(The Journal of Neuropsychiatry and Clinical Neurosciences 2010; 22:433-441)”
“The https://www.selleckchem.com/products/ulixertinib-bvd-523-vrt752271.html aim of this study was to determine the changes in the health-related quality of life (HRQoL) and predictors of change among patients with multiple sclerosis (MS) at 3 and 6 years during the follow-up period.

A group of 109 consecutive MS patients (McDonald’s criteria) referred to the Clinic of Neurology, Belgrade, were enrolled in the study.

At three time points during the study (baseline, and at 3 and 6 years during the follow-up period), the HRQoL (measured by MSQoL-54), Expanded Disability Status Scale, and Hamilton Rating Scale for Depression and Fatigue Severity Scale were assessed.

During the study period, 93 patients provided both follow-up assessments. Statistically significant deterioration in the HRQoL at each subsequent time point was detected for all scales of the MSQoL-54 except for the pain and change in health scales. A higher level of education was a significant prognostic factor for a better HRQoL on the cognitive function scale throughout the entire period of observation, while marital status (single, including divorced Kinase Inhibitor Library and widowed) and increased age at the onset of MS had significant predictive values of poorer quality-of-life

scores on the overall quality-of-life scale at 6-year follow-up. Higher levels of physical disability and depression at baseline were statistically significant prognostic markers for deterioration Tanespimycin datasheet in HRQoL for the majority of MSQoL-54 scales during the entire follow-up period.

Our study suggests that baseline demographic and clinical characteristics could be applied as prognostic markers of the HRQOL for patients diagnosed with MS.”
“To evaluate the effects of metformin on the ovarian stromal blood perfusion in the patients with polycystic ovary syndrome (PCOS).

Twenty-five women with PCOS who underwent a Doppler examination of the ovarian stroma was evaluated;

hormonal, anthropometric, and biochemical parameters of patients were determined. After the patients were treated with 850 mg metformin twice a day for 6 months, the same parameters were evaluated in the same patients.

After metformin treatment, although pulsatility index (PI) was increased from 1.80 +/- A 1.23, 1.84 +/- A 1.28 to 2.20 +/- A 1.10, 2.19 +/- A 0.83 in the right and left ovary, respectively, and resistance index was increased from 0.84 +/- A 0.25, 0.83 +/- A 0.23 to 1.16 +/- A 0.37, 1.10 +/- A 0.26 in the right and left ovary respectively (P < 0.05), peak systolic velocity (PSV) was decreased from 12.30 +/- A 1.72, 12.34 +/- A 1.55 to 10.25 +/- A 0.97, 10.53 +/- A 1.33 in the right and left ovary respectively (P < 0.05). PI and RI did not show any difference between the homeostatic model assessment insulin resistance index (HOMA-IR) a parts per thousand yen 2.38 and HOMA-IR < 2.

This case report presents two remarkable findings. First, the location of the gastroenteric cyst (anterior mediastinum) and the patient’s age at the time of detection (adulthood) were extremely rare. Secondly, the present case is also unusual in terms of glycometabolism. As this tumour decreased in size, the glycosylated haemoglobin value increased, which suggested a worsening of the patient’s diabetes mellitus. The diabetes mellitus further worsened after removal of the tumour.”
“In the present study the chemical composition of Cyperus esculentus L. (tiger nut) from four distinct geographical origin (Spain,

Egypt, Nigeria, and South Africa) was assessed to observe the possible effect of the cultivation site in the fatty acids profile, sterols composition, and squalene and alpha-tocopherol content.

It Daporinad ic50 was verified that the individual fatty acids as well

as the different fatty acids fractions were severely affected by the geographical origin. Tiger nut oils were predominantly monounsaturated with lower prevalence of saturated fatty acids, and with capability to provide appreciable amounts of essential fatty acids. The sterols fraction was affected as well, but in lower extent. beta-sitosterol was the most abundant sterol found, reaching nearly 60% of the total check details sterols found in tiger nut oils, with significant differences among geographical origins.

The fatty acids data, together with the sterols and alpha-tocopherol and squalene Selleckchem Volasertib data were capable to separate tiger nut samples according to their chemical composition and geographical origin when a principal component

analysis was applied. The fatty acids profile could be applied as a possible geographical authenticity marker. (C) 2013 Elsevier B.V. All rights reserved.”
“Objectives: This study sought to evaluate the outcome of fresh and vitrified-warmed cleavage-stage and blastocyst-stage embryo transfers in patients undergoing ART treatment within an ethnic Chinese population.

