The influence of the distance between the backrest of a chair and the position of the pelvis on the maximum pressure on the ischium and estimated shear force.

PURPOSE: For some people with leg disorders, the alternative to becoming bedridden is sitting in a wheelchair for long periods of time. The purpose of this study was to investigate the relation between the backrest of a chair and the position of the pelvis on the maximum pressure at the ischium and the estimated shear force encountered while sitting in a chair.METHODS: Ten healthy males aged 22.4 +/- 2.3 years without pathologies in the leg and/or trunk participated in this study. The subjects were instructed to sit in a chair and the pressure and shear forces were measured under three sitting conditions: In the standard position, a 5 cm forward position and a 10 cm forward position. The effects of the positions of the pelvis on the maximum pressure at the ischium were measured by an instrument for measuring pressure distribution and the shear forces were estimated using an experimental model proposed by us.RESULTS: Comparisons were made among the three sitting positions; the range of displacement of the maximum pressure point was not significant. The estimated shear force on the seat was 15.5 +/- 12.4 N in the standard position, 34.4 +/- 8.5 N in the 5-cm forward position, and 53.2 +/- 16.7 N in the 10 cm forward position. There were significant differences among the three values (p < 0.01).CONCLUSIONS: Displacing the pelvis forward and leaning against the backrest tends to increase the shear force and raise the risk of decubitus ulcers

Influence of water vapor on performance degradation and microstructural change of (La,Sr)(Co,Fe)O3-δ cathode

In this study, single cells employing a La0.6Sr0.4Co0.2Fe0.8O3−δ (LSCF) cathode were operated with a supply of humidified oxygen to the cathode at 1000°C for 100 h to investigate the influence of water vapor on the performance and microstructure of LSCF cathode. When a gaseous mixture of 20% H2O−80% O2 was supplied to the cathode, the performance of LSCF cathode continuously lowered during a discharge at 300 mA cm−2 for 100 h. Then, the microstructures of surface and cross-section of LSCF cathode were observed by scanning electron microscopy. The surface morphology was drastically changed by the discharge operation. A SrO layer was formed at the outermost surface of cathode, indicating that the strontium segregation was accelerated by water vapor. In response to this phenomenon, the formation amount of cobalt- and/or iron-based oxides enlarged inside the electrode. These microstructural and phase changes would be responsible for the performance deterioration of LSCF cathode

Successful perioperative management of a patient with idiopathic thrombocytopenic purpura undergoing emergent appendectomy: Report of a case

AbstractINTRODUCTIONIdiopathic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by a low platelet count and normal bone marrow. Patients with ITP undergoing surgery are thought to have increased risk for postoperative complications because of their thrombocytopenia.PRESENTATION OF CASEwe report the case of a 66-year-old woman with ITP who required an emergency operation for acute appendicitis associated with disseminated intravascular coagulation. Preoperative therapy consisted of platelet transfusions only, and intraoperative hemostasis was achieved. Postoperatively, high-dose intravenous immunoglobulin (IVIg) therapy led to an increased, stable, and adequate platelet count and good hemostasis.DISCUSSIONThe outcome of this case suggests that IVIg therapy is not always required for preoperative management of patients with.CONCLUSIONIVIg therapy may be useful for postoperative management after emergency surgery

Effect of febuxostat on left ventricular diastolic function in patients with asymptomatic hyperuricemia : a sub analysis of the PRIZE Study

Hyperuricemia is related to an increased risk of cardiovascular events from a meta-analysis and antihyperuricemia agents may influence to cardiac function. We evaluated the effect of febuxostat on echocardiographic parameters of diastolic function in patients with asymptomatic hyperuricemia as a prespecified endpoint in the subanalysis of the PRIZE study. Patients in the PRIZE study were assigned randomly to either add-on febuxostat treatment group or control group with only appropriate lifestyle modification. Of the 514 patients in the overall study, 65 patients (31 in the febuxostat group and 34 in the control group) who had complete follow-up echocardiographic data of the ratio of peak early diastolic transmitral flow velocity (E) to peak early diastolic mitral annular velocity (e′) at baseline and after 12 and 24 months were included. The primary endpoint was a comparison of the changes in the E/e′ between the two groups from baseline to 24 months. Interestingly, e′ was slightly decreased in the control group compared with in the febuxostat group (treatment p = 0.068, time, p = 0.337, treatment × Time, p = 0.217). As a result, there were significant increases in E/e′ (treatment p = 0.045, time, p = 0.177, treatment × time, p = 0.137) after 24 months in the control group compared with the febuxostat group. There was no significant difference in the serum levels of N-terminal-pro brain natriuretic peptide and high-sensitive troponin I between the two groups during the study period. In conclusions, additional febuxostat treatment in patients with asymptomatic hyperuricemia for 24 months might have a potential of preventable effects on the impaired diastolic dysfunction

