This study is to determine the impact of complications after total thyroidectomy on health-related quality of life (HR-QoL) and to identify significant predictive factors of HR-QoL changes. HR-QoL is ...usually impaired in patients with thyroid diseases compared to the general population. Thyroidectomy is largely performed in the case of benign thyroid benign and can be associated with long-term complications (vocal cord palsy, hypoparathyroidism).
The prospective ThyrQoL multicenter trial (NCT02167529) included 800 patients who underwent total thyroidectomy for benign or malignant non-extensive disease in seven French referral hospitals between 2014 and 2016.
HR-QoL was assessed using the MOS 36-item short form health survey (SF-36) self-questionnaire with a 6-month follow-up.
We observed a significant improvement of HR-QoL 6 months after surgery (P < 0.0001). Postoperative complications were associated with a non-significant impairment of HR-QoL. In multivariable analysis, Graves' disease was associated with a significant improvement of HR-QoL (OR = 2.39 1.49; 3.84) and thyroid malignant disease with an impairment of HR-QoL (OR = 1.44 0.99; 2.08) after thyroidectomy.
We observed a significant improvement of HR-QoL 6 months after total thyroid surgery for benign thyroid disease.
This handbook aims to provide a complete overview of modern floating-point arithmetic, including a detailed treatment of the newly revised (IEEE 754-2008) standard for floating-point arithmetic. ...Presented throughout are algorithms for implementing floating-point arithmetic as well as algorithms that use floating-point arithmetic. So that the techniques presented can be put directly into practice in actual coding or design, they are illustrated, whenever possible, by a corresponding program. Key topics and features include a presentation of the history and basic concepts of floating-point arithmetic, a development of smart and nontrivial algorithms, and algorithmic possibilities induced by the availability of a fused multiply-add (fma) instruction, implementation of floating-point arithmetic either in software-on an integer processor-or hardware, and a discussion of issues related to compilers and languages, coverage of several recent advances related to elementary functions, and extensions of floating-point arithmetic such as certification, verification, and precision. Handbook of Floating-Point Arithmetic is designed for programmers of numerical applications, compiler designers, programmers of floating-point algorithms, designers of arithmetic operators, and more generally, students and researchers in numerical analysis who wish to better understand a tool used in their daily work and research. TOC:List of Figures.- List of Tables.- Preface.- Part I. Introduction, Basic Definitions, and Standards. Introduction.- Definitions and Basic Notions.- Floating-Point Formats and Environment.- Part II. Cleverly Using Floating-Point Arithmetic. Basic Properties and Algorithms.- The Fused Multiply-Add Instructions.- Enhanced Floating-Point Sums, Dot Products, and Polynomial Values.- Languages and Compilers.- Part III. Implementing Floating-Point Operators. Algorithms for the Five Basic Operations.- Hardware Implementation of Floating-Point Arithmetic.- Software Implementation of Floating-Point Arithmetic.- Part IV. Elementary Functions. Evaluating Floating-Point Elementary Functions.- Solving the Table Maker`s Dilemma.- Part V. Extensions. Formalisms for Certifying Floating-Point Algorithms.- Extending the Precision.- Part VI. Perspectives and Appendix. Conclusion and Perspectives.- Appendix: Number Theory Tools for Floating-Point Arithmetic.- Bibliography.- Index.
La fermeture chirurgicale primaire dans le traitement de l´omphalocèle géante est émaillée des complications. Le traitement conservateur est une option adaptée aux pays à faible revenu où la ...chirurgie te la réanimation néonatales sont pourvoyeuses d´une grande mortalité. Ceci est une étude prospective menée aux cliniques universitaires de Lubumbashi, incluant les patients reçus entre janvier et avril 2020 et qui ont bénéficié d´un traitement conservateur à l´éosine aqueuse disodique selon un protocole défini. Trois patientes ont été inclues dans notre série. L´âge moyen était de 24 heures (1 - 48), toutes nées à terme (38 - 39 SA), et par voie basse, sans aucun diagnostic anténatal posé. La moyenne du poids de naissance était de 2.800 grammes (2.400 - 3.000). Le diamètre moyen du sac était de 13,7 cm (11 - 15 cm), le sac contenant le foie dans tous les cas. Le délai moyen de nutrition entérale était de 4,3 jours (4 - 5 jours), celui de granulation était de 31,7 jours (30 - 33 jours) et celui d´épithélialisation était de 71,7 jours (60 - 90 jours). Aucun décès n´a été déploré. Ces résultats préliminaires encouragent l´utilisation de l´éosine aqueuse disodique dans le traitement conservateur des omphalocèles géantes non rompues.
