Preoperative comprehensive geriatric assessment and multidisciplinary team input in older people undergoing elective orthopaedic surgery: A feasibility trial.

Objective: To determine the feasibility of preoperative comprehensive geriatric assessment (CGA) and multidisciplinary team (MDT) input for older people undergoing elective orthopaedic surgery in a tertiary New Zealand setting.

Methods: This single-centre retrospective study included elective orthopaedic patients older than 65 years (and Māori/Pasifika aged greater than 55 years) with hyperpolypharmacy, frailty, neurocognitive disorders and poor functional status. Patients attended a preoperative clinic where they had a geriatrician-led CGA along with MDT input.

Effects of pollution on marine organisms.

This review covers selected 2019 articles on the biological effects of pollutants, including human physical disturbances, on marine and estuarine plants, animals, ecosystems, and habitats. The review, based largely on journal articles, covers field, and laboratory measurement activities (bioaccumulation of contaminants, field assessment surveys, toxicity testing, and biomarkers) as well as pollution issues of current interest including endocrine disrupters, emerging contaminants, wastewater discharges, marine debris, dredging, and disposal. Special emphasis is placed on effects of oil spills and marine debris due largely to the 2010 Deepwater Horizon oil blowout in the Gulf of Mexico and proliferation of data on the assimilation and effects of marine debris microparticulates.

Effects of pollution on marine organisms.

This review covers selected 2018 articles on the biological effects of pollutants, including human physical disturbances, on marine and estuarine plants, animals, ecosystems, and habitats. The review, based largely on journal articles, covers field and laboratory measurement activities (bioaccumulation of contaminants, field assessment surveys, toxicity testing, and biomarkers) as well as pollution issues of current interest including endocrine disrupters, emerging contaminants, wastewater discharges, marine debris, dredging, and disposal. Special emphasis is placed on effects of oil spills and marine debris due largely to the 2010 Deepwater Horizon oil blowout in the Gulf of Mexico and proliferation of data on the assimilation and effects of marine debris.

Effects of Pollution on Marine Organisms.

This review covers selected 2017 articles on the biological effects of pollutants and human physical disturbances on marine and estuarine plants, animals, ecosystems and habitats. The review, based largely on journal articles, covers field and laboratory measurement activities (bioaccumulation of contaminants, field assessment surveys, toxicity testing and biomarkers) as well as pollution issues of current interest including endocrine disrupters, emerging contaminants, wastewater discharges, marine debris, dredging and disposal etc. Special emphasis is placed on effects of oil spills and marine debris due largely to the 2010 Deepwater Horizon oil blowout in the Gulf of Mexico and proliferation of data on the assimilation and effects of marine debris microparticulates.

Effects of Pollution on Marine Organisms.

This review covers selected 2016 articles on the biological effects of pollutants and human physical disturbances on marine and estuarine plants, animals, ecosystems and habitats. The review, based largely on journal articles, covers field and laboratory measurement activities (bioaccumulation of contaminants, field assessment surveys, toxicity testing and biomarkers) as well as pollution issues of current interest including endocrine disrupters, emerging contaminants, wastewater discharges, dredging and disposal etc. Special emphasis is placed on effects of oil spills and marine debris due largely to the 2010 Deepwater Horizon oil blowout in the Gulf of Mexico.

Effects of Pollution on Marine Organisms.

This review covers selected 2015 articles on the biological effects of pollutants and human physical disturbances on marine and estuarine plants, animals, ecosystems and habitats. The review, based largely on journal articles, covers field and laboratory measurement activities (bioaccumulation of contaminants, field assessment surveys, toxicity testing and biomarkers) as well as pollution issues of current interest including endocrine disrupters, emerging contaminants, wastewater discharges, dredging and disposal, etc. Special emphasis is placed on effects of oil spills and marine debris due largely to the 2010 Deepwater Horizon oil blowout in the Gulf of Mexico.

Effects of Pollution on Marine Organisms.

This review covers selected 2014 articles on the biological effects of pollutants and human physical disturbances on marine and estuarine plants, animals, ecosystems and habitats. The review, based largely on journal articles, covers field and laboratory measurement activities (bioaccumulation of contaminants, field assessment surveys, toxicity testing and biomarkers) as well as pollution issues of current interest including endocrine disrupters, emerging contaminants, wastewater discharges, dredging and disposal, etc. Special emphasis is placed on effects of oil spills and marine debris due in part to the 2010 Deepwater Horizon oil blowout in the Gulf of Mexico and the 2011 Japanese tsunami.

