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Lanctôt KL, Chen C, Mah E, Kiss A, Li A, Shade D, Scherer RW, Vieira D, Coulibaly H, Rosenberg PB, Lerner AJ, Padala PR, Brawman-Mintzer O, van Dyck CH, Porsteinsson AP, Craft S, Levey A, Burke WJ, Mintzer J, Herrmann N. Cost consequence analysis of Apathy in Dementia Methylphenidate Trial 2 (ADMET 2). Int Psychogeriatr 2023; 35:664-672. [PMID: 37066690 PMCID: PMC10579450 DOI: 10.1017/s1041610223000327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
BACKGROUND This paper used data from the Apathy in Dementia Methylphenidate Trial 2 (NCT02346201) to conduct a planned cost consequence analysis to investigate whether treatment of apathy with methylphenidate is economically attractive. METHODS A total of 167 patients with clinically significant apathy randomized to either methylphenidate or placebo were included. The Resource Utilization in Dementia Lite instrument assessed resource utilization for the past 30 days and the EuroQol five dimension five level questionnaire assessed health utility at baseline, 3 months, and 6 months. Resources were converted to costs using standard sources and reported in 2021 USD. A repeated measures analysis of variance compared change in costs and utility over time between the treatment and placebo groups. A binary logistic regression was used to assess cost predictors. RESULTS Costs were not significantly different between groups whether the cost of methylphenidate was excluded (F(2,330) = 0.626, ηp2 = 0.004, p = 0.535) or included (F(2,330) = 0.629, ηp2 = 0.004, p = 0.534). Utility improved with methylphenidate treatment as there was a group by time interaction (F(2,330) = 7.525, ηp2 = 0.044, p < 0.001). DISCUSSION Results from this study indicated that there was no evidence for a difference in resource utilization costs between methylphenidate and placebo treatment. However, utility improved significantly over the 6-month follow-up period. These results can aid in decision-making to improve quality of life in patients with Alzheimer's disease while considering the burden on the healthcare system.
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Affiliation(s)
| | - Clara Chen
- Faculty of Health Sciences, Western University, London, ON, Canada
| | - Ethan Mah
- Sunnybrook Research Institute, Toronto, ON, Canada
| | - Alex Kiss
- Sunnybrook Research Institute, Toronto, ON, Canada
| | - Abby Li
- Sunnybrook Research Institute, Toronto, ON, Canada
| | - Dave Shade
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roberta W. Scherer
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Hamadou Coulibaly
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Alan J. Lerner
- University Hospital – Case Western Reserve University, Cleveland, OH, USA
| | - Prasad R. Padala
- University of Arkansas for Medical Science, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA
| | - Olga Brawman-Mintzer
- Medical University of South Carolina and Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | | | | | - Suzanne Craft
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | | | - Jacobo Mintzer
- Medical University of South Carolina and Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
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Gaur A, Rivet L, Mah E, Bawa KK, Gallagher D, Herrmann N, Lanctôt KL. Novel fluid biomarkers for mild cognitive impairment: A systematic review and meta-analysis. Ageing Res Rev 2023; 91:102046. [PMID: 37647995 DOI: 10.1016/j.arr.2023.102046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 08/01/2023] [Accepted: 08/27/2023] [Indexed: 09/01/2023]
Abstract
Mild cognitive impairment (MCI) is a well-established prodromal stage of dementia (e.g., Alzheimer's disease) that is often accompanied by early signs of neurodegeneration. To facilitate a better characterization of the underlying pathophysiology, we assessed the available literature to evaluate potential fluid biomarkers in MCI. Peer-reviewed articles that measured cerebrospinal fluid (CSF) and/or peripheral biomarkers of neuronal injury (total-tau [T-tau], neurofilament light chain [NfL], heart-type fatty acid binding protein [HFABP], neuron-specific enolase, ubiquitin C-terminal hydrolase L1) and/or astroglial pathology (glial fibrillary acidic protein [GFAP], S100 calcium-binding protein B) in MCI and healthy controls were assessed. Group differences were summarized by standardized mean differences (SMDs) and 95% confidence intervals calculated using a random-effects model. Heterogeneity was quantified using I2. A total of 107 studies were included in the meta-analysis and 10 studies were qualitatively reviewed. In CSF, concentrations of NfL (SMD = 0.69 [0.56, 0.83]), GFAP (SMD = 0.41 [0.07, 0.75]), and HFABP (SMD = 0.57 [0.26, 0.89]) were elevated in MCI. In blood, increased concentrations of T-tau (SMD = 0.19 [0.09, 0.29]), NfL (SMD = 0.41 [0.32, 0.49]), and GFAP (SMD = 0.39 [0.23, 0.55]) were found in MCI. Heterogeneity that was identified in all comparisons was explored using meta-regression and subgroup analysis. Elevated NfL and GFAP can be detected in both CSF and peripheral blood. Monitoring these biomarkers in clinical settings may provide important insight into underlying neurodegenerative processes in MCI.
