To evaluate parents' satisfaction with medical and allied health services provided to children with Down syndrome in north-west England, comparing ENT and its allied services with other areas of ...health service provision.
A questionnaire survey of parents attending a north-west England Down syndrome association conference. Demographic data, departments visited, satisfaction with each service (scored one to five), waiting times for each service (scored one to five), service need (scored one to three) and accessibility (scored one to three) were recorded.
Otolaryngology had been used by 50 per cent of children, with a satisfaction of 2.63 (the second worst score). Speech and language therapy was used by 90 per cent of the children, with a satisfaction of 3.26 (the worst score). The service felt to be most needed and also most difficult to access was speech and language therapy.
Otorhinolaryngology departments should assess how they can improve their service to this population with specific ENT needs. Speech and language services for children with Down syndrome should be expanded.
Endogenous progesterone and synthetic progestins may induce hypersecretion of growth hormone (GH) of mammary origin, hyperplastic ductular changes in the mammary gland, and the development of cystic ...endometrial hyperplasia (CEH) in dogs. It was investigated whether progestin-induced mammary GH plays a role in the pathogenesis of CEH in the bitch. During 1 year, bitches with surgically excised mammary glands and healthy control bitches received medroxyprogesterone acetate (MPA). Before and after MPA treatment, uterine and mammary tissues were collected for histological, immunohistochemical, and RT-PCR examination.
After MPA administration, the mammary tissue in the control dogs had differentiated into lobulo-alveolar structures and CEH was present in all uteri of both dog groups. In the MPA-exposed mammary tissue of the control dogs, GH could only be demonstrated immunohistochemically in proliferating epithelium. After treatment with MPA the dogs of both groups had immunohistochemically demonstrable GH in the cytoplasm of hyperplastic glandular uterine epithelial cells. RT-PCR analysis of the mammary gland tissue after MPA administration demonstrated a significant higher GH gene, and lower GHR gene expression than before treatment. In the uterus, the expression of the gene encoding for GH was significantly increased in the mastectomized dogs, whereas in the control dogs the expression of the gene encoding for insulin-like growth factor-I had significantly increased with MPA administration. MPA treatment significantly down regulated PR gene expression in the uterus in both dog groups. These results indicate that progestin-induced GH of mammary origin is not an essential component in the development of CEH in the bitch.
Statement of Problem. When they are used to treat inflamed, irritated, or distorted tissues or in implant therapy, tissue conditioners are required to function over relatively long time periods. Most ...presently available materials have a short life span (3 to 4 days). Purpose. This study evaluated the effects of 2 different coatings on the surface integrity and softness of a tissue conditioner over a 4-week period. Material and Methods. Ten subjects with a complete maxillary denture and a functioning mandibular dentition were included in the study. Each maxillary denture had 3 troughs filled with a tissue conditioner (Coe Comfort). One trough was coated with Monopoly and one with Permaseal; the third trough was left uncoated (control). The specimens were tested at insertion and at 1 week, 2 weeks, and 4 weeks postinsertion for softness with a durometer and for surface integrity with a scanning electron microscope. Statistical differences were determined with analysis of variance (P<.05). Results. At the end of 4 weeks, the mean and standard deviation of softness on the ASTM scale was 85.1 (4.2) for the control, 81.6 (3.9) for Monopoly, and 77.9 (5.0) for Permaseal. The difference between the control and Permaseal was significant (P<.0042). Qualitatively, SEM analysis indicated that the control deteriorated by the end of the first week, whereas both Monopoly and Permaseal coatings remained intact for up to 2 weeks. All groups showed some conditioner deterioration by 4 weeks. The tissues under the denture-bearing areas remained healthy during the study period. Conclusion. Within the limitations of this study, the application of Permaseal or Monopoly coatings significantly reduced the loss of tissue conditioner softness. Permaseal-coated conditioner remained the softest over the length of the study. (J Prosthet Dent 2002;87:153-7.)
The <inline-formula> <tex-math notation="LaTeX">\sim</tex-math> </inline-formula>60-keV pulsed helium ions emitted from the plasma focus (PF) device are irradiated onto FP479 graphite to observe the ...irradiation-induced effects. Ion irradiation modifies the surface roughness and also alters the graphite properties locally by varying ion doses. Hence, surface feature analysis under varying experimental conditions, involving different PF shots is attempted. Porous morphologies were observed on the sample surface irradiated with fewer PF shots (<inline-formula> <tex-math notation="LaTeX">\le </tex-math> </inline-formula> 5). In contrast, with a higher number of PF shots (<inline-formula> <tex-math notation="LaTeX">\ge </tex-math> </inline-formula> 10), the morphology exhibited rounded and elongated structures. Surface and cross-sectional Raman characterizations of the irradiated samples suggest the development of defects in the form of nanocrystalline carbon, along with an increase in the <inline-formula> <tex-math notation="LaTeX">I_{D}</tex-math> </inline-formula>/<inline-formula> <tex-math notation="LaTeX">I_{G}</tex-math> </inline-formula> value. Additionally, the crystallite size decreases with fluence. Energy dispersive X-ray (EDX) measurements confirmed the presence of Fe and Cr impurities in very low concentrations, while XPS indicated a partial transformation of sp<inline-formula> <tex-math notation="LaTeX">^{2}</tex-math> </inline-formula> to sp<inline-formula> <tex-math notation="LaTeX">^{3}</tex-math> </inline-formula> hybridization in the irradiated samples. The layer structure of the reference samples disappeared, and some evidence of damaged graphite was noted in the transmission electron microscopy (TEM) measurement. Moreover, electron diffraction of the irradiated sample revealed a diffused ring pattern. These results will be valuable for fusion studies and for understanding the behavior of graphite electrodes used in plasma applications.
