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Sample records for intensified case finding

  1. Implementing intensified tuberculosis case-finding among street-connected youth and young adults in Kenya

    PubMed Central

    Mercer, T.; Kimani, S.; Braitstein, P.; Buziba, N.; Carter, E. J.

    2016-01-01

    Background: Street-connected youth and young adults (SCY) suffer a myriad of health problems. In Kenya, SCY are at high risk for tuberculosis (TB) due to their congregate living situations. TB screening is not routinely implemented in SCY and there has been no published literature on the burden of TB in SCY in western Kenya. Program description: In 2011, the AMPATH TB Program, an experienced TB screening program, partnered with the Tumaini Center, a trusted street youth organization, to conduct intensified case finding (ICF) for pulmonary TB among SCY. Our program aimed to investigate the numbers of SCY who reported symptoms and those diagnosed with smear-positive pulmonary TB, and link SCY with TB to treatment. Results: Of 116 SCY who were screened, 114 (98%) had a positive questionnaire; 104 (90%) provided a spot sputum sample, 39 (34%) provided a morning sputum sample, and 111 (97%) reported cough of >2 weeks. One street youth tested smear-positive for TB and was treated through to cure. Conclusions: Implementing TB ICF is feasible in low-resource settings through unique collaborations between health care programs and community-based organizations. In addition to identifying smear-positive TB, our program uncovered a high burden of respiratory symptoms among SCY in Eldoret, Kenya. PMID:27358809

  2. Can Intensified Tuberculosis Case Finding Efforts at Nutrition Rehabilitation Centers Lead to Pediatric Case Detection in Bihar, India?

    PubMed Central

    Mishra, Bal Krishna; Moonan, Patrick K.; Nair, Sreenivas A.; Kumar, Ajay M. V.; Gandhi, Mohit P.; Mannan, Shamim

    2016-01-01

    Introduction Seven district-level Nutritional Rehabilitation Centres (NRCs) in Bihar, India provide clinical and nutritional care for children with severe acute malnutrition (SAM). Aim To assess whether intensified case finding (ICF) strategies at NRCs can lead to pediatric case detection among SAM children and link them to TB treatment under the Revised National Tuberculosis Control Programme (RNTCP). Materials and Methods A retrospective cohort study was conducted that included medical record reviews of SAM children registered for TB screening and RNTCP care during July–December 2012. Results Among 440 SAM children screened, 39 (8.8%) were diagnosed with TB. Among these, 34 (87%) initiated TB treatment and 18 (53%) were registered with the RNTCP. Of 16 children not registered under the RNTCP, nine (56%) weighed below six kilograms—the current weight requirement for receiving drugs under RNTCP. Conclusion ICF approaches are feasible at NRCs; however, screening for TB entails diagnostic challenges, especially among SAM children. However, only half of the children diagnosed with TB were treated by the RNTCP. More effort is needed to link this vulnerable population to TB services in addition to introducing child-friendly drug formulations for covering children weighing less than six kilograms. PMID:27066518

  3. Yield of intensified tuberculosis case-finding activities using Xpert® MTB/RIF among risk groups in Nepal

    PubMed Central

    Baral, S.; Shrestha, P.; Puri, M.; Kandel, S.; Lamichanne, B.; Elsey, H.; Brouwer, M.; Goel, S.; Chinnakali, P.

    2016-01-01

    Setting: Twenty-two districts of Nepal, where intensified case-finding (ICF) activities for tuberculosis (TB) were implemented among risk groups under the TB REACH initiative in collaboration with the National TB Programme from July 2013 to November 2015. Objectives: To assess the yield of TB screening using an algorithm with smear microscopy followed by Xpert® MTB/RIF. Design: A descriptive study using routinely collected data. Results: Of 145 679 individuals screened, 28 574 (19.6%) had presumptive TB; 1239 (4.3%) of these were diagnosed with TB and 1195 (96%) were initiated on anti-tuberculosis treatment. The yield of screening was highest among people living with the human immunodeficiency virus (PLHIV) (6.1%), followed by household contacts (3.5%) and urban slum dwellers (0.5%). Among other risk groups, such as prisoners, factory workers, refugees and individuals with diabetes, the yield was less than 0.5%. The number needed to screen to diagnose an active TB case was 17 for PLHIV, 29 for household contacts and 197 for urban slum dwellers. Of 11 525 patients from ICF and the routine programme, 112 (1%) were diagnosed with multidrug-resistant TB. Conclusion: There was a substantial yield of TB cases among risk groups such as PLHIV and household contacts. Although the yield in urban slum dwellers was found to be moderate, some intervention should nonetheless be targeted because of the large population and poor access to care in this group. PMID:27358808

  4. Intensified tuberculosis case finding among HIV-infected persons using a WHO symptom screen and Xpert® MTB/RIF

    PubMed Central

    Adelman, M. W.; Tsegaye, M.; Kempker, R. R.; Alebachew, T.; Haile, K.; Tesfaye, A.; Aseffa, A.; Blumberg, H. M.

    2015-01-01

    SUMMARY SETTING Human immunodeficiency virus (HIV) clinic in Addis Ababa, Ethiopia. The World Health Organization (WHO) recommends active tuberculosis (TB) case-finding among people living with HIV (PLHIV) in high-burden settings. OBJECTIVE To evaluate the effectiveness of combining a WHO-recommended symptom screen and the Xpert® MTB/RIF test to enhance TB case finding. DESIGN In this cross-sectional study, PLHIV were screened for TB using a WHO-recommended symptom-based algorithm (cough, fever, night sweats, weight loss). Those with a positive symptom screen (≥1 symptom) underwent diagnostic testing with smear microscopy, culture, and Xpert. RESULTS Of 828 PLHIV (89% on antiretroviral therapy), 321 (39%) had a positive symptom screen. In multivariate analysis, an unscheduled clinic visit (aOR 3.78, 95%CI 2.69–5.32), CD4 count <100 cells/µl (aOR 2.62, 95%CI 1.23–5.59) and previous history of TB (aOR 1.62, 95%CI 1.12–2.31) were predictors of a positive symptom screen. Among those with a positive symptom screen, 6% had active pulmonary TB. Smear microscopy sensitivity for TB was poor (30%) compared to culture and Xpert. CONCLUSIONS A positive symptom screen was common among PLHIV, creating a substantial laboratory burden. Smear microscopy had poor sensitivity for active TB disease. Given the high rate of positive symptom screen, substantial additional resources are needed to implement intensified TB case finding among PLHIV in high-burden areas. PMID:26459533

  5. The Diagnostic Performance of a Single GeneXpert MTB/RIF Assay in an Intensified Tuberculosis Case Finding Survey among HIV-Infected Prisoners in Malaysia

    PubMed Central

    Al-Darraji, Haider Abdulrazzaq Abed; Razak, Humaira Abd; Ng, Kee Peng; Altice, Frederick L.; Kamarulzaman, Adeeba

    2013-01-01

    Background Delays in tuberculosis (TB) diagnosis, particularly in prisons, is associated with detrimental outcomes. The new GeneXpert MTB/RIF assay (Xpert) offers accurate and rapid diagnosis of active TB, but its performance in improving case detection in high-transmission congregate settings has yet to be evaluated. We assessed the diagnostic accuracy of a single Xpert assay in an intensified case finding survey among HIV-infected prisoners in Malaysia. Methods HIV-infected prisoners at a single site provided two early-morning sputum specimens to be examined using fluorescence smear microscopy, BACTEC MGIT 960 liquid culture and a single Xpert. The sensitivity, specificity, negative and positive predictive values of Xpert were calculated relative to gold-standard results using MGIT 960 liquid culture. Relevant clinical and demographic data were used to examine correlates of active TB disease. Results The majority of enrolled subjects with complete data (N=125) were men (90.4%), age <40 years (61.6%) and had injected drugs (75.2%). Median CD4 lymphocyte count was 337 cells/µL (IQR 149-492); only 19 (15.2%) were receiving antiretroviral therapy. Of 15 culture-positive TB cases, single Xpert assay accurately detected only eight previously undiagnosed TB cases, resulting in a sensitivity, specificity, positive predictive value and negative predictive value of 53.3% (95% CI 30.12-75.2%), 100% (95% CI 96.6-100%), 100% (95% CI 67.56-100%) and 94.0% (95% CI 88.2-97.1%), respectively. Only 1 of 15 (6.7%) active TB cases was smear-positive. The prevalence (12%) of undiagnosed active pulmonary TB (15 of 125 prisoners) was high and associated with longer duration of drug use (AOR 1.14, 95% CI 1.03-1.26, for each year of drug use). Conclusions Single Xpert assay improved TB case detection and outperformed AFB smear microscopy, but yielded low screening sensitivity. Further examination of the impact of HIV infection on the diagnostic performance of the new assay alongside

  6. Reinforcing element and demand sensitive pressure intensifier for sealing a well casing

    SciTech Connect

    Wambaugh, J. O.

    1985-10-08

    A reinforcing element for an elastomeric sealing element for use within a well casing and passable through production tubing is formed of two metallic plate members having a plurality of radially extending projections, and the radially extending projections are bent and joined to one another to allow the reinforcing element to be passed through production tubing. A demand sensitive pressure intensifier for use with a hydraulic fluid pump and passable through production tubing has a means for compressing hydraulic fluid to a pressure which exceeds the maximum output pressure of the pump, and the compression means is selectively actuated when the output pressure of the pump reaches a predetermined pressure value.

  7. [Omental infarction: CT findings (case report)].

    PubMed

    Yildiz, Seçil; Atasoy, Cetin; Yağci, Cemil; Akyar, Serdar

    2004-06-01

    Omental infarction, the end result of impaired perfusion of the greater omentum, is an uncommon cause of acute abdominal pain. Because its clinical symptoms are nonspecific, it is usually confused with more common conditions such as appendicitis or cholecystitis. Consequently, the diagnosis is generally made intraoperatively. However, computed tomography shows characteristic findings and allows a reliable preoperative diagnosis, preventing unnecessary laparotomy. We report two cases of omental infarction, and describe typical CT findings of this rare entitiy. PMID:15236134

  8. Value of intensified nursing

    PubMed Central

    Frank, Wilhelm; Konta, Brigitte; Prusa, Nina; Raymann, Cornelia

    2006-01-01

    The concept "intensified nursing" is mentioned in differentiation to concepts of "nursing care" or "nursing" which intensifies resources or patient contact. Especially psychic and social needs of patients are very appreciated in nursing. A similar type of nursing is known under the concept "advanced nursing practice" (ANP) which means, that a specialised, academically trained nurse offers an extended nursing care in which a focus on the published knowledge of evidence based research is made. From the thin literature to this topic a selection of predetermined topics was analysed where at least two articles with a sufficient high methodical quality were available. The selected topic groups were: „Infant and paediatric nursing", "gerontology" and "oncology". Generally the five publications concerning infant and paediatric nursing could conclusive show a benefit of intensified nursing. Further research is still needed to prove intensified nursing care. Two publications could be found to the gerontological intensified nursing; both used an extended nursing model and an enlarged use of resources. Both studies demonstrated a measurable success in the applied parameters. Two studies also could be analysed in the oncological field in which successes were also provable by the applied parameters. The success was given especially in a higher patient satisfaction, one study showed an improved scheduling (time planning) of nurses. There was not one article concerning economic questions of intensified nursing care. It has to be taken into account that the financial resources have to be used effectively also in nursing nowadays. It has to be assumed that the costs are driven by increased use of resources. Savings can be achieved, however, in the form of avoided therapies and days in hospital by intensified nursing. The intensified nursing can be considered as similar cost-effective as conventional models of nursing. Ethically it is necessary to consider that the possibilities of

  9. Imagery intensifier for recce

    NASA Astrophysics Data System (ADS)

    Sturz, Richard A.

    1998-11-01

    The image intensifier based night vision goggle which has proven so useful in low light or night observation applications, can be mated to the typical CD video camera for imaging under these adverse lighting conditions. Image intensifiers have specific spectral response, low light sensitivity, resolution, and electronic characteristics to augment standard CCD camera capability and thus provide video suited for reconnaissance. The variety of these devices include the Gen I, Gen II and the Gen II series of image intensifiers. Recent developments have increased the variety of spectral response, quantum efficiencies and spatial resolution within the Gen II and Gen III types. The SPIE Airborne Reconnaissance session paper presented in 1995 entitled 'Advanced in Low Light Level Video Imaging' described the then available image intensifiers. This paper explores and updates the data of the 1995 paper and discusses the changes and improvements in image intensifiers since the original paper. Additional information concerning the CCD camera and image intensification for reconnaissance applications is also presented.

  10. Radiographic intensifying screen

    SciTech Connect

    Ochiai, T.

    1985-02-26

    A radiographic intensifying screen comprising a substrate and a fluorescent layer provided thereon and consisting essentially of a binder and a radioluminescent phosphor dispersed therein. The binder comprises linear polyester resin or linear polyester resin crosslinked with a crosslinking agent. The screen exhibits improved physical properties.

  11. Neutron-image intensifier

    NASA Technical Reports Server (NTRS)

    Berger, H.

    1970-01-01

    Electronic intensifier tube with a demagnification ratio of 9-1 enhances the usefulness of neutron-radiographic techniques. A television signal can be obtained by optical coupling of a small-output phosphor-light image to a television camera.

  12. Evaluating intensified camera systems

    SciTech Connect

    S. A. Baker

    2000-06-30

    This paper describes image evaluation techniques used to standardize camera system characterizations. The authors group is involved with building and fielding several types of camera systems. Camera types include gated intensified cameras, multi-frame cameras, and streak cameras. Applications range from X-ray radiography to visible and infrared imaging. Key areas of performance include sensitivity, noise, and resolution. This team has developed an analysis tool, in the form of image processing software, to aid an experimenter in measuring a set of performance metrics for their camera system. These performance parameters are used to identify a camera system's capabilities and limitations while establishing a means for camera system comparisons. The analysis tool is used to evaluate digital images normally recorded with CCD cameras. Electro-optical components provide fast shuttering and/or optical gain to camera systems. Camera systems incorporate a variety of electro-optical components such as microchannel plate (MCP) or proximity focused diode (PFD) image intensifiers; electro-static image tubes; or electron-bombarded (EB) CCDs. It is often valuable to evaluate the performance of an intensified camera in order to determine if a particular system meets experimental requirements.

  13. Evaluating intensified camera systems

    SciTech Connect

    S. A. Baker

    2000-07-01

    This paper describes image evaluation techniques used to standardize camera system characterizations. Key areas of performance include resolution, noise, and sensitivity. This team has developed a set of analysis tools, in the form of image processing software used to evaluate camera calibration data, to aid an experimenter in measuring a set of camera performance metrics. These performance metrics identify capabilities and limitations of the camera system, while establishing a means for comparing camera systems. Analysis software is used to evaluate digital camera images recorded with charge-coupled device (CCD) cameras. Several types of intensified camera systems are used in the high-speed imaging field. Electro-optical components are used to provide precise shuttering or optical gain for a camera system. These components including microchannel plate or proximity focused diode image intensifiers, electro-static image tubes, or electron-bombarded CCDs affect system performance. It is important to quantify camera system performance in order to qualify a system as meeting experimental requirements. The camera evaluation tool is designed to provide side-by-side camera comparison and system modeling information.

  14. Characterization of photocathode dark current vs. temperature in image intensifier tube modules and intensified televisions

    NASA Astrophysics Data System (ADS)

    Bender, Edward J.; Wood, Michael V.; Hart, Steve; Heim, Gerald B.; Torgerson, John A.

    2004-10-01

    Image intensifiers (I2) have gained wide acceptance throughout the Army as the premier nighttime mobility sensor for the individual soldier, with over 200,000 fielded systems. There is increasing need, however, for such a sensor with a video output, so that it can be utilized in remote vehicle platforms, and/or can be electronically fused with other sensors. The image-intensified television (I2TV), typically consisting of an image intensifier tube coupled via fiber optic to a solid-state imaging array, has been the primary solution to this need. I2TV platforms in vehicles, however, can generate high internal heat loads and must operate in high-temperature environments. Intensifier tube dark current, called "Equivalent Background Input" or "EBI", is not a significant factor at room temperature, but can seriously degrade image contrast and intra-scene dynamic range at such high temperatures. Cooling of the intensifier's photocathode is the only practical solution to this problem. The US Army RDECOM CERDEC Night Vision & Electronic Sensors Directorate (NVESD) and Ball Aerospace have collaborated in the reported effort to more rigorously characterize intensifier EBI versus temperature. NVESD performed non-imaging EBI measurements of Generation 2 and 3 tube modules over a large range of ambient temperature, while Ball performed an imaging evaluation of Generation 3 I2TVs over a similar temperature range. The findings and conclusions of this effort are presented.

  15. Ultrasonographic findings in a cow with abomasal lymphosarcoma: Case report

    PubMed Central

    2011-01-01

    Background This case report describes the clinical and ultrasonographic findings in a Swiss Braunvieh cow with lymphosarcoma of the abomasum. Case Presentation The main clinical findings were vomiting in response to eating and melena. The results of serum biochemistry and rumen fluid analysis were indicative of abomasal reflux syndrome. The main ultrasonographic findings were two enlarged lymph nodes caudal to the reticulum and a severely enlarged abomasum with thickening of the abomasal wall and folds. Based on all the findings, pyloric stenosis caused by lymphosarcoma was tentatively diagnosed and later confirmed at postmortem examination. Conclusions This is an interesting case, which broadens the spectrum of abomasal reflux syndrome. PMID:21612590

  16. Nuggets: findings shared in multiple clinical case reports

    PubMed Central

    Smalheiser, Neil R.; Shao, Weixiang; Yu, Philip S.

    2015-01-01

    Objective The researchers assessed prevalence in the clinical case report literature of multiple reports independently reporting the same (or nearly the same) main finding. Methods Results from forty-five PubMed queries were examined for incidence and features of main findings (“nuggets”) shared in at least four case reports. Results The authors found that nuggets are surprisingly prevalent and large in the case report literature, the largest found so far was reported in seventeen articles. In most cases, the main findings of case reports were evident from examining titles alone. Conclusions Our curated examples should serve as gold standards for developing specific automated methods for finding nuggets. Nuggets potentially enable finding-based (instead of topic-based) information retrieval. PMID:26512214

  17. Active case finding of tuberculosis: historical perspective and future prospects

    PubMed Central

    Golub, J. E.; Mohan, C. I.; Comstock, G. W.; Chaisson, R. E.

    2015-01-01

    SUMMARY Despite a history of remarkable scientific achievements in microbiology and therapeutics, tuberculosis (TB) continues to pose an extraordinary threat to human health. Case finding and treatment of TB disease are the principal means of controlling transmission and reducing incidence. This review presents a historical perspective of active case finding (ACF) of TB, detailing case detection strategies that have been used over the last century. This review is divided into the following sections: mass radiography, house-to-house surveys, out-patient case detection, enhanced case finding, high-risk populations and cost-effectiveness. The report concludes with a discussion and recommendations for future case finding strategies. Understanding the strengths and weaknesses of these methods will help inform and shape ACF as a TB control policy in the twenty-first century. PMID:16333924

  18. Corrosion inhibition using mercury intensifiers

    SciTech Connect

    Cizek, A.

    1990-03-05

    This patent describes an intensified corrosion inhibitor composition for inhibiting the corrosion of steel in the presence of an acidic medium. It comprises: an effective amount of an acid soluble mercury metal intensifier; and a corrosion inhibitor. This patent also describes a method of treating a subterranean well for enhancement of production within the well, comprising the steps of introducing and positioning within the well a high alloy stec surface exposable to a treatment fluid therewith; introducing into the well and contacting the surface with a treatment fluid comprising an acidic injection medium, an acid corrosion inhibitor, and an intensifier for deposition on or effective treatment contact with the surface, the intensifier comprising an acid soluble mercury metal site circulating the fluid into the well for contact with at least one production zone within the well.

  19. School-Based Asthma Case Finding: The Arkansas Experience

    ERIC Educational Resources Information Center

    Vargas, Perla A.; Magee, James S.; Bushmiaer, Margo; Simpson, Pippa M.; Jones, Craig A.; Feild, Charles R.; Jones, Stacie M.

    2006-01-01

    This population-based case-finding study sought to determine asthma prevalence and characterize disease severity and burden among school-aged children in the Little Rock School District. Asthma cases were identified by validated algorithm and parental report of asthma diagnosis. The overall response rate was low. Among schools with greater than…

  20. Computed Tomographic Findings of Syphilitic Aortitis: A Case Report

    SciTech Connect

    Kimura, Fumiko; Satoh, Hideyuki; Sakai, Fumikazu; Nishii, Noriko; Tohda, Joe; Fujimura, Mikihiko; Haruta, Shoji; Yamazaki, Kenji; Endo, Masahiro; Sakomura, Yasunari; Kurosama, Hiromi; Kasanuki, Hiroshi

    2004-03-15

    We describe the computerized tomographic (CT) findings of the aortic wall in a case of acute-phase syphilitic arteritis. The delayed phase of the contrast-enhanced CT shows a double-ring configuration of the thick thoracic aortic wall, which is similar to CT findings previously reported for Takayasu arteritis. We speculate that the resemblance of the CT findings for these two diseases accounts for their similar histopathological features.

  1. An incidental case of biliary fascioliasis with subtle clinical findings: US and MRCP findings

    PubMed Central

    Önder, Hakan; Ekici, Faysal; Adin, Emin; Kuday, Suzan; Gümüş, Hatice; Bilici, Aslan

    2013-01-01

    Background Fascioliasis is a disease caused by the trematode Fasciola hepatica. Cholangitis is a common clinical manifestation. Although fascioliasis may show various radiological and clinical features, cases without biliary dilatation are rare. Case report We present unique ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) findings of a biliary fascioliasis case which doesn’t have biliary obstruction or cholestasis. Radiologically, curvilinear parasites compatible with juvenile and mature Fasciola hepatica within the gallbladder and common bile duct were found. The parasites appear as bright echogenic structures with no acoustic shadow on US and hypo-intense curvilinear lesions on T2 weighted MRCP images. Conclusions Imaging studies may significantly contribute to the diagnosis of patients with subtle clinical and laboratory findings, particularly in endemic regions. PMID:23801908

  2. Clinical and radiological findings of a bilateral coronoid hyperplasia case

    PubMed Central

    Torenek, Kubra; Duman, Suayip Burak; Bayrakdar, Ibrahim Sevki; Miloglu, Ozkan

    2015-01-01

    Coronoid hyperplasia (CH) is an infrequent condition that can be defined as an abnormal bony elongation of histologically normal bone. Progressive and painless difficulty in opening the mouth is the main clinical finding of CH. In this case report, the clinical and radiological findings for a 23-year-old male patient with bilateral CH are presented. When plain radiographies are not sufficient for diagnosis and evaluation of the CH, cone-beam computed tomography can be used. PMID:25713499

  3. Clinicopathological Findings of Suicide in the Elderly: Three Cases

    ERIC Educational Resources Information Center

    Peisah, Carmelle; Snowdon, John; Kril, Jillian; Rodriguez, Michael

    2007-01-01

    The neuropathological correlates of suicide in older persons have received little research attention. Our recent study of elderly suicide victims from an Australian forensic medicine department (n = 143), unlike a previous case-control study, did not find an increased prevalence of Alzheimer's disease (AD) in older persons who committed suicide…

  4. Fatal ammonia inhalation. A case report with autopsy findings.

    PubMed

    Price, S K; Hughes, J E; Morrison, S C; Potgieter, P D

    1983-12-01

    A 25-year-old refrigeration technician died 85 days after accidental massive anhydrous ammonia inhalation; the case history and autopsy findings are described. The latter included bronchiectasis and obliterative bronchiolitis, but interstitial fibrosis and emphysema were conspicuously absent. The roles of dosage, infection, and healing are discussed. PMID:6648731

  5. Hurler syndrome: orofacial, dental, and skeletal findings of a case.

    PubMed

    Thakur, Arpita Rai; Naikmasur, Venkatesh G; Sattur, Atul

    2015-04-01

    Hurler syndrome is a disorder of mucopolysaccharide metabolism caused due to inherited deficiencies of lysosomal α-l-iduronidase activity. We present a case of a 15-year-old male patient presenting with clinical and laboratory characteristics of the syndrome. A rare combination of skeletal, ophthalmologic, and dental findings was observed in this patient. Mucopolysaccharides excretion spot test of urine was positive and an assay of alpha-l-iduronidase enzyme was deficient, confirming the clinical diagnosis of Hurler syndrome. PMID:25134498

  6. Susac syndrome: a case report and PET imaging findings.

    PubMed

    Dielman, Charlotte; Laureys, Guy; Meurs, Alfred; Bissay, Veronique; Ebinger, Guy

    2009-09-01

    We describe the case of a twenty-year-old woman with subacute encephalopathy, who subsequently developed hearing loss and ophtalmopathy. The clinical triad and typical findings on magnetic resonance imaging and cerebrospinal fluid analysis led to the diagnosis of Susac syndrome. Brain positron emission tomography showed abnormalities which are comparable with other types of central nervous system vasculitis, and distinct from those found in multiple sclerosis. PMID:19902818

  7. A Case of Neurocutaneous Melanosis and Neuroimaging Findings

    PubMed Central

    Gocmen, Rahsan; Guler, Ezgi; Arslan, Elif Acar

    2015-01-01

    Neurocutaneous melanosis is a rare congenital disorder which presents with congenital cutaneous nevi and involvement of the central nervous system. We herein present a rare case of a 2-year-old girl who had central nervous system melanosis and giant congenital melanocytic nevi. Magnetic resonance imaging, especially precontrast T1 images play a crucial role in making the diagnosis combined with the skin findings of physical examination. PMID:25926927

  8. [Spinal extradural meningiomas: MRI findings in two cases].

    PubMed

    Vargas, M I; Abu Eid, M; Bogorin, A; Beltechi, R; Boyer, P; Javier, R M; Zöllner, G; Dietemann, J L

    2004-06-01

    Spinal extradural meningiomas are rare and may be easily confused with malignant neoplasms. We report two unusual cases of epidural spinal meningioma one within the left C6-C7 foramen and the other within the left posterolateral epidural space at the T3-T4 level. Low signal intensity of the tumor on T2-wi, thickening and enhancement of the dura with only the possibility of bone erosion are the most characteristic MR findings. PMID:15356447

  9. Nursing home case mix in Wisconsin. Findings and policy implications.

    PubMed

    Arling, G; Zimmerman, D; Updike, L

    1989-02-01

    Along with many other states, Wisconsin is considering a case mix approach to Medicaid nursing home reimbursement. To support this effort, a nursing home case mix model was developed from a representative sample of 410 Medicaid nursing home residents from 56 facilities in Wisconsin. The model classified residents into mutually exclusive groups that were homogeneous in their use of direct care resources, i.e., minutes of direct care time (weighted for nurse skill level) over a 7-day period. Groups were defined initially by intense, Special, or Routine nursing requirements. Within these nursing requirement categories, subgroups were formed by the presence/absence of behavioral problems and dependency in activities of daily living (ADL). Wisconsin's current Skilled/Intermediate Care (SNF/ICF) classification system was analyzed in light of the case mix model and found to be less effective in distinguishing residents by resource use. The case mix model accounted for 48% of the variance in resource use, whereas the SNF/ICF classification system explained 22%. Comparisons were drawn with nursing home case mix models in New York State (RUG-II) and Minnesota. Despite progress in the study of nursing home case mix and its application to reimbursement reform, methodologic and policy issues remain. These include the differing operational definitions for nursing requirements and ADL dependency, the inconsistency in findings concerning psychobehavioral problems, and the problem of promoting positive health and functional outcomes based on models that may be insensitive to change in resident conditions over time. PMID:2493112

  10. A rare incidental finding in a case of painless jaundice.

    PubMed

    Patel, Sundip N; Baumann, Brigitte M; Farner, Michael C; Farmer, Michael C

    2008-05-01

    Portal vein thrombosis secondary to protein C deficiency is a rare finding. Diagnosing a portal vein thrombosis itself is difficult due to nonspecific symptoms such as nausea, vomiting, anorexia, and weight loss. Proving that a protein C deficiency is the cause of a portal vein thrombosis is even more difficult as an extensive and thorough workup is required to rule out malignancies, myeloproliferative disorders, and hypercoaguable states which can all lead to thromboses. Patients require anticoagulation to prevent two dangerous complications of portal vein thrombosis; portal hypertension leading to esophageal varices with massive hemetemesis and extension of thrombus from the portal vein into the mesenteric veins leading to intestinal ischemia and death. In this case report, we present a patient with the complaint of painless jaundice who was found to have an incidental finding of portal vein thrombosis secondary to protein C deficiency. The different etiologies of portal vein thrombosis, along with diagnosis and treatment options will be discussed and highlighted. PMID:18410831

  11. [Clinical forensic examination findings in assault cases among adolescents].

