Abstract Background The incidence of urologic complications after kidney transplantation remains high despite improvements in diagnosis and operative techniques. Urinary tract reconstruction is ...usually done by ureteroneocystostomy (UCNS), and several techniques are available. In this study, we evaluated the outcomes of 2 different UCNS techniques performed in our department, the transvesical Leadbetter-Politano (L-P) and the extravesical Lich-Gregoire (L-G) technique. Material and Methods We evaluated the outcomes of 2 different UCNS techniques, L-P versus L-G, performed in our department between July 1, 2006, and December 31, 2011. During this period, we performed 524 consecutive renal transplantations—264 cases using the L-P technique (50.3%) and 260 cases with L-G technique (49.7%). Renal grafts were obtained from cadaveric donors in 146 cases (27.86%) and from living-related donors in 378 cases (72.14%). Recipient mean age was 35.64 years and the male to female ratio was 1.63:1. Results Urologic complications after kidney transplantation occurred in 22 cases in the L-P UCNS group (8.33%). The most common complications were ureteral stenosis (3.41%) and leakage (2.65%). Other complications recorded were lymphoceles (1.89%) and hematoma with secondary ureteral obstruction (0.38%). Compared with the L-P UCNS technique, the L-G technique was associated with fewer overall complications (6.15% vs 8.33%; P = .06), a lesser rate of ureteral stenosis (2.31% vs 3.41%; P = .08), and a similar rate of leakage. However, statistical analysis revealed no differences between the 2 techniques ( P = .06). In addition, we did not note any differences in graft and patient survival between the 2 groups. Conclusions In our study, the extravesical L-G technique has a lower complication rate compared with transvesical L-P procedure, but without statistical differences. Furthermore, the L-G technique is easier and faster to perform, it avoids a separate cystotomy, and requires a shorter ureteral length. In conclusion, we recommend L-G technique as technique of choice in kidney transplantation.
The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that in 2004, there were 39.4 million people living with HIV/AIDS worldwide (UNAIDS/WHO Report on the global HIV/AIDS epidemic,
2004
...). Children less than 15 years of age comprise 2.2 million of these individuals. As more children globally gain access to highly active antiretroviral therapy (HAART), more children are growing to the age when disclosure of their HIV status is inevitable. This information may affect a child's disease trajectory, and in the context of HAART, may have wide-ranging impact in the management of paediatric HIV infection. This study is an investigation of the effect of disclosure of a child's own HIV infection status on death and CD4 decline in a cohort of 325 HIV-infected Romanian children receiving highly active antiretroviral therapy (HAART). A retrospective database analysis was conducted. Data from a nearly three-year period were examined. Children who were aware of their HIV diagnosis were compared with those who were not aware. We found significant associations between not knowing the HIV diagnosis and death, and not knowing the HIV diagnosis and disease progression defined as either death or CD4 decline. Our results imply that in the context of HAART, knowledge of one's own HIV infection status is associated with delayed HIV disease progression.
Primary ovarian neuroendocrine tumors (NETs) develop in pure form or in association with other tumors, mainly teratomas. The available data regarding this rare condition are limited. Much of the ...literature focuses on single case reports, previously dismissed as a totally benign disorder, and thus long-term considerations and evidence-based management guidelines are lacking. The objective of the current study was to describe the clinical and pathologic characteristics and the effect of various therapeutic modalities on patient morbidity and mortality from 2 major centers. A secondary objective was to highlight that carcinoid syndrome may be manifest in the absence of metastatic disease.
The authors retrospectively studied a cohort of 34 consecutive patients with primary ovarian NETs who attended either the Oxford University Hospitals or Beatson Oncology Centre, Glasgow, between 1984 and 2014, and had their ovarian carcinoid data (eg, tumor growth, chemotherapy regimen) and mortality outcomes assessed.
All patients were women, with an average age of 53 years (range, 23-87 years) at diagnosis. Of the 34 patients, 8 patients (23.5%) presented with carcinoid symptoms. Carcinoid heart disease was evident in 2 of the 34 patients (6%). All patients had a primary ovarian carcinoid tumor on histopathology, and 2 patients had bilateral ovarian carcinoids. Teratoma associations could be assessed in 29 tumors, with 20 (69%) of 29 showing a pathological association. The mean tumor size was 48 mm (range, 4-120 mm; SD, 40 mm). The mean follow-up was 4.5 years, ranging up to 17 years. The disease has been quiescent with no evidence of relapse in 22 of 34 patients; in 12 of 34 patients, it was metastatic. There were 5 patients who received treatment with somatostatin analogs or chemotherapy, whereas 8 patients (23.5%) died of disease. Metastatic disease was found up to 11 years from initial diagnosis.
Primary ovarian NET is rare and likely underrepresented in the literature. It can no longer be simply dismissed as a generally benign entity and may present with both the carcinoid syndrome and carcinoid heart disease. It requires careful evaluation and long-term review.
The first double-blind placebo-controlled clinical trial of an atypical neuroleptic medication is being conducted in symptomatic treatment-seeking patients meeting new diagnostic criteria for a ...putative prodromal syndrome. This identifies them as being at high risk for developing psychosis in the near future. The study aims include prevention of psychosis onset and disability, as well as palliation of ongoing symptomatology.
