705 resultados para Lillian Lodge Kopenhaver


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v.11:no.6(1952)

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v.11:no.2(1951)

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v.11:no.10(1960)

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OBJECTIVE:: The purpose of this study was to assess outcomes and indications in a large cohort of patients who underwent liver transplantation (LT) for liver metastases (LM) from neuroendocrine tumors (NET) over a 27-year period. BACKGROUND:: LT for NET remains controversial due to the absence of clear selection criteria and the scarcity and heterogeneity of reported cases. METHODS:: This retrospective multicentric study included 213 patients who underwent LT for NET performed in 35 centers in 11 European countries between 1982 and 2009. One hundred seven patients underwent transplantation before 2000 and 106 after 2000. Mean age at the time of LT was 46 years. Half of the patients presented hormone secretion and 55% had hepatomegaly. Before LT, 83% of patients had undergone surgical treatment of the primary tumor and/or LM and 76% had received chemotherapy. The median interval between diagnosis of LM and LT was 25 months (range, 1-149 months). In addition to LT, 24 patients underwent major resection procedures and 30 patients underwent minor resection procedures. RESULTS:: Three-month postoperative mortality was 10%. At 5 years after LT, overall survival (OS) was 52% and disease-free survival was 30%. At 5 years from diagnosis of LM, OS was 73%. Multivariate analysis identified 3 predictors of poor outcome, that is, major resection in addition to LT, poor tumor differentiation, and hepatomegaly. Since 2000, 5-year OS has increased to 59% in relation with fewer patients presenting poor prognostic factors. Multivariate analysis of the 106 cases treated since 2000 identified the following predictors of poor outcome: hepatomegaly, age more than 45 years, and any amount of resection concurrent with LT. CONCLUSIONS:: LT is an effective treatment of unresectable LM from NET. Patient selection based on the aforementioned predictors can achieve a 5-year OS between 60% and 80%. However, use of overly restrictive criteria may deny LT to some patients who could benefit. Optimal timing for LT in patients with stable versus progressive disease remains unclear.

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This study identified and characterised class 1 and 2 integrons in clinical and environmental Vibrio cholerae O1 and non-O1/non-O139 strains isolated from the Brazilian Amazon. The aadA2 and aadA7 gene cassettes were found in class 1 integrons in two genotypes of environmental V. cholerae non-O1/non-O139. Empty integrons were found in strains from the Brazilian cholera epidemic. A class 2 integron was detected in one strain from the V. cholerae Amazonia lineage harbouring sat1 and aadA1 genes. All isolates were resistant to aminoglycosides, indicating aadA functionality. These findings suggest that environmental bacteria act as cassette reservoirs that favour the emergence of resistant pathogens.

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Background. Sevelamer is a phosphate-binder used effectively for the treatment of hyperphosphatemia in patients treated with dialysis. Objectives. To describe the safety of sevelamer in children with hyperphosphatemia secondary to tumor lysis syndrome and the serum phosphate concentrations observed following its administration. Procedure. A retrospective chart review of all children with leukemia/lymphoma diagnosed between November 2002 and April 2004 who received sevelamer during their initial admission was conducted. We monitored the effects of sevelamer on serum phosphate concentration, calcium/phosphate product and renal function at hours 24, 48, and 72 from sevelamer initiation. Results. Thirteen patients received sevelamer during the Study period. Their median age was 13 years (range 2.7-17.9) and eight were boys. Nine children had acute lymphoblastic leukemia, one had acute myeloid leukemia and 3 had non-Hodgkin's lymphoma. The most frequently used dose of sevelamer was 400 mg orally twice daily. The median duration of sevelamer therapy was 2 days (range 1 -7). Two children were excluded from the efficacy analysis due to concurrent use of dialysis. Mean serum phosphate levels decreased after sevelamer administration, in eleven patients, from a baseline 2.2 mmol/L +/- 0.4 (95% Cl, 1.7-3.1) to 1.1 mmol/L +/- 0.2 at hour 72 (95%Cl, 0.6-1.5). The only toxicity attributed to sevelamer was mild vomiting in three patients. Conclusions. Sevelamer appears to be effective and tolerable for the treatment of hyperphosphatemia associated with tumor lysis syndrome.

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The Iowa Department for the Blind partnered with The Lodge of Ashworth retirement community in West Des Moines to bring information to visually impaired residents, friends and family. The Lodge furnished refreshments, and the Department furnished the programming.

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El projecte de recerca titulat La tecnologia dels primers pobladors de l’Europa occidental s’ha centrat en l’anàlisi i comparació dels instruments lítics procedents d’una selecció de jaciments arqueològics de les illes Britàniques (Happisburgh sites 3 i 1, Pakefield, Boxgrove i High Lodge) i de la península Ibèrica (Sima del Elefante, Gran Dolina, Galería i la Boella). L’objectiu principal era avaluar si el primer poblament del continent mostrava o no una homogeneïtat tecnològica, si s’observaven patrons temporals similars, i si es podien distingir línies evolutives diferents en l’àmbit comportamental durant el primer mig milió d’anys de presència humana a Europa. El pla de treball ha consistit essencialment en una estada de membres de l’IPHES de Anglaterra i en una estada dels membres anglesos a Catalunya. A banda, s’ha generat un contracte de suport tècnic a l’IPHES, que ha permès gestionar satisfactòriament bona part de les dades obtingudes. Aquestes accions, a banda de consolidar la xarxa de científica anglo-catalana establerta en el marc de la convocatòria PBR de 2008, han permès obtenir un coneixement de primera mà tant dels jaciments com dels materials arqueològics presos en consideració. Els resultats preliminars obtinguts en aquest projecte estan actualment en discussió, i de ben segur tindran un paper central a l’hora de formular noves hipòtesis relatives al primer poblament humà d’Europa.

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