Intraobserver and interobserver variability of 64-row computed tomography abdominal aortic aneurysm neck measurements

BACKGROUND: Integrity of the abdominal aortic aneurysm (AAA) neck is crucial for the long-term success of endovascular AAA repair (EVAR). However, suitable tools for reliable assessment of changes in small aortic volumes are lacking. The purpose of this study was to assess the intraobserver and interobserver variability of software-enhanced 64-row computed tomographic angiography (CTA) AAA neck volume measurements in patients after EVAR. METHODS: A total of 25 consecutive patients successfully treated by EVAR underwent 64-row follow-up CTA in 1.5-mm collimation. Manual CTA measurements were performed twice by three blinded and independent readers in random order with at least a 4-week interval between readings. Maximum and minimum transverse aortic neck diameters were measured twice on two different levels within the proximal neck. Volumetry of the proximal aortic neck was performed by using dedicated software. Variability was calculated as 1.96 SD of the mean arithmetic difference according to Bland and Altman. Two-sided and paired t tests were used to compare measurements. P values <.05 were considered to indicate statistical significance. RESULTS: Intraobserver agreement was excellent for dedicated aneurysmal neck volumetry, with mean differences of less than 1 mL (P > .05), whereas it was poor for transverse aortic neck diameter measurements (P < .05). However, interobserver variability was statistically significant for both neck volumetry (P < .005) and neck diameter measurements (P < .015). CONCLUSIONS: The reliability of dedicated AAA neck volumetry by using 64-row CTA is excellent for serial measurements by individual readers, but not between different readers. Therefore, studies should be performed with aortic neck volumetry by a single experienced reader.

Platelet receptors for adhesion and activation. Variability as a factor in susceptibility to cardiovascular diseases

Polymorphisms in coagulation factors leading to altered susceptibility to cardiovascular diseases have been known for some time and some are now well-established risk factors. More recently, an increasing number of polymorphisms have been identified in platelet receptors and a series of studies indicate that these too may play a role as individual risk factors for stroke and myocardial infarction. The effect of these platelet polymorphisms appears less clear-cut than some of the coagulation factor effects and other, associated, risk factors may be important in defining their role. In this review platelet receptor polymorphisms and their role as risk factors are surveyed and their possible relevance discussed.

Distribution and genetic variability among Campylobacter spp. isolates from different animal species and humans in Switzerland

In Switzerland, a national database with 1028 Campylobacter isolates from poultry, pigs, cats, dogs, cattle, humans, zoo animals and water has been created. The database contains the genetic fingerprint and background information of each Campylobacter isolate. Dominant species could be identified in the different sources with a majority of Campylobacter jejuni in poultry (73%), humans (79%), cattle (95%), zoo animals (40%) and water (100%), of Campylobacter coli in pigs (72%), and of Campylobacter upsaliensis/helveticus in cats and dogs (55%). The comparison of three genotyping methods, amplified fragment length polymorphism (AFLP), pulsed field gel electrophoresis and restriction fragment length polymorphism, revealed that AFLP allows discrimination between the different Campylobacter species and is the most appropriate method to distinguish specific strains within the same species. Genotyping analysis demonstrated that the Campylobacter population is heterogeneous among the different sources and that no dominant clone is spread in the country. Genotyping and the resulting database are useful tools to trace back future Campylobacter infections.

Mid-Holocene Climate and Culture Change in the South Central Ande

This chapter reviews the history of study and the current status of Mid-Holocene climatic and cultural change in the South Central Andes, which host a wide range of different habitats from Pacific coastal areas up to extremely harsh cold and dry environments of the high mountain plateau, the altiplano or the puna. Paleoenvironmental information reveals high amplitude and rapid changes in effective moisture during the Holocene period and, consequently, dramatically changing environmental conditions. Therefore, this area is suitable to study the response of hunting and gathering societies to environmental changes, because the smallest variations in the climatic conditions have large impacts on resources and the living space of humans. This chapter analyzes environmental and paleoclimatic information from lake sediments, ice cores, pollen profiles, and geomorphic processes and relates these with the cultural and geographic settlement patterns of human occupation in the different habitats in the area of southern Peru, southwest Bolivia, northwest Argentina, and north Chile and puts in perspective of the early and late Holocene to present a representative range of environmental and cultural changes. It has been found that the largest changes took place around 9000 cal yr BP when the humid early Holocene conditions were replaced by extremely arid but highly variable climatic conditions. These resulted in a marked decrease of human occupation, “ecological refuges,” increased mobility, and an orientation toward habitats with relatively stable resources (such as the coast, the puna seca, and “ecological refuges”).

Temporal and spatial variability of personal exposure to radio frequency electromagnetic fields

BACKGROUND: Little is known about the population's exposure to radio frequency electromagnetic fields (RF-EMF) in industrialized countries. OBJECTIVES: To examine levels of exposure and the importance of different RF-EMF sources and settings in a sample of volunteers living in a Swiss city. METHODS: RF-EMF exposure of 166 volunteers from Basel, Switzerland, was measured with personal exposure meters (exposimeters). Participants carried an exposimeter for 1 week (two separate weeks in 32 participants) and completed an activity diary. Mean values were calculated using the robust regression on order statistics (ROS) method. RESULTS: Mean weekly exposure to all RF-EMF sources was 0.13 mW/m(2) (0.22 V/m) (range of individual means 0.014-0.881 mW/m(2)). Exposure was mainly due to mobile phone base stations (32.0%), mobile phone handsets (29.1%) and digital enhanced cordless telecommunications (DECT) phones (22.7%). Persons owning a DECT phone (total mean 0.15 mW/m(2)) or mobile phone (0.14 mW/m(2)) were exposed more than those not owning a DECT or mobile phone (0.10 mW/m(2)). Mean values were highest in trains (1.16 mW/m(2)), airports (0.74 mW/m(2)) and tramways or buses (0.36 mW/m(2)), and higher during daytime (0.16 mW/m(2)) than nighttime (0.08 mW/m(2)). The Spearman correlation coefficient between mean exposure in the first and second week was 0.61. CONCLUSIONS: Exposure to RF-EMF varied considerably between persons and locations but was fairly consistent within persons. Mobile phone handsets, mobile phone base stations and cordless phones were important sources of exposure in urban Switzerland.