Search

This study is to investigate the effects of addition self synthesised multi-walled carbon nanotubes (MWCNTs), to the final properties of polypropylene (PP) matrix nanocomposites. The influences of melt blending parameters were evaluated, where the interrelationship between the temperatures of compounding and roller rotor speed of shearing blade parameter, to the tensile properties of fabricated composites were studied. MWCNT was synthesised in the laboratory scale; by using the floating catalyst chemical vapour deposition (FC-CVD) method. Pre-compounding work is begun with de-agglomeration of MWCNT which carried out by combining the ultrasonication and mechanical stirrer means simultaneously. Carbon nanotubes produced was first verified by using SEM and TEM imaging microscopy techniques. It was later integrated with the thermoplastic PP matrix, via melt blending process through internally mixing approach. Very low weight percentage of chemically untreated MWCNT (0, 0.25, 0.50, 0.75 & 1.00 wt. %) was added into PP and later was compression moulded to the thin sheet of composites film. Composites were prepared by varying the compounding temperature into three processing temperature namely 165, 175 & 185°C and also into three shearing speed of roller rotor blade, 40, 60 & 80 rpm respectively. Later, it was mechanically tested via tensile testing following the ASTM D-638 standard method. The interrelationship between each parameter of compounding to the mechanical tensile properties was tested. It was shown that, the additional of very low loading of untreated-MWCNT filler content, does give moderate effects on reinforcement to the tensile properties of composite. Different compounding parameter gives significant difference to the pattern of plot which was comparable between each other.

An incorporation of waste tyre particles in concrete has been established to produce a green concrete. However, despite its advantages, strength reduction is an obvious handicap. To improve the strength, pre-treatments of the waste tyre particles and addition of Oil Palm Fruit Fibre (OPFF) were chosen and reported in this study. The addition of OPFF was to influence the internal structure in order to improve shrinkage and other strength properties. Performance of the composites in compressive, split tensile and flexural strengths, as well as shrinkage and microstructure were observed. Results showed better behaviour of the treated tyre crumb mortar rather compared to the untreated tyre, with the replacement of up to 40% by volume of the treated tyre crumb particles and 0.5-1.0% OPFF addition by mass of cement content. [ABSTRACT FROM AUTHOR]

Objectives: Our aim was to investigate the association of liver fibrosis and necroinflammation with HS in untreated young patients with chronic hepatitis B (CHB). Materials and Methods: A retrospective study was conducted in a military hospital in Turkey. A total of 254 subjects with CHB were included in this study. These subjects were divided into two groups: group 1 consisted of patients with hepatic steatosis (HS) according to ultrasonography (USG) and group 2 consisted of non-HS subjects. Sociodemographic, biochemical, histopathological, virological and USG results were recorded for both groups retrospectively. Statistical analysis was performed using SPSS 22.0. Results: The prevalence of HS was found to be 11.4%. A significant statistical difference was found between group 1 and group 2 regarding the fibrosis degree (p = 0.045). No statistically significant difference was noted between two groups for age, levels of ALT, AST, HBeAg, HBV-DNA levels, HAI scores, diagnosis age and duration of CHB. No difference was noted between the grade of HS and variables. A positive correlation was found between fibrosis groups and the grade of HS (p = 0.012, r = 0.158) and between HAI groups and the grade of HS (p = 0.029, r = 0.137). Conclusion: The prevalence of steatosis was not higher in patients with CHB. HS is associated with advanced hepatic fibrosis, but not viral liver disease. [ABSTRACT FROM AUTHOR]

In this article, the different chemical modifications of natural fiber on the physical and mechanical properties of polypropylene (PP)/wood flour (WF)/nanoclay hybrid composites were studied. To meet this objective, the chemical treatments on WF, namely alkali, acetylation, and benzoylation, were carried out. Then, the composites were prepared through the melt mixing of WF and PP at 50% weight ratios, with various amounts of nanoclay (0, 3, and 6 per hundred compounds (phc)) in Haake internal mixer and the test specimens were prepared by injection molding. The amount of coupling agent was fixed at 2 phc for all formulations. The tensile strength, impact strength, and water uptake of these composites were analyzed and the reinforcing properties of the chemically treated composites were compared with those of untreated composites. The chemical modification efficiency was verified by Fourier transform infrared (FTIR) analysis, and the dispersion state of nanoclay in the composites was examined using X-ray diffractometer and transmission electron microscopy. The results showed that the tensile modulus, tensile strength, and impact strength of the composites increased by applying chemical treatments. Modified composites had lower water absorption (WA) and thickness swelling than unmodified ones. Furthermore, the highest mechanical properties and the lowest water uptake were observed in the composite modified with acetic anhydride. FTIR spectra show that the intensity of O–H bond at 3444.2 cm–1 and formation of ester bond at 1741.4 cm–1 were indications of changes in the chemical structure of the fibers. The tensile modulus and strength increased with increase of nanoclay up to 3 phc and then decreased. However, the impact strength and WA decreased with increase of nanoclay loading. The morphological findings showed that the samples containing 3 phc of nanoclay had higher order of intercalation and better dispersion. [ABSTRACT FROM AUTHOR]

