Randomized controlled study comparing simultaneous modulated accelerated radiotherapy versus simultaneous integrated boost intensity modulated radiotherapy in the treatment of locally advanced head and neck cancer

Objectives

Comparison of two fractionation schedules of intensity modulated radiotherapy (IMRT) for locally advanced head and neck cancer – simultaneous integrated boost (SIB-IMRT) and simultaneous modulated accelerated radiotherapy (SMART) boost in terms of toxicity and survival end-point measures.

Endocardial Potential Mapping from a Noncontact Nonexpandable Catheter: A Feasibility Study

In previous studies, we established methodology for reconstructing endocardial potentials, electrograms and isochrones from a non-contact intracavitary probe during a single beat. The probe was too large to be introduced percutaneously. Here we examine the possibility of similar mapping with a small multielectrode catheter that could be introduced percutaneously and does not expand inside the cavity. Cavity geometry and endocardial potentials were recorded in an isolated canine left ventricle. Simulated catheter probes were introduced into the cavity. Probe potentials were computed from the measured endocardial potentials and perturbed to include measurement noise, geometrical errors, and limited electrode density. Endocardial potentials were then reconstructed from the perturbed probe potentials and compared to the actual measured potentials. Of all probes simulated, a 3.0 mm (9F) catheter that assumes a curved geometry (e.g., a J shape) inside the cavity performed best (better than a larger 7.6 mm cylinder simulating an inflatable probe). Without bending, a straight cylindrical probe of the same size (9F, 3.0 mm) did not perform well. Sixty probe electrodes were needed for accurate reconstruction. The J-probe reconstruction was very robust in the presence of noise (10%) and of geometry errors (3 mm shift, 10° rotation). The results demonstrate the feasibility of accurate single-beat endocardial mapping using a 9F percutaneous multielectrode catheter that assumes a J shape in the cavity without the need for expansion (e.g., into a balloon or a basket). The robustness of the procedure to noise and geometrical errors suggests its applicability in the clinical EP laboratory and the possibility of determining probe position in vivo using current imaging modalities. © 1998 Biomedical Engineering Society. PAC98: 8759Wc     

Missed opportunities for simultaneous administration of the fourth dose of DTaP among children in the United States

BackgroundSimultaneous administration of all age-appropriate doses of vaccines is an effective strategy for raising vaccination coverage. Vaccination coverage for ≥4 dose of DTaP (diphtheria, tetanus toxoids, and acellular pertussis vaccine) among children 19–35 months in the United States has not reached the Healthy People 2020 target of 90%. Risk factors for missed opportunities for simultaneous administration of the fourth dose of DTaP have not been investigated.MethodsA missed opportunity for simultaneous administration of the fourth dose of DTaP is defined as the failure to administer an age-eligible fourth dose of DTaP, and during the same age-eligible period for the fourth dose of DTaP other recommended and age-appropriate doses of vaccines are given to children. This study used 2001–2014 National Immunization Survey data to describe the trend in missed opportunities for simultaneous administration of the fourth dose of DTaP from 2001 through 2014, assess the prevalence of children who missed opportunities for simultaneous administration of the fourth dose of DTaP by selected factors, and recognize significant risk factors for missed opportunities for simultaneous administration of the fourth dose of DTaP.ResultsFrom 2001 to 2014, the prevalence of missed opportunities for simultaneous administration of the fourth dose of DTaP among children 19–35 months in the United States ranged from 5.7% to 9.0%; across 13 factors considered, the prevalence of missed opportunities varied from 3.3% to 22.9%. Children who were late in receiving the first to third dose of DTaP had significantly higher prevalence of missed opportunities for simultaneous administration of the fourth dose of DTaP than children who received these doses on-time, with adjusted prevalence ratios for late vs. on-time of 1.7, 1.6, and 3.2, and all P-value < 0.01.ConclusionsImproving on-time vaccination of the third dose of DTaP could substantially reduce missed opportunities for simultaneous administration of the fourth dose of DTaP.     

High prevalence of simultaneous rib and vertebral fractures in patients with hip fracture

PurposeThe purpose was to evaluate the prevalence and location of simultaneous fracture using bone scans in patients with hip fracture and to determine the risk factors associated with simultaneous fracture.Patients and methodsOne hundred eighty two patients with hip fracture were reviewed for this study. Clinical parameters and bone mineral density (BMD) of the lumbar vertebra and femoral neck were investigated. To identify acute simultaneous fracture, a bone scan was performed at 15.4 ± 4.1 days after hip fracture. The prevalence and location of simultaneous fracture were evaluated, and multivariate logistic regression analysis was performed to determine the risk factors.ResultsSimultaneous fracture was observed in 102 of 182 patients, a prevalence of 56.0%. Rib fracture was the most common type of simultaneous fracture followed by rib with vertebral fracture. The BMD of the lumbar vertebra was significantly lower in patients with simultaneous fracture (p = 0.044) and was identified as an independent risk factor (odds ratio: OR 0.05, 95% confidence interval: CI 0.01–0.57).ConclusionsThe prevalence of simultaneous fracture was relatively high among patients with hip fracture, and BMD was significantly lower in patients with simultaneous fracture than in patients without it. Surgeons should be aware of the possibility of simultaneous fracture in patients with hip fracture.     

