Group elicitations yield more consistent, yet more uncertain experts in understanding risks to ecosystem services in New Zealand bays

PubMed Central

Sinner, Jim; Ellis, Joanne; Kandlikar, Milind; Halpern, Benjamin S.; Satterfield, Terre; Chan, Kai

2017-01-01

The elicitation of expert judgment is an important tool for assessment of risks and impacts in environmental management contexts, and especially important as decision-makers face novel challenges where prior empirical research is lacking or insufficient. Evidence-driven elicitation approaches typically involve techniques to derive more accurate probability distributions under fairly specific contexts. Experts are, however, prone to overconfidence in their judgements. Group elicitations with diverse experts can reduce expert overconfidence by allowing cross-examination and reassessment of prior judgements, but groups are also prone to uncritical “groupthink” errors. When the problem context is underspecified the probability that experts commit groupthink errors may increase. This study addresses how structured workshops affect expert variability among and certainty within responses in a New Zealand case study. We find that experts’ risk estimates before and after a workshop differ, and that group elicitations provided greater consistency of estimates, yet also greater uncertainty among experts, when addressing prominent impacts to four different ecosystem services in coastal New Zealand. After group workshops, experts provided more consistent ranking of risks and more consistent best estimates of impact through increased clarity in terminology and dampening of extreme positions, yet probability distributions for impacts widened. The results from this case study suggest that group elicitations have favorable consequences for the quality and uncertainty of risk judgments within and across experts, making group elicitation techniques invaluable tools in contexts of limited data. PMID:28767694

Effect of socio-cultural factors on spontaneous abortion in Burdur, Turkey: A population based case-control study.

PubMed

Catak, Binali; Oner, Can; Sutlu, Sevinc; Kilinc, Selcuk

2016-01-01

To determine the sociocultural factors that have effect on spontaneous abortion in Burdur, Turkey. Study was designed as case-control study. The case group consist of 257 women whose pregnancies ended with spontaneous abortion. The control group consisted of 514 women whose pregnancy continued since 22 weeks and more during the study. Chi-square, and backward LR logistic regression were utilized in analyses. In multifactorial-analyses it was determined that four factors (educational status of women, employment status of women, exposure to physical violence and non-receipt of ANC) created independent risk on spontaneous abortions. Pregnant women with these risk factors should be followed up more frequently and in a more qualified way in primary and secondary and tertiary health institutions.

[Evaluation of intraarterial infusion chemotherapy for liver metastasis from gastric cancer FEM: combination therapy of 5-FU, epirubicin and MMC].

PubMed

Takada, Joji; Katsuki, Yoshio; Hamada, Hiromi; Tsuji, Yasushige

2003-10-01

We evaluated the effectiveness of FEM (5-FU, epirubicin, MMC) therapy. Data for 111 patients with liver metastasis from gastric cancer were collected from January 1977, until June 2003 (synchronous: 74 cases, asynchronous: 37 cases). Thirty patients were H1, 20 were H2 and 61 were classified as H3. The patients were divided into the following groups: Group A: Resection of the primary lesion and hepatic resection (n = 10), Group A1: Hepatic resection only (5 cases), Group A2: Hepatic resection and intraarterial infusion (5 cases). Group B: Resection of the primary lesion (n = 67), Group B1: Resection of the primary lesion only (46 cases), Group B2: Intraarterial infusion (21 cases). In Groups A2 and B2, FEM therapy was applied to A2a (4 cases) and B2a (8 cases). Non-FEM therapy was applied to A2b (1 case) and B2b (13 cases). Group C consisted of 34 cases in which resection of the primary lesion was not undertaken. Survival rates were then compared. 1-year survival rates and 50% survival period for each group were as follows: Group A: 33%, 5.9 months; Group B: 22%. 4.8 months; and Group C: 6%, 3.9 months, respectively. One case from Group A2a and 2 cases from Group B2a have survived for 3 years or longer. 1) We treated 3 patients with liver metastasis from gastric cancer who survived for 3 years or longer. 2) Resection of the primary lesion along with hepatic intraarterial infusion therapy (in addition to hepatic resection), especially in combination with FEM therapy, provided an extended length of survival.

Effects of case-based learning on communication skills, problem-solving ability, and learning motivation in nursing students.

PubMed

Yoo, Moon-Sook; Park, Hyung-Ran

2015-06-01

The purpose of this study was to explore the effects of case-based learning on communication skills, problem-solving ability, and learning motivation in sophomore nursing students. In this prospective, quasi-experimental study, we compared the pretest and post-test scores of an experimental group and a nonequivalent, nonsynchronized control group. Both groups were selected using convenience sampling, and consisted of students enrolled in a health communication course in the fall semesters of 2011 (control group) and 2012 (experimental group) at a nursing college in Suwon, South Korea. The two courses covered the same material, but in 2011 the course was lecture-based, while in 2012, lectures were replaced by case-based learning comprising five authentic cases of patient-nurse communication. At post-test, the case-based learning group showed significantly greater communication skills, problem-solving ability, and learning motivation than the lecture-based learning group. This finding suggests that case-based learning is an effective learning and teaching method. © 2014 Wiley Publishing Asia Pty Ltd.

GUIDANCE ON SELECTING AGE GROUPS FOR ...

EPA Pesticide Factsheets

This guidance document provides a set of early-lifestage age groups for Environmental Protection Agency scientists to consider when assessing children’s exposure to environmental contaminants and the resultant potential dose. These recommended age groups are based on current understanding of differences in behavior and physiology which may impact exposures in children. A consistent set of early-life age groups, supported by an underlying scientific rationale, is expected to improve Agency exposure and risk assessments for children by increasing the consistency and comparability of risk assessments across the Agency; by improving accuracy and transparency in assessments for those cases where current practice might too broadly combine behaviorally and physiologically disparate age groups; and by fostering a consistent approach to future exposure surveys and monitoring efforts to generate improved exposure factors for children. see description

Reviewing the Management of Obstructive Left Colon Cancer: Assessing the Feasibility of the One-stage Resection and Anastomosis After Intraoperative Colonic Irrigation.

PubMed

Awotar, Gavish Kumar; Guan, Guoxin; Sun, Wei; Yu, Hongliang; Zhu, Ming; Cui, Xinye; Liu, Jie; Chen, Jiaxi; Yang, Baoshun; Lin, Jianyu; Deng, Zeyong; Luo, Jianwei; Wang, Chen; Nur, Osman Abdifatah; Dhiman, Pankaj; Liu, Pixu; Luo, Fuwen

2017-06-01

The management of obstructive left colon cancer (OLCC) remains debatable with the single-stage procedure of primary colonic anastomosis after cancer resection and on-table intracolonic lavage now being supported. Patients with acute OLCC who were admitted between January 2008 and January 2015 were distributed into 5 different groups. Group ICI underwent emergency laparotomy for primary anastomosis following colonic resection and intraoperative colonic lavage; Group HP underwent emergency Hartmann's Procedure; Group CON consisted of patients treated by conservative management with subsequent elective open cancer resection; Group COL were colostomy patients; and Group INT consisted of patients who had interventional radiology followed by open elective colon cancer resection. The demographics of the patients and comorbidity, intraoperative data, and postoperative data were collected, with P < .05 as significant. There were 4 deaths in 138 cases (2.90%). There was only 1 patient who had anastomotic leakage (5.56%) in Group ICI, compared with none in Group HP and Group COL, 1 case in Group INT (7.69%), and 2 cases in Group CON (6.06%) (P > .05). Group INT and Group CON, when compared to the three surgical groups, Groups ICI, Group COL, and Group HP, individually, were statistically significant for the duration of surgery (P < .05). Primary anastomosis following colonic resection after irrigation can be safely performed in selected patients, with the necessary surgical expertise, with no increased risk in mortality, anastomotic leakage, and other postoperative complications. Copyright © 2017 Elsevier Inc. All rights reserved.

Physiologic study of the terminal digestive tract in chronic painful constipation.

PubMed Central

Meunier, P

1986-01-01

A manometric study of the sigmoid colon and of the anorectum was undertaken in 65 chronically constipated patients complaining of abdominal pain, and in a control group of 23 healthy volunteers. Rectal compliance was tested in both groups. The sigmoid motility study allowed for the segregation of the constipated patients into three groups: hypokinesia (12 cases), normokinesia (34 cases), hyperkinesia (19 cases). Rectal manometry showed anal hypertony in 24 patients, impaired rectal conscious sensitivity in 12 subjects, and normal functions in the remaining cases. The rectal compliance study disclosed a decreased compliance in 15 cases and increased compliance in 13 other patients. In 12 cases disordered sigmoid motility was the only abnormality; in 10 cases only a rectoanal abnormality was found. Most of the patients (52%) exhibited miscellaneous disorders. In contrast, all parameters were normal in nine subjects. No consistent pattern of motility disorders was thus demonstrated in this clinically homogeneous group of patients with chronic, painful, constipation. PMID:3758814

Association between cobalt allergy and dermatitis caused by leather articles--a questionnaire study.

PubMed

Bregnbak, David; Thyssen, Jacob P; Zachariae, Claus; Menné, Torkil; Johansen, Jeanne D

2015-02-01

Cobalt is a strong skin sensitizer and a prevalent contact allergen. Recent studies have recognized exposure to leather articles as a potential cause of cobalt allergy. To examine the association between contact allergy to cobalt and a history of dermatitis resulting from exposure to leather. A questionnaire case-control study was performed: the case group consisted of 183 dermatitis patients with a positive patch test reaction to cobalt chloride and a negative patch test reaction to potassium dichromate; the control group consisted of 621 dermatitis patients who did not react to either cobalt or chromium in patch testing. Comparisons were made by use of a χ(2) -test, Fisher's exact, and the Mann-Whitney test. Logistic regression analyses were used to test for associations while taking confounding factors into consideration. Leather was observed as the most frequent exposure source causing dermatitis in the case group. Although the case group significantly more often reported non-occupational dermatitis caused by leather exposure (p < 0.001), no association was found between cobalt allergy and dermatitis caused by work-related exposure to leather. Our study suggests a positive association between cobalt allergy and a history of dermatitis caused by non-occupational exposure to leather articles. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Our current approach in the treatment of sigmoid colon volvulus].

PubMed

Taviloğlu, Korhan; Aydin, Erol; Ertekin, Cemalettin; Güloğlu, Recep; Kurtoğlu, Mehmet

2002-04-01

Our aim was to emphasize the role of endoscopic detorsion in the treatment of sigmoid colon volvulus, which we currently apply in the majority of our cases. The data of 37 patients were analyzed in a retrospective manner, during a 86-month period, between May 1994 and July 2001. The patients were classified into three groups. The first group consisted of 9 patients with resection and anastomosis, the second group consisted of 20 patients with Hartmann's procedure, and the third group consisted of 8 patients with endoscopic detorsion. Complications were encountered in 7 patients (19%), and 3 patients (8%) died following treatment. We favor colonic resection following endoscopic treatment. Resection should be preferred, if endoscopic detorsion is not successful or in the presence of a complication.

Soft Tissue Changes in Cleft Lip and Palate Patients: Anterior Maxillary Distraction versus Conventional Le-Fort I Osteotomy.

PubMed

Markose, Eldho; Paulose, Joby; Paul, Eldho T

2013-12-01

The purpose of the study was to compare the soft tissue changes after maxillary advancement in patients with maxillary deficiency associated with cleft lip and palate (CLP) by two approaches-anterior maxillary distraction (AMD) and advancement LeFort I osteotomy (ALO). Twenty patients with maxillary hypoplasia associated with cleft lip and palate who had undergone either LeFort I osteotomy or distraction osteogenesis with maxillary advancement were included in this study. Lateral cephalogram taken at various intervals of time were used to evaluate soft tissue and hard tissue changes over time. In both groups, vertical as well as horizontal changes in pronasale was well observed. A substantial increase in nasal parameters was noted in case of AMD group in comparison to ALO. Though maxillary advancement was evident in both the groups, a significant and consistent change was observed in AMD. Significant vertical and horizontal changes were seen with respect to subnasale and labrale superius in AMD group. Soft tissue as well as hard tissue relapse was greater in ALO group than AMD group. Significant soft tissue and hard tissue changes were clearly observed in both the groups, but the treatment results were more consistent in cases treated with AMD. Hence AMD could be considered as a better treatment of choice in cases of maxillary hypoplasia associated with cleft lip and palate.

Clinical Evaluation of Ozone on Dentinal Lesions in Young Permanent Molars using the Stepwise Excavation.

PubMed

Safwat, Osama; Elkateb, Mona; Dowidar, Karin; El Meligy, Omar

To evaluate the clinical changes in dentin of deep carious lesions in young permanent molars, following ozone application with and without the use of a remineralizing solution, using the stepwise excavation. The sample included 162 first permanent immature molars, showing deep occlusal carious cavities that were indicated for indirect pulp capping. Teeth were divided into 2 main groups according to the method of ozone treatment. Each group was further subdivided equally into test and control subgroups. Following caries excavation, color, consistency and DIAGNOdent assessments of dentin were evaluated after 6 and 12 months. Regarding dentin color and consistency, no significant differences were observed following ozone application, with and without a remineralizing solution. There were no significant differences between ozone treatment, and calcium hydroxide during the different evaluation periods, except in group I cases after 6 months, concerning the dentin color. The DIAGNOdent values were significantly reduced following ozone application, with or without a remineralizing solution, as well as between test and control cases in group I after 6 months. Ozone application through the stepwise excavation had no significant effect on dentin color and consistency in young permanent molars. DIAGNOdent was unreliable in monitoring caries activity.

Water supply management using an extended group fuzzy decision-making method: a case study in north-eastern Iran

NASA Astrophysics Data System (ADS)

Minatour, Yasser; Bonakdari, Hossein; Zarghami, Mahdi; Bakhshi, Maryam Ali

2015-09-01

The purpose of this study was to develop a group fuzzy multi-criteria decision-making method to be applied in rating problems associated with water resources management. Thus, here Chen's group fuzzy TOPSIS method extended by a difference technique to handle uncertainties of applying a group decision making. Then, the extended group fuzzy TOPSIS method combined with a consistency check. In the presented method, initially linguistic judgments are being surveyed via a consistency checking process, and afterward these judgments are being used in the extended Chen's fuzzy TOPSIS method. Here, each expert's opinion is turned to accurate mathematical numbers and, then, to apply uncertainties, the opinions of group are turned to fuzzy numbers using three mathematical operators. The proposed method is applied to select the optimal strategy for the rural water supply of Nohoor village in north-eastern Iran, as a case study and illustrated example. Sensitivity analyses test over results and comparing results with project reality showed that proposed method offered good results for water resources projects.

DNA methylation-based reclassification of olfactory neuroblastoma.

PubMed

Capper, David; Engel, Nils W; Stichel, Damian; Lechner, Matt; Glöss, Stefanie; Schmid, Simone; Koelsche, Christian; Schrimpf, Daniel; Niesen, Judith; Wefers, Annika K; Jones, David T W; Sill, Martin; Weigert, Oliver; Ligon, Keith L; Olar, Adriana; Koch, Arend; Forster, Martin; Moran, Sebastian; Tirado, Oscar M; Sáinz-Japeado, Miguel; Mora, Jaume; Esteller, Manel; Alonso, Javier; Del Muro, Xavier Garcia; Paulus, Werner; Felsberg, Jörg; Reifenberger, Guido; Glatzel, Markus; Frank, Stephan; Monoranu, Camelia M; Lund, Valerie J; von Deimling, Andreas; Pfister, Stefan; Buslei, Rolf; Ribbat-Idel, Julika; Perner, Sven; Gudziol, Volker; Meinhardt, Matthias; Schüller, Ulrich

2018-05-05

Olfactory neuroblastoma/esthesioneuroblastoma (ONB) is an uncommon neuroectodermal neoplasm thought to arise from the olfactory epithelium. Little is known about its molecular pathogenesis. For this study, a retrospective cohort of n = 66 tumor samples with the institutional diagnosis of ONB was analyzed by immunohistochemistry, genome-wide DNA methylation profiling, copy number analysis, and in a subset, next-generation panel sequencing of 560 tumor-associated genes. DNA methylation profiles were compared to those of relevant differential diagnoses of ONB. Unsupervised hierarchical clustering analysis of DNA methylation data revealed four subgroups among institutionally diagnosed ONB. The largest group (n = 42, 64%, Core ONB) presented with classical ONB histology and no overlap with other classes upon methylation profiling-based t-distributed stochastic neighbor embedding (t-SNE) analysis. A second DNA methylation group (n = 7, 11%) with CpG island methylator phenotype (CIMP) consisted of cases with strong expression of cytokeratin, no or scarce chromogranin A expression and IDH2 hotspot mutation in all cases. T-SNE analysis clustered these cases together with sinonasal carcinoma with IDH2 mutation. Four cases (6%) formed a small group characterized by an overall high level of DNA methylation, but without CIMP. The fourth group consisted of 13 cases that had heterogeneous DNA methylation profiles and strong cytokeratin expression in most cases. In t-SNE analysis, these cases mostly grouped among sinonasal adenocarcinoma, squamous cell carcinoma, and undifferentiated carcinoma. Copy number analysis indicated highly recurrent chromosomal changes among Core ONB with a high frequency of combined loss of chromosome 1-4, 8-10, and 12. NGS sequencing did not reveal highly recurrent mutations in ONB, with the only recurrently mutated genes being TP53 and DNMT3A. In conclusion, we demonstrate that institutionally diagnosed ONB are a heterogeneous group of tumors. Expression of cytokeratin, chromogranin A, the mutational status of IDH2 as well as DNA methylation patterns may greatly aid in the precise classification of ONB.

Stochastic quantization and holographic Wilsonian renormalization group of free massive fermion

NASA Astrophysics Data System (ADS)

Moon, Sung Pil

2018-06-01

We examine a suggested relation between stochastic quantization and the holographic Wilsonian renormalization group in the massive fermion case on Euclidean AdS space. The original suggestion about the general relation between the two theories is posted in arXiv:1209.2242. In the previous researches, it is already verified that scalar fields, U(1) gauge fields, and massless fermions are consistent with the relation. In this paper, we examine the relation in the massive fermion case. Contrary to the other case, in the massive fermion case, the action needs particular boundary terms to satisfy boundary conditions. We finally confirm that the proposed suggestion is also valid in the massive fermion case.

Parental grief after a child's drug death compared to other death causes: investigating a greatly neglected bereavement population.

PubMed

Feigelman, William; Jordan, John R; Gorman, Bernard S

2011-01-01

This comparative survey contrasted 571 parents who lost children to various death causes: 48 to drug-related deaths and overdoses, 462 to suicide, 24 to natural death cases, and 37 to mostly accidental death cases. Groups were compared in terms of grief difficulties, mental health problems, posttraumatic stress, and stigmatization. Results did not show any appreciable differences in these respects between the suicide bereaved parents and those losing children to drug-related deaths. However, when the suicide and drug-related death survivors were specifically contrasted against accidental and natural death loss cases, a consistent pattern emerged showing the former group was consistently more troubled by grief and mental health problems than the latter two sub-groups. These differences remained when controls of time since the loss and gender differences were employed as covariates. These findings suggest that the powerful and intense stigma against drug use and mental illness, shared among the public-at-large, imposes challenges in healing of immense proportion for these parents as they find less compassionate responses from their significant others, following their losses.

Radiation therapy of carcinoma of the maxillary antrum (in Japanese)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Matsuura, S.; Taketa, C.; Ono, I.

1973-06-01

The total number of 187 cases with carcinoma of the maxillary antrum treated at National Cancer Center from 1962 to 1971 were divided into two groups. Group A (1962 to 1966) consisted of 90 cases, of which 72.2% received mainly radiotherapy with dose over 6000 rad. Group B (1967 to 1972) consisted of 97 cases, of which patients irradiated with over 6000 rad was 21.6% and intraarterial infusion of 5-FU was combined. As the injuries after irradiation, 48 cases developed radiation cataract. Advanced disturbances of visual acuity by cataract was caused by the radiation with over 4000 rad in aboutmore » two-thirds of them within 2yrs and in one third within 3to 5 yrs. In 13 patients with shielding of the eyeball from the beginning, no complications of the eyes were found except in one patient. In the injuries of the bone and the soft tissue, the fragments of the bones irradiated with high doses were easily infected and were incurable when osteomyelitis was complicated. Five cases in the over5-year survival cases showed third-degree injuries of the tissue from external irradiation with over 6000 rad. The 3-year crude survival rate of A and B group was 51.6 and 46.0% respectively, and the 5-year crude survival rate in the whole was 42.2%. Adequate combination of radiotherapy, intraarterial infusion for chemotherapy, and surgery are now under study. At present, the dose of 5-Fu was tentatively determined at 3000 mg and the radiation was 4000 rad. For the improvement of therapeutic results, programmings with plans of radiotherapy of each case and the managements of the detailed information on personal history are now under preparation as a radiotherapy using electric computer. (JA)« less

SU-E-T-511: Inter-Rater Variability in Classification of Incidents in a New Incident Reporting System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pappas, D; Reis, S; Ali, A

Purpose To determine how consistent the results of different raters are when reviewing the same cases within the Radiation Oncology Incident Learning System (ROILS). Methods Three second-year medical physics graduate students filled out incident reports in spreadsheets set up to mimic ROILS. All students studied the same 33 cases and independently entered their assessments, for a total of 99 reviewed cases. The narratives for these cases were obtained from a published International Commission on Radiological Protection (ICRP) report which included shorter narratives selected from the Radiation Oncology Safety Information System (ROSIS) database. Each category of questions was reviewed to seemore » how consistent the results were by utilizing free-marginal multirater kappa analysis. The percentage of cases where all raters shared full agreement or full disagreement was recorded to show which questions were answered consistently by multiple raters for a given case. The consistency among the raters was analyzed between ICRP and ROSIS cases to see if either group led to more reliable results. Results The categories where all raters agreed 100 percent in their choices were the event type (93.94 percent of cases 0.946 kappa) and the likelihood of the event being harmful to the patient (42.42 percent of cases 0.409 kappa). The categories where all raters disagreed 100 percent in their choices were the dosimetric severity scale (39.39 percent of cases 0.139 kappa) and the potential future toxicity (48.48 percent of cases 0.205 kappa). ROSIS had more cases where all raters disagreed than ICRP (23.06 percent of cases compared to 15.58 percent, respectively). Conclusion Despite reviewing the same cases, the results among the three raters was widespread. ROSIS narratives were shorter than ICRP, which suggests that longer narratives lead to more consistent results. This study shows that the incident reporting system can be optimized to yield more consistent results.« less

[The Thule case. Mortality and hospitalization after the crash of an American B-52 bomber in 1968].

PubMed

Juel, K

1993-07-26

In 1968, a B-52 bomber carrying nuclear bombs crashed near the Thule US Air-Base in Greenland. By 1986, many cases of disease had been reported among Danish workers employed at the base. A database has been constructed from staff files of workers employed from 1963 to 1971. Of 4,322 workers, 98.7% were identified in 1987. The study group consisted of 1,202 workers employed during the clean up period (from the time of the crash until the last of the contaminated material had been removed). The reference group consisted of 3,120 workers employed outside the clean up period. No differences were found in total mortality, or mortality from cancer, heart disease or accidents between the groups after adjusting for age, marital status and length of employment. Mortality from suicide was lower in the study group. The hospitalization rates for the period 1977-1985 also showed no differences between the two groups. The conclusion of the register surveys is that no harmful effect on health due to the crash can be established by measuring mortality or hospital admissions.

The risk assessment of a fall in patients with lumbar spinal stenosis.

PubMed

Kim, Ho-Joong; Chun, Heoung-Jae; Han, Chang-Dong; Moon, Seong-Hwan; Kang, Kyoung-Tak; Kim, Hak-Sun; Park, Jin-Oh; Moon, Eun-Su; Kim, Bo-Ram; Sohn, Joon-Seok; Shin, Seung-Yup; Jang, Ju-Woong; Lee, Kwang-Il; Lee, Hwan-Mo

2011-04-20

A prospective case control study. To investigate the risk of a fall by using functional mobility tests in patients with lumbar spinal stenosis (LSS) via a comparison with patients with knee osteoarthritis (KOA). LSS is a degenerative arthritic disease in the spine that results in decreasing function, impaired balance, and gait deficit, with increased levels of leg and back pain. This physical impairment may result in an increased risk of fall later in the disease process, as shown in KOA. However, there has been no study regarding the association between the risk of a fall and LSS. The study was an age- and weight-matched case control study consisting of two groups: one group consisting of 40 patients with LSS who were scheduled to undergo spine surgery (LSS group) and the other group consisting of 40 patients with advanced osteoarthritis in both knees, scheduled to undergo TKA on both knees (KOA group). For both groups, four functional mobility tests, such as a Six-Meter-Walk Test (SMT), Sit-to-Stand test (STS), Alternative-Step Test (AST), and Timed Up and Go Test (TUGT), were performed. There was no difference in demographic data between both groups except for body mass index. For the SMT and STS, the patients in the LSS group spent significantly more time performing these tests than the patients in the KOA. For the AST, however, patients in the KOA group presented a statistically worse performance in functional mobility, compared with the LSS group. The mean TUGT time was not statistically different between the two groups. The current study highlights that patients with symptomatic LSS have a risk of a fall comparable with the patients who had degenerative KOA based on the results of functional mobility tests (SMT, STS, AST, and TUGT).

Value of hemoglobin A1c in diagnosing diabetes mellitus within a chronic disease management system illustrated by the receiver operating characteristic curve.

PubMed

Eid, Wael E; Pottala, James V

2010-01-01

To develop a receiver operating characteristic (ROC) curve of glycosylated hemoglobin (HbA1c) for diagnosing diabetes mellitus within a chronic disease management system. A case-control study including medical records from January 1, 1997, to December 31, 2005, was conducted at the Sioux Falls Veterans Affairs Medical Center. Medical records for the case group (patients with diabetes) were selected based on 1 of 3 criteria: International Classification of Diseases, Ninth Revision, Clinical Modification or Current Procedural Terminology codes specific for type 1 and type 2 diabetes; patients' use of medications (oral hypoglycemic agents, antidiabetes agents, or insulin); or results from random blood or plasma glucose tests (at least 2 measurements of blood glucose > or = 200 mg/dL). Records for the control group were selected based on patients having HbA1c measured, but not meeting the above diagnostic criteria for diabetes during the study period. Records for cases and controls were randomly frequency-matched, one-to-one. The control group was randomly divided into 5 sets of an equal number of records. Five sets of an equal number of cases were then randomly selected from the total number of cases. Each test data set included 1 case group and 1 control group, resulting in 5 independent data sets. In total, 5040 patient records met the case definition in the diabetes registry. Records of 15 patients who were prescribed metformin only, but did not meet any other case criteria, were reviewed and excluded after determining the patients were not diabetic. The control group consisted of 5 sets of 616 records each (totaling 3080 records), and the case group consisted of 5 sets of 616 records each (totaling 3080 records). Thus, each of the 5 independent data sets of 1 case group and 1 control group contained 1232 records. The case group was predominantly composed of white men (mean age, 69 years; mean body mass index, 31 kg/m2). Demographic data were similar for control patients. The ROC curve revealed that a HbA1c > or = 6.3% (mean + 1 SD) offered the most accurate cutoff value for diagnosing type 2 diabetes mellitus, with the following statistical values: C statistic, 0.78; sensitivity, 70%; specificity, 85%; and positive likelihood ratio, 4.6 (95% confidence interval, 4.2-5.0). A HbA1c value > or = 6.3% may be a useful benchmark for diagnosing diabetes mellitus within a chronic disease management system and may be a useful tool for monitoring high-risk populations.

Neurological, Metabolic, and Psychiatric Adverse Events in Children and Adolescents Treated With Aripiprazole.

PubMed

Jakobsen, Klaus Damgaard; Bruhn, Christina Hedegaard; Pagsberg, Anne-Katrine; Fink-Jensen, Anders; Nielsen, Jimmi

2016-10-01

Aripiprazole is a partial dopamine agonist with only minor neurological and psychiatric adverse effects, making it a potential first-line drug for the treatment of psychiatric disorders. However, the evidence of its use in children and adolescents is rather sparse. The aim of this case study is to discuss adverse drug reaction (ADR) reports concerning aripiprazole-associated neurological and psychiatric events in children and adolescents. The ADR report database at Danish Medicines Agency was searched for all ADRs involving children and adolescents (<18 years) reported by the search term [aripiprazole] AND all spontaneous reports since the introduction of aripiprazole in 2003 until December 31, 2015. Nineteen case reports were included in the study and included both patients with psychotic disorders (PS group) and nonpsychotic disorders (non-PS group). The PS group consisted of 5 patients with schizophrenia and psychoses, not otherwise specified; and the non-PS group consisted of fourteen cases including autism spectrum disorders, attention deficit and hyperactivity disorder, obsessive-compulsive disorder, and Tourette syndrome. The main reported adverse effects in the non-PS group were chronic insomnia, Parkinsonism, behavioral changes psychoses, and weight gain, whereas the adverse effects in the PS group was predominantly anxiety, convulsions, and neuroleptic malignant syndrome. Although aripiprazole is considered safe and well tolerated in children and adolescents, severe adverse events as neuroleptic malignant syndrome, extreme insomnia, and suicidal behavior has been reported to health authorities. Clinicians should pay attention to these possible hazards when prescribing aripiprazole to this vulnerable group of patients.

Who Attends Physical Activity Programmes in Deprived Neighbourhoods?

ERIC Educational Resources Information Center

Withall, J.; Jago, R.; Fox, K. R.

2011-01-01

Objective: Physical activity can reduce the risk of several chronic diseases. Such diseases are most prevalent in economically-disadvantaged groups where physical activity levels are consistently lower. There is a need to engage disadvantaged groups in programmes to increase physical activity. This case study examined programmes on offer in a…

Teaching astronomy with case studies

NASA Astrophysics Data System (ADS)

Slater, Timothy F.

2015-11-01

Breaking the students into small, collaborative learning groups to solve a meaningful task together is one of the most successful and fully evaluated teaching techniques implemented over the last century. Although there are many ways to accomplish small group learning, a long-standing and consistently successful collaborative class activity is to use the case study teaching strategy. The use of case studies is common in medical schools and law schools, but not so common in the teaching of astronomy. Case studies create meaningful conversations among students and with the professor by focusing on life-like dilemmas to be solved. Case study tasks ask audience members to synthesize several ideas or evaluate scenarios that have not been explicitly presented to them in the lecture or in available readings.

A Multiple Group Measurement Model of Children's Reports of Parental Socioeconomic Status. Discussion Papers No. 531-78.

ERIC Educational Resources Information Center

Mare, Robert D.; Mason, William M.

An important class of applications of measurement error or constrained factor analytic models consists of comparing models for several populations. In such cases, it is appropriate to make explicit statistical tests of model similarity across groups and to constrain some parameters of the models to be equal across groups using a priori substantive…

Evaluating the Effects of Medical Explorers a Case Study Curriculum on Critical Thinking, Attitude Toward Life Science, and Motivational Learning Strategies in Rural High School Students

NASA Astrophysics Data System (ADS)

Brand, Lance G.

2011-12-01

The purpose of this study was three-fold: to measure the ability of the Medical Explorers case-based curriculum to improve higher order thinking skills; to evaluate the impact of the Medical Explorers case-based curriculum to help students be self directed learners; and to investigate the impact of the Medical Explorers case-based curriculum to improve student attitudes of the life sciences. The target population for this study was secondary students enrolled in advanced life science programs. The resulting sample (n = 71) consisted of 36 students in the case-based experimental group and 35 students in the control group. Furthermore, this study employed an experimental, pretest-posttest control group research design. The treatment consisted of two instructional strategies: case-based learning and teacher-guided learning. Analysis of covariance indicated no treatment effect on critical thinking ability or Motivation and Self-regulation of Learning. However, the Medical Explorers case-based curriculum did show a treatment effect on student attitudes toward the life sciences. These results seem to indicate that case-based curriculum has a positive impact on students' perspectives and attitudes about the study of life science as well as their interest in life science based careers. Such outcomes are also a good indicator that students enjoy and perceive the value to use of case studies in science, and because they see value in the work that they do they open up their minds to true learning and integration. Of additional interest was the observationthat on average eleventh graders showed consistently stronger gains in critical thinking, motivation and self-regulation of learning strategies, and attitudes toward the life sciences as compared to twelfth grade students. In fact, twelfth grade students showed a pre to post loss on the Watson-Glaser and the MSLQ scores while eleventh grade students showed positive gains on each of these instruments. This decline in twelfth grade performance is an endemic indicator of underlying problems that exists in this transitional year of education and supports the need to strengthen the transitional connections between high schools and institutions of higher learning.

Comparison of the CENTRM resonance processor to the NITAWL resonance processor in SCALE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hollenbach, D.F.; Petrie, L.M.

1998-01-01

This report compares the MTAWL and CENTRM resonance processors in the SCALE code system. The cases examined consist of the International OECD/NEA Criticality Working Group Benchmark 20 problem. These cases represent fuel pellets partially dissolved in a borated solution. The assumptions inherent to the Nordheim Integral Treatment, used in MTAWL, are not valid for these problems. CENTRM resolves this limitation by explicitly calculating a problem dependent point flux from point cross sections, which is then used to create group cross sections.

Immunohistochemical investigation of a pulmonary surfactant in fatal mechanical asphyxia.

PubMed

Zhu, B L; Ishida, K; Fujita, M Q; Maeda, H

2000-01-01

We evaluated the usefulness of pulmonary surfactant protein A (SP-A) as a practical diagnostic marker of fatal mechanical asphyxia in forensic autopsy cases. A total of 27 cases of asphyxia were examined histologically and immunohistochemically and compared with a control group consisting of 16 cases of poisoning (n = 9) and peracute death (n = 7). Both groups showed histological findings of local atelectasis and local emphysema, congestion, intra-alveolar and interstitial edema in most cases and pulmonary hemorrhages in some cases. The mechanical asphyxia group showed a significantly increased intensity of SP-A staining in the intra-alveolar space accompanied by many massive aggregates in approximately 60% of cases, which was not found in the control group. These structures may be interpreted as aggregates of pulmonary surfactant released from the alveolar wall due to enhanced secretion caused by strong forced breathing or over-excitement of the autonomic nervous system by mechanical asphyxia. The results of our investigation suggest the practical usefulness of the immunohistochemical detection of SP-A in distinguishing mechanical asphyxia from other types of hypoxia.

Birth defects in relation to Bendectin use in pregnancy. II. Pyloric stenosis.

PubMed

Mitchell, A A; Schwingl, P J; Rosenberg, L; Louik, C; Shapiro, S

1983-12-01

To test the hypothesis that the use of Bendectin in pregnancy increases the risk of pyloric stenosis, we determined rates of antenatal Bendectin exposure among 325 infants with pyloric stenosis and among two control groups comprising infants with other defects; one consisted of 3,153 infants with other conditions, and the other, a subset of that group, consisted of 724 infants with defects that may have had their origins at any time in pregnancy. Comparisons between the cases and the two control series yielded estimated relative risks of 0.9 (95% confidence interval, 0.6 to 1.2) and 1.0 (0.7 to 1.4), respectively. The findings from this large case-control study suggest that Bendectin does not increase the risk of pyloric stenosis.

Comparison of two control groups for estimation of oral cholera vaccine effectiveness using a case-control study design.

PubMed

Franke, Molly F; Jerome, J Gregory; Matias, Wilfredo R; Ternier, Ralph; Hilaire, Isabelle J; Harris, Jason B; Ivers, Louise C

2017-10-13

Case-control studies to quantify oral cholera vaccine effectiveness (VE) often rely on neighbors without diarrhea as community controls. Test-negative controls can be easily recruited and may minimize bias due to differential health-seeking behavior and recall. We compared VE estimates derived from community and test-negative controls and conducted bias-indicator analyses to assess potential bias with community controls. From October 2012 through November 2016, patients with acute watery diarrhea were recruited from cholera treatment centers in rural Haiti. Cholera cases had a positive stool culture. Non-cholera diarrhea cases (test-negative controls and non-cholera diarrhea cases for bias-indicator analyses) had a negative culture and rapid test. Up to four community controls were matched to diarrhea cases by age group, time, and neighborhood. Primary analyses included 181 cholera cases, 157 non-cholera diarrhea cases, 716 VE community controls and 625 bias-indicator community controls. VE for self-reported vaccination with two doses was consistent across the two control groups, with statistically significant VE estimates ranging from 72 to 74%. Sensitivity analyses revealed similar, though somewhat attenuated estimates for self-reported two dose VE. Bias-indicator estimates were consistently less than one, with VE estimates ranging from 19 to 43%, some of which were statistically significant. OCV estimates from case-control analyses using community and test-negative controls were similar. While bias-indicator analyses suggested possible over-estimation of VE estimates using community controls, test-negative analyses suggested this bias, if present, was minimal. Test-negative controls can be a valid low-cost and time-efficient alternative to community controls for OCV effectiveness estimation and may be especially relevant in emergency situations. Copyright © 2017. Published by Elsevier Ltd.

Electron microscopic changes of detrusor in benign enlargement of prostate and its clinical correlation.

PubMed

Yadav, Sher Singh; Bhattar, Rohit; Sharma, Lokesh; Banga, Gautam; Sadasukhi, Trilok Chandra

2017-01-01

To study the ultra structural changes in bladder musculature in cases of BPE and their clinical relevance. In this descriptive longitudinal, controlled, observational study patients were enrolled into three groups, group 1, group 2A and group 2B. Control group (group-1) consisted of age matched normal male patients, who underwent surveillance or diagnostic cystoscopy for microscopic hematuria or irritative symptoms. Case group (group-2) comprised of patients with BPE, undergoing TURP. Case group (group-2) was further classified into: Category 2A (patients not on catheter) and cat-egory 2B (patients on catheter). All relevant clinical parameters like IPSS, prostate size, Qmax, PVR were recorded. Cystoscopy and bladder biopsy were performed in all patients. Various ultrastructural parameters like myocytes, fascicular pattern, interstitial tissue, nerve hypertrophy and cell junction pattern were analyzed under electron microscope and they were clinically correlated using appropriate statistical tests. Control group had significant difference as compared to case group in terms of baseline parameters like IPSS, flow rate and prostate size, both preoperatively and postoperatively, except for PVR, which was seen only preoperatively. There was statistically significant difference in ultrastructural patterns between case and control group in all five electron microscopic patterns. However, no significant difference was found between the subcategories of case groups. BPE is responsible for ultra structural changes in detrusor muscle and these changes remain persistent even after TURP. Nerve hypertrophy, which was not thoroughly discussed in previous studies, is also one of the salient feature of this study. Copyright® by the International Brazilian Journal of Urology.

Consistency and reliability of judgements by assessors of case based discussions in general practice specialty training programmes in the United Kingdom.

PubMed

Bodgener, Susan; Denney, Meiling; Howard, John

2017-01-01

Case based discussions (CbDs) are a mandatory workplace assessment used throughout general practitioner (GP) specialty training; they contribute to the annual review of competence progression (ARCP) for each trainee. This study examined the judgements arising from CbDs made by different groups of assessors and whether or not these assessments supported ARCP decisions. The trainees selected were at the end of their first year of GP training and had been identified during their ARCPs to need extra training time. CbDs were specifically chosen as they are completed by both hospital and GP supervisors, enabling comparison between these two groups. The results raise concern with regard to the consistency of judgements made by different groups of assessors, with significant variance between assessors of different status and seniority. Further work needs to be done on whether the CbD in its current format is fit for purpose as one of the mandatory WPBAs for GP trainees, particularly during their hospital placements. There is a need to increase the inter-rater reliability of CbDs to ensure a consistent contribution to subsequent decisions about a trainee's overall progress.

Investigation of Aggression Levels of University Students (Kocaeli University Case)

ERIC Educational Resources Information Center

Keskin, Özlem; Akdeniz, Hakan

2018-01-01

The aim of this study was to investigate the aggression levels of university students in different departments in terms of sport and other variables. The population of the study consists of university students studying at Kocaeli University; the sample group consists of a total of 700 students, 378 male and 322 female, studying in the Faculty of…

The effect of a live vaccine on the horizontal transmission of Mycoplasma gallisepticum.

PubMed

Feberwee, A; Landman, W J M; von Banniseht-Wysmuller, Th; Klinkenberg, D; Vernooij, J C M; Gielkens, A L J; Stegeman, J A

2006-10-01

The effect of a live Mycoplasma gallisepticum vaccine on the horizontal transmission of this Mycoplasma species was quantified in an experimental animal transmission model in specific pathogen free White Layers. Two identical trials were performed, each consisting of two experimental groups and one control group. The experimental groups each consisted of 20 birds 21 weeks of age, which were housed following a pair-wise design. One group was vaccinated twice with a commercially available live attenuated M. gallisepticum vaccine, while the other group was not vaccinated. Each pair of the experimental group consisted of a challenged chicken (10(4) colony-forming units intratracheally) and a susceptible in-contact bird. The control group consisted of 10 twice-vaccinated birds housed in pairs and five individually housed non-vaccinated birds. The infection was monitored by serology, culture and quantitative polymerase chain reaction. The vaccine strain and the challenge strain were distinguished by a specific polymerase chain reaction and by random amplified polymorphic DNA analysis. In both experiments, all non-vaccinated challenged chickens and their in-contact 'partners' became infected with M. gallisepticum. In the vaccinated challenged and corresponding in-contact birds, a total of 19 and 13 chickens, respectively, became infected with M. gallisepticum. Analysis of the M. gallisepticum shedding patterns showed a significant effect of vaccination on the shedding levels of the vaccinated in-contact chickens. Moreover, the Cox Proportional Hazard analysis indicated that the rate of M. gallisepticum transmission from challenged to in-contact birds in the vaccinated group was 0.356 times that of the non-vaccinated group. In addition, the overall estimate of R (the average number of secondary cases infected by one typical infectious case) of the vaccinated group (R = 4.3, 95% confidence interval = 1.6 to 49.9) was significantly lower than that of the non-vaccinated group (R = infinity, 95% confidence interval = 9.9 to infinity). However, the overall estimate of R in the vaccinated group still exceeded 1, which indicates that the effect of the vaccination on the horizontal transmission M. gallisepticum is insufficient to stop its spread under these experimental conditions.

Collaborative, case-based learning: how do students actually learn from each other?

PubMed

Thurman, Joanne; Volet, Simone E; Bolton, John R

2009-01-01

The value of collaborative, case-based, and problem-based learning has received increased attention in recent years. Several studies have documented veterinary staff and students' generally positive feedback on group learning activities, but one largely unaddressed question is how students actually learn from each other. This study examined how second-year veterinary students learned from each other during a collaborative, case-based learning project. Data were students' written reflections on their learning in the veterinary course and the specific learning experience, and a matched pre- and post-task questionnaire. Consistent with prior research describing veterinary students as individualistic learners, only a third of students spontaneously mentioned learning from each other as one of their most effective strategies. However, when prompted to describe a time when they felt that group members were really learning from each other, students reported highly valuable collaborative learning processes, which they explicitly linked to learning and understanding benefits. Questionnaire data were consistent, showing that students became more positive toward several aspects of the activity as well as toward group work in general. One unexpected finding was the lack of a relationship between students' self-evaluation of their learning and how well group members knew each other. These findings provide strong support for the educational value of collaborative, case-based learning. In light of other research evidence (using observation data) that the amount of time students actually engage in high-level collaborative processes may be rather limited, this article points to the need for veterinary teachers to better prepare students for group learning activities.

Incomplete caries removal and indirect pulp capping in primary molars: a randomized controlled trial.

PubMed

Bressani, Ana Eliza Lemes; Mariath, Adriela Azevedo Souza; Haas, Alex Nogueira; Garcia-Godoy, Franklin; de Araujo, Fernando Borba

2013-08-01

To compare the effect of incomplete caries removal (ICR) and indirect pulp capping (IPC) with calcium hydroxide (CH) or an inert material (wax) on color, consistency and contamination of the remaining dentin of primary molars. This double-blind, parallel-design, randomized controlled trial included 30 children presenting one primary molar with deep caries lesion. Children were randomly assigned after ICR to receive IPC with CH or wax. All teeth were then restored with resin composite. Baseline dentin color and consistency were evaluated after ICR, and dentin samples were collected for contamination analyses using scanning electron microscopy. After 3 months, restorations were removed and the three parameters were re-evaluated. In both groups, dentin became significantly darker after 3 months. No cases of yellow dentin were observed after 3 months with CH compared to 33.3% of the wax cases (P < 0.05). A statistically significant difference over time was observed only for CH regarding consistency. CH stimulated a dentin hardening process in a statistically higher number of cases than wax (86.7% vs. 33.3%; P = 0.008). Contamination changed significantly over time in CH and wax without significant difference between groups. It was concluded that CH and wax arrested the carious process of the remaining carious dentin after indirect pulp capping, but CH showed superior dentin color and consistency after 3 months.

A Clinical Observation of Functional Abdominal Pain Syndrome in Patients Treated by Traditional Chinese Spinal Orthopedic Manipulation.

PubMed

Qu, Liu-Xin; Xing, Li-Yang; Wanda, Norman; Chen, Hong; Li, Ming-Ju; Gao, Song; Li, Ping

2018-02-01

To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation (TCSOM) in treating patients with functional abdominal pain syndrome (FAPS) in comparison with Pinaverium Bromide (Dicetel, PBD), and to assess a possible cause for FAPS. Eighty patients with FAPS were randomly and equally assigned to the TCSOM group and PBD group according to the random number table. All patients in the TCSOM group were treated with a maximum of 5 times of spinal manipulations. Patients in the PBD group were instructed to take 50 mg 3 times a day, consistently for 2 weeks. The symptoms of pre- and post-treatment were assessed on a visual analog scale (VAS) pain score. A symptom improvement rating (SIR) was implemented to evaluate the effects of the treatments. The symptoms of 27 cases of the TCSOM group were relieved soon after the first TCSOM treatment and 9 cases were significantly improved. The VAS pain scores in the TCSOM group were significantly lower than those in the PBD group after 2 weeks treatment. According to the SIR based on VAS, the TCSOM group included 30 cases with excellent results, 7 cases with good, and 3 cases with poor. Adverse events to the treatment were not reported. Based on VAS, the PBD group reported 8 cases with excellent results, 10 cases with good and 22 cases with poor. There was a significant difference between the two groups (P<0.01). The displacement of intervertebral discs and/or vertebra in the thoracic or lumbar region seems to be a contributing factor in the symptoms of FAPS. TCSOM is an effective treatment for FAPS.

Motivation in Technology Education among Novice and Technological Talents

ERIC Educational Resources Information Center

Autio, Ossi

2010-01-01

The purpose of this study was to determine the elements motivating comprehensive school students to study technology education. The research was carried out as a qualitative case study and the material was collected through individual theme interviews. The study group consisted of two different test groups: novice and technological talents. In…

Chemical composition of individual aerosol particles in workplace air during production of manganese alloys.

PubMed

Gunst, S; Weinbruch, S; Wentzel, M; Ortner, H M; Skogstad, A; Hetland, S; Thomassen, Y

2000-02-01

Aerosol particle samples were collected at ELKEM ASA ferromanganese (FeMn) and silicomanganese (SiMn) smelters at Porsgrunn, Norway, during different production steps: raw material mixing, welding of protective steel casings, tapping of FeMn and slag, crane operation moving the ladles with molten metal, operation of the Metal Oxygen Refinement (MOR) reactor and casting of SiMn. Aerosol fractions were assessed for the analysis of the bulk elemental composition as well as for individual particle analysis. The bulk elemental composition was determined by inductively coupled plasma atomic emission spectrometry. For individual particle analysis, an electron microprobe was used in combination with wavelength-dispersive techniques. Most particles show a complex composition and cannot be attributed to a single phase. Therefore, the particles were divided into six groups according to their chemical composition: Group I, particles containing mainly metallic Fe and/or Mn; Group II, slag particles containing mainly Fe and/or Mn oxides; Group III, slag particles consisting predominantly of oxidized flux components such as Si, Al, Mg, Ca, Na and K; Group IV, particles consisting mainly of carbon; Group V, mixtures of particles from Groups II, III and IV; Group VI, mixtures of particles from Groups II and III. In raw material mixing, particles originating from the Mn ores were mostly found. In the welding of steel casings, most particles were assigned to Group II, Mn and Fe oxides. During the tapping of slag and metal, mostly slag particles from Group III were found (oxides of the flux components). During movement of the ladles, most particles came from Group II. At the MOR reactor, most of the particles belonged to the slag phase consisting of the flux components (Group III). The particles collected during the casting of SiMn were mainly attributed to the slag phase (Groups III and V). Due to the compositional complexity of the particles, toxicological investigations on the kinetics of pure compounds may not be easily associated with the results of this study.

[The Expression of Pokemon in Endometrial Carcinoma Tissue and the Correlation with Mutant p53].