• The introduction of oral disease-modifying therapies (DMTs) translated to a higher rate of treatment in patients with remitting multiple sclerosis (RRMS). • In Patients with clinically isolated syndrome (CIS), there was no change in treatment rate. This could be due to limited therapeutic options in CIS. • Older age and mild course were associated with the decision against DMTs which highlights the need for guidelines in these circumstances. Several disease-modifying therapies (DMTs) show efficacy in relapsing-remitting multiple sclerosis (RRMS) and clinically isolated syndrome (CIS). However, there is still a relevant proportion of patients who remain untreated. We provide real-world data on untreated and treated patients and we report whether and how the introduction of oral DMTs changed the treatment decision. Furthermore, we discuss possible reasons for not receiving DMTs. We conducted a retrospective cross-sectional study and analysed demographic and clinical data of patients with RRMS and CIS at our MS center. Comparison was made between untreated and treated patients in 2010 (before the introduction of oral DMTs) and in 2014 (after the introduction of oral DMTs). Furthermore, we analysed reasons for the decision against DMTs in patients who never received DMTs and patients who discontinued DMTs. We analysed datasets of 344 MS patients in 2010 and 253 in 2014. There were more untreated patients in CIS than in RRMS. In RRMS, the proportion of untreated patients decreased significantly between 2010 and 2014 from 23.6% to 11.1%, while the use of oral medications increased significantly from <1% to more than 50% in 2014. In CIS, there was no significant change in untreated patients between 2010 and 2014 (61.1% in 2010 to 52.6% in 2014). Untreated patients with RRMS were significantly older and had lower ARR than treated patients. Patients who never received DMT had lower EDSS compared to patients that had been treated before. The main reasons for the decision against DMT were "belief in a benign course" and "fear of adverse effects". Treatment discontinuation was caused mainly by the adverse effects. In our data a relevant proportion of patients with RRMS and CIS did not receive any DMT. We hypothesize that in patients with RRMS the introduction of oral DMTs translated to a higher rate of treatment, whereas in CIS there no change was observed. This could be due to limited therapeutic options in CIS. There is more information needed regarding the treatment recommendation for older patients and patients with mild course of the disease. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to evaluate the long-term natural history of polypoidal choroidal vasculopathy (PCV) in untreated patients. Methods: This is a retrospective observational case series. Patients with symptomatic PCV who did not receive any treatment for at least 12 months were included from the records of three ophthalmic clinics in Asia. The medical records and imaging data were reviewed. Visual outcomes at month 12 and at last follow-up were analyzed. The influence of demographics and presenting features on visual outcome was analyzed. Results: A total of 32 eyes (32 patients) were included in this analysis. The mean follow-up was 59.9 months (range, 18-119 months), the mean age was 65.7 years and 21 (65.6 %) patients were male. The mean presenting logMAR visual acuity was 0.79 (Standard deviation [SD] 0.49). The center of the fovea was involved by the PCV complex in 25 eyes (78.1 %). The mean greatest linear dimension (GLD) of the PCV complex was 2584 μm (SD 880). Twenty-three eyes (71.9 %) had a cluster-of-grapes configuration on indocyanine green angiography. Leakage of fluorescein angiography was present in 29 eyes (90.6 %). The mean logMAR vision deteriorated from 0.79 at baseline to 0.88 at month 12 ( p = 0.11), and further to 1.14 ( p = 0.003) at the last follow-up. The proportion of eyes that improved, remained unchanged and worsened was 21.9 %, 31.3 % and 46.9 %, respectively, at month 12; and 28.1 %, 9.4 % and 62.5 %, respectively, at last follow-up. The proportion of eyes with logMAR vision worse than 1.0 was 28.1 % at presentation, and increased to 31.3 % at month 12 and further to 53.1 % at last follow-up. Reasons for poor vision were due to retinal, subretinal or vitreous hemorrhage, and retinal pigment epithelium (RPE) atrophy and scarring. None of the presenting features were found to significantly influence visual outcome. Conclusions: Half of eyes presenting with symptomatic PCV had a relatively benign course without treatment and some even had vision improvement. However, in the remaining eyes, vision deteriorated significantly, mainly due to hemorrhage and scarring. There may be subtypes of PCV with divergent natural history. [ABSTRACT FROM AUTHOR]

This study evaluated impact of untreated dye effluent on heavy metal uptake by Amaranthus cruentus L. under field condition. Amaranths grown for two consecutive dry seasons were irrigated with dye effluent concentrations of 0 (control) 10, 20, 30 and 40%. Effluent concentrations were analyzed for physico-chemical and heavy metal properties. The result showed that heavy metals taken up and accumulated in amaranths tissues increased significantly ( p ≤ 0.05) with dye effluent concentration. Heavy metals accumulated more in edible shoots than roots except chromium. Bioaccumulations of heavy metals in 2012 were in several folds higher than in 2011 dry season. In the second season, regardless of effluent sources, dye concentration of 20% gave the highest accumulations of Manganese (Mn), Iron (Fe) and Zinc (Zn) in the edible shoots. The highest accumulations of heavy metals were higher than 0.3 mg kg −1 allowable limits in vegetables by Food and Agricultural Organization/World Health Organization/Federal Environmental Protection Agency. Irrigation of vegetable with untreated dye effluent should be discouraged due to potential health risks on human and general contamination of the environment. [ABSTRACT FROM AUTHOR]

BACKGROUND: The use of chemotherapy in advanced metastatic breast cancer remains a subject of controversy. The thought of MicKinnon et al (early 1950s) that the course of breast cancer was unaffected by chemotherapy has been refuted by results of treatment in the developed countries. The poor result of treatment in developing centres still compares with prechemotherapy era. Consequently, The McKinnon's thought may still lurk. We compared the survival of chemotherapy treated with chemotherapy untreated cancer of breast patients. METHOD: Records of breast cancer patients who presented and died between January 2010 and May 2014 were reviewed. The primary outcome was overall survival. Records of patients that received chemotherapy with or without other tumor directed specific therapy were compared with records of patients who did not receive any tumor directed therapy. RESULT: Thirty-one patients received chemotherapy while 25 patients did not. All were females, more than 90% were of the patients had advanced or metastatic disease. Treatments were not biologically directed and treatment plans were largely compromised and suboptimal. The overall mean survival was 19.2 ±9.2 months, and the median duration was 17.5 months(range 6-44months). The overall survival was not statistically different between the two groups (p= 0.230, unequal variance assumed). The objective of using neoadjuvant chemotherapy for fungating lesions was not achieved. CONCLUSION: In advanced and metastatic breast cancer, outcomes of patients who receive suboptimal regimen of cytotoxic chemotherapy do not differ from chemotherapy untreated patients. [ABSTRACT FROM AUTHOR]

Immunomodulatory drugs have been shown to be of benefit in relapsed/refractory immunoglobulin light-chain ( AL) amyloidosis. We designed a prospective, multicentre phase II trial of lenalidomide, dexamethasone and cyclophosphamide for newly diagnosed patients with AL amyloidosis not eligible for autologous stem-cell transplantation. Twenty-eight patients were included in the study. Cardiac involvement was present in 23 patients; 14 of them had cardiac stage III. The overall haematological response rate was 46%, including complete and very good partial responses in 25% and 18% of patients respectively. Haematological response was mainly associated with absence of cardiac stage III and lower tumour burden. Organ response was observed in 46% of patients. After a median follow-up of 24 months, median progression-free and overall survival have not been reached, both being significantly longer in responders ( P < 0·001 and P = 0·001 respectively). Seventeen patients have discontinued treatment, mostly due to amyloid-related death, disease progression or lack of response. Only 14% of the patients discontinued treatment due to therapy-related adverse events. Our results support the efficacy of this regimen, with high quality responses and prolonged survival, as well as its tolerability, in patients with AL amyloidosis not eligible for stem cell transplant and without advanced cardiac involvement (clinicaltrials.gov identifier: NCT01194791). [ABSTRACT FROM AUTHOR]

Indolent non-follicular lymphomas (inFLs) are generally regarded as incurable, apart from extranodal mucosa-associated lymphatic tissue lymphomas, which can be partially cured by surgery, local radiotherapy, or antibiotic treatment. The aim of the present study was to test the degree of effectiveness and the safety of the regimen containing fludarabine, mitoxantrone, and rituximab (FMR) in inFL patients considering all the different entities belonging to this group. An observational retrospective study was conducted on 143 inFL patients providing that their first chemoimmunotherapy performed was FMR regimen and diagnosis from September 2000 to March 2011. There were 32 small lymphocytic lymphomas and 111 marginal zone lymphomas. At the end of treatment, overall response rate was 96.5% with 88% of complete responses (CR) and 8.5% of partial responses. With a median follow-up of 48 months, 10 out of 125 (8%) CR patients had disease relapse, yielding an estimated 9-year disease-free survival (DFS) of 74.9% and an estimated 10-year overall survival of 92.8%. The estimated 9-year progression free survival was 70.5%. The 10 relapsed patients showed lymphoma recurrence within 52 months: after this time, the DFS curve presented a plateau configuration. Only two (1.4%) patients developed a secondary hematological neoplasia. This study showed promising findings for the use of a fludarabine-based regimen in combination with rituximab in the front-line treatment of symptomatic inFL with a noteworthy high percentage of CR associated to an interesting long-term DFS and favorable acute and long-term safety profile. [ABSTRACT FROM AUTHOR]