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Affiliation(s)
- Amish Gaur
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Luc Rivet
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Ethan Mah
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Kritleen K Bawa
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Damien Gallagher
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada
| | - Nathan Herrmann
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada.
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Mah E, Lanctôt K, Chen QZ, Shade D, Scherer R, Vieira D, Coulibaly H, Rosenberg P, Lerner A, Padala P, Brawman-Mintzer O, van Dyck C, Porsteinsson A, Mintzer J, Herrmann N. Cost Consequence Analysis of ADMET 2. The American Journal of Geriatric Psychiatry 2023. [DOI: 10.1016/j.jagp.2022.12.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Gaur A, Rivet L, Mah E, Bawa K, Gallagher D, Herrmann N, Lanctôt K. A meta-analysis of neurofilament light chain as a biomarker for mild cognitive impairment. The American Journal of Geriatric Psychiatry 2023. [DOI: 10.1016/j.jagp.2022.12.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Brown A, Spazzoli B, Mah E, May D, Chu J, Spelman T, Choong P, Di Bella C. Planned combined onco-plastic (COP) surgical approach improves oncologic outcomes in soft tissue sarcomas. Eur J Surg Oncol 2020; 47:443-449. [PMID: 32660707 DOI: 10.1016/j.ejso.2020.06.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/22/2020] [Accepted: 06/29/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Combined modality of radiotherapy and surgery is the standard of treatment of soft tissue sarcomas (STS). The goal of this study was to assess whether a Combined Onco-Plastic (COP) surgical approach in the setting of neo-adjuvant radiotherapy can improve the oncologic outcomes of STS and reduce the rate of wound complications. METHODS We performed a retrospective review of all patients with STS treated at a single sarcoma centre (St Vincent's Hospital, Melbourne) between 2007 and 2018. Patients were stratified into two groups based on whether they have received the COP approach or were closed primarily by the orthopaedic surgeon. We analysed oncological outcomes and rate of wound complications. RESULTS A total of 546 patients with comparable demographics and tumor characteristics were included. The COP approach was performed in 75.6% of the patients. Wide margins were obtained in 97.4% of the cases, and this was significantly higher in the COP group (p < 0.001). The cumulative rate of local recurrence was 4.9%, with a 52% risk reduction in the COP approach, although this reduction was not significant (HR = 0.48; 95% CI 0.21-1.06; p = 0.070). The COP approach had better disease free survival (DFS) (aHR 1.86, 95% CI 1.45-2.37; p < 0.001) and Overall survival (risk of death aHR 0.49; 95% CI 0.30-0.79; p = 0.004). The overall wound complication rate was 18.6% with no difference between the two groups. CONCLUSION A planned collaboration between the orthopaedic oncologist and the plastic surgeon is beneficial in the treatment of STS after neo-adjuvant radiotherapy, allowing remarkably good oncological outcomes and a low rate of wound complications.
