1
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Corchis-Scott R, Geng Q, Seth R, Ray R, Beg M, Biswas N, Charron L, Drouillard KD, D'Souza R, Heath DD, Houser C, Lawal F, McGinlay J, Menard SL, Porter LA, Rawlings D, Scholl ML, Siu KWM, Tong Y, Weisener CG, Wilhelm SW, McKay RML. Averting an Outbreak of SARS-CoV-2 in a University Residence Hall through Wastewater Surveillance. Microbiol Spectr 2021; 9:e0079221. [PMID: 34612693 DOI: 10.1101/2021.06.23.21259176] [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] [Indexed: 05/26/2023] Open
Abstract
A wastewater surveillance program targeting a university residence hall was implemented during the spring semester 2021 as a proactive measure to avoid an outbreak of COVID-19 on campus. Over a period of 7 weeks from early February through late March 2021, wastewater originating from the residence hall was collected as grab samples 3 times per week. During this time, there was no detection of SARS-CoV-2 by reverse transcriptase quantitative PCR (RT-qPCR) in the residence hall wastewater stream. Aiming to obtain a sample more representative of the residence hall community, a decision was made to use passive samplers beginning in late March onwards. Adopting a Moore swab approach, SARS-CoV-2 was detected in wastewater samples just 2 days after passive samplers were deployed. These samples also tested positive for the B.1.1.7 (Alpha) variant of concern (VOC) using RT-qPCR. The positive result triggered a public health case-finding response, including a mobile testing unit deployed to the residence hall the following day, with testing of nearly 200 students and staff, which identified two laboratory-confirmed cases of Alpha variant COVID-19. These individuals were relocated to a separate quarantine facility, averting an outbreak on campus. Aggregating wastewater and clinical data, the campus wastewater surveillance program has yielded the first estimates of fecal shedding rates of the Alpha VOC of SARS-CoV-2 in individuals from a nonclinical setting. IMPORTANCE Among early adopters of wastewater monitoring for SARS-CoV-2 have been colleges and universities throughout North America, many of whom are using this approach to monitor congregate living facilities for early evidence of COVID-19 infection as an integral component of campus screening programs. Yet, while there have been numerous examples where wastewater monitoring on a university campus has detected evidence for infection among community members, there are few examples where this monitoring triggered a public health response that may have averted an actual outbreak. This report details a wastewater-testing program targeting a residence hall on a university campus during spring 2021, when there was mounting concern globally over the emergence of SARS-CoV-2 variants of concern, reported to be more transmissible than the wild-type Wuhan strain. In this communication, we present a clear example of how wastewater monitoring resulted in actionable responses by university administration and public health, which averted an outbreak of COVID-19 on a university campus.
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Affiliation(s)
- Ryland Corchis-Scott
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Qiudi Geng
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Rajesh Seth
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- Civil and Environmental Engineering, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Rajan Ray
- Civil and Environmental Engineering, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Mohsan Beg
- Student Counselling Centre, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Nihar Biswas
- Civil and Environmental Engineering, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Lynn Charron
- Residence Services, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Kenneth D Drouillard
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Ramsey D'Souza
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - Daniel D Heath
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- Department of Integrative Biology, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Chris Houser
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Felicia Lawal
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - James McGinlay
- Residence Services, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Sherri Lynne Menard
- Environmental Health and Safety, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Lisa A Porter
- Department of Biomedical Sciences, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Diane Rawlings
- Residence Services, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Matthew L Scholl
- Student Health Services, University of Windsorgrid.267455.7University of Windsor, grid.267455.7, Windsor, Ontario, Canada
| | - K W Michael Siu
- Department of Chemistry and Biochemistry, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Yufeng Tong
- Department of Chemistry and Biochemistry, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Christopher G Weisener
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
| | - Steven W Wilhelm
- Department of Microbiology, The University of Tennessee, Knoxville, Tennessee, USA
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
| | - R Michael L McKay
- Great Lakes Institute for Environmental Research, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- School of the Environment, University of Windsorgrid.267455.7, Windsor, Ontario, Canada
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
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2
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Corchis-Scott R, Geng Q, Seth R, Ray R, Beg M, Biswas N, Charron L, Drouillard KD, D’Souza R, Heath DD, Houser C, Lawal F, McGinlay J, Menard SL, Porter LA, Rawlings D, Scholl ML, Siu KWM, Tong Y, Weisener CG, Wilhelm SW, McKay RML. Averting an Outbreak of SARS-CoV-2 in a University Residence Hall through Wastewater Surveillance. Microbiol Spectr 2021; 9:e0079221. [PMID: 34612693 PMCID: PMC8510253 DOI: 10.1128/spectrum.00792-21] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/06/2021] [Indexed: 12/23/2022] Open
Abstract