PubMed

Yi, Tian-jin; Wang, Ping

2016-05-01

To detect the expression of Pokemon in endometrial carcinoma (EC), to provide preliminary theoretical basis for clarifying pathogenesis and searching for effective targets. Ninety-eight cases of endometrial tissue paraffin specimens form July 2012 to July 2014 in West China Second University Hospital, Sichuan University, were collected, including: EC group, consisting of adenocarcinoma 23 cases, adenosquamous 12 cases, serous 3 cases, mucinous 11 cases and clear cell 9 cases, and control group, consisting of atypical hyperplasia endometrium 20 cases and normal endometrium 20 cases (secretory 10 cases, hyperplasia 10 cases). Immunohistochemistry was used to detect the expression of Pokemonin each section, analyzing the correlation of Pokemon expression with clinicopathologic characteristics and p53 expression. The positive rate of Pokemon in normal endometrium was 25% (5/20), significantly lower than that in atypical hyperplasia endometrium (60.0%, 12/20) and EC (93.1%, 54/58) (P < 0.05); the rate in type II was 97. 12% (34/35), significantly higher than that in type I (86.96%, 20/23) (P = 0.018). The positive rate of Pokemon in III-IV stage, type II and Ki-67 ≥ 50 EC tissue was much higher (P = 0.012, 0.023, 0.029). In type II EC tissue, the correlation index between Pokemon and p53 is 0.669 (P = 0.000). The over expression of Pokemon upregulates the expression of mutant p53, which may be one of the carcinogenesis modes in type II EC.

Cruciferous vegetable intake is inversely associated with lung cancer risk among smokers: a case-control study

PubMed Central

2010-01-01

Background Inverse associations between cruciferous vegetable intake and lung cancer risk have been consistently reported. However, associations within smoking status subgroups have not been consistently addressed. Methods We conducted a hospital-based case-control study with lung cancer cases and controls matched on smoking status, and further adjusted for smoking status, duration, and intensity in the multivariate models. A total of 948 cases and 1743 controls were included in the analysis. Results Inverse linear trends were observed between intake of fruits, total vegetables, and cruciferous vegetables and risk of lung cancer (ORs ranged from 0.53-0.70, with P for trend < 0.05). Interestingly, significant associations were observed for intake of fruits and total vegetables with lung cancer among never smokers. Conversely, significant inverse associations with cruciferous vegetable intake were observed primarily among smokers, in particular former smokers, although significant interactions were not detected between smoking and intake of any food group. Of four lung cancer histological subtypes, significant inverse associations were observed primarily among patients with squamous or small cell carcinoma - the two subtypes more strongly associated with heavy smoking. Conclusions Our findings are consistent with the smoking-related carcinogen-modulating effect of isothiocyanates, a group of phytochemicals uniquely present in cruciferous vegetables. Our data support consumption of a diet rich in cruciferous vegetables may reduce the risk of lung cancer among smokers. PMID:20423504

Acute scrotum: is scrotal exploration the best management?

PubMed

Soccorso, G; Ninan, G K; Rajimwale, A; Nour, S

2010-09-01

Selective scrotal exploration of only those boys believed to have testicular torsion (TT), relying on history and clinical examination for diagnosis, can result in a missed or delayed diagnosis of TT. To minimise testicular loss we propose early scrotal exploration in all boys with acute scrotum (AS). To validate our approach we investigated the accuracy of clinical diagnoses of all boys with AS admitted to our unit. Clinical features and diagnoses were correlated with operative findings. A retrospective review of the records of all boys (1-16 years of age) presenting with AS between 2003 and 2007 was done. Overall, 138 boys were seen during this period. Three boys were treated conservatively. The 135 boys who underwent scrotal exploration were divided into three groups: Group A (47 boys) with a history and clinical features considered preoperatively to be consistent with torsion of appendix of testis (TAT); Group B (46 boys) whose characteristics were thought to be more consistent with TT; and finally Group C (42 boys) in whom a preoperative definitive diagnosis could not be made. The preoperative clinical features and diagnoses of the 135 boys were correlated with the operative findings. In Group A, exploration confirmed TAT in 37 (78%) boys, but in 7 (15%) boys it revealed TT. In Group B, exploration confirmed torsion in 31 (68%) boys, but 13 (28%) had TAT. In Group C, exploration revealed 39 (93%) cases of TAT and 3 (7%) cases of TT. Surgical exploration in all cases of paediatric AS offers an accurate diagnosis and treatment, thus minimising the risk of testicular loss. © Georg Thieme Verlag KG Stuttgart · New York.

[Effects of red ginseng on the congestive heart failure and its mechanism].

PubMed

Ding, D Z; Shen, T K; Cui, Y Z

1995-06-01

Forty-five patients with class IV cardiac function were divided into three groups: group I (digoxin group), group II (Red Ginseng group) and group III (Red Ginseng plus digoxin group). Each group consisted of 15 cases. After treatment, the improvement of the hemodynamical and biochemical indexes of group II and group III were greater than those of group I, and group III was the most significant amongst all. The results suggested that Red Ginseng and digoxin had synergism for treatment of congestive heart failure, and Red Ginseng was an effective and safe adjuvant without any side effects.

Teachers' Views about Educational Research: A Qualitative Study

ERIC Educational Resources Information Center

Bas, Gökhan; Kivilcim, Zafer Savas

2017-01-01

The purpose of this case study is to examine the views of teachers' about educational research. The present research is designed as a qualitative case study. The group of this study is consisted of teachers (n = 27), working in primary, middle, and high schools in the province of Nigde in Turkey. An extensive literature review was made on…

Achievement of Joint Perception in a Computer Supported Collaborative Learning Environment: A Case Study

ERIC Educational Resources Information Center

Afacan Adanir, Gulgun

2017-01-01

The case study focuses on the interactional mechanisms through which online collaborative teams co-construct a shared understanding of an analytical geometry problem by using dynamic geometry representations. The collaborative study consisted of an assignment on which the learners worked together in groups to solve a ship navigation problem as…

Assessment of the Basic Law Lesson Consistent with the Opinions of Social Studies Pre-Service Teachers

ERIC Educational Resources Information Center

Haçat, Sibel Oguz

2018-01-01

The aim of the present study is to identify the approach of social studies pre-service teachers to legal topics in the "Basic Law" lesson within the Social Studies Teaching Bachelor's Degree Program. A case study based on qualitative research methods was employed. The study group consisted of 57 social studies pre-service teachers. Data…

Evaluation of the learning curve for external cephalic version using cumulative sum analysis.

PubMed

Kim, So Yun; Han, Jung Yeol; Chang, Eun Hye; Kwak, Dong Wook; Ahn, Hyun Kyung; Ryu, Hyun Mi; Kim, Moon Young

2017-07-01

We evaluated the learning curve for external cephalic version (ECV) using learning curve-cumulative sum (LC-CUSUM) analysis. This was a retrospective study involving 290 consecutive cases between October 2013 and March 2017. We evaluated the learning curve for ECV on nulli and over para 1 group using LC-CUSUM analysis on the assumption that 50% and 70% of ECV procedures succeeded by description a trend-line of quadratic function with reliable R 2 values. The overall success rate for ECV was 64.8% (188/290), while the success rate for nullipara and over para 1 groups was 56.2% (100/178) and 78.6% (88/112), respectively. 'H' value, that the actual failure rate does not differ from the acceptable failure rate, was -3.27 and -1.635 when considering ECV success rates of 50% and 70%, respectively. Consequently, in order to obtain a consistent 50% success rate, we would require 57 nullipara cases, and in order to obtain a consistent 70% success rate, we would require 130 nullipara cases. In contrast, 8 to 10 over para 1 cases would be required for an expected success rate of 50% and 70% on over para 1 group. Even a relatively inexperienced physician can experience success with multipara and after accumulating experience, they will manage nullipara cases. Further research is required for LC-CUSUM involving several practitioners instead of a single practitioner. This will lead to the gradual implementation of standard learning curve guidelines for ECV.

[Ocular toxoplasmosis - seeking a strategy for treatment].

PubMed

Prášil, Petr; Plíšek, Stanislav; Boštík, Pavel

2014-12-01

To compare the effectiveness of treatment for ocular toxoplasmosis with pyrimethamine + clindamycin (or sulfadiazine) + a corticoid (Group 1), or azithromycin or a combination of azithromycin with a corticoid or a corticoid alone (Group 2). To determine the relapse rate depending on the treatment approach. A total of 25 patients treated for ocular toxoplasmosis over the last five years (2008-2013) were analyzed. Group 1 comprised 16 patients (3 were excluded) and Group 2 consisted of 6 patients. Visual improvement was more rapid in Group 1 (day 10.7) than in Group 2 (significant improvement on day 29.6). There were 5 cases of relapse in Group 1; in 13 cases, no relapse was noted; all patients in Group 2 relapsed (a total of 13 relapses). Twenty-three patients were positive for specific IgG antibodies. According to our experiences, pyrimethamine + clindamycin (or sulfadiazine) + a corticoid should be the treatment of choice in patients with ocular toxoplasmosis.

Dengue Outbreak in Hadramout, Yemen, 2010: An Epidemiological Perspective

PubMed Central

Ghouth, Abdulla Salim Bin; Amarasinghe, Ananda; Letson, G. William

2012-01-01

We analyzed surveillance data of a dengue outbreak (2010) reported to the Hadramout Health Office (Yemen) and retrospectively analyzed dengue-related epidemiological and entomological events reported in Hadramout from 2005 to 2009. A total of 630 immunoglobulin M (IgM) -confirmed dengue cases of 982 febrile cases was reported during the period from February to June of 2010; 12 cases died, giving case fatality a rate of 1.9%. Among febrile cases, the highest proportion of dengue cases (37.3%) was reported in the 15- to 24-year-old age group. The overall attack rate was 0.89/1,000. The average number of cases reported by month over the preceding 5-year period compared with the 2010 data is consistent with endemicity of dengue in the region and supports epidemic designation for the dengue activity in 2010. Recognition of endemic dengue transmission and potential for substantial dengue epidemics highlight the need for consistent laboratory-based surveillance that can support prevention and control activities accordingly. PMID:22665621

Quantum dressing orbits on compact groups

NASA Astrophysics Data System (ADS)

Jurčo, Branislav; Šťovíček, Pavel

1993-02-01

The quantum double is shown to imply the dressing transformation on quantum compact groups and the quantum Iwasawa decompositon in the general case. Quantum dressing orbits are described explicitly as *-algebras. The dual coalgebras consisting of differential operators are related to the quantum Weyl elements. Besides, the differential geometry on a quantum leaf allows a remarkably simple construction of irreducible *-representations of the algebras of quantum functions. Representation spaces then consist of analytic functions on classical phase spaces. These representations are also interpreted in the framework of quantization in the spirit of Berezin applied to symplectic leaves on classical compact groups. Convenient “coherent states” are introduced and a correspondence between classical and quantum observables is given.

Diet and the risk of breast cancer in a case-control study: does the threat of disease have an influence on recall bias?

PubMed

Männistö, S; Pietinen, P; Virtanen, M; Kataja, V; Uusitupa, M

1999-05-01

It has been suggested that recall bias may explain the discrepant results between case-control and cohort studies on diet and the risk of breast cancer. Two control groups were used for this case-control study of 25 to 75-year-old breast cancer cases (n = 310). The first group consisted of population controls drawn from the Finnish National Population Register (n = 454). The second group consisted of women who were referred to the same examinations as were the cases because of clinical suspicion of breast disease but who were later diagnosed as healthy (referral controls; n = 506). Because the diagnosis was unknown at the time of interview, it was possible to assess by comparing the two control groups whether the self-reporting of diet changed under the threat of disease. Dietary habits were examined using a validated, self-administered food-frequency questionnaire. Premenopausal women misreported their consumption of liquid milk products, tea, and sugar. Reporting bias was also associated with the intake of fat and vitamins. Postmenopausal women misreported consumption of milk products. When recall bias was taken into consideration, milk was associated with increased risk of premenopausal breast cancer, whereas high consumption of poultry or high intake of monounsaturated fatty acids, n-3 fatty acids, n-6 fatty acids, and vitamin E were related to lower risk. The study suggested that oil, milk, cheese, coffee and beta-carotene may act as protective factors in postmenopausal women, whereas butter and cream may be risk factors for breast cancer. In summary, it is possible that some food items may be overreported or underreported under the threat of disease in health-conscious population. However, most of the results in this study were not modified by recall bias.

Flying, Feathery and Beaked Objects: Children's Mental Models about Birds

ERIC Educational Resources Information Center

Ahi, Berat

2016-01-01

Purpose of this research is to state preschool students' mental model about birds by analyzing their drawing. This is a hermeneutical phenomenology research that is based on social constructivist philosophy. Typical case sampling method has used in order to form working group of this research. Working group consisting of 325 children who are in…

Internal consistency of the self-reporting questionnaire-20 in occupational groups

PubMed Central

Santos, Kionna Oliveira Bernardes; Carvalho, Fernando Martins; de Araújo, Tânia Maria

2016-01-01

ABSTRACT OBJECTIVE To assess the internal consistency of the measurements of the Self-Reporting Questionnaire (SRQ-20) in different occupational groups. METHODS A validation study was conducted with data from four surveys with groups of workers, using similar methods. A total of 9,959 workers were studied. In all surveys, the common mental disorders were assessed via SRQ-20. The internal consistency considered the items belonging to dimensions extracted by tetrachoric factor analysis for each study. Item homogeneity assessment compared estimates of Cronbach’s alpha (KD-20), the alpha applied to a tetrachoric correlation matrix and stratified Cronbach’s alpha. RESULTS The SRQ-20 dimensions showed adequate values, considering the reference parameters. The internal consistency of the instrument items, assessed by stratified Cronbach’s alpha, was high (> 0.80) in the four studies. CONCLUSIONS The SRQ-20 showed good internal consistency in the professional categories evaluated. However, there is still a need for studies using alternative methods and additional information able to refine the accuracy of latent variable measurement instruments, as in the case of common mental disorders. PMID:27007682

A mutation in the interferon regulatory element of HBV may influence the response of interferon treatment in chronic hepatitis B patients.

PubMed

Lu, Jia-Jie; Chen, En-Qiang; Yang, Jia-Hong; Zhou, Tao-You; Liu, Li; Tang, Hong

2012-01-10

A functional interferon regulatory element (IRE) has been found in the EnhI/X promoter region of hepatitis B virus (HBV) genome. The purpose of this study is to compare the gene order of responder and non-responder to interferon therapy in patients with chronic hepatitis B (CHB), so as to evaluate the relationship between IRE mutation and the response to interferon treatment for CHB patients. Synthetic therapeutic effect is divided into complete response (CR), partial response (PR) and non-response (NR). Among the 62 cases included in this study, 40 cases (64.5%) were in the response group (CR and PR) and 22 (35.5%) cases were in the NR group. Wild type sequence of HBV IRE TTTCACTTTC were found in 35 cases (56.5%), and five different IRE gene sequences. included TTTtACTTTC, TTTCAtTTTC, TTTtAtTTTC, TTTtACTTTt and cTTtACcTTC, were found in 22 cases (35.5%), 1 case (1.6%), 1 case (1.6%), 2 cases (3.2%) and 1 case (1.6%) respectively. There were 41.9%cases (26/62) with forth base C→T mutation, consisted of 32.5% (13/40) cases in response group and 59.1% (13/22) cases in NR group. Among the 35 cases with IRE sequences, there were 67.5% (27/40) cases in response group and 36.4% (8/22) in NR group, and the difference in IRE sequences between two groups was statistic significantly (P = 0.027). The result suggested that there is likely relationship between the forth base mutation (C→T) of IRE region and the response of HBV to Interferon therapy, and this mutation may partially decrease the inhibition effect of interferon on HBV. The forth base C→T mutation in IRE element of HBV may partially influence the response of Interferon treatment in CHB patients.

Value of case-based learning in a nuclear medicine clerkship.

PubMed

Lee, Bi-Fang; Chiu, Nan-Tsing; Li, Chung-Yi

2013-02-01

Medical imaging, including nuclear medicine, is a powerful tool for supporting learning in human morphology and physiology and understanding the nature of disease and response to treatment. The purposes of this study were to create a new case-based learning (CBL) model and to compare CBL and the traditional instructional approach (TIA) in a nuclear medicine clerkship. Internal consistency and expert validity were assessed for the instrument. A quasi-experimental, two-group pretest-posttest design was used for this study. A combination of CBL and the TIA was applied to the experimental group and the TIA only to the control group. Subjects were 70 undergraduate year 5 medical students in a clerkship curriculum. Before and after the educational intervention, students were tested with the instrument. Cronbach's α coefficients of the instrument ranged from 0.79 to 0.95, indicating acceptable to strong internal consistency. For expert validity, the suitability and fitness of the instrument were verified. The overall score was significantly improved for the experimental group (from 3.51 to 3.65, P = .03) but not for the control group (from 3.48 to 3.44, P = .49). The experimental group also showed significantly improved scores in teacher assessment and learning satisfaction, the latter the only domain showing a significant difference of the differences (P = .020). The integration of CBL, allied with the TIA, into clinical clerkships provides medical students with the opportunity to learn a nuclear medicine curriculum in an interactive and case-based format tailored specifically for medical students. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Experiences of Leaders in One Texas School District Integrating Social Media as a Communication Medium: Bounded Phenomenological Case Study

ERIC Educational Resources Information Center

Lewis, Bradley D.

2017-01-01

The purpose of this bounded phenomenological case study was to investigate the experiences of leaders in one Texas school district integrating social media into communication practices. The participants in this study were twelve campus leaders, four district level leaders, and the superintendent of schools. The focus groups consisted of three…

A Case Study of How Professional Learning Communities Influence Morale and Rigor in the Classroom

ERIC Educational Resources Information Center

McDonough, Jessica S.

2013-01-01

The purpose of this qualitative case study was to explore how professional learning communities influence teacher morale and rigor in the classroom. Participants of the study consisted of six to eight core subject teachers from two 4-A high school campuses in southeast Texas. Two focus group interviews were conducted, one at each school, and…

Online Case-Based Learning Design for Facilitating Classroom Teachers' Development of Technological, Pedagogical, and Content Knowledge

ERIC Educational Resources Information Center

Saltan, Fatih

2017-01-01

The aim of this study is to investigate whether, and if so how, online case-based learning influence pre-service classroom teachers' self-confidence on technological pedagogical content knowledge (TPACK). To achieve the goal, a control group pretest-posttest quasi experimental design was used. Participants of the study consisted of 160 pre-service…

A behaviourally anchored rating scale for evaluating the use of the WHO surgical safety checklist: development and initial evaluation of the WHOBARS.

PubMed

Devcich, Daniel A; Weller, Jennifer; Mitchell, Simon J; McLaughlin, Scott; Barker, Lauren; Rudolph, Jenny W; Raemer, Daniel B; Zammert, Martin; Singer, Sara J; Torrie, Jane; Frampton, Chris Ma; Merry, Alan F

2016-10-01

Realising the full potential of the WHO Surgical Safety Checklist (SSC) to reduce perioperative harm requires the constructive engagement of all operating room (OR) team members during its administration. To facilitate research on SSC implementation, a valid and reliable instrument is needed for measuring OR team behaviours during its administration. We developed a behaviourally anchored rating scale (BARS) for this purpose. We used a modified Delphi process, involving 16 subject matter experts, to compile a BARS with behavioural domains applicable to all three phases of the SSC. We evaluated the instrument in 80 adult OR cases and 30 simulated cases using two medical student raters and seven expert raters, respectively. Intraclass correlation coefficients were calculated to assess inter-rater reliability. Internal consistency and instrument discrimination were explored. Sample size estimates for potential study designs using the instrument were calculated. The Delphi process resulted in a BARS instrument (the WHOBARS) with five behavioural domains. Intraclass correlation coefficients calculated from the OR cases exceeded 0.80 for 80% of the instrument's domains across the SSC phases. The WHOBARS showed high internal consistency across the three phases of the SSC and ability to discriminate among surgical cases in both clinical and simulated settings. Fewer than 20 cases per group would be required to show a difference of 1 point between groups in studies of the SSC, where α=0.05 and β=0.8. We have developed a generic instrument for comprehensively rating the administration of the SSC and informing initiatives to realise its full potential. We have provided data supporting its capacity for discrimination, internal consistency and inter-rater reliability. Further psychometric evaluation is warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Voice disorders related to job stress in teaching: a case-control study].

PubMed

Giannini, Susana Pimentel Pinto; Latorre, Maria do Rosário Dias de Oliveira; Ferreira, Leslie Piccolotto

2012-11-01

This case-control study aimed to test the association between voice disorders and job stress among public schoolteachers in São Paulo, Brazil. The groups consisted of teachers with (n = 165) and without (n = 105) voice-related complaints. Both groups answered the questionnaires Conditions of Vocal Production and Job Stress Scale. Analysis of cases and controls showed comparable samples, differing only by vocal symptoms. There was a statistically significant difference between cases and controls in relation to job stress involving high strain (OR = 2.1; 95%CI: 1.1-3.9), which places high demands combined with low job control. High strain in cases in this study represents the highest risk of physical and mental disorders for teachers. Loss of voice prevents teachers from continuing in their professional role, eliminates their professional identity, and jeopardizes their career.

[Simultaneous meningitis caused by Candida and tuberculosis as manifestation of AIDS].

PubMed

Arias Gómez, M; Requena Caballero, I; Lema Devesa, C; Suárez Dono, J; Llovo Martínez, J; Martino, V

2001-09-01

Opportunistic germs meningoencephalitis plays an important role within neurologic pathology in aids. Treponema pallidum and Mycobacterium tuberculosis among bacteries, Cryptococcus neoformans in fungus group, Toxoplasma gondii in protozoos group and Papovavirus JC in virus one are the most frequently implicated germs. Sometimes infections are mixed. We present a simultaneous meningitis case produced by Candida albicans and Mycobacterium tuberculosis that coursed with neutrophilic pleocytosis in CSF and normal glucose CSF levels, consisting the clinical debut of aids. Repeated CSF examinations are the diagnostic clue owing, as in our case, instauration of early treatment. Present case of simultaneous tuberculous and candidiasic meningitis is the first one described in a HIV positive patient.

Elective ambulatory surgical care in Ireland-why it needs to be better coded, classified and managed.

PubMed

Keane, Frank; Hammond, Laura; Kelliher, Gerry; Mealy, Ken

2017-12-12

In the year to July 2017, surgical disciplines accounted for 73% of the total national inpatient and day case waiting list and, of these, day cases accounted for 72%. Their proper classification is therefore important so that patients can be managed and treated in the most suitable and efficient setting. We set out to sub-classify the different elective surgical day cases treated in Irish public hospitals in order to assess their need to be managed as day cases and the consistency of practice between hospitals. We analysed all elective day cases that came under the care of surgeons between January 2014 and December 2016 and sub-classified them into those that were (A) true day case surgical procedures; (B) minor surgery or outpatient procedures; (C) gastrointestinal endoscopies; (D) day case, non-surgical interventions and (E) unclassified or having no primary procedure identified. Of 813,236 day case surgical interventions performed over 3 years, 26% were adjudged to accord with group A, 41% with B, 23% with C, 5% with D and 5% with E. The ratio of A to B procedures did not vary significantly across the range of hospital types. However, there were some notable variations in coding and practices between hospitals. Our findings show that many day cases should have been performed as outpatient procedures and that there were variations in coding and practices between hospitals that could not be easily explained. Outpatient procedure coding and a better, more consistent, classification of day cases are both required to better manage this group of patients.

A Group Decision Framework with Intuitionistic Preference Relations and Its Application to Low Carbon Supplier Selection.

PubMed

Tong, Xiayu; Wang, Zhou-Jing

2016-09-19

This article develops a group decision framework with intuitionistic preference relations. An approach is first devised to rectify an inconsistent intuitionistic preference relation to derive an additive consistent one. A new aggregation operator, the so-called induced intuitionistic ordered weighted averaging (IIOWA) operator, is proposed to aggregate individual intuitionistic fuzzy judgments. By using the mean absolute deviation between the original and rectified intuitionistic preference relations as an order inducing variable, the rectified consistent intuitionistic preference relations are aggregated into a collective preference relation. This treatment is presumably able to assign different weights to different decision-makers' judgments based on the quality of their inputs (in terms of consistency of their original judgments). A solution procedure is then developed for tackling group decision problems with intuitionistic preference relations. A low carbon supplier selection case study is developed to illustrate how to apply the proposed decision model in practice.

A Group Decision Framework with Intuitionistic Preference Relations and Its Application to Low Carbon Supplier Selection

PubMed Central

Tong, Xiayu; Wang, Zhou-Jing

2016-01-01

This article develops a group decision framework with intuitionistic preference relations. An approach is first devised to rectify an inconsistent intuitionistic preference relation to derive an additive consistent one. A new aggregation operator, the so-called induced intuitionistic ordered weighted averaging (IIOWA) operator, is proposed to aggregate individual intuitionistic fuzzy judgments. By using the mean absolute deviation between the original and rectified intuitionistic preference relations as an order inducing variable, the rectified consistent intuitionistic preference relations are aggregated into a collective preference relation. This treatment is presumably able to assign different weights to different decision-makers’ judgments based on the quality of their inputs (in terms of consistency of their original judgments). A solution procedure is then developed for tackling group decision problems with intuitionistic preference relations. A low carbon supplier selection case study is developed to illustrate how to apply the proposed decision model in practice. PMID:27657097

Introducing Managers to Expert Systems.

ERIC Educational Resources Information Center

Finlay, Paul N.; And Others

1991-01-01

Describes a short course to expose managers to expert systems, consisting of (1) introductory lecture; (2) supervised computer tutorial; (3) lecture and discussion about knowledge structuring and modeling; and (4) small group work on a case study using computers. (SK)

Maintaining consistency in distributed systems

NASA Technical Reports Server (NTRS)

Birman, Kenneth P.

1991-01-01

In systems designed as assemblies of independently developed components, concurrent access to data or data structures normally arises within individual programs, and is controlled using mutual exclusion constructs, such as semaphores and monitors. Where data is persistent and/or sets of operation are related to one another, transactions or linearizability may be more appropriate. Systems that incorporate cooperative styles of distributed execution often replicate or distribute data within groups of components. In these cases, group oriented consistency properties must be maintained, and tools based on the virtual synchrony execution model greatly simplify the task confronting an application developer. All three styles of distributed computing are likely to be seen in future systems - often, within the same application. This leads us to propose an integrated approach that permits applications that use virtual synchrony with concurrent objects that respect a linearizability constraint, and vice versa. Transactional subsystems are treated as a special case of linearizability.

Consistent comparison of angle Kappa adjustment between Oculyzer and Topolyzer Vario topography guided LASIK for myopia by EX500 excimer laser.

PubMed

Sun, Ming-Shen; Zhang, Li; Guo, Ning; Song, Yan-Zheng; Zhang, Feng-Ju

2018-01-01

To evaluate and compare the uniformity of angle Kappa adjustment between Oculyzer and Topolyzer Vario topography guided ablation of laser in situ keratomileusis (LASIK) by EX500 excimer laser for myopia. Totally 145 cases (290 consecutive eyes )with myopia received LASIK with a target of emmetropia. The ablation for 86 cases (172 eyes) was guided manually based on Oculyzer topography (study group), while the ablation for 59 cases (118 eyes) was guided automatically by Topolyzer Vario topography (control group). Measurement of adjustment values included data respectively in horizontal and vertical direction of cornea. Horizontally, synclastic adjustment between manually actual values (dx manu ) and Oculyzer topography guided data (dx ocu ) accounts 35.5% in study group, with mean dx manu /dx ocu of 0.78±0.48; while in control group, synclastic adjustment between automatically actual values (dx auto ) and Oculyzer topography data (dx ocu ) accounts 54.2%, with mean dx auto /dx ocu of 0.79±0.66. Vertically, synclastic adjustment between dy manu and dy ocu accounts 55.2% in study group, with mean dy manu /dy ocu of 0.61±0.42; while in control group, synclastic adjustment between dy auto and dy ocu accounts 66.1%, with mean dy auto /dy ocu of 0.66±0.65. There was no statistically significant difference in ratio of actual values/Oculyzer topography guided data in horizontal and vertical direction between two groups ( P =0.951, 0.621). There is high consistency in angle Kappa adjustment guided manually by Oculyzer and guided automatically by Topolyzer Vario topography during corneal refractive surgery by WaveLight EX500 excimer laser.

Description of a Website Resource for Turbulence Modeling Verification and Validation

NASA Technical Reports Server (NTRS)

Rumsey, Christopher L.; Smith, Brian R.; Huang, George P.

2010-01-01

The activities of the Turbulence Model Benchmarking Working Group - which is a subcommittee of the American Institute of Aeronautics and Astronautics (AIAA) Fluid Dynamics Technical Committee - are described. The group s main purpose is to establish a web-based repository for Reynolds-averaged Navier-Stokes turbulence model documentation, including verification and validation cases. This turbulence modeling resource has been established based on feedback from a survey on what is needed to achieve consistency and repeatability in turbulence model implementation and usage, and to document and disseminate information on new turbulence models or improvements to existing models. The various components of the website are described in detail: description of turbulence models, turbulence model readiness rating system, verification cases, validation cases, validation databases, and turbulence manufactured solutions. An outline of future plans of the working group is also provided.

Telomere length and early trauma in schizophrenia.

PubMed

Riley, Gabriella; Perrin, Mary; Vaez-Azizi, Leila M; Ruby, Eugene; Goetz, Raymond R; Dracxler, Roberta; Walsh-Messinger, Julie; Keefe, David L; Buckley, Peter F; Szeszko, Philip R; Malaspina, Dolores

2018-04-02

Childhood trauma is emerging as a risk factor for schizophrenia, but its mechanism with respect to etiology is unknown. One possible pathway is through leucocyte telomere length (LTL) shortening, a measure of cellular aging associated with trauma. This study examined early trauma and LTL shortening in schizophrenia and considered sex effects. The early trauma inventory (ETI) was administered to 48 adults with DSM-5 schizophrenia and 18 comparison participants. LTL was measured using qPCR. Cases had significantly more global trauma (F=4.10, p<0.01) and traumatic events (F=11.23, p<0.001), but case and control groups had similar LTL (1.91±0.74 and 1.83±0.62: p=0.68). The association of early trauma and LTL differed by sex in cases and controls (Fisher's R: Z<0.05). Significant negative associations were shown in male cases and, conversely, in female controls. For example, physical punishment was associated LTL shortening in males' cases (r=-0.429, p<01). Only female controls showed significant telomere shortening in association with early trauma. This data confirms the substantial excess of early trauma among schizophrenia cases. There were significant sex-differences in the relationship of the trauma to LTL, with only male cases showing the expected shortening. There were converse sex effects in the control group. Mean LTL was notably similar in cases and controls, despite the trauma-related shortening in male cases, cigarette smoking, older age and chronic illness of the cases. Factors may lengthen LTL in some schizophrenia cases. The converse sex differences in the cases are consistent with findings defective sexual differentiation in schizophrenia, consistent with other findings in the field. Copyright © 2018 Elsevier B.V. All rights reserved.

Using Online Digital Tools and Video to Support International Problem-Based Learning

ERIC Educational Resources Information Center

Lajoie, Susanne P.; Hmelo-Silver, Cindy; Wiseman, Jeffrey; Chan, Lap Ki; Lu, Jingyan; Khurana, Chesta; Cruz-Panesso, Ilian; Poitras, Eric; Kazemitabar, Maedeh

2014-01-01

The goal of this study is to examine how to facilitate cross-cultural groups in problem-based learning (PBL) using online digital tools and videos. The PBL consisted of two video-based cases used to trigger student-learning issues about giving bad news to HIV-positive patients. Mixed groups of medical students from Canada and Hong Kong worked with…

Development of Protocol Materials in Teacher Education: A Case Study in Relating Theory and Practice.

ERIC Educational Resources Information Center

University of South Florida, Tampa.

A protocol materials program was developed to (1) train personnel who produce, use, and make budgetary decisions about protocol materials and (2) produce and disseminate effective materials and knowledge acquired as a result of the program. Two groups were selected to meet the goals of the program--one group consisting of project directors who…

Evaluation of the Course of the Flight Simulators from the Perspective of Students and University Teachers

ERIC Educational Resources Information Center

Kaysi, Feyzi; Bavli, Bünyamin; Gürol, Aysun

2016-01-01

The study evaluates the flight simulators course which was opened to fulfill the intermediate staff need of the sector. To collect data, Qualitative techniques were applied. Within this scope, the case study method was employed in the study. The study group consisted of students and instructors. In-depth and focus group interviews were conducted…

What lessons can operational planners infer from the NATO Partnership for Peace Program for the execution of contemporary US Regionally Aligned Force and UK Adaptable Force Security Cooperation missions

DTIC Science & Technology

2016-05-26

research questions consist of three groups . The first group addresses an analysis of PfP. The second group determines contemporary US and UK strategy...The second group of research questions focuses upon current US, UK security cooperation initiatives and the specific policy objectives they...Ambition, Austerity and the Case for Rethinking UK Military Spending.” Oxford Research Group . Last modified May 13, 2015. Accessed September 17, 2015

Association Study of Klotho Gene Polymorphism With Calcium Oxalate Stones in The Uyghur Population of Xinjiang, China.

PubMed

Ali, Abdusamat; Tursun, Halmurat; Talat, Alim; Abla, Akpar; Muhtar, Erpan; Zhang, Tao; Mahmut, Murat

2017-01-18

The aim of the present study was to investigate the correlation between Klotho gene polymorphisms andcalcium oxalate stones in Xinjiang Uyghur people. We compared 128 patients with calcium oxalate stones (case group) and 94 healthypeople (control group), detected the genotype and allele distributions of single-nucleotide polymorphisms (SNPs)of the Klotho gene (rs3752472, rs650439, and rs1207568) by reverse transcription polymerase chain reaction. The distributions of the genotype and allele frequencies of the SNPs were consistent with the Hardy-Weinberg equilibrium in the two groups. There were statistically significant differences between the genotype andallele distributions of rs3752472 between the case and control groups; the allele frequencies in the case/controlgroups were C = 240 (93.7%)/151 (80.3%) and T = 16 (6.3%)/37 (19.7%). There was no statistically significantdifference in the genotype distribution of rs650439 between the case and control groups, but there was a differencein the allele distribution; the allele frequencies in the case/control groups were A = 202 (78.9%)/143 (57.2%) andT = 54 (21.1%)/107 (42.8%). There were no statistically significant differences in genotype and allele distributionsbetween the case and control groups of rs1207568; the allele frequencies in the case/control groups were C = 194(71.3%)/145 (77.1%) and T = 78 (28.7%)/43 (22.9%). In rs3752472, the risk for patients with the C and A allelesincreased by 3.675 and 2.799 times, respectively. The rs3752472 and rs650439 SNPs are related to the risk of calcium oxalate stones in Xinjiang Uyghurpeople, and might be one of the risk factors.

EMG median frequency changes in the neck-shoulder stabilizers of symptomatic office workers when challenged by different physical stressors.

PubMed

Szeto, Grace Pui Yuk; Straker, Leon Melville; O'Sullivan, Peter Bruce

2005-12-01

The problem of work-related neck and upper limb disorders among computer users has been reported extensively in the literature, and commonly cited risk factors include static posture, speed and force of keyboard operation. The present study examined changes in median frequency (MF) of the neck-shoulder muscles in symptomatic and asymptomatic office workers when they were exposed to these three physical stressors. A quasi-experimental Case-Control design was used to examine MF changes in two groups of female office workers when they were subjected to controlled doses of computer work involving prolonged static posture, increased typing speed and increased typing force. The MF of four major neck-shoulder muscles were examined bilaterally and compared between groups. The MF changes over time-at-task did not clearly illustrate any muscle fatigue mechanism. However, Case Group consistently showed trends for higher MF than the Control Group, and this pattern was observed in response to all three physical stressors. The consistent group differences in MF suggest different muscle recruitment strategies between symptomatic and asymptomatic office workers. These results implied that symptomatic individuals had altered motor control, which may have important implications in understanding the etiology of work-related musculoskeletal disorders.

Prospective Comparison of Collagen Plug (Angio-Seal™) and Suture-Mediated (the Closer S™) Closure Devices at Femoral Access Sites

PubMed Central

Park, Yulri; Choo, Sung Wook; Lee, Sung Hoon; Shin, Sung Wook; Do, Young Soo; Byun, Hong Sik; Park, Kwang Bo; Jeon, Pyoung

2005-01-01

Objective Rapid and effective hemostasis at femoral puncture sites minimizes both the hospital stay and patient discomfort. Therefore, a variety of arterial closure devices have been developed to facilitate the closure of femoral arteriotomy. The objective of this prospective study was to compare the efficacy of two different closure devices; a collagen plug device (Angio-Seal) and a suture-mediated closure device (the Closer S). Materials and Methods From March 28, 2003 to August 31, 2004, we conducted a prospective study in which 1,676 cases of 1,180 patients were treated with two different types of closure device. Angio-Seal was used in 961 cases and the Closer S in 715 cases. The efficacy of the closure devices was assessed, as well as complications occurring at the puncture sites. Results Successful immediate hemostasis was achieved in 95.2% of the cases treated with Angio-Seal, and in 89.5% of the cases treated with the Closer S (p < 0.05). The rates of minor and major complications occurring between the two groups were not significantly different. In the Closer S group, we observed four major complications (0.6%), that consisted of one massive retroperitoneal hemorrhage (surgically explored) and three pseudoaneurysms. In the Angio-Seal group, we observed three major complications (0.3%) that consisted of one femoral artery occlusion, one case of infection treated with intravenous antibiotics and one pseudoaneurysm. Conclusion The use of Angio-Seal was found to be more effective than that of the Closer S with regard to the immediate hemostasis of the femoral puncture sites. However, we detected no significant differences in the rate at which complications occurred. PMID:16374083

Results of neurolysis in established upper limb Volkmann's ischemic contracture

PubMed Central

Meena, Dinesh K; Thalanki, Srikiran; Patni, Poornima; Meena, Ram Khiladi; Bairawa, Dinesh; Bhatia, Chirag

2016-01-01

Background: Treatment of established cases of Volkmann's ischemic contracture (VIC) of upper limb is very tedious. Since the period of Volkmann, various experimental works are being performed for its treatment, but none are effective. Disabilities from nerve palsy and hand muscle paralysis are more problematic than any other deformity in VIC. To solve these problems, we conducted a study to see the result of neurolysis of median and ulnar nerve and their subcutaneous placement in established cases of VIC. Materials and Methods: Twelve cases of established VIC operated between July 2007 and August 2010 with complete records and followup were included in the study. VIC of lower limb and contracture of nonischemic etiology were excluded from the study. Their evaluation was done by the British Medical Research Council grading system for sensory and motor recovery. Followup was done for an average period of 24.3 months (range 15-30 months) (the average age was 8.3 years). Results: To study the results, we divided the cases into two series. One group consisted of cases which were operated within 6 months from onset of VIC. The second group consisted of cases which were operated after 6 months from onset of VIC. Our results revealed that there was no statistically significant difference between the two groups operated, though both had significant improvement in motor and sensory recovery in both median and ulnar nerve distribution. Conclusions: Neurolysis of the nerves definitely improved the outcome for motor and sensory components of median and ulnar nerves but the timing of the surgery did not play a role in the outcome contrary to the clinical assumption. This study can serve as a template and further such studies could help us find the answer to a long standing issue. PMID:27904214

Evaluation of the learning curve for external cephalic version using cumulative sum analysis

PubMed Central

Kim, So Yun; Chang, Eun Hye; Kwak, Dong Wook; Ahn, Hyun Kyung; Ryu, Hyun Mi; Kim, Moon Young

2017-01-01

Objective We evaluated the learning curve for external cephalic version (ECV) using learning curve-cumulative sum (LC-CUSUM) analysis. Methods This was a retrospective study involving 290 consecutive cases between October 2013 and March 2017. We evaluated the learning curve for ECV on nulli and over para 1 group using LC-CUSUM analysis on the assumption that 50% and 70% of ECV procedures succeeded by description a trend-line of quadratic function with reliable R2 values. Results The overall success rate for ECV was 64.8% (188/290), while the success rate for nullipara and over para 1 groups was 56.2% (100/178) and 78.6% (88/112), respectively. ‘H’ value, that the actual failure rate does not differ from the acceptable failure rate, was −3.27 and −1.635 when considering ECV success rates of 50% and 70%, respectively. Consequently, in order to obtain a consistent 50% success rate, we would require 57 nullipara cases, and in order to obtain a consistent 70% success rate, we would require 130 nullipara cases. In contrast, 8 to 10 over para 1 cases would be required for an expected success rate of 50% and 70% on over para 1 group. Conclusion Even a relatively inexperienced physician can experience success with multipara and after accumulating experience, they will manage nullipara cases. Further research is required for LC-CUSUM involving several practitioners instead of a single practitioner. This will lead to the gradual implementation of standard learning curve guidelines for ECV. PMID:28791265

Masticatory muscle and temporomandibular joint pain in Croatian war veterans with posttraumatic stress disorder.

PubMed

Uhac, Ivone; Tariba, Petra; Kovac, Zoran; Simonić-Kocijan, Suncana; Lajnert, Vlatka; Mesić, Vesna Fugosić; Kuis, Davor; Braut, Vedrana

2011-12-01

The aim of this study was to investigate the prevalence and intensity of masticatory muscle and temporomandibular joint (TMJ) pain in Croatian war veterans with posttraumatic stress disorder (PTSD). The examined group consisted of 100 Croatian war veterans, in whom PTSD had previously been diagnosed. Patients were compared with 92 subjects who had not taken part in the war and in whom PTSD was excluded by psychiatric examination. The clinical examination consisted of palpation of the masticatory muscles, the prominent neck musculature, and TMJ. The examination technique used and the definition of items were previously tested for reliability and validity. 93% of the subjects with PTSD had masticatory muscle tenderness compared to 45.65% of the subjects in the control group (chi2 = 51.46, p < 0.0001). The most frequent painful location in the subjects with PTSD was the left lateral pterygoid site in 88%, and in subjects of the control group the right lateral pterygoid site in 28.26% of cases. The most painful location in the PTSD group was the left lateral pterygoid site in 72%, and in the control group the left posterior digastric in 4.35% of cases. 58% of the subjects with PTSD had TMJ tenderness compared to 3.26% of subjects in the control group (chi2 = 66.23, p < 0.0001). The most frequent painful location of TMJ in both groups was the left posterior capsule; in the PTSD group 38% and in subjects in the control group 2.17% of cases. The most painful location was the left posterior capsule in 28% of subjects with PTSD, while not one subject in the control group reported severe painful sensitivity. The very high frequency and intensity of pain in subjects with PTSD confirms the effect of stress on muscle and joint sensitivity, i.e. perception of pain.

Dialectical Behavior Therapy of Anorexia and Bulimia Nervosa among Adolescents: A Case Series

ERIC Educational Resources Information Center

Salbach-Andrae, Harriet; Bohnekamp, Inga; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Miller, Alec L.

2008-01-01

The aim of this study was to describe a case series of adolescents (mean age = 16.5 years, SD = 1.0) with anorexia nervosa (AN) and bulimia nervosa (BN) who received dialectical behavior therapy (DBT). Twelve outpatients with AN and BN took part in 25 weeks of twice weekly therapy consisting of individual therapy and a skills training group.…

Prevalence of dental attrition in in vitro fertilization children of West Bengal.

PubMed

Kar, Sudipta; Sarkar, Subrata; Mukherjee, Ananya

2014-01-01

Dental attrition is one of the problems affecting the tooth structure. It may affect both in vitro fertilization (IVF) and spontaneously conceived children. This study was aimed to evaluate and to compare the prevalence of dental attrition in deciduous dentition of IVF and spontaneously conceived children. In a cross-sectional case control study dental attrition status of 3-5 years old children were assessed. The case group consisted of term, singleton babies who were the outcome of IVF in the studied area in 2009. The control group consisted of term, first child, singleton and spontaneously conceived 3-5 years old children who were also resident of the studied area. A sample of 153 IVF and 153 spontaneously conceived children was examined according to Hansson and Nilner classification. Statistical analysis was carried out using Chi-square tests (χ(2) ) or Z test. No statistically significant difference found in studied (IVF children) and control group (spontaneously conceived children). IVF children are considered same as spontaneously conceived children when studied in relation to dental attrition status.

Nasal potential difference outcomes support diagnostic decisions in cystic fibrosis.

PubMed

Tridello, Gloria; Menin, Laura; Pintani, Emily; Bergamini, Gabriella; Assael, Baroukh Maurice; Melotti, Paola

2016-09-01

When cystic fibrosis (CF) is suspected Nasal Potential Difference (NPD) measurements are proposed to support controversial diagnosis: we investigated appropriate outcomes at the CF Centre of Verona. NPD were measured in 196 subjects: 50 non-CF, 65 classical CF (the reference group) and 81 with uncertain CF (case group). Discriminating power was determined by comparison between several outcomes from the CF reference group versus non-CF: basal, amiloride, 0Cl, isoproterenol, ATP, Delta-amiloride, Delta-0Cl, Delta-isoproterenol, Delta-ATP, Delta-isoproterenol+Delta-0Cl, Wilschanski Index (WI) and Sermet score (SS). The most appropriate cut-off values for variables with the best discriminating power were then applied to the case group. Descriptive statistics, logistic regression models and ROC curve analysis were applied. WI and SS were the most powerful in discriminating CF from non-CF subjects. In the reference group sensitivity of the 0.82 WI cut-off was 98%, specificity 96%; both sensitivity and specificity of the -0.44 SS cut-off value were 100%. For the case group, WI and SS were, respectively, consistent with CF diagnosis in 94% and 92% of the cases. Formulae have the highest discriminating power and can support the diagnosis in uncertain cases; they should be utilized for standardized interpretation of NPD for diagnosis and possibly for clinical research. Copyright © 2016. Published by Elsevier B.V.

Interactive learning research: application of cognitive load theory to nursing education.

PubMed

Hessler, Karen L; Henderson, Ann M

2013-06-25

The purpose of this research was to investigate the effectiveness of interactive self-paced computerized case study compared to traditional hand-written paper case study on the outcomes of student knowledge, attitude, and retention of the content delivered. Cognitive load theory (CLT) provided the theoretical framework for the study. A quasi-experimental pre-test post-test design with random group assignment was used to measure by self-report survey student cognitive load and interactivity level of the intervention. Student scores on quizzes in semester 1 and post-test follow-up quizzes in semester 3 were assessed for the intervention's effects on knowledge retention. While no significant statistical differences were found between groups, the students in the interactive case study group rated their case study as more fun and interactive. These students also scored consistently higher on the post-test quiz items in their third semester, showing the viability of using CLT to improve student retention of nursing curricula information.

CD5-expressing B-cell lymphomas/leukemias: relatively high frequency of CD5+ B-cell lymphomas with an overall poor prognosis in Nagasaki Japan.

PubMed

Kamihira, S; Hirakata, Y; Atogami, S; Sohda, H; Tsuruda, K; Yamada, Y; Tomonaga, M

1996-06-01

To characterize CD5+ B-cell neoplasms in Japan, where chronic lymphocytic leukemia (CLL) is rare and of different subtypes in comparison with Western countries, we collected 58 cases of CD5+ B-cell lymphomas/leukemias and analyzed their clinicopathologic features. According to the French-American-British (FAB) and standard histologic classification, the cases corresponded to small lymphocytic lymphoma (SLL, group I; n = 22, consisting of CLL, n = 10, CLL/PL, n = 3, and CLLmixed, n = 7); intermediate differentiated lymphoma/mantle cell lymphoma (IDL/MCL, group II, n = 18); and others with CD5-positive lymphomas (group III, n = 18). The CD5+ B-cell lymphomas showed morphologic and prognostic variability among the three groups. The clinical and immunophenotypic features were remarkably consistent in leukemic disease being seen in 73% of all cases, splenomegaly in 63%, and intense CD19, CD20, surface membrane immunogobulin M (SmIgM) or SmIgM and SmIgD, light-chain expression, and no CD10 expression. The median survival time of groups I, II, and III was 7.8, 3.3, and 0.8 years, respectively. These findings suggest that CD5 antigens may serve as valid markers for the prognosis and clinical features of B-cell lymphomas and that CD5+ B-cell lymphomas with an overall poor prognosis occurs at a relatively high frequency in Japan. This also suggests that a combination of immunophenotypic and morphologic features is of value for characterizing CD5+ B-cell neoplasms.

[Psychometric properties of the Eating Disorder Inventory (EDI-2) in adolescents].