Competitive adsorption versus surface complexation as models for the simultaneous adsorption of metal complexes and free ligands

A statistical thermodynamical approach to the study of anion-induced adsorption of Cd(II) from halide solutions is presented. The simultaneous adsorption of metal complex and ligand is introduced in the isotherms by considering two possible mechanisms — competitive adsorption and surface complexation. These isotherms have been tested for the system Cd(II) in KBr at several ionic strengths. The experimental surface excesses of Cd(II) calculated from single-step chronocoulometry can be simulated, giving an explanation for the desorption of the metal complex at positive potentials. Also, the change in ligand adsorption promoted by the adsorption of the metal complex has been calculated. Both approaches lead to the conclusion that the anionic tricoordinate metal complex CdBr₃^? and the tetracoordinate CdBr₄^2? are the absorbed species on the electrode surface, with CdBr₄^2? dominating at higher bromide concentrations.     

Method development and validation for the simultaneous determination of meloxicam and pridinol mesylate using RP-HPLC and its application in drug formulations

A simple and reliable reversed-phase high-perfomance liquid chromatographic method has been developed and validated for the simultaneous determination of meloxicam and pridinol mesylate in their synthetic mixtures and combined tablet formulations. Both drugs were separated on a 250 mm x 4.6mm C18 column packed with 5 microm particles. The mobile phase, optimized through an experimental design, was a 51:9:40 (v/v/v) mixture of methanol, isopropanol and 50mM potassium phosphate buffer (pH 5.9), pumped at a flow rate of 1.0 ml min(-1). UV detection was performed at 225 nm. The method was validated in the sample concentration ranges of 33.7-61.8 mg l(-1) for meloxicam and 8.8-16.8 mg l(-1) for pridinol mesylate, where it demonstrated good linearity with r=0.9989 and 0.9987 (n=15), respectively. The assay was shown to be repeatable at concentration levels of 70%, 100% and 130%, with relative standard deviation values of 1.09% and 0.82% for meloxicam and pridinol, respectively. For independent 100% level samples, the intra-day precision was 0.4% and 1.0% while the intermediate precision was 0.7% and 1.0% for the drugs. The method demonstrated to be robust, resisting to small deliberate changes in pH, flow rate and composition (organic:aqueous ratio) of the mobile phase. The LOD values were 0.22 and 0.20 mg l(-1), while the LOQ were 1.7 and 1.1 mg l(-1), for meloxicam and pridinol, respectively. The applicability of the method was demonstrated by determining the drug content of two commercial pharmaceutical formulations, where it exhibited good performance.     

UPLC法同时测定通天口服液中的3种有效成分

目的 采用UPLC法同时测定通天口服液中没食子酸、天麻素和芍药苷的含量.方法 采用Zorbax Eclipse Plus C18柱(100mm×2.1 mm,1.8μm),流动相为乙腈-0.05％磷酸溶液,梯度洗脱,流速0.3 mL·min-1,检测波长230 nm,柱温25℃.结果 没食子酸、天麻素和芍药苷的线性范围分别为23.84～238.4、9.552 ～95.52、33.56 ～335.6 ng;平均加样回收率分别为100.2％、101.0％、101.0％,RSD分别为1.6％、1.8％、1.5％(n=6).结论 所用方法简便、快速、准确,可为通天口服液的质量控制提供参考.     

矿井作业场所中呼吸尘与氡子体同时监测的方法研究

矿井作业面的粉尘与氡子体是危害工人健康的两在重要因素。有效地监测空气中的粉尘怀氡子体是工业卫生学者一直关心的课题,而如何有效地同时监测呼吸尘与氡子体更受到人们的关注。介绍了一种同时监测呼吸尘浓度与氡子体α潜能浓度的方法,该方法是将热释光探测元件组装在呼吸尘个体采样器中,使热释光元件受到与呼吸尘一起被采集在滤膜上的氡子体的放射照射。采样结束后,分别测出滤膜上的粉尘量及热释光探测元件的热释光计数,即可     

Use of tacrolimus and mycophenolate mofetil as induction and maintenance in simultaneous pancreas‐kidney transplantation

Abstract Clinical trials using quadruple immunosuppression that include the combination of tacrolimus and mycophenolate mofetil have been shown to reduce the incidence of acute rejection episodes in simultaneous pancreas‐kidney (SPK) transplantation. In an attempt to obtain a low rejection rate without antibody induction therapy, we undertook a prospective study of combined tacrolimus and mycophenolate mofetil and steroids as primary immunosuppression for SPK transplantation. In this study, we analyzed 17 patients who received low‐dose intravenous tacrolimus as induction therapy. This was combined with oral tacrolimus, mycophenolate mofetil, and steroids as the primary immunosuppression regimen. There was a significant reduction of empirically and biopsy‐proven rejection with an incidence of 23 % (4 patients). Leukopenia, gastroparesis, and gastrointestinal side‐effects were the cause of discontinuation of mycophenolate mofetil, or low tacrolimus trough level in those patients who developed rejection. All rejection episodes were easy to treat, and none of them required antibody therapy. The combination of tacrolimus with mycophenolate mofetil without antibody induction therapy is effective in preventing early acute rejection. This combination is safe and effective as an alternative immunosuppressive regimen after SPK transplantation.