Science.gov

Sample records for acute thermal challenge

  1. Cardiac function in an endothermic fish: cellular mechanisms for overcoming acute thermal challenges during diving.

    PubMed

    Shiels, H A; Galli, G L J; Block, B A

    2015-02-01

    Understanding the physiology of vertebrate thermal tolerance is critical for predicting how animals respond to climate change. Pacific bluefin tuna experience a wide range of ambient sea temperatures and occupy the largest geographical niche of all tunas. Their capacity to endure thermal challenge is due in part to enhanced expression and activity of key proteins involved in cardiac excitation-contraction coupling, which improve cardiomyocyte function and whole animal performance during temperature change. To define the cellular mechanisms that enable bluefin tuna hearts to function during acute temperature change, we investigated the performance of freshly isolated ventricular myocytes using confocal microscopy and electrophysiology. We demonstrate that acute cooling and warming (between 8 and 28°C) modulates the excitability of the cardiomyocyte by altering the action potential (AP) duration and the amplitude and kinetics of the cellular Ca(2+) transient. We then explored the interactions between temperature, adrenergic stimulation and contraction frequency, and show that when these stressors are combined in a physiologically relevant way, they alter AP characteristics to stabilize excitation-contraction coupling across an acute 20°C temperature range. This allows the tuna heart to maintain consistent contraction and relaxation cycles during acute thermal challenges. We hypothesize that this cardiac capacity plays a key role in the bluefin tunas' niche expansion across a broad thermal and geographical range. PMID:25540278

  2. Cardiac function in an endothermic fish: cellular mechanisms for overcoming acute thermal challenges during diving

    PubMed Central

    Shiels, H. A.; Galli, G. L. J.; Block, B. A.

    2015-01-01

    Understanding the physiology of vertebrate thermal tolerance is critical for predicting how animals respond to climate change. Pacific bluefin tuna experience a wide range of ambient sea temperatures and occupy the largest geographical niche of all tunas. Their capacity to endure thermal challenge is due in part to enhanced expression and activity of key proteins involved in cardiac excitation–contraction coupling, which improve cardiomyocyte function and whole animal performance during temperature change. To define the cellular mechanisms that enable bluefin tuna hearts to function during acute temperature change, we investigated the performance of freshly isolated ventricular myocytes using confocal microscopy and electrophysiology. We demonstrate that acute cooling and warming (between 8 and 28°C) modulates the excitability of the cardiomyocyte by altering the action potential (AP) duration and the amplitude and kinetics of the cellular Ca2+ transient. We then explored the interactions between temperature, adrenergic stimulation and contraction frequency, and show that when these stressors are combined in a physiologically relevant way, they alter AP characteristics to stabilize excitation–contraction coupling across an acute 20°C temperature range. This allows the tuna heart to maintain consistent contraction and relaxation cycles during acute thermal challenges. We hypothesize that this cardiac capacity plays a key role in the bluefin tunas' niche expansion across a broad thermal and geographical range. PMID:25540278

  3. Cardiac oxygen limitation during an acute thermal challenge in the European perch: effects of chronic environmental warming and experimental hyperoxia.

    PubMed

    Ekström, Andreas; Brijs, Jeroen; Clark, Timothy D; Gräns, Albin; Jutfelt, Fredrik; Sandblom, Erik

    2016-08-01

    Oxygen supply to the heart has been hypothesized to limit cardiac performance and whole animal acute thermal tolerance (CTmax) in fish. We tested these hypotheses by continuously measuring venous oxygen tension (Pvo2) and cardiovascular variables in vivo during acute warming in European perch (Perca fluviatilis) from a reference area during summer (18°C) and a chronically heated area (Biotest enclosure) that receives warm effluent water from a nuclear power plant and is normally 5-10°C above ambient (24°C at the time of experiments). While CTmax was 2.2°C higher in Biotest compared with reference perch, the peaks in cardiac output and heart rate prior to CTmax occurred at statistically similar Pvo2 values (2.3-4.0 kPa), suggesting that cardiac failure occurred at a common critical Pvo2 threshold. Environmental hyperoxia (200% air saturation) increased Pvo2 across temperatures in reference fish, but heart rate still declined at a similar temperature. CTmax of reference fish increased slightly (by 0.9°C) in hyperoxia, but remained significantly lower than in Biotest fish despite an improved cardiac output due to an elevated stroke volume. Thus, while cardiac oxygen supply appears critical to elevate stroke volume at high temperatures, oxygen limitation may not explain the bradycardia and arrhythmia that occur prior to CTmax Acute thermal tolerance and its thermal plasticity can, therefore, only be partially attributed to cardiac failure from myocardial oxygen limitations, and likely involves limiting factors on multiple organizational levels. PMID:27280433

  4. Physiological benefits of being small in a changing world: responses of Coho salmon (Oncorhynchus kisutch) to an acute thermal challenge and a simulated capture event.

    PubMed

    Clark, Timothy D; Donaldson, Michael R; Pieperhoff, Sebastian; Drenner, S Matthew; Lotto, Andrew; Cooke, Steven J; Hinch, Scott G; Patterson, David A; Farrell, Anthony P

    2012-01-01

    Evidence is building to suggest that both chronic and acute warm temperature exposure, as well as other anthropogenic perturbations, may select for small adult fish within a species. To shed light on this phenomenon, we investigated physiological and anatomical attributes associated with size-specific responses to an acute thermal challenge and a fisheries capture simulation (exercise+air exposure) in maturing male coho salmon (Oncorhynchus kisutch). Full-size females were included for a sex-specific comparison. A size-specific response in haematology to an acute thermal challenge (from 7 to 20 °C at 3 °C h(-1)) was apparent only for plasma potassium, whereby full-size males exhibited a significant increase in comparison with smaller males ('jacks'). Full-size females exhibited an elevated blood stress response in comparison with full-size males. Metabolic recovery following exhaustive exercise at 7 °C was size-specific, with jacks regaining resting levels of metabolism at 9.3 ± 0.5 h post-exercise in comparison with 12.3 ± 0.4 h for full-size fish of both sexes. Excess post-exercise oxygen consumption scaled with body mass in male fish with an exponent of b = 1.20 ± 0.08. Jacks appeared to regain osmoregulatory homeostasis faster than full-size males, and they had higher ventilation rates at 1 h post-exercise. Peak metabolic rate during post-exercise recovery scaled with body mass with an exponent of b~1, suggesting that the slower metabolic recovery in large fish was not due to limitations in diffusive or convective oxygen transport, but that large fish simply accumulated a greater 'oxygen debt' that took longer to pay back at the size-independent peak metabolic rate of ~6 mg min(-1) kg(-1). Post-exercise recovery of plasma testosterone was faster in jacks compared with full-size males, suggesting less impairment of the maturation trajectory of smaller fish. Supporting previous studies, these findings suggest that environmental change and non

  5. Acute cough: a diagnostic and therapeutic challenge

    PubMed Central

    2009-01-01

    Background Acute cough is one of the most common complaints prompting patient visits to healthcare professionals. Despite the broad repercussions of acute cough on patient quality of life, school and work productivity, and public health resources, research on this condition is minimal, as are the available treatment options. Many patients use over-the-counter medicines, which are often ineffective for symptom relief. Some therapies may achieve antitussive activity, but at the expense of unpleasant or intolerable side effects. Unmet needs When considering the treatments currently available for the management of acute cough, the multiple limitations of such treatments are quite apparent. Most of these treatments lack clinically proven efficacy and reliability to support their use. This reinforces the need for the generation of quality scientific data from well-performed clinical trials. Hopefully, the result will be the development of safer, more effective and more reliable therapeutic options in the management of acute cough. Cough assessment and management Acute cough can be due to a variety of causes, and it is worthwhile to consider these pathogenic factors in some detail. It is also important to be familiar with the effects that acute cough has on patients' quality of life, work productivity, and the healthcare system; proper awareness of these effects may contribute to better understanding of the social impact of cough. In reference to the available treatments for the management of acute cough, adequate knowledge of the type of over-the-counter and prescription products in the market, as well as their mode of action and advantages/disadvantages, may provide expanded pharmacotherapeutic opportunities and facilitate better clinical decisions. However, due to the drawbacks of current treatment options, ideas for future cough management and newer products need to be considered and tested. Conclusion In view of the socio-economic impact of acute cough and the

  6. Acute Pancreatitis—Progress and Challenges

    PubMed Central

    Afghani, Elham; Pandol, Stephen J.; Shimosegawa, Tooru; Sutton, Robert; Wu, Bechien U.; Vege, Santhi Swaroop; Gorelick, Fred; Hirota, Morihisa; Windsor, John; Lo, Simon K.; Freeman, Martin L.; Lerch, Markus M.; Tsuji, Yoshihisa; Melmed, Gil Y.; Wassef, Wahid; Mayerle, Julia

    2016-01-01

    An international symposium entitled “Acute pancreatitis: progress and challenges” was held on November 5, 2014 at the Hapuna Beach Hotel, Big Island, Hawaii, as part of the 45th Anniversary Meeting of the American Pancreatic Association and the Japanese Pancreas Society. The course was organized and directed by Drs. Stephen Pandol, Tooru Shimosegawa, Robert Sutton, Bechien Wu, and Santhi Swaroop Vege. The symposium objectives were to: (1) highlight current issues in management of acute pancreatitis, (2) discuss promising treatments, (3) consider development of quality indicators and improved measures of disease activity, and (4) present a framework for international collaboration for development of new therapies. This article represents a compilation and adaptation of brief summaries prepared by speakers at the symposium with the purpose of broadly disseminating information and initiatives. PMID:26465949

  7. The acute hepatic porphyrias: current status and future challenges.

    PubMed

    Siegesmund, Marko; van Tuyll van Serooskerken, Anne-Moniek; Poblete-Gutiérrez, Pamela; Frank, Jorge

    2010-10-01

    The porphyrias are predominantly inherited metabolic disorders, which result from a specific deficiency of one of the eight enzymes along the pathway of haem biosynthesis. Historically, they have been classified into hepatic and erythropoietic forms, based on the primary site of expression of the prevailing dysfunctional enzyme. From a clinical point of view, however, it is more convenient to subdivide them into acute and non-acute porphyrias, thereby primarily considering the potential occurrence of life-threatening acute neurovisceral attacks. Unrecognised or untreated, such an acute porphyric attack is associated with a significant mortality of up to 10%. The acute hepatic porphyrias comprise acute intermittent porphyria, variegate porphyria, hereditary coproporphyria, and δ-aminolevulinic acid dehydratase deficiency porphyria. Making a precise diagnosis may be difficult because the different types of porphyrias may show overlapping clinical and biochemical characteristics. To date, the therapeutic possibilities are limited and mainly symptomatic. In this overview we report on what is currently known about pathogenesis, clinic, diagnostics, and therapy of the acute hepatic porphyrias. We further point out actual and future challenges in the management of these diseases. PMID:20955962

  8. Passive Thermal Control Challenges for Future Exploration Missions

    NASA Technical Reports Server (NTRS)

    Rickman, Steven L.

    2004-01-01

    This slide presentation reviews the importance of developing passive thermal control for the future exploration missions envisioned in President Bush's call for human exploration of the Moon and Mars. Included in the presentation is a review of the conditions that make the thermal control very challenging on the Moon and Mars. With the future miniaturization of electronics components, power density and the associated challenges of electronics heat dissipation will provide new challenges. There is a challenge for improvement in modeling and analysis of thermal control systems, and for improved facilities to support testing of thermal-vacuum systems.

  9. Coping with new challenges in acute coronary syndromes

    PubMed Central

    Théroux, Pierre; Labarthe, Benoît

    2006-01-01

    The acute coronary syndromes have become well-established clinical entities and are used as working diagnoses tied in with elaborate investigation and treatment practice guidelines. However, these syndromes remain challenging because their prevalence, morbidity and mortality remain high. Furthermore, these syndromes are demanding on the health care system because an early invasive management strategy is recommended for most patients with these conditions. Coping with these challenges requires the following initiatives: stepping beyond current diagnostic and management algorithms to a better performing risk stratification scheme that considers specific patient risk factors in addition to the disease risk, and a reintegration of acute coronary syndromes into the more global perspective of coronary artery disease; more effective antithrombotic therapy that does not further compromise bleeding risk, or drugs that control thrombogenic stimuli; and medical and revascularization therapies targeted to more specific individual pathophysiologies identified by novel blood markers and imaging techniques. PMID:16929386

  10. Panoramic thermal imaging: challenges and tradeoffs

    NASA Astrophysics Data System (ADS)

    Aburmad, Shimon

    2014-06-01

    Over the past decade, we have witnessed a growing demand for electro-optical systems that can provide continuous 3600 coverage. Applications such as perimeter security, autonomous vehicles, and military warning systems are a few of the most common applications for panoramic imaging. There are several different technological approaches for achieving panoramic imaging. Solutions based on rotating elements do not provide continuous coverage as there is a time lag between updates. Continuous panoramic solutions either use "stitched" images from multiple adjacent sensors, or sophisticated optical designs which warp a panoramic view onto a single sensor. When dealing with panoramic imaging in the visible spectrum, high volume production and advancement of semiconductor technology has enabled the use of CMOS/CCD image sensors with a huge number of pixels, small pixel dimensions, and low cost devices. However, in the infrared spectrum, the growth of detector pixel counts, pixel size reduction, and cost reduction is taking place at a slower rate due to the complexity of the technology and limitations caused by the laws of physics. In this work, we will explore the challenges involved in achieving 3600 panoramic thermal imaging, and will analyze aspects such as spatial resolution, FOV, data complexity, FPA utilization, system complexity, coverage and cost of the different solutions. We will provide illustrations, calculations, and tradeoffs between three solutions evaluated by Opgal: A unique 3600 lens design using an LWIR XGA detector, stitching of three adjacent LWIR sensors equipped with a low distortion 1200 lens, and a fisheye lens with a HFOV of 180º and an XGA sensor.

  11. Clinical Manifestations and Diagnostic Challenges in Acute Porphyrias

    PubMed Central

    Trier, Henry; Krishnasamy, Vikram P.; Kasi, Pashtoon Murtaza

    2013-01-01

    The porphyrias are a group of disorders characterized by an enzyme deficiency in the heme biosynthetic pathway. These can be classified into either erythropoietic or hepatic forms depending on the site of the major enzyme deficiency. The diagnosis of acute porphyrias, however, can be very challenging due to overlapping features amongst the various types. Initial suspicion is based on a myriad of clinical manifestations, which then are confirmed by laboratory testing where available. Genetic testing is now also available for the different types of porphyrias, aiding in the definitive diagnosis. Here, we present a challenging case of porphyria in a patient with end-stage renal disease and present the diagnostic challenges associated with the case and the ways forward. PMID:23476835

  12. An Overview of the Thermal Challenges of Designing Microgravity Furnaces

    NASA Technical Reports Server (NTRS)

    Westra, Douglas G.

    2001-01-01

    Marshall Space Flight Center is involved in a wide variety of microgravity projects that require furnaces, with hot zone temperatures ranging from 300 C to 2300 C, requirements for gradient processing and rapid quench, and both semi-conductor and metal materials. On these types of projects, the thermal engineer is a key player in the design process. Microgravity furnaces present unique challenges to the thermal designer. One challenge is designing a sample containment assembly that achieves dual containment, yet allows a high radial heat flux. Another challenge is providing a high axial gradient but a very low radial gradient. These furnaces also present unique challenges to the thermal analyst. First, there are several orders of magnitude difference in the size of the thermal 'conductors' between various parts of the model. A second challenge is providing high fidelity in the sample model, and connecting the sample with the rest of the furnace model, yet maintaining some sanity in the number of total nodes in the model. The purpose of this paper is to present an overview of the challenges involved in designing and analyzing microgravity furnaces and how some of these challenges have been overcome. The thermal analysis tools presently used to analyze microgravity furnaces and will be listed. Challenges for the future and a description of future analysis tools will be given.

  13. An Overview of the Thermal Challenges of Designing Microgravity Furnaces

    NASA Technical Reports Server (NTRS)

    Westra, Douglas G.

    1999-01-01

    In the last few years, Marshall Space Flight Center has become heavily involved in a wide variety of microgravity projects that require furnaces, with hot zone temperatures ranging from 300 C to 2300 C, requirements for isothermal and gradient processing, and both semi-conductor and metal materials. On these types of projects, the thermal engineer is a key player in the design process. These furnaces present unique challenges to the thermal designer. One challenge is designing a sample containment system that achieves dual containment, yet allows a high radial heat flux. Another challenge is providing a high axial gradient but a very low radial gradient. These furnaces also present unique challenges to the thermal analyst. First, there are several orders of magnitude difference in the size of the thermal "conductors" between various parts of the model. A second challenge is providing high fidelity in the sample model, and connecting the sample with the rest of the furnace model, yet maintaining some sanity in the number of total nodes in the model. The purpose of this paper is to present an overview of the challenges involved in designing and analyzing microgravity furnaces and how some of these challenges have been overcome. The thermal analysis tools presently used to analyze microgravity furnaces and how they have been applied will be explained. Challenges for the future and a description of future analysis tools will be given.

  14. Liver transplantation in acute liver failure: A challenging scenario

    PubMed Central

    Mendizabal, Manuel; Silva, Marcelo Oscar

    2016-01-01

    Acute liver failure is a critical medical condition defined as rapid development of hepatic dysfunction associated with encephalopathy. The prognosis in these patients is highly variable and depends on the etiology, interval between jaundice and encephalopathy, age, and the degree of coagulopathy. Determining the prognosis for this population is vital. Unfortunately, prognostic models with both high sensitivity and specificity for prediction of death have not been developed. Liver transplantation has dramatically improved survival in patients with acute liver failure. Still, 25% to 45% of patients will survive with medical treatment. The identification of patients who will eventually require liver transplantation should be carefully addressed through the combination of current prognostic models and continuous medical assessment. The concerns of inaccurate selection for transplantation are significant, exposing the recipient to a complex surgery and lifelong immunosuppression. In this challenging scenario, where organ shortage remains one of the main problems, alternatives to conventional orthotopic liver transplantation, such as living-donor liver transplantation, auxiliary liver transplant, and ABO-incompatible grafts, should be explored. Although overall outcomes after liver transplantation for acute liver failure are improving, they are not yet comparable to elective transplantation. PMID:26819519

  15. Liver transplantation in acute liver failure: A challenging scenario.

    PubMed

    Mendizabal, Manuel; Silva, Marcelo Oscar

    2016-01-28

    Acute liver failure is a critical medical condition defined as rapid development of hepatic dysfunction associated with encephalopathy. The prognosis in these patients is highly variable and depends on the etiology, interval between jaundice and encephalopathy, age, and the degree of coagulopathy. Determining the prognosis for this population is vital. Unfortunately, prognostic models with both high sensitivity and specificity for prediction of death have not been developed. Liver transplantation has dramatically improved survival in patients with acute liver failure. Still, 25% to 45% of patients will survive with medical treatment. The identification of patients who will eventually require liver transplantation should be carefully addressed through the combination of current prognostic models and continuous medical assessment. The concerns of inaccurate selection for transplantation are significant, exposing the recipient to a complex surgery and lifelong immunosuppression. In this challenging scenario, where organ shortage remains one of the main problems, alternatives to conventional orthotopic liver transplantation, such as living-donor liver transplantation, auxiliary liver transplant, and ABO-incompatible grafts, should be explored. Although overall outcomes after liver transplantation for acute liver failure are improving, they are not yet comparable to elective transplantation. PMID:26819519

  16. Applications and challenges for thermal energy storage

    NASA Astrophysics Data System (ADS)

    Kannberg, L. D.; Tomlinson, J. T.

    1991-04-01

    New thermal energy storage (TES) technologies are being developed and applied as society strives to relieve increasing energy and environmental stresses. Applications for these new technologies range from residential and district heating and cooling using waste and solar energy, to high-temperature energy storage for power production and industrial processes. In the last two decades there has been great interest and development of heat storage systems, primarily for residential and commercial buildings. While development has continued, the rate of advancement has slowed with current technology considered adequate for electrically charged heat storage furnaces. Use of chill storage for building diurnal cooling has received substantial development.

  17. Addressing the challenges of thermal imaging for firefighting applications

    NASA Astrophysics Data System (ADS)

    Kostrzewa, Joseph; Meyer, William H.; Poe, George; Terre, William A.; Salapow, Thomas M.; Raimondi, John

    2003-09-01

    By providing visibility through smoke and absolute darkness, thermal imaging has the potential to radically improve the effectiveness and safety of the modern firefighter. Some of the roles of thermal imaging are assisting in detection of victims; navigating through dark, smoke-filled structures; detecting indications of imminent flash-over/roll-over; identifying and attacking the seat and extension of a fire; and surveying for lingering hot spots after a fire is nearly extinguished. In many respects, thermal imaging is ideally suited for these functions. However, firefighting applications present the infrared community some unique and challenging design constraints, not the least of which is an operating environment that is in some ways more harsh than most aerospace applications. While many previous papers have described the benefits of thermal imaging for firefighters, this paper describes several specific engineering challenges of this application. These include large ambient temperature range, rapidly changing scene dynamics, extreme demands on AGC, and large dynamic range requirements. This paper describes these and other challenges in detail and explains how they were addressed and overcome in the design of Evolution 5000, a state-of-the-art thermal imager designed and manufactured by Mine Safety Appliances (MSA) using Indigo System"s Omega miniature uncooled camera core.

  18. Validation of the thermal challenge problem using Bayesian Belief Networks.

    SciTech Connect

    McFarland, John; Swiler, Laura Painton

    2005-11-01

    The thermal challenge problem has been developed at Sandia National Laboratories as a testbed for demonstrating various types of validation approaches and prediction methods. This report discusses one particular methodology to assess the validity of a computational model given experimental data. This methodology is based on Bayesian Belief Networks (BBNs) and can incorporate uncertainty in experimental measurements, in physical quantities, and model uncertainties. The approach uses the prior and posterior distributions of model output to compute a validation metric based on Bayesian hypothesis testing (a Bayes' factor). This report discusses various aspects of the BBN, specifically in the context of the thermal challenge problem. A BBN is developed for a given set of experimental data in a particular experimental configuration. The development of the BBN and the method for ''solving'' the BBN to develop the posterior distribution of model output through Monte Carlo Markov Chain sampling is discussed in detail. The use of the BBN to compute a Bayes' factor is demonstrated.

  19. The Challenges of Credible Thermal Protection System Reliability Quantification

    NASA Technical Reports Server (NTRS)

    Green, Lawrence L.

    2013-01-01

    The paper discusses several of the challenges associated with developing a credible reliability estimate for a human-rated crew capsule thermal protection system. The process of developing such a credible estimate is subject to the quantification, modeling and propagation of numerous uncertainties within a probabilistic analysis. The development of specific investment recommendations, to improve the reliability prediction, among various potential testing and programmatic options is then accomplished through Bayesian analysis.

  20. Transcriptional Response to Acute Thermal Exposure in Juvenile Chinook Salmon Determined by RNAseq

    PubMed Central

    Tomalty, Katharine M. H.; Meek, Mariah H.; Stephens, Molly R.; Rincón, Gonzalo; Fangue, Nann A.; May, Bernie P.; Baerwald, Melinda R.

    2015-01-01

    Thermal exposure is a serious and growing challenge facing fish species worldwide. Chinook salmon (Oncorhynchus tshawytscha) living in the southern portion of their native range are particularly likely to encounter warmer water due to a confluence of factors. River alterations have increased the likelihood that juveniles will be exposed to warm water temperatures during their freshwater life stage, which can negatively impact survival, growth, and development and pose a threat to dwindling salmon populations. To better understand how acute thermal exposure affects the biology of salmon, we performed a transcriptional analysis of gill tissue from Chinook salmon juveniles reared at 12° and exposed acutely to water temperatures ranging from ideal to potentially lethal (12° to 25°). Reverse-transcribed RNA libraries were sequenced on the Illumina HiSeq2000 platform and a de novo reference transcriptome was created. Differentially expressed transcripts were annotated using Blast2GO and relevant gene clusters were identified. In addition to a high degree of downregulation of a wide range of genes, we found upregulation of genes involved in protein folding/rescue, protein degradation, cell death, oxidative stress, metabolism, inflammation/immunity, transcription/translation, ion transport, cell cycle/growth, cell signaling, cellular trafficking, and structure/cytoskeleton. These results demonstrate the complex multi-modal cellular response to thermal stress in juvenile salmon. PMID:25911227

  1. Adult vultures outperform juveniles in challenging thermal soaring conditions

    PubMed Central

    Harel, Roi; Horvitz, Nir; Nathan, Ran

    2016-01-01

    Due to the potentially detrimental consequences of low performance in basic functional tasks, individuals are expected to improve performance with age and show the most marked changes during early stages of life. Soaring-gliding birds use rising-air columns (thermals) to reduce energy expenditure allocated to flight. We offer a framework to evaluate thermal soaring performance, and use GPS-tracking to study movements of Eurasian griffon vultures (Gyps fulvus). Because the location and intensity of thermals are variable, we hypothesized that soaring performance would improve with experience and predicted that the performance of inexperienced individuals (<2 months) would be inferior to that of experienced ones (>5 years). No differences were found in body characteristics, climb rates under low wind shear, and thermal selection, presumably due to vultures’ tendency to forage in mixed-age groups. Adults, however, outperformed juveniles in their ability to adjust fine-scale movements under challenging conditions, as juveniles had lower climb rates under intermediate wind shear, particularly on the lee-side of thermal columns. Juveniles were also less efficient along the route both in terms of time and energy. The consequences of these handicaps are probably exacerbated if juveniles lag behind adults in finding and approaching food. PMID:27291590

  2. Adult vultures outperform juveniles in challenging thermal soaring conditions.

    PubMed

    Harel, Roi; Horvitz, Nir; Nathan, Ran

    2016-01-01

    Due to the potentially detrimental consequences of low performance in basic functional tasks, individuals are expected to improve performance with age and show the most marked changes during early stages of life. Soaring-gliding birds use rising-air columns (thermals) to reduce energy expenditure allocated to flight. We offer a framework to evaluate thermal soaring performance, and use GPS-tracking to study movements of Eurasian griffon vultures (Gyps fulvus). Because the location and intensity of thermals are variable, we hypothesized that soaring performance would improve with experience and predicted that the performance of inexperienced individuals (<2 months) would be inferior to that of experienced ones (>5 years). No differences were found in body characteristics, climb rates under low wind shear, and thermal selection, presumably due to vultures' tendency to forage in mixed-age groups. Adults, however, outperformed juveniles in their ability to adjust fine-scale movements under challenging conditions, as juveniles had lower climb rates under intermediate wind shear, particularly on the lee-side of thermal columns. Juveniles were also less efficient along the route both in terms of time and energy. The consequences of these handicaps are probably exacerbated if juveniles lag behind adults in finding and approaching food. PMID:27291590

  3. Novel Thrombolytics for Acute Ischemic Stroke: Challenges and Opportunities.

    PubMed

    Logallo, Nicola; Kvistad, Christopher E; Nacu, Aliona; Thomassen, Lars

    2016-02-01

    Progress in finding a better alternative to alteplase has been slow. Tenecteplase and desmoteplase have better pharmacological profiles compared with alteplase, but definite clinical evidence of their superiority is lacking. The two major phase III studies that have tested the efficacy and safety of desmoteplase in ischemic stroke patients have shown neutral results and a promising safety profile, but the trials compared desmoteplase with placebo only in late admitted patients. Future trials should focus on testing novel thrombolytics in the early time window either as the sole acute recanalizing treatment or combined with thrombectomy. PMID:26798040

  4. ECLSS and Thermal Systems Integration Challenges Across the Constellation Architecture

    NASA Technical Reports Server (NTRS)

    Carrasquillo, Robyn

    2010-01-01

    As the Constellation Program completes its initial capability Preliminary Design Review milestone for the Initial Capability phase, systems engineering of the Environmental Control and Life Support (ECLS) and Thermal Systems for the various architecture elements has progressed from the requirements to design phase. As designs have matured for the Ares, Orion, Ground Systems, and Extravehicular (EVA) System, a number of integration challenges have arisen requiring analyses and trades, resulting in changes to the design and/or requirements. This paper will address some of the key integration issues and results, including the Orion-to-Ares shared compartment venting and purging, Orion-to-EVA suit loop integration issues with the suit system, Orion-to-ISS and Orion-to-Altair intermodule ventilation, and Orion and Ground Systems impacts from post-landing environments.

  5. Acute liver failure in pregnancy: Challenges and management

    PubMed Central

    Pandey, Chandra Kant; Karna, Sunaina Tejpal; Pandey, Vijay Kant; Tandon, Manish

    2015-01-01

    Acute liver failure (ALF) in pregnancy negatively affects both maternal and foetal outcome. The spectrum of liver disease in pregnancy may range from mild asymptomatic transaminitis to fatal and irreversible deterioration in liver functions leading to significant morbidity and even mortality. In this comprehensive review, we searched articles published as review articles, clinical trials, and case series in the Medline from 1970 to 2012. The overall outcome of ALF in pregnancy depends on the aetiology, timely diagnosis, prompt management, and early referral to a centre equipped in managing medical or obstetric complication. The foetal outcome is affected by the stage of pregnancy in which the mother has a deterioration of the liver function, with a worst prognosis associated with first or second-trimester liver failure. When ALF complicates pregnancy, liver transplantation is the one of the viable options. Management protocols need to be individualised for each case keeping in mind the risk versus benefit to both the mother and the foetus. PMID:25838585

  6. Acute liver failure in pregnancy: Challenges and management.

    PubMed

    Pandey, Chandra Kant; Karna, Sunaina Tejpal; Pandey, Vijay Kant; Tandon, Manish

    2015-03-01

    Acute liver failure (ALF) in pregnancy negatively affects both maternal and foetal outcome. The spectrum of liver disease in pregnancy may range from mild asymptomatic transaminitis to fatal and irreversible deterioration in liver functions leading to significant morbidity and even mortality. In this comprehensive review, we searched articles published as review articles, clinical trials, and case series in the Medline from 1970 to 2012. The overall outcome of ALF in pregnancy depends on the aetiology, timely diagnosis, prompt management, and early referral to a centre equipped in managing medical or obstetric complication. The foetal outcome is affected by the stage of pregnancy in which the mother has a deterioration of the liver function, with a worst prognosis associated with first or second-trimester liver failure. When ALF complicates pregnancy, liver transplantation is the one of the viable options. Management protocols need to be individualised for each case keeping in mind the risk versus benefit to both the mother and the foetus. PMID:25838585

  7. [Special challenges in the highest-elevation acute-care hospital in Europe].

    PubMed

    Marugg, Donat

    2015-04-22

    Oberengadin Hospital in Samedan is faced with particular challenges, as the highest-elevation acute-care hospital in Europe (1750 m = 5,740 ft above sea level). The factors responsible for this are elevation-related and meteorological/climatic influences, as well as seasonal variations in Südbünden's demographic structure due to tourism. PMID:26072605

  8. Angus and Romosinuano steers exhibit differential acute phase responses following an endotoxin challenge

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our primary objective was to elucidate the acute phase response in cattle while evaluating potential genetic differences between two diverse Bos taurus breeds [Angus (AG) and Romosinuano (RO)] in response to an endotoxin challenge. The Romosinuano is a tropically adapted Bos taurus breed developed i...

  9. Profile of the bovine acute-phase response following an intravenous bolus-dose lipopolysaccharide challenge

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Two experiments were conducted to further define the acute-phase response to a lipopolysaccharide (LPS) challenge in beef steers. In Exp. 1, 9 crossbred beef steers (449 ± 12 kg BW) were used in a completely random design to determine the effects of 0.5, 1.0, or 2.0 micrograms of LPS/kilogram of bod...

  10. Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge.

    PubMed

    Stanley, Daphne A; Honko, Anna N; Asiedu, Clement; Trefry, John C; Lau-Kilby, Annie W; Johnson, Joshua C; Hensley, Lisa; Ammendola, Virginia; Abbate, Adele; Grazioli, Fabiana; Foulds, Kathryn E; Cheng, Cheng; Wang, Lingshu; Donaldson, Mitzi M; Colloca, Stefano; Folgori, Antonella; Roederer, Mario; Nabel, Gary J; Mascola, John; Nicosia, Alfredo; Cortese, Riccardo; Koup, Richard A; Sullivan, Nancy J

    2014-10-01

    Ebolavirus disease causes high mortality, and the current outbreak has spread unabated through West Africa. Human adenovirus type 5 vectors (rAd5) encoding ebolavirus glycoprotein (GP) generate protective immunity against acute lethal Zaire ebolavirus (EBOV) challenge in macaques, but fail to protect animals immune to Ad5, suggesting natural Ad5 exposure may limit vaccine efficacy in humans. Here we show that a chimpanzee-derived replication-defective adenovirus (ChAd) vaccine also rapidly induced uniform protection against acute lethal EBOV challenge in macaques. Because protection waned over several months, we boosted ChAd3 with modified vaccinia Ankara (MVA) and generated, for the first time, durable protection against lethal EBOV challenge. PMID:25194571

  11. Biogenic amines and acute thermal stress in the rat

    NASA Technical Reports Server (NTRS)

    Williams, B. A.; Moberg, G. P.

    1975-01-01

    A study is summarized which demonstrates that depletion of the biogenic amines 5-hydroxytryptamine (5-HT) or norepinephrine (NE) alters the normal thermoregulatory responses to acute temperature stress. Specifically, NE depletion caused a significant depression in equilibrium rectal temperature at 22 C and a greater depression in rectal temperature than controls in response to cold (6 C) stress; NE depletion also resulted in a significantly higher rectal temperature response to acute heat (38 C) stress. Depletion of 5-HT had less severe effects. It remains unclear whether the primary site of action of these agents is central or peripheral.

  12. The effects of acute versus chronic health challenges on the behavior of beef cattle.

    PubMed

    Szyszka, O; Tolkamp, B J; Edwards, S A; Kyriazakis, I

    2012-12-01

    The changes in behavior associated with a (subclinical) acute and a chronic health challenge were investigated to assess their potential value for the development of an early disease detection system in beef cattle. The hypothesis was that acute challenges would lead to acute but transient changes in behavior, whereas the converse would be the case during chronic challenges, with changes taking longer to develop, but being more persistent. For this purpose, Holstein-Friesian beef bulls were challenged either with a repeated lipopolysaccharide (LPS) intravenous bolus given at 3 increasing doses over the course of 5 d, or with a single dose of the abomasal parasite Ostertagia ostertagi, acting as models of acute and chronic challenge respectively. A third unchallenged group acted as controls. Fecal and blood samples were taken regularly and analyzed for fecal egg counts (FEC), pepsinogen concentration and LPS antibodies. A sensor was fitted to the front leg of each bull to record activity and posture. Video recordings were taken to monitor drinking and feeding behavior. Antibodies to LPS were detected only after the third LPS challenge. Fecal egg counts were detected 3 wk post infection, and pepsinogen increased roughly at the same time in parasitized bulls. Body weight of parasitized animals was reduced relative to controls after 17 d post infection (P < 0.001), whereas there was no difference in performance between the LPS and control animals (P > 0.05). Effects of LPS on behavior lasted only for a few hours, presenting themselves as reduction in activity approximately 10 h after the first challenge (P = 0.057). The clearest behavioral changes due to parasitism were on posture. Parasitized animals had less frequent (P = 0.003), but longer lying episodes (P = 0.038) than controls. Once established, these changes persisted for 30 d post infection. However, there was no treatment effect on overall activity, measured by the number of steps taken or on total lying time

  13. Acetazolamide attenuates chemical-stimulated but not thermal-stimulated acute pain in mice

    PubMed Central

    Sun, Ya-jie; Chen, Ying; Pang, Chong; Wu, Ning; Li, Jin

    2014-01-01

    Aim: Acetazolamide (AZA), a carbonic anhydrase (CA) inhibitor, has been found to alleviate inflammatory and neuropathic pain in rats. In the present study, we investigated the effects of AZA on thermal- and chemical-stimulated acute pain in mice and the possible mechanisms underlying the effects. Methods: Five acute pain models based on thermal and chemical stimuli were established to investigate the effects of AZA on different types of nociception in mice. The antinociceptive effects of methazolamide (another CA inhibitor) and diazepam (a positive allosteric modulator of GABAA receptor) were also examined. The drugs were administered either intraperitoneally (ip) or intrathecally. Results: AZA (50–200 mg/kg, ip) did not produce analgesia in two thermal-stimulated acute pain models, ie, mouse tail-flick and hot-plate tests. In contrast, AZA (50–200 mg/kg, ip) dose-dependently reduced paw licking time in both capsaicin and formalin tests in mice. A similar result was observed in a mouse acetic acid-induced writhing test. However, AZA (10 nmol/mouse, intrathecally) did not produce significant analgesia in the 3 chemical-stimulated acute pain models. In addition, methazolamide (50–200 mg/kg, ip) and diazepam (0.25–1.0 mg/kg, ip) did not produce significant analgesia in either thermal- or chemical-stimulated acute pain. Conclusion: AZA produces analgesia in chemical-stimulated, but not thermal-stimulated acute pain in mice. The attenuation of chemical-stimulated acute pain by AZA may not be due to enhancement of GABAA receptor-mediated inhibition via inhibiting CA activity but rather a peripheral ion channel-related mechanism. PMID:24335844

  14. Endovascular Interventions in Acute Ischemic Stroke: Recent Evidence, Current Challenges, and Future Prospects.

    PubMed

    Appireddy, Ramana; Zerna, Charlotte; Menon, Bijoy K; Goyal, Mayank

    2016-07-01

    After many years of clinical research, endovascular thrombectomy has been conclusively proven to be an effective treatment in acute ischemic stroke. The evidence is compelling; however, it is generated in high volume stroke centers with stroke expertise. Challenges remain ahead on translating and implementing this evidence in routine clinical care across the world. The current evidence has opened up avenues for further research and innovation in this field. In this review, we will discuss the evolution of evidence on endovascular thrombectomy followed by a discussion of challenges and future prospects in this exciting field of stroke care. PMID:27221502

  15. Heat-shock protein 70 expression in shrimp Fenneropenaeus chinensis during thermal and immune-challenged stress

    NASA Astrophysics Data System (ADS)

    Guo, Zhenyu; Jiao, Chuanzhen; Xiang, Jianhai

    2004-12-01

    Using western immunoblotting we obtained heat-shock protein 70 (HSP70) induction data and distribution in different tissues from shrimp Fenneropenaeus chinensis during thermal and immune-challenged stresses. This is probably the first report of the effects of various stressors on the expression of HSP70 in shrimp. HSP70 was prominently induced in hepatopancreas and gills, but not in muscle, eyestalk and hemolymph, when the shrimp were exposed to heat shock and Vibrio anguillavium-challenged stresses. Cold shock and WSSV treatment had no significant effects on the levels of HSP70 expression in all tissues examined. HSP70 induction was greatest after 2 h exposure to heat shock stress, which was elevated after acute heat shock exposure of 10°C above ambient temperature.

  16. Acute Pancreatitis-Progress and Challenges: A Report on an International Symposium.

    PubMed

    Afghani, Elham; Pandol, Stephen J; Shimosegawa, Tooru; Sutton, Robert; Wu, Bechien U; Vege, Santhi Swaroop; Gorelick, Fred; Hirota, Morihisa; Windsor, John; Lo, Simon K; Freeman, Martin L; Lerch, Markus M; Tsuji, Yoshihisa; Melmed, Gil Y; Wassef, Wahid; Mayerle, Julia

    2015-11-01

    An international symposium entitled "Acute pancreatitis: progress and challenges" was held on November 5, 2014 at the Hapuna Beach Hotel, Big Island, Hawaii, as part of the 45th Anniversary Meeting of the American Pancreatic Association and the Japanese Pancreas Society. The course was organized and directed by Drs. Stephen Pandol, Tooru Shimosegawa, Robert Sutton, Bechien Wu, and Santhi Swaroop Vege. The symposium objectives were to: (1) highlight current issues in management of acute pancreatitis, (2) discuss promising treatments, (3) consider development of quality indicators and improved measures of disease activity, and (4) present a framework for international collaboration for development of new therapies. This article represents a compilation and adaptation of brief summaries prepared by speakers at the symposium with the purpose of broadly disseminating information and initiatives. PMID:26465949

  17. Acute kidney injury: risk factors and management challenges in developing countries.

    PubMed

    Ponce, Daniela; Balbi, Andre

    2016-01-01

    Acute kidney injury (AKI) is a major global health problem in both developed and developing nations, negatively affecting patient morbidity and responsible for an estimated 1.4 million deaths per year. Although the International Society of Nephrology set a goal of eliminating preventable deaths from AKI by 2025, implementation of this program in developing countries presents major challenges not only because of the lack of resources but also because of the scarce data addressing the epidemiology and causes of AKI in developing countries, the limited health care resources to diagnose and treat AKI, and the poor awareness of the impact of AKI on patient outcomes. PMID:27578995

  18. Acute kidney injury: risk factors and management challenges in developing countries

    PubMed Central

    Ponce, Daniela; Balbi, Andre

    2016-01-01

    Acute kidney injury (AKI) is a major global health problem in both developed and developing nations, negatively affecting patient morbidity and responsible for an estimated 1.4 million deaths per year. Although the International Society of Nephrology set a goal of eliminating preventable deaths from AKI by 2025, implementation of this program in developing countries presents major challenges not only because of the lack of resources but also because of the scarce data addressing the epidemiology and causes of AKI in developing countries, the limited health care resources to diagnose and treat AKI, and the poor awareness of the impact of AKI on patient outcomes. PMID:27578995

  19. Dosage-Dependent Proteome Response of Shewanella oneidensis MR-1 to Acute Chromate Challenge

    SciTech Connect

    Thompson, Melissa R; Verberkmoes, Nathan C; Chourey, Karuna; Shah, Manesh B; Thompson, Dorothea K; Hettich, Robert {Bob} L

    2007-01-01

    Proteome alterations in the metal-reducing bacterium Shewanella oneidensis MR-1 in response to different acute dose challenges (0.3, 0.5, or 1 mM) of the toxic metal chromate [Cr(VI)] were characterized with multidimensional HPLC-MS/MS on a linear trapping quadrupole MS. A total of 2,406 functionally diverse proteins were identified, with a subset demonstrating dosage-dependent up- and down-regulated expression, such as proteins involved in detoxification and iron binding and transport.

  20. Khat use and trait anger: effects on affect regulation during an acute stressful challenge.

    PubMed

    Bongard, Stephan; al'Absi, Mustafa; Khalil, Najat Sayem; Al Habori, Molham

    2011-01-01

    Khat (Catha edulis) is a widely used stimulating drug often consumed in daily routine in Yemen and East African countries. Chewing khat acutely elicits states of euphoria and feelings of well-being which later shift into emotional instability and low mood. Little is known about emotional regulation in habitual khat chewers. In this study, we compared self-reports on trait anger as well as positive and negative affect responses to a mental arithmetic challenge. Participants included 135 men and women from Yemen who chew khat regularly, occasionally or not at all. Participants attended a laboratory session that involved resting periods and performing a math challenge. Analyses of variance and regression show that regular khat chewing is associated with higher trait anger, more pronounced negative responses during stress and less pronounced positive emotional states. These results suggest that regular khat chewing is associated with disturbances in emotion regulation processes. PMID:21860244

  1. Neutrophil lipoxygenase metabolism and adhesive function following acute thermal injury.

    PubMed

    Damtew, B; Marino, J A; Fratianne, R B; Spagnuolo, P J

    1993-02-01

    Leukotrienes, especially leukotriene B4, are important modulators of various neutrophil functions including adherence and chemotaxis. In previous work, we demonstrated that neutrophil adherence to extracellular matrixes was diminished in the acute stages of burn injury. In this study, we demonstrated that neutrophil adhesion to human and bovine endothelium in the baseline state and after stimulation with leukotriene B4 is depressed markedly after burn injury. The defect in stimulated adherence to endothelium was not specific to leukotriene B4 because impaired adhesion was observed with n-formyl-methionyl-leucyl-phenylalanine and ionophore A23187 as well. Moreover, the adherence defect correlated with 95% and 81% decreases in the release of leukotriene B4 and 5-hydroxy-(6E,87,117,147)-eicosatetraenoic acid, respectively, from burn PMN treated with A23187. Burn neutrophils also released proportionately more byproducts of leukotriene B4 omega oxidation, particularly 20-COOH-leukotriene B4, than did control neutrophils. When examined 3 1/2 weeks after injury, abnormalities in neutrophil leukotriene B4 generation and the adherence of burn neutrophils had recovered to near normal values. To determine whether the decreased release of leukotriene B4 from burn neutrophils was due to increased degradation or diminished synthesis of leukotriene B4, we examined the degradation of exogenous tritiated leukotriene B4 as well as the production of leukotriene B4 from tritiated arachidonic acid in neutrophils. Burn neutrophils converted significantly greater quantities of tritiated leukotriene B4 to tritiated 20-COOH-leukotriene B4 and synthesized markedly less tritiated leukotriene B4 from tritiated arachidonic acid than did control neutrophils, suggesting that decreased leukotriene B4 release by burn neutrophils was the result of both enhanced degradation and decreased synthesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8381849

  2. Challenges in Acute Heart Failure Clinical Management: Optimizing Care Despite Incomplete Evidence and Imperfect Drugs

    PubMed Central

    Maisel, Alan S.; Storrow, Alan B.

    2015-01-01

    Acute heart failure is a common condition associated with considerable morbidity, mortality, and cost. However, evidence-based data on treating heart failure in the acute setting are limited, and current individual treatment options have variable efficacy. The healthcare team must often individualize patient care in ways that may extend beyond available clinical guidelines. In this review, we address the question, “How do you do the best you can clinically with incomplete evidence and imperfect drugs?” Expert opinion is provided to supplement guideline-based recommendations and help address the typical challenges that are involved in the management of patients with acute heart failure. Specifically, we discuss 4 key areas that are important in the continuum of patient care: differential diagnosis and risk stratification; choice and implementation of initial therapy; assessment of the adequacy of therapy during hospitalization or observation; and considerations for discharge/transition of care. A case study is presented to highlight the decision-making process throughout each of these areas. Evidence is accumulating that should help guide patients and healthcare providers on a path to better quality of care. PMID:25679083

  3. Photo-elastic effect, thermal lensing and depolarization in a-cut tetragonal laser crystals

    NASA Astrophysics Data System (ADS)

    Yumashev, K. V.; Zakharova, A. N.; Loiko, P. A.

    2016-06-01

    We report on analytical description of thermal lensing effect in tetragonal crystals cut along the [1 0 0] crystallographic axis, for the two principal light polarizations, E ┴ c and E || c, under diode-pumping (plane stress approximation). Within this approach, we take into account anisotropy of elastic, photo-elastic, thermal and optical properties of the material. Expressions for the ‘generalized’ thermo-optic coefficient χ are presented. It is shown that astigmatism of thermal lens is determined both by the photo-elastic and end-bulging effects. The sign of the photo-elastic term χ″ can be either positive or negative affecting significantly the sign of the thermal lens. Depolarization loss in a-cut tetragonal crystals is few orders of magnitude lower than that in cubic crystals. Calculations are performed for a-cut tetragonal molybdates, Nd:CaMoO4, Nd:PbMoO4 and Nd:NaBi(MoO4)2.

  4. Necrotizing fasciitis in a young patient with acute myeloid leukemia – a diagnostic challenge

    PubMed Central

    2014-01-01

    Background Necrotizing fasciitis is characterized by a fulminant destruction of the soft tissue with an alarmingly high mortality rate. One of the main reasons for the continued high mortality is due to the challenge to punctual recognize and diagnose this disease, as specific cutaneous signs can vary or even be missing early in its evolution – especially in case of simultaneous first manifestation of an acute leukemia. Case presentation An untypical case of necrotizing fasciitis disease in a young patient with the first diagnosis of acute myeloid leukemia is presented. After her induction chemotherapy the only presenting clinical sign was fever in the presence of severe neutropenia without an evident infectious focus. After a few days a painless confluent, erythematous, pustular skin rash with a central necrosis on lateral thigh appeared. Escherichia coli was isolated from blood cultures. Surgical debridement was performed and showed subcutaneous tissue, fascia and underlying muscle around the site of initial cutaneous manifestation with typical necrosis on exploration. But, initially taken skin biopsy did not show any typical histopathological findings like bacteria or inflammatory cells confirming necrotizing fasciitis. Nevertheless, the intraoperative findings were impressive and highly indicative for a necrotizing soft tissue infection, so that the patient was treated according to clinical guidelines with extensive recurrent surgical debridement, broad-spectrum antibiotics and intensive care therapy. After recovering from NF, she successfully underwent further chemotherapy and stem cell transplantation. Conclusion The presented case highlights the risk of potential misinterpretation, delayed diagnosis and treatment of necrotizing fasciitis in patients presenting with an untypical clinical and histopathological manifestation of necrotizing fasciitis as a result of severe neutropenia following chemotherapy for acute myeloid leukemia. PMID:25002906

  5. The role of gaseous neurotransmitters in the antinociceptive effects of morphine during acute thermal pain.

    PubMed

    Gou, Gemma; Leánez, Sergi; Pol, Olga

    2014-08-15

    Treatment with a carbon monoxide-releasing molecule (tricarbonyldichlororuthenium(II) dimer, CORM-2) or a classical inducible heme oxygenase (HO-1) inducer (cobalt protoporphyrin IX, CoPP) enhanced the antinociceptive effects of morphine during chronic pain but the role played by these compounds in acute thermal nociception was not evaluated. The effects of CORM-2 and CoPP treatments on the local antinociceptive actions of morphine and their interactions with nitric oxide during acute pain were evaluated by using wild type (WT), neuronal (nNOS-KO) or inducible (iNOS-KO) nitric oxide synthase knockout mice and assessing their thermal nociception to a hot stimulus with the hot plate test. Our results showed that the absence of nNOS or iNOS genes did not alter licking and jumping responses nor the antinociceptive effects produced by morphine indicating that the local thermal inhibitory effects produced by this drug in the absence of inflammation or injury are not mediated by the nitric oxide pathway triggered by nNOS or iNOS enzymes. Moreover, while the systemic administration of CORM-2 or CoPP inhibited licking and jumping latencies in all genotypes, these treatments only enhanced the local inhibition of jumping latencies produced by morphine in WT and nNOS-KO mice which effects were reversed by the peripheral administration of an HO-1 inhibitor. These data indicate that the co-administration of morphine with CORM-2 or CoPP produced remarkable local antinociceptive effects in WT and nNOS-KO mice and reveal that a significant interaction between carbon monoxide and nitric oxide systems occurs on the local antinociceptive effects produced by morphine during acute thermal nociception. PMID:24846012

  6. Security surveillance challenges and proven thermal imaging capabilities in real-world applications

    NASA Astrophysics Data System (ADS)

    Francisco, Glen L.; Roberts, Sharon

    2004-09-01

    Uncooled thermal imaging was first introduced to the public in early 1980's by Raytheon (legacy Texas Instruments Defense Segment Electronics Group) as a solution for military applications. Since the introduction of this technology, Raytheon has remained the leader in this market as well as introduced commercial versions of thermal imaging products specifically designed for security, law enforcement, fire fighting, automotive and industrial uses. Today, low cost thermal imaging for commercial use in security applications is a reality. Organizations of all types have begun to understand the advantages of using thermal imaging as a means to solve common surveillance problems where other popular technologies fall short. Thermal imaging has proven to be a successful solution for common security needs such as: ¸ vision at night where lighting is undesired and 24x7 surveillance is needed ¸ surveillance over waterways, lakes and ports where water and lighting options are impractical ¸ surveillance through challenging weather conditions where other technologies will be challenged by atmospheric particulates ¸ low maintenance requirements due to remote or difficult locations ¸ low cost over life of product Thermal imaging is now a common addition to the integrated security package. Companies are relying on thermal imaging for specific applications where no other technology can perform.

  7. Eight challenges faced by general practitioners caring for patients after an acute coronary syndrome.

    PubMed

    Vickery, Alistair; Thompson, Peter L

    2014-11-17

    The general practitioner is essential in the management of the patient who has recently been discharged from hospital following an acute coronary syndrome (ACS), particularly as duration of hospital stay is shorter than in previous decades. GPs caring for patients after an ACS face numerous challenges. Often, the first of these is insufficient or delayed documentation from the discharging hospital, although electronic discharge summaries are alleviating this problem. Post-ACS patients often have comorbidities, and GPs play a key role in managing these. Patients taking dual antiplatelet therapy who need surgery, and post-ACS patients with atrial fibrillation, require particular care from GPs. Patients will often approach their GP for advice on the safety of other drugs, such as smoking cessation medication, and phosphodiesterase type 5 inhibitors for erectile dysfunction. For patients complaining of persistent lethargy after an ACS, GPs must consider several differential diagnoses, including depression, hypotension, hypovolaemia, and side effects of β-blockers. GPs play an important ongoing role in ensuring that target cholesterol levels are reached with statin therapy; this includes ensuring long-term adherence. They may also need to advise patients who want to stop statin therapy, usually due to perceived side effects. Many of these challenges can be met with improved and respectful communication between the hospital, the treating cardiologist and the GP. The patient needs to be closely involved in the decision-making process, particularly when balancing the risks of bleeding versus thrombosis. PMID:25390497

  8. Potential and challenges in use of thermal imaging for humid region irrigation system management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Thermal imaging has shown potential to assist with many aspects of irrigation management including scheduling water application, detecting leaky irrigation canals, and gauging the overall effectiveness of water distribution networks used in furrow irrigation. Many challenges exist for the use of the...

  9. Prenatal transportation alters the acute phase response (APR) of bull calves exposed to a lipopolysaccharide (LPS) challenge

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study was designed to determine if prenatal transportation influences the acute phase response (APR) to a postnatal Lipopolysaccharide (LPS) challenge. Pregnant Brahman cows (n=96) matched by age and parity were separated into transported (TRANS; n=48; transported for 2 hours on gestational day...

  10. Rising to the Challenge: Acute Stress Appraisals and Selection Centre Performance in Applicants to Postgraduate Specialty Training in Anaesthesia

    ERIC Educational Resources Information Center

    Roberts, Martin J.; Gale, Thomas C. E.; McGrath, John S.; Wilson, Mark R.

    2016-01-01

    The ability to work under pressure is a vital non-technical skill for doctors working in acute medical specialties. Individuals who evaluate potentially stressful situations as challenging rather than threatening may perform better under pressure and be more resilient to stress and burnout. Training programme recruitment processes provide an…

  11. Supplementation of Lactobacillus acidophilus fermentation product can attenuate the acute phase response following a lipopolysaccharide challenge in pigs.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study was designed to determine if feeding a Lactobacillus acidophilus fermentation product to weaned pigs would reduce stress and acute phase responses (APR) following a lipopolysaccharide (LPS) challenge. Pigs (n=30; 6.4±0.1 kilograms body weight) were housed individually in pens with ad libi...

  12. Improved BVDV1b challenge model for evaluating efficacy of protection against clinical signs following acute infection

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Introduction: Efficacy of bovine viral diarrhea virus (BVDV) vaccines in preventing acute infections is evaluated based on reduction of clinical disease. While high virulence BVDV2 strains are used in U.S. vaccine efficacy studies, the BVDV1 strain, NY-1, made available by the USDA as a challenge ...