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Affiliation(s)
- A Brown
- Department of Orthopaedics, Sarcoma Unit, St Vincent's Hospital, Melbourne, Australia
| | - B Spazzoli
- Department of Orthopaedics, Sarcoma Unit, St Vincent's Hospital, Melbourne, Australia; Rizzoli Orthopaedic Institute, Bologna, Italy
| | - E Mah
- Department of Plastic and Reconstructive Surgery, St Vincent's Hospital, Melbourne, Australia
| | - D May
- Department of Orthopaedics, Sarcoma Unit, St Vincent's Hospital, Melbourne, Australia
| | - J Chu
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Australia
| | - T Spelman
- Department of Surgery, The University of Melbourne, Australia
| | - P Choong
- Department of Orthopaedics, Sarcoma Unit, St Vincent's Hospital, Melbourne, Australia; Department of Surgery, The University of Melbourne, Australia
| | - C Di Bella
- Department of Orthopaedics, Sarcoma Unit, St Vincent's Hospital, Melbourne, Australia; Department of Surgery, The University of Melbourne, Australia.
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Nzana V, Oben T, Mah E, Ama Moor V, Teuwafeu D, Ashuntantang G. SUN-110 THE EFFECT OF PRETERM BIRTH ON BLOOD PRESSURE AND RENAL FUNCTION IN ADOLESCENTS AND YOUNG ADULTS IN YAOUNDE. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Chiabi A, Ngamgo Kamdem JC, Nkoro AG, Siyou H, Hamo S, Nguefack FD, Mah E, Nguefack S, Angwafo F. Facteurs de risques de l’érythème fessier du nourrisson à l’hôpital gynéco-obstétrique et pédiatrique de Yaoundé, Cameroun. Ann Dermatol Venereol 2019; 146:141-142. [DOI: 10.1016/j.annder.2018.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 04/03/2018] [Accepted: 07/31/2018] [Indexed: 10/27/2022]
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McMahon D, Mah E, Hynynen K. Angiogenic response of rat hippocampal vasculature to focused ultrasound-mediated increases in blood-brain barrier permeability. Sci Rep 2018; 8:12178. [PMID: 30111814 PMCID: PMC6093874 DOI: 10.1038/s41598-018-30825-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 08/06/2018] [Indexed: 01/12/2023] Open
Abstract
Focused ultrasound (FUS) and circulating microbubbles can induce a targeted and transient increase in blood-brain barrier permeability. While preclinical research has demonstrated the utility of FUS for efficacious drug deliver to the brain, there remain gaps in our knowledge regarding the long-term response of brain vasculature to this intervention. Previous work has demonstrated transcriptional changes in hippocampal microvessels following sonication that are indicative of the initiation of angiogenic processes. Moreover, blood vessel growth has been reported in skeletal muscle following application of FUS and microbubbles. The current study demonstrates that blood vessel density in the rat hippocampus is modestly elevated at 7 and 14 d post-FUS compared to the contralateral hemisphere (7 d: 10.9 ± 6.0%, p = 0.02; 14 d: 12.1 ± 3.2%, p < 0.01), but returns to baseline by 21 d (5.9 ± 2.6%, p = 0.12). Concurrently, relative newborn endothelial cell density and frequency of small blood vessel segments were both elevated in the sonicated hippocampus. While further work is required to determine the mechanisms driving these changes, the findings presented here may have relevance to the optimal frequency of repeated treatments.
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Affiliation(s)
- Dallan McMahon
- Sunnybrook Research Institute, Toronto, M4N 3M5, Canada. .,University of Toronto, Department of Medical Biophysics, Toronto, M4N 3M5, Canada.
