Feasibility study on the use of 230 MeV proton cyclotron in proton therapy centers as a spallation neutron source for BNCT.

AIM: The feasibility of using 230 MeV proton cyclotrons in proton therapy centers as a spallation neutron source for Boron Neutron Capture Therapy (BNCT) was investigated. BACKGROUND: BNCT is based on the neutron irradiation of a 10B-containing compound located selectively in tumor cells. Among various types of neutron generators, the spallation neutron source is a unique way to generate high-energy and high-flux neutrons. MATERIALS AND METHODS: Neutron beam was generated by a proton accelerator via spallation reactions and then the produced neutron beam was shaped to be appropriate for BNCT. The proposed Beam Shaping Assembly (BSA) consists of different moderators, a reflector, a collimator, as well as thermal and gamma filters. In addition, the simulated Snyder head phantom was utilized to evaluate the dose distribution in tumor and normal tissue due to the irradiation by the designed beam. MCNPX2.6 Monte Carlo code was used to optimize BSA as well as evaluate dose evaluation. RESULTS: A BSA was designed. With the BSA configuration and a beam current of 104 nA, epithermal neutron flux of 3.94 × 106 [n/cm2] can be achieved, which is very low. Provided that we use the beam current of 5.75 µA, epithermal neutron flux of 2.18 × 108 [n/cm2] can be obtained and the maximum dose of 38.2 Gy-eq can be delivered to tumor tissue at 1.4 cm from the phantom surface. CONCLUSIONS: Results for 230 MeV protons show that with proposed BSA, proton beam current about 5.75 µA is required for this purpose.

Childhood recurrent abdominal pain and Helicobacter pylori infection, Islamic Republic of Iran.

We examined the role of Helicobacter pylori infection as a cause of recurrent abdominal pain (RAP) among Iranian children in a population-based case-control study to determine the association between H. pylori infection and RAP among schoolchildren. A total of 1558 children aged 6-13 years were examined. Children with RAP confirmed by the Apley and Naish criteria were selected; 145 cases were selected for inclusion and were compared with 145 healthy children recruited from the same area. Both groups underwent stool antigen testing. The prevalence of RAP in the children tested was 9.3%. Children with RAP had a higher H. pylori infection rate than the control group (58.6% vs 44.8%) (OR = 1.744; 95% CI: 1.095-2.776). There was no significant difference between the RAP symptoms in children with positive stool test, i.e. infected with H. pylori, and those whose tests were negative. We identified H. pylori infection in more than 55% of the case group. Therefore, H. pylori infection can be considered an important factor for RAP in children.

Childhood recurrent abdominal pain and Helicobacter pylori infection, Islamic Republic of Iran

We examined the role of Helicobacter pylori infection as a cause of recurrent abdominal pain [RAP] among Iranian children in a population-based case-control study to determine the association between H. pylori infection and RAP among schoolchildren. A total of 1558 children aged 6-13 years were examined. Children with RAP confirmed by the Apley and Naish criteria were selected; 145 cases were selected for inclusion and were compared with 145 healthy children recruited from the same area. Both groups underwent stool antigen testing. The prevalence of RAP in the children tested was 9.3%. Children with RAP had a higher H. pylori infection rate than the control group [58.6% vs 44.8%] [OR = 1.744; 95% CI: 1.095-2.776]. There was no significant difference between the RAP symptoms in children with positive stool test, i.e. infected with H. pylori, and those whose tests were negative. We identified H. pylori infection in more than 55% of the case group. Therefore, H. pylori infection can be considered an important factor for RAP in children

Nous avons examiné le rôle de l'infection par Helicobacter pylori en tant que cause de douleur abdominale récurrente parmi des enfants iraniens au cours d'une étude cas-témoin populationnelle afin de déterminer l'association entre cette infection et la douleur abdominale récurrente chez les enfants scolarisés. Au total, 1558 enfants âgés de 6 à 13 ans ont été examinés. Des enfants souffrant d'une douleur abdominale récurrente confirmée selon les critères définis par Apley et Naish ont été sélectionnés: 145 cas répondant au critère d'inclusion ont été comparés avec 145 enfants en bonne santé de la même région. Les deux groupes ont été soumis à un test de recherche d'antigènes dans les selles. L'incidence de la douleur abdominale récurrente testée était de 9,3%. Les enfants ayant une douleur abdominale récurrente présentaient un taux d'infection par H. pylori plus élevé que le groupe témoin [58,6% contre 44,8% ; OR = 1,744 et IC à 95%: 1,095-2,776]. Il n'y avait pas de différence significative entre les symptômes de douleur abdominale récurrente chez les enfants ayant des coprocultures positives, donc une infection par H. pylori, et ceux dont les tests étaient négatifs. Nous avons identifié une infection par H. pylori chez plus de 55% d'enfants du groupe témoin. Par conséquent, l'infection par H. pylori peut être considérée comme un facteur important de douleur abdominale chez l'enfant

A break-even analysis for dementia care collaboration: Partners in Dementia Care.