A wastewater surveillance program targeting a university residence hall was implemented during the spring semester 2021 as a proactive measure to avoid an outbreak of COVID-19 on campus. Over a period of 7 weeks from early February through late March 2021, wastewater originating from the residence hall was collected as grab samples 3 times per week. During this time, there was no detection of SARS-CoV-2 by reverse transcriptase quantitative PCR (RT-qPCR) in the residence hall wastewater stream. Aiming to obtain a sample more representative of the residence hall community, a decision was made to use passive samplers beginning in late March onwards. Adopting a Moore swab approach, SARS-CoV-2 was detected in wastewater samples just 2 days after passive samplers were deployed. These samples also tested positive for the B.1.1.7 (Alpha) variant of concern (VOC) using RT-qPCR. The positive result triggered a public health case-finding response, including a mobile testing unit deployed to the residence hall the following day, with testing of nearly 200 students and staff, which identified two laboratory-confirmed cases of Alpha variant COVID-19. These individuals were relocated to a separate quarantine facility, averting an outbreak on campus. Aggregating wastewater and clinical data, the campus wastewater surveillance program has yielded the first estimates of fecal shedding rates of the Alpha VOC of SARS-CoV-2 in individuals from a nonclinical setting. IMPORTANCE Among early adopters of wastewater monitoring for SARS-CoV-2 have been colleges and universities throughout North America, many of whom are using this approach to monitor congregate living facilities for early evidence of COVID-19 infection as an integral component of campus screening programs. Yet, while there have been numerous examples where wastewater monitoring on a university campus has detected evidence for infection among community members, there are few examples where this monitoring triggered a public health response that may have averted an actual outbreak. This report details a wastewater-testing program targeting a residence hall on a university campus during spring 2021, when there was mounting concern globally over the emergence of SARS-CoV-2 variants of concern, reported to be more transmissible than the wild-type Wuhan strain. In this communication, we present a clear example of how wastewater monitoring resulted in actionable responses by university administration and public health, which averted an outbreak of COVID-19 on a university campus.
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Affiliation(s)
- Ryland Corchis-Scott
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
| | - Qiudi Geng
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
| | - Rajesh Seth
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- Civil and Environmental Engineering, University of Windsor, Windsor, Ontario, Canada
| | - Rajan Ray
- Civil and Environmental Engineering, University of Windsor, Windsor, Ontario, Canada
| | - Mohsan Beg
- Student Counselling Centre, University of Windsor, Windsor, Ontario, Canada
| | - Nihar Biswas
- Civil and Environmental Engineering, University of Windsor, Windsor, Ontario, Canada
| | - Lynn Charron
- Residence Services, University of Windsor, Windsor, Ontario, Canada
| | - Kenneth D. Drouillard
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
| | - Ramsey D’Souza
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - Daniel D. Heath
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- Department of Integrative Biology, University of Windsor, Windsor, Ontario, Canada
| | - Chris Houser
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
| | - Felicia Lawal
- Windsor-Essex County Health Unit, Windsor, Ontario, Canada
| | - James McGinlay
- Residence Services, University of Windsor, Windsor, Ontario, Canada
| | - Sherri Lynne Menard
- Environmental Health and Safety, University of Windsor, Windsor, Ontario, Canada
| | - Lisa A. Porter
- Department of Biomedical Sciences, University of Windsor, Windsor, Ontario, Canada
| | - Diane Rawlings
- Residence Services, University of Windsor, Windsor, Ontario, Canada
| | - Matthew L. Scholl
- Student Health Services, University of Windsor, Windsor, Ontario, Canada
| | - K. W. Michael Siu
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, Ontario, Canada
| | - Yufeng Tong
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, Ontario, Canada
| | - Christopher G. Weisener
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
| | - Steven W. Wilhelm
- Department of Microbiology, The University of Tennessee, Knoxville, Tennessee, USA
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
| | - R. Michael L. McKay
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, Canada
- School of the Environment, University of Windsor, Windsor, Ontario, Canada
- Great Lakes Center for Fresh Waters and Human Health, Bowling Green State University, Bowling Green, Ohio, USA
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Houser C, Vlodarchyk B. Impact of COVID-19 on drowning patterns in the Great Lakes region of North America. Ocean Coast Manag 2021; 205:105570. [PMID: 36570822 PMCID: PMC9759726 DOI: 10.1016/j.ocecoaman.2021.105570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/15/2021] [Accepted: 02/09/2021] [Indexed: 05/10/2023]
Abstract
The COVID-19 pandemic significantly altered personal and group behaviors that may directly or indirectly affect other public health issues. This paper examines if and how COVID-19 indirectly influenced beach safety and drownings within the Great Lakes region using daily drowning data from 2020 in comparison to historical trends in drownings pre-COVID. Results suggest that the number of beach drownings in the Great Lakes region was significantly greater compared to the pre-COVID period of 2010-2019. Statistically significant increases in drownings were observed in Lake Michigan (+14), Lake Ontario (+11) and Lake Huron (+4), while no change and a slight decrease was observed in Lake Superior and Lake Erie respectively. Drownings were lower than the historical average early in the pandemic but began to increase as stay-at-home orders were lifted through June and July. It is argued that the increase in drowning is due to a combination of reduced local lifeguard resources, cancelled swimming lessons, large beach crowds, warm weather, high-water levels and self-isolation fatigue. Whether in the Great Lakes region or elsewhere around the world, beach safety cannot be sacrificed in a future public health emergency by budget cuts or by reducing the focus of lifeguards with enforcement of social distancing.