PubMed

Salbach-Andrae, Harriet; Schneider, Nora; Bürger, Arne; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Holzhausen, Martin

2010-05-01

The present study examines the psychometric properties of the German version of the Eating Disorder Inventory EDI-2 (1997) in 371 adolescents aged 13 to 18 years. Internal consistency, convergent and divergent validity were examined and a confirmatory factor analysis was conducted. Internal consistency was high for the group of patients and satisfactory for both control groups. Associations with other clinical instruments point in the expected direction and support the external validity of the EDI-2. The EDI-2 differentiated very well between the group of eating disorder patients (n=71) and the female (n=150) and male control groups (n=150). A discriminant analysis demonstrated that 86.0% of the cases were correctly classified, and a confirmatory factor analysis largely supported the six-factor structure generated by the German version of the EDI-2 (Thiel et al., 1997).

Review of ear, nose and throat foreign bodies in Sarawak General Hospital. A five year experience.

PubMed

Chiun, Kian Chai; Tang, Ing Ping; Tan, Tee Yong; Jong, Doris Evelyn Yah Hui

2012-02-01

Ear, nose and throat foreign bodies are common in ENT clinical practice. This study was designed to establish the local data of otorhinolaryngeal foreign bodies in term of prevalence among paediatric and adult groups, the clinical features, types of foreign body at different sites, and laterality of foreign bodies. This study was carried out at ENT department, Sarawak General Hospital, Malaysia, from 1st January 2005 to 31st December 2009. A total of 1084 cases were included and statistically analyzed. Ear foreign bodies showed the highest incidence which was consisted of 480 (44.3%) cases, followed by nose in 270 (24.9%) cases, pharynx in 251 (23.2%) cases, esophagus in 57 (5.3%) cases and laryngo-tracheobronchial tree in 26 (2.4%) cases. Otorhinolaryngeal foreign bodies occurred more frequently in 0-10 year old age group which constituted 651 (60.1%) cases. The descending order of frequency for foreign body sites in adult was pharynx (17.2%), ear (12.8%), esophagus (3.1%), nose (1.7%) and laryngo-tracheobronchial tree (1.1%). The type of foreign bodies varies with age group and site of foreign body lodgement. In general, common foreign bodies in both adult and children were food related, with the additional of small objects such as plastic toy in paediatric group. Otorhinolaryngeal foreign bodies were found more frequently in children. The types of foreign body were different from age group and sites of foreign body lodgement. The local food constituted the highest incidence of ear, nose, and throat foreign bodies with additional of plastic toys in paediatric group.

Service guidelines based on Resource Utilization Groups Version III for Home Care provide decision-making support for case managers.

PubMed

Collister, Barbara; Stein, Glenda; Katz, Deborah; DeBruyn, Joan; Andrusiw, Linda; Cloutier, Sheila

2012-01-01

Increasing costs and budget reductions combined with increasing demand from our growing, aging population support the need to ensure that the scarce resources allocated to home care clients match client needs. This article details how Integrated Home Care for the Calgary Zone of Alberta Health Services considered ethical and economic principles and used data from the Resident Assessment Instrument for Home Care (RAI-HC) and case mix indices from the Resource Utilization Groups Version III for Home Care (RUG-III/HC) to formulate service guidelines. These explicit service guidelines formalize and support individual resource allocation decisions made by case managers and provide a consistent and transparent method of allocating limited resources.

Role of Kabat rehabilitation in facial nerve palsy: a randomised study on severe cases of Bell's palsy.

PubMed

Monini, S; Iacolucci, C M; Di Traglia, M; Lazzarino, A I; Barbara, M

2016-08-01

The treatment of Bell's palsy (BP), based on steroids and/or antiviral drugs, may still leave a certain percentage of affected subjects with disfiguring sequelae due to incomplete recovery. The different procedures of physical rehabilitation have not been demonstrated to play a favourable role in this disorder. The aim of the present study was to compare functional outcomes in severe cases of Bell's palsy when treated by steroids alone or by steroids accompanied by Kabat physical rehabilitation. This prospective study included 94 subjects who showed sudden facial nerve (FN) palsy with House-Brackmann grade IV or V and who were divided into two groups on the basis of the therapeutic approach: one group (a) was treated by steroids, and the other (b) received steroids in combination with physical rehabilitation. Medical treatment consisted in administration of steroids at a dosage of 60 mg per day for 15 days; physical rehabilitative treatment consisted in proprioceptive neuromuscular facilitation according to Kabat, and was administered to one of the two groups of subjects. Recovery rate, degree of recovery and time for recovery were compared between the two groups using the Mann-Whitney and univariate logistic regression statistical tests (Ward test). Kabat patients (group b) had about 20 times the odds of improving by three HB grades or more (OR = 17.73, 95% CI = 5.72 to 54.98, p < 0.001) than patients who did not receive physical treatment (group a). The mean speed of recovery in group b was the half of that recorded for group a (non-Kabat subjects). No difference was observed in the incidence of synkineses between the two groups. Steroid treatment appears to provide better and faster recovery in severe cases (HB IV and V) of BP when complemented with Kabat physical rehabilitation. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

Selection bias due to differential participation in a case-control study of mobile phone use and brain tumors.

PubMed

Lahkola, Anna; Salminen, Tiina; Auvinen, Anssi

2005-05-01

To evaluate the possible selection bias related to the differential participation of mobile phone users and non-users in a Finnish case-control study on mobile phone use and brain tumors. Mobile phone use was investigated among 777 controls and 726 cases participating in the full personal interview (full participants), and 321 controls and 103 cases giving only a brief phone interview (incomplete participants). To assess selection bias, the Mantel-Haenszel estimate of odds ratio was calculated for three different groups: full study participants, incomplete participants, and a combined group consisting of both full and incomplete participants. Among controls, 83% of the full participants and 73% of the incomplete participants had regularly used a mobile phone. Among cases, the figures were 76% and 64%, respectively. The odds ratio for brain tumor based on the combined group of full and incomplete participants was slightly closer to unity than that based only on the full participants. Selection bias tends to distort the effect estimates below unity, while analyses based on more comprehensive material gave results close to unity.

The Chinese version of the Child and Adolescent Scale of Environment (CASE-C): validity and reliability for children with disabilities in Taiwan.

PubMed

Kang, Lin-Ju; Yen, Chia-Feng; Bedell, Gary; Simeonsson, Rune J; Liou, Tsan-Hon; Chi, Wen-Chou; Liu, Shu-Wen; Liao, Hua-Fang; Hwang, Ai-Wen

2015-03-01

Measurement of children's participation and environmental factors is a key component of the assessment in the new Disability Evaluation System (DES) in Taiwan. The Child and Adolescent Scale of Environment (CASE) was translated into Traditional Chinese (CASE-C) and used for assessing environmental factors affecting the participation of children and youth with disabilities in the DES. The aim of this study was to validate the CASE-C. Participants were 614 children and youth aged 6.0-17.9 years with disabilities, with the largest condition group comprised of children with intellectual disability (61%). Internal structure, internal consistency, test-retest reliability, convergent validity, and discriminant (known group) validity were examined using exploratory factor analyses, Cronbach's α coefficient, intra-class correlation coefficients (ICC), correlation analyses, and univariate ANOVAs. A three-factor structure (Family/Community Resources, Assistance/Attitude Supports, and Physical Design Access) of the CASE-C was produced with 38% variance explained. The CASE-C had adequate internal consistency (Cronbach's α=.74-.86) and test-retest reliability (ICCs=.73-.90). Children and youth with disabilities who had higher levels of severity of impairment encountered more environmental barriers and those experiencing more environmental problems also had greater restrictions in participation. The CASE-C scores were found to distinguish children on the basis of disability condition and impairment severity, but not on the basis of age or sex. The CASE-C is valid for assessing environmental problems experienced by children and youth with disabilities in Taiwan. Copyright © 2014 Elsevier Ltd. All rights reserved.

Use of Cardiac Injury Markers in the Postmortem Diagnosis of Sudden Cardiac Death.

PubMed

Carvajal-Zarrabal, Octavio; Hayward-Jones, Patricia M; Nolasco-Hipolito, Cirilo; Barradas-Dermitz, Dulce Ma; Calderón-Garcidueñas, Ana Laura; López-Amador, Noé

2017-09-01

In the daily practice of forensic pathology, sudden cardiac death (SCD) is a diagnostic challenge. Our aim was to determine the usefulness of blood biomarkers [creatine kinase CK-MB, myoglobin, troponins I and T (cTn-I and T), and lactate dehydrogenase] measured by immunoassay technique, in the postmortem diagnosis of SCD. Two groups were compared, 20 corpses with SCD and 8 controls. Statistical significance was determined by variance analysis procedures, with a post hoc Tukey multiple range test for comparison of means (p < 0.05). SCD cases showed significantly higher levels (p < 0.05) of cTn-T and cTn-I compared to the control group. Although only cases within the first 8 h of postmortem interval were included, and the control group consisted mainly of violent death cases, our results suggest that blood troponin levels may be useful to support a diagnosis of SCD. © 2017 American Academy of Forensic Sciences.

Accuracy of probing attachment levels using a new computerized cemento-enamel junction probe.

PubMed

Deepa, R; Prakash, Shobha

2012-01-01

The assessment of clinical attachment level (CAL) represents the gold standard for diagnosing and monitoring periodontal disease. The aim of the present study was to evaluate the performance of the newly introduced cemento-enamel junction (CEJ) probe in detecting CAL, using CEJ as a fixed reference point, and to compare the CEJ probe with the Florida stent probe (FSP) as well as with a standard manual probe, University of North Carolina-15 (UNC-15). Three examiners recorded the probing attachment level in 384 sites in case group (chronic periodontitis), and in 176 sites, in control group (healthy periodontal status), using the three probes. Subjects included both the sexes and ranged from 35 to 45 years. The experimental design was structured to balance the intra- and inter-examiner consistency at the same site during the two visits. CEJ probe showed higher intra-and inter-examiner consistency over both FSP and UNC-15 in both the case and control groups. Frequency distribution of differences of various magnitudes of repeated measurements ≤1 mm was in the higher range of 86.8% to 87.5% for CEJ probe. The FSP was more reproducible than UNC-15 in detecting relative attachment level (RAL). CEJ automated probe was found to have greatest potential for accuracy and consistency in detecting CAL than FSP and UNC-15. The automated probes appeared to be more reproducible than manual probes.

Tutoring Trainees to Suture: An Alternative Method for Learning How to Suture and a Way to Compensate for a Lack of Suturing Cases.

PubMed

Wongkietkachorn, Apinut; Rhunsiri, Peera; Boonyawong, Pangpoom; Lawanprasert, Attaporn; Tantiphlachiva, Kasaya

2016-01-01

Tutoring in suturing was developed to compensate for a shortage of suturing cases. The objective of this study was to compare ideal suturing score (ISS; 9 points), suturing time (min:sec), and suture placement error (mm) between medical students completing the suturing tutoring program and medical students attending ordinary medical school training program. Participants consisted of 2 groups of medical students who had never performed suturing. The study group had the role of suturing tutor to teach interested high school students. The control group consisted of volunteers from the ordinary medical school program. Skills measurement was performed by having students from both the groups perform 3 vertical mattress sutures on a model. The study group was tested at weeks 1, 9, and 10 to assess improvement. Both the groups were tested at week 10 to compare final learning outcome. There were 41 and 40 participants in the study group and the control group, respectively. ISS was significantly improved in the study group from week 1-week 10 (7.0 ± 1.3 vs. 8.2 ± 0.9, p = 0.01). At week 10, the study group had a higher mean ISS than the control group (8.2 ± 0.9 vs. 7.8 ± 1.1, p = 0.68). Mean suturing time and mean placement error were also lower in the study group at the end of suturing training (5:1 ± 1:0 vs. 5:2 ± 1:2, p = 0.13; 7.4 ± 7.4 vs. 8.0 ± 10.8, p = 0.44). Tutoring trainees to suture can improve a student's ability to learn how to suture. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Evaluation of Aneurysm Neck Angle Change After Endovascular Aneurysm Repair Clinical Investigations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Le, Trong Binh; Moon, Mi Hyoung; Jeon, Yong Sun, E-mail: radjeon@inha.ac.kr

PurposeTo evaluate the aneurysm neck angle changes and post-endovascular aneurysm repair (EVAR) complications.MethodsWe retrospectively analyzed 72 cases of elective EVAR for abdominal aortic aneurysm among 109 consecutive cases from December 2005 to April 2014. Patients were divided into angulated and non-angulated groups. The angulated group was defined as neck angulation ≥60°. Neck angle was evaluated pre- and post-EVAR during short- (within 1 month), mid- (3–6 months), and long-term (>1 year) follow-up. Aneurysm sac diameter change, aneurysm neck morphology other than angulation, endoleaks, and other post-procedural complications were also documented.ResultsA total of 34 patients were enrolled in the angulated group. There were no statisticalmore » differences in age, sex, follow-up duration, and aneurysm neck profile between the two groups (p > 0.05). Both groups showed statistically significant and consistent decreases in angulation during the follow-up period (p < 0.01). The angulated group revealed 22.45 % more straightening than the non-angulated group. Recoil of the Endurant device occurred in the angulated group. No statistically significant intergroup differences were observed in any endoleaks, complications, or re-intervention rates (p > 0.05). Pre-EVAR angle was the only predictor for post-procedural angle change (p < 0.001).ConclusionEVAR is applicable for patients with highly angulated aneurysm neck and provides consistent neck straightening over long-term follow-up. Recoil was evident in the angulated group using the Endurant device.« less

Clinical effect of traditional Chinese spinal orthopedic manipulation in treatment of Functional Abdominal Pain Syndrome.

PubMed

Xing, Liyang; Qu, Liuxin; Chen, Hong; Gao, Song

2017-06-01

To evaluate the clinical effect of Traditional Chinese Spinal Orthopedic Manipulation (TCSOM) in treating Functional Abdominal Pain Syndrome (FAPS) in comparison with Pinaverium Bromide (Dicetel, PBD), and to assess a possible cause for FAPS. 60 cases of FAPS patients were randomly assigned to the TCSOM group and PBD group according to the random number table method. The TCSOM group was treated with thumb pressing manipulation, every other day in the first week, and once every three days in the second week, for 5 times treatments. Patients in the PBD group were instructed to take 50mg 3 times a day, consistently for 2 weeks. The symptoms of pre-treatment and post-treatment were assessed on a visual analog scale (VAS) pain score. A symptom improvement rating (SIR) was implemented in order to evaluate the effects of the treatments, and to statistically compare the two groups. The symptoms of 21 patients of the TCSOM group were resolved soon after the first spinal manipulation treatment and 4 cases were significantly improved. The VAS pain scores in the TCSOM group were significantly lower than those in the PBD group after 2 weeks treatment. According to the SIR based on VAS, the TCSOM research group included 20 cases with excellent results, 8 cases with good, and 2 cases with poor. There were no side effects in the TCSOM group after treatment. Based on VAS, the PBD research group reported 6 cases with excellent results, 8 cases with good and 16 cases with poor. All cases were statistically analyzed, revealing a significant difference (P<0.001) between the two groups. TCSOM group performed much better than PBD group for relief of the symptoms of FAPS. Thumb pressing manipulation on the thoracic and/or lumbar region can correct the displacement of inter-vertebral discs and/or vertebra, resolving the stimuli caused by pressure exerting on the nerves and vessels around the spine. with thumb pressing manipulation on the Back-Shu acupoints, the Jiaji (EX-B2) and the governor vessel acupoint had a very good clinical effect for abdominal pain indicating that it is an effective treatment for FAPS. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Access to Higher Education

ERIC Educational Resources Information Center

Briscoe, Felecia; De Oliver, Miguel

2006-01-01

This case study researches the degree to which the location and services offered by a multicampus university, geographically situated consistent with the commercial principles of a large mass-market enterprise, facilitate access for educationally underserved groups. First, the necessity of democratizing educational access to an underprivileged…

[Identification of human papilloma viruses (HPV) in inflammatory states and ear neoplasms].

PubMed

Rydzewski, Bogdan; Goździcka-Józefiak, Anna; Sokalski, Jerzy; Matusiak, Monika; Durzyński, Lukasz

2007-01-01

Human Papilloma Virus has a strong relation to oropharyngeal mucosa and is considered to be responsible for a wide range of upper respiratory tract pathologies, like laryngeal papilloma. There's a hypothesis, that it plays a significant role in middle ear chronic inflammations and neoplasm's. MATERIAL AND METHODIC. The examination was carried on a group of 53 patients, 39 of which was suffering from granulation tissue chronic otitis media, 7-cholesteatomatous otitis media, 6--middle ear malignant neoplasm, and 1 middle and/or external ear benign neoplasm. The control group consisted of 5 patients operated on: otosclerosis--4 cases and post-traumatic tympanic membrane perforation--1 case. The material was postoperative tissue, like polyps, inflammatory granulation tissue, cholesteatoma masses and malignant neoplasm's tissue. In the whole group of 53 examined cases, HPV DNA was confirmed in 22 cases (41.5%), in that group oncogenic types 16 or 18 in 12 cases (22.6%), and in 14 cases (26.4%) types 6 or 11. In a group of chronic granulomatous otitis media DNA characteristic for Papilloma was identified in 12 cases (25.6%), in it in 9 cases DNA HPV type 6 or 11 was confirmed, and in 7 cases type 16 or 18. Among cholesteatomatous chronic otitis media HPV DNA types 6 or 11 was identified in 70%. In every case of middle ear malignant neoplasm a presence of high-risk DNA Papilloma types 16 or 18 was confirmed. In any case of control group HPV DNA was detected. The results has been compared with other authors examinations and it is claimed that they confirm the observation, that Human Papilloma Viruses may be a factor, that might play an important role in pathology of chronic otitis media and ear neoplasm's. It is concluded, that differences in percentages of HPV presence in chronic inflammations (70%) and ear neoplasm's may be explained by viral co-infection during bacterial c. o. m. Viral infection probably evolves carcinogenesis, which leads to a neoplastic growth.

[An Analysis of Placement of a Self-Expanding Metallic Stent as Bridge to Surgery for Surgical Resection of StageⅣ Obstructive Colorectal Cancers].

PubMed

Kawahara, Yohei; Terada, Itsuro; Terai, Shiro; Watanabe, Toshifumi; Amaya, Koji; Yamamoto, Seiichi; Kaji, Masahide; Maeda, Kiichi; Shimizu, Koichi

2015-11-01

In our institution, placement of a self-expanding metallic stent (SEMS) for obstructive colorectal cancer to avoid emergency operations, namely as a bridge to surgery (BTS), was introduced in April 2012. Here, we assess the efficacy and safety of pre-operative SEMS placement for treatment of Stage Ⅳ obstructive colorectal cancer. We analyzed a total of 44 cases of Stage Ⅳ colorectal cancer, which consisted of 13 obstructive cases that were surgically resected following SEMS placement as BTS (BTS group), and 31 cases that were resected in elective operations without pre-operative SEMS placement (Ope group), from April 2012 to August 2014. None of the patients had any adverse events during the SEMS procedure or after SEMS placement, and all patients of BTS group could undergo the planned operations after sufficient decompression. In the postoperative period, 1 patient of BTS group (7.7%) had anastomosis bleeding, but no other complications, including anastomosis leakage, were observed in BTS group. However more progressive primary tumors were resected in BTS group (p=0.0115), there were no significant differences for post-operative course between the 2 groups; this indicated avoiding high-risk emergency operations contributed to adequate short-term outcomes in BTS group comparable to those in Ope group. SEMS placement as BTS could be performed safely for Stage Ⅳ obstructive colorectal cancer cases, and was 1 of the effective strategies for local treatment.

Investigation to identify a resource-efficient case-control methodology for determining antibiotics associated with Clostridium difficile infection.

PubMed

Chung, Philip; Currie, Brian; Guo, Yi; Talansky, Moshe; Brown, Shakara; Ostrowsky, Belinda

2014-10-01

Antimicrobial exposure remains an important risk factor for developing Clostridium difficile infection (CDI). Efficient method to identify antibiotics associated with CDI is important for formulating strategies to curtail their use. As a prelude to a more extensive Agency for Healthcare Research and Quality-funded project (Evaluation & Research on Antimicrobial Stewardship's Effect on Clostridium difficile), we undertook an exploratory evaluation to determine a resource-efficient method for identifying antibiotic targets for antimicrobial stewardship interventions. The study compared a series of 6 focused case-control studies. Cases consisted of patients with laboratory-confirmed CDI admitted from July-October 2009. Controls were selected from patients without CDI hospitalized during the same period. Five groups of controls were matched to cases (2:1 ratio) using group-specific matching criteria, including admission date, age, type of admission, length of stay (LOS) to discharge, and/or LOS to CDI diagnosis. The final control group was selected from patients who received antibiotics during hospitalization. Data, including demographics and antibiotic usage, were compared between case and control groups. A total of 126 cases were matched to 6 groups of 252 controls. For control groups 1-5, the use of piperacillin and tazobactam, ceftriaxone or cefepime, ciprofloxacin or moxifloxacin, intravenous vancomycin, azithromycin, and antibiotics of last resort were significantly more frequent in case than control patients. For the final control group, the associations between ceftriaxone or cefepime, and ciprofloxacin or moxifloxacin use and CDI no longer persisted. This could in part be explained by differences in comorbidities between case and control patients even with stringent matching criteria. Use of a simple matching strategy to conduct case-control studies is an efficient and feasible compromise strategy, especially in resource-limited settings, to identify high-risk antibiotics associated with CDI. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

What is case management in palliative care? An expert panel study

PubMed Central

2012-01-01

Background Case management is a heterogeneous concept of care that consists of assessment, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and service needs. This paper describes the result of an expert panel procedure to gain insight into the aims and characteristics of case management in palliative care in the Netherlands. Methods A modified version of the RAND®/University of California at Los Angeles (UCLA) appropriateness method was used to formulate and rate a list of aims and characteristics of case management in palliative care. A total of 76 health care professionals, researchers and policy makers were invited to join the expert panel, of which 61% participated in at least one round. Results Nine out of ten aims of case management were met with agreement. The most important areas of disagreement with regard to characteristics of case management were hands-on nursing care by the case manager, target group of case management, performance of other tasks besides case management and accessibility of the case manager. Conclusions Although aims are agreed upon, case management in palliative care shows a high level of variability in implementation choices. Case management should aim at maintaining continuity of care to ensure that patients and those close to them experience care as personalised, coherent and consistent. PMID:22709349

Associating Mathematical Stories That Are Written by the 8th Grade Students Who Are Studying at Advantageous and Disadvantageous Regions' Schools with Their Mathematical Perceptions: Istanbul Case

ERIC Educational Resources Information Center

Bahadir, Elif

2017-01-01

In this study, mathematical stories written by 50 middle school students were analyzed. The study group consisted of two different student groups who were living in advantageous and disadvantageous regions in Istanbul. At the first stage, the students were presented a mathematical story called "My Fractal Tree", then told about what the…

Effect of Using Different Vehicle Weight Groups on the Estimated Relationship Between Mass Reduction and U.S. Societal Fatality Risk per Vehicle Miles of Travel

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wenzel, Tom P.

This report recalculates the estimated relationship between vehicle mass and societal fatality risk, using alternative groupings by vehicle weight, to test whether the trend of decreasing fatality risk from mass reduction as case vehicle mass increases, holds over smaller increments of the range in case vehicle masses. The NHTSA baseline regression model estimates the relationship using for two weight groups for cars and light trucks; we re-estimated the mass reduction coefficients using four, six, and eight bins of vehicle mass. The estimated effect of mass reduction on societal fatality risk was not consistent over the range in vehicle masses inmore » these weight bins. These results suggest that the relationship indicated by the NHTSA baseline model is a result of other, unmeasured attributes of the mix of vehicles in the lighter vs. heavier weight bins, and not necessarily the result of a correlation between mass reduction and societal fatality risk. An analysis of the average vehicle, driver, and crash characteristics across the various weight groupings did not reveal any strong trends that might explain the lack of a consistent trend of decreasing fatality risk from mass reduction in heavier vehicles.« less

Thai health education program for improving TB migrant's compliance.

PubMed

Khortwong, Pornsak; Kaewkungwal, Jaranit

2013-03-01

Investigate the effectiveness of health education programs by using the PRECEDE-PROCEED Model to improve non-Thai migrant TB patient's compliance during treatment. This quasi-intervention study was conducted in three targeted hospitals, between August 2009 and December 2010. The study sample consisted of 100 cases, 50 cases who registered in Samutsakorn Province served as the intervention group and 50 cases who registered in Samutprakarn Province served as the control group. At the end of the health education intervention, the intervention group showedsignificantly improved health-behavior scores in nine domains-health promotion, health education, predisposing, reinforcing, enabling factors, behavior and lifestyle, environment, and health status, which were also significantly higher than the control group (p < 0.001). The percentage of patients achieving successful treatment outcomes was 76% in the intervention group and 62% in the control group. The tuberculosis treatment and care program, and the associated health education interventions enabled migrants to complete the treatment regimen and achieve treatment success. It could also help TB staff develop an appropriate program and clear understanding of TB control among migrants. It is recommended that this type of information and health education program be used in other hospitals and healthcare settings providing TB services for migrants throughout the nation.

Type 2 diabetes mellitus: A risk factor for Helicobacter pylori infection: A hospital based case-control study

PubMed Central

Devrajani, Bikha Ram; Shah, Syed Zulfiquar Ali; Soomro, Aftab Ahmed; Devrajani, Tarachand

2010-01-01

Objective: To determine the frequency of Helicobacter pylori (H. pylori) infection in diabetic and non-diabetic patients and to compare the frequency of H. pylori infection in both groups. Study Design: Case control. Place and Duration: Department of Medicine, Liaquat University Hospital from October 2007 to March 2008. Materials and Methods: This hospital-based case-control study was conducted on 148 subjects and divided into two groups i.e. type 2 diabetics and non-diabetics; each group consisting of 74 patients. All diabetic patients of ≥ 35 years of age, both gender and the known cases with history of dyspepsia, epigastric pain or bloating for more than a month were screened for Helicobacter pylori infection. The collected data of both groups was evaluated and separated for analysis. Results: Majority of the patients were male with mean age ± SD, 52.86 ± 8.51. Among the diabetic group, HpSA was positive in 54/74 (73%), whereas in the non-diabetic group HpSA was positive in 38/74 (51.4%) cases. Fasting blood glucose was identified as low in 04 (5.40%) H. pylori infected - diabetic patients where as the blood glucose level of 07 (9.45%) known diabetic patients was raised despite the ongoing medication. Conclusion: Diabetic patients are more prone and at risk to acquire H. Pylori infection. Therefore proper monitoring of blood glucose level and screening for H. pylori infection are effective preventive measures for this life threatening infection. PMID:20431802

Controls Astrophysics and Structures Experiment in Space (CASES) advanced studies and planning

NASA Technical Reports Server (NTRS)

Wu, S. T.

1989-01-01

The CASES (Controls, Astrophysics, and Structures Experiment in Space) program consists of a flight demonstration of CSI (Controls-Structures Interactions) technology on the Space Shuttle. The basis structure consists of a 32 m deployable boom with actuators and sensors distributed along its length. Upon deployment from the Orbiter bay, the CASES structure will be characterized dynamically and its deformations controlled by a series of experimental control laws; and cold gas thrusters at its tip will be used to orient the Orbiter to a fixed celestial reference. The scientific observations will consist of hard x-ray imaging, at high resolution, of the Sun and the Galactic center. The hard x-ray observations require stable (few arc min) pointing at these targets for one or more position-sensitive proportional counters in the Orbiter bay, which view the object to be imaged through an aperture-encoding mask at the boom tip. This report gives the concensus developed at the second CASES Science Working Group meeting, which took place at NASA Marshall Space Flight Center May 16-17, 1990. An earlier paper and scientific summaries are available and form the basis for the present discussion.

A case report of somnambulism associated with olanzapine.

PubMed

Faridhosseini, Farhad; Zamani, Azar

2012-01-01

Somnambulism consists of a group of behaviors leading to unwanted movements during sleep or even sleepwalking. Medications applied for psychiatric disorders could increase the likelihood of somnambulism in adults. The following article is a case report of somnambulism seen in a patient with schizophrenia, which occurred after remission of an acute episode following treatment with olanzapine. When olanzapine dosage was decreased, no previous and similar symptoms were reported after 6 months of follow up.

[Case management as a methodology for connecting the health and social care systems in Spain].

PubMed

Garcés, Jorge; Ródenas, Francisco

2015-10-01

The aim of this paper is to present the assessment of a case management project, implemented with chronic patients in Valencia, for the integration of health and social care. This project is linked with the 'Sustainable Socio-Health Model'. Health department 06 in Valencia. The target groups were chronic patients of 65 years and over. A non-randomized non-blinded comparative study with an intervention and control group. The intervention consisted in the creation of an interdisciplinary case management team, the use of a common portfolio of resources, and its application to a pilot sample with an intervention period of 6-9 months. Diseases (ICD-9), functional capacity, use of health and social resources, satisfaction, unit cost services. There was an increase in the combined use of health and social resources in the intervention group, which included social day centers (21.8% in the intervention group compared to 9.8% in the control group), in coordination with primary care (suggested as the only health resource in 55.4% of cases). There was a decrease in the number of medical visits in the intervention group (43.6% versus 74.5% in the control group). Increased patient satisfaction (55.5% in the intervention group compared to 29.4% in the control group) was observed. At least an extra 4.4% of patients were treated using hospital resources without increasing costs. Case management using a common unique portfolio of health and social resources can improve the coordination of resources, increases patient satisfaction and increases the capacity of using of hospital resources. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Shock Index Correlates with Extravasation on Angiographs of Gastrointestinal Hemorrhage: A Logistics Regression Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nakasone, Yutaka, E-mail: n-yutaka@cd5.so-net.ne.jp; Ikeda, Osamu; Yamashita, Yasuyuki

We applied multivariate analysis to the clinical findings in patients with acute gastrointestinal (GI) hemorrhage and compared the relationship between these findings and angiographic evidence of extravasation. Our study population consisted of 46 patients with acute GI bleeding. They were divided into two groups. In group 1 we retrospectively analyzed 41 angiograms obtained in 29 patients (age range, 25-91 years; average, 71 years). Their clinical findings including the shock index (SI), diastolic blood pressure, hemoglobin, platelet counts, and age, which were quantitatively analyzed. In group 2, consisting of 17 patients (age range, 21-78 years; average, 60 years), we prospectively appliedmore » statistical analysis by a logistics regression model to their clinical findings and then assessed 21 angiograms obtained in these patients to determine whether our model was useful for predicting the presence of angiographic evidence of extravasation. On 18 of 41 (43.9%) angiograms in group 1 there was evidence of extravasation; in 3 patients it was demonstrated only by selective angiography. Factors significantly associated with angiographic visualization of extravasation were the SI and patient age. For differentiation between cases with and cases without angiographic evidence of extravasation, the maximum cutoff point was between 0.51 and 0.0.53. Of the 21 angiograms obtained in group 2, 13 (61.9%) showed evidence of extravasation; in 1 patient it was demonstrated only on selective angiograms. We found that in 90% of the cases, the prospective application of our model correctly predicted the angiographically confirmed presence or absence of extravasation. We conclude that in patients with GI hemorrhage, angiographic visualization of extravasation is associated with the pre-embolization SI. Patients with a high SI value should undergo study to facilitate optimal treatment planning.« less

A proposal on teaching methodology: cooperative learning by peer tutoring based on the case method

NASA Astrophysics Data System (ADS)

Pozo, Antonio M.; Durbán, Juan J.; Salas, Carlos; del Mar Lázaro, M.

2014-07-01

The European Higher Education Area (EHEA) proposes substantial changes in the teaching-learning model, moving from a model based mainly on the activity of teachers to a model in which the true protagonist is the student. This new framework requires that students develop new abilities and acquire specific skills. This also implies that the teacher should incorporate new methodologies in class. In this work, we present a proposal on teaching methodology based on cooperative learning and peer tutoring by case study. A noteworthy aspect of the case-study method is that it presents situations that can occur in real life. Therefore, students can acquire certain skills that will be useful in their future professional practice. An innovative aspect in the teaching methodology that we propose is to form work groups consisting of students from different levels in the same major. In our case, the teaching of four subjects would be involved: one subject of the 4th year, one subject of the 3rd year, and two subjects of the 2nd year of the Degree in Optics and Optometry of the University of Granada, Spain. Each work group would consist of a professor and a student of the 4th year, a professor and a student of the 3rd year, and two professors and two students of the 2nd year. Each work group would have a tutoring process from each professor for the corresponding student, and a 4th-year student providing peer tutoring for the students of the 2nd and 3rd year.

Clothing damage analysis in alleged sexual assaults--the need for a systematic approach.

PubMed

Boland, C A; McDermott, S D; Ryan, J

2007-04-11

Clothing damage analysis is an integral part of the examinations carried out in sexual assault type cases. This analysis can be used to corroborate different versions of events and is at its most powerful in elucidating false allegation cases and consent cases. The purpose of this study was to determine to what extent people with varying levels of forensic awareness, experience and training could correctly carry out damage analysis. Two participant groups were asked to take part in this study. Group A ('forensic group') comprised participants at a forensic science conference, and Group B ('student group') comprised students undertaking a degree course in Forensic Science. Each group was given a practical workshop consisting of a lecture outlining common fabric types and general features observed in different damage types. Each participant was subsequently shown 25 pieces of 'damage' and asked to identify both the type of fabric construction (knit or weave) and the type of damage (cut, tear, rip, wear and tear). The ability to identify fabric construction and damage types varied within the two groups studied and across the groups. The forensic group performed better both in fabric and damage assessment than the student group. This paper suggests a systematic approach to clothing damage analysis to maximise the benefits that can be obtained from this area of forensic science and to minimise the subjectivity within the field.

Prevalence of dental attrition in in vitro fertilization children of West Bengal

PubMed Central

Kar, Sudipta; Sarkar, Subrata; Mukherjee, Ananya

2014-01-01

CONTEXT: Dental attrition is one of the problems affecting the tooth structure. It may affect both in vitro fertilization (IVF) and spontaneously conceived children. AIMS: This study was aimed to evaluate and to compare the prevalence of dental attrition in deciduous dentition of IVF and spontaneously conceived children. SETTINGS AND DESIGN: In a cross-sectional case control study dental attrition status of 3-5 years old children were assessed. The case group consisted of term, singleton babies who were the outcome of IVF in the studied area in 2009. SUBJECTS AND METHODS: The control group consisted of term, first child, singleton and spontaneously conceived 3-5 years old children who were also resident of the studied area. A sample of 153 IVF and 153 spontaneously conceived children was examined according to Hansson and Nilner classification. STATISTICAL ANALYSIS USED: Statistical analysis was carried out using Chi-square tests (χ2 ) or Z test. RESULTS: No statistically significant difference found in studied (IVF children) and control group (spontaneously conceived children). CONCLUSIONS: IVF children are considered same as spontaneously conceived children when studied in relation to dental attrition status. PMID:24829529

[Etiologies of non-hemolytic jaundice in infants: a retrospective analysis of 3113 cases].

PubMed

Peng, Xiaorong; Xu, Hongmei

2015-06-01

To investigate the causes of non-hemolytic jaundice among infants in Chongqing, China from the period of 1982 to 2011 and to determine whether the etiologies have changed over the past 30 years. The medical records of 3 113 infants,aged 1 month to 1 year,admitted to our hospital with non-hemolytic jaundice were collected and stratified according to decade-long time periods: group A (1982-1991), n=537; group B (1992-2001), n=786; group C (2002-2011), n=1 790. Data on sex, age, etiology and bilirubin level were retrospectively assessed using the chi-square test. In the three groups, boys consistently accounted for the majority of cases (group A:74.3%, group B:66.7%, group C:62.6%). In group A, 52% of the patients were 1-2 months of age; the peak age of patients in both group B and C was 2-3 months (group B:67.8%, group C:61.0%). Group A showed the highest level of patients with mildly elevated total bilirubin level (80.3%); however, moderately elevated total bilirubin level was most frequent in group B (53.4%) and group C (49.7%). The main etiologic diagnoses of the patients in group A were cytomegalovirus (CMV) infection (31.7%), sepsis (18.2%), hepatitis B virus (HBV) (1.3%), and biliary tract anomalies (1.3%); 46.6% of the cases had unclear cause. The main etiologic diagnoses of the cases in group B were CMV infection (36.0%), sepsis (21.5%), breast milk jaundice (2.0%), and HBV (1.9%); 37.9% of the cases had unclear cause. The main etiologic diagnoses of the cases in group C were CMV infection (42.6%), sepsis (7.5%), breast milk jaundice (17.7%), and biliary tract anomalies (2.46%); 29.1% of the cases had unclear cause. In Chongqing, infective factors, especially CMV, remain the main cause of nonhemolytic jaundice in infants, but bacterial etiologies have declined over the past 30 years.Non-infective factors, such as biliary tract anomalies and inherited metabolic diseases, have trended upwards. Although there has been great progress in the clinical management of non-hemolytic jaundice in infants, etiological diagnosis remains a challenge and further study is needed to eliminate this condition.

The influence of participation in target-shooting sport for children with inattentive, hyperactive and impulsive symptoms - A controlled study of best practice.

PubMed

Månsson, Annegrete Gohr; Elmose, Mette; Dalsgaard, Søren; Roessler, Kirsten K

2017-03-28

Practising target-shooting sport requires focused attention and motoric steadiness. A previous non-controlled pilot study suggests that children with impairing symptoms of attention-deficit/hyperactivity disorder (ADHD) benefit from participating in target-shooting sport in local shooting associations, as rated by parents and teachers. This study aims at examining if, and to which extent, target-shooting sport reduces parent- and teacher-reported severity of inattentiveness, hyperactivity, and impulsivity in children with attention difficulties, and if, and to which extend, target-shooting sport improves the children's wellbeing and quality of life. A mixed method approach is applied. A non-blinded, waiting list controlled study is combined with a case study, consisting of interviews and observations. The intervention consists of children practising target-shooting sport, by attending a local shooting association, once a week for six months, during regular school hours. Data from questionnaires (ADHD-RS, SDQ, Kidscreen-27), as well as a computerized continued performance test (Qb test), measure the children's activity and attention. The study includes 50 children in an intervention group and 50 children in a waiting list control group. The Qb test collects data from at least 20 children from the intervention group and at least 20 children from the waiting list control group. Data from the questionnaires and Qb-test is collected at baseline, and six months post intervention. In addition, a case study is carried out, consisting of interviews of at least five children from the intervention group, their parents, teachers and shooting instructors. Observations are carried out, when children are in school and while they are attending the local shooting association. The case study adds to an in-depth understanding of children's participation in target-shooting sports. At present, little is known about the effects and influence of practising target-shooting sport for children experiencing difficulties with inattentiveness, hyperactivity and impulsivity. This study is expected to contribute to an understanding of the influence of participating in target-shooting sports on inattentive, hyperactive and impulsive symptoms, and the effects on the children's psychological wellbeing and quality of life. Current Controlled Trials NCT02898532 . Retrospectively registered 14 September 2016.

Maxillofacial fracture experiences: a review of 152 cases.

PubMed

Aydin, Osman Enver; Tan, Onder; Algan, Said; Kuduban, Selma Denktas; Barin, Ensar Zafer; Cinal, Hakan; Sarici, Murat; Avsar, Umit

2012-12-01

The fractures of facial structures lead to great morbidity. Cross-sectional studies are needed to evaluate the current state of maxillofacial traumas. Thus, this study aims to evaluate these experiences and to compare these results with the current literature. The medical records of the maxillofacial fracture cases hospitalized between January 2004 and November 2011 were examined. The age, sex, etiology, fracture localization and treatment method for each case were documented. The affected facial bones were grouped as mandible, maxilla, zygoma, naso-orbitoethmoid complex (NOEC) and blow-out. Nasal fractures were excluded. The cases were assigned to 3 groups with respect to age (below 16, above 65 and between 17 and 64). The chi Square test was used to assess the significance of the difference in mandibular fracture rates in the pediatric population compared to others. The total number of cases was 152. The total number of fractures was 185. Of the 152 cases, 117 were male and 35 were female. The average age was 31.4 (±18.3), ranging between 2 and 81. Thirty-one cases were 16 years old or less. Nine cases were 65 years old or more. Mandibular and zygomatic fractures were the most prevalent fractures in the adult group. Mandibular fractures were significantly more common in the pediatric age group compared to rest of the population (X(2), p<0.05). Traffic accidents were the most common etiological factor, with a 55.3% ratio. Open reduction and internal fixation was the most frequently conducted treatment modality in all age groups. Retrospective studies are important for the projection of future prospects. In summary, our results indicate that pediatric fractures are mostly in the lower face and usually affect the condylar region, which is consistent with the literature.

Double pituitary adenomas: six surgical cases.

PubMed

Sano, T; Horiguchi, H; Xu, B; Li, C; Hino, A; Sakaki, M; Kannuki, S; Yamada, S

1999-05-01

While double pituitary adenomas have been found in approximately 1% of autopsy pituitaries, those in surgically resected material have been only rarely reported. We report herein 6 cases of double pituitary adenomas, which consisted of two histologically and/or immunohistochemically different areas among approximately 450 surgical specimens. Five out of 6 patients were men and the age was ranged between 18 and 61 years old. All these 6 patients presented acromegaly or acrogigantism and hyperprolactinemia was noted in 3 patients. In 2 patients (cases 1 and 2) the two adenomas belonged to different adenoma groups (GH-PRL-TSH group and FSH/LH group), while in the remaining 4 patients (cases 3-6) the two adenomas belonged to the same group (GH-PRL-TSH group). Thus, in all patients at least one of the two adenomas was GH-producing adenoma. Reasons for a high incidence of GH-producing adenomas in surgically resected double pituitary adenomas may include the presence of a variety of histologic subtypes among GH-producing adenomas and the advantage of cytokeratin immunostaining to distinguish these subtypes. In regard to pathogenesis of double pituitary adenomas, adenomas in cases 1 and 2 may be of multicentric occurrence, while those in cases 3-6 may occur through different clonal proliferation within originally one adenoma, resulting in diverse phenotypic expressions. Since there were patients with familial MEN 1 (case 2) and familial pituitary adenoma unrelated MEN 1 (case 3), genetic background should be also considered. Double pituitary adenomas in surgically resected material may not be so infrequent. Further molecular analysis will provide new insights into understanding the pathogenesis of pituitary adenomas and their mechanisms of multidirectional phenotypic diffrentiation.

ABO blood group and risk of cancer: A register-based cohort study of 1.6 million blood donors.

PubMed

Vasan, Senthil K; Hwang, Jinseub; Rostgaard, Klaus; Nyrén, Olof; Ullum, Henrik; Pedersen, Ole B V; Erikstrup, Christian; Melbye, Mads; Hjalgrim, Henrik; Pawitan, Yudi; Edgren, Gustaf

2016-10-01

The associations between ABO blood group and cancer risk have been studied repeatedly, but results have been variable. Consistent associations have only been reported for pancreatic and gastric cancers. We estimated associations between different ABO blood groups and site-specific cancer risk in a large cohort of healthy blood donors from Sweden and Denmark. A total of 1.6 million donors were followed over 27 million person-years (20 million in Sweden and 7 million in Denmark). We observed 119,584 cancer cases. Blood groups A, AB and B were associated either with increased or decreased risk of cancer at 13 anatomical sites (p≤0.05), compared to blood group O. Consistent with assessment using a false discovery rate approach, significant associations with ABO blood group were observed for cancer of the pancreas, breast, and upper gastrointestinal tract (mouth, salivary glands, pharynx, esophageal adenocarcinoma and stomach). Our study reconfirms the association between ABO blood group and cancer risk and exact underlying mechanisms involved needs further research. Copyright © 2016 Elsevier Ltd. All rights reserved.

"Grey" Areas and "Organized Chaos" in Emergency Response

ERIC Educational Resources Information Center

Taber, Nancy; Plumb, Donovan; Jolemore, Shawn

2008-01-01

Purpose: The purpose of this research is to explore the interaction between organizational policies and daily work practices of paramedics and firefighters within two emergency response organizations. Design/methodology/approach: Data were collected in a case study consisting of interviews, focus groups, and observations. The theoretical grounding…

Computed tomography of lobar collapse: 2. Collapse in the absence of endobronchial obstruction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Naidich, D.P.; McCauley, D.I.; Khouri, N.F.

1983-10-01

The computed tomographic appearance of collapse without endobronchial obstruction is reviewed. These 57 cases were classified by the etiology of collapse. The largest group consisted of 29 patients with passive atelectasis, i.e., collapse secondary to fluid, air, or both in the pleural space. Twenty-three of 29 proved secondary to malignant pleural disease. Computed tomography accurately predicted a malignant etiology in 22 of 23 cases. The second largest group of patients had lobar collapse secondary to cicatrization from chronic inflammation. In all cases the underlying etiology was tuberculosis. Radiation caused adhesive atelectasis in six patients secondary to a lack of productionmore » of surfactant. In each case a sharp line of demarcation could be defined between normal and abnormal collapsed pulmonary parenchyma. Three cases of unchecked tumor growth caused a peripheral form of collapse (replacement atelectasis). This form of collapse was characterized by an absence of endobronchial obstruction and extensive tumor not delineated by the normal boundaries of the pulmonary lobes.« less

Consequences of the Allee effect and intraspecific competition on population persistence under adverse environmental conditions.

PubMed

Petrovskii, Sergei; Blackshaw, Rod; Li, Bai-Lian

2008-02-01

The impact of intraspecific interactions on ecological stability and population persistence in terms of steady state(s) existence is considered theoretically based on a general competition model. We compare persistence of a structured population consisting of a few interacting (competitive) subpopulations, or groups, to persistence of the corresponding unstructured population. For a general case, we show that if the intra-group competition is stronger than the inter-group competition, then the structured population is less prone to extinction, i.e. it can persist in a parameter range where the unstructured population goes extinct. For a more specific case of a population with hierarchical competition, we show that relative viability of structured and unstructured populations depend on the type of density dependence in the population growth. Namely, while in the case of logistic growth, structured and unstructured populations exhibit equivalent persistence; in the case of Allee dynamics, the persistence of a hierarchically structured population is shown to be higher. We then apply these results to the case of behaviourally structured populations and demonstrate that an extreme form of individual aggression can be beneficial at the population level and enhance population persistence.

Evaluation of Salivary Flow Rate, pH and Buffer in Pre, Post & Post Menopausal Women on HRT.

PubMed

D R, Mahesh; G, Komali; K, Jayanthi; D, Dinesh; T V, Saikavitha; Dinesh, Preeti

2014-02-01

Climateric is considered to be a natural phase of life which by definition is the period of life starting from decline in ovarian activity until after the end of ovarian function. It is accompanied by various health consequences that include the changes in saliva too. This study was carried out to evaluate the salivary flow rate, pH, buffering capacity in pre-menopausal, post-menopausal and post-menopausal women on HRT. (1) To evaluate the salivary flow rate, pH of resting saliva and stimulated saliva and buffer capacity of stimulated saliva in pre-menopausal, post-menopausal and post-menopausal women on Hormone Replacement Therapy (HRT). (2) To compare the above salivary findings between pre-menopausal, post-menopausal and post-menopausal women on HRT. The study was carried out on 60 patients. These patients were divided into three groups of 20 patients: Group 1: Pre-menopausal women (control), Group 2: post-menopausal women (case), Group 3: post-menopausal women on HRT (case). The control group consisted of 20 women volunteers, having regular ovulatory menstrual cycles with no known systemic illness and deleterious habits and Group 2 consists of 20 post-menopausal women and Group 3 will consist of 20 post-menopausal women on HRT. After clearing the mouth by swallowing, stimulated saliva was collected after chewing paraffin for 10 mins in to a glass centrifuge tube graded in 0.1 mL increments up to 10mL.in rare cases the collection time will be reduced or extended (5-15 min), salivary flow rate will be determined as ml/min, immediately after collection, pH was determined by dipping pH test paper directly into the sample of oral fluid, salivary buffer capacity was determined by using saliva check buffer kit (GC corporation). The data obtained was statistically evaluated using chi-square test, fisher exact test ANOVA analysis. In our study we found salivary flow rate significantly lower in the post-menopausal women in comparison with the menstruating women and also there was improvement in the flow rate in individuals who were on HRT, it was also observed that salivary pH of the post-menopausal group was significantly lower than that of the control group, statistically significant difference in buffer capacity values was found between the groups however buffer capacity values were higher in the post-menopausal group than the control group. From the above study it is clear that post-menopausal women will present with oral discomfort, while HRT can improve the same. Hence our role as physicians and health care providers is to incorporate preventive dental health care in post-menopausal women and clearly inform patients about both the benefits and the limitations of HRT.

The Impact of Guiding Materials on Students' Conceptual Understanding: The Case of "What Is the Earth's Crust Composed of?