The purpose of this report is to describe the study's “prodromally symptomatic” sample at baseline, i.e., at intake immediately prior to randomization and prior to receiving study medication. Sixty treatment-seeking patients meeting prodromal inclusion criteria were recruited across four sites: New Haven, CT (
n=39), Toronto, Ontario (
n=9), Calgary, Alberta (
n=6), and Chapel Hill, NC (
n=6). The sample was young (median age 16), largely male (65%), and came from families with high titers of serious mental illness (44%). Most patients (93%) met criteria for the Attenuated Positive Symptom (APS) prodromal syndrome and presented with significant but nonpsychotic suspiciousness, perceptual aberrations, unusual thought content, and conceptual disorganization. They presented with minimal to mild affective symptoms and substance use/abuse, but they were quite functionally compromised (mean Global Assessment of Functioning (GAF) score=42). The prodromal sample was compared with other clinical-trial samples of adolescent depression, adolescent mania, and first episode schizophrenia. Prodromal patients proved not to be depressed or manic. They were less severely ill than untreated first episode schizophrenia but more severely ill than treated first episode schizophrenia. While not psychotically disabled, these patients nevertheless present with a clinical syndrome. Subsequent reports will detail the effects of drug versus placebo on prodromal symptoms, neuropsychological profile, and the rate of conversion to psychosis.
Abstract
The parity violation in nuclear reactions led to the discovery of the new class of toroidal multipoles. Since then, it was observed that toroidal multipoles are present in the ...electromagnetic structure of systems at all scales, from elementary particles, to solid state systems and metamaterials. The toroidal dipole T (the lowest order multipole) is the most common. This corresponds to the toroidal dipole operator
T
^
in quantum systems, with the projections
T
^
i
(
i
= 1, 2, 3) on the coordinate axes. These operators are observables if they are self-adjoint, but, although it is commonly discussed of toroidal dipoles of both, classical and quantum systems, up to now no system has been identified in which the operators are self-adjoint. Therefore, in this paper we use what are called the “natural coordinates” of the
T
^
3
operator to give a general procedure to construct operators that commute with
T
^
3
. Using this method, we introduce the operators
p
^
(
k
)
,
p
^
(
k
1
)
, and
p
^
(
k
2
)
, which, together with
T
^
3
and
L
^
3
, form sets of commuting operators:
(
p
^
(
k
)
,
T
^
3
,
L
^
3
)
and
(
p
^
(
k
1
)
,
p
^
(
k
2
)
,
T
^
3
)
. All these theoretical considerations open up the possibility to design metamaterials that could exploit the quantization and the general quantum properties of the toroidal dipoles.
We present the results from the analysis of a diffractive element with a quasi-periodic structure of phyllotaxis type. The output pattern obtained from such a diffractive element is characterized by ...an annular symmetry that can be used in different applications. We discuss the influence of the parameters defining the diffractive element geometry on the diffracted pattern, showing that the golden angle interval is optimal for an arrangement of circular elements. We also demonstrate that the properties of the diffraction pattern can be changed by using proper non-binary phase functions for the diffractive element to obtain a non-symmetrical pattern, to reduce the zero order or to increase the intensity in a specific diffraction order.
Since the theoretical discovery of Airy wave packet and its experimental confirmation, numerous attempts of manipulating the intensity peak dynamics have been made using the Airy function as the ...starting point of the analysis. In this paper, we propose a methodology of identifying local properties of the initial condition for the propagation equation that influence the dynamics. Based on this approach, one can construct numerical initial conditions that satisfy a desired dynamic by making use of the above-mentioned local properties.
This introductory essay reviews recent advances in the emergent field of social studies of finance (SSF) and, subsequently, sets out to illustrate how a closer engagement with SSF might benefit ...research interests in accounting and vice versa. Finally, it provides a sketch of how mutual engagements across the fields might be intensified in what is identified as an emerging accounting and finance track in the discourse of social science. The prospects of a broader field of research exploring the use of financial numbers across social settings, markets, organizations and cultures are projected, and the possibility of articulating a strong sociological programme of research is considered.
The paper examines two interrelated puzzles: the empirical one concerns communication in electronic anonymous markets. If trading screens provide traders with all the needed informational resources ...(including data interpretation), why do said traders constantly engage in chatter and instant messaging? These latter should be seen as time consuming, as distracting, and as increasing uncertainties. The theoretical puzzle is provided by the need to conceptualize communication as more than a set of maintenance and support functions for networks of traders, and as different from a tool used in reducing uncertainties about the future. I argue that in order to be able to act, actors need to typify transactions, based on their observable features. Typification is a collaborative activity, consisting in identifying particular, observable elements of market transactions as marks or tags characteristic for a certain type. Tags enable market participants to judge transactions as instances of particular types, along multiple criteria. Four kinds of tags are identified here: personal, agential, actional and procedural. Based on them, market actors solve action- and decision-relevant problems. The communicative engagement in typifications is a mechanism of differentiation and group building in online markets. Its investigation helps shed light on the social dynamics of electronic trading. Adapted from the source document.
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