54 research outputs found
Infections associated with cardiac electronic implantable devices: economic perspectives and impact of the TYRXTM antibacterial envelope
No full textThe occurrence of cardiac implantable electronic devices (CIED) infections and related adverse outcomes have an important financial impact on the healthcare system, with hospitalization length of stay (2-3 weeks on average) being the largest cost driver, including the cost of device system extraction and device replacement accounting for more than half of total costs. In the recent literature, the economic profile of the TYRXTM absorbable antibacterial envelope was analysed taking into account both randomized and non-randomized trial data. Economic analysis found that the envelope is associated with cost-effectiveness ratios below USA and European benchmarks in selected patients at increased risk of infection. Therefore, the TYRXTM envelope, by effectively reducing CIED infections, provides value according to the criteria of affordability currently adopted by USA and European healthcare systems
Immunohistochemical expression of pRb in pleomorphic adenoma and carcinoma ex pleomorphic adenoma
No full textAn immunohistochemical study of androgen receptor in carcinoma arising in pleomorphic salivary adenoma
No full textImmunohistochemical expression of p21 in normal tissues of salivary gland, pleomorphic adenoma and carcinoma ex pleomorphic adenoma (undifferentiated and adenocarcinoma types)
No full textObjective: Our study aimed to characterize alteration in the immunohistochemical expression of p21 in normal tissue of the salivary gland surrounding pleomorphic adenoma, the tumor cells of pleomorphic adenomas, and carcinoma arising in pleomorphic adenoma. Study design: A selected series of 29 cases of pleomorphic adenomas, and 27 cases of carcinoma ex-pleomorphic adenoma (undifferentiated and adenocarcinoma types) were examined. Results: The results showed that p21 expression was negative in the most components of normal tissue of the salivary gland surrounding pleomorphic adenoma, 24 cases out of 29 of the non tumour duct cells (82.8%), and 28 (96.6%) cases out of 29 of the acinar cells shows negative p21 expression. P21 expression in pleomorphic adenomas shows that 2 cases out of 29 (6.9%) strongly expressed in the duct cells. p21 was strongly expressed in carcinoma cells in 9 (33.3%) cases out of 27. Conclusion: Our data suggest that the strong nuclear staining as an indicator for altered p21, then the alteration of p21 expression would increase from pleomorphic adenoma to carcinoma arising in pleomorphic adenomas (6.9% versus 33.3%)
Cost-Effectiveness Analyses of an Absorbable Antibacterial Envelope for Use in Patients at Increased Risk of Cardiac Implantable Electronic Device Infection in Germany, Italy, and England
No full textObjectives: To model the cost-effectiveness of the TYRX Absorbable Antibacterial Envelope when used in patients at increased risk of cardiac implantable electronic device (CIED) infection in the context of 3 European healthcare systems: Germany, Italy, and England. Methods: A decision tree model with a lifetime horizon was populated using data from the Worldwide Randomized Antibiotic Envelope Infection Prevention Trial, a large multicenter randomized controlled trial. Use of the antibacterial envelope adjunctive to standard of care was compared to standard of care infection prevention alone. Patients in the model were divided into subgroups based on presence of factors known to increase infection risk. Results: The antibacterial envelope had the most favorable cost-effectiveness profile when patients had previously experienced CIED infection, had a history of immunosuppressive therapy, or had a Prevention of Arrhythmia Device Infection Trial (PADIT) score indicating high risk of infection (scores ≥6) at cost-effectiveness thresholds of €50 000 in Germany (assumed in the absence of an official threshold), €40 000 in Italy, and £30 000 in England. Probabilistic sensitivity analysis indicated that the antibacterial envelope was likely to be cost-effective in patients with other risk factors (including replacement of high power CIEDs, generator replacement with lead modification, and PADIT scores indicating intermediate risk of infection) when used with some device types and in some countries. Conclusions: The absorbable antibacterial envelope was associated with cost-effectiveness ratios below European benchmarks in selected patients at increased risk of infection, suggesting the envelope provides value for European healthcare systems by reducing CIED infections
Immunohistochemical expression of estrogens and progesterone receptors in carcinoma ex pleomorphic adenoma-undifferentiated and adenocarcinoma types