    PubMed

    Bode-Jänisch, Stefanie; Buddeke, Florian; Schulz, Yvonne; Fieguth, Armin

    2010-01-01

    Child and youth criminality has risen markedly over the past 25 years and causes increasing concern to the general public. The clinical forensic examination cases of youth violence victims examined at the Institute of Legal Medicine of the Hanover Medical School and its Oldenburg Branch between 1999 and 2008 were retrospectively analyzed. In all, 55 adolescents (37 females, 18 males; median age 15.5 years) were examined. In most cases the suspect was a close (40.0%) or passing (23.6%) acquaintance. 16 assaults were committed by two or more adolescents jointly. Most of the juveniles were victims of sexual assaults (56.4%). In 15 victims of sexual offences (51.7%) diagnostic findings were obtained on the basis of anogenital injuries and/or the presence of sperm. In summary, the analysis shows that adolescents frequently become victims of sexual assault. In addition, youth violence is often committed in a group. PMID:21254705

  12. MRI Findings of Talocalcaneal Coalition: Two Case Reports

    PubMed Central

    Umul, Ayşe

    2015-01-01

    Introduction: Tarsal coalition is abnormal fusion of two or more tarsal bones and is a common cause of foot pain. There are osseous, cartilaginous and fibrous subtypes. Calcaneonavicular and talocalcaneal coalitions are more frequent. Radiography is the primary diagnostic tool, however CT and MRI are precious examinations for differential diagnosis of osseous /non-osseous coalitions separations. Furthermore, cross-sectional imaging methods indicate the extension and secondary degenerative joint changes. Case reports: The detection of bone marrow of edema in the articulation area is valuable for diagnosis Hereby, we present two cases, 24 years old female and 35 years old male, with the diagnosis of talocalcaneal coaliation. We also discuss MRI and radiographic findings. PMID:26483601

  13. Diagnostic utility of lymphocyte subset analysis in AIDS case finding.

    PubMed Central

    Boyko, W J; Schechter, M T; MacLeod, A; Douglas, B; Maynard, M; Sharp, R; Wiggs, B

    1986-01-01

    Abnormalities of lymphocyte subsets, especially low absolute number of helper T cells, are characteristically present in acquired immune deficiency syndrome (AIDS). Similar abnormalities can be found in patients with persistent generalized lymphadenopathy (PGL) or AIDS-related complex (ARC) and, to a lesser degree, in asymptomatic people who have been exposed to human T-lymphotropic virus type III (HTLV-III). Nevertheless, there appears to be a widespread perception that lymphocyte subset analysis may be useful in AIDS case finding within high-risk groups. We evaluated the diagnostic utility of absolute number of helper T cells and ratio of helper to suppressor T cells in 33 patients with AIDS, 43 patients with PGL who had been referred for lymph node biopsy, 90 patients with PGL and 195 male homosexual controls. At conventional cutoff levels the tests did not appear to revise the probability of AIDS upward to any clinically significant degree when the pretest probability of AIDS was low. Lymphocyte subset analysis does not appear to be a cost-effective method of AIDS case finding in identified groups at risk in which the prevalence of AIDS is low. PMID:2938707

  14. Increased Case Notification through Active Case Finding of Tuberculosis among Household and Neighbourhood Contacts in Cambodia

    PubMed Central

    Morishita, Fukushi; Eang, Mao Tan; Nishikiori, Nobuyuki; Yadav, Rajendra-Prasad

    2016-01-01

    Background Globally, there has been growing evidence that suggests the effectiveness of active case finding (ACF) for tuberculosis (TB) in high-risk populations. However, the evidence is still insufficient as to whether ACF increases case notification beyond what is reported in the routine passive case finding (PCF). In Cambodia, National TB Control Programme has conducted nationwide ACF with Xpert MTB/RIF that retrospectively targeted household and neighbourhood contacts alongside routine PCF. This study aims to investigate the impact of ACF on case notifications during and after the intervention period. Methods Using a quasi-experimental cluster randomized design with intervention and control arms, we compared TB case notification during the one-year intervention period with historical baseline cases and trend-adjusted expected cases, and estimated additional cases notified during the intervention period (separately for Year 1 and Year 2 implementation). The proportion of change in case notification was compared between intervention and control districts for Year 1. The quarterly case notification data from all intervention districts were consolidated, aligning different implementation quarters, and separately analysed to explore the additionality. The effect of the intervention on the subsequent case notification during the post-intervention period was also assessed. Results In Year 1, as compared to expected cases, 1467 cases of all forms (18.5%) and 330 bacteriologically-confirmed cases (9.6%) were additionally notified in intervention districts, whereas case notification in control districts decreased by 2.4% and 2.3%, respectively. In Year 2, 2737 cases of all forms (44.3%) and 793 bacteriologically-confirmed cases (38%) were additionally notified as compared to expected cases. The proportions of increase in case notifications from baseline cases and expected cases to intervention period cases were consistently higher in intervention group than in control

  15. Intensified coastal development behind nourished beaches

    NASA Astrophysics Data System (ADS)

    Armstrong, Scott; Lazarus, Eli; Limber, Patrick; Goldstein, Evan; Thorpe, Curtis; Ballinger, Rhoda

    2016-04-01

    Population density, housing development, and property values in coastal counties along the U.S. Atlantic and Gulf Coasts continue to rise despite increasing hazard from storm impacts. Since the 1970s, beach nourishment, which involves importing sand to deliberately widen an eroding beach, has been the main strategy in the U.S. for protecting coastal properties from erosion and flooding hazards. Paradoxically, investment in hazard protection may intensify development. Here, we examine the housing stock of all existing shorefront single-family homes in Florida - a microcosm of U.S. coastal hazards and development - to quantitatively compare development in nourishing and non-nourishing towns. We find that nourishing towns now account for more than half of Florida's coastline, and that houses in nourishing towns are larger and more numerous. Even as the mean size of single-family homes nationwide has grown steadily since 1970, Florida's shorefront stock has exceeded the national average by 34%, and in nourishing towns by 45%. This emergent disparity between nourishing and non-nourishing towns in Florida demonstrates a pattern of intensifying coastal risk, and is likely representative of a dominant trend in coastal development more generally. These data lend empirical support to the hypothesis that US coastal development and hazard mitigation through beach nourishment have become dynamically coupled.

  16. Bilateral invasive lobular breast cancer in a female teenager: a rare finding of a common disease--case report and review of literature.

    PubMed

    Enownchong, Enow-Orock George; Thomas, Egbe Obinchemti; Akum, Achidi Eric; Defang, Asonganyi Etienne; Paul, Ndom; Emmanuel, Fongang; Peter, Ndumbe

    2010-01-01

    Management of cancer patients in low-resource communities presents enormous challenges. Breast cancer is a public health problem in Cameroon and occurs mostly in elderly women. The predominant histological type is a duct carcinoma. Lobular carcinoma in teenagers is rare. In this report we present a case of bilateral invasive lobular carcinoma of the breast that was confirmed on biopsies in a 22-year-old female. We present this rare finding and review the pathological, clinical and radiographic challenges of the disease. Nodules in the breast from patients of any age should be submitted for histology. Public education is beneficial and should be intensified. PMID:21436945

  17. A case of trichotillomania with recently defined trichoscopic findings.

    PubMed

    Yorulmaz, Ahu; Artuz, Ferda; Erden, Orkun

    2014-04-01

    Trichotillomania (TTM) is an impulse control disorder characterized by repetitive behavior of hair pulling resulting in secondary alopecia. It is among the psychocutaneous diseases known to be associated with psychiatric comorbidity, social, and functional impairment. Although most of the time, an experienced dermatologist easily recognizes the key features of TTM, a history and physical examination alone might not be enough to make a definitive diagnosis. As an effective noninvasive technique for the evaluation of scalp and hair diseases, trichoscopy also has proven to be a valuable tool in the diagnosis of TTM. Currently, new trichoscopic findings of TTM have been described. Here, we report a case of TTM with recently defined trichoscopic features. PMID:25191044

  18. A new mechanical arm trainer to intensify the upper limb rehabilitation of severely affected patients after stroke: design, concept and first case series.

    PubMed

    Hesse, S; Schmidt, H; Werner, C; Rybski, C; Puzich, U; Bardeleben, A

    2007-12-01

    Description and case series on a new mechanical arm trainer with three degrees of freedom (DoF), the REHA-SLIDE (RS), for stroke rehabilitation are presented. Similar to a rolling pin, it consists of two handles at either side of a connecting rod, the handles are bilaterally moved forward and backward, sideways, and rotated, the base plate is inclinable. A computer mouse attached to the rod enables playing games offering computer-biofeedback. Two patients, 6 and 5 weeks after a first-time supratentorial stroke, suffering from a flaccid non-functional upper extremity have been studied. Interventions performed were additional 30 min of RS-training every workday for 6 weeks; one session included 400 repetitions evenly distributed between the forward backward movement and drawing a circle clock- and counter clockwise. Afterwards the patients could play games. Upper extremity portion of the Fugl-Meyer Motor Assessment Score (FM, 0-66), and muscle strength by a Medical Research Council (MRC) sum score (0-45), the FM assessment was blinded. In the 2 patients, the FM (0-66) improved from 7 to 37, and from 17 to 43, their initial (terminal) MRC sum scores were 6 (36) and 13 (31). With the REHA-Slide (RS), severely affected patients practiced a bilateral 3 DoF movement. No conclusions can be drawn so far and a controlled clinical study must be the next step. PMID:18084168

  19. Findings

    MedlinePlus

    ... Issue All Issues Explore Findings by Topic Cell Biology Cellular Structures, Functions, Processes, Imaging, Stress Response Chemistry ... Glycobiology, Synthesis, Natural Products, Chemical Reactions Computers in Biology Bioinformatics, Modeling, Systems Biology, Data Visualization Diseases Cancer, ...

  20. [A case of Plasmodium vivax malaria with findings of DIC].

    PubMed

    Takaki, K; Aoki, T; Akeda, H; Kajiwara, T; Honda, S; Maeda, Y; Okada, K; Sawae, Y

    1991-04-01

    We reported a rare case of Plasmodium vivax malaria who showed findings of disseminated intravascular coagulation (DIC). A 50-year-old Japanese male was sent to our hospital with the diagnosis of Plasmodium vivax malaria on the 26th of April, 1990. He had stayed in the Solomon Islands from Oct. 1987 to Dec. 1989, and had febrile episodes during his stay in the island. On April 18, 1990, he complained of a high fever with chills, and showed the same episodes on the 20th, 22th and was diagnosed as malaria. He was treated successfully with the sulfadoxine 500 mg and pyrimethamine 25mg (Fansidar), following the normal temperature on the 4th day and disappearance of malarial parasites in the peripheral blood smear on the 6th day. Interestingly, he had thrombocytopenia and a high titer serum level of fibrin degradation product (FDP) supporting the questionable diagnosis of DIC. Even on the 12th day after improved thrombocytopenia by treatment with Gabexate (FOY), the serum level of FDP, D-dimer and thrombin-nati-thrombin (TAT)III complex still remained at high titer levels. One month later he was readmitted for a relapse of Plasmodium vivax malaria, when he showed thrombocytopenia but the serum level of FDP, D-dimer, TAT III complex and PM.alpha 2 PI complex were normal levels. We concluded that the thrombocytopenia and the high titer of FDP at his first admission was a manifestation of DIC. PMID:2071964

  1. Medico-Legal Findings, Legal Case Progression, and Outcomes in South African Rape Cases: Retrospective Review

    PubMed Central

    Jewkes, Rachel; Christofides, Nicola; Vetten, Lisa; Jina, Ruxana; Sigsworth, Romi; Loots, Lizle

    2009-01-01

    Background Health services for victims of rape are recognised as a particularly neglected area of the health sector internationally. Efforts to strengthen these services need to be guided by clinical research. Expert medical evidence is widely used in rape cases, but its contribution to the progress of legal cases is unclear. Only three studies have found an association between documented bodily injuries and convictions in rape cases. This article aims to describe the processing of rape cases by South African police and courts, and the association between documented injuries and DNA and case progression through the criminal justice system. Methods and Findings We analysed a provincially representative sample of 2,068 attempted and completed rape cases reported to 70 randomly selected Gauteng province police stations in 2003. Data sheets were completed from the police dockets and available medical examination forms were copied. 1,547 cases of rape had medical examinations and available forms and were analysed, which was at least 85% of the proportion of the sample having a medical examination. We present logistic regression models of the association between whether a trial started and whether the accused was found guilty and the medico-legal findings for adult and child rapes. Half the suspects were arrested (n = 771), 14% (209) of cases went to trial, and in 3% (31) of adults and 7% (44) of children there was a conviction. A report on DNA was available in 1.4% (22) of cases, but the presence or absence of injuries were documented in all cases. Documented injuries were not associated with arrest, but they were associated with children's cases (but not adult's) going to trial (adjusted odds ratio [AOR] for having genital and nongenital injuries 5.83, 95% confidence interval [CI] 1.87–18.13, p = 0.003). In adult cases a conviction was more likely if there were documented injuries, whether nongenital injuries alone AOR 6.25 (95% CI 1.14–34.3, p = 0

  2. Gynecologic findings in Goltz syndrome: A case series.

    PubMed

    Adeyemi-Fowode, Oluyemisi A; Mansouri, Roshanak; Dietrich, Jennifer E

    2016-03-01

    There is limited information available related to the gynecologic findings in Goltz syndrome. We report exclusively on external genitalia findings in 17 girls with a known diagnosis of focal dermal hypoplasia. This is the largest series to date. Some of our findings have been reported previously; however, some novel features including short perineum body not previously mentioned are noted as well. We recommend referral to a pediatric gynecologist for early evaluation of the reproductive tract as this can have an impact on the future fertility of these girls. © 2016 Wiley Periodicals, Inc. PMID:27001927

  3. Southwest Research Institute intensified detector development capability

    NASA Astrophysics Data System (ADS)

    Wilkinson, Erik; Vincent, Michael; Kofoed, Christopher; Andrews, John; Brownsberger, Judith; Siegmund, Oswald

    2012-09-01

    Imaging detectors for wavelengths between 10 nm and 105 nm generally rely on microchannel plates (MCPs) to provide photon detection (via the photo-electric effect) and charge amplification. This is because silicon-based detectors (CCD or APS) have near zero quantum detection efficiency (QDE) over this wavelength regime. Combining a MCP based intensifier tube with a silicon detector creates a detector system that can be tuned to the wavelength regime of interest for a variety of applications. Intensified detectors are used in a variety of scientific (e.g. Solar Physics) and commercial applications (spectroscopic test instrumentation, night vision goggles, low intensity cameras, etc.). Building an intensified detector requires the mastery of a variety of technologies involved in integrating and testing of these detector systems. We report on an internally funded development program within the Southwest Research Institute to architect, design, integrate, and test intensified imaging detectors for space-based applications. Through a rigorous hardware program the effort is developing and maturing the technologies necessary to build and test a large format (2k × 2k) UV intensified CCD detector. The intensified CCD is designed around a commercially available CCD that is optically coupled to a UV Intensifier Tube from Sensor Sciences, LLC. The program aims to demonstrate, through hardware validation, the ability to architect and execute the integration steps necessary to produce detector systems suitable for space-based applications.

  4. Presacral myelolipoma: a case report and review of imaging findings

    PubMed Central

    Baker, Kevin S; Lee, Dwight; Huang, Mingqian; Gould, Elaine S

    2012-01-01

    Extra-adrenal myelolipoma is a relatively rare entity, with fewer than 50 cases reported in literature. We present a case of a 79 year-old female who presented for evaluation of hip fracture following trauma, where a lobulated presacral mass with mixed fat/soft tissue attenuation was incidentally seen on initial bone algorithm pelvic CT. Subsequent MRI showed signal characteristics of a lesion with mixed fat and soft tissue composition. The lesion demonstrated stability on follow-up imaging. An elective surgical resection was performed which yielded a grossly fatty mass. The diagnosis of presacral myelolipoma was confirmed on microscopic examination. Following description of our case, we conduct a literature review of the imaging characteristics, diagnosis, and treatment of presacral myelolipoma. PMID:23378876

  5. Cardiac beriberi: morphological findings in two fatal cases

    PubMed Central

    2011-01-01

    Cardiovascular beriberi is categorized into two main groups, according to its cause: alcoholic and non-alcoholic (dietary). Cardiovascular beriberi can also be divided into a fulminant form (Shoshin beriberi) and a chronic form. Shoshin beriberi is characterized by hypotension, tachycardia, and lactic acidosis and is mainly encountered in non-alcoholic patients in Asian countries, although it has also been seen in alcoholics in Western countries. Due to the complex clinical presentation and to the lack of diagnostic tests, thiamine deficiency is still being missed, especially among non-alcoholics patients. We present two fatal cases of non - alcohol associated cardiac beriberi. An acute myocardial infarction was observed in one case; extensive colliquative myocytolisis (grade 2) was described in the second case respectively. Morphologically, myocardial necrosis and colliquative myocytolysis are the histologic hallmarks of this acute, rare clinical entity. An increase in apoptotic myocytes was demonstrated probably sustaining the cardiogenic shock. PMID:21244717

  6. Monilethrix: a typical case report with microscopic and dermatoscopic findings.

    PubMed

    Oliveira, Elisa Fontenelle de; Araripe, Ana Luiza Cotta de Alencar

    2015-01-01

    Monilethrix is a rare hereditary condition generally considered to be an autosomal dominant disorder with variable penetrance. A case of a 6-year-old girl without a familial background for this disease is reported. The diagnosis was made by optic microscopy and dermoscopy. A therapeutic trial with topical minoxidil was conducted. PMID:25672313

  7. Monilethrix: a typical case report with microscopic and dermatoscopic findings*

    PubMed Central

    de Oliveira, Elisa Fontenelle; Araripe, Ana Luiza Cotta de Alencar

    2015-01-01

    Monilethrix is a rare hereditary condition generally considered to be an autosomal dominant disorder with variable penetrance. A case of a 6-year-old girl without a familial background for this disease is reported. The diagnosis was made by optic microscopy and dermoscopy. A therapeutic trial with topical minoxidil was conducted. PMID:25672313

  8. Rapidly Intensifying Typhoon Examined By NASA's GPM

    NASA Video Gallery

    The GPM core observatory satellite flew above Nepartak on July 4 at 2151 UTC (5:51 p.m. EDT). GPM identified very tall thunderstorm towers near the center of the intensifying tropical storm. These ...

  9. [Some findings of the lung in medicolegal autopsy cases].

    PubMed

    Ohya, I

    1994-12-01

    "At first glance the lungs may seem uncomplicated, but many wise men have gone astray in their labyrinths." These words were written by Dr. A.A. Liebow, a famous pathologist, in a foreword to the first edition of Pathology of the Lung by H. Spencer. This same thought can also be applied to the field of medicolegal autopsies. 1. The gross appearance of the lungs in medicolegal autopsies Plucks consisting of the lungs, neck organs, the esophagus and the aorta were removed from human cadavers and after taking photos of the frontal and rear view, the lungs were carefully examined to reveal whether the lung shows characteristic morphological changes depending on causes of death. Based on their appearance, the lungs were classified into the 3 following types: a collapsed, a non-collapsed and an inflated type, each of these types reflecting the probable cause of death. The collapsed type of lung was seen in cases of death from exanguination, and the lung falling into shrinkage due to traumatic pneumo- and/or hemo-thorax was also classified into the collapsed type. The non-collapsed type of lung was seen in cases whose lungs were thermo-coagulated and in a case of death from a pulmonary embolism. Also, the deflating lungs of drowning victims before falling into collapse, were classified into a non-collapsed type. The inflated type of lung consisted of lungs that showed ballooning soon after death by drowning, and lungs that had inflated due to emphysema or edema from various causes. This lung study has reconfirmed that the lungs show hypostatic changes more clearly than any other organs of the body, and in the absence of skin color changes reflecting hypostasis, the settling of the blood in the lung could be detected in most cases. 2. Early histopathological lung changes induced by shock One hundred and thirty medicolegal cases were reviewed to detect early histopathological changes of the lung induced by shock. In many cases of death from various causes, pulmonary edema

  10. Cheilitis glandularis: Case report with respect to immunohistochemical findings

    PubMed Central

    Friedrich, Reinhard E.; Löning, Thomas

    2016-01-01

    Cheilitis glandularis (CG) is a rare benign affection of the lip mucosa. The etiology and pathogenesis of CG are unknown. Surgical measures are the leading therapeutic options to treat CG. This case report on a 55-year-old female illustrates the recurrent affection of the lips over several years and local therapy. Furthermore, the study of the resected glands intends to differentiate the lesions with respect to the recently introduced concept of immunoglobulin G4-related diseases. PMID:26816670

  11. Cheilitis glandularis: Case report with respect to immunohistochemical findings.

    PubMed

    Friedrich, Reinhard E; Löning, Thomas

    2016-01-01

    Cheilitis glandularis (CG) is a rare benign affection of the lip mucosa. The etiology and pathogenesis of CG are unknown. Surgical measures are the leading therapeutic options to treat CG. This case report on a 55-year-old female illustrates the recurrent affection of the lips over several years and local therapy. Furthermore, the study of the resected glands intends to differentiate the lesions with respect to the recently introduced concept of immunoglobulin G4-related diseases. PMID:26816670

  12. Wound botulism: clinical and microbiological findings of an Italian case.

    PubMed

    Aureli, P; Fenicia, L; Ferrini, A M; Martini, M; Beccia, G

    1992-09-01

    A case of wound botulism in a 41-year old man is reported. The patient had accidently been wounded when he fell on an iron bar. Some days later he developed typical clinical manifestations of botulism. Wound botulism was confirmed by detection and quantification of type B botulinal toxin in the serum. Ventilatory supportive care was necessary and botulinal antitoxin was not given. The patient was hospitalized for 30 days and recovery was complete. PMID:1426179

  13. Anterior Segment Findings in Vitamin A Deficiency: A Case Series

    PubMed Central

    Rubino, Pierangela; Mora, Paolo; Ungaro, Nicola; Gandolfi, Stefano A.; Orsoni, Jelka G.

    2015-01-01

    Vitamin A deficiency is a rare but vision threatening disorder in the developed world, which can lead to blindness for severe keratomalacia with cornea scarring and perforation or night blindness due to impaired dark adaptation. Conversely, the disease is quite common in developing countries, as a consequence of chronic malnutrition. The correct diagnosis and therapy with prompt vitamin A supplementation avoid blindness. We report a series of 3 local cases with different age and causes for vitamin A deficiency. The diagnostic workup, therapy, and prognosis are discussed. PMID:26509090

  14. Ultrasonographic findings of renal dysplasia in cocker spaniels: eight cases.

    PubMed

    Felkai, C; Vörös, K; Vrabély, T; Vetési, F; Karsai, F; Papp, L

    1997-01-01

    A retrospective study of eight young Cocker Spaniels aged 9-24 months was performed to describe the ultrasonographic findings of histologically confirmed renal dysplasia. Ultrasonography revealed kidneys of significantly (p < 0.001) reduced volume in all dogs. During qualitative evaluation, two different types of sonographic alterations could be seen. In one type of the ultrasound alterations, corticomedullary demarcation was distinct and the renal cortex was remarkably thin, which was best seen in the dorsal (frontal) imaging plane. In the other type of the ultrasound appearance, overall increased echogenicity with poor corticomedullary demarcation was noticed, and the kidneys could hardly be separated from their surroundings. These features were best recognised in the sagittal (coronal) imaging plane. In one dog with secondary hypercalcaemia, a hyperechoic corticomedullary area was also seen. Post-mortem histological diagnosis revealed renal dysplasia and secondary fibrosis. Based on ultrasound findings alone, renal dysplasia (renal familial disease) can be suspected when small kidneys with thin echogenic cortex are present in young dogs. An ultrasound image, similar to that of fibrotic kidneys (increased overall echogenicity and reduced corticomedullary definition) cannot be differentiated from chronic inflammatory disease and from end-stage kidneys. Therefore, ultrasound-guided biopsy or post-mortem histology is necessary for the definitive diagnosis of renal dysplasia. This is the first study reporting on the ultrasound appearance of renal dysplasia in Cocker Spaniel dogs. PMID:9557317

  15. Clinical Needs Finding: Developing the Virtual Experience, A Case Study

    PubMed Central

    Mittal, Vaishali; Thompson, Megan; Altman, Stuart M; Taylor, Peter; Summers, Alexander; Goodwin, Kelsey; Louie, Angelique Y

    2013-01-01

    We describe an innovative program at the University of California, Davis for students to engage in clinical needs finding. Using a team-based approach, students participated in clinical rotations to observe firsthand the needs of clinicians at the university affiliated medical center. The teams were asked to develop documentary-style videos to capture key experiences that would allow future viewers to use the videos as “virtual” clinical rotations. This was conceived as a strategy to allow students in prohibitively large classes, or students in programs at institutions without associated medical or veterinary school programs, to experience clinical rotations and perform needs assessments. The students' perspectives on the experience as well as instructor analysis of best practices for this type of activity are presented and discussed. We found that the internship experience was valuable to the students participating, by not only introducing the practice of needs finding but for increasing the students' confidence in the practice of engineering design and their ability to work independently. The videos produced were of such high quality that instructors from other institutions have requested copies for instructional use. Virtual clinical rotations through video experiences may provide a reasonable substitute for students who do not have the ability to participate in rotations in person. PMID:23483373

  16. Imaging findings of hepatosplenic schistosomiasis: a case report.

    PubMed

    Bilgin, Sabriye Sennur; Toprak, Huseyin; Seker, Mehmet

    2016-09-01

    In our study, in a 52-year-old man, specific and nonspecific findings of Schistosoma infestation were examined using ultrasonography, computed tomography, and magnetic resonance imaging. On computed tomography, capsular and septal calcifications and contrast enhancement of the liver capsule were seen. On T1-weighted magnetic resonance images diffuse hypointensity was seen in periportal spaces; on T2-weighted images in the same spaces, diffuse hyperintensity was seen. On dynamic contrast-enhanced T1-weighted images, in these same spaces marked contrast enhancement was manifested in the late venous phase. These signal changes indicate edema due to periportal fibrotic tissue inflammation and are accepted as pathognomonic for a liver infested by Schistosoma. PMID:27594939

  17. 5 CFR 890.1039 - Cases where additional fact-finding is required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Cases where additional fact-finding is... Imposed Against Health Care Providers Suspension § 890.1039 Cases where additional fact-finding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request...

  18. 5 CFR 890.1039 - Cases where additional fact-finding is required.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Cases where additional fact-finding is... Imposed Against Health Care Providers Suspension § 890.1039 Cases where additional fact-finding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request...

  19. 5 CFR 890.1037 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Suspension § 890.1037 Cases where additional fact-finding is not required. The suspending official may decide a contest without an additional fact-finding...

  20. 5 CFR 890.1037 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Suspension § 890.1037 Cases where additional fact-finding is not required. The suspending official may decide a contest without an additional fact-finding...

  1. 5 CFR 890.1039 - Cases where additional fact-finding is required.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Cases where additional fact-finding is... Imposed Against Health Care Providers Suspension § 890.1039 Cases where additional fact-finding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request...

  2. 5 CFR 890.1037 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Suspension § 890.1037 Cases where additional fact-finding is not required. The suspending official may decide a contest without an additional fact-finding...

  3. 5 CFR 890.1039 - Cases where additional fact-finding is required.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Cases where additional fact-finding is... Imposed Against Health Care Providers Suspension § 890.1039 Cases where additional fact-finding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request...

  4. 5 CFR 890.1039 - Cases where additional fact-finding is required.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cases where additional fact-finding is... Imposed Against Health Care Providers Suspension § 890.1039 Cases where additional fact-finding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request...

  5. 5 CFR 890.1037 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Suspension § 890.1037 Cases where additional fact-finding is not required. The suspending official may decide a contest without an additional fact-finding...

  6. 5 CFR 890.1037 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Suspension § 890.1037 Cases where additional fact-finding is not required. The suspending official may decide a contest without an additional fact-finding...

  7. Performance of image intensifiers in radiographic systems

    SciTech Connect

    Baker, S.A.

    2000-01-01

    Electronic charge-coupled device (CCD) cameras equipped with image intensifiers are increasingly being used for radiographic applications. These systems may be used to replace film recording for static imaging, or at other times CCDs coupled with electro-optical shutters may be used for static or dynamic (explosive) radiography. Image intensifiers provide precise shuttering and signal gain. The authors have developed a set of performance measures to calibrate systems, compare one system to another, and to predict experimental performance. The performance measures discussed in this paper are concerned with image quality parameters that relate to resolution and signal-to-noise ratio.

  8. Demountable readout technologies for optical image intensifiers

    NASA Astrophysics Data System (ADS)

    Lapington, J. S.; Howorth, J. R.; Milnes, J. S.

    2007-04-01

    We describe a generic microchannel plate intensifier design for use with a variety of demountable readout devices manufactured using standard multi-layer PCB techniques. We present results obtained using a 50 Ω multi-element design optimized for high speed operation and a four electrode multi-layer device developed from the wedge and strip anode with enhanced image resolution. The benefits of this intensifier design are discussed and a project to develop a detector system for bio-medical applications using a demountable readout device with integrated multi-channel ASIC-based electronics is announced.

  9. 5 CFR 890.1025 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1025 Cases where additional fact-finding is not required. In each contest, the debarring official shall determine whether a further...

  10. 5 CFR 890.1025 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1025 Cases where additional fact-finding is not required. In each contest, the debarring official shall determine whether a further...

  11. 5 CFR 890.1025 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1025 Cases where additional fact-finding is not required. In each contest, the debarring official shall determine whether a further...

  12. 5 CFR 890.1025 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1025 Cases where additional fact-finding is not required. In each contest, the debarring official shall determine whether a further...

  13. 5 CFR 890.1025 - Cases where additional fact-finding is not required.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cases where additional fact-finding is... Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1025 Cases where additional fact-finding is not required. In each contest, the debarring official shall determine whether a further...

  14. Ocular findings in a case of periorbital giant congenital melanocytic nevus

    PubMed Central

    Raina, Usha K.; Seth, Anisha; Gupta, Anika; Batta, Supriya

    2014-01-01

    Giant congenital melanocytic nevus (GCMN) is a large melanocytic nevus that rarely occurs in the periorbital region. Various systemic, as well as ophthalmic associations, have been reported with GCMN. However, there is only one case report describing ophthalmic findings in periorbital GCMN. We describe the ocular findings in a case of periorbital GCMN. PMID:25378884

  15. 5 CFR 890.1027 - Cases where an additional fact-finding proceeding is required.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Cases where an additional fact-finding... fact-finding proceeding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request another OPM official (“presiding official”) to hold an additional...

  16. 5 CFR 890.1027 - Cases where an additional fact-finding proceeding is required.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Cases where an additional fact-finding... fact-finding proceeding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request another OPM official (“presiding official”) to hold an additional...

  17. 5 CFR 890.1027 - Cases where an additional fact-finding proceeding is required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Cases where an additional fact-finding... fact-finding proceeding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request another OPM official (“presiding official”) to hold an additional...

  18. 5 CFR 890.1027 - Cases where an additional fact-finding proceeding is required.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cases where an additional fact-finding... fact-finding proceeding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request another OPM official (“presiding official”) to hold an additional...

  19. 5 CFR 890.1027 - Cases where an additional fact-finding proceeding is required.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Cases where an additional fact-finding... fact-finding proceeding is required. (a) Criteria for holding fact-finding proceeding. The debarring official shall request another OPM official (“presiding official”) to hold an additional...

