Factors Associated with Recurrence of Varicose Veins after Thermal Ablation: Results of The Recurrent Veins after Thermal Ablation Study

Background. The goal of this retrospective cohort study (REVATA) was to determine the site, source, and contributory factors of varicose vein recurrence after radiofrequency (RF) and laser ablation. Methods. Seven centers enrolled patients into the study over a 1-year period. All patients underwent previous thermal ablation of the great saphenous vein (GSV), small saphenous vein (SSV), or anterior accessory great saphenous vein (AAGSV). From a specific designed study tool, the etiology of recurrence was identified. Results. 2,380 patients were evaluated during this time frame. A total of 164 patients had varicose vein recurrence at a median of 3 years. GSV ablation was the initial treatment in 159 patients (RF: 33, laser: 126, 52 of these patients had either SSV or AAGSV ablation concurrently). Total or partial GSV recanalization occurred in 47 patients. New AAGSV reflux occurred in 40 patients, and new SSV reflux occurred in 24 patients. Perforator pathology was present in 64% of patients. Conclusion. Recurrence of varicose veins occurred at a median of 3 years after procedure. The four most important factors associated with recurrent veins included perforating veins, recanalized GSV, new AAGSV reflux, and new SSV reflux in decreasing frequency. Patients who underwent RF treatment had a statistically higher rate of recanalization than those treated with laser

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.</p

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P &lt; 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P &lt; 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Serological survey and risk factors of Aelurostrongylus abstrusus infection among owned cats in Italy

Feline lungworms affect the respiratory tract of domestic cats causing respiratory conditions of various degrees. In this study, we investigated the exposure of cats to feline lungworm infections by detecting antibodies in a large population of animals from several regions of Italy. Sera of 1087 domestic cats living in regions of the north (n = 700), the centre (n = 227) and the south (n = 160) of Italy were examined by a newly developed indirect ELISA conceived for detection of antibodies against the most frequently occurring feline lungworm Aelurostrongylus abstrusus. Individual cat data (i.e., age, sex, neutering status and provenience) were analysed as potential risk factors for exposure to lungworm infections. Samples were additionally screened for feline leukaemia virus (FeLV) and feline immunodeficiency virus (FIV) proviral DNAs. Overall, 9% (98/1087; 95% confidence interval (CI) 7.4–10.9%) of the animals tested seropositive to lungworm antibodies. Positive cats were identified in the north (7.1%; CI 5.5–9.3%), in the centre (5.3%; CI 3.0–9.0%) and in the South (22.5%; CI 16.7–29.6%), with more seropositive animals in the latter area (p &lt; 0.05). The risk of lungworm infection in cats was significantly associated with age less than 6&nbsp;months (i.e. 24.4%, p &lt; 0.05) and FIV infection (p &lt; 0.05). This large-scale serological survey confirms the exposure of cats to lungworm infections in Italy and that serological tests can be used to assess the distribution of lungworm infections in large populations of animals