Improving environmental assessments by integrating Species Sensitivity Distributions into environmental modeling: examples with two hypothetical oil spills.

A three dimensional (3D) trajectory model was used to simulate oil mass balance and environmental concentrations of two 795,000 L hypothetical oil spills modeled under physical and chemical dispersion scenarios. Species Sensitivity Distributions (SSD) for Total Hydrocarbon Concentrations (THCs) were developed, and Hazard Concentrations (HC) used as levels of concern. Potential consequences to entrained water column organisms were characterized by comparing model outputs with SSDs, and obtaining the proportion of species affected (PSA) and areas with oil concentrations exceeding HC5s (Area ⩾ HC5).

Effectiveness and potential ecological effects of offshore surface dispersant use during the Deepwater Horizon oil spill: a retrospective analysis of monitoring data.

The Special Monitoring of Applied Response Technologies (SMART) program was used during the Deepwater Horizon oil spill as a strategy to monitor the effectiveness of sea surface dispersant use. Although SMART was implemented during aerial and vessel dispersant applications, this analysis centers on the effort of a special dispersant missions onboard the M/V International Peace, which evaluated the effectiveness of surface dispersant applications by vessel only. Water samples (n = 120) were collected from background sites, and under naturally and chemically dispersed oil slicks, and were analyzed for polycyclic aromatic hydrocarbons (TPAHs), total petroleum hydrocarbons (TPH), and a chemical marker of Corexit (dipropylene glycol n-butyl ether, DPnB).

Mediastinal tuberculosis in Bradford, United Kingdom: the role of mediastinoscopy.

Objective: To evaluate patients with mediastinal tuberculosis (MT), their demographic profiles, symptoms, radiological features and the role of mediastinoscopy.

Methods: This retrospective study conducted at Bradford Teaching Hospitals, Bradford, United Kingdom, looked at the case notes of 160 (13%) patients with MT out of a cohort of 1252 notifications of tuberculosis (TB) cases from 1995 to 2004, analysing the demographic data, diagnostic findings, computed tomography (CT) scans and outcomes. Interventions included bronchoscopy, lymph node biopsy and mediastinoscopy.

Membrane type matrix metalloproteinases (MMPs) show differential expression in non-small cell lung cancer (NSCLC) compared to normal lung: correlation of MMP-14 mRNA expression and proteolytic activity.

Improved understanding of the involvement of matrix metalloproteinases (MMPs), including membrane-type MMPs (MT-MMPs), in human tumours has potential diagnostic, prognostic and therapeutic implications. We assessed the relationship between MT-MMP expression and clinicopathological parameters in human non-small cell lung cancer (NSCLC) and histologically normal lung tissue by quantitative Real Time PCR (qRT-PCR). All MT-MMPs (MMPs 14-17, 24 and 25) were detected by qRT-PCR with significantly higher MMP-14, -15 and -17 expression observed in tumour relative to normal lung specimens.

The significance of dilution in evaluating possible impacts of wastewater discharges from large cruise ships.

In response to public concerns about discharges from large cruise ships, Alaska's Department of Environmental Conservation (ADEC) sampled numerous effluents in the summer of 2000. The data showed that basic marine sanitation device (MSD) technology for black water (sewage) was not performing as expected. Untreated gray water had high levels of conventional pollutants and surprisingly high levels of bacteria.

MMP-10 is overexpressed, proteolytically active, and a potential target for therapeutic intervention in human lung carcinomas.

Matrix metalloproteinase (MMP)-mediated degradation of the extracellular matrix is a major factor for tumor development and expansion. This study analysed MMP-10 protein expression and activity in human lung tumors of various grade, stage, and type to address the relationship between MMP-10 and tumor characteristics and to evaluate MMP-10 as a therapeutic target in non small cell lung carcinoma (NSCLC). Unlike the majority of MMPs, MMP-10 was located in the tumor mass as opposed to tumor stroma.

A prospective, randomized comparison of preoperative and continuous balanced epidural or paravertebral bupivacaine on post-thoracotomy pain, pulmonary function and stress responses.