  20. Naeglaeria infection of the central nervous system, CT scan findings: a case series.

    PubMed

    Naqi, Rohana; Azeemuddin, Muhammad

    2013-03-01

    The imaging findings in four cases of a rare infection of the central nervous system caused by amoebae, Naeglaeria fowleri are presented. Naeglaeria fowleri are pathogenic free-living amoebae. They cause primary amoebic meningoencephalitis (PAM), a rapidly fatal disease of the central nervous system. The computed tomography brain findings in 3 (75%) of our cases of pan amoebic meningoencephalitis showed non-specific brain oedema; 2 (66%) of these cases also had moderate hydrocephalus and among that 1 (50%) case showed an old lacunar infarction in peri-ventricular region. In the remaining 1 (25%) case the scan was normal with no evidence of oedema or abnormal lesion. Out of three cases with diffuse brain oedema, postcontrast images showed abnormal meningeal enhancement throughout the brain parenchyma in 1 (33%) case. However, no definite focal enhancing lesion was noted. In the rest of the cases, no abnormal parenchymal or meningeal enhancement was seen on post-contrast images. PMID:23914650

  1. Turning off the tap: stopping tuberculosis transmission through active case-finding and prompt effective treatment.

    PubMed

    Yuen, Courtney M; Amanullah, Farhana; Dharmadhikari, Ashwin; Nardell, Edward A; Seddon, James A; Vasilyeva, Irina; Zhao, Yanlin; Keshavjee, Salmaan; Becerra, Mercedes C

    2015-12-01

    To halt the global tuberculosis epidemic, transmission must be stopped to prevent new infections and new cases. Identification of individuals with tuberculosis and prompt initiation of effective treatment to rapidly render them non-infectious is crucial to this task. However, in settings of high tuberculosis burden, active case-finding is often not implemented, resulting in long delays in diagnosis and treatment. A range of strategies to find cases and ensure prompt and correct treatment have been shown to be effective in high tuberculosis-burden settings. The population-level effect of targeted active case-finding on reducing tuberculosis incidence has been shown by studies and projected by mathematical modelling. The inclusion of targeted active case-finding in a comprehensive epidemic-control strategy for tuberculosis should contribute substantially to a decrease in tuberculosis incidence. PMID:26515675

  2. A Transdisciplinary Approach to Training: Preliminary Research Findings Based on a Case Analysis

    ERIC Educational Resources Information Center

    Bimpitsos, Christos; Petridou, Eugenia

    2012-01-01

    Purpose: The purpose of this paper is to discuss the benefits, barriers and challenges of the transdisciplinary approach to training, and to present findings of a case analysis. Design/methodology/approach: The paper is based on the research findings of an experimental training program for Greek local government managers co-funded by the European…

  3. Systemic Shifts in Instructional Technology: Findings of a Comparative Case Study of Two University Mathematics Departments

    ERIC Educational Resources Information Center

    Jarvis, Daniel H.; Lavicza, Zsolt; Buteau, Chantal

    2014-01-01

    This paper reports on the findings of an international case study in which researchers examined two mathematics departments (Canada/UK) in which the sustained use of technology was strategically established in a mathematics degree program. This case study forms part of a larger research initiative which involved an extensive literature review…

  4. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1960 Radiographic intensifying screen. (a) Identification. A radiographic intensifying screen is a device that is a thin radiolucent sheet... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Radiographic intensifying screen. 892.1960...

  5. Cardiac Findings of Pulmonary Thromboembolism by Autopsy: A Review of 48 Cases

    PubMed Central

    Yakar, Aysun; Yakar, Fatih; Ziyade, Nihan; Yıldız, Muhlis; Üzün, İbrahim

    2016-01-01

    Background To identify the overall effects of pulmonary thromboembolism (PTE) on the heart, we evaluated the heart findings and clinical characteristics of deceased patients diagnosed with PTE. Material/Methods PTEs were classified into 2 categories: fatal and contributory. Cases with a history of cardiopulmonary disease or a finding of significant disease at autopsy, including valvular heart disease and coronary artery obstruction >50%, were excluded from the cardiac evaluation. We defined an LV wall ≥1.2 cm thick and an RV wall ≥0.8 cm thick as abnormal. Results Forty-eight cases were included to the study (21 males and 27 females). The mean age was 41.42±16.5 years. Of the 48 cases, 5 were excluded due to cardiopulmonary diseases for determining heart findings. The thicknesses of the LV and RV walls were not measured in some patients. In the 43 cases, cardiac hypertrophy was detected in 28 patients (65.1%). The mean heart weight was 387±83.5 g. The mean thickness of the left ventricle (LV) wall was 1.40±0.41 cm in 40 cases, and the mean thickness of the RV wall was 0.41±0.135 cm in 41 cases. The LV walls of 35 (87.5%) cases and the RV walls of 2 cases met criteria for abnormal wall thickness. There were histopathological findings of heart in 24/43 cases (56%); these findings were necrosis, fibrosis, and hypertrophy. Conclusions The RV is affected by massive pulmonary embolism; however, the LV may also play a role in the pathogenesis of PTE. PMID:27117720

  6. Impact of awareness drives and community-based active tuberculosis case finding in Odisha, India.

    PubMed

    Parija, D; Patra, T K; Kumar, A M V; Swain, B K; Satyanarayana, S; Sreenivas, A; Chadha, V K; Moonan, P K; Oeltmann, J E

    2014-09-01

    India's Revised National Tuberculosis Control programme employs passive case detection. The new sputum smear-positive case detection rate is less than 70% in Odisha State. During April-June 2012, active case finding (ACF) was conducted through awareness drives and field-based tuberculosis (TB) screening in select communities with the lowest case detection rates. During the campaign, 240 sputum smear-positive TB cases were detected. The number of smear-positive cases detected increased by 11% relative to April-June 2011 in intervention communities compared to an 0.8% increase in non-intervention communities. ACF brought TB services closer to the community and increased TB case detection. PMID:25189560

  7. A Unique Incidental Finding in Two Young Dancers: A Case Series.

    PubMed

    Miller, Marshal N; Close, Jeremy D

    2015-01-01

    Dancers frequently present to the sports medicine clinic with a variety of lower extremity complaints ranging from acute and traumatic injuries to more chronic, overuse injuries. This case series depicts a similar and unique incidental radiographic finding found in 2 young dancers seen at the same sports medicine clinic. While the findings are likely benign and unrelated to both patients' initial presentation, the finding of acroosteolysis can be found in more serious systemic and genetic processes as well an early finding in repetitive trauma. PMID:26502417

  8. Feeling more together: group attention intensifies emotion.

    PubMed

    Shteynberg, Garriy; Hirsh, Jacob B; Apfelbaum, Evan P; Larsen, Jeff T; Galinsky, Adam D; Roese, Neal J

    2014-12-01

    The idea that group contexts can intensify emotions is centuries old. Yet, evidence that speaks to how, or if, emotions become more intense in groups remains elusive. Here we examine the novel possibility that group attention--the experience of simultaneous coattention with one's group members--increases emotional intensity relative to attending alone, coattending with strangers, or attending nonsimultaneously with one's group members. In Study 1, scary advertisements felt scarier under group attention. In Study 2, group attention intensified feelings of sadness to negative images, and feelings of happiness to positive images. In Study 3, group attention during a video depicting homelessness led to greater sadness that prompted larger donations to charities benefiting the homeless. In Studies 4 and 5, group attention increased the amount of cognitive resources allocated toward sad and amusing videos (as indexed by the percentage of thoughts referencing video content), leading to more sadness and happiness, respectively. In all, these effects could not be explained by differences in physiological arousal, emotional contagion, or vicarious emotional experience. Greater fear, gloom, and glee can thus result from group attention to scary, sad, and happy events, respectively. PMID:25151520

  9. Signs of overload after an intensified training.

    PubMed

    Bresciani, G; Cuevas, M J; Molinero, O; Almar, M; Suay, F; Salvador, A; de Paz, J A; Marquez, S; González-Gallego, J

    2011-05-01

    This study investigated effects of a 9-week intensified aerobic training and 3-weeks of recovery on signs of overload in 9 healthy active young males. Blood and saliva samples were collected and psychological questionnaires were administered during baseline (T1), intermediate load (T2), maximal load (T3), and recovery (T4) periods. Maximal oxygen uptake increased and blood lactate concentration decreased in T3, while running time in a 3 000  m track field test was significantly shorter. No significant changes were found in hematocrit, haemoglobin concentration, white blood cell count, lactate dehydrogenase, transaminases, interleukin-6, tumour necrosis factor-α, myeloperoxidase and markers of oxidative stress in plasma, or salivary cortisol and testosterone. Increases in different negative affect scales and in the total mood disturbance score of the Profile of Mood States were observed during T3. Scores in the stress scales of the Recovery-Stress Questionnaire for Athletes and in the State Anxiety Scale of the State-Trait Anxiety Inventory also showed significant increases during T3. The lack of effects in biomarkers together with the changes observed in psychological assessment indicates that an intensified training can produce psychological disturbances prone to early overreaching development. Additionally, it seems that psychological parameters are sensitive markers to detect stress produced by load increases. PMID:21380974

  10. Cost-Effectiveness Analysis of Community Active Case Finding and Household Contact Investigation for Tuberculosis Case Detection in Urban Africa

    PubMed Central

    Sekandi, Juliet N.; Dobbin, Kevin; Oloya, James; Okwera, Alphonse; Whalen, Christopher C.; Corso, Phaedra S.

    2015-01-01

    Introduction Case detection by passive case finding (PCF) strategy alone is inadequate for detecting all tuberculosis (TB) cases in high burden settings especially Sub-Saharan Africa. Alternative case detection strategies such as community Active Case Finding (ACF) and Household Contact Investigations (HCI) are effective but empirical evidence of their cost-effectiveness is sparse. The objective of this study was to determine whether adding ACF or HCI compared with standard PCF alone represent cost-effective alternative TB case detection strategies in urban Africa. Methods A static decision modeling framework was used to examine the costs and effectiveness of three TB case detection strategies: PCF alone, PCF+ACF, and PCF+HCI. Probability and cost estimates were obtained from National TB program data, primary studies conducted in Uganda, published literature and expert opinions. The analysis was performed from the societal and provider perspectives over a 1.5 year time-frame. The main effectiveness measure was the number of true TB cases detected and the outcome was incremental cost-effectiveness ratios (ICERs) expressed as cost in 2013 US$ per additional true TB case detected. Results Compared to PCF alone, the PCF+HCI strategy was cost-effective at US$443.62 per additional TB case detected. However, PCF+ACF was not cost-effective at US$1492.95 per additional TB case detected. Sensitivity analyses showed that PCF+ACF would be cost-effective if the prevalence of chronic cough in the population screened by ACF increased 10-fold from 4% to 40% and if the program costs for ACF were reduced by 50%. Conclusions Under our baseline assumptions, the addition of HCI to an existing PCF program presented a more cost-effective strategy than the addition of ACF in the context of an African city. Therefore, implementation of household contact investigations as a part of the recommended TB control strategy should be prioritized. PMID:25658592

  11. CT findings of human Fasciola hepatica infection: case reports and review of the literature.

    PubMed

    Patel, Nayana U; Bang, Tami J; Dodd, Gerald D

    2016-01-01

    Due to increasing rates of international travel, hepatic fascioliasis is appearing in nonendemic areas, where diagnosis can be difficult. We present two confirmed cases of hepatic fascioliasis in a nonendemic region. The purposes of this report are to discuss computed tomography (CT) findings of hepatic fascioliasis and to review the literature. While travel history is most important, characteristic findings of hypoattenuating tracts extending from liver capsule into the parenchyma on contrast-enhanced CT scan strongly suggest hepatic fascioliasis. PMID:26995582

  12. Perinatal Autopsy Findings in a Case of De Novo Hypohidrotic Ectodermal Dysplasia

    PubMed Central

    Chikkannaiah, Panduranga; Nagaraju, Smitha; Kangle, Rajit; Gosavi, Mansi

    2015-01-01

    Ectodermal dysplasia are group of inherited disorders involving the developmental defects of ectodermal structures like hair, teeth, nails, sweat glands, and others. X-linked recessive inheritance is most common. Here we describe perinatal autopsy findings in a case of de novo ectodermal dysplasia in a female fetus. To the best of our knowledge, this is the first fetal autopsy description in a case of ectodermal dysplasia. PMID:26417167

  13. Unusual periodontal findings in an AIDS patient with Burkitt's lymphoma. A case report.

    PubMed

    Hernández Vallejo, G; García, M D; López, A; Mendieta, C; Moskow, B S

    1989-12-01

    This report deals with a case of AIDS-related Burkitt's lymphoma in which some of the earliest findings were dental and periodontal in nature. The patient presented initially with painless and extremely loose teeth accompanied by progressive paresthesia of the lower jaw. Unique radiographic findings included extensive periodontal ligament space widening and bulbous, granuloma-like lesions about the apices of the teeth. These findings were associated with progressive tumor infiltration of the mandible and do not appear to be related to other reports of aggressive periodontitis associated with impaired immunologic functions in AIDS patients. PMID:2614637

  14. Epithelioid Myofibroblastoma in an Old-Male Breast: A Case Report with MRI Findings

    PubMed Central

    Yildiz, Seyma; Gucin, Zuhal; Erdogan, Ezgi Basak

    2015-01-01

    Myofibroblastoma of the breast (MFB) is a very rare benign stromal tumor. In recent years, increase in mammographic screenings has resulted in increased diagnosis of MFB. Most cases are old males and postmenopausal women. MFB may be confused as malignant, clinically, morphologically, or by imaging. Immunohistochemistry is essential for final diagnosis in these cases. We report a case of a pathologically diagnosed MFB in an 80-year-old male patient who had coexisting prostate cancer and describe its imaging characteristics, especially magnetic resonance imaging (MRI). In this paper, histopathological and MRI findings of the MFB were discussed. PMID:26294999

  15. Range gated imaging experiments using gated intensifiers

    SciTech Connect

    McDonald, T.E. Jr.; Yates, G.J.; Cverna, F.H.; Gallegos, R.A.; Jaramillo, S.A.; Numkena, D.M.; Payton, J.; Pena-Abeyta, C.R.

    1999-03-01

    A variety of range gated imaging experiments using high-speed gated/shuttered proximity focused microchannel plate image intensifiers (MCPII) are reported. Range gated imaging experiments were conducted in water for detection of submerged mines in controlled turbidity tank test and in sea water for the Naval Coastal Sea Command/US Marine Corps. Field experiments have been conducted consisting of kilometer range imaging of resolution targets and military vehicles in atmosphere at Eglin Air Force Base for the US Air Force, and similar imaging experiments, but in smoke environment, at Redstone Arsenal for the US Army Aviation and Missile Command (AMCOM). Wavelength of the illuminating laser was 532 nm with pulse width ranging from 6 to 12 ns and comparable gate widths. These tests have shown depth resolution in the tens of centimeters range from time phasing reflected LADAR images with MCPII shutter opening.

  16. Electrostatically focused intensified charge coupled devices

    NASA Technical Reports Server (NTRS)

    Walker, J. W.

    1977-01-01

    Work performed to develop intensified charge coupled devices (ICCDs) is presented. Four ICCDs, containing 100 x 160 arrays, were fabricated. Electron gains up to 3200 at 15 keV were achieved. Photocathode sensitivities ranged from 190 to 410 micro A/lumen. Dark currents varied from 11 nA/sq cm to 37 nA/sq cm. There was serious concern about the reliability of the bonding scheme for ICCDs due to occassional bond failure. Two solutions to this problem were developed. One involved a modification of the existing bonding technique, and the other was the development of a protected bond pad employing a barrier metal between the aluminum metallization and the gold bond wire. An accumulation process was characterized with respect to its most critical variable. This characterization led to the achievement of reproducible spectral response and the discovery and elimination of dark current increase associated with this process.

  17. Applying Corpus-Based Findings to Form-Focused Instruction: The Case of Reported Speech

    ERIC Educational Resources Information Center

    Barbieri, Federica; Eckhardt, Suzanne E. B.

    2007-01-01

    Arguing that the introduction of corpus linguistics in teaching materials and the language classroom should be informed by theories and principles of SLA, this paper presents a case study illustrating how corpus-based findings on reported speech can be integrated into a form-focused model of instruction. After overviewing previous work which…

  18. [Mesenteric panniculitis of the colon: barium enema, US, CT, and MRI findings (case report)].

    PubMed

    Kebapçi, Mahmut; Adapinar, Baki; Kaya, Tamer; Kebapçi, Nur

    2004-12-01

    Mesenteric panniculitis as an uncommon disease of unknown etiology characterised by nonspecific inflammation of the fat tissue of the mesentery. In this report, we are presenting a case of mesenteric panniculitis of the rectosigmoid colon in which characteristic findings of barium enema, ultrasonography, computed tomography, and magnetic resonance imaging were noted. We emphasized the diagnostic significance of these methods. PMID:15611917

  19. CT findings associated with blastic plasmacytoid dendritic cell neoplasm: a case report

    PubMed Central

    Choi, Jung W; Jeong, Katherine; Sokol, Lubomir

    2016-01-01

    Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy that is frequently misdiagnosed. We present a case of a 53-year-old man diagnosed with blastic plasmacytoid dendritic cell neoplasm with extensive computed tomography (CT) findings and provide an imaging focused review of this uncommon malignancy. PMID:27504192

  20. Case finding for COPD in primary care: a qualitative study of the views of health professionals

    PubMed Central

    Haroon, Shamil; Jordan, Rachel E; Fitzmaurice, David A; Adab, Peymane

    2015-01-01

    Background Chronic obstructive pulmonary disease (COPD) is common but largely underdiagnosed. Case-finding initiatives have been evaluated in primary care, but few studies have explored the views of service providers on implementing them in practice. Aim To explore the views of primary health care providers on case finding for COPD. Methods A total of 20 semi-structured interviews were conducted from March 2014 to September 2014 among general practitioners, nurses, and managers from practices participating in a large COPD case-finding trial based in primary care in the West Midlands, UK. Participants’ views were sought to explore perceived benefits, harms, barriers, and facilitators to implementing COPD case finding in practice. Interviews were transcribed and analyzed using the framework method. Results Participants felt that case finding improves patient care but also acknowledged potential harms to providers (increase in workload) and to patients (overdiagnosis). Insufficient resources, poor knowledge of COPD, and limited access to diagnostic services were viewed as barriers to diagnosis, while provision of community respiratory services, including COPD specialist nurses, and support from secondary care were thought to be facilitators. Participants also expressed a need for more education on COPD for both patients and clinicians. Conclusion Care providers believe that early detection of COPD improves patient care but also has accompanying harms. Barriers to diagnosing COPD, such as insufficient expertise in primary care and limited access to diagnostic services in the community, should be explored and addressed. The knowledge and attitudes of the public about COPD and its symptoms should also be investigated to inform future education and awareness-raising strategies. PMID:26357469

  1. From Noun to Intensifier: Massa and Massa's in Flemish Varieties of Dutch

    ERIC Educational Resources Information Center

    De Clerck, Bernard; Colleman, Timothy

    2013-01-01

    In this paper a case of synchronic layering is examined in which Dutch "massa" ("mass") and plural "massa's" ("masses") are attested with lexical uses as a collective noun, quantifying uses ("a large quantity of") and intensifying uses ("very")--with plural "massa's" only--in some Flemish varieties of Dutch. Against the background of…

  2. Various Upper Endoscopic Findings of Acute Esophageal Thermal Injury Induced by Diverse Food: A Case Series

    PubMed Central

    Lee, Yu Mi; Kim, Ji Young; Song, Hyun Jung; Koo, Hoon Sup; Song, Kyung Ho; Kim, Yong Seok; Huh, Kyu Chan

    2014-01-01

    Esophageal thermal injury caused by food has been reported to occur mostly after drinking hot liquid food, and is known to produce alternating white and red linear mucosal bands. In addition, thermal injury caused by ingestion of hot solid foods is documented to be a cause of esophageal ulcers or pseudomembranes. From January 2006 to August 2012, five patients with suspected esophageal thermal injury underwent esophagogastroduodenoscopy with biopsy. A "candy-cane" appearance was observed in one case, pseudomembrane was observed in two cases, an esophageal ulcer was observed in one case, and a friable and edematous mucosa was noted in one case. We believe that the endoscopic findings of esophageal thermal injury depend on the following factors: causative materials, amount of food consumed, exposure period, and time to endoscopy after the incident. Therefore, physicians who encounter patients with suspected esophageal thermal injury should carefully take the patient's history considering these factors. PMID:25325006

  3. Case-finding options for COPD: Results from the BOLD Study

    PubMed Central

    Jithoo, Anamika; Enright, Paul; Burney, Peter; Buist, A Sonia; Bateman, Eric D; Tan, Wan C; Studnicka, Michael; Mejza, Filip; Gillespie, Suzanne; Vollmer, William M

    2012-01-01

    Aim To compare strategies for COPD case-finding using data from the Burden of Obstructive Lung Disease (BOLD) study. Methods Population-based samples of adults aged ≥40 years (n= 9390) from 14 countries completed a questionnaire and spirometry. We compared the screening efficiency of different staged algorithms that used questionnaire data and/or PEF to identify persons at risk for COPD and hence needing confirmatory spirometry. Separate algorithms were fitted for moderate/severe COPD and for severe COPD. We estimated the cost of each algorithm in 1000 people. Results For moderate/severe COPD, use of questionnaire data alone permitted high sensitivity (97%), but required confirmatory spirometry on 80% of participants. Use of PEF only required confirmatory spirometry in only 19-22% of subjects with 83-84% sensitivity. For severe COPD, use of PEF achieved 91-93% sensitivity, requiring confirmatory spirometry in <9% of participants. Cost analysis suggested that a staged screening algorithm using only PEF initially, followed by confirmatory spirometry as needed, was the most cost-effective case finding strategy. Conclusion Our results support the use of PEF as a simple, cost-effective initial screening tool for conducting COPD case-finding in adults ≥40 years. These findings should be validated in real-world settings such as the primary care environment. PMID:22743668

  4. Human water consumption intensifies hydrological drought worldwide

    NASA Astrophysics Data System (ADS)

    Wada, Y.; Van Beek, L. P.; Wanders, N.; Bierkens, M. F.

    2012-12-01

    Over the past decades, human water consumption has more than doubled, and reduced streamflow over various regions of the world. However, it remains unclear to what degree human water consumption intensifies hydrological droughts, i.e. the occurrence of anomalously low streamflow. Here, we quantify over the period 1960-2010 the impact of human water consumption on the intensity and frequency of hydrological droughts worldwide. We simulated streamflow by the global hydrological and water resources model PCR-GLOBWB at a 0.5 degree spatial resolution, and reduced the amount of streamflow with different levels of human water consumption over the period 1960-2010. We applied the commonly used variable threshold level method to identify below-normal water availability as the onset of hydrological droughts. We then standardized the deficit volume dividing relative to the threshold level to express the intensity of drought conditions to normal streamflow conditions. The results show that human water consumption substantially reduced local and downstream streamflow in many regions of the world. This subsequently intensified hydrological droughts regionally by 10-500%. Irrigation is responsible for the intensification of hydrological droughts over western and central U.S., southern Europe, Asia, and southeastern Australia, whereas the impact of industrial and households' consumption on the intensification is considerably larger over eastern U.S., and western and central Europe. The results also show that drought frequency increased by more than 27% compared to pristine or natural condition as a result of human water consumption. The intensification of drought frequency is most severe over Asia, but also substantial over North America and Europe. Importantly, global population under severe hydrological droughts considerably increased from 0.7 billion in 1960 to 2.2 billion in 2010 due to rapid population growth. As a limited validation exercise, we compared simulated deficit

  5. Cobalamin (Cbl) C/D deficiency: clinical, neurophysiological and neuroradiologic findings in 14 cases.

    PubMed

    Biancheri, R; Cerone, R; Schiaffino, M C; Caruso, U; Veneselli, E; Perrone, M V; Rossi, A; Gatti, R

    2001-02-01

    The early onset type of cobalamin (Cbl) C/D deficiency is characterised by feeding difficulties, failure to thrive, hypotonia, seizures, microcephaly and developmental delay. It has an unfavourable outcome, often with early death and significant neurological impairment in survivors. While clinical and biochemical features of Cbl C/D deficiency are well known, only a few isolated case reports are available concerning neurophysiological and neuroimaging findings. We carried out clinical, biochemical, neurophysiological and neuroradiologic investigations in 14 cases with early-onset of the Cbl CID defect. Mental retardation was identified in most of the cases. A variable degree of supratentorial white matter atrophy was detected in 11 cases by MR imaging and tetraventricular hydrocephalus was present in the remaining 3 patients. Waking EEG showed a clear prevalence of epileptiform abnormalities, possibly related to the high incidence of seizures in these cases. Increased latency of evoked responses and/or prolongation of central conduction time were the most significant neurophysiological abnormalities. The selective white matter involvement, shown both by neuroradiologic and neurophysiological studies, seems to be the most consistent finding of Cbl C/D deficiency and may be related to a reduced supply of methyl groups, possibly caused by the dysfunction in the methyl-transfer pathway. PMID:11315197

  6. An Unusual Case of Ascending Pancreatitis with Mediastinal Involvement: A Case Report with CT and MRI Findings

    PubMed Central

    Di Cesare, Ernesto; Di Sibio, Alessandra; Gennarelli, Antonio; Felli, Valentina; Vellucci, Valentina; Casazza, Ines; Masciocchi, Carlo

    2014-01-01

    Fluid collections are common findings of pancreatitis and spread, more often, along preferential drainage pathways in the abdomen. In some rare cases, fluid collections may spread towards extra-abdominal sites like the mediastinum leading to the formation of mediastinal collections. We present the case of a 52-years-old man with pain in the right upper quadrant of the abdomen and mid-epigastrium lasting for some hours. Laboratory tests suggested a diagnosis of pancreatitis. CT and subsequent MRI revealed changes consistent with acute exacerbation on chronic pancreatitis spreading to the mediastinum and to the greater omentum. The patient received medical treatment and reported gradual improvement in his laboratory results and CT findings. PMID:24955277

  7. CT and MRI Findings in a Rare Case of Renal Primitive Neuroectodermal Tumor

    PubMed Central

    Akkaya, Zehra; Peker, Elif; Gulpinar, Basak; Karadag, Hale; Erden, Ayse

    2016-01-01

    Summary Background Primary renal primitive neuroectodermal tumor/extraskeletal Ewing’s sarcoma (PNET/EES) is a very rare renal tumor. Case Report We report a case of primary renal PNET/EES of the kidney in an adult patient and describe its computed tomography and magnetic resonance imaging findings, including diffusion weighted images along with a review of the current medical literature. Conclusions Although very rare, a relatively large renal mass which shows very infiltrative growth pattern on CT and MR imaging and striking diffusion restriction should raise the suspicion of a renal primitive neuroectodermal tumor, in a young adult.

  8. Oral mucosal involvement and petechial lesions: a SDRIFE case with unusual findings.

    PubMed

    Karadag, Ayse Serap; Ozlu, Emin; Akdeniz, Necmettin; Uzuncakmak, Tugba Kevser; Turkoglu, Zafer; Ozkanli, Seyma; Zemheri, Ebru

    2016-06-01

    Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) is a type IV hypersensitivity reaction characterized by a symmetrical erythematous rash in the gluteal and intertriginous areas. SDRIFE was previously considered to be the same presentation as Baboon Syndrome, however, has been suggested to be a different entity in the recent publications. The lesions are generally maculopapular and there is no mucosal involvement. To date, no case with petechial findings and mucosal involvement has been reported in the literature. The present study reports a SDRIFE case with a symmetrical erythematous petechial rash and oral mucosal involvement after taking oral amoxicillin. PMID:26339719

  9. Four cases of brown-vialetto-van laere syndrome from Iran: Clinical and electrophysiologic findings

    PubMed Central

    Yadegari, Samira; Ghorbani, Askar; Dezfouli, Mitra Ansari

    2011-01-01

    Brown-Vialetto-Van Laere syndrome (BVVLS) is a rare neurological disorder. We report our finding about four patients clinically and electrophysiologically diagnosed as BVVLS and denoted their clinical features with comparison to previous reports. The first symptom was bilateral hearing loss and the onset of other cranial nerves involvement varied between 0-15 years. Our patients represented some rare features like upper motor neuron signs in one patient and two cases interestingly developed some clinical improvement. This is the first report of BVVLS from Iran. Our patients which represent Caucasian population had generally similar features like previously reported cases. PMID:24250848

  10. Four cases of brown-vialetto-van laere syndrome from Iran: Clinical and electrophysiologic findings.

    PubMed

    Yadegari, Samira; Ghorbani, Askar; Dezfouli, Mitra Ansari; Nafissi, Shahriar

    2011-01-01

    Brown-Vialetto-Van Laere syndrome (BVVLS) is a rare neurological disorder. We report our finding about four patients clinically and electrophysiologically diagnosed as BVVLS and denoted their clinical features with comparison to previous reports. The first symptom was bilateral hearing loss and the onset of other cranial nerves involvement varied between 0-15 years. Our patients represented some rare features like upper motor neuron signs in one patient and two cases interestingly developed some clinical improvement. This is the first report of BVVLS from Iran. Our patients which represent Caucasian population had generally similar features like previously reported cases. PMID:24250848

  11. Clinical findings in children with congenital anomalies and misoprostol intrauterine exposure: a study of 38 cases

    PubMed Central

    Vendramini-Pittoli, Siulan; Guion-Almeida, Maria L.; Richieri-Costa, Antonio; Santos, Juliana M.; Kokitsu-Nakata, Nancy M.

    2013-01-01

    The authors describe the clinical findings of 38 children with congenital anomalies and misoprostol intrauterine exposure. This study included 38 cases, ascertained from case series of the Hospital of Rehabilitation of Craniofacial Anomalies from University of São Paulo, with evidence of intrauterine exposure to misoprostol in the first trimester of the pregnancy. Information about misoprostol intake and drug administration route was obtained through interviews with mothers. Clinical evaluation showed 18 individuals with facial phenotype compatible with Moebius syndrome; 11 individuals with multiple congenital anomalies; and nine individuals with nonsyndromic cleft lip and/or cleft palate. This study showed a widening of the phenotypic spectrum associated with misoprostol embryotoxicity.