  13. Acute pain management in opioid-tolerant patients: a growing challenge.

    PubMed

    Huxtable, C A; Roberts, L J; Somogyi, A A; MacIntyre, P E

    2011-09-01

    In Australia and New Zealand, in parallel with other developed countries, the number of patients prescribed opioids on a long-term basis has grown rapidly over the last decade. The burden of chronic pain is more widely recognised and there has been an increase in the use of opioids for both cancer and non-cancer indications. While the prevalence of illicit opioid use has remained relatively stable, the diversion and abuse of prescription opioids has escalated, as has the number of individuals receiving methadone or buprenorphine pharmacotherapy for opioid addiction. As a result, the proportion of opioid-tolerant patients requiring acute pain management has increased, often presenting clinicians with greater challenges than those faced when treating the opioid-naïve. Treatment aims include effective relief of acute pain, prevention of drug withdrawal, assistance with any related social, psychiatric and behavioural issues, and ensuring continuity of long-term care. Pharmacological approaches incorporate the continuation of usual medications (or equivalent), short-term use of sometimes much higher than average doses of additional opioid, and prescription of non-opioid and adjuvant drugs, aiming to improve pain relief and attenuate opioid tolerance and/or opioid-induced hyperalgesia. Discharge planning should commence at an early stage and may involve the use of a 'Reverse Pain Ladder' aiming to limit duration of additional opioid use. Legislative requirements may restrict which drugs can be prescribed at the time of hospital discharge. At all stages, there should be appropriate and regular consultation and liaison with the patient, other treating teams and specialist services. PMID:21970125

  14. Acute myocardial infarction: the enduring challenge for cardiac protection and survival.

    PubMed

    Yasuda, Satoshi; Shimokawa, Hiroaki

    2009-11-01

    Although considerable advances have been made in the diagnosis and management of acute myocardial infarction (AMI), the disorder is still a major cause of morbidity and mortality worldwide and continues to pose significant therapeutic challenges. The use of biomarkers to aid the diagnosis of AMI is now increasing and has enabled better understanding of the pathophysiology of the disorder and identification of patients who require urgent reperfusion therapy. Early percutaneous coronary intervention (PCI) appears to be beneficial when performed in a timely manner with a door-to-balloon time <90 min. The goal of PCI is now shifting from simple revascularization of occluded coronary arteries to optimum reperfusion at the microvascular level. Effective strategies and pharmacological agents need to be developed for better cardiac protection during AMI. Most deaths resulting from AMI occur within 1 h of its onset, and half of them occur before hospital admission. Thus, an effective pre-hospital lifeline system should be an important priority, achieved through the chain of survival, including the immediate implementation of definitive resuscitative efforts and rapidly transporting the patients to the hospital. PMID:19809203

  15. Targeting thrombin long-term after an acute coronary syndrome: Opportunities and challenges.

    PubMed

    De Caterina, Raffaele; Goto, Shinya

    2016-06-01

    Patients after an acute coronary syndrome (ACS) are at increased risk of recurrent thrombotic events, justifying the search for additional antithrombotic treatments. The pathophysiology of ACS involves arterial thrombus formation, in turn occurring because of a combination of platelet activation and fibrin formation, with thrombin playing a key role in both. Antiplatelet therapy, targeting the thromboxane pathway and the ADP P2Y12 receptor has been widely accepted for secondary prevention after an ACS. Now, data from recent clinical trials in such patients also encourage the pursuit of inhibiting thrombin formation or thrombin-mediated platelet activation in addition to antiplatelet therapy. This "triple pathway inhibition", including inhibition of thrombin activity or thrombin receptor(s), is currently an option in pure ACS, but already a must in the setting of ACS accompanied by atrial fibrillation (AF), where anticoagulants have been shown to be much more effective than antiplatelet agents in preventing stroke. We here discuss the challenges of managing combined thrombin activity or receptor inhibition and antiplatelet therapy in all such patients. Translating this into practice still requires further studies and patient tailoring to fully exploit its potential. PMID:26994821

  16. Challenges in the Anesthetic and Intensive Care Management of Acute Ischemic Stroke.

    PubMed

    Kirkman, Matthew A; Lambden, Simon; Smith, Martin

    2016-07-01

    Acute ischemic stroke (AIS) is a devastating condition with high morbidity and mortality. In the past 2 decades, the treatment of AIS has been revolutionized by the introduction of several interventions supported by class I evidence-care on a stroke unit, intravenous tissue plasminogen activator within 4.5 hours of stroke onset, aspirin commenced within 48 hours of stroke onset, and decompressive craniectomy for supratentorial malignant hemispheric cerebral infarction. There is new class I evidence also demonstrating benefits of endovascular therapy on functional outcomes in those with anterior circulation stroke. In addition, the importance of the careful management of key systemic physiological variables, including oxygenation, blood pressure, temperature, and serum glucose, has been appreciated. In line with this, the role of anesthesiologists and intensivists in managing AIS has increased. This review highlights the main challenges in the endovascular and intensive care management of AIS that, in part, result from the paucity of research focused on these areas. It also provides guidelines for the management of AIS based upon current evidence, and identifies areas for further research. PMID:26368664

  17. Genetic Abnormalities and Challenges in the Treatment of Acute Myeloid Leukemia

    PubMed Central

    Kumar, C. Chandra

    2011-01-01

    Acute myeloid leukemia (AML) is a hematopoietic disorder in which there are too many immature blood-forming cells accumulating in the bone marrow and interfering with the production of normal blood cells. It has long been recognized that AML is a clinically heterogeneous disease characterized by a multitude of chromosomal abnormalities and gene mutations, which translate to marked differences in responses and survival following chemotherapy. The cytogenetic and molecular genetic aberrations associated with AML are not mutually exclusive and often coexist in the leukemic cells. AML is a disease of the elderly, with a mean age of diagnosis of 70 years. Adverse cytogenetic abnormalities increase with age, and within each cytogenetic group, prognosis with standard treatment worsens with age. In the past 20 years, there has been little improvement in chemotherapeutic regimens and hence the overall survival for patients with AML. A huge unmet need exists for efficacious targeted therapies for elderly patients that are less toxic than available chemotherapy regimens. The multitude of chromosomal and genetic abnormalities makes the treatment of AML a challenging prospect. A detailed understanding of the molecular changes associated with the chromosomal and genetic abnormalities in AML is likely to provide a rationale for therapy design and biomarker development. This review summarizes the variety of cytogenetic and genetic changes observed in AML and gives an overview of the clinical status of new drugs in development. PMID:21779483

  18. Early weaning alters the acute-phase reaction to an endotoxin challenge in beef calves.

    PubMed

    Carroll, J A; Arthington, J D; Chase, C C

    2009-12-01

    Previous research indicates that early weaning before shipment can reduce transportation-induced increases in acute-phase proteins (APP) and can increase feedlot performance in beef calves. These data suggest that the combination of weaning and transport stress may compromise the immune system of calves, thus hindering subsequent performance and health. Therefore, our objective was to determine if the innate immune response of early weaned calves (EW; 80 d of age) differed from normal-weaned calves (NW; 250 d of age) in response to an endotoxin challenge. Eighteen Brahman x Angus calves (8 and 10 EW and NW, respectively; 233 +/- 5 kg of BW) were used. Calves were maintained on pasture with supplement and then moved into individual pens for 1 wk of acclimation before the start of the study. Calves were fitted with an indwelling jugular catheter 1 d before LPS challenge (0 h; 1.0 microg/kg of BW, intravenously). Blood samples were collected at 30-min intervals from -2 to 8 h. Serum samples were stored at -80 degrees C until analyzed for cortisol, tumor necrosis factor-alpha (TNF), IL-1 beta, IL-6, interferon-gamma (IFN), ceruloplasmin, and haptoglobin. Whereas LPS increased serum cortisol (P or= 0.15) was observed. A weaning age x time interaction (P challenge compared with that of NW calves. Additionally, the differential IFN response indicates that the immune system of EW calves may be more

  19. Human thermal bioclimatic conditions associated with acute cardiovascular syndromes in Crete Island, Greece

    NASA Astrophysics Data System (ADS)

    Bleta, Anastasia G.; Nastos, Panagiotis T.

    2013-04-01

    The aim of this study is to quantify the association between bioclimatic conditions and daily counts of admissions for non-fatal acute cardiovascular (acute coronary syndrome, arrhythmia, decompensation of heart failure) syndromes (ACS) registered by the two main hospitals in Heraklion, Crete Island, during a five-year period 2008-2012. The bioclimatic conditions analyzed are based on human thermal bioclimatic indices such as the Physiological Equivalent Temperature (PET) and the Universal Thermal Climate Index (UTCI). Mean daily meteorological parameters, such as air temperature, relative humidity, wind speed and cloudiness, were acquired from the meteorological station of Heraklion (Hellenic National Meteorological Service). These parameters were used as input variables in modeling the aforementioned thermal indices, in order to interpret the grade of the thermo-physiological stress. The PET and UTCI analysis was performed by the use of the radiation and bioclimate model, "RayMan", which is well-suited to calculate radiation fluxes and human biometeorological indices. Generalized linear models (GLM) were applied to time series of daily numbers of outpatients with ACS against bioclimatic variations, after controlling for possible confounders and adjustment for season and trends. The interpretation of the results of this analysis suggests a significant association between cold weather and increased coronary heart disease incidence, especially in the elderly and males. Additionally, heat stress plays an important role in the configuration of daily ACS outpatients, even in temperate climate, as that in Crete Island. In this point it is worth mentioning that Crete Island is frequently affected by Saharan outbreaks, which are associated in many cases with miscellaneous phenomena, such as Föhn winds - hot and dry winds - causing extreme bioclimatic conditions (strong heat stress). Taking into consideration the projected increased ambient temperature in the future, ACS

  20. Thermal Energy for Lunar In Situ Resource Utilization: Technical Challenges and Technology Opportunities

    NASA Technical Reports Server (NTRS)

    Gordon, Pierce E. C.; Colozza, Anthony J.; Hepp, Aloysius F.; Heller, Richard S.; Gustafson, Robert; Stern, Ted; Nakamura, Takashi

    2011-01-01

    Oxygen production from lunar raw materials is critical for sustaining a manned lunar base but is very power intensive. Solar concentrators are a well-developed technology for harnessing the Sun s energy to heat regolith to high temperatures (over 1375 K). The high temperature and potential material incompatibilities present numerous technical challenges. This study compares and contrasts different solar concentrator designs that have been developed, such as Cassegrains, offset parabolas, compound parabolic concentrators, and secondary concentrators. Differences between concentrators made from lenses and mirrors, and between rigid and flexible concentrators are also discussed. Possible substrate elements for a rigid mirror concentrator are selected and then compared, using the following (target) criteria: (low) coefficient of thermal expansion, (high) modulus of elasticity, and (low) density. Several potential lunar locations for solar concentrators are compared; environmental and processing-related challenges related to dust and optical surfaces are addressed. This brief technology survey examines various sources of thermal energy that can be utilized for materials processing on the lunar surface. These include heat from nuclear or electric sources and solar concentrators. Options for collecting and transporting thermal energy to processing reactors for each source are examined. Overall system requirements for each thermal source are compared and system limitations, such as maximum achievable temperature are discussed.

  1. Haematological malignancies and acute kidney injury requiring nephrology consultation: challenging the worst of the worst

    PubMed Central

    Chuva, Teresa; Maximino, José; Barbosa, Joselina; Silva, Sandra; Paiva, Ana; Baldaia, Jorge; Loureiro, Alfredo

    2016-01-01

    Background Acute kidney injury (AKI) often complicates the course of haematological malignancies (HMs) and confers a worse prognosis. The majority of these patients are managed by the attending physician, yet, a small group, mostly coincident with the worst presentation and outcomes, requires nephrology consultation, challenging the clinician with ethical issues regarding the decision to initiate or forgo renal support therapy. The purpose of this work is to identify the prognostic determinants for in-hospital mortality in this population. Methods A retrospective, observational chart review was undertaken at a single tertiary referral oncological centre. We reviewed the medical records of in-hospital patients with AKI and HM between 1 January 1995 and 31 December 2014 who met the criteria for RIFLE (Risk, Injury, and Failure; and Loss; and End-stage kidney disease) classification of I or higher and were followed by a nephrologist. Results Three hundred and forty-five patients were included in the study. Predictors of in-hospital death in patients with HM and AKI were septic shock [odds ratio (OR) 4.290 (95% CI 2.058–8.943)], invasive mechanical ventilation (IMV) [OR 4.305 (95% CI 2.075–8.928)] and allogeneic stem cell transplantation (SCT) [OR 2.232 (95% CI 1.260–3.953)]. The combination of each risk factor was used to estimate the probability of dying. Patients with all three risk factors had a risk of death of 86%. Conclusions Septic shock, IMV and allogeneic SCT were identified as independent predictors of death in patients with HM and AKI, with only a small chance of survival if all three were present. Depending on the combination of risk factors, the indication for aggressive life support therapies, such as RST, might be questionable. PMID:27274827

  2. Whole-body and splanchnic amino acid metabolism in sheep during an acute endotoxin challenge.

    PubMed

    McNeil, C J; Hoskin, S O; Bremner, D M; Holtrop, G; Lobley, G E

    2016-07-01

    Supplemented protein or specific amino acids (AA) are proposed to help animals combat infection and inflammation. The current study investigates whole-body and splanchnic tissue metabolism in response to a lipopolysaccharide (LPS) challenge with or without a supplement of six AA (cysteine, glutamine, methionine, proline, serine and threonine). Eight sheep were surgically prepared with vascular catheters across the gut and liver. On two occasions, four sheep were infused through the jugular vein for 20 h with either saline or LPS from Escherichia coli (2 ng/kg body weight per min) in a random order, plus saline infused into the mesenteric vein; the other four sheep were treated with saline or LPS plus saline or six AA infused via the jugular vein into the mesenteric vein. Whole-body AA irreversible loss rate (ILR) and tissue protein metabolism were monitored by infusion of [ring-2H2]phenylalanine. LPS increased (P<0·001) ILR (+17 %), total plasma protein synthesis (+14 %) and lymphocyte protein synthesis (+386 %) but decreased albumin synthesis (-53 %, P=0·001), with no effect of AA infusion. Absorption of dietary AA was not reduced by LPS, except for glutamine. LPS increased the hepatic removal of leucine, lysine, glutamine and proline. Absolute hepatic extraction of supplemented AA increased, but, except for glutamine, this was less than the amount infused. This increased net appearance across the splanchnic bed restored arterial concentrations of five AA to, or above, values for the saline-infused period. Infusion of key AA does not appear to alter the acute period of endotoxaemic response, but it may have benefits for the chronic or recovery phases. PMID:27189533

  3. Technical challenges and future direction for high-efficiency metal hydride thermal energy storage systems

    NASA Astrophysics Data System (ADS)

    Ward, Patrick A.; Corgnale, Claudio; Teprovich, Joseph A.; Motyka, Theodore; Hardy, Bruce; Sheppard, Drew; Buckley, Craig; Zidan, Ragaiy

    2016-04-01

    Recently, there has been increasing interest in thermal energy storage (TES) systems for concentrated solar power (CSP) plants, which allow for continuous operation when sunlight is unavailable. Thermochemical energy storage materials have the advantage of much higher energy densities than latent or sensible heat materials. Furthermore, thermochemical energy storage systems based on metal hydrides have been gaining great interest for having the advantage of higher energy densities, better reversibility, and high enthalpies. However, in order to achieve higher efficiencies desired of a thermal storage system by the US Department of Energy, the system is required to operate at temperatures >600 °C. Operation at temperatures >600 °C presents challenges including material selection, hydrogen embrittlement and permeation of containment vessels, appropriate selection of heat transfer fluids, and cost. Herein, the technical difficulties and proposed solutions associated with the use of metal hydrides as TES materials in CSP applications are discussed and evaluated.

  4. Rapid changes in cell physiology as a result of acute thermal stress house sparrows, Passer domesticus.

    PubMed

    Jimenez, Ana G; Williams, Joseph B

    2014-12-01

    Given that our climate is rapidly changing, Physiological Ecologists have the critical task of identifying characteristics of species that make them either resilient or susceptible to changes in their natural air temperature regime. Because climate change models suggest that heat events will become more common, and in some places more extreme, it is important to consider how extreme heat events might affect the physiology of a species. The implications of more frequent heat wave events for birds have only recently begun to be addressed, however, the impact of these events on the cellular physiology of a species is difficult to assess. We have developed a novel approach using dermal fibroblasts to explore how short-term thermal stress at the whole animal level might affect cellular rates of metabolism. House sparrows, Passer domesticus were separated into a "control group" and a "heat shocked" group, the latter acclimated to 43°C for 24h. We determined the plasticity of cellular thermal responses by assigning a "recovery group" that was heat shocked as above, but then returned to room temperature for 24h. Primary dermal fibroblasts were grown from skin of all treatment groups and the pectoralis muscle was collected. We found that glycolysis (ECAR) and oxygen consumption rates (OCR), measured using a Seahorse XF 96 analyzer, were significantly higher in the fibroblasts from the heat shocked group of House sparrows compared with their control counterparts. Additionally, muscle fiber diameters decreased and, in turn, Na(+)-K(+)-ATPase maximal activity in the muscle significantly increased in heat shocked sparrows compared with birds in the control group. All of these physiological alterations due to short-term heat exposure were reversible within 24h of recovery at room temperature. These results show that acute exposure to heat stress significantly alters the cellular physiology of sparrows, but that this species is plastic enough to recover from such a thermal

  5. Hypohydration and acute thermal stress affect mood state but not cognition or dynamic postural balance.

    PubMed

    Ely, Brett R; Sollanek, Kurt J; Cheuvront, Samuel N; Lieberman, Harris R; Kenefick, Robert W

    2013-04-01

    Equivocal findings have been reported in the few studies that examined the impact of ambient temperature (T a) and hypohydration on cognition and dynamic balance. The purpose of this study was to determine the impact of acute exposure to a range of ambient temperatures (T(a) 10-40 °C) in euhydration (EUH) and hypohydration (HYP) states on cognition, mood and dynamic balance. Thirty-two men (age 22 ± 4 years, height 1.80 ± 0.05 m, body mass 85.4 ± 10.8 kg) were grouped into four matched cohorts (n = 8), and tested in one of the four T(a) (10, 20, 30, 40 °C) when EUH and HYP (-4 % body mass via exercise-heat exposure). Cognition was assessed using psychomotor vigilance, 4-choice reaction time, matching to sample, and grammatical reasoning. Mood was evaluated by profile of mood states and dynamic postural balance was tested using a Biodex Balance System. Thermal sensation (TS), core (T core) and skin temperature (T(sk)) were obtained throughout testing. Volunteers lost -4.1 ± 0.4 % body mass during HYP. T sk and TS increased with increasing T(a), with no effect of hydration. Cognitive performance was not altered by HYP or thermal stress. Total mood disturbance (TMD), fatigue, confusion, anger, and depression increased during HYP at all T(a). Dynamic balance was unaffected by HYP, but 10 °C exposure impaired balance compared to all other T(a). Despite an increase in TMD during HYP, cognitive function was maintained in all testing environments, demonstrating cognitive resiliency in response to body fluid deficits. Dynamic postural stability at 10 °C appeared to be hampered by low-grade shivering, but was otherwise maintained during HYP and thermal stress. PMID:23064870

  6. Early treatment of hypertension in acute ischemic and intracerebral hemorrhagic stroke: progress achieved, challenges, and perspectives.

    PubMed

    Feldstein, Carlos A

    2014-03-01

    Hypertension is the leading risk factor for ischemic and intracerebral hemorrhagic subtypes of stroke. Additionally, high blood pressure (BP) in the acute cerebrovascular event is associated with poor outcome, and a high percentage of stroke survivors have inadequate control of hypertension. The present is a systematic review of prospective, randomized, and controlled trials carried out on safety and efficacy of antihypertensive treatment of both subtypes of acute stroke. Six trials involving 7512 patients were included, which revealed controversies on the speed and the goals of treatment. These controversies could be due at least in part, from the fact that some studies analyzed the results of antihypertensive treatment in ischemic and intracerebral hemorrhagic subtypes of acute stroke together, and from a different prevalence of past-stroke in the randomized groups. Further research is necessary to establish whether standard antihypertensive treatment provides greater benefit than simple observation in patients with ischemic acute stroke and Stage 2 hypertension of JNC 7, albeit they were not candidates for acute reperfusion. In that case, the target reduction in BP could be 10% to 15% within 24 hours. The recently published INTERACT 2 has provided evidence that patients with hemorrhagic stroke may receive intensive antihypertensive treatment safely with the goal of reducing systolic BP to levels no lower than 130 mm Hg. It is important to take into account that marked BP lowering in acute stroke increases the risk of poor outcome by worsening cerebral ischemia from deterioration of cerebral blood flow autoregulation. PMID:24220549

  7. Rising to the challenge: acute stress appraisals and selection centre performance in applicants to postgraduate specialty training in anaesthesia.

    PubMed

    Roberts, Martin J; Gale, Thomas C E; McGrath, John S; Wilson, Mark R

    2016-05-01

    The ability to work under pressure is a vital non-technical skill for doctors working in acute medical specialties. Individuals who evaluate potentially stressful situations as challenging rather than threatening may perform better under pressure and be more resilient to stress and burnout. Training programme recruitment processes provide an important opportunity to examine applicants' reactions to acute stress. In the context of multi-station selection centres for recruitment to anaesthesia training programmes, we investigated the factors influencing candidates' pre-station challenge/threat evaluations and the extent to which their evaluations predicted subsequent station performance. Candidates evaluated the perceived stress of upcoming stations using a measure of challenge/threat evaluation-the cognitive appraisal ratio (CAR)-and consented to release their demographic details and station scores. Using regression analyses we determined which candidate and station factors predicted variation in the CAR and whether, after accounting for these factors, the CAR predicted candidate performance in the station. The CAR was affected by the nature of the station and candidate gender, but not age, ethnicity, country of training or clinical experience. Candidates perceived stations involving work related tasks as more threatening. After controlling for candidates' demographic and professional profiles, the CAR significantly predicted station performance: 'challenge' evaluations were associated with better performance, though the effect was weak. Our selection centre model can help recruit prospective anaesthetists who are able to rise to the challenge of performing in stressful situations but results do not support the direct use of challenge/threat data for recruitment decisions. PMID:26271681

  8. How can we keep patients with dementia safe in our acute hospitals? A review of challenges and solutions

    PubMed Central

    George, Jim; Long, Susannah; Vincent, Charles

    2013-01-01

    Maintaining patient safety in acute hospitals is a global health challenge. Traditionally, patient safety measures have been concentrated on critical care and surgical patients. In this review the medical literature was reviewed over the last ten years on aspects of patient safety specifically related to patients with dementia. Patients with dementia do badly in hospital with frequent adverse events resulting in the geriatric syndromes of falls, delirium and loss of function with increased length of stay and increased mortality. Contributory factors include inadequate assessment and treatment, inappropriate intervention, discrimination, low staff levels and lack of staff training. Unfortunately there is no one simple solution to this problem, but what is needed is a multifactorial, multilevel approach at the seven levels of care – patient, task, staff, team, environment, organisation and institution. Improving safety and quality of care for patients with dementia in acute hospitals will benefit all patients and is an urgent priority for the NHS. PMID:23759885

  9. The challenges of fuel options for the new generation of Indian thermal power plants

    SciTech Connect

    Roy, C.; Pande, S.; Sanyal, A.

    1999-11-01

    The selection of fuel supply is probably the most important challenge a potential power project developer for a new Indian thermal power plant has to face when considering the overall project economics. The paper reviews the essential issues and the effect of fuel selection on project costs of the new generation of thermal power plants of India. The electric power sector has taken great strides since the beginning of the planning process, over 45 years ago. It has been unable to keep pace with the rapid growth of demand, primarily due to resource constraints. Changes in the Government policy in 1991 brought fundamental changes to the power sector. The opening up of the sector and the consequent changes in the power policy, evoked great interest from private local and foreign-investors. However, mainly dud to the poor financial position of the State Electricity Boards (SEBs), few proposals settled. Uncertainty relating to fuel, multiple negotiating agencies and financing posed great challenges for developers. As of March 1997, the installed capacity of Indian utilities was 85,266 MW. Power generation in 1996--97 was 394 billion units with a plant load factor of a more 64.5%.

  10. A challenging diagnosis for potential fatal diseases: recommendations for diagnosing acute porphyrias.

    PubMed

    Ventura, Paolo; Cappellini, Maria Domenica; Biolcati, Gianfranco; Guida, Claudio Carmine; Rocchi, Emilio

    2014-07-01

    Acute porphyrias are a heterogeneous group of metabolic disorders resulting from a variable catalytic defect of four enzymes out of the eight involved in the haem biosynthesis pathway; they are rare and mostly inherited diseases, but in some circumstances, the metabolic disturbance may be acquired. Many different environmental factors or pathological conditions (such as drugs, calorie restriction, hormones, infections, or alcohol abuse) often play a key role in triggering the clinical exacerbation (acute porphyric attack) of these diseases that may often mimic many other more common acute medical and neuropsychiatric conditions and whose delayed diagnosis and treatment may be fatal. In order to obtain an accurate diagnosis of acute porphyria, the knowledge and the use of appropriate diagnostic tools are mandatory, even in order to provide as soon as possible the more effective treatment and to prevent the use of potentially unsafe drugs, which can severely precipitate these diseases, especially in the presence of life-threatening symptoms. In this paper, we provide some recommendations for the diagnostic steps of acute porphyrias by reviewing literature and referring to clinical experience of the board members of the Gruppo Italiano Porfiria (GrIP). PMID:24809927

  11. Acute Chagas Disease: New Global Challenges for an Old Neglected Disease

    PubMed Central

    Andrade, Daniela V.; Gollob, Kenneth J.; Dutra, Walderez O.

    2014-01-01

    Chagas disease is caused by infection with the protozoan Trypanosoma cruzi, and although over 100 years have passed since the discovery of Chagas disease, it still presents an increasing problem for global public health. A plethora of information concerning the chronic phase of human Chagas disease, particularly the severe cardiac form, is available in the literature. However, information concerning events during the acute phase of the disease is scarce. In this review, we will discuss (1) the current status of acute Chagas disease cases globally, (2) the immunological findings related to the acute phase and their possible influence in disease outcome, and (3) reactivation of Chagas disease in immunocompromised individuals, a key point for transplantation and HIV infection management. PMID:25077613

  12. Acute abdominal pain in patients with lassa fever: Radiological assessment and diagnostic challenges

    PubMed Central

    Eze, Kenneth C.; Salami, Taofeek A.; Kpolugbo, James U.

    2014-01-01

    Background: To highlight the problems of diagnosis and management of acute abdomen in patients with lassa fever. And to also highlight the need for high index of suspicion of lassa fever in patients presenting with acute abdominal pain in order to avoid surgical intervention with unfavourable prognosis and nosocomial transmission of infections, especially in Lassa fever-endemic regions. Materials and Methods: A review of experiences of the authors in the management of lassa fever over a 4-year period (2004-2008). Literature on lassa fever, available in the internet and other local sources, was studied in November 2010 and reviewed. Results: Normal plain chest radiographic picture can change rapidly due to pulmonary oedema, pulmonary haemorrhage and acute respiratory distress syndrome. Plain abdominal radiograph may show dilated bowels with signs of paralytic ileus or dynamic intestinal obstruction due to bowel wall haemorrhage or inflamed and enlarged Peyer's patches. Ultrasound may show free intra-peritoneal fluid due to peritonitis and intra-peritoneal haemorrhage. Bleeding into the gall bladder wall may erroneously suggest infective cholecystitis. Pericardial effusion with or without pericarditis causing abdominal pain may be seen using echocardiography. High index of suspicion, antibody testing for lassa fever and viral isolation in a reference laboratory are critical for accurate diagnosis. Conclusion: Patients from lassa fever-endemic regions may present with features that suggest acute abdomen. Radiological studies may show findings that suggest acute abdomen but these should be interpreted in the light of the general clinical condition of the patient. It is necessary to know that acute abdominal pain and vomiting in lassa fever-endemic areas could be caused by lassa fever, which is a medical condition. Surgical option should be undertaken with restraint as it increases the morbidity, may worsen the prognosis and increase the risk of nosocomial transmission

  13. Mucormycosis Rhinosinusitis at Diagnosis of Acute Lymphoblastic Leukemia: Diagnostics and Management Challenges in a Low-Middle-income Country.

    PubMed

    Mandegari, Elham; Fu, Ligia; Arambú, Carolina; Montoya, Sandra; Peña, Armando; Johnson, Kyle M; Perfect, John R; Caniza, Miguela A

    2015-04-01

    We present the case of an adolescent with mucor rhinosinusitis diagnosed concomitantly with acute lymphoblastic leukemia at a hospital in Tegucigalpa, Honduras. We also discuss the challenges faced in the dual management of hematologic malignancies and invasive fungal disease in a low-middle-income country, such as access to diagnostics, immunosuppressants, imaging, and antifungals. Despite these shortcomings, the patient was successfully treated for both the diseases. Low-middle-income country hospitals can effectively treat invasive fungal diseases by providing adequate diagnostic and support services, which can improve the outcomes of pediatric cancer patients. PMID:24942033

  14. Fulminant isolated cardiac sarcoidosis with pericardial effusion and acute heart failure: Challenging aspects of diagnosis and treatment

    PubMed Central

    Fluschnik, Nina; Lund, Gunnar; Becher, Peter Moritz; Blankenberg, Stefan; Muellerleile, Kai

    2016-01-01

    This case report illustrates challenging aspects of diagnosis and treatment of isolated sarcoid heart disease (SHD) and the role of cardiovascular magnetic resonance (CMR) imaging. Here, we present a previously healthy 45-year-old man, who was admitted with pericardial effusion and symptoms of acute heart failure. CMR followed by targeted left ventricular endomyocardial biopsy (EMB) revealed the diagnosis of isolated SHD. The combined use of CMR and EMB was crucial in diagnosing SHD. Furthermore, this case report demonstrates the value of CMR for monitoring response to therapy and lesion healing. PMID:26989672

  15. Calcium/calmodulin-dependent protein kinase IV mediates acute nicotine-induced antinociception in acute thermal pain tests

    PubMed Central

    Jackson, Kia J.; Damaj, M. Imad

    2014-01-01

    Calcium activated second messengers such as calcium/calmodulin-dependent protein kinase II have been implicated in drug-induced antinociception. The less abundant calcium activated second messenger, calcium/calmodulin-dependent protein kinase IV (CaMKIV), mediates emotional responses to pain and tolerance to morphine analgesia; however its role in nicotine-mediated antinociception is currently unknown. The goal of this study was to evaluate the role of CaMKIV in the acute effects of nicotine, primarily acute nicotine- induced antinociception. CaMKIV knockout (−/−), heterozygote (+/−), and wild-type (+/+) mice were injected with various doses of nicotine and evaluated in a battery of tests, including the tail-flick and hot-plate tests for antinociception, body temperature, and locomotor activity. Our results show a genotype-dependent reduction in tail-flick and hot- plate latency in CaMKIV (+/−) and (−/−) mice after acute nicotine treatment, while no difference was observed between genotypes in the body temperature and locomotor activity assessments. The results of this study support a role for CaMKIV in acute nicotine-induced spinal and supraspinal pain mechanisms, and further implicate involvement of calcium-dependent mechanisms in drug-induced antinociception. PMID:24196027

  16. THE ACUTE PHASE RESPONSE IN E. COLI CHALLENGED PIGS TREATED WITH SYSTEMIC ANTIBIOTICS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Changes in serum C-reactive protein (CRP), haptoglobin (HG) and cortisol (CS), and rectal temperature (RT) were evaluated in response to an acute enterotoxemia elicited by antibiotic injection. Twenty-four, 24-day old, pigs were individually housed and provided feed and water ad libitum. Twelve pig...

  17. Early weaning alters the acute phase response to an endotoxin challenge in beef calves

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Previous research indicates that early weaning prior to shipment can reduce transportation-induced increases in acute phase proteins (APP), and can increase subsequent performance in the feedlot. These data suggest that the combination of weaning and transport stress may compromise the immune system...

  18. Heart rate in Palaemon northropi (Rankin) in relation to acute changes in thermal environment

    SciTech Connect

    Swanson, C.J.; Wingard, C.; Kitakis, F. )

    1991-03-15

    The Glass Shrimp (Palaemon northropi), common to shallow water/tide pool environs of Atlantic waters, was examined in a series of experiments whereby the temperature-dependence of steady-state heart rate was assessed after acute, controlled changed in their thermal environment. Collection site, tide pool variations averaged 17.2-31.6C/24 hr. period. Accordingly, steady-state heart rates were determined at 5, 15, 25, and 30C by using both timed, optical recording and impedance methods. Mean values obtained were 88bpm (5C), 181 bpm(15C), 236bpm(25C), and 52bpm(30C). Calculated Q{sub 10} determinations ranged from the limits of 1.3 to 2.1 excluding the highest temperature state used. Specimens used averaged 0.62gm wet body weight, and no significant difference between males and gravid females was found. Additionally, the impedance method employed allowed for more precise rate determinations at high heart rates: at the lower heart rates, there was no difference between optically-timed vs. impedance method. Measurement at 30C characteristically showed a severe depression of heart rate, and high mortality after determinations. It is concluded that in situ field survival of Palaemon northropi may involve a time-dependence and/or other mechanisms whereby upper environmental temperatures may be abated.

  19. Endocannabinoid Catabolic Enzymes Play Differential Roles in Thermal Homeostasis in Response to Environmental or Immune Challenge.

    PubMed

    Nass, Sara R; Long, Jonathan Z; Schlosburg, Joel E; Cravatt, Benjamin F; Lichtman, Aron H; Kinsey, Steven G

    2015-06-01

    Cannabinoid receptor agonists, such as Δ(9)-THC, the primary active constituent of Cannabis sativa, have anti-pyrogenic effects in a variety of assays. Recently, attention has turned to the endogenous cannabinoid system and how endocannabinoids, including 2-arachidonoylglycerol (2-AG) and anandamide, regulate multiple homeostatic processes, including thermoregulation. Inhibiting endocannabinoid catabolic enzymes, monoacylglycerol lipase (MAGL) or fatty acid amide hydrolase (FAAH), elevates levels of 2-AG or anandamide in vivo, respectively. The purpose of this experiment was to test the hypothesis that endocannabinoid catabolic enzymes function to maintain thermal homeostasis in response to hypothermic challenge. In separate experiments, male C57BL/6J mice were administered a MAGL or FAAH inhibitor, and then challenged with the bacterial endotoxin lipopolysaccharide (LPS; 2 mg/kg ip) or a cold (4 °C) ambient environment. Systemic LPS administration caused a significant decrease in core body temperature after 6 h, and this hypothermia persisted for at least 12 h. Similarly, cold environment induced mild hypothermia that resolved within 30 min. JZL184 exacerbated hypothermia induced by either LPS or cold challenge, both of which effects were blocked by rimonabant, but not SR144528, indicating a CB1 cannabinoid receptor mechanism of action. In contrast, the FAAH inhibitor, PF-3845, had no effect on either LPS-induced or cold-induced hypothermia. These data indicate that unlike direct acting cannabinoid receptor agonists, which elicit profound hypothermic responses on their own, neither MAGL nor FAAH inhibitors affect normal body temperature. However, these endocannabinoid catabolic enzymes play distinct roles in thermoregulation following hypothermic challenges. PMID:25715681

  20. Yeast cell wall supplementation alters aspects of the physiological and acute phase responses of crossbred heifers to an endotoxin challenge.

    PubMed

    Burdick Sanchez, Nicole C; Young, Tanner R; Carroll, Jeffery A; Corley, Jimmie R; Rathmann, Ryan J; Johnson, Bradley J

    2013-01-01

    A study was conducted to determine the effect of feeding yeast cell wall (YCW) products on the physiological and acute phase responses of crossbred, newly-received feedlot heifers to an endotoxin challenge. Heifers (n = 24; 219 ± 2.4 kg) were separated into treatment groups receiving either a control diet (n = 8), YCW-A (2.5 g/heifer/d; n = 8) or YCW-C (2.5 g/heifer/d; n = 8) and were fed for 52 d. On d 37 heifers were challenged i.v. with LPS (0.5 µg/kg body mass) and blood samples were collected from -2 h to 8 h and again at 24 h relative to LPS challenge. There was an increase in vaginal temperature in all heifers post-LPS, with YCW-C maintaining a lower vaginal temperature post-LPS than control and YCW-A heifers. Sickness behavior scores increased post-LPS in all heifers, but were not affected by treatment. Cortisol concentrations were greatest in control heifers post-LPS compared with YCW-A or YCW-C heifers. Concentrations of IFN-γ and TNF-α increased post-LPS, but were not affected by treatment. Serum IL-6 concentrations increased post-LPS and were greater in control heifers than YCW-A and YCW-C heifers. These data indicate that YCW supplementation can decrease the physiological and acute phase responses of newly-received heifers following an endotoxin challenge. PMID:23288885

  1. Acute airway narrowing in monkeys from challenge with 2. 5 ppm formaldehyde generated from formalin

    SciTech Connect

    Biagini, R.E.; Moorman, W.J.; Knecht, E.A.; Clark, J.C. ); Bernstein, I.L. )

    1988-10-01

    Nine adult male Cynomolgus monkeys (Macaca fascicularis) were exposed for 10 min to 2.55 {plus minus} 0.03 ppm formaldehyde (HCHO; mean {plus minus} standard error of the mean, SEM) generated from formalin with a newly developed HCHO challenge system. The generation system was capable of producing highly stable HCHO vapor concentrations with fluctuations of HCHO concentrations of less than {plus minus} 5%. The experimental design included pre-exposure methacholine challenge to determine if responses to HCHO were associated with pre-existing bronchial hyperreactivity. Significant changes in average pulmonary flow resistance (R{sub L}) were observed (compared to control R{sub L} values) at 2, 5, and 10 min post-HCHO challenge. Pre-challenge R{sub L} values (mean {plus minus} SEM) were 11,3 {plus minus} 1,4 cm H{sub 2}O {center dot} l/s, while at 2, 5, and 10 min after HCHO challenge, values were 16,1 {plus minus} 2,1, 16,9 {plus minus} 2,8, and 20,0 {plus minus} 3,4 cm H{sub 2}O {center dot} l/s, respectively. Methacholine challenge data suggest that reactions to HCHO tend to be greater in monkeys hyperreactive to methacholine, but the relationship does not reach statistical significance in this small series of animals. These data indicate that significant pulmonary function deficits occur immediately after challenge with 2.55 ppm HCHO vapor in monkeys.

  2. Erythema multiforme due to arsenic trioxide in a case of acute promyelocytic leukemia: A diagnostic challenge

    PubMed Central

    Badarkhe, Girish V.; Sil, Amrita; Bhattacharya, Sabari; Nath, Uttam Kumar; Das, Nilay Kanti

    2016-01-01

    Erythema multiforme (EM) is an acute, self-limited, Type IV hypersensitivity reactions associated with infections and drugs. In this case of acute promyelocytic leukemia, EM diagnosed during the induction phase was mistakenly attributed to vancomycin used to treat febrile neutropenia during that period. However, the occurrence of the lesions of EM again during the consolidation phase with arsenic trioxide (ATO) lead to a re-evaluation of the patient and both the Naranjo and World Health Organization-Uppsala Monitoring Centre scale showed the causality association as “probable.” The rash responded to topical corticosteroids and antihistamines. This rare event of EM being caused by ATO may be attributed to the genetic variation of methyl conjugation in the individual which had triggered the response, and the altered metabolic byproducts acted as a hapten in the subsequent keratinocyte necrosis. PMID:27114640

  3. Erythema multiforme due to arsenic trioxide in a case of acute promyelocytic leukemia: A diagnostic challenge.

    PubMed

    Badarkhe, Girish V; Sil, Amrita; Bhattacharya, Sabari; Nath, Uttam Kumar; Das, Nilay Kanti

    2016-01-01

    Erythema multiforme (EM) is an acute, self-limited, Type IV hypersensitivity reactions associated with infections and drugs. In this case of acute promyelocytic leukemia, EM diagnosed during the induction phase was mistakenly attributed to vancomycin used to treat febrile neutropenia during that period. However, the occurrence of the lesions of EM again during the consolidation phase with arsenic trioxide (ATO) lead to a re-evaluation of the patient and both the Naranjo and World Health Organization-Uppsala Monitoring Centre scale showed the causality association as "probable." The rash responded to topical corticosteroids and antihistamines. This rare event of EM being caused by ATO may be attributed to the genetic variation of methyl conjugation in the individual which had triggered the response, and the altered metabolic byproducts acted as a hapten in the subsequent keratinocyte necrosis. PMID:27114640

  4. Managing acute severe hypertension during coronary angiography: Lessons from a challenging case.

    PubMed

    Zabulon, Audrey; Ozier-Lafontaine, Nathalie; Jocelyn, Inamo

    2016-06-01

    We report the clinical case of a 52-year-old man referred to our catheterization laboratory for an acute coronary syndrome. The coronary angiogram course was soon disrupted by a life-threatening blood pressure chaos lasting for hours. An abdominal paraganglioma was eventually diagnosed, requiring surgery. This case outlines the potential diagnosis and therapeutic missteps in managing such patients and suggests strategies for quick improvement. PMID:26729064

  5. The challenges of fuel options for the new generation of Indian thermal power plants

    SciTech Connect

    Roy, C.; Sanyal, A.

    1999-07-01

    The selection of fuel supply is probably the most important challenge a potential power project developer for a new Indian thermal power plant has to face when considering the overall project economics. The paper reviews the essential issues and the effect of fuel selection on project costs of the new generation of thermal power plants of India. Coal, lignite and natural gas are India's indigenous fossil fuel resources for power generation. The country has a modest reserve of petroleum crude. India is the world's third largest coal producer and has 205 billion metric tons of assessed and 73 billion tons of proven reserves. The indigenous supply of petroleum is unlikely to improve much in the near future. Liquid fuel based generation is therefore marginal in the country. Although coal will continue to be the mainstay fuel, there is a short term need to examine the possibility of using alternative fuels due to two basic reasons: (a) A 70 million tons of shortfall is forecast for the power sector during the 1997--2002 period. The deficit has to be met by either import of coal or other fuels. Development of new mines is a long gestation activity. (b) There is an uneven geographical location of Indian coal reserves. For the load centers, which are distant from the indigenous coal sources, use of alternative fuel could also prove to be economical in the long term. Moving coal will become harder in view of the high demands being placed on the railways by many other sectors.

  6. Challenges in the development of the orbiter active thermal control subsystem

    NASA Technical Reports Server (NTRS)

    Nason, J. R.; Wierum, F. A.; Yanosy, J. L.

    1985-01-01

    A number of major challenges were faced in the design and development of the Orbiter Active Thermal Control Subsystem (ATCS). At the system level, the initial challenges were to define an approach that would interface dual Freon coolant loops with multiple coolant loops from other vehicle subsystems with the lowest weight penalty to the Orbiter; and to provide highly responsive vehicle heat rejection throughout all of the Orbiter mission phases. Optimized heat exchangers, representing an advance in the state-of-the-art in heat exchanger design, were developed to transfer heat between the orbiter Freon coolant loops and five other vehicle systems. Flash evaporation was selected as a highly efficient and responsive means for cooling the Orbiter Freon loops during ascent and entry. The Flash Evaporator Subsystem (FES) utilizes cyclic water spray cooling in a chamber maintained at or below the water triple point pressure. A summary of the basic heat transfer research conducted to identify the fundamental heat transfer processes involved in water spray cooling in support of the FES design is given. The high fidelity dynamic analytical model of the FES that was generated to aid in the design of control logic, evaluate performance and simulate ground test and flight anomalies is discussed. A description of the FES and Integrated ATCS testing conducted in the SESL chamber A at NASA-JSC is also presented.

  7. Acute coronary syndrome and decompression illness: a challenge for the diving physician.

    PubMed

    Brauzzi, Marco; Andreozzi, Fabio; De Fina, Laura; Tanasi, Paolo; Falini, Stefano

    2013-12-01

    Decompression illness (DCI) is a syndrome with diverse clinical manifestations but in which cardiac symptoms are rare. In the presence of cardiac symptoms, the necessity to rule out an acute coronary syndrome (ACS) which requires prompt treatment may result in delay to appropriate recompression treatment. We describe three cases with cardiologic symptoms referred to our centre by the Emergency Department (ED) of our facility. The first was a 48-year-old woman who lost consciousness during a dive and required cardiopulmonary resuscitation. The final diagnosis was acute myocardial infarction and the patient did not undergo recompression treatment. The second case was that of a 27-year-old man who complained of tachycardia, dyspnoea and vertigo soon after a dive. He was referred by helicopter ambulance and in the ED was diagnosed with new-onset atrial fibrillation. Recompression resulted in disappearance of his vertigo, and sinus rhythm was restored pharmacologically. The third case was a 43-year-old man, with a history of coronary artery disease, who had undergone coronary artery bypass grafting three years previously. After a repetitive dive without adequate decompression, he complained of crushing retrosternal pain and numbness in the upper left arm. All cardiovascular examinations were negative and the patient was recompressed, with resolution of his symptoms. Features to consider in arriving at the correct differential diagnosis in divers presenting with cardiac symptoms are discussed in the light of these three illustrative cases. PMID:24510330

  8. Meeting ethical challenges in acute care work as narrated by enrolled nurses.

    PubMed

    Sørlie, Venke; Kihlgren, Annica Larsson; Kihlgren, Mona

    2004-03-01

    Five enrolled nurses (ENs) were interviewed as part of a comprehensive investigation into the narratives of registered nurses, ENs and patients about their experiences in an acute care ward. The ward opened in 1997 and provides patient care for a period of up to three days, during which time a decision has to be made regarding further care elsewhere or a return home. The ENs were interviewed concerning their experience of being in ethically difficult care situations and of acute care work. The method of phenomenological-hermeneutic interpretation inspired by the French philosopher Paul Ricoeur was used. The most prominent feature was the focus on relationships, as expressed in concern for society's and administrators' responsibility for health care and the care of older people. Other themes focus on how nurse managers respond to the ENs' work as well as their relationships with fellow ENs, in both work situations and shared social and sports activities. Their reflections seem to show an expectation of care as expressed in their lived experiences and their desire for a particular level and quality of care for their own family members. A lack of time could lead to a bad conscience over the 'little bit extra' being omitted. This lack of time could also lead to tiredness and even burnout, but the system did not allow for more time. PMID:15030025

  9. Acute Pancreatitis Induced by Azathioprine and 6-mercaptopurine Proven by Single and Low Dose Challenge Testing in a Child with Crohn Disease.

    PubMed

    Yi, Geum-Chae-Won; Yoon, Ka-Hyun; Hwang, Jin-Bok

    2012-12-01

    We report here a case of drug-induced acute pancreatitis proved by elimination and single, low dose challenge test in a child with Crohn disease. A 14-year-old boy with moderate/severe Crohn disease was admitted due to high fever and severe epigastric pain during administration of mesalazine and azathioprine. Blood test and abdominal ultrasonography revealed acute pancreatitis. After discontinuance of the medication and supportive care, the symptoms and laboratory findings improved. A single, low dose challenge test was done to confirm the relationship of the adverse drug reaction and acute pancreatitis, and to discriminate the responsible drug. Azathioprine and 6-mercaptopurine showed positive responses, and mesalazine showed a negative response. We introduce the method of single, low dose challenge test and its interpretation for drug-induced pancreatitis. PMID:24010098

  10. Enhancement of the acute phase response to lipopolysaccharide (LPS) challenge in steers supplemented with chromium

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The study examined the effect of chromium supplementation on the response of steers to an LPS challenge. Twenty steers received a premix that added 0 (control) or 0.2 mg/kg of chromium (KemTRACE®brandChromiumProprionate 0.04%, Kemin Industries) to the total diet on a dry matter basis for 55 d. Steer...

  11. Acute Stroke Care at Rural Hospitals in Idaho: Challenges in Expediting Stroke Care

    ERIC Educational Resources Information Center

    Gebhardt, James G.; Norris, Thomas E.

    2006-01-01

    Context: Thrombolytics are currently the most effective treatment for stroke. However, the National Institute for Neurological Disorders and Stroke criteria for initiation of thrombolytic therapy, most notably the 3-hour time limit from symptom onset, have proven challenging for many rural hospitals to achieve. Purpose: To provide a snapshot of…

  12. Chromium supplementation enhances the acute phase response of steers to a lipopolysaccharide (LPS) challenge

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The study examined the effect of chromium supplementation on the response of steers to an LPS challenge. Twenty crossbred steers (235±4 kg BW) received 0 ppb (Control; C) or 200 ppb chromium propionate (CHR) for 55 days. Steers were fitted with jugular catheters and rectal temperature (RT) recording...

  13. INTERCONNECTION BETWEEN NITRIC OXIDE FORMATION AND HYPERSENSITIVITY PARAMETERS UNDER GUINEA PIG MODEL OF ACUTE ASTHMA WITH MULTIPLE CHALLENGES.

    PubMed

    Parilova, O O; Shandrenko, S G

    2015-01-01

    An immunoregulatory role of nitric oxide (NO) in the development of adaptive immune responses associated with allergic diseases is very important. The present study extended these observations by the examination of the reciprocal changes in characteristic immunologic parameters of the disease and NO level of bronchoalveolar lavage (BAL) cells under guinea pig model of acute asthma with multiple challenges. Development of guinea pig Th2 mediated asthma was accompanied by increasing the level of allergic markers: ovalbumin (OVA) specific IgG and IL-4. We demonstrated that the infiltrate of airway cells contributes to NO synthesis in the respiratory tract during allergic inflammation. The level of intracellular NO formation significantly correlated with plasma allergen specific IgG value in OVA-induced asthma. The presented data evidence that the elevated intracellular NO level in BAL fluid may reflect a nitrosative stress in respiratory tract in general, when allergic asthma exacerbation is present. PMID:26717602

  14. Update: outbreak of acute febrile illness among athletes participating in Eco-Challenge-Sabah 2000--Borneo, Malaysia, 2000.

    PubMed

    2001-01-19

    During September 7-11, 2000, CDC was notified by the Idaho Department of Health, the Los Angeles County Department of Health Services, and the GeoSentinel Global Surveillance Network of at least 20 cases of acute febrile illness in three countries; all ill patients had participated in the Eco-Challenge-Sabah 2000 multisport expedition race in Borneo, Malaysia, during August 21-September 3, 2000. Participants included athletes from 29 U.S. states and 26 countries. This report updates the ongoing investigation of this outbreak through December 2, which suggests that Leptospira were the cause of illness and that water from the Segama River was the primary source of infection. Participants in adventure sports and exotic tourism should be aware of potential exposure to unusual and emerging infectious agents. PMID:11215718

  15. Challenges in the Etiology and Diagnosis of Acute Febrile Illness in Children in Low- and Middle-Income Countries.

    PubMed

    Iroh Tam, Pui-Ying; Obaro, Stephen K; Storch, Gregory

    2016-06-01

    Acute febrile illness is a common cause of hospital admission, and its associated infectious causes contribute to substantial morbidity and death among children worldwide, especially in low- and middle-income countries. Declining transmission of malaria in many regions, combined with the increasing use of rapid diagnostic tests for malaria, has led to the increasing recognition of leptospirosis, rickettsioses, respiratory viruses, and arboviruses as etiologic agents of fevers. However, clinical discrimination between these etiologies can be difficult. Overtreatment with antimalarial drugs is common, even in the setting of a negative test result, as is overtreatment with empiric antibacterial drugs. Viral etiologies remain underrecognized and poorly investigated. More-sensitive diagnostics have led to additional dilemmas in discriminating whether a positive test result reflects a causative pathogen. Here, we review and summarize the current epidemiology and focus particularly on children and the challenges for future research. PMID:27059657

  16. Nurses in Action: A Response to Cultural Care Challenges in a Pediatric Acute Care Setting.

    PubMed

    Mixer, Sandra J; Carson, Emily; McArthur, Polly M; Abraham, Cynthia; Silva, Krystle; Davidson, Rebecca; Sharp, Debra; Chadwick, Jessica

    2015-01-01

    Culturally congruent care is satisfying, meaningful, fits with people's daily lives, and promotes their health and wellbeing. A group of staff nurses identified specific clinical challenges they faced in providing such care for Hispanic and underserved Caucasian children and families in the pediatric medical-surgical unit of an urban regional children's hospital in the southeastern U.S. To address these challenges, an academic-practice partnership was formed between a group of nurse managers and staff nurses at the children's hospital and nursing faculty and graduate students at a local, research-intensive public university. Using the culture care theory, the partners collaborated on a research study to discover knowledge that would help the nursing staff resolve the identified clinical challenges. Twelve families and 12 healthcare providers participated. Data analysis revealed five care factors that participants identified as most valuable: family, faith, communication, care integration, and meeting basic needs. These themes were used to formulate nursing actions that, when applied in daily practice, could facilitate the provision of culturally congruent care for these children and their families. The knowledge generated by this study also has implications for healthcare organizations, nursing educators, and academic-practice partnerships that seek to ensure the delivery of equitable care for all patients. PMID:26072213

  17. Interleukin-6 Induced "Acute" Phenotypic Microenvironment Promotes Th1 Anti-Tumor Immunity in Cryo-Thermal Therapy Revealed By Shotgun and Parallel Reaction Monitoring Proteomics.

    PubMed

    Xue, Ting; Liu, Ping; Zhou, Yong; Liu, Kun; Yang, Li; Moritz, Robert L; Yan, Wei; Xu, Lisa X

    2016-01-01

    Cryo-thermal therapy has been emerged as a promising novel therapeutic strategy for advanced breast cancer, triggering higher incidence of tumor regression and enhanced remission of metastasis than routine treatments. To better understand its anti-tumor mechanism, we utilized a spontaneous metastatic mouse model and quantitative proteomics to compare N-glycoproteome changes in 94 serum samples with and without treatment. We quantified 231 highly confident N-glycosylated proteins using iTRAQ shotgun proteomics. Among them, 53 showed significantly discriminated regulatory patterns over the time course, in which the acute phase response emerged as the most enhanced pathway. The anti-tumor feature of the acute response was further investigated using parallel reaction monitoring target proteomics and flow cytometry on 23 of the 53 significant proteins. We found that cryo-thermal therapy reset the tumor chronic inflammation to an "acute" phenotype, with up-regulation of acute phase proteins including IL-6 as a key regulator. The IL-6 mediated "acute" phenotype transformed IL-4 and Treg-promoting ICOSL expression to Th1-promoting IFN-γ and IL-12 production, augmented complement system activation and CD86(+)MHCII(+) dendritic cells maturation and enhanced the proliferation of Th1 memory cells. In addition, we found an increased production of tumor progression and metastatic inhibitory proteins under such "acute" environment, favoring the anti-metastatic effect. Moreover, cryo-thermal on tumors induced the strongest "acute" response compared to cryo/hyperthermia alone or cryo-thermal on healthy tissues, accompanying by the most pronounced anti-tumor immunological effect. In summary, we demonstrated that cryo-thermal therapy induced, IL-6 mediated "acute" microenvironment shifted the tumor chronic microenvironment from Th2 immunosuppressive and pro-tumorigenic to Th1 immunostimulatory and tumoricidal state. Moreover, the magnitude of "acute" and "danger" signals play a key

  18. Challenger

    ERIC Educational Resources Information Center

    Allday, Jonathan

    2002-01-01

    The events that led to the spectacular destruction of the Space Shuttle "Challenger" in 1986 are detailed here. They show how NASA should have heeded engineers' worries over materials problems resulting from a launch in cold weather. Suggestions are made of how pupils could also learn from this tragedy. (Contains 4 figures and 2 footnotes.)

  19. Challenger

    NASA Astrophysics Data System (ADS)

    Allday, Jonathan

    2002-09-01

    The events that led to the spectacular destruction of the Space Shuttle Challenger in 1986 are detailed here. They show how NASA should have heeded engineers' worries over materials problems resulting from a launch in cold weather. Suggestions are made of how pupils could also learn from this tragedy.

  20. Challenges

    ERIC Educational Resources Information Center

    Moore, Thomas R.

    1975-01-01

    Domestic and international challenges facing the National Society for the Prevention of Blindness are discussed; and U.S. and Russian programs in testing and correcting children's vision, developing eye safety programs in agriculture and industry, and disseminating information concerning the detection and treatment of cataracts are compared. (SB)

  1. Effects of an acute silver challenge on survival, silver distribution and ionoregulation within developing rainbow trout eggs (Oncorhynchus mykiss).

    PubMed

    Guadagnolo, C M; Brauner, C J; Wood, C M

    2000-12-01

    Rainbow trout eggs were acutely challenged with silver (as AgNO(3)) at different stages of development from fertilization through to hatch in moderately hard water (120 mg CaCO(3) l(-1), 0.70 mM (25 mg l(-1)) Cl(-), 1.3 mg l(-1) DOC, 12.3+/-0.1 degrees C) at measured total silver concentrations of 0.11+/-0.004, 1.55+/-0.15, and 14.15+/-1.52 microg l(-1). Four separate acute challenges were conducted, each consisting of 5 days exposure to the respective silver concentration, followed by 4 days recovery after transfer to silver-free water (series 1, 1-10 days post-fertilization; series 2, 8-17 days post-fertilization; series 3, 16-25 days post-fertilization; series 4, 23-32 days post-fertilization). Mortality was not significantly different from control during exposure to 0.11, 1.55, and 14.15 microg l(-1) total silver in series 2, 3 and 4 (mortality for series 1 data could not be calculated for technical reasons). In the four days of recovery following silver exposure, however, there was significant mortality at 14.15 microg l(-1) total silver reaching 100, 31 and 72% in series 2, 3 and 4, respectively, indicating eggs are more sensitive in the period of 8-17 and 23-32 days post-fertilization at this temperature. Mortality following silver exposure was associated with ionoregulatory impairment in series 3 and 4, where up to 60% of whole egg [Na(+)] and [Cl(-)] was lost relative to controls at 14.15 microg l(-1) total silver. Significant but smaller reductions in egg [Na(+)] and/or [Cl(-)] were also observed at 0.11 and 1.55 microg l(-1) total silver. The greatest accumulation of silver in whole eggs and chorions occurred in series 4, reaching concentrations of 0.53 microg g(-1) (eggs) and 15.5 microg g(-1) (chorions) in the 14.15 microg l(-1) treatment. The accumulation of silver in the whole eggs and chorions of the 0.11 microg l(-1) treatment was not different from controls throughout embryonic development. Of the total silver content, only a small proportion of

  2. Acute Upper Thermal Limits of Three Aquatic Invasive Invertebrates: Hot Water Treatment to Prevent Upstream Transport of Invasive Species

    NASA Astrophysics Data System (ADS)

    Beyer, Jessica; Moy, Philip; de Stasio, Bart

    2011-01-01

    Transport of aquatic invasive species (AIS) by boats traveling up rivers and streams is an important mechanism of secondary spread of AIS into watersheds. Because physical barriers to AIS movement also prevent navigation, alternate methods for preventing spread are necessary while allowing upstream navigation. One promising approach is to lift boats over physical barriers and then use hot water immersion to kill AIS attached to the hull, motor, or fishing gear. However, few data have been published on the acute upper thermal tolerance limits of potential invaders treated in this manner. To test the potential effectiveness of this approach for a planned boat lift on the Fox River of northeastern WI, USA, acute upper thermal limits were determined for three AIS, adult zebra mussels ( Dreissena polymorpha), quagga mussels ( Dreissena rostriformis bugensis), and spiny water fleas ( Bythotrephes longimanus) from the local area employing temperatures from 32 to 54°C and immersion times from 1 to 20 min. Mortality was determined after immersion followed by a 20-min recovery period. Immersion at 43°C for at least 5 min was required to ensure 100% mortality for all three species, but due to variability in the response by Bythotrephes a 10 min immersion would be more reliable. Overall there were no significant differences between the three species in acute upper thermal limits. Heated water can be an efficient, environmentally sound, and cost effective method of controlling AIS potentially transferred by boats, and our results should have both specific and wide-ranging applications in the prevention of the spread of aquatic invasive species.