ERIC Educational Resources Information Center

Çoruhlu, Tülay Senel; Er Nas, Sibel

2017-01-01

The aim of this research is to determine the effect of the use of guidance material based on the 5E model on students' conceptual understanding of a topic entitled "What is the earth's crust composed of?" The sample consists of 40 students from the 5th grade (experimental group 20, control group 20). A concept test, a drawing test, and…

A Lie-Theoretic Perspective on O(n) Mass Matrix Inversion for Serial Manipulators and Polypeptide Chains.

PubMed

Lee, Kiju; Wang, Yunfeng; Chirikjian, Gregory S

2007-11-01

Over the past several decades a number of O(n) methods for forward and inverse dynamics computations have been developed in the multi-body dynamics and robotics literature. A method was developed in 1974 by Fixman for O(n) computation of the mass-matrix determinant for a serial polymer chain consisting of point masses. In other recent papers, we extended this method in order to compute the inverse of the mass matrix for serial chains consisting of point masses. In the present paper, we extend these ideas further and address the case of serial chains composed of rigid-bodies. This requires the use of relatively deep mathematics associated with the rotation group, SO(3), and the special Euclidean group, SE(3), and specifically, it requires that one differentiates functions of Lie-group-valued argument.

A detailed phylogeny for the Methanomicrobiales

NASA Technical Reports Server (NTRS)

Rouviere, P.; Mandelco, L.; Winker, S.; Woese, C. R.

1992-01-01

The small subunit rRNA sequence of twenty archaea, members of the Methanomicrobiales, permits a detailed phylogenetic tree to be inferred for the group. The tree confirms earlier studies, based on far fewer sequences, in showing the group to be divided into two major clusters, temporarily designated the "methanosarcina" group and the "methanogenium" group. The tree also defines phylogenetic relationships within these two groups, which in some cases do not agree with the phylogenetic relationships implied by current taxonomic names--a problem most acute for the genus Methanogenium and its relatives. The present phylogenetic characterization provides the basis for a consistent taxonomic restructuring of this major methanogenic taxon.

Operative volume in the new era: a comparison of resident operative volume before and after implementation of 80-hour work week restrictions.

PubMed

Bruce, Pamela J; Helmer, Stephen D; Osland, Jacqueline S; Ammar, Alex D

2010-01-01

To determine the effect of the 80-hour work week restrictions on general surgery resident operative volume in a large, community-based, university-affiliated, general surgery residency program. We performed a retrospective review of Accreditation Council for Graduate Medical Education (ACGME) operative logs of general surgery residents graduating from a single residency. The control group consisted of the residents graduating in the 3 years prior to the work-hour restriction implementation (2001, 2002, and 2003). Our comparison group consisted of those residents graduating in the first 2 classes whose entire residency was conducted after the implementation of the 80-hour work week (2008 and 2009). Comparisons were made between the control and the comparison groups in the 19 ACGME defined categories, total number of major cases, total number of chief cases, and total number of teaching assist cases. Operative volumes in 13 categories (skin/soft tissue/breast, alimentary tract, abdominal, liver, pancreas, vascular, endocrine, pediatrics, endoscopy, laparoscopic-complex, total chief cases, total major cases, and teaching cases) were not significantly affected by the implementation of the 80-hour work week. One of the 19 categories (laparoscopic-basic) showed a significant increase in operative volume (p < 0.0001). In 4 of the 19 categories (head/neck, operative-trauma, thoracic, and plastics), operative volume was significantly decreased in the post-80-hour work week era (p < 0.05). Nonoperative trauma could not be assessed, as the category did not exist before the work-hour restrictions. Resident operative volume at our institution's general surgery residency program largely has been unaffected by implementation of the 80-hour work week. Residencies in general surgery can be structured in a manner to allow for compliance with duty-hour regulations while maintaining the required operative volume outlined by the ACGME defined categories. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Identification of a B lymphoid disorder defined by specific morphologic features, a del(11)(q13) and a same breakpoint far from CCND1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morel, D.; Callet, E.; Reynaud, S.

Chromosome rearrangements in 11q13 have been shown to occur in a variety of diffuse small B-cell lymphomas/leukemias, including, beside mantle cell lymphomas (MCL), some cases of CLL/SLL, PLL, and SLVL. If t(11;14)(q13;q32) may be considered as a hallmark of MCL, less is known about deletions involving 11q13. A series of 13 patients with a diffuse small B-lymphoma/leukemia was examined for morphology (cytology and histology), immunology, cytogenetics and FISH for some of them. According to karyotype findings, 2 groups were identified: Group 1: 9 patients (6M,3F), median age 60 yrs. without 11q anomalies. Apart from trisomy 12 (3 cases), diverse anomaliesmore » were identified including chromosomes 1, 2, 7, 8, 12, 17. Cases were classified as CLL (2), SLL/SLP (5), blast-rich immunocytomas (2). Group 2: 4 patients, all males, median age 52 yrs. with breakpoints in 11q13; there were 3 deletions, and a t(11;14) was present in another case. 2 patients presented with refractory disease followed for 23 and 9 months, respectively, without any consistent morphologic change, the chromosomal anomaly being present at diagnosis in 1.3 cases. Cytologically, a nucleolated cell component was the constant and striking feature and FISH study by cos 14, pHS 11, cos 17, cos 105 revealed the same breakpoint located far from CCND1. The fourth case, bearing the t(11;14), was diagnosed as CLL/PLL in cytology, but was histologically consistent with MCL; the breakpoint was located by FISH into the BCL1 locus. Even if this study needs further confirmation, it points at the 11q13 deletion as a genetic event leading to a more aggressive disease, associated with distinct cytologic features differing from MCL and a molecular event probably not involving BCL1/CCND1.« less

A Case Report of Somnambulism Associated With Olanzapine

PubMed Central

Faridhosseini, Farhad; Zamani, Azar

2012-01-01

Somnambulism consists of a group of behaviors leading to unwanted movements during sleep or even sleepwalking. Medications applied for psychiatric disorders could increase the likelihood of somnambulism in adults. The following article is a case report of somnambulism seen in a patient with schizophrenia, which occurred after remission of an acute episode following treatment with olanzapine. When olanzapine dosage was decreased, no previous and similar symptoms were reported after 6 months of follow up. PMID:24644473

Test-Enhanced Learning in Competence-Based Predoctoral Orthodontics: A Four-Year Study.

PubMed

Freda, Nicolas M; Lipp, Mitchell J

2016-03-01

Dental educators intend to promote integration of knowledge, skills, and values toward professional competence. Studies report that retrieval, in the form of testing, results in better learning with retention than traditional studying. The aim of this study was to evaluate test-enhanced experiences on demonstrations of competence in diagnosis and management of malocclusion and skeletal problems. The study participants were all third-year dental students (2011 N=88, 2012 N=74, 2013 N=91, 2014 N=85) at New York University College of Dentistry. The 2013 and 2014 groups received the test-enhanced method emphasizing formative assessments with written and dialogic delayed feedback, while the 2011 and 2012 groups received the traditional approach emphasizing lectures and classroom exercises. The students received six two-hour sessions, spaced one week apart. At the final session, a summative assessment consisting of the same four cases was administered. Students constructed a problem list, treatment objectives, and a treatment plan for each case, scored according to the same criteria. Grades were based on the number of cases without critical errors: A=0 critical errors on four cases, A-=0 critical errors on three cases, B+=0 critical errors on two cases, B=0 critical errors on one case, F=critical errors on four cases. Performance grades were categorized as high quality (B+, A-, A) and low quality (F, B). The results showed that the test-enhanced groups demonstrated statistically significant benefits at 95% confidence intervals compared to the traditional groups when comparing low- and high-quality grades. These performance trends support the continued use of the test-enhanced approach.

The Clinical Accuracy of Endoscopic Ultrasonography and White Light Imaging in Gastric Endoscopic Submucosal Dissection

PubMed Central

Park, Soon Hong; Sung, Sang Hun; Lee, Seung Jun; Jung, Min Kyu; Kim, Sung Kook

2012-01-01

Purpose Gastric mucosal neoplastic lesions should have characteristic endoscopic features for successful endoscopic submucosal dissection. Materials and Methods Out of the 1,010 endoscopic submucosal dissection, we enrolled 62 patients that had the procedure cancelled. Retrospectively, whether the reasons for cancelling the endoscopic submucosal dissection were consistent with the indications for an endoscopic submucosal dissection were assessed by analyzing the clinical outcomes of the patients that had the surgery. Results The cases were divided into two groups; the under-diagnosed group (30 cases; unable to perform an endoscopic submucosal dissection) and the over-diagnosed group (32 cases; unnecessary to perform an endoscopic submucosal dissection), according to the second endoscopic findings, compared with the index conventional white light image. There were six cases in the under-diagnosed group with advanced gastric cancer on the second conventional white light image endoscopy, 17 cases with submucosal invasion on endoscopic ultrasonography findings, 5 cases with a size greater than 3 cm and ulcer, 1 case with diffuse infiltrative endoscopic features, and 1 case with lymph node involvement on computed tomography. A total of 25 patients underwent a gastrectomy to remove a gastric adenocarcinoma. The overall accuracy of the decision to cancel the endoscopic submucosal dissection was 40% (10/25) in the subgroup that had the surgery. Conclusions The accuracy of the decision to cancel the endoscopic submucosal dissection, after conventional white light image and endoscopic ultrasonography, was low in this study. Other diagnostic options are needed to arrive at an accurate decision on whether to perform a gastric endoscopic submucosal dissection. PMID:22792522

Malignancy in solitary solid cold thyroid nodule.

PubMed

Fariduddin, M; Amin, A H; Ahmed, M U; Karim, S S; Moslem, F; Kamal, M

2012-04-01

Solitary thyroid nodule is a common endocrine problem. The main concern of solitary thyroid nodule lies in excluding the malignancy & to operate on as few patients as possible. Other than history & clinical examination, hormone assessment, USG of thyroid gland, radionuclide scan & FNAC were used to differentiate malignant nodules from benign ones. In this study 127 cases with solitary thyroid nodule of all age group & both sexes were included from Endocrine & Thyroid clinic of BSMMU. They were clinically & biochemically euthyroid & had cold nodule on radionuclide scan. USG & FNAC were done & subsequently they underwent surgical procedure. On the basis of postoperative histopathological report the specimens were divided into benign & malignant groups. All the nodules were cold among which 104 were solid & 23 were mixed in consistency. Of the 104 solid cold nodules histopathology revealed 36(34.6%) malignant & 68(65.4%) benign cases. From the 23 mixed cold solitary nodule 5(21.7%) appeared malignant & 18(78.3%) were benign. So malignancy was higher in solid cold group than the mixed cold one but this was not statistically significant (p=0.673). FNAC was done & it revealed that 83(65.5%) cases were benign, 10(7.8%) cases were suspicious & 34(26.7%) were malignant. Finally histopathology showed 41(32.3%) cases were positive & 86(67.7%) cases were negative for malignancy.

Human patient simulators and interactive case studies: a comparative analysis of learning outcomes and student perceptions.

PubMed

Howard, Valerie Michele; Ross, Carl; Mitchell, Ann M; Nelson, Glenn M

2010-01-01

Although human patient simulators provide an innovative teaching method for nursing students, they are quite expensive. To investigate the value of this expenditure, a quantitative, quasi-experimental, two-group pretest and posttest design was used to compare two educational interventions: human patient simulators and interactive case studies. The sample (N = 49) consisted of students from baccalaureate, accelerated baccalaureate, and diploma nursing programs. Custom-designed Health Education Systems, Inc examinations were used to measure knowledge before and after the implementation of the two educational interventions. Students in the human patient simulation group scored significantly higher than did those in the interactive case study group on the posttest Health Education Systems, Inc examination, and no significant difference was found in student scores among the three types of nursing programs that participated in the study. Data obtained from a questionnaire administered to participants indicated that students responded favorably to the use of human patient simulators as a teaching method.

Impact of long-term filter cigarette usage on lung and larnyx cancer risk: a case-control study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wynder, E.L.; Stellman, S.D.

A case-control study was conducted among 1034 white male and female hospital patients with histologically proved lung cancer (Kreyberg type I) or larynx cancer. After adjustment for duration of the smoking habit, inhalation, and butt length relative risks of developing lung or larynx cancer were consistently lower among long-term of filter cigarettes than among smokers of nonfilter cigarettes, irrespective of quantity smoked. Relative risks in all groups declined with increased years of smoking cessation. The observed risk reduction among current smokers of filter cigarettes was consistent with that expected, considering that these persons had smoked the older high-tar nonfilter cigarettesmore » for a large proportion of their lives.« less

Sustaining a Mature Teacher Inquiry Network

ERIC Educational Resources Information Center

Satter, Sarah Bea

2014-01-01

This research consisted of a case study of an active network for teacher inquiry. Specifically, I investigated how an organization dedicated to teacher inquiry had provided the structure, leadership, and resources to sustain, maintain, and expand the network. The group studied was the Mid-Ohio Writing Project, a teacher inquiry network affiliated…

Pilot Decision-Making in Irreversible Emergencies

ERIC Educational Resources Information Center

Winter, Scott R.

2013-01-01

The purpose of this study was to determine if a reflexive learning treatment utilizing select case studies could enhance the decision-making of pilots who encounter an irreversible emergency. Participants, who consisted of members of the subject university's professional pilot program, were divided into either a control or experimental group and…

Intelligent Tutoring and the Development of Argumentative Competence

ERIC Educational Resources Information Center

Paneque, Juan J.; Cobo, Pedro; Fortuny, Josep M.

2017-01-01

This ethnographical study aims to interpret how an intelligent tutorial system, geogebraTUTOR, mediates to the student's argumentative processes. Data consisted of four geometrical problems proposed to a group of four students aged 16-17. Qualitative analysis of two selected cases led to the identification of the development of argumentative…

Terri Schiavo: A Disability Rights Case

ERIC Educational Resources Information Center

Johnson, Mary

2006-01-01

The author argues that Terri Schiavo was a "person with a disability" who faced disability discrimination, a view that is consistent with national disability rights groups. The author notes that Schiavo was not "terminally ill" and that feeding tubes should not be considered "medical equipment." The belief that people with severe disabilities want…

[Efficacy and Safety Evaluation of Bushen Shuji Granule in Treating Ankylosing Spondylitis Patients: a Clinical Study].

PubMed

Kong, Wei-ping; Tao, Qing-wen; Zhang, Ying-ze; Yang, Shu; Xu, Yuan; Zhu, Xiao-xia; Jin, Yue; Yang, Wen-xue; Yan, Xiao-ping

2015-06-01

To evaluate the short-term efficacy and safety of Bushen Shuji Granule (BSG) in treating ankylosing spondylitis (AS) patients. A prospective randomized controlled clinical trial was carried out in 62 active stage AS patients with Shen deficiency Du-channel cold syndrome (SDDCS), who were randomly assigned to the BSG group (treated with BSG) and the control group (treated with Celecoxib Capsule). Twelve weeks consisted of one therapeutic course. Therapeutic effects were evaluated by ASAS20 and ASAS40 (set by Assessments in Ankylosing Spondylitis working group) , BASDA150, Chinese medical (CM) syndrome efficacy evaluation standards. BASDAI, the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath AS Metrology Index (BASMI), scores for spine pain, scores for pain at night, patient global assessment (PGA) , erythrocyte sedimentation rate (ESR) , and C reactive protein (CRP) were observed before and after treatment. After three-month treatment by BSG, ASAS20 standard rate was 63. 33% (19/30 cases) in the BSG group and 66.67% (20/30 cases) in the control group with no significant difference between the two groups (χ2 = 0.073, P > 0.05). The efficacy for CM syndromes was 70.00% (21/30 cases) in the BSG group, higher than that in the control group [40.00% (12/30 cases), χ2 = 5.455, P < 0.05]. Scores for CM syndromes, BASDAI, night pain index, spinal pain index, PGA, CRP were improved in the BSG group (P < 0.05, P < 0.01). The incidence of adverse events in the BSG group was lower than that of the control group. BSG based on Shen supplementing, Du-channel strengthening, blood activating, and channels dredging method had good short-term clinical efficacy and safety in treating AS.

Case studies on clinical evaluation of biosimilar monoclonal antibody: scientific considerations for regulatory approval.

PubMed

Kudrin, Alex; Knezevic, Ivana; Joung, Jeewon; Kang, Hye-Na

2015-01-01

The objective of this paper is to provide considerations based on comprehensive case studies important for regulatory evaluation of monoclonal antibodies as similar biotherapeutic products (SBPs) with a special emphasis on clinical aspects. Scientific principles from WHO Guidelines on SBPs were used as a basis for the exercise. Working groups consisted of regulators, manufacturers and academia. The following topics were discussed by the working groups: clinical criteria for biosimilarity, extrapolation approach and the overall regulatory decision making process. In order to determine typical pitfalls in the design of a SBP clinical programme and evaluate the gap of knowledge, amongst different industry and regulatory stakeholders on the appraisal of the data arising from SBP clinical studies, we have presented two fictional but realistic clinical case studies. The first case consists of the fictional development programme for an infliximab SBP candidate. The second case describes clinical studies proposed for a fictional rituximab SBP candidate. In the first scenario a highly similar quality profile has been taken forward into clinical studies whereas there was an important residual difference in functional attributes for the rituximab SBP candidate. These case studies were presented at the WHO implementation workshop for the WHO guidelines on evaluation of similar biotherapeutic products held in Seoul, Republic of Korea, in May 2014. The goal was to illustrate the interpretation of the clinical data arising from studies with SBP candidates and elicit knowledge gaps in clinical assessment. This paper reflects the outcome of the exercise and discussions held in Seoul and offers an analysis of the case studies as a learning opportunity on clinical development and evaluation of SBPs. Copyright © 2014 The International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

Clinical, radiographic, and histological findings of florid cemento-osseous dysplasia: a case report.

PubMed

Kim, Jeong-Hee; Song, Byeong-Chul; Kim, Sun-Ho; Park, Yang-Soon

2011-09-01

Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissue and involve, essentially, the same pathological process. They are usually classified into three main groups: periapical, florid, and focal cemental dysplasias depending on their extent and radiographic appearances. Radiographically, florid cementoosseous dysplasia (FCOD) appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. The best management for the asymptomatic FCOD patient consists of regular recall examinations with prophylaxis. The management of the symptomatic patient is more difficult. A case of FCOD occurring in a 52-year-old edentulous Korean female is reported which is rare with regard to race and sex.

SPOTTED FEVER GROUP RICKETTSIA RETINITIS IN A TRAVELER TO AFRICA.

PubMed

Duval, Renaud; Merrill, Pauline T

2016-01-01

To describe a case of rickettsial retinitis in a traveler returning from Africa. Case description. A 67-year-old woman returning from an excursion in the jungles of Africa presented with a 2-day history of floaters and decreased vision in the right eye. In the two preceding weeks, she had experienced fever, malaise, a black eschar on the right elbow, and a rash on her extremities. Examination revealed panuveitis with a solitary, white retinal lesion adjacent to a retinal vessel in the posterior pole of each eye. Extensive diagnostic workup revealed a positive serology for rickettsial antibodies. Her treatment consisted of a course of oral doxycycline. Rickettsial retinitis is an emerging ocular infection in several endemic areas. This case description constitutes the first report of spotted fever group rickettsial retinitis in a traveler to Africa.

An astrophysical interpretation of the remarkable g-mode frequency groups of the rapidly rotating γ Dor star, KIC 5608334

NASA Astrophysics Data System (ADS)

Saio, Hideyuki; Bedding, Timothy R.; Kurtz, Donald W.; Murphy, Simon J.; Antoci, Victoria; Shibahashi, Hiromoto; Li, Gang; Takata, Masao

2018-06-01

The Fourier spectrum of the γ-Dor variable KIC 5608334 shows remarkable frequency groups at ˜3, ˜6, ˜9, and 11-12 d-1. We explain the four frequency groups as prograde sectoral g modes in a rapidly rotating star. Frequencies of intermediate-to-high radial order prograde sectoral g modes in a rapidly rotating star are proportional to |m| (i.e. ν ∝ |m|) in the corotating frame as well as in the inertial frame. This property is consistent with the frequency groups of KIC 5608334 as well as the period versus period-spacing relation present within each frequency group, if we assume a rotation frequency of 2.2 d-1, and that each frequency group consists of prograde sectoral g modes of |m| = 1, 2, 3, and 4, respectively. In addition, these modes naturally satisfy near-resonance conditions νi ≈ νj + νk with mi = mj + mk. We even find exact resonance frequency conditions (within the precise measurement uncertainties) in many cases, which correspond to combination frequencies.

The use of conferencing technologies to support drug policy group knowledge exchange processes: an action case approach.

PubMed

Househ, Mowafa Said; Kushniruk, Andre; Maclure, Malcolm; Carleton, Bruce; Cloutier-Fisher, Denise

2011-04-01

To describe experiences, lessons and the implications related to the use of conferencing technology to support three drug policy research groups within a three-year period, using the action case research method. An action case research field study was executed. Three different drug policy groups participated: research, educator, and decision-maker task groups. There were a total of 61 participants in the study. The study was conducted between 2004 and 2007. Each group used audio-teleconferencing, web-conferencing or both to support their knowledge exchange activities. Data were collected over three years and consisted of observation notes, interviews, and meeting transcripts. Content analysis was used to analyze the data using NIVIO qualitative data analysis software. The study found six key lessons regarding the impact of conferencing technologies on knowledge exchange within drug policy groups. We found that 1) groups adapt to technology to facilitate group communication, 2) web-conferencing communication is optimal under certain conditions, 3) audio conferencing is convenient, 4) web-conferencing forces group interactions to be "within text", 5) facilitation contributes to successful knowledge exchange, and 6) technology impacts information sharing. This study highlights lessons related to the use of conferencing technologies to support distant knowledge exchange within drug policy groups. Key lessons from this study can be used by drug policy groups to support successful knowledge exchange activities using conferencing technologies. 2010 Elsevier Ireland Ltd. All rights reserved.

Targeted Next Generation Sequencing in Patients with Inborn Errors of Metabolism

PubMed Central

Yubero, Dèlia; Brandi, Núria; Ormazabal, Aida; Garcia-Cazorla, Àngels; Pérez-Dueñas, Belén; Campistol, Jaime; Ribes, Antonia; Palau, Francesc

2016-01-01

Background Next-generation sequencing (NGS) technology has allowed the promotion of genetic diagnosis and are becoming increasingly inexpensive and faster. To evaluate the utility of NGS in the clinical field, a targeted genetic panel approach was designed for the diagnosis of a set of inborn errors of metabolism (IEM). The final aim of the study was to compare the findings for the diagnostic yield of NGS in patients who presented with consistent clinical and biochemical suspicion of IEM with those obtained for patients who did not have specific biomarkers. Methods The subjects studied (n = 146) were classified into two categories: Group 1 (n = 81), which consisted of patients with clinical and biochemical suspicion of IEM, and Group 2 (n = 65), which consisted of IEM cases with clinical suspicion and unspecific biomarkers. A total of 171 genes were analyzed using a custom targeted panel of genes followed by Sanger validation. Results Genetic diagnosis was achieved in 50% of patients (73/146). In addition, the diagnostic yield obtained for Group 1 was 78% (63/81), and this rate decreased to 15.4% (10/65) in Group 2 (X2 = 76.171; p < 0.0001). Conclusions A rapid and effective genetic diagnosis was achieved in our cohort, particularly the group that had both clinical and biochemical indications for the diagnosis. PMID:27243974

Immunoglobulin derived depositions in the nervous system: novel mass spectrometry application for protein characterization in formalin-fixed tissues.

PubMed

Rodriguez, Fausto J; Gamez, Jeffrey D; Vrana, Julie A; Theis, Jason D; Giannini, Caterina; Scheithauer, Bernd W; Parisi, Joseph E; Lucchinetti, Claudia F; Pendlebury, William W; Bergen, H Robert; Dogan, Ahmet

2008-10-01

Proteinaceous deposits are occasionally encountered in surgically obtained biopsies of the nervous system. Some of these are amyloidomas, although the precise nature of other cases remains uncertain. We studied 13 cases of proteinaceous aggregates in clinical specimens of the nervous system. Proteins contained within laser microdissected areas of interest were identified from tryptic peptide sequences by liquid chromatography-electrospray tandem mass spectrometry (LC-MS/MS). Immunohistochemical studies for immunoglobulin heavy and light chains and amyloidogenic proteins were performed in all cases. Histologically, the cases were classified into three groups: 'proteinaceous deposit not otherwise specified' (PDNOS) (n=6), amyloidoma (n=5), or 'intracellular crystals' (n=2). LC-MS/MS demonstrated the presence of lambda, but not kappa, light chain as well as serum amyloid P in all amyloidomas. lambda-Light-chain immunostaining was noted in amyloid (n=5), although demonstrable monotypic lymphoplasmacytic cells were seen in only one case. Conversely, in PDNOS kappa, but not lambda, was evident in five cases, both light chains being present in a single case. In three cases of PDNOS, a low-grade B-cell lymphoma consistent with marginal zone lymphoma was present in the brain specimen (n=2) or spleen (n=1). Lastly, in the 'intracellular crystals' group, the crystals were present within CD68+ macrophages in one case wherein kappa-light chain was found by LC-MS/MS only; the pathology was consistent with crystal-storing histiocytosis. In the second case, the crystals contained immunoglobulin G within CD138+ plasma cells. Our results show that proteinaceous deposits in the nervous system contain immunoglobulin components and LC-MS/MS accurately identifies the content of these deposits in clinical biopsy specimens. LC-MS/MS represents a novel application for characterization of these deposits and is of diagnostic utility in addition to standard immunohistochemical analyses.

A tool for assessing case history and feedback skills in audiology students working with simulated patients.

PubMed

Hughes, Jane; Wilson, Wayne J; MacBean, Naomi; Hill, Anne E

2016-12-01

To develop a tool for assessing audiology students taking a case history and giving feedback with simulated patients (SP). Single observation, single group design. Twenty-four first-year audiology students, five simulated patients, two clinical educators, and three evaluators. The Audiology Simulated Patient Interview Rating Scale (ASPIRS) was developed consisting of six items assessing specific clinical skills, non-verbal communication, verbal communication, interpersonal skills, interviewing skills, and professional practice skills. These items are applied once for taking a case history and again for giving feedback. The ASPIRS showed very high internal consistency (α = 0.91-0.97; mean inter-item r = 0.64-0.85) and fair-to-moderate agreement between evaluators (29.2-54.2% exact and 79.2-100% near agreement; κ weighted up to 0.60). It also showed fair-to-moderate absolute agreement amongst evaluators for single evaluator scores (intraclass correlation coefficient [ICC] r = 0.35-0.59) and substantial consistency of agreement amongst evaluators for three-evaluator averaged scores (ICC r = 0.62-0.81). Factor analysis showed the ASPIRS' 12 items fell into two components, one containing all feedback items and one containing all case history items. The ASPIRS shows promise as the first published tool for assessing audiology students taking a case history and giving feedback with an SP.

Misdiagnosing Whipple's disease in the young.

PubMed

Papakonstantinou, Danai; Riste, Michael J; Langman, Gerald; Moran, Ed

2017-03-21

Whipple's disease is considered an infection of middle-aged white men of European ancestry. Cases are rare and disproportionately associated with occupational exposure to soil or animals. We report the case of a man aged 22 years with no risk factors, erroneously diagnosed with, and treated for, toxoplasmosis on the basis of consistent lymph node histology. The correct diagnosis was delayed by the dramatic symptomatic improvement resulting from this therapy. Whipple's disease should be considered in cases of granulomatous lymphadenopathy of unknown cause, even if the age of the patient does not fit the classic presentation of the disease. 2017 BMJ Publishing Group Ltd.

Anatomic findings and complications after surgical treatment of chronic, partial distal biceps tendon tears: a case cohort comparison study.

PubMed

Ruch, David S; Watters, Tyler Steven; Wartinbee, Daniel A; Richard, Marc J; Leversedge, Fraser J; Mithani, Suhail K

2014-08-01

To describe pertinent anatomic findings during repair of chronic, partial distal biceps tendon tears and to compare the complications of surgery with a similar cohort of acute, complete tears. Group 1 included 14 patients (15 elbows) with partial tears managed operatively an average of 10 months from onset of injury or symptoms. Group 2 included a matched cohort of 16 patients (17 elbows) treated for complete, acute tears an average of 19 days from injury. A retrospective review of all 30 patients focused on demographic data, intraoperative findings, and postoperative complications. A single, anterior incision was used in all cases with multiple suture anchors or a bicortical toggling button for fixation of the repair. We evaluated 27 men and 3 women with an average age of 55 years (group 1) and 48 years (group 2). Intratendinous ganglion formation at the site of rupture of the degenerative tendon was observed in 5 cases of partial tears and none of the complete tears. Partial tears involved the lateral aspect or short head of the biceps tendon insertion in all cases. Postoperative complications included lateral antebrachial cutaneous nerve neuritis in 8 group 1 patients and 6 group 2 patients and transient posterior interosseus nerve palsy in 3 group 1 patients. Partial distal biceps tendon ruptures showed a consistent pattern of pathology involving disruption of the lateral side of the tendon insertion involving the small head of the biceps. Degenerative intratendinous ganglion formation was present in one third of cases. Repair of chronic, partial distal biceps tendon injuries may have a higher incidence of posterior interosseous and lateral antebrachial cutaneous nerve palsies. Therapeutic III. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Blood groups and acute aortic dissection type III.

PubMed

Fatic, Nikola; Nikolic, Aleksandar; Vukmirovic, Mihailo; Radojevic, Nemanja; Zornic, Nenad; Banzic, Igor; Ilic, Nikola; Kostic, Dusan; Pajovic, Bogdan

2017-04-01

Acute aortic type III dissection is one of the most catastrophic events, with in-hospital mortality ranging between 10% and 12%. The majority of patients are treated medically, but complicated dissections, which represent 15% to 20% of cases, require surgical or thoracic endovascular aortic repair (TEVAR). For the best outcomes adequate blood transfusion support is required. Interest in the relationship between blood type and vascular disease has been established. The aim of our study is to evaluate distribution of blood groups among patients with acute aortic type III dissection and to identify any kind of relationship between blood type and patient's survival. From January 2005 to December 2014, 115 patients with acute aortic type III dissection were enrolled at the Clinic of Vascular and Endovascular Surgery in Belgrade, Serbia and retrospectively analyzed. Patients were separated into two groups. The examination group consisted of patients with a lethal outcome, and the control group consisted of patients who survived. The analysis of the blood groups and RhD typing between groups did not reveal a statistically significant difference ( p = 0.220). Our results indicated no difference between different blood groups and RhD typing with respect to in-hospital mortality of patients with acute aortic dissection type III.

The Use of Benzodiazepine Receptor Agonists and Risk of Respiratory Failure in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Population-Based Case-Control Study.

PubMed

Chen, Su-Jung; Yeh, Chiu-Mei; Chao, Tze-Fan; Liu, Chia-Jen; Wang, Kang-Ling; Chen, Tzeng-Ji; Chou, Pesus; Wang, Fu-Der

2015-07-01

Insomnia is prevalent in patients with chronic obstructive pulmonary disease (COPD), and benzodiazepine receptor agonists (BZRAs) are the most commonly used drugs despite their adverse effects on respiratory function. The aim of this study was to investigate whether the use of BZRAs was associated with an increased risk of respiratory failure (RF) in COPD patients. Matched case-control study. National Health Insurance Research Database (NHIRD) in Taiwan. The case group consisted of 2,434 COPD patients with RF, and the control group consisted of 2,434 COPD patients without RF, matched for age, sex, and date of enrollment. Exposure to BZRAs during the 180-day period preceding the index date was analyzed and compared in the case and control groups. Conditional logistic regression was performed, and the use of BZRAs was associated with an increased risk of RF (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI] 1.14-2.13). In subgroup analysis, we found that the benzodiazepine (BZD) users had a higher risk of RF (aOR 1.58, 95% CI 1.14-2.20), whereas the risk in non-benzodiazepine (non-BZD) users was insignificant (aOR 0.85, 95% CI 0.51-1.44). A greater than 2-fold increase in risk was found in those who received two or more kinds of BZRAs and those using a combination of BZD and non-BZD medications. The use of benzodiazepine receptor agonists was a significant risk factor for respiratory failure in patients with chronic obstructive pulmonary disease (COPD). Compared to benzodiazepine, the prescription of non-benzodiazepine may be safer for the management of insomnia in COPD patients. © 2015 Associated Professional Sleep Societies, LLC.

A 9-year comparison of practice profiles of candidates for primary and recertification examinations of the American Board of Plastic Surgery relative to economic indicators.

PubMed

Gosain, Arun K; Haller, Harold S; Lee, Michelle; Cullison, Terry M; Noone, R Barrett

2013-03-01

This study compared the practice profiles of plastic surgeons applying for recertification/maintenance of certification with those applying for primary certification by the American Board of Plastic Surgery between 2003 and 2011. American Board of Plastic Surgery case logs from both recertification and primary certification candidates from 2003 to 2011 were examined. Deidentified data included operative year, Current Procedural Terminology codes, and the candidate's designation of the case relative to (1) cosmetic or reconstructive and (2) the Maintenance of Certification in Plastic Surgery module (i.e., comprehensive, cosmetic, craniomaxillofacial, and hand). Department of Commerce unemployment data from 2003 to 2011 served as an economic indicator for the period studied. A negative trend in the median number of cases per candidate was observed for both groups for cosmetic, reconstructive, and total number of cases, corresponding to a rise in unemployment. With every 1 percent increase in the unemployment rate, recertification candidates demonstrated a greater loss of cosmetic cases relative to primary candidates and an accelerated decline in reconstructive cases starting in 2007. Distribution of the four Maintenance of Certification modules demonstrated a negative trend for cosmetic and comprehensive cases in both groups. Hand and craniofacial consistently constituted approximately 20 percent of cases for primary and 14 percent of cases for recertification candidates. There was a shift away from hand cases toward craniofacial cases in both groups. Both primary and recertification candidates reported a decline in overall caseload from 2003 to 2011. Negative economic trends have a greater impact on the practice profile of recertification candidates.

Evaluation of a colloidal gold immunochromatography assay in the detection of Treponema pallidum specific IgM antibody in syphilis serofast reaction patients: a serologic marker for the relapse and infection of syphilis.

PubMed

Lin, Li-Rong; Tong, Man-Li; Fu, Zuo-Gen; Dan, Bing; Zheng, Wei-Hong; Zhang, Chang-Gong; Yang, Tian-Ci; Zhang, Zhong-Ying

2011-05-01

Syphilis remains as a worldwide public health problem; hence, it is necessary to develop a new diagnostic approach that is easier and faster than conventional tests. A new testing method to detect Treponema pallidum IgM (TP-IgM), named colloidal gold immunochromatography assay (GICA), is presented in place of fluorescent treponemal antibody absorption (FTA-Abs). TP-IgM was detected using GICA developed on syphilis-specific recombinant proteins TPN17 and TPN47. The FTA-Abs IgM test was set as the gold standard. A GICA TP-IgM test was performed to detect syphilis in 1208 patients who received recommended therapy for syphilis for more than 1 year at the Xiamen Center of Clinical Laboratory in China from June 2005 to May 2009. One hundred blood donors were set up as control. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were 98.21%, 99.04%, 93.75%, 99.73%, 102.3, and 0.018, respectively. Detection on 500 interference specimens indicated that the biological false-positive rate of the GICA test was extremely low and was free from other biological and chemical factors. The patients were divided into the following experimental groups based on the results of toluidine red unheated serum test (TRUST) and treponemal pallidum particle agglutination (TPPA): (1) the syphilis serofast reaction (SSR) group consisted of 411 cases with (+) TRUST and (+) TPPA, which exhibited no clinical manifestations of syphilis after 1 year of recommended syphilis treatment; (2) the serum cure group, which was further subdivided into group A, a group that consisted of 251 cases with (-) TRUST and (+) TPPA, and (3) group B, a group that consisted of 546 cases with (-) TRUST and (-) TPPA; and (4) the blood donor control group, which consisted of 100 healthy persons with (-) ELISA-TP and (-) TPPA. We used the FTA-Abs method and the GICA method to detect TP-IgM; the positive rate of TP-IgM in 411 SSR patients was 34.55% and 36.01%, respectively. However, in serum cure group A, the positive rate of TP-IgM was 10.36% and 11.16%, respectively. The χ(2) test revealed that there is a significant difference in the positive rate between these 2 groups (P < 0.01). The TP-IgM positive rate in the same group, as detected by the GICA method and the FTA-Abs method, had no significant difference in statistics. However, as detected by the GICA method and the FTA-Abs method, all the samples in serum cure group B and the control group were negative for TP-IgM. The TP-IgM-positive result demonstrated that active T. pallidum remained in the bodies of SSR patients. In summary, the characteristics of GICA TP-IgM correspond to that of FTA-Abs TP-IgM; this can be used as a serologic marker for the relapse and infection of syphilis in place of the conventional FTA-Abs IgM test. Copyright © 2011 Elsevier Inc. All rights reserved.

Clinical characteristics of adult patients with tics and/or Tourette's syndrome.

PubMed

Ohta, Masataka; Kano, Yukiko

2003-12-01

This study was conducted to describe the natural course of tic disorders over a long period of time in Japanese adults patients with Tourette's syndrome (TS) in terms of symptomatology. An extensive literature on TS cases was reviewed selectively and 31 TS patients (mean age: 31.4 years; sex: 28 males and 3 females) at our outpatient clinic were examined. The mean follow-up period of the patients was 7.6 years (SD: 8.1; 0 to 26). All the data available for this study, including medical charts, were examined systematically by two experienced child psychiatrists. The adult patients with tic disorders could be classified into the four groups: group A - tics only, group B - tics + comorbidities, group C - comorbidities only and group D - sub-clinical (remission) cases. Our 31 subjects consisted of 10 patients (32.3%) for group A, 14 (45.2%) for group B, 7 (22.6%) for group C, and 0 for group D. Further investigation into the natural course and clinical characteristics of adult TS needs to be done in order to acquire a better understanding of the broad spectrum of TS and to make improvements to the treatment for this illness.

A Lie-Theoretic Perspective on O(n) Mass Matrix Inversion for Serial Manipulators and Polypeptide Chains

PubMed Central

Lee, Kiju; Wang, Yunfeng; Chirikjian, Gregory S.

2010-01-01

Over the past several decades a number of O(n) methods for forward and inverse dynamics computations have been developed in the multi-body dynamics and robotics literature. A method was developed in 1974 by Fixman for O(n) computation of the mass-matrix determinant for a serial polymer chain consisting of point masses. In other recent papers, we extended this method in order to compute the inverse of the mass matrix for serial chains consisting of point masses. In the present paper, we extend these ideas further and address the case of serial chains composed of rigid-bodies. This requires the use of relatively deep mathematics associated with the rotation group, SO(3), and the special Euclidean group, SE(3), and specifically, it requires that one differentiates functions of Lie-group-valued argument. PMID:20165563

Sensitivity derivatives for advanced CFD algorithm and viscous modelling parameters via automatic differentiation

NASA Technical Reports Server (NTRS)

Green, Lawrence L.; Newman, Perry A.; Haigler, Kara J.

1993-01-01

The computational technique of automatic differentiation (AD) is applied to a three-dimensional thin-layer Navier-Stokes multigrid flow solver to assess the feasibility and computational impact of obtaining exact sensitivity derivatives typical of those needed for sensitivity analyses. Calculations are performed for an ONERA M6 wing in transonic flow with both the Baldwin-Lomax and Johnson-King turbulence models. The wing lift, drag, and pitching moment coefficients are differentiated with respect to two different groups of input parameters. The first group consists of the second- and fourth-order damping coefficients of the computational algorithm, whereas the second group consists of two parameters in the viscous turbulent flow physics modelling. Results obtained via AD are compared, for both accuracy and computational efficiency with the results obtained with divided differences (DD). The AD results are accurate, extremely simple to obtain, and show significant computational advantage over those obtained by DD for some cases.

Postoperative dysphagia versus neurogenic dysphagia: scintigraphic assessment.

PubMed

Galli, Jacopo; Valenza, Venanzio; D'Alatri, Lucia; Reale, Francesca; Gajate, AnaMaria Samanes; Di Girolamo, Stefano; Paludetti, Gaetano

2003-01-01

In order to differentiate the features of dysphagia that occur after supraglottic horizontal laryngectomy from those that occur during neurologic diseases, we divided 38 subjects into 3 groups and submitted them to oropharyngoesophageal scintigraphy. Group 1 (control group) included 15 healthy volunteeers; group 2 comprised 8 patients who had residual dysphagia at least 1 year after supraglottic laryngectomy; and group 3 included 15 patients with various neurologic and neuromuscular disorders. In group 1, the mean values (+/- 2 SD) of selected semiquantitative parameters were consistent with those reported in the literature for normal subjects. In group 2, oral, pharyngeal, and esophageal transit times were not significantly altered, and moderate tracheobronchial post-deglutitive aspiration was present (maximum value, 6.7%; mean value, 2.04%). The pharyngeal retention index was significantly increased (p = .0003) as compared to normal subjects in all cases (maximum value, 40%; mean value, 23%) and was associated in all cases with slight but consistent post-deglutitive aspiration. In group 3, the oral and esophageal phases were significantly prolonged and the retention indices were significantly increased. Statistical analysis documented a significant increase in oral transit time (p = .003), esophageal transit time (p = .01), oral retention index (p = .006), pharyngeal retention index (p = .0007), and esophageal retention index (p = .009) as compared to normal subjects. The swallowing pattern was also altered by 1) an early loss of the bolus from the oral cavity; 2) bolus fragmentation due to double or triple deglutition, reduced lingual propulsion, or the return of a small part of the bolus into the oral cavity during deglutition; and/or 3) double pharyngeal peaks in the activity-time curves. Tracheobronchial aspiration (maximum value, 90%; mean value, 9.70%) was present in some cases, mainly in patients affected by post-stroke dysphagia. On the basis of the obtained results and considering the low doses of radiation delivered to the patient (0.043 Gy), the limited invasiveness, and the excellent patient tolerance, scintigraphy appears to be clinically valid in the functional study of swallowing and in identifying different deglutition disorders.

Retrospective multicenter evaluation of the "fly-catching syndrome" in 24 dogs: EEG, BAER, MRI, CSF findings and response to antiepileptic and antidepressant treatment.

PubMed

Wrzosek, Marcin; Płonek, Marta; Nicpoń, Józef; Cizinauskas, Sigitas; Pakozdy, Akos

2015-12-01

The fly-catching syndrome (FCS) is a rare canine condition of sudden, occasional, or constant episodes of biting the air. It may be accompanied by jumping, licking, and swallowing. The etiology of FCS is unknown and controversial. Various explanations for its occurrence have included epileptoid disorders such as visual cortex epileptiform disturbances and simple and complex partial seizures as well as compulsive disorders, hallucinatory behavior, and stereotypy. A retrospective multicenter analysis of 24 dogs with clinical symptoms of FCS is presented. Clinical signs at the time of presentation, the mean age at onset of the disease, the response to treatment, and the clinical outcome were recorded and analyzed in all patients. All dogs underwent clinical, neurological, and otoscopic examinations. Complete blood cell counts (CBCs) and serum chemistry panels were obtained from each dog. Diagnostic testing included MRI and EEG examinations in 21 cases, BAER in 19 cases, and CSF analysis in 20 cases. The EEG revealed spike activity in 8 (38%) of the 21 cases, 7 of which had activity in the occipital lobes. The brainstem auditory evoked response (BAER) revealed three cases of bilateral deafness. The MRI revealed six cases of Chiari malformation (CM), one case of syringohydromyelia (SM), and one case of a falx cerebri meningioma. The dogs were divided into groups according to their treatment protocol. Group A included dogs treated with phenobarbital (PB), and group B consisted of dogs treated with fluoxetine (FLX). Thirty-six percent of the dogs in group A responded to PB, while 100% of the dogs in group B responded to FLX. The results suggest that FCS is more responsive to FLX than PB. However, the etiology of this behavior remains unclear in most cases. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Implementing Summative Assessment with a Formative Flavour: A Case Study in a Large Class

ERIC Educational Resources Information Center

Broadbent, Jaclyn; Panadero, Ernesto; Boud, David

2018-01-01

Teaching a large class can present real challenges in design, management and standardisation of assessment practices. One of the main dilemmas for university teachers is how to implement effective formative assessment practices with accompanying high-quality feedback consistently over time with large classroom groups. This article reports on how…

Perspectives of Physicians, Families, and Case Managers Concerning Access to Health Care by Individuals with Developmental Disabilities

ERIC Educational Resources Information Center

Reichard, Amanda; Turnbull, H. Rutherford, III

2004-01-01

This study of the status of medical care for Kansans with developmental disabilities consists of reports from physicians, service providers, and family members. Overall, these three groups indicated satisfaction with medical care across the four criteria of availability, accessibility, appropriateness, and affordability. The bases for these…

Sin Papeles y Rompiendo Barreras: Latino Students and the Challenges of Persisting in College

ERIC Educational Resources Information Center

Contreras, Frances

2009-01-01

Undocumented Latino students in higher education represent a resilient, determined, and inspirational group of high achievers who persevere and serve as a model for success. Here, Frances Contreras presents a qualitative case study consisting of twenty semistructured, in-depth interviews with undocumented Latino students in an effort to help…

Elective Drama Course in Mathematics Education: An Assessment of Pre-Service Teachers

ERIC Educational Resources Information Center

Sagirli, Meryem Özturan

2014-01-01

This study aimed to evaluate a newly introduced elective course "Drama in Mathematics Education" into mathematics education curriculum from the viewpoints of pre-service mathematics teachers. A case study was employed in the study. The study group consisted of 37 pre-service mathematics teachers who were enrolled in a Turkish state…

Prospective Science Teachers' Perception Related to Formative Assessment Approaches in Turkey

ERIC Educational Resources Information Center

Yasar, M. Diyaddin

2017-01-01

In this study, it was aimed to investigate the perceptions and competences of prospective science teachers about formative assessment approaches. Qualitative case study methodology was used in the study. Research group consisted of 17 senior students of science education. As a data collection tool, a semi-structured "Formative Assessment…

Motor Profile of Children with Attention Deficit Hyperactivity Disorder, Combined Type

ERIC Educational Resources Information Center

Goulardins, Juliana B.; Marques, Juliana C. Bilhar; Casella, Erasmo B.; Nascimento, Roseane O.; Oliveira, Jorge A.

2013-01-01

Objectives: The aim of this study was to assess the motor profile of children with attention deficit hyperactivity disorder (ADHD), combined type. Method: The case group consisted of 34 treatment-naive, male patients, aged 7-11 years, who had been diagnosed with ADHD, combined type, without comorbidities (except oppositional defiant disorder). The…

Revitalising Mathematics Classroom Teaching through Lesson Study (LS): A Malaysian Case Study

ERIC Educational Resources Information Center

Lim, Chap Sam; Kor, Liew Kee; Chia, Hui Min

2016-01-01

This paper discusses how implementation of Lesson Study (LS) has brought about evolving changes in the quality of mathematics classroom teaching in one Chinese primary school. The Japanese model of LS was adapted as a teacher professional development to improve mathematics teachers' teaching practices. The LS group consisted of five mathematics…

Stop the Presses! Using the Journalism Field as a Case Study to Help Community College Administrators Today

ERIC Educational Resources Information Center

Basham, Matthew J.; Campbell, Dale F.; Garcia, Emmanual

2010-01-01

A focus group consisting of board of trustee members, community college presidents, senior administrators, administrators, and faculty members from community colleges around the United States developed the top six critical issues facing community colleges with respect to instructional planning and services; planning, governance, and finance; and…

Case Study of Characteristics of Effective Leadership in Graduate Student Collaborative Work

ERIC Educational Resources Information Center

Duemer, Lee S.; Christopher, Mary; Hardin, Fred; Olibas, Lezlie; Rodgers, Terry; Spiller, Kevin

2004-01-01

The purpose of the study was to determine the effective leadership characteristics of graduate students working in a collaborative setting. A secondary goal was to develop recommendations that will help faculty better utilize group collaboration as a learning experience for graduate students. Data consisted of interviews of graduate students who…

The implementation of problem-based learning in collaborative groups in a chiropractic program in Malaysia.

PubMed

Win, Ni Ni; Nadarajah, Vishna Devi V; Win, Daw Khin

2015-01-01

Problem-based learning (PBL) is usually conducted in small-group learning sessions with approximately eight students per facilitator. In this study, we implemented a modified version of PBL involving collaborative groups in an undergraduate chiropractic program and assessed its pedagogical effectiveness. This study was conducted at the International Medical University, Kuala Lumpur, Malaysia, and involved the 2012 chiropractic student cohort. Six PBL cases were provided to chiropractic students, consisting of three PBL cases for which learning resources were provided and another three PBL cases for which learning resources were not provided. Group discussions were not continuously supervised, since only one facilitator was present. The students' perceptions of PBL in collaborative groups were assessed with a questionnaire that was divided into three domains: motivation, cognitive skills, and perceived pressure to work. Thirty of the 31 students (97%) participated in the study. PBL in collaborative groups was significantly associated with positive responses regarding students' motivation, cognitive skills, and perceived pressure to work (P<0.05). The students felt that PBL with learning resources increased motivation and cognitive skills (P<0.001). The new PBL implementation described in this study does not require additional instructors or any additional funding. When implemented in a classroom setting, it has pedagogical benefits equivalent to those of small-group sessions. Our findings also suggest that students rely significantly on available learning resources.