Objective The aim of this study is to investigate emotional and behavioral problems among Indonesian patients with disorders of sex development (DSD) who recently came under clinical management. As diagnostic procedures and treatment had been delayed, patients progressively developed ambiguous bodies, difficult to conceal from outsiders. Method We compared 118 Indonesian patients with DSD aged 6–41 years (60 children, 24 adolescents, 34 adults) and 118 healthy control subjects matched for age, gender, and residential settings. We used the Child Behavioral Checklist (CBCL), Youth Self-Report (YSR), and Adult Self-Report (ASR) to examine differences between patient and control groups as well as differences within patients groups. Results On the CBCL, parents of young children with DSD reported significantly more emotional and behavioral problems than parents of matched control. Parents of daughters with CAH reported that their daughters withdrew themselves from social interactions. On the ASR, adults with DSD reported significantly more internalizing problems than controls, particularly anxiety and depression. No other differences in emotional functioning were found across different diagnostic groups. Conclusions Indonesian patients with DSD who were untreated for most of their lives suffered more emotional and behavioral problems than matched controls. Differences and similarities between our findings and observations in patients from Western countries will be discussed. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the outcome of giant intra-dural aneurysms managed with endovascular techniques. Materials and Methods: We retrospectively reviewed a series of 39 consecutive giant intra-dural aneurysms. The technical feasibility of endovascular treatment, its complications, the angiographic results and the clinical outcome were assessed. Logistic regression analysis was performed to evaluate for predictors of a poor outcome. Results: Nine patients were left untreated. During a 30 month follow-up, four of them (44.4%) died and two (22.2%) deteriorated. Thirty aneurysms (12 located in the anterior circulation and 18 located in the posterior circulation) were treated using endovascular methods. Of these, 11 were treated by parent vessel occlusion, 11 by stent-assisted coiling, one using only coils, six using solely a stent, and, one using both coils and onyx. During a 28 month follow-up, seven (23.3%) patients died and two (6.7%) patients experienced permanent neurological deficits. The mortality and morbidity in the endovascular group seemed lower than that in the untreated group (P = 0.045, 30% vs. 66.7%). There was no difference in the results of endovascular treatment between giant intra-dural aneurysms located in the posterior and the anterior circulation. Conclusions: Giant intra-dural aneurysms, whether treated or not, may have a poor clinical outcome. The outcome following endovascular treatment of these lesions is better than its natural history when left untreated. However, endovascular treatment may often be associated with high complication rates and a low chance of cure. [ABSTRACT FROM AUTHOR]

This study aimed to examine the severity of posttraumatic stress disorder (PTSD) symptoms in individuals suffering from chronic untreated PTSD. The study population consisted of 329 politically persecuted Poles who had never been treated for PTSD. The severity of PTSD symptoms was assessed through a psychiatric examination and a Polish version of the civilian Mississippi PTSD Questionnaire. The results from our clinical examination correlated closely with those from the Mississippi PTSD Questionnaire. PTSD symptoms tended to be moderate or mild in severity. Politically persecuted people may demonstrate the full spectrum of posttraumatic symptoms decades after the trauma. [ABSTRACT FROM AUTHOR]

The affect of gender differences on clinical presentation of Parkinson's disease (PD) remains controversial. De novo PD subjects were recruited from a trial-based multicenter cohort in clinical sites of Chinese Parkinson Study Group. Demographic information, motor and non-motor symptom measurements were performed by face-to-face interview using specific scales. Scores and frequencies of symptoms were compared between male and female patients, and regression models were used to control the effects of age and disease duration. Totally 428 PD patients were enrolled in this study, and 60.3 % of them were male. Total UPDRS scores were not significantly different between male and female (25.02 ± 12.84 vs. 25.24 ± 13.22, adjusted p = 0.984). No significant gender differences were found on scores for four cardinal motor signs, neither on motor subtypes (PIGD 19.0 vs. 15.9 %, adjusted p = 0.303). Female patients more likely had depressive symptoms (38.8 vs. 27.5 %, adjusted p = 0.023; CES-D score 13.78 ± 10.91 vs. 11.23 ± 9.42, adjusted p = 0.015). Male patients had significantly higher scores for MMSE (28.26 ± 2.21 vs. 27.00 ± 3.38, adjusted p = 0.0001), and lower scores for identification (1.39 ± 1.63 vs. 2.01 ± 2.63, adjusted p = 0.002) in ADAS-cog. No significant differences were found for other non-motor symptoms including motivation problems (male 29.8 % vs. female 30.6 %, adjusted p = 0.760), fatigue (62.6 vs. 70.5 %, adjusted p = 0.140), constipation (37.2 vs. 30.1 %, adjusted p = 0.243), and sleep quality (57.6 vs. 61.3 %, adjusted p = 0.357; PSQI score: 5.62 ± 3.31 vs. 6.10 ± 3.53, adjusted p = 0.133). Female might be more depressed and have worse performance on cognition in early untreated PD patients, but gender differences are not apparent on motor and other non-motor symptoms. [ABSTRACT FROM AUTHOR]

Abstract: We report on 348 patients≥70 years (median age 78 years) with acute myeloid leukemia (>50% with secondary AML) randomized to receive either 600mg or 300mg of tipifarnib orally twice daily on days 1–21 or days 1–7 and 15–21, repeated every 28 days (4 treatment regimens). Responses were seen in all regimens, with overall response rate (CR+CRi+PR) highest (20%) among patients receiving tipifarnib 300mg twice daily on days 1–21. Toxicities were acceptable. Unless predictors of response to tipifarnib are identified, further study as a single agent in this population is unwarranted. [Copyright &y& Elsevier]

The aim of the meta-analysis of randomized controlled trials (RCTs) was to compare the effectiveness of glycemic control and hypoglycemia risk of combination therapy (metformin plus a low hypoglycemic risk antidiabetic drug) vs. standard metformin monotherapy, in patients with untreated type 2 diabetes mellitus (T2DM). We searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials through October 31, 2021 to find relevant RCTs. Efficacy outcomes were changes in hemoglobulin A1c (HbA1c) and fast plasma glucose (FPG) from baseline as well as proportion of patients achieving HbA1c < 7%; the safety outcome was hypoglycemia risk. We identified 14 RCTs comprising 5326 patients with untreated T2DM. Mean treatment duration was 28.1 weeks. Pooled results showed that compared to metformin monotherapy, combination therapy was associated with a reduction in HbA1c (mean difference: −0.48 %, −0.58 to − 0.38) and FPG (mean difference: −0.92 mmol/L, −1.14 to − 0.69), and more patients achieving HbA1c < 7% (odds ratio: 2.21, 1.87 to 2.60). Hypoglycemic events and people experiencing hypoglycemia were not different between 2 groups. Initial combination of metformin plus a low hypoglycemic risk antidiabetic drug may achieve better glycemic control, without a rise in hypoglycemia, in patients with untreated T2DM. [ABSTRACT FROM AUTHOR]