  3. Community-acquired acute kidney injury: A challenge and opportunity for primary care in kidney health.

    PubMed

    Mesropian, Paul Der; Othersen, Jennifer; Mason, Darius; Wang, Jeffrey; Asif, Arif; Mathew, Roy O

    2016-09-01

    Community-acquired acute kidney injury (CA-AKI) has been found to be a common event in the population. Current incidence estimates are not available, but evaluations of severe elevations in serum creatinine indicate that incidence can be as high as 989 cases per million population in those older than 80 years. Data on risk factors are limited, but older age and higher comorbid illness burden, especially diabetes and cardiovascular disease, seem to be more common in patients who suffer CA-AKI. In addition to being more common than hospital-acquired AKI, the long-term sequelae of CA-AKI seem to be just as severe, including renal disease progression and mortality. Efforts to better understand the aetiology of CA-AKI and how ultimately to prevent the development of this condition will need to be taken. In the meantime, a concerted effort by general internists and nephrologists will be needed to prevent CA-AKI in the highest risk patients and thus limit the poor outcomes associated with this entity. PMID:26890822

  4. Acute human brain responses to intracortical microelectrode arrays: challenges and future prospects.

    PubMed

    Fernández, Eduardo; Greger, Bradley; House, Paul A; Aranda, Ignacio; Botella, Carlos; Albisua, Julio; Soto-Sánchez, Cristina; Alfaro, Arantxa; Normann, Richard A

    2014-01-01

    The emerging field of neuroprosthetics is focused on the development of new therapeutic interventions that will be able to restore some lost neural function by selective electrical stimulation or by harnessing activity recorded from populations of neurons. As more and more patients benefit from these approaches, the interest in neural interfaces has grown significantly and a new generation of penetrating microelectrode arrays are providing unprecedented access to the neurons of the central nervous system (CNS). These microelectrodes have active tip dimensions that are similar in size to neurons and because they penetrate the nervous system, they provide selective access to these cells (within a few microns). However, the very long-term viability of chronically implanted microelectrodes and the capability of recording the same spiking activity over long time periods still remain to be established and confirmed in human studies. Here we review the main responses to acute implantation of microelectrode arrays, and emphasize that it will become essential to control the neural tissue damage induced by these intracortical microelectrodes in order to achieve the high clinical potentials accompanying this technology. PMID:25100989

  5. CHALLENGE WITH BOVINE VIRAL DIARRHEA VIRUS BY EXPOSURE TO PERSISTENTLY INFECTED CALVES: PROTECTION BY VACCINATION AND NEGATIVE RESULTS OF ANTIGEN TESTING IN NONVACCINATED ACUTELY INFECTED CALVES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Calves persistently infected (PI) with Bovine viral diarrhea virus (BVDV) represent an important source of infection for susceptible cattle. We evaluated vaccine efficacy using calves PI with noncytopathic BVDV2a for the challenge and compared tests to detect BVDV in acutely or transiently infected ...

  6. Silicon Deprivation Does Not Significantly Modify the Acute White Blood Cell Response but Does Modify Tissue Mineral Distribution Response to an Endotoxin Challenge

    Technology Transfer Automated Retrieval System (TEKTRAN)

    An experiment with rats was conducted to determine whether silicon deprivation affects the acute-phase immune response to an endotoxin challenge. Weanling female rats were assigned to two weight-matched groups of 24; one group was fed a basal diet containing about 1.9 µg Si/kg, the other group was f...

  7. Thermal Hydraulic Challenges of Gas Cooled Fast Reactors with Passive Safety Features

    SciTech Connect

    Michael Pope; Jeong-Ik Lee; Pavel Hejzlar; Michael J. Driscoll

    2009-05-01

    Transient response of a Gas cooled Fast Reactor (GFR) coupled to a recompression supercritical CO2 (S-CO2) power conversion system (PCS) in a direct cycle to Loss of Coolant and Loss of Generator Load Accidents is analyzed using RELAP5-3D. A number of thermal hydraulic challenges for GFR design are pointed out as the designers strive to accommodate cooling of the high power density core of a fast reactor by a gas with its inherently low heat transfer capability, in particular under post LOCA events when system pressure is lost and when reliance on passive decay heat removal is emphasized. Although it is possible to design a S-CO2 cooled GFR that can survive LOCA by cooling the core through natural circulating loops between the core and elevated emergency cooling heat exchangers, it is not an attractive approach because of various bypass paths that can, depending on break location, degrade core cooling. Moreover, natural circulation gas loops can operate in deteriorated heat transfer regimes with substantial reduction of heat transfer coefficient: as low as 30% of forced convection values, and data and correlations in these regimes carry large uncertainties. Therefore, reliable battery powered blowers for post-LOCA decay heat removal (DHR) that provide flow in well defined regimes with low uncertainty, and can be easily over-designed to accommodate bypass flows were selected. The results confirm that a GFR with such a DHR system and negative coolant void worth can withstand LOCA with and without scram as well as loss of electrical load without exceeding core temperature and turbomachinery overspeed limits.

  8. Transcriptional expression levels of cell stress marker genes in the Pacific oyster Crassostrea gigas exposed to acute thermal stress

    PubMed Central

    Farcy, Émilie; Voiseux, Claire; Lebel, Jean-Marc

    2008-01-01

    During the annual cycle, oysters are exposed to seasonal slow changes in temperature, but during emersion at low tide on sunny summer days, their internal temperature may rise rapidly, resulting in acute heat stress. We experimentally exposed oysters to a 1-h acute thermal stress and investigated the transcriptional expression level of some genes involved in cell stress defence mechanisms, including chaperone proteins (heat shock proteins Hsp70, Hsp72 and Hsp90 (HSP)), regulation of oxidative stress (Cu-Zn superoxide dismutase, metallothionein (MT)), cell detoxification (glutathione S-transferase sigma, cytochrome P450 and multidrug resistance (MDR1)) and regulation of the cell cycle (p53). Gene mRNA levels were quantified by reverse transcription-quantitative polymerase chain reaction and expressed as their ratio to actin mRNA, used as a reference. Of the nine genes studied, HSP, MT and MDR1 mRNA levels increased in response to thermal stress. We compared the responses of oysters exposed to acute heat shock in summer and winter and observed differences in terms of magnitude and kinetics. A larger increase was observed in September, with recovery within 48 h, whereas in March, the increase was smaller and lasted more than 2 days. The results were also compared with data obtained from the natural environment. Though the functional molecule is the protein and information at the mRNA level only has limitations, the potential use of mRNAs coding for cell stress defence proteins as early sensitive biomarkers is discussed. PMID:19002605

  9. 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

  10. Effects of acute thermal stress on the survival, predator avoidance, and physiology of juvenile fall Chinook salmon

    USGS Publications Warehouse

    Mesa, M.G.; Weiland, L.K.; Wagner, P.

    2002-01-01

    We subjected juvenile fall chinook salmon from the Hanford Reach of the Columbia River to acute thermal stressors in the laboratory that were derived from field data. We assessed the effects of thermal stress on: (1) the extent of direct mortality; (2) the vulnerability of fish to predation by smallmouth bass; and (3) some general physiological stress responses and synthesis of heat shock protein 70 (hsp70). Thermally-stressed fish showed little direct mortality and no increases in vulnerability to predation. However, these fish showed transient increases in plasma concentrations of cortisol, glucose, and lactate, and a dramatic (25-fold higher than controls) and persistent (lasting 2 wk) increase in levels of liver hsp70. Our results indicate that exposure of Hanford Reach juvenile fall chinook salmon to such stressors did not lead to significant increases in direct mortality or vulnerability to predation, but did alter physiological homeostasis, which should be of concern to those managing this resource. Because our fish received only a single exposure to one of the stressors we examined, we are also concerned about the consequences of exposing fish to multiple, cumulative stressors - a likely scenario for fish in the wild.

  11. Recurrent acute thermal lesion induces esophageal hyperproliferative premalignant lesions in mice esophagus.

    PubMed

    Rapozo, D C M; Blanco, T C M; Reis, B B; Gonzaga, I M; Valverde, P; Canetti, C; Barja-Fidalgo, C; Simao, T A; Albano, R M; Kruel, C D P; Ribeiro Pinto, L F

    2016-04-01

    Hot beverage consumption is a risk factor for esophageal squamous cell carcinoma, but the underlying mechanisms are still unknown. We developed an experimental mouse model to understand the mechanism of thermal lesion to esophageal carcinogenesis. Female BALB/c mice were treated by gavage with water at different temperatures three times a week and nitrosamines in the drinking water. Water at 70°C, but not at lower temperatures, initially induced an esophageal necrosis that healed and became resistant to necrosis after further administrations. However, when 70°C water was associated with N-nitrosodiethylamine at doses above 1ppm, there was interference in epithelial regeneration, allowing recurrent thermal injury and inflammation. Recurrent thermal injury resulted in hyper proliferative premalignant lesions being induced earlier (at 4weeks) and at a higher frequency (4-fold increase at 16weeks) when compared to mice treated with NDEA only. Ki-67 immunostaining revealed that recurrent thermal injury induced basal cell proliferation resulting in the expansion of epithelial basal cells, confirmed by the increase in cytokeratin 14 positive cells with concomitant reduction of differentiated cytokeratin 5 positive cells. We conclude that recurrent thermal lesion may act as a tumor promoter though a strong proliferation stimulus of esophageal epithelial basal cells. PMID:26899552

  12. Repeated thermal stressor causes chronic elevation of baseline corticosterone and suppresses the physiological endocrine sensitivity to acute stressor in the cane toad (Rhinella marina).

    PubMed

    Narayan, Edward J; Hero, Jean-Marc

    2014-04-01

    Extreme environmental temperature could impact the physiology and ecology of animals. The stress endocrine axis provides necessary physiological stress response to acute (day-day) stressors. Presently, there are no empirical evidences showing that exposure to extreme thermal stressor could cause chronic stress in amphibians. This could also modulate the physiological endocrine sensitivity to acute stressors and have serious implications for stress coping in amphibians, particularly those living in fragmented and disease prone environments. We addressed this important question using the cane toad (Rhinella marina) model from its introduced range in Queensland, Australia. We quantified their physiological endocrine sensitivity to a standard acute (capture and handling) stressor after exposing the cane toads to thermal shock at 35°C for 30min daily for 34 days. Corticosterone (CORT) responses to the capture and handling protocol were measured on three sampling intervals (days 14, 24, and 34) to determine whether the physiological endocrine sensitivity was maintained or modulated over-time. Two control groups (C1 for baseline CORT measurement only and C2 acute handled only) and two temperature treatment groups (T1 received daily thermal shock up to day 14 only and a recovery phase of 20 days and T2 received thermal shock daily for 34 days). Results showed that baseline CORT levels remained high on day 14 (combined effect of capture, captivity and thermal stress) for both T1 and T2. Furthermore, baseline CORT levels decreased for T1 once the thermal shock was removed after day 14 and returned to baseline by day 29. On the contrary, baseline CORT levels kept on increasing for T2 over the 34 days of daily thermal shocks. Furthermore, the magnitudes of the acute CORT responses or physiological endocrine sensitivity were consistently high for both C1 and T1. However, acute CORT responses for T2 toads were dramatically reduced between days 24 and 34. These novel findings

  13. Structural changes associated with the acute thermal instability of Rubisco activase

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The inhibition of photosynthesis at moderately high temperatures has been linked to a decrease in Rubisco activation, thought to be a consequence of the thermal instability of Rubisco's chaperone, Rubisco activase. To determine the structural basis for inactivation of Rubisco activase, the effects o...

  14. Structural Changes Associated with the Acute Thermal Instability of Rubisco Activase

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The inhibition of photosynthesis at moderately high temperatures has been linked to a decrease in ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco) activation. This decrease is thought to be a consequence of the thermal instability of Rubisco’s chaperone, ribulose-1,5-bisphosphate carboxyla...

  15. [The effect of extracorporeal thermal-modified autologous plasma exchanges on dynamics of hormone-metabolic homeostasis indices in patients with acute myocardial infarction].

    PubMed

    Ust'iantseva, I M; Kreĭnes, V M; Panin, L E; Petukhova, O V; Khokhlova, O I; Agadzhanian, V V

    1998-01-01

    Changes of biochemical indexes in the blood of 56 patients with acute myocardial infarction against the background of conventional and complex treatment using plasma exchange of extracorporeal-termally modified autoplasma have been analysed. The findings show that complex treatment of patients with AMI, using plasma exchange of extracorporal-thermally modified autoplasma, leads to much earlier decrease of KPK, LDH, LDH-1 enzyme activity in blood; it indicates the reduction of the period of myocardiocyte function restoration. The usage of plasma exchange of extracorporeal-thermally modified autoplasma in patients with acute myocardial infarction is accompanied by the absence of increase of glucose concentration in blood (owing to the normalization of insulin production), favourable influence on stress-reaction of biological systems of organism decrease of atherogenity index. Optimisation and efficiency of AMI therapy during treatment in the hospital is possible, with plasma exchange of extracorporeal-thermally modified autoplasma included in complex therapy. PMID:9575618

  16. Comparison of treatment effect of neuromuscular electrical stimulation and thermal-tactile stimulation on patients with sub-acute dysphagia caused by stroke

    PubMed Central

    Byeon, Haewon; Koh, Hyeung Woo

    2016-01-01

    [Purpose] The effectiveness of neuromuscular electrical stimulation in the rehabilitation of swallowing remains controversial. This study compared the effectiveness of neuromuscular electrical stimulation and thermal tactile oral stimulation, a traditional swallowing recovery treatment, in patients with sub-acute dysphagia caused by stroke. [Subjects and Methods] Subjects of the present study were 55 patients diagnosed with dysphagia caused by stroke. This study had a nonequivalent control group pretest-posttest design. [Results] Analysis of pre-post values of videofluoroscopic studies of the neuromuscular electrical stimulation and thermal tactile oral stimulation groups using a paired t-test showed no significant difference between the two groups despite both having decreased mean values of the videofluoroscopic studies after treatment. [Conclusion] This study’s findings show that both neuromuscular electrical stimulation and thermal tactile oral stimulation significantly enhanced the swallowing function of patients with sub-acute dysphagia. PMID:27390421

  17. Exceptional thermal tolerance and water resistance in the mite Paratarsotomus macropalpis (Erythracaridae) challenge prevailing explanations of physiological limits.

    PubMed

    Wu, Grace C; Wright, Jonathan C

    2015-11-01

    Physiological performance and tolerance limits in metazoans have been widely studied and have informed our understanding of processes such as extreme heat and cold tolerance, and resistance to water loss. Because of scaling considerations, very small arthropods with extreme microclimatic niches provide promising extremophiles for testing predictive physiological models. Corollaries of small size include rapid heating and cooling (small thermal time constants) and high mass-specific metabolic and water exchange rates. This study examined thermal tolerance and water loss in the erythracarid mite Paratarsotomus macropalpis (Banks, 1916), a species that forages on the ground surface of the coastal sage scrub habitat of Southern California, USA. Unlike most surface-active diurnal arthropods, P. macropalpis remains active during the hottest parts of the day in midsummer. We measured water-loss gravimetrically and estimated the critical thermal maximum (CTmax) by exposing animals to a given temperature for 1h and then increasing temperature sequentially. The standardized water flux of 4.4ngh(-1)cm(-2)Pa(-1), averaged for temperatures between 22 and 40°C, is among the lowest values reported in the literature. The CTmax of 59.4°C is, to our knowledge, the highest metazoan value reported for chronic (1-h) exposure, and closely matches maximum field substrate temperatures during animal activity. The extraordinary physiological performance seen in P. macropalpis likely reflects extreme selection resulting from its small size and resultant high mass-specific water loss rate and low thermal time-constant. Nevertheless, the high water resistance attained with a very thin lipid barrier, and the mite's exceptional thermal tolerance, challenge existing theories seeking to explain physiological limits. PMID:26255840

  18. Effects of a Dissostichus mawsoni-CaM recombinant proteins feed additive on the juvenile orange-spotted grouper (Epinephelus coioides) under the acute low temperature challenge.

    PubMed

    Luo, Sheng-Wei; Wang, Wei-Na; Cai, Luo; Qi, Zeng-Hua; Wang, Cong; Liu, Yuan; Peng, Chang-Lian; Chen, Liang-Biao

    2015-10-01

    The effects of Dissostichus mawsoni-Calmodulin (Dm-CaM) on growth performance, enzyme activities, respiratory burst, MDA level and immune-related gene expressions of the orange-spotted grouper (Epinephelus coioides) exposed to the acute low temperature stress were evaluated. The commercial diet supplemented with Dm-CaM protein was fed to the groupers for 6 weeks. No significant difference was observed in the specific growth rates, weight gains and survivals. After the feeding trial, the groupers were exposed to acute low temperature challenge. The groupers fed with Dm-CaM additive diet showed a significant decrease in the respiratory burst activity, while the blood cell number increased significantly at 25 °C by comparing with the control and additive control group. The enzymatic activity of SOD, ACP and ALP increased significantly in Dm-CaM additive group, while MDA level maintained stable with the lowest value. qRT-PCR analysis indicated that the up-regulated transcript expressions of CaM, C3, SOD2, LysC and HSPA4 were observed in Dm-CaM additive group. These results indicated that Dm-CaM additive diet may regulate the grouper immune response to the acute low temperature challenge. PMID:26122279

  19. Temperature regulation in adult quail (Colinus virginianus) during acute thermal stress.

    PubMed

    Spiers, D E; Adams, T; Ringer, R K

    1983-01-01

    1. Evaporative heat loss, O2 consumption, CO2 production, and internal body temperature were measured in unanesthetized, unrestrained bobwhite (Colinus virginianus) at specific ambient temperatures (Ta). 2. No significant change in body temperature occurred at any Ta tested, but metabolic heat production (H) increased from 42.17 W/m2 at Ta 35 degrees C to 102.89 W/m2 at Ta 10 degrees C. 3. Evaporative heat loss (E) increased approximately two-fold from Ta 10-35 degrees C, with E/H increasing exponentially over the same temperature range. 4. No significant change in thermal insulation occurred from Ta 10-30 degrees C. 5. Combined convective and radiative heat transfer for the bobwhite was 2.96 W/m2 X C from Ta 10-35 degrees C. PMID:6131780

  20. Thermal sensation during mild hyperthermia is modulated by acute postural change in humans

    NASA Astrophysics Data System (ADS)

    Takeda, Ryosuke; Imai, Daiki; Suzuki, Akina; Ota, Akemi; Naghavi, Nooshin; Yamashina, Yoshihiro; Hirasawa, Yoshikazu; Yokoyama, Hisayo; Miyagawa, Toshiaki; Okazaki, Kazunobu

    2016-05-01

    Thermal sensation represents the primary stimulus for behavioral and autonomic thermoregulation. We assessed whether the sensation of skin and core temperatures for the driving force of behavioral thermoregulation was modified by postural change from the supine (Sup) to sitting (Sit) during mild hyperthermia. Seventeen healthy young men underwent measurements of noticeable increase and decrease (±0.1 °C/s) of skin temperature (thresholds of warm and cold sensation on the skin, 6.25 cm2 of area) at the forearm and chest and of the whole-body warm sensation in the Sup and Sit during normothermia (NT; esophageal temperature (Tes), ˜36.6 °C) and mild hyperthermia (HT; Tes, ˜37.2 °C; lower legs immersion in 42 °C of water). The threshold for cold sensation on the skin at chest was lower during HT than NT in the Sit (P < 0.05) but not in Sup, and at the forearm was lower during HT than NT in the Sup and further in Sit (both, P < 0.05), with interactive effects of temperature (NT vs. HT) × posture (Sup vs. Sit) (chest, P = 0.08; forearm, P < 0.05). The threshold for warm sensation on the skin at both sites remained unchanged with changes in body posture or temperature. The whole-body warm sensation was higher during HT than NT in both postures and higher in the Sit than Sup during both NT and HT (all, P < 0.05). Thus, thermal sensation during mild hyperthermia is modulated by postural change from supine to sitting to sense lesser cold on the skin and more whole-body warmth.

  1. Acute heat stress and thermal acclimation induce CCAAT/enhancer-binding protein delta in the goby Gillichthys mirabilis.

    PubMed

    Buckley, Bradley A

    2011-08-01

    Members of the CCAAT/enhancer-binding protein (C/EBP) family of transcription factors have regulatory control over numerous processes related to cell fate determination, including differentiation, proliferation, cell cycle arrest and apoptosis. In mammals, abnormalities in the expression of some isoforms of C/EBPs are pathogenic and are implicated as being involved in myeloid leukemia and breast cancers. Next to nothing is known about their regulation, function or stress-responsiveness in poikilotherms. Here, both acute heat stress and thermal acclimation were demonstrated to induce the expression of one isoform, C/EBP-δ, in the liver, white muscle and gill of the eurythermal estuarine goby, Gillichthys mirabilis. The established role of C/EBP-δ in causing cell cycle arrest and/or promoting apoptosis in other vertebrates suggests that the heat-inducibility of this protein in poikilotherms may be part of the conserved cellular stress response with the hypothesized role of causing temporary cessation of cell growth and/or programmed cell death during bouts of environmental stress. The observed regulation of c/ebp-δ during hyperthermia represents a novel, heat-inducible signaling pathway in fishes. PMID:21442321

  2. Impact of variation in acute virulence of BVDV1 strains on design of better vaccine efficacy challenge models

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Due to antigenic differences between BVDV1 and BVDV2 strains both pestivirus species are included in U.S. vaccines. The efficacy of these vaccines in preventing acute infections is evaluated based on reduction of clinical disease. While high virulence BVDV2 strains are used in U.S. vaccine efficac...

  3. A RESPIRATORY DISEASE MODEL FOR ASSESSMENT OF CLINICAL AND PATHOLOGIC CROSS-PROTECTION FOLLOWING HETEROLOGOUS ACUTE-TYPE PRRSV CHALLENGE.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Acute-type PRRS outbreaks were first observed in 1996. They are characterized by severe reproductive and respiratory clinical disease losses (including sow mortalities) in PRRSV “immune” herds (regularly vaccinated or systematically exposed). This study was designed to document and validate the inef...

  4. Identifying Thermally Challenging Landscapes and Time Periods for Wildlife Using Remote Sensing

    NASA Astrophysics Data System (ADS)

    Albright, T. P.; Pidgeon, A.; Radeloff, V.; Wardlow, B.

    2011-12-01

    Recent events and climate model outputs indicate an increase in the occurrence and magnitude of heat waves and other high temperature events in many locations. Temperatures at the land surface may be much higher than air temperatures making this a particularly relevant consideration for animals that nest, forage, or seek refuge at or near the ground. Often associated with heat waves are prolonged and/or rapid onset drought events, which can combine to place stress on vegetation and animals. In order to assess the influence of heat waves and drought on communities of birds, we developed statistical models between avian abundance and species richness data collected by volunteer observers as part of the North American Breeding Bird Survey and a suite of precipitation and temperature metrics. We used station data, gridded standardized precipitation indices, and remotely sensed vegetation indices, and developed an index of accumulated temperature exceedance using time series MODIS land surface temperature (LST) products. Mixed effects models accounting for nuisance factors and temporal autocorrelation revealed that LST was among the strongest predictors of same year and following-year avian abundance. In particular, declines in abundance were largest and most common among ground-nesting birds and long-distance migrants in the US Southwest. In cooler regions, high LST exceedances were sometimes associated with increases in abundance. Because these results do not indicate whether dispersal, reproductive effort, or mortality explain the changes, one area of current research focuses on identifying demographic mechanisms and population consequences of such responses. A second area of active research focuses on using LST data in conjunction with digital elevation models and derivatives and dense networks of ground-level observations to produce physiologically-relevant indicators of thermally stressful conditions for birds and other animals.

  5. Functional analysis of a dietary recombinant fatty acid binding protein 10 (FABP10) on the Epinephelus coioides in response to acute low temperature challenge.

    PubMed

    Luo, Sheng-Wei; Cai, Luo; Liu, Yuan; Wang, Wei-Na

    2014-02-01

    The effect of Ec-FABP10 (Epinephelus coiodes-FABP10) on growth performance, enzyme activity, respiratory burst, MDA level, ATP content, immune-related gene expression of juvenile orange-spotted grouper (E. coioides). The commercial diet supplemented with FABP10 protein was feed to orange-spotted grouper for six weeks. No significant difference was observed in the specific growth rates, while the survival rate in the FABP10 additive group was significantly higher. After the feeding trial, the groupers were exposed to acute low temperature challenge. The decreased level of respiratory burst activity was observed in the FABP10 additive group after the exposure to the acute low temperature stress, while the blood cell count increased significantly at 15 °C and a significant increase of ATP content was observed at 10 °C. Higher enzymatic activities of CAT and SOD were observed at 20 °C and 15 °C, respectively. Meanwhile, the lower level of MDA was observed after the exposure to acute low temperature challenge by comparing with the controls. Further transcript expression analyses of FABP10, SOD2, GPX4, HSPA4 and LIPC in liver by quantitative real-time PCR demonstrated that the up-regulated transcript expression of FABP10, SOD2, HSPA4 and LIPC was observed in FABP10 additive group at 15 °C, while the transcript expression of GPX4 increased significantly at 20 °C. Western blotting analysis confirmed that FABP10 protein expression strongly increased at 15 ± 0.5 °C in FABP10 additive group. These results showed that FABP10 additive diet could moderate the metabolic and immune abilities mainly via ROS pathway in the orange-spotted grouper. PMID:24412164

  6. Challenges and Rewards on the Road to Translational Systems Biology in Acute Illness: Four Case Reports from Interdisciplinary Teams

    PubMed Central

    An, Gary; Hunt, C. Anthony; Clermont, Gilles; Neugebauer, Edmund; Vodovotz, Yoram

    2007-01-01

    Introduction Translational systems biology approaches can be distinguished from mainstream systems biology in that their goal is to drive novel therapies and streamline clinical trials in critical illness. One systems biology approach, dynamic mathematical modeling (DMM), is increasingly used in dealing with the complexity of the inflammatory response and organ dysfunction. The use of DMM often requires a broadening of research methods and a multidisciplinary team approach that includes bioscientists, mathematicians, engineers, and computer scientists. However, the development of these groups must overcome domain-specific barriers to communication and understanding. Methods We present four case studies of successful translational, interdisciplinary systems biology efforts, which differ by organizational level from an individual to an entire research community. Results Case 1 is a single investigator involved in DMM of the acute inflammatory response at Cook County Hospital, in which extensive translational progress was made using agent-based models of inflammation and organ damage. Case 2 is a community-level effort from the University of Witten-Herdecke in Cologne, whose efforts have led to the formation of the Society for Complexity in Acute Illness. Case 3 is an institution-based group, the Biosystems Group at the University of California, San Francisco, whose work has included a focus on a common lexicon for DMM. Case 4 is an institution-based, trans-disciplinary research group (the Center for Inflammation and Regenerative Modeling at the University of Pittsburgh, whose modeling work has led to internal education efforts, grant support, and commercialization. Conclusion A transdisciplinary approach, which involves team interaction in an iterative fashion to address ambiguity and is supported by educational initiatives, is likely to be necessary for DMM in acute illness. Community-wide organizations such as the Society of Complexity in Acute Illness (SCAI) must

  7. Acute generalized exanthematous pustulosis x Von Zumbusch’s pustular psoriasis: A diagnostic challenge in a psoriatic patient*

    PubMed Central

    de Sousa, Aline Soares; Lara, Osório Alves Corrêa de Castro; Papaiordanou, Francine; Marchioro, Gláucia Silva Simioni; Tebcherani, Antonio José

    2015-01-01

    Severe cutaneous drug reactions include a wide spectrum of clinical manifestations ranging from mild morbilliform cutaneous rash, to severe forms of hypersensitivity. Special attention is given in this report to the acute generalized exanthematous pustulosis (AGEP), induced in 90% of cases by the use of systemic drugs, especially aminopenicillins and macrolides. The incidence of the disease is low, 1-5 cases per million patients / year. The main differential diagnosis is Von Zumbusch's Pustular Psoriasis. The prognosis is generally good and the disease self limited, after withdrawal of the triggering drug. In this report the authors describe a case of AGEP, triggered by ceftriaxone in a patient with psoriasis vulgaris. PMID:26375226

  8. Dopamine and Pain Sensitivity: Neither Sulpiride nor Acute Phenylalanine and Tyrosine Depletion Have Effects on Thermal Pain Sensations in Healthy Volunteers

    PubMed Central

    Becker, Susanne; Ceko, Marta; Louis-Foster, Mytsumi; Elfassy, Nathaniel M.; Leyton, Marco; Shir, Yoram; Schweinhardt, Petra

    2013-01-01

    Based on animal studies and some indirect clinical evidence, dopamine has been suggested to have anti-nociceptive effects. Here, we investigated directly the effects of increased and decreased availability of extracellular dopamine on pain perception in healthy volunteers. In Study 1, participants ingested, in separate sessions, a placebo and a low dose of the centrally acting D2-receptor antagonist sulpiride, intended to increase synaptic dopamine via predominant pre-synaptic blockade. No effects were seen on thermal pain thresholds, tolerance, or temporal summation. Study 2 used the acute phenylalanine and tyrosine depletion (APTD) method to transiently decrease dopamine availability. In one session participants ingested a mixture that depletes the dopamine amino acid precursors, phenylalanine and tyrosine. In the other session they ingested a nutritionally balanced control mixture. APTD led to a small mood-lowering response following aversive thermal stimulation, but had no effects on the perception of cold, warm, or pain stimuli. In both studies the experimental manipulation of dopaminergic neurotransmission was successful as indicated by manipulation checks. The results contradict proposals that dopamine has direct anti-nociceptive effects in acute experimental pain. Based on dopamine’s well-known role in reward processing, we hypothesize that also in the context of pain, dopamine acts on stimulus salience and might play a role in the initiation of avoidance behavior rather than having direct antinociceptive effects in acute experimental pain. PMID:24236199

  9. World Health organization guidelines for management of acute stress, PTSD, and bereavement: key challenges on the road ahead.

    PubMed

    Tol, Wietse A; Barbui, Corrado; Bisson, Jonathan; Cohen, Judith; Hijazi, Zeinab; Jones, Lynne; de Jong, Joop T V M; Magrini, Nicola; Omigbodun, Olayinka; Seedat, Soraya; Silove, Derrick; Souza, Renato; Sumathipala, Athula; Vijayakumar, Lakshmi; Weissbecker, Inka; Zatzick, Douglas; van Ommeren, Mark

    2014-12-01

    Wietse Tol and colleagues discuss some of the key challenges for implementation of new WHO guidelines for stress-related mental health disorders in low- and middle-income countries. Please see later in the article for the Editors' Summary. PMID:25514024

  10. Acute mortality, bacterial load and pathology of select lines of adult rainbow trout challenged with Weissella sp. NC36

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A challenge of genetic improvement for disease resistance in fish is to understand specificity of resistance and whether selection for one pathogen alters the response to unrelated pathogenic microorganisms. Adult rainbow trout Oncorhynchus mykiss that had been bred for differential susceptibility...

  11. Acute sacroiliitis.

    PubMed

    Slobodin, Gleb; Rimar, Doron; Boulman, Nina; Kaly, Lisa; Rozenbaum, Michael; Rosner, Itzhak; Odeh, Majed

    2016-04-01

    The purpose of this study was to review the data on the etiology, risk factors, clinical presentations, and diagnosis of acute sacroiliitis. A Pubmed search utilizing the indexing term "acute sacroiliitis" was conducted and the data pertinent to the aim of the review was extracted and organized in accordance with the preplanned structure of the manuscript. The diagnosis of acute sacroiliitis is often challenging because of both the relative rarity of this presentation and diverse character of acute sacroiliac pain, frequently mimicking other, more prevalent disorders. Technetium bone scintigraphy can localize the disease process to the sacroiliac joint, while computed tomography or magnetic resonance imaging can be used for the detailed characterization and the extent of the disease as well as the diagnosis of complications. Pyogenic sacroiliitis is by far the most common cause of acute sacroiliitis. Brucellosis, acute sacroiliitis in the course of reactive arthritis, and crystalline-induced sacroiliitis frequently imitate pyogenic sacroiliitis. Acute sacroiliitis can rarely be also related to hematological malignancies or treatment with isotretinoin. Awareness to the possibility of acute sacroiliitis and a thorough physical examination are the necessary prerequisites to its timely diagnosis, while the appropriate laboratory and imaging studies should confirm the precise diagnosis and direct the appropriate treatment strategy. PMID:26847855

  12. A novel challenge test incorporating irradiation (60Co) of compost sub-samples to validate thermal lethality towards pathogenic bacteria.

    PubMed

    Moore, John E; Watabe, Miyuki; Stewart, Andrew; Cherie Millar, B; Rao, Juluri R

    2009-01-01

    Maturing compost heaps normally attaining temperatures ranging from 55 to 65 degrees C is generally regarded to conform to recommended biological risks and sanitation standards for composts stipulated by either EU or US-EPA. Composted products derived from animal sources are further required by EU biohazard safety regulatory legislation that such composts either attain 70 degrees C for over 3h during maturation or via treatment at 70 degrees C for 1h before being considered for dispensation on land. The setting of the upper limit of thermal lethality at 70 degrees C/1h for achieving biosecurity of the animal waste composted products (e.g. pelleted fertilizer formulations) is not properly substantiated by specific validation tests, comprising a 'wipe-out' step (usually via autoclaving) followed by inoculation of a prescribed bacterium, exposure to 70 degrees C/1h and the lethality determined. Pelleted formulations of composts are not amenable for wet methods (autoclaving) for wipe-out sterilization step as this is detrimental to the pellet and compromises sample integrity. This study describes a laboratory method involving the employment of ((60)Co) irradiation 'wipe-out' step to: (a) compost sub-samples drawn from compost formulation heaps and (b) pelleted products derived from composted animal products while determining the thermal lethality of a given time/temperature (70 degrees C/1h) treatment process and by challenging the irradiated sample (not just with one bacterium but), out with 10 potential food-poisoning organisms from the bacterial genera (Campylobacter, Escherichia, Listeria, Salmonella, Yersinia) frequently detected in pig and poultry farm wastes. This challenge test on compost sub-samples can be a useful intervention ploy for 'inspection and validation' technique for composters during the compost maturity process, whose attainment of temperatures of 55-65 degrees C is presumed sufficient for attainment of sanitation. Stringent measures are further

  13. Acute Effects of Pathogenic Simian-Human Immunodeficiency Virus Challenge on Vaccine-Induced Cellular and Humoral Immune Responses to Gag in Rhesus Macaques†

    PubMed Central

    Steger, Krista K.; Waterman, Paul M.; Pauza, C. David

    1999-01-01

    Simian-human immunodeficiency virus (SHIV) infection in macaques provides a convenient model for testing vaccine efficacy and for understanding viral pathogenesis in AIDS. We immunized macaques with recombinant, Salmonella typhimurium (expressing Gag) or soluble Gag in adjuvant to generate T-cell-dependent lymphoproliferative or serum antibody responses. Immunized animals were challenged by intrarectal inoculation with SHIV89.6PD. Virus infection was accompanied by rapid losses of lymphoproliferative responses to Gag or phytohemagglutinin. By 8 weeks, mitogen responses recovered to near normal levels but antigen-specific immunity remained at low or undetectable levels. Serum antibody levels were elevated initially by virus exposure but soon dropped well below levels achieved by immunization. Our studies show a rapid depletion of preexisting Gag-specific CD4+ T cells that prevent or limit subsequent antiviral cellular and humoral immune responses during acute SHIV infection. PMID:9971763

  14. Effects of fermented soybean meal on innate immunity-related gene expressions in nursery pigs acutely challenged with lipopolysaccharides.

    PubMed

    Roh, Sang-Gun; Carroll, Jeffery A; Kim, Sung Woo

    2015-05-01

    This experiment was to determine if replacing soybean meal with fermented soybean meal (FSBM) would reduce the innate immune response after lipopolysaccharide challenge and the changes of gene expression profiles associated with this response. Forty-eight 21 day-old pigs were housed individually and fed three diets for 15 days: CON (a diet without FSBM or spray-dried plasma protein; SDPP), PP7 (a diet with 7% SDPP), and FS10 (a diet with 10% FSBM). Pigs were fitted with a jugular vein catheters receiving lipopolysaccharide challenge (25 μg/kg body weight (BW)) on day 15. Blood was collected for 5 h at 30-min intervals to measure cortisol. Expressions of gene transcripts in total RNA from leukocytes were compared using an oligonucleotide microarray at 210 min after lipopolysaccharides injection. Cortisol of FS10 was lower (P < 0.05) than CON after lipopolysaccharides challenge. The expression levels of 17 transcripts, including cytosolic glutathione peroxidase and glutathione S-transferase A4-4 were increased (P < 0.05), whereas 23 genes including adiponectin, neonatal Fc receptor and tumor necrosis factor ligand superfamily member 5 were decreased (P < 0.05) in FS10. This study suggests that FSBM-fed pigs can modulate expression of genes related to inflammatory response and anti-oxidant activity which can be a potential reason for reduced serum cortisol. PMID:25440755

  15. Oxygen consumption and haematology of juvenile shortnose sturgeon Acipenser brevirostrum during an acute 24 h saltwater challenge.

    PubMed

    Penny, F M; Kieffer, J D

    2014-04-01

    This study focused on the acute physiological responses to saltwater exposure in juvenile shortnose sturgeon Acipenser brevirostrum. In two separate laboratory experiments, 2 year-old A. brevirostrum were exposed to either full (32) or half-strength (16) seawater for up to 24 h. First, oxygen consumption rates were used to estimate the metabolic costs over 24 h. Secondly, blood and muscle samples were analysed at 6, 12 and 24 h for water loss, various measures of osmoregulatory status (plasma osmolality and ions) and other standard haematological variables. Juveniles exposed to full-strength seawater showed significant decreases in oxygen consumption rates during the 24 h exposure. Furthermore, seawater-exposed fish had significantly increased plasma osmolality, ions (Na(+) and Cl(-)) and a 17% decrease in total wet mass over the 24 h exposure period. To a lesser extent, increases in osmolality, ions and mass loss were observed in fish exposed to half-strength seawater but no changes to oxygen consumption. Cortisol was also significantly increased in fish exposed to full-strength seawater. While plasma protein was elevated following 24 h in full-strength seawater, haemoglobin, haematocrit and plasma glucose levels did not change with increased salinity. These results imply an inability of juvenile A. brevirostrum to regulate water and ions in full-strength seawater within 24 h. Nonetheless, no mortality occurred in any exposure, suggesting that juvenile A. brevirostrum can tolerate short periods in saline environments. PMID:24628001

  16. Acute care hospital strategic priorities: perceptions of challenges, control, competition and collaboration in Ontario's evolving healthcare system.

    PubMed

    Brown, Adalsteinn D; Alikhan, L Miin; Sandoval, Guillermo A; Seeman, Neil; Baker, G Ross; Pink, George H

    2005-01-01

    To explore the current and pending strategic agenda of Ontario hospitals (the largest consumers of the provincial healthcare budget), a survey of Ontario acute care hospital CEOs was conducted in January 2004. The survey, with an 82% response rate, identifies 29 strategic priorities under seven key strategic themes consistent across different hospital types. These themes include (1) human resources cultivation, (2) service integration and partnerships, (3) consumer engagement, (4) corporate governance and management, (5) organizational efficiency and redesign, (6) improved information use for decision-making, (7) patient care management. The extent to which an individual hospital's control over strategic resolutions is perceived may affect multilevel strategic priority-setting and action-planning. In addition to supporting ongoing development of meaningful performance measures and information critical to strategic decision-making, this study's findings may facilitate a better understanding of hospitals' key resource commitments, the extent of competition and collaboration for key resources, the perceived degree of individual control over strategic issue resolution and where systemic resolutions may be required. PMID:16078398

  17. Acclimation-dependent expression of heat shock protein 70 in Pacific abalone ( Haliotis discus hannai Ino) and its acute response to thermal exposure

    NASA Astrophysics Data System (ADS)

    Li, Jiaqi; He, Qingguo; Sun, Hui; Liu, Xiao

    2012-01-01

    Heat shock protein 70 (Hsp70) is one important member of heat shock protein (Hsp) family that is responsible for various stresses, especially thermal stress. Here we examined the response of Hsp70 gene to both chronic and acute thermal exposure in Pacific abalone ( Haliotis discus hannai Ino). For the chronic exposure, abalones were maintained at 8, 12, 20, and 30°C for four months and their mRNA levels were measured. The highest mRNA level of Hsp70 gene relative to actin gene was detected in the 30°C-acclimated group, followed by the 8°C-acclimated group and then the 12°C- and 20°C-acclimated groups. After the long-term acclimation, gills from each of the above acclimation groups were dissected and exposed to different temperatures between 8°C and 38°C for 30 min. Hsp70 expression in gills acclimated to different temperatures responded differentially to the same temperature exposure. The incubation temperature that induced maximum Hsp70 mRNA expression was higher in the higher temperature acclimation groups than lower temperature groups. Pacific abalones could alter the expression pattern of Hsp70 gene according to environmental thermal conditions, through which they deal with the stress of thermal variations.

  18. Responses in whole-body amino acid kinetics to an acute, sub-clinical endotoxin challenge in lambs.

    PubMed

    Hoskin, S O; Bremner, D M; Holtrop, G; Lobley, G E

    2016-02-28

    Some effects of parasitism, endotoxaemia or sepsis can be mitigated by provision of extra protein. Supplemented protein may encompass a metabolic requirement for specific amino acids (AA). The current study investigates a method to identify and quantify the amounts of AA required during inflammation induced by an endotoxin challenge. One of each pair of six twin sheep was infused in the jugular vein for 20 h with either saline (control) or lipopolysaccharide (LPS, 2 ng/kg body weight per min) from Escherichia coli. Between 12 and 20 h a mixture of stable isotope-labelled AA was infused to measure irreversible loss rates. From 16 to 20 h all sheep were supplemented with a mixture of unlabelled AA infused intravenously. Blood samples were taken before the start of infusions, and then continuously over intervals between 14 and 20 h. At 20 h the sheep were euthanised, and liver and kidney samples were taken for measurement of serine-threonine dehydratase (SDH) activity. LPS infusion decreased plasma concentrations of most AA (P<0·05; P<0·10 for leucine and tryptophan), except for phenylalanine (which increased P=0·022) and tyrosine. On the basis of the incremental response to the supplemental AA, arginine, aspartate, cysteine, glutamate, lysine (tendency only), glycine, methionine, proline, serine and threonine were important in the metabolic response to the endotoxaemia. The AA infusion between 16 and 20 h restored the plasma concentrations in the LPS-treated sheep for the majority of AA, except for glutamine, isoleucine, methionine, serine and valine. LPS treatment increased (P<0·02) SDH activity in both liver and kidney. The approach allows quantification of key AA required during challenge situations. PMID:26652711

  19. Acute BVDV-2 infection in beef calves delays humoral responses to a non-infectious antigen challenge

    PubMed Central

    McCorkell, Robert; Horsman, Shawn R.; Wynne-Edwards, Katherine; Muench, Greg; van Drunen Littel-van den Hurk, Sylvia; Waeckerlin, Regula; Eschbaumer, Michael; Dardari, Rkia; Chaiyakul, Mark; Gajda, Pawel; Czub, Markus; van der Meer, Frank

    2015-01-01

    Immunosuppressive effects of an intranasal challenge with non-cytopathic bovine viral diarrhea virus (BVDV) 2a (strain 1373) were assessed through acquired and innate immune system responses to ovalbumin (OVA). Concurrent BVDV infection was hypothesized to delay and reduce the humoral response to ovalbumin (administered on days 3 and 15 post-inoculation). Infected animals followed the expected clinical course. BVDV titers, and anti-BVDV antibodies confirmed the course of infection and were not affected by the administration of OVA. Both the T-helper (CD4+) and B-cell (CD20+) compartments were significantly (P < 0.05) reduced in infected animals, while the gamma-delta T-cell population (Workshop cluster 1+, WC1+) decreased slightly in numbers. Infection with BVDV delayed the increase in OVA IgG by approximately 3 d from day 12 through day 21 post-inoculation. Between days 25 and 37 post-inoculation following BVDV infection the IgM concentration in the BVDV− group decreased while the OVA IgM titer still was rising in the BVDV+ animals. Thus, active BVDV infection delays IgM and IgG responses to a novel, non-infectious antigen. PMID:26483584

  20. The effects of acute salinity challenges on osmoregulation in Mozambique tilapia reared in a tidally changing salinity.

    PubMed

    Moorman, Benjamin P; Lerner, Darren T; Grau, E Gordon; Seale, Andre P

    2015-03-01

    This study characterizes the differences in osmoregulatory capacity among Mozambique tilapia, Oreochromis mossambicus, reared in freshwater (FW), in seawater (SW) or under tidally driven changes in salinity. This was addressed through the use of an abrupt exposure to a change in salinity. We measured changes in: (1) plasma osmolality and prolactin (PRL) levels; (2) pituitary expression of prolactin (PRL) and its receptors, PRLR1 and PRLR2; (3) branchial expression of PRLR1, PRLR2, Na(+)/Cl(-) co-transporter (NCC), Na(+)/K(+)/2Cl(-) co-transporter (NKCC), α1a and α1b isoforms of Na(+)/K(+)-ATPase (NKA), cystic fibrosis transmembrane conductance regulator (CFTR), aquaporin 3 (AQP3) and Na(+)/H(+) exchanger 3 (NHE3). Mozambique tilapia reared in a tidal environment successfully adapted to SW while fish reared in FW did not survive a transfer to SW beyond the 6 h sampling. With the exception of CFTR, the change in the expression of ion pumps, transporters and channels was more gradual in fish transferred from tidally changing salinities to SW than in fish transferred from FW to SW. Upon transfer to SW, the increase in CFTR expression was more robust in tidal fish than in FW fish. Tidal and SW fish successfully adapted when transferred to FW. These results suggest that Mozambique tilapia reared in a tidally changing salinity, a condition that more closely represents their natural history, gain an adaptive advantage compared with fish reared in FW when facing a hyperosmotic challenge. PMID:25617466

  1. Influences of thermal acclimation and acute temperature change on the motility of epithelial wound-healing cells (keratocytes) of tropical, temperate and Antarctic fish.

    PubMed

    Ream, Rachael A; Theriot, Julie A; Somero, George N

    2003-12-01

    The ability to heal superficial wounds is an important element in an organism's repertoire of adaptive responses to environmental stress. In fish, motile cells termed keratocytes are thought to play important roles in the wound-healing process. Keratocyte motility, like other physiological rate processes, is likely to be dependent on temperature and to show adaptive variation among differently thermally adapted species. We have quantified the effects of acute temperature change and thermal acclimation on actin-based keratocyte movement in primary cultures of keratocytes from four species of teleost fish adapted to widely different thermal conditions: two eurythermal species, the longjaw mudsucker Gillichthys mirabilis (environmental temperature range of approximately 10-37 degrees C) and a desert pupfish, Cyprinodon salinus (10-40 degrees C), and two species from stable thermal environments, an Antarctic notothenioid, Trematomus bernacchii (-1.86 degrees C), and a tropical clownfish, Amphiprion percula (26-30 degrees C). For all species, keratocyte speed increased with increasing temperature. G. mirabilis and C. salinus keratocytes reached maximal speeds at 25 degrees C and 35 degrees C, respectively, temperatures within the species' normal thermal ranges. Keratocytes of the stenothermal species continued to increase in speed as temperature increased above the species' normal temperature ranges. The thermal limits of keratocyte motility appear to exceed those of whole-organism thermal tolerance, notably in the case of T. bernacchii. Keratocytes of T. bernacchii survived supercooling to -6 degrees C and retained motility at temperatures as high as 20 degrees C. Mean keratocyte speed was conserved at physiological temperatures for the three temperate and tropical species, which suggests that a certain rate of motility is advantageous for wound healing. However, there was no temperature compensation in speed of movement for keratocytes of the Antarctic fish, which

  2. Co-expression of heat shock protein (HSP) 40 and HSP70 in Pinctada martensii response to thermal, low salinity and bacterial challenges.

    PubMed

    Li, Jun; Zhang, Yuehuan; Liu, Ying; Zhang, Yang; Xiao, Shu; Yu, Ziniu

    2016-01-01

    Heat shock protein (HSP) 40 proteins are a family of molecular chaperones that bind to HSP70 through their J-domain and regulate the function of HSP70 by stimulating its adenosine triphosphatase activity. In the present study, a HSP40 homolog named PmHSP40 was cloned from the hemocytes of pearl oyster Pinctada martensii using EST and rapid amplification of cDNA ends (RACE) techniques. The full-length cDNA of PmHSP40 was 1251 bp in length, which included a 5' untranslated region (UTR) of 75 bp, an open reading frame (ORF) of a 663 bp, and a 3' UTR of 513 bp. The deduced amino acid sequence of PmHSP40 contains a J domain in the N-terminus. In response to thermal and low salinity stress challenges, the expression of PmHSP40 in hemocytes and the gill were inducible in a time-dependent manner. After bacterial challenge, PmHSP40 transcripts in hemocytes increased and peaked at 6 h post injection. In the gill, PmHSP40 expression increased, similar to expression in hemocytes; however, transcript expression of PmHSP40 was significantly up-regulated at 12 h post injection. Furthermore, the transcripts of PmHSP70 showed similar kinetics as that of PmHSP40, with highest induction during thermal, low salinity stress and bacterial challenges. Altogether these results demonstrate that PmHSP40 is an inducible protein under thermal, low salinity and bacterial challenges, suggesting its involvement in both environmental and biological stresses, and in the innate immunity of the pearl oyster. PMID:26679110

  3. Challenges of Establishing the Correct Diagnosis of Outbreaks of Acute Febrile Illnesses in Africa: The Case of a Likely Brucella Outbreak among Nomadic Pastoralists, Northeast Kenya, March–July 2005

    PubMed Central

    Ari, Mary D.; Guracha, Argata; Fadeel, Moustafa Abdel; Njuguna, Charles; Njenga, M. Kariuki; Kalani, Rosalia; Abdi, Hassan; Warfu, Osman; Omballa, Victor; Tetteh, Christopher; Breiman, Robert F.; Pimentel, Guillermo; Feikin, Daniel R.

    2011-01-01

    An outbreak of acute febrile illness was reported among Somali pastoralists in remote, arid Northeast Kenya, where drinking raw milk is common. Blood specimens from 12 patients, collected mostly in the late convalescent phase, were tested for viral, bacterial, and parasitic pathogens. All were negative for viral and typhoid serology. Nine patients had Brucella antibodies present by at least one of the tests, four of whom had evidence suggestive of acute infection by the reference serologic microscopic agglutination test. Three patients were positive for leptospiral antibody by immunoglobulin M enzyme-linked immunosorbent assay, and two were positive for malaria. Although sensitive and specific point-of-care testing methods will improve diagnosis of acute febrile illness in developing countries, challenges of interpretation still remain when the outbreaks are remote, specimens collected too late, and positive results for multiple diseases are obtained. Better diagnostics and tools that can decipher overlapping signs and symptoms in such settings are needed. PMID:22049048

  4. Assessment of thermal sensitivity in rats using the thermal place preference test: description and application in the study of oxaliplatin-induced acute thermal hypersensitivity and inflammatory pain models.

    PubMed

    Balayssac, David; Ling, Bing; Ferrier, Jérémy; Pereira, Bruno; Eschalier, Alain; Authier, Nicolas

    2014-04-01

    Thermal sensitivity is an essential characteristic of some painful states, including oxaliplatin-induced neuropathy. The thermal place preference test (TPPT) was designed to finely assess thermal sensitivity in rodents. The TPPT monitors the time spent by unrestrained rodents on a test plate at fixed temperatures (5-50°C) compared with an adjacent reference plate at a neutral temperature (25°C). Here, we report the results of a study designed (i) to validate the optimal methodological parameters for measuring thermal sensitivity in rats, (ii) to assess the thermal sensitivity of healthy rats and animal models of pain and (iii) to explore the pharmacological effects of analgesic drugs. The most reproducible conditions occurred when the TPPT was performed in the morning and in the dark for 3 min with the reference plate set to 25°C. The temperature preferences of healthy rats were more than 17°C and less than 40°C. When compared with control animals, oxaliplatin-treated rats showed thermal hypersensitivity at 12, 20 and 35°C, and carrageenan-treated rats showed thermal hypersensitivity at 15 and 45°C. Duloxetine (2.5 mg/kg, intraperitoneal) reversed oxaliplatin-induced cold hypersensitivity (20°C) and morphine (1 mg/kg, intravenous) reversed carrageenan-induced heat hypersensitivity (45°C). We conclude that the TPPT enables a fine-grained assessment of thermal sensitivity that is relevant to the pathophysiological exploration of animal pain models and to the pharmacological assessment of analgesic drugs. PMID:24525711

  5. Challenges in detecting pre-malignant pancreatic lesions during acute pancreatitis using a serum microRNA assay: a study based on KrasG12D transgenic mice

    PubMed Central

    Hong, Xiafei; Zhang, Jie; Wu, Qiao; Wang, Wenze; Ye, Adam Yongxin; Song, Wei; Dai, Hongmei; Wang, Xianze; Wu, Fan; You, Lei; Wu, Wenming; Zhao, Yupei

    2016-01-01

    Caerulein-induced acute pancreatitis accelerates the progression of pancreatic intraepithelial neoplasia (PanIN) lesions in a pancreas-specific KrasG12D mouse model. The purpose of this study was to explore whether serum microRNAs (miRNAs) can serve as sensitive biomarkers to detect occult PanIN in the setting of acute pancreatitis. Serum miRNA profiles were quantified by an array-based method and normalized by both Variance Stabilization Normalization (VSN) and invariant methods. Individual miRNAs were validated by TaqMan real-time PCR with synthetic spike-in C. elegans miRNAs as external controls. Serum miRNA profiles distinguished KrasG12D mice with pancreatitis from wild-type mice without pancreatitis, but failed to differentiate KrasG12D mice with pancreatitis from wild-type mice with pancreatitis. Most individual miRNAs that increased in KrasG12D mice with pancreatitis were not significantly different between KrasG12D mice without pancreatitis and wild-type mice without pancreatitis. Mechanistically, Gene Set Enrichment Analysis (GSEA) of the mRNA array data and immunohistochemical assays showed that caerulein-induced acute pancreatitis involved acinar cell loss and immune cell infiltration, which might contribute to serum miRNA profile changes. This study highlighted the challenges in using sensitive serum miRNA biomarker screening for the early detection of pancreatic malignancies during acute pancreatitis. PMID:27009811

  6. Some computational challenges of developing efficient parallel algorithms for data-dependent computations in thermal-hydraulics supercomputer applications

    SciTech Connect

    Woodruff, S.B.

    1992-05-01

    The Transient Reactor Analysis Code (TRAC), which features a two- fluid treatment of thermal-hydraulics, is designed to model transients in water reactors and related facilities. One of the major computational costs associated with TRAC and similar codes is calculating constitutive coefficients. Although the formulations for these coefficients are local the costs are flow-regime- or data-dependent; i.e., the computations needed for a given spatial node often vary widely as a function of time. Consequently, poor load balancing will degrade efficiency on either vector or data parallel architectures when the data are organized according to spatial location. Unfortunately, a general automatic solution to the load-balancing problem associated with data-dependent computations is not yet available for massively parallel architectures. This document discusses why developers algorithms, such as a neural net representation, that do not exhibit algorithms, such as a neural net representation, that do not exhibit load-balancing problems.

  7. Acute porphyric disorders.

    PubMed

    Moore, A W; Coke, J M

    2000-09-01

    Acute porphyrias are classified into 3 distinct groups of rare genetic disorders of metabolic enzyme biosynthesis. Acute porphyrias can significantly impact multiple organ systems, which often provides a challenge to the dentist presented with such a patient. A case of hereditary coproporphyria is reported in a patient with many of the classical signs and symptoms. The patient also had complex dental needs that required special medical and pharmacotherapeutic modifications. The acute porphyrias are reviewed by the authors with presentation of this challenging case. Recommendations for other dental health care professionals encountering these patients are then presented. PMID:10982942

  8. An adenine nucleotide translocase (ANT) gene from Apostichopus japonicus; molecular cloning and expression analysis in response to lipopolysaccharide (LPS) challenge and thermal stress.