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Affiliation(s)
- Chris Houser
- School of the Environment, University of Windsor, Windsor, Ontario, N9C 2J9, Canada
- Great Lakes Institute for Environmental Research, University of Windsor, Windsor, Ontario, N9C 2J9, Canada
| | - Brent Vlodarchyk
- School of the Environment, University of Windsor, Windsor, Ontario, N9C 2J9, Canada
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Keller A, Rodríguez-López J, Patel A, Kim H, Houser C, Sukumvanich P, Berger J, Boisen M, Edwards R, Taylor S, Courtney-Brooks M, Olawaiye A, Orr B, Beriwal S. PO-0178 Feasibility and Outcomes for Cervical Cancer Patients Treated with Hybrid Brachytherapy Applicators. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06337-4] [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: 10/21/2022]
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5
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Houser C, Nunez J, Miller K. Pathways to the geosciences through 2YR community colleges: A strategic recruitment approach being used at Texas A&M University. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/10899995.2018.1412189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Chris Houser
- College of Geosciences, Texas A&M University, College Station, Texas 77845-3148
| | - Judy Nunez
- College of Geosciences, Texas A&M University, College Station, Texas 77845-3148
| | - Kate Miller
- College of Geosciences, Texas A&M University, College Station, Texas 77845-3148
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Watson J, Bhat R, Izzo J, Blumenthal J, Hoffman D, Descallar E, Houser C, Booker E. 325 Telemedicine Model of Physician Intake Decreases Door-to-Provider Time. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Barrineau P, Wernette P, Weymer B, Trimble S, Hammond B, Houser C. The Critical Zone of Coastal Barrier Systems. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/b978-0-444-63369-9.00016-1] [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: 03/17/2023]
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8
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Gill BS, Kim H, Houser C, Olsen A, Kelley J, Edwards RP, Comerci J, Sukumvanich P, Olawaiye AB, Huang M, Courtney-Brooks M, Beriwal S. Image-based three-dimensional conformal brachytherapy for medically inoperable endometrial carcinoma. Brachytherapy 2014; 13:542-7. [DOI: 10.1016/j.brachy.2014.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/27/2014] [Accepted: 07/08/2014] [Indexed: 10/24/2022]
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9
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Gill B, Kim H, Houser C, Hosseinzadeh K, Beriwal S. Clinical Outcomes for 3D High-Dose-Rate Intracavitary Brachytherapy With MRI-Based Planning for the Treatment of Cervical Cancer. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.084] [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: 10/26/2022]
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10
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Kim H, Rajagopalan MS, Houser C, Beriwal S. Dosimetric comparison of multichannel with one single-channel vaginal cylinder for vaginal cancer treatments with high-dose-rate brachytherapy. Brachytherapy 2013; 13:263-7. [PMID: 24080298 DOI: 10.1016/j.brachy.2013.08.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 08/15/2013] [Accepted: 08/22/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare the three-dimensional (3D) image (CT/MR)-based planning with a multichannel vaginal cylinder (MVC) to a single-channel vaginal cylinder (SVC) for the treatment of vaginal cancer. METHODS AND MATERIALS A total of 20 consecutive patients were treated with 3D CT/MR image-based high-dose-rate (HDR) brachytherapy using an MVC. All patients received external beam radiation therapy before HDR brachytherapy. A brachytherapy dose of 20-25Gy of more than five fractions was delivered to clinical target volume (CTV). Retrospectively, treatment plans for all patients were generated using the central channel only to mimic an SVC applicator. The SVC plans were optimized to match CTV coverage with MVC plans. Dose homogeneity index as well as bladder, rectum, sigmoid, and urethral doses were compared. RESULTS The mean D90 for CTV was 74.2Gy (range: 48.8-84.1Gy). The mean (±standard deviation) of dose homogeneity index for