Prospective Study on the Incidence of Bone Metastasis (BM) and Skeletal-Related Events (SREs) in Patients (pts) with Stage IIIB and IV Lung Cancer—CSP-HOR 13

Background:Bone metastasis (BM) is a frequent complication in patients with advanced lung cancer and it causes skeletal-related events (SREs). Our study aim is to prospectively investigate the incidence of BM, incidence and types of SRE, and predictive factors of BM and SREs.Methods:Newly diagnosed, advanced non–small-cell lung cancer (NSCLC) or small-cell lung cancer (SCLC) patients were enrolled into the study. Patients were followed up every 4 weeks to monitor the development of SREs. Treatment for lung cancer was performed at the discretion of the investigator.Results:Two hundred seventy-four patients were enrolled in this study between April 2007 and December 2009 from 12 institutions. Patients included 77 cases of SCLC and 197 of NSCLC (stage IIIB/IV = 73/124). Median follow-up time was 13.8 months. The incidence of BM at initial diagnosis was 48% in stage IV NSCLC and 40% in extensive stage (ED)-SCLC. Forty-five percent of patients who developed BM had SREs consisting of pathologic fracture (4.7%), radiation to bone (15.3%), spinal cord compression (1.1%), and hypercalcemia (2.2%). Multivariate analysis revealed that factors predicting BM are stage IV, performance status 1 or greater and higher bone alkaline phosphatase in NSCLC patients, higher lactate dehydrogenase, and lower parathyroid hormone–related peptide in SCLC patients. Factors predicting SREs were stage IV, age 64 or younger, and lower albumin in NSCLC patients. Multivariate analysis of SRE was not performed for SCLC because of the small number of events.Conclusion:Predictive factors should be taken into consideration in future randomized studies evaluating BM and SREs

Common Peak Approach Using Mass Spectrometry Data Sets for Predicting the Effects of Anticancer Drugs on Breast Cancer

We propose a method for biomarker discovery from mass spectrometry data, improving the common peak approach developed by Fushiki et al. (BMC Bioinformatics, 7:358, 2006). The common peak method is a simple way to select the sensible peaks that are shared with many subjects among all detected peaks by combining a standard spectrum alignment and kernel density estimates. The key idea of our proposed method is to apply the common peak approach to each class label separately. Hence, the proposed method gains more informative peaks for predicting class labels, while minor peaks associated with specific subjects are deleted correctly. We used a SELDI-TOF MS data set from laser microdissected cancer tissues for predicting the treatment effects of neoadjuvant therapy using an anticancer drug on breast cancer patients. The AdaBoost algorithm is adopted for pattern recognition, based on the set of candidate peaks selected by the proposed method. The analysis gives good performance in the sense of test errors for classifying the class labels for a given feature vector of selected peak values

Effect of ipragliflozin on carotid intima-media thickness in type 2 diabetes patients

Aims To examine the effects of a 24-month treatment with ipragliflozin on carotid intima-media thickness (IMT) in type 2 diabetes patients. Methods and results In this multicenter, prospective, randomized, open-label, and blinded-endpoint investigator-initiated clinical trial, adults with type 2 diabetes and haemoglobin A1C (HbA1c) of 6.0–10.0% (42–86 mmol/mol) were randomized equally to ipragliflozin (50 mg daily) and non-sodium-glucose cotransporter-2 (SGLT2) inhibitor use of standard-care (control group) for type 2 diabetes and were followed-up to 24 months. The primary endpoint was the change in mean common carotid artery IMT (CCA-IMT) from baseline to 24 months. A total of 482 patients were equally allocated to the ipragliflozin (N = 241) and control (N = 241) groups, and 464 patients (median age 68 years, female 31.7%, median type 2 diabetes duration 8 years, median HbA1c 7.3%) were included in the analyses. For the primary endpoint, the changes in the mean CCA-IMT from baseline to 24 months were 0.0013 [95% confidence interval (CI), −0.0155–0.0182] mm and 0.0015 (95% CI, −0.0155–0.0184) mm in the ipragliflozin and control groups, respectively, with an estimated group difference (ipragliflozin-control) of −0.0001 mm (95% CI, −0.0191–0.0189; P = 0.989). A group difference in HbA1c change at 24 months was also non-significant between the treatment groups [−0.1% (95% CI, −0.2–0.1); P = 0.359]. Conclusion Twenty-four months of ipragliflozin treatment did not affect carotid IMT status in patients with type 2 diabetes recruited in the PROTECT study, relative to the non-SGLT2 inhibitor-use standard care for type 2 diabetes