    PubMed

    Liu, Qiu-Ning; Chai, Xin-Yue; Tu, Jie; Xin, Zhao-Zhe; Li, Chao-Feng; Jiang, Sen-Hao; Zhou, Chun-Lin; Tang, Bo-Ping

    2016-02-01

    The adenine nucleotide translocases (ANTs) play a vital role in energy metabolism via ADP/ATP exchange in eukaryotic cells. Apostichopus japonicus (Echinodermata: Holothuroidea) is an important economic species in China. Here, a cDNA representing an ANT gene of A. japonicus was isolated and characterized from respiratory tree and named AjANT. The full-length AjANT cDNA is 1924 bp, including a 5'-untranslated region (UTR) of 38 bp, 3'-UTR of 980 bp and an open reading frame (ORF) of 906 bp encoding a polypeptide of 301 amino acids. The protein contains three homologous repeat Mito_carr domains (Pfam00153). The deduced AjANT protein sequence has 49-81% in comparison to ANT proteins from other individuals. The predicted tertiary structure of AjANT protein is highly similar to animal ANT proteins. Phylogenetic analysis showed that the AjANT is closely related to Holothuroidea ANT genes. Real-time quantitative reverse transcription-PCR (qPCR) analysis showed that AjANT expression is higher in the respiratory tree than in other examined tissues. After thermal stress or LPS challenge, expression of AjANT was significantly fluctuant compared to the control. These results suggested that changes in the expression of ANT gene might be involved in immune defense and in protecting A. japonicus against thermal stress. PMID:26706223

  9. Thermal manipulation during broiler chicken embryogenesis: Effect on mRNA expressions of Hsp108, Hsp70, Hsp47 and Hsf-3 during subsequent post-hatch thermal challenge.

    PubMed

    Al-Zghoul, Mohammad-Borhan; Dalab, Abd Elhafeed S; Yahya, Imaad E; Althnaian, Thnaian A; Al-Ramadan, Saeed Y; Ali, Abdelhadi M; Albokhadaim, Ibrahim F; El-Bahr, Sabry M; Al Busadah, Khalid Ahmed; Hannon, Kevin M

    2015-12-01

    Effects of thermal manipulation during broiler chicken embryonic days 12-18 on body temperature (T(b)) and mRNA expressions of Hsp108, Hsp70, Hsp47 and Hsf-3 in muscle, heart and brain tissues during subsequent thermal challenge (TC) were investigated. Fertile chicken eggs were divided randomly into four groups (n=375): eggs in the control group were maintained at 37.8°C and 56% (RH). Eggs in TM1 group were subjected to TM at 39°C for 9h during ED 12-18. Eggs in the TM2 and TM3 groups were subjected to the same protocol of TM1 except for increasing the period of exposure to 12h and 18h, respectively. During TC (43°C for 6h) at days 10 and 28, T(b) of TM chicks was significantly lower compared to controls. Furthermore, significant changes in mRNA expressions of Hsp108, Hsp70 and Hsp47 in muscle, heart and brain tissues were observed. PMID:26679820

  10. A challenge for diagnosing acute liver injury with concomitant/sequential exposure to multiple drugs: can causality assessment scales be utilized to identify the offending drug?

    PubMed

    Lim, Roxanne; Choudry, Hassan; Conner, Kim; Karnsakul, Wikrom

    2014-01-01

    Drug-induced hepatotoxicity most commonly manifests as an acute hepatitis syndrome and remains the leading cause of drug-induced death/mortality and the primary reason for withdrawal of drugs from the pharmaceutical market. We report a case of acute liver injury in a 12-year-old Hispanic boy, who received a series of five antibiotics (amoxicillin, ceftriaxone, vancomycin, ampicillin/sulbactam, and clindamycin) for cervical lymphadenitis/retropharyngeal cellulitis. Histopathology of the liver biopsy specimen revealed acute cholestatic hepatitis. All known causes of acute liver injury were appropriately excluded and (only) drug-induced liver injury was left as a cause of his cholestasis. Liver-specific causality assessment scales such as Council for the International Organization of Medical Sciences/Roussel Uclaf Causality Assessment Method scoring system (CIOMS/RUCAM), Maria and Victorino scale, and Digestive Disease Week-Japan were applied to seek the most likely offending drug. Although clindamycin is the most likely cause by clinical diagnosis, none of causality assessment scales aid in the diagnosis. PMID:25506455

  11. Acute Bronchitis

    MedlinePlus

    ... or though physical contact (for example, on unwashed hands). Being exposed to tobacco smoke, air pollution, dusts, vapors, and fumes can also cause acute bronchitis. Less often, bacteria can also cause acute bronchitis. To diagnose acute ...

  12. Cystitis - acute

    MedlinePlus

    Uncomplicated urinary tract infection; UTI - acute; Acute bladder infection; Acute bacterial cystitis ... control. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  13. Mechanical and thermal design challenges in building a semi-cold near infrared spectrograph: the Robert Stobie -Near Infrared Spectrograph for SALT

    NASA Astrophysics Data System (ADS)

    Smith, Michael P.; Adler, Douglas P.; Jaehnig, Kurt P.; Wolf, Marsha J.; Smee, Stephen; Bartosz, Curtis; Garot, Kristine; Mason, William P.; Mulligan, Mark P.; Percival, Jeffrey W.; Thielman, Donald J.; Wong, Jeffrey P.

    2014-07-01

    The near infrared upgrade to the Robert Stobie Spectrograph (RSS/NIR) for the Southern African Large Telescope (SALT) extends the capabilities of the visible arm RSS into the Near Infrared (NIR). In order to extend into the NIR range, the upgrade components of the instrument are required to be cooled. Thus the NIR arm is predominantly housed in the instrument pre-dewar which is cooled to -40°C, at ambient pressure. The multiple modes, prime focus location and partially cooled instrument introduce interesting engineering considerations. The NIR spectrograph has an ambient temperature collimator, a cooled (-40°C) dispersers and camera and a cryogenic detector. The cryogenic dewar and many of the mechanisms are required to operate within the cooled, atmospheric environment. Cooling the pre-dewar to - 40°C at prime focus of the telescope is also an engineering challenge. Mechanical and thermal aspects of the design are addressed in this paper with a particular emphasis on the unique considerations of building a semi-warm infrared spectrograph.

  14. Challenges in predicting the need for coronary artery bypass grafting at presentation in patients with non-ST-segment elevation acute coronary syndromes.

    PubMed

    Mehta, Rajendra H; Chen, Anita Y; Pollack, Charles V; Roe, Matthew T; Zalenski, Robert J; Clements, Elizabeth A; Gibler, W Brian; Ohman, E Magnus; Harrington, Robert A; Peterson, Eric D

    2006-09-01

    In the case of non-ST-segment elevation acute coronary syndromes (NSTE-ACSs), the acute use of certain antiplatelet agents is complicated by concerns about perioperative bleeding risks in patients requiring coronary artery bypass grafting (CABG) during the index hospitalization. As a result, clinicians often withhold potentially useful agents, such as clopidogrel, before determining patients' coronary anatomy. An accurate predictive model could allow for a better balance of this safety concern with the demonstrated benefits of agents such as clopidogrel. To create an accurate decision-making tool that would assess, at hospital presentation, the need for CABG in patients with NSTE-ACSs, we studied 61,974 high-risk patients with NSTE-ACS admitted to 311 CABG-capable hospitals participating in Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology/American Heart Association Guidelines (CRUSADE) from 2001 to 2003. A total of 8,395 patients (14%) underwent CABG during their initial hospital stay. A multivariate model was developed and identified 13 presenting clinical characteristics significantly associated with the likelihood of CABG (previous CABG, male gender, previous heart failure, diabetes, hyperlipidemia, renal insufficiency, ST depression and transient ST elevation, age > or = 75 years, previous percutaneous coronary intervention, family history of coronary artery disease, hypertension, trends in CABG rates, and previous stroke). This model had only modest predictive accuracy and calibration (c-index = 0.67). In conclusion, although certain presenting clinical features are associated with an increased likelihood of CABG in patients with NSTE-ACSs during the index hospitalization, it remains difficult to reliably identify, before diagnostic angiography, those who will subsequently undergo surgical revascularization. PMID:16923449

  15. Effects of acute levodopa challenge on resting cerebral blood flow in Parkinson’s Disease patients assessed using pseudo-continuous arterial spin labeling

    PubMed Central

    Pressman, Peter; Simuni, Tanya; Parrish, Todd B.; Gitelman, Darren R.

    2015-01-01

    Introduction. Levodopa is the gold-standard for treatment of Parkinson’s disease (PD) related motor symptoms. In this study, we used pseudo-continuous arterial spin labeling (pCASL) to quantify changes in cerebral blood flow (CBF) after acute oral administration of levodopa in PD patients. Materials and Methods. Thirteen patients (3 females, age 66.2 ± 8.7 years) with moderately advanced PD (Hoehn and Yahr stage >2 (median 2.5), disease duration >3 years) were scanned on a 3T Siemens MR scanner before and after oral levodopa administration. Statistical parametric mapping was used to detect drug-induced changes in CBF and its correlation to clinical severity scales. Images were normalized and flipped in order to examine effects on the more affected (left) and less affected (right) cerebral hemispheres across the cohort. Results. Levodopa did not change global CBF but increased regional CBF in dorsal midbrain, precuneus/cuneus, more affected inferior frontal pars opercularis and triangularis, bilateral pre- and postcentral gyri, more affected inferior parietal areas, as well as less affected putamen/globus pallidus by 27–74% (p < 0.05, FWE corrected for multiple comparisons). CBF change was negatively correlated with improvement in bradykinesia UPDRS-III subscore in the more affected precentral gyrus, and total predrug UPDRS-III score in the mid-cingulate region. Drug-induced CBF change in a widespread network of regions including parietal and postcentral areas was also negatively correlated with the predrug rigidity UPDRS-III subscore. Conclusion. These findings are in line with prior reports of abnormal activity in the nigrostriatal pathway of PD patients and demonstrate the feasibility of pCASL as a neuroimaging tool for investigating in vivo physiological effects of acute drug administration in PD. PMID:26734502

  16. Protocol for a human in vivo model of acute cigarette smoke inhalation challenge in smokers with COPD: monitoring the nasal and systemic immune response using a network biology approach

    PubMed Central

    Ross, Clare L; Galloway-Phillipps, Neil; Armstrong, Paul C; Mitchell, Jane A; Warner, Timothy D; Brearley, Christopher; Ito, Mari; Tunstall, Tanushree; Elkin, Sarah; Kon, Onn Min; Hansel, Trevor T; Paul-Clark, Mark J

    2015-01-01

    Introduction Cigarette smoke contributes to a diverse range of diseases including chronic obstructive pulmonary disease (COPD), cardiovascular disorders and many cancers. There currently is a need for human challenge models, to assess the acute effects of a controlled cigarette smoke stimulus, followed by serial sampling of blood and respiratory tissue for advanced molecular profiling. We employ precision sampling of nasal mucosal lining fluid by absorption to permit soluble mediators measurement in eluates. Serial nasal curettage was used for transcriptomic analysis of mucosal tissue. Methods and analysis Three groups of strictly defined patients will be studied: 12 smokers with COPD (GOLD Stage 2) with emphysema, 12 matched smokers with normal lung function and no evidence of emphysema, and 12 matched never smokers with normal spirometry. Patients in the smoking groups are current smokers, and will be given full support to stop smoking immediately after this study. In giving a controlled cigarette smoke stimulus, all patients will have abstained from smoking for 12 h, and will smoke two cigarettes with expiration through the nose in a ventilated chamber. Before and after inhalation of cigarette smoke, a series of samples will be taken from the blood, nasal mucosal lining fluid and nasal tissue by curettage. Analysis of plasma nicotine and metabolites in relation to levels of soluble inflammatory mediators in nasal lining fluid and blood, as well as assessing nasal transcriptomics, ex vivo blood platelet aggregation and leucocyte responses to toll-like receptor agonists will be undertaken. Implications Development of acute cigarette smoke challenge models has promise for the study of molecular effects of smoking in a range of pathological processes. Ethics and dissemination This study was approved by the West London National Research Ethics Committee (12/LO/1101). The study findings will be presented at conferences and will be reported in peer-reviewed journals

  17. Sonography of acute appendicitis and its mimics in children

    PubMed Central

    Sargar, Kiran M; Siegel, Marilyn J

    2014-01-01

    The diagnosis of acute right lower quadrant pain in a pediatric population is challenging. Acute appendicitis is the most common cause of an acute surgical abdomen. The common mimics of acute appendicitis are acute gastrointestinal and gynecologic diseases. This article reviews the sonographic findings of the spectrum of common acute abdominal emergencies in children with a focus on imaging clues to a specific diagnosis. This awareness can impact on diagnostic accuracy and impact patient management. PMID:25024527

  18. Acute Bronchitis

    MedlinePlus

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis ...

  19. Thermal transitions in serum amyloid A in solution and on the lipid: implications for structure and stability of acute-phase HDL.

    PubMed

    Jayaraman, Shobini; Haupt, Christian; Gursky, Olga

    2015-08-01

    Serum amyloid A (SAA) is an acute-phase protein that circulates mainly on plasma HDL. SAA interactions with its functional ligands and its pathogenic deposition in reactive amyloidosis depend, in part, on the structural disorder of this protein and its propensity to oligomerize. In vivo, SAA can displace a substantial fraction of the major HDL protein, apoA-I, and thereby influence the structural remodeling and functions of acute-phase HDL in ways that are incompletely understood. We use murine SAA1.1 to report the first structural stability study of human plasma HDL that has been enriched with SAA. Calorimetric and spectroscopic analyses of these and other SAA-lipid systems reveal two surprising findings. First, progressive displacement of the exchangeable fraction of apoA-I by SAA has little effect on the structural stability of HDL and its fusion and release of core lipids. Consequently, the major determinant for HDL stability is the nonexchangeable apoA-I. A structural model explaining this observation is proposed, which is consistent with functional studies in acute-phase HDL. Second, we report an α-helix folding/unfolding transition in SAA in the presence of lipid at near-physiological temperatures. This new transition may have potentially important implications for normal functions of SAA and its pathogenic misfolding. PMID:26022803

  20. Contrasting changes in extracellular dopamine and glutamate along the rostrocaudal axis of the anterior cingulate cortex of the rat following an acute d-amphetamine or dopamine challenge

    PubMed Central

    Ash, Elizabeth S.; Heal, David J.; Clare Stanford, S.

    2014-01-01

    There is evidence for functional specificity of subregions along the rostrocaudal axis of the anterior cingulate cortex (ACC). The subregion-specific distribution of dopaminergic afferents and glutamatergic efferents along the ACC make these obvious candidates for coding such regional responses. We investigated this possibility using microdialysis in freely-moving rats to compare changes in extracellular dopamine and glutamate in the rostral (‘rACC': Cg1 and Cg3 (prelimbic area)) and caudal (‘cACC’: Cg1 and Cg2) ACC induced by systemic or local administration of d-amphetamine. Systemic administration of d-amphetamine (3 mg/kg, i.p.) caused a transient increase in extracellular dopamine in the rACC, but an apparent increase in the cACC of the same animals was less clearly defined. Local infusion of d-amphetamine increased dopamine efflux in the rACC, only. Glutamate efflux in the rACC was increased by local infusion of dopamine (5–50 μM), which had negligible effect in the cACC, but only systemic administration of d-amphetamine increased glutamate efflux and only in the cACC. The asymmetry in the neurochemical responses within the rACC and cACC, to the same experimental challenges, could help explain why different subregions are recruited in the response to specific environmental and somatosensory stimuli and should be taken into account when studying the regulation of neurotransmission in the ACC. This article is part of the Special Issue entitled ‘CNS Stimulants’. PMID:24747182

  1. The importance of thermal history: costs and benefits of heat exposure in a tropical, rocky shore oyster.

    PubMed

    Giomi, Folco; Mandaglio, Concetta; Ganmanee, Monthon; Han, Guo-Dong; Dong, Yun-Wei; Williams, Gray A; Sarà, Gianluca

    2016-03-01

    Although thermal performance is widely recognised to be pivotal in determining species' distributions, assessment of this performance is often based on laboratory-acclimated individuals, neglecting their proximate thermal history. The thermal history of a species sums the evolutionary history and, importantly, the thermal events recently experienced by individuals, including short-term acclimation to environmental variations. Thermal history is perhaps of greatest importance for species inhabiting thermally challenging environments and therefore assumed to be living close to their thermal limits, such as in the tropics. To test the importance of thermal history, the responses of the tropical oyster Isognomon nucleus to short-term differences in thermal environments were investigated. Critical and lethal temperatures and oxygen consumption were improved in oysters that previously experienced elevated air temperatures, and were associated with an enhanced heat shock response, indicating that recent thermal history affects physiological performance as well as inducing short-term acclimation to acute conditions. These responses were, however, associated with trade-offs in feeding activity, with oysters that experienced elevated temperatures showing reduced energy gain. Recent thermal history, therefore, seems to rapidly invoke physiological mechanisms that enhance survival of short-term thermal challenge but also longer term climatic changes and consequently needs to be incorporated into assessments of species' thermal performances. PMID:26747904

  2. Acute oral ulcers.

    PubMed

    Lehman, Julia S; Rogers, Roy S

    2016-01-01

    Accurate diagnosis of acute oral ulcers can be challenging. Important historic details include the pattern of recurrence, anatomic areas of involvement within the mouth and elsewhere on the mucocutaneous surface, associated medical symptoms or comorbidities, and symptomology. Careful mucocutaneous examination is essential. When necessary, biopsy at an active site without ulceration is generally optimal. Depending on the clinical scenario, supplemental studies that may be useful include cultures; perilesional biopsy for direct immunofluorescence testing; and evaluation for infectious diseases, gluten sensitivity, inflammatory bowel disease, human immunodeficiency virus infection, connective tissue diseases, or hematinic deficiencies. Clinicians should maintain a broad differential diagnosis when evaluating patients with acute oral ulcers. PMID:27343961

  3. Acute nephritic syndrome

    MedlinePlus

    Glomerulonephritis - acute; Acute glomerulonephritis; Nephritis syndrome - acute ... Acute nephritic syndrome is often caused by an immune response triggered by an infection or other disease. Common causes ...

  4. Development of a Dry Inoculation Method for Thermal Challenge Studies in Low-Moisture Foods by Using Talc as a Carrier for Salmonella and a Surrogate (Enterococcus faecium).

    PubMed

    Enache, Elena; Kataoka, Ai; Black, D Glenn; Napier, Carla D; Podolak, Richard; Hayman, Melinda M

    2015-06-01

    The objective of this study was to obtain dry inocula of Salmonella Tennessee and Enterococcus faecium, a surrogate for thermal inactivation of Salmonella in low-moisture foods, and to compare their thermal resistance and stability over time in terms of survival. Two methods of cell growth were compared: cells harvested from a lawn on tryptic soy agar (TSA-cells) and from tryptic soy broth (TSB-cells). Concentrated cultures of each organism were inoculated onto talc powder, incubated at 35 °C for 24 h, and dried for additional 24 h at room temperature (23 ± 2 °C) to achieve a final water activity of ≤ 0.55 before sieving. Cell reductions of Salmonella and E. faecium during the drying process were between 0.14 and 0.96 log CFU/g, depending on growth method used. There was no difference between microbial counts at days 1 and 30. Heat resistance of the dry inoculum on talc inoculated into a model peanut paste (50 % fat and 0.6 water activity) was determined after 1 and 30 days of preparation, using thermal death time tests conducted at 85 °C. For Salmonella, there was no significant difference between the thermal resistance (D(85 °C)) for the TSB-cells and TSA-cells (e.g. day 1 cells D(85 °C) = 1.05 and 1.07 min, respectively), and there was no significant difference in D(85 °C) between dry inocula on talc used either 1 or 30 days after preparation (P > 0.05). However, the use the dry inocula of E. faecium yielded different results: the TSB-grown cells had a significantly (P < 0.05) greater heat resistance than TSA-grown cells (e.g. D(85 °C) for TSB-cells = 3.42 min versus 2.60 min for TSA-cells). E. faecium had significantly (P < 0.05) greater heat resistance than Salmonella Tennessee regardless what cell type was used for dry inoculum preparation; therefore, it proved to be a conservative but appropriate surrogate for thermal inactivation of Salmonella in low-moisture food matrices under the tested conditions. PMID:26038899

  5. Acute malocclusion.

    PubMed

    Dupont, John S

    2006-01-01

    Acute malocclusion can result from disturbances in the maxillary/mandibular tooth relationship. These alterations in the occlusal position can result from high fillings, sinus problems, abscesses, periodontal disease, and moving or erupting teeth. Conditions seen less frequently include acute malocclusions secondary to an event (such as trauma) that make a stable dental relationship an unstable one. Patients can demonstrate any of a number of clinical conditions that interfere with their comfort and ability to function. This article provides information on some of the less familiar causes of acute malocclusion. PMID:16689064

  6. Acute and persistent effects of pre- and posthatching thermal environments on growth and metabolism in the red-eared slider turtle, Trachemys scripta elegans.

    PubMed

    Ligon, Day B; Peterson, Charles C; Lovern, Matthew B

    2012-04-01

    Many ectotherms possess the capacity to survive a wide range of thermal conditions. Long-term exposure to temperature can induce acclimational and/or organizational effects, and the developmental stage at which temperature exposure occurs may affect the type, degree, and persistence of these effects. We incubated red-eared slider turtle embryos at three different constant temperatures (T(inc); 26.5, 28.5, 30.5°C), then divided the resulting hatchlings between two water temperatures (T(water); 25, 30°C). We calculated growth rates to assess the short- and long-term effects of thermal experience on this metabolically costly process. We also measured resting metabolic rate (RMR) at three body temperatures (T(body;) 26.5, 28.5, 30.5°C) shortly after hatching and 6 months posthatching to characterize the degree and persistence of acclimation to T(inc) and T(water) . Hatchling RMRs were affected by T(body) and T(inc) , and fit a pattern consistent with positive but incomplete metabolic compensation to T(inc) . Average growth rates over the first 11 weeks posthatching were strongly affected by T(water) but only marginally influenced by T(inc) , and only at T(water) = 30°C. Six-month RMRs exhibited strong acclimation to T(water) consistent with positive metabolic compensation. However, within each T(water) treatment, RMR fit patterns indicative of inverse metabolic compensation to T(inc) , opposite of the pattern observed in hatchlings. Average growth rates calculated over 6 months continued to show a strong effect of T(water) , and the previously weak effect of T(inc) observed within the 30°C T(water) treatment became more pronounced. Our results suggest that metabolic compensation was reversible regardless of the life stage during which exposure occurred, and therefore is more appropriately considered acclimational than organizational. PMID:22311775

  7. Ultra-fast photo-patterning of hydroxamic acid layers adsorbed on TiAlN: The challenge of modeling thermally induced desorption

    NASA Astrophysics Data System (ADS)

    Hemgesberg, Maximilian; Schütz, Simon; Müller, Christine; Schlörholz, Matthias; Latzel, Harald; Sun, Yu; Ziegler, Christiane; Thiel, Werner R.

    2012-10-01

    Long-chain n-alkyl terminated hydroxamic acids (HA) are used for the modification of titanium aluminum nitride (TiAlN) surfaces. HA coatings improve the hydrophobicity of this wear resistant and industrially relevant ceramic. Therefore, HAs with different structural properties are evaluated with respect to their wear resistance and their thermal desorption properties. In order to find new coatings for rewritable offset printing plates, the changes in the surface polarity, composition, and morphology are analyzed by contact angle measurements, X-ray photoemission spectroscopy (XPS), and scanning force microscopy (SFM), respectively. The results are referenced to the strongly bonding molecule n-dodecyl phosphonate (PO11M), which has been used for surface hydrophobization before but proved difficult to remove due to the high laser outputs required for thermal desorption. It is found that for certain HAs, an equally good hydrophobization compared to PO11M can be achieved. Contact angles obtained for different hydroxamic acid coatings can be correlated to their modes of adsorption. Only for selected HA species, resistance to mechanical wear is sufficient for further investigations. Photo-patterning of these hydroxamic acid layers is achieved using a high energy IR laser beam at different energy inputs. Fitting of the obtained data and further evaluation using finite element analysis (FEM) calculations reveal significantly reduced energy consumption of about 20% for the removal of a specific hydroxamic acid coating from the ceramic surface compared to PO11M.

  8. Acute Bronchitis

    MedlinePlus

    ... bronchitis? Acute bronchitis is almost always caused by viruses that attack the lining of the bronchial tree ... infection. As your body fights back against these viruses, more swelling occurs and more mucus is produced. ...

  9. Acute Pericarditis

    MedlinePlus

    ... large pericardial effusions). Acute pericarditis usually responds to colchicine or NSAIDs (such as aspirin and ibuprofen ) taken ... reduce pain but relieves it by reducing inflammation. Colchicine also decreases the chance of pericarditis returning later. ...

  10. Cardiovascular response to thermoregulatory challenges.

    PubMed

    Liu, Cuiqing; Yavar, Zubin; Sun, Qinghua

    2015-12-01

    A growing number of extreme climate events are occurring in the setting of ongoing climate change, with an increase in both the intensity and frequency. It has been shown that ambient temperature challenges have a direct and highly varied impact on cardiovascular health. With a rapidly growing amount of literature on this issue, we aim to review the recent publications regarding the impact of cold and heat on human populations with regard to cardiovascular disease (CVD) mortality/morbidity while also examining lag effects, vulnerable subgroups, and relevant mechanisms. Although the relative risk of morbidity/mortality associated with extreme temperature varied greatly across different studies, both cold and hot temperatures were associated with a positive mean excess of cardiovascular deaths or hospital admissions. Cause-specific study of CVD morbidity/mortality indicated that the sensitivity to temperature was disease-specific, with different patterns for acute and chronic ischemic heart disease. Vulnerability to temperature-related mortality was associated with some characteristics of the populations, including sex, age, location, socioeconomic condition, and comorbidities such as cardiac diseases, kidney diseases, diabetes, and hypertension. Temperature-induced damage is thought to be related to enhanced sympathetic reactivity followed by activation of the sympathetic nervous system, renin-angiotensin system, as well as dehydration and a systemic inflammatory response. Future research should focus on multidisciplinary adaptation strategies that incorporate epidemiology, climatology, indoor/building environments, energy usage, labor legislative perfection, and human thermal comfort models. Studies on the underlying mechanism by which temperature challenge induces pathophysiological response and CVD await profound and lasting investigation. PMID:26432837

  11. Thermal skin injury: I. Acute hemodynamic effects of fluid resuscitation with lactated Ringer's, plasma, and hypertonic saline (2,400 mosmol/l) in the rat.

    PubMed

    Onarheim, H; Lund, T; Reed, R

    1989-01-01

    Heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP), and cardiac index (CI) were measured in anesthetized rats subjected to a 40% body surface area full-thickness scald burn. Postburn intravenous fluid therapy with lactated Ringer's (5 ml/hr), plasma (2.5 ml/hr), or very hypertonic saline (2,400 mosmol/l) (0.75 ml/hr) was compared to unburned or burned, untreated controls. HR and CVP were not influenced significantly by thermal injury. MAP decreased steadily in the untreated group from 110 mmHg to 80 mmHg at 3 hr postburn. In the fluid-treated groups MAP did not change significantly. During the first 15 min postburn, CI was reduced to 58-71% of control values (P less than 0.01). CI increased during Ringer's and plasma infusion to 74-80% of control values (P less than 0.02 vs. unburned). Despite infusion therapy, hematocrit increased from 48 to 52%, clearly less than in the unresuscitated group (increase from 48 to 58%). Theoretically, the 2,400 mosmol/l saline would expand extracellular volume by five to six times the infused volume. Still, CI was reduced by 55% at 3 hr postburn in the hypertonic saline as well as in the burned, untreated group (P less than 0.001 vs. unburned). The low CI was mainly due to a reduced stroke volume. PMID:2917370

  12. Acute myelogenous leukemia (AML) - children

    MedlinePlus

    Acute myelogenous leukemia - children; AML; Acute myeloid leukemia - children; Acute granulocytic leukemia - children; Acute myeloblastic leukemia - children; Acute non-lymphocytic leukemia (ANLL) - children

  13. Acute aortic syndrome

    PubMed Central

    2016-01-01

    Acute aortic syndrome (AAS) is a term used to describe a constellation of life-threatening aortic diseases that have similar presentation, but appear to have distinct demographic, clinical, pathological and survival characteristics. Many believe that the three major entities that comprise AAS: aortic dissection (AD), intramural hematoma (IMH) and penetrating aortic ulcer (PAU), make up a spectrum of aortic disease in which one entity may evolve into or coexist with another. Much of the confusion in accurately classifying an AAS is that they present with similar symptoms: typically acute onset of severe chest or back pain, and may have similar radiographic features, since the disease entities all involve injury or disruption of the medial layer of the aortic wall. The accurate diagnosis of an AAS is often made at operation. This manuscript will attempt to clarify the similarities and differences between AD, IMH and PAU of the ascending aorta and describe the challenges in distinguishing them from one another. PMID:27386405

  14. Acute aortic syndrome.

    PubMed

    Corvera, Joel S

    2016-05-01

    Acute aortic syndrome (AAS) is a term used to describe a constellation of life-threatening aortic diseases that have similar presentation, but appear to have distinct demographic, clinical, pathological and survival characteristics. Many believe that the three major entities that comprise AAS: aortic dissection (AD), intramural hematoma (IMH) and penetrating aortic ulcer (PAU), make up a spectrum of aortic disease in which one entity may evolve into or coexist with another. Much of the confusion in accurately classifying an AAS is that they present with similar symptoms: typically acute onset of severe chest or back pain, and may have similar radiographic features, since the disease entities all involve injury or disruption of the medial layer of the aortic wall. The accurate diagnosis of an AAS is often made at operation. This manuscript will attempt to clarify the similarities and differences between AD, IMH and PAU of the ascending aorta and describe the challenges in distinguishing them from one another. PMID:27386405

  15. Acute Pneumonia.

    PubMed

    Arshad, Hammad; Fasanya, Adebayo; Cheema, Tariq; Singh, Anil C

    2016-01-01

    Acute pneumonia is an active infection of the lungs that results when an individual at risk gets exposed to a particular microbiological pathogen. Acute pneumonia is the leading cause of death in the United States that is attributable to an infection. The risk factors, pathogenesis, and microbiological organisms involved differ if the pneumonia develops in the community versus health care-associated environment. The development of concise and comprehensive guidelines has led to an improvement in the management of the problem. However, the emergence of multidrug-resistant organisms and the increase in the percentage of elderly population keep mortality risk very substantial. PMID:26919676

  16. TFAWS: Ares Thermal Overview

    NASA Technical Reports Server (NTRS)

    Sharp, John R.

    2007-01-01

    As part of a Constellation session at the 2007 Thermal & Fluids Analysis Workshop (TFAWS), an overview of the Crew Launch Vehicle (CLV), Crew Exploration Vehicle (CEV) and Lunar Lander systems will be given. This presentation provides a general description of the CLV (also known as Ares-I)and Ares-V vehicles portion of the session. The presentation will provide an overview of the thermal requirements, design environments, challenges and thermal modeling examples.

  17. Acute Alcoholic Hepatitis: Therapy.

    PubMed

    Phillips, Paulina K; Lucey, Michael R

    2016-08-01

    Alcoholic hepatitis (AH) causes great morbidity and mortality in the United States and throughout the world. Advances in therapy have proven difficult. In part, this reflects challenges in diagnosis, including the distinction between AH and acute-on-chronic liver failure. Liver biopsy is the best method to clarify the cause in circumstances whereby conflicting clinical data confound the diagnosis. All treatment of AH begins with abstinence from alcohol. All patients with AH should be given sufficient nutrition. Prednisolone has become the principal agent for treating patients with severe AH. PMID:27373613

  18. Acute Pancreatitis

    PubMed Central

    Geokas, Michael C.

    1972-01-01

    For many decades two types of acute pancreatitis have been recognized: the edematous or interstitial and the hemorrhagic or necrotic. In most cases acute pancreatitis is associated with alcoholism or biliary tract disease. Elevated serum or urinary α-amylase is the most important finding in diagnosis. The presence of methemalbumin in serum and in peritoneal or pleural fluid supports the diagnosis of the hemorrhagic form of the disease in patients with a history and enzyme studies suggestive of pancreatitis. There is no characteristic clinical picture in acute pancreatitis, and its complications are legion. Pancreatic pseudocyst is probably the most common and pancreatic abscess is the most serious complication. The pathogenetic principle is autodigestion, but the precise sequence of biochemical events is unclear, especially the mode of trypsinogen activation and the role of lysosomal hydrolases. A host of metabolic derangements have been identified in acute pancreatitis, involving lipid, glucose, calcium and magnesium metabolism and changes of the blood clotting mechanism, to name but a few. Medical treatment includes intestinal decompression, analgesics, correction of hypovolemia and other supportive and protective measures. Surgical exploration is advisable in selected cases, when the diagnosis is in doubt, and is considered imperative in the presence of certain complications, especially pancreatic abscess. PMID:4559467

  19. NASA Microclimate Cooling Challenges

    NASA Technical Reports Server (NTRS)

    Trevino, Luis A.

    2004-01-01

    The purpose of this outline form presentation is to present NASA's challenges in microclimate cooling as related to the spacesuit. An overview of spacesuit flight-rated personal cooling systems is presented, which includes a brief history of cooling systems from Gemini through Space Station missions. The roles of the liquid cooling garment, thermal environment extremes, the sublimator, multi-layer insulation, and helmet visor UV and solar coatings are reviewed. A second section is presented on advanced personal cooling systems studies, which include heat acquisition studies on cooling garments, heat rejection studies on water boiler & radiators, thermal storage studies, and insulation studies. Past and present research and development and challenges are summarized for the advanced studies.

  20. Clinical challenge.

    PubMed

    2016-09-01

    Questions for this month's clinical challenge are based on articles in this issue. The clinical challenge is endorsed by the RACGP Quality Improvement and Continuing Professional Development (QI&CPD) program and has been allocated four Category 2 points (Activity ID:59922). Answers to this clinical challenge are available immediately following successful completion online at http://gplearning.racgp.org.au. Clinical challenge quizzes may be completed at any time throughout the 2014-16 triennium; therefore, the previous months' answers are not published. Each of the questions or incomplete statements below is followed by four suggested answers or completions. Select the most appropriate statement as your answer. PMID:27606376

  1. Acute diarrhea.

    PubMed

    Barr, Wendy; Smith, Andrew

    2014-02-01

    Acute diarrhea in adults is a common problem encountered by family physicians. The most common etiology is viral gastroenteritis, a self-limited disease. Increases in travel, comorbidities, and foodborne illness lead to more bacteria-related cases of acute diarrhea. A history and physical examination evaluating for risk factors and signs of inflammatory diarrhea and/or severe dehydration can direct any needed testing and treatment. Most patients do not require laboratory workup, and routine stool cultures are not recommended. Treatment focuses on preventing and treating dehydration. Diagnostic investigation should be reserved for patients with severe dehydration or illness, persistent fever, bloody stool, or immunosuppression, and for cases of suspected nosocomial infection or outbreak. Oral rehydration therapy with early refeeding is the preferred treatment for dehydration. Antimotility agents should be avoided in patients with bloody diarrhea, but loperamide/simethicone may improve symptoms in patients with watery diarrhea. Probiotic use may shorten the duration of illness. When used appropriately, antibiotics are effective in the treatment of shigellosis, campylobacteriosis, Clostridium difficile, traveler's diarrhea, and protozoal infections. Prevention of acute diarrhea is promoted through adequate hand washing, safe food preparation, access to clean water, and vaccinations. PMID:24506120

  2. Sinusitis (acute)

    PubMed Central

    2008-01-01

    Introduction Acute sinusitis is defined pathologically, by transient inflammation of the mucosal lining of the paranasal sinuses lasting less than 4 weeks. Clinically, it is characterised by nasal congestion, rhinorrhoea, facial pain, hyposmia, sneezing, and, if more severe, additional malaise and fever. It affects 1−5% of the adult population each year in Europe. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with clinically diagnosed acute sinusitis, and with radiologically or bacteriologically confirmed acute sinusitis? We searched: Medline, Embase, The Cochrane Library and other important databases up to August 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides, different doses [amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides], long-course regimens), antihistamines, cephalosporins or macrolides, decongestants (xylometazoline, phenylephrine, pseudoephedrine), doxycycline, saline nasal washes, steam inhalation, and topical corticosteroids (intra-nasal). PMID:19450327

  3. Sinusitis (acute)

    PubMed Central

    2011-01-01

    Introduction Acute sinusitis is defined pathologically, by transient inflammation of the mucosal lining of the paranasal sinuses lasting less than 4 weeks. Clinically, it is characterised by nasal congestion, rhinorrhoea, facial pain, hyposmia, sneezing, and, if more severe, additional malaise and fever. It affects 1% to 5% of the adult population each year in Europe. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with clinically diagnosed acute sinusitis, and in people with radiologically or bacteriologically confirmed acute sinusitis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (amoxicillin, amoxicillin–clavulanic acid [co-amoxiclav], doxycycline, cephalosporins, macrolides; different doses, long-course regimens), antihistamines, decongestants (xylometazoline, phenylephrine, pseudoephedrine), saline nasal washes, steam inhalation, and topical corticosteroids (intranasal). PMID:22189346

  4. Acute glomerulonephritis.

    PubMed

    Yoshizawa, N

    2000-09-01

    Acute glomerulonephritis (AGN) is a representative disease of acute nephritic syndrome characterized by the sudden appearance of edema, hematuria, proteinuria, and hypertension. The prototype of AGN is acute poststreptococcal glomerulonephritis (APSGN). "Nephritogenic streptococci" are defined as organisms that are cultured from a patient who develops AGN. Although only a limited number of M-types of streptococci have been recognized as "nephritogenic streptococci", all M-types of streptococci may have nephritogenic potential because the genes for major putative nephritogenic antigens such as SPEB and NAPIr are found to be present in all group A streptococci thus far examined. Pathogenic mechanisms for APSGN involving both humoral and cell-mediated immunity have been recently proposed. The role of humoral immunity is presumed to be mediated by the in situ formation of nephritogenic streptococcal antigen-antibody complexes and circulating immune complexes. While in the cellular immune component a role for delayed-type hypersensitivity has been suggested to contribute to the pathogenesis of APSGN. PMID:10969898

  5. Featherweight Challenge

    ERIC Educational Resources Information Center

    Love, Tyler S.; Ryan, Larry

    2012-01-01

    As science, technology education, and engineering programs suffer budget cuts, educators continue to seek cost-effective activities that engage students and reinforce standards. The featherweight challenge is a hands-on activity that challenges students to continually refine their design while not breaking the budget. This activity uses one of the…

  6. [Acute myocarditis].

    PubMed

    Combes, Alain

    2012-06-01

    Myocarditis is defined as inflammation of the myocardium accompanied by myocellular necrosis. Acute myocarditis must be considered in patients who present with recent-onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackievirus and adenovirus being the most frequently viruses responsible for the disease. Treatment of myocarditis remains largely supportive, since immunosuppression has not been proven to be beneficial for acute lymphocytic myocarditis. Trials of antiviral therapies, or immunostimulants such as interferons, suggest a potential therapeutic role but require further investigation. Lastly, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted. In this setting, ECMO should be the first-line mechanical assistance. For highly unstable patients, a Mobile Cardiac Assistance Unit, that rapidly travels to primary care hospitals with a portable ECMO system and hooks it up before refractory multiorgan failure takes hold, is the preferred option. PMID:22515999

  7. [Acute myocarditis].

    PubMed

    Combes, Alain

    2013-05-01

    Myocarditis is defined as inflammation of the myocardium accompanied by myocellular necrosis. Acute myocarditis must be considered in patients who present with recent onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackievirus and adenovirus being the most frequently viruses responsible for the disease. Treatment of myocarditis remains largely supportive, since immunosuppression has not been proven to be beneficial for acute lymphocytic myocarditis. Trials of antiviral therapies, or immunostimulants such as interferons, suggest a potential therapeutic role but require further investigation. Lastly, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted. In this setting, ECMO should be the first-line mechanical assistance. For highly unstable patients, a Mobile Cardiac Assistance Unit, that rapidly travels to primary care hospitals with a portable ECMO system and hooks it up before refractory multiorgan failure takes hold, is the preferred option. PMID:23789482

  8. Acute cerebellar ataxia

    MedlinePlus

    Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA ... Acute cerebellar ataxia in children, especially younger than age 3, may occur several weeks after an illness caused by a virus. ...

  9. Ear infection - acute

    MedlinePlus

    Otitis media - acute; Infection - inner ear; Middle ear infection - acute ... Casselbrandt ML, Mandel EM. Acute otitis media and otitis media with effusion. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. ...

  10. Thermal Cameras in School Laboratory Activities

    ERIC Educational Resources Information Center

    Haglund, Jesper; Jeppsson, Fredrik; Hedberg, David; Schönborn, Konrad J.

    2015-01-01

    Thermal cameras offer real-time visual access to otherwise invisible thermal phenomena, which are conceptually demanding for learners during traditional teaching. We present three studies of students' conduction of laboratory activities that employ thermal cameras to teach challenging thermal concepts in grades 4, 7 and 10-12. Visualization of…

  11. Acute pain.

    PubMed

    Good, M

    1999-01-01

    The review of acute pain describes the problem of unresolved pain and its effects on the neural, autonomic, and immune systems. Conceptualizations and mechanisms of pain are reviewed as well as theories of pain management. Descriptive studies of patient and nurse factors that inhibit effective pain management are discussed, followed by studies of pharmacological and nonpharmacological interventions. Critical analysis reveals that most studies were atheoretical, and therefore, this proliferation of information lacked conceptual coherence and organization. Furthermore, the nature and extent of barriers to pain management were described, but few intervention studies have been devised, as yet, to modify the knowledge, beliefs, and attitudes of nurses and patients that are barriers to pain management. Although some of the complementary therapies have sufficient research support to be used in clinical pain management, the physiological mechanisms and outcomes need to be studied. It is critical at this time to design studies of interventions to improve assessment, decision making, attentive care, and patient teaching. PMID:10418655

  12. Targeting the p53-MDM2 interaction by the small-molecule MDM2 antagonist Nutlin-3a: a new challenged target therapy in adult Philadelphia positive acute lymphoblastic leukemia patients

    PubMed Central

    Trino, Stefania; Iacobucci, Ilaria; Erriquez, Daniela; Laurenzana, Ilaria; De Luca, Luciana; Ferrari, Anna; Luserna Di Rorà, Andrea Ghelli; Papayannidis, Cristina; Derenzini, Enrico; Simonetti, Giorgia; Lonetti, Annalisa; Venturi, Claudia; Cattina, Federica; Ottaviani, Emanuela; Abbenante, Maria Chiara; Russo, Domenico; Perini, Giovanni; Musto, Pellegrino; Martinelli, Giovanni

    2016-01-01

    MDM2 is an important negative regulator of p53 tumor suppressor. In this study, we sought to investigate the preclinical activity of the MDM2 antagonist, Nutlin-3a, in Philadelphia positive (Ph+) and negative (Ph−) leukemic cell line models, and primary B-acute lymphoblastic leukemia (ALL) patient samples. We demonstrated that Nutlin-3a treatment reduced viability and induced p53-mediated apoptosis in ALL cells with wild-type p53 protein, in a time and dose-dependent manner, resulting in the increased expression of pro-apoptotic proteins and key regulators of cell cycle arrest. The dose-dependent reduction in cell viability was confirmed in primary blast cells from B-ALL patients, including Ph+ ALL resistant patients carrying the T315I BCR-ABL1 mutation. Our findings provide a strong rational for further clinical investigation of Nutlin-3a in Ph+ and Ph− ALL. PMID:26887044

  13. Targeting the p53-MDM2 interaction by the small-molecule MDM2 antagonist Nutlin-3a: a new challenged target therapy in adult Philadelphia positive acute lymphoblastic leukemia patients.

    PubMed

    Trino, Stefania; Iacobucci, Ilaria; Erriquez, Daniela; Laurenzana, Ilaria; De Luca, Luciana; Ferrari, Anna; Di Rorà, Andrea Ghelli Luserna; Papayannidis, Cristina; Derenzini, Enrico; Simonetti, Giorgia; Lonetti, Annalisa; Venturi, Claudia; Cattina, Federica; Ottaviani, Emanuela; Abbenante, Maria Chiara; Russo, Domenico; Perini, Giovanni; Musto, Pellegrino; Martinelli, Giovanni

    2016-03-15

    MDM2 is an important negative regulator of p53 tumor suppressor. In this study, we sought to investigate the preclinical activity of the MDM2 antagonist, Nutlin-3a, in Philadelphia positive (Ph+) and negative (Ph-) leukemic cell line models, and primary B-acute lymphoblastic leukemia (ALL) patient samples. We demonstrated that Nutlin-3a treatment reduced viability and induced p53-mediated apoptosis in ALL cells with wild-type p53 protein, in a time and dose-dependent manner, resulting in the increased expression of pro-apoptotic proteins and key regulators of cell cycle arrest. The dose-dependent reduction in cell viability was confirmed in primary blast cells from B-ALL patients, including Ph+ ALL resistant patients carrying the T315I BCR-ABL1 mutation. Our findings provide a strong rational for further clinical investigation of Nutlin-3a in Ph+ and Ph- ALL. PMID:26887044

  14. The challenge of change in acute mental health services: measuring staff perceptions of barriers to change and their relationship to job status and satisfaction using a new measure (VOCALISE)

    PubMed Central

    2014-01-01

    Background Health services are subject to frequent changes, yet there has been insufficient research to address how staff working within these services perceive the climate for implementation. Staff perceptions, particularly of barriers to change, may affect successful implementation and the resultant quality of care. This study measures staff perceptions of barriers to change in acute mental healthcare. We identify whether occupational status and job satisfaction are related to these perceptions, as this might indicate a target for intervention that could aid successful implementation. As there were no available instruments capturing staff perceptions of barriers to change, we created a new measure (VOCALISE) to assess this construct. Methods All nursing staff from acute in-patient settings in one large London mental health trust were eligible. Using a participatory method, a nurse researcher interviewed 32 staff to explore perceptions of barriers to change. This generated a measure through thematic analyses and staff feedback (N = 6). Psychometric testing was undertaken according to standard guidelines for measure development (N = 40, 42, 275). Random effects models were used to explore the associations between VOCALISE, occupational status, and job satisfaction (N = 125). Results VOCALISE was easy to understand and complete, and showed acceptable reliability and validity. The factor analysis revealed three underlying constructs: ‘confidence,’ ‘de-motivation’ and ‘powerlessness.’ Staff with negative perceptions of barriers to change held more junior positions, and had poorer job satisfaction. Qualitatively, nursing assistants expressed a greater sense of organisational unfairness in response to change. Conclusions VOCALISE can be used to explore staff perceptions of implementation climate and to assess how staff attitudes shape the successful outcomes of planned changes. Negative perceptions were linked with poor job satisfaction and to

  15. Ethical Challenges

    ERIC Educational Resources Information Center

    Morris, Michael

    2004-01-01

    All evaluators face the challenge of striving to adhere to the highest possible standards of ethical conduct. Translating the AEA's Guiding Principles and the Joint Committee's Program Evaluation Standards into everyday practice, however, can be a complex, uncertain, and frustrating endeavor. Moreover, acting in an ethical fashion can require…

  16. Quill Challenge

    ERIC Educational Resources Information Center

    Stevens, Lori

    2006-01-01

    Teaching high school students the "grammar" of art--the principles and elements of art and design--while also teaching them about creativity and concept can be difficult. This author has found that combining beginning lessons in line, shape, value, texture, form, and color with projects requiring innovation and inspiration, though challenging, is…

  17. Environmental challenge

    SciTech Connect

    Conable, B.; Warford, J.; Partow, Z.; Lutz, E.; Munasinghe, M.

    1991-09-01

    The contents include the following: Development and the Environment: A Global Balance; Evolution of the World Bank's Environmental Policy; Accounting for the Environment; Public Policy and the Environment; Managing Drylands; Environmental Action Plans in Africa; Agroforestry in Sub-Saharan Africa; Irrigation and the Environmental Challenge; Curbing Pollution in Developing Countries; Global Warming and the Developing World; and The Global Environment Facility.

  18. Assessing and Treating the Patient with Acute Psychotic Disorders.

    PubMed

    Jensen, Lisa; Clough, Rebecca

    2016-06-01

    Patients with acute psychosis often present to emergency departments. Management of acute agitation and psychosis can be a challenge for the staff. Medical stabilization, appropriate assessment, and diagnosis are important. Verbal de-escalation and other psychosocial interventions are helpful in creating a safe and therapeutic environment. Psychiatric and emergency room nurses are poised to treat patients presenting with acute psychosis and must be knowledgeable of evidence-based approaches to treat these complex disorders. PMID:27229275

  19. ACUTE AND CHRONIC PARATHION TOXICITY TO FISH AND INVERTEBRATES

    EPA Science Inventory

    Acute and chronic aquatic bioassays were conducted with a variety of organisms using parathion (0,0-diethyl 0-(p-nitrophenyl) phosphorothioate) as the challenge compound. Acute LC50 values ranged from a low of 0.38 micrograms/l in invertebrates to a high of 2.0 mg/l in freshwater...

  20. Acute pancreatitis following granulosa cell tumor removal in a mare

    PubMed Central

    Gomez, Diego E.; Radtke, Catherine L.; Russell, Lauren A.; Lopez, Alfonso; Wichtel, Maureen W.

    2015-01-01

    Acute pancreatitis is a rare disease in horses and is often associated with gastrointestinal disorders. Accurate diagnosis is challenging due to the presence of nonspecific clinical signs. This case represents the first documentation of acute pancreatitis in a horse following surgery of the reproductive tract. PMID:26483579

  1. Orion Passive Thermal Control Overview

    NASA Technical Reports Server (NTRS)

    Miller, Stephen W.

    2007-01-01

    An viewgraph presentation of Orion's passive thermal control system is shown. The topics include: 1) Orion in CxP Hierarchy; 2) General Orion Description/Orientation; 3) Module Descriptions and Images; 4) Orion PTCS Overview; 5) Requirements/Interfaces; 6) Design Reference Missions; 7) Natural Environments; 8) Thermal Models; 9) Challenges/Issues; and 10) Testing

  2. Management of acute myeloid leukemia during pregnancy.

    PubMed

    Avivi, Irit; Brenner, Benjamin

    2014-06-01

    Diagnosis of acute leukemia during pregnancy presents significant medical challenges. Pancytopenia, caused by bone marrow substitution with leukemic cells, impairs maternal and fetal health. Chemotherapeutic agents required to be immediately used to save the mother's life are likely to adversely affect fetal development and outcome, especially if administered at an early gestational stage. Patients diagnosed with acute leukemia during the first trimester are, therefore, recommended to undergo pregnancy termination. At later gestational stages, antileukemic therapy can be administered, although in this case, fetal outcome is still associated with increased incidence of growth restriction and loss. Special attention to the issue of future reproduction, adopting a personalized fertility preservation approach, is required. This article addresses these subjects, presenting women diagnosed with acute myeloid and acute promyelocytic leukemia in pregnancy. The rarity of this event, resulting in insufficient data, emphasizes the need for collaborative efforts to optimize management of this complicated clinical condition. PMID:25052751

  3. Drug Therapy for Acute Heart Failure.

    PubMed

    Di Somma, Salvatore; Magrini, Laura

    2015-08-01

    Acute heart failure is globally one of most frequent reasons for hospitalization and still represents a challenge for the choice of the best treatment to improve patient outcome. According to current international guidelines, as soon as patients with acute heart failure arrive at the emergency department, the common therapeutic approach aims to improve their signs and symptoms, correct volume overload, and ameliorate cardiac hemodynamics by increasing vital organ perfusion. Recommended treatment for the early management of acute heart failure is characterized by the use of intravenous diuretics, oxygen, and vasodilators. Although these measures ameliorate the patient's symptoms, they do not favorably impact on short- and long-term mortality. Consequently, there is a pressing need for novel agents in acute heart failure treatment with the result that research in this field is increasing worldwide. PMID:26088867

  4. Imaging for acute pelvic pain in pregnancy.

    PubMed

    Masselli, Gabriele; Brunelli, Roberto; Monti, Riccardo; Guida, Marianna; Laghi, Francesca; Casciani, Emanuele; Polettini, Elisabetta; Gualdi, Gianfranco

    2014-04-01

    Acute pelvic pain in pregnancy presents diagnostic and therapeutic challenges. Standard imaging techniques need to be adapted to reduce harm to the foetus from X-rays because of their teratogenic and carcinogenic potential. Ultrasound remains the primary imaging investigation of the pregnant abdomen. Magnetic resonance imaging (MRI) has been shown to be useful in the diagnosis of gynaecological and obstetric problems during pregnancy and in the setting of acute abdomen during pregnancy. MRI overcomes some of the limitations of ultrasound, mainly the size of the gravid uterus. MRI poses theoretical risks to the foetus and care must be taken to minimise these with the avoidance of contrast agents. Teaching Points • Ultrasound and MRI are the preferred investigations for acute pelvic pain during pregnancy. • Ultrasound remains the primary imaging investigation because of availability and portability. • MRI helps differentiate causes of acute pelvic pain when ultrasound is inconclusive. PMID:24535757

  5. The challenge

    NASA Astrophysics Data System (ADS)

    Freeman, Roger L.

    1988-01-01

    Radio systems in space are on the brink of achieving throughout data rates in the hundred of megabits. At present, radio systems operate below 60 GHz and are the traditional workhorses of satellite communications. Legal constraints and the laws of physics limit data rates on the systems. It is maintained that the challenge to provide high technology tools to develop viable high-data-rate space transmission systems can be met before the next century if three optical system and technology issues are overcome. In declining order of importance, the issues are: precise optical pointing, acquisition, and tracking; efficient laser diode optical sources producing sufficient output power; and advanced optical detector technology.

  6. Continuing challenges in influenza

    PubMed Central

    Webster, Robert G.; Govorkova, Elena A.

    2014-01-01

    Influenza is an acute respiratory disease in mammals and domestic poultry that emerges from zoonotic reservoirs in aquatic birds and bats. Although influenza viruses are among the most intensively studied pathogens, existing control options require further improvement. Influenza vaccines must be regularly updated because of continuous antigenic drift and sporadic antigenic shifts in the viral surface glycoproteins. Currently, influenza therapeutics are limited to neuraminidase inhibitors; novel drugs and vaccine approaches are therefore urgently needed. Advances in vaccinology and structural analysis have revealed common antigenic epitopes on hemagglutinins across all influenza viruses and suggest that a universal influenza vaccine is possible. In addition, various immunomodulatory agents and signaling pathway inhibitors are undergoing preclinical development. Continuing challenges in influenza include the emergence of pandemic H1N1 influenza in 2009, human infections with avian H7N9 influenza in 2013, and sporadic human cases of highly pathogenic avian H5N1 influenza. Here, we review the challenges facing influenza scientists and veterinary and human public health officials; we also discuss the exciting possibility of achieving the ultimate goal of controlling influenza’s ability to change its antigenicity. PMID:24891213

  7. Clinical challenges in mechanical ventilation.

    PubMed

    Goligher, Ewan C; Ferguson, Niall D; Brochard, Laurent J

    2016-04-30

    Mechanical ventilation supports gas exchange and alleviates the work of breathing when the respiratory muscles are overwhelmed by an acute pulmonary or systemic insult. Although mechanical ventilation is not generally considered a treatment for acute respiratory failure per se, ventilator management warrants close attention because inappropriate ventilation can result in injury to the lungs or respiratory muscles and worsen morbidity and mortality. Key clinical challenges include averting intubation in patients with respiratory failure with non-invasive techniques for respiratory support; delivering lung-protective ventilation to prevent ventilator-induced lung injury; maintaining adequate gas exchange in severely hypoxaemic patients; avoiding the development of ventilator-induced diaphragm dysfunction; and diagnosing and treating the many pathophysiological mechanisms that impair liberation from mechanical ventilation. Personalisation of mechanical ventilation based on individual physiological characteristics and responses to therapy can further improve outcomes. PMID:27203509

  8. Acute kidney failure

    MedlinePlus

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... There are many possible causes of kidney damage. They include: ... cholesterol (cholesterol emboli) Decreased blood flow due to very ...

  9. Acute arterial occlusion - kidney

    MedlinePlus

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidneys need a good blood supply. The main artery to the kidney is called the renal artery. ...

  10. Acute arterial occlusion - kidney

    MedlinePlus

    ... arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury ...

  11. Acute Lymphocytic Leukemia

    MedlinePlus

    ... hard for blood to do its work. In acute lymphocytic leukemia (ALL), also called acute lymphoblastic leukemia, there are too ... of white blood cells called lymphocytes or lymphoblasts. ALL is the most common type of cancer in ...