No full textCancer of the salivary gland is one of the common cancers in the head and the neck regions. This type of cancer develops in the minor and the major salivary glands, and it sometimes metastasizes to other organs, particularly the lung. Morphologic mimicry and similarity in the expression of steroid hormone receptors between salivary gland tumors and breast tumors are well-known phenomena and are occasionally debated in the field of surgical pathology. The expression of sex hormone receptors in some tumors suggests a role for these receptors in tumor pathogenesis and therapy. Previous studies of the expression of estrogens and progesterone receptors in salivary gland tumors have reported conflicting results. Objective: Our study aimed to characterize alteration in the immunohistochemical expression of estrogens receptor and progesterone receptor in the tumor cells of carcinoma arising in pleomorphic adenoma. Study design: 27 cases of carcinoma arising in pleomorphic adenoma (undifferentiated and adenocarcinoma types) were examined. Results: The results showed that 27 (100 %) of 27 cases had negative nuclear staining for either estrogens or progesterone receptors. Conclusion: Our data suggest that carcinomas arising in pleomorphic adenoma were not dependent on endocrine function
An immunohistochemical study of the distribution of p 16 protein in oral mucosa in smokers, non-smokers and in frictional keratosis
No full textObjective: Our study aimed to characterize alteration in the immunohistochemical p16 expression in normal oral mucosa and non-neoplastic hyperproliferative disorders (i.e. frictional keratosis and mucosa from smokers). Study design: 43 specimen of oral mucosa were examined using immunohistochemistry. Results: In normal mucosa, there was strong positive nuclear staining in a proportion of fibroblasts and endothelial cells in the lamina propria, with variable expression in nuclei of the epithelial layer. However, when the patient?s tobacco smoking was examined, p16 nuclear staining in oral epithelium was seen in 4/20 (20%) of smokers and 0/23 (0%) of non-smokers. In every case of frictional keratosis (n=11), there was strong nuclear staining of some basal and supra-basal cells. In addition, there was strong nuclear staining of parakeratinizing squamous in a band above the spinous layer. In clinically normal oral epithelium of smokers and in frictional keratosis, basal and supra-basal cells expressed strong p16 nuclear staining which was absent in the control tissue examined. Conclusion: Our data suggest that p16 expression may be involved in the long-term loss of proliferation in cell senescence of oral mucosa
Examining the factors that predict the likelihood of the success of a terrorist attack, and severity from a machine learning and regression lens
No full textTerrorism and the proactive and reactive policies enacted to counter further terrorism incidents have consequential effects on both a microeconomic and macroeconomic level. Although terrorism has existed prior to the modernization of the global economy, we are witnessing a recent increase in the aggregate number of attacks, as well as in the severity of the attacks, in recent decades. This rise in terrorism and its impacts can be attributed to the rise of religious Islamic terrorism, and the shift in motivations of terrorist organizations since the post-cold war era. Furthermore, terrorist organizations are adapting to counter-terrorism efforts as they shift their activities to regions that are less secure and adapt their methodologies of attack to increase their likelihood of success. As governments and global organizations continue to increase their spending in efforts to counter terrorism, if efforts are to be effective and efficient it requires a systematic approach in considering the magnitude of impact of various methods of attack, the likelihood of success each method, and the expected risk reduction and implications of implementing security measures.
The political and social science fields have yet to be able to reach an agreed upon definition of terrorism, or determine the underlying factors which are both controversial topics in the field of terrorism. This lack of a standardized definition constitutes an obstacle to effectively implement proactive policies that reduce individuals’ participation in terroristic activities. In the meanwhile, the field of applied economics can contribute to the effective implementation of defensive strategies by lending its statistical and econometric tools to the research in this field. Furthermore, as data on this topic continues to expand and with the availability and maintenance of large datasets by governmental agencies, machine learning is a useful tool in researching this issue as it is largely data driven and does not assume any functionality of the relationships. Machine learning is not to a replacement for classical econometric methodology but can instead enhance these models by being better suited for predicting out of sample observations when utilizing large datasets. By merging these two field together, economics and machine learning, we can better predict the likelihood of success of a terrorist attacks and its magnitude while not sacrificing the ease of interpretability provided by regression modeling techniques.