MVC vs. SVC was 0.49 (±0.19) and 0.52 (±0.23), respectively (p=0.09). Mean bladder 0.1, 1, and 2cc doses for MVC vs. SVC were 69 vs. 71.2Gy (p=0.35), 61.4 vs. 63.8Gy (p=0.1), and 59.5 vs. 60.9Gy (p=0.31), respectively. Similarly, mean rectum 0.1, 1, and 2cc doses for MVC vs. SVC were 67.2 vs. 75.4Gy (p=0.005), 60.0 vs. 65.6Gy (p=0.008), and 57.3 vs. 62.0Gy (p=0.015), respectively, and mean sigmoid doses were 56.3 vs. 60.5Gy (p=0.10), 50.9 vs. 53.1Gy (p=0.09), and 49.1 vs. 50.7Gy (p=0.10), respectively. CONCLUSION The 3D CT-/MR-based plan with MVC may provide better dose distribution in the management of certain clinical situations of vaginal cancer requiring intracavitary brachytherapy, especially in minimizing potential late rectal complications.
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Affiliation(s)
- Hayeon Kim
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Magee-Womens Hospital, Pittsburgh, PA
| | - Malolan S Rajagopalan
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Magee-Womens Hospital, Pittsburgh, PA
| | - Chris Houser
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Magee-Womens Hospital, Pittsburgh, PA
| | - Sushil Beriwal
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Magee-Womens Hospital, Pittsburgh, PA.
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Kim H, Kim C, Houser C, Vargo JA, Beriwal S. Dosimetric Comparison of Multi-Channel Vaginal Cylinder High-Dose-Rate Brachytherapy to One Single Channel Vaginal Cyliner for Patients with Vaginal Cancer. Brachytherapy 2013. [DOI: 10.1016/j.brachy.2013.01.117] [Citation(s) in RCA: 3] [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] [Indexed: 11/28/2022]
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12
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Kannan N, Kim H, Houser C, Beriwal S. Is There an Advantage to Delivering Breast Boost in the Lateral Decubitus Position? Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.585] [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]
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13
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Kim C, Beriwal S, Benoit R, Houser C, Smith R. Is There a Secondary Spike in Urinary Symptoms With Cs131 Prostate Brachytherapy? A Longitudinal Analysis With Patient Reported EPIC Survey and AUA Score. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1102] [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: 11/29/2022]
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14
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Beriwal S, Smith RP, Houser C, Benoit RM. Prostate-specific antigen spikes with ¹³¹Cs brachytherapy. Is there a difference with other radioisotopes? Brachytherapy 2012; 11:457-9. [PMID: 22818407 DOI: 10.1016/j.brachy.2012.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 03/29/2012] [Accepted: 04/18/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE There is a suggestion that a dose-rate effect exists for the prostate-specific antigen (PSA) spike after brachytherapy. ¹³¹Cs is a newer radioisotope with a half-life of 9.7 days that is being used for prostate brachytherapy. There is no published data on the PSA spike with this radioisotope and the goal of this study was to quantify PSA spikes with ¹³¹Cs and compare it with published data for other isotopes. METHODS AND MATERIALS We have been maintaining a prospective database for all patients treated with ¹³¹Cs prostate brachytherapy at our institution. We selected patients for whom followup PSA was available for at least 24 months. The PSA spike was defined as an increase of 0.2 ng/mL, followed by a decline to prespike level. RESULTS One hundred twenty-three patients had monotherapy, whereas 32 had external beam radiation therapy followed by a brachytherapy boost. Median followup was 36 months and mean numbers of PSAs obtained were 7. Forty-six (29.7%) patients had a PSA spike. The mean time and duration for the PSA spike were 12.5 and 8.8 months, respectively. The mean magnitude of increase and mean PSA value at increase were 0.63 and 1.56 ng/mL, respectively. CONCLUSIONS The incidence of a PSA spike in our series is consistent with reported numbers for other radioisotopes. The occurrence of the spike at 12.5 months appears to be at the early end of the spectrum reported for (125)I, but the duration and magnitude are similar to other radioisotopes.
