Prospective comparison of loop excision under colposcopic guidance versus vitom guidance

Background: Aim of the study was to compare the quality of loop excision using a colposcope with results using the VITOM system. Results compared included cervical volume removed, intra- and postoperative complications, and positive resection margins. Methods: A total of 200 patients with histologically confirmed high-grade cervical premalignant lesions, persistent atypical cytological results and/or suspicious colposcopic findings, and cytological and histological discrepancies were included in the study. In transformation zone type 1 (T1) only a superficial cone biopsy was done, in zones type 2 and 3 (T2 and T3) a superficial outside cone biopsy or a deeper inside cone biopsy were done respectively, followed by endocervical curettage. Volume of removed tissue, complications, and positive resection margins were compared for the colposcopy and the VITOM groups. Findings: Demographic and reproductive features were similar between groups. In the VITOM group 49% of patients had zone T1, 30% had zone T2, and 21% had zone T3. In the group of patients managed by colposcopy, 48, 45, and 7% of patients had zone T1, T2 and T3 zone, respectively (p0.05). There were no significant differences in the type of procedure or the mean volume of removed tissue. Results were similar for both groups with respect to positive resection margins and complications. Conclusion: VITOM is a safe and reliable system. Results using the VITOM system are comparable to those obtained with conventional colposcopy. The potential advantage of VITOM is the broader availability of endoscopic systems in the operating theatre. © Georg Thieme Verlag KG Stuttgart · New York

Правове життя та правова активність: співвідношення понять

В статті розкрито теоретичний аспект пізнання двох юридичних категорій: «правове життя» і «правова активність», а також проаналізовано поняття «активність», «соціальна активність», «правова активність», їх взаємозвязок та взаємозалежність. Ключові слова: правове життя, активність, соціальна активність, правова активність, позитивна правова активність, негативна правова активність.В статье раскрыт теоретический аспект познания двух юридических категорий: «правовая жизнь» и «правовая активность», а также проанализировано понятия «активность», «социальная активность», «правовая активность», их взаимосвязь и взаимозависимость. Ключевые слова: правовая жизнь, активность, социальная активность, правовая активность, позитивная правовая активность, негативная правовая активность.The theoretical aspect of two legal categories «legal life» and «legal activity» cognition were researched in this article, the conception of "activity", «social activity», «legal activity, their interrelation and interdependence were analyzed. Key words: a legal life, activity, social activity, legal activity, positive legal activity, negative legal activit

Characterization of global fields by Dirichlet L-series

We prove that two global fields are isomorphic if and only if there is an isomorphism of groups of Dirichlet characters that preserves L-series

Risk factors for falls in older adults in a South African Urban Community

Background: Studies on falls in older adults have mainly been conducted in high income countries. Scant, if any, information exists on risk factors for falls in the older population of sub-Saharan African countries. Methods: A cross-sectional survey and a 12-month follow-up study were conducted to determine risk factors for falls in a representative multi-ethnic sample of 837 randomly selected ambulant community-dwelling subjects aged ≥65 years in three suburbs of Cape Town, South Africa. Logistic regression models were fitted to determine the association between (1) falls and (2) recurrent falls occurring during follow-up and their potential socio-demographic, self-reported medical conditions and physical assessment predictors. Results: Prevalence rates of 26.4 % for falls and 11 % for recurrent falls at baseline and 21.9 % for falls and 6.3 % for recurrent falls during follow-up. In both prospective analyses of falls and recurrent falls, history of previous falls, dizziness/vertigo, ethnicity (white or mixed ancestry vs black African) were significant predictors. However, poor cognitive score was a significant predictor in the falls analysis, and marital status (unmarried vs married) and increased time to perform the timed Up and Go test in the recurrent fall analysis but not in both. Other than the timed Up and Go test in recurrent falls analysis, physical assessment test outcomes were not significant predictors of falls. Conclusion: Our study provides simple criteria based on demographic characteristics, medical and physical assessments to identify older persons at increased risk of falls. History taking remains an important part of medical practice in the determination of a risk of falls in older patients. Physical assessment using tools validated in developed country populations may not produce results needed to predict a risk of falls in a different setting

Changes of a frailty index based on common blood and urine tests during a hospital stay on geriatric wards predict 6-month and 1-year mortality in older people

Jakob Jäger,1,2 Cornel Christian Sieber,1,3 Karl-Günter Gaßmann,1,2 Martin Ritt1,2 1Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), D-90408 Nürnberg, Germany; 2Department of Internal Medicine III (Medicine of Ageing), Geriatrics Center Erlangen, Malteser Hospital Erlangen, D-91054 Erlangen, Germany; 3Department of General Internal Medicine and Geriatrics, Hospital of the Order of St John of God, D-93049 Regensburg, Germany Background: We aimed to evaluate the abilities of a 21-item frailty index based on laboratory blood and urine tests (FI-Lab21) assessed at different points in time, ie, at admission to hospital (FI-Lab21admission) and before discharge from hospital (FI-Lab21discharge), and the change of the FI-Lab21 during the hospital stay to predict 6-month and 1-year mortality in hospitalized geriatric patients. Methods: Five hundred hospitalized geriatric patients aged ≥65 years were included in this analysis. Follow-up data were acquired after a period of 6 months and 1 year. Results: The FI-Lab21admission and FI-Lab21discharge scores were 0.33±0.15 and 0.31±0.14, respectively (P<0.001). The FI-Lab21admission and FI-Lab21discharge both predicted 6-month and 1-year mortality (areas under the receiver operating characteristic curves: 0.72, 0.72, 0.77, and 0.75, respectively, all P<0.001). The predictive abilities for 6-month and 1-year mortality of the FI-Lab21admission were inferior compared with those of the FI-Lab21discharge (all P<0.05). Patients with a reduction in or stable FI-Lab21 score during the hospital stay revealed lower 6-month and 1-year mortality rates compared with the persons whose FI-Lab21 score increased during the hospital stay (all P<0.05). After adjustment for age, sex, and FI-Lab21admission, each 1% decrease in the FI-Lab21 during the hospital stay was associated with a decrease in 6-month and 1-year mortality of 5.9% and 5.3% (both P<0.001), respectively. Conclusion: The FI-Lab21 assessed at admission or discharge and the changes of the FI-Lab21 during the hospital stay emerged as interesting and feasible approaches to stratify mortality risk in hospitalized geriatric patients. Keywords: geriatric wards, frailty, frailty index, cumulative deficit, older peopl