BACKGROUND: Dementia is a costly disease. People with dementia, their families, and their friends are affected on personal, emotional, and financial levels. Prior work has shown that the "Partners in Dementia Care" (PDC) intervention addresses unmet needs and improves psychosocial outcomes and satisfaction with care. OBJECTIVE: We examined whether PDC reduced direct Veterans Health Administration (VHA) health care costs compared with usual care. DESIGN: This study was a cost analysis of the PDC intervention in a 30-month trial involving five VHA medical centers. PARTICIPANTS: Study subjects were veterans (N = 434) 50 years of age and older with dementia and their caregivers at two intervention (N = 269) and three comparison sites (N = 165). INTERVENTIONS: PDC is a telephone-based care coordination and support service for veterans with dementia and their caregivers, delivered through partnerships between VHA medical centers and local Alzheimer's Association chapters. MAIN MEASURES: We tested for differences in total VHA health care costs, including hospital, emergency department, nursing home, outpatient, and pharmacy costs, as well as program costs for intervention participants. Covariates included caregiver reports of veterans' cognitive impairment, behavior problems, and personal care dependencies. We used linear mixed model regression to model change in log total cost post-baseline over a 1-year follow-up period. KEY RESULTS: Intervention participants showed higher VHA costs than usual-care participants both before and after the intervention but did not differ significantly regarding change in log costs from pre- to post-baseline periods. Pre-baseline log cost (p ≤ 0.001), baseline cognitive impairment (p ≤ 0.05), number of personal care dependencies (p ≤ 0.01), and VA service priority (p ≤ 0.01) all predicted change in log total cost. CONCLUSIONS: These analyses show that PDC meets veterans' needs without significantly increasing VHA health care costs. PDC addresses the priority area of care coordination in the National Plan to Address Alzheimer's Disease, offering a low-cost, structured, protocol-driven, evidence-based method for effectively delivering care coordination.

Prehospital treatment of burns: a qualitative study of experiences, perceptions and reactions of victims.

BACKGROUND: The manner in which burns are initially managed, at an incident scene, can affect the extent and depth of burn wounds and their final prognosis. The aim of this study was to understand people's experiences, perceptions and reactions towards the initial management of burns and fire accidents in Ardabil Province, Iran. METHODS: In a qualitative study, 48 burn victims accompanied by their caregivers were enrolled. Focus group discussion (FGD) was used to collect data. All the interviews were recorded, transcribed and analysed using content analysis method. RESULTS: Four categories of information were retrieved in this study, including fire control, scald and burn wound management, seeking medical consultation and severity indicators. Uncertainty regarding what to do when someone catches fire was an evident finding that was explored through the discussions. The results revealed that transferring the patient to the hospital most often takes place after initial treatments administered at home. People believed that cooling a burn wound for a time longer than a few seconds may harm the wound. A strong belief in the efficacy of traditional remedies was disclosed when the statements of participants revealed that traditional or home-made remedies were widely used either to control pain immediately after burn and later during the wound repair process to accelerate the repair or to control the infection and prevent oedema and scar. Among these remedies, pennyroyal and grated potatoes seemed to be the most popular ones. Pennyroyal was thought to prevent infection and potatoes were used to relieve pain. People doubted the capability of health-care workers who work in rural health houses. People considered electrical burns and burns on the chest to be the most severe types of burns. CONCLUSION: Inappropriate perceptions regarding initial management of burns existed among the participants that should be addressed in future quantitative research or through developing programmes on secondary prevention of burns.

How do transplanted olfactory ensheathing cells restore function?

In this article, we review our work on regeneration of the corticospinal tract in rats following a lesion at upper cervical level. We outline the rationale for using olfactory ensheathing cells, and summarize the evidence for regeneration and functional recovery. The present interpretation on the mechanisms of functional recovery is partly hypothetical, and we emphasize where further experimental evidence is needed.

Cloning, characterization and central nervous system distribution of receptor activity modifying proteins in the rat.

Calcitonin gene-related peptide (CGRP), adrenomedullin (ADM), amylin and calcitonin (CT) are structurally and functionally related neuropeptides. It has recently been shown that the molecular pharmacology of CGRP and ADM is determined by coexpression of one of three receptor activity-modifying proteins (RAMPs) with calcitonin receptor-like receptor (CRLR). Furthermore, RAMP proteins have also been shown to govern the pharmacology of the calcitonin receptor, which in association with RAMP1 or RAMP3, binds amylin with high affinity. In this study, we have cloned the rat RAMP family and characterized the pharmacology of rat CGRP and ADM receptors. Rat RAMP1, RAMP2 and RAMP3 shared 72%, 69% and 85% homology with their respective human homologues. As expected CRLR-RAMP1 coexpression conferred sensitivity to CGRP, whilst association of RAMP2 or RAMP3 with CRLR conferred high affinity ADM binding. Using specific oligonucleotides we have determined the expression of RAMP1, RAMP2 and RAMP3 mRNAs in the rat central nervous system by in situ hybridization. The localization of RAMP mRNAs was heterogeneous. RAMP1 mRNA was predominantly expressed in cortex, caudate putamen and olfactory tubercles; RAMP2 mRNA was most abundant in hypothalamus; and RAMP3 was restrictively expressed in thalamic nuclei. Interestingly, in specific brain areas only a single RAMP mRNA was often detected, suggesting mutual exclusivity in expression. These data allow predictions to be made of where each RAMP protein may heterodimerize with its partner G-protein-coupled receptor(s) at the cellular level and consequently advance current understanding of cellular sites of action of CGRP, ADM, amylin and CT. Furthermore, these localization data suggest that the RAMP family may associate and modify the behaviour of other, as yet unidentified neurotransmitter receptors.