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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Water and environment journal 18 (2004), S. 0 
    ISSN: 1747-6593
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Energy, Environment Protection, Nuclear Power Engineering
    Notes: This paper reviews the design and performance experience with sludge-drying reed-beds over the past fourteen years. Whilst there are very few of these systems in the UK, there is much experience in Europe and particularly in Denmark. The Danish experience is reviewed in some detail. The design of and experience gained from two UK systems is described. The final dry-solids concentration depends upon the concentration in the initial sludge dose. It is possible, when treating anaerobically digested sludges containing 3–4% DS, to achieve about 90% volume reduction and a final dry-solids content of up to 40%. With thinner activated sludges containing 0.3–0.6% DS, a reduction (in volume) of greater than 97% is possible with a final solids concentration in the range 10–20%.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 58 (2003), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 57 (2002), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Spinal fentanyl can improve analgesia during Caesarean section. However, there is evidence that, following its relatively short-lived analgesic effect, there is a more prolonged spinal opioid tolerance effect. The effectiveness of postoperative epidural fentanyl analgesia may therefore be reduced following the use of spinal fentanyl at operation. This randomised, double-blind study was designed␣to assess whether patient-controlled epidural fentanyl could produce effective analgesia following 25 µg of spinal fentanyl at operation. Patients undergoing elective Caesarean section received spinal bupivacaine combined with either fentanyl 25 µg (fentanyl group; n = 18) or␣normal saline (saline group; n = 18). Patient-controlled epidural fentanyl was used for postoperative analgesia. The fentanyl group used a mean of 23.4 (SD 14.5) µg.h−1 of fentanyl, compared with 27.0 (10.8) µg.h−1 for the saline group (p = 0.41). Using a 0–100 mm visual analogue score for pain, the maximum pain score recorded at rest for the fentanyl group was median 24 [IQR 15–35] mm, compared with 15 [13–45] mm for the saline group (p = 0.41). The maximum pain score recorded on coughing for the fentanyl group was 29 [24–46] mm, compared with 27 [19–47] mm for the saline group (p = 0.44). Nine of the fentanyl group rated postoperative analgesia as excellent and nine as good, compared with 10 of the saline group who rated it as excellent and eight as good (p = 0.74). Epidural fentanyl can produce effective analgesia following the use of 25 µg spinal fentanyl at Caesarean section.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 56 (2001), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    Journal of oral pathology & medicine 33 (2004), S. 0 
    ISSN: 1600-0714
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  Information on alcohol-associated oral mucosal lesions (OMLs) and conditions is meagre. A prevalence survey among alcohol misusers in south London was therefore undertaken.Methods:  Six hundred and ninety-three subjects (388 alcohol misusers and 305 alcohol + substance abuse) attending several clinical care facilities in south London between 1994 and 1999 were interviewed on their alcohol and drug habits. A comprehensive oral mucosal examination was performed, and soft tissue lesions found were classified by the clinical criteria of Axéll.Results:  Mean age of the sample was 40.5 years. The majority was white (92.6%); of the whites, 29.9% were Celts (i.e. Irish, Scots resident in London). Many subjects reported misusing more than one type of beverage. Two hundred and twenty-seven OMLs were found in 195 subjects (28.1%). The highest prevalences were found for frictional keratosis (8.8%), scar tissue of the lips (4.8%) and candidiasis (3.8%). Angular cheilitis was present in 21 subjects (3.0%). The alcohol-related OMLs detected were three white patches compatible with a diagnosis of leukoplakia and one treated oral carcinoma. No erythroplakias were detected. The differences in prevalence of mucosal lesions in the two groups were not significant (χ2 = 2.18; P = 0.14). The prevalence of tobacco smoking was high in both study groups. OMLs were found with all four types of beverages consumed, and there was little variation by the units per week consumed. Concurrent use of substances and alcohol did not make a significant difference to the prevalence of OML. In the logistic regression analysis, minority ethnic groups (Black or Asian), smokers, those with a body mass index (BMI) under 20 and beer drinkers had an increased risk of an OML in this group of alcohol misusers.Conclusions:  In comparison with previous oral mucosal screening programmes undertaken in several settings in the UK, the present study has yielded a higher prevalence of oral mucosal diseases and conditions in this risk population. There are several ways in which alcohol could contribute to these detected oral lesions, either directly or indirectly.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1600-0714
