Laminectomy versus interlaminar approach for Lumbar disc herniation

Background: Low back pain is the most common health problem in men and women between the ages of 20 and 50 years. The lumbar disc prolapse has a major role in this condition. Treatment is either conservative or surgical. The most common surgical interventions are either laminectomy or interlaminar approach. Objective: To determine which is the best surgical approach for the patient according to his/her type of disc herniation. Patients and methods: A comparative clinical study conducted in the Neurosciences Hospital, Baghdad, Iraq from January 2016 to January 2018. In this paper we evaluated the clinical outcome following both approaches Results: We studied sixty cases; thirty-four patients had interlaminar approach for lumbar discectomy while twenty-six patients had laminectomy with discectomy. Conclusion: Both methods can manage different types of lumbar disc prolapse, apart from far-lateral disc which favors laminectomy approach

Development of Mountain Climate Generator and Snowpack model for Erosion Predictions in the Western United States using WEPP, Reserach Completion Report for Phase II

Executive Summary: This report summarizes work conducted during the funding period (July 1 through September 30, 1990) of a Cooperative Agreement between the United States Forest Service (USFS) and the Utah Water Research Laboratory (UWRL), Utah State University. The purpose of the agreement is to develop a Western Mountain Climate Generator (MCLIGEN) similar in function to the existing Climate Generator (CLIGEN), which is part of the Water Erosion Prediction Project (WEPP) procedure. Also, we are developing a Western U.S. snowpack simulation model for inclusion in WEPP. In the Western U.S., few meteorological observations exist in high elecation areas where Forest Service properties are located. Therefore, a procedure for estimating climatological variables in mountainous areas is needed to apply WEPP in these regions. A physically-based approach, using an expanded and improved orographic precipitation model, is being utilized. It will use radiosonde data and also lighning data to simualte convective storms. Climatological sequences thus estimated at ungaged locatiosn will be represented using stochastic models, similar to the approach used in the existing CLIGEN, and their parameters will be available to users through maps. By using these stochastic models, WEPP usters can synthsize climate sequences for input to WEPP. During the reporting period we have implemented the the Rhea orographic precipitation model and begun preliminary model testing in two regions. Also, we have begun formulation of model modifications for handling convective events. Various snowplack and meteorological data sets have been acquired and others have been ordered. Some of these have been applied in ititial applications of several snowpack models which have been recorded in a modeular form. Work has commenced on the statistical analysis of western climate sequences, including the preliminary assessment of the alternative stochastic model structures. Additional review of literature has been commenced for establishing desing storms and design hydrographs for events of various return periods in mountainous regions. Accomplishments are summarized in three parts: 1) climatological process models, 2) snowpack simulation models, and 3) stochastic models of climatological variablse and parameter regionalization. A chapter of the report is devoted to each of these three parts

Development of Mountain Climate Generator and Snowpack model for Erosion Predictions in the Western United States Using WEPP, Progress Report No. 1

Executive Summary: This report summarizes work conducted during the initial funding period (November 1, 1989 through June 30, 1990) of a Cooperative Agreement between the United States Forest Service (USFS) and the Utah Water Research Laboratory (UWRL), Utah State University. The purpose of the agreement is to develop a procedure for incorporating western mountain climate into the existing Climate Generator (CLIGEN), which is part of the Water Erosion Prediction Project (WEPP) procedure. In the Western U.S., few meteorological observations exist in high elevation areas where Forest Service properties are located. Therefore, a procedure for estimating climatological variables in mountainous areas is needed to apply WEPP in these regions. A physically-based approach, an expanded and improved orographic precipitation model, is proposed in this report. It will use radiosonde data and also lightning data to simulate convective storms. Climatological sequences thus estimated at ungaged locations will be represented using stochastic models, similar to the approach used in the existing CLIGEN, and their parameters will be available to users through maps. By using these stochastic models, WEPP users can synthesize climate sequences for input to WEPP. Several alternative approaches to developing the Mountain Climate Generator (MCLIGEN) have been formulated and evaluated. These options vary in their spatial resolution. Some will provide synthetic climate inputs whereas others will provide synthetic sequences of water delivery to the ground surface or overland flow delivery. The latter will reduce the user\u27s responsibility for judging adequate snowpack or hydrological simulations, but will enormously increase the effort required for parameterization during the developmental phase. Based on our evaluation, we recommend that Option 2 for generating fine scale climate sequences be adopted. This option appears to satisfy the WEPP spatial resolution requirements of the USFS and requires a reasonable level of developmental effort. We also recommend that Option 3 be available to the users. We recomment that under this option snowpack initial conditions at a specified date be available based on a return period or exceedance probability. Under this option discontinuous simulation periods could be considered. The data, models, and parameters needed to implement the recommended approach can be divided into three parts: 1) climatological process models, 2) a snowpack imulation model, and 3) stochastic models of climatological variables and parameter regionalization. A chapter of the report is devoted to each of these three parts. Each chapter includes a literature review and a description of the proposed methodology and work plan for its development. We further recommend that a comprehensive plan for data collection for validation of the entire WEPP methodology applied to the mountainous Western U.S. be developed. Also, we propose that UWRL take the lead in settin gup a user group for orographic precipitation modelers

Phase 1B, randomized, double-blind, dose-escalation trial of CPG 10101 in patients with chronic hepatitis C virus

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Att leva med kronisk hjärtsvikt : En litteraturöversikt