Study design: We compared the clinical results of embryo transfer on the 3rd (cleavage stage) or 5th (blastocyst stage) day after oocyte retrieval, including clinical pregnancy rates, implantation rates and multiple pregnancy rates.

Results: Our data showed that blastocyst transfer on day 5 did not significantly increase clinical pregnancy rate (41.07% vs 47.08%, p>0.05) and implantation rate (31.8% vs 31.2%, p>0.05) in patients under 35 years of age, in comparison with day 3 cleavage stage embryo transfer. In patients older than 35 years of age, the clinical pregnancy rate after blastocyst transfer was slightly decreased compared with cleavage stage embryo transfer (33.33% vs 42.31%, p>0.05). Unexpectedly, It was found that vitrified-warmed blastocyst transfer resulted in significantly higher clinical pregnancy rate (56.

“
“A Particle-in-Cell simulation click here with Monte Carlo Collisions (PIC-MCC) was conducted of the application of tailored

DC voltage steps on an electrode, during the afterglow of a capacitively-coupled pulsed-plasma argon discharge, to control the energy of ions incident on the counter-electrode. Staircase voltage waveforms with selected amplitudes and durations resulted in ion energy distributions (IED) with distinct narrow peaks, with controlled energies and fraction of ions under each peak. Temporary electron heating at the moment of application of a DC voltage step did not influence the electron density decay in the afterglow. The IED peaks were “”smeared”" by collisions, especially at the higher pressures of the range (10-40 mTorr) investigated. (C) 2011

American Institute of Physics. [doi:10.1063/1.3573488]“
“To prevent osteoporotic fracture occurrence, a variety of treatment regimens with different mechanisms of action is available. The antiresorptive bisphosphonate drugs are currently the most commonly prescribed agents in the management of patients with osteoporosis. The recombinant amino-terminal fragment of human parathyroid hormone (Teriparatide) is a bone anabolic agent which reduces fracture risk by increasing bone mass and improving bone microarchitecture. Teriparatide treatment reduces vertebral and non-vertebral fracture selleck chemicals risk markedly in women and men with

idiopathic osteoporosis, or with glucocorticoid-induced osteoporosis. Teriparatide should thus be considered as first line treatment for postmenopausal women and for men with severe osteoporosis.”
“To evaluate the quality of maternity care, women’s perception of the quality of care and factors influencing the same in Delhi.

Women who delivered a viable live birth in the past 6 months were recruited from South Delhi find more by a two-stage stratified cluster randomized sampling. In stage 1, two colonies each from three predefined economic strata (high-, middle- or low-income areas) were selected by simple-random sampling. In stage 2, a sequential house-to-house survey was conducted in each selected colony. The information was collected by interview and review of medical records.

A total of 5,279 houses were screened to recruit 249 subjects. Several disparities were notable. 25.2 and 14.8% of the women from middle- and lower-income areas delivered by cesarean section, while the rate was 53.6% in the higher-income areas. In women from lower-income areas urine testing was not done in 76.9% and blood sugar was not tested in 18.2%, while in high-income areas 44.6% had a parts per thousand yen10 antenatal visits and 87.8% had a parts per thousand yen3 ultrasounds.

“
“A range of chemicals found in the aquatic environment have the potential to influence endocrine function and affect sexual development by mimicking or antagonizing the effects of hormones, or by altering the synthesis and metabolism of hormones. The aim of this study was to evaluate whether the effects of chemicals interfering with sex hormone synthesis may affect the regulation of early ovarian development via the modulation of sex steroid and insulin-like growth factor (IGF) systems. To this end, ex vivo ovary cultures of juvenile brown trout (Salmo trutta fario) were exposed for 2 days to either

1,4,6-androstatriene-3,17-dione (ATD, a specific aromatase inhibitor), prochloraz (an imidazole fungicide), or tributyltin (TBT, a persistent organic pollutant). selleck products Further, juvenile MCC950 mw female brown trout were exposed in vivo for 2 days to prochloraz or TBT. The ex vivo and in vivo ovarian gene expression of the aromatase (CYP19), responsible for estrogen production, and of IGF1 and 2 were compared. Moreover, 17-estradiol (E2) and testosterone (T) production from ex vivo ovary cultures was assessed. Ex vivo exposure to ATD inhibited ovarian E2 synthesis, while T levels accumulated. However,