  12. Clonal differences in IgE antibodies affect cutaneous anaphylaxis-associated thermal sensitivity in mice

    PubMed Central

    Mack, Madison; Tonc, Elena; Ashbaugh, Alyssa; Wetzel, Abigail; Sykes, Akilah; Engblom, Camilla; Shabani, Estela; Mora-Solano, Carolina; Trier, Anna; Swanson, Linnea; Ewan, Emily; Martinov, Tijana; Chatterjea, Devavani

    2014-01-01

    Cellular and molecular mediators of immune responses are increasingly implicated in acute and chronic pain pathophysiologies. Here we demonstrate that passive cutaneous IgE/Ag anaphylaxis provokes increased thermal sensitivity in the hind paw tissue of mice. The murine anti-DNP IgE antibodies SPE-7 and ε26 are known to induce differential cytokine production in bone marrow cultured mast cells in vitro without antigen challenge. We found a novel, antigen-dependent heterogeneity in the thermal pain responses elicited in the hind paws between SPE-7 and ε26 sensitized DNP-challenged mice. Mice experienced pronounced hind paw thermal sensitivity lasting 6 hours after DNP challenge when sensitized with SPE-7 but not ε26 IgE. The two IgE clones induced equivalent hind paw edema, neutrophil influx, cytokine production, and reduction in tissue histamine content in vivo, and bound to the same or overlapping epitopes on the DNP antigen in vitro. Therefore IgE antibodies against the same antigen can induce comparable inflammation, yet contribute to markedly different anaphylaxis-associated pain within an allergic response, suggesting that non-canonical IgE binding partners such as sensory neurons may play a role in allergy-related pain responses. PMID:25149207

  13. Clonal differences in IgE antibodies affect cutaneous anaphylaxis-associated thermal sensitivity in mice.

    PubMed

    Mack, Madison; Tonc, Elena; Ashbaugh, Alyssa; Wetzel, Abigail; Sykes, Akilah; Engblom, Camilla; Shabani, Estela; Mora-Solano, Carolina; Trier, Anna; Swanson, Linnea; Ewan, Emily; Martinov, Tijana; Chatterjea, Devavani

    2014-11-01

    Cellular and molecular mediators of immune responses are increasingly implicated in acute and chronic pain pathophysiologies. Here we demonstrate that passive cutaneous IgE/Ag anaphylaxis provokes increased thermal sensitivity in the hind paw tissue of mice. The murine anti-DNP IgE antibodies SPE-7 and ɛ26 are known to induce differential cytokine production in bone marrow cultured mast cells in vitro without antigen challenge. We found a novel, antigen-dependent heterogeneity in the thermal pain responses elicited in the hind paws between SPE-7 and ɛ26 sensitized DNP-challenged mice. Mice experienced pronounced hind paw thermal sensitivity lasting 6h after DNP challenge when sensitized with SPE-7 but not ɛ26 IgE. The two IgE clones induced equivalent hind paw edema, neutrophil influx, cytokine production, and reduction in tissue histamine content in vivo, and bound to the same or overlapping epitopes on the DNP antigen in vitro. Therefore IgE antibodies against the same antigen can induce comparable inflammation, yet contribute to markedly different anaphylaxis-associated pain within an allergic response, suggesting that non-canonical IgE binding partners such as sensory neurons may play a role in allergy-related pain responses. PMID:25149207

  14. Relative thermalization

    NASA Astrophysics Data System (ADS)

    del Rio, Lídia; Hutter, Adrian; Renner, Renato; Wehner, Stephanie

    2016-08-01

    Locally thermal quantum systems may contradict traditional thermodynamics: heat can flow from a cold body to a hotter one, if the two are highly entangled. We show that to recover thermodynamic laws, we must use a stronger notion of thermalization: a system S is thermal relative to a reference R if S is both locally thermal and uncorrelated with R . Considering a general quantum reference is particularly relevant for a thermodynamic treatment of nanoscale quantum systems. We derive a technical condition for relative thermalization in terms of conditional entropies. Established results on local thermalization, which implicitly assume a classical reference, follow as special cases.

  15. Relative thermalization.

    PubMed

    Del Rio, Lídia; Hutter, Adrian; Renner, Renato; Wehner, Stephanie

    2016-08-01

    Locally thermal quantum systems may contradict traditional thermodynamics: heat can flow from a cold body to a hotter one, if the two are highly entangled. We show that to recover thermodynamic laws, we must use a stronger notion of thermalization: a system S is thermal relative to a reference R if S is both locally thermal and uncorrelated with R. Considering a general quantum reference is particularly relevant for a thermodynamic treatment of nanoscale quantum systems. We derive a technical condition for relative thermalization in terms of conditional entropies. Established results on local thermalization, which implicitly assume a classical reference, follow as special cases. PMID:27627243

  16. Thermal modeling of stratospheric airships

    NASA Astrophysics Data System (ADS)

    Wu, Jiangtao; Fang, Xiande; Wang, Zhenguo; Hou, Zhongxi; Ma, Zhenyu; Zhang, Helei; Dai, Qiumin; Xu, Yu

    2015-05-01

    The interest in stratospheric airships has increased and great progress has been achieved since the late 1990s due to the advancement of modern techniques and the wide range of application demands in military, commercial, and scientific fields. Thermal issues are challenging for stratospheric airships, while there is no systematic review on this aspect found yet. This paper presents a comprehensive literature review on thermal issues of stratospheric airships. The main challenges of thermal issues on stratospheric airships are analyzed. The research activities and results on the main thermal issues are surveyed, including solar radiation models, environmental longwave radiation models, external convective heat transfer, and internal convective heat transfer. Based on the systematic review, guides for thermal model selections are provided, and topics worthy of attention for future research are suggested.

  17. [Acute gastrointestinal bleeding].

    PubMed

    Baumbach, Robert; Faiss, Siegbert; Cordruwisch, Wolfgang; Schrader, Carsten

    2016-04-01

    Acute gastrointestinal bleeding is a common major emergency (Internal medical or gastroenterological or medical), approximately 85 % of which occur in the upper GI tract. It is estimated that about a half of upper GI bleeds are caused by peptic ulcers. Upper GI bleeds are associated with more severe bleeding and poorer outcomes when compared to middle or lower GI bleeds. Prognostic determinants include bleeding intensity, patient age, comorbid conditions and the concomitant use of anticoagulants. A focused medical history can offer insight into the bleeding intensity, location and potential cause (along with early risk stratification). Initial measures should focus on rapid assessment and resuscitation of unstable patients. The oesophagogastroduodenoscopy (OGD) is the gold standard method for localizing the source of bleeding and for interventional therapy. Bleeding as a result of peptic ulcers is treated endoscopically with mechanical and / or thermal techniques in combination with proton pump inhibitor (PPI) therapy. When variceal bleeding is suspected, pre-interventional use of vasopressin analogues and antibiotic therapies are recommended. Endoscopically, the first line treatment of esophageal varices is endoscopic ligature therapy, whereas that for gastric varices is the use of Histoacryl injection sclerotherapy. When persistent and continued massive hemorrhage occurs in a patient with known or suspected aortic disease the possibility of an aorto-enteric fistula must be considered. PMID:27078246

  18. Age-related thermal response: the cellular resilience of juveniles.

    PubMed

    Clark, M S; Thorne, M A S; Burns, G; Peck, L S

    2016-01-01

    Understanding species' responses to environmental challenges is key to predicting future biodiversity. However, there is currently little data on how developmental stages affect responses and also whether universal gene biomarkers to environmental stress can be identified both within and between species. Using the Antarctic clam, Laternula elliptica, as a model species, we examined both the tissue-specific and age-related (juvenile versus mature adult) gene expression response to acute non-lethal warming (12 h at 3 °C). In general, there was a relatively muted response to this sub-lethal thermal challenge when the expression profiles of treated animals, of either age, were compared with those of 0 °C controls, with none of the "classical" stress response genes up-regulated. The expression profiles were very variable between the tissues of all animals, irrespective of age with no single transcript emerging as a universal biomarker of thermal stress. However, when the expression profiles of treated animals of the different age groups were directly compared, a very different pattern emerged. The profiles of the younger animals showed significant up-regulation of chaperone and antioxidant transcripts when compared with those of the older animals. Thus, the younger animals showed evidence of a more robust cellular response to warming. These data substantiate previous physiological analyses showing a more resilient juvenile population. PMID:26364303

  19. Thermal Management and Thermal Protection Systems

    NASA Technical Reports Server (NTRS)

    Hasnain, Aqib

    2016-01-01

    During my internship in the Thermal Design Branch (ES3), I contributed to two main projects: i) novel passive thermal management system for future human exploration, ii) AVCOAT undercut thermal analysis. i) As NASA prepares to further expand human and robotic presence in space, it is well known that spacecraft architectures will be challenged with unprecedented thermal environments. Future exploration activities will have the need of thermal management systems that can provide higher reliability, mass and power reduction and increased performance. In an effort to start addressing the current technical gaps the NASA Johnson Space Center Passive Thermal Discipline has engaged in technology development activities. One of these activities was done through an in-house Passive Thermal Management System (PTMS) design for a lunar lander. The proposed PTMS, functional in both microgravity and gravity environments, consists of three main components: a heat spreader, a novel hybrid wick Variable Conductance Heat Pipe (VCHP), and a radiator. The aim of this PTMS is to keep electronics on a vehicle within their temperature limits (0 and 50 C for the current design) during all mission phases including multiple lunar day/night cycles. The VCHP was tested to verify its thermal performance. I created a thermal math model using Thermal Desktop (TD) and analyzed it to predict the PTMS performance. After testing, the test data provided a means to correlate the thermal math model. This correlation took into account conduction and convection heat transfer, representing the actual benchtop test. Since this PTMS is proposed for space missions, a vacuum test will be taking place to provide confidence that the system is functional in space environments. Therefore, the model was modified to include a vacuum chamber with a liquid nitrogen shroud while taking into account conduction and radiation heat transfer. Infrared Lamps were modelled and introduced into the model to simulate the sun

  20. Imaging of Acute Pancreatitis.

    PubMed

    Thoeni, Ruedi F

    2015-11-01

    Acute pancreatitis is an acute inflammation of the pancreas. Several classification systems have been used in the past but were considered unsatisfactory. A revised Atlanta classification of acute pancreatitis was published that assessed the clinical course and severity of disease; divided acute pancreatitis into interstitial edematous pancreatitis and necrotizing pancreatitis; discerned an early phase (first week) from a late phase (after the first week); and focused on systemic inflammatory response syndrome and organ failure. This article focuses on the revised classification of acute pancreatitis, with emphasis on imaging features, particularly on newly-termed fluid collections and implications for the radiologist. PMID:26526433

  1. Thermal engine

    SciTech Connect

    Karnes, T.E.; Trupin, R.J.

    1984-01-03

    A thermal engine utilizing a strip of nitinol material or other thermally responsive shape memory effect material to drive a reciprocating output shaft, said strip of material forming a common wall between two different alternating temperature sources which thermally cycle the material.

  2. Acute loss of consciousness.

    PubMed

    Tristán, Bekinschtein; Gleichgerrcht, Ezequiel; Manes, Facundo

    2015-01-01

    Acute loss of consciousness poses a fascinating scenario for theoretical and clinical research. This chapter introduces a simple yet powerful framework to investigate altered states of consciousness. We then explore the different disorders of consciousness that result from acute brain injury, and techniques used in the acute phase to predict clinical outcome in different patient populations in light of models of acute loss of consciousness. We further delve into post-traumatic amnesia as a model for predicting cognitive sequels following acute loss of consciousness. We approach the study of acute loss of consciousness from a theoretical and clinical perspective to conclude that clinicians in acute care centers must incorporate new measurements and techniques besides the classic coma scales in order to assess their patients with loss of consciousness. PMID:25702218

  3. Acute cell death rate of vascular smooth muscle cells during or after short heating up to 20s ranging 50 to 60°C as a basic study of thermal angioplasty

    NASA Astrophysics Data System (ADS)

    Shinozuka, Machiko; Shimazaki, Natsumi; Ogawa, Emiyu; Machida, Naoki; Arai, Tsunenori

    2014-02-01

    We studied the relations between the time history of smooth muscle cells (SMCs) death rate and heating condition in vitro to clarify cell death mechanism in heating angioplasty, in particular under the condition in which intimal hyperplasia growth had been prevented in vivo swine experiment. A flow heating system on the microscope stage was used for the SMCs death rate measurement during or after the heating. The cells were loaded step-heating by heated flow using a heater equipped in a Photo-thermo dynamic balloon. The heating temperature was set to 37, 50-60°C. The SMCs death rate was calculated by a division of PI stained cell number by Hoechst33342 stained cell number. The SMCs death rate increased 5-10% linearly during 20 s with the heating. The SMCs death rate increased with duration up to 15 min after 5 s heating. Because fragmented nuclei were observed from approximately 5 min after the heating, we defined that acute necrosis and late necrosis were corresponded to within 5 min after the heating and over 5 min after the heating, respectively. This late necrosis is probably corresponding to apoptosis. The ratio of necrotic interaction divided the acute necrosis rate by the late necrosis was calculated based on this consideration as 1.3 under the particular condition in which intimal hyperplasia growth was prevented in vivo previous porcine experiment. We think that necrotic interaction rate is larger than expected rate to obtain intimal hyperplasia suppression.

  4. Daunting challenges.

    PubMed

    Wirth, T E

    1994-09-01

    Excerpts of a speech on behalf of the United States at the Third Preparatory Meeting of the International Conference on Population and Development on April 5, 1994 are presented. The Draft Program of Action defines an international agenda for the Cairo Conference and for sustained, priority action in the remainder of this century and on into the 21st. 1) Quality voluntary family planning and reproductive health services must be universally available early in the 21st century by broadening the contraceptive choice as well as expanding and improving reproductive health services without coercion. As President Clinton has said, abortion should be safe, legal, and rare. 2) Educating females is a priority because it raises the status of women as well as lowers infant and maternal mortality and poverty. 3) The extent must be assessed of the national unmet need for antenatal care, childbirth care, immunization, and the monitoring of growth and development. 4) Emphasizing to adolescents the responsibilities of sexuality will reinforce health, education, and economic objectives. 5) As women are empowered, so must men be empowered to be responsible in relation to fertility as well as sexual and reproductive health. 6) Responsible mutually respectful sexual behavior must be encouraged among both men and women and the importance of such behavior must be taught to both boys and girls. 7) Any discussion of responsibility must also include emphasis on the family, which is challenged globally as never before. 8) The Cairo conference provides the opportunity to discuss the current unprecedented migrations of human populations around the world; the link between environmental degradation and migration; and the potential effect of development programs on population movements. 9) North-South partnerships must be nurtured, recognizing the mutually reinforcing roles and responsibilities of all countries for sustainable development. PMID:12288264

  5. Decitabine in Treating Children With Relapsed or Refractory Acute Myeloid Leukemia or Acute Lymphoblastic Leukemia

    ClinicalTrials.gov

    2013-01-22

    Childhood Acute Myeloblastic Leukemia With Maturation (M2); Childhood Acute Promyelocytic Leukemia (M3); Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia

  6. Nanoscale thermal probing

    PubMed Central

    Yue, Yanan; Wang, Xinwei

    2012-01-01

    Nanoscale novel devices have raised the demand for nanoscale thermal characterization that is critical for evaluating the device performance and durability. Achieving nanoscale spatial resolution and high accuracy in temperature measurement is very challenging due to the limitation of measurement pathways. In this review, we discuss four methodologies currently developed in nanoscale surface imaging and temperature measurement. To overcome the restriction of the conventional methods, the scanning thermal microscopy technique is widely used. From the perspective of measuring target, the optical feature size method can be applied by using either Raman or fluorescence thermometry. The near-field optical method that measures nanoscale temperature by focusing the optical field to a nano-sized region provides a non-contact and non-destructive way for nanoscale thermal probing. Although the resistance thermometry based on nano-sized thermal sensors is possible for nanoscale thermal probing, significant effort is still needed to reduce the size of the current sensors by using advanced fabrication techniques. At the same time, the development of nanoscale imaging techniques, such as fluorescence imaging, provides a great potential solution to resolve the nanoscale thermal probing problem. PMID:22419968

  7. Identification of molecular and physiological responses to chronic environmental challenge in an invasive species: the Pacific oyster, Crassostrea gigas

    PubMed Central

    Clark, Melody S; Thorne, Michael A S; Amaral, Ana; Vieira, Florbela; Batista, Frederico M; Reis, João; Power, Deborah M

    2013-01-01

    Understanding the environmental responses of an invasive species is critical in predicting how ecosystem composition may be transformed in the future, especially under climate change. In this study, Crassostrea gigas, a species well adapted to the highly variable intertidal environment, was exposed to the chronic environmental challenges of temperature (19 and 24°C) and pH (ambient seawater and a reduction of 0.4 pH units) in an extended 3-month laboratory-based study. Physiological parameters were measured (condition index, shell growth, respiration, excretion rates, O:N ratios, and ability to repair shell damage) alongside molecular analyses. Temperature was by far the most important stressor, as demonstrated by reduced condition indexes and shell growth at 24°C, with relatively little effect detected for pH. Transcriptional profiling using candidate genes and SOLiD sequencing of mantle tissue revealed that classical “stress” genes, previously reported to be upregulated under acute temperature challenges, were not significantly expressed in any of the treatments, emphasizing the different response between acute and longer term chronic stress. The transcriptional profiling also elaborated on the cellular responses underpinning the physiological results, including the identification of the PI3K/AKT/mTOR pathway as a potentially novel marker for chronic environmental challenge. This study represents a first attempt to understand the energetic consequences of cumulative thermal stress on the intertidal C. gigas which could significantly impact on coastal ecosystem biodiversity and function in the future. PMID:24223268

  8. Acute chylous peritonitis due to acute pancreatitis.

    PubMed

    Georgiou, Georgios K; Harissis, Haralampos; Mitsis, Michalis; Batsis, Haralampos; Fatouros, Michalis

    2012-04-28

    We report a case of acute chylous ascites formation presenting as peritonitis (acute chylous peritonitis) in a patient suffering from acute pancreatitis due to hypertriglyceridemia and alcohol abuse. The development of chylous ascites is usually a chronic process mostly involving malignancy, trauma or surgery, and symptoms arise as a result of progressive abdominal distention. However, when accumulation of "chyle" occurs rapidly, the patient may present with signs of peritonitis. Preoperative diagnosis is difficult since the clinical picture usually suggests hollow organ perforation, appendicitis or visceral ischemia. Less than 100 cases of acute chylous peritonitis have been reported. Pancreatitis is a rare cause of chyloperitoneum and in almost all of the cases chylous ascites is discovered some days (or even weeks) after the onset of symptoms of pancreatitis. This is the second case in the literature where the patient presented with acute chylous peritonitis due to acute pancreatitis, and the presence of chyle within the abdominal cavity was discovered simultaneously with the establishment of the diagnosis of pancreatitis. The patient underwent an exploratory laparotomy for suspected perforated duodenal ulcer, since, due to hypertriglyceridemia, serum amylase values appeared within the normal range. Moreover, abdominal computed tomography imaging was not diagnostic for pancreatitis. Following abdominal lavage and drainage, the patient was successfully treated with total parenteral nutrition and octreotide. PMID:22563182

  9. Challenge of biomechanics.

    PubMed

    Volokh, K Y

    2013-06-01

    The application of mechanics to biology--biomechanics--bears great challenges due to the intricacy of living things. Their dynamism, along with the complexity of their mechanical response (which in itself involves complex chemical, electrical, and thermal phenomena) makes it very difficult to correlate empirical data with theoretical models. This difficulty elevates the importance of useful biomechanical theories compared to other fields of engineering. Despite inherent imperfections of all theories, a well formulated theory is crucial in any field of science because it is the basis for interpreting observations. This is all-the-more vital, for instance, when diagnosing symptoms, or planning treatment to a disease. The notion of interpreting empirical data without theory is unscientific and unsound. This paper attempts to fortify the importance of biomechanics and invigorate research efforts for those engineers and mechanicians who are not yet involved in the field. It is not aimed here, however, to give an overview of biomechanics. Instead, three unsolved problems are formulated to challenge the readers. At the micro-scale, the problem of the structural organization and integrity of the living cell is presented. At the meso-scale, the enigma of fingerprint formation is discussed. At the macro-scale, the problem of predicting aneurysm ruptures is reviewed. It is aimed here to attract the attention of engineers and mechanicians to problems in biomechanics which, in the author's opinion, will dominate the development of engineering and mechanics in forthcoming years. PMID:24015479

  10. Measurement of clothing thermal insulation and moisture vapour resistance using a novel perspiring fabric thermal manikin

    NASA Astrophysics Data System (ADS)

    Fan, J.; Chen, Y. S.

    2002-07-01

    Thermal manikins are necessary instruments for measuring the thermal insulation and moisture vapour resistance of clothing systems, which are important parameters relevant to clothing thermal comfort. Although many thermal manikins have been developed since the first example in the 1940s, simulation of human perspiration in thermal manikins remains a challenge. This paper reports on a novel perspiring fabric thermal manikin, which simulates gaseous perspiration by moisture transfer through a `skin' made of a breathable fabric. The manikin has been used to measure the thermal insulation and moisture vapour resistances of clothing ensembles, and demonstrated high accuracy and reproducibility.

  11. Acute Rhabdomyolysis Following Synthetic Cannabinoid Ingestion

    PubMed Central

    Adedinsewo, Demilade A.; Odewole, Oluwaseun; Todd, Taylor

    2016-01-01

    Context: Novel psychoactive substances, including synthetic cannabinoids, are becoming increasingly popular, with more patients being seen in the emergency room following acute ingestion. These substances have been associated with a wide range of adverse effects. However, identification of complications, clinical toxicity, and management remain challenging. Case Report: We present the case of a young African-American male who developed severe agitation and bizarre behavior following acute K2 ingestion. Laboratory studies revealed markedly elevated serum creatine phosphokinase (CPK) with normal renal function. The patient was managed with aggressive intravenous (IV) fluid hydration and treatment of underlying psychiatric illness. Conclusion: We recommend the routine evaluation of renal function and CPK levels with early initiation of IV hydration among patients who present to the emergency department following acute ingestion of synthetic cannabinoids to identify potential complications early as well as institute early supportive therapy. PMID:27500131

  12. Nutrition in acute pancreatitis: a critical review.

    PubMed

    Lodewijkx, Piet J; Besselink, Marc G; Witteman, Ben J; Schepers, Nicolien J; Gooszen, Hein G; van Santvoort, Hjalmar C; Bakker, Olaf J; On Behalf Of The Dutch Pancreatitis Study Group

    2016-05-01

    Severe acute pancreatitis poses unique nutritional challenges. The optimal nutritional support in patients with severe acute pancreatitis has been a subject of debate for decades. This review provides a critical review of the available literature. According to current literature, enteral nutrition is superior to parenteral nutrition, although several limitations should be taken into account. The optimal route of enteral nutrition remains unclear, but normal or nasogastric tube feeding seems safe when tolerated. In patients with predicted severe acute pancreatitis an on-demand feeding strategy is advised and when patients do not tolerate an oral diet after 72 hours, enteral nutrition can be started. The use of supplements, both parenteral as enteral, are not recommended. Optimal nutritional support in severe cases often requires a tailor-made approach with day-to-day evaluation of its effectiveness. PMID:26823272

  13. Acute Arterial Emergencies

    PubMed Central

    Dagnone, L. E.; Brown, P. M.

    1983-01-01

    The response of the primary care physician in the initial assessment and management of acute arterial injuries will often be the deciding factor in survival of life, limb or organ system. Most arterial emergencies occur as a result of trauma, disruption of vessel wall and/or occlusion of flow. The common clinical syndromes of acute arterial emergencies are injuries to and beyond the aorta, acute aortic dissection, ruptured aortic aneurysm, and thromboembolic occlusive arterial disease. The role of arteriography and the urgency of definitive surgical repair in acute arterial emergencies is summarized. PMID:21283323

  14. Laparoscopic Cholecystectomy for Acute Calcular Cholecystitis in a Patient with Ventriculoperitoneal Shunt: A Case Report and Literature Review

    PubMed Central

    Albarrak, Abdullah A.; Khairy, Sami; Ahmed, Alzahrani Mohammed

    2015-01-01

    Management of patients who have ventriculoperitoneal shunt presenting with acute calcular cholecystitis has remained a clinical challenge. In this paper, the hospital course and the follow-up of a patient presenting with acute calcular cholecystitis and ventriculoperitoneal shunt managed with laparoscopic cholecystectomy are presented followed by literature review on the management of acute calcular cholecystitis in patients who have ventriculoperitoneal shunts. PMID:26798543

  15. Inhalation of diethylamine--acute nasal effects and subjective response

    SciTech Connect

    Lundqvist, G.R.; Yamagiwa, M.; Pedersen, O.F.; Nielsen, G.D. )

    1992-03-01

    Adult volunteers were exposed to 25 ppm (75 mg/m3) diethylamine in a climate chamber for 15 min in order to study the acute nasal reactions to an exposure equivalent to the present threshold limit value-short-term exposure limit. Changes in nasal volume and nasal resistance were measured by acoustic rhinometry and by rhinomanometry. Acute change in nasal volume, usually seen as acute nasal mucosa response to thermal stimuli, was not observed, nor was an acute change in nasal airway resistance. In a subsequent experiment, the aim was to measure acute sensory effects. Exposure to a concentration increasing from 0 to 12 ppm took place for 60 min, equal to an average concentration of 10 ppm (30 mg/m3). A moderate to strong olfactory response and distinct nasal and eye irritation were observed. In spite of considerable individual variation, the results were in agreement with sensory effect estimates obtained from animal studies.

  16. Acute phase reaction and acute phase proteins*

    PubMed Central

    Gruys, E.; Toussaint, M.J.M.; Niewold, T.A.; Koopmans, S.J.

    2005-01-01

    A review of the systemic acute phase reaction with major cytokines involved, and the hepatic metabolic changes, negative and positive acute phase proteins (APPs) with function and associated pathology is given. It appears that APPs represent appropriate analytes for assessment of animal health. Whereas they represent non-specific markers as biological effect reactants, they can be used for assessing nutritional deficits and reactive processes, especially when positive and negative acute phase variables are combined in an index. When such acute phase index is applied to separate healthy animals from animals with some disease, much better results are obtained than with single analytes and statistically acceptable results for culling individual animals may be reached. Unfortunately at present no cheap, comprehensive and easy to use system is available for assessing various acute phase proteins in serum or blood samples at the same time. Protein microarray or fluid phase microchip technology may satisfy this need; and permit simultaneous analysis of numerous analytes in the same small volume sample and enable integration of information derived from systemic reactivity and nutrition with disease specific variables. Applying such technology may help to solve health problems in various countries not only in animal husbandry but also in human populations. PMID:16252337

  17. Thermal Environments.

    ERIC Educational Resources Information Center

    Rutgers, Norman

    The role that a good thermal environment plays in the educational process is discussed. Design implications arise from an analysis of the heating and ventilating principles as apply to vocational-technical facilities. The importance of integrating thermal components in the total design is emphasized. (JS)

  18. Management of acute upside-down stomach

    PubMed Central

    2013-01-01

    Background Upside-down stomach (UDS) is characterized by herniation of the entire stomach or most gastric portions into the posterior mediastinum. Symptoms may vary heavily as they are related to reflux and mechanically impaired gastric emptying. UDS is associated with a risk of incarceration and volvulus development which both might be complicated by acute gastric outlet obstruction, advanced ischemia, gastric bleeding and perforation. Case presentation A 32-year-old male presented with acute intolerant epigastralgia and anterior chest pain associated with acute onset of nausea and vomiting. He reported on a previous surgical intervention due to a hiatal hernia. Chest radiography and computer tomography showed an incarcerated UDS. After immediate esophago-gastroscopy, urgent laparoscopic reduction, repair with a 360° floppy Nissen fundoplication and insertion of a gradually absorbable GORE® BIO-A®-mesh was performed. Conclusion Given the high risk of life-threatening complications of an incarcerated UDS as ischemia, gastric perforation or severe bleeding, emergent surgery is indicated. In stable patients with acute presentation of large paraesophageal hernia or UDS exhibiting acute mechanical gastric outlet obstruction, after esophago-gastroscopy laparoscopic reduction and hernia repair followed by an anti-reflux procedure is suggested. However, in cases of unstable patients open repair is the surgical method of choice. Here, we present an exceptionally challenging case of a young patient with a giant recurrent hiatal hernia becoming clinically manifest in an incarcerated UDS. PMID:24228771

  19. Acute kidney injury.

    PubMed

    Lang, Joanna; Zuber, Kim; Davis, Jane

    2016-04-01

    Acute kidney injury (AKI) complicates up to 20% of all hospital admissions. Responding to the increase in admissions, complications, mortality, morbidity, and cost of AKI, Kidney Disease: Improving Global Outcomes convened an expert panel to study the issue, review the literature, and publish guidelines to evaluate and treat patients with AKI in the acute setting. This article reviews those guidelines. PMID:27023656

  20. Acute Disseminated Encephalomyelitis.

    PubMed

    Gray, Matthew Philip; Gorelick, Marc H

    2016-06-01

    Acute disseminated encephalomyelitis is a primarily pediatric, immune-mediated disease characterized by demyelination and polyfocal neurologic symptoms that typically occur after a preceding viral infection or recent immunization. This article presents the pathophysiology, diagnostic criteria, and magnetic resonance imaging characteristics of acute disseminated encephalomyelitis. We also present evaluation and management strategies. PMID:27253358

  1. Poznan acute Astronomical Observatory

    NASA Astrophysics Data System (ADS)

    Murdin, P.

    2000-11-01

    This Poznan acute Astronomical Observatory is a unit of the Adam Mickiewicz University, located in Poznan acute, Poland. From its foundation in 1919, it has specialized in astrometry and celestial mechanics (reference frames, dynamics of satellites and small solar system bodies). Recently, research activities have also included planetary and stellar astrophysics (asteroid photometry, catalysmic b...

  2. Thermal modelling using discrete vasculature for thermal therapy: a review

    PubMed Central

    Kok, H.P.; Gellermann, J.; van den Berg, C.A.T.; Stauffer, P.R.; Hand, J.W.; Crezee, J.

    2013-01-01

    Reliable temperature information during clinical hyperthermia and thermal ablation is essential for adequate treatment control, but conventional temperature measurements do not provide 3D temperature information. Treatment planning is a very useful tool to improve treatment quality and substantial progress has been made over the last decade. Thermal modelling is a very important and challenging aspect of hyperthermia treatment planning. Various thermal models have been developed for this purpose, with varying complexity. Since blood perfusion is such an important factor in thermal redistribution of energy in in vivo tissue, thermal simulations are most accurately performed by modelling discrete vasculature. This review describes the progress in thermal modelling with discrete vasculature for the purpose of hyperthermia treatment planning and thermal ablation. There has been significant progress in thermal modelling with discrete vasculature. Recent developments have made real-time simulations possible, which can provide feedback during treatment for improved therapy. Future clinical application of thermal modelling with discrete vasculature in hyperthermia treatment planning is expected to further improve treatment quality. PMID:23738700

  3. Treatment of acute silicoproteinosis by whole-lung lavage.

    PubMed

    Stafford, Marshall; Cappa, Anthony; Weyant, Michael; Lara, Abigail; Ellis, James; Weitzel, Nathaen S; Puskas, Ferenc

    2013-06-01

    Acute silicoproteinosis is a rare disease that occurs following a heavy inhalational exposure to silica dusts. Clinically, it resembles pulmonary alveolar proteinosis (PAP); silica exposure is thought to be a cause of secondary PAP. We describe a patient with biopsy-confirmed acute silicoproteinosis whose course was complicated by acute hypoxemic respiratory failure requiring mechanical ventilation. Without clinical improvement despite antibiotic and steroid treatment, the patient was scheduled for whole-lung lavage under general anesthesia. Anesthetic challenges included double-lumen tube placement and single-lung ventilation in a hypoxic patient, facilitating lung lavage, and protecting the contralateral lung from catastrophic spillage. PMID:23632425

  4. Endometrial decidualization: a rare cause of acute appendicitis during pregnancy.

    PubMed

    Murphy, Skyle J; Kaur, Anupinder; Wullschleger, Martin E

    2016-01-01

    Appendicular endometriosis is a rare and poorly understood pathology that affects women in their reproductive years. In the gravid woman, ectopic endometrial tissue undergoes decidualization. This physiological process can result in acute appendicitis in exceptional cases. Here we describe a patient in her second trimester of pregnancy who presented with right iliac fossa pain and clinical, laboratory and imaging findings consistent with acute appendicitis. A laparoscopic appendectomy was performed with intraoperative findings suspicious for malignancy. Histological analysis made the surprising diagnosis of decidualized endometriosis causing luminal constriction resulting in acute appendicitis. We also detail the challenging diagnostic and management issues faced by clinicians in such cases. PMID:27106612

  5. [Definition, primary examination and differential diagnostics in acute dyspnea].

    PubMed

    Hüfner, A; Dodt, C

    2015-09-01

    The topic of acute dyspnea is presented in two separate articles. This first part deals with the definition and pathophysiology of dyspnea as well as important considerations on the history of the present illness, physical examination, initial therapy and differential diagnostic considerations. The second part covers relevant diagnostic investigations and principles for the initial management. The causes, consequences and perception of acute dyspnea can be very different. The adult patient with acute dyspnea presents difficult challenges in the diagnosis and management. The emergency clinician must work through a wide range of differential diagnostic considerations while providing appropriate initial treatment for a potentially life-threatening disease. PMID:26335293

  6. Endometrial decidualization: a rare cause of acute appendicitis during pregnancy

    PubMed Central

    Murphy, Skyle J.; Kaur, Anupinder; Wullschleger, Martin E.

    2016-01-01

    Appendicular endometriosis is a rare and poorly understood pathology that affects women in their reproductive years. In the gravid woman, ectopic endometrial tissue undergoes decidualization. This physiological process can result in acute appendicitis in exceptional cases. Here we describe a patient in her second trimester of pregnancy who presented with right iliac fossa pain and clinical, laboratory and imaging findings consistent with acute appendicitis. A laparoscopic appendectomy was performed with intraoperative findings suspicious for malignancy. Histological analysis made the surprising diagnosis of decidualized endometriosis causing luminal constriction resulting in acute appendicitis. We also detail the challenging diagnostic and management issues faced by clinicians in such cases. PMID:27106612

  7. NASA/Goddard Thermal Technology Overview 2012

    NASA Technical Reports Server (NTRS)

    Butler, Dan; Swanson, Ted

    2012-01-01

    New Technology program is underway at NASA NASA/GSFC's primary mission of science satellite development is healthy and vibrant, although new missions are scarce Future mission applications promise to be thermally challenging Direct technology funding is still very restricted

  8. Upper thermal tolerances of early life stages of freshwater mussels

    USGS Publications Warehouse

    Pandolfo, Tamara J.; Cope, W. Gregory; Arellano, Consuelo; Bringolf, Robert B.; Barnhart, M. Christopher; Hammer, E

    2010-01-01

    Freshwater mussels (order Unioniformes) fulfill an essential role in benthic aquatic communities, but also are among the most sensitive and rapidly declining faunal groups in North America. Rising water temperatures, caused by global climate change, industrial discharges, drought, or land development, could further challenge imperiled unionid communities. The aim of our study was to determine the upper thermal tolerances of the larval (glochidia) and juvenile life stages of freshwater mussels. Glochidia of 8 species of mussels were tested: Lampsilis siliquoidea, Potamilus alatus, Ligumia recta, Ellipsaria lineolata,Lasmigona complanata, Megalonaias nervosa, Alasmidonta varicosa, and Villosa delumbis. Seven of these species also were tested as juveniles. Survival trends were monitored while mussels held at 3 acclimation temperatures (17, 22, and 27°C) were exposed to a range of common and extreme water temperatures (20–42°C) in standard acute laboratory tests. The average median lethal temperature (LT50) among species in 24-h tests with glochidia was 31.6°C and ranged from 21.4 to 42.7°C. The mean LT50 in 96-h juvenile tests was 34.7°C and ranged from 32.5 to 38.8°C. Based on comparisons of LT50s, thermal tolerances differed among species for glochidia, but not for juveniles. Acclimation temperature did not affect thermal tolerance for either life stage. Our results indicate that freshwater mussels already might be living close to their upper thermal tolerances in some systems and, thus, might be at risk from rising environmental temperatures.

  9. Management of acute ventilatory failure

    PubMed Central

    Chakrabarti, B; Calverley, P M A

    2006-01-01

    Acute ventilatory failure is a challenging yet increasingly common medical emergency reflecting the growing burden of respiratory disease. It is not a diagnosis in itself but the end result of a diversity of disease processes culminating in arterial hypoxaemia and hypercapnia. This review focuses on key management issues including giving appropriate oxygen therapy, treatment of the underlying aetiology as well as any precipitant factors and provision of assisted ventilation if required. Ventilatory assistance can be provided both invasively and non‐invasively and the indications for either or both forms of assisted ventilation are discussed. Further emphasis is needed regarding advanced directives of care and clinicians should be aware of ethical issues regarding assisted ventilation. PMID:16822920

  10. Advanced thermal control for spacecraft applications

    NASA Astrophysics Data System (ADS)

    Hardesty, Robert; Parker, Kelsey

    2015-09-01

    In optical systems just like any other space borne system, thermal control plays an important role. In fact, most advanced designs are plagued with volume constraints that further complicate the thermal control challenges for even the most experienced systems engineers. Peregrine will present advances in satellite thermal control based upon passive heat transfer technologies to dissipate large thermal loads. This will address the use of 700 W/m K and higher conducting products that are five times better than aluminum on a specific basis providing enabling thermal control while maintaining structural support.

  11. Acute Hepatic Porphyria

    PubMed Central

    Bissell, D. Montgomery; Wang, Bruce

    2015-01-01

    The porphyrias comprise a set of diseases, each representing an individual defect in one of the eight enzymes mediating the pathway of heme synthesis. The diseases are genetically distinct but have in common the overproduction of heme precursors. In the case of the acute (neurologic) porphyrias, the cause of symptoms appears to be overproduction of a neurotoxic precursor. For the cutaneous porphyrias, it is photosensitizing porphyrins. Some types have both acute and cutaneous manifestations. The clinical presentation of acute porphyria consists of abdominal pain, nausea, and occasionally seizures. Only a small minority of those who carry a mutation for acute porphyria have pain attacks. The triggers for an acute attack encompass certain medications and severely decreased caloric intake. The propensity of females to acute attacks has been linked to internal changes in ovarian physiology. Symptoms are accompanied by large increases in delta-aminolevulinic acid and porphobilinogen in plasma and urine. Treatment of an acute attack centers initially on pain relief and elimination of inducing factors such as medications; glucose is administered to reverse the fasting state. The only specific treatment is administration of intravenous hemin. An important goal of treatment is preventing progression of the symptoms to a neurological crisis. Patients who progress despite hemin administration have undergone liver transplantation with complete resolution of symptoms. A current issue is the unavailability of a rapid test for urine porphobilinogen in the urgent-care setting. PMID:26357631

  12. Thermal Insulation

    NASA Technical Reports Server (NTRS)

    1984-01-01

    Commercially known as Solimide, Temptronics, Inc.'s thermal insulation has application in such vehicles as aircraft, spacecraft and surface transportation systems (i.e. rapid transit cars, trains, buses, and ships) as acoustical treatment for door, wall, and ceiling panels, as a means of reducing vibrations, and as thermal insulation (also useful in industrial equipment). Product originated from research conducted by Johnson Space Center on advanced flame-resistant materials for minimizing fire hazard in the Shuttle and other flight vehicles.

  13. Thermal Expansion

    NASA Astrophysics Data System (ADS)

    Ventura, Guglielmo; Perfetti, Mauro

    All solid materials, when cooled to low temperatures experience a change in physical dimensions which called "thermal contraction" and is typically lower than 1 % in volume in the 4-300 K temperature range. Although the effect is small, it can have a heavy impact on the design of cryogenic devices. The thermal contraction of different materials may vary by as much as an order of magnitude: since cryogenic devices are constructed at room temperature with a lot of different materials, one of the major concerns is the effect of the different thermal contraction and the resulting thermal stress that may occur when two dissimilar materials are bonded together. In this chapter, theory of thermal contraction is reported in Sect. 1.2 . Section 1.3 is devoted to the phenomenon of negative thermal expansion and its applications.

  14. Acute Lung Failure

    PubMed Central

    Mac Sweeney, Rob; McAuley, Daniel F.; Matthay, Michael A.

    2013-01-01

    Lung failure is the most common organ failure seen in the intensive care unit. The pathogenesis of acute respiratory failure (ARF) can be classified as (1) neuromuscular in origin, (2) secondary to acute and chronic obstructive airway diseases, (3) alveolar processes such as cardiogenic and noncardiogenic pulmonary edema and pneumonia, and (4) vascular diseases such as acute or chronic pulmonary embolism. This article reviews the more common causes of ARF from each group, including the pathological mechanisms and the principles of critical care management, focusing on the supportive, specific, and adjunctive therapies for each condition. PMID:21989697

  15. The Effect of Core Configuration on Thermal Barrier Thermal Performance

    NASA Technical Reports Server (NTRS)

    DeMange, Jeffrey J.; Bott, Robert H.; Druesedow, Anne S.

    2015-01-01

    Thermal barriers and seals are integral components in the thermal protection systems (TPS) of nearly all aerospace vehicles. They are used to minimize heat transfer through interfaces and gaps and protect underlying temperature-sensitive components. The core insulation has a significant impact on both the thermal and mechanical properties of compliant thermal barriers. Proper selection of an appropriate core configuration to mitigate conductive, convective and radiative heat transfer through the thermal barrier is challenging. Additionally, optimization of the thermal barrier for thermal performance may have counteracting effects on mechanical performance. Experimental evaluations have been conducted to better understand the effect of insulation density on permeability and leakage performance, which can significantly impact the resistance to convective heat transfer. The effect of core density on mechanical performance was also previously investigated and will be reviewed. Simple thermal models were also developed to determine the impact of various core parameters on downstream temperatures. An extended understanding of these factors can improve the ability to design and implement these critical TPS components.

  16. JPL Advanced Thermal Control Technology Roadmap - 2012

    NASA Technical Reports Server (NTRS)

    Birur, Gaj; Rodriguez, Jose I.

    2012-01-01

    NASA's new emphasis on human exploration program for missions beyond LEO requires development of innovative and revolutionary technologies. Thermal control requirements of future NASA science instruments and missions are very challenging and require advanced thermal control technologies. Limited resources requires organizations to cooperate and collaborate; government, industry, universities all need to work together for the successful development of these technologies.

  17. Chip Scale Package Implementation Challenges

    NASA Technical Reports Server (NTRS)

    Ghaffarian, Reza

    1998-01-01

    The JPL-led MicrotypeBGA Consortium of enterprises representing government agencies and private companies have jointed together to pool in-kind resources for developing the quality and reliability of chip scale packages (CSPs) for a variety of projects. In the process of building the Consortium CSP test vehicles, many challenges were identified regarding various aspects of technology implementation. This paper will present our experience in the areas of technology implementation challenges, including design and building both standard and microvia boards, and assembly of two types of test vehicles. We also discuss the most current package isothermal aging to 2,000 hours at 100 C and 125 C and thermal cycling test results to 1,700 cycles in the range of -30 to 100 C.

  18. Challenges in Developing Clinical Workstation

    SciTech Connect

    Narayanan, Venkatesh; Vedula, Venumadhav

    2008-09-26

    Over the years, medical imaging has become very common and data intensive. New technology is needed to help visualize and analyze these large, complex data sets, especially in an acute care situation where time is of the essence. Also it is very important to present the data in an efficient and simple manner to aid the clinical decision making processes. There is a need for a clinical workstation that handles data from different modalities and performs the necessary post- processing operations on the data in order to enhance the image quality and improve the reliability of diagnosis. This paper briefly explains clinical workstation, emphasizing the requirements and challenges in design and architecture for the development of such systems.

  19. Challenges in pediatric renal transplantation

    PubMed Central

    Peruzzi, Licia; Amore, Alessandro; Coppo, Rosanna

    2014-01-01

    Transplantation in children is the best option to treat renal failure. Over the last 25 years the improvements in therapy have dramatically reduced the risk of early acute rejection and graft loss, however the long term results in terms of graft survival and morbidity still require search for new immunosuppressive regimens. Tolerance of the graft and minimization of side effects are the challenges for improving the outcome of children with a grafted kidney. Notwithstanding the difficulties in settling in children large multicenter trials to derive statistically useful data, many important contributions in the last years brought important modifications in the immunosuppressive therapy, including minimization protocols of steroids and calcineurin inhibitors and new induction drugs. New methods for diagnosis of anti HLA antibodies and some new protocols to improve both chance and outcome of transplantation in immunized subjects represent area of ongoing research of extreme interest for children. PMID:25540732

  20. Emerging infections: a perpetual challenge

    PubMed Central

    Morens, David M; Folkers, Gregory K; Fauci, Anthony S

    2008-01-01

    Emerging and re-emerging infectious diseases, and their determinants, have recently attracted substantial scientific and popular attention. HIV/AIDS, severe acute respiratory syndrome, H5N1 avian influenza, and many other emerging diseases have either proved fatal or caused international alarm. Common and interactive co-determinants of disease emergence, including population growth, travel, and environmental disruption, have been increasingly documented and studied. Are emerging infections a new phenomenon related to modern life, or do more basic determinants, transcending time, place, and human progress, govern disease generation? By examining a number of historically notable epidemics, we suggest that emerging diseases, similar in their novelty, impact, and elicitation of control responses, have occurred throughout recorded history. Fundamental determinants, typically acting in concert, seem to underlie their emergence, and infections such as these are likely to continue to remain challenges to human survival. PMID:18992407

  1. Weight Loss & Acute Porphyria

    MedlinePlus

    ... Sale You are here Home Diet and Nutrition Weight loss & acute Porphyria Being overweight is a particular problem ... one of these diseases before they enter a weight-loss program. Also, they should not participate in a ...

  2. Acute mountain sickness

    MedlinePlus

    High altitude cerebral edema; Altitude anoxia; Altitude sickness; Mountain sickness; High altitude pulmonary edema ... Acute mountain sickness is caused by reduced air pressure and lower oxygen levels at high altitudes. The faster you ...

  3. Acute respiratory distress syndrome

    MedlinePlus

    ... chap 33. Lee WL, Slutsky AS. Acute hypoxemic respiratory failure and ARDS. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: ...

  4. Acute coronary syndrome

    MedlinePlus

    Heart attack-ACS; Myocardial infarction-ACS; MI-ACS; Acute MI-ACS; ST-elevation myocardial infarction-ACS; Non-ST-elevation myocardial infarction-ACS; Unstable angina-ACS; Accelerating angina-ACS; New- ...

  5. Ear infection - acute

    MedlinePlus

    ... Risk factors for acute ear infections include: Attending day care (especially centers with more than 6 children) Changes ... hands and toys often. If possible, choose a day care that has 6 or fewer children. This can ...

  6. Acute Pancreatitis and Pregnancy

    MedlinePlus

    ... sudden inflammation of the pancreas manifested clinically by abdominal pain, nausea and dehydration that is usually self-limiting ... room for evaluation should they develop any abnormal abdominal pain symptoms. Conclusions While a rare event, acute pancreatitis ...

  7. Acute Flaccid Myelitis

    MedlinePlus

    ... on Facebook Tweet Share Compartir Acute flaccid myelitis (AFM) is a condition that affects the nervous system, ... from a variety of causes including viral infections. AFM is characterized by a sudden weakness in one ...

  8. Acute genital ulcers

    PubMed Central

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-01

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers. PMID:24473429

  9. Acute Radiation Syndrome

    MedlinePlus

    ... Dictionary Radiation Emergencies & Your Health Possible Health Effects Contamination and Exposure Acute Radiation Syndrome (ARS) Cutaneous Radiation ... Decision Making in Radiation Emergencies Protective Actions Internal Contamination Clinical Reference (ICCR) Application Psychological First Aid in ...

  10. Thermal Analysis Methods For Earth Entry Vehicle

    NASA Technical Reports Server (NTRS)

    Amundsen, Ruth M.; Dec, John A.; Lindell, Michael C.

    2000-01-01

    Thermal analysis of a vehicle designed to return samples from another planet, such as the Earth Entry vehicle for the Mars Sample Return mission, presents several unique challenges. The Earth Entry Vehicle (EEV) must contain Martian material samples after they have been collected and protect them from the high heating rates of entry into the Earth's atmosphere. This requirement necessitates inclusion of detailed thermal analysis early in the design of the vehicle. This paper will describe the challenges and solutions for a preliminary thermal analysis of an Earth Entry Vehicle. The aeroheating on the vehicle during entry would be the main driver for the thermal behavior, and is a complex function of time, spatial position on the vehicle, vehicle temperature, and trajectory parameters. Thus, the thermal analysis must be closely tied to the aeroheating analysis in order to make accurate predictions. Also, the thermal analysis must account for the material response of the ablative thermal protection system (TPS). For the exo-atmospheric portion of the mission, the thermal analysis must include the orbital radiation fluxes on the surfaces. The thermal behavior must also be used to predict the structural response of the vehicle (the thermal stress and strains) and whether they remain within the capability of the materials. Thus, the thermal analysis requires ties to the three-dimensional geometry, the aeroheating analysis, the material response analysis, the orbital analysis, and the structural analysis. The goal of this paper is to describe to what degree that has been achieved.

  11. Challenges and opportunities in LED based lighting

    NASA Astrophysics Data System (ADS)

    Panahi, Allen

    2013-05-01

    Solid state lighting technology has made great advances over the last decade and has become the technology of choice to displace legacy incandescent and as well as the more efficient fluorescent lights. While efficiencies have been improved and cost of the LEDs has been steadily lowered still many challenges exist in the thermal, electrical, optical, and packaging implementations.

  12. Feigning Acute Intermittent Porphyria

    PubMed Central

    Elkhatib, Rania; Idowu, Modupe; Brown, Gregory S.; Jaber, Yasmeen M.; Reid, Matthew B.; Person, Cheryl

    2014-01-01

    Acute intermittent porphyria (AIP) is an autosomal dominant genetic defect in heme synthesis. Patients with this illness can have episodic life-threatening attacks characterized by abdominal pain, neurological deficits, and psychiatric symptoms. Feigning this illness has not been reported in the English language literature to date. Here, we report on a patient who presented to the hospital with an acute attack of porphyria requesting opiates. Diligent assessment of extensive prior treatment records revealed thirteen negative tests for AIP. PMID:25525547

  13. Developing a Watershed Challenge

    ERIC Educational Resources Information Center

    Roman, Harry T.

    2010-01-01

    This article presents a watershed challenge that gives students an opportunity to investigate the challenge of using a watershed area as a site for development, examining the many aspects of this multifaceted problem. This design challenge could work well in a team-based format, with students taking on specific aspects of the challenges and…

  14. Transfusion-free treatment strategies for acute anemia in critical care.

    PubMed

    Morgan, Caitlin A; Byul Sarah, Sae; Forest, Christopher P

    2016-08-01

    Acute anemia is a frequently encountered diagnosis in critically ill patients, and can be a challenge if blood products are not readily available or if patients refuse these products on the basis of their religious beliefs. This article discusses the goals of anemia management and summarizes several alternatives to blood transfusions that can be used to prevent and treat acute anemia. PMID:27467297

  15. Acute retinal necrosis secondary to herpes simplex virus type 2 with preexisting chorioretinal scarring.

    PubMed

    Moesen, Ingemarie; Khemka, Sneh; Ayliffe, William

    2008-01-01

    Acute retinal necrosis in children is a devastating disease that requires early diagnosis and treatment. The authors describe a rarely reported case of bilateral acute retinal necrosis in a child caused by neonatal herpes simplex virus type 2, where the presence of previous chorioretinal scarring made diagnosis challenging. PMID:18286969

  16. Acute chest pain emergencies - spouses' prehospital experiences.

    PubMed

    Forslund, Kerstin; Quell, Robin; Sørlie, Venke

    2008-10-01

    The call to the Emergency Medical Dispatch Centre is often a person's first contact with the health-care system in cases of acute illness or injury and acute chest pain is a common reason for calling. The aim was to illuminate how spouses to persons with acute chest pain experienced the alarm situation, the emergency call and the prehospital emergency care. Interviews were conducted with nineteen spouses. A phenomenological-hermeneutic approach was used for the analyses. The themes responsibility and uneasiness emerged as well as an overall theme of aloneness. Being a spouse to a person in need of acute medical and nursing assistance was interpreted as "Being responsible and trying to preserve life" and "Being able to manage the uneasiness and having trust in an uncertain situation." When their partners' life was at risk the spouses were in an escalating spiral of worry, uncertainty, stress, fear of loss, feeling of loneliness and desperation. They had to manage emotional distress and felt compelled to act to preserve life, a challenging situation. PMID:18929341

  17. A family with acute intermittent porphyria.

    PubMed

    Billoo, Abdul Gaffar; Lone, Saira Waqar

    2008-05-01

    Porphyrias are inherited defects in heme metabolism that result in excessive secretion of porphyrins and porphyrin precursors. Porphyrias can be classified into acute, (neuropsychiatric), cutaneous and mixed forms. There are seven main types of porphyrias; acute intermittent porphyria and plumboporphyria are predominantly neuropsychiatric; congenital erythropoietic porphyria, porphyria cutanea tarda and erythropoietic protoporphyria have predominantly cutaneous manifestations and hereditary coproporphyria and variegate porphyria are classified as mixed as they both have neuropsychiatric and cutaneous features. They cause life-threatening attacks of neurovisceral symptoms that mimic many other acute medical and psychiatric conditions. Lack of clinical recognition often delays effective treatment, and inappropriate diagnostic tests may lead to misdiagnosis and inappropriate treatment. Although the specific enzyme and gene defect have been identified, diagnosis and treatment of these disorders present formidable challenges because their signs and symptoms mimic other common conditions. We present a case report of a 13 years old girl who suffers from acute intermittent porphyria and the family tree showing all members who suffer from it. PMID:18541093

  18. Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children.

    PubMed

    Laulajainen-Hongisto, Anu; Aarnisalo, Antti A; Jero, Jussi

    2016-10-01

    Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children. PMID:27613655

  19. Assessing candidacy for acute hepatitis C treatment among active young injection drug users: a case-series report.

    PubMed

    Asher, Alice; Lum, Paula J; Page, Kimberly

    2012-01-01

    Treatment for acute hepatitis C virus (HCV) infection has significantly better outcomes than treatment for chronic infection. The short window of the acute period poses challenges for young injection drug users (IDU), who are at highest risk of HCV infection, to demonstrate treatment candidacy. We recruited patients with acute HCV from a prospective cohort study to examine clinical and behavioral issues related to treatment candidacy. We report on outcomes and how nursing case management affected candidacy. All five acutely-infected participants reported daily drug use at baseline. All established primary care and decreased their drug use. None received treatment for their acute infection; one was treated within 12 months of infection. Establishing treatment candidacy for young IDU in the acute phase involves various health domains. An acute infection's short period poses many challenges to establishing candidacy, but it is a window of opportunity to engage young IDU in health care. PMID:21497111

  20. Assessing Candidacy for Acute Hepatitis C Treatment Among Active Young Injection Drug Users: A Case-Series Report

    PubMed Central

    Asher, Alice; Lum, Paula J.; Page, Kimberly

    2011-01-01

    Treatment for acute hepatitis C virus (HCV) infection has significantly better outcomes than treatment for chronic infection. The short window of the acute period poses challenges for young injection drug users (IDU), who are at highest risk of HCV infection, to demonstrate treatment candidacy. We recruited patients with acute HCV from a prospective cohort study to examine clinical and behavioral issues related to treatment candidacy. We report on outcomes and how nursing case management affected candidacy. All 5 acutely-infected participants reported daily drug use at baseline. All established primary care and decreased their drug use. None received treatment for their acute infection; one was treated within 12 months of infection. . Establishing treatment candidacy for young IDU in the acute phase involves various health domains. Acute infection's short period poses many challenges to establishing candidacy, but it is a window of opportunity to engage young IDU in health care. PMID:21497111

  1. JWST ISIM Distortion Analysis Challenge

    NASA Technical Reports Server (NTRS)

    Cifie, Emmanuel; Matzinger, Liz; Kuhn, Jonathan; Fan, Terry

    2004-01-01

    Very tight distortion requirements are imposed on the JWST's ISM structure due to the sensitivity of the telescope's mirror segment and science instrument positioning. The ISIM structure is a three dimensional truss with asymmetric gusseting and metal fittings. One of the primary challenges for ISIM's analysis team is predicting the thermal distortion of the structure both from the bulk cooldown from ambient to cryo, and the smaller temperature changes within the cryogenic operating environment. As a first cut to estimate thermal distortions, a finite element model of bar elements was created. Elements representing joint areas and metal fittings use effective properties that match the behavior of the stack-up of the composite tube, gusset and adhesive under mechanical and thermal loads. These properties were derived by matching tip deflections of a solid model simplified T-joint. Because of the structure s asymmetric gusseting, this effective property model is a first attempt at predicting rotations that cannot be captured with a smeared CTE approach. In addition to the finite element analysis, several first order calculations have been performed to gauge the feasibility of the material design. Because of the stringent thermal distortion requirements at cryogenic temperatures, a composite tube material with near zero or negative CTE is required. A preliminary hand analysis of the contribution of the various components along the distortion path between FGS and the other instruments, neglecting second order effects were examined. A plot of bounding tube longitudinal and transverse CTEs for thermal stability requirements was generated to help determine the feasibility of meeting these requirements. This analysis is a work in progress en route to a large degree of freedom hi-fidelity FEA model for distortion analysis. Methods of model reduction, such as superelements, are currently being investigated.

  2. Thermal defoliation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The negative perception some consumers hold regarding agricultural chemicals has resulted in an increased demand for organic foods and fibers, and in increasing political pressure for the regulation of agricultural production practices. This has revived interest in thermal defoliation of cotton and ...

  3. Thermal Effects.

    PubMed

    Zhang, Panyue; Ye, Jie; Zeng, Guangming

    2015-10-01

    This review focuses on the research literatures published in 2014 relating to topics of thermal effects in water pollution control. This review is divided into the following sections: anaerobic wastewater and sludge treatment, biological nitrogen and phosphorus removal, membrane biological treatment, sewage sludge pyrolysis, natural treatment, resource recovery, electrolysis, oxidation and adsorption treatment. PMID:26420108

  4. Thermal effects

    SciTech Connect

    Harrelson, M.E.; Talmadge, S.S.; Cravens, J.B.

