Sarcopenia in patients with diabetes mellitus.

IntroductionDiseases such as diabetes mellitus may be associated with adverse changes in body composition. Sarcopenia is characterized by a progressive and generalized loss of skeletal muscle mass and functionality.AimTo investigate the relationship between type 2 diabetes mellitus (T2DM) and sarcopenia.Materials and methodsIn a retrospective, non-randomized study, 35 T2DM patients, aged 20-80 years, were assessed for sarcopenia prevalence compared to controls (n=16). Appendicular skeletal mass (ASM) (kg) was measured, and sarcopenia was defined as SMI ResultsIncidence of sarcopenia was significantly higher in T2DM patients vs. controls (27% vs. 20%, p=0.01) and elderly vs. young participants (40% vs. 12%, pConclusionsA moderate prevalence of sarcopenia in patients with type 2 diabetes mellitus was observed, which appeared to increase significantly in older men. Finally, incidence of T2DM displayed decreased physical performance in both genders

MMP9 but Not EGFR, MET, ERCC1, P16, and P-53 Is Associated with Response to Concomitant Radiotherapy, Cetuximab, and Weekly Cisplatin in Patients with Locally Advanced Head and Neck Cancer

Concomitant administration of radiotherapy with cisplatin or radiotherapy with cetuximab appear to be the treatment of choice for patients with locally advanced head and neck cancer. In the present retrospective analysis, we investigated the predictive role of several biomarkers in an unselected cohort of patients treated with concomitant radiotherapy, weekly cisplatin, and cetuximab (CCRT). We identified 37 patients treated with this approach, of which 13 (35%) achieved a complete response and 10 (27%) achieved a partial response. Severe side effects were mainly leucopenia, dysphagia, rash, and anemia. Tumor EGFR, MET, ERCC1, and p-53 protein and/or gene expression were not associated with treatment response. In contrast, high MMP9 mRNA expression was found to be significantly associated with objective response. In conclusion, CCRT is feasible and active. MMP9 was the only biomarker tested that appears to be of predictive value in cetuximab treated patients. However, this is a hypothesis generating study and the results should not be viewed as definitive evidence until they are validated in a larger cohort

Does a bed rail system of alcohol-based handrub antiseptic improve compliance of health care workers with hand hygiene? Results from a pilot study

Background: Hand hygiene is the cornerstone of prevention of nosocomial infections and a challenge for infection-control teams. Methods: Bed-rail dispensers of alcohol-based hand rub antiseptic (AHRA) were first initiated only in department A (period I), followed by department B (period II). Opportunities for hand hygiene (OHH) were recorded during periods I, II, and III (post-trial follow-up). Only application of AHRA before and after contacting each patient was considered as appropriate. Comparative evaluation between periods I and II, as well as II and III. was performed. Predictors of AHRA compliance were also assessed by regression analysis. Results: HCWs’ compliance was improved after the initiation of the bed-rail approach in department B (51.5%, vs 36.4% P = .005). In department A, where this system already existed, no changes were observed. The bed-rail AHRA system (P = .007 [OR 1.8(1.2-3.0)]) and nurses (P <.0001 [OR 5.6 (3.1-9.9)]) were predictors of hand hygiene in department B. HCWs’ compliance declined in department B (26.5% vs 51.5%, P <.0001) and department A (27.5% vs 35.9%, P = .1) during period III. Conclusions: The bed-rail approach initially improved HCWs’ compliance with AHRA but did not radically influence behavior in internal medicine settings. Multidisciplinary strategies are required to establish hand hygiene recommendations. Copyright (C) 2009 Association or Professionals in Infection Control and Epidemiology. Inc

Model for end-stage liver disease (MELD) score, as a prognostic factor for post-operative morbidity and mortality in cirrhotic patients, undergoing hepatectomy for hepatocellular carcinoma

AbstractBackground/aimsTo evaluate the ability of the model for end-stage liver disease (MELD) in predicting the post-hepatectomy outcome for hepatocellular carcinoma (HCC).MethodsBetween 2001 and 2004, 69 cirrhotic patients with HCC underwent hepatectomy and the results were retrospectively analysed. MELD score was associated with post-operative mortality and morbidity, hospital stay and 3-year survival.ResultsSeventeen major and 52 minor resections were performed. Thirty-day mortality rate was 7.2%. MELD ≤ 9 was associated with no peri-operative mortality vs. 19% when MELD > 9 (P<0.02). Overall morbidity rate was 36.23%; 48% when MELD > 9 vs. 25% when MELD ≤ 9 (P<0.02). Median hospital stay was 12 days [8.8 days, when MELD ≤ 9 and 15.6 days when MELD > 9 (P=0.037)]. Three-year survival reached 49% (66% when MELD ≤ 9; 32% when MELD > 9 (P<0.01). In multivariate analysis, MELD > 9 (P<0.01), clinical tumour symptoms (P<0.05) and American Society of Anesthesiologists (ASA) score (P<0.05) were independent predictors of peri-operative mortality; MELD > 9 (P<0.01), tumour size >5cm (P<0.01), high tumour grade (P=0.01) and absence of tumour capsule (P<0.01) were independent predictors of decreased long-term survival.ConclusionMELD score seems to predict outcome of cirrhotic patients with HCC, after hepatectomy

SECURITY ECONOMICS: A GUIDE FOR DATA AVAILABILITY AND NEEDS

The rapid and accelerating development of security economics has generated great demand for more and better data, to accommodate the empirical research agenda. The present paper serves as a guide to policy makers and researchers for security-related databases. The paper focuses on two main issues. First, it takes stock of the existing databases and highlights their main components. Second, it discusses data shortages and needs that are considered essential for enhancing our understanding of the complex phenomenon of terrorism, as well as designing and evaluating policy.Security economics, Datasets, Terrorism,