| | - Ethan Mah
- Sunnybrook Research Institute, Toronto, M4N 3M5, Canada
| | - Kullervo Hynynen
- Sunnybrook Research Institute, Toronto, M4N 3M5, Canada.,University of Toronto, Department of Medical Biophysics, Toronto, M4N 3M5, Canada.,University of Toronto, Institute of Biomaterials and Biomedical Engineering, Toronto, M5S 3G9, Canada
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Nguefack S, Massi Gams D, Moifo B, Mah E, Chiabi A, Bogne JB, Mbonda PC, Tchokoteu PF, Mbonda E. [Clinical and etiological aspects of focal epilepsy in children at Yaoundé Gynaeco-obstetric Hospital (Cameroon)]. Mali Med 2014; 29:5-16. [PMID: 30049122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To describe the clinical and etiological aspects of child focal epilepsy at Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH) in Cameroon. PATIENTS AND METHODS It was a cross-sectional descriptive study carried out in pediatric neurology and epileptology unit of YGOPH from October 1st 2011 to March 30th 2012. We included 218 patients aged 0-16 years with a diagnosis of focal epilepsy in whom an electroencephalogram (EEG) was performed. The studied variables were epidemiological, etiological factors, type of epilepsy, EEG abnormalities, abnormalities in brain CT-scan, and probable etiology. RESULTS The sex ratio was 1.34 M/1F. The mean age of patients was 8 ± 4 years. In 58.71% (128/218) the onset of crises was before the age of five and decreased gradually until adolescence. The EEG showed an epileptic focus in 161 patients (73.85%). The main foci were centro-temporal (19.9%), frontal (19.2%), temporal (14.9%) and fronto-temporal (14.9%). The CT-scan was abnormal in 58 (56.86%) of 102 patients, who performed head CT-scan, with as major abnormalities, brain atrophy and after-effects lesions. Etiological factors were found in 76.15 % of patients, it was mainly neonatal asphyxia (21%), family history of epilepsy (20.6%) and febrile seizures (19.7%). Focal epilepsies were of structural (51.4%), genetic (24.3%) or unknown causes. Neurological abnormalities associated were more frequently in focal epilepsies of structural causes. CONCLUSION The focal child epilepsies are mostly of structural causes and preferentially temporal and/or frontal in location. The main etiological factors are family history of epilepsy and neonatal asphyxia.
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Affiliation(s)
- S Nguefack
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
| | - D Massi Gams
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
| | - B Moifo
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
- Service de radiologie-Hôpital gynéco-obstérique et pédiatrique de Yaoundé
| | - E Mah
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
| | - A Chiabi
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
| | - J B Bogne
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
| | - P C Mbonda
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
| | - P F Tchokoteu
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
| | - E Mbonda
- Service de pédiatrie et des sous spécialités pédiatriques- Hôpital gynéco-obstétrique et pédiatrique de Yaoundé
- Faculté de médicine et des sciences biomédicales- Université de Yaoundé I
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Nelson J, Christianson O, Harkness B, Madsen M, Mah E, Thomas S, Zaidi H, Samei E. SU-D-217A-03: Nuclear Medicine Uniformity Assessment Using 2D Noise Power Spectrum. Med Phys 2012; 39:3621. [DOI: 10.1118/1.4734700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
Actinomycosis is a rare cause of infection in the hand. We report a case of actinomycosis infection involving proximal phalanx, with the clinical presentation mimicking that of a bony neoplasm.
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Affiliation(s)
- E Mah
- Department of Surgery and Plastic and Reconstructive Surgery Unit, University of Melbourne, St Vincent Hospital Melbourne, Victoria 3065, Australia
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Moifo B, Nguefack S, Neossi Guena M, Mah E, Guegang Goudjou E, Mbonda E, Gonsu Fotsing J. [Clinical and CT-scan presentations in tuberous sclerosis complex: report of eight pediatric cases revealed by epilepsy]. Mali Med 2012; 27:51-56. [PMID: 22766009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To describe the clinical and CT-scan features of the Tuberous sclerosis complex (TSC) revealed in children by epilepsy. PATIENTS AND METHOD It was a cross sectional descriptive study carried out in the Yaounde Gyneco-Obstetric and Pediatric Hospital (YGOPH). Eight consecutive patients consulting for epilepsy between January 2005 and December 20010 with clinical and CT-scan diagnosis criteria of TSC were included in this study. RESULTS There were two girls and six boys (aged 25months to 14years) with drug-resistant epilepsy and characteristics skin lesions of TSC (hypomelanotic macules, angiofibroma of Pringle, shagreen patches). The delay between the onset of epileptic crisis and the diagnosis of TSC varied from 10 months to 6years. One case of renal involvement and another of ophthalmic involvement were found. Cerebral CT-scan was abnormal for each patient with calcified sub-ependymal nodules in 100%, cortical tubers in 5 patients (62.5%) and one suspicion of giant sub-ependymal atrocytoma. CONCLUSION Features of TSC are ruled by epilepsy, skin lesions, calcified sub-ependymal nodules and cortical tubers. Thus children presenting with epilepsy, should have a careful dermatological examination to search for TSC lesions. Cerebral CT-scan will afterwards seek for characteristic brain lesions.