[Measles in Germany: An Epidemiological Analysis and First Measures for Containment].

PubMed

Matysiak-Klose, Dorothea; Wicker, Sabine

2017-11-01

Measles are one of the most contagious diseases of mankind. Measles incidence has declined worldwide since the introduction of vaccinations. Due to low numbers of measles cases in countries with high vaccination rates the population is not aware of possible complications of measles any more. Measles elimination is an important goal set by all regions of the World Health Organization. However, it remains a challenge for Germany and other European countries. Because of a high proportion of susceptibles in specific population and age groups outbreaks take place in Germany every year after importation of the virus. More than 50 % of measles cases are 20 years and older. However, the highest incidences have been seen in two-year-olds since several years. In addition to epidemiological findings such as case numbers and risk groups, genotyping permits e. g. an assessment of the endemic circulation of viruses. Suspicion of a measles case should result in immediate and consistent measures. © Georg Thieme Verlag KG Stuttgart · New York.

Prenatal diagnosis of xeroderma pigmentosum group A in Japan.

PubMed

Moriwaki, Shinichi; Yamashita, Yoshiki; Nakamura, Sachiko; Fujita, Daisuke; Kohyama, Jun; Takigawa, Masahiro; Ohmichi, Masahide

2012-06-01

We performed a prenatal diagnosis for 10 fetuses from nine unrelated Japanese xeroderma pigmentosum complementation group A (XP-A) families. All parents had at least one XP-A child (proband) with a homozygous founder mutation (IVS3-1G>C) in the XPA gene. A genetic analysis was performed by a restriction enzyme; AlwNI fragment length polymorphism of polymerase chain reaction (PCR)-amplified DNA, mostly from amniotic fluid (AF) and cultured cells established from AF. However, for the first family, we tried amniocentesis as well as chorionic villus sampling (CVS). Among the 10 cases, we confirmed the results of PCR-based genetic diagnosis by post-ultraviolet survival of amniotic cells in eight cases. Unfortunately, 6 weeks after CVS and 4 days after the amniocentesis in the first case we examined, the fetus died in utero, the reason for which remains unexplained. We prenatally determined two XP-A cases, six XP-A carriers and two wild-type fetuses, which appears to be consistent with Mendel's law. © 2011 Japanese Dermatological Association.

A case-control study evaluating relative risk factors for decompression sickness: a research report.

PubMed

Suzuki, Naoko; Yagishita, Kazuyosi; Togawa, Seiichiro; Okazaki, Fumihiro; Shibayama, Masaharu; Yamamoto, Kazuo; Mano, Yoshihiro

2014-01-01

Factors contributing to the pathogenesis of decompression sickness (DCS) in divers have been described in many studies. However, relative importance of these factors has not been reported. In this case-control study, we compared the diving profiles of divers experiencing DCS with those of a control group. The DCS group comprised 35 recreational scuba divers who were diagnosed by physicians as having DCS. The control group consisted of 324 apparently healthy recreational divers. All divers conducted their dives from 2009 to 2011. The questionnaire consisted of 33 items about an individual's diving profile, physical condition and activities before, during and just after the dive. To simplify dive parameters, the dive site was limited to Izu Osezaki. Odds ratios and multiple logistic regression were used for the analysis. Odds ratios revealed several items as dive and health factors associated with DCS. The major items were as follows: shortness of breath after heavy exercise during the dive (OR = 12.12), dehydration (OR = 10.63), and maximum dive depth > 30 msw (OR = 7.18). Results of logistic regression were similar to those by odds ratio analysis. We assessed the relative weights of the surveyed dive and health factors associated with DCS. Because results of several factors conflict with previous studies, future studies are needed.

Regional brain volumes and cognition in childhood epilepsy: does size really matter?

PubMed

Zelko, Frank A; Pardoe, Heath R; Blackstone, Sarah R; Jackson, Graeme D; Berg, Anne T

2014-05-01

Recent studies have correlated neurocognitive function and regional brain volumes in children with epilepsy. We tested whether brain volume differences between children with and without epilepsy explained differences in neurocognitive function. The study sample included 108 individuals with uncomplicated non-syndromic epilepsy (NSE) and 36 healthy age- and gender-matched controls. Participants received a standardized cognitive battery. Whole brain T1-weighted MRI was obtained and volumes analyzed with FreeSurfer (TM). Total brain volume (TBV) was significantly smaller in cases. After adjustment for TBV, cases had significantly larger regional grey matter volumes for total, frontal, parietal, and precentral cortex. Cases had poorer performance on neurocognitive indices of intelligence and variability of sustained attention. In cases, TBV showed small associations with intellectual indices of verbal and perceptual ability, working memory, and overall IQ. In controls, TBV showed medium associations with working memory and variability of sustained attention. In both groups, small associations were seen between some TBV-adjusted regional brain volumes and neurocognitive indices, but not in a consistent pattern. Brain volume differences did not account for cognitive differences between the groups. Patients with uncomplicated NSE have smaller brains than controls but areas of relative grey matter enlargement. That this relative regional enlargement occurs in the context of poorer overall neurocognitive functioning suggests that it is not adaptive. However, the lack of consistent associations between case-control differences in brain volumes and cognitive functioning suggests that brain volumes have limited explanatory value for cognitive functioning in childhood epilepsy. Copyright © 2014 Elsevier B.V. All rights reserved.

Three-week or one-week bladder catheterization for hypospadias repair? A retrospective-prospective observational study of 189 patients.

PubMed

Daher, Paul; Khoury, Antoine; Riachy, Edward; Atallah, Bachir

2015-06-01

While there is little scientific evidence over the optimal duration for transurethral bladder catheterization after hypospadias repair, most surgeons leave the catheter for 7-10 days. We herein describe our experience with bladder catheterization for three weeks after hypospadias repair, an approach not previously described in the literature. We reviewed the charts of 189 patients who underwent hypospadias repair by a single pediatric urologist. The study population was divided as follows: group 1 consisted of children operated between March 2007 and September 2010 and whose catheters were left for one week (n=95); group 2 consisted of those operated between September 2010 and July 2013 and whose catheters were left for three weeks (n=94). The primary objective of the study was to compare complication rates between the two groups. Secondary outcomes were evaluation of the effect of age, surgical technique, curvature, and hypospadias degree as potential factors for postoperative complications. Median age at hypospadias repair was 18 months (range, 3-100 months) in group 1, and 16 months (range, 2-96 months) in group 2, P=.209. The complication rate was 22.1% (n=21) for group 1 and 7.4% (n=7) for group 2, P=.005. Complications observed in group 1 and 2 were meatal stenosis (n=4 and 2, respectively) and urethro-cutaneous fistulas (n=17 and 5, respectively). Coronal fistulas manifested more frequently in patients in group 1 compared to those in group 2 (13.7% vs. 3.2%, P=.01). Complications were observed in 20 patients out of 139 (11.5%) after Duplay, and in 8 patients out of 15 (53.3%) after Duckett (P<.001). In Duplay cases, complications were significantly associated with one-week bladder catheterization (OR: 5.00; 95% CI: 1.53-16.32; P=.008) and higher age group at operation (OR: 1.88; 95% CI 1.07-3.28; P=.026). In Duckett cases, number of surgeries, age, severity, curvature and catheter duration were not found to be associated with complications. In cases of Duplay, a three-week instead of one-week catheterization and age below 6 months at hypospadias repair are associated with a better outcome and fewer complications. Copyright © 2015 Elsevier Inc. All rights reserved.

["Addiction" to phenelzine - case report].

PubMed

Antosik-Wójcińska, Anna Z; Bzinkowska, Dorota; Chojnacka, Magdalena; Swiecicki, Łukasz; Torbiński, Jarosław

2013-01-01

The use of non-selective monoamine oxidase inhibitors (IMAO) may be associated with the risk of addiction, which is confirmed by case studies published so far. Harmful use of antidepressants in patients with affective disorders and anxiety is not frequent, but due to the fact that in clinical practice can meet with this phenomenon, we present the case of a 30-year-old patient with a history of using phenelzine who presented a combination of symptoms that meet criteria for addiction. The current classification of ICD- 10 does not consist the diagnosis of dependence on antidepressants. In this case, the category F55.0: abuse of a substance which does not cause addiction, should be used. In the literature most often mentioned as a possible substances with addictive potential is a group of non-selective MAO, particularly tranylcypromine. The mechanism of non-selective MAO dependence may be associated with the similarity of their chemical structure to amphetamine (both amphetamine and IMAO are derivatives of phenylethylamine), although the mechanism of action is different. Furthermore, it was noted that there is a group of patients in whom treatment with IMAO is associated with greater risk of abuse of these substances. The study contains the characteristics of this group of patients.

Observations of Student Behavior in Collaborative Learning Groups

NASA Astrophysics Data System (ADS)

Adams, Jeffrey P.; Brissenden, Gina; Lindell, Rebecca S.; Slater, Timothy F.; Wallace, Joy

In an effort to determine how our students were responding to the use of collaborative learning groups in our large enrollment introductory astronomy (ASTRO 101) courses, we systematically observed the behavior of 270 undergraduate students working in 48 self-formed groups. Their observed behaviors were classified as: (i) actively engaged; (ii) watching actively; (iii) watching passively; and (iv) disengaged. We found that male behavior is consistent regardless of the sex-composition of the groups. However, females were categorized as watching passively and or disengaged significantly more frequently when working in groups that contained uneven numbers of males and females. This case study observation suggests that faculty who use collaborative learning groups might find that the level of student participation in collaborative group learning activities can depend on the sex-composition of the group.

Trial of an electronic decision support system to facilitate shared decision making in community mental health.

PubMed

Woltmann, Emily M; Wilkniss, Sandra M; Teachout, Alexandra; McHugo, Gregory J; Drake, Robert E

2011-01-01

Involvement of community mental health consumers in mental health decision making has been consistently associated with improvements in health outcomes. Electronic decision support systems (EDSSs) that support both consumer and provider decision making may be a sustainable way to improve dyadic communication in a field with approximately 50% workforce turnover per year. This study examined the feasibility of such a system and investigated proximal outcomes of the system's performance. A cluster randomized design was used to evaluate an EDSS at three urban community mental health sites. Case managers (N=20) were randomly assigned to the EDSS-supported planning group or to the usual care planning group. Consumers (N=80) were assigned to the same group as their case managers. User satisfaction with the care planning process was assessed for consumers and case managers (possible scores range from 1 to 5, with higher summary scores indicating more satisfaction). Recall of the care plan was assessed for consumers. Linear regression with adjustment for grouping by worker was used to assess satisfaction scores. A Wilcoxon rank-sum test was used to examine knowledge of the care plan. Compared with case managers in the control group, those in the intervention group were significantly more satisfied with the care planning process (mean ± SD score=4.0 ± .5 versus 3.3 ± .5; adjusted p=.01). Compared with consumers in the control group, those in the intervention group had significantly greater recall of their care plans three days after the planning session (mean proportion of plan goals recalled=75% ± 28% versus 57% ± 32%; p=.02). There were no differences between the clients in the intervention and control groups regarding satisfaction. This study demonstrated that clients can build their own care plans and negotiate and revise them with their case managers using an EDSS.

Epidemiology of traumatic upper limb amputations.

PubMed

Pomares, G; Coudane, H; Dap, F; Dautel, G

2018-04-01

While published data on functional outcomes after upper limb amputations are plentiful, epidemiology data are relatively rare. This led us to performing an epidemiology study of traumatic upper limb amputations at our facility. This retrospective study spanned a 10-year period of cases seen at the SOS Main (Hand emergency center) of the Nancy University Hospital in France. Patients who suffered traumatic amputation of the upper limb were identified and divided into two groups: replantation and surgical amputation. All anatomical amputation levels were retained. Non-traumatic amputations were excluded. Epidemiology data (sex, age, dominant side, injured side) was collected along with the specific anatomical level of the injury, the injury mechanism and whether it was work-related. We also looked at the success rate of microsurgery and whether multi-finger amputations were partial or complete. In parallel, the annual incidence of amputations seen at the SOS Main over this period was calculated. Over the 10-year period, 1715 traumatic upper-limb amputations were identified, which was 3% of all cases seen at the SOS Main. Most of the cases involved middle-aged men. Revascularization was attempted in one-third of cases and microsurgery was successful in 70% of cases. The surgical amputation group consisted of 1132 patients with a mean age of 59 years, while the replantation group consisted of 583 patients with a mean age of 48 years. The primary mechanism of injury was a table saw. This injury, which must be addressed urgently, is not very common in everyday practice. This is contrary to lower limb amputations, which are more common and occur in the context of micro- and macroangiopathy in older patients. The success rate of microsurgery in this cohort must be placed in the context of age, amputation level and mechanism. The functional outcomes are not always as good as the vascular outcomes. This data is invaluable as it fills a gap in our knowledge about amputations. IV. Copyright © 2018. Published by Elsevier Masson SAS.

The importance of surgeon experience for clinical and economic outcomes from thyroidectomy.

PubMed Central

Sosa, J A; Bowman, H M; Tielsch, J M; Powe, N R; Gordon, T A; Udelsman, R

1998-01-01

OBJECTIVE: To determine whether individual surgeon experience is associated with improved short-term clinical and economic outcomes for patients with benign and malignant thyroid disease who underwent thyroid procedures in Maryland between 1991 and 1996. SUMMARY BACKGROUND DATA: There is a prevailing belief that surgeon experience affects patient outcomes in endocrine surgery, but there is a paucity of objective evidence outside of clinical series published by experienced surgeons that supports this view. METHODS: A cross-sectional analysis of all patients who underwent thyroidectomy in Maryland between 1991 and 1996 was conducted using a computerized statewide hospital discharge data base. Surgeons were categorized by volume of thyroidectomies over the 6-year study period: A (1 to 9 cases), B (10 to 29 cases), C (30 to 100 cases), and D (>100 cases). Multivariate regression was used to assess the relation between surgeon caseload and in-hospital complications, length of stay, and total hospital charges, adjusting for case mix and hospital volume. RESULTS: The highest-volume surgeons (group D) performed the greatest proportion of total thyroidectomies among the 5860 discharges, and they were more likely to operate on patients with cancer. After adjusting for case mix and hospital volume, highest-volume surgeons had the shortest length of stay (1.4 days vs. 1.7 days for groups B and C and 1.9 days for group A) and the lowest complication rate (5.1 % vs. 6.1% for groups B and C and 8.6% for group A). Length of stay and complications were more determined by surgeon experience than hospital volume, which had no consistent association with outcomes. CONCLUSIONS: Individual surgeon experience is significantly associated with complication rates and length of stay for thyroidectomy. PMID:9742915

Nursing Case Management and Glycemic Control Among Brazilians With Type 2 Diabetes: Pragmatic Clinical Trial.

PubMed

Moreira, Ricardo Castanho; Mantovani, Maria de Fátima; Soriano, José Verdú

2015-01-01

Type 2 diabetes mellitus is a chronic condition that requires ongoing, life-long care in order to be controlled. The aims of the study were to assess the effect of nursing case management on glycated hemoglobin (HbA1c) levels compared to usual care in people with type 2 diabetes mellitus and to determine if effects of nursing case management varied by gender, age, duration of disease, education, and income. This is a pragmatic clinical trial, conducted in the municipality of Bandeirantes, Paraná, Brazil, in 2011 and 2012. Eighty individuals were recruited and randomized equally to receive nursing case management or usual care. Covariates were sociodemographic and clinical factors. The outcome was HbA1c measured at baseline, 6 months, and 12 months. The sample consisted predominately of women; most had been diagnosed with type 2 diabetes mellitus within the previous 5 years. Mean age was 50.14 (SD = 7.00), with 5.27 (SD = 4.39) years of schooling and an average HbA1c of 9.90% (SD = 2.49). Hemoglobin A1c was reduced from an average of 10.33% to 9.0% (p < .01) in the nursing case management group and from 9.57% to 8.93% (p = .05) in the usual care group; the group by time effect was not significant. Case management effects varied by younger age (p = .05), duration of type 2 diabetes less than 5 years (p = .03), up to 4 years of schooling (p = .04), and being in the lowest-income stratum (p = .02). Both groups showed a statistically significant reduction of HbA1c at 6 and 12 months following baseline. The difference in proportional reduction of HbA1c between groups was not statistically significant.

Trends and risk factors of hepatitis A in Catalonia after the introduction of a hepatitis A+B vaccination programme.

PubMed

Godoy, P; Carmona, G; Manzanares, S; Jane, M; Borràs, E; Camps, N; Álvarez, J; Barrabeig, I; Sala, M-R; Rius, C; Minguell, S; Carol, M; Ferras, J; Domínguez, A

2018-03-31

At the end of 1998, universal hepatitis A+B vaccination of 12 year olds was introduced in Catalonia. The aim was to examine trends in hepatitis A during 2005-2015 and assess risk factors by age group. We carried out an observational epidemiological study of the incidence and risk factors of hepatitis A reported to the surveillance system. Information on exposure was recorded for each case for the 2-6 weeks before symptom onset. Spearman's coefficient was used to evaluate the trends of rates. The chi-square test was used to compare categorical. We studied 2621 hepatitis A cases; the age mean was 26.6 years (SD=18.2), and >50% of cases were in the 20-49 years age group. The incidence decreased from 3.28/100 000 in 2005 to 1.50/100 000 in 2015. The rate for women decreased over time (P = .008), but the reduction was not significant in men (P = .234). Men consistently had higher rates than women with the biggest difference being in the 20-34 years age group (rate 8.8 vs 2.8). The greatest risk factor was travel to an endemic country (42.1%) in the 0-19 years age group and male-to-male sexual contact (18.6%) in the 20-49 years age group. The case fatality rate in adults aged >49 years was 0.4%. In conclusion, the vaccination programme of preadolescents resulted in a reduction in hepatitis A cases. However, a significant amount of cases still appear in immigrants and men who have sex with men. Hepatitis A in adults is an emerging health problem that will require new strategies. © 2018 John Wiley & Sons Ltd.

Evaluation of Salivary Flow Rate, pH and Buffer in Pre, Post & Post Menopausal Women on HRT

PubMed Central

D.R., Mahesh; G., Komali; K., Jayanthi; D., Dinesh; T.V., Saikavitha; Dinesh, Preeti

2014-01-01

Background: Climateric is considered to be a natural phase of life which by definition is the period of life starting from decline in ovarian activity until after the end of ovarian function. It is accompanied by various health consequences that include the changes in saliva too. This study was carried out to evaluate the salivary flow rate, pH, buffering capacity in pre-menopausal, post-menopausal and post-menopausal women on HRT. Aims and objectives: (1) To evaluate the salivary flow rate, pH of resting saliva and stimulated saliva and buffer capacity of stimulated saliva in pre-menopausal, post-menopausal and post-menopausal women on Hormone Replacement Therapy (HRT). (2) To compare the above salivary findings between pre-menopausal, post-menopausal and post-menopausal women on HRT. Materials and Methods: The study was carried out on 60 patients. These patients were divided into three groups of 20 patients: Group 1: Pre-menopausal women (control), Group 2: post-menopausal women (case), Group 3: post-menopausal women on HRT (case). The control group consisted of 20 women volunteers, having regular ovulatory menstrual cycles with no known systemic illness and deleterious habits and Group 2 consists of 20 post-menopausal women and Group 3 will consist of 20 post-menopausal women on HRT. After clearing the mouth by swallowing, stimulated saliva was collected after chewing paraffin for 10 mins in to a glass centrifuge tube graded in 0.1 mL increments up to 10mL.in rare cases the collection time will be reduced or extended (5-15 min), salivary flow rate will be determined as ml/min, immediately after collection, pH was determined by dipping pH test paper directly into the sample of oral fluid, salivary buffer capacity was determined by using saliva check buffer kit (GC corporation). The data obtained was statistically evaluated using chi-square test, fisher exact test ANOVA analysis. Results: In our study we found salivary flow rate significantly lower in the post-menopausal women in comparison with the menstruating women and also there was improvement in the flow rate in individuals who were on HRT, it was also observed that salivary pH of the post-menopausal group was significantly lower than that of the control group, statistically significant difference in buffer capacity values was found between the groups however buffer capacity values were higher in the post-menopausal group than the control group. Conclusion: From the above study it is clear that post-menopausal women will present with oral discomfort, while HRT can improve the same. Hence our role as physicians and health care providers is to incorporate preventive dental health care in post-menopausal women and clearly inform patients about both the benefits and the limitations of HRT. PMID:24701542

[Association between mothers' body mass index before pregnancy or weight gain during pregnancy and autism in children].

PubMed

Ling, Ziyu; Wang, Jianmin; Li, Xia; Zhong, Yan; Qin, Yuanyuan; Xie, Shengnan; Yang, Senbei; Zhang, Jing

2015-09-01

To explore the relationship between mothers' body mass index (BMI) before pregnancy or weight gain during pregnancy and autism in children. From 2013 to 2014, the 181 children with autism and 181 healthy children matched by sex and age from same area were included in this study. According to mothers' BMI before pregnancy, the selected cases were divided into 3 groups: low, normal and high group. Then 3 groups were divided into 3 subgroups based on mother' s weight gain during pregnancy: low, normal and high group, according to the recommendations of Institute of Medicine. Logistic regression analysis and χ(2) test were conducted with SPSS 18.0 software to analysis the relationship between mothers' BMI before pregnancy or weight gain during pregnancy and autism in children. The age and sex distributions of case group and control group were consistent (χ(2)=0.434, P>0.05). The mothers' BMI before pregnancy of case group was higher than that of control group (χ(2)=9.580, P<0.05) ,which was (21.28±3.80) kg/m(2) for case group and (19.87±2.83) kg/m(2) for control group. The proportion of cases in high BMI group (10.5%) was much higher than that in control group (2.8%) . The risk of children with autism in high BMI group was 3.7 times higher than that in normal BMI group (OR=3.71, 95% CI: 1.34-10.24). In normal BMI group, the proportion of mothers who had excessive weight gain during pregnancy was higher in case group (44.1%) than in control group (33.9%). In high BMI group, the proportion of mothers who had excessive weight gain was higher in case group (52.6%) than in control group (20.0%) . In normal BMI group (χ(2) =8.690, P<0.05) and high BMI group (χ(2)=4.775, P<0.05), the weight gain during pregnancy was associated with autism in children. Logistic regression analysis showed that mothers' BMI before pregnancy (unadjusted OR=1.89, 95% CI: 1.26-2.85, adjusted OR=1.52, 95% CI: 1.19-2.27) and weight gain during pregnancy were the risk factors for autism in children (unadjusted OR=1.63, 95% CI: 1.08-1.25, adjusted OR=1.64, 95% CI: 1.21-2.21). Overweight or obesity before pregnancy and excessive weight gain during pregnancy were associated with autism in children, suggesting that women who plan to be pregnant should pay attention to body weight control.

Discriminating nutritional quality of foods using the 5-Color nutrition label in the French food market: consistency with nutritional recommendations.

PubMed

Julia, Chantal; Ducrot, Pauline; Péneau, Sandrine; Deschamps, Valérie; Méjean, Caroline; Fézeu, Léopold; Touvier, Mathilde; Hercberg, Serge; Kesse-Guyot, Emmanuelle

2015-09-28

Our objectives were to assess the performance of the 5-Colour nutrition label (5-CNL) front-of-pack nutrition label based on the Food Standards Agency nutrient profiling system to discriminate nutritional quality of foods currently on the market in France and its consistency with French nutritional recommendations. Nutritional composition of 7777 foods available on the French market collected from the web-based collaborative project Open Food Facts were retrieved. Distribution of products across the 5-CNL categories according to food groups, as arranged in supermarket shelves was assessed. Distribution of similar products from different brands in the 5-CNL categories was also assessed. Discriminating performance was considered as the number of color categories present in each food group. In the case of discrepancies between the category allocation and French nutritional recommendations, adaptations of the original score were proposed. Overall, the distribution of foodstuffs in the 5-CNL categories was consistent with French recommendations: 95.4% of 'Fruits and vegetables', 72.5% of 'Cereals and potatoes' were classified as 'Green' or 'Yellow' whereas 86.0% of 'Sugary snacks' were classified as 'Pink' or 'Red'. Adaptations to the original FSA score computation model were necessary for beverages, added fats and cheese in order to be consistent with French official nutritional recommendations. The 5-CNL label displays a high performance in discriminating nutritional quality of foods across food groups, within a food group and for similar products from different brands. Adaptations from the original model were necessary to maintain consistency with French recommendations and high performance of the system.

Age-related Decline in Case-Marker Processing and its Relation to Working Memory Capacity.

PubMed

Sung, Jee Eun

2017-09-01

Purposes of the current study were to investigate whether age-related decline emerged in a case-marker assignment task (CMAT) and to explore the relationship between working-memory (WM) capacity and case-marker processing. A total of 121 individuals participated in the study with 62 younger adults and 59 elderly adults. All were administered a CMAT that consisted of active and passive constructions with canonical and noncanonical word-order conditions. A composite measure of WM tasks served as an index of participants' WM capacity. The older group performed worse than the younger group, and the noncanonical word order elicited worse performance than the canonical condition. The older group demonstrated greater difficulty in case-marker processing under the canonical condition and passive construction. Regression results revealed that age, education, and sentence type were the best predictors to account for performance on the CMAT. The canonicity of word order and passive construction were critical factors related to decline in abilities in a case-marker assignment. The combination of age, education, and sentence type factors accounted for overall performance on case-marker processing. Results indicated the crucial necessity to find a cognitively and linguistically demanding condition that elicits aging effects most efficiently, considering language-specific syntactic features. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Papillary proliferation of the endometrium: a clinicopathologic study of 59 cases of simple and complex papillae without cytologic atypia.

PubMed

Ip, Philip P C; Irving, Julie A; McCluggage, W Glenn; Clement, Philip B; Young, Robert H

2013-02-01

Papillary proliferation of the endometrium (PPE) without cytologic atypia is uncommon and has only been studied in detail by Lehman and Hart in 2001. On histologic examination, PPE ranges from simple papillae with fibrovascular cores, often involving the surface of endometrial polyps, to complex intracystic proliferations; some consider the latter to be analogous to nonatypical complex hyperplasia. To further characterize PPE, with emphasis on the risk of and features associated with concurrent or subsequent neoplasia, the clinicopathologic features of 59 cases without cytologic atypia were studied. The cases were classified into 2 groups according to the degree of architectural complexity and extent of proliferation. Group 1 consisted of those with localized simple papillae. Simple papillae were defined as those with short, predominantly nonbranching stalks; those with occasional secondary branches and/or detached papillae were also included in this group. Localized proliferations were those with 1 or 2 foci involving the surface or the subjacent glands of polyps or nonpolypoid endometrium. Group 2 consisted of those with complex papillae and/or those with diffuse and crowded intracystic papillae. Complex papillae were those with either short or long stalks, with frequent secondary and complex branches. Diffuse proliferation was defined as presence of 3 or more foci within a specimen or involvement of >50% of the endometrial polyp by simple or complex PPE. Any coexistent or subsequent hyperplasia of conventional type (World Health Organization classification) or adenocarcinoma was recorded. The age of patients ranged from 23 to 82 years (median, 53 y); 36 (61%) were postmenopausal. The majority presented with abnormal vaginal bleeding. Sixteen patients (27%) were receiving hormonal preparations including 5 who were treated with a progestogen for preexisting endometrial hyperplasia or low-grade endometrioid adenocarcinoma. The histologic diagnosis of PPE was made in 49 biopsies and in 10 hysterectomy specimens. Thirty-six cases (61%) were classified as group 1 and 23 (39%) as group 2. In 47 cases (80%), there was a coexisting endometrial polyp, 39 (66%) of which were involved by the PPE. Fifty-three cases (90%) had coexisting epithelial metaplastic changes, 41 (77%) of which were involved by the PPE. The most common type of metaplasia was mucinous (41 of 59 cases, or 69%). Follow-up information was known for 46 patients (78%). Coexistent or subsequent nonatypical and atypical hyperplasia was found in 8 (17%) and 6 cases (13%), respectively. In 6 of the 46 cases (13%), a low-grade endometrioid adenocarcinoma was present either in the original specimen or during follow-up. In contrast to group 1 PPE, those with group 2 features were significantly associated with concurrent or subsequent premalignant lesions (nonatypical and atypical hyperplasia) or carcinoma (P<0.0001). This study indicates that localized and architecturally simple PPEs confined to a completely removed polyp are usually associated with a benign outcome and may be appropriately labeled as "benign papillary proliferation of the endometrium." Lesions with architecturally complex papillae, especially when extensive, have an increased risk of concurrent or subsequent endometrial hyperplasia and carcinoma and should probably be regarded as analogous to atypical complex hyperplasia, and the term "complex papillary hyperplasia" is appropriate. As the distinction between simple and complex PPE may be difficult in small endometrial aspirational samples, consideration for curettage should be given to ascertain whether the lesion has been completely removed.

Selective immediate responders to amoxicillin and clavulanic acid tolerate penicillin derivative administration after confirming the diagnosis.

PubMed

Blanca-Lopez, N; Perez-Alzate, D; Ruano, F; Garcimartin, M; de la Torre, V; Mayorga, C; Somoza, M L; Perkins, J; Blanca, M; Canto, M G; Torres, M J

2015-08-01

An increasing number of patients show immediate selective hypersensitivity reactions to clavulanic acid (CLV) and amoxicillin (AX), probably due to their increased prescription. The maintenance of this response should be established. To assess that the immediate hypersensitivity selective response to AX or to CLV is maintained after repeated administration of penicillin G (PG)/penicillin V (PV) and AX. Patients with proven immediate hypersensitivity to AX (Group A) or CLV (Group B) were included. Diagnosis was performed using skin tests with major and minor determinants of PG (PPL/MDM), AX and CLV and by drug provocation test (DPT) if required. Selectivity was established by confirming tolerance to PG/PV (Group A) and to PG/PV and AX (Group B). The maintenance of the selective response was verified by repeating DPT, 15 days after the initial investigation, with the same procedure. Of 51 patients, 78% belonged to Group A and 22% to Group B. Most had anaphylaxis. In Group A, 72% were skin test positive; 28% required DPT. In Group B, 63% were skin test positive; 37% required DPT. Only two AX-selective cases developed positive responses after re-provocation with PG/PV. No cases selective for CLV developed a positive response to PG, PV or AX. The selective response to AX appears consistent, and a response to penicillin determinants only develops in a minority of cases. For the case of CLV, the selective response appears not to be modified by exposure to penicillin determinants, meaning that patients with CLV allergy can take penicillin derivatives safely. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Does high flexion after total knee replacement really improve our patients' quality of life at a short-term follow-up? : a comparative case-control study with hyperflex PFC Sigma versus a Triathlon knee series.

PubMed

Mencière, Maxime L; Epinette, Jean-Alain; Gabrion, Antoine; Arnalsteen, Damien; Mertl, Patrice

2014-10-01

A full range of motion after total knee arthroplasty has become more and more requested by our patients, leading to novel designs of knee implants, the so-called "hyperflex" knees. The aim of the present study was to confirm whether or not hyperflexion of operated knees really improves the patients' quality of life. A retrospective comparative case-control study has been carried out to compare clinical results shown in two types of knee prosthesis, from two homogeneous paired groups of patients including 45 cases of a "hyperflex" model (RP-F), while the control group consisted of 43 cases of a "regular design" model (Triathlon) in terms of expected postoperative flexion. The hyperflex group demonstrated significant higher mean values of passive flexion at 119.9° in the RP-F group versus 111.1° in the Triathlon group. However, global results in the "regular" control group were significantly better than the "hyperflex" study group, in both IKS knee and functional scores at 84.4 points (RP-F) vs. 89.8 points (Triathlon), and 84.6 points (RP-F) vs. 89.5 points (Triathlon), respectively. Moreover, the self-administered KOOS questionnaire was significantly in favor of the control group, with 73.5 points in RP-F knees versus 86.0 points for Triathlon knees at global KOOS postoperative scores. The quality of life of operated patients after TKA obviously would be considered as the main priority, which was better obtained by a "regular design" in our study. Hence "high flexion" cannot be considered as an absolute target when choosing a model for total knee arthroplasty.

During computing tasks symptomatic female office workers demonstrate a trend towards higher cervical postural muscle load than asymptomatic office workers: an experimental study.

PubMed

Szeto, Grace P Y; Straker, Leon M; O'Sullivan, Peter B

2009-01-01

Do symptomatic female office workers perform computing tasks with higher cervical postural muscle loads (in terms of higher amplitudes and less muscular rest) and more discomfort compared with asymptomatic individuals? Are these differences in postural muscle loads consistent across bilateral (typing) and unilateral (mousing) conditions? an experimental case-control study. 18 symptomatic female office workers and 21 asymptomatic female office workers. Three conditions (typing, mousing, and type-and-mouse) were performed in random order. Muscle load was measured as median amplitude and gap frequency using surface EMG of bilateral cervical erector spinae and upper trapezius. Discomfort was measured using a numerical rating scale. The case group demonstrated 4.3% (95% CI 0.1 to 8.4) higher amplitude during typing and 3.5% (95% CI 0.1 to 6.9) higher amplitude during type-and-mouse in the right cervical erector spinae compared with the control group. There was a similar difference between groups in the left cervical erector spinae which also demonstrated a 1.2 gaps/min (95% CI -2.3 to 0.0) lower frequency during typing. The case group had significantly higher discomfort during all conditions compared with the control group. The case group demonstrated higher median amplitudes and lower gap frequencies than the control group during bilateral conditions (typing and type-and-mouse) compared with unilateral conditions (mousing) for both muscle groups. There was increased amplitude and decreased muscular rest in the cervical erector spinae of office workers performing typing and mousing tasks. These findings may represent a mechanism underlying computer-related musculoskeletal disorders.

Virtual Research Environments for Natural Hazard Modelling

NASA Astrophysics Data System (ADS)

Napier, Hazel; Aldridge, Tim

2017-04-01

The Natural Hazards Partnership (NHP) is a group of 17 collaborating public sector organisations providing a mechanism for co-ordinated advice to government and agencies responsible for civil contingency and emergency response during natural hazard events. The NHP has set up a Hazard Impact Model (HIM) group tasked with modelling the impact of a range of UK hazards with the aim of delivery of consistent hazard and impact information. The HIM group consists of 7 partners initially concentrating on modelling the socio-economic impact of 3 key hazards - surface water flooding, land instability and high winds. HIM group partners share scientific expertise and data within their specific areas of interest including hydrological modelling, meteorology, engineering geology, GIS, data delivery, and modelling of socio-economic impacts. Activity within the NHP relies on effective collaboration between partners distributed across the UK. The NHP are acting as a use case study for a new Virtual Research Environment (VRE) being developed by the EVER-EST project (European Virtual Environment for Research - Earth Science Themes: a solution). The VRE is allowing the NHP to explore novel ways of cooperation including improved capabilities for e-collaboration, e-research, automation of processes and e-learning. Collaboration tools are complemented by the adoption of Research Objects, semantically rich aggregations of resources enabling the creation of uniquely identified digital artefacts resulting in reusable science and research. Application of the Research Object concept to HIM development facilitates collaboration, by encapsulating scientific knowledge in a shareable format that can be easily shared and used by partners working on the same model but within their areas of expertise. This paper describes the application of the VRE to the NHP use case study. It outlines the challenges associated with distributed partnership working and how they are being addressed in the VRE. A case study is included focussing on the application of Research Objects to development work for the surface water flooding hazard impact model, a key achievement for the HIM group.

Transperitoneal laparoscopic pyeloplasty in children: does upper urinary tract anomalies affect surgical outcomes?

PubMed

Brunhara, João Arthur; Moscardi, Paulo Renato Marcelo; Mello, Marcos Figueiredo; Andrade, Hiury Silva; Carvalho, Paulo Afonso; Cezarino, Bruno Nicolino; Dénes, Francisco Tibor; Lopes, Roberto Iglesias

2018-01-01

To assess the feasibility and outcomes of laparoscopic pyeloplasty in children with complex ureteropelvic junction obstruction (UPJO) and compare to children with iso-lated UPJO without associated urinary tract abnormalities. Medical records of 82 consecutive children submitted to transperitoneal laparoscopic pyeloplasty in a 12-year period were reviewed. Eleven cases were con-sidered complex, consisting of atypical anatomy including horseshoe kidneys in 6 patients, pelvic kidneys in 3 patients, and a duplex collecting system in 2 patients. Patients were di-vided into 2 groups: normal anatomy (group 1) and complex cases (group 2). Demographics, perioperative data, outcomes and complications were recorded and analyzed. Mean age was 8.9 years (0.5-17.9) for group 1 and 5.9 years (0.5-17.2) for group 2, p=0.08. The median operative time was 200 minutes (180-230) for group 1 and 203 minutes (120-300) for group 2, p=0.15. Major complications (Clavien ≥3) were 4 (5.6%) in group 1 and 1 (6.3%) in group 2, p=0.52. No deaths or early postoperative complications such as: urinoma or urinary leakage or bleeding, occurred. The success rate for radiologic improvement and flank pain improvement was comparable between the two groups. Re-garding hydronephrosis, significant improvement was present in 62 patients (93.4%) of group 1 and 10 cases (90.9%) of group 2, p=0.99. The median hospital stay was 4 days (IQR 3-4) for group 1 and 4.8 days (IQR 3-6) for group 2, p=0.27. Transperitoneal laparoscopic pyeloplasty is feasible and effective for the management of UPJO associated with renal or urinary tract anomalies. Copyright® by the International Brazilian Journal of Urology.

Estimating vaccine effectiveness against severe influenza in England and Scotland 2011/2012: applying the screening method to data from intensive care surveillance systems.

PubMed

Thomas, H L; Andrews, N; Green, H K; Boddington, N L; Zhao, H; Reynolds, A; McMenamin, J; Pebody, R G

2014-01-01

Methods for estimating vaccine effectiveness (VE) against severe influenza are not well established. We used the screening method to estimate VE against influenza resulting in intensive care unit (ICU) admission in England and Scotland in 2011/2012. We extracted data on confirmed influenza ICU cases from severe influenza surveillance systems, and obtained their 2011/2012 trivalent influenza vaccine (TIV) status from primary care. We compared case vaccine uptake with population vaccine uptake obtained from routine monitoring systems, adjusting for age group, specific risk group, region and week. Of 60 influenza ICU cases reported, vaccination status was available for 56 (93%). Adjusted VE against ICU admission for those aged ≥ 65 years was -10% [95% confidence interval (CI) -207 to 60], consistent with evidence of poor protection from the 2011/2012 TIV in 2011/2012. Adjusted VE for those aged <65 years in risk groups was -296% (95% CI -930 to -52), suggesting significant residual confounding using the screening method in those subject to selective vaccination.

Micronuclei: An essential biomarker in oral exfoliated cells for grading of oral squamous cell carcinoma.

PubMed

Jadhav, Kiran; Gupta, Nidhi; Ahmed, Mujib Br

2011-01-01

Micronuclei in exfoliated oral epithelial cells have been shown in some studies to correlate with severity of this genotoxic damage. This severity can be measured in terms of grading of the lesions. To correlate frequency of micronuclei (MN) in oral exfoliated cells in clinically diagnosed cases of oral squamous cell carcinoma (OSCC) followed by a histopathological grading. The study subjects consisted of clinically diagnosed cases of OSCC. Healthy subjects without any tobacco consumption habits formed the control group. The cytosmears from both groups were stained with rapid Papanicolaou stain. MN were identified according to the criteria given by Countryman and Heddle with some modifications. The frequency of MN was three to four times higher in patients with OSCC as compared to patients in the control group and the difference was found to be highly significant. In 75% cases, the cytological grade as determined by the frequency of micronuclei correlated with the histopathological grade and this observation was statistically significant. MN can be a candidate to serve as a biomarker for prediction of the grade of OSCC.

The Effect of Consanguineous Marriage on Mental Health among the Students of the Shahrekord University of Medical Sciences.

PubMed

Hosseinpour, Maryam; Deris, Fatemeh; Solati-Dehkordi, Kamal; Heidari-Soreshjani, Sheida; Karimi, Negar; Teimori, Hossein

2016-11-01

In Iran, after unintentional accidents, mental health problems are the second leading burden of disease. Consanguineous marriage is very common in Iran and the association between parental consanguinity and mental health is an important issue that has not yet been studied sufficiently in Iran. To investigate the effect of consanguinity and the degree of relationship on different levels of mental health. In this cross-sectional study, conducted in the Shahrekord University of Medical Sciences, two groups of students were enrolled. The first group consisted of 156 students that had consanguineous parent (case group) and the second group was 156 students whose parents had non-blood relationship (control group). The students were evaluated using General Health Questionnaire (GHQ-28). Statistical analysis was conducted by Pearson's correlation coefficient, independent t-test and the one-way analysis of variance. Odd ratio was used to estimate the relative risk. Over 30% of the individuals were suffering from mental health problems. The most and least common mental health problems in both groups were social dysfunction (54.5% in the case group and the control group 50%) and depression (15.4% in the case group and 17.3% in the control group), respectively. No statistically significant difference was observed in the frequency of overall mental health and its subscales between student with non-consanguineous parent (control group) and the students that had consanguineous parent (case group) (p>0.05) and the status of mental health was not significantly different among student with different degree of kinship (p>0.05). The study revealed that social dysfunction was very common among the study students and also there were no relationship between parental consanguineous marriage and mental health. Parental consanguinity and genetic factors may not be the major causes of high prevalence of mental health problems in Iran and the effects of the environmental factors on these problems may be greater than those of the inherited ones.

[IL-1beta and PGE2 production in whole blood and gingival fluid in women with periodontitis and preterm low birth weight].

PubMed

Konopka, Tomasz; Rutkowska, Monika; Hirnle, Lidia; Kopeć, Wacław

2004-05-01

The aim of the investigation was to evaluate of IL-1beta and PGE2 concentrations in gingival fluid, whole blood as well as IL-1beta, PGE2 production after Escherichia coli lipopolysaccharide stimulation in whole blood in women with preterm low birth weight (PLBW), as compared to the control group. A case-control study of 88 postpartum women aged 17 to 39 was performed. The case group consisted of 52 women with PLBW and the control group consisted of 36 women giving birth in time. Concentration of inflammatory mediators in gingival fluid, blood serum and IL-1beta, PGE2 production in whole blood after bacterial lipopolysaccharide stimulation were determined by means of immunoenzymatic method. The levels of IL-1beta and PGE2 in gingival fluid were significantly higher in all PLBW mothers (also PLBW primiparous) than in the control group. In addition in the primiparous with PLBW group significantly higher PGE2 concentration in blood serum was found compared to the primiparous controls. There were no significant differences between women with PLBW and the controls together with a significantly higher production of IL-1beta and PGE2 in whole blood after LPS stimulation in women with periodontitis and gingivitis compared to subjects with healthy periodontium. Such findings suggest that inflammatory mediator synthesis is mainly result of specific cells exposition to bacterial products. Therefore it seems that more frequent occurrence of the phenotype of hyperactive cells that synthesise these mediators is not responsible for PLBW.

Family Stress with Chronic Childhood Illness: Cystic Fibrosis, Neuromuscular Disease, and Renal Disease.

ERIC Educational Resources Information Center

Holroyd, Jean; Guthrie, Donald

1986-01-01

Parents of children with neuromuscular disease, cystic fibrosis, and renal disease were compared with parents of control subjects matched by age to the clinical cases. The three clinical groups exhibited different patterns of stressful response, consistent with the nature of their illnesses and the requirements for care imposed on the families.…

Improving Ascertainment of Risk Factors for HIV Infection: Results of a Group-Randomized Evaluation

ERIC Educational Resources Information Center

Harrison, Kathleen McDavid; Pals, Sherri L.; Sajak, Tammy; Chase, Jennifer; Kajese, Tebitha

2010-01-01

To allow appropriate allocation of prevention and care funding, HIV/AIDS surveillance data must include risk factor information, currently available for less than 70% of cases reported in the United States. The authors evaluated an intervention consisting of provider training and materials to improve risk factor reporting. Facilities were matched…

Spiritual Expressions' Prediction of Mindfulness: The Case of Prospective Teachers

ERIC Educational Resources Information Center

Yalçin, S. Barbaros

2018-01-01

The purpose of this research is to determine whether prospective teachers' spiritual expressions have predicted their mindfulness. The research was conducted in relational screening model. The study group consisted of 411 students (81.2%) females and 94 (18.6%) males, totally 505 undergraduate students who are studying in the last year and who…

Factor Structure, Stability, and Congruence in the Functional Movement Screen

ERIC Educational Resources Information Center

Kelleher, Leila K.; Beach, Tyson A. C.; Frost, David M.; Johnson, Andrew M.; Dickey, James P.

2018-01-01

The scoring scheme for the functional movement screen implicitly assumes that the factor structure is consistent, stable, and congruent across different populations. To determine if this is the case, we compared principal components analyses of three samples: a healthy, general population (n = 100), a group of varsity athletes (n = 101), and a…

Middle School Mathematics Teachers' Reflection Activities in the Context of Lesson Study

ERIC Educational Resources Information Center

Bozkurt, Erhan; Yetkin-Özdemir, Iffet Elif

2018-01-01

The aim of this case study is to define reflection activities of a lesson study group that consisted of three middle school mathematics teachers in Usak, Turkey. In the process, the participants worked in collaboration for about 5 months to implement three study lesson practices. The data were collected through observations in the reflection…

Integration of Cultural Values in the Treatment of a Suicidal Adolescent.

ERIC Educational Resources Information Center

DiPilato, Marina

Identity formation is a process in which successive identifications with parents, siblings, peers, teachers, folk heroes, and cultural groups are synthesized into a coherent, consistent, and unique whole. This study reports the case of a 13 year old female, Jane, of mixed Latino and European American heritage who was admitted for long-term…

Causes of Student Absenteeism and School Dropouts

ERIC Educational Resources Information Center

Sahin, Seyma; Arseven, Zeynep; Kiliç, Abdurrahman

2016-01-01

The aim of the study is to investigate the causes of student absenteeism and school dropouts at primary, secondary and high school level in Düzce Province and to develop suggestions for solving these problems. A "case study" design, which is one of the qualitative research approaches, was used in this study. The study group consisted of…

University Students' Views about Their Cyber Bullying Behaviors and Self-Exposition

ERIC Educational Resources Information Center

Usta, Ertugrul

2017-01-01

The purpose of this research is to examine the views of university students on the presence and exposure of cyber bully behavior. The research study group consists of 10 male students who are higher education students. One of the qualitative research methods is "case study". In this direction, a "semi-structured interview form"…

A Case Study on the Relationships between Participation in Online Discussion and Achievement of Project Work

ERIC Educational Resources Information Center

Chang, Chi-Cheng

2008-01-01

The objective of the study is to discuss about the correlation between each group's performances of participation in online discussion and their achievements of project-based works. Performances of online discussion consist of content, frequency, and frequency of participation in discussion after each login into the Web community system. Research…

The Use of Case Studies in an Undergraduate Biochemistry Course

NASA Astrophysics Data System (ADS)

Cornely, Kathleen

1998-04-01

Most college biochemistry courses are taught in a format in which the professor lectures and the student memorizes. Although this is the best method for conveying large amounts of material, it puts the student in the position of passive learner. The lecture-based format has not been abandoned, but has been supplemented with case study projects assigned to the students upon completion of the intermediary metabolism unit. The case study assignment is modeled on similar exercises carried out in medical school biochemistry courses in the US and around the world. A description of the assignment follows: a group of 4-5 students is given a case study which gives the medical history of a patient with an inherited metabolic disease. The group is asked to provide biochemical explanations for the patient's symptoms and to suggest an effective course of treatment. The evaluation consists of a short paper that the students write as a group. The assignment provides the opportunity for small group interaction within a larger class and emphasizes cooperative-collaborative learning. Students learn by researching the topic on their own and debating it in small group discussions, and in so doing, gain a sense of confidence in themselves and the material they have learned over the course of the semester. Solving a "real-life" problem helps develop analytical and higher-order thinking skills and allows the students to see how biochemical concepts they have learned apply to a clinical situation.

[Development and Effects of a Children's Sex Education Program for the Parents of Lower Elementary Grade Students].