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Affiliation(s)
- Sushil Beriwal
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA 15213, USA.
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15
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Kannan N, Kim H, Houser C, Beriwal S. PO-236 3D IMAGE BASED VS. POINT BASED DOSIMETRY FOR CERVICAL CANCER: EARLY OUTCOME ANALYSIS. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72202-8] [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: 10/28/2022]
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16
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Beriwal S, Rwigema JCM, Higgins E, Kim H, Houser C, Sukumvanich P, Olawaiye A, Richard S, Kelley JL, Edwards RP, Krivak TC. Three-dimensional image-based high-dose-rate interstitial brachytherapy for vaginal cancer. Brachytherapy 2012; 11:176-80. [DOI: 10.1016/j.brachy.2011.05.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 05/16/2011] [Accepted: 05/18/2011] [Indexed: 11/30/2022]
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17
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Kannan N, Beriwal S, Kim H, Houser C, Mogus R, Sukumvanich P, Olawaiye A, Richard S, Kelley J, Edwards R, Edwards R. HDR Interstitial CT based Brachytherapy For the Treatment of Cervical Cancer: Early Results. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.975] [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: 10/15/2022]
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18
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McKinney N, Houser C, Meyer-Arendt K. Direct and indirect mortality in Florida during the 2004 hurricane season. Int J Biometeorol 2011; 55:533-46. [PMID: 20924612 DOI: 10.1007/s00484-010-0370-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 09/14/2010] [Accepted: 09/20/2010] [Indexed: 05/17/2023]
Abstract
Previous studies have shown that natural disasters, and hurricanes in particular, have led to more deaths than those usually documented in short post-storm surveys. Such indirect deaths, thought to be related to dietary, stress or pre-existing medical conditions, can exceed the number of direct deaths and may persist for weeks or even months beyond the event itself. In the present study, cumulative sum of deviations plots are used to quantify the number of direct and indirect deaths resulting from Hurricanes Charley, Frances, Ivan and Jeanne that made landfall in Florida in 2004. Results suggest that there was an elevated mortality for up to 2 months following each storm, resulting in a total of 624 direct and indirect deaths attributable to the storm. Trauma-related deaths that can be associated directly with the storm account for only ∼4% of the total storm-related mortality, while indirect mortality accounts for most storm-related deaths. Specifically, a large percentage of the elevated mortality was associated with heart (34%) and cancer-related deaths (19%), while diabetes (5%) and accident-related deaths (9%) account for a smaller but still significant percentage of the elevated mortality. The results further suggest that the elevated mortality was the result of additional deaths that would not have otherwise occurred within that 5 month period, and not simply a clustering of deaths that were inevitable between 1 August and 31 December 2004. The elevated mortality identified in this study is significantly greater than the official count of 31 direct and 113 indirect deaths resulting from the four hurricanes combined. This suggests a need for improved mortality counts and surveillance in order to better evaluate and identify effective prevention policies, and to identify preventable deaths.
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Affiliation(s)
- Nathan McKinney
- Department of Environmental Studies, University of West Florida, Pensacola, FL 32514, USA
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Kim H, Beriwal S, Houser C, Huq MS. Dosimetric analysis of 3D image-guided HDR brachytherapy planning for the treatment of cervical cancer: is point A-based dose prescription still valid in image-guided brachytherapy? Med Dosim 2010; 36:166-70. [PMID: 20488690 DOI: 10.1016/j.meddos.2010.02.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 02/09/2010] [Accepted: 02/18/2010] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to analyze the dosimetric outcome of 3D image-guided high-dose-rate (HDR) brachytherapy planning for cervical cancer treatment and compare dose coverage of high-risk clinical target volume (HRCTV) to traditional Point A dose. Thirty-two patients with stage IA2-IIIB cervical cancer were treated using computed tomography/magnetic resonance imaging-based image-guided HDR brachytherapy (IGBT). Brachytherapy dose prescription was 5.0-6.0 Gy per fraction for a total 5 fractions. The HRCTV and organs at risk (OARs) were delineated following the GYN GEC/ESTRO guidelines. Total doses for HRCTV, OARs, Point A, and Point T from external beam radiotherapy and brachytherapy were summated and normalized to a biologically equivalent dose of 2 Gy per fraction (EQD2). The total planned D90 for HRCTV was 80-85 Gy, whereas the dose to 2 mL of bladder, rectum, and sigmoid was limited to 85 Gy, 75 Gy, and 75 Gy, respectively. The mean D90 and its standard deviation for HRCTV was 83.2 ± 4.3 Gy. This is significantly higher (p < 0.0001) than the mean value of the dose to Point A (78.6 ± 4.4 Gy). The dose levels of the OARs were within acceptable limits for most patients. The mean dose to 2 mL of bladder was 78.0 ± 6.2 Gy, whereas the mean dose to rectum and sigmoid were 57.2 ± 4.4 Gy and 66.9 ± 6.1 Gy, respectively. Image-based 3D brachytherapy provides adequate dose coverage to HRCTV, with acceptable dose to OARs in most patients. Dose to Point A was found to be significantly lower than the D90 for HRCTV calculated using the image-based technique. Paradigm shift from 2D point dose dosimetry to IGBT in HDR cervical cancer treatment needs advanced concept of evaluation in dosimetry with clinical outcome data about whether this approach improves local control and/or decreases toxicities.