  12. MR Imaging Findings of a Leiomyosarcoma of the Thoracic Spine: A Case Report.

    PubMed

    Tahara, K; Yamashita, K; Hiwatashi, A; Togao, O; Kikuchi, K; Endo, M; Otsuka, H; Oda, Y; Honda, H

    2016-06-01

    We report a case of leiomyosarcoma of the thoracic spine. Primary leiomyosarcoma is a malignant connective tissue tumor originating from smooth muscle cells. Leiomyosarcoma frequently occurs in the uterus, retroperitoneal space, gastrointestinal tract, and deep soft tissues; primary leiomyosarcoma of the bone is rare. The MR imaging including intravoxel incoherent motion (IVIM) imaging findings of the current case indicated a low diffusion coefficient and high blood flow, which were in concurrence with high cell density on histology and increased vascularity by angiography. Although some benign tumors such as osteoblastoma and giant cell tumor would show similar findings on IVIM imaging, these additional imaging features may narrow the differential diagnosis of spinal tumors. PMID:26170221

  13. Gingival fibromatosis with multiple unusual findings: report of a rare case

    PubMed Central

    He, Long; Ping, Fei-Yun

    2012-01-01

    Gingival fibromatosis is a rare disease, especially its syndromic form. Here, we review the literatures on gingival fibromatosis and briefly summarize some characters on clinical, etiological, genetic and histopathological aspects. We also present a rare case of gingival fibromatosis with multiple unusual findings in a 21-year-old man. And we differentiate it from some well-known syndromes including gingival fibromatosis. Maybe it implies a new syndrome within the spectrum of those including gingival fibromatosis. PMID:22955199

  14. Tailgut Cyst and Perineal Hydatid Cyst: A Case Report with Multimodality Imaging Findings

    PubMed Central

    Alghofaily, Khalefa Ali

    2016-01-01

    A tailgut cyst is a rare developmental lesion and usually is located in the retrorectal or presacral space. Extrahepatic hydatid disease has been reported in several locations including the pelvis and it often poses a diagnostic challenge. There are very few reported cases of primary perineal hydatid cysts. We present the multimodality imaging findings of a tailgut cyst and concurrent perineal hydatid disease in a 32-year-old male patient.

  15. Nevoid Basal Cell Carcinoma Syndrome - Clinical and Radiological Findings of Three Cases

    PubMed Central

    Ali, Ibrahim K; Karjodkar, Freny R; Sansare, Kaustubh; Salve, Prashant; Goyal, Shikha

    2016-01-01

    Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder, characterized by skeletal anomalies and multiple keratocystic odontogenic tumors of the jaws. The skeletal anomalies of this syndrome are mandibular prognathism, bossing of frontal and parietal bones, high-arched palate, and bifid rib. We report three cases with NBCCS, emphasizing the clinical and radiographic findings, the importance of the early diagnosis of NBCCS, and a preventive multidisciplinary approach in the management of NBCCS.

  16. (18)F-FDG PET/CT findings in a case with HIV (-) Kaposi sarcoma.

    PubMed

    Ozdemir, E; Poyraz, N Y; Keskin, M; Kandemir, Z; Turkolmez, S

    2014-01-01

    Although mucocutaneous sites are the most frequently encountered sites of involvement, Kaposi Sarcoma (KS) may also occasionally involve the breast and the skeletal, endocrine, urinary and nervous systems.. Various imaging modalities may be used to delineate the extent of the disease by detecting unexpected sites of involvement. Herein, we report a case of classical type KS, in whom staging with (18)F-FDG PET/CT imaging disclosed widespread disease and unexpected findings of bone and salivary gland involvement. PMID:24119549

  17. MRI and MR spectroscopy findings of a case of subacute sclerosing panencephalitis affecting the corpus callosum.

    PubMed

    Öztürk, Mehmet; Sığırcı, Ahmet; Yakıncı, Cengiz

    2015-01-01

    Subacute sclerosing panencephalitis (SSPE) is a rare, slowly progressive, fatal, inflammatory and neurodegenerative disease that is seen mostly in children and young adolescents, and primarily affects the parieto-occipital lobes. The corpus callosum, cerebellum and basal ganglia are less frequently involved. MR spectroscopy (MRS) may illustrate the pathophysiological features of SSPE. To the best of our knowledge, this is the second report of MRS findings of corpus callosum involvement in a stage 3 SSPE case. PMID:26163552

  18. A case control study on autopsy findings in sudden unexplained nocturnal death syndrome

    PubMed Central

    Gervacio, G; Lim, M; Reganit, P; Encinas, M; Macapugay, L; Palmero, J; Nierras, C; De los Reyes, C; Geronimo, F

    2014-01-01

    Aim Sudden unexplained nocturnal death syndrome (SUNDS) has been linked to the Brugada syndrome. In some places, acute haemorrhagic pancreatitis is widely held to cause it. We conducted a systematic, controlled autopsy study on Filipino SUNDS victims to rule out structural heart findings as well as acute haemorrhagic pancreatitis as causes. Methods and results A case control autopsy study was conducted comparing SUNDS victims between 18 and 50 years of age who died within 1 h of symptom onset with age- and gender-matched controls. There were 24 SUNDS (mean age 34.5 years) and 24 controls (mean 32.7 years). The autopsy incidence of structural heart disease was 8.3% (95% CI (1% to 27%)) and focal pancreatic haemorrhage was 4.17% (95% CI (0.1% to 20%)) but zero for true acute haemorrhagic pancreatitis among SUNDS victims. Autopsy findings in SUNDS versus controls were not significantly different from each other, showing no diagnostic abnormality in any of the organs. There was no significant difference in the incidence of acute haemorrhagic pancreatitis in both the SUNDS and control groups. We did not find fetal dispersion of the atrioventricular (AV) node, sclerosis or fibrosis of the AV conduction system, in a substudy of SUNDS cases. Conclusions We have shown that there is no significant difference in the overall autopsy findings between SUNDS and controls. Autopsy findings were normal in 70% of SUNDS; no cardiac structural pathology was found in 87% of cases. Haemorrhagic pancreatitis is the cause of death in a minority of SUNDS. The cardiac conduction system is normal in a subgroup of SUNDS studied. PMID:27326155

  19. Has the DOTS Strategy Improved Case Finding or Treatment Success? An Empirical Assessment

    PubMed Central

    Obermeyer, Ziad; Abbott-Klafter, Jesse; Murray, Christopher J. L.

    2008-01-01

    Background Nearly fifteen years after the start of WHO's DOTS strategy, tuberculosis remains a major global health problem. Given the lack of empirical evidence that DOTS reduces tuberculosis burden, considerable debate has arisen about its place in the future of global tuberculosis control efforts. An independent evaluation of DOTS, one of the most widely-implemented and longest-running interventions in global health, is a prerequisite for meaningful improvements to tuberculosis control efforts, including WHO's new Stop TB Strategy. We investigate the impact of the expansion of the DOTS strategy on tuberculosis case finding and treatment success, using only empirical data. Methods and Findings We study the effect of DOTS using time-series cross-sectional methods. We first estimate the impact of DOTS expansion on case detection, using reported case notification data and controlling for other determinants of change in notifications, including HIV prevalence, GDP, and country-specific effects. We then estimate the effect of DOTS expansion on treatment success. DOTS programme variables had no statistically significant impact on case detection in a wide range of models and specifications. DOTS population coverage had a significant effect on overall treatment success rates, such that countries with full DOTS coverage benefit from at least an 18% increase in treatment success (95% CI: 5–31%). Conclusions The DOTS technical package improved overall treatment success. By contrast, DOTS expansion had no effect on case detection. This finding is less optimistic than previous analyses. Better epidemiological and programme data would facilitate future monitoring and evaluation efforts. PMID:18320042

  20. Feline perforating dermatitis resembling human reactive perforating collagenosis: clinicopathological findings and outcome in four cases.

    PubMed

    Albanese, Francesco; Tieghi, Chiara; De Rosa, Luigi; Colombo, Silvia; Abramo, Francesca

    2009-08-01

    The clinicopathological findings of perforating dermatitis in two young and two adult cats are described. In all cases, the lesions were characterized by single or multiple papules and plaques, 0.5-3.0 cm in diameter, each containing a central, firm, exophytic, cone-shaped, yellow-orange keratotic plug, tightly adherent to the underlying skin. Removal of the protruding material was associated with bleeding and left the ulcerated surface exposed. In one case, the lesions showed a linear configuration and identical lesions occurred on the suture sites following biopsy. Histopathologically, the diagnosis was straightforward because of the presence of vertically orientated collagen bundles extruded from ulcerated, concave-shaped invaginations of the skin. In two cases, vitamin C administration failed to resolve the disease. In two cases, methyl-prednisolone acetate was used to manage relapsing episodes and vitamin C helped to reduce glucocorticoid requirements. In one case, treatment with methyl-prednisolone acetate only appeared to be curative. The fourth case was lost to follow-up immediately after the diagnosis. PMID:19659539

  1. [A case of stunned myocardium: dual SPECT findings similar to acute myocardial infarction (AMI)].

    PubMed

    Itho, K; Kohno, Y; Sudo, Y; Azuma, A; Sugihara, H; Asayama, J; Katsume, H; Nakagawa, M

    1993-02-01

    Emergent cardiac catheterization was performed on a 70-year-old female patient who was admitted for further evaluation of acute myocardial infarction. Coronary angiography didn't reveal any significant stenotic lesion, but levogram showed extensively abnormal contractility around the center of the apex region. On the second hospital day, 99mTc-PYP/201TlCl dual SPECT gave findings similar to those found in acute myocardial infarction, but myocardium--released enzyme stayed within the normal range. Two weeks after, 201TlCl myocardial scintigraphy showed disappearance of the perfusion defect, and normal contractility was observed on the levogram of the chronic phase. Since this case was clinically denied to be myocardial infarction, it was considered a typical case of stunned myocardium which showed prolonged left ventricular abnormal contractility with transient myocardial ischemia. This is a case suggestive for estimations of myocardial reversibility in patients with myocardial perfusion and metabolic disorder in dual SPECT. PMID:8434179

  2. Secondary injury potential of assistive technologies used by farmers with disabilities: findings from case studies.

    PubMed

    Mathew, Samuel N; Field, William E; French, Brian F

    2011-01-01

    In order to complete essential tasks, farmers with disabilities often make and use assistive technology (AT), which itself may cause further injuries known as secondary injuries. A set of 19 case studies was used to investigate the potential for injury on home-fabricated assistive technologies (ATs) used by farmers with disabilities. The case studies consisted of close-ended and open-ended interviews that were designed to help understand the farmers' perception of potential for injuries and safety measures implemented or not implemented. The qualitative study used grounded theory principles and the collected data were analyzed to arrive at a list of features on ATs that have substantial potential to cause injury to the user. Based on the case study results, AT user characteristics and environmental factors were also considered as factors that contribute to potential injuries. Findings were used to develop an instrument for use by rehabilitation professionals to evaluate ATs for potential injury causing hazards. PMID:21728872

  3. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic intensifying screen. 892.1960 Section 892.1960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1960 Radiographic intensifying...

  4. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiographic intensifying screen. 892.1960 Section 892.1960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1960 Radiographic intensifying...

  5. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiographic intensifying screen. 892.1960 Section 892.1960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1960 Radiographic intensifying...

  6. 21 CFR 892.1960 - Radiographic intensifying screen.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiographic intensifying screen. 892.1960 Section 892.1960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1960 Radiographic intensifying...

  7. Surface Signature of Subsurface-Intensified Vortices

    NASA Astrophysics Data System (ADS)

    Ciani, D.; Carton, X. J.; Chapron, B.; Bashmachnikov, I.

    2014-12-01

    The ocean at mesoscale (20-200 km) and submesoscale (0.5-20km) is highly populated by vortices. These recirculating structures are more energetic than the mean flow, they trap water masses from their origin areas and advect them across the ocean, with consequent impact on the 3D distribution of heat and tracers. Mesoscale and submesoscale structures characterize the ocean dynamics both at the sea surface and at intrathermocline depths (0-1500m), and are presently investigated by means of model outputs, in-situ and satellite (surface) data, the latest being the only way to get high resolution and synoptic observations at planetary scale (e.g., thermal-band observations, future altimetric observations given by the SWOT satellite mission). The scientific question arising from this context is related to the role of the ocean surface for inferring informations on mesoscale and submesoscale vortices at depth. This study has also been motivated by the recent detection of subsurface eddies east of the Arabian Peninsula (PHYSINDIEN experiment - 2011).Using analytical models in the frame of the QG theory, we could describe the theoretical altimetric signature of non-drifting and of drifting subsurface eddies. Numerical experiments, using both coupled QG-SQG and primitive equations models, allowed us to investigate the surface expression of intrathermocline eddies interacting with baroclinic currents or evolving under planetary beta-effect. The eddy characteristics (radius, depth, thickness, velocity) were varied, to represent various oceanic examples (Meddies, Swoddies, Reddies, Peddies, Leddies). Idealized simulations with the ROMS model, confirming theoretical estimates, showed that drifting subsurface-intensified vortices can induce dipolar sea level anomalies, up to 3 cm. This result, compatibly with future SWOT measurement accuracies (about 2 cm), is a first step towards systematic and synoptic detection of subsurface vortices.

  8. Phosphaturic mesenchymal tumour mixed connective tissue variant: report of three cases with unusual histological findings.

    PubMed

    Shustik, David A; Ng, David Ce; Sittampalam, Kesavan

    2015-01-01

    Phosphaturic mesenchymal tumour mixed connective tissue variant (PMTMCT) is a rare tumour occurring in bone and soft tissue that usually behaves in a benign manner. Elaboration of biologically active substances by this tumour gives rise to a paraneoplastic syndrome known as oncogenic osteomalacia, manifesting clinically as bone pain, generalized weakness and pathological fractures. Recognition of PMTMCT and its associated syndrome is important, as resection of the tumour in most instances results in prompt resolution of symptoms. Previously reported cases of this tumour have emphasized the consistent presence of certain histological features that are considered prerequisite for making the diagnosis of PMTMCT. We describe three cases of PMTMCT, of which two first presented with progressive symptoms of osteomalacia and one remained clinically silent aside from the symptom of a palpable lump. Our cases highlight the wide-ranging histological patterns displayed by these tumours, and draw attention to certain microscopic findings that until now have been given little if any mention. Tentacular growth pattern and satellite nodules appear to be common findings in PMTMCTs, and can make complete surgical excision of these tumours challenging. The ability of this otherwise histologically benign tumour to permeate vascular spaces has to our knowledge never been described previously. One tumour lacked the characteristic calcifying matrix of PMTMCT, suggesting that in some tumours this defining feature may be focal if not entirely absent. PMTMCT shares features with and can resemble a variety of bone and soft tissue neoplasms, requiring the surgical pathologist to be familiar with this entity. PMID:26261662

  9. A comparison between passive and active case finding in TB control in the Arkhangelsk region

    PubMed Central

    Kuznetsov, Vladimir N.; Grjibovski, Andrej M.; Mariandyshev, Andrey O.; Johansson, Eva; Bjune, Gunnar A.

    2014-01-01

    Background In Russia, active case finding (ACF) for certain population groups has been practiced uninterruptedly for many decades, but no studies comparing ACF and passive case finding (PCF) approaches in Russia have been published. Objective The aim of this study was to describe the main differences in symptoms and diagnostic delay between patients who come to TB services through PCF and ACF strategies. Methods A cross-sectional study was conducted among 453 new pulmonary tuberculosis (PTB) patients, who met criteria of TB diagnostic delay in Arkhangelsk. Results ACF patients used self-treatment more often than PCF patients (90.1% vs. 24.6%) and 36.3% of them were alcohol abusers (as opposed to only 26.2% of PCF patients). The median patient delay (PD) in PCF was 4 weeks, IQR (1–8 weeks), and less than 1 week in ACF. Twenty-three per cent of the PCF patients were seen by a medical provider within the first week of their illness onset. Conclusion Patients diagnosed through ACF tended to under-report their TB symptoms and showed low attention to their own health. However, ACF allowed for discovering TB patients earlier than PCF, and this was also the case for alcohol abusing patients. PCF systems should be supplemented with ACF strategies. PMID:24563859

  10. Barriers to the effective use of medico-legal findings in sexual assault cases worldwide.

    PubMed

    Mont, Janice Du; White, Deborah

    2013-09-01

    Despite the increasing implementation of standardized rape kits across jurisdictions, the medico-legal findings generated by these tools are often not related to positive criminal justice outcomes. Given that there has been no global investigation of the factors that might impede their successful use in cases of sexual assault, we conducted a review of relevant scholarly and "grey" literature from industrialized and less-developed regions. One key theme to emerge from the analysis concerned certain problematic practices and behaviors of professional groups involved in the various stages of the post-sexual assault process. We found that a lack of competence in handling sexual assault cases, contempt for women who have been victimized, and corruption among some forensic examiners, police, scientists, and legal personnel often have shaped the collection, processing, analysis, and use of medico-legal evidence. We discuss recent initiatives and future directions for research that might serve to address these issues. PMID:23935160

  11. Second case of histoplasmosis in a captive mara (Dolichotis patagonum): pathological findings.

    PubMed

    Pérez-Torres, A; Rosas-Rosas, A; Parás-García, A; Juan-Sallés, C; Taylor, M L

    2009-08-01

    A second case of histoplasmosis in a captive mara (Dolichotis patagonum) from a colony at the wildlife park Africam Safari, Puebla, Mexico, is described, and the mara died with disseminated clinical form of the disease, affecting mostly the large intestine and adrenal. The pathological findings of this case 2 revealed severe granulomatous typhlocolitis and moderate granulomatous gastrohepatic lymphadenitis with numerous yeast-like cells, 2-4 mum in diameter, with a clear halo surrounding them inside the cytoplasm of macrophages, suggesting the parasitic form of Histoplasma capsulatum. Adrenocortical cells had abundant similar microorganisms in their cytoplasm without any associated lesion. Gomori's methenamine silver and periodic acid Schiff stained positively these microorganisms. Immunohistochemistry, using a rabbit anti-H. capsulatum serum, and transmission electron microscopy supported the diagnosis of H. capsulatum infection. PMID:19360479

  12. Giant cell interstitial pneumonia: an unusual finding in a case of preoperative death.

    PubMed

    Sisodia, Shantilal M; Bendale, Kiran; Khan, Wasif Ali Zafarali; Sanklecha, Vandana

    2013-06-01

    Giant cell interstitial pneumonia (GIP) is an exceedingly rare, debatable, perplexing, occupational lung disease, which most commonly affects individuals exposed to hard metal dust. We report a case of GIP in a 60-year-old man, scheduled for coronary artery bypass graft surgery and died during induction of general anesthesia despite all efforts to resuscitate him. Patient's relatives lodged complaint with the police alleging the negligence by the attending physicians. Despite inaccessible data pertaining to the occupation, clinical history, and radiographic findings, the diagnosis was GIP due to the presence of intra-alveolar, bizarre, "cannibalistic" multinucleated giant cells-the histologic sine qua non of GIP. To the best of our knowledge, this is the first case report of GIP in the world literature that was diagnosed on histopathologic examination of lung tissue obtained at medicolegal autopsy. PMID:23629398

  13. Neuropsychological findings in a case of punding before and after cessation of pramipexole.

    PubMed

    Larson, Eric R

    2015-01-01

    Clinical neuropsychologists are well trained to recognize neurological and psychiatric conditions that impact behavior, but tend to have less familiarity with iatrogenic consequences of various pharmacological treatments. One such consequence is the development of an impulse control disorder (ICD), which can result from treatment with dopamine agonists. Knowledge of ICDs is important because they can mimic obsessive-compulsive disorder, mania, or the behavioral variant of frontotemporal dementia. The current case examines a patient who developed punding, which is a type of ICD characterized by repetitive behavior, as a result of treatment with pramipexole. Neuropsychological testing was conducted before and after cessation of pramipexole, and showed that the removal of the medication was consistent with improvement in frontal-subcortical-mediated cognitive functions. Findings suggest that neuropsychologists should be familiar with the symptoms of ICDs and incorporate such knowledge into their case conceptualizations. PMID:25658417

  14. Ocular, Neurologic and Systemic Findings of the Cases with Optic Nerve Hypoplasia

    PubMed Central

    Karahan, Eyyup; Tulin Berk, Ayse

    2016-01-01

    Aim: To describe the associated ocular, neurologic, and systemic findings in a population of children with optic nerve hypoplasia (ONH) and to evaluate the relationship between ocular signs and neurologic findings. Method: A retrospective chart review of 53 patients with the diagnosis of ONH seen between December 1998 and September 2012 was performed. All neurodevelopmental anomalies, neuroradiologic findings, endocrinologic and systemic findings were recorded. Poor vision was defined as the visual acuity poorer than logMAR 1.0 or inadequate central steady maintained fixation. Results: Thirty (56.6%) of the 53 children with ONH were boys. Mean age at presentation was 56.2±46.8 months (range; 3 months to 18 years). Poor vision defined for the purpose of this study was found in 47.2% of 53 patients. Thirty-three (62.3%) children had nystagmus. Thirty-four (64.2%) children had strabismus. Thirteen (38.2%) of those with strabismus had esotropia, 20 (58.8%) had exotropia. The total number of the children with neurodevelopmental deficit was 22 (41.5%) in our study. Conclusion: The vision of young children with ONH should be monitored at least annually, and any refractive errors should be treated. Neuroimaging of the brain and endocrinologic evaluation is necessary in all cases with ONH. PMID:27014380

  15. Quantification of neuropathological findings by image data for the diagnosis of dementia in forensic autopsy cases.

    PubMed

    Takayama, Mio; Kashiwagi, Masayuki; Matsusue, Aya; Waters, Brian; Hara, Kenji; Ikematsu, Natsuki; Kubo, Shin-ichi

    2016-01-01

    The aim of the present study was to quantify neuropathological findings using image analysis software for the diagnosis of dementia in deceased who underwent forensic autopsy. Of the autopsies performed within 48 hours of death and excluding those of patients with head injury, thermal injury, heat stroke, or intracranial lesions, 8 were of autopsy cases clinically diagnosed with dementia and thus included in the dementia group (D). The non-dementia group (non-D) consisted of 6 deceased without dementia. To compare the D and non-D groups, 6 regions and 7 types of pathological findings were observed semi-quantitatively using 4 conventional stainings. Quantitative analysis of collected image data was performed using image analysis software. Semiquantitative analysis of senile plaques and neurofibrillary tangles was performed with Bielschowsky-Hirano's silver staining image data. An easy, simple, and effective quantification method of the pathological findings was achieved. However, no significant differences were observed between the two groups, and diagnosis of dementia by the quantification of pathological findings was not successful. Diagnosis of dementia using image data may be possible in future studies with an increased number of autopsies, and by utilizing staining techniques with higher specificity and sensitivity, such as immunohistochemical staining. PMID:27040064

  16. Periodic electroencephalogram discharges in a case of Lafora body disease: An unusual finding.

    PubMed

    Jain, Rajendra Singh; Gupta, Arti; Gupta, Pankaj Kumar; Agrawal, Rakesh

    2016-01-01

    Lafora body disease (LBD) is a form of progressive myoclonic epilepsy, characterized by seizures, myoclonic jerks, cognitive decline, ataxia, and intracellular polyglucosan inclusion bodies (Lafora bodies) in the neurons, heart, skeletal muscle, liver, and sweat gland duct cells. Electroencephalogram (EEG) findings in LBD may include multiple spikes and wave discharges, photosensitivity, multifocal epileptiform discharges, and progressive slowing in background activity. Periodicity in epileptiform discharges has not been frequently depicted in LBD. We herein report an unusual case of LBD who showed generalized periodic epileptiform discharges in EEG. PMID:27293346

  17. DWI findings in a iatrogenic lumbar epidermoid cyst. A case report.

    PubMed

    Manzo, G; De Gennaro, A; Cozzolino, A; Martinelli, E; Manto, A

    2013-08-01

    Epidermoid cysts comprise less than 1% of intraspinal tumors. They can be congenital, frequently associated with other spinal malformations, or iatrogenic, resulting from the implantation of epidermal cells within the spinal canal during the execution of a variety of procedures such as spinal puncture. At MR imaging epidermoid tumors can mimic cystic lesions with fluid content such as arachnoid cysts. DWI can help obtain a correct diagnosis. We describe a case of iatrogenic lumbar epidermoid cyst with DWI findings in a young woman who had undergone epidural anesthesia for Cesarean section three years before the onset of symptoms. PMID:24007735

  18. Incidental optochiasmatic cavernoma: Case report of an unusual finding on 3 Tesla MRI.

    PubMed

    Trentadue, Mirko; Pozzi Mucelli, Roberto; Piovan, Enrico; Pizzini, Francesca Benedetta

    2016-08-01

    Cavernoma is a vascular hamartoma, which represents 10-20% of all central nervous system vascular malformations. The majority (80%) of them are supratentorial, while involvement of the cranial nerves and the optic pathways is extremely rare. The main clinical presentation of optochiasmatic cavernomas consists of chiasmatic apoplexy, which is a neurosurgical emergency. Here, we report a case in which the finding was incidentally detected in a 49-year-old man. We describe the imaging characteristics of the lesion in such a rare location, highlighting the role of magnetic resonance imaging (MRI) (specifically 3 Tesla) in the management of asymptomatic patients. PMID:27145992

  19. Periodic electroencephalogram discharges in a case of Lafora body disease: An unusual finding

    PubMed Central

    Jain, Rajendra Singh; Gupta, Arti; Gupta, Pankaj Kumar; Agrawal, Rakesh

    2016-01-01

    Lafora body disease (LBD) is a form of progressive myoclonic epilepsy, characterized by seizures, myoclonic jerks, cognitive decline, ataxia, and intracellular polyglucosan inclusion bodies (Lafora bodies) in the neurons, heart, skeletal muscle, liver, and sweat gland duct cells. Electroencephalogram (EEG) findings in LBD may include multiple spikes and wave discharges, photosensitivity, multifocal epileptiform discharges, and progressive slowing in background activity. Periodicity in epileptiform discharges has not been frequently depicted in LBD. We herein report an unusual case of LBD who showed generalized periodic epileptiform discharges in EEG. PMID:27293346

  20. Depression case finding in primary care: a method for the mandates.

    PubMed

    Nease, Donald E; Klinkman, Michael S; Aikens, James E

    2006-01-01

    The current mandates for depression screening in primary care create a dilemma for clinicians. How should screening be implemented in the face of limited evidence for sustainable strategies for effective depression monitoring and management in primary care. In this article we review the issues surrounding primary care depression screening, and develop the argument for a case-finding strategy that includes careful choice of a single instrument, focused identification of high-risk patients, and systematic monitoring of outcomes. We believe this is a sustainable method that primary care clinicians can implement to address the spirit of current depression screening mandates. PMID:17154144

  1. Quantitative evaluation of integrated schistosomiasis control: the example of passive case finding in Ghana.

    PubMed

    de Vlas, Sake J; Danso-Appiah, Anthony; van der Werf, Marieke J; Bosompem, Kwabena M; Habbema, J Dik F

    2004-06-01

    Passive case finding based on adequate diagnosis and treatment of symptomatic individuals with praziquantel by the health care facilities is a minimum requirement for integrated schistosomiasis control. Two field studies were conducted in Ghana to obtain quantifications about the steps in this process: (1) a study of health-seeking behaviour through interview of individuals with reported schistosomiasis-related symptoms; (2) a study of the performance of the Ghanaian health system with regard to schistosomiasis case management by presenting clinical scenarios to health workers and collecting information about availability of praziquantel. It appeared that cases of blood in urine (the most typical symptom of Schistosoma haematobium) and blood in stool (the most typical symptom of S. mansoni) have a very small probability of receiving praziquantel (4.4% and 1.4%, respectively) from health facilities. Programmes aimed at making the drug available at all levels of the health care delivery system and encouraging health-seeking behaviour through health education are not likely to increase these probabilities beyond 30%. This is because many cases with blood in urine do not consider it serious enough to seek health care, and blood in stool usually requires (imperfect) diagnostic testing and referral. We therefore conclude that additional control activities, especially for high-risk groups, will remain necessary. PMID:15189470

  2. Radiological Findings and Endovascular Management of Three Cases with Segmental Arterial Mediolysis

    SciTech Connect

    Davran, Ramazan; Cinar, Celal; Parildar, Mustafa; Oran, Ismail

    2010-06-15

    Segmental arterial mediolysis (SAM) is an uncommon self-limited disorder that can cause abdominal catastrophes through massive bleeding or bowel infarction. The former arise from arterial aneurysms, and the latter from arterial stenosis or occlusions. Although this is an acute self-limiting disease, the catastrophic consequence, originating from intra-abdominal hemorrhage (arterial dilatation, aneurysms, dissecting hematomas) or bowel infarction (arterial stenosis, arterial occlusions), is not rare. The identification of these lesions is very important in the differential diagnosis of suspected patients with complaints of abdominal pain with hemorrhage. We report computerized tomography angiography and digital subtraction angiography findings of three cases with abdominal SAM, who were treated with endovascular management due to abdominal bleeding. Angiography showed arterial dilatations, aneurysms, and occlusions of visceral arteries in all three cases, The string-of-beads appearance was present in only one case. Bleeding stopped immediately after embolization of three cases and follow-up revealed no evidence of recurrences at 23, 18, and 15 months, respectively, Arterial coil embolization is an effective treatment modality for bleeding complications of SAM. Close follow-up is recommended, primarily to ascertain the fate of the nontreated arterial lesions.