Both epidural and paravertebral blocks are effective in controlling post-thoracotomy pain, but comparison of preoperative and balanced techniques, measuring pulmonary function and stress responses, has not been undertaken previously. We studied 100 adult patients, premedicated with morphine and diclofenac, allocated randomly to receive thoracic epidural bupivacaine or thoracic paravertebral bupivacaine as preoperative bolus doses followed by continuous infusions. All patients also received diclofenac and patient-controlled morphine.

Pleural bupivacaine placement for optimal postthoracotomy pulmonary function: a prospective, randomized study.

Objective: To determine dependent chest tube losses of bupivacaine with paravertebral versus interpleural administration, thereby helping to explain the significant differences in pulmonary function that exist between these two techniques.

Design: A prospective, randomized study.

Setting: A single hospital.

Continuous paravertebral block for post thoracotomy analgesia in children.

The use of continuous paravertebral analgesia was studied in 15 children with a mean age of 9.8 years (2-16 years). Nine patients received pre-emptive and postoperative paravertebral analgesia while six children studied earlier in the series received only post operative paravertebral analgesia.

Surgical treatment of primary malignant chest wall tumours.

Objective: Primary malignant tumours of the bony chest wall are uncommon and data concerning treatment and results are sparse.

Methods: To assess the results of surgical resection and chest wall reconstruction we reviewed our experience with primary malignant chest wall tumours treated since 1958.

Results: Of the 49 lesions, 42 were found in the ribs and the remaining 7 in the sternum.

Chest wall resection and reconstruction.

Chest wall reconstruction may be required after resection of malignant tumours, radiation injuries, massive trauma or infection. The ideal reconstruction should provide enough stability in the chest wall to allow adequate, spontaneous ventilation, while protecting intrathoracic organs, and be cosmetically acceptable. Recent developments have enabled the reconstruction of defects of almost any size with minimal functional disturbance.

Results of surgical treatment of oesophageal cancer.

Oesophagogastrectomy is the best available treatment for patients with carcinoma of the oesophagus or cardia. A retrospective analysis of our experience with 485 patients who were treated surgically forms the basis of this report. Of the 317 patients who underwent resection (resectability rate of 65%) only 210 were considered to be potentially curative.

Stenting in malignant obstruction of superior vena cava.

The treatment of patients with malignant superior vena caval obstruction with minimal morbidity has been made possible by the recent introduction of expandable metal stents as the sole palliative treatment or as an adjunct to other treatment modalities. To alleviate the distressing symptoms of superior vena caval obstruction, self-expanding metal stents were used successfully in 12 (Wallstent device in 6 and Gianturco device in 6 patients) of 13 patients. The diagnoses were small cell carcinoma (n = 4), squamous cell carcinoma (n = 4), non-Hodgkin's lymphoma (n = 1), and mesothelioma (n = 1), and a diagnosis of malignancy was not confirmed (although strongly suspected) in the remaining three cases.

Tumor embolism to LAD during pneumonectomy. A case report.

Arterial embolization from bronchogenic carcinoma is a rare complication and more commonly occurs intraoperatively during pneumonectomy. We report an unusual case of intraoperative tumour embolism to LAD (left anterior descending artery) and aorta during left pneumonectomy due to tumour involvement of the inferior pulmonary vein. High risk cases should be evaluated by preoperative transesophageal echocardiography.

Results of surgical treatment of stage I and II lung cancer.

Pulmonary resection remains the most appropriate treatment for localised bronchogenic carcinoma, since prognosis and outcome are currently dependent on surgical resectability. A retrospective analysis of our experience with three hundred and thirteen stage I (n=250) and stage II (n=63) patients treated surgically form the basis of this report. The initial pulmonary resection was lobectomy in 173 patients, bilobectomy in 38, sleeve lobectomy in 12, pneumonectomy in 59, wedge excision or segmentectomy in 31.

Traumatic rupture of diaphragm.

Traumatic diaphragmatic rupture remains a diagnostic challenge, and associated injuries determine the outcome in those diagnosed early, whereas that of latent cases is dependent on the consequence of the diaphragmatic rupture: namely, the diaphragmatic hernia. To analyze the clinical and radiologic features and the therapeutic implications, we reviewed 980 patients reported in the English-language literature. This injury affects predominantly males (male:female = 4:1) in the third decade of life, and is often caused by blunt trauma (75%).