PubMed

Lee, Eun Mi; Kim, Hyunlye

2017-04-01

This study was done to develop a children's sex education program for the parents of lower elementary grade students and to evaluate its effects on sexual knowledge, gender role attitude, parent efficacy for child's sex education, and marital consistency. A quasi-experimental with a non-equivalent control group pretest-posttest design was used. The participants were 29 couples (58 parents, experimental group=28, control group=30) from G city. The 5-week (5-session) program was developed based on 'A theory of protection: parents as sex educators' and used the case-based small group learning method. Data were collected during July and August 2015. The characteristics of the program developed in the present study were a theoretical-based, client-centered, multi-method. After the intervention, the experimental group showed a significant improvement in sexual knowledge, gender role attitudes, parent efficacy for child's sex education, and marital consistency, compared to the control group. The effect sizes of the program were .64 (knowledge), .65 (gender role attitudes), and .68 (parent efficacy). The results of this study provided implications for the parents as effective sex educator and the role expansion of school health nurses. © 2017 Korean Society of Nursing Science

Is case-based learning an effective teaching strategy to challenge students' alternative conceptions regarding chemical kinetics?

NASA Astrophysics Data System (ADS)

Yalçınkaya, Eylem; Taştan-Kırık, Özgecan; Boz, Yezdan; Yıldıran, Demet

2012-07-01

Background: Case-based learning (CBL) is simply teaching the concept to the students based on the cases. CBL involves a case, which is a scenario based on daily life, and study questions related to the case, which allows students to discuss their ideas. Chemical kinetics is one of the most difficult concepts for students in chemistry. Students have generally low levels of conceptual understanding and many alternative conceptions regarding it. Purpose: This study aimed to explore the effect of CBL on dealing with students' alternative conceptions about chemical kinetics. Sample: The sample consists of 53 high school students from one public high school in Turkey. Design and methods : Nonequivalent pre-test and post-test control group design was used. Reaction Rate Concept Test and semi-structured interviews were used for data collection. Convenience sampling technique was followed. For data analysis, the independent samples t-test and ANOVA was performed. Results : Both concept test and interview results showed that students instructed with cases had better understanding of core concepts of chemical kinetics and had less alternative conceptions related to the subject matter compared to the control group students, despite the fact that it was impossible to challenge all the alternative conceptions in the experimental group. Conclusions: CBL is an effective teaching method for challenging students' alternative conceptions in the context of chemical kinetics. Since using cases in small groups and whole class discussions has been found to be an effective way to cope with the alternative conceptions, it can be applied to other subjects and grade levels in high schools with a higher sample size. Furthermore, the effect of this method on academic achievement, motivation and critical thinking skills are other variables that can be investigated for future studies in the subject area of chemistry.

Peptic ulcer disease in endogenous hypercortisolism: myth or reality?

PubMed

Hatipoglu, Esra; Caglar, Asli Sezgin; Caglar, Erkan; Ugurlu, Serdal; Tuncer, Murat; Kadioglu, Pinar

2015-11-01

Many clinicians believe hypercortisolism is ulcerogenic. However, data from clinical studies show that prophylaxis for peptic ulcer disease is no longer recommended in patients receiving corticosteroid treatment. This has not yet been verified in endogenous hypercortisolism by controlled clinical studies. The purpose of the current study was to evaluate the relationship between endogenous Cushing's syndrome (CS) and peptic ulcer disease and Helicobacter pylori infection. The study group contained 20 cases with CS resulting from ACTH-dependent endogenous hypercortisolism. The control groups consisted of 14 age- and gender-matched cases receiving exogenous corticosteroid therapy and 100 cases of dyspepsia with non-cushingoid features. Upper gastrointestinal endoscopy was performed on all cases. Biopsies were taken from five different points: two samples from the antrum, two samples from the corpus, and one sample from the fundus. A histological diagnosis of Helicobacter pylori infection was also obtained from evaluation of biopsy specimens. The frequency of stomach and duodenal ulcers did not vary between the groups (p = 0.5 and p = 0.7). Antral gastritis was less frequent and pangastritis was more common in cases with CS compared to the healthy controls (p = 0.001 and p < 0.001). The incidence of Candida esophagitis was more frequent in cases with CS compared to cases with corticosteroid treatment and healthy controls (p = 0.03). Histopathological findings and frequency of Helicobacter pylori based on pathology results did not vary between the three groups. It is possible that neither exogenous nor endogenous corticosteroid excess directly causes peptic ulcer or Helicobacter pylori infection. Prophylactic use of proton pump inhibitors is not compulsory for hypercortisolism of any type.

Double-blind, randomized, clinical trial of metformin as add-on treatment with clozapine in treatment of schizophrenia disorder.

PubMed

Hebrani, Paria; Manteghi, Ali Akhoundpour; Behdani, Fatemeh; Hessami, Elham; Rezayat, Kambiz Akhavan; Marvast, Majid Nabizadeh; Rezayat, Amir Akhavan

2015-04-01

One of the major causes of death in schizophrenia is a metabolic syndrome. The clozapine has the highest rate of weight gain among antipsychotics. It has been shown that metformin can promote weight loss. We aimed to investigate the effect of metformin as an adjunctive therapy with clozapine to prevent metabolic syndrome in patients with schizophrenia. A total of 37 patients consisting metformin group (19 cases) and a group of placebo consisting of 18 cases were evaluated. A brief psychiatric rating scale score (BPRS) and metabolic profiles was determined for all patients. All of the variables were also determined at 2, 8, 16, and 20 weeks after the onset of the study. The mean age of the group of metformin was 47.2 ± 10.4 compared with 45.8 ± 10.2 for the group of placebo. The difference in mean waist circumference and serum level of triglyceride at baseline compared with the end of study showed a statistically significant difference between two groups (P = 0. 000). A statistically significant difference was also observed in a comparison of mean difference of weight and body mass index at baseline compared with end of study (P = 0. 000). There was a statistically significant difference of fasting blood sugar (P = 0.011) and serum high-density lipoprotein (P = 0.000) between two groups but this difference was not significant for mean BPRS scores, mean systolic and diastolic blood pressure, serum level of triiodothyronine, thyroxin and thyroid stimulating hormone, serum low-density lipoprotein and serum cholesterol. Metformin could be considered an adjunctive therapy with clozapine to prevent metabolic syndrome in schizophrenic patients.

Acute generalized exanthematous pustulosis induced by the essential oil of Pistacia lentiscus.

PubMed

Zaraa, I; Ben Taazayet, S; Trojjet, S; El Euch, D; Chelly, I; Haouet, S; Mokni, M; Ben Osman, A

2012-06-01

Acute generalized exanthematous pustulosis (AGEP) is an uncommon pustular eruption characterized by small nonfollicular pustules on an erythematous background, sometimes associated with fever and neutrophilia. Over 90% of cases are drug-induced; however, it can be caused in rare cases by other agents. We report two cases of AGEP secondary to ingestion of Pistacia lentiscus essential oil, the first two such cases to our knowledge. The cutaneous morphology, disease course and histological findings were consistent with a definite diagnosis of AGEP, based on the criteria of the EuroSCAR study group. These two cases highlight the need to consider herbal extracts as a potential rare cause of AGEP and to ensure the safety of herbal medicines. © The Author(s). CED © 2012 British Association of Dermatologists.

Methodology or method? A critical review of qualitative case study reports.

PubMed

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2014-01-01

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

Speeded Probed Recall Is Affected by Grouping.

PubMed

Morra, Sergio; Epidendio, Valentina

2015-01-01

Most of the evidence from previous studies on speeded probed recall supported primacy-gradient models of serial order representation. Two experiments investigated the effect of grouping on speeded probed recall. Six-word lists, followed by a number between 1 and 6, were presented for speeded recall of the word in the position indicated by the number. Grouping was manipulated through interstimulus intervals. In both experiments, a significant Position × Grouping interaction was found in RT. It is concluded that the results are not consistent with models of order representation only based on a primacy gradient. Possible alternative representations of serial order are also discussed; a case is made for a holistic order representation.

Pathway-based outlier method reveals heterogeneous genomic structure of autism in blood transcriptome

PubMed Central

2013-01-01

Background Decades of research strongly suggest that the genetic etiology of autism spectrum disorders (ASDs) is heterogeneous. However, most published studies focus on group differences between cases and controls. In contrast, we hypothesized that the heterogeneity of the disorder could be characterized by identifying pathways for which individuals are outliers rather than pathways representative of shared group differences of the ASD diagnosis. Methods Two previously published blood gene expression data sets – the Translational Genetics Research Institute (TGen) dataset (70 cases and 60 unrelated controls) and the Simons Simplex Consortium (Simons) dataset (221 probands and 191 unaffected family members) – were analyzed. All individuals of each dataset were projected to biological pathways, and each sample’s Mahalanobis distance from a pooled centroid was calculated to compare the number of case and control outliers for each pathway. Results Analysis of a set of blood gene expression profiles from 70 ASD and 60 unrelated controls revealed three pathways whose outliers were significantly overrepresented in the ASD cases: neuron development including axonogenesis and neurite development (29% of ASD, 3% of control), nitric oxide signaling (29%, 3%), and skeletal development (27%, 3%). Overall, 50% of cases and 8% of controls were outliers in one of these three pathways, which could not be identified using group comparison or gene-level outlier methods. In an independently collected data set consisting of 221 ASD and 191 unaffected family members, outliers in the neurogenesis pathway were heavily biased towards cases (20.8% of ASD, 12.0% of control). Interestingly, neurogenesis outliers were more common among unaffected family members (Simons) than unrelated controls (TGen), but the statistical significance of this effect was marginal (Chi squared P < 0.09). Conclusions Unlike group difference approaches, our analysis identified the samples within the case and control groups that manifested each expression signal, and showed that outlier groups were distinct for each implicated pathway. Moreover, our results suggest that by seeking heterogeneity, pathway-based outlier analysis can reveal expression signals that are not apparent when considering only shared group differences. PMID:24063311

Prevalence and typing of HPV DNA in atypical squamous cells in pregnant women.

PubMed

Lu, Danielle W; Pirog, Edyta C; Zhu, Xiaopei; Wang, Hanlin L; Pinto, Karen R

2003-01-01

To determine the prevalence and typing of HPV DNA in pregnant women with a diagnosis of atypical squamous cells (ASC) and to assess whether pregnancy-related changes contribute to the diagnosis of ASC. HPV testing was performed on residual specimens from the ThinPrep Pap test (Cytyc Corp., Boxborough, Massachusetts, U.S.A.) in pregnant women diagnosed as ASC (study group, n = 105), low and high grade squamous intraepithelial lesion (LSIL and HSIL) (positive control, n = 33) and negative for epithelial cell abnormality (negative control, n = 20). All cases were reviewed by 2 cytopathologists to obtain consensus diagnoses using the Bethesda System 2001 criteria. The study group cases were further subcategorized into ASC of undetermined significance (ASCUS, n = 99) and ASC cannot exclude HSIL (ASC-H, n = 6). HPV testing was also performed on an ASC control group consisting of 68 consecutive ASC cases in nonpregnant women, matched by age. Mean patient age was 23.7 years for the study group and 25.6 years for the ASC control group. HPV DNA was detected in 88.6% of cases in the study group, including 87.9% of ASC-US and 100% of ASC-H cases. Of the HPV positive cases, 79.6%, 4.3%, 5.4% and 10.8% had high-risk, mixed high- and low-risk, low-risk and unknown HPV types, respectively. The most frequent HPV types detected were: types 52 (31.2%), 16 (15.1%), 39 (11.8%), 53 (10.8%), and 18 and 58 (9.7% each). Multiple viral types were detected in 43.0% of cases. The prevalence of HPV DNA in the positive and negative controls in pregnant women was 100% and 55%, respectively. HPV DNA was detected in 83.8% of the ASC control group. Regardless of pregnancy-related changes, the prevalence of HPV DNA in pregnant women (88.6%) was similar to that found in ASC in nonpregnant women of the same reproductive-age group (83.8%), and the high-risk types accounted for the vast majority of cases (83.9%). These findings demonstrate that pregnancy-related changes do not contribute to the diagnosis of ASC in this subset of women. Furthermore, the high HPV DNA prevalence in reproductive-age women (< 40 years) suggests that HPV testing may have limited utility in effective management of these patients.

Could Neutrophil CD64 Expression Be Used as a Diagnostic Parameter of Bacteremia in Patients with Febrile Neutropenia?

PubMed

Efe İris, Nur; Yıldırmak, Taner; Gedik, Habip; Şimşek, Funda; Aydın, Demet; Demirel, Naciye; Yokuş, Osman

2017-06-05

The aim of this study is to investigate if neutrophil CD64 expression in febrile neutropenia patients could be used as an early indicator of bacteremia. All consecutive patients older than 18 years of age who had developed febrile neutropenia episodes due to hematological malignancies were included in the study. Those patients who had significant growth in their blood cultures constituted the case group, while those who had febrile neutropenia without any growth in their cultures and who did not have any documented infections formed the control group. Blood culture bottles were incubated in the Bact ALERT 3D system (bioMerieux, France), identification and susceptibility testing were performed using an automated broth microdilution method (VITEK 2, bioMerieux), and CD64 expression analysis was performed by the flow cytometry method. C-reactive protein (CRP) was measured by turbidimetric methods (Biosystems, Spain) and erythrocyte sedimentation rate (ESR) was measured by the Wintrobe method. In total, we prospectively evaluated 31 febrile episodes. The case group consisted of 17 patients while the control group included 14 patients. CD64 was found on neutrophils of the case group patients with a mean count of 8006 molecules/cell and of control group with a mean count of 2786 molecules/cell. CD64 levels of the case group were significantly higher than those of the control group (p=0.005). In the differentiation of the case group from the control group, a 2500 cut-off value for CD64 had significant [AUC=0.792 (0.619-0.965)] predictive value (p=0.001). In the prediction of patients with a 2500 cut-off value for CD64, sensitivity was 94.1%, positive predictive value was 76.2%, specificity was 64.3%, and negative predictive value was 90.0%. CRP levels and ESR values did not differ significantly between the groups (p=0.005). Neutrophil CD64 expression could be a good predictor as an immune parameter with high sensitivity and a negative predictive value for bacteremia in febrile neutropenic patients.

Giant kidney worms in a patient with renal cell carcinoma.

PubMed

Kuehn, Jemima; Lombardo, Lindsay; Janda, William M; Hollowell, Courtney M P

2016-03-07

Dioctophyma renale (D. renale), or giant kidney worms, are the largest nematodes that infect mammals. Approximately 20 cases of human infection have been reported. We present a case of a 71-year-old man with a recent history of unintentional weight loss and painless haematuria, passing elongated erythematous tissue via his urethra. CT revealed a left renal mass with pulmonary nodules and hepatic lesions. On microscopy, the erythematous tissue passed was identified as D. renale. On subsequent renal biopsy, pathology was consistent with renal cell carcinoma. This is the first reported case of concomitant D. renale infection and renal cell carcinoma, and the second reported case of D. renale infection of the left kidney alone. 2016 BMJ Publishing Group Ltd.

DOME/GALT type adenocarcimoma of the colon: a case report, literature review and a unified phenotypic categorization.

PubMed

Kannuna, Hala; Rubio, Carlos A; Silverio, Patricia Caseiro; Girardin, Marc; Goossens, Nicolas; Rubbia-Brandt, Laura; Puppa, Giacomo

2015-07-09

Several types of colorectal cancers are associated with a prominent lymphoid component, which is considered a positive prognostic factor. We report a case of a dome-type carcinoma of the cecum in a 57 year old female. The sessile, non-polypoid lesion histologically consisted of a tubulovillous adenoma with low-grade dysplasia. The submucosal invasive component showed low-grade architectural features that included cystically dilated glands containing eosinohilic debris. Immunohistochemical studies displayed retention of the four mistmach repair proteins, consistent with a stable phenotype. After 3 years, the patient remains free of recurrence. A literature review highlighted striking similarities between dome-type carcinoma and the gut-associated lymphoid tissue carcinoma, the two sharing an intimate association with the gut associated lymphoid tissue.The two variants might therefore be grouped into a unified category.

The Effect of Aerobic Exercise on Quantity and Quality of Sleep Among Elderly People Referring to Health Centers of Lar City, Southern of Iran; A Randomized Controlled Clinical Trial.

PubMed

Sharif, Farkhondeh; Seddigh, Maryam; Jahanbin, Iran; Keshavarzi, Sareh

2015-01-01

Aging is associated with reduced quality and quantity of sleep. 50% of senior citizens living in the community and 70% of those living in nursing homes suffer from sleep disorders. Moreover, insomnia increases the risk of mortality and morbidity in older adults. We aimed to investigate the effect of aerobic exercise on quantity and quality of sleep among the elderly people referring to health centers of Lar city, southern Iran. We enrolled 60 elderly people whose age range was 60-75 years and (mean ±SD) age was (64.8±5.2). Participants were randomly assigned into two groups of 30 each (case group= 30 and control group=30). The patients in the case group participated in exercise trainings consisted of three one-hour sessions per week for 12 consecutive weeks. Sleep quantity and quantity in the participants was evaluated before and after intervention using Pittsburgh Sleep Quality Index (PSQI). Independent t-test showed that sleep quality score was improved by 44.46% in the case group (p<0.0001). Furthermore, sleep duration was improved by 98/16% (p=0.038) and sleep latency was improved by 76/6% in the case group; while, the difference between the two groups regarding the changes in the sleep latency was not statistically significant (p=0.089). Aerobic exercise program could improve the sleep quality and quantity in the elderly. It could also be used as a cost effective and long lasting method of therapy with no side effect which could be used for the treatment of insomnia in older people.

Sagittal plane analysis of the spine and pelvis in degenerative lumbar scoliosis.

PubMed

Han, Fei; Weishi, Li; Zhuoran, Sun; Qingwei, Ma; Zhongqiang, Chen

2017-01-01

Previous studies have reported the normative values of pelvic sagittal parameters, but no study has analyzed the sagittal spino-pelvic alignment in degenerative lumbar scoliosis (DLS) and its role in the pathogenesis. Retrospective analysis was applied to 104 patients with DLS, together with 100 cases of asymptomatic young adults as a control group and another control group consisting of 145 cases with cervical spondylosis. The coronal and sagittal parameters were measured on the anteroposterior and lateral radiograph of the whole spine in the DLS group as well as in the two control groups. Statistical analysis showed that the DLS group had a higher pelvic incidence (PI) value (50.5° ± 10.2°), than the normal control group (with PI 47.2° ± 8.8°) and the cervical spondylosis group (46.9° ± 9.1°). In DLS group, there were 38 cases (36.5%) complicated with degenerative lumbar spondylolisthesis, who had higher PI values than patients without it. Besides, the lumbar lordosis (LL) and sacral slope (SS) of DLS group were lower; the scoliosis Cobb's angle was correlated with pelvic tilt (PT); thoracic kyphosis was correlated with LL, SS, and PT; and LL was correlated with other sagittal parameters. Patients with DLS may have a higher PI, which may impact the pathogenesis of DLS. A high PI value is probably associated with the high prevalence of degenerative lumbar spondylolisthesis among DLS patients. In DLS patients, the lumbar spine maintains the ability of regulating the sagittal balance, and the regulation depends more on thoracic curve.

Effect of depressor septi nasi muscle activity on nasal lengthening with time.

PubMed

Beiraghi-Toosi, Arash; Rezaei, Ezzatollah; Jabbari Nooghabi, Mehdi; Izadpanah, Shahram

2013-10-01

The depressor septi nasi (DSN) muscle is an important muscle in nose dynamics. Its hyperactivity causes smile deformity including nasal tip depression. The nasal tip of individuals with a hyperactive DSN muscle depresses repeatedly while they are speaking and smiling. This may result in nasal lengthening as they age. Pairs of cases consisting of a child and one of his or her parents were studied in two groups: case group (with DSN muscle hyperactivity) and the control group (with DSN muscle inactivity in both child and parent). Nasal length from nasion to tip and facial length from nasion to menton were measured during repose and during smiling. This study investigated 80 pairs of children and parents. In both groups, a significant linear correlation between the nasal length of the parent and the child was found. In both groups (case and control), the nasal length of the child differed significantly from that of the parent. The increase in the nasal length of the parents compared with the children was greater in the control group. This study demonstrated that nasal length increases with age and that DSN muscle hyperactivity is not an effective factor in this increase. This unpredictable result may affect the presumption that patients with DSN muscle hyperactivity will have longer noses in the future. Long-term prospective studies investigating cohort groups are required to clarify the variables affecting nasal lengthening with aging, and interventional studies are needed to examine the effects of DSN muscle resection on this phenomenon.

Allergic reactions to antithyroid drugs are associated with autoimmunity a retrospective case-control study.

PubMed

Chivu, R D; Chivu, Laura Ioana; Ion, Daniela Adriana; Barbu, Carmen; Fica, Simona

2006-01-01

Thiamazole is the most used antithyroid drug for thyrotoxicosis in Basedow-Graves' (BG) (autoimmune) disease and in toxic multinodular goitre (TMG) (non-autoimmune). This study aims to find whether allergic reactions to thiamazole occur more frequently during the treatment of BG than of TMG. Retrospective study, of 128 patients newly diagnosed and treated for thyrotoxicosis in the first 6 months of 2006, in the Endocrinology Department of "Elias" Hospital, Bucharest. Cases were all patients treated with thiamazole who developed allergic reactions. Controls were all patients treated with thiamazole without allergic reactions. Risk factor was considered to be the presence of BG. Cases group consisted of 6 patients. All 6 started treatment with thiamazole for BG, and developed allergic reactions after 2-4 weeks of treatment. When thiamazole was withdrawn, allergic symptoms ceased under antihistamines and steroids. In order to control the thyrotoxicosis, antihistamines and oral steroids was administered, together with thiamazole in slow increasing doses. After about 4 weeks under this combination, a tolerance to thiamazole seems to appear. Control group consisted of 122 patients who started thiamazole: 66 for BG and 56 for TMG (without allergic reactions). Allergy to thiamazole was significantly associated with the autoimmune BG, and not with TMG (p = 0.03, OR = 11.04). None of the patients with TMG developed allergic reactions to the drug. Tolerance to this drug may occur.

Application of hygrine and cuscohygrine as possible markers to distinguish coca chewing from cocaine abuse on WDT and forensic cases.

PubMed

Rubio, N C; Strano-Rossi, S; Tabernero, M J; Gonzalez, J L; Anzillotti, L; Chiarotti, M; Bermejo, A M

2014-10-01

The objectives of present work are twofold. First, we want to verify that hygrine and cuscohygrine are good markers to distinguish between chewing coca leaves and cocaine abuse. Secondly, we try to develop a quick and easy qualitative method to determine the two mentioned markers. We analyzed two kinds of urine samples: the first group consisted of twenty-four (24) subjects: urine samples were obtained from various types of workers (e.g. doctors, chemists, nurses, technicians, painters, contractors, employees and some retired persons) who admitted chewing coca leaves. Frequency of the habit of chewing coca leaves was variable. They practiced "coqueo" between two (2) and forty-four (44) years. Sixteen (16) of them used alkaline substances to enhance the extraction of cocaine from the leaves The second group of urine samples consisted on thirty-eight (38) cocaine abusers, from forensic cases from Spain and Argentina. A GC/MS qualitative method, performed after liquid-liquid extraction, was developed and validated (the parameters studied were selectivity/specificity, LOD and stability), and then applied to the urine samples. Hygrine and cuscohygrine are good markers to distinguish between chewing coca leaves and cocaine abuse, and the qualitative method presented can be used successfully in workplace drug testing and forensic cases. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Pharmacokinetic, bacteriological and clinical studies of ceftizoxime in neonates and low birth weight infants].

PubMed

Motohiro, T; Sakata, Y; Tominaga, K; Oda, K; Aramaki, M; Tanaka, K; Kawakami, A; Shimada, Y; Koga, T; Tomita, S

1988-08-01

Ceftizoxime (CZX), one of the fifth group in cephem-antibiotics classified by Fujii, was administrated intravenously with a one shot dose of 20 mg/kg to neonates and low birth weight infants with ages ranged 4-21 day old and plasma and urinary concentrations and urinary recovery rates of the drug were determined. Clinical, prophylactic and bacteriological effects of CZX were evaluated and adverse reactions and effects on laboratory test values due to this drug were studied in 22 neonates and low birth weight infants (0-76 day old) consisting of 16 cases with various bacterial infections including presumptive cases of bacterial infections and 6 cases with prophylactic administration against infectious diseases. An average CZX daily dose of 55.3 mg/kg was given once or divided into 2-4 times daily (twice: 16 cases, 3 times: 3 cases, 4 times: 2 cases) through intravenous one shot administration for 6 days on the average. The results obtained are summarized as follows. 1. Neonates and low birth weight infants were classified into 3 groups by age: 4-7, 8-14, 15-21 day old. Plasma peak levels of CZX were observed at an average of 5 minutes after administration in all 3 groups with mean values of 58.3, 74.9 and 76.9 micrograms/ml, respectively, and the 4-7 day old-group showed a lower value than with other 2 groups. Mean values of AUC were 218.9, 221.0 and 197.0 micrograms.hr/ml, respectively, and no notable difference was observed within each group. Mean values of half-lives of CZX were 3.61, 2.72 and 2.37 hours, respectively, and the younger group tended to have the longer value. 2. Urinary concentrations of CZX ranged 10.9-1.190 micrograms/ml in all of the 3 groups during 0-2, 2-4, 4-6, 6-8 hours after administration. Mean values of urinary recovery rates during 8 hours of the 3 age-groups were 60.1, 68.7, 56.7%, respectively. The oldest group showed the lowest mean value because one of the cases had the lowest value of 34.5% for an unknown reason. 3. Clinical effect of CZX in 16 cases with various bacterial infections and presumptive bacterial infections was evaluated with an efficacy rate of 87.5%. The prophylactic effect was recognized in all 6 cases that were given CZX to prevent infectious diseases. 4. The bacteriological effect was evaluated in only one case with an infection due to Escherichia coli, which was eradicated by the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Intestinal complications following irradiation for gynecologic cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ashbaugh, D G; Owens, J C

1963-07-01

Intestinal injury following irradiation for gynecologic cancer is discussed with reference to 49 cases. These cases could be divided into three groups on the basis of the severity of the damage: group 1, (8 cases), those with mild injury and littie or no residual damage and symptoms; group II (9 cases), those with moderate injury and some permanent changes with or without symptoms; and group III (32 cases), those with severe injury who were incapacitated or required surgery. Group III includes seven patients who were cured of their malignancies but who died of the complications of radiation injury and themore » subsequent attempts to correct this damage. In group I the symptoms consisted mainly of rectal pain, diarrhea, tenesmus, and constipation, and in two instances, mild rectal stricture. All patients became asymptomatic with nonoperative management. In group II the initial symptoms were also pain, diarrhea, constipation, tenesmus, and rectal bleeding, persistent in varying degrees. Five patients developed stricture or narrowing of the rectum and sigmoid, but none required operation. In group III there were 19 bowel strictures and 32 fistulss, and 84 operations were performed in attempts to correct these problems. In the seven patients who died from complications of radiation therapy no tumor was found at postmortem examination. A review of other reports shows an incidence of intestinal complications following pelvic irradiation ranging from 2.4% to 17%, with one estimate as high as 50 to 75%. The problem here was not and overdosage of radiation, but the necessity in treating carcinoma, the primary aim of which is eradication of the malignancy, in using adequate dosage. It is suggested that with prompt recognition and early, vigorous treatment, many of the more severe cases could probably have been greatly modified. Treatment is generally nonoperative in the acute stsge, which is best mansged by supportive measures and the cessation of radiation therapy. The chronic stage frequently requires operative intervention for the relief of stricture or fistula, and and initial diverting colostomy is the operation of choice. Subsequently, additional procedures may be performed, but these sometimes lead to increased morbidity and even mortality.« less

Purulent pericarditis and pneumonia caused by Streptococcus equi subsp. zooepidemicus.

PubMed

Held, Jürgen; Schmitz, Roland; van der Linden, Mark; Nührenberg, Thomas; Häcker, Georg; Neumann, Franz-Josef

2014-02-01

Purulent pericarditis is a life-threatening disease that usually manifests following bacteraemia or through spreading from an intrathoracic focus. Only a few cases of this disease have been reported with Lancefield group C streptococci as aetiological agents, and the primary focus in these infections remains unknown. We report a case of purulent pericarditis with septic and cardiogenic shock, caused by Streptococcus equi subsp. zooepidemicus (group C) in a 51-year-old patient. The pathogen was possibly contracted through contact with horses. Most probably, it caused initially pneumonia before spreading to the pericardium, either directly or via the bloodstream. A combined therapeutic approach, consisting of antibiotic therapy and repeated pericardial drainage, was necessary to ensure a clinical cure. After discharge, long-term follow-up for development of constrictive pericarditis is considered mandatory.

Increasing trend of illicit drug abuse in Thai parturient at Siriraj Hospital.

PubMed

Inthawiwat, Suchada; Rattanachaiyanont, Manee; Leerasiri, Pichai; Manoch, Darapa; Titapant, Vitaya

2002-10-01

To report the magnitude of the problem and to evaluate the outcome of maternal illicit drug use in Thai parturients. Retrospective case-control study. Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. The subjects were 44,640 parturients who had deliveries at Siriraj Hospital from January 1998 to December 2001 and were divided into two groups. The study group consisted of 66 parturients with a history of illicit drug use and the control group consisted of 44,574 parturients without a history of illicit drug use. Medical records of 66 parturients with a history of illicit drug use were reviewed. Obstetric statistics of the department were retrieved from the computerized database in the Division of Obstetric and Gynecologic Registry. The data were analyzed using descriptive statistics. Characteristics of parturients, pregnancy outcome, type and incidence of illicit drug. Within the study period, 66 cases of maternal illicit drug use were identifiable during the intrapartum period; 65 cases used amphetamine or derivatives and 1 case used an opioid derivative. The number had risen from 1 case in 1998 to 58 cases in 2001. Mean age of the patients was 23.30 +/- 6.04 years. Compared to the control group which included 44,574 parturients, the patients had a lower incidence of antenatal care (ANC rate = 21.21% vs 94.35%; RR = 0.23, 95% CI = 0.14-0.26), a higher incidence of HIV infection (10% vs 2%; RR = 6.09, 95% CI = 2.83-13.12), a higher incidence of birth before arrival (BBA rate = 9.09% vs 1.06%; RR = 8.59, 95% CI = 3.98-18.51), and a lower cesarean section rate (10.60% vs 26.36%; RR = 0.40, 95% CI = 0.20-0.81). There were no serious intrapartum, immediate postpartum and neonatal complication. Fetal outcome included a higher incidence of low birth weight infants (22.73% vs 10.23%; RR = 2.22, 95% CI = 1.42-3.46) and a smaller head circumference than the normal range of Thai fetal biometry (31.85 +/- 1.47 cm). There is an increasing trend of illicit drug use in Thai parturients. Although the present case series of drug abuse in Thai parturients cannot give the whole picture of maternal drug abuse in the Thai population, the dramatic increase in the identifiable cases during the past 4 years is very alarming. Currently, the outcome of pregnancy in case detected during intrapartum is not much different from that in the general population. However, there are potential risks for the patients and their babies. All medical staffs should be aware of this condition. Careful clinical data gathering and laboratory testing are suggested for prevention of complications and the potential hazards of this problem.

Basaloid Squamous Cell Carcinoma of the Anus Revisited.

PubMed

Graham, Rondell P; Arnold, Christina A; Naini, Bita V; Lam-Himlin, Dora M

2016-03-01

Basaloid squamous cell carcinoma (SCC) of the anus, previously called cloacogenic carcinoma, is a subtype of SCC. There are very few data on the morphologic variation within basaloid SCC of the anus, which may contribute to misdiagnosis. We retrospectively evaluated cases originally diagnosed as basaloid SCC for histologic characterization. We retrieved and reviewed cases of basaloid SCC from 1994 to 2013. Ten (27%) cases were reclassified after review, including basal cell carcinoma (n=6), melanoma (n=2), and neuroendocrine carcinoma (n=2). The final group of basaloid SCC (n=27) showed a female predominance (median age=60 y; range, 42 to 92 y). Morphologically, basaloid SCC could be categorized into 4 groups: transitional carcinoma like (n=10), basaloid with peripheral palisade (n=13), adenoid cystic carcinoma like (n=3), and mucinous microcystic (n=1). In 19 cases the histologic patterns were pure and were mixed in the remainder. CK5/6, p16, and high-risk HPV were positive in all cases (n=27). SOX2 was positive in 18/22 cases. Clinical follow-up was available on 60% of cases; 9 patients (53%) developed local recurrence or metastasis, and 5 (29%) died of disease. Basaloid SCC of the anus is characterized by 4 major histologic patterns and is consistently HPV driven.

RG flows for λ-deformed CFTs

NASA Astrophysics Data System (ADS)

Sagkrioti, E.; Sfetsos, K.; Siampos, K.

2018-05-01

We study the renormalization group equations of the fully anisotropic λ-deformed CFTs involving the direct product of two current algebras at different levels k1,2 for general semi-simple groups. The exact, in the deformation parameters, β-function is found via the effective action of the quantum fluctuations around a classical background as well as from gravitational techniques. Furthermore, agreement with known results for symmetric couplings and/or for equal levels, is demonstrated. We study in detail the two coupling case arising by splitting the group into a subgroup and the corresponding coset manifold which consistency requires to be either a symmetric-space one or a non-symmetric Einstein-space.

Aggressive natural killer (NK)-cell leukaemia and extranodal NK/T-cell lymphoma are two distinct diseases that differ in their clinical presentation and cytogenetic findings.

PubMed

Yang, Ching-Fen; Hsu, Chih-Yi; Ho, Donald M-T

2018-05-01

Aggressive natural killer (NK)-cell leukaemia (ANKCL) and extranodal NK/T-cell lymphoma (ENKTCL) with secondary bone marrow involvement are rare bone marrow NK/T-cell neoplasms and share similar features. This study aimed to distinguish these two entities. We studied bone marrow NK/T-cell neoplasms by classifying them into those with no extramedullary mass (group 1, eight cases) and those with extramedullary mass (group 2, 13 cases). The two groups showed similar clinical presentations and pathological features. Fever and cytopenia were the most common clinical presentations in both groups. The neoplastic cells varied from small and relatively monotonous cells to large pleomorphic cells. In six cases (two in group 1, and four in group 2), the neoplastic infiltrate was inconspicuous, consisting of ≤10% of marrow cells in the interstitium, which were hardly identified by haematoxylin and eosin staining alone. Nearly all patients rapidly died, regardless of the neoplastic infiltrate volume. All of the group 1 patients fulfilled the World Health Organisation 2017 diagnostic criteria of ANKCL, and their survival was significantly worse than that of the group 2 patients (P = 0.035). In addition, there was a significant association between being in group 1 and chromosome 7 abnormalities. Chromosome 6q deletion, which is commonly reported in ENKTCL, was seen in two of our group 2 patients, and was not observed in any of our group 1 patients. ANKCL with no extramedullary mass should be distinguished from ENKTCL with bone marrow involvement, as the former shows distinct outcomes and genetic features. © 2018 John Wiley & Sons Ltd.

Study of ECG changes and its relation to mortality in cases of cerebrovascular accidents.

PubMed

Purushothaman, Suja; Salmani, Deepalaxmi; Prarthana, Kaleramma Gopalakrishna; Bandelkar, Srinidhi Muddanna Gundappa; Varghese, Sarah

2014-07-01

Its being long recognized about the highly debilitating and destructive nature of cerebrovascular accidents (CVAs). Around the world CVAs has posed as a major factor in medical morbidity and mortality. It has thrown up challenges with regards to their medical management and also towards posttreatment rehabilitation. It is well-known that neurologic disorder contributes variously towards varied electrocardiogram (ECG) changes and stroke is no exception. To study the ECG changes and its relation to mortality in cases of CVA. A total of 100 patients with acute stroke were enrolled in the study. All the 100 patients underwent ECG recording within first 24 h of admission. The patients were divided into ischemic and hemorrhagic group depending on the nature of lesion. Out of 100 cases, 58 were ischemic and 42 were hemorrhagic. The ECG changes were noted in 78 patients. Among the ischemic group, the changes noted in the ECG were: T wave inversion (34.48%), ST segment depression (32.75%), QTc prolongation (29.31%), and presence of U waves (27.58%). In cases of hemorrhagic stroke, it was: T wave inversion (33.33%), arrhythmias (33.33%), U waves (30.95%), and ST segment depression (23.80%). Mortality was higher in patients with ST-T changes in ischemic group (66.66%) and in patients with positive U waves (60%) in hemorrhagic group. In acute stroke patients, changes in ECG were commonly seen. The changes varied from T-wave inversion to ST segment depression in ischemic stroke. In hemorrhagic stroke it consisted of T wave inversion and arrhythmias. Overall mortality was high in cases of hemorrhagic compared to ischemic group.

Study of ECG changes and its relation to mortality in cases of cerebrovascular accidents

PubMed Central

Purushothaman, Suja; Salmani, Deepalaxmi; Prarthana, Kaleramma Gopalakrishna; Bandelkar, Srinidhi Muddanna Gundappa; Varghese, Sarah

2014-01-01

Background: Its being long recognized about the highly debilitating and destructive nature of cerebrovascular accidents (CVAs). Around the world CVAs has posed as a major factor in medical morbidity and mortality. It has thrown up challenges with regards to their medical management and also towards posttreatment rehabilitation. It is well-known that neurologic disorder contributes variously towards varied electrocardiogram (ECG) changes and stroke is no exception. Objective: To study the ECG changes and its relation to mortality in cases of CVA. Materials and Methods: A total of 100 patients with acute stroke were enrolled in the study. All the 100 patients underwent ECG recording within first 24 h of admission. The patients were divided into ischemic and hemorrhagic group depending on the nature of lesion. Results: Out of 100 cases, 58 were ischemic and 42 were hemorrhagic. The ECG changes were noted in 78 patients. Among the ischemic group, the changes noted in the ECG were: T wave inversion (34.48%), ST segment depression (32.75%), QTc prolongation (29.31%), and presence of U waves (27.58%). In cases of hemorrhagic stroke, it was: T wave inversion (33.33%), arrhythmias (33.33%), U waves (30.95%), and ST segment depression (23.80%). Mortality was higher in patients with ST-T changes in ischemic group (66.66%) and in patients with positive U waves (60%) in hemorrhagic group. Conclusion: In acute stroke patients, changes in ECG were commonly seen. The changes varied from T-wave inversion to ST segment depression in ischemic stroke. In hemorrhagic stroke it consisted of T wave inversion and arrhythmias. Overall mortality was high in cases of hemorrhagic compared to ischemic group. PMID:25097430

Measurement invariance of the strength of motivation for medical school: a multi-group confirmatory factor analysis.

PubMed

An, M; Kusurkar, R A; Li, L; Xiao, Y; Zheng, C; Hu, J; Chen, M

2017-07-11

The Strength of Motivation for Medical School-Revised (SMMS-R) questionnaire measures students' motivation for studying medicine. It includes three subscales: 'willingness to sacrifice', 'readiness to start', and 'persistence'. Measurement invariance is a prerequisite for group comparisons. The objectives of this study were to verify the factorial structure of the SMMS-R questionnaire and to investigate it's measurement invariance. A total of 989 medical students were approached, 930 cases were kept for data analysis. Factorial structure of and measurement invariance of the SMMS-R were tested using single and multiple group confirmatory factor analyses with Mplus. Trational Cronbach's α along with McDonald's ω and glb were used to measure internal consistency for each subscale. Internal consistency for subscales and the full instrument were within the acceptable range. A 3-factor structure of the Chinese version of the SMMS-R was supported. Full configural, metric and partial scalar invariance were obtained. The SMMS-R showed measurement invariance across gender and two independent samples. So it can be used for group and cross-cultural comparisons.

Incidence of Branching Patterns Variations of the Arch in Aortic Dissection in Chinese Patients

PubMed Central

Tapia, G. Pullas; Zhu, Xiaohua; Xu, Jing; Liang, Pan; Su, Gang; Liu, Hai; Liu, Yang; Shu, Liliang; Liu, Shuiqi; Huang, Chen

2015-01-01

Abstract Several authors have described anatomic variations of the aortic arch in 13% to 20% of the patients who do not have aortic disease. However, few studies have evaluated these patterns in the thoracic aortic dissection (TAD). In the authors’ knowledge, this is the first survey that specifically investigates the frequency of these variations in a broad, nonselected group of Chinese patients with aortic dissection. Furthermore, it compares this group with a group of patients without aortic disease. The objective of this study was to define the variation frequency of the aortic arch branches pattern using the tomographic studies of 525 Chinese patients with a diagnosis of TAD. The Stanford classification was used to set the site of the initial tear of the dissection. In addition, we performed an epidemiological analysis of the aortic arch anatomic variations in TAD, and its possible implications for surgical or endovascular treatment. The general hypothesis proposal asserted that Chinese patients with dissection of the aorta have a similar incidence of variations of the aortic arch to the patients without aortic disease. A retrospective study of cases and controls was carried out using the tomographic studies (CT) of all patients admitted to the First Affiliated Hospital of Zhengzhou University, located at Henan-China, with a confirmed diagnosis of aortic dissection from January 2012 until December 2014. The group of cases consisted of 525 patients: 374 men and 151 women, with a mean age of 52.27 years (range, 20–89). The average age of the patients with Stanford A and B aortic dissection was 49.46 and 53.67, respectively. The control group consisted of 525 unselected patients without TAD who underwent a CT scan of the chest due to other indications. This group consisted of 286 men and 239 women, with a mean age of 53.60 years (range, 18–89). All the patients with aneurysm or dissection were excluded from the control group. We performed a statistical analysis of demographic data. The study found 7 different patterns of the aortic arch on both groups of cases and controls. Within the 525 patients with TAD were observed 85 (16.19%) anatomical variations, while the control group showed 112 variations (21.33%); P = 0.033. The most common anatomical variant was the bovine arch, found in 62 (11.80%) cases of TAD compared with 77 (14.66%) in the control group; P = 0.172. Anatomical variations were observed in 14.32% of the patients with Stanford A dissection and 17.09% of the patients with Stanford B dissection; P = 0.425. Patients with Stanford A dissection showed the pattern of bovine arch in 23 (13.21%) of 174 cases. In contrast, the patients with Stanford B dissection showed it in 39 (11.11%) of 351 cases; P = 0.481. The anatomical variant defined as vertebral artery of direct origin of the aortic arch was more frequent in the patients with Stanford B dissection (5.12%). The patients with Stanford A dissection presented this pattern in 1.14% of the cases; P = 0.025. This study observed an increased frequency of aortic dissection in the subgroup from 41 to 60 years old. In the subgroup from 41 to 60 years old without TAD, a greater frequency of anatomical variations were found than in the patients with TAD (20.81% vs 14.23%; P = 0.050). The same fashion was seen in patients older than 80 years (27.27% vs 0%; P = 0.030). The anatomical variations of the aortic arch with TAD occurred in 14.97% of the male patients and 19.20% of the female patients compared to 21.67% to 20.92% in the control group; P = 0.026 and P = 0.681, respectively. The aortic arch variations were found less frequently in the TAD group than in the control group in the present Chinese series. The bovine arch was considered the variant pattern of the major frequency in the patients with TAD and the control group. The anatomical variant of 4 branches, defined as vertebral artery of direct origin of the aortic arch, was more frequent in patients with Stanford B aortic dissection than in the patients with Stanford A. This finding might show an association between the geometry of the aortic arch and the site of onset of first intimal tear of dissection. PMID:25929931

Incidence of branching patterns variations of the arch in aortic dissection in Chinese patients.

PubMed

Tapia, G Pullas; Zhu, Xiaohua; Xu, Jing; Liang, Pan; Su, Gang; Liu, Hai; Liu, Yang; Shu, Liliang; Liu, Shuiqi; Huang, Chen

2015-05-01

Several authors have described anatomic variations of the aortic arch in 13% to 20% of the patients who do not have aortic disease. However, few studies have evaluated these patterns in the thoracic aortic dissection (TAD). In the authors' knowledge, this is the first survey that specifically investigates the frequency of these variations in a broad, nonselected group of Chinese patients with aortic dissection. Furthermore, it compares this group with a group of patients without aortic disease.The objective of this study was to define the variation frequency of the aortic arch branches pattern using the tomographic studies of 525 Chinese patients with a diagnosis of TAD. The Stanford classification was used to set the site of the initial tear of the dissection. In addition, we performed an epidemiological analysis of the aortic arch anatomic variations in TAD, and its possible implications for surgical or endovascular treatment. The general hypothesis proposal asserted that Chinese patients with dissection of the aorta have a similar incidence of variations of the aortic arch to the patients without aortic disease.A retrospective study of cases and controls was carried out using the tomographic studies (CT) of all patients admitted to the First Affiliated Hospital of Zhengzhou University, located at Henan-China, with a confirmed diagnosis of aortic dissection from January 2012 until December 2014. The group of cases consisted of 525 patients: 374 men and 151 women, with a mean age of 52.27 years (range, 20-89). The average age of the patients with Stanford A and B aortic dissection was 49.46 and 53.67, respectively. The control group consisted of 525 unselected patients without TAD who underwent a CT scan of the chest due to other indications. This group consisted of 286 men and 239 women, with a mean age of 53.60 years (range, 18-89). All the patients with aneurysm or dissection were excluded from the control group. We performed a statistical analysis of demographic data.The study found 7 different patterns of the aortic arch on both groups of cases and controls. Within the 525 patients with TAD were observed 85 (16.19%) anatomical variations, while the control group showed 112 variations (21.33%); P = 0.033. The most common anatomical variant was the bovine arch, found in 62 (11.80%) cases of TAD compared with 77 (14.66%) in the control group; P = 0.172. Anatomical variations were observed in 14.32% of the patients with Stanford A dissection and 17.09% of the patients with Stanford B dissection; P = 0.425. Patients with Stanford A dissection showed the pattern of bovine arch in 23 (13.21%) of 174 cases. In contrast, the patients with Stanford B dissection showed it in 39 (11.11%) of 351 cases; P = 0.481. The anatomical variant defined as vertebral artery of direct origin of the aortic arch was more frequent in the patients with Stanford B dissection (5.12%). The patients with Stanford A dissection presented this pattern in 1.14% of the cases; P = 0.025. This study observed an increased frequency of aortic dissection in the subgroup from 41 to 60 years old. In the subgroup from 41 to 60 years old without TAD, a greater frequency of anatomical variations were found than in the patients with TAD (20.81% vs 14.23%; P = 0.050). The same fashion was seen in patients older than 80 years (27.27% vs 0%; P = 0.030). The anatomical variations of the aortic arch with TAD occurred in 14.97% of the male patients and 19.20% of the female patients compared to 21.67% to 20.92% in the control group; P = 0.026 and P = 0.681, respectively.The aortic arch variations were found less frequently in the TAD group than in the control group in the present Chinese series. The bovine arch was considered the variant pattern of the major frequency in the patients with TAD and the control group. The anatomical variant of 4 branches, defined as vertebral artery of direct origin of the aortic arch, was more frequent in patients with Stanford B aortic dissection than in the patients with Stanford A.This finding might show an association between the geometry of the aortic arch and the site of onset of first intimal tear of dissection.

Photocoagulation in the treatment of bleeding peptic ulcer

NASA Astrophysics Data System (ADS)

Otto, Wlodzimierz; Paczkowski, Pawel M.

1996-03-01

The authors present their experience in the endoscopic laser photocoagulation of bleeding peptic ulcer. From 1991 to June 1995, 203 patients admitted for UGI bleeding from peptic ulcer have been treated by this method. The source of bleeding was confirmed by endoscopy. The patients were divided into two groups: actively bleeding peptic ulcer (group IA and IB according to Forrest's classification) and ulcer with stigmata of recent bleeding (group IIA/IIB). The former group consisted of 106 patients, among whom over 40 percent (45 patients) presented signs of hypovolemic shock on admission. Nd:YAG laser (Surgical Laser Technologies) was used in a continuous mode with a contact (8 - 20 watts) or non-contact (over 50 watts) method of coagulation. In actively bleeding patients photocoagulation resulted in stopping the hemorrhage in 95 (90%). Recurrent bleeding occurred in 16 cases; in 9 of them it was stopped by repeated photocoagulation. In this group 18 patients required surgical intervention. The mortality was of 10.3% (11 patients). In 97 patients with recent bleeding stigmata photocoagulation provoked heavy hemorrhage in 3 (in 2 cases stopped by prolonged coagulation). In 9 of the remaining 94 patients recurrent bleeding occurred. Nine patients required surgical intervention. Mortality in this group was of 6%.

The effect of massage therapy on the quality of sleep in breast cancer patients.