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  Human Immunodeficiency Virus (HIV) infection is associated with oral manifestations of diagnostic and prognostic importance. With the advent of Highly Active Anti-retroviral Therapy (HAART) there is anecdotal evidence to suggest that the prevalence of oral lesions has declined. The number of prevalence studies, carried out in the era of HAART is, however, meagre. Our aim was to study the prevalence of the oral manifestations of HIV in a population, predominantly on HAART, attending a Genito-Urinary Medicine Centre in South London.Methods:  This cross sectional study included 203 adult volunteers, comprising 76% males and 24% females. One third of the subjects were from the predominantly African or Afro- Caribbean ethnic minority groups resident in London. The relationship between the prevalence of oral lesions and demographic variables, therapeutic regimes, viral load and CD4 counts were evaluated.Results:  One hundred (49%) of the patients had no detectable oral lesions. Oral lesions detected most frequently included oral hairy leukoplakia (9.9%), HIV associated periodontal diseases (9.9%) and oral candidiasis (4.9%). Three subjects had multiple papillomatous growths. Most cases (n = 17/20) of oral hairy leukoplakia were in individuals with a detectable (〉 400 copies/ml) plasma RNA viral load. The majority (n = 8/10) of our patients with oral candidiasis had a plasma RNA viral load 〉 10,000 copies/ml and half (n = 5/10) had a CD4 count 〈 200 cells/mm3. Logistic regression analysis suggested that the presence of an oral lesion was not associated with any demographic features except for periodontal diseases which were associated with tobacco smoking (P = 0.023).Conclusions:  The prevalence of so called ‘strongly associated’ oral lesions of HIV is low in this South London HIV-infected population on HAART, and the relative frequency is different from that cited in the literature from the pre-HAART era. The oral lesions detected were found mostly in people with low CD4 counts and high HIV-1 RNA viral loads, suggesting they were very immunocompromised, not on, or declining therapy, or that their therapy was failing.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract. Factor VII (FVII) deficiency is a rare haemorrhagic condition, normally inherited as an autosomal recessive trait, in which clinical presentation is highly variable and correlates poorly with laboratory phenotype. The FVII (F7) gene was sequenced in 48 unrelated individuals with FVII deficiency, yielding a total of 23 novel lesions including 15 missense mutations, 2 micro-deletions, 5 splice junction mutations and a single base-pair substitution in the 5' untranslated region. Family studies were performed in order to distinguish the contributions of individual mutant F7 alleles to the clinical and laboratory phenotypes. Specific missense mutations were evaluated by molecular modelling in the context of the FVIIa-tissue factor crystal structure. Single base-pair substitutions in splice sites and the 5' untranslated region were studied by in vitro splicing assay and luciferase reporter gene assay, respectively. All probands were also typed for four previously reported F7 polymorphisms. In the majority of cases of FVII deficiency studied here, consideration of both mutational and polymorphism data permitted the derivation of plausible explanations for the FVII activity and antigen levels measured in the laboratory. Inter-familial variation in FVII activity and the antigen levels of heterozygous relatives of probands was found to be significantly higher than intra-familial variation, consistent with the view that the nature of the F7 gene lesion(s) segregating in a given family is a prime determinant of laboratory phenotype. Although no relationship could be discerned between laboratory phenotype and polymorphism genotype, the frequencies of the A2 and M2 polymorphic alleles were significantly higher in the FVII-deficient individuals tested than in controls. This suggests that the presence of these alleles may have served to increase the likelihood of pathological F7 gene lesions coming to clinical attention.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1569-8041
    Keywords: autologous peripheral blood progenitor-cell transplantation ; CD34+ cells ; high-dose chemotherapy ; Hodgkin's disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:The use of autologous peripheral blood progenitorcells (PBPC) expedites hematologic recovery and reduces the costs oftransplantation in comparison with autologous bone marrow; however, itsefficacy in patients with Hodgkin's disease has been questioned. We evaluatedthe results of autologous PBPC transplantation in a population of unselectedand uniformly treated patients with primary refractory or relapsed Hodgkin'sdisease. Patients and methods:Forty consecutive adult patients withprimary refractory (n = 7) or relapsed (n = 33) Hodgkin'sdisease received high-dose BEAM (BCNU, etoposide, ara-C, and melphalan)followed by autologous PBPC infusion. Twenty-four patients (60%)received high-dose BEAM as outpatients. Consolidative radiation therapy wasadministered to 14 patients (35%). Results:Thirty-seven patients (92%) achieved a posttransplant complete response. The 3-year progression-free survival (PFS) was69%, and the 3-year overall survival (OS) was 77%, with a medianfollow-up of surviving patients of 28 months. Severe non-hematologictoxicities included gastrointestinal side effects (diarrhea 17%,mucositis 25%), and interstitial pneumonitis (15%). One patientdied of acute transplant-related complications (mortality rate 2.5%).Strong predictors of poor PFS were chemoresistant versuschemosensitive/untested disease (actuarial PFS 89% versus22%, P = 0.0000) and stage IIB–IV versusI–IIA at relapse/progression (86% versus46%, P = 0.005). All five patients with elevated lactatedehydrogenase at the time of transplantation died of their disease. There wasa trend toward worse PFS for patients receiving a higher number of CD34+ cells(≥11 × 106 per kg). Conclusions:High-dose BEAM chemotherapy with autologous PBPCtransplantation is associated with low mortality and results in satisfactoryPFS for patients with primary refractory or relapsed Hodgkin's disease. Thesubset of patients with progressive disease at the time of transplantationperforms poorly and may benefit from alternative strategies.
    Type of Medium: Electronic Resource
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