RESUMEN
Purpose: Pediatric acute myeloid leukemia (AML) often involves extramedullary sites, which can be resistant to standard induction chemotherapy. Consolidative radiation therapy can be used in select cases to improve local control rates and help bridge patients to curative stem cell transplants. However, there is no previously published data to support the use of proton radiotherapy (PT) in this setting. We present radiographic findings and pathologic outcomes of the first reported patient with extramedullary ocular AML to be treated with PT. Patients and Methods: Details regarding diagnostic evaluation and treatment were obtained from the electronic medical records at the University of Florida Proton Therapy Institute, Nemours Children's Health, and St. Joseph's Children's Hospital. Results: This 7-month-old patient presented with biopsy-proven relapsed AML in the bilateral anterior chambers of the eyes, which did not resolve with induction chemotherapy. The patient then received PT to a dose of 24 cobalt gray equivalent to both eyes and was found to have no evidence of disease following treatment. Conclusion: This case provides further evidence that consolidative radiotherapy may be considered for select patients with extramedullary AML who have limited response to induction chemotherapy. Given the increased prevalence of extramedullary AML in pediatric patients, it is worth considering the utilization of PT to mitigate damage to nearby organs and the risk of secondary malignancies.
RESUMEN
As underdeveloped nations continue to industrialize and world population continues to increase, the need for energy, natural resources, and goods will lead to ever increasing inorganic contaminants, such as heavy metals, in various waste streams that can have damaging effects on plant life, wildlife, and human health. This work is focused on the evaluation of the potential of Nannochloropsis salina to be integrated with contaminated water sources for the concurrent production of a biofuel feedstock while providing an environmental service through bioremediation. Individual contaminants (As, Cd, Cr, Co, Cu, Pb, Ni, Hg, Se, and Zn) at various concentrations ranging from a low concentration (1X) to higher concentrations (10X, and 40X) found in contaminated systems (mine tailings, wastewater treatment plants, produced water) were introduced into growth media. Biological growth experimentation was performed in triplicate at the various contaminant concentrations and at 3 different light intensities. Results show that baseline concentrations of each contaminant slightly decreased biomass growth to between 89% and 99% of the control with the exception of Ni which dramatically reduced growth. Increased contaminant concentrations resulted in progressively lower growth rates for all contaminants tested. Lipid analysis shows most baseline contaminant concentrations slightly decrease or have minimal effects on lipid content at all light levels. Trace contaminant analysis on the biomass showed Cd, Co, Cu, Pb, and Zn were sorbed by the microalgae with minimal contaminants remaining in the growth media illustrating the effectiveness of microalgae to bioremediate these contaminants when levels are sufficiently low to not detrimentally impact productivity. The microalgae biomass was less efficient at sorption of As, Cr, Ni, and Se.
Asunto(s)
Biodegradación Ambiental , Metales Pesados/metabolismo , Microalgas/crecimiento & desarrollo , Microalgas/metabolismo , Estramenopilos , Biomasa , Relación Dosis-Respuesta a Droga , Metales Pesados/análisis , Metales Pesados/farmacología , Microalgas/químicaRESUMEN
Increasing demand for renewable fuels has researchers investigating the feasibility of alternative feedstocks, such as microalgae. Inherent advantages include high potential yield, use of non-arable land and integration with waste streams. The nutrient requirements of a large-scale microalgae production system will require the coupling of cultivation systems with industrial waste resources, such as carbon dioxide from flue gas and nutrients from wastewater. Inorganic contaminants present in these wastes can potentially lead to bioaccumulation in microalgal biomass negatively impact productivity and limiting end use. This study focuses on the experimental evaluation of the impact and the fate of 14 inorganic contaminants (As, Cd, Co, Cr, Cu, Hg, Mn, Ni, Pb, Sb, Se, Sn, V and Zn) on Nannochloropsis salina growth. Microalgae were cultivated in photobioreactors illuminated at 984 µmol m(-2) sec(-1) and maintained at pH 7 in a growth media polluted with inorganic contaminants at levels expected based on the composition found in commercial coal flue gas systems. Contaminants present in the biomass and the medium at the end of a 7 day growth period were analytically quantified through cold vapor atomic absorption spectrometry for Hg and through inductively coupled plasma mass spectrometry for As, Cd, Co, Cr, Cu, Mn, Ni, Pb, Sb, Se, Sn, V and Zn. Results show N. salina is a sensitive strain to the multi-metal environment with a statistical decrease in biomass yieldwith the introduction of these contaminants. The techniques presented here are adequate for quantifying algal growth and determining the fate of inorganic contaminants.
