Mannitol in diuretic resistant nephrotic syndrome: a case report

A 6 year old presented with generalized oedema to Kagando hospital, Uganda, and was diagnosed with nephrotic syndrome. Despite treatment with a fluid restriction, prednisolone and furosemide, the oedema worsened and the weight increased. Mannitol was added to the treatment regime and the oedema improved. The patient was able to be discharged four days later without any diuretic therapy. The case highlights the use of mannitol in the treatment of diuretic resistant oedema with nephrotic syndrome. It provides an alternative therapy for the resource-poor setting to the expensive albumin-furosemide combination often used elsewhere

Concept definition study for recovery of tumbling satellites. Volume 1: Executive summary, study results

The first assessment is made of the design requirements and conceptual definition of a front end kit to be transported on the currently defined Orbital Maneuvering Vehicle (OMV) and the Space Transportation System Shuttle Orbiter, to conduct remote, teleoperated recovery of disabled and noncontrollable, tumbling satellites. Previous studies did not quantify the dynamic characteristics of a tumbling satellite, nor did they appear to address the full spectrum of Tumbling Satellite Recovery systems requirements. Both of these aspects are investigated with useful results

Concept definition study for recovery of tumbling satellites. Volume 2: Supporting research and technology report

A number of areas of research and laboratory experiments were identified which could lead to development of a cost efficient remote, disable satellite recovery system. Estimates were planned of disabled satellite motion. A concept is defined as a Tumbling Satellite Recovery kit which includes a modular system, composed of a number of subsystem mechanisms that can be readily integrated into varying combinations. This would enable the user to quickly configure a tailored remote, disabled satellite recovery kit to meet a broad spectrum of potential scenarios. The capability was determined of U.S. Earth based satellite tracking facilities to adequately determine the orientation and motion rates of disabled satellites

Advanced orbit transfer vehicle propulsion system study

A reuseable orbit transfer vehicle concept was defined and subsequent recommendations for the design criteria of an advanced LO2/LH2 engine were presented. The major characteristics of the vehicle preliminary design include a low lift to drag aerocapture capability, main propulsion system failure criteria of fail operational/fail safe, and either two main engines with an attitude control system for backup or three main engines to meet the failure criteria. A maintenance and servicing approach was also established for the advanced vehicle and engine concepts. Design tradeoff study conclusions were based on the consideration of reliability, performance, life cycle costs, and mission flexibility

Acquisition of sexual orientation and gender identity data among NCI Community Oncology Research Program practice groups

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149296/1/cncr31925_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149296/2/cncr31925.pd

Containing, embracing and hyper-activating Britishness: British-based foreign-owned firms

There are in the UK ownership forms different to the characteristics of Britishness – British-based foreign-owned firms where dominant owners may have differentiated control interests. These may contain, that is, override, national institutional characteristics embedded in a particular national capitalism. Accordingly, separating the agency of these firms from presumed business system structures may reveal how diverse patterns of firm ownership – those associated with British-based foreign-owned firms – can inform dynamic ownership developments in British capitalism which contain and hyper-activate Britishness. The article theorizes British-based foreign-owned firms and provides empirical detail on how ownership characteristics influence financial commitment and strategic control in 10 of these firms

Analysis of open and intracorporeal robotic assisted radical cystectomy shows no significant difference in recurrence patterns and oncological outcomes

OBJECTIVES: To report and compare early oncological outcomes and cancer recurrence sites among patients undergoing open radical cystectomy (ORC) and robotic-assisted radical cystectomy with intracorporeal urinary diversion (iRARC). METHODS AND MATERIALS: A total of 184 patients underwent radical cystectomy for bladder cancer. ORC cases (n = 94) were performed between June 2005 and July 2014 while iRARC cases (n = 90) were performed between June 2011 and July 2014. Primary outcome was recurrence free survival (RFS). Secondary outcomes were sites of local and metastatic recurrence, cancer specific survival (CSS) and overall survival (OS). RESULTS: Median follow-up for patients without recurrence was 33.8 months (interquartile range [IQR]: 20.5–45.4) for ORC; and 16.1 months (IQR: 11.2–27.0) for iRARC. No significant difference in age, sex, precystectomy T stage, precystectomy grade, or lymph node yield between ORC and iRARC was observed. The ORC cohort included more patients with≥pT2 (64.8% ORC vs. 38.9% iRARC) but fewer pT0 status (8.5% ORC vs.vs. 22.2% iRARC) due to lower preoperative chemotherapy use (22.3% ORC vs. 34.4% iRARC). Positive surgical margin rate was significantly higher in the ORC cohort (19.3% vs. 8.2%; P = 0.042). Kaplan-Meir analysis showed no significant difference in RFS (69.5% ORC vs. 78.8% iRARC), cancer specific survival (80.9% ORC vs. 84.4% iRARC), or OS (73.5% ORC vs.vs. iRARC 83.8%) at 24 months. Cox regression analysis showed RFS, cancer specific survival and OS were not influenced by cystectomy technique. No significant difference between local and metastatic RFS between ORC and iRARC was observed. CONCLUSION: This study has found no difference in recurrence patterns or oncological outcomes between ORC and iRARC. Recurrent metastatic sites vary, but are not related to surgical technique

Comparison of Treatment-Related Toxicity With Hypofractionated or Conventionally Fractionated Radiation Therapy for Prostate Cancer: A National Population-Based Study.

AIMS: Randomised controlled trials have shown comparable early oncological outcomes after hypofractionated and conventionally fractionated radiotherapy in the radical treatment of prostate cancer (PCa). The effect of hypofractionation on treatment-related gastrointestinal and genitourinary toxicity remains uncertain, especially in older men and those with locally advanced PCa. MATERIALS AND METHODS: A population-based study of all patients treated with radical conventionally fractionated radiotherapy (n = 9106) and hypofractionated radiotherapy (n = 3027) in all radiotherapy centres in the English National Health Service between 2014 and 2016 was carried out. We identified severe gastrointestinal and genitourinary toxicity using a validated coding framework and compared conventionally fractionated and hypofractionated radiotherapy using a competing-risks proportional hazards regression analysis. RESULTS: The median age in our cohort was 72 years old and most patients had locally advanced disease (65%). There was no difference in gastrointestinal toxicity (conventionally fractionated radiotherapy: 5.0 events/100 person-years; hypofractionated radiotherapy: 5.2 events/100 person-years; adjusted subdistribution hazard ratio: 1.00, 95% confidence interval: 0.89-1.13; P = 0.95) or genitourinary toxicity (conventionally fractionated radiotherapy: 2.3 events/100 person-years; hypofractionated radiotherapy: 2.3 events/100 person-years; adjusted subdistribution hazard ratio: 0.92, 95% confidence interval: 0.77-1.10; P = 0.35) between patients who received conventionally fractionated radiotherapy and those who received hypofractionated radiotherapy. CONCLUSIONS: This national cohort study has shown that the use of hypofractionated radiotherapy in the radical treatment of PCa does not increase rates of severe gastrointestinal or genitourinary toxicity. Our findings also support the use of hypofractionated radiotherapy in older men and those with locally advanced PCa