PubMed

Kashani, Fahimeh; Kashani, Parisa

2014-03-01

Annually, about 6000 new cases are diagnosed with breast cancer in Iran. In Iran, more women are affected with breast cancer than a decade earlier in comparison with other countries, and 70% of them are diagnosed at an advanced phase. Insomnia is the most common disorder following breast cancer, and interference in sleep quality and rest causes changes in physiological functions and reduces the body's daily performance. The objective of this study was to determine the effect of massage therapy on the quality of sleep in patients with breast cancer. This clinical trial was conducted for about 1 month in a referral chemotherapy clinic of a teaching hospital in Isfahan, Iran. The participants consisted of 57 women with breast cancer who were selected by simple random sampling. They were randomly assigned to two groups of control and experimental. The control group was treated only by usual medical therapy, whereas the case group was treated by combined medical-massage therapy. Data collection tools were the validated Pittsburgh Sleep Quality Index and a demographic questionnaire. Data were analyzed by SPSS using descriptive statistics, Chi-square test, paired t-test, and Student's t-test. The results showed significant differences in the mean scores of quality of sleep before and after the intervention in the case group, while no significant differences were observed in the mean scores of quality of sleep before and after the intervention in the control group. In addition, no significant differences were observed in the mean scores of quality of sleep before the intervention between case and control groups. However, significant differences were observed in the mean scores of quality of sleep after the intervention between case and control groups. According to the results of this study, learning and applying massage techniques by medical staff causes health promotion and improves the quality of sleep in cancer patients. Furthermore, massage therapy is suggested as a non-pharmacologic method to improve sleep quality in these patients.

Plasminogen activator inhibitor 1 is elevated in the children of men with premature myocardial infarction.

PubMed

Rallidis, L S; Megalou, A A; Papageorgakis, N H; Trikas, A G; Chatzidimitriou, G I; Tsitouris, G K

1996-09-01

To assess whether plasminogen activator inhibitor 1 (PAI-1) activity is elevated in the progeny of young coronary men, 193 young subjects were recruited and divided into two groups. Group A consisted of 104 children whose fathers had suffered a myocardial infarction before the age of 55 ("cases"). Eighty-nine young subjects matched for age, sex, body mass index (BMI) and smoking habits without familial history of coronary artery disease (CAD) served as controls (group B). Children with a family history of diabetes mellitus or hypertension were excluded from both groups. We measured PAI-1 activity, tissue-type plasminogen activator (t-PA) antigen, a2-antiplasmin, fibrinogen, lipids and apolipoproteins in both groups. PAI-1 activity levels were also determined in the men who suffered a premature myocardial infarction 4 months after their discharge. PAI-1 activity levels were higher in cases compared to controls (3.13 +/- 1.9 vs 2.17 +/- 1.9 U/ml, p = 0.0014). t-PA antigen and a2-antiplasmin did not differ significantly between the two groups, while fibrinogen, total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B and lipoprotein(a) were significantly higher in group A. PAI-1 was positively correlated with triglycerides (r = 0.22, p = 0.024), apolipoprotein B (r = 0.21, p = 0.039) and fibrinogen (r = 0.22, p = 0.029) in cases and with BMI in both cases (r = 0.37, p = 0.0003) and controls (r = 0.23, p = 0.044). In stepwise multiple regression analysis, only apolipoprotein B (p = 0.008) and BMI (p = 0.0014) were significant determinants of PAI-1 activity in cases. There was also a positive correlation between PAI-1 activity levels of the affected fathers and their children (r = 0.30, p = 0.01). The present data support the hypothesis that elevated PAI-1 levels in the offspring of men with premature myocardial infarction impair their fibrinolytic capacity contributing to their familial predisposition to CAD.

Home visit program improves technique survival in peritoneal dialysis.

PubMed

Martino, Francesca; Adıbelli, Z; Mason, G; Nayak, A; Ariyanon, W; Rettore, E; Crepaldi, Carlo; Rodighiero, Mariapia; Ronco, Claudio

2014-01-01

Peritoneal dialysis (PD) is a home therapy, and technique survival is related to the adherence to PD prescription at home. The presence of a home visit program could improve PD outcomes. We evaluated its effects on clinical outcome during 1 year of follow-up. This was a case-control study. The case group included all 96 patients who performed PD in our center on January 1, 2013, and who attended a home visit program; the control group included all 92 patients who performed PD on January 1, 2008. The home visit program consisted of several additional visits to reinforce patients' confidence in PD management in their own environment. Outcomes were defined as technique failure, peritonitis episode, and hospitalization. Clinical and dialysis features were evaluated for each patient. The case group was significantly older (p = 0.048), with a lower grade of autonomy (p = 0.033), but a better hemoglobin level (p = 0.02) than the control group. During the observational period, we had 11 episodes of technique failure. We found a significant reduction in the rate of technique failure in the case group (p = 0.004). Furthermore, survival analysis showed a significant extension of PD treatment in the patients supported by the home visit program (52 vs. 48.8 weeks, p = 0.018). We did not find any difference between the two groups in terms of peritonitis and hospitalization rate; however, trends toward a reduction of Gram-positive peritonitis rates as well as prevalence and duration of hospitalization related to PD problems were identified in the case group. The retrospective nature of the analysis was a limitation of this study. The home visit program improves the survival of PD patients and could reduce the rate of Gram-positive peritonitis and hospitalization. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi=365168.

[The strategy and process of out-hospital emergency care of acute cardiovascular events].

PubMed

Sun, Gang; Wu, Li-e; Li, Qian-ying; Yang, Ye; Wang, Zi-chao; Zhang, Jing-yin; Li, Shu-jun; Yan, Xu-long; Wang, Ming; Zhang, Wen-xiang; Huang, Guan-hua

2009-06-01

To study the strategy and process of out-hospital emergency care of acute cardiovascular events. One hundred and eighty-three patients in the Second Affiliated Hospital of Baotou Medical College were prospectively studied. The patients were divided into two groups according to the different ways of out-hospital care, one group consisted of patients who received first-aid care after calling "120" (94 cases), another was self-aid group consisting of patients sent to hospital by relatives (89 cases). The proportion of persons with higher than high school education and better knowledge for emergency care of patients with heart disease in first-aid group was higher than self-aid group (50.0% vs. 29.2%, 83.0% vs. 60.7%, both P<0.05). When the patients were brought to the emergency room, they were all treated according to our standard procedure and then registered. All patients were followed up at the end of first and third month after illness. Cardiovascular events were mainly myocardial infarction (61.7%) among 183 patients. There were statistically significant differences between two groups in self-aid response time, first disposal time and out-hospital rescuing time [(32.3+/-5.6) minutes vs. (89.6+/- 8.4) minutes, (47.3+/-7.3) minutes vs. (149.8+/-13.5) minutes, (61.7+/-8.3) minutes vs. [(149.8+/- 13.5) minutes, all P<0.01], but no difference was found in in-hospital rescuing time [(29.9+/-5.3) minutes vs. (31.1+/-4.5) minutes, P>0.05]. Morbidity rate was lower in first-aid group than self-aid group in 1st and 3rd month, respectively (2.1% vs. 9.0%, 4.2% vs. 12.4%, both P<0.05). Excellent emergency system and procedure can shorten initial disposal time and out-hospital rescuing time, thus improve patients' prognosis. The education level and health knowledge of patients and their relatives directly affect their mode of arriving hospital and prognosis.

Resounding failure to replicate links between developmental language disorder and cerebral lateralisation

PubMed Central

Bishop, Dorothy V.M.

2018-01-01

Background It has been suggested that failure to establish cerebral lateralisation may be related to developmental language disorder (DLD). There has been weak support for any link with handedness, but more consistent reports of associations with functional brain lateralisation for language. The consistency of lateralisation across different functions may also be important. We aimed to replicate previous findings of an association between DLD and reduced laterality on a quantitative measure of hand preference (reaching across the midline) and on language laterality assessed using functional transcranial Doppler ultrasound (fTCD). Methods From a sample of twin children aged from 6;0 to 11;11 years, we identified 107 cases of DLD and 156 typically-developing comparison cases for whom we had useable data from fTCD yielding a laterality index (LI) for language function during an animation description task. Handedness data were also available for these children. Results Indices of handedness and language laterality for this twin sample were similar to those previously reported for single-born children. There were no differences between the DLD and TD groups on measures of handedness or language lateralisation, or on a categorical measure of consistency of left hemisphere dominance. Contrary to prediction, there was a greater incidence of right lateralisation for language in the TD group (19.90%) than the DLD group (9.30%), confirming that atypical laterality is not inconsistent with typical language development. We also failed to replicate associations between language laterality and language test scores. Discussion and Conclusions Given the large sample studied here and the range of measures, we suggest that previous reports of atypical manual or language lateralisation in DLD may have been false positives. PMID:29333343

Students' Successes and Challenges Applying Data Analysis and Measurement Skills in a Fifth-Grade Integrated STEM Unit

ERIC Educational Resources Information Center

Glancy, Aran W.; Moore, Tamara J.; Guzey, Selcen; Smith, Karl A.

2017-01-01

An understanding of statistics and skills in data analysis are becoming more and more essential, yet research consistently shows that students struggle with these concepts at all levels. This case study documents some of the struggles four groups of fifth-grade students encounter as they collect, organize, and interpret data and then ultimately…

Evaluation of the Professional Development Program on Web Based Content Development

ERIC Educational Resources Information Center

Yurdakul, Bünyamin; Uslu, Öner; Çakar, Esra; Yildiz, Derya G.

2014-01-01

The aim of this study is to evaluate the professional development program on web based content development (WBCD) designed by the Ministry of National Education (MoNE). Based on the theoretical CIPP model by Stufflebeam and Guskey's levels of evaluation, the study was carried out as a case study. The study group consisted of the courses that…

Effects of the Leadership Roles of Administrators Who Work at Special Education Schools upon Organizational Climate

ERIC Educational Resources Information Center

Üstün, Ahmet

2017-01-01

This research aims to determine the effects of the leadership roles of administrators who work at special education schools upon organizational climate. This research has been conducted using the case study technique, which is a kind of qualitative research approach. The study group of this research consists of four administrators including three…

From Hierarchy to Pluralism in American High Schools: Changing Patterns in Status Distinctions and Racial Segregation.

ERIC Educational Resources Information Center

Comas, Jordi, R.; Milner, Murray, Jr.

Previous research on high school status consistently found a status structure characterized by extensive ranking and group salience. This case study, using observations and interviews, documents the emergence of a new pattern: status pluralism. The study was conducted in a medium-sized urban high school of about 1,000 students, who were nearly…

A Comparison of Three Types of Test Development Procedures Using Classical and Latent Trait Methods.

ERIC Educational Resources Information Center

Benson, Jeri; Wilson, Michael

Three methods of item selection were used to select sets of 38 items from a 50-item verbal analogies test and the resulting item sets were compared for internal consistency, standard errors of measurement, item difficulty, biserial item-test correlations, and relative efficiency. Three groups of 1,500 cases each were used for item selection. First…

Pre-Service Social Studies Teachers' Views about the Teaching Knowledge Test

ERIC Educational Resources Information Center

Beldag, Adem

2017-01-01

The aim of this study is to determine pre-service social studies teachers' views about the Teaching Knowledge Test (TKT). The study was conducted within the framework of case-study which is one of the qualitative research methods. The study-group consists of 13 pre-service teachers. Two semi-structured interview forms were used to collect data.…

The Role of High School History Teachers on University Students' Attitudes toward History Classes

ERIC Educational Resources Information Center

Köse, Meliha

2017-01-01

This study is a qualitative case study aimed at revealing the roles of high school history teachers on university students' attitudes towards history courses. The study group consists of 30 teacher candidates studying in the department of social sciences and mathematics teaching of a faculty of education at a university in the Western Black Sea.…

Differential Perceptions of the Seriousness of Male Violence Against Female Intimate Partners Among Jews and Arabs in Israel

ERIC Educational Resources Information Center

Herzog, Sergio

2004-01-01

Crime seriousness studies have consistently shown wide consensus regarding the high perceived seriousness of violent offenses. However, socio-cultural models suggest wide variability between social groups with regard to the seriousness of certain types of violent crime. This is particularly true in the case of male violence against female intimate…

A Survey of Students' Experiences on Collaborative Virtual Learning Activities Based on Five-Stage Model

ERIC Educational Resources Information Center

Karaman, M. Kemal; Özen, Sevil Orhan

2016-01-01

In this study, we aimed to design collaborative virtual learning (CVL) activities by using a five-stage model (FSM) and survey of students' experiences. The study group consisted of 14 voluntary students in the Turkish Teaching Department. In this case study, data were collected through observations, recordings in Second Life (SL) and interviews.…

Use of the Movies in the Turkish Language and Literature Education in Turkey

ERIC Educational Resources Information Center

Yakar, Halide Gamze Ince

2018-01-01

The aim of the present research is to investigate the teachers' use of movies in their classes for the teaching of literature and their opinions on this technique. The research is designed as a case study. The target group of the research, selected on information-oriented sampling, consists of 44 Turkish Language and Literature teachers who…

Genetic constraints on wing pattern variation in Lycaeides butterflies: A case study on mapping complex, multifaceted traits in structured populations.

PubMed

Lucas, Lauren K; Nice, Chris C; Gompert, Zachariah

2018-03-13

Patterns of phenotypic variation within and among species can be shaped and constrained by trait genetic architecture. This is particularly true for complex traits, such as butterfly wing patterns, that consist of multiple elements. Understanding the genetics of complex trait variation across species boundaries is difficult, as it necessitates mapping in structured populations and can involve many loci with small or variable phenotypic effects. Here, we investigate the genetic architecture of complex wing pattern variation in Lycaeides butterflies as a case study of mapping multivariate traits in wild populations that include multiple nominal species or groups. We identify conserved modules of integrated wing pattern elements within populations and species. We show that trait covariances within modules have a genetic basis and thus represent genetic constraints that can channel evolution. Consistent with this, we find evidence that evolutionary changes in wing patterns among populations and species occur in the directions of genetic covariances within these groups. Thus, we show that genetic constraints affect patterns of biological diversity (wing pattern) in Lycaeides, and we provide an analytical template for similar work in other systems. © 2018 John Wiley & Sons Ltd.

[Analysis for Discordance of Positive and Negative Blood Typing by Gel Card].

PubMed

Li, Cui-Ying; Xu, Hong; Lei, Hui-Fen; Liu, Juan; Li, Xiao-Wei

2017-08-01

To explore the method of Gel card identifying ABO blood group, determine the inconsistent cause and the distribution of disease affecting factors, and put forward a method of its solutions. To collect 240 positive and negative typing-discordant blood speciments from patients examined by Gel card and send these speciments to blood type reference laboratory for examining with the classic tube method and serological test, such as salivary blood-group substance, in order to performe genotyping method when serologic test can not be determined. Among 240 positive and negative typing-discordant blood speciments from patients examined by Gel card, 107 blood speciments were positive and negative consistent examined by false agglutination test (44.58%), 133 blood specinents were discordent examined by false agglutination (55.42%), out of them, 35 cases (14.58%) with inconsistent cold agglutination test, 22 cases (9.17%) with weakened AB antigenicity, 16 cases (6.67%) with ABO subtyping, 12 cases (5.00%) with positive direct antiglobulin test, 11 cases (4.58%) with reduced or without antibodies, 11 cases (4.58%) with false aggregation caused by drugs or protein, 11 cases (4.58%) with salivary blood-type substances, 8 cases (3.33%) with non-ABO alloantibody, and 7 cases (2.92%) with allogeneic bone marrow transplantation. The distribution of disease were following: blood disease (16.83%), tumor (11.88%), and cardiopulmonary diseases (11.39%); chi-square test results indicated that the distribution significantly different. The analysis of ABO blood grouping shows a variety factors influencing positive and negative blood typing, and the Gel Card identification can produc more false positive blood types. Therefore, more attention should be paid on the high incidence diseases, such as blood disease, tumor, and cardiopulmonary disease.

Angiofibroma in a cockatiel (Nymphicus hollandicus).

PubMed

Doss, G A; Miller, J L; Steinberg, H; Mans, C

2015-01-01

Human angiofibromas are rare and arise typically in the nasopharynx. In veterinary medicine they have only been described in the dog. Microscopically, angiofibromas consist of irregular groups of blood vessels within a stroma of connective tissue, with oedema and secondary inflammation often present. A cockatiel (Nymphicus hollandicus) was presented with an oral mass that consisted of aggregates of blood vessels surrounded by a connective tissue stroma, with the presence of oedema and secondary inflammation. Tumours of the oral cavity are uncommon in birds and to the authors' knowledge this is the first case of avian angiofibroma. Copyright © 2015 Elsevier Ltd. All rights reserved.

Leadership profiles of senior nurse executives.

PubMed

Hemman, E A

2000-01-01

As hospitals reorganize to meet the demand for accessible, cost-effective quality healthcare, nursing's active participation as part of the top management team is vital. The purpose of this study was to describe the leadership profiles of four senior nurse executives and determine their congruence with the theoretical perspectives of the stratified systems theory. A multiple case study methodology was employed to develop individual and group leadership profiles through related experiences obtained during an interview, the organization's expectations based on their job descriptions, and a survey of their self-perceptions of how they spent most of their time. The findings indicated that the executives' leadership behavior was consistent with the theory in that they reported more frequent leadership behaviors at the strategic domain, less activity at the organizational domain, and infrequent activity at the production domain. Individual profiles were uniformly consistent with the group profile.

Ovarian cysts and breast cancer: results from the Women's Contraceptive and Reproductive Experiences Study.

PubMed

Knight, Julia A; Lesosky, Maia; Blackmore, Kristina M; Voigt, Lynda F; Holt, Victoria L; Bernstein, Leslie; Marchbanks, Polly A; Burkman, Ronald T; Daling, Janet R; Whittemore, Alice S

2008-05-01

A diagnosis of ovarian cysts is likely an indicator of hormonal milieu and thus may be related to breast cancer risk. Recent studies have reported an inverse relationship between prior ovarian cyst diagnosis and breast cancer risk. We evaluated this relationship in the Women's Contraceptive and Reproductive Experiences (CARE) Study, a population-based case-control study conducted in Atlanta, Detroit, Philadelphia, Los Angeles, and Seattle. Cases had first primary invasive breast cancer diagnosed between 1994 and 1998 at ages 35-64 years. African American women were over-sampled. Controls were identified through random digit dialling and were frequency matched to cases on centre, race, and five-year age group. A total of 4575 cases and 4682 controls were interviewed. We used unconditional logistic regression adjusted for age and study centre within racial groups to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship between prior ovarian cysts and breast cancer. Ovarian cyst diagnosis was associated with a significantly reduced risk among Caucasians (OR=0.85, 95% CI 0.76-0.96) and among African Americans (OR=0.68, 95% CI 0.57-0.81). The association in Caucasians was not significant within subgroups defined by menopausal status, hormone use, or gynecological surgery while the OR estimates in African Americans were consistently lower and frequently significant. These data are consistent with the previously reported inverse association between ovarian cysts and breast cancer, but the evidence for a relationship was stronger in African Americans than Caucasians. Additional studies are required to determine the specific cyst type(s) responsible for the observed relationship.

Loyalty conflicts in medical practice. A comparative study of general practitioners', paediatricians' and gynaecologists' assessments of three cases.

PubMed

Lynöe, N; Mattsson, B

1998-09-01

To shed light on attitudes towards loyalty conflicts among general practitioners (GPs) compared with related specialists such as gynaecologists and paediatricians. A postal questionnaire containing three case histories with arguments for and against different ways of acting in loyalty conflicts. The medical problems of the clinical cases varied, but the ethical ones were in principle similar. A random sample of all Swedish GPs, gynaecologists, and paediatricians. GPs (n = 313), paediatricians (n = 197), and gynaecologists (n = 236). On average 71% of the doctors replied. The gynaecologists differed from the other groups by being markedly loyal to the individual patient especially in one case. The paediatricians tended to reply most consistently and they seemed to favour the family perspective, compared with the other doctors. The GPs' response pattern fell in between the other two groups. The study indicates that ethical reasoning depends on the doctors' different medical background with regard to specialty. This study should be followed by others in order to give further explanation of the findings.

Is a synthetic augmentation in medial open wedge high tibial osteotomies superior to no augmentation in terms of bone-healing?

PubMed

Ferner, Felix; Dickschas, Joerg; Ostertag, Helmut; Poske, Ulrich; Schwitulla, Judith; Harrer, Joerg; Strecker, Wolf

2016-01-01

Medial open-wedge high tibial osteotomy (MOWHTO) is an established method to treat unicompartimental osteoarthritis of the knee joint. However, augmentation of the created tibial gap after osteotomy is controversially discussed. We performed a prospective investigation of 49 consecutive cases of MOWHTO at our department. Patients were divided into two groups: group A consisted of 19 patients while group B consisted of 30 patients. In group A, the augmentation of the opening gap after osteotomy was filled with a synthetic bone graft, whereas group B received no augmentation. As an indicator for bone healing we investigated the non-union rate in our study population and compared the non-union-rate between the two groups. The non-union rate was 28% in group A (five of 19 patients had to undergo revision) which received synthetic augmentation, while it was 3.3% in group B (one of 30 patients had to undergo revision) which received no augmentation. The difference between the groups was statistically significant (p-value 0.027). With regard to bone healing after MOWHTO, synthetic augmentation was not superior to no augmentation in terms of non-union rates after surgery. In fact, we registered a significantly higher rate of non-union after augmentation with synthetic bone graft. III. Copyright © 2015 Elsevier B.V. All rights reserved.

Usefulness of skin immunofluorescence for distinguishing SLE from SLE-like renal lesions: a pilot study.

PubMed

L'Erario, Ines; Frezzolini, Alessandra; Ruggiero, Barbara; De Pità, Ornella; Emma, Francesco; Gianviti, Alessandra

2011-01-01

Lupus nephritis (LN) may represent a diagnostic problem, particularly in pediatric patients that present with typical histological lesions but do not fulfill the American Rheumatism Association (ARA) criteria for the diagnosis of systemic lupus erythematosus (SLE). Based on the well-described deposition of immunoglobulins (Ig) and complement at the dermoepithelial junction in SLE, we hypothesized that skin biopsies may help in the diagnosis of LN. To test this hypothesis, we carried out a pilot study, performing a skin biopsy in 22 patients with LN and 13 patients with lupus-like lesions, regardless of the time elapsed from onset of renal disease. The latter group of patients was further divided into a purely renal group, designated as isolated full-house nephropathy (FHN), and a dubious cases group, presenting with additional clinical and biological features consistent with SLE but insufficient for diagnosing SLE. None of the 6 isolated FHN patients had positive skin immunofluorescence. Conversely, 5/7 patients in the dubious cases group (p<0.02) and 13/22 in the LN group (p<0.002) had positive staining for C1q, and 5/7 patients in the dubious cases group (p<0.02) and 16/22 patients in the LN group (p<0.001) had positive staining for IgM. No correlation was observed with the time elapsed from the initial diagnosis. These data suggest that skin biopsies may help distinguishing LN from isolated FHN. In addition, they identify an intermediate group of patients with evidence of systemic involvement despite the absence of a sufficient number of ARA criteria to be labeled as SLE.

Association between androgenetic alopecia and coronary artery disease in young male patients.

PubMed

Sharma, Kamal H; Jindal, Anchal

2014-01-01

Several studies have demonstrated an association between androgenetic alopecia (AGA) and cardiovascular disease. Still controversies exist regarding the association. Are they truly associated? The purpose of the present study was to assess the prevalence of AGA and establish its association in young (<45 years) Asian Indian Gujarati male patients having coronary artery disease (CAD). Case-control prospective multicentric study was carried out on 424 men. Case group consisted of 212 male subjects having CAD (Group 1) and another 212, either sibling or first degree male relative of the case subjects (having no evidence of CAD) were considered as the control group (Group 2). Age, total cholesterol, incidence of diabetes mellitus, and hypertension were similar in both groups. The degree of alopecia was assessed using the Norwood-Hamilton scale for men. Statistical analysis was performed using Chi-square test. AGA was found in 80 (37.73%) young CAD patients (Group 1), whereas 44 (20.7%) of patients had alopecia in the control group (Group 2). There was statistically significant association between male AGA and CAD (P = 0.001). Odds ratio was 2.70 (95% confidence interval [CI], 1.72 ± 4.26). Statistically significant association was found between high grade baldness (Grades IV-VII) and CAD in young men (P < 0.05). Odds ratio = 2.36 (95% CI, 1.108 ± 5.033). There is statistically significant association of AGA in young Asian Gujarati male with CAD and the prevalence of AGA in young CAD patient is 37.73%. This study implies early onset AGA in male is independently associated with CAD, though mechanisms need to be investigated.

The effect of group play therapy on social-emotional skills in pre-school children.

PubMed

Chinekesh, Ahdieh; Kamalian, Mehrnoush; Eltemasi, Masoumeh; Chinekesh, Shirin; Alavi, Manijeh

2013-12-24

Childhood is important and critical period in human life. The foundation of ego is shaped in childhood. Play therapy is one of the successful strategies to help children with inner conflicts problems. This method of psychotherapy is base on the normal learning processes of children, provides solutions to relieve feelings of stress, and expands self-expression. Group play therapy can enhance the self-awareness, self- regulation, social communication, empathy and adoptability in children. Present study investigated the effects of play therapy on relational and emotional skills of pre-school children. For this purpose, the total numbers of 372 pre-school children were randomly selected, and divided into two equal groups (case and control). In next step, the BUSSE-SR methodology was used for evaluation and comparison of self-awareness, self-regulation, social interaction, empathy, adoptability, and control groups. Pre-test were performed for both groups and case group was involved in-group play therapy. According to the results of post-test, correlation of variables between case-control groups was examined by multivariate analysis of covariance. Frequency of boys and girls in our sample were 51.3 and 48.7 percent, respectively. The mean age of children was 5.1±0.6 year. According to the results of present study, play therapy significantly enhanced the social-emotional skills (P< 0.001). Our findings are consistent with the results of previous studies in other nations with different environmental and cultural properties. In conclusion, it seems that play therapy can be used in pre-school centers to help children learn problem-solving skills and communicate with others.

High-resolution array comparative genomic hybridization (aCGH) identifies copy number alterations in diffuse large B-cell lymphoma that predict response to immuno-chemotherapy

PubMed Central

Kreisel, F.; Kulkarni, S.; Kerns, R. T.; Hassan, A.; Deshmukh, H.; Nagarajan, R.; Frater, J. L.; Cashen, A.

2013-01-01

Despite recent attempts at sub-categorization, including gene expression profiling into prognostically different groups of “germinal center B-cell type” and “activated B-cell type”, diffuse large B-cell lymphoma (DLBCL) remains a biologically heterogenous tumor with no clear prognostic biomarkers to guide therapy. Whole genome, high resolution array comparative genomic hybridization (aCGH) was performed on 4 cases of chemoresistant DLBCL and 4 cases of chemo-responsive DLBCL to identify genetic differences which may correlate with response to R-CHOP therapy. Array CGH analysis identified 7 DNA copy number alteration (CNA) regions exclusive to the chemoresistant group, consisting of amplifications at 1p36.13, 1q42.3, 3p21.31, 7q11.23, and 16p13.3, and loss at 9p21.3, and 14p21.31. Copy number loss of the tumor suppressor genes CDKN2A (p16, p14) and CDKN2B (p15) at 9p21.3 was validated by fluorescence in situ hybridization and immunohistochemistry as independent techniques. In the chemo-sensitive group, 12 CNAs were detected consisting of segment gains on 1p36.11, 1p36.22, 2q11.2, 8q24.3, 12p13.33, and 22q13.2 and segment loss on 6p21.32. RUNX3, a tumor suppressor gene located on 1p36.11 and MTHFR, which encodes for the enzyme methylenetetrahydrofolate reductase, located on 1p36.22 are the only known genes in this group associated with lymphoma. Whole genome aCGH analysis has detected copy number alterations exclusive to either chemoresistant or chemo-responsive DLBCL that may represent consistent clonal changes predictive for prognosis and outcome of chemotherapy. PMID:21504712

Terminology and definitions on groin pain in athletes: building agreement using a short Delphi method.

PubMed

Weir, Adam; Hölmich, Per; Schache, Anthony G; Delahunt, Eamonn; de Vos, Robert-Jan

2015-06-01

Groin pain in athletes occurs frequently and can be difficult to treat, which may partly be due to the lack of agreement on diagnostic terminology. To perform a short Delphi survey on terminology agreement for groin pain in athletes by a group of experts. A selected number of experts were invited to participate in a Delphi questionnaire. The study coordinator sent a questionnaire, which consisted of demographic questions and two 'real-life' case reports of athletes with groin pain. The experts were asked to complete the questionnaire and to provide the most likely diagnosis for each case. Questionnaire responses were analysed by an independent researcher. The Cohen's κ statistic was used to evaluate the level of agreement between the diagnostic terms provided by the experts. Twenty-three experts participated (96% of those invited). For case 1, experts provided 9 different terms to describe the most likely diagnosis; for case 2, 11 different terms were provided to describe the most likely diagnosis. With respect to the terms provided for the most likely diagnosis, the Cohen's κ was 0.06 and 0.002 for case 1 and 2, respectively. This heterogeneous taxonomy reflects only a slight agreement between the various diagnostic terms provided by the selected experts. This short Delphi survey of two 'typical, straightforward' cases demonstrated major inconsistencies in the diagnostic terminology used by experts for groin pain in athletes. These results underscore the need for consensus on definitions and terminology on groin pain in athletes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Intra- versus retroplacental hematomas: a retrospective case-control study on pregnancy outcomes.

PubMed

Ott, Johannes; Pecnik, Philipp; Promberger, Regina; Pils, Sophie; Binder, Julia; Chalubinski, Kinga M

2017-10-26

Intrauterine hematomas are a common pregnancy complication. The literature lacks studies about outcomes based on hematoma localization. Thus, we aimed to compare pregnancies complicated by an intraplacental hematoma to cases with a retroplacental hematoma and to a control group. In a retrospective case-control study, 32 women with an intraplacental hematoma, 199 women with a retroplacental hematoma, and a control group consisting of 113 age-matched women with no signs of placental abnormalities were included. Main outcome measures were pregnancy complications. Second-trimester miscarriage was most common in the intraplacental hematoma group (9.4%), followed by women with a retroplacental hematoma (4.2%), and controls (0%; p = 0.007). The intraplacental hematoma group revealed the highest rates for placental insufficiency, intrauterine growth retardation, premature preterm rupture of membranes, preterm labor, preterm delivery <37 weeks, and early preterm delivery <34 weeks (p < 0.05), followed by the retroplacental hematoma group. When tested in multivariate models, intraplacental hematomas were independent predictors for placental insufficiency (ß = 4.19, p < 0.001) and intrauterine growth restriction (ß = 1.44, p = 0.035). Intrauterine fetal deaths occurred only in women with a retroplacental hematoma (p = 0.042). Intra- and retroplacental hematomas have different risk profiles for the affected pregnancy and act as independent risk factors.

Evaluating Options for Measurement of Neighborhood Socioeconomic Context: Evidence from a Myocardial Infarction Case-Control Study

PubMed Central

Lovasi, Gina S.; Moudon, Anne Vernez; Smith, Nicholas L.; Lumley, Thomas; Larson, Eric B.; Sohn, Dong W; Siscovick, David S; Psaty, Bruce M

2008-01-01

We hypothesized that neighborhood socioeconomic context would be most stronly associated with risk of myocardial infarction (MI) for smaller “neighborhood” definitions. We used data on 487 non-fatal, incident MI cases and 1,873 controls from a case-control study in Washington State. Census data on income, home ownership, and education were used to estimate socioeconomic context across four neighborhood definitions: one-kilometer buffer, block group, census tract, and ZIP code. No neighborhood definition led to consistently stronger associations with MI. Although we confirmed the association between neighborhood socioeconomic measures and risk of MI, we did not find these associations sensitive to neighborhood definition. PMID:17950024

A familial outbreak of fascioliasis in Eastern Anatolia: a report with review of literature.

PubMed

Karahocagil, Mustafa Kasim; Akdeniz, Hayrettin; Sunnetcioglu, Mahmut; Cicek, Muttalip; Mete, Rafet; Akman, Nevzat; Ceylan, Ebubekir; Karsen, Hasan; Yapici, Kubilay

2011-06-01

To present the results of a cross-sectional epidemiological analysis of a familial outbreak of fascioliasis in Eastern Anatolia and to discuss the clinical, diagnostic and therapeutic properties of the patients. A screening group consisting of 92 individuals from the same family with a history of watercress ingestion and a control group consisting of 30 individuals from neighboring families were included in the study. In both groups, full blood count, erythrocyte sedimentation rate, liver function tests and total IgE levels were assessed. Stool analysis was performed on three consecutive days with native, lugol and sedimentation methods. The diagnosis was based on the detection of parasite ova in the stool or alternatively based on consistent clinical, laboratory, and radiological findings or positive clinical findings in combination with a positive ELISA test. Abdominal ultrasonography and computerized tomography scans were performed on all patients. 24 patients (21 women and 3 men) were diagnosed with fascioliasis. The mean age was 24.5±18.6 years (range, 5-64 years). All cases had a history of watercress ingestion, malaise, fatigue, lack of appetite, and abdominal pain. Clinical features included: weight loss was present in 18 cases (75%), dyspepsia in 12 (50%), headache in 11 (45.8%), sweating in 10 (41.7%), fever and dyspnea each in 8 (33.3%), nausea and vomiting in 6 (25%), and itching in 4 (16.75). The most common laboratory abnormalities were total IgE elevation in 19 cases (79.2%) and eosinophilia in 17 (70.8%). The eosinophilia was >20% in 14 cases (58.3%) and the total IgE was >500IU/ml in 15 cases (62.5%). Stool examination for ova was positive in 11 cases. 10 patients had positive clinical, laboratory and radiological findings. A further three patients were diagnosed based on their clinical findings and their ELISA results. All cases had positive ELISA results. All patients, except one pregnant woman, were treated with 10mg/kg triclabendazole. Two patients required a second treatment course of triclabendazole 20mg/kg in two divided doses due to persistence of ova in the stool. One patient who developed acute urticaria as a side effect of the drug was given three additional courses of 10mg/kg triclabendazole in combination with prednisolone and antihistamines. The pregnant woman initially received four courses of 25mg/kg praziquantel treatment for 1 week. As ova were still detected in her stool following delivery, she was subsequently treated with triclabendazole. One case of fascioliasis may indicate a familial outbreak. In the acute stage radiological investigations can assist in confirming the diagnosis. ELISA testing is a reliable and sensitive method for the diagnosis of fascioliasis during any stage of the disease and may also be useful during follow-up. Copyright © 2008 Elsevier B.V. All rights reserved.

Maternal prenatal cigarette, alcohol and illicit drug use and risk of infant leukaemia: a report from the Children's Oncology Group.

PubMed

Slater, Megan E; Linabery, Amy M; Blair, Cindy K; Spector, Logan G; Heerema, Nyla A; Robison, Leslie L; Ross, Julie A

2011-11-01

Several case-control studies have evaluated associations between maternal smoking, alcohol consumption and illicit drug use during pregnancy and risk of childhood leukaemia. Few studies have specifically focused on infants (<1 year) with leukaemia, a group that is biologically and clinically distinct from older children. We present data from a Children's Oncology Group case-control study of 443 infants diagnosed with acute leukaemia [including acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML)] between 1996 and 2006 and 324 population controls. Mothers were queried about their cigarette, alcohol and illicit drug use 1 year before and throughout pregnancy. Odds ratios (ORs) and 95% confidence intervals [CI] were calculated using adjusted unconditional logistic regression models. Maternal smoking (>1 cigarette/day) and illicit drug use (any amount) before and/or during pregnancy were not significantly associated with infant leukaemia. Alcohol use (>1 drink/week) during pregnancy was inversely associated with infant leukaemia overall [OR = 0.64; 95% CI 0.43, 0.94], AML [OR = 0.49; 95% CI 0.28, 0.87], and leukaemia with mixed lineage leukaemia gene rearrangements ('MLL+') [OR = 0.59; 95% CI 0.36, 0.97]. While our results agree with the fairly consistent evidence that maternal cigarette smoking is not associated with childhood leukaemia, the data regarding alcohol and illicit drug use are not consistent with prior reports and are difficult to interpret. It is possible that unhealthy maternal behaviours during pregnancy, some of which carry potential legal consequences, may not be adequately measured using only self-report. Future case-control studies of childhood leukaemia that pursue these exposures may benefit from incorporation of validated instruments and/or biomarkers when feasible. © 2011 Blackwell Publishing Ltd.

Aortic wrapping for stanford type A acute aortic dissection: short and midterm outcome.

PubMed

Demondion, Pierre; Ramadan, Ramzi; Azmoun, Alexandre; Raoux, François; Angel, Claude; Nottin, Rémi; Deleuze, Philippe

2014-05-01

Conventional surgical treatment of Stanford type A acute aortic dissection (AAD) is associated with considerable in-hospital mortality. As regards very elderly or high-risk patients with type A AAD, some may meet the criteria for less invasive surgery likely to prevent the complications associated with aortic replacement. We have retrospectively analyzed a cohort of patients admitted to our center for Stanford type A AAD and having undergone surgery between 2008 and 2012. The outcomes of the patients having had an aortic replacement under cardiopulmonary bypass (group A) have been compared with the outcomes of the patients who underwent off-pump wrapping of the ascending aorta (group B). Among the 54 patients admitted for Stanford type A AAD, 15 with a mean age of 77 years [46 to 94] underwent wrapping of the aorta. Regarding the new standard European system for cardiac operative risk evaluation (EuroSCORE II), the median result in our group B patients was 10.47 [5.02 to 30.07]. In-hospital mortality was 12.80% in group A and 6.6% in group B (p=0.66). For patients who underwent external wrapping of the ascending aorta, follow-up mortality rate was 13.3% with a median follow-up of 15 months [range 0 to 47]. The gold standard in cases of Stanford type A AAD consists of emergency surgical replacement of the dissected ascending aorta. In some cases in which the aortic root is not affected a less invasive surgical approach consisting of wrapping the dissected ascending aorta can be suggested as an alternative. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Surgical Results of the Cephalomedullary Nail for the Femoral Intertrochanteric Fracture: Comparison between Non-experienced Surgeons and Experienced Surgeon

PubMed Central

Seo, Jae-Seong; Min, Hak-Jin; Kim, Dong Min; Oh, Seung-Min

2016-01-01

Purpose Cephalomedullary nail (CM nail) in the treatment of femoral intertrochanteric fractures is in the lime light in recent years. The purpose of this study is to compare surgical outcomes between experienced surgeon and non-experienced surgeons in respect of CM nail for femoral intertrochanteric fractures. Materials and Methods The 129 patients underwent CM nail for femoral intertrochanteric fracture more than six months of follow-up from April 2011 to March 2014 in Seoul Medical Center (Seoul, Korea) were participated in this study. For this study, group A consisted of experienced surgeons who performed more than 500 times of CM nail, and group B consisted of non-experienced surgeons who performed less than 50 times of CM nail. Clinical and radiologic outcomes, complications and the need for reoperation between both groups were compared in the study. Results According to clinical result, both the mean operation time and transfusion volume were significantly longer and greater in group B (P<0.05). In the radiologic outcomes, adequacy of reduction, tip-apex distance and numbers of case placed in the Cleveland zones 5, 6 and 8; there was no statistical difference between both groups. Moreover, rate of complication and reoperation had same results as radiologic outcomes. Conclusion There was no significant difference with statistical data in complications from CM nail for femoral intertrochanteric fractures between experienced surgeon and non-experienced surgeon. Although the operation time and transfusion volume were significantly longer and greater in the case of operation by non-experienced surgeon, satisfactory performance was seen in the complications and the need for reoperation. PMID:28097112

[Presence of inhibitors of activated partial thromboplastin time (TTPA). Clinical repercussion in obstetric patients].

PubMed

Bustos, H H; Huber, R; Baptista, H; Izquierdo, H; Sánchez Contreras, J

1992-01-01

Partial thromboplastin time, activated with kaolin (TTPA) is a qualitative test used to find defects of some factor of intrinsic via of coagulation or to rule out the presence of some circulating inhibitor. The lupus anticoagulant (LA) is part of a group of several auto-antibody with pathogenic potential in several branches of medicine, mainly rheumatology, hematology and gyneco-obstetrics. In this last area the LA has been associated with different obstetrical repercussions. The purpose of this study was to determine the main obstetrical events associated with patients with circulating anticoagulants identified by TTPA with kaolin. Ninety six patients were included in cases-control study. Group I (n = 48) cases and Group II (n = 48) controls, were selected from the same population and information source. The cases were included when presenting prolongation of more than 4 seconds of TTPA activated with kaolin regarding a control with lack of correction with normal plasma. A registration sheet for data captation, was designed specially for this study. The comparability of both groups was established, as there were no differences (significant) among the variable considered as basal. The group of cases presented with a greater frequency of habitual abortion, neonatal death and thrombotic phenomena. This relationship of autoimmunological pictures with recurrent fetal loss and thromboembolic incidents has been consistently described in literature. To this respect, several immunological abnormalities. Including positive anticardiolipin antibodies and VDRL falsely positive. The incidence, in this country of these entities, is unknown. These observations show the need of a methodologic superation.(ABSTRACT TRUNCATED AT 250 WORDS)

Streptococcus pyogenes pharyngeal colonization resulting in recurrent, prepubertal vulvovaginitis.

PubMed

Hansen, Megan T; Sanchez, Veronica T; Eyster, Kathleen; Hansen, Keith A

2007-10-01

Recurrent, prepubertal, vaginal infections are an uncommon, troublesome problem for the patient and her family. Failure of initial therapy to alleviate vulvovaginitis may be related to vulvar skin disease, foreign body, sexual abuse, pinworms, reactions to medications, anatomic anomalies, or allergies. This report describes a case of recurrent Streptococcus pyogenes vulvovaginitis secondary to presumed vaginal re-inoculation from pharyngeal colonization. A 4-yr-old presented with one year of culture proven, recurrent Streptococcus pyogenes vulvovaginitis. Her symptoms repeatedly resolved with penicillin therapy, but continued to recur following cessation of antibiotic therapy. Evaluation included physical examination, trans-abdominal pelvic ultrasound, and vaginoscopy which all revealed normal upper and lower genital tract anatomy. Both the patient and her mother demonstrated culture proven, Group A Streptococcus pharyngeal colonization. Because of the possibility of repeated inoculations of the vaginal area from the colonized pharynx, they were both treated for decolonization with a regimen of amoxicillin and rifampin for ten days. Following this therapy there was resolution of vaginal symptoms with no further recurrence. Follow-up pharyngeal culture done on both mother and child on their last visit were negative for Group A Streptococcus. This case demonstrated an unusual specific cause of recurrent vaginitis resulting from presumed self or maternal re-inoculation with group A beta-hemolytic streptococcus from pharyngeal colonization. Group A beta-hemolytic streptococcus are consistently sensitive to penicillin, but up to 25% of acute pharyngitis cases treated with penicillin having continued asymptomatic, bacterial carriage within the nasopharynx. Thus initial alleviation of symptoms in a patient with Group A beta-hemolytic vulvovaginitis treated with penicillin, can have continued asymptomatic pharyngeal colonization which can result in recurrence of the vulvovaginitis. This case stresses the importance of considering re-infection through this route in the patient with recurrent Group A beta-hemolytic streptococcus vulvovaginitis.

Relationship between female sexual difficulties and mental health in patients referred to two public and private settings in Tehran, Iran.

PubMed

Azar, Mahyar; Noohi, Sima; Shafiee Kandjani, Ali Reza

2007-09-01

Sexual difficulty has various effects on patients suffering from this condition that can impact on interpersonal and marital relationships. Sexual function may be adversely affected by stress of any kind and emotional disorders. There have been limited studies focusing on the mental health of those suffering from this problem. To determine the relationship between sexual difficulties and mental health in female patients seeking help in psychiatric clinics. The study was based on the case-control design methodology in which the case group consisted of 165 outpatients of two psychiatric clinics, who were diagnosed with different mental disorders such as depression, anxiety, phobia, aggression, and somatic complaints (33 subjects for each type of disorder). The 33 subjects in the control group were chosen among the patients' relatives and visitors who had no history of either seeking psychiatric help or taking psychiatric drugs. The subjects of both case and control groups were selected based on a convenience sampling method. Moreover, the data were collected based on two techniques of "interview" and "questionnaire;" the latter was of three different subcategories, each dealt with demographic characteristics, sexual difficulties, and a Symptom Check-List-90-Revised. Assessing female sexual difficulties associated with mental health and differences between women with and without psychiatric problems. The obtained results indicated that there was a significant difference between the prevalence of sexual difficulties (e.g., sexual desire and orgasm disorders) in the case group and that of the control group. It was also revealed that there was a significant difference between the depressed, aggressive, as well as those with somatic complaints, and their control group counterparts. In Iran, sexual difficulties seem to be more frequent in those seeking psychiatric help in clinics than in those within the normal population.

The effects of opt-out legislation on data collection and surveillance of birth defects by the New Hampshire Birth Conditions Program, New Hampshire, United States, 2007-2009.

PubMed

Gill, Simerpal; Miller, Stephanie; Broussard, Cheryl; Reefhuis, Jennita

2012-01-01

The New Hampshire Birth Conditions Program (NHBCP) is a population-based, active case ascertainment surveillance system that monitors the occurrence of 45 birth defects across the state. A 2008 law requires a new opt-out procedure whereby legal guardians can choose whether or not to have identifiable information retained in the NHBCP database. The purpose of this study was to determine the effects of implementing this opt-out legislation on data collection and surveillance of birth defects by the NHBCP. Using surveillance data collected following implementation of the opt out legislation for the period January 1, 2007, through December 31, 2009, 2 opt-out groups were created: the identifiable information retained (IIR) group, consisting of families who did not choose to opt out, and the de-identified information retained group (DIIR), consisting of those who either chose to opt out or were treated as opt-out birth defect cases because their opt-out package was undeliverable. Descriptive statistics were calculated for each group, and chi-square or Fisher's exact tests were used to compare the proportion of select sociodemographic and medical characteristics between the 2 opt-out groups. Of 776 infants, 120 (15.5%) fell into the DIIR group. Differences were observed by race/ethnicity (among non-Hispanic whites, 15% were in the DIIR group and among Hispanics, 33% were in the DIIR group; p=0.01) and by maternal age (among women 30-34 years of age, 11% were in the DIIR group, and among those 25 years of age or younger, 22% were in the DIIR group; p=0.05). Birth outcomes, payer source, county of residence, and common birth defect diagnoses did not differ between the opt-out groups. This study demonstrated that there were significant differences in race/ethnicity and maternal age between parents who had de-identified information included in the NHBCP compared with those who did not choose to opt out. Although the surveillance of birth defects is not affected, the opportunities for certain types of research will be limited.

Medication error reduction and the use of PDA technology.

PubMed

Greenfield, Sue

2007-03-01

The purpose of this study was to determine whether nursing medication errors could be reduced and nursing care provided more efficiently using personal digital assistant (PDA) technology. The sample for this study consisted of junior and senior undergraduate baccalaureate nursing students. By self-selection of owning a PDA or not, students were placed in the PDA (experimental) group or the textbook (control) group, provided with a case study to read, and asked to answer six questions (i.e., three medication administration calculations and three clinical decisions based on medication administration). The analysis of collected data, calculated using a t test, revealed that the PDA group answered the six questions with greater accuracy and speed than did the textbook group.

[Prevalence of risk factors and mechanisms of transmission of acute viral hepatitis type B and C in Bucharest municipality: 2001-2008].

PubMed

Ion-Nedelcu, Niculae; Iordăchescu, Corina; Gherasim, Patricia; Mihailovici, Rodica; Dragomirescu, Cornelia; Dumitrache-Marian, Ruxanda; Moculescu, Cristina

2009-01-01

Analysis of risk factors for achieving clinically overt hepatitis B and hepatitis C in the population of Bucharest municipality. retrospective and descriptive study on hospital patients cohort. Cases - in the study have been enrolled all acute viral hepatitis B and C confirmed by the two infectious diseases university clinics of Bucharest municipality, during the time interval 2001-2008, among the residents of the municipality. Infection risk factors - for every case of hepatitis B and hepatitis C with the simptoms onset placed during the time interval 2001-2008, it was associated "the most plausible" risk factor, detected by case investigation. For contemplation of control strategies the risk factors were stratified by mechanisms of virus transmission and by age groups. The analysis consists mainly in statistical comparing of cases prevalence in each etiology by risk factors and mechanisms of visus transmission. Patients cohort included 1440 hepatitis B cases and 227 hepatitis C cases, respectively. The most prevalent individual risk factor in hepatitis B was the sexual contact with multiple partners (51,0%) while in hepatitis C the use of ilegal injectable drugs (46,3%). The prevalences of hepatitis B and hepatitis C cases by the four mechanisms of virus transmmission were similar (p = 0,52). For both etiologies the high risk behaviours represented the principal mechanism of virus transmission (64,1% in hepatitis B and 63,4% in hepatitis C, respectively); additionaly, for both etiologies the most prevalent mechanisms of virus transmission by age groups were indentically, namely: (a) consumption of medical services in the age group 55+ years, (b) high risk behaviours in the age group 13-54 years and (c) contact with case or virus carrier in the age group 0-12 years, respectively. in the time period 2001 - 2008 the structure by mechanisms of virus transmission in hepatitis B and hepatitis C cases reported in the population of Bucharest municipaly was statistically similar, for both etiologies the most prevalent mechanism (> 60%) was represented by high risk behaviours. This reality strongly suggests that additionaly to the current strategies for prevention of the infection with hepatitic visuses B and C, the decisive strategy to control of the two infection needs to be extended with an effective education satelite focused on high risk groups.