The empirical use of vancomycin in combination with a broad-spectrum beta-lactam is currently recommended after the initial surgery of prosthetic joint infection (PJI). However, the tolerability of ...such high-dose intravenous regimens is poorly known. Adult patients receiving an empirical antimicrobial therapy (EAT) for a PJI were enrolled in a prospective cohort study (2011 to 2016). EAT-related adverse events (AE) were described according to the common terminology criteria for AE (CTCAE), and their determinants were assessed by logistic regression and Kaplan-Meier curve analysis. The EAT of the 333 included patients (median age, 69.8 years; interquartile range IQR, 59.3 to 79.1 years) mostly relies on vancomycin (
= 229, 68.8%), piperacillin-tazobactam (
= 131, 39.3%), and/or third-generation cephalosporins (
= 50, 15%). Forty-two patients (12.6%) experienced an EAT-related AE. Ten (20.4%) AE were severe (CTCAE grade ≥ 3). The use of vancomycin (odds ratio OR, 6.9; 95% confidence interval 95%CI, 2.1 to 22.9), piperacillin-tazobactam (OR, 3.7; 95%CI, 1.8 to 7.2), or the combination of both (OR, 4.1; 95%CI, 2.1 to 8.2) were the only AE predictors. Acute kidney injury (AKI) was the most common AE (
= 25; 51.0% of AE) and was also associated with the use of the vancomycin and piperacillin-tazobactam combination (OR, 6.7; 95%CI, 2.6 to 17.3). A vancomycin plasma overexposure was noted in nine (37.5%) of the vancomycin-related AKIs only. Other vancomycin-based therapies were significantly less at risk for AE and AKI. The EAT of PJI is associated with an important rate of AE, linked with the use of the vancomycin and the piperacillin-tazobactam combination. These results corroborate recent findings suggesting a synergic toxicity of these drugs in comparison to vancomycin-cefepime, which remains to be evaluated in PJI. (This study has been registered at ClinicalTrials.gov under identifier NCT03010293.).
Choanal stenosis is usually a congenital anomaly in children. Acquired choanal stenosis after radiotherapy for nasopharyngeal carcinoma is a very rare pathology; only two publications report seven ...cases in the literature. We describe the clinical history, preoperative evaluation, surgical treatment and outcome of a case of acquired choanal stenosis after radiotherapy. The patient, a 56-year-old woman, presented with a history of nasopharyngeal carcinoma (T2- NO-MO) one year before that had been successful treated with radiotherapy (68 Gy). At the end of radiotherapy, she complained of complete nasal obstruction, anosmia and hearing loss due to a bilateral serous otitis media. Bilateral complete choanal stenosis was confirmed by endoscopy and CT scan. Functional endoscopic surgery was performed, and nasal stents were left in place for 3 weeks. One year after, the patient have good airflow, and a patent nasopharynx without choanal stenosis. In conclusion, choanal stenosis is an unusual complication of radiotherapy that can be successfully treated with transnasal endoscopic resection.
The recent revision of ISO15189 has further strengthened its position as the standard for accreditation for medical laboratories. Both for laboratories and their customers it is important that the ...scope of such accreditation is clear. Therefore the European co-operation for accreditation (EA) demands that the national bodies responsible for accreditation describe the scope of every laboratory accreditation in a way that leaves no room for doubt about the range of competence of the particular laboratories. According to EA recommendations scopes may be fixed, mentioning every single test that is part of the accreditation, or flexible, mentioning all combinations of medical field, examination type and materials for which the laboratory is competent. Up to now national accreditation bodies perpetuate use of fixed scopes, partly by inertia, partly out of fear that a too flexible scope may lead to over-valuation of the competence of laboratories, most countries only use fixed scopes. The EA however promotes use of flexible scopes, since this allows for more readily innovation, which contributes to quality in laboratory medicine. In this position paper, the Working Group Accreditation and ISO/CEN Standards belonging to the Quality and Regulation Committee of the EFLM recommends using an approach that has led to successful introduction of the flexible scope for ISO15189 accreditation as intended in EA-4/17 in The Netherlands. The approach is risk-based, discipline and competence-based, and focuses on defining a uniform terminology transferable across the borders of scientific disciplines, laboratories and countries.
