An update on radiation therapy for brain metastases

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Recording of natural head position using stereophotogrammetry: A new technique and reliability study

The purpose of this study was to develop a technique to record physical references and orient digital mesh models to natural head position (NHP) using stereo-photogrammetry (SP). The first step was to record the digital mesh model of a hanging reference board placed at the capturing position of the SP machine. The board was aligned to the true vertical using a plumb bob. It was also aligned with laser plane parallel to the hanging mirror which was located at the center of the machine. Parameter derived from the digital mesh model of the board was then used to adjust the roll, pitch and yaw of the subsequent captures of subjects. This information was valid until the next machine calibration. The board placement was repeatable with standard deviation of less than 0.1 degrees for both pitch and yaw; 0.15 degrees for roll angles.postprin

Seroprevalence of Human Immunodeficiency Virus, Hepatitis B, Hepatitis C, syphilis, and co infections among antenatal women in a tertiary institution in south east, Nigeria

Background: Sexually transmitted infections and human immunodeficiency virus (HIV)/AIDS are a major public health concern owing to both their prevalence and propensity to affect offspring through vertical transmission. Aim: The aim was to determine the seroprevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, and co‑infections among antenatal women in Enugu, South‑East Nigeria. Materials and Methods: A retrospective study of antenatal women at the University of Nigeria Teaching Hospital, Enugu, South‑East Nigeria from 1st May 2006 to 30th April 2008. A pretested data extraction form was used to obtain data on sociodemographic variables and screening test results from the antenatal records. The analysis was done with SPSS version 17 (Chicago, IL, USA). Results: A total of 1239 antenatal records was used for the study. The seroprevalence of HIV, HBV, HCV, and syphilis among the antenatal women were 12.4% (154/1239), 3.4% (42/1239) 2.6 (32/1239) 0.08% (1/1239), respectively. The HIV/HBV and HIV/HCV co‑infection prevalence rates were 0.24% (3/1239), 0.16% (2/1239), respectively. There was no HBC and HCV co‑infection among both HIV positive and negative antenatal women. There was no statistically significant difference in HBV and HCV infection between the HIV positive and negative antenatal women. The only woman that was seropositive for syphilis was also positive to HIV. Conclusion: The seroprevalence of HIV, HBV, HCV, and syphilis is still a challenge in Enugu. Community health education is necessary to reduce the prevalence of this infection among the most productive and economically viable age bracket.Keywords: Antenatal women, Co‑infection, Human immunodeficiency virus, Hepatitis C virus, Hepatitis B virus, Seroprevalence, Syphili

The effect of an alginate carrier on bone formation in a hydroxyapatite scaffold.

This study investigated the osteoconductive properties of a porous hydroxyapatite (HA) scaffold manufactured using a novel technique similar to the bread-making process, alone and in combination with an alginate polysaccharide fiber gel (HA/APFG putty) and autologous bone marrow aspirate (BMA). The hypothesis was that the HA/APFG putty would be as osteoconductive as granular HA and that the presence of BMA would further enhance bone formation in an ovine femoral condyle critical defect model. Thirty-six defects were created and either (1) porous HA granules, (2) HA/APFG putty, or (3) HA/APFG putty + BMA were implanted. After retrieval at 6 and 12 weeks, image analysis techniques were used to quantify bone apposition rates, new bone area, bone-HA scaffold contact, and implant resorption. At 6 weeks postsurgery, significantly lower bone apposition rates were observed in the HA/APFG putty group when compared to the HA (p = 0.014) and HA/APFG putty + BMA (p = 0.014) groups. At 12 weeks, significantly increased amounts of new bone formation were measured within the HA scaffold (33.56 ± 3.53%) when compared to both the HA/APFG putty (16.69 ± 2.7%; p = 0.043) and the defects containing HA/APFG putty + BMA (19.31 ± 3.8%; p = 0.043). The use of an APFG gel as a carrier for injectable CaP bone substitute materials delayed bone formation in this model compared to HA granules alone which enhanced bone formation especially within the interconnected smaller pores. Our results also showed that the addition of autologous BMA did not further enhance its osteoconductive properties. Further study is required to optimize the degradation rate of this APFG binding agent before using as a directly injectable material for repair of bone defect. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2015

Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers

<p>Abstract</p> <p>Background</p> <p>This study reviewed the impact of pre-operative chemoradiotherapy or post-operative chemotherapy and/or radiotherapy on total mesorectal excision (TME) for ultralow rectal cancers that required either low anterior resection with peranal coloanal anastomosis or abdomino-perineal resection (APR). We examined surgical complications, local recurrence and survival.</p> <p>Methods</p> <p>Of the 1270 patients who underwent radical resection for rectal cancer from 1994 till 2007, 180 with tumors within 4 cm with either peranal coloanal anastomosis or APR were analyzed. Patients were compared in groups that had surgery only (Group A), pre-operative chemoradiotherapy (Group B), and post-operative therapy (Group C).</p> <p>Results</p> <p>There were 115 males and the mean age was 65.43 years (range 30-89). APR was performed in 134 patients while 46 had a sphincter-preserving resection with peranal coloanal anastomosis. The mean follow-up period was 52.98 months (range: 0.57 to 178.9). There were 69, 58 and 53 patients in Groups A, B, and C, respectively. Nine patients in Group B could go on to have sphincter-saving rectal resection. The overall peri-operative complication rate was 43.4% in Group A vs. 29.3% in Group B vs. 39.6% in Group C, respectively. The local recurrence rate was significantly lower in Group B (8.6.9% vs. 21.7% in Group A vs. 33.9% in Group C) <it>p < 0.05</it>. The 5-year cancer-specific survival rates for Group A was 49.3%, Group B was 69.9% and Group C was 38.8% (<it>p </it>= 0.14).</p> <p>Conclusion</p> <p>Pre-operative chemoradiation in low rectal cancer is not associated with a higher incidence of peri-operative complications and its benefits may include reduction local recurrence.</p

RNA-Seq of Huntington's disease patient myeloid cells reveals innate transcriptional dysregulation associated with proinflammatory pathway activation

Innate immune activation beyond the central nervous system is emerging as a vital component of the pathogenesis of neurodegeneration. Huntington's disease (HD) is a fatal neurodegenerative disorder caused by a CAG repeat expansion in the huntingtin gene. The systemic innate immune system is thought to act as a modifier of disease progression; however, the molecular mechanisms remain only partially understood. Here we use RNA-sequencing to perform whole transcriptome analysis of primary monocytes from thirty manifest HD patients and thirty-three control subjects, cultured with and without a proinflammatory stimulus. In contrast with previous studies that have required stimulation to elicit phenotypic abnormalities, we demonstrate significant transcriptional differences in HD monocytes in their basal, unstimulated state. This includes previously undetected increased resting expression of genes encoding numerous proinflammatory cytokines, such as IL6 Further pathway analysis revealed widespread resting enrichment of proinflammatory functional gene sets, while upstream regulator analysis coupled with Western blotting suggests that abnormal basal activation of the NFĸB pathway plays a key role in mediating these transcriptional changes. That HD myeloid cells have a proinflammatory phenotype in the absence of stimulation is consistent with a priming effect of mutant huntingtin, whereby basal dysfunction leads to an exaggerated inflammatory response once a stimulus is encountered. These data advance our understanding of mutant huntingtin pathogenesis, establish resting myeloid cells as a key source of HD immune dysfunction, and further demonstrate the importance of systemic immunity in the potential treatment of HD and the wider study of neurodegeneration

Corpo-oralidades y territorio en la dramaturgia de Felipe Vergara, de la experiencia del conflicto al correlato artístico