ATD did not affect ex vivo expression of cyp19, igf1, or igf2. Ex vivo exposure to prochloraz inhibited ovarian E2 production, but did not affect T levels. Further prochloraz up-regulated igf1 expression in both ex vivo and in vivo exposures. TBT exposure did not modify ex vivo synthesis of either E2 or T. However, in vivo exposure to TBT down-regulated igf2 expression. The results indicate that

ovarian inhibition of E2 production in juvenile brown trout might not directly affect cyp19 and igf gene expression. Thus, we suggest that the test chemicals may interfere with both sex steroid and IGF systems in an independent manner, and based on published literature, potentially lead to endocrine dysfunction and altered sexual development. (c) 2011 Wiley Periodicals, Inc. Environ Toxicol 29: 199-206, 2014.”
“Segmented-cladding fibers (SCF) consist of a uniform core of high refractive index and a cladding with regions selleck chemicals llc of high and low refractive index alternating angularly, which can effectively realize single mode with a large core diameter. Because polymer optical fibers are usually Of large diameter, theoretical model for SCF was further extended to segmented-cladding polymer optical fibers (SCPOF) doped with rare earth complex in this article. Oil the basis of the physical principle, a material model for SCPOF was established, from which refractive index and glass transition temperature of polymer materials was pre-determined for the core and cladding of SCPOF, respectively.

After the first 69 patients, the technique was changed from upright to RAO. Hiatal hernia was assessed intraoperatively by laxity of the phrenoesophageal ligament and, if present, was repaired posteriorly. Two

board-certified radiologists specializing in gastrointestinal radiology, who were blinded to the intraoperative results, retrospectively reviewed the esophagrams. Consensus reads were utilized for divergent opinions. Sensitivity and specificity were calculated for each technique.

Between 2008 and 2010, a total of 388 patients underwent EGFR targets preoperative esophagrams (69 upright, 388 RAO). For upright esophagram, sensitivity was 50 % and specificity was 97 %. For RAO esophagram, sensitivity was 70 % and specificity was 77 %. RAO had a lower percentage of false negatives (11 vs. 21 %) than upright esophagram.

The use of RAO technique for preoperative esophagram is more sensitive for diagnosis of hiatal hernia than upright esophagram. If surgeons desire routine preoperative esophagram, RAO technique is the best.”
“Background Restoration of intestinal continuity is usually the second step

after Hartmann’s procedure and an established procedure in abdominal surgery, particularly for complicated diverticular disease. This descriptive study aimed to examine the morbidity and mortality associated with the procedure and to define potential risk factors.

Patients and methods Data from 161 consecutive patients (median age 62 years, median BMI 25.2) undergoing elective surgery with restoration www.selleckchem.com/products/tideglusib.html of bowel continuity between October 2001 and November 2008 at the Department of Surgery, University click here of Heidelberg, were included in this study. The association of potential prognostic variables with postoperative morbidity and mortality were examined by univariate and multivariate analyses.

Results The median time between the initial operation and the restoration of bowel

continuity was 7 months. The median operation time was 185 min with a blood loss of 150 ml and median postoperative hospital stay of 9 days. Fifty-one percent of the patients had an uneventful recovery, whereas 49% had a postoperative complication. Surgical infections occurred in 18% of patients, 3.8% suffered from anastomotic leakage, and surgical re-exploration was necessary in 11.2%. Medical complications occurred in 21.1% of the patients, with pneumonia in 2.5% and urinary tract infections in 1.3%. One patient died 17 days after surgery. Univariate analysis showed that patients taking immunosuppressant drugs had significantly more wound infections and, interestingly, protective ileostomy was associated with postoperative anastomotic stenosis in our cohort. The administration of PRBC and a prolonged hospital were significantly associated with increased postoperative morbidity in the multivariate analysis.

Conclusions Restoration of bowel continuity is a surgical procedure with high overall morbidity.