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Affiliation(s)
- Hayeon Kim
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA 15213, USA
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Olson AC, Beriwal S, Kim H, Houser C, Wegner RE, Heron DE, Richard SD, Kelly JL, Edwards RP, Sukumvanich P, Zorn KK, Krivak TC, Olawaiye AB. 3D Treatment Planning for Medically Inoperable Endometrial Cancer: Dosimetric Analysis and Early Clinical Outcomes. Brachytherapy 2010. [DOI: 10.1016/j.brachy.2010.02.017] [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] [Indexed: 11/26/2022]
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Chew MS, Xue J, Houser C, Misic V, Cao J, Cornwell T, Handler J, Yu Y, Gressen E. Impact of transrectal ultrasound- and computed tomography-based seed localization on postimplant dosimetry in prostate brachytherapy. Brachytherapy 2009; 8:255-264. [DOI: 10.1016/j.brachy.2008.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Revised: 08/13/2008] [Accepted: 11/12/2008] [Indexed: 11/15/2022]
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Bradley K, Houser C. Relative velocity of seagrass blades: Implications for wave attenuation in low-energy environments. ACTA ACUST UNITED AC 2009. [DOI: 10.1029/2007jf000951] [Citation(s) in RCA: 130] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Misic V, Houser C, Den R, Valicenti R. Dosimetry Optimization for Miami Vaginal Applicator. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.190] [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]
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Chew M, Xue J, Houser C, Misic V, Cao J, Cornwell T, Yu Y, Gressen E, Handler J. SU-GG-T-48: Impact of Seed Localization On Post-Implant Dosimetry in Prostate Brachytherapy. Med Phys 2008. [DOI: 10.1118/1.2961798] [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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Harrison A, Misic V, Podder T, Bednarz G, Cryan G, Fallon K, Houser C, Yu Y, Xiao Y. SU-FF-T-382: Special Dosimetric/Measurement Considerations in Commissioning a Novel Integrated MiniMLC Linear Accelerator. Med Phys 2007. [DOI: 10.1118/1.2761107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Houser C, Nawaz AO, Galvin J, Xiao Y. TH-D-ValA-04: Quantitative Evaluation of Cone Beam CT Data Used for Treatment Planning. Med Phys 2006. [DOI: 10.1118/1.2241926] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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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Nawaz AO, Houser C, Bednarz G, Dicker A, Galvin J. SU-FF-J-12: A Phantom Study to Compare 2D Electronic Portal Imaging with 3D KV Cone-Beam Imaging. Med Phys 2006. [DOI: 10.1118/1.2240791] [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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Chen Y, Valicenti R, Suh D, Houser C, Galvin J. SU-FF-J-90: An Accurate Method for Determining Prostate Shift and Rotation Using Portal Images with Implanted Fiducial Seeds. Med Phys 2005. [DOI: 10.1118/1.1997636] [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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Xiao Y, Werner-Wasik M, Michalski D, Houser C, Bednarz G, Curran W, Galvin J. Comparison of three IMRT inverse planning techniques that allow for partial esophagus sparing in patients receiving thoracic radiation therapy for lung cancer. Med Dosim 2004; 29:210-6. [PMID: 15324918 DOI: 10.1016/j.meddos.2004.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2003] [Accepted: 03/10/2004] [Indexed: 12/25/2022]
Abstract
The purpose of this study is to compare 3 intensity-modulated radiation therapy (IMRT) inverse treatment planning techniques as applied to locally-advanced lung cancer. This study evaluates whether sufficient radiotherapy (RT) dose is given for durable control of tumors while sparing a portion of the esophagus, and whether large number of segments and monitor units are required. We selected 5 cases of locally-advanced lung cancer with large central tumor, abutting the esophagus. To ensure that no more than half of the esophagus circumference at any level received the specified dose limit, it was divided into disk-like sections and dose limits were imposed on each. Two sets of dose objectives were specified for tumor and other critical structures for standard dose RT and for dose escalation RT. Plans were generated using an aperture-based inverse planning (ABIP) technique with the Cimmino algorithm for optimization. Beamlet-based inverse treatment planning was carried out with a commercial simulated annealing package (CORVUS) and with an in-house system that used the Cimmino projection algorithm (CIMM). For 3 of the 5 cases, results met all of the constraints from the 3 techniques for the 2 sets of dose objectives. The CORVUS system without delivery efficiency consideration required the most segments and monitor units. The CIMM system reduced the number while the ABIP techniques showed a further reduction, although for one of the cases, a solution was not readily obtained using the ABIP technique for dose escalation objectives.
