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Objectives: To compare incidence rates of serious cardiovascular events, particularly arterial thromboembolic events (ATE), in users of hormone replacement therapy (HRT), particularly oral continuous combined preparations.Methods: Prospective, controlled cohort study with four arms: women using (1) drospirenone (DRSP)/estradiol, (2) other oral continuous combined HRT (HRTcc), (3) all other oral HRTs, and (4) non-oral HRT. The study population consisted of women aged 40+ years in seven European countries who were new users of HRT at the time of inclusion. All patient-reported outcomes of interest were validated by the treating physicians. A multifaceted, four-level follow-up procedure ensured low loss to follow-up rates. The final analysis is based on Cox regression models comparing the cohorts.Results: In total, 30 597 women were recruited by 1052 study centers. Follow-up reflects 101 715 woman-years of observation. Loss to follow-up was about 2.8%. Risk estimates for general serious adverse events were similar for all cohorts. Incidence rates for serious cardiovascular events were 98.4 (DRSP/estradiol) and 169.7 (HRTcc) per 10 000 woman-years. The corresponding incidence rates for ATE were 10.9 and 29.7 events per 10 000 woman-years with an adjusted hazard ratio of 0.5 (95% confidence interval 0.3-0.8). The initiation rate for antihypertensive treatment after start of HRT was substantially lower for women using DRSP/estradiol compared to the other cohorts.Conclusions: DRSP/estradiol is associated with general health risks similar to other oral and non-oral HRT but is probably associated with lower ATE risk.Clinical Trial Registration: NCT00214903, US National Library of Medicine. [ABSTRACT FROM AUTHOR]

PURPOSE: In the Pierre Robin sequence, retrognathia and glossoptosis lead to airway obstruction in infants with or without cleft palate. Mandibular distraction has gained acceptance for the treatment of airway obstruction. However, surgical interventions can result in complications. In our institution, mandibular traction is the standard treatment in cases of severe respiratory distress. PATIENTS AND METHODS: A retrospective study was performed of all infants treated for Pierre Robin sequence at our institution from 1979 to 2007. The diagnosis and type of treatment (positioning/palatal plate or mandibular traction) were evaluated. The palatal plate had several knobs at the anterior alveolar ridge to direct the tongue forward. Mandibular traction was applied using weights transmitted onto the mandible by a custom-made plate fixed at the mandible with circumferential wiring. RESULTS: Nineteen children required airway treatment because of repeated cyanotic episodes and respiratory adaptation disorders. Of these 19 children, 8 had been diagnosed with pure Pierre Robin sequence and 11 also had other congenital abnormalities. Of the 19 patients, 10 (56%) were treated nonoperatively by lateral or prone positioning and/or wearing a palatal plate to stimulate the tongue. In 8 patients, conservative management was not sufficient, and continuous mandibular traction was performed for 2 to 5 weeks using weights of 50 to 200 g. One patient required a tracheostomy because of tracheomalacia. CONCLUSIONS: Surgical therapy using mandibular traction is a minimally invasive alternative to more invasive procedures because no serious complications such as scars or damage to the nerves were encountered. [ABSTRACT FROM AUTHOR]

In eastern USA, karst sinkholes are responsible for millions of dollars of damage to buildings, infrastructure, agribusiness, and land availability. Drilling and geophysical techniques have been employed to locate developing sinkholes that have not yet expressed themselves at land surface through cover collapse, but these techniques are expensive and time consuming if not targeted to specific, small areas. This paper presents initial research into locating cover-collapse sinkholes through the use of aerial remote sensing. National Agricultural Imagery Program imagery, captured in the summer of 2004 with 1-m ground resolution, in 3, 8-bit bands (visible, RGB), was found to be effective in highlighting circular features that appear to be related to sinkhole occurrence on two farm sites. In some instances, the features were sinkholes up to 5 m in depth. In other instances, the features did not represent existing sinkholes but potential sites of incipient cover collapse. Differences in agriculturally related vegetative cover at this time affected the efficiency of determining the extent of karst development. Surface geophysical techniques and drilling will be used to characterize the subsurface when cropping practices allow. The goal is to correlate imagery features to subsurface characteristics so that remotely sensed imagery can be used as a means of delineating potential cover-collapse sinkholes before they express themselves at the surface. Development of such a tool will provide a time- and cost-effective approach to land-use planning and, therefore, substantially reduce damage done by cover collapse. [ABSTRACT FROM AUTHOR]

Aim: To report survival and morbidity until discharge in preterm infants <501 g with life support started immediately after birth.Methods/study Design: Cohort study of all preterm infants with birthweights < 501 g born in three tertiary perinatal centres between 1 January 1998 and 31 December 2001 (gestational age (GA) 25.2 [21.0-30.7] wk; birthweight 435 [290-500] g; median [range]).Results: A total of 107 infants with birthweights <501 g were born. Twenty-nine were stillborn. A prenatal decision to initiate life support immediately after birth was reached in 9/37 (24%) infants <24.0 wk GA and in 39/42 (93%) infants > or =24.0 wk GA. Survival was 3/37 (8%) and 26/41 (63%) in infants <24 wk GA and > or =24.0 wk GA, respectively. Twenty-nine of the 48 infants with immediate life support (60%) survived (95% CI: 46-75%). Forty-two of these 48 (88%) infants were small for gestational age. No infant without immediate life support survived (0/30). Twenty-three (79%) survivors developed chronic lung disease (CLD) and eight (28%) received photocoagulation for retinopathy of prematurity (ROP).Conclusion: In this population of extremely low birthweight infants, survival was higher than in previous studies when life support was provided immediately after birth. Short-term morbidity was similar to other studies. The presented data on survival support our concept to offer immediate life support after birth in preterm infants with birthweights <501 g. The long-term outcome of these infants needs to be assessed urgently. [ABSTRACT FROM AUTHOR]

In this paper an alternative method of off-line Kikuchi pattern centre calibration and orientation mapping, utilising the cross-correlation between entire experimental patterns and dynamical simulated patterns is applied and evaluated. To demonstrate the improvement in angular resolution compared to Hough transform based methods, EBSD datasets of a silicon monocrystal were analysed using both, classical and the presented cross-correlation based method, which revealed significant enhancement of angular resolution for the refined method. The mean misorientation over the monocrystalline sample was found to be up to one order of magnitude lower compared to common methods, with an angular resolution of up to 0.06° indicating a substantial gain in orientation precision. The pattern centres were determined for a number of patterns on the map, using pattern matching refinement as well. Subsequently, a multiple linear regression model was computed to correlate pattern centre positions ( X PC , Y PC ) and detector distances ( Z SSD ) to x - and y -coordinates on the map by means of plane equations. Employing this method, a reduction of orientation noise was achieved in highly deformed Silicon crystals with large intragranular orientation ranges. Furthermore, it was shown that the cross correlation coefficient CC can be used as a parameter indicating the pattern quality and hence can be utilised to create a pseudo greyscale image of the surface, showing grain boundaries and also depicting lattice distortions. [ABSTRACT FROM AUTHOR]