  3. Phylloides tumor: findings on mammography, sonography, and aspiration cytology in 10 cases.

    PubMed

    Buchberger, W; Strasser, K; Heim, K; Müller, E; Schröcksnadel, H

    1991-10-01

    Phylloides tumor is a rare fibroepithelial breast tumor that occasionally has unpredictable clinical behavior. In nine cases of histologically benign tumors and one case of malignant phylloides tumor, the findings on physical examination, mammography, sonography, and aspiration biopsy were correlated retrospectively with the histologic diagnosis of resected specimens. Mammograms showed a round or lobulated benign-appearing opacity in nine cases; one small tumor was missed mammographically. Sonography depicted all tumors as mostly solid masses. Sonographic features included low-level internal echoes, either uniform or scattered; smooth contours; and no significant posterior shadowing. Intramural cysts were shown in six cases. Neither mammography nor sonography allowed reliable differentiation between benign and malignant phylloides tumors. Aspiration biopsy permitted accurate diagnosis of seven benign tumors. The malignant phylloides tumor was classified as a malignant tumor, but the definite differentiation from a carcinoma could not be made. Two histologically benign phylloides tumors were misdiagnosed as carcinomas. Although uncommon, phylloides tumor should be considered in the differential diagnosis of mammographically benign-appearing breast masses, especially if sonography shows intramural cysts within a well-defined solid lesion. Aspiration cytology is unreliable because of the inhomogeneity of the tumor; both intraoperative frozen section and permanent sections are needed for correct histologic diagnosis. PMID:1654022

  4. Clinical Findings and Results of Surgical Resection in 19 Cases of Spinal Osteoid Osteoma

    PubMed Central

    Etemadifar, Mohammad Reza

    2015-01-01

    Study Design Descriptive cases series. Purpose To evaluate clinical findings and results of conventional surgery in patients with spinal osteoid osteoma (OO). Overview of Literature OO is a rare benign tumor with spinal involvement rate of about 10%-20%. Methods This descriptive study was conducted on 19 patients (11 males and 8 females with an average age of 19.8 years) with documented histopathological and imaging findings of OO referred to a university hospital. Neurologic symptoms and pain were scored before and after the open surgical excision. Data were analyzed by SPSS ver. 16 software using chi-square and significance level of 0.05. Results The most common complaint was back or neck pain (84.2%) and in 68.4% spinal deformity (mostly scoliosis) shown with an average cobb angle of 21° at presentation. The sites of involvement were 35% in the lumbar, 35% in the thoracic, 25% in the cervical, and 5% in the sacrum. Lamina was the most common site (50%) of involvement with predilection for the right side (p=0.001). All patients were treated by conventional surgical excision with a complete recovery of pain and deformity. No recurrence occurred after a mean follow up of 44.5 months, but 4 of 19 cases instrumented because of induced instability. In one case there were two levels of involvement (C7-T1) simultaneously. Interestingly, 10 out of 19 of our cases belonged to a specific race (Bakhtiari). Conclusions Surgical intra-lesional curettage is potentially an effective method without any recurrence, which can lead to spontaneous scoliosis recovery and pain relief. Race may be a potential risk factor for spinal (OO). PMID:26097653

  5. Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006–2011)

    PubMed Central

    Arzi, Boaz; Cissell, Derek D.; Verstraete, Frank J. M.; Kass, Philip H.; DuRaine, Grayson D.; Athanasiou, Kyriacos A.

    2013-01-01

    Objective To describe CT findings in dogs and cats with temporomandibular joint (TMJ) disorders. Design Retrospective case-series. Animals 41 dogs and 17 cats. Procedures Medical records and CT images of the skull were reviewed for dogs and cats that were examined at a dentistry and oral surgery specialty practice between 2006 and 2011. Results Of 142 dogs and 42 cats evaluated, 41 dogs and 17 cats had CT findings consistent with a TMJ disorder. In dogs, the most common TMJ disorder was osteoarthritis; however, in most cases, there were other TMJ disorders present in addition to osteoarthritis. Osteoarthritis was more frequently identified at the medial aspect rather than the lateral aspect of the TMJ, whereas the frequency of osteoarthritic involvement of the dorsal and ventral compartments did not differ significantly. In cats, fractures were the most common TMJ disorder, followed by osteoarthritis. Clinical signs were observed in all dogs and cats with TMJ fractures, dysplasia, ankylosis, luxation, and tumors; however, only 4 of 15 dogs and 2 of 4 cats with osteoarthritis alone had clinical signs. Conclusions and Clinical Relevance Results indicated that TMJ disorders are frequently present in combination. Osteoarthritis was the most common TMJ disorder in dogs and the second most common TMJ disorder in cats. Computed tomography should be considered as a tool for the diagnosis of TMJ disorders in dogs and cats with suspected orofacial disorders and pain. PMID:23234284

  6. Early MRI and intraoperative findings in rapidly destructive osteoarthritis of the hip: A case report

    PubMed Central

    Fukui, Kiyokazu; Kaneuji, Ayumi; Fukushima, Mana; Matsumoto, Tadami

    2015-01-01

    Introduction The pathophysiology of rapidly destructive hip osteoarthritis (OA) of the hip is still unclear. Also, there have been only few reports on the initial stage of the disease. We report a case of an initial-stage rapidly destructive hip OA, documented by magnetic resonance imaging and intraoperative findings. Presentation of case A 77-year-old woman reported left hip pain without any antecedent trauma. Initial radiographs showed no obvious abnormality. After 4 months of conservative therapy, radiographs showed progressive joint-space narrowing and T1-weighted magnetic resonance images revealed a bone-marrow edema pattern not only on the femoral head but also on the lateral side of the acetabulum. Then during total hip arthroplasty, we found extensive inversion of the anterosuperior portion of the acetabular labrum, and the location was mostly consistent with the bone-marrow edema lesions in the femoral head and acetabulum. Discussion Several theories for the etiology of rapidly destructive hip OA have been proposed, including idiopathic chondrolysis, abnormal immunoreaction, intra-articular deposition of hydroxyapatite crystals, and subchondral insufficiency fracture. One of the reasons rapidly destructive hip OA is still considered idiopathic is the lack of reports regarding the initial stage of the disease. Our report is the first to demonstrate magnetic resonance imaging for initial-stage disease with intraoperative findings before collapse of the femoral head. Conclusion Inversion of the acetabular labrum may be a mechanism of rapidly destructive hip OA. PMID:25603485

  7. Semantic change in English intensifiers that have developed from a prepositional phrase and a noun phrase.

    PubMed

    Ohashi, Hiroshi

    2007-12-01

    In the advance of research in grammaticalization, there has been some inquiry into the development of English intensifiers. While most studies focus on the process of semantic shift from adverbs or adjectives that are the primary sources of intensifiers, little attention has been drawn to minor members of the category that have developed from a prepositional phrase or noun phrase. However, it is of great interest from the viewpoint of semantic change in general as well as that of grammaticalization and subjectification to examine what factors are engaged in the development of these intensifiers. This paper examines the development of indeed, a lot, a great/good deal, big time and all X wants/likes, and found that such mechanisms as metaphor, metonymy, conversational implicature, reanalysis, and the speaker's intention of producing illocutionary forces contribute to the semantic change of these intensifiers. Furthermore, as a theoretical implication of this study, it is observed that during the semantic shift that is regarded as a case of grammaticalization, most items have undergone subjectification, which gives support to the claim by E. C. Traugott, among others, that subjectification is found to take place concomitantly with PMID:18170960

  8. Unexpected Histopathological Findings in Appendectomy Specimens: a Retrospective Study of 1627 Cases.

    PubMed

    Limaiem, Faten; Arfa, Nafaa; Marsaoui, Lobna; Bouraoui, Saadia; Lahmar, Ahlem; Mzabi, Sabeh

    2015-12-01

    Pathologic evaluation of the appendix after appendectomy is routine and can occasionally identify unexpected findings. The aim of the present study was to determine the incidence and type of pathologic diagnoses found in appendectomy specimens at our institution. The clinicopathological data of 1627 patients who underwent appendectomies for presumed acute appendicitis from January 2008 to October 2014 were reviewed retrospectively. There were 986 men and 641 women (sex ratio M/F = 1.5) aged between 16 months and 90 years (mean = 30 years). All patients underwent appendectomy (either open or laparoscopic). Histological examination of the surgical specimen showed acute inflammation of the appendix in 1455 cases (89.42 %), fibrosed appendix in 37 cases (2.27 %), and Enterobius vermicularis (n = 23). In 101 cases (6.2 %), the appendix was histologically normal. Incidental unexpected pathological diagnoses were noted in 57 appendectomy specimens. They included pinworm (n = 23), mucinous neoplasms (n = 12), neuroendocrine tumors (NET) (n = 8), adenocarcinoma (n = 2), granulomatous inflammation (n = 5), tuberculosis (n = 2), hyperplastic polyp (n = 1), tubular adenoma (n = 1), diverticulitis (n = 1), endometriosis (n = 1), and actinomycosis (n = 1). The routine histopathological examination of the appendix is of value for identifying unsuspected conditions requiring further postoperative management. Gross examination alone does not appear to be a good indicator of an unexpected finding on microscopic exam. It is recommended that in order to avoid misdiagnoses, all appendices should be histopathologically examined. PMID:27011552

  9. Dynamic computed tomography findings of an accessory spleen in the pelvis: a case report.

    PubMed

    Ota, Hiroshi; Ojima, Yasutomo; Sumitani, Daisuke; Okajima, Masazumi

    2016-12-01

    We report the case of a 60-year-old man with an accessory spleen in the pelvis. He visited our outpatient clinic because of abdominal discomfort. Computed tomography (CT) showed an enhanced mass (40 mm in diameter) in the pelvis. Preoperative diagnosis was difficult even after magnetic resonance imaging and colonoscopy. The patient underwent surgery for suspicion of a gastrointestinal stromal tumor or malignant lymphoma of the rectum. Intraoperative findings showed a mass in the pelvis and a long cord-like tissue reaching the mass and arising from the great omentum; the mass was excised. Histopathologic examination indicated that the mass was splenic tissue, and feeding vessels were found in the cord-like tissue, which were determined to be derived from the left gastroepiploic artery and vein. Thus, we diagnosed it as an accessory spleen in the pelvis. An accessory spleen is not rare and can occur anywhere in the abdominal cavity. However, an accessory spleen in the pelvis is an infrequent finding, and only 9 other cases of an accessory spleen in the pelvis have been reported. Therefore, it is very difficult to make a correct diagnosis preoperatively. However, 7 of the 9 cases (77.8 %) of a pelvic accessory spleen had vascular pedicles from the great omentum or splenic hilum as feeding vessels; hence, determining the feeding blood vessels on dynamic CT may be useful for diagnosing an accessory spleen in the pelvis. Additionally, if the accessory spleen is symptomatic or has a vascular pedicle, surgeons should attempt to resect the accessory spleen in the pelvis using minimally invasive laparoscopy. PMID:26970956

  10. Stratified mucin-producing intraepithelial lesion with invasive carcinoma: 12 cases with immunohistochemical and ultrastructural findings.

    PubMed

    Onishi, Junji; Sato, Yuichiro; Sawaguchi, Akira; Yamashita, Atsushi; Maekawa, Kazunari; Sameshima, Hiroshi; Asada, Yujiro

    2016-09-01

    Stratified mucin-producing intraepithelial lesion (SMILE) is considered to be a variant of adenocarcinoma in situ (defined as intraepithelial malignant glandular epithelium without invasion) or adenosquamous carcinoma in situ of the uterine cervix. However, recent study suggested that SMILE is more similar to high-grade squamous epithelial lesion by their immunohistochemical findings. An invasive form of SMILE "invasive stratified mucin-producing carcinoma (ISMC)" has been also proposed, but immunohistochemical features are not well documented. Therefore, this study aimed to clarify the immunohistochemical characteristics of SMILE and ISMC. Twelve cases of SMILE were found among 445 patients (2.7%) with high-grade intraepithelial lesions or invasive carcinomas, 3 of whom had solely intraepithelial disease with SMILE component (mean age, 37 years; range, 30-48 years) and 9 with invasive carcinomas (mean age, 47 years; range, 37-66 years; including ISMC). Immunohistochemically, SMILE and ISMC were diffusely positive for p16 and CAM5.2, focally for IMP3, and almost negative or only focally positive for p63. Nuclear signals in SMILE and invasive carcinomas were detected by human papillomavirus (HPV) in situ hybridization; 5 cases showed HPV16 and/or HPV18 polymerase chain reaction products. The ultrastructural study of 1 case showed surface microvilli and small vacuolar structure in SMILE; ISMC had mucous-like vacuoles, many mitochondria and intracytoplasmic lumen but lacked tonofilament. These findings were more similar to adenocarcinoma in situ or adenocarcinoma than squamous intraepithelial lesion or squamous cell carcinoma. We suggest that SMILE is an intraepithelial neoplasm and ISMC is an invasive form of SMILE. PMID:27237368

  11. Massive right-sided Bochdalek hernia with two unusual findings: a case report

    PubMed Central

    2011-01-01

    Introduction In this report, the case of an adult patient with a massive right-sided Bochdalek hernia with multiple displaced abdominal organs, including the liver and gallbladder, is described. This patient presented with acute cholecystitis of the malpositioned gallbladder. During surgery, nodular regenerative hyperplasia of the liver was also found. To the best of this author's knowledge, these two entities have never been reported in association with this rare condition. Case presentation A 54-year-old Caucasian man presented with nausea and epigastric pain. He had a known history of right-sided Bochdalek hernia which was being managed expectantly. A computerized tomogram revealed the massive hernia with displaced stomach, liver, intestine and omentum into his right thorax. It was believed that our patient had bowel incarceration and he was therefore taken to surgery, where acute cholecystitis and a macronodular liver was identified. A thoracoabdominal approach was used to remove his gallbladder, reduce the herniated viscera and reconstruct his diaphragm. A liver biopsy identified nodular regenerative hyperplasia of the ectopic liver. There were no postoperative complications and at 12 month follow-up, our patient continues to do well. Conclusion This case report describes two unusual findings associated with a congenital Bochdalek diaphragmatic hernia that have never been reported. In addition, unique caveats to the surgical management of this complex rare condition are discussed. PMID:22017965

  12. Hepatic metastases of primary jejunal carcinoid tumor: A case report with radiological findings

    PubMed Central

    Avcu, Serhat; Özen, Özkan; Bulut, Mehmet Deniz; Bora, Aydın

    2009-01-01

    Context: Carcinoid tumors represent a group of well-differentiated tumors originating from the diffuse endocrine system outside the pancreas and thyroid. The overall prevalence of carcinoid tumors in the United States is estimated to be one to two cases per 100,000 persons. Various sites of origin of this neoplasm are appendix - 30-45%, small bowel - 25-35% (duodenum 2%, jejunum 7%, ileum 91%, multiple sites 15-35%), rectum 10-15%, caecum - 5%, and stomach - 0.5%. Liver metastases from jejunal and ileal carcinoids are generally hypervascular. Case report: Here we report a case of primary jejunal carcinoid tumor in a 66-year-old woman metastasizing to liver with ultrasonography, computed tomography, and diffusion-weighted magnetic resonance imaging (DWI) findings. Conclusion: Primary jejunal carcinoid tumor is a rare entity. DWI can help in the differential diagnosis of hepatic hypervascular metastatic mass lesions from benign ones, as well as in the diagnosis of carcinoid tumor. PMID:22666712

  13. CT findings and clinical features of pancreatic hemolymphangioma: a case report and review of the literature.

    PubMed

    Pan, Liang; Jian-bo, Gao; Javier, Pullas Tapia Gonzalo

    2015-01-01

    Pancreatic hemolymphangioma is a very rare benign tumor. There were only 10 reports of this disease until June 2014.The aim of the present study was to describe a hemolymphangioma in the neck and body of the pancreas in a 57-year-old woman.The method used in the present study consists of description of the clinical history, image lab features, and pathological result.The patient complained of a 10-day history of epigastric discomfort. Abdominal computed tomography (CT) showed a cystic-solid tumor with an irregular shape, in the neck and body of the pancreas. The tumoral cystic wall and its internal division could be seen intensified on contrast-enhanced CT images compared with those on precontrast images. The pathological examination confirmed the diagnosis.The clinical feature of pancreatic hemolymphangioma includes a lack of specificity. The CT appearance combined with age and sex may be useful in making an early diagnosis. PMID:25621699

  14. A sensitive image intensifier which uses inert gas

    NASA Technical Reports Server (NTRS)

    Kerns, Q. A.; Miller, H. M.

    1972-01-01

    High gain optical image intensifier utilizes inert gas cavity with copper electrodes to form electron avalanches without excessive pulse voltages. Estimated optical gain for device is two times 10 to the power of seven.

  15. NASA's GPM Sees Towering Thunderstorms in Intensifying Tropical Storm Earl

    NASA Video Gallery

    The Global Precipitation Measurement mission, or GPM, core observatory satellite passed over intensifying tropical storm Earl in the Caribbean Sea northeast of Honduras on Aug. 2, 2016 at 11:56 p.m...

  16. Improved intensifying screen reduces X-ray exposure

    NASA Technical Reports Server (NTRS)

    Buchanan, R. A.

    1972-01-01

    X-ray intensifying screen may make possible radiographic procedures where detection speed and X-ray tube power have been the limiting factors. Device will reduce total population exposure to harmful radiation in the United States.

  17. Agriculture intensifies soil moisture decline in Northern China.

    PubMed

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; Miralles, Diego G; Teuling, Adriaan J; Zhang, Tonglin; An, Pingli; Dong, Zhiqiang; Zhang, Jingting; He, Di; Wang, Liwei; Pan, Xuebiao; Bai, Wei; Niyogi, Dev

    2015-01-01

    Northern China is one of the most densely populated regions in the world. Agricultural activities have intensified since the 1980s to provide food security to the country. However, this intensification has likely contributed to an increasing scarcity in water resources, which may in turn be endangering food security. Based on in-situ measurements of soil moisture collected in agricultural plots during 1983-2012, we find that topsoil (0-50 cm) volumetric water content during the growing season has declined significantly (p < 0.01), with a trend of -0.011 to -0.015 m(3) m(-3) per decade. Observed discharge declines for the three large river basins are consistent with the effects of agricultural intensification, although other factors (e.g. dam constructions) likely have contributed to these trends. Practices like fertilizer application have favoured biomass growth and increased transpiration rates, thus reducing available soil water. In addition, the rapid proliferation of water-expensive crops (e.g., maize) and the expansion of the area dedicated to food production have also contributed to soil drying. Adoption of alternative agricultural practices that can meet the immediate food demand without compromising future water resources seem critical for the sustainability of the food production system. PMID:26158774

  18. Intensified deep Pacific inflow and ventilation in Pleistocene glacial times.

    PubMed

    Hall, I R; McCave, I N; Shackleton, N J; Weedon, G P; Harris, S E

    2001-08-23

    The production of cold, deep waters in the Southern Ocean is an important factor in the Earth's heat budget. The supply of deep water to the Pacific Ocean is presently dominated by a single source, the deep western boundary current east of New Zealand. Here we use sediment records deposited under the influence of this deep western boundary current to reconstruct deep-water properties and speed changes during the Pleistocene epoch. In physical and isotope proxies we find evidence for intensified deep Pacific Ocean inflow and ventilation during the glacial periods of the past 1.2 million years. The changes in throughflow may be directly related to an increased production of Antarctic Bottom Water during glacial times. Possible causes for such an increased bottom-water production include increasing wind strengths in the Southern Ocean or an increase in annual sea-ice formation, leaving dense water after brine rejection and thereby enhancing deep convection. We infer also that the global thermohaline circulation was perturbed significantly during the mid-Pleistocene climate transition between 0.86 and 0.45 million years ago. PMID:11518963

  19. Agriculture intensifies soil moisture decline in Northern China

    NASA Astrophysics Data System (ADS)

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; Miralles, Diego G.; Teuling, Adriaan J.; Zhang, Tonglin; An, Pingli; Dong, Zhiqiang; Zhang, Jingting; He, Di; Wang, Liwei; Pan, Xuebiao; Bai, Wei; Niyogi, Dev

    2015-07-01

    Northern China is one of the most densely populated regions in the world. Agricultural activities have intensified since the 1980s to provide food security to the country. However, this intensification has likely contributed to an increasing scarcity in water resources, which may in turn be endangering food security. Based on in-situ measurements of soil moisture collected in agricultural plots during 1983-2012, we find that topsoil (0-50 cm) volumetric water content during the growing season has declined significantly (p < 0.01), with a trend of -0.011 to -0.015 m3 m-3 per decade. Observed discharge declines for the three large river basins are consistent with the effects of agricultural intensification, although other factors (e.g. dam constructions) likely have contributed to these trends. Practices like fertilizer application have favoured biomass growth and increased transpiration rates, thus reducing available soil water. In addition, the rapid proliferation of water-expensive crops (e.g., maize) and the expansion of the area dedicated to food production have also contributed to soil drying. Adoption of alternative agricultural practices that can meet the immediate food demand without compromising future water resources seem critical for the sustainability of the food production system.

  20. Agriculture intensifies soil moisture decline in Northern China

    SciTech Connect

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; Miralles, Diego; Teuling, Adriann; Zhang, Tonglin; An, Pingli; Dong, Zhiqiang; Zhang, Jingting; He, Di; Wang, Liwei; Pan, Xuebiao; Bai, Wei; Niyogi, Dev

    2015-07-09

    Northern China is one of the most densely populated regions in the world. Agricultural activities have intensified since the 1980s to provide food security to the country. However, this intensification has likely contributed to an increasing scarcity in water resources, which may in turn be endangering food security. Based on in-situ measurements of soil moisture collected in agricultural plots during 1983–2012, we find that topsoil (0–50 cm) volumetric water content during the growing season has declined significantly (p<0.01), with a trend of -0.011 to -0.015 m3 m-3 per decade. Observed discharge declines for the three large river basins are consistent with the effects of agricultural intensification, although other factors (e.g. dam constructions) likely have contributed to these trends. Practices like fertilizer application have favoured biomass growth and increased transpiration rates, thus reducing available soil water. In addition, the rapid proliferation of water-expensive crops (e.g., maize) and the expansion of the area dedicated to food production have also contributed to soil drying. Adoption of alternative agricultural practices that can meet the immediate food demand without compromising future water resources seem critical for the sustainability of the food production system.

  1. Agriculture intensifies soil moisture decline in Northern China

    DOE PAGESBeta

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; Miralles, Diego; Teuling, Adriann; Zhang, Tonglin; An, Pingli; Dong, Zhiqiang; Zhang, Jingting; He, Di; et al

    2015-07-09

    Northern China is one of the most densely populated regions in the world. Agricultural activities have intensified since the 1980s to provide food security to the country. However, this intensification has likely contributed to an increasing scarcity in water resources, which may in turn be endangering food security. Based on in-situ measurements of soil moisture collected in agricultural plots during 1983–2012, we find that topsoil (0–50 cm) volumetric water content during the growing season has declined significantly (p<0.01), with a trend of -0.011 to -0.015 m3 m-3 per decade. Observed discharge declines for the three large river basins are consistentmore » with the effects of agricultural intensification, although other factors (e.g. dam constructions) likely have contributed to these trends. Practices like fertilizer application have favoured biomass growth and increased transpiration rates, thus reducing available soil water. In addition, the rapid proliferation of water-expensive crops (e.g., maize) and the expansion of the area dedicated to food production have also contributed to soil drying. Adoption of alternative agricultural practices that can meet the immediate food demand without compromising future water resources seem critical for the sustainability of the food production system.« less

  2. Case Mining for Research Findings in a Case-based Reasoning System in the Biology of Aging.

    PubMed

    Bichindaritz, Isabelle

    2014-01-01

    Scientific literature has been quickly expanding as the availability of articles in electronic form has increased rapidly. For the scientific researcher and the practitioner alike, keeping track with the advancement of the research is an ongoing challenge, and for the most part, the mass of experience recorded in the scientific literature is largely untapped. In particular, novice scientists, non researchers, and students would benefit from a system proposing recommendations for the problems they are interested in resolving. This article presents the first stages of the Digital Knowledge Finder design, a case-based reasoning system to manage experience from the scientific literature. One of the main functionality of the system is to enable both to represent the experience in a declarative and searchable form, and to reason from it through reuse - the latter being a consequence of the former. This article focuses on research findings mining and results from an aging literature dataset. PMID:25488226

  3. Agriculture intensifies soil moisture decline in Northern China

    PubMed Central

    Liu, Yaling; Pan, Zhihua; Zhuang, Qianlai; Miralles, Diego G.; Teuling, Adriaan J.; Zhang, Tonglin; An, Pingli; Dong, Zhiqiang; Zhang, Jingting; He, Di; Wang, Liwei; Pan, Xuebiao; Bai, Wei; Niyogi, Dev

    2015-01-01

    Northern China is one of the most densely populated regions in the world. Agricultural activities have intensified since the 1980s to provide food security to the country. However, this intensification has likely contributed to an increasing scarcity in water resources, which may in turn be endangering food security. Based on in-situ measurements of soil moisture collected in agricultural plots during 1983–2012, we find that topsoil (0–50 cm) volumetric water content during the growing season has declined significantly (p < 0.01), with a trend of −0.011 to −0.015 m3 m−3 per decade. Observed discharge declines for the three large river basins are consistent with the effects of agricultural intensification, although other factors (e.g. dam constructions) likely have contributed to these trends. Practices like fertilizer application have favoured biomass growth and increased transpiration rates, thus reducing available soil water. In addition, the rapid proliferation of water-expensive crops (e.g., maize) and the expansion of the area dedicated to food production have also contributed to soil drying. Adoption of alternative agricultural practices that can meet the immediate food demand without compromising future water resources seem critical for the sustainability of the food production system. PMID:26158774

  4. Imaging findings of anaplastic astrocytoma in a child with maple syrup urine disease: a case report.

    PubMed

    Aw-Zoretic, Jessie; Wadhwani, Nitin R; Lulla, Rishi R; Rishi, Lulla R; Ryan, Maura E

    2015-09-01

    Maple syrup urine disease (MSUD) is an inborn error of branched-chain amino acid metabolism, which usually presents in childhood with encephalopathy due to cerebral edema and dysmyelination. Even with treatment, metabolic stressors may precipitate later episodes of acute decompensation. Changes related to cerebral and white matter edema have been described by magnetic resonance imaging (MRI), and imaging can aid in both initial diagnosis and evaluation of decompensation. To date, there are no published known reports of cancer in patients with MSUD. Here, we present the first case report of an anaplastic astrocytoma in a teenager with MSUD, with a discussion of imaging findings and the use of magnetic resonance spectroscopy (MRS) to help distinguish between tumor and metabolic changes. PMID:26084772

  5. A Case of Metastatic Esophageal Carcinoma in a Pregnant Woman with Radiologic Findings.

    PubMed

    Akdemir, Zülküf; Karaman, Erbil; Arslan, Harun; Çalli, Iskan; Akdeniz, Hüseyin

    2016-01-01

    The incidence of all malignant tumours during pregnancy is extremely rare and esophageal carcinoma ranges from 0.07 to 0.1% of all malignant neoplasms. The physiological changes during pregnancy frequently mask the complaints and symptoms related to the disease. The physical and physiological clinical conditions limit the diagnostic approaches. Therefore, the stage of cancer at the time of diagnosis is usually advanced. The management with cancer surgery and chemotherapy regimens must be modified in pregnant women in order to minimize fetal and maternal risks. Here, we report a very rare case of metastatic esophagus cancer in a 39-year-old woman with 28 weeks of pregnancy and aim to show the ultrasound (USG) and magnetic resonance imaging (MRI) findings with treatment and follow up management. PMID:26894146

  6. A case of MELAS associated with histochemical findings of muscles characteristic of MERRF.

    PubMed

    Suzuki, Hidefumi; Ono, Michio; Kojima, Yasuhiro; Kanda, Masutaro; Shibasaki, Hiroshi; Oki, Mituaki; Nakano, Satoshi

    2016-03-30

    We here report a 39-year-old woman of short stature with sensorineural deafness, who suddenly developed status epilepticus. T2-weighed image of brain magnetic resonance imaging (MRI) revealed a high signal lesion in the left temporal area, the distribution of which was not compatible with any particular arterial supply. Lactate and pyruvate were elevated in the serum and cerebrospinal fluid. As the mitochondrial gene analysis revealed the m.3243A>G mutation, diagnosis of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episode (MELAS) was made. In the histochemical study of a biopsied muscle, the intramuscular blood vessels reacted strongly with SDH (SSV), but the SSV was negative for cytochrome c oxidase (COX), the findings characteristic of myoclonic epilepsy with ragged-red fibers (MERRF). This is the first case of MELAS in which the muscle histochemistry showed positive SSV unassociated with increased COX. PMID:26960269

  7. Computer Tomography Imaging Findings of Abdominal Follicular Dendritic Cell Sarcoma: A Report of 5 Cases.

    PubMed

    Li, Jing; Geng, Zhi-Jun; Xie, Chuan-Miao; Zhang, Xin-Ke; Chen, Rui-Ying; Cai, Pei-Qiang; Lv, Xiao-Fei

    2016-01-01

    Follicular dendritic cell sarcoma (FDCS) is a neoplasm that arises from follicular dendritic cells. FDCSs originating in the abdomen are extremely rare. Clinically, they often mimic a wide variety of other abdominal tumors, and correct preoperative diagnosis is often a challenging task. To date, only scattered cases of abdominal FDCS have been reported and few data are available on their radiological features. Here we present the computer tomography imaging findings of 5 patients with surgically and pathologically demonstrated abdominal FDCS. An abdominal FDCS should be included in the differential diagnosis when single or multiple masses with relatively large size, well- or ill-defined borders, complex internal architecture with marked internal necrosis and/or focal calcification, and heterogeneous enhancement with "rapid wash-in and slow wash-out" or "progressive enhancement" enhancement patterns in the solid component are seen. PMID:26735543

  8. Fluorescein angiography findings in a case of Rubinstein-Taybi syndrome.

    PubMed

    Jacobs, David J; Sein, Julia; Berrocal, Audina M; Grajewski, Alana L; Hodapp, Elizabeth

    2012-01-01

    The purpose of this report is to describe the fluorescein angiography findings in a case of Rubinstein-Taybi syndrome. Fundus photography and fluorescein angiography were performed on a 6-year-old male with Rubinstein-Taybi syndrome due to CREB binding protein gene mutation. Fundus photography showed glaucomatous cupping and diffusely attenuated retinal vasculature. Choroidal vasculature was prominent due to diffuse retinal atrophy with scattered focal retinal pigment epithelial changes. Fluorescein angiography showed retinal vascular attenuation, prolonged arteriovenous transit time with delayed venous filling, late small vessel leakage, and 360 degrees of peripheral avascularity. Peripheral retinal avascularity and retinal vascular inflammation evidenced by late small vessel leakage can be demonstrated by fluorescein angiography in the retinal dystrophy of Rubinstein-Taybi syndrome. PMID:22942640