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Affiliation(s)
- B Moifo
- Service de radiologie, Hopital Gyneco-obstetrique et pediatrique de Yaounde, Cameroun.
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Chiabi A, Kamga BG, Mah E, Bogne JB, Nguefack S, Fokam P, Tafen W, Tchokoteu PF. Breastfeeding practices in infants in the west region of cameroon. Iran J Public Health 2011; 40:11-7. [PMID: 23113068 PMCID: PMC3481777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 04/04/2011] [Indexed: 12/01/2022]
Abstract
BACKGROUND The study was conducted to evaluate the knowledge, attitudes and practices of breast-feeding in the West region of Cameroon. METHODS A cross sectional descriptive study was conducted in two health facilities on 195 mother-infant pairs, seen at the out patient and vaccination units of the Bafoussam Regional Hospital over a period of one month from 1(st) to 30(th) September 2008. The socio-demographic characteristics of mothers, knowledge on breastfeeding and the practice of breastfeeding were studied. Data was analyzed using the SPSS software. The chi square and student t- test were used for comparison and results considered significant for P< 0.05. RESULTS Breastfeeding was practised by 99.48% of the mothers. Only 33.8% of the mothers knew that they had to exclusively breastfeed up to 6 months, and 20% effectively breastfed up to 6 months. The mean duration of breastfeeding was 5.06 months and negatively correlated with the number of children and the profession of the mother. In 69.74% of the women, nothing was given to the baby before the first breastfeed. Discontinuation of breastfeeding was done averagely around 15.24 months and earlier in married women and in those with a higher educational level. CONCLUSION Although the majority of parents practised breast feeding, only a minority understood its benefits, so more should be done to educate the community on the benefits of exclusive breast-feeding for up to six months.
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Affiliation(s)
- A Chiabi
- Dept. of Pediatrics, Faculty of Medicine and Biomedical Sciences/Yaounde Gynaeco-Obstetric and Pediatric Hospital, Cameroon
| | - BG Kamga
- Dept. of Health Sciences, Higher Institute of Health Sciences, Bangangté, Cameroon
| | - E Mah
- Dept. of Pediatrics, Faculty of Medicine and Biomedical Sciences/Yaounde Gynaeco-Obstetric and Pediatric Hospital, Cameroon
| | - JB Bogne
- Pediatric Unit, Yaounde Gynaeco-Obstetric and Pediatric Hospital, Cameroon
| | - S Nguefack
- Dept. of Pediatrics, Faculty of Medicine and Biomedical Sciences/Yaounde Gynaeco-Obstetric and Pediatric Hospital, Cameroon
| | - P Fokam
- Dept. of Health Sciences, Higher Institute of Health Sciences, Bangangté, Cameroon
| | - W Tafen
- Pediatric Unit, Yaounde Gynaeco-Obstetric and Pediatric Hospital, Cameroon
| | - PF Tchokoteu
- Dept. of Pediatrics, Faculty of Medicine and Biomedical Sciences/Yaounde Gynaeco-Obstetric and Pediatric Hospital, Cameroon
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Naveed M, Huda W, Tipnis S, Mah E, Frey G. SU-E-I-78: CT Usage in Adult Patients at An Academic Medical Center: A Snapshot. Med Phys 2011. [DOI: 10.1118/1.3611652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Magill D, Huda W, He W, Tipnis S, Mah E, Frey G. SU-GG-I-89: Absorbed Dose to the Conceptus and Patient Size in X-Ray Projection Imaging. Med Phys 2010. [DOI: 10.1118/1.3468122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Mah E, Magill D, Huda W, Tipnis S. SU-GG-I-60: Radiation Risks in Nuclear Cardiac Imaging. Med Phys 2010. [DOI: 10.1118/1.3468093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tipnis S, Marzolf S, Frey G, Huda W, He W, Mah E, Yao H. SU-GG-I-52: Kerma Area Product and Energy Incident on Patients in X-Ray Imaging. Med Phys 2010. [DOI: 10.1118/1.3468085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tipnis S, Daniels W, Frey G, Huda W, He W, Mah E, Yao H. SU-GG-I-84: What Fraction of the Energy Incident on Patients Is Absorbed in X-Ray Imaging? Med Phys 2010. [DOI: 10.1118/1.3468117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Nguefack S, Ngo Kana C, Mah E, Kuate Tegueu C, Chiabi A, Fru F, Tchokoteu P, Mbonda E. Aspects cliniques, étiologiques et thérapeutiques des convulsions fébriles. À propos de 325 cas à Yaoundé. Arch Pediatr 2010; 17:480-5. [DOI: 10.1016/j.arcped.2010.02.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2009] [Revised: 12/16/2009] [Accepted: 02/14/2010] [Indexed: 10/19/2022]
