Evaluation of quality of life related to i-131 therapy in patients with well-differentiated thyroid cancer and emphasis in salivary morbidity: a follow up study after treatment

To evaluate the impact of iodine-131 therapy received during childhood and adolescence and correlate it with the quality of life in these patients. Methods: We studied 19 patients diagnosed with cancer in childhood or adolescence who underwent thyroidectomy and supplemental therapy with I-131. We also recruited a control group of healthy subjects with the same demographic parameters. All patients were subjected to a scintigraphy examination of the salivary glands, and were also asked to complete a questionnaire in order to assess their overall quality of life. In addition, a more specific questionnaire for patients with head and neck cancer was also given to all study participants. Results: The quantitative and qualitative analyses of the salivary glands showed functional deficits with greater involvement of the parotid gland for volume, concentration and excretion. The right submandibular gland showed significant changes for volume in the patient group. The questionnaires made it possible to observe significant differences between the patient and control groups for symptoms such as thick saliva, dry mouth and speech problems. Conclusion: In spite of being very effective and widely used, iodine radionuclide therapy is correlated with a lower quality of life in young people.

New 2010 Crop Enterprise Budgets

The 2010 Crop Enterprise Budgets will soon be published. They will be available on the web in two places: the University of Nebraska’s “Crop Watch” website (http://cropwatch.unl.edu) in the Economics and Marketing section, and on the Agricultural Economics website at http://www.agecon.unl.edu.

No more than Conjectures: Popper and the Ethics of Scientific Enterprise

Karl Popper dealt with both problems Yurevich (Integrative Psychological and Behavioral Science, 43(2), 2009, doi:10.1007/s12124-008-9082-7) deals: the crisis in Psychology and in the discourse about the nature of science. Although he failed to provide a complete response for both problems, his proposals can yet be fruitful to the reflection on these matters in the context of the present discussion. He offers some tentative answers to what could be considered a healthy epistemic activity, something Yurevich does not provide. More interestingly, some of the Popper proposals seem to fit, and in some extent correct, the quest for ""collaborative work"" proposed by Zittoun et al. (Integrative Psychological and Behavioral Science, 43(2), 2009, doi:10.1007/s12124-008-9082-7) as a way of transforming crisis in development.

Morbidity following sural nerve harvesting: A prospective study

Objective: To evaluate donor site morbidity following sural nerve harvesting, with special attention to the recovery of sensory loss. Methods: We prospectively followed 38 subjects who underwent sural nerve harvest, including two with bilateral nerve excision. Symptoms related to sural nerve excision were evaluated and demarcation of the area with reduced touch sensation was quantified. Assessments were performed periodically up to 1 year after surgery and the results of different sensory evaluations were compared. Results: A significant reduction of sensory deficit was identified between consecutive evaluations (p < 0.05). Decreases of 26.85%, 20.69% and 24.29% were observed 3, 6 and 12 months after surgery, respectively. Shock-like pain (7.5%), stabbing pain (7.5%), and numbness (5%) were the most frequently reported symptoms. All symptoms were brief and resolved spontaneously 3-6 months after surgery. Conclusion: Sural nerve harvest can be performed with acceptable morbidity. When present, symptoms resolve between the third and sixth month after surgery and a significant reduction of sensory loss in the area innervated by the sural nerve was observed during the first year of follow-up. (C) 2012 Elsevier B.V. All rights reserved.

Enhanced Morbidity of Pectoralis Major Myocutaneous Flap Used for Salvage after Previously Failed Oncological Treatment and Unsuccessful Reconstructive Head and Neck Surgery

Introduction. The reconstruction of complex cervicofacial defects arising from surgical treatment for cancer is a real challenge for head and neck surgeons, especially in salvage reconstruction surgery and/or failed previous reconstruction. The pectoralis major myocutaneous flap (PMMF) has been widely used in these specific situations due to its reliability and low rate of failure or complications. Objectives. Identify factors that determine complications and influence the final outcome of the reconstructions with PMMF in salvage cancer surgery or in salvage reconstruction. Methods. A cross-sectional study design was used to evaluate a sample including 17 surgical patients treated over a period of ten years that met the inclusion criteria. Results. Reconstruction was successful in 13 cases (76.5%), with two cases of partial flap loss and no case of total loss. Complications occurred in 13 cases (76.5%) and were specifically related to the flap in nine instances (52.9%). An association was identified between the development of major complications and reconstruction of the hypopharynx (P = 0.013) as well as in patients submitted to surgery in association with radiation therapy as a previous cancer treatment (P = 0.002). The former condition is also associated with major reconstruction failure (P = 0.018). An even lower incidence of major complications was noted in patients under the age of 53 (P = 0.044). Conclusion. Older patients, with hypopharyngeal defects and submitted to previous surgery plus radiation therapy, presented a higher risk of complications and reconstruction failure with PMMF.

Morbidity among nursing personnel and its association with working conditions and work organization

Introduction: Work organization patterns and working conditions experienced by nursing personnel in the hospital settings may be associated to increased morbidity among these health workers. Aim: To estimate the prevalence and factors associated with self-reported diseases among nursing personnel at the emergency hospital in Rio Branco/ State of Acre, Brazil. Methods: A cross-sectional study was conducted involving 272 participants who answered a questionnaire including sociodemographic characteristics, working conditions, lifestyles, work ability, and a fatigue perception scale. The self-reported diseases in the 12 months prior to data collection were considered the dependent variable. Results: A total of 85.7% of the participants reported one or more diseases in the past 12 months. Most prevalent diseases were: musculoskeletal diseases (37.1%), digestive diseases (28.7%), mental disorders (28.3%), work injuries (27.9%), and respiratory diseases (26.8%). The following significant variables remained in the final model: high work demands (OR 2.69), reported fatigue (OR 3.59), night work (OR 6.55) and being a technician or nursing assistant (OR 4.23). Conclusions: Variables related to working conditions and work organization were associated with the occurrence of reported diseases among nursing professionals. Health promotion measures at work require a comprehensive approach including the working conditions and the work organization.

Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data

OBJECTIVE: To determine whether the use of vaginal progesterone in asymptomatic women with a sonographic short cervix (<= 25 mm) in the midtrimester reduces the risk of preterm birth and improves neonatal morbidity and mortality. STUDY DESIGN: Individual patient data metaanalysis of randomized controlled trials. RESULTS: Five trials of high quality were included with a total of 775 women and 827 infants. Treatment with vaginal progesterone was associated with a significant reduction in the rate of preterm birth <33 weeks (relative risk [RR], 0.58; 95% confidence interval [CI], 0.42-0.80), <35 weeks (RR, 0.69; 95% CI, 0.55-0.88), and <28 weeks (RR, 0.50; 95% CI, 0.30-0.81); respiratory distress syndrome (RR, 0.48; 95% CI, 0.30-0.76); composite neonatal morbidity and mortality (RR, 0.57; 95% CI, 0.40-0.81); birthweight <1500 g (RR, 0.55; 95% CI, 0.38-0.80); admission to neonatal intensive care unit (RR, 0.75; 95% CI, 0.59-0.94); and requirement for mechanical ventilation (RR, 0.66; 95% CI, 0.44-0.98). There were no significant differences between the vaginal progesterone and placebo groups in the rate of adverse maternal events or congenital anomalies. CONCLUSION: Vaginal progesterone administration to asymptomatic women with a sonographic short cervix reduces the risk of preterm birth and neonatal morbidity and mortality.

Analisi e sviluppo di strumenti performance-aware per la migrazione cloud enterprise

Questa tesi affronta il tema dell'analisi della migrazione verso un ambiente cloud enterprise, con considerazioni sui costi e le performance rispetto agli ambienti di origine

Introduzione di un sistema di accesso wireless distribuito a gestione centralizzata in ambiente di tipo Enterprise o Campus

Nata dal progetto di migrazione, in un ambiente consolidato, di una infrastruttura Wireless distribuita su territorio all'interno di una MAN (Metropolitan Area Network), si cerca di illustrare quali sono i passi fondamentali da seguire e con cosa ci si deve misurare per progettare una soluzione funzionale ed elaborare una strategia avendo a che fare con architetture complesse, dove la messa in esercizio di un servizio offerto ad un numero elevato di utenti prevede uno studio ben preciso delle attività da svolgere. Un'attenta analisi, ci consentirà di seguire e riadattare le scelte implementative in funzione delle esigenze infrastrutturali, illustrandone le difficoltà, gli imprevisti e le modifiche intraprese passo passo. Gli argomenti trattati tendono a far comprendere con quali problematiche si ha a che fare nella fase implementativa passando dalla fase di analisi a quella decisionale, quella di migrazione architetturale e di installazione, oltre che alla scelta delle componenti e delle tecnologie specifiche che, prima di essere portate a regime, devono essere sottoposte agli opportuni test per la comprensione/risoluzione di problematiche complesse; come le operazioni necessarie per operare con una efficace metodologia.

Progetto e strumenti di federazione di endpoint sparql per Enterprise Architecture

La Federazione è un concetto molto utilizzato ed implementato in vari ambiti dell’informatica. In particolare sta avendo grande interesse nel Semantic Web, e risulta essere significativo e importante il suo utilizzo in una disciplina in grande evoluzione come l’Enterprise Architecture. L’obiettivo di questa tesi è stato implementare il concetto di Federazione di Endpoint SPARQL, dove l’elemento centrale è stata la condivisione del modello dei dati tra i vari membri, il quale rappresenta il patto della federazione. Successivamente sono stati messi in luce i benefici che questo tipo di soluzione apporta alla disciplina dell’Enterprise Architecture, in particolar modo nell’ambito dell’analisi dei dati. In relazione a quest’ultimo aspetto, il Semantic Web offre un linguaggio flessibile e facilmente evolvibile per rappresentare l’azienda e i suoi dati, oltre che ad un protocollo standard per la loro interrogazione, ovvero lo SPARQL. La federazione, invece, apporta dei miglioramenti rendendo le fonti dato omogenee dal punto di vista del modello, utilizza un unico protocollo per l’accesso ad essi (SPARQL), ed elimina le criticità in relazione alla normalizzazione dei dati nei processi di analisi. Questi due aspetti risultano abilitanti proprio per l’Enterprise Architecture. Infine sono state definite due possibili evoluzioni, in particolare un costrutto che permetta l’implementazione e la gestione della federazione a livello di linguaggio SPARQL, ed una ontologia standard e condivisibile tramite la quale gestire la federazione in modo trasparente.

Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer

This study investigated whether nutritional risk scores applied at hospital admission predict mortality and complications after colorectal cancer surgery.

Neck treatment and shoulder morbidity: Still a challenge

Shoulder complaints and functional impairment are common sequelae of neck dissection. This is often attributed to injury of the spinal accessory nerve by dissection or direct trauma. Nevertheless, shoulder morbidity may also occur in cases in which the spinal accessory nerve has been preserved. In this article, the physiology and pathophysiology of the shoulder are discussed, followed by a consideration of the impact of neck dissection on shoulder complaints, functional impairment, and quality of life. Finally, rehabilitation will be considered. © 2010 Wiley Periodicals, Inc. Head Neck, 2010.