Methods of stent placement in patients with upper-third and middle-third esophageal cancer

Relevance. At that moment of diagnosis patients with esophageal cancer (EC) are often inoperable due to locally advanced disease. Life expectancy in such cases augmented with dysphagia comprises 90 days in average. Curative treatment can be performed only in 20-30 % of patients with a 5-year survival rate varying from 10,3 to 35%.Objective. Assessing short-term and long-term outcomes of patients with stents with EC depending on the localization of the primary tumor.Materials and methods. We analyzed our experience of using intraesophageal self-expanding stents in ЕС patients. 49 of patients them had tumor in upper-third of esophagus and 73 patients had middle-third esophageal tumor location as compared to those who underwent stoma formation (53 patients) in EC patients.Results. All patients who were stented had significantly lower grade of dysphagia and could eat in the ordinary way. It also improved quality of life, and many of such patients had an opportunity to continue treatment. It has been revealed that stenting of inoperable cancer patients with upper and middle-third esophageal cancer gives benefit to patients as it allows to continue to eat naturally and thereby significantly improves the quality of life in contrast to stoma placement. Patients with upper-third esophageal cancer who were not stented because of fistula formation had significantly better long-term survival than EC patients with stoma and similar cancer patients with middle-third esophageal tumors. Survival rate of patients with cancer of upper-third of esophagus after stenting not because of fistula was significantly better. Patients with cancer of the middle esophagus, who experienced stent placement because of fistulae, had the same long-term survival rate as cancer patients with middle esophageal tumors  and with fistula who were not stented. It shows high efficacy of stenting in cancer of the middle-third esophagus with presence of fistula.Conclusion. Stent placement in case of inoperable cancer of upper and middle-third of esophagus shows significant benefit. It allows patients to eat in an ordinary was, and thereby significantly improves the quality of life in comparison with stoma formation

Hydrodynamic Pair Attractions Between Driven Colloidal Particles

Colloidal spheres driven through water along a circular path by an optical ring trap display unexpected dynamical correlations. We use Stokesian Dynamics simulations and a simple analytical model to demonstrate that the path's curvature breaks the symmetry of the two-body hydrodynamic interaction, resulting in particle pairing. The influence of this effective nonequilibrium attraction diminishes as either the temperature or the stiffness of the radial confinement increases. We find a well defined set of dynamically paired states whose stability relies on hydrodynamic coupling in curving trajectories.Comment: 5 pages, 4 figure

Health information seeking on the Internet: a double divide? Results from a representative survey in the Paris metropolitan area, France, 2005–2006

<p>Abstract</p> <p>Background</p> <p>The Internet is a major source of information for professionals and the general public, especially in the field of health. However, despite ever-increasing connection rates, a digital divide persists in the industrialised countries. The objective of this study was to assess the determinants involved in: 1) having or not having Internet access; and 2) using or not using the Internet to obtain health information.</p> <p>Methods</p> <p>A cross-sectional survey of a representative random sample was conducted in the Paris metropolitan area, France, in the fall of 2005 (n = 3023).</p> <p>Results</p> <p>Close to 70% of the adult population had Internet access, and 49% of Internet users had previously searched for medical information. Economic and social disparities observed in online health information seeking are reinforced by the economic and social disparities in Internet access, hence a double divide. While individuals who reported having a recent health problem were less likely to have Internet access (odds ratio (OR): 0.72, 95% confidence interval (CI): 0.53–0.98), it is they who, when they have Internet access, are the most likely to search for health information (OR = 1.44, 95% CI = 1.11–1.87).</p> <p>Conclusion</p> <p>In the French context of universal health insurance, access to the Internet varies according to social and socioeconomic status and health status, and its use for health information seeking varies also with health beliefs, but not to health insurance coverage or health-care utilisation. Certain economic and social inequalities seem to impact cumulatively on Internet access and on the use of the Internet for health information seeking. It is not obvious that the Internet is a special information tool for primary prevention in people who are the furthest removed from health concerns. However, the Internet appears to be a useful complement for secondary prevention, especially for better understanding health problems or enhancing therapeutic compliance.</p

Mechanisms of dipolar ortho/para-H2O conversion in ice

In this paper a possible explanation for an unexpected ortho/para-water ratio in the gas clouds of comets is given. The description is based on the quantum-mechanical density matrix formalism and the spin temperature concept. Only the nuclear spin system is treated quantum-mechanically. Employing the model of a four spin system, created by two nearest neighbour water molecules, spin eigenstates and their dynamics under the influence of their mutual dipolar interactions are studied. It is shown that a fast conversion between ortho- and para-states occurs on a msec time scale, caused by the intermolecular homonuclear magnetic dipolar interaction. Moreover the spin eigenstates of water in an ice crystal are determined by magnetic dipolar interactions and are not given by normal ortho- and para-H2O states of gaseous water. As a result of this the spin temperature of gaseous water evaporated from ice depends strongly on its evaporation history and the ortho/para-ratio of water molecules are only an indirect measure of the temperature of ice crystals from where they descend. This result could explain the unexpected experimentally observed ortho/para-ratios in the clouds of comets