  9. A Case of Metastatic Esophageal Carcinoma in a Pregnant Woman with Radiologic Findings

    PubMed Central

    Akdemir, Zülküf; Arslan, Harun; Çalli, Iskan; Akdeniz, Hüseyin

    2016-01-01

    The incidence of all malignant tumours during pregnancy is extremely rare and esophageal carcinoma ranges from 0.07 to 0.1% of all malignant neoplasms. The physiological changes during pregnancy frequently mask the complaints and symptoms related to the disease. The physical and physiological clinical conditions limit the diagnostic approaches. Therefore, the stage of cancer at the time of diagnosis is usually advanced. The management with cancer surgery and chemotherapy regimens must be modified in pregnant women in order to minimize fetal and maternal risks. Here, we report a very rare case of metastatic esophagus cancer in a 39-year-old woman with 28 weeks of pregnancy and aim to show the ultrasound (USG) and magnetic resonance imaging (MRI) findings with treatment and follow up management. PMID:26894146

  10. Death following the ingestion of detergent: an autopsy case with special regard to the histochemical findings.

    PubMed

    Kawamoto, Osamu; Ishikawa, Takaki; Oritani, Shigeki; Kuramoto, Yuko; Michiue, Tomomi; Maeda, Hitoshi

    2013-06-01

    We report an autopsy case of death due to accidental ingestion of a liquid laundry detergent with special regard to the histochemical findings. A female inpatient suffering from schizophrenia in a psychiatric institution, was found unconscious lying on the floor of her room, with a container of detergent nearby, and died despite intensive life-support measures. At autopsy, the stomach and duodenum contained whitish translucent foamy viscous fluid, and the mucous membranes, from the esophagus to the duodenum, had diffuse erosions with congestion and edema. There was otherwise no significant pathology other than signs of acute death and hemolysis. Toxicological investigations detected 1-methyl-4-prop-1-en-2-ylcyclohexene (detergent additive) in the gastric contents using headspace-gas chromatography/mass spectrometry, and a nonionic surfactant by a color identification test. Although these substances could not be detected in the blood, body fluid or viscera, histochemical examination using Oil red O demonstrated droplet-like staining in the pulmonary alveoli, suggesting aspiration of detergent, and similar staining in the vasculature of the lung, Kupffer cells of the liver, Bowman capsules of the kidney, and capillaries of the brain, suggesting the systemic effect of ingested/aspirated detergent. These findings were in keeping with death from ingestion of detergent and demonstrated the importance of preventing accidents such as this in healthcare facilities for elderly people. PMID:23212210

  11. Reactive lymphoid hyperplasia of the liver mimicking hepatocellular carcinoma: incidental finding of two cases.

    PubMed

    Lv, Ang; Liu, Wendy; Qian, Hong-Gang; Leng, Jia-Hua; Hao, Chun-Yi

    2015-01-01

    Reactive lymphoid hyperplasia is a rare disease that forms a mass-like lesion and is characterized by the proliferation of non-neoplastic, polyclonal lymphocytes forming follicles. We recently encountered 2 cases of reactive lymphoid hyperplasia of liver, both of which were asymptomatic and mimicked hepatocellular carcinoma by various imaging modalities. Based on the clinical impression of hepatocellular carcinoma, surgical resections were performed. Microscopic findings revealed that both lesions consisted of an aggregation of lymphocytes consisting of predominantly B-cells, with multiple lymphoid follicles positive for CD10 and negative for bcl-2, consistent with the diagnosis of reactive lymphoid hyperplasia. Polyclonality of both lesions was further confirmed by B cell receptor gene rearrangement study. The incidence of reactive lymphoid hyperplasia in the liver is exceedingly rare, and it is difficult to differentiate such lesions from hepatic malignancies based upon clinical grounds. The clinicopathological findings and literature review of this report may be helpful to improve the clinical decision-making. PMID:26191310

  12. Autopsy findings for a case of acute gastric volvulus in a child.

    PubMed

    Kozawa, Shuji; Murakami, Tomonori; Kakizaki, Eiji; Ikemura, Mayumi; Nakagawa, Yasuhisa; Kiyofuji, Yuma; Ikematsu, Kazuya; Nata, Masayuki

    2015-09-01

    Acute gastric volvulus resulting in abdominal compartment syndrome was determined to be the cause of death in a 4-year-old girl who presented with abdominal distension. At about 1AM on the day of her death, she was brought to our emergency medical center. Physical examination and plain abdominal X-ray revealed pronounced gastric dilatation. A decompression procedure was performed, followed by observation. She went into cardiopulmonary arrest around 1PM on the same day and died. Postmortem investigation, including an autopsy and computed tomography (CT), was performed to determine the cause of death. The findings included that the stomach was severely distended. Evidence was seen of mucosal hemorrhage in the gastric mucosa on the greater curvature side, which was thinned in places but without perforation. No necrosis of the gastric mucosa was observed; reversible changes were evident on histopathological examination. The postmortem CT images suggested that the pyloric region was positioned cranioventrally to the cardiac region. None of the findings indicated sudden blockage, and the cause of death was determined to be acute gastric volvulus resulting in abdominal compartment syndrome. The abnormal placement of the organs was difficult to determine based on physical examination alone; postmortem CT and careful examination were helpful in conducting the autopsy in this case. PMID:25957510

  13. Cutaneous mucormycosis and motor vehicle accidents: Findings from an Australian case series.

    PubMed

    Ingram, Paul R; Suthananthan, Arul E; Rajan, Ruben; Pryce, Todd M; Sieunarine, Kishore; Gardam, Dianne J; Heath, Christopher H

    2014-11-01

    Cutaneous disease is the third most frequent manifestation of mucormycosis. The clinical manifestations of and subsequent mortality due to cutaneous mucormycosis are dependent on the mode of acquisition and the host immune status. Here, we describe the epidemiology, clinical presentation, microbiology, and outcomes of 16 cutaneous mucormycosis infections managed in an Australian tertiary hospital over a 15-year period. The proportion with localized (56%), deep (38%), and disseminated (6%) cutaneous disease as well as the overall mortality (25%) were consistent with findings reported in the published literature. Two novel forms of hospital-acquired infection were reported following a sacral pressure sore and insertion of a foreign body during a bone graft procedure. The majority of patients were immunocompetent (75%) and/or suffered trauma (56%) with associated environmental contamination. A novel finding was that motor vehicle accidents (MVAs) accounted for 78% of all trauma-related cases, suggesting MVAs should receive greater recognition as a potential precipitant of cutaneous mucormycosis. Aggressive decontamination and debridement of devitalized tissue following trauma is therefore likely to play an important role in the prevention of this rare but potentially devastating infection. PMID:25288654

  14. Descriptive epidemiology of injury cases: findings from a pilot injury surveillance system in Abu Dhabi.

    PubMed

    Rahman, M Hafizur; Allen, Katharine A; Hyder, Adnan A

    2016-06-01

    Considering the high burden of injuries, the Health Authority - Abu Dhabi developed a draft electronic and paper-based injury and poisoning notification system (IPNS) to generate better data on the nature and severity of injuries. The pilot testing and evaluation of IPNS was conducted with the specific objectives to (1) identify the characteristics of injury cases, (2) explore potential risk factors, (3) illustrate the nature and type of data, and (4) the working mechanism of data collection. Data were collected from selected hospitals on patient demographics, injury information and clinical assessment. Descriptive, bivariate and multivariate analyses were conducted. Of 4226 injury cases, nearly three-fourths were male, majority were non-UAE nationals, and the mean age was 21.9. Multivariate findings suggested that compared to UAE nationals, non-UAE nationals were 27% more likely to experience fatal, severe or moderate injuries (p = 0.01). Individuals with health insurance were 31% less likely to suffer a fatal, severe or moderate injury compared to those having no health insurance (p < 0.001). This is the first systematically standardised collection of injury data across three facilities in Abu Dhabi, and provides initial information on characteristics and injury risk factors that will help identify the need for evidence-based intervention for injury prevention and control. PMID:25262785

  15. Longitudinal neuropsychological findings in amyloid beta-related angiitis (AβRA): a case report.

    PubMed

    Omisade, Antonina; Rigby, Heather; Easton, Alexander; Phillips, Stephen J; Carter, Sherri L

    2013-01-01

    Amyloid β-related angiitis (AβRA) is a clinicopathological diagnosis of primary central nervous system angiitis theoretically triggered by vascular deposition of amyloid β peptide. Deposits of Aβ are associated with degeneration of the vasculature, thereby increasing risks of a stroke and/or cognitive impairment. Despite this, no prior studies have presented a detailed neuropsychological profile associated with AβRA. We present longitudinal neuropsychological findings for the case of a 58-year-old man with biopsy-diagnosed AβRA. Neuropsychological test results and clinical presentation demonstrated a mild to moderate dysexecutive syndrome implicating dorsolateral frontal and orbitofrontal-subcortical systems involvement. Despite prior reports of cognitive decline following a diagnosis of AβRA, cognitive functioning remained relatively stable over a 15-month period after immunosuppressive treatment. For the most part, objective measures did not demonstrate a measurable change in cognitive functioning, except for a mild decline in memory. There were subjective reports of improvement in cognitive and adaptive functioning from the patient and his spouse over this time period. The clinical significance of these results is discussed in the context of theories of executive dysfunction, and with reference to previously-published cases of AβRA. PMID:23244572

  16. Imaging findings of bile duct hamartomas: a case report and literature review

    PubMed Central

    Shi, Qiu-Sheng; Xing, Ling-Xi; Jin, Li-Fang; Wang, Han; Lv, Xiu-Hong; Du, Lian-Fang

    2015-01-01

    Bile duct hamartomas (BHs), also called von Meyenburg complex (VMC), are benign biliary malformations that originate from disorganization of the small intrahepatic bile ducts. This disorganization is often associated with the abnormal involution of embryonic ductal end plates in the liver. This is clinically significant, as the development of BHs can cause diagnostic confusion with liver metastases and small hepatocellular carcinoma (SHCC). Currently, we report a specific case of BHs and review the literature to better define and diagnose BHs. In the following case, a 37 year-old male bearing a lesion in his liver is presented and undergoes both radiological and pathological diagnosis. The lesion is preliminarily suspected to be a hepatic hemangioma by examination of conventional ultrasound (US), contrast enhanced ultrasound (CEUS), computerized tomographic scanning (CT) and magnetic resonance imaging (MRI). However, SHCC is suspected by follow-up analysis of US and CEUS, due to the patient’s background history of hepatitis B and growth of the lesion and a tumor-feeding vessel in BHs via CEUS. However, BHs are finally diagnosed by biopsy pathology under the guidance of ultrasound. Therefore, we believe pathology is imperative for correct diagnosis of BHs over other similar diseases when the imaging findings are atypical. Here we report the novel and unique detection of a tumor-feeding vessel, which mimicked SHCC strongly, during the course of CEUS. We also present a comprehensive review of the previous reported radiological examination related to BHs. PMID:26550237

  17. Atmospheric science: Pacific trade wind intensifier

    NASA Astrophysics Data System (ADS)

    Collier, Mark

    2016-08-01

    The unprecedented recent intensification of the Pacific trade winds cannot simply be explained by natural variability alone. Now research finds that the more local influence of sulfate aerosols of human and volcanic origin play a significant role, in addition to the Pacific's coupling to the Atlantic Ocean via the 'atmospheric bridge'.

  18. Early diagnostic imaging findings in juvenile dogs with presumed diskospondylitis: 10 cases (2008-2014).

    PubMed

    Kirberger, Robert M

    2016-09-01

    OBJECTIVE To describe early diagnostic imaging findings in juvenile dogs with diskospondylitis. DESIGN Retrospective case series. ANIMALS 10 client-owned dogs < 6 months of age. PROCEDURES Medical records were searched to identify juvenile dogs with a presumptive diagnosis of diskospondylitis. Signalment, history, examination findings, diagnostic test results, and imaging procedures were reviewed. Archived diagnostic images were retrieved and retrospectively evaluated. Data analysis was descriptive. RESULTS All dogs were evaluated for signs of vertebral pain ≤ 3 weeks after treatment for blunt trauma, bite wounds, or systemic illness. The earliest radiographic change was a narrowed intervertebral disk space (found for 28 disk spaces ≤ 2 weeks after evaluation for signs of vertebral pain); subluxation of adjacent vertebrae was identified for 8 of 28 affected disks, either initially or within the following 2 weeks. Vertebral end plate lysis was not an initial radiographic feature but was evident in follow-up radiographs. Ultrasonographic and transverse, multiformatted, volume-rendered CT images were obtained for 5 and 4 dogs, respectively. Ultrasonographic changes included ventrally bulging hypoechoic material at the affected disk site and loss of typical normal reverberation artifact in 4 dogs; these were detected prior to radiographic changes in 2 dogs. Affected disks on volume-rendered CT images had altered coloration in 3 of 4 dogs, and this was identified prior to radiographic changes in 1 dog. CONCLUSIONS AND CLINICAL RELEVANCE Juvenile dogs with a presumptive diagnosis of diskospondylitis had early imaging findings that were atypical, compared with the changes described for adult dogs with this condition. PMID:27556268

  19. Report of a new case with pentasomy X and novel clinical findings

    PubMed Central

    Demirhan, O; Tanriverdi, N; Yilmaz, MB; Kocaturk-Sel, S; Inandiklioglu, N; Luleyap, U; Akbal, E; Comertpay, G; Tufan, T; Dur, O

    2015-01-01

    Pentasomy X is an extremely rare sex chromosome abnormality, a condition that only affects females, in which three more X chromosomes are added to the normally present two chromosomes in females. We investigated the novel clinical findings in a 1-year-old female baby with pentasomy X, and determined the parental origins of the X chromosomes. Our case had thenar atrophy, postnatal growth deficiency, developmental delay, mongoloid slant, microcephaly, ear anomalies, micrognathia and congenital heart disease. A conventional cytogenetic technique was applied for the diagnosis of the polysomy X, and quantitative fluorescent polymerase chain reaction (QF-PCR) using 11 inherited short tandem repeat (STR) alleles specific to the chromosome X for the determination of parental origin of X chromosomes. A cytogenetic evaluation revealed that the karyotype of the infant was 49,XXXXX. Comparison of the infant’s features with previously reported cases indicated a clinically recognizable specific pattern of malformations referred to as the pentasomy X syndrome. However, to the best of our know-ledge, this is the first report of thenar atrophy in a patient with 49,XXXXX. The molecular analysis suggested that four X chromosomes of the infant originated from the mother as a result of the non disjunction events in meiosis I and meiosis II. We here state that the clinical manifestations seen in our case were consistent with those described previously in patients with pentasomy X. The degree of early hypotonia constitutes an important early prognostic feature in this syndrome. The pathogenesis of pentasomy X is not clear at present, but it is thought to be caused by successive maternal non disjunctions. PMID:26929910

  20. Incentivised case finding for depression in patients with chronic heart disease and diabetes in primary care: an ethnographic study

    PubMed Central

    Alderson, Sarah L; Russell, Amy M; McLintock, Kate; Potrata, Barbara; House, Allan; Foy, Robbie

    2014-01-01

    Objective To examine the process of case finding for depression in people with diabetes and coronary heart disease within the context of a pay-for-performance scheme. Design Ethnographic study drawing on observations of practice routines and consultations, debriefing interviews with staff and patients and review of patient records. Setting General practices in Leeds, UK. Participants 12 purposively sampled practices with a total of 119 staff; 63 consultation observations and 57 patient interviews. Main outcome measure Audio recorded consultations and interviews with patients and healthcare professionals along with observation field notes were thematically analysed. We assessed outcomes of case finding from patient records. Results Case finding exacerbated the discordance between patient and professional agendas, the latter already dominated by the tightly structured and time-limited nature of chronic illness reviews. Professional beliefs and abilities affected how case finding was undertaken; there was uncertainty about how to ask the questions, particularly among nursing staff. Professionals were often wary of opening an emotional ‘can of worms’. Subsequently, patient responses potentially suggesting emotional problems could be prematurely shut down by professionals. Patients did not understand why they were asked questions about depression. This sometimes led to defensive or even defiant answers to case finding. Follow-up of patients highlighted inconsistent systems and lines of communication for dealing with positive results on case finding. Conclusions Case finding does not fit naturally within consultations; both professional and patient reactions somewhat subverted the process recommended by national guidance. Quality improvement strategies will need to take account of our results in two ways. First, despite their apparent simplicity, the case finding questions are not consultation-friendly and acceptable alternative ways to raise the issue of depression

  1. Digital imaging with solid state x-ray image intensifiers

    NASA Astrophysics Data System (ADS)

    Damento, Michael A.; Radspinner, Rachel; Roehrig, Hans

    1999-10-01

    X-ray cameras in which a CCD is lens coupled to a large phosphor screen are known to suffer from a loss of x-ray signal due to poor light collection from conventional phosphors, making them unsuitable for most medical imaging applications. By replacing the standard phosphor with a solid-state image intensifier, it may be possible to improve the signal-to-noise ratio of the images produced with these cameras. The solid-state x-ray image intensifier is a multi- layer device in which a photoconductor layer controls the light output from an electroluminescent phosphor layer. While prototype devices have been used for direct viewing and video imaging, they are only now being evaluated in a digital imaging system. In the present work, the preparation and evaluation of intensifiers with a 65 mm square format are described. The intensifiers are prepared by screen- printing or doctor blading the following layers onto an ITO coated glass substrate: ZnS phosphor, opaque layer, CdS photoconductor, and carbon conductor. The total thickness of the layers is approximately 350 micrometers , 350 VAC at 400 Hz is applied to the device for operation. For a given x-ray dose, the intensifiers produce up to three times the intensity (after background subtracting) of Lanex Fast Front screens. X-ray images produced with the present intensifiers are somewhat noisy and their resolution is about half that of Lanex screens. Modifications are suggested which could improve the resolution and noise of the intensifiers.

  2. Targeted case finding for dementia in primary care: Surrey Downs dementia diagnosis project

    PubMed Central

    Kallumpuram, Sen; Sudhir Kumar, CT; Khan, Bilal; Gavins, Victoria; Khan, Aalia; Iliffe, Steve

    2015-01-01

    Currently less than half of the estimated number of people with dementia in England receive a formal diagnosis of dementia or have contact with specialist dementia services. Case finding focused on high risk groups may be an effective way to identify the undiagnosed. This joint Surrey Downs Clinical Commissioning Group and Surrey and Borders NHS Foundation Trust quality improvement project aimed to increase the rate of dementia diagnosis across Surrey Downs using specialist link nurses (SLNs). Thirty three GP surgeries covering the entire Surrey Downs area took part in the project. Individuals at high risk of developing dementia were identified from GP electronic disease registers, and were offered screening at their GP practices by SLNs, using a combination of mini cognitive test (Mini-Cog) and functional assessment questionnaire (FAQ). Suitable individuals who screened positive were seen by their GP and where appropriate referred to secondary care services for further evaluation. Based on the presence of risk factors, 6657 (11.9%) people were identified from a total population of 55 845 over 65s, and 1980 (29.7%) completed the screening assessment. Three hundred and fifty eight (18.1%) individuals screened positive and were referred to their GP, who referred 205 (57.2%) of them to the memory services for further assessment. Of those referred, 164 (80%) had a comprehensive specialist assessment. Forty one (20%) declined further assessment, and their GPs were informed. The mean age of the cohort who completed the comprehensive assessment was 82.3 years (SD=4.26), and were predominantly white and male. Fifty four (32.9%) had mild cognitive disorder (MCD), and 101 (61.6%) patients were diagnosed with dementia. The most common dementia was mixed type (43; 42.6%), followed by Alzheimer's dementia (32; 31.7%). The most common risk factor among patients with cognitive impairment (MCD or dementia) was hypertension (69; 44.5 %), followed by ischemic heart disease (64, 41

  3. Magnetic resonance imaging findings of extraventricular anaplastic ependymoma: A report of 11 cases

    PubMed Central

    Leng, Xi; Tan, Xin; Zhang, Chi; Lin, Huan; Qiu, Shijun

    2016-01-01

    Anaplastic ependymomas are rare malignant tumors of the central nervous system. Few studies are available regarding their neuroradiological characteristics. The present study aimed to retrospectively review a series of patients with extraventricular anaplastic ependymoma and to analyze the magnetic resonance imaging (MRI) characteristics to distinguish anaplastic ependymoma from other intracranial tumors. The clinical and pathological images of 11 patients who presented with histologically proven anaplastic ependymoma at Nanfang Hospital (Southern Medical University, Guangzhou, Guangdong, China) between September 2004 and March 2015 were retrospectively reviewed. MRI scans were obtained in all 11 cases. Computed tomography scans were obtained in only 3 cases. In total, 8 tumors were located at the supratentorial parenchyma, and 3 tumors were derived from the cerebellar hemisphere. Images displayed quasi-circular (4/11), irregularly-lobulated (7/11) variable-intensity masses. The masses presented with cysts or necrosis (8/11), hemorrhage (7/11), marked (9/11) or mild (2/11) enhancement, and moderate (4/11), mild (3/11) or absent (4/11) peritumoral edema. The tumors were also frequently closely associated with the lateral ventricle (6/11). Tumors appeared isointense to hypointense on T1-weighted imaging (T1WI) and heterogeneously hyperintense or hypointense on T2WI, demonstrating wreath-like and ring-like characteristics, with intratumoral nodules (3/11) or marked flake-like inhomogeneous (6/11) enhancement on post-contrast MRI. Only 2 solid lesions showed mild enhancement (2/11). Although the MRI features of the extraventricular anaplastic ependymomas varied and were non-specific, these characteristic MRI findings, combined with the locations of the lesions, the age of onset and the short disease course, could be useful in differentiating anaplastic ependymomas from other intracranial neoplasms in the future. PMID:27602137

  4. MRI findings of lumbosacral metastasis from occult follicular thyroid cancer: report of a case.

    PubMed

    Çoban, Gökçen; Yildirim, Erkan; Gemici, Kazim; Erinanç, Hilal

    2014-03-01

    A 63-year-old female was admitted to our hospital with bowel and bladder incontinence. Magnetic resonance imaging (MRI) showed a 13 × 12 × 12 cm mass invading the posterior regions of the L4, L5, S1 and S2 vertebrae with broad paravertebral soft tissue invasion. A Tru-cut biopsy of the mass was performed. The histopathological examination revealed metastatic follicular carcinoma of the thyroid. Thyroid functional tests were within the normal limits. Thyroid sonography revealed a heterogeneous, ill-defined, 14 × 9 mm hypoechoic solid nodule in the right lobe of the thyroid gland. On thyroid scintigraphy, an area of focal hyperactivity was detected in the right lobe at the nodule localization. Total thyroidectomy was performed, and the primary tumor pathology was determined to be follicular thyroid cancer. To our knowledge, only a few cases of lumbosacral cord compression as the initial manifestation of follicular thyroid carcinoma have been reported in the literature. We aimed to discuss the MRI findings of tumors in this age group with lumbosacral localization. PMID:23129029

  5. Pseudoepitheliomatous changes in a case of vegetating Darier–White disease: a unique histopathological finding.

    PubMed

    Pezzini, Claudia; Vassallo, Camilla; Grasso, Vincenzo; Rivetti, Nicolò; Borroni, Giovanni

    2015-04-01

    Darier–White disease (DWD) is a rare autosomal dominant genodermatosis, characterized by constant and typical histopathological findings, such as hyperkeratosis, dyskeratosis with corps ronds and grains and papillary microvilli formation with suprabasal clefting. Despite its nearly constant histopathological presentation, unusual clinical variants are reported, such as the vegetating and cornifying ones. These variants share the same histopathological features of the classic type, except for the striking hyperkeratosis and acanthosis. Here, unreported pseudoepitheliomatous features are described in an elderly male patient with a long history of vegetating and verrucous papules and nodules of DWD, associated with typical nail involvement. These unique histolopathological changes were closely in conjunction with the characteristic microscopic features of DWD. Differential diagnosis with other pseudoepitheliomatous and acantholytic conditions such as reticulated seborrheic keratosis, inverted follicular keratosis, and acantholytic squamous cell carcinoma is also considered. Pseudoepitheliomatous features, in this case of vegetating DWD, could be regarded as a reactive epidermal phenomenon because of different stimuli, i.e. maceration, bacterial superinfection, and chronic scratching. PMID:25238450

  6. A fatal case of a paint thinner ingestion: comparison between toxicological and histological findings.

    PubMed

    Argo, Antonina; Bongiorno, David; Bonifacio, Antonino; Pernice, Valentina; Liotta, Rosa; Indelicato, Serena; Zerbo, Stefania; Fleres, Pierangela; Ceraulo, Leopoldo; Procaccianti, Paolo

    2010-06-01

    Toluene and xylene are aromatic hydrocarbons commonly used as an industrial solvent for the manufacturing of pharmaceuticals, paints, and chemicals. The Occupational Safety and Health Administration has determined that toluene levels of 2000 parts per million (ppm) are considered dangerous to life and health. Several studies have examined the absorption of toluene and xylene following inhalation and oral ingestion in humans. Volatile organic compounds that are absorbed into the blood are distributed throughout the body; in particular, distribution of absorbed toluene and xylene in humans and rodents is characterized by preferential uptake in well-perfused and lipophil tissues such as the brain, liver, lungs, and body fat and also in central nervous system. The available studies indicate that xylenes are rapidly absorbed independently from the kind of exposition. We illustrate a fatal case of self-poisoning by ingestion of varnishes diluting solvents, reporting the identification and quantification of volatile organic compounds (toluene, o-m-p xylene) from human biologic liquids and viscera samples using the Solid-Phase Microextraction-Headspace-Gas Chromatography/Mass Spectrometry to toxicological analysis, and the histopathological findings evaluated in liver, kidney, and lungs. PMID:20010286

  7. Hurler's syndrome: dental findings in a case treated with bone marrow transplantation in infancy.

    PubMed

    Hingston, E J; Hunter, M L; Hunter, B; Drage, N

    2006-05-01

    Hurler's syndrome, also known as mucopolysaccharidosis I (MPS I-H), is a rare condition inherited as an autosomal recessive trait. It is caused by a deficiency in alpha-L-iduronidase, an enzyme that participates in the degradation of the glycosaminoglycans (GAGs) heparin sulphate and dermatan sulphate. Children with Hurler's syndrome appear nearly normal at birth but, left untreated, show a progressive mental and physical deterioration caused by a build-up of GAGs in all organs of the body. Death is often caused by cardiac or respiratory failure and usually occurs before the second decade of life. In recent years, bone marrow transplantation (BMT) has been employed in the management of patients with Hurler's syndrome. However, the dental findings observed in these cases have not previously been reported in the dental literature. Here we report a patient aged 11 years and 6 months, presented to a Specialist Paediatric Dentistry Unit, who was successfully treated by BMT at 18 months of age. PMID:16643543

  8. Anterior interosseous nerve syndrome diagnosis and intraoperative findings: A case report

    PubMed Central

    Aljawder, Abdulla; Faqi, Mohammed Khalid; Mohamed, Abeer; Alkhalifa, Fahad

    2016-01-01

    Introduction Anterior Interosseous Nerve (AIN) is a motor branch from the Median nerve and runs deep in the forearm along with the anterior interosseous artery. It innervates three muscles in the forearm; an isolated palsy of these muscles is known as AIN Syndrome. There are several documented causes of AIN syndrome but its pathophysiology remains unclear. Presentation of case A 48-year old male that presented with right elbow pain and inability to flex his right interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger. MR images denoted mild atrophy of the radial half of the flexor digitorum profundus and the pronator quadratus. Although there were no compressing lesions identifiable on MRI, Electrodiagnostic studies suggested compression neuropathy affecting the AIN. During surgical decompression of the median nerve in the proximal forearm, the operative findings were several tendinous fasciae and a tight fibrous arch of the flexor digitorum superficialis compressing the median nerve at the level of the AIN branch. Discussion Different treatment schemes with reasonable outcome have been reported. Both nonsurgical and surgical intervention have been described in most of these schemes but differed in the timing of intervention with variable outcome. Conclusion Clinical suspicion should arise in the presence of isolated paralysis of the AIN-supplied muscles. MRI and electrodiagnostic studies will confirm the diagnosis and identify the etiology. The optimal treatment of AIN syndrome has not been established. We recommend surgical intervention in confirmed AIN syndrome from compression neuropathy, refractive to conservative therapy. PMID:26921536

  9. Ultrasonographic and Scintigraphic Findings of Thyroid Hemiagenesis in a Child: Report of a Rare Male Case

    PubMed Central

    Ayaz, Ümit Yaşar; Ayaz, Sevin; Döğen, Mehmet Ercüment; Api, Arman

    2015-01-01

    Thyroid hemiagenesis is a rare congenital anomaly in which one lobe of thyroid gland fails to develop. It is much rarer in males. There is a higher incidence of associated thyroid disorders in patients with thyroid hemiagenesis; therefore early and prompt diagnosis is important for children. We present the ultrasonographic and scintigraphic findings of thyroid hemiagenesis in an eight-year-old-boy. On ultrasonography (US), left lobe of the thyroid gland could not be demonstrated and the right lobe showed minimal hyperplasia. Its echogenicity was normal and no nodule was seen. On thyroid scintigraphy, left lobe of thyroid gland or any ectopic thyroid tissue could not be demonstrated, while the right lobe showed minimal hyperplasia. Without performing any invasive procedure, we enrolled the child in a follow-up program with the guidance of US and scintigraphy, which were effective both in making the final diagnosis of thyroid hemiagenesis and in evaluating the current status of the present thyroid tissue. In conclusion, if only one thyroid lobe is detected in a pediatric case initially with US or scintigraphy, the diagnosis of thyroid hemiagenesis should be suggested and, before any unnecessary or invasive attempt, the other complementary method (scintigraphy/US) should be performed. PMID:25785218