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Hardin LV, Ravenel J, Gordon L, Huda W, Mah E. Radiation risks to lymphoma patients undergoing 18F-FDG studies. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e22024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22024 Background: To investigate radiation risks to patients undergoing 18F-FDG studies that take into account patient age, sex, and weight. Methods: We obtained patient demographics and weights of 54 consecutive patients with lymphoma who each underwent a18F-FDG PET study. The administered activity was converted into an effective dose using the patient size dependent dosimetry data provided in ICRP Publication 80. Patient effective doses were converted into estimates of the lifetime attributable risk of cancer incidence and cancer mortality using age and sex dependent risk factors provided in BEIR VII. Results: The average patient age/weight in this study was 43 years/68 kg for males and 33 years/61 kg for females. Patient effective dose are proportional to patient weight(-0.784) (r2 >0.99). The average administered activity was 410 MBq, which resulted in an average effective dose of 8.5 mSv for males and 8.9 mSv for females. The average cancer incidence was 0.71/1,000 cases for males, and 1.27/1,000 cases for females, with cancer mortality being about half the incidence. Cancer rates for the youngest patients were an order of magnitude higher than those for the oldest patients. Conclusions: Average lifetime attributable cancer risks to lymphoma patients from a single FDG-PET study is approximately 1 per 1,000, but are strongly influenced by patient age, gender and weight. Cancer risk in younger patients is a magnitude of order greater. No significant financial relationships to disclose.
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Affiliation(s)
- L. V. Hardin
- Medical University of South Carolina, Charleston, SC
| | - J. Ravenel
- Medical University of South Carolina, Charleston, SC
| | - L. Gordon
- Medical University of South Carolina, Charleston, SC
| | - W. Huda
- Medical University of South Carolina, Charleston, SC
| | - E. Mah
- Medical University of South Carolina, Charleston, SC
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Mah E, Brannan R. Reduction of Oil Absorption in Deep-Fried, Battered, and Breaded Chicken Patties Using Whey Protein Isolate as a Postbreading Dip: Effect on Flavor, Color, and Texture. J Food Sci 2009; 74:S9-S16. [DOI: 10.1111/j.1750-3841.2008.00973.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mah E, Price J, Brannan R. Reduction of Oil Absorption in Deep-Fried, Battered, and Breaded Chicken Patties Using Whey Protein Isolate as a Postbreading Dip: Effect on Lipid and Moisture Content. J Food Sci 2008; 73:S412-7. [DOI: 10.1111/j.1750-3841.2008.00902.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kwan A, Mah E, Boone J. SU-GG-I-46: An Automatic Region Detection Algorithm for Analyzing Module 1 of the ACR CT Accreditation Phantom. Med Phys 2008. [DOI: 10.1118/1.2961444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
PURPOSE To compare the results of Achilles tendon repair using a standard open procedure or a minimally invasive technique using a double-ended needle, and to determine whether the latter technique reduces the incidence of sural nerve injury and soft-tissue complications. METHODS Between the period February 1995 and September 2000 inclusive, 68 consecutive patients with acute Achilles tendon rupture underwent surgical repair in our hospitals. A standard open repair was performed on 43 patients (mean age 36 years and range 17-74 years, 30 males), while 25 patients (mean age 34 years and range 19-68 years, 17 males) elected to undergo the minimally invasive procedure involving a double-ended needle. Postoperative protocols were identical for the 2 groups. Patients were assessed for re-rupture, calf muscle strength, calf atrophy, wound healing, and ability to return to pre-injury activity. The mean follow-up period was 65.5 (range, 34-90) months. RESULTS One late re-rupture and one sural nerve injury occurred in the standard open repair group. No rerupture or sural nerve injury occurred in those having minimally invasive surgery, they also reported fewer complications related to wound healing and a shorter hospital stay. Calf atrophy was also significantly less in this group (p<0.05). CONCLUSION This double-ended needle repair technique is simple and reproducible. The needle is easy to make using a standard mini Steinmann pin with minimal cost. Combined with appropriate rehabilitation, the technique achieves good results and is associated with a low morbidity and complications.