    1984-06-01

    A literature review is presented of recent studies on the role of temperature effects and change in temperature caused by thermal power plants on aquatic life. Several of these studies involve the use of models that allow testing of hypotheses concerning the effects of temperature on fish and insects. 91 references.

  5. THERMAL DEFOLIATION

    Technology Transfer Automated Retrieval System (TEKTRAN)

    An apparatus designed to defoliate cotton with hot air was tested in two varieties and two field conditions. Cotton defoliation using hot air was as effective as defoliation using tyical chemicals under some conditions. Aphid populations were eliminated by the thermal treatment, reducing the risk ...

  6. Flavopiridol, Cytarabine, and Mitoxantrone in Treating Patients With Acute Leukemia

    ClinicalTrials.gov

    2013-10-07

    Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia; Untreated Adult Acute Lymphoblastic Leukemia; Untreated Adult Acute Myeloid Leukemia

  7. Acute care management of spinal cord injuries.

    PubMed

    Mitcho, K; Yanko, J R

    1999-08-01

    Meeting the health care needs of the spinal cord-injured patient is an immense challenge for the acute care multidisciplinary team. The critical care nurse clinician, as well as other members of the team, needs to maintain a comprehensive knowledge base to provide the care management that is essential to the care of the spinal cord-injured patient. With the active participation of the patient and family in care delivery decisions, the health care professionals can help to meet the psychosocial and physical needs of the patient/family unit. This article provides an evidence-based, comprehensive review of the needs of the spinal cord-injured patient in the acute care setting including optimal patient outcomes, methods to prevent complications, and a plan that provides an expeditious transition to rehabilitation. PMID:10646444

  8. Effects of Acute Exercise on Long-Term Memory

    ERIC Educational Resources Information Center

    Labban, Jeffrey D.; Etnier, Jennifer L.

    2011-01-01

    In this study, we tested the effect of acute exercise on long-term memory, specifically the timing of exercise relative to the memory challenge. We assessed memory via paragraph recall, in which participants listened to two paragraphs (exposure) and recounted them following a 35-min delay. Participants (n = 48) were randomly assigned to one of…

  9. Treatment strategies for acute metabolic disorders in neonates

    PubMed Central

    Mohamed, Sarar

    2011-01-01

    Acute metabolic emergencies in neonates represent a challenge to the medical and nursing staff. If not treated optimally, these disorders are associated with poor outcome. Early diagnosis, supportive therapy and specific measures addressing the derranged metabolic process are the gold standards for favorable results. This review highlights treatment strategies for Inborn Errors of Metabolism (IEM) presenting in the neonatal period.

  10. Advanced thermal management technologies for defense electronics

    NASA Astrophysics Data System (ADS)

    Bloschock, Kristen P.; Bar-Cohen, Avram

    2012-05-01

    Thermal management technology plays a key role in the continuing miniaturization, performance improvements, and higher reliability of electronic systems. For the past decade, and particularly, the past 4 years, the Defense Advanced Research Projects Agency (DARPA) has aggressively pursued the application of micro- and nano-technology to reduce or remove thermal constraints on the performance of defense electronic systems. The DARPA Thermal Management Technologies (TMT) portfolio is comprised of five technical thrust areas: Thermal Ground Plane (TGP), Microtechnologies for Air-Cooled Exchangers (MACE), NanoThermal Interfaces (NTI), Active Cooling Modules (ACM), and Near Junction Thermal Transport (NJTT). An overview of the TMT program will be presented with emphasis on the goals and status of these efforts relative to the current State-of-the-Art. The presentation will close with future challenges and opportunities in the thermal management of defense electronics.

  11. Experimental models of hepatotoxicity related to acute liver failure.

    PubMed

    Maes, Michaël; Vinken, Mathieu; Jaeschke, Hartmut

    2016-01-01

    Acute liver failure can be the consequence of various etiologies, with most cases arising from drug-induced hepatotoxicity in Western countries. Despite advances in this field, the management of acute liver failure continues to be one of the most challenging problems in clinical medicine. The availability of adequate experimental models is of crucial importance to provide a better understanding of this condition and to allow identification of novel drug targets, testing the efficacy of new therapeutic interventions and acting as models for assessing mechanisms of toxicity. Experimental models of hepatotoxicity related to acute liver failure rely on surgical procedures, chemical exposure or viral infection. Each of these models has a number of strengths and weaknesses. This paper specifically reviews commonly used chemical in vivo and in vitro models of hepatotoxicity associated with acute liver failure. PMID:26631581

  12. Experimental models of hepatotoxicity related to acute liver failure

    PubMed Central

    Maes, Michaël; Vinken, Mathieu; Jaeschke, Hartmut

    2015-01-01

    Acute liver failure can be the consequence of various etiologies, with most cases arising from drug-induced hepatotoxicity in Western countries. Despite advances in this field, the management of acute liver failure continues to be one of the most challenging problems in clinical medicine. The availability of adequate experimental models is of crucial importance to provide a better understanding of this condition and to allow identification of novel drug targets, testing the efficacy of new therapeutic interventions and acting as models for assessing mechanisms of toxicity. Experimental models of hepatotoxicity related to acute liver failure rely on surgical procedures, chemical exposure or viral infection. Each of these models has a number of strengths and weaknesses. This paper specifically reviews commonly used chemical in vivo and in vitro models of hepatotoxicity associated with acute liver failure. PMID:26631581

  13. Severe acute pancreatitis: nutritional management in the ICU.

    PubMed

    Kaushik, Neeraj; O'Keefe, Stephen J D

    2004-02-01

    Patients with acute pancreatitis have elevated nutritional needs due to increased energy expenditure and catabolism. It is a clinical challenge to provide adequate nutrition to these patients while maintaining gut function, preventing pancreatic stimulation, and minimizing the risk of septic and metabolic complications associated with nutritional support. We present the case of a patient who had severe acute pancreatitis and was initially given total parenteral nutrition. After a period of initial improvement, he developed hyperglycemia, bacteremia, and sepsis. Parenteral nutrition was discontinued and infection was treated with antibiotics. Subsequent nutritional support consisted of enteral feeding with an elemental diet infused via a nasojejunal feeding tube. His condition improved gradually and he made a full recovery. This case illustrates the difficulties encountered while managing a case of severe acute pancreatitis and provides an evidence based approach to the nutritional management of severe acute pancreatitis in the intensive care unit setting. PMID:16215093

  14. Diagnosis and treatment of acute extremity compartment syndrome.

    PubMed

    von Keudell, Arvind G; Weaver, Michael J; Appleton, Paul T; Appelton, Paul T; Bae, Donald S; Dyer, George S M; Heng, Marilyn; Jupiter, Jesse B; Vrahas, Mark S

    2015-09-26

    Acute compartment syndrome of the extremities is well known, but diagnosis can be challenging. Ineffective treatment can have devastating consequences, such as permanent dysaesthesia, ischaemic contractures, muscle dysfunction, loss of limb, and even loss of life. Despite many studies, there is no consensus about the way in which acute extremity compartment syndromes should be diagnosed. Many surgeons suggest continuous monitoring of intracompartmental pressure for all patients who have high-risk extremity injuries, whereas others suggest aggressive surgical intervention if acute compartment syndrome is even suspected. Although surgical fasciotomy might reduce intracompartmental pressure, this procedure also carries the risk of long-term complications. In this paper in The Lancet Series about emergency surgery we summarise the available data on acute extremity compartment syndrome of the upper and lower extremities in adults and children, discuss the underlying pathophysiology, and propose a clinical guideline based on the available data. PMID:26460664

  15. Acute bronchial asthma.

    PubMed

    Grover, Sudhanshu; Jindal, Atul; Bansal, Arun; Singhi, Sunit C

    2011-11-01

    Acute asthma is the third commonest cause of pediatric emergency visits at PGIMER. Typically, it presents with acute onset respiratory distress and wheeze in a patient with past or family history of similar episodes. The severity of the acute episode of asthma is judged clinically and categorized as mild, moderate and severe. The initial therapy consists of oxygen, inhaled beta-2 agonists (salbutamol or terbutaline), inhaled budesonide (three doses over 1 h, at 20 min interval) in all and ipratropium bromide and systemic steroids (hydrocortisone or methylprednisolone) in acute severe asthma. Other causes of acute onset wheeze and breathing difficulty such as pneumonia, foreign body, cardiac failure etc. should be ruled out with help of chest radiography and appropriate laboratory investigations in first time wheezers and those not responding to 1 h of inhaled therapy. In case of inadequate response or worsening, intravenous infusion of magnesium sulphate, terbutaline or aminophylline may be used. Magnesium sulphate is the safest and most effective alternative among these. Severe cases may need ICU care and rarely, ventilatory support. PMID:21769523

  16. Acute Appendicitis Secondary to Acute Promyelocytic Leukemia

    PubMed Central

    Rodriguez, Eduardo A.; Lopez, Marvin A.; Valluri, Kartik; Wang, Danlu; Fischer, Andrew; Perdomo, Tatiana

    2015-01-01

    Patient: Female, 43 Final Diagnosis: Myeloid sarcoma appendicitis Symptoms: Abdominal pain • chills • fever Medication: — Clinical Procedure: Laparoscopic appendectomy, bone marrow biopsy Specialty: Gastroenterology and Hepatology Objective: Rare disease Background: The gastrointestinal tract is a rare site for extramedullary involvement in acute promyelocytic leukemia (APL). Case Report: A 43-year-old female with no past medical history presented complaining of mild abdominal pain, fever, and chills for the past day. On examination, she was tachycardic and febrile, with mild tenderness of her right lower quadrant and without signs of peritoneal irritation. Laboratory examination revealed pancytopenia and DIC, with a fibrinogen level of 290 mg/dL. CT of the abdomen showed a thickened and hyperemic appendix without perforation or abscess, compatible with acute appendicitis. The patient was given IV broad-spectrum antibiotics and was transfused with packed red blood cells and platelets. She underwent uncomplicated laparoscopic appendectomy and bone marrow biopsy, which revealed neo-plastic cells of 90% of the total bone marrow cellularity. Flow cytometry indicated presence of 92.4% of immature myeloid cells with t (15: 17) and q (22: 12) mutations, and FISH analysis for PML-RARA demonstrated a long-form fusion transcript, positive for APL. Appendix pathology described leukemic infiltration with co-expression of myeloperoxidase and CD68, consistent with myeloid sarcoma of the appendix. The patient completed a course of daunorubicin, cytarabine, and all trans-retinoic acid. Repeat bone marrow biopsy demonstrated complete remission. She will follow up with her primary care physician and hematologist/oncologist. Conclusions: Myeloid sarcoma of the appendix in the setting of APL is very rare and it might play a role in the development of acute appendicitis. Urgent management, including bone marrow biopsy for definitive diagnosis and urgent surgical intervention

  17. Organismal Responses to Hypoxemic Challenges.

    PubMed

    Fitzgerald, Robert S; Dehghani, Gholam A; Kiihl, Samara

    2015-01-01

    As a counterpoint to the volumes of beautiful work exploring how the carotid bodies (CBs) sense and transduce stimuli into neural traffic, this study explored one organismal reflex response to such stimulation. We challenged the anesthetized, paralyzed, artificially ventilated cat with two forms of acute hypoxemia: 10 % O(2)/balance N(2) (hypoxic hypoxia [HH] and carbon monoxide hypoxia [COH]). HH stimulates both CBs and aortic bodies (ABs), whereas COH stimulates only the ABs. Our design was to stimulate both with HH (HHint), then to stimulate only the ABs with COH (COHint); then, after aortic depressor nerve transaction, only the CBs with HH (HHabr), and finally neither with COH (COHabr). We recorded whole animal responses from Group 1 cats (e.g., cardiac output, arterial blood pressure, pulmonary arterial pressure/and vascular resistance) before and after sectioning the aortic depressor nerves. From Group 2 cats (intact) and Group 3 cats (aortic body resected) we recorded the vascular resistance in several organs (e.g., brain, heart, spleen, stomach, pancreas, adrenal glands, eyes). The HHint challenge was the most effective at keeping perfusion pressures adequate to maintain homeostasis in the face of a systemic wide hypoxemia with locally mediated vasodilation. The spleen and pancreas, however, showed a vasoconstrictive response. The adrenals and eyes showed a CB-mediated vasodilation. The ABs appeared to have a significant impact on the pulmonary vasculature as well as the stomach. Chemoreceptors via the sympathetic nervous system play the major role in this organism's response to hypoxemia. PMID:26303472

  18. 78 FR 49296 - Centennial Challenges 2014 Sample Return Robot Challenge

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ... SPACE ADMINISTRATION Centennial Challenges 2014 Sample Return Robot Challenge AGENCY: National Aeronautics and Space Administration (NASA). ACTION: Notice of Centennial Challenges 2014 Sample Return Robot... Robot Challenge is scheduled and teams that wish to compete may register. Centennial Challenges is...

  19. Thermal Hardware for the Thermal Analyst

    NASA Technical Reports Server (NTRS)

    Steinfeld, David

    2015-01-01

    The presentation will be given at the 26th Annual Thermal Fluids Analysis Workshop (TFAWS 2015) hosted by the Goddard Space Flight Center (GSFC) Thermal Engineering Branch (Code 545). NCTS 21070-1. Most Thermal analysts do not have a good background into the hardware which thermally controls the spacecraft they design. SINDA and Thermal Desktop models are nice, but knowing how this applies to the actual thermal hardware (heaters, thermostats, thermistors, MLI blanketing, optical coatings, etc...) is just as important. The course will delve into the thermal hardware and their application techniques on actual spacecraft. Knowledge of how thermal hardware is used and applied will make a thermal analyst a better engineer.

  20. [Acute pancreatitis in children].

    PubMed

    Rottier, B L; Holl, R A; Draaisma, J M

    1998-02-21

    Acute pancreatitis is probably commoner in children than was previously thought. In children it is most commonly associated with trauma or viral infection. The presentation may be subtler than in adults, requiring a high index of suspicion in the clinician. In three children, two boys aged 4 and 10 and a girl of 15 years, acute pancreatitis was suspected because of the findings at ultrasonography and endoscopic retrograde cholangiopancreatography performed when the disease recurred (the boy aged 4), apathy and immobility without dehydration or other obvious causes (the boy aged 10), and severe abdominal pain in combination with vomiting (the girl). All three patients had severely increased (urinary) amylase levels. Most often, acute pancreatitis in children tends to be a self-limiting disease which responds well to conservative treatment. PMID:9562770

  1. Minority Innovation Challenges Institute

    NASA Video Gallery

    Do you want to learn more about how to compete in NASA’s technical challenges for both prestige and significant cash prizes? NASA’s Minority Innovation Challenges Institute trains and mentors mino...

  2. Green Flight Challenge

    NASA Video Gallery

    The CAFE Green Flight Challenge sponsored by Google will be held at the CAFE Foundation Flight Test Center at Charles M. Schulz Sonoma County Airport in Santa Rosa, Calif. The Green Flight Challeng...

  3. Apollo experience report: Thermal protection subsystem

    NASA Technical Reports Server (NTRS)

    Pavlosky, J. E.; St.leger, L. G.

    1974-01-01

    The Apollo command module was the first manned spacecraft to be designed to enter the atmosphere of the earth at lunar-return velocity, and the design of the thermal protection subsystem for the resulting entry environment presented a major technological challenge. Brief descriptions of the Apollo command module thermal design requirements and thermal protection configuration, and some highlights of the ground and flight testing used for design verification of the system are presented. Some of the significant events that occurred and decisions that were made during the program concerning the thermal protection subsystem are discussed.

  4. Acute acalculous cholecystitis.

    PubMed

    Barie, Philip S; Eachempati, Soumitra R

    2003-08-01

    Acute cholecystitis can develop without gallstones in critically ill or injured patients. However, the development of acute acalculous cholecystitis is not limited to surgical or injured patients, or even to the intensive care unit. Diabetes, malignant disease, abdominal vasculitis, congestive heart failure, cholesterol embolization, and shock or cardiac arrest have been associated with acute acalculous cholecystitis. Children may also be affected, especially after a viral illness. The pathogenesis of acute acalculous cholecystitis is a paradigm of complexity. Ischemia and reperfusion injury, or the effects of eicosanoid proinflammatory mediators, appear to be the central mechanisms, but bile stasis, opioid therapy, positive-pressure ventilation, and total parenteral nutrition have all been implicated. Ultrasound of the gallbladder is the most accurate diagnostic modality in the critically ill patient, with gallbladder wall thickness of 3.5 mm or greater and pericholecystic fluid being the two most reliable criteria. The historical treatment of choice for acute acalculous cholecystitis has been cholecystectomy, but percutaneous cholecystostomy is now the mainstay of therapy, controlling the disease in about 85% of patients. Rapid improvement can be expected when the procedure is performed properly. The mortality rates (historically about 30%) for percutaneous and open cholecystostomy appear to be similar, reflecting the severity of illness, but improved resuscitation and critical care may portend a decreased risk of death. Interval cholecystectomy is usually not indicated after acute acalculous cholecystitis in survivors; if the absence of gallstones is confirmed and the precipitating disorder has been controlled, the cholecystostomy tube can be pulled out after the patient has recovered. PMID:12864960

  5. The Vulnerable Researcher: Some Unanticipated Challenges of Doctoral Fieldwork

    ERIC Educational Resources Information Center

    Ballamingie, Patricia; Johnson, Sherrill

    2011-01-01

    This paper draws explicitly on the field experiences of two doctoral researchers in geography to elucidate some of the challenges and issues related to researcher vulnerability that are especially acute for graduate students. In spite of significant differences in context, both researchers experienced an unanticipated degree of professional…

  6. Acute Prevertebral Calcific Tendinitis

    PubMed Central

    Tamm, Alexander; Jeffery, Caroline C; Ansari, Khalid; Naik, Sandeep

    2015-01-01

    We present a case of neck pain in a middle-aged woman, initially attributed to a retropharyngeal infection and treated with urgent intubation. With the help of computed tomography, the diagnosis was later revised to acute prevertebral calcific tendinitis, a self-limiting condition caused by abnormal calcium hydroxyapatite deposition in the longus colli muscles. It is critical to differentiate between these two disease entities due to dramatic differences in management. A discussion of acute prevertebral calcific tendinitis and its imaging findings is provided below. PMID:27252789

  7. The Acute Abdominal Aorta.

    PubMed

    Mellnick, Vincent M; Heiken, Jay P

    2015-11-01

    Acute disorders of the abdominal aorta are potentially lethal conditions that require prompt evaluation and treatment. Computed tomography (CT) is the primary imaging method for evaluating these conditions because of its availability and speed. Volumetric CT acquisition with multiplanar reconstruction and three-dimensional analysis is now the standard technique for evaluating the aorta. MR imaging may be useful for select applications in stable patients in whom rupture has been excluded. Imaging is indispensable for diagnosis and treatment planning, because management has shifted toward endoluminal repair. Acute abdominal aortic conditions most commonly are complications of aneurysms and atherosclerosis. PMID:26526434

  8. Acute acalculous cholecystitis

    SciTech Connect

    Fox, M.S.; Wilk, P.J.; Weissmann, H.S.; Freeman, L.M.; Gliedman, M.L.

    1984-07-01

    Sixty-eight patients with acute acalculous cholecystitis were reviewed. The results of history and physical examinations were usually nondiagnostic. IDA cholescintigraphy (93 per cent accuracy rate) was the only reliable diagnostic modality. The results of oral cholecystography, intravenous cholangiography and ultrasonography were considerably less reliable. One-half of the patients had gangrenous cholecystitis. Cholecystectomy was the preferred operation with an over-all mortality of 9 per cent. IDA cholescintigraphy is an important new modality for the diagnosis of acute acalculous cholecystitis which, in the past, has often been difficult to diagnose.

  9. Acute Gynecologic Disorders.

    PubMed

    Donaldson, Carolyn K

    2015-11-01

    Premenopausal women with acute pelvic pain comprise a significant percentage of patients who present to the emergency room. Etiologies can be gynecologic, urologic, gastrointestinal, or vascular. Signs and symptoms are often nonspecific and overlapping. The choice of imaging modality is determined by the clinically suspected differential diagnosis. Ultrasound (US) is the preferred imaging modality for suspected obstetric or gynecologic disorders. CT is more useful when gastrointestinal or urinary tract pathology is likely. MR imaging is rarely used in the emergent setting, except to exclude appendicitis in pregnant women. This article presents a comprehensive review of imaging of acute gynecologic disorders. PMID:26526439

  10. Innovative use of tele-ICU in long-term acute care hospitals.

    PubMed

    Mullen-Fortino, Margaret; Sites, Frank D; Soisson, Michael; Galen, Julie

    2012-01-01

    Tele-intensive care units (ICUs) typically provide remote monitoring for ICUs of acute care, short-stay hospitals. As part of a joint venture project to establish a long-term acute level of care, Good Shepherd Penn Partners became the first facility to use tele-ICU technology in a nontraditional setting. Long-term acute care hospitals care for patients with complex medical problems. We describe describes the benefits and challenges of integrating a tele-ICU program into a long-term acute care setting and the impact this model of care has on patient care outcomes. PMID:22828067

  11. Appendicular mass complicating acute appendicitis in a patient with dengue fever.

    PubMed

    Low, Y N; Cheong, B M K

    2016-04-01

    Abdominal pain with dengue fever can be a diagnostic challenge. Typically, pain is localised to the epigastric region or associated with hepatomegaly. Patients can also present with acute abdomen. We report a case of a girl with dengue fever and right iliac fossa pain. The diagnosis of acute appendicitis was made only after four days of admission. An appendicular mass and a perforated appendix was noted during appendectomy. The patient recovered subsequently. Features suggestive of acute appendicitis are persistent right iliac fossa pain, localised peritonism, persistent fever and leucocytosis. Repeated clinical assessment is important to avoid missing a concurrent diagnosis like acute appendicitis. PMID:27326951

  12. The Backpack Design Challenge

    ERIC Educational Resources Information Center

    Roman, Harry T.

    2010-01-01

    Something as simple as carrying books to school can be an interesting design challenge for students. It's an old problem that gets reinvented from time to time. In this article, the author discusses a backpack design challenge in which teachers work with students to design another way to carry books to school. The challenge started by trying to…

  13. Thermal Clothing

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Gateway Technologies, Inc. is marketing and developing textile insulation technology originally developed by Triangle Research and Development Corporation. The enhanced thermal insulation stems from Small Business Innovation Research contracts from NASA's Johnson Space Center and the U.S. Air Force. The effectiveness of the insulation comes from the microencapsulated phase-change materials originally made to keep astronauts gloved hands warm. The applications for the product range from outer wear, housing insulation, and blankets to protective firefighting gear and scuba diving suits. Gateway has developed and begun marketing thermal regulating products under the trademark, OUTLAST. Products made from OUTLAST are already on the market, including boot and shoe liners, winter headgear, hats and caps for hunting and other outdoor sports, and a variety of men's and women's ski gloves.

  14. Thermal Analysis

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The University of Georgia used NASTRAN, a COSMIC program that predicts how a design will stand up under stress, to develop a model for monitoring the transient cooling of vegetables. The winter use of passive solar heating for poultry houses is also under investigation by the Agricultural Engineering Dept. Another study involved thermal analysis of black and green nursery containers. The use of NASTRAN has encouraged student appreciation of sophisticated computer analysis.

  15. Thermal Effects.

    PubMed

    Yan, Ming; Zhang, Panyue; Zeng, Guangming

    2016-10-01

    This review focuses on the research literatures published in 2015 relating to topics of thermal effects in water pollution control. This review is divided into the following sections: biological nitrogen and phosphorus removal, wastewater treatment for organic conversion, industrial wastewater treatment, anaerobic digestion of sewage sludge and solid waste, sludge biochar preparation and application, pyrolysis of sewage sludge, reduction heavy metal in sewage sludge and soil, and other issues of wastewater and sludge treatment. PMID:27620109

  16. Tension chylothorax complicating acute malignant airway obstruction.

    PubMed

    Piastra, Marco; Pietrini, Domenico; Ruggiero, Antonio; Rizzo, Daniela; Marzano, Laura; Attinà, Giorgio; De Luca, Daniele; De Rosa, Gabriella; Conti, Giorgio

    2011-05-01

    Acute upper airway obstruction represents one of the most challenging emergencies in pediatric practice. In particular, a tension chylothorax complicating a malignant airway obstruction is a rare and life-threatening complication. We report a rapidly progressing tension chylothorax associated with a cervical mass in a 10-month-old male infant. To our knowledge, the extension of a cervical mass to the supraclavear region resulting in a compressive chylothorax represents an exceptional event in pediatrics. Early recognition and prompt treatment resulted to be essential to relieve the compression and to avoid end-stage hemodynamic and respiratory function derangement. PMID:21546802

  17. What Is Acute Myeloid Leukemia?

    MedlinePlus

    ... about acute myeloid leukemia? What is acute myeloid leukemia? Cancer starts when cells in a part of ... the body from doing their jobs. Types of leukemia Not all leukemias are the same. There are ...

  18. JPL Advanced Thermal Control Technology Roadmap - 2008

    NASA Technical Reports Server (NTRS)

    Birur, Gaj

    2008-01-01

    This slide presentation reviews the status of thermal control technology at JPL and NASA.It shows the active spacecraft that are in vairous positions in the solar syatem, and beyond the solar system and the future missions that are under development. It then describes the challenges that the past missions posed with the thermal control systems. The various solutions that were implemented duirng the decades prior to 1990 are outlined. A review of hte thermal challenges of the future misions is also included. The exploration plan for Mars is then reviewed. The thermal challenges of the Mars Rovers are then outlined. Also the challenges of systems that would be able to be used in to explore Venus, and Titan are described. The future space telescope missions will also need thermal control technological advances. Included is a review of the thermal requirements for manned missions to the Moon. Both Active and passive technologies that have been used and will be used are reviewed. Those that are described are Mechanically Pumped Fluid Loops (MPFL), Loop Heat Pipes, an M3 Passive Cooler, Heat Siwtch for Space and Mars surface applications, phase change material (PCM) technology, a Gas Gap Actuateor using ZrNiH(x), the Planck Sorption Cooler (PCS), vapor compression -- Hybrid two phase loops, advanced pumps for two phase cooling loops, and heat pumps that are lightweight and energy efficient.

  19. Nutrition, Inflammation, and Acute Pancreatitis

    PubMed Central

    Petrov, Max

    2013-01-01

    Acute pancreatitis is acute inflammatory disease of the pancreas. Nutrition has a number of anti-inflammatory effects that could affect outcomes of patients with pancreatitis. Further, it is the most promising nonspecific treatment modality in acute pancreatitis to date. This paper summarizes the best available evidence regarding the use of nutrition with a view of optimising clinical management of patients with acute pancreatitis. PMID:24490104

  20. Acute Septic Arthritis

    PubMed Central

    Shirtliff, Mark E.; Mader, Jon T.

    2002-01-01

    Acute septic arthritis may develop as a result of hematogenous seeding, direct introduction, or extension from a contiguous focus of infection. The pathogenesis of acute septic arthritis is multifactorial and depends on the interaction of the host immune response and the adherence factors, toxins, and immunoavoidance strategies of the invading pathogen. Neisseria gonorrhoeae and Staphylococcus aureus are used in discussing the host-pathogen interaction in the pathogenesis of acute septic arthritis. While diagnosis rests on isolation of the bacterial species from synovial fluid samples, patient history, clinical presentation, laboratory findings, and imaging studies are also important. Acute nongonococcal septic arthritis is a medical emergency that can lead to significant morbidity and mortality. Therefore, prompt recognition, rapid and aggressive antimicrobial therapy, and surgical treatment are critical to ensuring a good prognosis. Even with prompt diagnosis and treatment, high mortality and morbidity rates still occur. In contrast, gonococcal arthritis is often successfully treated with antimicrobial therapy alone and demonstrates a very low rate of complications and an excellent prognosis for full return of normal joint function. In the case of prosthetic joint infections, the hardware must be eventually removed by a two-stage revision in order to cure the infection. PMID:12364368

  1. Acute coronary care 1986

    SciTech Connect

    Califf, R.M.; Wagner, G.S.

    1985-01-01

    This book contains 22 chapters. Some of the titles are: The measurement of acute myocardial infarct size by CT; Magnetic resonance imaging for evaluation of myocardial ischemia and infarction; Poistron imaging in the evaluation of ischemia and myocardial infarction; and New inotropic agents.

  2. Acute radiation risk models

    NASA Astrophysics Data System (ADS)

    Smirnova, Olga

    Biologically motivated mathematical models, which describe the dynamics of the major hematopoietic lineages (the thrombocytopoietic, lymphocytopoietic, granulocytopoietic, and erythropoietic systems) in acutely/chronically irradiated humans are developed. These models are implemented as systems of nonlinear differential equations, which variables and constant parameters have clear biological meaning. It is shown that the developed models are capable of reproducing clinical data on the dynamics of these systems in humans exposed to acute radiation in the result of incidents and accidents, as well as in humans exposed to low-level chronic radiation. Moreover, the averaged value of the "lethal" dose rates of chronic irradiation evaluated within models of these four major hematopoietic lineages coincides with the real minimal dose rate of lethal chronic irradiation. The demonstrated ability of the models of the human thrombocytopoietic, lymphocytopoietic, granulocytopoietic, and erythropoietic systems to predict the dynamical response of these systems to acute/chronic irradiation in wide ranges of doses and dose rates implies that these mathematical models form an universal tool for the investigation and prediction of the dynamics of the major human hematopoietic lineages for a vast pattern of irradiation scenarios. In particular, these models could be applied for the radiation risk assessment for health of astronauts exposed to space radiation during long-term space missions, such as voyages to Mars or Lunar colonies, as well as for health of people exposed to acute/chronic irradiation due to environmental radiological events.

  3. [Acute pancreatitis and pregnancy].

    PubMed

    Scollo, P; Licitra, G

    1993-12-01

    Aetiologic factors (gallstones, hyperlipidemia I-IV, hypertriglyceridaemia) make their occurrence, mainly, in the third trimester of gestation. Two cases of acute pancreatitis in pregnancy are described; in both cases patients referred healthy diet, no habit to smoke and no previous episode of pancreatitis. An obstructive pathology of biliary tract was the aetiologic factor. Vomiting, upper abdominal pain are aspecific symptoms that impose a differential diagnosis with acute appendicitis, cholecystitis and obstructive intestinal pathology. Laboratory data (elevated serum amylase and lipase levels) and ultrasonography carry out an accurate diagnosis. The management of acute pancreatitis is based on the use of symptomatic drugs, a low fat diet alternated to the parenteral nutrition when triglycerides levels are more than 28 mmol/L. Surgical therapy, used only in case of obstructive pathology of biliary tract, is optimally collected in the third trimester or immediately after postpartum. Our patients, treated only medically, delivered respectively at 38th and 40th week of gestation. Tempestivity of diagnosis and appropriate therapy permit to improve prognosis of a pathology that, although really associated with pregnancy, presents high maternal mortality (37%) cause of complications (shock, coagulopathy, acute respiratory insufficiency) and fetal (37.9%) by occurrence of preterm delivery. PMID:8139793

  4. [Acute blood pressure elevations].

    PubMed

    Chamontin, B; Amar, J; Chollet, F; Rouge, P; Bonetti-d'Esteve, L; Guittard, J; Salvador, M

    2000-11-01

    Blood pressure (BP) elevations may correspond to different clinical situations. Hypertensives emergencies are situations that require immediate reduction in BP because of acute or rapidly progressing target organ damage: accelerated malignant hypertension, hypertensive encephalopathy, acute myocardial infarction, acute aortic dissection, acute left ventricular failure, and eclampsia. Hypertensive urgencies are those with marked elevated BP in which it is desirable to reduce BP progressively within few hours, such as severe hypertension, progressive target organ damage, perioperative hypertension. Cerebrovascular accidents have to be individualized. In most patients in the immediate post-stroke period, BP should not be lowered. Caution is advised in lowering BP in these patients because excessive falls may precipitate cerebral ischemia. In situations without symptoms or progressive target organ it is necessary to exclude proximate causes of elevated BP such as pain and elevated BP alone rarely requires antihypertensive treatment. Among parenteral antihypertensive (AH) drugs labetalol, nicardipine, urapidil, and nitroprussiate are generally used, and the choice of AH drug depends on the clinical situation. It is not required to normalize BP immediately but to reduce mean BP no more than 25%, then toward 160/100 mmHg as recommended by JNC VI, in order to avoid an impairment of renal, cerebral or coronary ischemia. Oral long-acting dihydropyridines are often subsequently administrated, except in myocardial ischemia. Therapeutic attitudes vary considerably according to the clinical situation: abstention, immediate decrease or progressive decrease in BP have to be decided. PMID:11190294

  5. Gadolinium induced recurrent acute pancreatitis.

    PubMed

    Blasco-Perrin, H; Glaser, B; Pienkowski, M; Peron, J M; Payen, J L

    2013-01-01

    Acute pancreatitis is a sudden swelling and inflammation of the pancreas. The two most common causes are alcohol use and biliary stones. Drug-induced acute pancreatitis are rare (1.4-2%). In this present study, we present a case of recurrent acute pancreatitis induced by a specific magnetic-resonance-imaging (MRI) contrast agent called gadobenate dimeglumine. PMID:23395575

  6. Acute hepatitis E complicated by acute pancreatitis and multiorgan dysfunction

    PubMed Central

    Karanth, Suman S; Khan, Zohaib; Rau, Nileshwar Radhakrishna; Rao, Karthik

    2014-01-01

    We report this rare case of a 27-year-old man who presented with acute hepatitis E and went on to develop acute epigastric pain. He was diagnosed to have acute severe pancreatitis with shock and acute renal failure due to hepatitis E. Such a phenomenon has rarely been reported in the literature, with patients following a benign course and complete recovery after conservative management and analgesia. Awareness of this potentially life-threatening complication, especially in young men from endemic areas with acute hepatitis E presenting with abdomen pain has been highlighted. PMID:24899005

  7. Fusion power: a challenge for materials science.

    PubMed

    Duffy, D M

    2010-07-28

    The selection and design of materials that will withstand the extreme conditions of a fusion power plant has been described as one of the greatest materials science challenges in history. The high particle flux, high thermal load, thermal mechanical stress and the production of transmutation elements combine to produce a uniquely hostile environment. In this paper, the materials favoured for the diverse roles in a fusion power plant are discussed, along with the experimental and modelling techniques that are used to advance the understanding of radiation damage in materials. Areas where further research is necessary are highlighted. PMID:20566513

  8. Thermal insulator

    SciTech Connect

    Yamamoto, R.; Asada, Y.; Matsuo, Y.; Mikoda, M.

    1985-07-16

    A thermal insulator comprises an expanded resin body having embedded therein an evacuated powder insulation portion which consists of fine powder and a container of film-like plastics or a film-like composite of plastics and metal for enclosing the powder. The resin body has been expanded by a Freon gas as a blowing agent. Since a Freon gas has a larger molecular diameter than the constituent gases of air, it is less likely to permeate through the container than air. Thus present invention provides a novel composite insulator which fully utilizes the benefits of vacuum insulation without necessitating a strong and costly material for a vacuum container.

  9. Creating Learning Momentum through Overt Teaching Interactions during Real Acute Care Episodes

    ERIC Educational Resources Information Center

    Piquette, Dominique; Moulton, Carol-Anne; LeBlanc, Vicki R.

    2015-01-01

    Clinical supervisors fulfill a dual responsibility towards patient care and learning during clinical activities. Assuming such roles in today's clinical environments may be challenging. Acute care environments present unique learning opportunities for medical trainees, as well as specific challenges. The goal of this paper was to better understand…

  10. Mouse models of acute exacerbations of allergic asthma.

    PubMed

    Kumar, Rakesh K; Herbert, Cristan; Foster, Paul S

    2016-07-01

    Most of the healthcare costs associated with asthma relate to emergency department visits and hospitalizations because of acute exacerbations of underlying chronic disease. Development of appropriate animal models of acute exacerbations of asthma is a necessary prerequisite for understanding pathophysiological mechanisms and assessing potential novel therapeutic approaches. Most such models have been developed using mice. Relatively few mouse models attempt to simulate the acute-on-chronic disease that characterizes human asthma exacerbations. Instead, many reported models involve relatively short-term challenge with an antigen to which animals are sensitized, followed closely by an unrelated triggering agent, so are better described as models of potentiation of acute allergic inflammation. Triggers for experimental models of asthma exacerbations include (i) challenge with high levels of the sensitizing allergen (ii) infection by viruses or fungi, or challenge with components of these microorganisms (iii) exposure to environmental pollutants. In this review, we examine the strengths and weaknesses of published mouse models, their application for investigation of novel treatments and potential future developments. PMID:26922049

  11. Cryptosporidiosis: Environmental, therapeutic, and preventive challenges

    PubMed Central

    Collinet-Adler, Stefan; Ward, Honorine D.

    2014-01-01

    Cryptosporidium spp. are responsible for endemic and epidemic disease worldwide. Clinical manifestations may include acute, persistent, or chronic diarrhea, biliary, and pulmonary disease. Disease severity ranges from asymptomatic or mild to severe, intractable diarrhea with wasting depending on immune status, nutrition, and age. Transmission is fecal-oral with both human and animal reservoirs. Disease is often self limited in healthy individuals, but therapy remains a challenge in the immune-compromised. Prevention currently depends on appropriate hygiene and proper water management and treatment. PMID:20521158

  12. Acute gangrenous cholecystitis: radionuclide diagnosis

    SciTech Connect

    Brachman, M.B.; Tanasescu, D.E.; Ramanna, L.; Waxman, A.D.

    1984-04-01

    Radionuclide hepatobiliary imaging with Tc-99m IDA is a useful procedure for the diagnosis of acute cholecystitis. Visualization of the gallbladder essentially rules out acute cholecystitis. Nonvisualization suggest acute cholecystitis but may also be associated with chronic gallbladder disease or other conditions. The authors recently observed five patients in whom a rim of increased parenchymal liver activity was seen adjacent to the gallbladder fossa. All five patients had acute gangrenous cholecystitis. The rim of increased activity appears to be a useful secondary sign of acute cholecystitis.

  13. Severe Acute Pancreatitis in Pregnancy

    PubMed Central

    Abdullah, Bahiyah; Kathiresan Pillai, Thanikasalam; Cheen, Lim Huay; Ryan, Ray Joshua

    2015-01-01

    This is a case of a pregnant lady at 8 weeks of gestation, who presented with acute abdomen. She was initially diagnosed with ruptured ectopic pregnancy and ruptured corpus luteal cyst as the differential diagnosis. However she then, was finally diagnosed as acute hemorrhagic pancreatitis with spontaneous complete miscarriage. This is followed by review of literature on this topic. Acute pancreatitis in pregnancy is not uncommon. The emphasis on high index of suspicion of acute pancreatitis in women who presented with acute abdomen in pregnancy is highlighted. Early diagnosis and good supportive care by multidisciplinary team are crucial to ensure good maternal and fetal outcomes. PMID:25628906

  14. Acute pancreatitis induced by methimazole therapy.

    PubMed

    Abraham, Albin; Raghavan, Pooja; Patel, Rajshree; Rajan, Dhyan; Singh, Jaspreet; Mustacchia, Paul

    2012-05-01

    Among the causative factors for acute pancreatitis, adverse drug reactions are considered to be rare. The diagnosis of drug-induced pancreatitis (DIP) is challenging to establish, and is often underestimated because of the difficulties in determining the causative agent and the need for a retrospective re-evaluation of the suspected agent. We present the case of an 80-year-old woman who presented with complaints of abdominal pain. Her medications included methimazole (MMI) which she had been on for the past 3 months. Computed tomography of her abdomen showed peripancreatic fat stranding with trace amount of surrounding fluid, along with amylase and lipase levels suggestive of acute pancreatitis. In the absence of classical risk factors for acute pancreatitis, a diagnosis of DIP secondary to MMI use was made. Withdrawal of the drug from her medication regimen was accompanied by relief of symptoms and resolution of clinical evidence of pancreatitis. The aim of this paper is to report only the fourth case of MMI-induced pancreatitis in the published literature, and to illustrate the significance of an appropriate and timely diagnosis of DIP. PMID:22679409

  15. Acute intermittent porphyria associated with respiratory failure: a multidisciplinary approach.

    PubMed

    Menegueti, Mayra Gonçalves; Gil Cezar, Alkmim-Teixeira; Casarini, Karin Aparecida; Muniz Cordeiro, Kátia Simone; Basile-Filho, Anibal; Martins-Filho, Olindo Assis; Auxiliadora-Martins, Maria

    2011-01-01

    Despite being challenging, delivery of effective nursing care to patients with acute intermittent porphyria is a matter of utmost importance. In this paper, the diversity of symptoms and the difficult diagnosis of this condition are emphasized, and details concerning the treatment of this disorder in the intensive care unit are presented. We believe that acute intermittent porphyria should be borne in mind during performance of differential diagnosis of neurological, psychiatric, and gastroenterological disorders on patients whose routine investigation tests are normal, especially when precipitating factors exist. Intensive care measures and a multidisciplinary team approach are essential. PMID:21687623

  16. Acute Management of Nutritional Demands after Spinal Cord Injury

    PubMed Central

    Thibault-Halman, Ginette; Casha, Steven; Singer, Shirley

    2011-01-01

    Abstract A systematic review of the literature was performed to address pertinent clinical questions regarding nutritional management in the setting of acute spinal cord injury (SCI). Specific metabolic challenges are present following spinal cord injury. The acute stage is characterized by a reduction in metabolic activity, as well as a negative nitrogen balance that cannot be corrected, even with aggressive nutritional support. Metabolic demands need to be accurately monitored to avoid overfeeding. Enteral feeding is the optimal route following SCI. When oral feeding is not possible, nasogastric, followed by nasojejunal, then by percutaneous endoscopic gastrostomy, if necessary, is suggested. PMID:20373845

  17. Migraine headache confounding the diagnosis of acute mountain sickness.

    PubMed

    Karle, Francis J; Auerbach, Paul S

    2014-03-01

    A 36-year-old man with a history of migraine headache attempted to hike from Lukla, Nepal, to Mount Everest Base Camp. On the sixth day of hiking, he had a migraine headache. After achieving resolution with typical therapies and rest, he ascended higher. Another headache developed that was interpreted to be a migraine. The headache was treated, and he ascended higher, after which severe symptoms of acute mountain sickness developed, necessitating his evacuation by helicopter. Persons with headaches in daily life may present challenges to diagnosis when traveling to high altitude. Careful evaluation and decision making are needed to achieve proper diagnosis and treatment of acute mountain sickness. PMID:24462763

  18. Evaluating the Acute Abdomen in the Pregnant Patient.

    PubMed

    Masselli, Gabriele; Derme, Martina; Laghi, Francesca; Framarino-dei-Malatesta, Marialuisa; Gualdi, Gianfranco

    2015-11-01

    Acute abdominal pain in pregnancy presents diagnostic and therapeutic challenges. Ultrasound remains the primary imaging investigation of the pregnant abdomen because of its availability, portability, and lack of ionizing radiation. MR imaging has been shown to be useful in the diagnosis of gynecologic and obstetric problems and in the setting of acute abdomen during pregnancy. MR imaging is often used when ultrasound is inconclusive. Computed tomography is the investigation of choice when there is a life-threatening situation and in case of traumatic injuries, when a rapid diagnosis is required. PMID:26526440

  19. Acute Intermittent Porphyria Associated with Respiratory Failure: A Multidisciplinary Approach

    PubMed Central

    Menegueti, Mayra Gonçalves; Gil Cezar, Alkmim-Teixeira; Casarini, Karin Aparecida; Muniz Cordeiro, Kátia Simone; Basile-Filho, Anibal; Martins-Filho, Olindo Assis; Auxiliadora-Martins, Maria

    2011-01-01

    Despite being challenging, delivery of effective nursing care to patients with acute intermittent porphyria is a matter of utmost importance. In this paper, the diversity of symptoms and the difficult diagnosis of this condition are emphasized, and details concerning the treatment of this disorder in the intensive care unit are presented. We believe that acute intermittent porphyria should be borne in mind during performance of differential diagnosis of neurological, psychiatric, and gastroenterological disorders on patients whose routine investigation tests are normal, especially when precipitating factors exist. Intensive care measures and a multidisciplinary team approach are essential. PMID:21687623

  20. Acute chylous ascites mimicking acute appendicitis in a patient with pancreatitis

    PubMed Central

    Smith, Emily K; Ek, Edmund; Croagh, Daniel; Spain, Lavinia A; Farrell, Stephen

    2009-01-01

    We report a case of acute chylous peritonitis mimicking acute appendicitis in a man with acute on chronic pancreatitis. Pancreatitis, both acute and chronic, causing the development of acute chylous ascites and peritonitis has rarely been reported in the English literature. This is the fourth published case of acute chylous ascites mimicking acute appendicitis in the literature. PMID:19824123

  1. Materials for Space: It's Challenging!

    NASA Technical Reports Server (NTRS)

    Johnson, Sylvia M.

    2016-01-01

    Space environments place tremendous demands on materials that must perform with exceptional reliability to realize the goals of human or robotic space exploration missions. Materials are subjected to extremes of temperature, pressure, radiation and mechanical loads during all phases of use, including takeoff and ascent, exposure to space or entry into an atmosphere, and operation in a planetary atmosphere. Space materials must be robust and enable the formation of lightweight structures or components that perform the required functions; materials that perform multiple functions are of particular interest. This talk will review the unique challenges for materials in space and some of the specific material capabilities that will be needed for future exploration missions. A description of needs and trends in thermal protection materials and systems will complete the talk.

  2. NASA Centennial Challenges: After the Challenge

    NASA Video Gallery

    What's it like to participate in a NASA Centennial Challenge? In their own words: "We really had no idea what to expect when we got here. Being able to take all of this...now we have an idea for ne...

  3. Challenging Behaviour: A Challenge To Change.

    ERIC Educational Resources Information Center

    van Berckelaer-Onnes, I. A.; van Loon, J.; Peelen, A.

    2002-01-01

    This article discusses the role in the Netherlands of independent regional advisory teams made up of professionals who have experience with individuals who exhibit challenging behaviors. One team's methods are illustrated by describing the case of a completely isolated 24-year-old man who, after a 7-year intervention, was able to fulfill a long…

  4. Bacterial challenges in food

    PubMed Central

    Collee, J. G.

    1974-01-01

    Qualitative and quantitative aspects of bacterial challenges that might be encountered in food are discussed with reference to recognized and relatively unrecognized hazards. Mechanisms of pathogenicity are reviewed and the populations at risk are noted. The bacterial content of food as it is served at table merits more study. The challenge of prevention by education is discussed. Indirect bacterial challenges in our food are considered. The real challenge of diagnosis depends upon an awareness of a complex range of conditions; the importance of effective communication with efficient laboratory and epidemiological services is stressed. There is an increasing need for care in the preparation and distribution of food. PMID:4467860

  5. NASA Exploration Design Challenge

    NASA Video Gallery

    From the International Space Station, astronaut Sunita Williams welcomes participants to the NASA Exploration Design Challenge and explains the uncertainties about the effects of space radiation on...

  6. Acute Heart Failure Treatment.

    PubMed

    Levy, Phillip D; Bellou, Abdel

    2013-06-01

    Dyspnea is the predominant symptom for patients with acute heart failure and initial treatment is largely directed towards the alleviation of this. Contrary to conventional belief, not all patients present with fluid overload and the approach to management is rapidly evolving from a solitary focus on diuresis to one that more accurately reflects the complex interplay of underlying cardiac dysfunction and acute precipitant. Effective treatment thus requires an understanding of divergent patient profiles and an appreciation of various therapeutic options for targeted patient stabilization. The key principle within this paradigm is directed management that aims to diminish the work of breathing through situation appropriate ventillatory support, volume reduction and hemodynamic improvement. With such an approach, clinicians can more efficiently address respiratory discomfort while reducing the likelihood of avoidable harm. PMID:24223323

  7. Acute Biliary Septic Shock

    PubMed Central

    1990-01-01

    Forty-seven cases of biliary tract infection with septic shock are presented. The sepsis was caused by empyema of the gallbladder in 23 cases and by cholangitis in the remainder. Gallstones were most frequently the cause of the sepsis. An appropriate diagnostic description of the syndrome of biliary tract infection and septic shock should therefore include a description of the underlying biliary disease as well as the term acute biliary shock. In this series, emergency surgical management by removal of gallstones and drainage of suppuration was felt to be the most appropriate treatment. There was a high incidence of gallbladder rupture (10.6%) and intrahepatic stones (53.2%). Of the 13 patients who died, 8 might have survived if early operation had been performed after the diagnosis of acute biliary septic shock was established. PMID:2278914

  8. [Acute aortic syndrome].

    PubMed

    Nienaber, Christoph A

    2016-06-01

    Acute aortic syndrome is the common denominator for acute events to the aortic wall and encompasses dissection of the aorta, intramural hematoma, formation of aortic ulcers and trauma to the aorta with an annual incidence of up to 35 cases/100.000 between 65 and 75 years of age. Both, inflammation and/or microtrauma at the level of the aortic media layer, and a genetic disposition are promoting elements of AAS, while the extent and anatomic involvement of the ascending aorta call for either surgical resection/repair in the proximal part of the aorta, or an endovascular solution for pathologies in the distal aorta; in all cases of dissection (regardless of location) reconstruction/realignment has been proven to portend better long-term outcomes (in addition to medical management of blood pressure). PMID:27254622

  9. Acute Ischemic Stroke Intervention.

    PubMed

    Khandelwal, Priyank; Yavagal, Dileep R; Sacco, Ralph L

    2016-06-01

    Acute ischemic stroke (AIS) is the leading cause of disability worldwide and among the leading causes of mortality. Although intravenous tissue plasminogen activator (IV-rtPA) was approved nearly 2 decades ago for treatment of AIS, only a minority of patients receive it due to a narrow time window for administration and several contraindications to its use. Endovascular approaches to recanalization in AIS developed in the 1980s, and recently, 5 major randomized trials showed an overwhelming superior benefit of combining endovascular mechanical thrombectomy with IV-rtPA over IV-rtPA alone. In this paper, we discuss the evolution of catheter-based treatment from first-generation thrombectomy devices to the game-changing stent retrievers, results from recent trials, and the evolving stroke systems of care to provide timely access to acute stroke intervention to patients in the United States. PMID:27256835

  10. Old and new challenges in Chagas disease.

    PubMed

    Pérez-Molina, Jose A; Perez, Angela Martinez; Norman, Francesca F; Monge-Maillo, Begoña; López-Vélez, Rogelio

    2015-11-01

    Chagas disease, caused by the parasite Trypanosoma cruzi, is a neglected disease, which can lead to cardiomyopathy, arrhythmias, megaviscera, and more rarely, polyneuropathy in up to 30-40% of patients around 20 to 30 years after acute infection. Although it is endemic in the Americas, global population movements mean that it can be located wherever migrants from endemic areas settle. The disease was first described 100 years ago and still challenges clinicians worldwide, since diagnostic, therapeutic, and prognostic methods remain insufficient. Furthermore, factors such as HIV co-infection, immunosuppressive drugs, transplantation, and neoplastic disease can alter the natural course of the infection. We present the case of a Bolivian woman with chronic T cruzi infection diagnosed at our clinic in Madrid, Spain, who subsequently developed non-Hodgkin lymphoma. Our report illustrates the challenges of an increasingly common infection seen in non-endemic countries, and highlights both daily management dilemmas and associated difficulties that arise. PMID:26231478

  11. [Acute Chest Pain].

    PubMed

    Gmür, Christian

    2016-02-17

    Acute chest pain is a frequent consultation reason in general practice as well as in emergency departments. With the help of history, physical examination, ECG, laboratory and newly developed risk scores, potentially life-threatening diseases and high-risk patients may be detected and treated early, quickly and cost-effectively. New biomarkers and their combination with risk scores can increase the negative predictive value to exclude certain diseases. PMID:26886697

  12. Diarrhoea in adults (acute)

    PubMed Central

    2008-01-01

    Introduction An estimated 4000 million cases of diarrhoea occurred worldwide in 1996, resulting in 2.5 million deaths. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for acute diarrhoea in adults living in resource-rich countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults from resource-rich countries traveling to resource-poor countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults living in resource-poor countries? What are the effects of treatments for acute severe diarrhoea in adults living in resource-poor countries? We searched: Medline, Embase, The Cochrane Library and other important databases up to January 2007 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 71 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, antimotility agents, antisecretory agents, bismuth subsalicylate, diet, intravenous rehydration, nasogastric tube rehydration, and oral rehydration solutions (amino acid oral rehydration solution, bicarbonate oral rehydration solution, reduced osmolarity oral rehydration solution, rice-based oral rehydration solution, standard oral rehydration solution). PMID:19450323

  13. Diarrhoea in adults (acute)

    PubMed Central

    2011-01-01

    Introduction An estimated 4.6 billion cases of diarrhoea occurred worldwide in 2004, resulting in 2.2 million deaths. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for acute diarrhoea in adults living in resource-rich countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults from resource-rich countries travelling to resource-poor countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults living in resource-poor countries? What are the effects of treatments for acute severe diarrhoea in adults living in resource-poor countries? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 72 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, antimotility agents, antisecretory agents, bismuth subsalicylate, diet, intravenous rehydration, nasogastric tube rehydration, oral rehydration solutions (amino acid oral rehydration solution, bicarbonate oral rehydration solution, reduced osmolarity oral rehydration solution, rice-based oral rehydration solution, standard oral rehydration solution), vitamin A supplementation, and zinc supplementation. PMID:21718555

  14. Acupuncture for acute hordeolum

    PubMed Central

    Cheng, Ke; Wang, Xue; Guo, Menghu; Wieland, L. Susan; Shen, Xueyong; Lao, Lixing

    2014-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: The objective of this review is to determine the effects and, when possible, the safety of acupuncture for the treatment of acute hordeola, in comparison to no specific treatment (e.g., observation), sham acupuncture, or other active treatments. Acupuncture as an adjuvant to another treatment also will be compared to that treatment alone. PMID:25214814

  15. IMMUNOTHERAPY IN ACUTE LEUKEMIA

    PubMed Central

    Leung, Wing

    2010-01-01

    Recent advances in immunotherapy of cancer may represent a successful example in translational research, in which progress in knowledge and technology in immunology has lead to new strategies of immunotherapy, and even past failure in many clinical trials have led to a better understanding of basic cancer immunobiology. This article reviews the latest concepts in antitumor immunology and its application in the treatment of cancer, with particular focus on acute leukemia. PMID:19100371

  16. Streptococcal acute pharyngitis.

    PubMed

    Anjos, Lais Martins Moreira; Marcondes, Mariana Barros; Lima, Mariana Ferreira; Mondelli, Alessandro Lia; Okoshi, Marina Politi

    2014-07-01

    Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci) is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-streptococcal glomerulonephritis. Symptom onset in streptococcal infection is usually abrupt and includes intense sore throat, fever, chills, malaise, headache, tender enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate. Cough, coryza, conjunctivitis, and diarrhea are uncommon, and their presence suggests a viral cause. A diagnosis of pharyngitis is supported by the patient's history and by the physical examination. Throat culture is the gold standard for diagnosing streptococcus pharyngitis. However, it has been underused in public health services because of its low availability and because of the 1- to 2-day delay in obtaining results. Rapid antigen detection tests have been used to detect S. pyogenes directly from throat swabs within minutes. Clinical scoring systems have been developed to predict the risk of S. pyogenes infection. The most commonly used scoring system is the modified Centor score. Acute S. pyogenes pharyngitis is often a self-limiting disease. Penicillins are the first-choice treatment. For patients with penicillin allergy, cephalosporins can be an acceptable alternative, although primary hypersensitivity to cephalosporins can occur. Another drug option is the macrolides. Future perspectives to prevent streptococcal pharyngitis and post-infection systemic complications include the development of an anti-Streptococcus pyogenes vaccine. PMID:25229278

  17. [Acute coronary syndromes: epidemiology].