  10. Ultrasonographic and scintigraphic findings of thyroid hemiagenesis in a child: report of a rare male case.

    PubMed

    Ayaz, Ümit Yaşar; Ayaz, Sevin; Döğen, Mehmet Ercüment; Api, Arman

    2015-01-01

    Thyroid hemiagenesis is a rare congenital anomaly in which one lobe of thyroid gland fails to develop. It is much rarer in males. There is a higher incidence of associated thyroid disorders in patients with thyroid hemiagenesis; therefore early and prompt diagnosis is important for children. We present the ultrasonographic and scintigraphic findings of thyroid hemiagenesis in an eight-year-old-boy. On ultrasonography (US), left lobe of the thyroid gland could not be demonstrated and the right lobe showed minimal hyperplasia. Its echogenicity was normal and no nodule was seen. On thyroid scintigraphy, left lobe of thyroid gland or any ectopic thyroid tissue could not be demonstrated, while the right lobe showed minimal hyperplasia. Without performing any invasive procedure, we enrolled the child in a follow-up program with the guidance of US and scintigraphy, which were effective both in making the final diagnosis of thyroid hemiagenesis and in evaluating the current status of the present thyroid tissue. In conclusion, if only one thyroid lobe is detected in a pediatric case initially with US or scintigraphy, the diagnosis of thyroid hemiagenesis should be suggested and, before any unnecessary or invasive attempt, the other complementary method (scintigraphy/US) should be performed. PMID:25785218

  11. Hypohidrotic ectodermal dysplasia: dental, clinical, genetic and dermatoglyphic findings of three cases.

    PubMed

    Kargül, B; Alcan, T; Kabalay, U; Atasu, M

    2001-01-01

    Patients with hypohidrotic ectodermal dysplasia (HED) are characterized by the clinical manifestations of hypodontia, hypohidrosis, hypotrichosis and a highly characteristic facial physiognomy. This disorder is inherited as an X-linked trait. This report presents three cases with HED in which the clinical evaluation (intraoral and radiological), genetic findings and SEM examination of hair. Boys 6 to 14 year old and a 11 year old girl were referred to the Marmara University, Faculty of Dentistry, complaining of oligodontia in the maxillary and mandibular arches and delay in eruption of other teeth. Peg-shaped teeth have been observed. The dermatoglyphs of the patients were striking. SEM examination of hair demonstrated a distinctly abnormal longitudinal grooving along the entire length of each hair and a desquamation of the surface cuticles. The treatment was planned in a multidisciplinary odontological group involving pediatric dentistry, orthodontics, prosthodontics and oral surgery and maxillofacial radiology of future dental habilitation. A specially designed overdenture, a removable prosthesis and osseointegrated implants were constructed. Periodic recall visits were advised, to monitor the dentures and implants during periods of growth and development, and eruption of the permanent teeth. PMID:11688814

  12. Two cases of myotonic dystrophy manifesting various ophthalmic findings with genetic evaluation.

    PubMed

    Kang, Min Ji; Yim, Hye Bin; Hwang, Hyung Bin

    2016-07-01

    We report two cases of myotonic dystrophy in one family; both diagnosed from genetic analysis following ophthalmic indications, but before the manifestation of systemic symptoms. A 39-year-old female visited our clinic for routine examination. Mild ptosis, sluggish pupillary response, and bilateral snowflake cataracts were found. Fundus examination revealed an increased cup-to-disc ratio (CDR) in both eyes and a defect in the retinal nerve fiber layer in the right eye. Intraocular pressure was low, but within the normal range in both eyes. Because cataracts are characteristic of myotonic dystrophy, we suggested that her 14-year-old daughter, who did not have any systemic complaints, undergo ophthalmic examination. She also had mild ptosis and snowflake cataracts. Both patients underwent genetic evaluation and were diagnosed with myotonic dystrophy caused by unstable expansion of cytosine-thymine-guanine trinucleotide repeats in the dystrophia myotonica-protein kinase gene. Ophthalmologists can diagnose myotonic dystrophy based on clinical and genetic findings, before the manifestation of systemic abnormalities. PMID:27609169

  13. Active Tuberculosis Case Finding Interventions Among Immigrants, Refugees and Asylum Seekers in Italy

    PubMed Central

    Schepisi, Monica Sañé; Gualano, Gina; Piselli, Pierluca; Mazza, Marta; D’Angelo, Donatella; Fasciani, Francesca; Barbieri, Alberto; Rocca, Giorgia; Gnolfo, Filippo; Olivani, Piefranco; Ferrarese, Maurizio; Codecasa, Luigi Ruffo; Palmieri, Fabrizio; Girardi, Enrico

    2016-01-01

    In Italy tuberculosis (TB) is largely concentrated in vulnerable groups such as migrants and in urban settings. We analyzed three TB case finding interventions conducted at primary centers and mobile clinics for regular/irregular immigrants and refugees/asylum seekers performed over a four-year period (November 2009-March 2014) at five different sites in Rome and one site in Milan, Italy. TB history and presence of symptoms suggestive of active TB were investigated by verbal screening through a structured questionnaire in migrants presenting for any medical condition to out-patient and mobile clinics. Individuals reporting TB history or symptoms were referred to a TB clinic for diagnostic workup. Among 6347 migrants enrolled, 891 (14.0%) reported TB history or symptoms suggestive of active TB and 546 (61.3%) were referred to the TB clinic. Of them, 254 (46.5%) did not present for diagnostic evaluation. TB was diagnosed in 11 individuals representing 0.17% of those screened and 3.76% of those evaluated. The overall yield of this intervention was in the range reported for other TB screening programs for migrants, although we recorded an unsatisfactory adherence to diagnostic workup. Possible advantages of this intervention include low cost and reduced burden of medical procedures for the screened population. PMID:27403270

  14. Endocrine and anatomical findings in a case of Solitary Median Maxillary Central Incisor Syndrome.

    PubMed

    Szakszon, Katalin; Felszeghy, Enikő; Csízy, István; Józsa, Tamás; Káposzta, Rita; Balogh, Erzsébet; Oláh, Eva; Balogh, István; Berényi, Ervin; Knegt, Alida C; Ilyés, István

    2012-02-01

    Solitary Median Maxillary Central Incisor Syndrome (SMMCI) is a rare malformation syndrome consisting of multiple, mainly midline defects. Some authors suggest that it is a mild manifestation of the wide spectrum of holoprosencephaly, others classify it rather as a distinct entity. Authors report a case of SMMCI presenting with growth retardation, mild intellectual disability and absence of puberty. Cytogenetic and molecular cytogenetic investigations could identify no abnormalities. The presence of a single maxillary incisor called for further investigations to clarify hidden anomalies, these were empty sella, panhypopituitarism, hypothyroidism, and hypoplasia of the inner genitals. Based on the above findings, growth hormone, estrogen, and L-thyroxine substitution was introduced, which resulted in satisfactory longitudinal growth and onset of sexual maturation. We suggest genetic counselling and if needed, invasive investigations in female patients with short stature and absent/delayed puberty, with or without sex chromosomal anomalies, as the adequate therapy and even the quality of life of patient depends largely on the knowledge of their anatomical and endocrine status. PMID:22138217

  15. Active case finding for tuberculosis among people who inject drugs on methadone treatment in Dar es Salaam, Tanzania

    PubMed Central

    Gupta, A.; Mbwambo, J.; Mteza, I.; Shenoi, S.; Lambdin, B.; Nyandindi, C.; Doula, B. I.; Mfaume, S.; Bruce, R. D.

    2015-01-01

    SUMMARY SETTING Active case finding is a World Health Organization (WHO) endorsed strategy for improving tuberculosis (TB) case detection. Despite WHO recommendations for active case finding among people who inject drugs (PWID), few studies have been published. The historical focus of case finding has been in populations that are human immunodeficiency virus-positive, incarcerated or at higher occupational risk. OBJECTIVE We sought to examine the yield of active case finding among PWID newly started on methadone in Tanzania. DESIGN Of 222 methadone clients, 156 (70%) met with study administrators; 150 consented to participate, 139 (93%) of whom were male. The median age was 34 years. A symptom-based questionnaire was developed by the investigators and administered to every consenting patient by a native Swahili speaker. RESULTS Of the 150 patients surveyed, 16 (11%) had one or more TB symptoms and were referred for laboratory testing. Six new TB cases were identified in this active case finding program, with a prevalence of 4%. CONCLUSION This study presents the first data on TB prevalence in a population of PWID in Tanzania. This prevalence is 23 times that of the general Tanzanian TB prevalence of 0.2%. These results have significant implications for TB control. PMID:24902554

  16. Measured responsivities of generation II and hybrid image intensifiers

    SciTech Connect

    Yates, G.J.; King, N.S.P.; Thomas, M.C.

    1995-07-01

    We have measured the absolute and coupled system responsivities of several image intensifier types at several wavelengths in the visible spectrum. Intensifiers characterized include microchannel plate (MCP) generation II proximity-focused and hybrid generation I/generation II electrostatic-focused designs. Configurations including single plate, double plate, nominal and high strip current MCPs, and standard S20 and super generation II enhanced S-20 photocathodes were evaluated. Absolute responsivity measurements were performed using NIST-traceable radiometry instrumentation. The normalized relative sensitivities and overall optical luminous gain performance provided by individual intensifiers when similarly coupled to either high resolution 10-bit RS-170 CCD or FPS cameras are presented along with their radiometric data.

  17. Effect of temperature gradient of EBI of image intensifier

    SciTech Connect

    Chen, Q.

    1994-12-31

    In this paper the authors give the experiments for the measurement of EBI of an image intensifier with the change of temperature gradient of it. At the same time, the authors give the curves of EBI versus the different temperature gradients. The paper shows the causes for EBI of an image intensifier with the change of temperature gradient. The paper concluded, from the calculations and experiments, that there is need for the waiting measurement time for us to minimize the measuremental difference of EBI caused by temperature gradient. It is also indicated that the paper provides some scientific basis for improving possibly detecting objective performance of low light level night vision system in field if they adopt the scheme for the effect of temperature gradient on EBI of an image intensifier.

  18. Finding a Balance: Fifteen Institutional Case Studies on the Relationship between Part-Time Work and Advanced Level Study. Report.

    ERIC Educational Resources Information Center

    Hodgson, Ann, Ed.; Spours, Ken, Ed.

    This document presents and discusses case studies that examined the relationship between part-time employment and advanced level study at 15 schools in Essex, England. "Foreword" (David Jones) provides a brief overview of the project. "Finding a Balance--Fifteen Institutional Case Studies on the Relationship between Part-time Work and Advanced…

  19. Persistence of phosphor glow in microchannel plate image intensifiers

    NASA Technical Reports Server (NTRS)

    Torr, M. R.

    1985-01-01

    Image intensifier tubes using microchannel plate amplification stages and phosphor output stages are being increasingly used in various detection applications. In this paper, measurements of the decay times of what are attributed to be the P20 phosphors in various image intensifiers are reported. It is found that the long tail on the decay curve of the phosphor following illumination can be a limitation for certain observations. In addition, the background level of phosphor glow (which is seen by the subsequent detection system as a light signal) continues to build with continuing illumination.

  20. Feedback circuit design of an auto-gating power supply for low-light-level image intensifier

    NASA Astrophysics Data System (ADS)

    Yang, Ye; Yan, Bo; Zhi, Qiang; Ni, Xiao-bing; Li, Jun-guo; Wang, Yu; Yao, Ze

    2015-11-01

    This paper introduces the basic principle of auto-gating power supply which using a hybrid automatic brightness control scheme. By the analysis of current as image intensifier to special requirements of auto-gating power supply, a feedback circuit of the auto-gating power supply is analyzed. Find out the reason of the screen flash after the auto-gating power supply assembled image intensifier. This paper designed a feedback circuit which can shorten the response time of auto-gating power supply and improve screen slight flicker phenomenon which the human eye can distinguish under the high intensity of illumination.

  1. A meta-analysis of milk intake and fracture risk: low utility for case finding.

    PubMed

    Kanis, John A; Johansson, Helena; Oden, Anders; De Laet, Chris; Johnell, Olof; Eisman, John A; Mc Closkey, Eugene; Mellstrom, Dan; Pols, Huibert; Reeve, Jonathan; Silman, Alan; Tenenhouse, Alan

    2005-07-01

    A low intake of calcium is widely considered to be a risk factor for future fracture. The aim of this study was to quantify this risk on an international basis and to explore the effect of age, gender and bone mineral density (BMD) on this risk. We studied 39,563 men and women (69% female) from six prospectively studied cohorts comprising EVOS/EPOS, CaMos, DOES, the Rotterdam study, the Sheffield study and a cohort from Gothenburg. Cohorts were followed for 152,000 person-years. The effect of calcium intake as judged by the intake of milk on the risk of any fracture, any osteoporotic fracture and hip fracture alone was examined using a Poisson model for each sex from each cohort. Covariates examined were age and BMD. The results of the different studies were merged by using the weighted beta-coefficients. A low intake of calcium (less than 1 glass of milk daily) was not associated with a significantly increased risk of any fracture, osteoporotic fracture or hip fracture. There was no difference in risk ratio between men and women. When both sexes were combined there was a small but non-significant increase in the risk of osteoporotic and of hip fracture. There was also a small increase in the risk of an osteoporotic fracture with age which was significant at the age of 80 years (RR = 1.15; 95% CI = 1.02-1.30) and above. The association was no longer significant after adjustment for BMD. No significant relationship was observed by age for low milk intake and hip fracture risk. We conclude that a self-reported low intake of milk is not associated with any marked increase in fracture risk and that the use of this risk indicator is of little or no value in case-finding strategies. PMID:15502959

  2. Case-finding for hepatitis C in primary care: a mixed-methods service evaluation

    PubMed Central

    Datta, Shivani; Horwood, Jeremy; Hickman, Matthew; Sharp, Debbie

    2014-01-01

    Background Hepatitis C is often asymptomatic, presenting with liver failure and cancer decades after infection. People who inject drugs (PWID) and immigrant populations from countries with a moderate-to-high prevalence of hepatitis C virus (HCV) are the main risk groups. Deaths and hospital admissions due to HCV cirrhosis tripled between 1998 and 2010, but the majority of people with chronic HCV are unaware of it. Aim To identify patients at risk of developing hepatitis C using routine GP data, to determine the proportion not tested, and to explore GPs’ views regarding testing. Design and setting Mixed-methods service evaluation (density-based selection of PWID) in six NHS practices in Bristol. Method Patients at risk of HCV were identified. The Health Protection Agency laboratory (now part of Public Health England) provided test results. Semi-structured interviews with 17 GPs were audiorecorded and thematic analyses conducted on anonymised transcripts. Results Of 3765 patients identified as being at risk of developing hepatitis C, 3051 (81%) had no test result, including 53% of PWID and 93% of the ‘ethnicity’ group. All GPs said they usually test PWID. Most GPs test for HIV and hepatitis B in immigrants more often than they test for HCV. Barriers to testing included not questioning patients about risk factors, competing priorities, the chaotic lifestyle of PWID, difficulty extracting information from computerised records, and forgetting to address HCV. Conclusion Computer prompts and GP education on whom to test are warranted. Ensuring that country of origin and drug use is included on the new-patient questionnaire might also aid case-finding for HCV. PMID:24567619

  3. Narrative-Based Intervention for Word-Finding Difficulties: A Case Study

    ERIC Educational Resources Information Center

    Marks, Ian; Stokes, Stephanie F.

    2010-01-01

    Background: Children with word-finding difficulties manifest a high frequency of word-finding characteristics in narrative, yet word-finding interventions have concentrated on single-word treatments and outcome measures. Aims: This study measured the effectiveness of a narrative-based intervention in improving single-word picture-naming and…

  4. Neoadjuvant-intensified treatment for rectal cancer: Time to change?

    PubMed Central

    Musio, Daniela; De Felice, Francesca; Bulzonetti, Nadia; Guarnaccia, Roberta; Caiazzo, Rossella; Bangrazi, Caterina; Raffetto, Nicola; Tombolini, Vincenzo

    2013-01-01

    AIM: To investigate whether neoadjuvant-intensified radiochemotherapy improved overall and disease-free survival in patients with locally advanced rectal cancer. METHODS: Between January 2007 and December 2011, 80 patients with histologically confirmed rectal adenocarcinoma were enrolled. Tumors were clinically classified as either T3 or T4 and by the N stage based on the presence or absence of positive regional lymph nodes. Patients received intensified combined modality treatment, consisting of neoadjuvant radiation therapy (50.4-54.0 Gy) and infusional chemotherapy (oxaliplatin 50 mg/m2) on the first day of each week, plus five daily continuous infusions of fluorouracil (200 mg/m2 per die) from the first day of radiation therapy until radiotherapy completion. Patients received five or six cycles of oxaliplatin based on performance status, clinical lymph node involvement, and potential risk of a non-sphincter-conserving surgical procedure. Surgery was planned 7 to 9 wk after the end of radiochemotherapy treatment; adjuvant chemotherapy treatment was left to the oncologist’s discretion and was recommended in patients with positive lymph nodes. After treatment, all patients were monitored every three months for the first year and every six months for the subsequent years. RESULTS: Of the 80 patients enrolled, 75 patients completed the programmed neoadjuvant radiochemotherapy treatment. All patients received the radiotherapy prescribed total dose; five patients suspended chemotherapy indefinitely because of chemotherapy-related toxicity. At least five cycles of oxaliplatin were administered to 73 patients. Treatment was well tolerated with high compliance and a good level of toxicity. Most of the acute toxic effects observed were classified as grades 1-2. Proctitis grade 2 was the most common symptom (63.75%) and the earliest manifestation of acute toxicity. Acute toxicity grades 3-4 was reported in 30% of patients and grade 3 or 4 diarrhoea reported in just three

  5. Tuberculosis Case Finding in Benin, 2000-2014 and Beyond: A Retrospective Cohort and Time Series Study.

    PubMed

    Ade, Serge; Békou, Wilfried; Adjobimey, Mênonli; Adjibode, Omer; Ade, Gabriel; Harries, Anthony D; Anagonou, Séverin

    2016-01-01

    Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The "R" software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22%) were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT) represented 78%  ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15-34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country. PMID:27293887

  6. Tuberculosis Case Finding in Benin, 2000–2014 and Beyond: A Retrospective Cohort and Time Series Study

    PubMed Central

    Ade, Serge; Békou, Wilfried; Adjobimey, Mênonli; Adjibode, Omer; Ade, Gabriel; Harries, Anthony D.; Anagonou, Séverin

    2016-01-01

    Objective. To determine any changes in tuberculosis epidemiology in the last 15 years in Benin, seasonal variations, and forecasted numbers of tuberculosis cases in the next five years. Materials and Methods. Retrospective cohort and time series study of all tuberculosis cases notified between 2000 and 2014. The “R” software version 3.2.1 (Institute for Statistics and Mathematics Vienna Austria) and the Box-Jenkins 1976 modeling approach were used for time series analysis. Results. Of 246943 presumptive cases, 54303 (22%) were diagnosed with tuberculosis. Annual notified case numbers increased, with the highest reported in 2011. New pulmonary bacteriologically confirmed tuberculosis (NPBCT) represented 78%  ± SD 2%. Retreatment cases decreased from 10% to 6% and new pulmonary clinically diagnosed cases increased from 2% to 8%. NPBCT notification rates decreased in males from 2012, in young people aged 15–34 years and in Borgou-Alibori region. There was a seasonal pattern in tuberculosis cases. Over 90% of NPBCT were HIV-tested with a stable HIV prevalence of 13%. The ARIMA best fit model predicted a decrease in tuberculosis cases finding in the next five years. Conclusion. Tuberculosis case notifications are predicted to decrease in the next five years if current passive case finding is used. Additional strategies are needed in the country. PMID:27293887

  7. Using Brief Experimental Analysis to Intensify Tier 3 Reading Interventions

    ERIC Educational Resources Information Center

    Coolong-Chaffin, Melissa; Wagner, Dana

    2015-01-01

    As implementation of multi-tiered systems of support becomes common practice across the nation, practitioners continue to need strategies for intensifying interventions and supports for the subset of students who fail to make adequate progress despite strong programs at Tiers 1 and 2. Experts recommend making several changes to the structure and…

  8. Use of Linguistic Qualifiers and Intensifiers in a Computer Conference.

    ERIC Educational Resources Information Center

    Fahy, Patrick J.

    2002-01-01

    Describes a study that investigated a possible gender-related communications difference, the use of linguistic qualifiers and intensifiers, in the online computer conference transcript in a graduate course. Explains the use of sentences as the units of analysis and the use of a new tool for coding, the Transcript Analysis Tool. (Author/LRW)

  9. Thermal neutron image intensifier tube provides brightly visible radiographic pattern

    NASA Technical Reports Server (NTRS)

    Berger, H.; Kraska, I.; Niklas, W.; Schmidt, A.

    1967-01-01

    Vacuum-type neutron image intensifier tube improves image detection in thermal neutron radiographic inspection. This system converts images to an electron image, and with electron acceleration and demagnification between the input target and output screen, produces a bright image viewed through a closed circuit television system.

  10. The Effect of Intensified Language Exposure on Accommodating Talker Variability

    ERIC Educational Resources Information Center

    Antoniou, Mark; Wong, Patrick C. M.; Wang, Suiping

    2015-01-01

    Purpose: This study systematically examined the role of intensified exposure to a second language on accommodating talker variability. Method: English native listeners (n = 37) were compared with Mandarin listeners who had either lived in the United States for an extended period of time (n = 33) or had lived only in China (n = 44). Listeners…

  11. Final Report for the Intensified Career Exploration Program.

    ERIC Educational Resources Information Center

    McCauley, Lynne D.; Rusling, Diane E.

    An intensified Career Exploration Program was evaluated through an analysis of the cognitive and affective learning resulting from ninth- and tenth-grade students' participation in the program. Designed to supplement the existing ninth- and tenth-grade components of the Ohio Career Development Program, this three-year program offered additional…

  12. Statistical performance of the intensified charged coupled device

    NASA Technical Reports Server (NTRS)

    Sandel, B. R.; Broadfoot, A. L.

    1986-01-01

    The first analysis of the statistical performance of the intensified charge coupled device (CCD) is presented. The Poisson statistics of the arriving photons, the exponential pulse height distribution of the microchannel plate in the image intensifier, and the effects of discrete digitization of the charge in reading the CCD are included. A range of intensifier gains from the high levels that permit pulse counting to the low levels that can be used with the accumulation of charge on the CCD is considered. As a tool for this analysis, an analytical model of the performance of the detector system that is generally useful for predicting many aspects of system performance under a wide range of conditions is developed. The statistical penalty for operating the intensified CCD in the charge accumulation mode is not severe, and in some applications it may be desirable to accept this penalty to gain the advantages of increased dynamic range through charge accumulation. This investigation has revealed no pathological aspects of the operation of the detector system.

  13. Effectiveness of case finding strategies for COPD in primary care: a systematic review and meta-analysis

    PubMed Central

    Haroon, Shamil MM; Jordan, Rachel E; O’Beirne-Elliman, Joanne; Adab, Peymane

    2015-01-01

    Background: Chronic obstructive pulmonary disease (COPD) is widely underdiagnosed, but the most effective approach for identifying these patients is unknown. Aims: The aim of this study was to summarise and compare the effectiveness of different case finding approaches for undiagnosed COPD in primary care. Methods: A systematic review of primary studies of any design evaluating case finding strategies for COPD in primary care among individuals aged ⩾35 years with no prior diagnosis was conducted. Medline, Embase and other bibliographic databases were searched from 1997 to 2013, and methodological quality was assessed using standard tools. Results were described and meta-analysis of the uptake and yield from different approaches was performed where there was sufficient homogeneity. Results: Three randomised controlled trials (RCTs), 1 controlled trial and 35 uncontrolled studies were identified that assessed the identification of new cases of COPD through systematic case finding. A range of approaches were used including pre-screening with questionnaires (n=13) or handheld flow meters (n=5) or direct invitation to diagnostic spirometry (n=30). Overall, any approach identified more undiagnosed COPD compared with usual care. Targeting those at higher risk (e.g., smokers) and pre-screening (e.g., using questionnaires) is likely to increase the yield. However, studies were heterogeneous and were limited by a lack of comparison groups, inadequate reporting and diversity in the definition of COPD, which limited our ability to draw firm conclusions. Conclusions: There is extensive heterogeneity among studies evaluating case finding strategies for COPD, with few RCTs. Well-conducted RCTs comparing case finding approaches are needed to identify the most effective target population, recruitment strategy and screening tests, using a clinical definition of COPD, and addressing the limitations highlighted in this review. There is also a need to evaluate the impact of case

  14. Building Strong Geoscience Departments: Case Studies and Findings from Six Years of Programming

    NASA Astrophysics Data System (ADS)

    Iverson, E. A.; Lee, S.; Ormand, C. J.; Feiss, P. G.; Macdonald, H.; Manduca, C. A.; Richardson, R. M.

    2011-12-01

    Begun in 2005, the Building Strong Geoscience Departments project sought to help geoscience departments respond to changes in geosciences research, academic pressures, and the changing face of the geosciences workforce by working as a team, planning strategically, and learning from the experiences of other geoscience departments. Key strategies included becoming more central to their institution's mission and goals; articulating the department's learning goals for students; designing coordinated curricula, co-curricular activities, and assessments to meet these goals; and recruiting students effectively. A series of topical workshops identified effective practices in use in the U.S. and Canada. These practices were documented on the project website and disseminated through a national workshop for teams of faculty, through activities at the AGU Heads and Chairs workshops, and in a visiting workshop program bringing leaders to campuses. The program has now involved over 450 participants from 185 departments. To understand the impact of the program, we engaged in ongoing discussion with five departments of various sizes and institutional types, and facing a variety of immediate challenges. In aggregate they made use of the full spectrum of project offerings. These departments all reported that the project brought an important new perspective to their ability to work as a department: they have a better understanding of how their departments' issues relate to the national scene, have more strategies for making the case for the entire department to college administrators, and are better poised to make use of campus resources including the external review process. These results were consistent with findings from end-of-workshop surveys. Further they developed the ability to work together as a team to address departmental challenges through collective problem solving. As a result of their workshop participation, two of the departments who considered their department to be

  15. Case Studies on the Symbolism of Difference-Finding Problems in First Grade.

    ERIC Educational Resources Information Center

    Hasegawa, Junichi

    2002-01-01

    Discusses a class on subtraction or difference-finding, problems such as "There are eight white flowers and five red flowers, how many more white flowers are there than red flowers?" used in the teaching of Japanese first grade children. Describes three instances of introductory teaching of "difference-finding" problems in the first grade.…

  16. Student Perceptions of Peer versus Instructor Facilitation of Asynchronous Online Discussions: Further Findings from Three Cases

    ERIC Educational Resources Information Center

    Hew, Khe Foon

    2015-01-01

    This study aims to extend a previous work on the role of peer facilitation of asynchronous online discussions. Specifically, in this paper I report three cases that examine students' preference for peer or instructor facilitation of online discussion forums, as well as their respective reasons for it. These three cases involved the following…

  17. Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series*

    PubMed Central

    Nogueira-Barbosa, Marcello H.; Gregio-Junior, Everaldo; Lorenzato, Mario Muller

    2015-01-01

    Objective The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Materials and Methods Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Results Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5%) patients (mean age, 50.9 years; age range, 42-58 years; 42% female). Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Conclusion Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion. PMID:26811551

  18. Clinicopathologic findings associated with chronic renal disease in cats: 74 cases (1973-1984).

    PubMed

    DiBartola, S P; Rutgers, H C; Zack, P M; Tarr, M J

    1987-05-01

    The historic, physical, laboratory, and histologic findings for 74 cats with chronic renal disease were reviewed. Most cats were older, and no breed or sex predilection was detected. This most common clinical signs detected by owners were lethargy, anorexia, and weight loss. Dehydration and emaciation were common physical examination findings. Common laboratory findings were nonregenerative anemia, lymphopenia, azotemia, hypercholesterolemia, metabolic acidosis, hyperphosphatemia, and isosthenuria. The most common morphologic diagnosis was chronic tubulointerstitial nephritis of unknown cause. The other pathologic diagnoses were renal lymphosarcoma, renal amyloidosis, chronic pyelonephritis, chronic glomerulonephritis, polycystic renal disease, and pyogranulomatous nephritis secondary to feline infectious peritonitis. PMID:3583899

  19. Intralobar pulmonary sequestration in elderly woman: a rare case report with emphasis on imaging findings.

    PubMed

    Al-Timimy, Qays Ahmed Hassan; Al-Shamseei, Hind Fadhil

    2016-09-01

    Intralobar pulmonary sequestration is a rare malformation that predisposes to recurrent respiratory infections. It is difficult to diagnose unless a more extensive directed investigation (to the vasculature and pulmonary parenchyma) is take on. Failure to diagnose and treat this condition can lead to recurrent pneumonia and fatal hemoptysis. Most cases are diagnosed before the age of 20 years. In this report, we present an extremely rare case of elderly woman with initial diagnosis of intralobar sequestration, and to our knowledge, this case represents the oldest diagnosed patient in the literature. PMID:27594937

  20. How did soil dryness intensify recent European heatwaves?

    NASA Astrophysics Data System (ADS)

    Miralles, Diego; Teuling, Ryan; van Heerwaarden, Chiel; Vilá-Guerau de Arellano, Jordi

    2014-05-01

    In August 2010 a mega-heatwave hit large parts of Eastern Europe and Russia, breaking the historical records from the 2003 event in Western Europe. While such heatwaves are predicted to become common by the end of this century, our understanding of the physics behind these phenomena is still imperfect, and so is their representation in climate models. In this presentation we will provide new evidence of how land-atmosphere feedbacks contribute to the development of the extreme temperatures based on satellite observations, climate model reanalyses data (ERA Interim), balloon sounding measurements, soil moisture-temperature coupling diagnostics and mechanistic modelling of the lower atmosphere. Results of our analyses show that in both European mega-heatwaves, persistent synoptic conditions favored evaporation and intensified soil desiccation. As a consequence of soil dryness, a deep residual atmospheric boundary layer (ABL) developed, which allowed the multi-day storage of heat coming from: (a) large-scale horizontal advection, (b) intense warming from the land surface associated to the increasingly dry soils, and (c) enhanced warm air entrainment from the top of the ABL (which counteracted the dilution effect of the gradually deeper layer). This progressive storage of heat in the residual ABL played a crucial role in the escalation of temperatures, and therefore in the regulation and intensification of land feedbacks. Soil moisture deficits have both direct and indirect effects in all these processes, effects that have not been scrutinized separately in previous model studies. This suggests the need of revisiting the traditional view of the soil moisture-temperature coupling during mega-heatwaves, in which only the direct impact of dry soils on the surface energy balance is explicitly considered. Reinforced by our findings, a more complete conceptualization can be provided, with dry soils enhancing diurnal warm air entrainment and leading to the formation of

  1. Tuberculosis case-finding through a village outreach programme in a rural setting in southern Ethiopia: community randomized trial.