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Reactores Biológicos/microbiología , Metales Pesados/toxicidad , Microalgas/efectos de los fármacos , Microalgas/crecimiento & desarrollo , Biomasa , Dióxido de Carbono/análisis , Gases/análisis , Residuos Industriales , Metales Pesados/análisis , Metales Pesados/farmacocinética , Microalgas/metabolismo , Espectrofotometría Atómica , Estramenopilos/efectos de los fármacos , Estramenopilos/crecimiento & desarrollo , Estramenopilos/metabolismo , Aguas Residuales/químicaRESUMEN
At this study's commencement, 17 states had enacted sex offender civil commitment legislation. Although each statute outlines broad criteria that must be met, civil commitment evaluators are given considerable latitude in how to conduct their assessment. Forty-one experts who conduct sex offender civil commitment evaluations were surveyed to identify the usual practice of these evaluators. A great deal of agreement exists across experts regarding the conduct of sex offender civil commitment evaluations. However, these patterns appear quite different from the usual practice outlined in other types of forensic evaluations. Experts in sex offender civil commitment endorsed documentation as the core method for evaluation. The majority of evaluators reported the assessment of paraphilias, substance abuse, other Axis I disorders, Axis II disorders, and psychopathy as essential to the evaluation. Virtually all survey respondents utilized actuarial risk assessment measures, primarily the Static-99, in assessing for risk of future sexual violence. Although several approaches to assessing volitional impairment were described, the majority of respondents reported that a history of sex offending combined with a personality disorder or a paraphilia established the necessary link between mental abnormality and risk of future sexual violence. An overwhelming majority of experts indicated that it was essential for evaluators to report their ultimate opinion as to whether criteria had been met for civil commitment. Future research regarding the use and incorporation of documentation should be conducted to determine whether the heavy reliance on documentation is unique to sex offender civil commitment evaluations, or whether it is commonly used in other forensic evaluations.
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Internamiento Obligatorio del Enfermo Mental , Psiquiatría Forense/métodos , Servicios de Salud Mental/legislación & jurisprudencia , Delitos Sexuales/legislación & jurisprudencia , Adulto , Femenino , Humanos , Masculino , Trastornos Mentales/rehabilitación , Salud Mental , Persona de Mediana Edad , Reproducibilidad de los Resultados , Proyectos de Investigación , Medición de Riesgo/métodos , Prevención Secundaria , Estados UnidosRESUMEN
PURPOSE: We sought to investigate the outcomes of children who underwent simultaneous intraocular lens (IOL) implant and glaucoma implant surgery. METHODS: Medical records of all patients who underwent simultaneous IOL implant and glaucoma implant surgery from January 1995 through August 2003 by a single surgeon were reviewed. Criteria for success included intraocular pressure =22 mm Hg, or judged adequate for glaucoma severity, without vision loss or devastating complication. RESULTS: The study included 9 eyes of 8 children who had a mean age of 7.6 years (range, 1-16) and a mean follow-up time of 21 months (range, 8.5-35 months) after simultaneous IOL (either cataract removal with primary IOL, 2 eyes; or secondary IOL implantation, 7 eyes), and glaucoma implant surgery (6 Baerveldt, 3 Ahmed). The indications for combined surgery fell into 3 basic categories: unilateral aphakia with glaucoma (4/9), anatomical features (such as shallow anterior chamber and/or vitreous in the pupillary plane) making an IOL helpful in positioning the tube away from corneal endothelium and/or vitreous (4/9), and unilateral traumatic cataract (1/9). Mean intraocular pressure for operated eyes was 29 mm Hg (range, 21-44) preoperatively and fell to 17 mm Hg (range, 11-22) at last follow up, P = 0.01. The mean number of glaucoma medications was 3.5 preoperatively (range, 2-5) versus 1.9 (range, 0-4) at last follow-up (p = NS). Complications (n = 5) were varied, only 2 of which required additional surgery. Eighty-nine percent (8/9) of patients met criteria for success at last follow-up. CONCLUSIONS: Selected children can do well after combined glaucoma implant and IOL surgery, achieving both satisfactory glaucoma control and stable visual acuity.
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Extracción de Catarata/métodos , Catarata/terapia , Implantes de Drenaje de Glaucoma , Glaucoma/cirugía , Implantación de Lentes Intraoculares , Implantación de Prótesis/métodos , Adolescente , Catarata/complicaciones , Extracción de Catarata/efectos adversos , Niño , Preescolar , Glaucoma/complicaciones , Humanos , Lactante , Presión Intraocular , Lentes Intraoculares , Complicaciones Posoperatorias , Estudios Retrospectivos , Resultado del Tratamiento , Agudeza VisualRESUMEN
PURPOSE: To evaluate macular and nerve fiber layer (NFL) thickness in normal and glaucomatous eyes of children 3 to 17 years old using optical coherence tomography (OCT-3). DESIGN: Observational cross-sectional study. METHODS: One hundred fifty-six eyes of 79 patients were enrolled in this institutional study. Fifty-two eyes (33.3%) met criteria for glaucoma and 104 (66.7%) were normal. There were 44 female (55.6%) and 35 male (44.3%) subjects whose ages ranged from 3 to 17 years old (mean 9.5 years, standard deviation 3.5 years, median 9 years). The OCT-3 (Carl Zeiss Meditec, Dublin, California) was used to obtain a fast macular thickness map as well as a fast retinal NFL map of each eye. Data from specific locations around the macula, as well as total macular volume, was analyzed. Similarly, the retinal NFL scan reports average NFL thickness from specific locations around the optic nerve. Data from the superior temporal and inferior temporal sections was analyzed. RESULTS: There was a statistically significant difference in macular thickness and NFL thickness when normal eyes were compared against those with glaucoma, in all quadrants studied (all P values Asunto(s)
Glaucoma/diagnóstico
, Mácula Lútea/patología
, Fibras Nerviosas/patología
, Enfermedades del Nervio Óptico/diagnóstico
, Células Ganglionares de la Retina/patología
, Tomografía de Coherencia Óptica
, Adolescente
, Niño
, Preescolar
, Estudios Transversales
, Técnicas de Diagnóstico Oftalmológico
, Femenino
, Glaucoma/congénito
, Humanos
, Presión Intraocular
, Masculino