Purpose: We evaluated mid-term results of a single-center consecutive series of endovascular stent-grafts implanted for aortic aneurysm repair with transrenal fixation, to determine clinical outcome, ...aneurysm anatomy, renal artery patency, and renal complications. Methods: Modular stent-grafts were placed with transrenal fixation in 37 patients between November 1998 and July 2000. Follow-up evaluation included clinical examination, laboratory evaluation of serum creatine concentration, computed tomographic angiography, and renal duplex scanning. Results: Thirty-seven patients underwent transrenal fixation of aortic stent-grafts as part of a Phase II US Food and Drug Administration study. Two patients subsequently underwent follow-up at institutions closer to their homes, and thus provided clinical information but no long-term renal or aneurysm morphologic data. There were no perioperative deaths. Five patients died during follow-up, at a mean of 9 months, because of myocardial infarction in 4 patients and respiratory failure in 1 patient. Thirty patients, ages 75 ± 8 years, have been followed up for 28.5 ± 7.2 months. Aneurysm diameter at follow-up was 5.0 ± 0.8 cm, compared with 5.7 ± 0.8 cm preoperatively. In 5 patients, endoleak developed during follow-up: 1 type I leak was treated with an aortic cuff, with temporary stabilization of the aneurysm and correction of the endoleak; 2 type II endoleaks were treated with translumbar coil embolization, and 1 resolved spontaneously; and 1 type III endoleak was treated with a combination of coil embolization and stent-graft extension to cover a graft defect. Preoperatively, serum creatinine concentration was normal in 23 patients, but increaesd persistently in 2 patients and was abnormal in 7 patients. Postoperatively, creatine concentration increased in 4 patients to greater than 20% of baseline level. Seventeen patients had no evidence of renal artery stenosis, compared with 13 patients with renal artery stenosis. Of 41 normal renal arteries, 90% remained unchanged, 1 became occluded, 3 demonstrated 60% stenosis. Nephrectomy was necessary in 1 patient because of cancer. Of 19 abnormal renal arteries, progression of disease was noted in 3 arteries. Conclusions: Transrenal fixation of aortic stent-grafts can be performed with acceptable mid-term outcome with respect to mortality, need for follow-up intervention, and aneurysm exclusion with protection from rupture. Postprocedural stenosis can develop in both normal and abnormal renal arteries. Rate of progression of disease was greater in patients with preprocedural renal dysfunction compared with patients with normal renal arteries. This is merely an observation, and may not be related to transrenal fixation. Long-term follow up is needed. (J Vasc Surg 2003;37:938-42.)
Summary
1. The hydrologic connectivity between landscape elements and streams means that fragmentation of terrestrial habitats could affect the distribution of stream faunas at multiple spatial ...scales. We investigated how catchment‐ and site‐scale influences, including proportion and position of forest cover within a catchment, and presence of riparian forest cover affected the distribution of a diadromous fish.
2. The occurrence of koaro (Galaxias brevipinnis) in 50‐m stream reaches with either forested or non‐forested riparian margins at 172 sites in 24 catchments on Banks Peninsula, South Island, New Zealand was analysed. Proportions of catchments forested and the dominant position (upland or lowland) of forest within catchments were determined using geographical information system spatial analysis tools.
3. Multivariate analysis of variance indicated forest position and proportion forested at the catchment accounted for the majority of the variation in the overall proportion of sites in a catchment with koaro.
4. Where forest was predominantly in the lower part of the catchments, the presence of riparian cover was important in explaining the proportion of sites with koaro. However, where forest was predominantly in the upper part of the catchment, the effect of riparian forest was not as strong. In the absence of riparian forest cover, no patterns of koaro distribution with respect to catchment forest cover or forest position were detected.
5. These results indicate that landscape elements, such as the proportion and position of catchment forest, operating at catchment‐scales, influence the distribution of diadromous fish but their influence depends on the presence of riparian vegetation, a site‐scale factor.
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