    PubMed Central

    Shargie, Estifanos Biru; Mørkve, Odd; Lindtjørn, Bernt

    2006-01-01

    OBJECTIVE: To ascertain whether case-finding through community outreach in a rural setting has an effect on case-notification rate, symptom duration, and treatment outcome of smear-positive tuberculosis (TB). METHODS: We randomly allocated 32 rural communities to intervention or control groups. In intervention communities, health workers from seven health centres held monthly diagnostic outreach clinics at which they obtained sputum samples for sputum microscopy from symptomatic TB suspects. In addition, trained community promoters distributed leaflets and discussed symptoms of TB during house visits and at popular gatherings. Symptomatic individuals were encouraged to visit the outreach team or a nearby health facility. In control communities, cases were detected through passive case-finding among symptomatic suspects reporting to health facilities. Smear-positive TB patients from the intervention and control communities diagnosed during the study period were prospectively enrolled. FINDINGS: In the 1-year study period, 159 and 221 cases of smear-positive TB were detected in the intervention and control groups, respectively. Case-notification rates in all age groups were 124.6/10(5) and 98.1/10(5) person-years, respectively (P = 0.12). The corresponding rates in adults older than 14 years were 207/10(5) and 158/10(5) person-years, respectively (P = 0.09). The proportion of patients with >3 months' symptom duration was 41% in the intervention group compared with 63% in the control group (P<0.001). Pre-treatment symptom duration in the intervention group fell by 55-60% compared with 3-20% in the control group. In the intervention and control groups, 81% and 75%, respectively of patients successfully completed treatment (P = 0.12). CONCLUSION: The intervention was effective in improving the speed but not the extent of case finding for smear-positive TB in this setting. Both groups had comparable treatment outcomes. PMID:16501728

  2. Some improvements on the auto-gated power for low-light level image intensifier

    NASA Astrophysics Data System (ADS)

    Yang, Ye; Yan, Bo; Zhi, Qiang; Yao, Ze; Li, Jun-guo; Fu, Ling-yun; Yuan, Yuan; Deng, Guang-xu

    2014-09-01

    The basic principle and formation of the auto-gated power using hybrid automatic brightness control scheme were described in detail. The auto-gated power supply in the application process because the device precision and the low-light level image intensifier between individual differences, fall may cause some products in some cases the SNR and resolution, and decrease the consistency of the product. This paper puts forward the corresponding solutions to these problems. And through experiments on the improved auto gated power supply with automatic gated power has not been improved compared. Applications of the auto-gated power in military, police and civil area were forecasted.

  3. Case Report of Fire Eater’s Pneumonia in Adolescent Female Patient – Evolution of Radiologic Findings

    PubMed Central

    Olchowy, Cyprian; Łasecki, Mateusz; Inglot, Marcin; Zaleska-Dorobisz, Urszula

    2015-01-01

    Summary Background We present a case of a 16-year-old girl with fire-eater’s pneumonia (hydrocarbon pneumonitis). The goal of this report was to assess evolution of radiological findings. Case Report The reported case was unique because that was the first completely described case of fire-eater’s pneumonia reported in an under-aged person. Moreover, this disease is very rare even in adults and only a few scientific reports can be found, mostly because of a small occupational group. Conclusions The aim of this report was to show that the problem of fire-eater’s pneumonia can occur in under-aged patients and should be taken into consideration in case of severe pneumonia. Another objective was to point out that chest radiograph is not sufficient to depict the evolution of radiological manifestations. PMID:25593634

  4. Childhood Leukemia and 50 Hz Magnetic Fields: Findings from the Italian SETIL Case-Control Study

    PubMed Central

    Salvan, Alberto; Ranucci, Alessandra; Lagorio, Susanna; Magnani, Corrado

    2015-01-01

    We report on an Italian case-control study on childhood leukemia and exposure to extremely low frequency magnetic fields (ELF-MF). Eligible for inclusion were 745 leukemia cases, aged 0–10 years at diagnosis in 1998–2001, and 1475 sex- and age-matched population controls. Parents of 683 cases and 1044 controls (92% vs. 71%) were interviewed. ELF-MF measurements (24–48 h), in the child’s bedroom of the dwelling inhabited one year before diagnosis, were available for 412 cases and 587 controls included in the main conditional regression analyses. The magnetic field induction was 0.04 μT on average (geometric mean), with 0.6% of cases and 1.6% of controls exposed to >0.3 μT. The impact of changes in the statistical model, exposure metric, and data-set restriction criteria was explored via sensitivity analyses. No exposure-disease association was observed in analyses based on continuous exposure, while analyses based on categorical variables were characterized by incoherent exposure-outcome relationships. In conclusion, our results may be affected by several sources of bias and they are noninformative at exposure levels >0.3 μT. Nonetheless, the study may contribute to future meta- or pooled analyses. Furthermore, exposure levels among population controls are useful to estimate attributable risk. PMID:25689995

  5. Childhood leukemia and 50 Hz magnetic fields: findings from the Italian SETIL case-control study.

    PubMed

    Salvan, Alberto; Ranucci, Alessandra; Lagorio, Susanna; Magnani, Corrado

    2015-02-01

    We report on an Italian case-control study on childhood leukemia and exposure to extremely low frequency magnetic fields (ELF-MF). Eligible for inclusion were 745 leukemia cases, aged 0-10 years at diagnosis in 1998-2001, and 1475 sex- and age-matched population controls. Parents of 683 cases and 1044 controls (92% vs. 71%) were interviewed. ELF-MF measurements (24-48 h), in the child's bedroom of the dwelling inhabited one year before diagnosis, were available for 412 cases and 587 controls included in the main conditional regression analyses. The magnetic field induction was 0.04 μT on average (geometric mean), with 0.6% of cases and 1.6% of controls exposed to >0.3 μT. The impact of changes in the statistical model, exposure metric, and data-set restriction criteria was explored via sensitivity analyses. No exposure-disease association was observed in analyses based on continuous exposure, while analyses based on categorical variables were characterized by incoherent exposure-outcome relationships. In conclusion, our results may be affected by several sources of bias and they are noninformative at exposure levels >0.3 μT. Nonetheless, the study may contribute to future meta- or pooled analyses. Furthermore, exposure levels among population controls are useful to estimate attributable risk. PMID:25689995

  6. Pathological findings in 2 cases of fatal 25I-NBOMe toxicity.

    PubMed

    Walterscheid, Jeffrey P; Phillips, Garrett T; Lopez, Ana E; Gonsoulin, Morna L; Chen, Hsin-Hung; Sanchez, Luis A

    2014-03-01

    The research compound 25I-NBOMe, also known as CIMBI-5 or INBMeO, was created in academic laboratories as a potent serotonin 2A receptor agonist. Because of its high affinity and ambiguous legal status, recreational drug enthusiasts have used this compound as a powerful alternative to other hallucinogenic drugs such as lysergic acid diethylamide. We report 2 deaths after 25I-NBOMe ingestion by decedents who attended separate "rave" parties. The first case involved a 21-year-old male who admitted taking "acid" to his friend. A sudden violent rage caused him to flail about, and he subsequently became unresponsive. The postmortem examination revealed numerous external injuries that were consistent with physical aggression. The second case involved a 15-year-old female who was socializing outside a rave party, became ill, and rapidly deteriorated as her friend transported her to the hospital. The postmortem assessment was similar to the first case in that external contusions featured prominently. Comprehensive toxicology screens in both cases revealed only evidence of marijuana use. A deeper analysis using time-of-flight mass spectrometry revealed the presence of 25I-NBOMe, which was further confirmed by tandem-mass spectrometry. The behavior and injuries in these cases reveal a consistent pattern preceding fatal 25I-NBOMe toxicity. PMID:24457586

  7. Collimator application for microchannel plate image intensifier resolution improvement

    DOEpatents

    Thomas, S.W.

    1996-02-27

    A collimator is included in a microchannel plate image intensifier (MCPI). Collimators can be useful in improving resolution of MCPIs by eliminating the scattered electron problem and by limiting the transverse energy of electrons reaching the screen. Due to its optical absorption, a collimator will also increase the extinction ratio of an intensifier by approximately an order of magnitude. Additionally, the smooth surface of the collimator will permit a higher focusing field to be employed in the MCP-to-collimator region than is currently permitted in the MCP-to-screen region by the relatively rough and fragile aluminum layer covering the screen. Coating the MCP and collimator surfaces with aluminum oxide appears to permit additional significant increases in the field strength, resulting in better resolution. 2 figs.

  8. Collimator application for microchannel plate image intensifier resolution improvement

    DOEpatents

    Thomas, Stanley W.

    1996-02-27

    A collimator is included in a microchannel plate image intensifier (MCPI). Collimators can be useful in improving resolution of MCPIs by eliminating the scattered electron problem and by limiting the transverse energy of electrons reaching the screen. Due to its optical absorption, a collimator will also increase the extinction ratio of an intensifier by approximately an order of magnitude. Additionally, the smooth surface of the collimator will permit a higher focusing field to be employed in the MCP-to-collimator region than is currently permitted in the MCP-to-screen region by the relatively rough and fragile aluminum layer covering the screen. Coating the MCP and collimator surfaces with aluminum oxide appears to permit additional significant increases in the field strength, resulting in better resolution.

  9. Motivation and Web-Based Instruction: A Case Study of Using CANE Model To Access Motivation Problems and Find Solutions.

    ERIC Educational Resources Information Center

    Lin, Chia-Jung Maigo

    1999-01-01

    Uses a cognitive motivation approach to view students' learning on Web-based instruction (WBI). Introduces the new CANE Model as a means for diagnosing motivation problems. Presents one WBI class at a teacher education institution in Taiwan as a case study to illustrate the process of how to diagnose motivation problems and find appropriate…

  10. [Late presentation of an extrarenal pseudoaneurysm in a renal transplant patient: CT and color Doppler US findings (case report)].

    PubMed

    Düşünceli, Ebru; Atasoy, Cetin; Fitoz, Suat; Yağci, Cemil

    2004-12-01

    Vascular complications associated with renal transplants are a significant cause of graft dysfunction or failure. The most common complications are arterial and venous stenoses/thromboses, intrarenal and extrarenal arteriovenous fistulas, and pseudoaneurysms. In this case report, an extremely rare complication following renal transplantation, an extrarenal pseudoaneurysm, is presented with CT, gray scale, and color Doppler US findings. PMID:15611918

  11. Sonographic findings in horses with mediastinal lymphosarcoma: 13 cases (1985-1992).

    PubMed

    Garber, J L; Reef, V B; Reimer, J M

    1994-11-15

    Sonographic findings correlated with necropsy findings in 8 of 9 horses in which the cranial portion of the mediastinum was evaluated by use of both methods. Cranial mediastinal masses were imaged as multilobular and homogeneously hypoechoic; a complex echogenic pattern was observed with necrosis within the mass. Pleural effusion was a common finding in horses with mediastinal lymphosarcoma. Cytologic evaluation of pleural fluid samples was useful in diagnosis of lymphosarcoma in 10 of 12 horses that had thoracentesis. Sonographic examination of the thorax and cranial portion of the mediastinum can aid in the diagnosis of mediastinal lymphosarcoma in horses. Such examination should be performed in horses with clinical signs of cranial vena cava obstruction in which pleural effusion is detected, or when thoracic lymphosarcoma is suspected. PMID:7698925

  12. Endobronchial tumor in children: Unusual finding in recurrent pneumonia, report of three cases

    PubMed Central

    Madafferi, Silvia; Catania, Vincenzo D; Accinni, Antonella; Boldrini, Renata; Inserra, Alessandro

    2015-01-01

    We are reporting 3 cases of pediatric endobronchial tumors presented with recurrent pneumonia. The median age of patients, at time of presentation, was 10.6 years. All patients presented with recurrent pneumonia with a mean time to occurrence, after onset of symptoms, of 14 mo. Bronchoscopy was early performed as part of diagnostic work-up and it revealed an endobronchial mass in every case. Complete surgical resection was performed in all cases, with lung preservation in two of them. Neither post-operative chemotherapy nor radiotherapy was required. The mean duration of follow-up was 7 years and all patients are still alive and disease-free. Recurrent pneumonia, in pediatrics, should raise the suspicion of an obstructing lesion, congenital malformation or systemic disease. A systematic approach is useful for organize the clinicians initial workup. Prompt diagnosis allows parenchymal-sparing surgery, which offers the best chance of cure and reduces clinical and functional complications in these patients. PMID:26015878

  13. Multiple idiopathic external and internal resorption: Case report with cone-beam computed tomography findings

    PubMed Central

    Uzuntas, Ceren Feriha; Kurt, Hakan

    2014-01-01

    Root resorption is loss of dental hard tissue as a result of clastic activities. The dental hard tissue of permanent teeth does not normally undergo resorption, except in cases of inflammation or trauma. However, there are rare cases of tooth resorption of an unknown cause, known as "idiopathic root resorption." This report would discuss a rare case of multiple idiopathic resorption in the permanent maxillary and mandibular teeth of an otherwise healthy 36-year-old male patient. In addition to a clinical examination, the patient was imaged using conventional radiography and cone-beam computed tomography (CBCT). The examinations revealed multiple external and internal resorption of the teeth in all four quadrants of the jaws with an unknown cause. Multiple root resorption is a rare clinical phenomenon that should be examined using different radiographic modalities. Cross-sectional CBCT is useful in the diagnosis and examination of such lesions. PMID:25473640

  14. A retrospective study on clinical findings of 7300 cases (2007-2014) of barren female dromedaries.

    PubMed

    Ali, A; Derar, R; Al-Sobayil, F; Al-Hawas, A; Hassanein, K

    2015-08-01

    The objective of this study was to investigate the clinical findings in barren female dromedaries examined for different complaints. Female camels were examined for repeat breeding with regular heat interval (RB-R, n = 5444), refused mating (RM, n = 1299), repeat breeding with long heat interval (RB-L, n = 489), difficulties or bleeding during mating (DM, n = 53), and for manifestation of male-like behavior (MB, n = 15). The genital tracts of all females were evaluated using transrectal palpation, ultrasonography, and exploration of the vagina. Cervical swabs were obtained for bacteriologic examination. Clinical endometritis, ovarian hydrobursitis, and vaginal adhesions were the main clinical findings in the female camels examined for RB-R, RM, and RB-L, respectively. Parity affected the frequency of occurrence of these findings. The incidences of clinical endometritis, ovarian hydrobursitis, and vaginal adhesions in nullipara and multipara were 28% versus 32.3% (P = 0.004), 37.1% versus 23.7% (P = 0.001), and 5.7% versus 18.3% (P = 0.001), respectively. Vaginal adhesions, persistent hymen, pelvic abscess, and vulvar atresia were the clinical findings in the female camels presented due to bleeding at mating or with a history of an incomplete intromission of the penis. The male-like behavior was associated with an enlargement of the clitoris and narrowing of the vulva and vagina. Trueperella pyogenes, Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumonia, Streptococcus zooepidemicus, and β-hemolytic Streptococcus were isolated from females presented for repeat breeding syndrome. In conclusion, clinical endometritis, ovarian hydrobursitis, and vaginal adhesions were the main clinical findings in barren female dromedaries. Parity affected the frequency of the clinical findings. PMID:25935372

  15. Diffuse Axonal Injury: CT Findings and Clinical Profiles in Six Consecutive Cases.

    PubMed

    Moschnegootz, S; Ushakov, A; Gatin, D; Shalyakin, K; Rokhlenko, O

    2010-06-01

    Diffuse axonal injury is a relatively rare type of brain trauma when prolonged coma with generally poor clinical outcome is often associated with negative neuroimaging findings. Although magnetic resonance imaging is the method of choice for evaluation of diffuse axonal injury, computed tomography still plays an important role as an emergency visualization modality. We compared computed tomography findings with clinical data, short and medium-term outcomes and, if available, autopsy results of six consecutive patients admitted to our hospital during the year of 2009. We found that corpus callosum lesions were most closely associated with diffuse axonal injury, followed by subdural hematoma or hygroma. PMID:24148587

  16. Cost-effectiveness of a tuberculosis active case finding program targeting household and neighborhood contacts in Cambodia.

    PubMed

    Yadav, Rajendra P; Nishikiori, Nobuyuki; Satha, Peou; Eang, Mao T; Lubell, Yoel

    2014-05-01

    In many high-risk populations, access to tuberculosis (TB) diagnosis and treatment is limited and pockets of high prevalence persist. We estimated the cost-effectiveness of an extensive active case finding program in areas of Cambodia where TB notifications and household poverty rates are highest and access to care is restricted. Thirty operational health districts with high TB incidence and household poverty were randomized into intervention and control groups. In intervention operational health districts, all household and symptomatic neighborhood contacts of registered TB patients of the past two years were encouraged to attend screening at mobile centers. In control districts, routine passive case finding activities continued. The program screened more than 35,000 household and neighborhood contacts and identified 810 bacteriologically confirmed cases. The cost-effectiveness analysis estimated that in these cases the reduction in mortality from 14% to 2% would result in a cost per daily adjusted life year averted of $330, suggesting that active case finding was highly cost-effective. PMID:24615134

  17. A case report and DSA findings of cerebral hemorrhage caused by syphilitic vasculitis.

    PubMed

    Zhang, Xia; Xiao, Guo-Dong; Xu, Xing-Shun; Zhang, Chun-Yuan; Liu, Chun-Feng; Cao, Yong-Jun

    2012-12-01

    Syphilis is now rare and easily misdiagnosed because of the wide use of antibiotics in the clinical. We report a case of cerebral hemorrhage in a patient with hypertension who was first diagnosed as hypertensive cerebral hemorrhage. However, treponema pallidum particle agglutination and rapid plasma regain tests of cerebrospinal fluid revealed the existence of neurosyphilis. Interestingly, digital subtraction angiography (DSA) showed severe stenosis in both middle cerebral arteries and right anterior cerebral artery. The case reminded us to pay attention to syphilitic vasculitis in patients with cryptogenic stroke. DSA sometimes may play a critical role in differential diagnosis of neurosyphilis. PMID:22198645

  18. Perineal nodular indurations ("accessory testicles") in cyclists. Fine needle aspiration cytologic and pathologic findings in two cases.

    PubMed

    Vuong, P N; Camuzard, P; Schoonaert, M F

    1988-01-01

    The cytologic and histologic findings from two cases of perineal nodular indurations observed in two cyclists are reported. These lesions, also referred to as "accessory testicles" or "third testicle" or "ischial hygromas" of cyclists, consist of a localized aseptic area of necrosis with pseudocyst formation involving connective tissue in the superficial fascia of the perineum. These histologic findings, which were seen in the subsequent surgical specimens in these two cases, were reflected in the fine needle aspiration findings. The aspirates contained few cellular elements, mainly a few vacuolated histiocytes, against a background of fibrinous material. These indurations, which develop as a result of repeated, chronic microtrauma to the perineum impressed by the vibration of the saddle of the bicycle, constitute an authentic handicap for the professional cyclist and are a contraindication to cycling for amateur cyclists. PMID:3336958

  19. Test and analysis of spectral response for UV image intensifier

    NASA Astrophysics Data System (ADS)

    Qian, Yunsheng; Liu, Jian; Feng, Cheng; Lv, Yang; Zhang, Yijun

    2015-10-01

    The UV image intensifier is one kind of electric vacuum imaging device based on principle of photoelectronic imaging. To achieve solar-blind detection, its spectral response characteristic is extremely desirable. A broad spectrum response measurement system is developed. This instrument uses EQ-99 laser-driven light source to get broad spectrum in the range of 200 nm to 1700 nm. A special preamplifier as well as a test software is work out. The spectral response of the image intensifier can be tested in the range of 200~1700 nm. Using this spectrum response measuring instrument, the UV image intensifiers are tested. The spectral response at the spectral range of 200 nm to 600 nm are obtained. Because of the quantum efficiency of Te-Cs photocathode used in image intens ifier above 280nm wavelength still exists, especially at 280 nm to 320nm.Therefore, high-performance UV filters is required for solar blind UV detection. Based on two sets of UV filters, the influence of solar radiation on solar blind detection is calculated and analyzed.

  20. Intensifying Insulin Therapy in Type 2 Diabetes: Choices & Challenges.

    PubMed

    Kumar, Ajay; Kesavadev, Jothydev; Sethi, Bipin; Jain, Sunil M; Guruprasad, C S; Shah, Siddharth N

    2015-05-01

    Insulin therapy remains the cornerstone of effective diabetes management. Timely intensification of insulin therapy reduces the progression of diabetes and the development of diabetes-related complications. Given that overall hyperglycaemia is a relative contribution of both fasting and postprandial hyperglycaemia, use of basal insulin alone may not achieve optimal glucose control due to its inability to cover postprandial glucose excursions. Intensifying therapy with addition of bolus insulin or switching to premixed insulin is a viable option in patients failing on basal alone therapy. Although the benefits of early insulin treatment are well established, a considerable delay in intensifying insulin therapy in patients with sub-optimal glycaemic control is still observed. Most of the patients and physicians are reluctant to intensify therapy due to the fear of hypoglycaemia, regimen complexity, and increased burden of multiple daily injections. In this context, there is a need for a flexible, alternative intensification option taking into account individual patient considerations to achieve or maintain individual glycaemic targets. An ideal insulin regimen should mimic physiological insulin release while providing optimal glycaemic control with low risk of hypoglycaemia, weight gain and fewer daily injections. The current paper reviews the challenges of insulin intensification in patients with type 2 diabetes mellitus poorly controlled on current treatment regimens. PMID:26548029

  1. Characterization of domestic and foreign image intensifier tubes

    NASA Astrophysics Data System (ADS)

    Bender, Edward J.; Wood, Michael V.; Hosek, Daniel J.; Hart, Steve D.

    2013-06-01

    The market for military-use Generation 2 and Generation 3 image intensifier (I2) tubes has become truly global, with major manufacturers and customers spanning five continents. This worldwide market is becoming increasingly important to U.S. manufacturers, with the majority of U.S. Army intensifier fielding having been completed in 2012. Given this keen global competition, it is not surprising that the advertised tube performance of a given source is often discounted by competitors, and the customers have no objective "honest broker" to determine the relative accuracy of these claims. To help fill this void, the U.S. Army RDECOM CERDEC NVESD recently measured a number of domestic and foreign image intensifier tubes, using consistent test equipment/procedures with which the U.S. industry must correlate for Army tube deliveries. Data and analysis will be presented for the major tube parameters of luminance gain, equivalent background input (EBI), signal-to-noise ratio (SNR), limiting resolution, halo, and modulation transfer function (MTF). The bright-light resolution provided by various auto-gated and non-gated tubes will also be addressed, since this area has been an important factor in the international market. RDECOM CERDEC NVESD measurement data will be compared to the corresponding manufacturer specifications whenever possible.

  2. Imaging findings of extensive splenic infarction after cyanoacrylate injection for gastric varices--a case report.

    PubMed

    Chan, R S; Vijayananthan, A; Kumar, G; Hilmi, I N

    2012-08-01

    Endoscopic injection of N-Butyl-2-cyanoacrylate is a widely accepted treatment for esophagogastric varices. This procedure is commonly associated with minor complications which include transient pyrexia and abdominal discomfort. Serious vascular complications secondary to systemic embolization of cyanoacrylate have rarely been reported. We describe the CT findings of extensive splenic infarction in a patient following cyanoacrylate injection for gastric varices. PMID:23082456

  3. Methylmalonic Acidemia: Diagnosis and Neuroimaging Findings of This Neurometabolic Disorder (An Iranian Pediatric Case Series)

    PubMed Central

    KARIMZADEH, Parvaneh; JAFARI, Narjes; AHMAD ABADI, Farzad; JABBEDARI, Sayena; TAGHDIRI, Mohammad-Mahdi; NEMATI, Hamid; SAKET, Sasan; SHARIATMADARI, Seyed-fakhreddin; ALAEE, Mohammad-Reza; GHOFRANI, Mohammad; TONEKABONI, Seyed Hasan

    2013-01-01

    Objective Methylmalonic acidemia is one of the inborn errors of metabolism resulting in the accumulation of acylcarnitine in blood and increased urinary methylmalonic acid excretion. This disorder can have symptoms, such as neurological and gastrointestinal manifestations, lethargy, and anorexia. Materials & Methods The patients who were diagnosed as methylmalonic acidemia in the Neurology Department of Mofid Children’s Hospital in Tehran, Iran, between 2002 and 2012 were included in our study. The disorder was confirmed by clinical findings, neuroimaging findings, and neurometabolic and genetic assessment in reference laboratory in Germany. We assessed the age, gender, past medical history, developmental status, clinical manifestations, and neuroimaging findings of 20 patients with methylmalonic acidemia. Results Eighty percent of the patients were offspring of consanguineous marriages. Half of the patients had Failure to thrive (FTT) due to anorexia; 85% had history of developmental delay or regression, and 20% had refractory seizure, which all of them were controlled. The patients with methylmalonic acidemia were followed for approximately 5 years and the follow-up showed that the patients with early diagnosis had a more favorable clinical response in growth index, refractory seizure, anorexia, and neurodevelopmental delay. Neuroimaging findings included brain atrophy, basal ganglia involvement (often in putamen), and periventricular leukomalacia. Conclusion According to the results of this study, we suggest that early assessment and diagnosis have an important role in the prevention of disease progression and clinical signs. PMID:24665309

  4. Fatal Case of Hydrocarbon Aspiration and Use of Lipoid Cells as Corroborative Finding for Rapid Autopsy Diagnosis in Cases of Delayed Death

    PubMed Central

    Jaybhaye, Prasad L.; Shilawant, Santosh S.

    2014-01-01

    Accidental aspiration of diesel can cause consolidation, atelectasis, and abscess formation. Aspiration of diesel usually results into pneumonitis, which resolves completely within 5–7 days of treatment. Diesel aspiration resulting in bilateral pneumonia and death is rare and is scarcely documented in literature. Finding of lipoid cells in lung autopsy specimen is one of the important features of hydrocarbon aspiration. Unfortunately this important finding is not mentioned in most of the toxicology textbooks. Hence, we are reporting this case. PMID:25948973

  5. Fatal case of hydrocarbon aspiration and use of lipoid cells as corroborative finding for rapid autopsy diagnosis in cases of delayed death.

    PubMed

    Jaybhaye, Prasad L; Shilawant, Santosh S

    2014-01-01

    Accidental aspiration of diesel can cause consolidation, atelectasis, and abscess formation. Aspiration of diesel usually results into pneumonitis, which resolves completely within 5-7 days of treatment. Diesel aspiration resulting in bilateral pneumonia and death is rare and is scarcely documented in literature. Finding of lipoid cells in lung autopsy specimen is one of the important features of hydrocarbon aspiration. Unfortunately this important finding is not mentioned in most of the toxicology textbooks. Hence, we are reporting this case. PMID:25948973

  6. Case Studies in Planning Small College Library Buildings for Information Technology: Findings and Recommendations.

    ERIC Educational Resources Information Center

    Sebright, Terence F.

    1996-01-01

    To accommodate new information technology, academic libraries have been enlarging and updating their facilities. Presents case studies of four small college libraries to examine their approaches to planning and incorporating technology into new facilities. Factors considered include flexibility of environment, thoroughness of need assessments,…

  7. A rare case of cystic ganglionosis in a child with associated imaging findings.

    PubMed

    Meyer, Nathan P; Meyers, Arthur B; Szabo, Sara; Vo, Nghia J

    2016-03-01

    Ganglia are benign soft tissue masses that are found adjacent to joints and tendons. They can be multifocal but they are rarely more numerous than a few around any given joint. "Cystic ganglionosis" has been used to describe a condition in which multifocal and extensive ganglia are present. We present a rare case of cystic ganglionosis in a Caucasian girl with clinical symptoms detected at 6 months of age. To the authors' knowledge, only a single other case report of cystic ganglionosis is documented in the English medical literature. The ganglia in this case are more extensive, manifested at an earlier age and caused erosions of multiple bones, a rarely observed complication of ganglia. Additionally, radiograph, MR and sonographic images collected over 9 years time allows for a detailed description of the imaging characteristics of this case of cystic ganglionosis, and offers unique insight into the natural history of this diagnosis. Extensive ganglia in multiple locations in a young child should alert clinicians to the possibility of cystic ganglionosis. Disease progression may lead to deleterious effects on bone warranting the use of maintenance imaging and possibly surgical resection of symptomatic lesions. PMID:26577814

  8. Problems Teachers Face When Doing Action Research and Finding Possible Solutions: Three Cases

    ERIC Educational Resources Information Center

    Zhou, Jun

    2012-01-01

    Through case studies, this paper explores problems teachers face when doing action research: for instance, teachers may misunderstand the research, mistrust university researchers, lack the time or adequate library resources to conduct research, lack theoretical guidance or knowledge of research methodology, and feel pressure or frustration during…

  9. Leiomyosarcoma of the buccal mucosa: a case report with immunohistochemistry findings.

    PubMed

    Yadav, Renu; Bharathan, Shantha

    2008-06-01

    Leiomyosarcoma is a relatively uncommon malignant lesion that exhibits smooth muscle differentiation. Occurrence of this tumor in the oral cavity is exceedingly rare, reflecting the paucity of smooth muscle in this region. This article presents a rare case of leiomyosarcoma of the buccal mucosa, which was confirmed by immunohistochemical staining. PMID:18587214

  10. Dystonia an unusual presentation in pediatric moyamoya disease: Imaging findings of a case.

    PubMed

    Kumar, Suresh; Sharma, Sudhir; Jhobta, Anupam; Sood, Ram Gopal

    2016-01-01

    Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by idiopathic occlusion of bilateral internal carotid arteries and the development of characteristic leptomeningeal collateral vessels along anterior or posterior circulation. We present an unusual case of MMD presenting with generalized dystonia as the predominant manifestation. PMID:27606018