Depression is a common illness during pregnancy, yet it often goes undetected and/or untreated. Untreated depression during pregnancy has been associated with increased rates of adverse maternal, obstetrical and fetal outcomes; consequently, it is crucial to manage these women effectively and adequately during this vulnerable time of their lives. The barriers to treatment include the stigma surrounding mental health and the challenges of navigating the constantly growing, and apparently conflicting, evidence regarding the safety of antidepressant use during pregnancy, as well as other concerns unique to pregnant women. In this paper, we suggest the management of women with depression during pregnancy, using evidence-based information, taking into account all of the aspects of treatment, including screening, risks of untreated depression and evaluation of the safety data regarding pharmaceutical treatments. In addition, we have designed a treatment algorithm to assist clinicians in making evidence-based decisions in this highly sensitive and complex clinical field. Finally, it is important to evaluate each woman on an individual, case-by-base basis, in order to ensure the best outcome for both the mother and her baby. [ABSTRACT FROM AUTHOR]

Purpose: This study reevaluates the potential role of different tumour markers as prognostic indicators in untreated nephroblastoma. Methods: Expression of a broad panel of tumour markers was investigated by means of immunohistochemical analysis in 43 WT patients. Patients were treated by radical nephrectomy and had a mean follow-up of 11.9 years. Results: Generally, all the tumour markers studied were expressed in normal kidney tissue and at variable levels in the three cell types of WT (blastema, epithelium and stroma). Immunoreactive blastemal (Bcl-X, Bcl-2 and CD44s) and epithelial (Bcl-X, Bcl-2 and MIB-1) cells were present in the majority of tumours. No correlation was found between their expression and pathological stages. Univariate analysis showed that blastemal WT-1, TGF-α, VEGF, MIB-1 and p27 Kip1 were indicative for clinical progression. In a multivariate analysis, WT-1 protein expression by blastemal cells was an independent prognostic marker for clinical progression. Conclusions: The blastemal WT-1, TGF-α, VEGF, MIB-1 and p27Kip1 expression correlate with clinical progression in untreated nephroblastoma. Therefore, their expression may be of value in identifying patients with a high propensity to develop distant metastases. [ABSTRACT FROM AUTHOR]

Abstract: Today, environmental concerns push for new technologies to reduce our energy dependence on fossil fuels. The use of treated biogas in dual-fuel diesel engines is common as it has no major effects on engine performance and it only requires minor engine modifications, consisting mostly on premixing and injection timing advance. However, biogas itself cannot be directly used in engines because of degradation caused by acid attacks and sulfidation, making sulfur compound filtration a necessity. In this case, biogas use is economically competitive for relatively big installations with electrical power above ≈100–200 kW. Simple, low-costs solutions are needed for small installations (below 100 kW). The objective of this paper is to assess the degradation of a 3.1 kW diesel engine in dual-fuel mode with preheated untreated biogas with phase separation. The modifications on the engine consist only in an exhaust/biogas heat exchanger with phase separation and lubricant replacement with a higher total base number. These changes are relatively costless compared to removing sulfur from the biogas. A test engine did function for 550 h with preheated untreated biogas containing 2000 ppmv of H2S. The load was maintained at 60% of maximum load with 50% of diesel replacement with biogas. Degradation was monitored by visual inspection, weight and size measurements of engine parts, in-cylinder pressure measurements, and oil analysis. Dismantling of the engine at the end of the experiment showed almost negligible signs of degradation. For comparison purposes, a similar test was conducted on the engine with the same operating conditions but without biogas preheating or phase separation. The degradation observed was noticeably more important in that experiment as the oil total base number decreased faster and cylinder head gasket wear was more important. Biogas preheating with phase separation seems a promising low-cost alternative for biogas use in small farms as it limits acid attacks and sulfidation in engines. [Copyright &y& Elsevier]

The purpose of this lecture was to give an overview of the natural history of adolescent idiopathic scoliosis (AIS), in order to serve as guidance in the decision of performing surgery or not for the specific patient with AIS. A literature review was performed. Studies concerning long-term outcome in patients with adolescent idiopathic scoliosis that had received no treatment were used. Outcome in terms of curve size, pulmonary function, back function and quality or life/social life was compared. The literature review showed that single thoracic curves of 50°-75° progress 0.73°/year over a 40-year period. AIS do not result in increased mortality, but pulmonary symptoms may be associated with larger curves. Back pain is more frequent among patients with AIS. No study using modern quality of life questionnaires exists, but for social function, childbearing, and marriage no apparent disadvantageous effects were reported compared to the healthy population. The conclusion is that most individuals with AIS and moderate curve size around maturity function well and lead an acceptable life in terms of work and family. Some patients with larger curves have pulmonary problems, but not to the extent that this affects the life span. This needs to be taken into account when discussing surgery with the individual patient. [ABSTRACT FROM AUTHOR]

BACKGROUND: A subset of patients who present with metastatic solid tumors never receive anticancer therapy. Reasons may include poor functional status, comorbidities, and patient preference. To the authors' knowledge, the prevalence and characteristics of this population have not previously been described. METHODS: The National Cancer Data Base was queried for patients diagnosed with metastatic (stage IV according to the American Joint Committee on Cancer) solid tumors (including those of the breast, cervix, colon, and kidney; small cell and nonsmall cell lung cancer [NSCLC]; and tumors of the prostate, rectum, and uterus) who received neither radiotherapy nor systemic therapy. Log-binomial regression analysis was used to estimate prevalence ratios (PRs) for the percentage of untreated to treated patients with stage IV cancer. RESULTS: Between 2000 and 2008, 773,233 patients with stage IV cancer were identified, 159,284 of whom (20.6%; 95% confidence interval, 20.5%-20.7%) received no anticancer therapy. Patients with NSCLC accounted for 55% of the untreated population. Patients with cancers of the kidney and lung had the highest rates of no treatment at 25.5% and 24.0%, respectively, whereas patients with prostate cancer had the lowest rate of no treatment at 11.1%. Across all cancer types, older age (PR range, 1.37-1.49; all P < .001), black race (PR range, 1.05-1.32; all P < .001), lack of medical insurance (PR range, 1.47-2.46; all P < .001), and lower income (except for cancer of the uterus; PR range, 0.91-0.98 for every $10,000-increase in income [all P < .001]) were associated with a lack of treatment. CONCLUSIONS: Approximately 20% of patients who present with stage IV solid tumors do not receive anticancer therapy. Although there are likely multiple reasons for this lack of treatment, including appropriate indications, these findings have potential implications with regard to health care policy and access to care. Cancer 2012. © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