    PubMed

    Ozkan, Alev Arat

    2013-04-01

    Coronary heart disease is the main cause of death in the world as well as in Turkey. It's not only a health issue but also a social problem with a high economic burden and negative impact on quality of life. The majority of deaths are attributable to acute coronary syndromes (ACS) and their complications.This review summarizes some important facts regarding ACS epidemiology in the world and in Turkey. PMID:27323430

  18. Acute tubulointerstitial nephritis.

    PubMed

    Ulinski, Tim; Sellier-Leclerc, Anne-Laure; Tudorache, Elena; Bensman, Albert; Aoun, Bilal

    2012-07-01

    Acute tubulointerstitial nephritis (TIN) is a frequent cause of acute renal failure, characterised by the presence of inflammatory cell infiltrate in the interstitium of the kidney. Immuno-allergic reaction to certain medications, mainly non-steroidal anti-inflammatory drugs and antibiotics are by far the most important etiology for TIN today, but other situations such as infections, toxins, and vasculitis are known to induce TIN. Incidence of TIN is increasing, probably due to prescription habits and NSAID overuse, representing 3-7% of acute kidney injury in biopsies in children. Avoidance of the causal substance and rapid steroid therapy are hallmarks for patient care, but spontaneous initial recovery is very frequent and the general prognosis seems satisfactory. However, development of chronic TIN, without response to steroid or other immunosuppressive treatment, is possible. As the largest part of TIN is secondary to certain drugs, clear indications in particular for NSAID or antibiotics should be respected to reduce the number of TIN cases. PMID:21638156

  19. Acute lung injury review.

    PubMed

    Tsushima, Kenji; King, Landon S; Aggarwal, Neil R; De Gorordo, Antonio; D'Alessio, Franco R; Kubo, Keishi

    2009-01-01

    The first report of acute respiratory distress syndrome (ARDS) was published in 1967, and even now acute lung injury (ALI) and ARDS are severe forms of diffuse lung disease that impose a substantial health burden all over the world. Recent estimates indicate approximately 190,000 cases per year of ALI in the United States each year, with an associated 74,500 deaths per year. Common causes of ALI/ARDS are sepsis, pneumonia, trauma, aspiration pneumonia, pancreatitis, and so on. Several pathologic stages of ALI/ARDS have been described: acute inflammation with neutrophil infiltration, fibroproliferative phase with hyaline membranes, with varying degrees of interstitial fibrosis, and resolution phase. There has been intense investigation into the pathophysiologic events relevant to each stage of ALI/ARDS, and much has been learned in the alveolar epithelial, endobronchial homeostasis, and alveolar cell immune responses, especially neutrophils and alveolar macrophages in an animal model. However, these effective results in the animal models are not equally adoptive to those in randomized, controlled trials. The clinical course of ALI/ARDS is variable with the likely pathophysiologic complexity of human ALI/ARDS. In 1994, the definition was recommended by the American-European Consensus Conference Committee, which facilitated easy nomination of patients with ALI/ARDS for a randomized, clinical trial. Here, we review the recent randomized, clinical trials of ALI/ARDS. PMID:19420806

  20. Materials Challenges in Space Exploration

    NASA Technical Reports Server (NTRS)

    Bhat, Biliyar N.

    2005-01-01

    United States civil space program administered by National Aeronautics and Space Administration has a new strategic direction to explore the solar system. This new 'vision for space exploration' encompasses a broad range of human and robotic missions, including the Moon. Mars and destinations beyond. These missions require advanced systems and capabilities that will accelerate the development of many critical technologies, including advanced materials and structural concepts. Specifically, it is planned to develop high-performance materials for vehicle structures, propulsion systems, and space suits; structural concepts for modular assembly for space infrastructure: lightweight deployable and inflatable structures for large space systems and crew habitats; and highly integrated structural systems and advanced thermal management systems for reducing launch mass and volume. This paper will present several materials challenges in advanced space systems-high performance structural and thermal materials, space durable materials, radiation protection materials, and nano-structural materials. Finally, the paper will take a look at the possibility of utilizing materials in situ, i.e., processing materials on the surface of the Moon and Mars.

  1. Differential aspects of the disease and treatment of Thoracic Acute Aortic Dissection (TAAD)-the European experience.

    PubMed

    Pepper, John

    2016-07-01

    The management of patients with acute aortic dissection continues to be a challenge. It is an uncommon but lethal condition which continues to be under-diagnosed and under-treated. In this review, the term acute aortic syndrome is preferred in order to embrace the closely related pathologies of intramural hematoma (IMH) and penetrating aortic ulcer (PAU). PMID:27563549

  2. Differential aspects of the disease and treatment of Thoracic Acute Aortic Dissection (TAAD)—the European experience

    PubMed Central

    2016-01-01

    The management of patients with acute aortic dissection continues to be a challenge. It is an uncommon but lethal condition which continues to be under-diagnosed and under-treated. In this review, the term acute aortic syndrome is preferred in order to embrace the closely related pathologies of intramural hematoma (IMH) and penetrating aortic ulcer (PAU). PMID:27563549

  3. Anisotropic Thermal Diffusion

    NASA Astrophysics Data System (ADS)

    Gardiner, Thomas

    2013-10-01

    Anisotropic thermal diffusion in magnetized plasmas is an important physical phenomena for a diverse set of physical conditions ranging from astrophysical plasmas to MFE and ICF. Yet numerically simulating this phenomenon accurately poses significant challenges when the computational mesh is misaligned with respect to the magnetic field. Particularly when the temperature gradients are unresolved, one frequently finds entropy violating solutions with heat flowing from cold to hot zones for χ∥ /χ⊥ >=102 which is substantially smaller than the range of interest which can reach 1010 or higher. In this talk we present a new implicit algorithm for solving the anisotropic thermal diffusion equations and demonstrate its characteristics on what has become a fairly standard set of test problems in the literature. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000. SAND2013-5687A.

  4. The Multimedia Challenge.

    ERIC Educational Resources Information Center

    Penuel, William R.; Means, Barbara; Simkins, Michael

    2000-01-01

    Teachers implementing a local history project in Belmont, California, had help from a federally funded technology innovation challenge grant: the Challenge 2000 Multimedia Project. Sponsored by a Silicon Valley school-business partnership, the initiative illustrates how technology can transform classroom learning while supporting instructional…

  5. A Call to Challenge

    ERIC Educational Resources Information Center

    Colleary, Shawn

    2004-01-01

    This article features the Challenge School, a magnet school in the CherryCreek School District in Colorado that focuses on academically advanced, motivated, and gifted students. The school was developed as an alternative to best meet the needs of these students. The Challenge School focuses on high student achievement and commensurate academic…

  6. Virtual Bridge Design Challenge

    ERIC Educational Resources Information Center

    Mitts, Charles R.

    2013-01-01

    This design/problem-solving activity challenges students to design a replacement bridge for one that has been designated as either structurally deficient or functionally obsolete. The Aycock MS Technology/STEM Magnet Program Virtual Bridge Design Challenge is an authentic introduction to the engineering design process. It is a socially relevant…

  7. The Intersection Challenge

    ERIC Educational Resources Information Center

    Roman, Harry T.

    2011-01-01

    Street intersections are a source of accidents--for both automobiles and pedestrians. This article presents an intersection challenge that allows students to explore some possible ways to change the traditional intersection. In this challenge, teachers open up the boundaries and allow students to redesign their world. The first step is to help…

  8. Challenges Facing Special Education.

    ERIC Educational Resources Information Center

    Meyen, Edward L., Ed.; And Others

    This book presents 17 selected papers from recent issues of the journal, "Focus on Exceptional Children," concerning current and emerging challenges facing the field of special education. The book is organized in two parts. Part 1, "Contemporary Challenges," includes the following articles: "Transitions in Early Childhood Special Education: Issues…

  9. Challenges and Roadblocks

    ERIC Educational Resources Information Center

    Hargrove, Kathy

    2011-01-01

    Gifted education has many challenges, and gifted programs sometimes throw up significant roadblocks. But passionate teachers can still make a difference in developing the gifts of the children. In this article, the author summarizes the challenges teachers face in serving gifted students and the roadblocks preventing a strong, supportive gifted…

  10. Science Challenge Day

    ERIC Educational Resources Information Center

    Siegel, Deborah

    2013-01-01

    Science fairs can be good motivators, but as extracurricular activities, they leave some students behind. However, by staging a Science Challenge Day at school, educators can involve all students in doing everything from choosing activities to judging projects. This article presents a model for running a successful Science Challenge Day. The…

  11. First Aid Challenge

    ERIC Educational Resources Information Center

    Roman, Harry T.

    2011-01-01

    This article describes a challenge wherein students will be asked to design a portable first aid kit that is normally carried in a recreational vehicle (RV), but can also be hand-carried or backpacked off road for distances of approximately 1-2 miles. This can be a very practical challenge for the students because it touches everyone. Everybody…

  12. Challenge and Change

    ERIC Educational Resources Information Center

    Mehaffy, George L.

    2012-01-01

    In the past twenty years, various industries have been forever altered by technology: newspapers, book publishing, the photography business, and many more. Higher education too faces unprecedented challenges primarily driven by rapid changes in technology. To meet these challenges and adapt to these changes, new models are needed. Six challenges…

  13. Dewey's Challenge to Teachers

    ERIC Educational Resources Information Center

    Fishman, Stephen M.; McCarthy, Lucille

    2010-01-01

    Given the serious social problems confronting Americans and others worldwide, the authors propose that Dewey's 1932 challenge to teachers is worthy of reconsideration by educators at all levels. In times similar to our own, Dewey challenged teachers to cultivate students' capacities to identify their happiness with what they can do to improve the…

  14. The Jet Travel Challenge

    ERIC Educational Resources Information Center

    Roman, Harry T.

    2007-01-01

    Airplane travelers are dismayed by the long lines and seemingly chaotic activities that precede boarding a full airplane. Surely, the one who can solve this problem is going to make many travelers happy. This article describes the Jet Travel Challenge, an activity that challenges students to create some alternatives to this now frustrating…

  15. Challenge College, Bradford

    ERIC Educational Resources Information Center

    Flecknoe, Mervyn

    2004-01-01

    What can you expect from a school in an area of high crime where 50 percent of the pupils take free school meals and which operates on a site that cannot be accessed from its main catchment area? In this article, the author shares his experience when he visited Challenge College. A low wall separates Challenge College from the area where most of…

  16. Rotavirus vaccines: successes and challenges.

    PubMed

    Glass, Roger I; Parashar, Umesh; Patel, Manish; Gentsch, Jon; Jiang, Baoming

    2014-01-01

    Since 2006, the availability of two new rotavirus vaccines has raised enthusiasm to consider the eventual control and elimination of severe rotavirus diarrhea through the global use of vaccines. Rotavirus remains the most severe cause of acute diarrhea in children worldwide responsible for several hundred thousands of deaths in low income countries and up to half of hospital admissions for diarrhea around the world. The new vaccines have been recommended by WHO for all infants and in more than 47 countries, their introduction into routine childhood immunization programs has led to a remarkable decline in hospital admissions and even deaths within 3 years of introduction. Challenges remain with issues of vaccine finance globally and the problem that these live oral vaccines perform less well in low income settings where they are needed most. Ongoing research that will accompany vaccine introduction might help address these issues of efficacy and new vaccines and novel financing schemes may both help make these vaccines universally available and affordable in the decade. PMID:24156947

  17. A design perspective on thermal barrier coatings

    SciTech Connect

    Soechting, F.O.

    1995-10-01

    This technical paper addresses the challenges for maximizing the benefit of thermal barrier coatings for turbine engine applications. The perspective is from a customer`s viewpoint, a turbine airfoil designer, who is continuously challenged to increase the turbine inlet temperature capability for new products while maintaining cooling flow levels or even reducing them. This is a fundamental requirement to achieve increased engine thrust levels. Developing advanced material systems for the turbine flowpath airfoils is one approach to solve this challenge; such as high temperature nickel based superalloys or thermal barrier coatings to insulate the metal airfoils from the hot flowpath environment. The second approach is to increase the cooling performance of the turbine airfoil, which enables increased flowpath temperatures and reduced cooling flow levels. Thermal barrier coatings have been employed in jet engine applications for almost 30 years. The initial application was on augmentor liners to provide thermal protection during afterburner operation. However, the production use of thermal barrier coating in the turbine section has only occurred in the past 15 years. The application was limited to stationary parts, and only recently incorporated on the rotating turbine blades. This lack of endorsement of thermal barrier coatings resulted from the poor initial durability of these coatings in high heat flux environments. Significant improvements have been made to enhance spallation resistance and erosion resistance which has resulted in increased reliability of these coatings in turbine applications.

  18. A design perspective on thermal barrier coatings

    NASA Technical Reports Server (NTRS)

    Soechting, Friedrich O.

    1995-01-01

    This technical paper addresses the challenges for maximizing the benefit of thermal barrier coatings for turbine engine applications. The perspective is from a customer's viewpoint, a turbine airfoil designer, who is continuously challenged to increase the turbine inlet temperature capability for new products while maintaining cooling flow levels or even reducing them. This is a fundamental requirement to achieve increased engine thrust levels. Developing advanced material systems for the turbine flowpath airfoils is one approach to solve this challenge; such as high temperature nickel based superalloys or thermal barrier coatings to insulate the metal airfoils from the hot flowpath environment. The second approach is to increase the cooling performance of the turbine airfoil, which enables increased flowpath temperatures and reduced cooling flow levels. Thermal barrier coatings have been employed in jet engine applications for almost 30 years. The initial application was on augmentor liners to provide thermal protection during afterburner operation. However, the production use of thermal barrier coating in the turbine section has only occurred in the past 15 years. The application was limited to stationary parts, and only recently incorporated on the rotating turbine blades. This lack of endorsement of thermal barrier coatings resulted from the poor initial durability of these coatings in high heat flux environments. Significant improvements have been made to enhance spallation resistance and erosion resistance which has resulted in increased reliability of these coatings in turbine applications.

  19. A design perspective on thermal barrier coatings

    NASA Technical Reports Server (NTRS)

    Soechting, F. O.

    1995-01-01

    This technical paper addresses the challenges for maximizing the benefit of thermal barrier coatings for turbine engine applications. The perspective is from a customer's viewpoint, a turbine airfoil designer, who is continuously challenged to increase the turbine inlet temperature capability for new products while maintaining cooling flow levels or even reducing them. This is a fundamental requirement to achieve increased engine thrust levels. Developing advanced material systems for the turbine flowpath airfoils is one approach to solve this challenge, for example, high temperature nickel based superalloys or thermal barrier coatings to insulate the metal airfoil from the hot flowpath environment. The second approach is to increase the cooling performance of the turbine airfoil, which enables increased flowpath temperatures and reduced cooling flow levels. Thermal barrier coatings have been employed in jet engine applications for almost 30 years. The initial application was on augmenter lines to provide thermal protection during afterburner operation. However, the production use of thermal barrier coating in the turbine section has only occurred in the past 15 years. The application was limited to stationary parts, and only recently incorporated on the rotating turbine blades. This lack of endorsement of thermal barrier coatings resulted from the poor initial durability of these coatings in high heat flux environments. Significant improvements have been made to enhance spallation resistance and erosion resistance which has resulted in increased reliability of these coatings in turbine applications.

  20. A design perspective on thermal barrier coatings

    NASA Astrophysics Data System (ADS)

    Soechting, F. O.

    1999-12-01

    This article addresses the challenges for maximizing the benefit of thermal barrier coatings for turbine engine applications. The perspective is from the viewpoint of a customer, a turbine airfoil designer who is continuously challenged to increase the turbine inlet temperature capability for new products while maintaining cooling flow levels or even reducing them. This is a fundamental requirement for achieving increased engine thrust levels. Developing advanced material systems for the turbine flowpath airfoils, such as high-temperature nickel-base superalloys or thermal barrier coatings to insulate the metal airfoils from the hot flowpath environment, is one approach to solve this challenge. The second approach is to increase the cooling performance of the turbine airfoil, which enables increased flowpath temperatures and reduced cooling flow levels. Thermal barrier coatings have been employed in jet engine applications for almost 30 years. The initial application was on augmentor liners to provide thermal protection during afterburner operation. However, the production use of thermal barrier coatings in the turbine section has only occurred in the past 15 years. The application was limited to stationary parts and only recently incorporated on the rotating turbine blades. This lack of endorsement of thermal barrier coatings resulted from the poor initial duratbility of these coatings in high heat flux environments. Significant improvements have been made to enhance spallation resistance and erosion resistance, which has resulted in increased reliability of these coatings in turbine applications.

  1. Acute Cardiac Tamponade: An Unusual Cause of Acute Renal Failure

    PubMed Central

    Phadke, Gautam; Whaley-Connell, Adam; Dalal, Pranavkumar; Markley, John; Rich, Andrew

    2012-01-01

    We are reporting a case of acute renal failure after cardiac surgery due to acute pericardial effusion. The patient had normal baseline renal function but developed acute oliguric renal failure with a significant increase in serum creatinine postoperatively. Pericardiotomy led to an improvement in blood pressure, immediate diuresis and quick recovery of renal function back to baseline. Pericardial tamponade should be included in the consideration of causes of the cardiorenal syndrome. PMID:22619656

  2. Silicon photonics: some remaining challenges

    NASA Astrophysics Data System (ADS)

    Reed, G. T.; Topley, R.; Khokhar, A. Z.; Thompson, D. J.; Stanković, S.; Reynolds, S.; Chen, X.; Soper, N.; Mitchell, C. J.; Hu, Y.; Shen, L.; Martinez-Jimenez, G.; Healy, N.; Mailis, S.; Peacock, A. C.; Nedeljkovic, M.; Gardes, F. Y.; Soler Penades, J.; Alonso-Ramos, C.; Ortega-Monux, A.; Wanguemert-Perez, G.; Molina-Fernandez, I.; Cheben, P.; Mashanovich, G. Z.

    2016-03-01

    This paper discusses some of the remaining challenges for silicon photonics, and how we at Southampton University have approached some of them. Despite phenomenal advances in the field of Silicon Photonics, there are a number of areas that still require development. For short to medium reach applications, there is a need to improve the power consumption of photonic circuits such that inter-chip, and perhaps intra-chip applications are viable. This means that yet smaller devices are required as well as thermally stable devices, and multiple wavelength channels. In turn this demands smaller, more efficient modulators, athermal circuits, and improved wavelength division multiplexers. The debate continues as to whether on-chip lasers are necessary for all applications, but an efficient low cost laser would benefit many applications. Multi-layer photonics offers the possibility of increasing the complexity and effectiveness of a given area of chip real estate, but it is a demanding challenge. Low cost packaging (in particular, passive alignment of fibre to waveguide), and effective wafer scale testing strategies, are also essential for mass market applications. Whilst solutions to these challenges would enhance most applications, a derivative technology is emerging, that of Mid Infra-Red (MIR) silicon photonics. This field will build on existing developments, but will require key enhancements to facilitate functionality at longer wavelengths. In common with mainstream silicon photonics, significant developments have been made, but there is still much left to do. Here we summarise some of our recent work towards wafer scale testing, passive alignment, multiplexing, and MIR silicon photonics technology.

  3. Post poliomyelitis syndrome: A rare sequel of acute poliomyelitis.

    PubMed

    Abrar, Anam; Ahmad, Arsalan

    2015-03-01

    Post poliomyelitis syndrome (PPS) is a rare sequel of acute poliomyelitis, usually seen 30-40 years after an acute episode. It is characterized by new muscle weakness seen in survivors of acute poliomyelitis. We describe a rare case of a 50 year old man; with a previous history of poliomyelitis in right lower limb who now presented with complaints of progressive left lower limb weakness for past two years. The diagnosis was made on the basis of clinical suspicion and EMG findings. PPS is not a well recognized disease in Pakistan and due to the lack of documentation; its true prevalence is not known. Though, over the years, cases of Poliomyelitis have decreased worldwide, however, PPS still remains a constant challenge for the physicians. This report highlights the impact of the disease on the quality of life of patients suffering from PPS and emphasis on the need for new therapeutic approach. PMID:25933575

  4. Testicular torsion and the acute scrotum: current emergency management.

    PubMed

    Ta, Anthony; D'Arcy, Frank T; Hoag, Nathan; D'Arcy, John P; Lawrentschuk, Nathan

    2016-06-01

    The acute scrotum is a challenging condition for the treating emergency physician requiring consideration of a number of possible diagnoses including testicular torsion. Prompt recognition of torsion and exclusion of other causes may lead to organ salvage, avoiding the devastating functional and psychological issues of testicular loss and minimizing unnecessary exploratory surgeries. This review aims to familiarize the reader with the latest management strategies for the acute scrotum, discusses key points in diagnosis and management and evaluates the strengths and drawbacks of history and clinical examination from an emergency perspective. It outlines the types and mechanisms of testicular torsion, and examines the current and possible future roles of labwork and radiological imaging in diagnosis. Emergency departments should be wary of younger males presenting with the acute scrotum. PMID:26267075

  5. What have drugs to offer the patient with acute stroke?

    PubMed Central

    Grosset, D G

    1992-01-01

    1. Drug treatment for acute stroke is designed to salvage neuronal tissue, and to prevent complications of stroke, which are often non-neurological. This review addresses the areas of recent advance in treatment designed to reduce the size of the cerebral infarct. With the exception of cardiac-source embolism, for which anticoagulation in the acute phase is sometimes considered, prevention of recurrent events is not discussed. 2. It is to be hoped that pharmaceutical developments will improve the current bleak picture in which there are no proven treatments for ischaemic stroke or intracerebral haemorrhage. To meet this challenge will require careful, controlled evaluation of treatment early after acute stroke in large scale clinical studies. PMID:1524958

  6. Management of Acute-on-Chronic Liver Failure.

    PubMed

    Durand, Francois; Nadim, Mitra K

    2016-05-01

    Acute-on-chronic liver failure (ACLF) is defined by the occurrence of organ failure(s) other than the liver in patients with cirrhosis. Even though mortality rates are high, there should no longer be reluctance to admit patients with ACLF in the intensive care unit. The prevalence of multidrug-resistant bacteria is high and broad spectrum antibiotics should be initiated as soon as infection is suspected. In patients with circulatory failure, the assessment of circulatory status is challenging due to the hyperkinetic state and an imbalance between the splanchnic and systemic blood volume. Acute kidney injury is common in patients with ACLF. Acute tubular necrosis should be differentiated from hepatorenal syndrome, which justifies vasoconstrictive agents. Renal replacement therapy and mechanical ventilation should be decided on clinical grounds. Recent trials on extracorporeal liver support failed to demonstrate a survival benefit. Aggressive management may serve as a bridge to transplantation provided patients are likely to survive after transplantation. PMID:27172356

  7. Boron nitride nanomaterials for thermal management applications.

    PubMed

    Meziani, Mohammed J; Song, Wei-Li; Wang, Ping; Lu, Fushen; Hou, Zhiling; Anderson, Ankoma; Maimaiti, Halidan; Sun, Ya-Ping

    2015-05-18

    Hexagonal boron nitride nanosheets (BNNs) are analogous to their two-dimensional carbon counterparts in many materials properties, in particular, ultrahigh thermal conductivity, but also offer some unique attributes, including being electrically insulating, high thermal stability, chemical and oxidation resistance, low color, and high mechanical strength. Significant recent advances in the production of BNNs, understanding of their properties, and the development of polymeric nanocomposites with BNNs for thermally conductive yet electrically insulating materials and systems are highlighted herein. Major opportunities and challenges for further studies in this rapidly advancing field are also discussed. PMID:25652360

  8. CEQATR Thermal Test Overview

    NASA Technical Reports Server (NTRS)

    Balusek, Alan R.

    2009-01-01

    A thermal test overview of the Constellation Environmental Qualification and Acceptance Test Requirement (CEQATR) is presented. The contents include: 1) CEQATR Thermal Test Overview; 2) CxP Environments; 3) CEQATR Table 1.2-1; 4) Levels of Assembly; 5) Definitions for Levels of Assembly; 6) Hardware Applicability; 7) CEQATR Thermal-Related Definitions; 8) Requirements for unit-level thermal testing; 9) Requirements for major assembly level thermal testing; 10) General thermal testing requirements; 11) General thermal cycle, thermal vacuum profiles; 12) Test tolerances; 13) Vacuum vs Ambient; 14) Thermal Gradient; 15) Sequence of Testing; 16) Alternative Strategies; 17) Protoflight; 18) Halt/Hass; 19) Humidity; and 20) Tailoring.

  9. Targeted Therapy in Treating Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia or Acute Myelogenous Leukemia

    ClinicalTrials.gov

    2016-07-28

    Chronic Myelomonocytic Leukemia; Myelodysplastic Syndrome; Recurrent Acute Myeloid Leukemia With Myelodysplasia-Related Changes; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Refractory Adult Acute Lymphoblastic Leukemia

  10. ELN implementation challenges.

    PubMed

    Drake, David J

    2007-08-01

    Electronic Laboratory Notebooks are becoming foundation platforms within many pharmaceutical companies because of the benefits that they offer to both the business and the scientists alike. Implementing an ELN within an established organisation presents challenges for the project team, both in terms of managing the impact on the scientists and the technical requirements for integration and data management. Implementation of a commercial ELN is not exempt from such challenges, and working with a third party supplier offers both advantages and additional challenges. PMID:17706546

  11. Cholescintigraphy in acute acalculous cholecystitis

    SciTech Connect

    Ramanna, L.; Brachman, M.B.; Tanasescu, D.E.; Berman, D.S.; Waxman, A.D.

    1984-08-01

    Acute acalculous cholecystitis is a relatively rare but potentially lethal condition if not treated promptly. Since stones are not present, diagnostic procedures such as ultrasound or other radiological procedures are frequently not helpful. Tc-99m iminodiacetic acid scan results were analyzed in 11 proven cases of acute acalculous cholecystitis. All had positive tests with nonvisualization of the gallbladder giving a sensitivity of 100%. Tc-99m iminodiacetic acid cholescintigraphy is a highly reliable test and is easily performed even in acutely ill patients and should be the test of choice in all patients predisposed to and suspected of acute acalculous cholecystitis.

  12. [Acute abdomen in gynecology].

    PubMed

    von Hugo, R; Meyer, B; Loos, W; Dirmeier, H

    1988-09-01

    The aim of the present study is, to describe the morbidity and mortality of 196 patients with an acute abdominal condition who underwent surgery at the Department of Gynecology and Obstetrics of the TU Munich between 1982 and 1986. This is a percentage of 2.7 of all 7,167 operations carried out during this period. 118 of these patients had an extrauterine pregnancy and were therefore excluded from the study. The second group of 79 patients, mostly with inflammatory diseases, were analyzed. In most of these cases the acute abdominal condition was caused by a tuboovarian abscess (48.1%), followed by peritonitis because of a bowel-disease (11.4%). 6 patients suffered from an abscessing endometritis due to a caesarean section with sepsis in 5 cases. A generalized peritonitis occurred in 5 cases and was treated with a planned relaparatomy with lavage. 63% of the patients had no complications within 28 days after operation, 13% developed a subileus; in 7% a relaparatomy was necessary. 6% of the patients had problems of wound-healing. One patient with stomach-cancer died 3 weeks after the operation because of a fulminant lung-embolism. Thus the mortality rate was 1.5%. A further 27% were treated at the intensive care-unit and 18% needed artificial respiration. The average postoperative period of hospitalisation was 15 days. In comparison, patients with elective operations remained 13 days. The morbidity and mortality of patients due to surgery of an acute abdominal condition was relatively small; postoperative complications could be well treated in all cases and is probably the result of a positive and early indication for surgical intervention. PMID:3181709

  13. [Acute toxic pneumopathies].

    PubMed

    Garnier, R

    1998-06-15

    The nature and extent of the acute injury due to toxic inhalants depend on the inhalant's solubility in water pH and chemical reactivity, on the aerodynamic diameter of particles (when the inhalant is an aerosol), and on the degree of exposure. Initial signs and symptoms indicate upper airways and bronchial irritation. Laryngeal oedema and (or) severe bronchospasm may be rapidly lethal. After cessation of exposure a transient improvement is generally observed; however a delayed pulmonary oedema may occur within the first 48 hours. On the following days, bacterial surinfection is a common complication. Possible long-term sequelae are reactive airways dysfunction syndrome and bronchiolitis obliterans. PMID:9781191

  14. Acute Compartment Syndrome.

    PubMed

    Schmidt, Andrew H

    2016-07-01

    Acute compartment syndrome (ACS) is a well-known pathophysiologic complication of trauma or tissue ischemia. ACS affects the appearance, function, and even the viability of the involved limb, and demands immediate diagnosis and treatment. However, ACS is difficult to diagnose and the only effective treatment is decompressive surgical fasciotomy. The clinical signs and symptoms may easily be attributed to other aspects of the injury, which further complicates the diagnosis. This article highlights the latest information regarding the diagnosis of ACS, how to perform fasciotomies, how to manage fasciotomy wounds, and also reviews complications and outcomes of ACS. PMID:27241376

  15. Feedlot Acute Interstitial Pneumonia.

    PubMed

    Woolums, Amelia R

    2015-11-01

    Acute interstitial pneumonia (AIP) of feedlot cattle is a sporadically occurring respiratory condition that is often fatal. Affected cattle have a sudden onset of labored breathing. There is no confirmed effective treatment of feedlot AIP; however, administration of antibiotics effective against common bacterial respiratory pathogens and nonsteroidal anti-inflammatory drugs, especially aspirin, has been recommended. Protective strategies are not well defined, but efforts to limit dust exposure and heat stress; to ensure consistent formulation, mixing, and delivery of feed; and to identify and treat infectious respiratory disease in a timely manner may decrease rates of feedlot AIP. PMID:26253266

  16. Challenging behaviour: a challenge to change.

    PubMed

    van Berckelaer-Onnes, I A; van Loon, J; Peelen, A

    2002-09-01

    People with intellectual disability often exhibit severe behavioural problems. Treatment of these problems is frequently very difficult. In The Netherlands, parents, institutes, schools and others can request the services of an independent advisory team with a pool of professionals who have experience with individuals who exhibit challenging behaviour. In this article the methods of the team will be described using a 24-year-old man as an example. The process took almost 7 years. Finally, this man, who had been living full time in one room in total isolation from the rest of the world, fulfilled his heart's desire--visiting the UK by Hovercraft. PMID:12212917

  17. Effects of thermal fluctuations on thermal inflation

    SciTech Connect

    Hiramatsu, Takashi; Miyamoto, Yuhei; Yokoyama, Jun’ichi

    2015-03-12

    The mechanism of thermal inflation, a relatively short period of accelerated expansion after primordial inflation, is a desirable ingredient for a certain class of particle physics models if they are not to be in contention with the cosmology of the early Universe. Though thermal inflation is most simply described in terms of a thermal effective potential, a thermal environment also gives rise to thermal fluctuations that must be taken into account. We numerically study the effects of these thermal fluctuations using lattice simulations. We conclude that though they do not ruin the thermal inflation scenario, the phase transition at the end of thermal inflation proceeds through phase mixing and is therefore not accompanied by the formations of bubbles nor appreciable amplitude of gravitational waves.

  18. Effects of thermal fluctuations on thermal inflation

    NASA Astrophysics Data System (ADS)

    Hiramatsu, Takashi; Miyamoto, Yuhei; Yokoyama, Jun'ichi

    2015-03-01

    The mechanism of thermal inflation, a relatively short period of accelerated expansion after primordial inflation, is a desirable ingredient for a certain class of particle physics models if they are not to be in contention with the cosmology of the early Universe. Though thermal inflation is most simply described in terms of a thermal effective potential, a thermal environment also gives rise to thermal fluctuations that must be taken into account. We numerically study the effects of these thermal fluctuations using lattice simulations. We conclude that though they do not ruin the thermal inflation scenario, the phase transition at the end of thermal inflation proceeds through phase mixing and is therefore not accompanied by the formations of bubbles nor appreciable amplitude of gravitational waves.

  19. Green Flight Challenge Highlights

    NASA Video Gallery

    On Monday, October 3, 2011, NASA's Centennial Challenges program awarded the largest prize in aviation history, created to inspire the development of more fuel-efficient aircraft and spark the star...

  20. Overcoming Breastfeeding Challenges

    MedlinePlus Videos and Cool Tools

    ... and Human Services Office on Women's Health Skip Navigation Skip top navigation Home A-Z Health Topics ePublications News About Us Contact Us Text size | Print | Skip left navigation It's Only Natural Planning ahead Overcoming challenges Overcoming ...

  1. Mars Balance Challenge

    NASA Video Gallery

    The Challenge is to develop ideas for how NASA can turn available entry, descent, and landing balance mass on a future Mars mission into a scientific or technological payload. Proposed concepts sho...

  2. International Space Apps Challenge

    NASA Video Gallery

    During the 2013 Space Apps Challenge, space enthusiasts with diverse backgrounds gathered April 20-21 for a collaborative, global problem-solving effort. Held at Kennedy Space Center Visitor Comple...

  3. Better Buildings Challenge Overview

    SciTech Connect

    2011-06-01

    The Better Buildings Challenge is a national leadership initiative calling on corporate chief executive officers, university presidents, and state and local leaders to make a significant commitment to building energy efficiency.

  4. The 2061 Challenge.

    ERIC Educational Resources Information Center

    Hundt, Lin

    1999-01-01

    Presents an interview with George Nelson, former astronaut and director of Project 2061 at the American Association for the Advancement of Science (AAAS). Nelson discusses his interest in science and math education, and future challenges for educators. (WRM)

  5. The Electric Car Challenge.

    ERIC Educational Resources Information Center

    Diehl, Brian E.

    1997-01-01

    Describes the Electric Car Challenge during which students applied methods of construction to build lightweight, strong vehicles that were powered by electricity. The activity required problem solving, sheet metal work, electricity, design, and construction skills. (JOW)

  6. Solving Aviation Challenges

    NASA Video Gallery

    This video highlights the challenges NASA aeronautics researchers are tackling to reduce aircraft noise, emissions, fuel consumption, and the innovative ways they're helping to debut NextGen, a rev...

  7. 2002 Controls Design Challenge

    NASA Technical Reports Server (NTRS)

    Hess, Ronald A.; Vetter, T. K.; Wells, S. R.

    2002-01-01

    This document is intended to provide the specifications and requirements for a flight control system design challenge. The response to the challenge will involve documenting whether the particular design has met the stated requirements through analysis and computer simulation. The response should be written in the general format of a technical publication with corresponding length limits, e.g., an approximate maximum length of 45 units, with each full-size figure and double-spaced typewritten page constituting one unit.

  8. The new productivity challenge.

    PubMed

    Drucker, P F

    1991-01-01

    "The single greatest challenge facing managers in the developed countries of the world is to raise the productivity of knowledge and service workers," writes Peter F. Drucker in "The New Productivity Challenge." Productivity, says Drucker, ultimately defeated Karl Marx; it gave common laborers the chance to earn the wages of skilled workers. Now five distinct steps will raise the productivity of knowledge and service workers--and not only stimulate new economic growth but also defuse rising social tensions. PMID:10114929

  9. Seasonal thermal energy storage

    SciTech Connect

    Allen, R.D.; Kannberg, L.D.; Raymond, J.R.

    1984-05-01

    This report describes the following: (1) the US Department of Energy Seasonal Thermal Energy Storage Program, (2) aquifer thermal energy storage technology, (3) alternative STES technology, (4) foreign studies in seasonal thermal energy storage, and (5) economic assessment.

  10. Acute Kidney Injury.

    PubMed

    Zuk, Anna; Bonventre, Joseph V

    2016-01-01

    Acute kidney injury (AKI) is a global public health concern associated with high morbidity, mortality, and healthcare costs. Other than dialysis, no therapeutic interventions reliably improve survival, limit injury, or speed recovery. Despite recognized shortcomings of in vivo animal models, the underlying pathophysiology of AKI and its consequence, chronic kidney disease (CKD), is rich with biological targets. We review recent findings relating to the renal vasculature and cellular stress responses, primarily the intersection of the unfolded protein response, mitochondrial dysfunction, autophagy, and the innate immune response. Maladaptive repair mechanisms that persist following the acute phase promote inflammation and fibrosis in the chronic phase. Here macrophages, growth-arrested tubular epithelial cells, the endothelium, and surrounding pericytes are key players in the progression to chronic disease. Better understanding of these complex interacting pathophysiological mechanisms, their relative importance in humans, and the utility of biomarkers will lead to therapeutic strategies to prevent and treat AKI or impede progression to CKD or end-stage renal disease (ESRD). PMID:26768243

  11. Acute traumatic patellar dislocation.

    PubMed

    Duthon, V B

    2015-02-01

    Inaugural traumatic patellar dislocation is most often due to trauma sustained during physical or sports activity. Two-thirds of acute patellar dislocations occur in young active patients (less than 20 years old). Non-contact knee sprain in flexion and valgus is the leading mechanism in patellar dislocation, accounting for as many as 93% of all cases. The strong displacement of the patella tears the medial stabilizing structures, and notably the medial patellofemoral ligament (MPFL), which is almost always injured in acute patellar dislocation, most frequently at its femoral attachment. Lateral patellar glide can be assessed with the knee in extension or 20° flexion. Displacement by more than 50% of the patellar width is considered abnormal and may induce apprehension. Plain X-ray and CT are mandatory to diagnose bony risk factors for patellar dislocation, such as trochlear dysplasia or increased tibial tubercle-trochlear groove distance (TT-TG), and plan correction. MRI gives information on cartilage and capsulo-ligamentous status for treatment planning: free bodies or osteochondral fracture have to be treated surgically. If patellar dislocation occurs in an anatomically normal knee and osteochondral fracture is ruled out on MRI, non-operative treatment is usually recommended. PMID:25592052

  12. Acute Bacterial Cholangitis

    PubMed Central

    Zimmer, Vincent; Lammert, Frank

    2015-01-01

    Background Acute bacterial cholangitis for the most part owing to common bile duct stones is common in gastroenterology practice and represents a potentially life-threatening condition often characterized by fever, abdominal pain, and jaundice (Charcot's triad) as well as confusion and septic shock (Reynolds' pentad). Methods This review is based on a systematic literature review in PubMed with the search items ‘cholangitis’, ‘choledocholithiasis’, ‘gallstone disease’, ‘biliary infection’, and ‘biliary sepsis’. Results Although most patients respond to empiric broad-spectrum antibiotic treatment, timely endoscopic biliary drainage depending on the severity of the disease is required to eliminate the underlying obstruction. Specific recommendations have been derived from the Tokyo guideline working group consensus 2006 and its update in 2013, albeit poorly evidence-based, providing a comprehensive overview of diagnosis, classification, risk stratification, and treatment algorithms in acute bacterial cholangitis. Conclusion Prompt clinical recognition and accurate diagnostic workup including adequate laboratory assessment and (aetiology-oriented) imaging are critical steps in the management of cholangitis. Treatment is directed at the two major interrelated pathophysiologic components, i.e. bacterial infection (immediate antimicrobial therapy) and bile duct obstruction (biliary drainage). As for the latter, transpapillary endoscopic drainage by stent or nasobiliary drain and/or same-session bile duct clearance, depending on individual disease severity, represent first-line treatment approaches. PMID:26468310

  13. Imaging acute ischemic stroke.

    PubMed

    González, R Gilberto; Schwamm, Lee H

    2016-01-01

    Acute ischemic stroke is common and often treatable, but treatment requires reliable information on the state of the brain that may be provided by modern neuroimaging. Critical information includes: the presence of hemorrhage; the site of arterial occlusion; the size of the early infarct "core"; and the size of underperfused, potentially threatened brain parenchyma, commonly referred to as the "penumbra." In this chapter we review the major determinants of outcomes in ischemic stroke patients, and the clinical value of various advanced computed tomography and magnetic resonance imaging methods that may provide key physiologic information in these patients. The focus is on major strokes due to occlusions of large arteries of the anterior circulation, the most common cause of a severe stroke syndrome. The current evidence-based approach to imaging the acute stroke patient at the Massachusetts General Hospital is presented, which is applicable for all stroke types. We conclude with new information on time and stroke evolution that imaging has revealed, and how it may open the possibilities of treating many more patients. PMID:27432672

  14. Acute Promyelocytic Leukemia

    PubMed Central

    Kingsley, Edwin C.; Durie, Brian G. M.; Garewal, Harinder S.

    1987-01-01

    Acute promyelocytic leukemia (APL) is a subtype of acute myelogenous leukemia frequently associated with disseminated intravascular coagulation (DIC). Data on 11 patients with APL treated at our institution were analyzed and compared with those of 147 published cases. Most had a bleeding diathesis at presentation and evidence of DIC eventually developed in all. Seven patients (64%) showed the t(15;17)(q22;q21) karyotype or a similar translocation. Using a chemotherapy induction regimen containing an anthracycline, complete remission, requiring a total of 14 courses of treatment, was achieved in six patients (55%). The median duration of response and median survival for complete responders were 10 and 15 months, respectively. Three patients (27%) died of bleeding complications during induction therapy. The tritiated-thymidine labeling index of leukemia cells predicted which patients would achieve a complete remission. Review of six studies of 147 patients with APL from the past 12 years supports the use of a chemotherapy induction regimen containing anthracycline or amsacrine and heparin for the treatment of DIC. PMID:3472414

  15. Acute pyelonephritis in children.

    PubMed

    Morello, William; La Scola, Claudio; Alberici, Irene; Montini, Giovanni

    2016-08-01

    Acute pyelonephritis is one of the most serious bacterial illnesses during childhood. Escherichia coli is responsible in most cases, however other organisms including Klebsiella, Enterococcus, Enterobacter, Proteus, and Pseudomonas species are being more frequently isolated. In infants, who are at major risk of complications such as sepsis and meningitis, symptoms are ambiguous and fever is not always useful in identifying those at high risk. A diagnosis of acute pyelonephritis is initially made on the basis of urinalysis; dipstick tests for nitrites and/or leukocyte esterase are the most accurate indicators of infection. Collecting a viable urine sample for urine culture using clean voided methods is feasible, even in young children. No gold standard antibiotic treatment exists. In children appearing well, oral therapy and outpatient care is possible. New guidelines suggest less aggressive imaging strategies after a first infection, reducing radiation exposure and costs. The efficacy of antibiotic prophylaxis in preventing recurrence is still a matter of debate and the risk of antibiotic resistance is a warning against its widespread use. Well-performed randomized controlled trials are required in order to better define both the imaging strategies and medical options aimed at preserving long-term renal function. PMID:26238274

  16. Incinerator thermal release valve risk assessment

    SciTech Connect

    Stevens, J.B.

    1998-12-31

    Human health risk assessments were conducted on emissions from several types of incinerators--a hazardous waste combustor, a medical waste/tire combustor, and a refuse derived fuel combustor in three different states. As part of these studies, the short-term emissions from thermal release valves operating during upset conditions were additionally evaluated. The latter assessments addressed two specific risk-related questions: (1) what are the incremental long-term risks/hazards associated with these short-term emissions; (2) what are the acute health hazards associated with these emissions? For each study, emission estimates for both the incinerator stack and the thermal release valve were obtained from the facility. Stack testing was utilized to obtain stack gas concentrations of emissions at one facility; engineering estimates were used to ascertain emissions from the thermal release valve. The two facilities were proposed incinerators, so literature-derived emissions were used throughout.

  17. LDCM Preliminary Thermal Trades

    NASA Technical Reports Server (NTRS)

    Ryan, Robert; Pagnutti, Mary; Blonski, Slawomir; Spruce, Joe

    2001-01-01

    The expected cost of adding thermal bands to the next generation Landsat Data Continuity Mission (LDCM) could be significant. This viewgraph presentation investigates both traditional cooled cross-track scanners and new architectures (cooled and uncooled) which could enable a low cost thermal capability. The presentation includes surveys of applications of Landsat thermal data and the architecture of thermal instruments. It also covers new thermal architecture sensor trades, ALI Architecture with Uncooled TIR Detectors, and simulated thermal imagery.

  18. Lower body positive pressure application with an antigravity suit in acute carotid occlusion.

    PubMed

    Berthet, Karine; Lukaszewicz, Anne Claire; Bousser, Marie-Germaine; Payen, Didier

    2010-01-01

    The challenge in acute stroke is still to reperfuse as early as possible the ischemic territory. Since fibrinolytic therapies have a limited window with potential risk of bleeding, having a nonpharmacologic mean to recruit vessels in area surrounding necrosis might be useful. We propose here to use antigravity suit inflated at "venous" pressure levels to shift blood towards thoracic and brain territories. We report two cases of spectacular clinical recovery after acute carotid occlusion. PMID:20798842

  19. Use of chest sonography in acute-care radiology☆

    PubMed Central

    De Luca, C.; Valentino, M.; Rimondi, M.R.; Branchini, M.; Baleni, M. Casadio; Barozzi, L.

    2008-01-01

    Diagnosis of acute lung disease is a daily challenge for radiologists working in acute-care areas. It is generally based on the results of chest radiography performed under technically unfavorable conditions. Computed tomography (CT) is undoubtedly more accurate in these cases, but it cannot always be performed on critically ill patients who need continuous care. The use of thoracic ultrasonography (US) has recently been proposed for the study of acute lung disease. It can be carried out rapidly at the bedside and does not require any particularly sophisticated equipment. This report analyzes our experience with chest sonography as a supplement to chest radiography in an Emergency Radiology Unit. We performed chest sonography – as an adjunct to chest radiography – on 168 patients with acute chest pathology. Static and dynamic US signs were analyzed in light of radiographic findings and, when possible, CT. The use of chest US improved the authors' ability to provide confident diagnoses of acute disease of the chest and lungs. PMID:23397048

  20. Thermally cascaded thermoelectric generator

    NASA Technical Reports Server (NTRS)

    Flaherty, R.

    1970-01-01

    High efficiency thermoelectric generator utilizes a high-temperature thermoelectric material in thermal series with a low-temperature material. A thermally cascaded generator increases system efficiency.

  1. What Is Acute Lymphocytic Leukemia (ALL)?

    MedlinePlus

    ... key statistics about acute lymphocytic leukemia? What is acute lymphocytic leukemia? Cancer starts when cells in the body begin ... leukemias). The rest of this document focuses on acute lymphocytic leukemia (ALL) in adults. For information on ALL in ...

  2. Mars Science Laboratory thermal control architecture

    NASA Technical Reports Server (NTRS)

    Bhandari, Pradeep; Birur, Gajanana; Pauken, Michael; Paris, Anthony; Novak, Keith; Prina, Mauro; Ramirez, Brenda; Bame, David

    2005-01-01

    The Mars Science Laboratory (MSL) mission to land a large rover on Mars is being planned for launch in 2009. This paper will describe the basic architecture of the thermal control system, the challenges and the methods used to overcome them by the use of an innovative architecture to maximize the use of heritage from past projects while meeting the requirements for the design.

  3. Thermal conductivity of zirconia thermal barrier coatings

    NASA Technical Reports Server (NTRS)

    Dinwiddie, R. B.; Beecher, S. C.; Nagaraj, B. A.; Moore, C. S.

    1995-01-01

    Thermal barrier coatings (TBC's) applied to the hot gas components of turbine engines lead to enhanced fuel efficiency and component reliability. Understanding the mechanisms which control the thermal transport behavior of the TBC's is of primary importance. Physical vapor description (PVD) and plasma spraying (PS) are the two most commonly used coating techniques. These techniques produce coatings with unique microstructures which control their performance and stability. The PS coatings were applied with either standard power or hollow sphere particles. The hollow sphere particles yielded a lower density and lower thermal conductivity coating. The thermal conductivity of both fully and partially stabilized zirconia, before and after thermal aging, will be compared. The thermal conductivity of the coatings permanently increase upon being exposed to high temperatures. These increases are attributed to microstructural changes within the coatings. Sintering of the as fabricated plasma sprayed lamellar structure is observed by scanning electron microscopy of coatings isothermally heat treated at temperatures greater than 1100 C. During this sintering process the planar porosity between lamella is converted to a series of small spherical pores. The change in pore morphology is the primary reason for the observed increase in thermal conductivity. This increase in thermal conductivity can be modeled using a relationship which depends on both the temperature and time of exposure. Although the PVD coatings are less susceptible to thermal aging effects, preliminary results suggest that they have a higher thermal conductivity than PS coatings, both before and after thermal aging. The increases in thermal conductivity due to thermal aging for partially stabilized plasma sprayed zirconia have been found to be less than for fully stabilized plasma sprayed zirconia coatings. The high temperature thermal diffusivity data indicates that if these coatings reach a temperature above

  4. Thermal conductivity of zirconia thermal barrier coatings

    NASA Technical Reports Server (NTRS)

    Dinwiddie, R. B.; Beecher, S. C.; Nagaraj, B. A.; Moore, C. S.

    1995-01-01

    Thermal barrier coatings (TBC's) applied to the hot gas components of turbine engines lead to enhanced fuel efficiency and component reliability. Understanding the mechanisms which control the thermal transport behavior of the TBC's is of primary importance. Physical vapor deposition (PVD) and plasma spraying (PS) are the two most commonly used coating techniques. These techniques produce coatings with unique microstructures which control their performance and stability. The PS coatings were applied with either standard powder or hollow sphere particles. The hollow sphere particles yielded a lower density and lower thermal conductivity coating. The thermal conductivity of both fully and partially stabilized zirconia, before and after thermal aging, will be compared. The thermal conductivity of the coatings permanently increases upon exposed to high temperatures. These increases are attributed to microstructural changes within the coatings. Sintering of the as-fabricated plasma sprayed lamellar structure is observed by scanning electron microscopy of coatings isothermally heat treated at temperatures greater than 1100 C. During this sintering process the planar porosity between lamella is converted to a series of small spherical pores. The change in pore morphology is the primary reason for the observed increase in thermal conductivity. This increase in thermal conductivity can be modeled using a relationship which depends on both the temperature and time of exposure. Although the PVD coatings are less susceptible to thermal aging effects, preliminary results suggest that they have a higher thermal conductivity than PS coatings, both before and after thermal aging. The increases in thermal conductivity due to thermal aging for partially stabilized plasma sprayed zirconia have been found to be less than for fully stabilized plasma sprayed zirconia coatings. The high temperature thermal diffusivity data indicate that if these coatings reach a temperature above 1100 C

  5. Meloxicam-induced rhabdomyolysis in the context of an acute ross river viral infection.

    PubMed

    Al Kindi, Mahmood; Limaye, Vidya; Hissaria, Pravin

    2012-01-01

    Acute rhabdomyolysis is a clinical and laboratory syndrome resulting from the breakdown of skeletal muscle, with the release of intracellular contents into the circulatory system, which can cause potentially lethal complications. Here, we present the case of a patient who developed acute rhabdomyolysis after consumption of meloxicam for jaw pain and experienced generalized myalgias in the context of an acute febrile illness with generalized urticaria. Further investigation indicated elevated muscle enzymes and acute renal failure. Serological analysis revealed that the patient was positive for Ross River virus (RRV) IgM. Genetic studies to detect CYP2C9 polymorphisms were negative. Meloxicam was discontinued. He responded to conservative measures within 2 weeks. Oral aspirin challenge was negative, suggesting a drug-specific effect of meloxicam rather than a class effect. Our case indicates a causative role for meloxicam and/or acute RRV in rhabdomyolysis. PMID:22211172

  6. Acute diabetic abdomen in childhood.

    PubMed

    Valerio, D

    1976-01-10

    Three children presented as acute surgical emergencies due to undiagnosed diabetes mellitus. Where diabetic ketoacidosis mimicks the acute abdomen three clinical features are important in reaching the right diagnosis-namely, a history of polydipsia, polyuria, and anorexia preceding the abdominal pain, the deep sighing and rapid respirations, and severe dehydration. PMID:54584

  7. Thermal Ignition

    NASA Astrophysics Data System (ADS)

    Boettcher, Philipp Andreas

    Accidental ignition of flammable gases is a critical safety concern in many industrial applications. Particularly in the aviation industry, the main areas of concern on an aircraft are the fuel tank and adjoining regions, where spilled fuel has a high likelihood of creating a flammable mixture. To this end, a fundamental understanding of the ignition phenomenon is necessary in order to develop more accurate test methods and standards as a means of designing safer air vehicles. The focus of this work is thermal ignition, particularly auto-ignition with emphasis on the effect of heating rate, hot surface ignition and flame propagation, and puffing flames. Combustion of hydrocarbon fuels is traditionally separated into slow reaction, cool flame, and ignition regimes based on pressure and temperature. Standard tests, such as the ASTM E659, are used to determine the lowest temperature required to ignite a specific fuel mixed with air at atmospheric pressure. It is expected that the initial pressure and the rate at which the mixture is heated also influences the limiting temperature and the type of combustion. This study investigates the effect of heating rate, between 4 and 15 K/min, and initial pressure, in the range of 25 to 100 kPa, on ignition of n-hexane air mixtures. Mixtures with equivalence ratio ranging from 0.6 to 1.2 were investigated. The problem is also modeled computationally using an extension of Semenov's classical auto-ignition theory with a detailed chemical mechanism. Experiments and simulations both show that in the same reactor either a slow reaction or an ignition event can take place depending on the heating rate. Analysis of the detailed chemistry demonstrates that a mixture which approaches the ignition region slowly undergoes a significant modification of its composition. This change in composition induces a progressive shift of the explosion limit until the mixture is no longer flammable. A mixture that approaches the ignition region

  8. Creating learning momentum through overt teaching interactions during real acute care episodes.

    PubMed

    Piquette, Dominique; Moulton, Carol-Anne; LeBlanc, Vicki R

    2015-10-01

    Clinical supervisors fulfill a dual responsibility towards patient care and learning during clinical activities. Assuming such roles in today's clinical environments may be challenging. Acute care environments present unique learning opportunities for medical trainees, as well as specific challenges. The goal of this paper was to better understand the specific contexts in which overt teaching interactions occurred in acute care environments. We conducted a naturalistic observational study based on constructivist grounded theory methodology. Using participant observation, we collected data on the teaching interactions occurring between clinical supervisors and medical trainees during 74 acute care episodes in the critical care unit of two academic centers, in Toronto, Canada. Three themes contributed to a better understanding of the conditions in which overt teaching interactions among trainees and clinical supervisors occurred during acute care episodes: seizing emergent learning opportunities, coming up against challenging conditions, and creating learning momentum. Our findings illustrate how overt learning opportunities emerged from certain clinical situations and how clinical supervisors and trainees could purposefully modify unfavorable learning conditions. None of the acute care episodes encountered in the critical care environment represented ideal conditions for learning. Yet, clinical supervisors and trainees succeeded in engaging in overt teaching interactions during many episodes. The educational value of these overt teaching interactions should be further explored, as well as the impact of interventions aimed at increasing their use in acute care environments. PMID:25476262

  9. Acute recurrent appendicitis with appendicolith.

    PubMed

    Hollerman, J J; Bernstein, M A; Kottamasu, S R; Sirr, S A

    1988-11-01

    Appendiceal disease can be acute, acute recurrent, or chronic. Acute appendicitis is the most common form. Acute recurrent appendicitis is more common than chronic appendicitis. In children the clinical manifestations of appendicitis are variable. Patients who have an appendicolith usually develop appendicitis, often with perforation. A case is presented of 3-year follow-up of a patient with an appendicolith and acute recurrent appendicitis. The literature about appendicoliths is reviewed. In the appropriate clinical setting, a history of prior episodes of similar right lower quadrant pain does not preclude the diagnosis of appendiceal disease. Awareness of the less common forms of appendicitis is important so that appropriate treatment is not delayed. PMID:3052484

  10. Pain Assessment with Cognitively Impaired Older People in the Acute Hospital Setting

    PubMed Central

    2011-01-01

    Research reveals that older people continue to experience much suffering from acute and chronic pain conditions. People with cognitive impairment receive less analgesia than their cognitively intact peers. Postoperative pain assessment with older people in the acute hospital setting remains a challenge. Context and culture have a significant impact of pain assessment practices. Due to a paucity of research exploring how pain assessment and management practices with cognitively impaired older people may be realised in the acute hospital setting, there is a need for further research to be conducted. PMID:26524985

  11. Cytokines in Acute Chikungunya

    PubMed Central

    Venugopalan, Anuradha; Ghorpade, Ravi P.; Chopra, Arvind

    2014-01-01

    Introduction Acute chikungunya (CHIKV) is predominantly an acute onset of excruciatingly painful, self-limiting musculoskeletal (MSK) arbovirus illness and this was further reported by us during the 2006 Indian epidemic [Chopra et al. Epidemiol Infect 2012]. Selected serum cytokines profile in subjects within one month of onset of illness is being presented. Methods Out of 509 clinical CHIKV cases (43% population) identified during a rural population survey, 225 subjects consented blood investigations. 132 examined within 30 days of febrile onset are the study cohort. Anti-CHIKV IgM and IgG antibodies tested by immunochromatography and indirect immunofluorescence respectively. Interferons (IFN)-α, -β and -γ, Interferon Gamma-Induced Protein-10 (CXCL-10/IP-10), Tumor Necrosis Factor-α (TNF-α), Interleukin-1β (IL-1β), Interleukin-6 (IL-6), Interleukin-13 (IL-13), Monocyte Chemoattractant Protein-1 (MCP-1), Interleukin–4 (IL-4) and Interleukin–10 (IL-10) performed by ELISA. Samples collected from neighboring community a year prior to the epidemic used as healthy controls. Results Seropositivity for anti-CHIKV IgM and IgG was 65% and 52% respectively. IFN-α, IFN-β, IFN-γ, CXCL10/IP-10 and IL-1β showed intense response in early acute phase. Cytokines (particularly TNF-α, MCP-1, IL-4, IL-6 and IL-10) was maximum in extended symptomatic phase and remained elevated in recovered subjects. Higher (p<0.05) IFN and IL-4 seen in patients seropositive for anti-CHIKV IgG. Elderly cases (≥65 years) showed elevated cytokines (except IFN) and anti-CHIKV antibodies near similar to younger subjects. Significant correlations (p<0.05) found between cytokines and clinical features (fatigue, low back ache, myalgia) and anti-CHIKV antibodies. Conclusion An intense cytokine milieu was evident in the early and immediate persistent symptomatic phase and in recovered subjects. Early persistent IgM and lower IgG to anti-CHKV and intense Th2 cytokine phenotype seem to be

  12. Radiation Shielding for Nuclear Thermal Propulsion

    NASA Technical Reports Server (NTRS)

    Caffrey, Jarvis A.

    2016-01-01

    Design and analysis of radiation shielding for nuclear thermal propulsion has continued at Marshall Space Flight Center. A set of optimization tools are in development, and strategies for shielding optimization will be discussed. Considerations for the concurrent design of internal and external shielding are likely required for a mass optimal shield design. The task of reducing radiation dose to crew from a nuclear engine is considered to be less challenging than the task of thermal mitigation for cryogenic propellant, especially considering the likely implementation of additional crew shielding for protection from solar particles and cosmic rays. Further consideration is thus made for the thermal effects of radiation absorption in cryogenic propellant. Materials challenges and possible methods of manufacturing are also discussed.