Dissertação apresentada ao Programa de Pós- Graduação em Literatura Comparada da Universidade Federal da Integração Latino- Americana, como requisito parcial à obtenção do título de Mestre em Literatura Comparada. Orientador: Andrea Ciacchi (Pós-Doutor Universidade Estadual de Campinas , Doutor em Iberistica, Università di Bologn , a Mestro em Letras, Universidade Federal da Paraíba , Graduação em Antropologia, Università di Roma)Propongo una lectura de la poética teatral de Felipe Vergara desde el estudio de tres piezas: Kilele, una epopeya artesanal; Arimbato, el camino del árbol; y Coragyps Sapiens, partiendo por considerar el teatro como un encuentro vital entre los artistas y su público, que instala escrituras permeadas por el tiempo, la historia y el contexto de su surgimiento. En ese sentido planteo que la dramaturgia Vergara funciona como un correlato que revive el rastro de la experiencia de guerra de las comunidades del Pacífico colombiano, a la vez que toma una posición autónoma de resistencia artística, social y cultural, y que porta en su discurso las versiones silenciadas históricamente, las versiones subterráneas. Para el análisis abordo: la relación indisoluble de las comunidades con su territorio, manifiesta en las obras; las representaciones de cuerpo y su fragmentación tanto a nivel individual como colectivo; y su reconstrucción a través de los duelos que se encarnan en transmisiones rituales, corporales y orales, en actos de memoria viva. Presento así un recorrido por la propuesta artística de Felipe Vergara y un acercamiento a algunas propuestas teatrales las comunidades del Pacífico colombiano, en las que curiosamente, Vergara trabajó de la mano de Inge Kleutgens, Catalina Medina y otros colaboradores. Retomaremos tres obras de Vergara, así como tres de las creaciones colectivas de las comunidades con las que , rastreando en ellas los procesos y procedimientos para la reconstrucción de una porción de los relatos alternativos de la historia social de las vivencias del conflicto social y armado colombiano, traducidas en las relaciones entre los imaginarios y las representaciones simbólicas de las obras, que asocian las gamas de sentido del texto y de la puesta en escena, con el cauce efectivo que propicia su escritura.Proponho uma leitura da poesia teatral de Felipe Vergara a partir do estudo de três obras: Kilele, una epopeya artesanal; Arimbato, el camino del árbol; y Coragyps Sapiens, começando por considerar o teatro como um encontro vital entre os artistas e seu público, que instala escritos permeados pelo tempo, pela história e pelo contexto de seu surgimento. Nesse sentido, proponho que a dramaturgia de Vergara funcione como um correlato que revive o traço da experiência de guerra das comunidades do Pacífico colombiano, ao mesmo tempo em que assume uma posição autônoma de resistência artística, social e cultural, e que carrega em seu discurso as versões silenciadas historicamente, as versões subterrâneas. Pela análise a bordo: a relação indissolúvel das comunidades com seu território, manifestada nos trabalhos; representações corporais e sua fragmentação individual e coletiva; e sua reconstrução através dos duelos que se encarnam em transmissões rituais, corporais e orais, em atos de memória viva. Apresento um encontro com a proposta artística de Felipe Vergara, propostas teatrais das comunidades do Pacífico colombiano, nas quais curiosamente, Vergara trabalhou com Inge Kleutgens, Catalina Medina e outros colaboradores. Retornaremos a três obras de Vergara, bem como a três das criações coletivas das comunidades com as quais traçamos os processos e procedimentos para a reconstrução de uma parte dos relatos alternativos da história social das experiências do conflito social e armado colombiano , traduzido nas relações entre o imaginário e as representações simbólicas das obras, que associam as faixas de significado do texto e da encenação, ao canal efetivo que propicia sua escrit

Designing theoretically-informed implementation interventions

Clinical and health services research is continually producing new findings that may contribute to effective and efficient patient care. However, the transfer of research findings into practice is unpredictable and can be a slow and haphazard process. Ideally, the choice of implementation strategies would be based upon evidence from randomised controlled trials or systematic reviews of a given implementation strategy. Unfortunately, reviews of implementation strategies consistently report effectiveness some, but not all of the time; possible causes of this variation are seldom reported or measured by the investigators in the original studies. Thus, any attempts to extrapolate from study settings to the real world are hampered by a lack of understanding of the effects of key elements of individuals, interventions, and the settings in which they were trialled. The explicit use of theory offers a way of addressing these issues and has a number of advantages, such as providing: a generalisable framework within which to represent the dimensions that implementation studies address, a process by which to inform the development and delivery of interventions, a guide when evaluating, and a way to allow for an exploration of potential causal mechanisms. However, the use of theory in designing implementation interventions is methodologically challenging for a number of reasons, including choosing between theories and faithfully translating theoretical constructs into interventions. The explicit use of theory offers potential advantages in terms of facilitating a better understanding of the generalisability and replicability of implementation interventions. However, this is a relatively unexplored methodological area

The Osteoporosis Society of Hong Kong (OSHK): 2013 OSHK Guideline for Clinical Management of Postmenopausal Osteoporosis in Hong Kong

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Shift Work Is Not Associated with High Blood Pressure or Prevalence of Hypertension

Background: Working mostly at night has been suggested to be associated with upset of chronobiological rhythms and high blood pressure, but the evidence from epidemiological studies is weak. Methods: In a cross-sectional survey, we evaluated the association between shift work and blood pressure, pre-hypertension and hypertension. In total, 493 nurses, nurse technicians and assistants, were selected at random in a large general hospital setting. Hypertension was diagnosed by the mean of four automatic blood pressure readings $140/ 90 mmHg or use of blood pressure lowering agents, and pre-hypertension by systolic blood pressure$120–139 or diastolic blood pressure $80–89 mmHg. Risk factors for hypertension were evaluated by a standardized questionnaire and anthropometric measurements. The association between the shift of work and blood pressure, pre-hypertension and hypertension was explored using univariate and multivariate analyses that controlled for risk factors for hypertension by covariance analysis and modified Poisson regression. Results: The mean age of the participants was 34.369.4 years and 88.2 % were women. Night shift workers were older, more frequently married or divorced, and less educated. The prevalence of hypertension in the whole sample was 16%, and 28% had pre-hypertension. Blood pressure (after adjustment for confounding) was not different in day and night shift workers. The prevalence of hypertension and pre-hypertension by shift work was not different in the univariate analysis and afte