Abstract: Background: Combination highly active antiretroviral therapy (HAART) has significantly decreased HIV-1 related morbidity and mortality globally transforming HIV into a controllable condition. HAART has a number of limitations though, including limited access in resource constrained countries, which have driven the search for simpler, affordable HIV-1 treatment modalities. Therapeutic HIV-1 vaccines aim to provide immunological support to slow disease progression and decrease transmission. We evaluated the safety, immunogenicity and clinical effect of a novel recombinant plasmid DNA therapeutic HIV-1 vaccine, GTU®-multi-HIVB, containing 6 different genes derived from an HIV-1 subtype B isolate. Methods: 63 untreated, healthy, HIV-1 infected, adults between 18 and 40 years were enrolled in a single-blinded, placebo-controlled Phase II trial in South Africa. Subjects were HIV-1 subtype C infected, had never received antiretrovirals, with CD4≥350cells/mm3 and pHIV-RNA≥50copies/mL at screening. Subjects were allocated to vaccine or placebo groups in a 2:1 ratio either administered intradermally (ID) (0.5mg/dose) or intramuscularly (IM) (1mg/dose) at 0, 4 and 12 weeks boosted at 76 and 80 weeks with 1mg/dose (ID) and 2mg/dose (IM), respectively. Safety was assessed by adverse event monitoring and immunogenicity by HIV-1-specific CD4+ and CD8+ T-cells using intracellular cytokine staining (ICS), pHIV-RNA and CD4 counts. Results: Vaccine was safe and well tolerated with no vaccine related serious adverse events. Significant declines in logpHIV-RNA (p =0.012) and increases in CD4+ T cell counts (p =0.066) were observed in the vaccine group compared to placebo, more pronounced after IM administration and in some HLA haplotypes (B*5703) maintained for 17 months after the final immunisation. Conclusions: The GTU®-multi-HIVB plasmid recombinant DNA therapeutic HIV-1 vaccine is safe, well tolerated and favourably affects pHIV-RNA and CD4 counts in untreated HIV-1infected individuals after IM administration in subjects with HLA B*57, B*8101 and B*5801haplotypes. [Copyright &y& Elsevier]

Objectives To establish the effectiveness or efficacy of psychological interventions, it is important to understand the nature of changes that occur in the absence of therapy. Design In this study, clinically distressed college students from 2 universities ( n = 228) completed the Outcome Questionnaire (OQ)-45.2 on a weekly basis throughout a single semester. Results Although 56.6% of the sample made no change or deteriorated, 43.4% made a reliable improvement. Change status was predicted by previous therapy experience and length of study participation. Multilevel growth modeling also indicated that participants' OQ-45.2 scores decreased over time (following a cubic trend) and the amount of decrease was associated with Time 1 OQ-45.2 scores. Conclusions Limitations of the study and further implications for treatment outcome research are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Background: Imatinib is an effective treatment for patients with newly diagnosed chronic phase chronic myeloid leukemia (CML-CP), but resistance to imatinib can occur. Second-generation BCR-ABL inhibitors have shorter onset times and higher rates of complete cytogenetic response (CCyR) than imatinib. Dasatinib has a half-maximal inhibitory concentration 325 times lower than imatinib for BCR-ABL substrate phosphorylation in vitro and is less susceptible to most known molecular mechanisms of BCR-ABL imatinib resistance. Objectives: This study summarized published data on the use of dasatinib in CML-CP, reviewed the importance of early response to therapy, and discussed additional therapies for patients with newly diagnosed disease. Methods: PubMed was searched through June 2011 for English-language publications with the following search terms: imatinib, dasatinib, nilotinib, chronic myeloid/myelogenous leukemia or CML, and clinical trial. To identify follow-up data from published trials and data on trials in progress and products in development, similar searches were conducted for abstract and clinical trial databases. Relevant articles and abstracts were identified as those reporting results of Phase II and III clinical trials, predictors of treatment response, and treatment guidelines. No prespecified inclusion or exclusion criteria were used. Results: Dasatinib was effective in patients resistant to imatinib and more effective than high-dose imatinib in patients with newly diagnosed CML who were resistant to standard dose imatinib. Compared with imatinib, dasatinib induced superior response rates and patient outcomes earlier in the disease. In a Phase III trial in patients with newly diagnosed CML-CP, dasatinib 100 mg once daily induced significantly higher and faster rates of confirmed CCyR and major molecular response by 12 months versus imatinib and was generally well tolerated. Early achievement of CCyR was associated with better long-term progression-free survival. Dasatinib was approved by the U.S. Food and Drug Administration and the European Medicines Agency for initial treatment of CML-CP. Conclusions: Dasatinib was an effective treatment with the potential to improve long-term outcomes for patients with newly diagnosed CML-CP. [Copyright &y& Elsevier]

Summary: Nasopharyngeal carcinoma (NPC) is a non-lymphomatous carcinoma that develops in the epithelial lining of the nasopharynx. The knowledge of natural course of tumor progression has been based on anatomical model without clinical correlation. This study is the first to describe and analyze the natural progression of NPC based on clinical information and calculate the tumor growth rate of NPC. Fifteen NPC patients who refused treatment after initial work-up and then subsequent re-presentation at a later time were recruited during the period from January 2003 to August 2009. Clinical data were analyzed and CT scans were used to calculate the tumor volumes. The time interval between the first planning CT image and the subsequent planning CT image was used to calculate the rate of tumor growth in this group of patients. The tumor volume doubling time can be calculated by using the formula , where t is the time interval between measurements and V 2 and V 1 are the tumor volumes at the end and beginning of the time interval, respectively. Cranial nerves palsies such as diplopia and systemic upset were the most common reason for re-presentation and the consent for treatment. The median growth rate was 1.63mm3 per day and the median tumor doubling time was 279days. This study is the first report in the literature looking at the natural progression of nasopharyngeal carcinoma (NPC) based on clinical information. The current study showed that NPC has a propensity to grow superiorly to involve the skull base rather than laterally or anteriorly. Although the tumor growth rate was very variable, the median natural NPC growth rate was 1.63mm3/day. [Copyright &y& Elsevier]

Chronic lymphocytic leukemia (CLL) is the most common adult leukemia and has a heterogeneous clinical course. Some patients experience an indolent disease course, which does not require treatment or affect their overall quality of life. Other patients present with symptomatic advanced disease that rapidly progresses and requires therapy. For these patients, chemotherapy is the mainstay of treatment and has undergone significant evolution in the past few decades. From alkylating agents to purine analogs, response rates have greatly improved with new chemotherapy regimens. The development of chemoimmunotherapy regimens has also transformed the treatment of CLL. This article will review front-line treatment options for CLL and discuss the updated National Comprehensive Cancer Network guidelines. J Oncol Pharm Practice (2011) 17: 91—103. [ABSTRACT FROM PUBLISHER]