The constrained Next-to-Minimal Supersymmetric StandardModel (cNMSSM) with mSugra-like boundary conditions at the GUT scale implies a singlino-like LSP with a mass just a few GeV below a stau NLSP. ...Hence, most of the squark/gluino decay cascades contain two
τ
leptons. The gluino mass ≳ 1
.
2 TeV is somewhat larger than the squark masses of ≳ 1 TeV. We simulate signal and background events for such a scenario at the LHC, and propose cuts on the transverse momenta of two jets, the missing transverse energy and the transverse momentum of a hadronically decaying
τ
lepton. This dedicated analysis allows to improve on the results of generic supersymmetry searches for a large part of the parameter space of the cNMSSM. The distribution of the effective mass and the signal rate provide sensitivity to distinguish the cNMSSM from the constrained Minimal Supersymmetric Standard Model in the stau-coannihilation region.
L'atrésie choanale est une anomalie congénitale du jeune enfant. Les sténoses acquises après radiothérapie sont exceptionnelles
; seulement deux articles rapportant sept cas ont été publiés dans la ...littérature. Nous rapportons l'histoire clinique, le bilan préopératoire, le traitement chirurgical et son suivi d'un cas de sténose choanale post-radique. La patiente, âgée de 56 ans, avait bénéficié d'une radiothérapie de 68 Gy avec succès pour un carcinome nasopharyngé (T2-N0-M0). À la fin de la radiothérapie, elle se plaignait d'une obstruction nasale totale, d'une perte complète de l'odorat et d'une surdité par otite séromuqueuse bilatérale. L'atrésie choanale complète bilatérale a été confirmée par la fibroscopie et l'examen tomodensitométrique. Un traitement chirurgical endoscopique a permis de réséquer la sténose puis un calibrage a été maintenu trois semaines. Un an après, la patiente n'avait plus d'obstruction nasale et la région choanale avait un aspect normal. En conclusion, la sténose choanale est une complication rare de la radiothérapie et peut être traitée par une résection endoscopique avec succès.
Choanal stenosis is usually a congenital anomaly in children. Acquired choanal stenosis after radiotherapy for nasopharyngeal carcinoma is a very rare pathology; only two publications report seven cases in the literature. We describe the clinical history, preoperative evaluation, surgical treatment and outcome of a case of acquired choanal stenosis after radiotherapy. The patient, a 56-year-old woman, presented with a history of nasopharyngeal carcinoma (T2- NO-MO) one year before that had been successful treated with radiotherapy (68 Gy). At the end of radiotherapy, she complained of complete nasal obstruction, anosmia and hearing loss due to a bilateral serous otitis media. Bilateral complete choanal stenosis was confirmed by endoscopy and CT scan. Functional endoscopic surgery was performed, and nasal stents were left in place for 3 weeks. One year after, the patient have good airflow, and a patent nasopharynx without choanal stenosis. In conclusion, choanal stenosis is an unusual complication of radiotherapy that can be sucessfully treated with transnasal endoscopic resection.
Buckfast
IIC - International Review of Intellectual Property and Competition Law,
7/2018, Letnik:
49, Številka:
6
Journal Article
Recenzirano
Trade mark owners may not prohibit a third party from using, in the course of trade, indications concerning the kind, the quality, quantity, the intended purpose, the value, the geographical origin, ...the production time of goods or of rendering of the service or other characteristics thereof, provided that such use is in accordance with honest practices in industrial and commercial matters.
The use of a term that has been registered as a trade mark but is also understood by the relevant trade circles as a customary indication of certain products (here “Buck” and “Buckfast” for bees and beehives) is in compliance with honest practices in industrial and commercial matters and thus not infringing.
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