7% and 61.8%. The ROC curve area of A and A x was 0.91 and 0.90 in the middle segments. The ROC area of A was 0.52 in the base segments. The sensitivity and specificity of gated-SPECT for assessment of CAD were 84.8% and 82.7%, respectively. The sensitivity of multi-indexes RT-MCE increased. The sensitivity was 89.1%, 90.4%, and 96.3% by A + , A + A x , and + A x .

Conclusions Quantitative RT-MCE is an effective method for the detection of coronary artery stenosis. Quantitative RT-MCE is segmented for assessment to ischemic myocardium. RT-MCE with multi-indexes has a valuable application for assessment of CAD surpassing

SPECT.”
“Trimethylsilyl P-aryl-N-[(RS)-, (S)-(-)-, and (R)-(+)-(1-phenylethyl)]phosphonamidodithioates were synthesized by reactions of 2,4-diaryl-1,3,2 lambda(5),4 lambda(5)-dithiadiphosphetane Savolitinib 2,4-disulfides with racemic and and enantiomerically pure trimethyl-N-(1-phenylethyl)silanamine.”
“Objective: To describe the correlations between ambient air pollutants (TSP, SO(2), NO(x)) and the level of children’s LY294002 inhibitor lung function

(FVC, FEV(1), MMEF) in China.

Methods: We collected the research articles on ambient air pollution and children’s lung function published from 1985 to 2006 and selected 11 articles finally according to the following criteria: (1) Children between the age of 7 and 15 as objects; (2) Local air quality monitoring results were reported; (3) Strict quality control was taken when testing children’s lung function; (4) The results were expressed by the average of measured value. Then we analyzed the correlation relationship between the level of ambient air pollutants and children’s lung function and compared the effects of ambient air pollutants on children’s lung function of boy and girl.

Results: The selected articles included the results of 7 cities in China. Among them, the results of 6

cities’ studies revealed that the levels of children’s lung function were significantly lower in the areas with heavy ambient air pollution than those in the areas with light ambient air pollution. According to the articles. the average levels of TSP were at the range of 0.084 mg/m(3)-0.835 mg/m(3), SO(2) were 0.013 mg/m(3)-0.929 mg/m(3), NO, were 0.044 mg/m(3) -0.229 mg/m(3). Correlation analysis showed significant negative correlation between the levels Selleck Poziotinib of TSP and SO(2) and children’s FVC and FEV(1), as well as the levels of NO(x) and children’s MMEF. The correlation coefficient was -0.797 (t=-4.384, P=0.001) between TSP and FVC, -0.693 (t=-4.190, P < 0.001) between Ln (SO(2)) and FVC, -0.886 (t=-5.392, P=0.001) and -0.685 (t=-4.101, P=0.001) between FEV(1) and TSP and Ln (SO(2)), and -0.973 (t=-5.993. P=0.027) between NO(x)NO(x) and MMEF, respectively. The results also suggested that the decreases of lung function for girl with the increasing of ambient air pollution were significantly greater for boy.

The DMSO-PSi colloid in combination with an NIR laser resulted in a cell viability of 5.70 %, which is a sufficiently high cytotoxic effect.”
“A 9 alpha-hydrolase

activity of a new actinobacterium strain identified as Rhodococcus erythropolis based on the analysis of a 16S rRNA gene sequence (1417 nucleotides) towards androst-4-en-3,17-dione (AD) was studied. In the presence of glucose in the medium, this strain completely transformed AD (4-20 g/l) into 9 alpha-hydroxy-AD over 20-48 h. This culture was able to grow and perform AD 9 alpha-hydroxylation at a concentration of dimethyl formamide up to 9%. Crystalline 9 alpha-hydroxy-AD was isolated with a yield of GDC-0994 in vitro over 90%.”
“Objectives: Ten to twenty percent of children have persistent obstructive sleep apnea (OSA) after adenotonsillectomy (T&A). We hypothesize that sleep endoscopy, a flexible fiberoptic examination of the pharynx under anesthesia, is

an effective tool for identifying sites of persistent obstruction.

Methods: In this retrospective cohort study, we reviewed records of children who had symptoms consistent VX-765 with OSA and a positive polysomnogram (PSG) who underwent sleep endoscopy followed by sleep endoscopy directed surgery. Data collection included age, BMI and co-morbidities. Apnea-hypopnea index (AHI) was compared to pre and post surgery for each child using a paired t-test.