Bakgrund: Kronisk hjärtsvikt är en folkhälsosjukdom som påverkar ca 2% av Sveriges befolkning. Sjukdomen orsakar fysiska symtom som dyspné och ödem i lungor samt extremiteter, vilket kan påverka patienter fysiskt, socialt och psykiskt.Syfte: Syftet med studien var att kartlägga befintlig kunskap om patienters upplevelser av kronisk hjärtsvikt. Metod: Studien genomfördes som en litteraturöversikt och analyserades med Fribergs (2022a) fyrstegsmodell. Studien baserades på kvalitativa artiklar som har inhämtats genom sökningar i Cinahl och PubMed. Resultat: Elva artiklar valdes ut för analys. Efter analysen skapades fyra kategorier med sex underkategorier som beskriver olika avseenden av patienternas upplevelser. Fynden som presenteras beskriver den fysiska, sociala och psykiska påverkan som patienterna upplever. Fynden visar även på utmaningarna som uppstår när patienterna anpassar sig till sin sjukdom. Slutsats: Kronisk hjärtsvikt påverkar patienter på olika sätt. Patienterna upplever både fysiska, sociala och psykiska begränsningar. För sjuksköterskan innebär det en utmaning att hjälpa patienten på ett holistiskt och personcentrerat sätt. Ett behov av vidare forskning kan finnas för att kunna kartlägga upplevelserna för specifika populationer

Att leva med kronisk hjärtsvikt : En litteraturöversikt

Bakgrund: Kronisk hjärtsvikt är en folkhälsosjukdom som påverkar ca 2% av Sveriges befolkning. Sjukdomen orsakar fysiska symtom som dyspné och ödem i lungor samt extremiteter, vilket kan påverka patienter fysiskt, socialt och psykiskt.Syfte: Syftet med studien var att kartlägga befintlig kunskap om patienters upplevelser av kronisk hjärtsvikt. Metod: Studien genomfördes som en litteraturöversikt och analyserades med Fribergs (2022a) fyrstegsmodell. Studien baserades på kvalitativa artiklar som har inhämtats genom sökningar i Cinahl och PubMed. Resultat: Elva artiklar valdes ut för analys. Efter analysen skapades fyra kategorier med sex underkategorier som beskriver olika avseenden av patienternas upplevelser. Fynden som presenteras beskriver den fysiska, sociala och psykiska påverkan som patienterna upplever. Fynden visar även på utmaningarna som uppstår när patienterna anpassar sig till sin sjukdom. Slutsats: Kronisk hjärtsvikt påverkar patienter på olika sätt. Patienterna upplever både fysiska, sociala och psykiska begränsningar. För sjuksköterskan innebär det en utmaning att hjälpa patienten på ett holistiskt och personcentrerat sätt. Ett behov av vidare forskning kan finnas för att kunna kartlägga upplevelserna för specifika populationer

Improvements in hematologic markers and decreases in fatigue with pegcetacoplan for patients with paroxysmal nocturnal hemoglobinuria and mild or moderate anemia (hemoglobin ≥10 g/dL) who had received eculizumab or were naive to complement inhibitors.

BackgroundAlthough complement component 5 inhibitors (C5is) eculizumab and ravulizumab improve paroxysmal nocturnal hemoglobinuria (PNH) outcomes, patients may experience persistent anemia. This post hoc analysis investigated whether the complement component 3-targeted therapy pegcetacoplan also improved hematologic outcomes and reduced fatigue in patients with PNH and mild/moderate anemia.MethodsPatients with PNH and hemoglobin ≥10.0 g/dL at baseline of PADDOCK (N = 6), PRINCE (N = 8), and PEGASUS (N = 11) were included. Before receiving pegcetacoplan, PADDOCK and PRINCE patients were C5i-naive; PEGASUS patients had hemoglobin ResultsFrom baseline to week 16, mean (SD) hemoglobin concentrations increased in C5i-naive patients (PADDOCK: 10.5 [0.4] to 12.7 [1.1] g/dL; PRINCE: 11.3 [1.0] to 14.0 [1.3] g/dL) and those with suboptimal eculizumab responses (PEGASUS: 10.2 [0.2] to 12.8 [2.6] g/dL). Percentage of patients with hemoglobin ≥12 g/dL increased (PADDOCK: 0 to 60.0% [3 of 5 patients]; PRINCE: 25.0% [2 of 8] to 87.5% [7 of 8]; PEGASUS: 0 to 72.7% [8 of 11]). Sex-specific hemoglobin normalization at week 16 occurred in 40.0% (2 of 5) (PADDOCK), 62.5% (5 of 8) (PRINCE), and 63.6% (7 of 11) (PEGASUS). In all studies, mean ARCs decreased from above normal to normal and ARC normalization increased. Mean Functional Assessment of Chronic Illness Therapy-Fatigue scores improved from below to above or near normal. Two patients had serious adverse events (PEGASUS: post-surgery sepsis, breakthrough hemolysis); breakthrough hemolysis resolved without study discontinuation.ConclusionPatients with PNH and mild/moderate anemia who were C5i-naive or who had suboptimal hemoglobin concentrations despite eculizumab treatment had improved hematologic outcomes and reduced fatigue after initiating or switching to pegcetacoplan.Trial registrationTrial registration numbers: PADDOCK (NCT02588833), PRINCE (NCT04085601; EudraCT, 2018-004220-11), PEGASUS (NCT03500549)