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Affiliation(s)
- E S Ng
- Hospital Seremban, Malaysia
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Abstract
Recommended methods to test the performance of computed radiography (CR) digital radiographic systems have been recently developed by the AAPM Task Group No. 10. Included are tests for dark noise, uniformity, exposure response, laser beam function, spatial resolution, low-contrast resolution, spatial accuracy, erasure thoroughness, and throughput. The recommendations may be used for acceptance testing of new CR devices as well as routine performance evaluation checks of devices in clinical use. The purpose of this short communication is to provide a tabular summary of the tests recommended by the AAPM Task Group, delineate the technical aspects of the tests, suggest quantitative measures of the performance results, and recommend uniform quantitative criteria for the satisfactory performance of CR devices. The applicability of the acceptance criteria is verified by tests performed on CR systems in clinical use at five different institutions. This paper further clarifies the recommendations with respect to the beam filtration to be used for exposure calibration of the system, and the calibration of automatic exposure control systems.
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Affiliation(s)
- E Samei
- Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710, USA.
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Abstract
The pencil beam method of calculating dose distributions for electron-beam radiotherapy has been very useful, however, several limitations in the approach have been recognized. One such limitation is the lack of a mechanism to model range straggling of electrons. For stationary electron-beam calculations, range straggling is incorporated incompletely in the planar-fluence-to-dose conversion factor, which uses measured percentage depth dose curves to force the calculated percentage depth dose to reproduce the measurement. When calculating the dose distribution for an arced beam using a pencil beam algorithm, insufficient modeling of the pencil beams leads to larger errors than when using a stationary beam algorithm. The calculated depth of maximum dose is systematically over-estimated by the pencil beam calculations. We will show that the lack of a way to account for range straggling in the arc-electron pencil beam calculation is primarily responsible for this discrepancy. Methods of incorporating range straggling into the electron pencil beam dose calculation have been presented before, but no data have been shown to support their use for heterogeneous phantoms (patients). This paper presents a similar range-straggling modification, as well as data to show that this model can predict pencil beam width to within 20% for heterogeneous slab phantoms. For stationary electron-beam calculations, the calculated isodose lines follows the measured isodose lines to within 1 mm down to the 10% dose level.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J A Antolak
- Cross Cancer Institute, Edmonton, Alberta, Canada
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Antolak JA, Scrimger JW, Mah E. Optimization of a cord shielding technique for electrons. Australas Phys Eng Sci Med 1992; 15:91-4. [PMID: 1642576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Large anterior electron fields are sometimes used to irradiate the neck when treating head & neck tumors. To offer a degree of spinal cord shielding, wax bolus, approximately the width of the vertebral bodies, is placed on the immobilization shell. The thickness of the bolus is adjusted so that the radiological depth of the anterior edge of the vertebral bodies is equal to the R80 depth for the energy used. This approach ignores electron scattering. Using a CT study of a thyroid cancer patient, neck contours were generated at 0.5 cm intervals and entered into the Alberta Treatment Planning system. Internal contours for the trachea and vertebral bodies were added and CT information was used for treatment planning purposes. The bolus outline was added as described above, and the dose calculated using a 3D implementation of the M.D. Anderson (Hogstrom) algorithm. The calculation shows that the simple bolus technique described above is inappropriate. The spinal cord is adequately shielded, but the target volume is not covered by the 80% isodose line. Qualitatively, the results can be explained by the lateral scatter non-equilibrium introduced by the bolus. By iteratively adjusting the shape and thickness of the wax bolus and recalculating the dose distribution, we were able to better fulfill the dose prescription. Comparison with measured data shows reasonable, but not perfect agreement. In conclusion, electron beam treatments must be examined closely to ensure that the treatment goals are met. In some cases, treatment integrity may be compromised by incorrect assumptions regarding the nature of the electron transport and dose deposition.