Results: Of the 80 children who underwent sleep endoscopy Selleck Copanlisib followed by directed surgery, 65% were male, mean age was 6 years (SD 3.75 years), average BMI was 19 (SD 0.43 years) and 28% had co-morbidities. For the 51% of patients who had persistent OSA after T&A, the mean AHI after sleep endoscopy directed surgery was significantly lower then before surgery (7.9 vs. 15.7, p < .01). For the 49% of patients who had never undergone surgery for OSA, or who were surgically naive, and underwent sleep endoscopy directed surgery, the mean AHI was significantly lower then before surgery (8.0 vs. 13.8, p < .01).

Conclusions:

Sleep endoscopy is a consistently reliable tool for identifying the sites of obstruction in both surgically naive children and those with persistent USA after T&A. (C) 2012 Elsevier Ireland Ltd. All rights reserved.”
“Contents The objective of the study was to assess apoptosis and DNA defragmentation in equine semen diluted and chilled to +4 degrees C. Semen was collected from nine fertile stallions, including four Arabian thoroughbreds and five coldbloods. Examinations were carried out immediately after semen collection (0) and at five storage times (24, 48, 72, 96 and 120h). The basic semen evaluation was performed in terms of volume, sperm concentration, viable sperm percentage, progressive motility and morphology. Using flow cytometry, DNA defragmentation and cell membrane integrity of spermatozoa were determined.

At day P7, apoptosis and hypomyelination in periventricular white matter were evaluated by immunohistochemical assessments.

Results: High-dose maternal omega 3 FA treatment reduced brain weight loss. Maternal omega 3 FA treatment given either in low or high doses greatly decreased caspase-3 immunoreactivity and increased myelin basic protein immunoreactivity, indicating a decrease in apoptosis and hypomyelination. Conclusion: Considering that no specific Z-DEVD-FMK in vivo treatment is available for PVL, maternal omega 3 FA supplementation may provide a nutritional strategy to limit periventricular white matter damage caused by infections during pregnancy.”
“Introduction: Reversible protein cysteine oxidation is recognised as a pivotal post-transitional modification that transduces physiological

as well as pathological signalling. Pharmacological interventions that target specific sources of oxidant formation are currently being trialled learn more to ascertain their potential ability to prevent disease progression. To determine the selectivity of such pharmacological treatments and to indentify new drug targets, a suitable method is required to detect target cysteine oxidation. Method: Using a polyethylene glycol (PEG)-based alkylating agent the reversible oxidation of target proteins can be determined using a novel switch method. After reduction and specific labelling of reversibly oxidised thiols with a ‘heavy’ PEG-tag, samples are resolved on sodiumdodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) gels, Western blotted and immunostained for protein(s) of interest. A mobility shift in a target protein following PEG-alkylation correlates with the reversible oxidative modification. Results: The oxidation

of cAMP-and cGMP-dependent protein kinases was detected using the PEG-switch assay Savolitinib datasheet in Langendorff-perfused hearts after hydrogen peroxide was administered. Discussion: The PEG-switch assay is a fast effective semi-quantitative method for measuring target reversible cysteine oxidation in complex protein mixtures derived from tissue or cultured cells. (C) 2013 Elsevier Inc. All rights reserved.”
“OBJECTIVES: Oncological surgery of the chest wall should be performed to achieve free margins of at least 2 cm for metastasis or 4 cm for primary tumours. When the lesion is not visible or palpable, difficulty in identification may lead to a larger incision and a resection wider than is necessary.

METHODS: We report three cases of non-palpable metastatic chest wall lesions in which the preoperative surgical planning and the intra-operative identification of the tumour, and thus the subsequent chest wall reconstruction, was supported using computer-based surgery.

RESULTS: The application of high-resolution three-dimensional imaging technology and navigational systems is used in preoperative surgical planning to provide virtual simulations of a patient’s skeletal changes and new soft tissue profile.

J Appl Polym Sci, 2011″
“Background: Policy makers, governments and donors are faced with an information gap when considering ways to improve access to artemisinin-based combination therapy (ACT) and malaria NF-��B inhibitor diagnostics including rapid diagnostic tests (RDTs). To help address some of these gaps, a five-year multi-country research project called ACTwatch was launched. The project is designed to provide a comprehensive picture of the anti-malarial market to inform national and international anti-malarial drug policy decision-making.