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Affiliation(s)
- Ying Xiao
- Kimmel Cancer Center, Jefferson Medical College, Philadelphia, PA, USA.
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Valicenti R, Wernicke A, DiEva K, Houser C, Pequignot E. Critical evaluation of the temporal change of sexual function after 3D conformal radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)01417-2] [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]
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Bednarz G, Michalski D, Houser C, Huq MS, Xiao Y, Anne PR, Galvin JM. The use of mixed-integer programming for inverse treatment planning with pre-defined field segments. Phys Med Biol 2002; 47:2235-45. [PMID: 12164584 DOI: 10.1088/0031-9155/47/13/304] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [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: 11/12/2022]
Abstract
Complex intensity patterns generated by traditional beamlet-based inverse treatment plans are often very difficult to deliver. In the approach presented in this work the intensity maps are controlled by pre-defining field segments to be used for dose optimization. A set of simple rules was used to define a pool of allowable delivery segments and the mixed-integer programming (MIP) method was used to optimize segment weights. The optimization problem was formulated by combining real variables describing segment, weights with a set of binary variables, used to enumerate voxels in targets and critical structures. The MIP method was compared to the previously used Cimmino projection algorithm. The field segmentation approach was compared to an inverse planning system with a traditional beamlet-based beam intensity optimization. In four complex cases of oropharyngeal cancer the segmental inverse planning produced treatment plans, which competed with traditional beamlet-based IMRT plans. The mixed-integer programming provided mechanism for imposition of dose-volume constraints and allowed for identification of the optimal solution for feasible problems. Additional advantages of the segmental technique presented here are: simplified dosimetry, quality assurance and treatment delivery.
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Affiliation(s)
- Greg Bednarz
- Department of Radiation Oncology, Kimmel Cancer Center of the Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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Galvin J, Xiao Y, Michalski D, Censor Y, Houser C, Bednarz G, Anne P, Huq S, Curran W. Treating oropharyngeal cancer with an inverse planning method that starts from the definition of field segments. Int J Radiat Oncol Biol Phys 2001. [DOI: 10.1016/s0360-3016(01)01964-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sanders TG, Linares RC, Lawhorn KW, Tirman PF, Houser C. Oblique meniscomeniscal ligament: another potential pitfall for a meniscal tear--anatomic description and appearance at MR imaging in three cases. Radiology 1999; 213:213-6. [PMID: 10540664 DOI: 10.1148/radiology.213.1.r99oc20213] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.3] [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: 11/11/2022]
Abstract
Three patients with an arthroscopically proved normal variant, the oblique meniscomeniscal ligament, underwent prospective magnetic resonance (MR) imaging of the knee. In the first case, the ligament was misinterpreted as a displaced flap tear of the posterior horn of the lateral meniscus. In the two subsequent cases, the ligament was identified correctly at MR imaging as the oblique meniscomeniscal ligament.
