Background In 2006, we reported results of a randomized trial of laparoscopic paraesophageal hernia repair (LPEHR), comparing primary diaphragm repair (PR) with primary repair buttressed with a ...biologic prosthesis (small intestinal submucosa SIS). The primary endpoint, radiologic hiatal hernia (HH) recurrence, was higher with PR (24%) than with SIS buttressed repair (9%) after 6 months. The second phase of this trial was designed to determine the long-term durability of biologic mesh-buttressed repair. Methods We systematically searched for the 108 patients in phase I of this study to assess current clinical symptoms, quality of life (QOL) and determine ongoing durability of the repair by obtaining a follow-up upper gastrointestinal series (UGI) read by 2 radiologists blinded to treatment received. HH recurrence was defined as the greatest measured vertical height of stomach being at least 2 cm above the diaphragm. Results At median follow-up of 58 months (range 42 to 78 mo), 10 patients had died, 26 patients were not found, 72 completed clinical follow-up (PR, n = 39; SIS, n = 33), and 60 repeated a UGI (PR, n = 34; SIS, n = 26). There were 20 patients (59%) with recurrent HH in the PR group and 14 patients (54%) with recurrent HH in the SIS group (p = 0.7). There was no statistically significant difference in relevant symptoms or QOL between patients undergoing PR and SIS buttressed repair. There were no strictures, erosions, dysphagia, or other complications related to the use of SIS mesh. Conclusions LPEHR results in long and durable relief of symptoms and improvement in QOL with PR or SIS. There does not appear to be a higher rate of complications or side effects with biologic mesh, but its benefit in reducing HH recurrence diminishes at long-term follow-up (more than 5 years postoperatively) or earlier.
Chitosan (CS) and polylactide (PLA) at different ratios were blended with different wt% of montmorillonite (MMT) (Cloisite 30B) solution by the solvent evaporation method. MMT was incorporated in the ...formulation as a matrix material component which also plays the role of a co-emulsifier in the nanocomposite preparation. Paclitaxel (PTX) with different concentrations was loaded with CS–PLA/MMT nanocomposites for studying in vitro drug delivery systems. The composites were characterized by FTIR, SEM, and XRD methods. The drug release was studied as a function of, pH and drug concentrations. The kinetics of the drug release was studied in order to ascertain the type of release mechanism. Based on the diffusion as well as the kinetics, the mechanism of the drug release from the composite matrix has been reported.
Irrigation is commonly used as an adjuvant treatment during the intralesional curettage of bone tumors. The goal of the present study was to analyze the in vitro cytotoxicity of commonly used ...irrigation solutions on chondrosarcoma and giant cell tumor (GCT) cells as there is no consensus on which solution leads to the greatest amount of cell death.
An in vitro evaluation was performed by exposing human GCT and human chondrosarcoma cell lines to 0.9% saline solution, sterile water, 70% ethanol, 3% hydrogen peroxide, 0.05% chlorhexidine gluconate (CHG), and 0.3% povidone iodine solutions independently for 2 and 5 minutes. A low-cytotoxicity control (LCC) and a high-cytotoxicity control (HCC) were established to determine the mean cytotoxicity of each solution and each solution's superiority to LCC and non-inferiority to HCC.
The present study demonstrated that 0.05% CHG was non-inferior to the HCC when chondrosarcoma was exposed for 5 minutes and when GCT was exposed for 2 and 5 minutes (mean cytotoxicity, 99% to 102%) (p < 0.003 for all). Sterile water was superior to the LCC when chondrosarcoma was exposed for 5 minutes and when GCT was exposed for 2 minutes (mean, 28% to 37%) (p < 0.05). Sterile water (mean, 18% to 38%) (p < 0.012) and 3% hydrogen peroxide (mean, 7% to 16%) (p < 0.001) were both inferior to the HCC. The 3 other solutions were non-superior to the LCC (mean, -24% to -5%) (p < 0.023).
In vitro irrigation in 0.05% CHG provided high cytotoxicity, comparable with the HCC. Therefore, the use of a 0.05% CHG solution clinically could serve as a potential chemical adjuvant during intralesional curettage of chondrosarcoma and GCT.
In an effort to reduce the burden of residual tumor cells, irrigation solutions are often utilized as adjuvant local therapy. Use of a 0.05% CHG solution clinically could serve as a potential chemical adjuvant to intralesional curettage of chondrosarcoma and GCT. Further in vivo studies may be indicated to assess clinical outcomes and safety associated with the use of 0.05% CHG in the treatment of chondrosarcoma and GCT.