  13. Kinematics and energetics of swimming performance during acute warming in brown trout Salmo trutta.

    PubMed

    Lea, J M D; Keen, A N; Nudds, R L; Shiels, H A

    2016-01-01

    This study examined how acute warming of water temperature affects the mechanical efficiency of swimming and aerobic capabilities of the brown trout Salmo trutta. Swimming efficiency was assessed using the relationship between swimming kinematics and forward speed (U), which is thought to converge upon an optimum range of a dimensionless parameter, the Strouhal number (St ). Swim-tunnel intermittent stopped-flow respirometry was used to record kinematics and measure oxygen consumption (ṀO2) of S. trutta during warming and swimming challenges. Salmo trutta maintained St between 0·2 and 0·3 at any given U over a range of temperatures, irrespective of body size. The maintenance of St within the range for maximum efficiency for oscillatory propulsion was achieved through an increase in tail-beat frequency (ftail) and a decrease in tail-beat amplitude (A) as temperature increased. Maintenance of efficient steady-state swimming was fuelled by aerobic metabolism, which increased as temperature increased up to 18° C but declined above this temperature, decreasing the apparent metabolic scope. As St was maintained over the full range of temperatures whilst metabolic scope was not, the results may suggest energetic trade-offs at any given U at temperatures above thermal optima. PMID:26563644

  14. Normothermic Mouse Functional MRI of Acute Focal Thermostimulation for Probing Nociception

    PubMed Central

    Reimann, Henning Matthias; Hentschel, Jan; Marek, Jaroslav; Huelnhagen, Till; Todiras, Mihail; Kox, Stefanie; Waiczies, Sonia; Hodge, Russ; Bader, Michael; Pohlmann, Andreas; Niendorf, Thoralf

    2016-01-01

    Combining mouse genomics and functional magnetic resonance imaging (fMRI) provides a promising tool to unravel the molecular mechanisms of chronic pain. Probing murine nociception via the blood oxygenation level-dependent (BOLD) effect is still challenging due to methodological constraints. Here we report on the reproducible application of acute noxious heat stimuli to examine the feasibility and limitations of functional brain mapping for central pain processing in mice. Recent technical and procedural advances were applied for enhanced BOLD signal detection and a tight control of physiological parameters. The latter includes the development of a novel mouse cradle designed to maintain whole-body normothermia in anesthetized mice during fMRI in a way that reflects the thermal status of awake, resting mice. Applying mild noxious heat stimuli to wildtype mice resulted in highly significant BOLD patterns in anatomical brain structures forming the pain matrix, which comprise temporal signal intensity changes of up to 6% magnitude. We also observed sub-threshold correlation patterns in large areas of the brain, as well as alterations in mean arterial blood pressure (MABP) in response to the applied stimulus. PMID:26821826

  15. Normothermic Mouse Functional MRI of Acute Focal Thermostimulation for Probing Nociception

    NASA Astrophysics Data System (ADS)

    Reimann, Henning Matthias; Hentschel, Jan; Marek, Jaroslav; Huelnhagen, Till; Todiras, Mihail; Kox, Stefanie; Waiczies, Sonia; Hodge, Russ; Bader, Michael; Pohlmann, Andreas; Niendorf, Thoralf

    2016-01-01

    Combining mouse genomics and functional magnetic resonance imaging (fMRI) provides a promising tool to unravel the molecular mechanisms of chronic pain. Probing murine nociception via the blood oxygenation level-dependent (BOLD) effect is still challenging due to methodological constraints. Here we report on the reproducible application of acute noxious heat stimuli to examine the feasibility and limitations of functional brain mapping for central pain processing in mice. Recent technical and procedural advances were applied for enhanced BOLD signal detection and a tight control of physiological parameters. The latter includes the development of a novel mouse cradle designed to maintain whole-body normothermia in anesthetized mice during fMRI in a way that reflects the thermal status of awake, resting mice. Applying mild noxious heat stimuli to wildtype mice resulted in highly significant BOLD patterns in anatomical brain structures forming the pain matrix, which comprise temporal signal intensity changes of up to 6% magnitude. We also observed sub-threshold correlation patterns in large areas of the brain, as well as alterations in mean arterial blood pressure (MABP) in response to the applied stimulus.

  16. Use of Hemospray in the treatment of patients with acute UGIB - short review.

    PubMed

    Babiuc, R D; Purcarea, M; Sadagurschi, R; Negreanu, L

    2013-06-15

    Gastrointestinal bleeding remains one of the most important emergencies in gastroenterology. It has been widely accepted that the first-line treatment for acute upper gastrointestinal bleeding, especially peptic ulcer bleeding, is endoscopic hemostasis. Several techniques are available to achieve hemostasis during endoscopy. However, some 5%-10% of the patients still experience recurrence of bleeding after initial hemostasis with combined endoscopic therapy including injection, thermal coagulation, or mechanical hemostasis. Endotherapy for upper gastrointestinal bleeding can be challenging. A simple and effective method of endoscopic hemostasis would have a significant impact on the treatment of active gastrointestinal bleeding. Hemospray (Cook Medical, Winston-Salem, North Carolina, USA) is a novel hemostatic agent for the treatment of upper gastrointestinal bleeding. Its efficacy has been shown in peptic ulcer bleeding, as well as in cancer-related gastrointestinal bleeding and in patients taking antithrombotic therapy. These initial reports are very promising, but they are limited by the small number of patients. Further studies are needed to confirm the efficacy of Hemospray in the management of upper gastrointestinal bleeding. PMID:23904868

  17. Use of Hemospray in the treatment of patients with acute UGIB – short review

    PubMed Central

    Babiuc, RD; Purcarea, M; Sadagurschi, R; Negreanu, L

    2013-01-01

    Gastrointestinal bleeding remains one of the most important emergencies in gastroenterology. It has been widely accepted that the first-line treatment for acute upper gastrointestinal bleeding, especially peptic ulcer bleeding, is endoscopic hemostasis. Several techniques are available to achieve hemostasis during endoscopy. However, some 5%–10% of the patients still experience recurrence of bleeding after initial hemostasis with combined endoscopic therapy including injection, thermal coagulation, or mechanical hemostasis. Endotherapy for upper gastrointestinal bleeding can be challenging. A simple and effective method of endoscopic hemostasis would have a significant impact on the treatment of active gastrointestinal bleeding. Hemospray (Cook Medical, Winston-Salem, North Carolina, USA) is a novel hemostatic agent for the treatment of upper gastrointestinal bleeding. Its efficacy has been shown in peptic ulcer bleeding, as well as in cancer-related gastrointestinal bleeding and in patients taking antithrombotic therapy. These initial reports are very promising, but they are limited by the small number of patients. Further studies are needed to confirm the efficacy of Hemospray in the management of upper gastrointestinal bleeding. PMID:23904868

  18. Analysis of temporal dynamics in imagery during acute limb ischemia and reperfusion

    NASA Astrophysics Data System (ADS)

    Irvine, John M.; Regan, John; Spain, Tammy A.; Caruso, Joseph D.; Rodriquez, Maricela; Luthra, Rajiv; Forsberg, Jonathon; Crane, Nicole J.; Elster, Eric

    2014-03-01

    Ischemia and reperfusion injuries present major challenges for both military and civilian medicine. Improved methods for assessing the effects and predicting outcome could guide treatment decisions. Specific issues related to ischemia and reperfusion injury can include complications arising from tourniquet use, such as microvascular leakage in the limb, loss of muscle strength and systemic failures leading to hypotension and cardiac failure. Better methods for assessing the viability of limbs/tissues during ischemia and reducing complications arising from reperfusion are critical to improving clinical outcomes for at-risk patients. The purpose of this research is to develop and assess possible prediction models of outcome for acute limb ischemia using a pre-clinical model. Our model relies only on non-invasive imaging data acquired from an animal study. Outcome is measured by pathology and functional scores. We explore color, texture, and temporal features derived from both color and thermal motion imagery acquired during ischemia and reperfusion. The imagery features form the explanatory variables in a model for predicting outcome. Comparing model performance to outcome prediction based on direct observation of blood chemistry, blood gas, urinalysis, and physiological measurements provides a reference standard. Initial results show excellent performance for the imagery-base model, compared to predictions based direct measurements. This paper will present the models and supporting analysis, followed by recommendations for future investigations.

  19. Acute epiploic appendagitis and its mimics.

    PubMed

    Singh, Ajay K; Gervais, Debra A; Hahn, Peter F; Sagar, Pallavi; Mueller, Peter R; Novelline, Robert A

    2005-01-01

    Acute epiploic appendagitis most commonly manifests with acute lower quadrant pain. Its clinical features are similar to those of acute diverticulitis or, less commonly, acute appendicitis. The conditions that may mimic acute epiploic appendagitis at computed tomography (CT) include acute omental infarction, mesenteric panniculitis, fat-containing tumor, and primary and secondary acute inflammatory processes in the large bowel (eg, diverticulitis and appendicitis). Whereas the location of acute epiploic appendagitis is most commonly adjacent to the sigmoid colon, acute omental infarction is typically located in the right lower quadrant and often is mistaken for acute appendicitis. It is important to correctly diagnose acute epiploic appendagitis and acute omental infarction on CT images because these conditions may be mistaken for acute abdomen, and the mistake may lead to unnecessary surgery. The CT features of acute epiploic appendagitis include an oval lesion 1.5-3.5 cm in diameter, with attenuation similar to that of fat and with surrounding inflammatory changes, that abuts the anterior sigmoid colon wall. The CT features of acute omental infarction include a well-circumscribed triangular or oval heterogeneous fatty mass with a whorled pattern of concentric linear fat stranding between the anterior abdominal wall and the transverse or ascending colon. As CT increasingly is used for the evaluation of acute abdomen, radiologists are likely to see acute epiploic appendagitis and its mimics more often. Recognition of these conditions on CT images will allow appropriate management of acute abdominal pain and may help to prevent unnecessary surgery. PMID:16284132

  20. Thermally multiplexed polymerase chain reaction

    PubMed Central

    Phaneuf, Christopher R.; Pak, Nikita; Saunders, D. Curtis; Holst, Gregory L.; Birjiniuk, Joav; Nagpal, Nikita; Culpepper, Stephen; Popler, Emily; Shane, Andi L.; Jerris, Robert; Forest, Craig R.

    2015-01-01

    Amplification of multiple unique genetic targets using the polymerase chain reaction (PCR) is commonly required in molecular biology laboratories. Such reactions are typically performed either serially or by multiplex PCR. Serial reactions are time consuming, and multiplex PCR, while powerful and widely used, can be prone to amplification bias, PCR drift, and primer-primer interactions. We present a new thermocycling method, termed thermal multiplexing, in which a single heat source is uniformly distributed and selectively modulated for independent temperature control of an array of PCR reactions. Thermal multiplexing allows amplification of multiple targets simultaneously—each reaction segregated and performed at optimal conditions. We demonstrate the method using a microfluidic system consisting of an infrared laser thermocycler, a polymer microchip featuring 1 μl, oil-encapsulated reactions, and closed-loop pulse-width modulation control. Heat transfer modeling is used to characterize thermal performance limitations of the system. We validate the model and perform two reactions simultaneously with widely varying annealing temperatures (48 °C and 68 °C), demonstrating excellent amplification. In addition, to demonstrate microfluidic infrared PCR using clinical specimens, we successfully amplified and detected both influenza A and B from human nasopharyngeal swabs. Thermal multiplexing is scalable and applicable to challenges such as pathogen detection where patients presenting non-specific symptoms need to be efficiently screened across a viral or bacterial panel. PMID:26339317

  1. Challenges in obesity research.

    PubMed

    Palou, Andreu; Bonet, M Luisa

    2013-09-01

    Obesity is the main nutritional problem and one of the most important health problems in developed societies. Central to the challenge of obesity prevention and management is a thoroughly understanding of its determinants. Multiple socio-cultural, socio-economic, behavioural and biological factors--often interrelated and many of them still unknown or poorly understood--can contribute to the establishment and perpetuation of obese phenotypes. Here, we address current research challenges regarding basic aspects of obesity and emerging science for its control, including brown adipose tissue thermogenesis and browning of white fat as possible therapeutic targets for obesity, the influence of the microbioma, and genetics, epigenetics, nutrigenomics and nutrigenetics of obesity. We also highlight hot topics in relation to food and lifestyle as determinants of obesity, including the brain mechanisms underlying environmental motivation to eat, the biological control of spontaneous physical activity, the possible role of concrete foods and food components, and the importance of early life nutrition and environment. Challenges regarding the connections of obesity with other alterations and pathologies are also briefly addressed, as well as social and economical challenges in relation to healthy food production and lifestyle for the prevention of obesity, and technological challenges in obesity research and management. The objective is to give a panoramic of advances accomplished and still ahead relevant to the different stakeholders engaged in understanding and combating obesity. PMID:24010755

  2. Gemtuzumab Ozogamicin in Treating Patients With Relapsed or Refractory Acute Myeloid Leukemia or Acute Promyelocytic Leukemia

    ClinicalTrials.gov

    2015-07-27

    Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Acute Promyelocytic Leukemia (M3); Childhood Acute Promyelocytic Leukemia (M3); Recurrent Adult Acute Myeloid Leukemia; Recurrent Childhood Acute Myeloid Leukemia

  3. Tailoring thermal interfaces with nanomaterials

    NASA Astrophysics Data System (ADS)

    Seshadri, Indira

    Thermal interfaces are key to ensure the reliable performance of many semiconductor, energy and electronic systems. High thermal conductivity (k), low elastic modulus (E) interface materials are required to dissipate heat and relieve thermo-mechanical stresses. The aim of this thesis is to develop compliant, high k nanocomposite materials for thermal interface applications utilizing nanostructured networks. Realizing high k nanocomposites is a challenge because of difficulties in incorporating high fractions of uniformly dispersed nanofillers and countering low filler-matrix interfacial conductance, while retaining a low elastic modulus. In this thesis, it is demonstrated that these issues are obviated by using < 5 volume % sub-10-nm cold welded gold nanowire fillers to obtain an unprecedented 30-fold increase in polydimethylsiloxane thermal conductivity that is 6-fold higher than previously reported nanocomposites at low nanofiller loadings and exceeds theoretical predictions. The nanowire diameter and aspect ratio are key to obtain cold-welded networks that enhance k at low filler fractions, while fostering low E. Along with high k, tailoring high thermal contact conductance G c is crucial for many applications. This thesis reveals a critical correlation between the rheological behavior of a high k gold-nanowire-filled polydimethylsiloxane nanocomposite and its thermal contact conductance with copper. At a critical filler fraction, an abrupt increase in the nanocomposite k is accompanied by a liquid-solid transition and a multifold decrease in Gc. These concurrent changes are attributed to nanowire percolation network formation and pre-cure polymer gelation that inhibits the formation of conformal void-free interfaces. These findings will be important for designing processing sequences to realize heterointerfaces with nanowire filled high k nanocomposite materials. Another important finding of this thesis is that nanowire networks can result in mechanical

  4. Challenges in media delivery systems and servers

    NASA Astrophysics Data System (ADS)

    Swaminathan, Viswanathan

    2005-03-01

    Although multimedia compression formats and protocols to stream such content have been around for a long time, there has been limited success in the adoption of open standards for streaming over IP (Internet Protocol) networks. The elements of such an end-to-end system will be introduced outlining the responsibilities of each element. The technical and financial challenges in building a viable multimedia streaming end-to-end system will be analyzed in detail in this paper outlining some solutions and areas for further research. Also, recent migration to IP in the backend video delivery network infrastructures have made it possible to use IP based media streaming solutions in non-IP last mile access networks like cable and wireless networks in addition to the DSL networks. The advantages of using IP streaming solutions in such networks will be outlined. However, there is a different set of challenges posed by such applications. The real time constraints are acute in each element of the media delivery end-to-end system. Meeting these real time constraints in general purpose non real time server systems is quite demanding. Quality of service, resource management, session management, fail-over, reliability, and cost are some important but challenging requirements in such systems. These will also be analyzed with suggested solutions. Content protection and rights management requirements are also very challenging for open standards based multimedia delivery systems. Interoperability unfortunately interferes with security in most of the current day systems. Some approaches to solve the interoperability problems will also be presented. The requirements, challenges, and possible solutions for delivering broadcast, on demand, and interactive video delivery applications for IP based media streaming systems will be analyzed in detail.

  5. Acute and persistent diarrhea.

    PubMed

    Grimwood, Keith; Forbes, David A

    2009-12-01

    Socially disadvantaged Indigenous infants and children living in western industrialized countries experience high rates of infectious diarrhea, no more so than Aboriginal children from remote and rural regions of Northern Australia. Diarrheal disease, poor nutrition, and intestinal enteropathy reflect household crowding, inadequate water and poor sanitation and hygiene. Acute episodes of watery diarrhea are often best managed by oral glucose-electrolyte solutions with continuation of breastfeeding and early reintroduction of feeding. Selective use of lactose-free milk formula, short-term zinc supplementation and antibiotics may be necessary for ill children with poor nutrition, persistent symptoms, or dysentery. Education, high standards of environmental hygiene, breastfeeding, and immunization with newly licensed rotavirus vaccines are all needed to reduce the unacceptably high burden of diarrheal disease encountered in young children from Indigenous communities. PMID:19962025

  6. [Acute intermittent porphyria].

    PubMed

    Catania, A; Caimi, G

    1983-11-10

    Acute intermittent porphyria (AIP) is a congenital disease which as its name suggests, runs intermittently. Biochemically it is characterised by over-production of hepatic ALA synthetase (ALA-s), inducible mitochondrial enzyme and an increase in prophyrinic precursors (PBG, ac S-ALA). Clinically it is characterised by an abdominal nervous symptomatology. The primary metabolic error has been identified as a deficiency in enzyme activity which partially blocks haem biosynthesis. During the appearance of clinical manifestations, certain factors are present which have the capacity of inducing hepatic ALA-s production in vitro. Apart from some preventive measures treatment is mainly of symptomatology and complications. More recently the use of ALA-s inhibitors has been introduced. PMID:6657112

  7. Acute lymphoblastic leukaemia

    PubMed Central

    Inaba, Hiroto; Greaves, Mel; Mullighan, Charles G.

    2013-01-01

    Summary Acute lymphoblastic leukaemia (ALL) is seen in both children and adults, but its incidence peaks between ages 2 and 5 years. The causation of ALL is considered to be multi-factorial, including exogenous or endogenous exposures, genetic susceptibility, and chance. The survival rate of paediatric ALL has improved to approximately 90% in recent trials with risk stratification by biologic features of leukaemic cells and response to therapy, therapy modification based on patient pharmacodynamics and pharmacogenomics, and improved supportive care. However, innovative approaches are needed to further improve survival while reducing adverse effects. While most children can be cured, the prognosis of infants and adults with ALL remains poor. Recent genome-wide profiling of germline and leukaemic cell DNA has identified novel submicroscopic structural genetic alterations and sequence mutations that contribute to leukaemogenesis, define new ALL subtypes, influence responsiveness to treatment, and may provide novel prognostic markers and therapeutic targets for personalized medicine. PMID:23523389

  8. Acute Inhalation Injury

    PubMed Central

    Gorguner, Metin; Akgun, Metin

    2010-01-01

    Inhaled substances may cause injury in pulmonary epithelium at various levels of respiratory tract, leading from simple symptoms to severe disease. Acute inhalation injury (AII) is not uncommon condition. There are certain high risk groups but AII may occur at various places including home or workplace. Environmental exposure is also possible. In addition to individual susceptibility, the characteristics of inhaled substances such as water solubility, size of substances and chemical properties may affect disease severity as well as its location. Although AII cases may recover in a few days but AII may cause long-term complications, even death. We aimed to discuss the effects of short-term exposures (minutes to hours) to toxic substances on the lungs. PMID:25610115

  9. Massive acute arsenic poisonings.

    PubMed

    Lech, Teresa; Trela, Franciszek

    2005-07-16

    Arsenic poisonings are still important in the field of toxicology, though they are not as frequent as about 20-30 years ago. In this paper, the arsenic concentrations in ante- and post-mortem materials, and also forensic and anatomo-pathological aspects in three cases of massive acute poisoning with arsenic(III) oxide (two of them with unexplained criminalistic background, in which arsenic was taken for amphetamine and one suicide), are presented. Ante-mortem blood and urine arsenic concentrations ranged from 2.3 to 6.7 microg/ml, respectively. Post-mortem tissue total arsenic concentrations were also detected in large concentrations. In case 3, the contents of the duodenum contained as much as 30.1% arsenic(III) oxide. The high concentrations of arsenic detected in blood and tissues in all presented cases are particularly noteworthy in that they are very rarely detected at these concentrations in fatal arsenic poisonings. PMID:15939162

  10. Acute upper gastrointestinal bleeding.

    PubMed

    Kurien, Matthew; Lobo, Alan J

    2015-10-01

    Acute upper gastrointestinal bleeding (AUGIB) is a frequently encountered medical emergency with an incidence of 84-160/100000 and associated with mortality of approximately 10%. Guidelines from the National Institute for Care and Care Excellence outline key features in the management of AUGIB. Patients require prompt resuscitation and risk assessment using validated tools. Upper gastrointestinal endoscopy provides accurate diagnosis, aids in estimating prognosis and allows therapeutic intervention. Endoscopy should be undertaken immediately after resuscitation in unstable patients and within 24 hours in all other patients. Interventional radiology may be required for bleeding unresponsive to endoscopic intervention. Drug therapy depends on the cause of bleeding. Intravenous proton pump inhibitors should be used in patients with high-risk ulcers. Terlipressin and broad-spectrum antibiotics should be used following variceal haemorrhage. Hospitals admitting patients with AUGIB need to provide well organised services and ensure access to relevant services for all patients, and particularly to out of hours endoscopy. PMID:26430191

  11. [Acute retinal necrosis].

    PubMed

    Lucke, K; Reinking, U; el-Hifnawi, E; Dennin, R H; Laqua, H

    1988-12-01

    The authors report on three patients with acute retinal necrosis who were treated with the virostatic agent Acyclovir and who underwent vitreoretinal surgery with silicone oil filling for total retinal detachment. In two eyes the retina was reattached, but useful vision was only preserved in one patient. Titers from blood and the vitreous, as well as microscopic findings in retinal biopsies, support the view that the necrosis is caused by a herpes simplex virus infection. After therapy with Acyclovir was instituted no further progression on the necrosis was observed. However, the development of retinal detachment could not be prevented. Early diagnosis and antiviral therapy are essential to improve the otherwise poor prognosis in this rare syndrome. PMID:3221657

  12. [Acute epiglottitis in adults].

    PubMed

    Castillo, A

    1992-09-01

    The author presents the clinical history of 14 patients, from 21 to 48 years of age, 10 men and 4 women, with a final diagnosis of acute epiglottitis who were hospitalized at Gorgas Army Hospital or at the San Fernando Clinic. All the patients had pharyngitis and dysphagia, a few with nasal voice, stridor and difficulty breathing, as the chief complaint. All the patients were initially intubated orally for diagnostic purposes and immediately after nasotracheal intubation was done until the patient improved in 2 or 3 days (one patient remained intubated for 5 days). All patients were kept in the Intensive Care Unit and were treated with Ampicillin and Chloramphenicol IV and lately with a second generation cephalosporin (Cefamandole). The patients allergic to Penicillin were treated with Clindamycin and Chloramphenicol. Corticosteroids were not used in any of the patients. There were no sequelae and none of the patients expired. PMID:1439005

  13. Acute Methylenedioxypyrovalerone Toxicity.

    PubMed

    Froberg, Blake A; Levine, Michael; Beuhler, Michael C; Judge, Bryan S; Moore, Philip W; Engebretsen, Kristin M; Mckeown, Nathanael J; Rosenbaum, Christopher D; Young, Amy C; Rusyniak, Daniel E

    2015-06-01

    The objective of this study was to characterize the acute clinical effects, laboratory findings, complications, and disposition of patients presenting to the hospital after abusing synthetic cathinone. We conducted a retrospective multicenter case series of patients with synthetic cathinone abuse by searching for the terms bath salts, MDPV, methylenedioxypyrovalerone, mephedrone, methcathinone, methylone, methedrone, and cathinone within the "agent" field of a national clinical toxicology database (ToxIC). The medical records of these patients were obtained and abstracted by investigators at each study site. Patients with confirmatory testing that identified a synthetic cathinone in either blood or urine were included in the series. Patients who had either an undetectable synthetic cathinone test or no confirmatory testing were excluded. A data abstraction sheet was used to obtain information on each patient. We entered data into an Excel spreadsheet and calculated descriptive statistics. We identified 23 patients with confirmed synthetic cathinone exposure--all were positive for methylenedioxyprovalerone (MDPV). Eighty-three percent were male and 74 % had recreational intent. The most common reported clinical effects were tachycardia (74 %), agitation (65 %), and sympathomimetic syndrome (65 %). Acidosis was the most common laboratory abnormality (43 %). Seventy-eight percent of patients were treated with benzodiazepines and 30 % were intubated. Ninety-six percent of patients were hospitalized and 87 % were admitted to the ICU. The majority (61 %) of patients was discharged home but 30 % required inpatient psychiatric care. There was one death in our series. The majority of patients presenting to the hospital after abusing MDPV have severe sympathomimetic findings requiring hospitalization. A number of these patients require inpatient psychiatric care after their acute presentation. PMID:25468313

  14. Asthma in adults (acute)

    PubMed Central

    2011-01-01

    Introduction About 10% of adults have suffered an attack of asthma, and up to 5% of these have severe disease that responds poorly to treatment. Patients with severe disease have an increased risk of death, but patients with mild to moderate disease are also at risk of exacerbations. Most guidelines about the management of asthma follow stepwise protocols. This review does not endorse or follow any particular protocol, but presents the evidence about specific interventions. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for acute asthma? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 100 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: beta2 agonists (plus ipratropium bromide, pressured metered-dose inhalers, short-acting continuous nebulised, short-acting intermittent nebulised, short-acting iv, and inhaled formoterol); corticosteroids (inhaled); corticosteroids (single oral, combined inhaled, and short courses); education about acute asthma; generalist care; helium–oxygen mixture (heliox); magnesium sulphate (iv and adding isotonic nebulised magnesium to inhaled beta2 agonists); mechanical ventilation; oxygen supplementation (controlled 28% oxygen and controlled 100% oxygen); and specialist care. PMID:21463536

  15. [Acute acromioclavicular dislocations].

    PubMed

    Riand, N; Sadowski, C; Hoffmeyer, P

    1999-12-01

    Acromioclavicular dislocations represent over 10% of acute traumatic injuries to the shoulder girdle. The mechanism is usually a direct impact on the shoulder with the arm in adduction, producing rupture of the acromioclavicular (AC) ligaments, then of the coracoclavicular (CC) ligament, with displacement of the lateral end of the clavicle. Rockwood described 6 grades of injury. Physical examination usually provides the diagnosis, which is confirmed by radiological examination. X-rays centered on the AC joint, if necessary with forceful adduction of both shoulders or under traction, are useful to evaluate the severity of the lesion. Grade I and II lesions are usually treated conservatively by simply immobilizing the arm for 3 to 4 weeks. Surgical treatment is usually advocated for grade IV, V and VI lesions: AC or CC fixation, sometimes associated with ligament repair, depending on the surgeons. AC pinning or C-C screw fixation are the techniques most often used. Management of grade III lesions remains controversial. Some authors advocate immediate surgical treatment in young, active patients, in heavy laborers and even in slender individuals. The choice of the operative technique is controversial, as no single technique has clearly proved to be superior to others. Other authors advocate conservative treatment, which gives functional results which patients consider quite acceptable, with faster recovery; patients should be informed that results are essentially similar, whatever the treatment. The possibility of performing secondary operations with good results in cases with failure of conservative management is a further argument in favor of applying conservative therapy first in acute injuries. PMID:10675933

  16. [Acute respiratory distress syndrome].

    PubMed

    Estenssoro, Elisa; Dubin, Arnaldo

    2016-01-01

    Acute respiratory distress syndrome (ARDS) is an acute respiratory failure produced by an inflammatory edema secondary to increased lung capillary permeability. This causes alveolar flooding and subsequently deep hypoxemia, with intrapulmonary shunt as its most important underlying mechanism. Characteristically, this alteration is unresponsive to high FIO2 and only reverses with end-expiratory positive pressure (PEEP). Pulmonary infiltrates on CXR and CT are the hallmark, together with decreased lung compliance. ARDS always occurs within a week of exposition to a precipitating factor; most frequently pneumonia, shock, aspiration of gastric contents, sepsis, and trauma. In CT scan, the disease is frequently inhomogeneous, with gravitational infiltrates coexisting with normal-density areas and also with hyperaerated parenchyma. Mortality is high (30-60%) especially in ARDS associated with septic shock and neurocritical diseases. The cornerstone of therapy lies in the treatment of the underlying cause and in the use mechanical ventilation which, if inappropriately administered, can lead to ventilator-induced lung injury. Tidal volume = 6 ml/kg of ideal body weight to maintain an end-inspiratory (plateau) pressure = 30 cm H2O ("protective ventilation") is the only variable consistently associated with decreased mortality. Moderate-to-high PEEP levels are frequently required to treat hypoxemia, yet no specific level or titration strategy has improved outcomes. Recently, the use of early prone positioning in patients with PaO2/FIO2 = 150 was associated with increased survival. In severely hypoxemic patients, it may be necessary to use adjuvants of mechanical ventilation as recruitment maneuvers, pressure-controlled modes, neuromuscular blocking agents, and extracorporeal-membrane oxygenation. Fluid restriction appears beneficial. PMID:27576283

  17. Acute management of migraine.

    PubMed

    Chowdhury, Debashish

    2010-04-01

    Migraine is a brain disease whose principal symptom is episodic intense throbbing pain in the head which is often accompanied by photophobia, phonophobia, nausea and vomiting. Primary objectives of migraine treatment are to abort the acute attacks, treat associated symptoms and prevent future attacks. With a majority of migraine patients being young, they will need a treatment plan to suit their professional work, leisure and reproductive concerns. Non specific anti-migraine drugs like non-steroidal anti-inflammatory drugs, anti-emetics, narcotics, and sympathomimetics are usually helpful in mild to moderate attacks. Specific drugs like triptans and ergots are useful for moderate to severe attacks. In step care approach, the patients are started with the simplest options like simple analgesics first followed by non-steroidal agents, then ergot preparations and eventually triptans if they do not respond. In stratified care approach, the attacks and the patients are stratified according to the severity and therapeutic response. Those with severe disabling episodes are given specific anti-migraine medications like triptans whereas patients with mild or low disability are treated with simple analgesics. Currently, the most favored acute anti-migraine medication is a triptan. At marketed doses all triptans are effective as compared to placebos and generally well tolerated. Amongst them however, rizatriptan 10 mg, eletriptan 80 mg and almotriptan 12.5 mg provide the highest likelihood of consistent success. Triptan related adverse events are usually short lived, mild and clinically insignificant. Ergots are slowly being replaced by triptans. This is because of their adverse side-effects, low bioavailability and high potential for abuse that can lead to overuse headache. PMID:21049703

  18. The clinics of acute coronary syndrome

    PubMed Central

    Rastelli, Gianni

    2016-01-01

    Risk stratification and management of patients with chest pain continues to be challenging despite considerable efforts made in the last decades by many clinicians and researchers. The throutful evaluation necessitates that the physicians have a high index of suspicion for acute coronary syndrome (ACS) and always keep in mind the myriad of often subtle and atypical presentations of ischemic heart disease, especially in certain patient populations such as the elderly ones. In this article we aim to review and discuss the available evidence on the value of clinical presentation in patients with a suspected ACS, with special emphasis on history, characteristics of chest pain, associated symptoms, atypical presentations, precipitating and relieving factors, drugs, clinical rules and significance of clinical Gestalt. PMID:27294087

  19. Acute myocardial infarction in the obstetric patient

    PubMed Central

    Firoz, Tabassum; Magee, Laura A

    2012-01-01

    Acute myocardial infraction (AMI) in the obstetric patient is a rare event, although the incidence is rising due to advancing maternal age and pre-existing cardiac risk factors and medical co-morbidities. While atherosclerotic disease is the leading cause of AMI, coronary artery dissection is an important consideration in pregnancy and in the postpartum period. The physiological changes of pregnancy as well as pregnancy-specific risk factors can predispose the obstetric patient to AMI. Diagnosis of AMI can be challenging as symptoms may be atypical. Furthermore, diagnostic tests must be interpreted in the context of pregnancy. While the overall management of the obstetric patient with AMI is similar to that outside of pregnancy, drug therapy requires modification as some medications may be contraindicated in pregnancy and breastfeeding. There is limited information about prognosis and risk stratification but it is anticipated that future studies will address this issue.

  20. The clinics of acute coronary syndrome.

    PubMed

    Cervellin, Gianfranco; Rastelli, Gianni

    2016-05-01

    Risk stratification and management of patients with chest pain continues to be challenging despite considerable efforts made in the last decades by many clinicians and researchers. The throutful evaluation necessitates that the physicians have a high index of suspicion for acute coronary syndrome (ACS) and always keep in mind the myriad of often subtle and atypical presentations of ischemic heart disease, especially in certain patient populations such as the elderly ones. In this article we aim to review and discuss the available evidence on the value of clinical presentation in patients with a suspected ACS, with special emphasis on history, characteristics of chest pain, associated symptoms, atypical presentations, precipitating and relieving factors, drugs, clinical rules and significance of clinical Gestalt. PMID:27294087

  1. Novel Therapeutic Strategies in Acute Lymphoblastic Leukemia.

    PubMed

    Dias, Ajoy; Kenderian, Saad J; Westin, Gustavo F; Litzow, Mark R

    2016-08-01

    Chemotherapy cures only a minority of adult patients with acute lymphoblastic leukemia (ALL). In addition, relapsed ALL has a poor outcome with 5-year survival as low as 7 %. Hence, there is a need to develop effective therapies to treat relapsed disease and to combine these agents with chemotherapy to improve outcomes in newly diagnosed patients. ALL cells express several antigens amenable to target therapies including CD19, CD20, CD22, and CD52. Over the last decade, there has been a surge in the development of immune therapies which target these receptors and that have induced robust responses. In this manuscript, we review these novel immune agents in the treatment of B-ALL. As these new therapies mature, the challenge going forward will be to find safe and effective combinations of these agents with chemotherapy and to determine their place in the current treatment schema. PMID:27101015

  2. Thermal Analysis Methods for an Earth Entry Vehicle

    NASA Technical Reports Server (NTRS)

    Amundsen, Ruth M.; Dec, John A.; Lindell, Michael C.

    2000-01-01

    Thermal analysis of a vehicle designed to return samples from another planet, such as the Earth Entry vehicle for the Mars Sample Return mission, presents several unique challenges. The Earth Entry Vehicle (EEV) must contain Martian material samples after they have been collected and protect them from the high heating rates of entry into the Earth's atmosphere. This requirement necessitates inclusion of detailed thermal analysis early in the design of the vehicle. This paper will describe the challenges and solutions for a preliminary thermal analysis of an Earth Entry Vehicle. The aeroheatina on the vehicle during entry would be the main driver for the thermal behavior. and is a complex function of time, spatial position on the vehicle, vehicle temperature, and trajectory parameters. Thus. the thermal analysis must be closely tied to the aeroheating analysis in order to make accurate predictions. Also, the thermal analysis must account for the material response of the ablative thermal protection system TPS. For the exo-atmospheric portion of the mission, the thermal analysis must include the orbital radiation fluxes on the surfaces. The thermal behavior must also be used to predict the structural response of the vehicle (the thermal stress and strains) and whether they remain within the capability of the materials. Thus, the thermal analysis requires ties to the three-dimensional geometry, the aeroheating analysis, the material response analysis, the orbital analysis. and the structural analysis. The goal of this paper is to describe to what degree that has been achieved.

  3. Acute pancreatitis and acute renal failure complicating doxylamine succinate intoxication.

    PubMed

    Lee, Yang Deok; Lee, Soo Teik

    2002-06-01

    Doxylamine succinate is an antihistaminic drugwith additional hypnotic, anticholinergic and local anesthetic effects first described in 1948. In Korea and many other countries, it is a common-over-the counter medication frequently involved in overdoses. Clinical symtomatology of doxylamine succinate overdose includes somnolence, coma, seizures, mydriasis, tachycardia, psychosis, and rhabdomyolysis. A serious complication may be rhabdomyolysis with subsequent impairment of renal function and acute renal failure. We report a case of acute renal failure and acute pancreatitis complicating a doxylamine succinate intoxication. PMID:12046971

  4. Gallbladder melanoma mimicking acute acalculous cholecystitis.

    PubMed

    De Simone, P; Mainente, P; Bedin, N

    2000-06-01

    Gallbladder (GB) melanoma is a rare entity with a dismal prognosis. Its primary or secondary status is difficult to establish in the absence of an overt cutaneous localization. We report herein the case of a misdiagnosed GB melanoma mimicking acute acalculous cholecystitis that was treated by means of laparoscopic cholecystectomy (LC). A 54-year-old man was referred to our institution for acute cholecystitis. Apart from the ablation of some nevocytic nevi 7 years before admission, the patient's medical history was unremarkable. The ultrasound (US) examination showed a slightly enlarged acalculous gallbladder with thickened walls and a well-circumscribed polypoid mass in the fundus. The patient was treated medically and referred to LC. At surgery, some satellite nodules were visualized in the GB hepatic bed. The GB was removed, and two hepatic nodules were excised. Histology showed a pT3 melanoma. The patient underwent an open hepatic wedge resection 3 weeks after laparoscopy. No recurrence was observed at 6-month follow-up. To date, only one case of melanoma of the gallbladder treated with LC has been reported. GB melanoma is a diagnostic challenge when there is no evidence of a primary lesion. However, the occurrence of acalculous cholecystitis and a GB polyp in patients with a positive history of mole ablation should alert surgeons to the possibility of a melanoma. PMID:11265063

  5. Prognostic Implications of Acute Renal Failure after Surgery for Type A Acute Aortic Dissection

    PubMed Central

    Sansone, Fabrizio; Morgante, Alessandro; Ceresa, Fabrizio; Salamone, Giovanni; Patanè, Francesco

    2015-01-01

    Background “Type A” acute aortic dissection (AAAD) is the most challenging among the emergency operations in cardiac surgery. The aim of this study was the evaluation of the role of acute renal failure (ARF) in postoperative survival of patients operated for AAAD. Methods From February 2010 to April 2012, 37 consecutive patients were operated at our department for AAAD. We studied our population by subdividing the patients within groups according to the presence of ARF requiring continuous veno-venous hemofiltration (CVVH) and according to hypothermic circulatory arrest (HCA) times and degrees. Results The overall 30-day mortality was 27% (50% group A with ARF, 13% group B no ARF). Acute renal failure requiring CVVH was 37.8%. Multivariate analysis revealed a significant association with 30-day mortality (odds ratio 6.6 and p = 0.020). Preoperative oliguria [urine output less than 30 ml/h (odds ratio 4.7 p = 0.039)], CPB greater than 180 minutes (odds ratio 6.5 p = 0.023) and postoperative bleeding requiring a surgical reopening (odds ratio 12.2 and p = 0.021) were the variables significantly associated with acute kidney injury. Conclusions The data obtained from our analysis bring out the high incidence of renal injuries after surgery for AAAD, and indicate a negative impact on renal injuries of a preoperative oliguria, longer Cardiopulmonary bypass (CBP)/HCA times, and postoperative bleeding requiring a surgical revision. Our data also suggest a better 30-day survival and better renal outcomes in case of shorter HCA and lesser degree of hypothermia. The option of lesser and shorter hypothermia may be very useful, especially for the elderly patients and octogenarians. PMID:27069938

  6. Banff Challenge 2

    SciTech Connect

    Junk, Thomas R.; /Fermilab

    2011-08-01

    Experimental particle physics collaborations constantly seek newer and better ideas for improving the sensitivity of their searches for new particles and phenomena. Statistical techniques are the last step in interpreting the results of an experiment; they are used to make discoveries (hypothesis testing), and to measure parameters (point estimation). They are also used in the first step - experiment and analysis design. Banff Challenge 2 asks participants to test their methods of discovering hidden signals in simulated datasets and of measuring the properties of these signals. The Challenge problems are described, and the performances of the submitted entries is summarized, for datasets with and without simulated signals present.

  7. Challenges facing production grids

    SciTech Connect

    Pordes, Ruth; /Fermilab

    2007-06-01

    Today's global communities of users expect quality of service from distributed Grid systems equivalent to that their local data centers. This must be coupled to ubiquitous access to the ensemble of processing and storage resources across multiple Grid infrastructures. We are still facing significant challenges in meeting these expectations, especially in the underlying security, a sustainable and successful economic model, and smoothing the boundaries between administrative and technical domains. Using the Open Science Grid as an example, I examine the status and challenges of Grids operating in production today.

  8. THERMAL ENVIRONMENT AND LEARNING.

    ERIC Educational Resources Information Center

    LANE, W.R.

    RESEARCH ON THERMAL ENVIRONMENT IN SCHOOLS IS SUMMARIZED AND THE STATUS OF "THERMAL ENVIRONMENT AND LEARNING" RESEARCH COMPLETED AND/OR UNDERWAY IN THE IOWA CENTER FOR RESEARCH IN SCHOOL ADMINISTRATION IS REPORTED. RESULTS ARE--(1) CHILDREN DID LEARN BETTER UNDER MODEL THERMAL CONDITIONS, (2) TEACHERS MUST BECOME MORE AWARE OF THERMAL CONDITIONS,…

  9. Thermal barrier research

    SciTech Connect

    Moses, K.G.

    1990-03-07

    The thermal barrier region in the TARA device is a complex arrangement combining ion-plugging by sloshing ions with an ECRH-generated thermal barrier plasma. An axisymmetric, high-mirror-ratio magnetic field, adjacent to the central cell, provides the confinement of the thermal barrier plasma and sloshing ions. This paper discusses research being done in this thermal barrier region.

  10. Thermal conductivity of zirconia thermal barrier coatings

    SciTech Connect

    Dinwiddie, R.B.; Beecher, S.C.; Nagaraj, B.A.; Moore, C.S.

    1995-10-01

    Thermal barrier coatings (TBC`s) applied to the hot gas components of turbine engines lead to enhanced fuel efficiency and component reliability. Understanding the mechanisms which control the thermal transport behavior of the TBC`s is of primary importance. Physical vapor deposition (PVD) and plasma spraying (PS) are the two most commonly used coating techniques. These techniques produce coatings with unique microstructures which control their performance and stability. The PS coatings were applied with either standard powder or hollow sphere particles. The hollow sphere particles yielded a lower density and lower thermal conductivity coating. The thermal conductivity of both fully and partially stabilized zirconia, before and after thermal aging, will be compared. The thermal conductivity of the coatings permanently increases upon exposed to high temperatures. These increases are attributed to microstructural changes within the coatings. Sintering of the as-fabricated plasma sprayed lamellar structure is observed by scanning electron microscopy of coatings isothermally heat treated at temperatures greater than 1100 C. During this sintering process the planar porosity between lamella is converted to a series of small spherical pores. The change in pore morphology is the primary reason for the observed increase in thermal conductivity. This increase in thermal conductivity can be modeled using a relationship which depends on both the temperature and time of exposure. Although the PVD coatings are less susceptible to thermal aging effects, preliminary results suggest that they have a higher thermal conductivity than PS coatings, both before and after thermal aging. The increases in thermal conductivity due to thermal aging for partially stabilized plasma sprayed zirconia have been found to be less than for fully stabilized plasma sprayed zirconia coatings.

  11. HELIOS Technology Challenge, Part 2

    NASA Video Gallery

    The HELIOS Technology Challenge seeks to combine open source innovation, collaboration and partnership with makerspace and input from the general public to help NASA solve major technology challeng...

  12. HELIOS Technology Challenge, Part 5

    NASA Video Gallery

    The HELIOS Technology Challenge seeks to combine open source innovation, collaboration and partnership with makerspace and input from the general public to help NASA solve major technology challeng...

  13. HELIOS Technology Challenge, Part 3

    NASA Video Gallery

    The HELIOS Technology Challenge seeks to combine open source innovation, collaboration and partnership with makerspace and input from the general public to help NASA solve major technology challeng...

  14. HELIOS Technology Challenge, Part 1

    NASA Video Gallery

    The HELIOS Technology Challenge seeks to combine open source innovation, collaboration and partnership with makerspace and input from the general public to help NASA solve major technology challeng...

  15. HELIOS Technology Challenge, Part 4

    NASA Video Gallery

    The HELIOS Technology Challenge seeks to combine open source innovation, collaboration and partnership with makerspace and input from the general public to help NASA solve major technology challeng...

  16. Ready-to-use foods for management of moderate acute malnutrition: Considerations for scaling up production and use in programs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Ready-to-use foods are one of the available strategies for the treatment of moderate acute malnutrition (MAM), but challenges remain in the use of these products in programs at scale. This paper focuses on two challenges: the need for cheaper formulations using locally available ingredients that are...

  17. [Latest advances in acute pancreatitis].

    PubMed

    de-Madaria, Enrique

    2015-09-01

    The present article analyses the main presentations on acute pancreatitis at Digestive Disease Week 2015. Arterial pseudoaneurysm is an uncommon complication of acute pancreatitis (incidence 0.7%) and mortality from this cause is currently anecdotal. Diabetes mellitus has little impact on the clinical course of acute pancreatitis, unlike cirrhosis, which doubles the risk of mortality. Intake of unsaturated fat could be associated with an increased severity of acute pancreatitis and is a confounding factor in studies evaluating the relationship between obesity and morbidity and mortality. PET-CT (positron emission tomography-computed tomography) could be a non-invasive tool to detect infection of collections in acute pancreatitis. Peripancreatic fat necrosis is less frequent than pancreatic fat necrosis and is associated with a better clinical course. If the clinical course is poor, increasing the calibre of the percutaneous drains used in the treatment of infected necrosis can avoid surgery in 20% of patients. The use of low molecular-weight heparin in moderate or severe pancreatitis could be associated with a better clinical course, specifically with a lower incidence of necrosis. In acute recurrent pancreatitis, simvastatin is a promising drug for prophylaxis of new episodes of acute pancreatitis. Nutritional support through a nasogastric tube does not improve clinical course compared with oral nutrition. PMID:26520203

  18. Biomarkers in acute heart failure.

    PubMed

    Mallick, Aditi; Januzzi, James L

    2015-06-01

    The care of patients with acutely decompensated heart failure is being reshaped by the availability and understanding of several novel and emerging heart failure biomarkers. The gold standard biomarkers in heart failure are B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide, which play an important role in the diagnosis, prognosis, and management of acute decompensated heart failure. Novel biomarkers that are increasingly involved in the processes of myocardial injury, neurohormonal activation, and ventricular remodeling are showing promise in improving diagnosis and prognosis among patients with acute decompensated heart failure. These include midregional proatrial natriuretic peptide, soluble ST2, galectin-3, highly-sensitive troponin, and midregional proadrenomedullin. There has also been an emergence of biomarkers for evaluation of acute decompensated heart failure that assist in the differential diagnosis of dyspnea, such as procalcitonin (for identification of acute pneumonia), as well as markers that predict complications of acute decompensated heart failure, such as renal injury markers. In this article, we will review the pathophysiology and usefulness of established and emerging biomarkers for the clinical diagnosis, prognosis, and management of acute decompensated heart failure. PMID:25911167

  19. Immediate and Complex Cardiovascular Adaptation to an Acute Alcohol Dose

    PubMed Central

    Buckman, Jennifer F.; Eddie, David; Vaschillo, Evgeny G.; Vaschillo, Bronya; Garcia, Aaron; Bates, Marsha E.

    2016-01-01

    Background The detrimental effects of chronic heavy alcohol use on the cardiovascular system are well established and broadly appreciated. Integrated cardiovascular response to an acute dose of alcohol has been less studied. This study examined the early effects of an acute dose of alcohol on the cardiovascular system, with particular emphasis on system variability and sensitivity. The goal was to begin to understand how acute alcohol disrupts dynamic cardiovascular regulatory processes prior to the development of cardiovascular disease. Methods Healthy participants (N = 72, age 21 to 29) were randomly assigned to an alcohol, placebo, or no-alcohol control beverage condition. Beat-to-beat heart rate (HR) and blood pressure (BP) were assessed during a low-demand cognitive task prior to and following beverage consumption. Between-group differences in neurocardiac response to an alcohol challenge (blood alcohol concentration ~ 0.06 mg/dl) were tested. Results The alcohol beverage group showed higher average HR, lower average stroke volume, lower HR variability and BP variability, and increased vascular tone baroreflex sensitivity after alcohol consumption. No changes were observed in the placebo group, but the control group showed slightly elevated average HR and BP after beverage consumption, possibly due to juice content. At the level of the individual, an active alcohol dose appeared to disrupt the typically tight coupling between cardiovascular processes. Conclusions A dose of alcohol quickly invoked multiple cardiovascular responses, possibly as an adaptive reaction to the acute pharmacological challenge. Future studies should assess how exposure to alcohol acutely disrupts or dissociates typically integrated neurocardiac functions. PMID:26614647

  20. 76 FR 56819 - Centennial Challenges 2012 Sample Return Robot Challenge

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... SPACE ADMINISTRATION Centennial Challenges 2012 Sample Return Robot Challenge AGENCY: National... 42 U.S.C. 2451(314)(d). The 2012 Sample Return Robot Challenge is scheduled and teams that wish to... technologies of interest and value to NASA and the nation. The 2012 Sample Return Robot Challenge is a...

  1. 77 FR 70835 - Centennial Challenges 2013 Sample Return Robot Challenge

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ... SPACE ADMINISTRATION Centennial Challenges 2013 Sample Return Robot Challenge AGENCY: National... in accordance with 51 U.S.C. 20144(c). The 2013 Sample Return Robot Challenge is scheduled and teams... Robot Challenge is a prize competition designed to encourage development of new technologies...

  2. Toward Green Challenge Courses.

    ERIC Educational Resources Information Center

    Johnson, Karl E.

    1999-01-01

    Designing environmentally friendly challenge courses involves considering factors such as clearing, trees versus poles, soil erosion and compaction, toilet design, waste disposal, and carrying capacity. Strategies used in "green development" such as systems thinking, solution multipliers, and brainstorming with stakeholders could promote challenge…

  3. Elementary Design Challenges

    ERIC Educational Resources Information Center

    Gerlach, Jonathan W.

    2010-01-01

    How many of our students come to the classroom with little background knowledge about the world around them and how things work? To help students develop conceptual understanding and explore the design process, the author brought the NASA "Engineering Design Challenges" program to his school district, redeveloped for elementary students. In this…

  4. Challenges to LRS Materials.

    ERIC Educational Resources Information Center

    Austin Community Coll., TX.

    The Learning Resource Services (LRS) department at Austin Community College, in Texas, has developed a procedure for dealing with situations when a library user objects to items in a collection or display or protests that an item is not in the collection. First, three resources have been created to handle challenges. The LRS Materials Selection…

  5. The Wall Coverings Challenge

    ERIC Educational Resources Information Center

    Roman, Harry T.

    2012-01-01

    Students love nothing better than personalizing their space--desk, bedroom, or even their cars. This article describes a classroom challenge that gives students a chance to let their spirits soar with the invention of a new form of wall treatment. A trip to a big box store might prove to be most helpful for students to visualize their new product…

  6. Rooftop Garden Design Challenge

    ERIC Educational Resources Information Center

    Roman, Harry T.

    2010-01-01

    A small commercial building in a nearby industrial park has decided to install a rooftop garden for its employees to enjoy. The garden will be about 100 feet long and 75 feet wide. This article presents a design challenge for technology and engineering students wherein they will assist in the initial conceptual design of the rooftop garden. The…

  7. Curriculum Challenges in California.

    ERIC Educational Resources Information Center

    Adler, Louise

    1993-01-01

    This paper presents findings from a longitudinal study that examined the extent and types of challenges to curriculum in California school districts. A survey of school districts conducted in 1990 yielded 421 usable responses. The second survey, sent in 1991, elicited 379 responses, a 37.5 percent response rate. Findings indicate that the number…

  8. The Better Boat Challenge

    ERIC Educational Resources Information Center

    Schomburg, Aaron

    2008-01-01

    "On your mark, get set, go!" Elementary students love to hear these words as they participate in the annual Third Grade Better Boat Challenge. This highly motivational project started a few years ago as the author was developing the third-grade science curriculum to include a study that revolved around models, design, and problem solving. It has…

  9. Kayak Design Challenge

    ERIC Educational Resources Information Center

    Wood, Anson

    2011-01-01

    Living in the Adirondack Park and being an avid outdoorsman has often resulted in the author's love of the outdoors working its way into class projects. In 2010, the author gave a group of 25 students in grades 9-12 a challenge that required them to design and construct a prototype inexpensive, lightweight kayak for backpackers and fisherman. In…

  10. Meeting the Challenge

    ERIC Educational Resources Information Center

    Mathews, Jay

    2005-01-01

    The Challenge Index ranks high schools according to how many students take AP and IB exams, not on how well they do or how many pass. This index is published in Newsweek and the magazine calls it "America's Best High Schools." In this article, the author, also the creator of this index, answers some frequently asked questions about the index and…

  11. Symposium on Contemporary Challenges

    ERIC Educational Resources Information Center

    Berry, David A.; Graff, Gerald; Nelson, Cary

    2010-01-01

    In this article, the authors discuss contemporary challenges. David Berry offers advice on teaching the humanities at a community college; Gerald Graff examines how the traditional organization of universities undermines student learning; and Cary Nelson considers the effects on the humanities of the increasing reliance on contingent faculty.

  12. Challenge Beginning Teacher Beliefs

    ERIC Educational Resources Information Center

    Lannin, John K.; Chval, Kathryn B.

    2013-01-01

    As beginning teachers start to recognize the complexity of teaching mathematics in elementary school classrooms and how their new vision for teaching mathematics creates new challenges, they experience discomfort--a healthy awareness that much is to be learned. Brousseau (1997) notes that changes in the roles that are implicitly assigned to the…

  13. Challenges of the Presidency.

    ERIC Educational Resources Information Center

    McLean, Sandi, Ed.

    "Challenges of the Presidency" explores the circumstances and forces that affect the college president's leadership in identifying and accomplishing the educational mission of the institution. These four papers examine the external forces of government and population trends as well as the internal pressures from faculty and students, and offer…

  14. Leadership in Challenging Times

    ERIC Educational Resources Information Center

    City, Elizabeth A.

    2013-01-01

    In spite of tough financial times, resourceful school leaders devise ways to overcome challenges and improve education. To do this, they make strategic use of the resources they have. And they also cultivate learning communities. In this article, Elizabeth A. City describes how school leaders can make more strategic use of three essential…

  15. A Cool Challenge

    ERIC Educational Resources Information Center

    Roman, Harry T.

    2012-01-01

    The world of man-made design is all around, in everyday objects and appliances people use without a second thought. In this exercise, students have an opportunity to challenge the common refrigerator's design--and improve it. This approach can be used with many other appliances.

  16. Challenges for Visual Analytics

    SciTech Connect

    Thomas, James J.; Kielman, Joseph

    2009-09-23

    Visual analytics has seen unprecedented growth in its first five years of mainstream existence. Great progress has been made in a short time, yet great challenges must be met in the next decade to provide new technologies that will be widely accepted by societies throughout the world. This paper sets the stage for some of those challenges in an effort to provide the stimulus for the research, both basic and applied, to address and exceed the envisioned potential for visual analytics technologies. We start with a brief summary of the initial challenges, followed by a discussion of the initial driving domains and applications, as well as additional applications and domains that have been a part of recent rapid expansion of visual analytics usage. We look at the common characteristics of several tools illustrating emerging visual analytics technologies, and conclude with the top ten challenges for the field of study. We encourage feedback and collaborative participation by members of the research community, the wide array of user communities, and private industry.

  17. Challenges of Retrenchment.

    ERIC Educational Resources Information Center

    Mingle, James R.; And Others

    The retrenchment experiences of a variety of institutions--large and small, public and private--are described and evaluated using an extensive spectrum of case studies sponsored by the Southern Regional Education Board. Part One discusses challenges of retrenchment (James R. Mingle) and strategies for the 1980s (David W. Breneman). Part Two,…

  18. The Store Challenge

    ERIC Educational Resources Information Center

    Roman, Harry T.

    2014-01-01

    Biomedical and robotic technologies are merging to present a wonderful opportunity to develop artificial limbs and prosthetic devices for humans injured on the job, in the military, or due to disease. In this challenge, students will have the opportunity to design a store or online service that specifically dedicates itself to amputees. Described…

  19. Challenging Entropic Gravity

    NASA Astrophysics Data System (ADS)

    Roveto, Jonathan

    2011-11-01

    A recent proposal by Erik Verlinde claims that gravity should be viewed not as a fundamental force, but an emergent thermodynamic phenomenon due to some yet undetermined microscopic theory. We present a challenge to this reformulation of gravity. Our claim is that a detailed derivation using Verlinde's proposed theory fails to correctly give Newton's laws or Einstein gravity.

  20. The Challenge of Leadership.

    ERIC Educational Resources Information Center

    Young, Andrew

    1979-01-01

    The challenge is still before Black people to give the kind of moral leadership that would help this nation to see what it is that the poor are struggling with. Black people who become successful must not forget the sufferings of those who made it possible for them to get where they are today. (Author/WI)