analysing twelve countries, Cavadino and Dignan offer an integrated and theoretically rigorous approach to comparative penology. They draw upon material provided by a team of eminent penologists to produce an important and highly readable contribution to scholarship in this area. Early chapters introduce the reader to comparative penology, set out the theoretical framework and consider whether there is currently a 'global penal crisis'. Each country is then discussed in turn. Chapters on comparative youth justice and the privatization of prisons follow. Comparisons between countries are drawn within each chapter, giving the reader a synoptic and truly comparative vision of penality in different jurisdictions