Our research contributes to the study of terrorism by examining the factors that predict the likelihood of success of a terrorist attack as well as the severity by utilizing a combination of machine learning algorithmic approaches and economic regression modeling techniques. To the best of our knowledge, this approach has yet to be implemented to the research in this field, and thus constitutes a novel contribution to the literature. From our results we observe that the decade, region, method of attack, weapon utilized in the attack, attack target, whether the attack was transnational or domestic, whether the perpetrator/s committed suicide, and the duration of the attacks are statistically significant predictors as to whether the attack was successful or not. Furthermore, these factors are also significant in regard to measuring the magnitude of the severity of the attack, as measured by individuals killed and number of wounded casualties. Separate from our model that predicts the likelihood of the success of the attack, two separate models for each measurement of severity are also constructed throughout our research. Considering the lack of definition and agreement on the underlying factors that motivate individuals to participate in terrorism, our focus is on identifying the factors that predict the likelihood of the success and severity of a terrorist attack. By examining the factors and methodologies that contribute the highest to the predictive likelihood of the success a terrorist attack and that have the highest magnitude of impact, this study offers policy implications to the design of effective defensive policy measures and efficient resource allocation recommendations to policymakers and governmental agencies to further thwart terrorism efforts.M.S.Includes bibliographical reference
Xanthogranulomatous Pyelonephritis: A Retrospective Study of 10 Cases and Review of the Literature
No full textWe herewith report 10 patients with xanthogranulomatous pyelonephritis (XGP) who were treated in our department between the years 1988 and 2000. The patients′ age ranged from 20 to 60 years (mean 45 years); there were seven males and three females giving a male-female ratio of 2.3:1. Sixty percent of the patients were over 50 years old. The lesion was unilateral in all cases and pyonephrosis was found in seven patients. Nine cases had associated renal stones (90%), which led to non-functioning kidney in all these cases. Two cases had associated fistulae (one uretero-colonic fistula and one reno-cutaneous fistula). One case of focal XGP was found to be associated with renal cell carcinoma while a second patient with diffuse obstructive type of XGP and renal stone had associated transitional cell carcinoma of the renal pelvis. In all patients, the urine culture was negative. Pus culture revealed Escherechia coli in four cases (40%), Salmonella Para B in one, and no organism could be grown in four other cases. One case did not have any pus. All patients were treated with nephrectomy
Designing cobalt chromium removable partial dentures for patients with shortened dental arches - a pilot survey
No full textThe aim of this survey was to investigate the quality of prescription for the fabrication of cobalt chromium removable partial dentures (RPDs) that are used to extend the shortened dental arches (SDAs). A survey of four commercial dental laboratories located in northern England was conducted. The target of this survey was cobalt chromium RPDs that were requested to restore SDAs comprising the anterior teeth and 2-4 premolars. Dentists' prescriptions were scrutinised, and a special data collection form was completed accordingly. A total of 94 dentists' prescriptions and associated SDA casts were examined. Almost all the requested cobalt chromium RPDs were clasp-retained RPDs (97%). Scrutinising the 91 prescriptions for clasp-retained cobalt chromium RPDs showed that dentists' prescriptions did not have any instructions about the design of the partial denture in a considerable proportion of the cases (32%). Teeth to be clasped were identified clearly in 45% of the prescriptions. A majority of the dentists (64%) failed to provide any instructions about the design of the rests to be placed on the most posterior premolar abutment teeth. A considerable proportion of the dentists delegated the task of selecting the type of the major connector to the dental technician (41%). Only 21 (23%) of the examined casts had clearly defined rest seat preparation. The outcome of this pilot survey shows inadequate quality of prescription in designing RPDs for patients with SDAs. This finding has an ethical and clinical bearing and does not fit with current legal guidelines relevant to designing RPD
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