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Affiliation(s)
- T G Sanders
- Department of Radiology, Wilford Hall Medical Center, Lackland AFB, TX 78236-5300, USA
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Grafman J, Schwartz V, Dale JK, Scheffers M, Houser C, Straus SE. Analysis of neuropsychological functioning in patients with chronic fatigue syndrome. J Neurol Neurosurg Psychiatry 1993; 56:684-9. [PMID: 8509784 PMCID: PMC489620 DOI: 10.1136/jnnp.56.6.684] [Citation(s) in RCA: 80] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Memory impairment dominates the cognitive complaints of patients with chronic fatigue syndrome (CFS). Twenty CFS patients were available for studies with a clinical and experimental battery composed of memory and cognitive tests. The results on objective testing indicated that the CFS patients had some mild memory impairment, but only on tasks requiring conceptually driven encoding and retrieval processes. There were no associations between the nature of the precipitating illness, self ratings of fatigue, physical findings, or laboratory determination and objective memory performance or self report of memory functioning. These generally negative results indicate that memory impairment in CFS patients is typically mild and involves memory processes that participate in conceptualising information.
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Affiliation(s)
- J Grafman
- Cognitive Neuroscience Section, NINDS, NIH, Bethesda, MD 20892
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Abstract
Thirty normal infants aged two months (N=10), five months (N=11) and eight months (N=9) participated in a three-month longitudinal study of the Landau reaction. Each infant's response to horizontal suspension was filmed and electromyographically recorded. Thoraco-lumbar extension and head elevation 90 degrees above the horizontal (face vertical to the horizontal) were present in 45 per cent of infants at four months and in 90 per cent of infants between five and 10 months. The postural response changed little between five and ten months of age. Less than 10 per cent of the infants regressed in postural response between monthly examinations. No infant hung limply over the examiner's hand, and electromyographic activity of the neck extensors never decreased to zero. All infants were able to reassume neck and spinal extension following active and passive flexion of the neck. Kicking activity was observed in 80 per cent of infants over four months of age. A pattern of motor responses for the normal infant was noted and variations from this pattern which have been observed in infants with motor dysfunction are discussed. The EMG recordings correlated well with the visual observations and provided an accurate written record of the responses. They proved to be a reliable research tool in the study of infants' gross motor responses.
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Abstract
The foot-balancing reactions to posterior and lateral displacement of the body were compared in 20 normal children and 30 children with spastic cerebral palsy. The children were divided into five functional groups in order to describe the normal developmental sequence and to contrast the responses of the feet of the spastic children with those of normal children. Normal children who had been walking for more than six months (advanced walkers) showed adult-like reactions, including ankle and tow dorsiflexion, medial-arch reactions and stepping responses. Normal children who had been walking for less than six weeks (Beginning Walkers) showed less developed ankle and medial-arch reactions and exhibited clawing rather than toe dorsiflexion. Children with spastic cerebral palsy differed significantly from the normal Advanced Walkers in each of the reactions observed. When compared with the normal Beginning Walkers they demonstrated less ankle dorsiflexion and medial-arch reactions but appeared similar in other factors. Differences were noted between the three functional spastic groups.
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Abstract
The effect of rewarding desirable sitting positions in six children with cerebral palsy (mean age of 3.7 years) was examined. Each subject's sitting behavior was documented at home under both pretreatment and treatment conditions. Treatment of all subjects consisted of rewarding the use of positions other than the reverse tailor sitting position. In addition, half of the subjects were asked to sit in desirable positions. All subjects demonstrated significant increases in the frequency and duration of desirable sitting positions after the onset of treatment. Those children asked to sit in desirable positions showed even greater increases, but only initially. Sitting behavior was documented (but not treated) in another setting, before and after treatment was insituted in the home. Four subjects showed some increases in the frequency of desirable sitting in the other setting. Further research is suggested in the management of reverse tailor sitting at home and in school.
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Abstract
Flexion contracture, internal rotation and external rotation of the hip were reported in 40 infants at 6 weeks and 3 months and in an independent sample of 40 infants at 6 months of age. Population means and normal ranges of motion were determined for use in the evaluation of hip problems and their treatment. A mean hip flexion contracture of 19 degrees was present at 6 weeks of age, decreasing to 7 degrees by three months, but still persisting at 6 months suggesting that forceful extension of the hip in infants may be contraindicated. Hip flexion contracture decreased in every child from 6 weeks to three months. In all cases, external rotation was greater than internal rotation. Internal rotation greater than external rotation before the age of 6 months appears contrary to normal development. There was a significant correlation between the changes in hip flexion contracture and internal rotation from 6 weeks to 3 months. An interesting extension of this study would be a longitudinal follow-up of infants beyond 6 months of age to further define these developmental trends.
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Cawley LP, Riner A, Houser C, Huaman AM. Thyroid and auto-immune disorders. Thyroid auto-antibodies in hospital patients. J Kans Med Soc 1966; 67:263-8. [PMID: 5910439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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