Acute necrotising encephalopathy (ANE) is a rare encephalitis-like syndrome usually reported in East Asia. This clinical syndrome tends to be triggered by viral febrile illness with rapid deterioration to seizures, coma and a generally poor outcome. Diagnosis is usually made on Magnetic Resonance Imaging (MRI). Its epidemiology is unknown largely due to under-recognition. Recurrent ANE has recently been associated with a newly discovered autosomal dominant mutation RAN-binding protein 2 now termed ANE1. There had been reports encouraging the use of empirical corticosteroids as treatment for this condition. However, there have not been any clinical trials to date. Here we report an unusual case of a Caucasian toddler who had suffered two episodes of ANE, but did not receive any specific treatment and has normal physical and cognitive outcome at 1 year follow up. He has this missense mutation in the gene of the RAN-binding protein 2 as have his mother and brother who are both well. This case adds to the worldwide literature and expands on the spectrum of outcomes in order to bring about better recognition in the Caucasian population. [ABSTRACT FROM AUTHOR]

Untreated Scots pine (Pinus sylvestris) and Norway spruce (Picea abies) samples were exposed above ground in a durability test for 6 years. The samples consisted of three pieces of wood, 22×95×500 mm, screwed together; two pieces lengthwise with a third piece overlapping. Weight was measured, to calculate moisture content (MC), and samples checked regularly for cracks and fungal growth. Parameters investigated were heartwood/sapwood (pine), annual ring orientation (spruce), stand site, annual ring width and density. Stand site, annual ring width and density had no influence on MC or fungal growth for either pine or spruce. Spruce samples with vertical annual rings had fewer cracks than samples with horizontal annual rings. Pine sapwood samples had a high MC and a large amount of rot fungi, while heartwood had a lower MC and no rot. Most spruce samples were similar to pine heartwood, except from a few samples that had high MC and fungal growth. Those were all sawn from the outer part of the log. Therefore, it can be stated that spruce sawn from the inner part has almost the same properties as pine heartwood, while spruce from the outer part of the log has similar properties to pine sapwood. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Antipsychotic medication and lifestyle factors are implicated in the high rates of obesity and metabolic syndrome in schizophrenia. While the two Consensus Statements made in 2004 concluded they were unclear whether psychiatric disorders per se accounted for increased prevalence of metabolic disorders several later studies have presented the case for an association between schizophrenia and metabolic disorders, especially impaired glucose metabolism and Type 2 diabetes mellitus, independent of antipsychotic drug treatment. Methods: This is a comparative study of 51 patients with chronic schizophrenia who never received antipsychotic drug treatment and 51 healthy controls. Physical and laboratory assessments were made to measure body-mass index and diagnose metabolic syndrome using the International Diabetes Federation (2006) criteria. Results: The study observed a significantly lower mean body-mass index in patients (19.4) than controls (22.7) and very low and comparable rates of metabolic syndrome (3.9% in patients, 7.8% in controls). Discussion: Economic affordability and lifestyles modified by living conditions were discussed as factors underlying the high rates of underweight in the patient population and low rates of metabolic disorders in all the study subjects. The study concluded that schizophrenia in the absence of antipsychotic drug treatment is not a factor contributing to high prevalence of metabolic abnormalities. Lifestyle factors and the social and economic circumstances that drive them should be considered for better understanding and management of excess weight gain and metabolic abnormalities in people with schizophrenia. [Copyright &y& Elsevier]

In 2006 a comprehensive sampling program was undertaken in two pre-selected peri-urban villages in Faisalabad, Pakistan to evaluate the soil and agronomic impacts of long-term (25–30 years) untreated wastewater re-use on wheat grain and straw yields and attributes of wheat straw fodder quality. Soil SAR, ESP, RSC and ECe were 63%, 37%, 31%, and 50% higher under wastewater (WW) as compared with canal water (CW) irrigated plots. Further, 2.7 and 6.65 fold increases in soil NO + NO - N and Olsen-P were observed in WW as compared with CW irrigated plots. However, no significant differences in grain yield, wheat straw biomass, or fodder quality attributes were observed between WW and CW irrigated plots. In addition, for both CW and WW irrigated plots wheat straw, Cd and Pb concentrations were orders of magnitude below the EC Maximum permissible levels for Pb and Cd in feed materials and thus pose no threat to the fodder-livestock food chain. Further, elevated soil N associated with WW irrigated plots has a significant ( p < 0.01) positive influence on fodder quality by increasing the N content. Factorial ANOVA with covariance indicates that effective management of the elevated soil ECe in WW irrigated plots would increase grain yield and wheat straw biomass by 853 kg ha−1 (19.5%) and 819 kg ha−1 (18.6%) respectively as compared with CW irrigated plots. In Faisalabad, if managed appropriately to address emerging salinity issues the contribution of wastewater irrigation to the achievement of MDGs 1 and 7 could be significant if adverse impacts remain as marginal as found in this study. [ABSTRACT FROM AUTHOR]

The standard-free method developed by ourselves 13 years ago has been widely applied to quantitative analyses of hairs such as head hair taken from human and body hair taken from companion and domestic animals. In the present work, the standard-free method for feather and down samples taken from wild birds such as swan, waxwing, osprey, heron and crow is developed. It is found that the standard-free method developed for human hairs can be successfully applied to feather samples without essential modification since the main constituents of feather are almost the same as those for human and animal hairs and, consequently, the shape of continuous X-rays is also the same. Accuracy and sensitivity of the present method were examined by comparing the results with those obtained by an internal-standard method combined with a chemical-ashing method. The method allows us to quantitatively analyze untreated feather samples of very small quantities and to prepare the target without complicated preparation technique. It is expected that the method will become a powerful tool for the studies not only on the mode of life of wild birds but also on environmental contamination by toxic elements. [ABSTRACT FROM AUTHOR]

A standard-free method for hoof samples taken from cattle such as cow, calf, pony and sheep has been developed in order to estimate the state of health of these animals. The standard-free method developed for human nails was confirmed to be applicable to quantitative analysis of hoof samples since the shape of continuous X-rays is almost the same for nail and hoof taken from these ungulate animals. Accuracy and sensitivity of the present standard method were examined by comparing the results with those obtained by an internal-standard method combined with a chemical-ashing method, and it is confirmed that the method is applicable to hoof samples taken from domestic animals of many species. The method allows us to quantitatively analyze untreated hoof samples and to prepare the targets without complicated preparation technique which often brings ambiguous factors such as elemental loss from the sample and contamination of the sample during preparation procedure. It is also confirmed that halogens, which are important elements for estimating the state of health and are mostly lost during chemical-ashing, can be analyzed without problem by the present method. It is found that elemental concentration of more than twenty elements can be constantly analyzed and it is expected to be quite useful in order to estimate the state of health and to make diagnosis of domestic animals. It is also confirmed that elemental concentration of essential elements in hoof is not so changed depending on the positions in the sliced sample along both horizontal and vertical axis. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The aim of the study was to prospectively examine all patients with a diagnosis of RLS consulting a sleep disorders clinic and to assess RLS severity and augmentation and their associations, including ferritin levels. Methods: Patients were stratified into patients with RLS as ancillary diagnosis, RLS sufferers without current augmentation and RLS sufferers with current augmentation. Work-up included RLS severity scales and blood biochemical variables including indices of iron metabolism. Results: In an 18-month period, 302 patients with RLS (183 women, 119 men; mean age, 59.1±13.7 years) were recruited. RLS was considered idiopathic in 291 patients (96.4%). Most patients (240, 79.5%) were RLS sufferers, whereas the remaining 62 (20.5%) had RLS as ancillary diagnosis. Nineteen out of 162 patients treated with dopaminergic agents (11.7%) had current augmentation. Almost one-third of all patients (31.1%) had ferritin levels <50μg/l. Patients with an ancillary diagnosis of RLS had higher ferritin levels than RLS sufferers without current augmentation. The lowest ferritin levels were present in RLS sufferers with current augmentation 132.8±98.0μg/l vs. 100.6±84.5μg/l vs. 55.8±43.6μg/l; p =0.002). Patients with augmentation did not differ from non-augmented patients regarding age, gender, RLS etiology, presence of previous augmentation, or any other documented comorbidity (p >0.05). Conclusion: The severity spectrum of RLS in this clinical cohort ranged from the ancillary diagnosis of RLS to augmented RLS. There was an inverse correlation between RLS severity and ferritin levels. Patients with current augmentation had the lowest ferritin levels. Our data further strengthen a putative role of low iron stores as a potential aggravator of idiopathic RLS. Moreover, low ferritin might represent a potential biomarker of RLS augmentation under dopaminergic therapy. [Copyright &y& Elsevier]