Methods: The project is being conducted in seven malaria-endemic

countries: Benin, Cambodia, the Democratic Republic of Congo, Madagascar, Nigeria, Uganda and Zambia from 2008 to 2012. ACTwatch measures which anti-malarials are available, where they are available and at what price and who they are used by. These indicators are measured over time and across countries through three study components: outlet surveys, supply chain studies and household surveys. Nationally representative outlet surveys examine the market share of different anti-malarials passing through public facilities and private retail outlets. Supply chain research provides a picture of the supply chain serving drug outlets, and measures mark-ups at each supply chain level. On the demand side, nationally representative household surveys capture treatment seeking patterns and use of anti-malarial drugs, as well as respondent

knowledge of anti-malarials.

Discussion: The research project provides findings on both the demand and LY2603618 supplier supply side determinants

of antimalarial access. There are four key features of ACTwatch. First is the overlap of the three study components where nationally representative data are collected over similar periods, using a common sampling approach. A second feature is the number and diversity of countries that are studied which allows for cross-country comparisons. Another distinguishing feature is its ability to measure trends over time. Finally, the project aims to disseminate findings widely for decision-making.

Conclusions: ACTwatch is a unique multi-country research project that threads together anti-malarial supply and consumer behaviour to provide an evidence base to policy makers that can help determine where interventions may positively impact access to and use of quality-assured see more ACT and RDTs. Because of its ability to detect change over time, it is well suited to monitor the effects of policy or intervention developments in a country.”
“When tooth ankylosis occurs in growing children, the ankylosed tooth fails to erupt and gradually positions itself below the occlusal plane. This causes functional and esthetic problems, and orthodontic treatment is often impossible. To clarify this problem, we developed a new treatment protocol for the movement of ankylosed teeth. This consists of single-tooth dento-osseous osteotomy and alveolar bone distraction using orthodontic multibracket appliances.

2: 1. Overall survival was 78% at the time of follow-up, with death related to meningioma in 7% of the total cohort. Local control was 85% overall, 93% for grade 1 disease, 45% for grade 2 disease and 82% for grade 3 disease. Patients with

non-benign disease were more likely to receive >50 Gy (27% of grade 1 lesions vs 65% of grade 2/3 lesions), but despite this local control remained Dinaciclib chemical structure poor, even with the higher dose delivered (local control 60 and 40% for grade 2 lesions treated with 50 and >50 Gy, respectively, and 100 and 75% for grade 3 lesions treated with 50 and >50 Gy, respectively).

Conclusions: Our cohort of patients had an overall local control and survival similar to those documented from other departments. Grade was an important prognostic factor. Patients selleck inhibitor treated with > 50 Gy had worse local control outcomes, probably due to selection bias. Dose escalation may still be appropriate for high-risk disease, and may be more effective with more conformal techniques, such as intensity-modulated radiotherapy. Estall, V. et al. (2009). Clinical Oncology 21, 745-752 (C) 2009 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.”
“Mesh in pelvic reconstructive surgery is being used increasingly in clinical practice. Complications such as mesh erosion and dyspareunia can cause

significant patient morbidity. In cases where vaginal mesh erosions are large or multifocal resulting in inadequate healthy epithelium for repair, this may lead to recurrent mesh erosion or vaginal stenosis.

Nine patients with AZD1080 supplier synthetic mesh erosion who failed to respond to conservative measures were managed surgically with Surgisis.

The median time at which patients presented with mesh erosion was 12 weeks. The size of erosion ranged from 1 to 4 cm in diameter. At follow-up, five patients were cured, three still had evidence of mesh erosion although the overall defects were smaller, and one patient required further surgery.

With

mesh erosion being a troublesome reality following insertion of synthetic mesh repairs, Surgisis may prove to be a useful option in the treatment of large vaginal mesh defects.”
“Aims: Spinal metastatic disease (SMD) is a serious complication of cancer. To our knowledge, only one population-based study of metastatic spinal cord compression (MSCC) has been carried out. The purpose of the present study was to describe population-based incidences of SMD that required local treatment, such as radiotherapy, surgery or vertebroplasty, including patients with or without cord compression, and to characterise the neurological status of these patients.

Materials and methods: During 18 months, all patients with SMD who received local treatment in the South-Eastern Health Region of Norway (population 2.6 million inhabitants) were identified and their medical records were reviewed.