The research on host–pathogen interactions is an ever-emerging and evolving field. Every other day a new pathogen gets discovered, along with comes the challenge of its prevention and cure. As the ...intelligent human always vies for prevention, which is better than cure, understanding the mechanisms of host–pathogen interactions gets prior importance. There are many mechanisms involved from the pathogen as well as the host sides while an interaction happens. It is a vis-a-vis fight of the counter genes and proteins from both sides. Who wins depends on whether a host gets an infection or not. Moreover, a higher level of complexity arises when the pathogens evolve and become resistant to a host’s defense mechanisms. Such pathogens pose serious challenges for treatment. The entire human population is in danger of such long-lasting persistent infections. Some of these infections even increase the rate of mortality. Hence there is an immediate emergency to understand how the pathogens interact with their host for successful invasion. It may lead to discovery of appropriate preventive measures, and the development of rational therapeutic measures and medication against such infections and diseases. This review, a state-of-the-art updated scenario of host–pathogen interaction research, has been done by keeping in mind this urgency. It covers the biological and computational aspects of host–pathogen interactions, classification of the methods by which the pathogens interact with their hosts, different machine learning techniques for prediction of host–pathogen interactions, and future scopes of this research field.
Background Magnetic resonance imaging (MRI) can noninvasively assess changes in atherosclerotic plaque morphology and composition. The ORION trial assessed the effects of rosuvastatin on carotid ...plaque volume and composition. Methods The randomized, double-blind ORION trial used 1.5-T MRI to image carotid atherosclerotic plaques at baseline and after 24 months of treatment. Forty-three patients with fasting low-density lipoprotein cholesterol ≥100 and <250 mg/dL and 16% to 79% carotid stenosis by duplex ultrasound were randomized to receive either a low (5 mg) or high (40/80 mg) dose of rosuvastatin. Results After 24 months, 33 patients had matched serial MRI scans to compare by reviewers blinded to clinical data, dosage, and temporal sequence of scans. Low-density lipoprotein cholesterol was significantly reduced from baseline in both the low- and high-dose groups (38.2% and 59.9%, respectively, both P < .001). At 24 months, there were no significant changes in carotid plaque volume for either dosage group. In all patients with a lipid-rich necrotic core (LRNC) at baseline, the mean proportion of the vessel wall composed of LRNC (%LRNC) decreased by 41.4% ( P = .005). Conclusions In patients with moderate hypercholesterolemia, both low- and high-dose rosuvastatin were effective in reducing low-density lipoprotein cholesterol. Furthermore, rosuvastatin was associated with a reduction in %LRNC, whereas the overall plaque burden remained unchanged over the course of 2 years of treatment. These findings provide evidence that statin therapy may have a beneficial effect on plaque volume and composition, as assessed by noninvasive MRI.
Uncertain theory which was initially introduced by Liu 2016. Unceratinty Theory. 5th ed. Berlin: Springer-Verlag is significantly speared in various fields of engineering and scientific computing ...such as probability theory, statistics, fuzzy set theory, measure theory, summability theories, etc. As a part of this theory, the problems of convergence with different perspectives such as the idea of convergence in distribution, in mean and in measure along with the convergence uniformly almost surely of the sequence of complex numbers have been studied using uncertain variables. Later on, the results analogue to statistical convergence have been generalized and studied by Tripathy and Nath 2017. "Statistical Convergence of Complex Uncertain Sequences." New Mathematics and Natural Computation 13 (3): 359-374.. In this paper, we indent to extend the investigation for the sequences of fuzzy numbers and study the uncertainty of the above ideas of convergence via deferred Cesàro mean. Certain results on deferred-statistical convergence of order
for real uncertain sequences are established.
À partir d’une enquête qualitative réalisée par entretiens avec des personnes considérées comme « handicapées mentales » et des éducateurs spécialisés en France et en Suisse, cet article présente une ...typologie des scripts sexuels développés par des personnes « handicapées mentales », dans le contexte de promotion du concept de « santé sexuelle » qui se diffuse actuellement dans le milieu de l’éducation spécialisée. Les résultats opèrent une rupture avec les représentations dominantes en déconstruisant les spécificités communément prêtées à la sexualité des personnes ainsi désignées. Alors que, de façon quasi systématique, leurs comportements sexuels sont expliqués par leur seul handicap, l’analyse montre que les différentes catégories de sexualité observées ne sont pas propres aux personnes « handicapées ». En revanche, elle met en évidence l’influence de la désignation en tant que personnes « handicapées mentales » sur la vie sexuelle de celles et ceux qui en ont fait l’objet, et donc le caractère socialement construit de cette sexualité.
This article is based on a qualitative survey held by interviews with people considered as “intellectually disable” and specialised social workers in France and Switzerland. It presents a typology of the sexual scripts developed by “intellectually disable” people in the context of promotion of the “sexual health” concept which is presently spreading in the environment of specialised education. The results operate a break with the dominant representations by deconstructing the specificities lent to the sexuality of “intellectually disable” people. Whereas their sexual behaviours are almost systematically explained by their disability only, the analysis shows that the various categories of sexuality observed are not peculiar to the « disable » people. On the other hand, it highlights the influence of the « intellectually disable » labelling on their sexual life and consequently demonstrate the socially constructed character of this sexuality.
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