The impact of irrigation of distillery spent on the nutrients uptake in pulses in untreated and treated soil were studied. The 50% and 33% concentrations of spent wash were analyzed for their additive plant nutrients such as nitrogen, phosphorous, potassium and other physical and chemical parameters. The pulse seeds (Namadhari and Mayhco) were sown in the prepared land and irrigated with raw water (RW), 50% and 33% spent wash, respectively. The impact of spent wash in untreated and treated soils on proximate principles (moisture, protein, fat, fiber, carbohydrate, energy, calcium, phosphorous and iron) vitamin content (carotene and vitamin-C) and mineral and trace elements (magnesium, sodium, potassium, copper, manganese, zinc, chromium and nickle) of pulses were also investigated. It was found that the uptake of all the nutrients was surplus in 33% spent wash as compared to 50% spent wash treatment and raw water irrigation (control). Aslo, the nutrients uptake was largely influenced in spent wash treated soils in comparison to raw water irrigation than the untreated soil. [ABSTRACT FROM AUTHOR]

Background: The proportion of the population aged 85 years and older has increased rapidly in Japan, reaching 2.5 million (1.99%) in 2002. Under these circumstances, the number of dementia patients increases annually. However, few studies have focused on Alzheimer's disease (AD) with an age at onset older than 85 years (oldest old AD). The aims of the present study were to determine the prevalence of the behavioral and psychological symptoms of dementia (BPSD) in patients with oldest old AD compared with those with young old AD. Methods: Fifty-eight untreated AD patients were divided into two groups: young old AD patients (age at onset between 65 and 70 years; n = 28) and oldest old AD patients (age at onset 85 years or older; n = 30). Then, BPSD were compared between the two groups. Results: There were significant differences in the frequencies of hallucinations (χ2 = 7.43; P = 0.011) and delusional misidentification syndrome (DMS; χ2 = 7.26; P = 0.011) between the two groups. Conclusions: The results of the present study suggest that aging may play a part in the occurrence of hallucinations and DMS in oldest old AD patients. [ABSTRACT FROM AUTHOR]

Standard-free method for untreated hair samples in in-air PIXE has been developed. It is confirmed that the method gives us good sensitivity and accuracy within several minutes' measurement if more than twenty hairs are attached onto the target. Even in the case where the number of hairs is less than eight, which is regular for usual in-vacuum PIXE, 10-15 minutes measurement is found to be sufficient to achieve almost satisfactory sensitivity and accuracy for elements from Cl to Pb. As the present method allows us to carry out analyses without labor in target preparation, it is expected to be quite helpful in the studies on human exposure to toxic elements. Its availability will more and more increase when the method is combined with the method of simultaneous measurement of in-vacuum and in-air PIXE we have just developed. [ABSTRACT FROM AUTHOR]

Abstract: An increasing number of new hepatitis C virus NS3-protease inhibitors are being evaluated for the treatment of chronic hepatitis C. Treatment-induced selection of mutants conferring resistance to protease inhibitors has been shown both in vivo and in vitro. A specific mutation, A156T has been shown to confer high-level resistance to several such agents (BILN2061, VX-950, SCH446211 (SCH6) and SCH503034). Here we report the presence of the A156T mutation in close to 1% of NS3 sequences within the liver quasispecies of a chronic hepatitis C patient never treated with anti-NS3-protease inhibitors. [Copyright &y& Elsevier]

Thalidomide – either alone or in combination with dexamethasone or chemotherapy – has shown significant activity in relapsed/refractory disease. When used in the induction regimens in untreated patients, it significantly increases the response rates as well progression-free survival. Moreover, thalidomide as a maintenance therapy has become a very attractive option. However, the toxicity profile of the drug, mainly neurotoxicity and thrombotic events, mandate careful monitoring of patients treated with thalidomide, whether as the first line, in the relapsed setting, or as maintenance. In this chapter we will review the pharmacology, mechanisms of action, and toxicity of the drug, and will focus on available data from clinical experience and randomized trials of thalidomide in the different settings of multiple myeloma: refractory/relapsed disease, upfront treatment in patients who are eligible for high-dose therapy as well as those who are not, and finally the use of thalidomide as a maintenance treatment. [Copyright &y& Elsevier]

Summary: Background: Several studies have reported reduced heart rate variability (HRV) in patients with chronic epilepsy under treatment with antiepileptic drugs. This impairment in cardiac autonomic control might be of relevance in relation to the risk of sudden unexpected death in patients with chronic refractory epilepsy. Little information is, however, available on HRV in untreated patients with newly diagnosed epilepsy. Methods: We used spectral analysis to assess HRV based on 24h ambulatory EKG recordings in 22 consecutive untreated patients with epilepsy (15 with localization-related, 4 with generalized idiopathic and 3 with undetermined epilepsy). The HRV in these patients was compared with 22 age and sex matched healthy controls. Results: When analysing the full 24h recordings, there were no significant difference between the patients and the controls in any of the analyzed measures of HRV: standard deviation of RR-intervals (P =0.191), total power (P =0.170), very low frequency power (P =0.329), low frequency power (LF) (P =0.161), high frequency power (HF) (P =0.186) and the LF/HF ratio (P =0.472). The results were very similar for daytime and nighttime recordings. Conclusion: Our results suggest that there is no major effect of epilepsy as such on HRV in patients with untreated epilepsy. It should be emphasized that this study assessed newly diagnosed patients and that the results may not be applicable to patients with chronic epilepsy. [Copyright &y& Elsevier]

