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ObjectiveTo define the prevalence of neuromuscular, musculoskeletal, pain, visceral, oncologic and other late effects impacting function and quality of life in Hodgkin lymphoma(HL) survivors presenting to an outpatient cancer rehabilitation clinic.DesignA retrospective cohort analysis.SettingOutpatient cancer rehabilitation clinic.ParticipantsOne hundred consecutive HL survivors.InterventionsNone.Main Outcome MeasuresThe prevalence of neuromuscular, musculoskeletal, pain, visceral, oncologic and other late effects contributing to functional impairment and disability in HL survivors.ResultsAmong the 100 HL survivors, 43% received chemotherapy, 94% radiation therapy, and 38% a combination of chemotherapy and radiation for initial treatment. Nearly all HL survivors were diagnosed with myelopathy (83%), radiculo-plexopathy (93%), mononeuropathy (95%) and localized myopathy (93%). Musculoskeletal sequelae were extremely common and included dropped head syndrome (83%), cervicalgia (79%), shoulder girdle dysfunction (73%), and dysphagia (42%). Visceral disorders were also common and included cardiovascular (70%), pulmonary (44%), endocrine (63%), gastrointestinal (29%), and genitourinary (11%) dysfunction. Lymphedema affected 21% of survivors and 30% had a history of a secondary malignancy. Pain (71%), fatigue (45%), and dyspnea (43%) were major function-limiting impairments. Nearly all (95%) of survivors were referred to at least one therapy discipline including physical therapy, occupational therapy, speech and language pathology and/or lymphedema therapy.ConclusionNeuromuscular, musculoskeletal, pain, visceral, oncologic and other late effectsare extremely common in HL survivors seeking physiatric evaluation. Multiple function-limiting disorders can co-exist in HL survivors with the potential to severely compromise function and quality of life. Safe and effective rehabilitation may depend on the physiatrist’s ability to identify, evaluate and manage the multitude of complex and often interrelated functional late effects seen in HL survivors.

Assessment of the impact of pneumococcal conjugate vaccines on the burden of pneumonia, meningitis, and septicemia in Hungary is limited.The aim of this retrospective study was to quantify rates of hospitalized multi-cause and pneumococcal pneumonia, meningitis, and septicemia in all age groups in Hungary between 2006 and 2011.Aggregate data were obtained from the Hungarian National Healthcare Fund using pre-specified ICD-10 codes. Comparisons included average rates pre-vaccine (2006-2007) versus post-vaccine (2010-2011) using a χ2 test.Hospitalization rates among children aged 0-4 years significantly declined for multi-cause pneumonia and meningitis, but increased for septicemia. There were significant increases in multi-cause pneumonia and septicemia in other age groups. In-hospital mortality rates increased with age. Limited use of pneumococcal-specific codes led to inconclusive findings for pneumococcal diseases.Declines in multi-cause pneumonia and meningitis in children aged 0-4 years suggest direct effects of pneumococcal conjugate vaccination on hospitalization rates.Bevezetés: Kevés adat áll rendelkezésre a konjugált pneumococcusvakcináknak a pneumonia, meningitis és septikaemia előfordulására gyakorolt hatásáról Magyarországon. Célkitűzés: A szerzők retrospektív vizsgálattal kívánták felmérni a 2006–2011 között Magyarországon minden korosztályban előforduló, kórházi kezelést igénylő, bármely kórokú és pneumococcus okozta pneumonia-, meningitis- és septikaemiaeseteket. Módszer: Összesített adatokat gyűjtöttek az Országos Egészségbiztosítási Pénztár adatbázisából előre meghatározott BNO-10-kódok segítségével. Az összehasonlítás χ2-próba segítségével készült a következők alapján: átlagos arány a védőoltás bevezetését megelőzően (2006–2007) versus átlagos arány a védőoltás bevezetését követően (2010–2011). Eredmények: A 0–4 éves korú gyermekeknél a kórházi kezelést igénylő esetek aránya jelentősen csökkent a bármely kórokú tüdőgyulladás és agyhártyagyulladás esetében, de nőtt a septikaemia esetében. A többi korcsoportnál jelentősen növekedett a bármely kórokú pneumonia- és septikaemiaesetek száma. A kórházi halálozás aránya az életkorral emelkedett. A pneumococcusspecifikus kódok korlátozott alkalmazása miatt nem állapítottak meg egyértelmű eredményeket a pneumococcus okozta betegségeket illetően. Következtetések: A bármely kórokú tüdőgyulladás és agyhártyagyulladás csökkenése a 0–4 éves korosztálynál a konjugált pneumococcusvakcinációnak a kórházi kezelés arányára gyakorolt közvetlen hatására utal. Orv. Hetil., 2014, 155(36), 1426–1436.

Hewlett-Packard (HP) offers many innovative products to meet diverse customer needs. The breadth of its product offering has helped the company achieve unparalleled market reach; however, it has come with significant costs and challenges. By offering multiple similar products, a manufacturer increases its overall demand volatility, reduces forecast accuracy, and can adversely affect revenue and costs across the entire product life cycle. At HP, these impacts included increases in inventory-driven costs and order-cycle time; liabilities to channel partners; and costs of operations, research and development, marketing, and administration. Furthermore, complexity in HP's product lines confused customers, sales representatives, and channel partners, sometimes driving business to competitors. HP developed two powerful operations research-based solutions for managing product variety. The first, a framework for screening new products, uses custom-built return-on-investment (ROI) calculators to evaluate each proposed new product before introduction; those that do not meet a threshold ROI level are targeted for exclusion from the proposed lineup. The second, HP's Revenue Coverage Optimization (RCO) tool, which is based on a fast, new maximum-flow algorithm, is used to manage product variety after introduction. By identifying a core portfolio of products that are important to order coverage, RCO enables HP businesses to increase operational focus on their most critical products. These tools have enabled HP to increase its profits across business units by more than $500 million since 2005. Moreover, HP has streamlined its product offerings, improved execution, achieved faster delivery, lowered overhead, and increased customer satisfaction and market share.

Vitamin D3 is integral to both bone remodeling and calcium homeostasis [1]. With vitamin D deficiency, rickets develops during growth and osteomalacia results in adulthood [2]; in both cases, mineralization is altered and bones are more prone to fracture. Although the degenerative effects of vitamin D deficiency on trabecular architecture have been studied, investigations examining both compromised tissue material properties and mechanical properties in the vertebrae of growing animals are scarce. Therefore, the objective of this study was to investigate cancellous bone architecture and mechanical property changes caused by altered mineralization through vitamin D deficiency in growing rats.Copyright © 2011 by ASME