Docetaxel is an active chemotherapeutic agent in patients with müllerian carcinoma previously treated with paclitaxel-based chemotherapy, especially in the patients who had a long taxane-free interval after a previous short response to paclitaxel.
One- and 2-level ACDF groups improved significantly and maintained improvement throughout 60 month follow-up. When comparing groups, outcomes were often similar, though the 1-level group demonstrated higher fusion rates at 6 and 12 months, greater improvement in NDI scores from 18 to 60-month follow-up, and greater improvement in SF-12 PCS from 12 to 60 months.
work is licensed under a Creative Commons IGO 3.0 AttributionNonCommercial-NoDerivatives (CC-IGO BY-NC-ND 3.0 IGO) license (http://creativecommons.org/licenses/by-nc-nd/3.0/igo/ legalcode) and may be reproduced with attribution to the IDB and for any non-commercial purpose. No derivative work is allowed.Any dispute related to the use of the works of the IDB that cannot be settled amicably shall be submitted to arbitration pursuant to the UNCITRAL rules. The use of the IDB's name for any purpose other than for attribution, and the use of IDB's logo shall be subject to a separate written license agreement between the IDB and the user and is not authorized as part of this CC-IGO license.Note that link provided above includes additional terms and conditions of the license.The opinions expressed in this publication are those of the authors and do not necessarily reflect the views of the Inter-American Development Bank, its Board of Directors, or the countries they represent.http://www.iadb.org 2016 AbstractThe government of Guyana signed a rice compensation agreement with Venezuela in 2009 wherein Guyanese rice exports were accepted in partial payment for imports of Venezuelan oil. The agreement ended in November 2015 and was not renewed for 2016. The scheme had provided stimulus to the Guyanese rice sector, resulting in higher levels of investments in improved inputs and machinery, an expansion in area cultivated, higher levels of outputs, higher levels of exports, and increased employment. The main incentive was the payment of a market premium, averaging 20 percent greater than world price. Despite improvements in yields, the average cost of production for a metric ton of Guyanese rice has remained uncompetitive compared with other leading exporters of rice ( US, India, Pakistan, Thailand, Vietnam), limiting export market diversification opportunities. Because the scheme ended, Guyana must now place all of its exportable surplus in alternative markets. Without dramatic reductions in the cost of production, Guyana's response strategy will be limited to searching for premium bilateral deals and improving value-added processing activities. At present, Cambodia and Myanmar are displacing Guyana's rice exports to the European Union market, and Vietnam has entered into a supply agreement with Haiti, one of Guyana's Caribbean Community markets. This paper assesses the implications of Guyana's vulnerability in this scenario and offers recommendations to assuage the risks of a sharp price reduction. JEL classification codes: F13, F14, F18
Introduction Anterior cervical discectomy and fusion (ACDF) has become a standard surgical option for patients with neck pain or radicular symptoms who failed nonoperative care. Although outcomes are generally good in patients undergoing single-level procedures, results for two-level cases have been less consistent. The purpose of this study was to compare results of single level. ACDF with those of two-level ACDF in patients serving as control groups in a total disc replacement trial. Materials and Methods This was a post hoc analysis of data from two control arms of the Food and Drug Administration regulated trial for the Mobi-C artificial disc. As the control treatment, ACDF with allograft and anterior plate was performed at one level in 81 patients and at two levels in 105 patients for the treatment of symptomatic disc degeneration. The study selection criteria, surgical technique, and outcome measures were identical with the only exception being pathology and surgery at one or two levels. Radiographic assessments were performed by an independent laboratory. In the two-level group, both the levels had to be radiographically fused for the patient to be considered fused. Results Gender, age, body mass index, and 5-year follow-up rates (∼ 75%) were similar in the two groups. Operative time and blood loss were significantly less in the single-level cases ( p < 0.05). Preoperative Neck Disability Index (NDI) scores were similar in the two groups and both improved significantly by 6 weeks and remained significantly improved through follow-up ( p < 0.05). The scores improved by approximately 50% in both the groups. Scores in the single-level group were significantly less at several time points. Visual analog scale scores assessing neck and arm pain followed a pattern similar to NDI, with significant improvement in both groups at 6 weeks' postoperative being maintained through 5 years, with few significant differences between groups. Both groups had significant improvements in SF-12 PCS and MCS scores by 6 months which were maintained throughout follow-up. The single-level group had significantly greater PCS scores at 12-month follow-up and thereafter ( p < 0.05). There were no significant differences in MCS scores between the groups. At 5 years, there was no significant difference in index level secondary surgery rates (11.1 vs. 16.2%). At 60 months, the one-level group fusion rate was 93.3versus 86.1% in the two-level group (not statistically significant). Fusion rates were significantly greater in the one-level group at 6 and 12 months. There was a trend (not statistically significant) for greater adjacent segment degeneration at the inferior segment in the two-level group. Conclusion The design of the disc replacement study created a unique opportunity to compare one- versus two-level ACDF control groups, which used the same inclusion/exclusion criteria and evaluations. Single-level ACDF outcomes were better on a few measures. However, patients in both groups had significantly improved scores on various outcome measures early after surgery and these improvements were maintained throughout 5-year follow-up.
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