This exploratory study examines whether the attitudes towards change and treatment of untreated non-abstinent substance abusers differ from those of patients undergoing treatment in residential care. The sample (n = 97) consists of untreated, voluntarily and compulsorily treated substance abusers who completed a questionnaire in 2003. Attitudes were measured with scales on e.g. problem recognition, desire for help, treatment readiness and aspects of time perspectives, e.g. past, present and future orientation. The attitudes of the three groups - untreated, voluntarily and compulsorily treated subjects - differed with respect to lifestyle change. Factor analysis of the measures revealed one component of primary interest, general willingness to change. Results show that willingness to change was correlated with other attitudinal characteristics in the three groups. The stability of substance abusers' motivation is discussed with the focus on different social contexts' influence on change-compliant attitudes and behaviour. [ABSTRACT FROM AUTHOR]

This article uses qualitative methods to compare two groups of heavy drinkers - those who had recently sought specialist help, and those who were currently 'self-directing' change in drinking. Thirty-six heavy drinkers, selected from a larger cohort in the English West Midlands, took part in semi-structured interviews on drinking change. Key themes for the 'self-directed change' group were: confidence in self-sufficiency to change, internalised social pressure for change, and social collaboration with other drinkers for changing drinking. In contrast, themes for the 'specialist help' group were: feeling 'out of control', lacking confidence in the decision to change drinking, external social pressure for change, and alienation from social collaboration in changing drinking. Results suggest that specialist help might exploit or develop opportunities for collaboration with others. To maintain change, specialist help may need to take more into account those social roles that appear to encourage the stabilisation of drinking in the long term. [ABSTRACT FROM AUTHOR]

Objective: This study was undertaken to assess the natural course of endometrial endometrioid carcinoma by identifying untreated patients and those with a prolonged (> 6 months) treatment delay. Study design: A chart review of 252 patients with histologically confirmed endometrial endometrioid carcinoma was conducted and clinical data of untreated patients and those with a prolonged treatment delay were abstracted. Results: Seven patients (3 untreated and 4 with prolonged treatment delay) were identified. Five had clinical stage 1 and 5 had well-differentiated tumors. The survival of the untreated patients ranged from 5 to 59 months. Of the patients with prolonged treatment delay, 2 died more than 5 years after diagnosis and 2 are alive more than 5 years after diagnosis. Conclusion: The lengthy survival of our patients seems to indicate that the natural progression course, even in untreated patients, may be very slow in endometrial endometrioid carcinoma with favorable prognostic factors. [ABSTRACT FROM AUTHOR]

Creatine, which is well known as an important substance for muscular activity, is synthesized from amino acids such as glycine, arginine and ornithine in liver and kidney. It then accumulates in skeletal muscle as creatine phosphoric acid. The aim of this study was to understand the dehydration behavior of untreated and pulverized creatine monohydrate at various temperatures. The removal of crystal water was investigated by using differential scanning calorimetry (DSC), X-ray powder diffraction and scanning electron microscopy (SEM). The X-ray diffraction pattern of untreated and pulverized creatine monohydrate agreed with reported data for creatine monohydrate. However, the diffraction peaks of the (1 0 0), (2 0 0) and (3 0 0) planes of pulverized creatine monohydrate were much stronger than those of untreated creatine monohydrate. On the other hand, the diffraction peaks of the (0 1 2) and (0 1 3) planes of untreated creatine monohydrate were much stronger than those of pulverized creatine monohydrate. The dehydration of untreated and pulverized creatine monohydrate was investigated at various storage temperatures, and the results indicated that untreated and pulverized creatine monohydrate were transformed into the anhydrate at more than 30 °C. After dehydration, the particles of untreated and pulverized creatine anhydrate had many cracks. The dehydration kinetics of untreated and pulverized creatine monohydrate were analyzed by the Hancock–Sharp equation on the basis of the isothermal DSC data. The dehydrations of untreated and pulverized creatine monohydrate both followed a zero-order mechanism (Polany–Winger equation). However, the transition rate constant, calculated from the slope of the straight line, was about 2.2–7.7 times higher for pulverized creatine monohydrate than for untreated creatine monohydrate. The Arrhenius plots (natural logarithm of the dehydration rate constant versus the reciprocal of absolute temperature) of the isothermal DSC data for untreated and pulverized creatine monohydrate were linear. The activation energies of dehydration in the 40–60 °C range for untreated and pulverized creatine monohydrate were 15.02 and 10.1 kJ/mol, respectively. Dehydration of untreated creatine monohydrate had a pronounced effect on the particle size of the powder. Compared with pulverized creatine monohydrate, the particle size of untreated creatine monohydrate was significantly decreased by dehydration. [Copyright &y& Elsevier]

Summary: Purpose: Patients with epilepsy are reported to have an increased risk of physical injury. One of clinicians' concerns for diagnosing epilepsy early is to try to prevent such injuries and also to allay parental anxiety that seizures may cause injuries. The purpose of this study was to investigate injuries in children with newly diagnosed epilepsy and before starting antiepileptic medication. Methods: A prospective study was undertaken of all newly diagnosed and untreated patients with at least two unprovoked, afebrile seizures of any type, aged 1–16 years, presenting consecutively to seven paediatric/paediatric neurology outpatient departments over a 12-month period. Information was collected on the duration of epilepsy before diagnosis, the epilepsy syndrome, the seizure type causing the injury, how and the age at which the injury was sustained, and whether hospital treatment was required for the injury. Results: One hundred ninety-eight patients (116 boys) were surveyed. No patient died as a result of an injury. Twenty-five (12.6%) children experienced an injury before the diagnosis of epilepsy was established. Only four of the 25 patients (2% of all 198 patients) required medical attention for the injury. The injuries occurred at a mean age of 10.3 years (range, 4–15.1 years), and epilepsy was diagnosed at a mean age of 11.1 (range, 4.2–15.8) years. Fifteen patients were injured at home, six at school, and four outside the home. The seizures causing the injuries were tonic–clonic (17), complex partial (four), myoclonic (one), and of uncertain type (three). None of the 32 patients with childhood-onset typical absence epilepsy had accidental injuries. Conclusions: Injuries caused by epileptic seizures were uncommon in this newly diagnosed and untreated, consecutive paediatric outpatient series. These unique data could help to reassure clinicians that the diagnosis of epilepsy should not be influenced by any concern that... [ABSTRACT FROM AUTHOR]

The method of quantitative analysis for untreated hair samples, which we developed three years ago, has proved to be quite useful for investigating environments contaminated by certain toxic elements. In the present work, the experimental conditions are improved. Loss of certain elements owing to irradiation damage, which has remained as one of the experimental uncertainties, was examined. It was found that the concentration of sulfur decreases gradually throughout the irradiation, while for the other elements, including arsenic and mercury, no changes occur under our measuring conditions. Furthermore, the degree of alteration of elemental concentration depending on the position along the hair was investigated. As a result, concentrations of some elements at different positions on a 14-cm-length hair, which was taken from a small-scale miner in the Philippines, showed some dependence on the distance from the root reflecting her history as a miner, while mercury does not show large deviation from a main trend. It was also found that concentration of mercury in hairs taken from different parts of a body does not show large difference. These results demonstrate that mercury and arsenic concentration in hairs, obtained by the present method, become a good index for an estimation of human exposure to these toxic elements. Changes of concentration of some elements depending on the way of cleaning before irradiation are studied in detail and the optimum way of washing is established. [Copyright &y& Elsevier]