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Affiliation(s)
- J A Antolak
- Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta, Canada
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Abstract
In the commissioning or quality assurance of a medical linear accelerator or a computerized radiotherapy planning system, the traditional approach usually consists of acquiring and comparing one-dimensional dose profiles. This methodology is tedious and incomplete since only a portion of the radiation field can realistically be sampled. We have developed an automated measurement system which allows efficient measurement and display of complete two-dimensional dose distributions. The general purpose microcomputer used (IBM PC/XT compatible) can be interfaced economically to any water phantom dosimetry system equipped with a three axis scan controller, and can also communicate data to the treatment planning system. This allows for direct comparison of measured with computed dose distributions, thus revealing discrepancies in the dose computation algorithms used. In this paper, we describe the interface between the microcomputer, a conventional water dosimetry system (Therados RFA-3), and a treatment planning computer. We report our early experience with acquiring dose distributions and show sample comparisons with computed results for megavoltage electron beams incident on homogeneous and heterogeneous systems.
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Affiliation(s)
- J Antolak
- Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta, Canada
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Cygler J, Battista JJ, Scrimger JW, Mah E, Antolak J. Electron dose distributions in experimental phantoms: a comparison with 2D pencil beam calculations. Phys Med Biol 1987; 32:1073-86. [PMID: 3671495 DOI: 10.1088/0031-9155/32/9/001] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Dose distributions were measured and computed within inhomogeneous phantoms irradiated with beams of electrons having initial energies of 10 and 18 MeV. The measurements were made with a small p-type silicon diode and the calculations were performed using the pencil beam algorithm developed originally at the M D Anderson Hospital (MDAH). This algorithm, which is available commercially on many radiotherapy planning computers, is based on the Fermi-Eyges theory of electron transport. The phantoms used in this work were composed of water into which two- and three-dimensional inhomogeneities of aluminum and air (embedded in wax) were introduced. This was done in order to simulate the small bones and the air cavities encountered clinically in radiation therapy of the chest wall or neck. Our intent was to test the adequacy of the two-dimensional implementation of the pencil beam approach. The agreement between measured and computed doses is very good for inhomogeneities which are essentially two-dimensional but discrepancies as large as 40% were observed for more complex three-dimensional inhomogeneities. We can only trace the discrepancies to the complex interplay of numerous approximations in the Fermi-Eyges theory of multiple scattering and its adaptation for practical computer-aided radiotherapy planning.
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Affiliation(s)
- J Cygler
- Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta, Canada
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Abstract
Treatment of (3,4-dihydro-4-hydroxy-3-oxo-2H-1,4-benzothiazin-2-yl)acetic acid (1a) with sodium hydroxide yields the corresponding lactam, i.e. (3,4-dihydro-3-oxo-2H-1,4-benzothiazin-2-yl)acetic acid, together with the α,β-unsaturated acid, 3,4-dihydro-3-oxo-2H-1,4-benzothiazine-Δ2,α-acetic acid. The 6-methyl- and 6-bromo-derivatives of 1a behaved similarly when reacted with sodium hydroxide but when 3,4-dihydro-4-hydroxy-3-oxo-2H-1,4-benzothiazine was so treated a more complex reaction occurred.Methyl (6-bromo-3,4-dihydro-4-hydroxy-3-oxo-2H-1,4-benzothiazin-2-yl)acetate was also treated with hydrochloric acid. The two products isolated were (6-bromo-3,4-dihydro-3-oxo-2H-1,4-benzothiazin-2-yl)acetic acid and (6-bromo-7-chloro-3,4-dihydro-3-oxo-2H-1,4-benzothiazin-2-yl)acetic acid.The action of hydrochloric acid on 3,4-dihydro-4-hydroxy-7-methyl-3-oxo-2H-1,4-benzothiazine also gave two products. One was the corresponding lactam; the other was unexpected and has been tentatively identified as bis[2-(3,4-dihydro-7-methyl-3-oxo-2H-1,4-benzothiazine].
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Abstract
The preparation and the mass spectra of the title compounds are discussed.
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