Visual, auditory, sensory, and motor impairments in long-term survivors of hematopoietic stem cell transplantation performed in childhood

BACKGROUND Because of treatment-related toxicity, research is increasingly being focused on long-term sequelae secondary to hematopoietic stem cell transplantation (HSCT) in survivor populations. METHODS This study describes the incidence of auditory, sensory, motor, and visual impairments, including cataracts, among 235 individuals who were treated with HSCT during childhood or adolescence. Outcomes were compared with 705 siblings of childhood cancer survivors. Participants completed a survey with questions on posttransplant organ system impairments. Approximately half of survivors were transplanted when younger than 10 years of age. The median length of followup was 11 years. RESULTS The cumulative incidence of cataracts was 36% at 15 years post-HSCT, although cataracts occurred only in those who received total body irradiation as an HSCT conditioning agent or head irradiation before transplant. Persistent pain was reported by 21% of survivors. Loss of hearing in one or both ears, and legal blindness in one or both eyes, each occurred after transplant in 2% of survivors. Occurrences were uncommon, but survivors were 4.3 times (95% confidence interval [CI]: 2.0–9.4) more likely to report coordination problems, 7.7 times (95% CI: 3.2–18.5) more likely to report chewing or swallowing problems, and 3.5 times (3.5; 95% CI: 1.6–7.9) more likely to report muscle weakness than those in the comparison group. Muscle weakness was strongly associated with positive history of chronic graft-versus-host disease. CONCLUSIONS Increased risks were found for motor impairments, hearing loss, vision loss, and persistent pain among study participants. Cataracts were a frequent adverse effect, suggesting that close monitoring with appropriate intervention for preservation of vision, particularly among those who received total body irradiation, should be a primary goal in survivors of HSCT performed in childhood. Cancer 2006. © 2006 American Cancer Society.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/49517/1/21752_ftp.pd

A Reliquia d'Eça de Queirós. Notes sur la structure d'un anti-roman picaresque

Les unités qui composent les structures d'A Reliquia semblent obéir à un système de contrastes. Ce système détermine l'ordre sur lequel le récit est fondé: l'ordre des différentes causalités, événementielle, psychologique et irrationnelle, de même que l'ordre temporel (étroitement lié aux causalités). La temporalité référentielle est donc à plusieurs reprises interrompue par des unités atemporelles, unités qui sont hors de l'ordre chronologique et qui constituent en effet des contrastes avec les unités temporelles. Les différentes perspectives sous lesquelles le personnage-narrateur envisage les faits qu'il raconte, et qui provoquent une sorte d'action réciproque, font également partie du système de contrastes. L'intention des notes données ci-dessus a été de donner un aperçu de ces particularités que renferme la forme «picaresque» de l'anti-roman d'Eça: A Reliquia

Automatic dynamic stabilization and correction of feedback amplifiers. II. Synthesis of correcting dipoles

This paper is the second part of the description of a novel stabilization algorithm suitable for feedback amplifiers. It deals with the effectiveness check of the proposed corrections. This test is based on return difference computations and gives limit values and nature determination for the correcting dipole. Optimization is introduced for improving the final characteristics. Two classical feedback amplifiers are analyzed and improved.Anglai