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The optimal method for establishing enteral access in patients with head and neck cancer remains controversial. Percutaneous gastrostomy is an increasingly used alternative to surgical gastrostomy. We used a randomized trial to compare percutaneous and surgical gastrostomy tube placement in a population of patients with head and neck cancer. Forty-five percutaneous and 53 surgical gastrostomy tubes were placed in 88 patients. Differences in demographic and clinical characteristics, complications, and the rate of nutritional recovery between the two groups were analyzed. Factors associated with nutritional recovery were also evaluated. The demographic and clinical characteristics and complication rates between the percutaneous and surgical gastrostomy groups were similar. The tubes that failed to mature were removed by the radiologist, and they healed without further intervention. There was no difference in the rate of tube maturation between the two groups. A significantly higher percentage of patients in the percutaneous gastrostomy group had a complication rate of 10 percent or more. Fifteen patients (33 percent) experienced at least one major complication after percutaneous gastrostomy. None of the patients had major complications after surgical gastrostomy. Length of hospital stay and rate of nutritional recovery were not significantly different between the two groups. Submucosal injection and an endotracheal tube were used more frequently in the surgical group. In this randomized trial, we found no difference in the rate of nutritional recovery between percutaneous and surgical gastrostomy tube placement in patients with head and neck cancer.Atlas Shrugged Part II: Is There a Solution?
The book that is history, and now a film, was authored by Ayn Rand. The concept behind Atlas Shrugged is to show how an incredible world collapses because people are never willing to sacrifice their own economic interest, and that a single thinker and a unique worldview can change this world.
But Atlas Shrugged has a solution in the very first chapter, where a man named Dagny Taggart, after looking into the giant wheel in the middle of the city, described by Ayn Rand as “the spoked wheel of the universe,” suggests a new symbol for capitalism as an answer to the problem. Atlas Shrugged is a work that is mostly about philosophical worldviews, but this brief line of narration is significant, and it leads up to the inevitable new system that
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Try this software at no cost. There is absolutely no setup required. Our software is an absolutely clean download for all users. Please be reminded that, we don’t provide any kind of email support. Please feel free to contact us if you have any questions about it. Thank you for visiting our website.Markers in DNA repair: an overview.
Mutations induced by reactive oxygen species (ROS) are widely viewed as major human carcinogens. Ionizing radiation (IR) is a major cause of human cancer as well. Both ROS and IR cause DNA damage by the formation of DNA-protein cross-links (DPC). This damage is either removed by the p53 pathway, which is often compromised in cancer cells, or repaired by the repair system of the cell. Human cells contain a set of proteins that participate in the repair of DPC. Here we have reviewed briefly the involvement of six DNA repair proteins in ROS/IR-induced DPC. Mutant p53, DNA-dependent protein kinase and mismatch repair proteins are involved in the repair of DPC produced by ROS/IR. The Fanconi anemia proteins, involved in the repair of DPC produced by DNA inter-strand cross-links, are also involved in the repair of ROS/IR-induced DPC. Single-strand break repair proteins, involved in the repair of IR-induced DPC, are also involved in the repair of ROS/IR-induced DPC. The key to the understanding of ROS-induced DPC repair lies in the elucidation of how the related proteins interact. Also, a complete understanding of the repair proteins would provide means to repair DNA damage induced by ROS or IR.Q:
Is there a difference in the ways DISTINCT is applied to columns?
We are working on migrating some Oracle applications and there is code like:
SELECT DISTINCT       
         Col1          
FROM     Table
--
SELECT DISTINCT       
         Col1          
FROM     Table
WHERE    Col2 =...
Is there any difference in how distinct is applied to the columns?
A:
From the documentation:
DISTINCT is applied to
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