Hocheffiziente CIS-Solarbandzelle Abschlussbericht

A new approach for a thin film technology, in which Cu/In/S based flexible solar cells are continuously fabricated on a metal-tape in consecutive roll-to-roll processes, (CISCuT) has been introduced. Then, the completion of cells proceeds by deposition of a thin Cul buffer layer and a highly transparent conductive ZnO-layer. Basics of the CISCuT-concept are metal tapes as mechanical carrier of the cells, continuous roll-to-roll processes, and rapid deposition techniques. The seven work packages of the project were dedicated to show the ability of an efficient tape-like CIS solar cell based of the international new CISCuT idea to develop the scientific and technological basics for the production of those CISCuT-based cells, and to investigate the electronic structure of the cell to find out possibilities or limitations for the efficiency. At the beginning of the project there were single test structures without transparent front electrode of an area of 2 mm&quot;2 and an efficiency of max. 4.5% a technological concept and particular machines for roll-to-roll production of the tape cells in a laboratory scale, and a very simple model of the solar cell physics, based of an ono phase CuInS_2-absorber of n-type and a CuS buffer layer of p-type. A significant progress has been achieved in all of these fields. At the end of the project we can show complete solar cells of an area of 400 mm&quot;2 with an efficiency of 7% solar cell tapes of a length of up to 150 m are produced in continuous roll-to-roll processes, implemented in a base line with a theoretical throughput of 100 kWp/a at 5% efficiency, and the electronic structure of the CISCuT solar cell was found as p-i-n and no principal limitation for theoretic efficiency of those cells must take into account to the best of our knowledge. That means that the basic scientific, technological, and equipment conditions for an economic implementation of the starting CISCuT concept are fulfilled at the end of the project. The results yield directly to the registration of two patents in Germany and a number of scientific publications and contributions at national and international conferences. (orig.)Kernstueck der im Weltmassstab neuen Technologie zur Herstellung flexibler Solarzellen ist die einseitige Erzeugung einer CIS-Absorberschicht auf 30 #mu#m bis 100 #mu#m duennen und nur 1 cm breiten Metallbaendern (CISCuT). Die fertige Bandsolarzelle entsteht in weiteren Schritten. Hierbei wird auf den CIS-Bandabsorber eine sehr duenne Cul-Pufferschicht aufgebracht und darueber eine transparente, hoch leitfaehige ZnO-Schicht abgeschieden. Grundelemente des CISCUT-Konzeptes sind die Nutzung von Metallbaendern als Traeger der Solarzelle, kontinuierliche Rolle-zu-Rolle-Prozesse und schnelle Abscheideverfahren. Die sieben Arbeitspakete des Projektes waren den Zielen, eine effiziente CIS-Bandsolarzelle auf Grundlage der international neuen CISCuT Idee nachzuweisen, die wissenschaftlichen und verfahrenstechnischen Grundlagen ihrer Herstellung zu entwickeln, die Struktur der Solarzelle und moegliche Begrenzungen im Wirkungsgrad zu untersuchen untergeordnet. Ausgehend vom Projektbeginn, bei dem einzelne Teststrukturen (ohne transparenter Frontelektrode) (2 mm&quot;2) mit einem Wirkungsgrad von max. 4.5%, ein Verfahrenskonzept und einzelne Anlagen zur Rolle-zu-Rolle-Herstellung der Bandsolarzellen im Labormassstab, ein einfaches Modell der Solarzelle mit einem einphasigen CulnS_2-Absorber vom n-Leitungstyp und einem CuS-Bufferlayer vom p-Leitungstyp vorlagen, wurden in allen Bereichen wesentliche Fortschritte erzielt. Bei Projektende liegen komplette Solarzellen mit einem Wirkungsgrad von 7% auf einer Flaeche von 400 mm&quot;2 vor, werden in kontinuierlichen Rolle-zu-Rolle-Durchlaeufen in der aufgebauten Base-Line (Theoretischer Durchsatz von 100 KWp/a bei 5% Wirkungsgrad) Solarzellen von 150 m Laenge gefertigt, konnte die p-i-n-Struktur der CISCuT-Solarzelle nachgewiesen werden, die nach gegenwaertigen Stand keine prinzipielle Beschraenkung im Wirkungsgrad aufweist. Damit sind wesentliche wissentschaftliche, technologische und anlagentechnische Voraussatzungen fuer eine wirtschaftliche Umsetzung des CISCuT-Konzeptes erarbeitet worden. Die Ergebnisse fuehrten zur Anmeldung zweier Patente beim Deutschen Patent- und Markenamt sowie zu einer Vielzahl von Veroeffentlichungen und Konferenzbeitraegen. (orig.)Available from TIB Hannover: F03B479+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEBundesministerium fuer Bildung und Forschung, Berlin (Germany)DEGerman

Aerobic training increases the stimulated percentage of CD4+CD25+ in older men but not older women

The purpose of the present study was to determine whether 12 months of moderate intensity cycling would increase the expression of IL-2 (CD25+) receptors in T helper (CD4+) lymphocytes in men and women aged 65– 75 years. Fourteen men and 10 women completed 52 weeks of moderate intensity cycling (60% VO2peak). Subjects trained (TR) three times per week for 45 min per session. Eight age-matched untrained (UT) male and eight UT female subjects acted as controls. Resting blood samples were taken from TR and UT subjects every 4 weeks. Leukocyte concentration was measured using a full blood count. PHA-stimulated CD4+ lymphocytes were analysed for changes in the expression of CD25+, by Xow cytometry. Training signiWcantly increased VO2peak (l min¡1, ml kg¡1 min¡1) in male (+14.3, +16%) and female (+16.7, +27.8%) groups. The TR male group showed a signiWcantly lower percentage of CD4+CD25+ than the male UT in January but the TR male percentage was signiWcantly higher than the UT male group during February, March, April, May, June, September B and December. The female TR group showed a signiWcantly higher percentage CD4+CD25+ than the female UT only during July. There were also signiWcant sequential monthly changes in the percentage of CD4+CD25+ for male and female UT and TR groups. SigniWcant increases in the percentage of CD4+CD25+ in the male TR group suggest training-enhanced lymphocyte mitogenic responsiveness. Moderate intensity long-term training may increase the recruitment of active memory CD4+CD25+ in men rather than women