Laparoscopic surgery in the treatment of nonruptured tubal pregnancy

NASA Astrophysics Data System (ADS)

Mutrynowski, Andrzej; Zabielska, Renata

1996-03-01

Introduction of the endoscopic techniques into gynecology enabled a change in the procedures in the case of ectopic pregnancy. This paper aims at presenting 76 cases of non-ruptured tubal pregnancies treated conservatively by the laparoscopic surgery with the application of the electrocoagulation or the Nd:YAG laser. The investigated group consisted of 76 patients. Forty-one (54%) of them were operated on using electrocoagulation and 35 (46%) using the Nd:YAG laser. Sixty-three pregnancies (83%) were localized in the ampulla. The ectopic pregnancy was confirmed histopathologically in 74 cases (97%). There were no complications noticed in the postoperative course. There were no differences in the efficacy and the postoperative general condition in cases treated conservatively by the laparoscopic surgery with the application of the electrocoagulation or the laser.

Rehabilitation in severe memory deficit: A case study

PubMed Central

Sousa, Nariana Mattos Figueiredo

2017-01-01

The term amnesia refers to a pathological state of mind in which memory and learning are affected to a greater extent than other cognitive functions in a patient without altered level of consciousness. The aim of the current study was to describe a case of severe amnesia in a patient during neurological rehabilitation and to report the importance of preserved cognitive functions to compensate for the mnemonic deficit. VJA presented a clinical condition suggestive of encephalopathy due to caloric-protein malnutrition following several abdominal surgical procedures for complicated choledocholithiasis. A descriptive analysis of the results was carried out to outline the goals attained and the factors limiting implementation of memory aids. After the intervention program, consisting of individual and group activities, VJA showed improvement in level of recall with repetition of tasks, but still required constant external monitoring. Longitudinal follow-up is necessary to obtain more consistent results. PMID:29213515

Rehabilitation in severe memory deficit: A case study.

PubMed

Sousa, Nariana Mattos Figueiredo

2017-01-01

The term amnesia refers to a pathological state of mind in which memory and learning are affected to a greater extent than other cognitive functions in a patient without altered level of consciousness. The aim of the current study was to describe a case of severe amnesia in a patient during neurological rehabilitation and to report the importance of preserved cognitive functions to compensate for the mnemonic deficit. VJA presented a clinical condition suggestive of encephalopathy due to caloric-protein malnutrition following several abdominal surgical procedures for complicated choledocholithiasis. A descriptive analysis of the results was carried out to outline the goals attained and the factors limiting implementation of memory aids. After the intervention program, consisting of individual and group activities, VJA showed improvement in level of recall with repetition of tasks, but still required constant external monitoring. Longitudinal follow-up is necessary to obtain more consistent results.

"Skip the infection, get the injection": a case study in emergency preparedness education.

PubMed

Adams, Lavonne M; Canclini, Sharon B; Frable, Pamela Jean

2015-01-01

The frequency of natural and manmade disasters along with increasing potential for public health emergencies emphasizes the need for emergency preparedness education. Because nurses are the largest group of health professionals to meet the needs of those affected by disasters and public health emergencies, schools of nursing need to prepare graduates who are knowledgeable about disaster and public health emergency management. The use of core competencies may be a means to ensure consistent application of best practices in disaster health care. The next step in competency development involves validation through evidence. Through documentation and dissemination of their experiences with emergency preparedness education, schools of nursing can provide supportive evidence to aid in competency development. The purpose of this paper is present a case study of an ongoing and evolving public health nursing education project consistent with disaster health care and emergency preparedness competencies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Stakeholder Perceptions of Cyberbullying Cases: Application of the Uniform Definition of Bullying.

PubMed

Moreno, Megan A; Suthamjariya, Nina; Selkie, Ellen

2018-04-01

The Uniform Definition of Bullying was developed to address bullying and cyberbullying, and to promote consistency in measurement and policy. The purpose of this study was to understand community stakeholder perceptions of typical cyberbullying cases, and to evaluate how these case descriptions align with the Uniform Definition. In this qualitative case analysis we recruited stakeholders commonly involved in cyberbullying. We used purposeful sampling to identify and recruit adolescents and young adults, parents, and professionals representing education and health care. Participants were asked to write a typical case of cyberbullying and descriptors in the context of a group discussion. We applied content analysis to case excerpts using inductive and deductive approaches, and chi-squared tests for mixed methods analyses. A total of 68 participants contributed; participants included 73% adults and 27% adolescents and young adults. A total of 650 excerpts were coded from participants' example cases and 362 (55.6%) were consistent with components of the Uniform Definition. The most frequently mentioned component of the Uniform Definition was Aggressive Behavior (n = 218 excerpts), whereas Repeated was mentioned infrequently (n = 19). Most participants included two to three components of the Uniform Definition within an example case; none of the example cases included all components of the Uniform Definition. We found that most participants described cyberbullying cases using few components of the Uniform Definition. Findings can be applied toward considering refinement of the Uniform Definition to ensure stakeholders find it applicable to cyberbullying. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

On Consistency Test Method of Expert Opinion in Ecological Security Assessment

PubMed Central

Wang, Lihong

2017-01-01

To reflect the initiative design and initiative of human security management and safety warning, ecological safety assessment is of great value. In the comprehensive evaluation of regional ecological security with the participation of experts, the expert’s individual judgment level, ability and the consistency of the expert’s overall opinion will have a very important influence on the evaluation result. This paper studies the consistency measure and consensus measure based on the multiplicative and additive consistency property of fuzzy preference relation (FPR). We firstly propose the optimization methods to obtain the optimal multiplicative consistent and additively consistent FPRs of individual and group judgments, respectively. Then, we put forward a consistency measure by computing the distance between the original individual judgment and the optimal individual estimation, along with a consensus measure by computing the distance between the original collective judgment and the optimal collective estimation. In the end, we make a case study on ecological security for five cities. Result shows that the optimal FPRs are helpful in measuring the consistency degree of individual judgment and the consensus degree of collective judgment. PMID:28869570

On Consistency Test Method of Expert Opinion in Ecological Security Assessment.

PubMed

Gong, Zaiwu; Wang, Lihong

2017-09-04

To reflect the initiative design and initiative of human security management and safety warning, ecological safety assessment is of great value. In the comprehensive evaluation of regional ecological security with the participation of experts, the expert's individual judgment level, ability and the consistency of the expert's overall opinion will have a very important influence on the evaluation result. This paper studies the consistency measure and consensus measure based on the multiplicative and additive consistency property of fuzzy preference relation (FPR). We firstly propose the optimization methods to obtain the optimal multiplicative consistent and additively consistent FPRs of individual and group judgments, respectively. Then, we put forward a consistency measure by computing the distance between the original individual judgment and the optimal individual estimation, along with a consensus measure by computing the distance between the original collective judgment and the optimal collective estimation. In the end, we make a case study on ecological security for five cities. Result shows that the optimal FPRs are helpful in measuring the consistency degree of individual judgment and the consensus degree of collective judgment.

Air pollution and ED visits for asthma in Australian children: a case-crossover analysis.

PubMed

Jalaludin, Bin; Khalaj, Behnoosh; Sheppeard, Vicky; Morgan, Geoff

2008-08-01

We aimed to determine the effects of ambient air pollutants on emergency department (ED) visits for asthma in children. We obtained routinely collected ED visit data for asthma (ICD9 493) and air pollution (PM(10), PM(2.5), O(3), NO(2), CO and SO(2)) and meteorological data for metropolitan Sydney for 1997-2001. We used the time stratified case-crossover design and conditional logistic regression to model the association between air pollutants and ED visits for four age-groups (1-4, 5-9, 10-14 and 1-14 years). Estimated relative risks for asthma ED visits were calculated for an exposure corresponding to the inter-quartile range in pollutant level. We included same day average temperature, same day relative humidity, daily temperature range, school holidays and public holidays in all models. Associations between ambient air pollutants and ED visits for asthma in children were most consistent for all six air pollutants in the 1-4 years age-group, for particulates and CO in the 5-9 years age-group and for CO in the 10-14 years age-group. The greatest effects were most consistently observed for lag 0 and effects were greater in the warm months for particulates, O(3) and NO(2). In two pollutant models, effect sizes were generally smaller compared to those derived from single pollutant models. We observed the effects of ambient air pollutants on ED attendances for asthma in a city where the ambient concentrations of air pollutants are relatively low.

PATHOLOGIC SIGNIFICANCE OF BLOOD VOLUME CHANGES IN UNTREATED POLYCYTHEMIA VERA AND AFTER P$sup 32$ THERAPY (in Hungarian)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burger, T.; Keszthelyi, B.; Peer, J.

1962-02-25

Ten patients suffering from polycythemia vera were divided into three groups for evaluation purposes. The first group (2 patients) consisted of the mildest cases in which the hematocrit values were 55% or less. The second group (2 patients) had a hematocrit values of 55% or higher, and the red cell and plasma voiumes were higher than normal. The third group consisted of the severest cases with hematocrit values of 70 to 80%, red cell counts of 6 to 8 million/ mm/sup 3, and red cell and plasma volumes two to four times normai. Blood volumes were determined with /sup 32/Pmore » or /sup 51/Cr. The patients showed clinical improvement after the first treatment with /sup 32/P and hematologic examination indicated that the red cell count dropped, while hemogiobin value, white cell count, thrombocyte count, and hematocrit decreased. After the second / sup 32/P treatment the blood volume did not decrease appreciably, but plasma volume increased, leading to improvement of the patient's condition. Venesection may still be used as a therapeutic means when an immediate reduction of the blood volume is desired. This can be achieved by /sup 32/P therapy only after severai treatments. The /sup 32/P dose varied with the severity of the illness from one treatment of five mC /sup 32/P in the patients with hematocrits of 55% to two doses of 4.2 mC in those with values of 58%, and three mC /sup 32/P in another patient with a hematocrit of 82%. (BBB)« less

Micronuclei: An essential biomarker in oral exfoliated cells for grading of oral squamous cell carcinoma

PubMed Central

Jadhav, Kiran; Gupta, Nidhi; Ahmed, Mujib BR

2011-01-01

Background: Micronuclei in exfoliated oral epithelial cells have been shown in some studies to correlate with severity of this genotoxic damage. This severity can be measured in terms of grading of the lesions. Aim: To correlate frequency of micronuclei (MN) in oral exfoliated cells in clinically diagnosed cases of oral squamous cell carcinoma (OSCC) followed by a histopathological grading. Materials and Methods: The study subjects consisted of clinically diagnosed cases of OSCC. Healthy subjects without any tobacco consumption habits formed the control group. The cytosmears from both groups were stained with rapid Papanicolaou stain. MN were identified according to the criteria given by Countryman and Heddle with some modifications. Results: The frequency of MN was three to four times higher in patients with OSCC as compared to patients in the control group and the difference was found to be highly significant. In 75% cases, the cytological grade as determined by the frequency of micronuclei correlated with the histopathological grade and this observation was statistically significant. Conclusions: MN can be a candidate to serve as a biomarker for prediction of the grade of OSCC. PMID:21552400

[Comparative evaluation of ultrasonography, computerized tomography, angiography and lipiodol CT in defining extent of hepatocarcinoma. A multicenter study].

PubMed

Dalla Palma, L; Pozzi Mucelli, R; Sponza, M; Bartolozzi, C; De Santis, M; Gandini, G; Mannella, P; Matricardi, L; Rossi, C; Simonetti, G

1995-03-01

The authors report the results of a multicentric trial on hepatocellular carcinoma (HCC) patients, whose lesions were confirmed with biopsy or by high (> 400 ng/ml) alpha-fetoprotein levels. The series consisted of 149 patients examined in 8 different centers and submitted to ultrasonography (US), Computed Tomography (CT) before and after contrast agent administration, angiography and Lipiodol CT. According to lesion size and number, the patients were divided with each imaging modality into three groups: a) group 1: unifocal HCC < 5 cm diameter; b) group 2: multifocal HCC with 2-3 nodules and/or tumor mass < 80 ml; c) multifocal HCC with more than 3 nodules (with total tumor mass not exceeding 40% of liver volume) or with total tumor mass > 80 ml. In 77 patients all the examinations were available for comparison. US and CT diagnosed more patients as belonging to group 1 than angiography and Lipiodol CT, while more patients were classified as groups 2 and 3 with angiography and Lipiodol CT, meaning that US and CT may understage some HCC cases (about 15%) because they show a lower number of nodules. This observation was confirmed by the direct comparison between US and Lipiodol CT (in 114 patients), CT and Lipiodol CT (in 103 patients) and angiography and Lipiodol CT (in 116 patients). US and Lipiodol CT were in disagreement in 18 cases, CT and Lipiodol CT in 16 cases and angiography and Lipiodol CT in 13 cases. In most of these cases, Lipiodol CT showed more lesions than the other techniques. The size of the undetected lesions was small, ranging few mm to 2 cm in nearly all cases. To conclude, the results of this multicentric trial show that Lipiodol CT is a fundamental tool to evaluate HCC extent. In contrast, conventional CT appeared not to add any significant piece of information and can therefore be excluded from the diagnostic protocol of HCC.

Surgical treatment of sagittal fracture of mandibular condyle using long-screw osteosynthesis.

PubMed

Luo, Shufang; Li, Bo; Long, Xing; Deng, Mohong; Cai, Hengxing; Cheng, Yong

2011-07-01

The retrospective study evaluated long-screw (bicortical screw) osteosynthesis used in the surgical treatment of sagittal fracture of the mandibular condyle and compared it with titanium plates and removal of the condylar fragment. Ninety-five patients with sagittal fracture of the mandibular condyle received open surgical treatment from 1997 to 2008. Among these patients, the condylar fragments were fixed with long screws in 56 cases (group A), were fixed with titanium plates in 12 cases (group B), and were completely removed in 24 cases (group C). Follow-up was carried out clinically and radiologically. The clinical features included limitation of mandibular mobility, occlusion disturbance, lateral deviation on mouth opening, joint pain, clicking, facial asymmetry, and patient's subjective evaluation. The radiologic parameters consisted of degree of bony resorption, bony change, change of osteosynthesis material, and shortening of mandibular ramus height. Anatomic reduction and functional restoration were obtained and no severe complication was detected in group A. However, 3 of 14 patients had severe osteoarthrosis and 2 of 14 patients had ankylosis in group B. In group C 3 of 24 patients had mandibular retrusion, 4 of 24 patients had front teeth open bite, 4 of 24 patients had severe osteoarthrosis, and 1 of 24 patients had ankylosis. The long-screw fixation group had a more favorable prognosis than the titanium plate group and the group in which removal of the condylar fragment was performed. The long-screw fixation technique might be suitable for use in the surgical treatment of sagittal fractures of the mandibular condyle. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Comparison of disposable sutureless silicone ring and traditional metal ring in 23-gauge vitrectomy combined with cataract surgery

PubMed Central

Wu, Jian-Guo; Wei, Rui-Hua; Liu, Ai-Hua; Zhou, Xiao-Xu; Sun, Guo-Ling; Li, Xiao-Rong

2011-01-01

Background: The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery. Methods: We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15). In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15). The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit. Results: Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01), and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ≤ 0.05). Conclusion: This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures. PMID:21760720

Comparison of disposable sutureless silicone ring and traditional metal ring in 23-gauge vitrectomy combined with cataract surgery.

PubMed

Wu, Jian-Guo; Wei, Rui-Hua; Liu, Ai-Hua; Zhou, Xiao-Xu; Sun, Guo-Ling; Li, Xiao-Rong

2011-01-01

The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery. We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15). In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15). The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit. Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01), and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ≤ 0.05). This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures.

Usefulness of StereoEEG-based tailored surgery for medial temporal lobe epilepsy. Preliminary results in 11 patients.

PubMed

Kubota, Yuichi; Ochiai, Taku; Hori, Tomokatsu; Kawamata, Takakazu

2017-07-01

Surgical options for medial temporal lobe epilepsy (MTLE) include anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (SAH). Optimal criteria for choosing the appropriate surgical approach remain uncertain. This article reports 11 consecutive cases in which electrophysiological findings of stereoelectroencephalography (SEEG) were used to determine the optimal surgical approach. Eleven consecutive patients with MTLE underwent SEEG evaluation and were placed in either the medial or the medial+lateral group based on the findings. Patients in the medial group underwent SAH using the subtemporal approach, and patients in the medial+lateral group underwent SEEG-guided anterior temporal lobectomy. SEEG findings were also compared with other examinations including flumazenil (FMZ)-positron emission tomography (PET), fluorine-18 labeled fluorodeoxyglucose (FDG)-PET, and magnetoencephalography (MEG). Results were evaluated to determine which examinations most consistently identified the epileptogenic zone. Of the 11 cases, 4 patients were placed in the medial group, and 7 patients in the medial+lateral group. Of patients, 90.9% were classified in class I of the Engel Epilepsy Surgery Outcome Scale, while 72.7% were classified in class I by the International League Against Epilepsy (ILAE) system. Analyzed by group, 100% of the medial group experienced an Engel class I outcome in the medial group, compared to 85.7% in the medial+lateral group. SEEG findings were comparable with FDG-PET results (10 of 11, 91%). Tailored surgery guided by SEEG is an electrophysiologically feasible treatment for MTLE that can result in favorable outcomes. Although seizures are thought to originate in the medial temporal lobe in MTLE, it is important for involvement of the lateral temporal cortex to be also considered in some cases. Copyright © 2017. Published by Elsevier B.V.

The Use of Benzodiazepine Receptor Agonists and Risk of Respiratory Failure in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Population-Based Case-Control Study

PubMed Central

Chen, Su-Jung; Yeh, Chiu-Mei; Chao, Tze-Fan; Liu, Chia-Jen; Wang, Kang-Ling; Chen, Tzeng-Ji; Chou, Pesus; Wang, Fu-Der

2015-01-01

Study Objectives: Insomnia is prevalent in patients with chronic obstructive pulmonary disease (COPD), and benzodiazepine receptor agonists (BZRAs) are the most commonly used drugs despite their adverse effects on respiratory function. The aim of this study was to investigate whether the use of BZRAs was associated with an increased risk of respiratory failure (RF) in COPD patients. Design: Matched case-control study. Setting: National Health Insurance Research Database (NHIRD) in Taiwan. Participants: The case group consisted of 2,434 COPD patients with RF, and the control group consisted of 2,434 COPD patients without RF, matched for age, sex, and date of enrollment. Measurements and Results: Exposure to BZRAs during the 180-day period preceding the index date was analyzed and compared in the case and control groups. Conditional logistic regression was performed, and the use of BZRAs was associated with an increased risk of RF (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI] 1.14–2.13). In subgroup analysis, we found that the benzodiazepine (BZD) users had a higher risk of RF (aOR 1.58, 95% CI 1.14–2.20), whereas the risk in non-benzodiazepine (non-BZD) users was insignificant (aOR 0.85, 95% CI 0.51–1.44). A greater than 2-fold increase in risk was found in those who received two or more kinds of BZRAs and those using a combination of BZD and non-BZD medications. Conclusions: The use of benzodiazepine receptor agonists was a significant risk factor for respiratory failure in patients with chronic obstructive pulmonary disease (COPD). Compared to benzodiazepine, the prescription of non-benzodiazepine may be safer for the management of insomnia in COPD patients. Citation: Chen SJ, Yeh CM, Chao TF, Liu CJ, Wang KL, Chen TJ, Chou P, Wang FD. The use of benzodiazepine receptor agonists and risk of respiratory failure in patients with chronic obstructive pulmonary disease: a nationwide population-based case-control study. SLEEP 2015;38(7):1045–1050. PMID:25669186

Hydrogen atom initiated chemistry. [chemical evolution in planetary atmospheres

NASA Technical Reports Server (NTRS)

Hong, J. H.; Becker, R. S.

1979-01-01

H Atoms have been created by the photolysis of H2S. These then initiated reactions in mixtures involving acetylene-ammonia-water and ethylene-ammonia-water. In the case of the acetylene system, the products consisted of two amino acids, ethylene and a group of primarily cyclic thio-compounds, but no free sulfur. In the case of the ethylene systems, seven amino acids, including an aromatic one, ethane, free sulfur, and a group of solely linear thio-compounds were produced. Total quantum yields for the production of amino acids were about 3 x 10 to the -5th and about 2 x 10 to the -4th with ethylene and acetylene respectively as carbon substrates. Consideration is given of the mechanism for the formation of some of the products and implications regarding planetary atmosphere chemistry, particularly that of Jupiter, are explored.

Critical Exponents, Scaling Law, Universality and Renormalization Group Flow in Strong Coupling QED

NASA Astrophysics Data System (ADS)

Kondo, Kei-Ichi

The critical behavior of strongly coupled QED with a chiral-invariant four-fermion interaction (gauged Nambu-Jona-Lasinio model) is investigated through the unquenched Schwinger-Dyson equation including the fermion loop effect at the one-loop level. It is shown that the critical exponents satisfy the (hyper)scaling relations as in the quenched case. However, the respective critical exponent takes the classical mean-field value, and consequently unquenched QED belongs to the same universality class as the zero-charge model. On the other hand, it is pointed out that quenched QED violates not only universality but also weak universality, due to continuously varying critical exponents. Furthermore, the renormalization group flow of constant renormalized charge is given. All the results are consistent with triviality of QED and the gauged Nambu-Jona-Lasinio model in the unquenched case.

Methodology or method? A critical review of qualitative case study reports

PubMed Central

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2014-01-01

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners. PMID:24809980

Case-based learning and simulation: useful tools to enhance nurses' education? Nonrandomized controlled trial.

PubMed

Raurell-Torredà, Marta; Olivet-Pujol, Josep; Romero-Collado, Àngel; Malagon-Aguilera, Maria Carmen; Patiño-Masó, Josefina; Baltasar-Bagué, Alícia

2015-01-01

To compare skills acquired by undergraduate nursing students enrolled in a medical-surgical course. To compare skills demonstrated by students with no previous clinical practice (undergraduates) and nurses with clinical experience enrolled in continuing professional education (CPE). In a nonrandomized clinical trial, 101 undergraduates enrolled in the "Adult Patients 1" course were assigned to the traditional lecture and discussion (n = 66) or lecture and discussion plus case-based learning (n = 35) arm of the study; 59 CPE nurses constituted a comparison group to assess the effects of previous clinical experience on learning outcomes. Scores on an objective structured clinical examination (OSCE), using a human patient simulator and cases validated by the National League for Nursing, were compared for the undergraduate control and intervention groups, and for CPE nurses (Student's t test). Controls scored lower than the intervention group on patient assessment (6.3 ± 2.3 vs 7.5 ± 1.4, p = .04, mean difference, -1.2 [95% confidence interval (CI) -2.4 to -0.03]) but the intervention group did not differ from CPE nurses (7.5 ± 1.4 vs 8.8 ± 1.5, p = .06, mean difference, -1.3 [95% CI -2.6 to 0.04]). The CPE nurses committed more "rules-based errors" than did undergraduates, specifically patient identifications (77.2% vs 55%, p = .7) and checking allergies before administering medication (68.2% vs 60%, p = .1). The intervention group developed better patient assessment skills than the control group. Case-based learning helps to standardize the process, which can contribute to quality and consistency in practice: It is essential to correctly identify a problem in order to treat it. Clinical experience of CPE nurses was not associated with better adherence to safety protocols. Case-based learning improves the patient assessment skills of undergraduate nursing students, thereby preparing them for clinical practice. © 2014 Sigma Theta Tau International.

Comparison of keratometric values and corneal eccentricity.

PubMed

Benes, Pavel; Synek, Svatopluk; Petrová, Sylvie

2013-04-01

The aim of this work is to compare the findings of keratometric values and their differences at various refractive errors. The eccentricity of the cornea in the sense compared to the possible influence of refraction of the eye is topographically observed. Groups of myopia, hyperopia and emmetropia (as a control group) are always represented in total 600 eyes. The studied cohort in total of 300 clients enrolled. Autorefraktokeratometer with Placido disc was used to measure the steepest and the flattest meridian to determine the corneal eccentricity. Group I consisted of 100 myopes, 35 men and 65 women, average age 37.3 years. Objective refraction--sphere: -2.9 D, cylinder: -0.88 D. Keratometry in this group is in the steepest meridian 7.62 mm and the flattest meridian is 7.76 mm. The eccentricity was 0.37. Group II consisting of 100 hyperopic subjects, 40 men and 60 women, average age 61.6 years. Objective refraction--sphere: +2.71 D, cylinder: -1.0 D. Keratometric measurement looks as follows: the steepest meridian is 7.67 mm, the flattest meridian then is 7.81 mm. The value of the eccentricity is 0.37. The third group III consists of 100 emetropic subjects, then clients without refractive errors who achieve without corrective aids Vmin = 1.0. This group is composed of 42 men and 58 women, mean age 41.4 years. Objective refraction--sphere: +0.32 D, cylinder: -0.28 D. The steepest meridian is 7.72 mm the flattest meridian then 7.83 mm. The eccentricity is represented by the observed values of 0.36. Keratometry as well as topography are fundamental methods of corneal anterior surface measurement. Their proportions are essential for the proper parameters selection especially in case of contact lenses as one of the possible means intended to correct refractive errors.

Effective Children's Rights Education from the Perspectives of Expert Teachers in Children's Rights Education: A Turkish Sample

ERIC Educational Resources Information Center

Öztürk, Ayse; Dogan, Gülay Özdemir

2017-01-01

The purpose of this study was to investigate Effective Children's Rights Education (ECRE) from the perspectives of classroom teachers who are experts in children's rights education (TECR). The data were collected through focus group interview method in this research designed as a case study. The sample of the study consists of six qualified…

The Influence of Computer-Assisted Instruction on Students' Conceptual Understanding of Chemical Bonding and Attitude toward Chemistry: A Case for Turkey

ERIC Educational Resources Information Center

Ozmen, Haluk

2008-01-01

In this study, the effect of computer-assisted instruction on conceptual understanding of chemical bonding and attitude toward chemistry was investigated. The study employed a quasi-experimental design involving 11 grade students; 25 in an experimental and 25 in a control group. The Chemical Bonding Achievement Test (CBAT) consisting of 15…

How Powerful Is Feedforward in University Education? A Case Study in Romanian Geography Education on Increasing Learning Efficiency

ERIC Educational Resources Information Center

Dulama, Maria Eliza; Ilovan, Oana-Ramona

2016-01-01

There are different opinions about the meaning of feedforward: some consider it a response to feedback, while others think it consists of suggestions given to a person in order to help them before learning or starting a task. This study analyzed the professor's and university students' actions during a seminar activity with a group of 60 students…

Transfer Practices at Los Angeles Southwest College: Case Study #3 of 7 Featuring Colleges with Consistently Higher than Expected Transfer Rates, Fall 2008

ERIC Educational Resources Information Center

Inciong, Denice; Over, Lucinda

2008-01-01

In Spring 2007, the State Chancellor's Office of the California Community Colleges awarded the Transfer Leadership Center (TLC) study to investigate two-to-four year transfer practices and strategies. As part of the study's qualitative component, research teams from the Center for Student Success of the Research & Planning Group of the…

Facebook as a Learning Tool? A Case Study on the Appropriation of Social Network Sites from Mobile Phones in Developing Countries

ERIC Educational Resources Information Center

Pimmer, Christoph; Linxen, Sebastian; Grohbiel, Urs

2012-01-01

This exploratory research investigates how students and professionals use social network sites (SNSs) in the setting of developing and emerging countries. Data collection included focus groups consisting of medical students and faculty as well as the analysis of a Facebook site centred on medical and clinical topics. The findings show how users,…

Prospective Teachers' Representations for Teaching Note Values: An Analysis in the Context of Mathematics and Music

ERIC Educational Resources Information Center

Özgül, Ilhan; Incikabi, Lütfi

2017-01-01

In this study, the representations preferred by prospective teachers in the teaching of note values were determined and the accuracy of these representations was analyzed in the context of mathematics and music. The case study, one of the qualitative research designs, was used in the study. Study group of the research consisted of 113 pre-school…

Transfer Practices at San Diego City College: Case Study #6 of 7 Featuring Colleges with Consistently Higher than Expected Transfer Rates, Fall 2008

ERIC Educational Resources Information Center

Kozeracki, Carol; Inciong, Denice

2008-01-01

In Spring 2007, the State Chancellor's Office of the California Community Colleges awarded the Transfer Leadership Center (TLC) study to investigate two-to-four year transfer practices and strategies. As part of the study's qualitative component, research teams from the Center for Student Success of the Research & Planning Group of the…

The Use of Humor by Primary School Administrators and Its Organizational Effect on Schools

ERIC Educational Resources Information Center

Sahin, Ahmet

2017-01-01

The purpose of this study is to determine the aim of primary school administrators' use of humor and the organizational effects of their use of humor according to the opinions of the school administrators and teachers. The study was modelled as a multiple holistic case study. The study group consists of 9 administrators and 12 teachers working in…

Vitamin D in the General Population of Young Adults with Autism in the Faroe Islands

ERIC Educational Resources Information Center

Kocovská, Eva; Andorsdóttir, Guðrið; Weihe, Pál; Halling, Jónrit; Fernell, Elisabeth; Stóra, Tormóður; Biskupstø, Rannvá; Gillberg, I. Carina; Shea, Robyn; Billstedt, Eva; Bourgeron, Thomas; Minnis, Helen; Gillberg, Christopher

2014-01-01

Vitamin D deficiency has been proposed as a possible risk factor for developing autism spectrum disorder (ASD). 25-Hydroxyvitamin D3 (25(OH)D3) levels were examined in a cross-sectional population-based study in the Faroe Islands. The case group consisting of a total population cohort of 40 individuals with ASD (aged 15-24 years) had significantly…

The Effect of Consanguineous Marriage on Mental Health among the Students of the Shahrekord University of Medical Sciences

PubMed Central

Hosseinpour, Maryam; Deris, Fatemeh; Solati-Dehkordi, Kamal; Heidari-Soreshjani, Sheida; Karimi, Negar; Teimori, Hossein

2016-01-01

Introduction In Iran, after unintentional accidents, mental health problems are the second leading burden of disease. Consanguineous marriage is very common in Iran and the association between parental consanguinity and mental health is an important issue that has not yet been studied sufficiently in Iran. Aim To investigate the effect of consanguinity and the degree of relationship on different levels of mental health. Materials and Methods In this cross-sectional study, conducted in the Shahrekord University of Medical Sciences, two groups of students were enrolled. The first group consisted of 156 students that had consanguineous parent (case group) and the second group was 156 students whose parents had non-blood relationship (control group). The students were evaluated using General Health Questionnaire (GHQ-28). Statistical analysis was conducted by Pearson’s correlation coefficient, independent t-test and the one-way analysis of variance. Odd ratio was used to estimate the relative risk. Results Over 30% of the individuals were suffering from mental health problems. The most and least common mental health problems in both groups were social dysfunction (54.5% in the case group and the control group 50%) and depression (15.4% in the case group and 17.3% in the control group), respectively. No statistically significant difference was observed in the frequency of overall mental health and its subscales between student with non-consanguineous parent (control group) and the students that had consanguineous parent (case group) (p>0.05) and the status of mental health was not significantly different among student with different degree of kinship (p>0.05). Conclusion The study revealed that social dysfunction was very common among the study students and also there were no relationship between parental consanguineous marriage and mental health. Parental consanguinity and genetic factors may not be the major causes of high prevalence of mental health problems in Iran and the effects of the environmental factors on these problems may be greater than those of the inherited ones. PMID:28050399

Case Definitions for Conditions Identified by Newborn Screening Public Health Surveillance.

PubMed

Sontag, Marci K; Sarkar, Deboshree; Comeau, Anne M; Hassell, Kathryn; Botto, Lorenzo D; Parad, Richard; Rose, Susan R; Wintergerst, Kupper A; Smith-Whitley, Kim; Singh, Sikha; Yusuf, Careema; Ojodu, Jelili; Copeland, Sara; Hinton, Cynthia F

2018-01-01

Newborn screening (NBS) identifies infants with rare conditions to prevent death or the onset of irreversible morbidities. Conditions on the Health and Human Services Secretary's Recommended Uniform Screening Panel have been adopted by most state NBS programs, providing a consistent approach for identification of affected newborns across the United States. Screen-positive newborns are identified and referred for confirmatory diagnosis and follow-up. The designation of a clinically significant phenotype precursor to a clinical diagnosis may vary between clinical specialists, resulting in diagnostic variation. Determination of disease burden and birth prevalence of the screened conditions by public health tracking is made challenging by these variations. This report describes the development of a core group of new case definitions, along with implications, plans for their use, and links to the definitions that were developed by panels of clinical experts. These definitions have been developed through an iterative process and are piloted in NBS programs. Consensus public health surveillance case definitions for newborn screened disorders will allow for consistent categorization and tracking of short- and long-term follow-up of identified newborns at the local, regional, and national levels.

Case Definitions for Conditions Identified by Newborn Screening Public Health Surveillance

PubMed Central

Sontag, Marci K.; Sarkar, Deboshree; Comeau, Anne M.; Hassell, Kathryn; Botto, Lorenzo D.; Parad, Richard; Rose, Susan R.; Wintergerst, Kupper A.; Smith-Whitley, Kim; Singh, Sikha; Yusuf, Careema; Ojodu, Jelili; Copeland, Sara; Hinton, Cynthia F.

2018-01-01

Newborn screening (NBS) identifies infants with rare conditions to prevent death or the onset of irreversible morbidities. Conditions on the Health and Human Services Secretary’s Recommended Uniform Screening Panel have been adopted by most state NBS programs, providing a consistent approach for identification of affected newborns across the United States. Screen-positive newborns are identified and referred for confirmatory diagnosis and follow-up. The designation of a clinically significant phenotype precursor to a clinical diagnosis may vary between clinical specialists, resulting in diagnostic variation. Determination of disease burden and birth prevalence of the screened conditions by public health tracking is made challenging by these variations. This report describes the development of a core group of new case definitions, along with implications, plans for their use, and links to the definitions that were developed by panels of clinical experts. These definitions have been developed through an iterative process and are piloted in NBS programs. Consensus public health surveillance case definitions for newborn screened disorders will allow for consistent categorization and tracking of short- and long-term follow-up of identified newborns at the local, regional, and national levels.

The incidence of preeclampsia in ICSI pregnancies

PubMed Central

Ulkumen, BurcuArtunc; Silfeler, DilekBenk; Sofuoglu, Kenan; Silfeler, Ibrahim; Dayicioglu, Vedat

2014-01-01

Objective: We aimed to evaluate the association between infertility etiology in ICSI pregnancies and preeclampsia; besides, we aimed to discuss the effect of the paternal factor in the pathogenesis of preeclampsia. Hypothesis:We hypothesized that preeclampsia is more common in ICSI pregnancies with male factor. It is known that maternal exposure to paternal sperm cells over a time period has a protective effect against preeclampsia. Male partners with azospermia have no sperm cells in their seminal fluid, whose female partners will not be able to develop some protective immunity against preeclampsia. We hypothesized that the infertile couples with male factor (partner with azoospermia and also oligospermia) would be an ideal model to test the partner-specific protective immunity against preeclampsia, as the women had no chance to develop adequate protective immunity via the partner’s sperm exposure. Methods: This Single-center, retrospective study included 508 infertile couples admitted to our IVF center between January 2001 and March 2008. The data regarding the maternal age, etiology of the infertility, the pregnancy rates, abortus ratio and viable pregnancy rates was collected from the case files. Antenatal complications such as preeclampsia, placenta previa, abruptio placenta, premature rupture of membranes, premature labor, oligohydramnios, gestational diabetes, postmaturity, postpartum complications and neonatal outcomes were evaluated via the file records and phone interviewing. The study population was divided into two main groups according to the etiology of infertility. 301 of the study population (group 1) was infertile due to male factor and 207 of the study population (group 2) was female factor and unexplained infertility cases.Group 1 patients were divided further into two subgroups: group 1a included 56 cases in which TESE (testicular sperm extraction) was used to obtain the sperm cells as the male factor was severe and as there was no sperm cells in seminal fluid. Group 1 b consists of 245oligospermic cases who obtained sperm cells via conventional methods. Results: The mean ages of women in Group one and two were 30.22±5.06 and 31.58±4.36 years respectively (p=0.001). 129 cases (42,8%) from group one and 106 cases (51,2%) from Group two ended in first trimester and early second trimester (<24 gestational weeks) pregnancy loss. In group one, only 172 cases of 301 pregnancies passed over 24 weeks of gestational age, whereas in group two, 101 cases of 207 patients passed over 24 gestational weeks. There was no significant difference between two groups regarding chemical pregnancies and early pregnancy loss (p=0.314). There was no significant difference between the groups regarding placenta previa, gestational diabetes, oligo hydramnios and intrauterine growth retardation. One one pregnancy was 1.5 times more vulnerable for preeclampsia. Conclusion: Pregnancies with azoospermic and oligospermic partners had an increased risk for developing preeclampsia. PMID:24639840

Factors influencing flap and INTACS decentration after femtosecond laser application in normal and keratoconic eyes.

PubMed

Ertan, Aylin; Karacal, Humeyra

2008-10-01

To compare accuracy of LASIK flap and INTACS centration following femtosecond laser application in normal and keratoconic eyes. This is a retrospective case series comprising 133 eyes of 128 patients referred for refractive surgery. All eyes were divided into two groups according to preoperative diagnosis: group 1 (LASIK group) comprised 74 normal eyes of 72 patients undergoing LASIK with a femtosecond laser (IntraLase), and group 2 (INTACS group) consisted of 59 eyes of 39 patients with keratoconus for whom INTACS were implanted using a femtosecond laser (IntraLase). Decentration of the LASIK flap and INTACS was analyzed using Pentacam. Temporal decentration was 612.56 +/- 384.24 microm (range: 30 to 2120 microm) in the LASIK group and 788.33 +/- 500.34 microm (range: 30 to 2450 microm) in the INTACS group. A statistically significant difference was noted between the groups in terms of decentration (P < .05). Regression analysis showed that the amount of decentration of the LASIK flap and INTACS correlated with the central corneal thickness in the LASIK group and preoperative sphere and cylinder in the INTACS group, respectively. Decentration with the IntraLase occurred in most cases, especially in keratoconic eyes. The applanation performed for centralization during IntraLase application may flatten and shift the pupil center, and thus cause decentralization of the LASIK flap and INTACS. Central corneal thickness in the LASIK group and preoperative sphere and cylinder in the INTACS group proved to be statistically significant parameters associated with decentration.

[Setting up of a day group service system for severely disabled children, the "Koala Club"].

PubMed

Ozawa, Hiroshi; Kubota, Masaya; Tanaka, Yoshiko; Atsumi, So; Arimoto, Kiyoshi; Kimiya, Satoshi

2006-01-01

This is a report of the setting up of a day group service system for severely disabled children, the "Koala Club". The "Koala Club" was started in 1993, and has been running outside of the hospital since 1997. A support group for the "Koala Club" was established in 1999. Currently 13 children attend the "Koala Club". The staff of the "Koala Club" consists of one coordinater, four nurses and eight care workers. The medical care is fulfilled by nurses. The "Koala Club" open two days a week. It has been supervised by a doctor and a case worker. There is an important role for physicians in the regional care of disabled children.

Surgical treatment of scoliosis in Marfan syndrome: outcomes and complications.

PubMed

Qiao, Jun; Xu, Leilei; Liu, Zhen; Zhu, Feng; Qian, Bangping; Sun, Xu; Zhu, Zezhang; Qiu, Yong; Jiang, Qing

2016-10-01

To investigate surgical outcomes and complications of scoliosis associated with Marfan syndrome. Inclusion criteria were patients who were 10-20 years of age, had a diagnosis of Marfan syndrome by the Ghent nosology, had scoliosis and had undergone spinal fusion, and had at least 2 years of postoperative follow-up. The medical records of all patients were reviewed for age at the time of surgery, surgical procedures performed, instrumentation type, estimated blood loss (EBL) during surgery, operation time and complications related to surgery. Health-related quality-of-life measures (obtained with the SRS-22 Questionnaire before operation and at the last clinical follow-up) were also recorded. Patients were analyzed as two different groups, Group 1 and Group 2, according to the different approaches employed. Patients receiving combined anterior and posterior surgery were assigned to Group 1 and those who received posterior-only surgery to Group 2. Group 1 consisted of 30 patients (14 males, 16 females) with a mean age at surgery of 16.8 years (range: 10-20 years). Complications in Group 1 included two cases of instrumentation loosening with one removed, one case of instrumentation breakage and one case of chylothorax and hemothorax during video assisted thoracoscopic release. 66 patients (28 males, 38 females) with a mean age at surgery of years 16.4 years (range: 10-20 years) were included in Group 2. Complications in Group 2 included six cases of cerebro-spinal fluid leak, one case of deep wound infection secondary to cerebro-spinal fluid leak, one case of leg weakness and one case of pleural rupture cause by misplacement of pedicle screw. There is no difference of age at surgery, preoperative Cobb angles, and SRS-22 total scores (3.0 vs. 3.1) between the two groups (P > 0.05). Group 1 yielded larger correction rate than Group 2 for both thoracic (62.5 % vs. 56.2 %) and lumbar scoliosis (68.3 % vs. 62.7 %). Loss of correction was similar between the two groups for both thoracic (4.1° vs. 3.6°) and lumbar (4.2° vs. 4.6°) curves (P > 0.05). EBL (1972 ml vs. 1530) and operation time (669 min vs. 419 min) were significantly increased in Group 1 than in Group 2 (P < 0.05). No difference was noted for SRS-22 total scores in the last follow-up between the two groups (3.7 vs. 3.8, P > 0.05). In conclusion, as compared to anterior release combined with posterior spinal fusion, posterior-only spinal fusion could yield comparable clinical outcomes for scoliosis associated with Marfan syndrome with lower EBL, and operation time. However, longer follow-up is needed to verify these findings.

Non-Fermi-liquid superconductivity: Eliashberg approach versus the renormalization group

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Huajia; Raghu, Srinivas; Torroba, Gonzalo

Here, we address the problem of superconductivity for non-Fermi liquids using two commonly adopted, yet apparently distinct, methods: (1) the renormalization group (RG) and (2) Eliashberg theory. The extent to which both methods yield consistent solutions for the low-energy behavior of quantum metals has remained unclear. We show that the perturbative RG beta function for the 4-Fermi coupling can be explicitly derived from the linearized Eliashberg equations, under the assumption that quantum corrections are approximately local across energy scales. We apply our analysis to the test case of phonon-mediated superconductivity and show the consistency of both the Eliashberg and RGmore » treatments. We next study superconductivity near a class of quantum critical points and find a transition between superconductivity and a “naked” metallic quantum critical point with finite, critical BCS couplings. We speculate on the applications of our theory to the phenomenology of unconventional metals.« less

Non-Fermi-liquid superconductivity: Eliashberg approach versus the renormalization group

DOE PAGES

Wang, Huajia; Raghu, Srinivas; Torroba, Gonzalo

2017-04-15

Here, we address the problem of superconductivity for non-Fermi liquids using two commonly adopted, yet apparently distinct, methods: (1) the renormalization group (RG) and (2) Eliashberg theory. The extent to which both methods yield consistent solutions for the low-energy behavior of quantum metals has remained unclear. We show that the perturbative RG beta function for the 4-Fermi coupling can be explicitly derived from the linearized Eliashberg equations, under the assumption that quantum corrections are approximately local across energy scales. We apply our analysis to the test case of phonon-mediated superconductivity and show the consistency of both the Eliashberg and RGmore » treatments. We next study superconductivity near a class of quantum critical points and find a transition between superconductivity and a “naked” metallic quantum critical point with finite, critical BCS couplings. We speculate on the applications of our theory to the phenomenology of unconventional metals.« less

TERMTrial--terminology-based documentation systems for cooperative clinical trials.

PubMed

Merzweiler, A; Weber, R; Garde, S; Haux, R; Knaup-Gregori, P

2005-04-01

Within cooperative groups of multi-center clinical trials a standardized documentation is a prerequisite for communication and sharing of data. Standardizing documentation systems means standardizing the underlying terminology. The management and consistent application of terminology systems is a difficult and fault-prone task, which should be supported by appropriate software tools. Today, documentation systems for clinical trials are often implemented as so-called Remote-Data-Entry-Systems (RDE-systems). Although there are many commercial systems, which support the development of RDE-systems there is none offering a comprehensive terminological support. Therefore, we developed the software system TERMTrial which consists of a component for the definition and management of terminology systems for cooperative groups of clinical trials and two components for the terminology-based automatic generation of trial databases and terminology-based interactive design of electronic case report forms (eCRFs). TERMTrial combines the advantages of remote data entry with a comprehensive terminological control.

Impact of payment system change from per-case to per-diem on high severity patient's length of stay.

PubMed

Jang, Sung-In; Nam, Chung Mo; Lee, Sang Gyu; Kim, Tae Hyun; Park, Sohee; Park, Eun-Cheol

2016-09-01

A new payment system, the diagnosis-related group (DRG) system, and Korean diagnosis procedure combination (KDPC, per-diem) payment system were officially introduced in 2002 and in 2012, respectively. We evaluated the impact of payment system change from per-case to per-diem on high severity patient's length of stay (LOS).Claim data was used. A total of 36,240 case admissions and 72,480 control admissions were included in the analysis. Segmented regression analysis of interrupted time series between cases and controls was conducted. Hospitals that consistently participated in the DRG payment system and changed to the KDPC payment system were defined as case hospitals. Hospitals that consistently participated in the DRG payment system were defined as control hospitals.LOS increased by 0.025 days per month (P = 0.0055) for 3 surgical diagnosis-related admissions due to the bundled payment system change. LOS among emergency admissions also increased and showed an increasing tendency under the KDPC. The LOS increase was observed specifically for complex procedure admissions and high severity cases (CCI 0, 1: 0.022, P = 0.0142; CCI 2, 3: 0.026, P = 0.0288; CCI ≥ 4: 0.055, P = 0.0003).Although both payment systems are optimized to decrease LOS, incentives to reduce LOS are stronger under the DRG system than under the KDPC system. It is worth noting that too strong incentive for reducing LOS is suitable to high severity cases.

The use of magnetic resonance mammography in women at increased risk for developing breast cancer

PubMed Central

Popiela, Tadeusz J.; Herman-Sucharska, Izabela; Urbanik, Andrzej

2012-01-01

Introduction The use of conventional imaging techniques, namely mammography (MMG) and ultrasound (US), for breast cancer (BC) detection in women at high risk for the disease does not bring optimal results in many cases. Aim The present study evaluated the effectiveness of magnetic resonance (MR) mammography (MRM) in cases where US and MMG failed to detect suspected breast lesions. Material and methods The study group consisted of 379 women who had had no breast pathologies detected by US and MMG. This group was then divided into 4 groups according to the relative risk of breast cancer development. All the women underwent MRM, and any breast pathology detected by MRM was then verified by open surgical biopsy (OSB). Results Based on the MRM findings, 37 women with breast pathologies were identified. All detected pathologies were then classified into one of the BIRADS (Breast Imaging Reporting and Data System) categories. Of these, 33 patients underwent open surgical biopsy. There were a total of 17 benign and 16 malignant breast pathologies that were not visualized by US and MMG. The types of malignancies found, in order of their frequency, were as follows: invasive ductal carcinoma (11 cases), ductal carcinoma in situ (2 cases), invasive lobular carcinoma (2 cases), and lobular carcinoma in situ (1 case). An analysis of MRM effectiveness in detecting BC showed 93.7% sensitivity and 64.71% specificity. Conclusions All women with a 20% or greater lifetime risk of developing BC should undergo annual MRM as a diagnostic adjunct to US and MMG. PMID:23630555

Child protective services utilization of child abuse pediatricians: A mixed methods study.

PubMed

Girardet, Rebecca; Bolton, Kelly; Hashmi, Syed; Sedlock, Emily; Khatri, Rachna; Lahoti, Nina; Lukefahr, James

2018-02-01

Several children's hospitals and medical schools across Texas have child abuse pediatricians (CAPs) who work closely with child protection workers to help ensure accurate assessments of the likelihood of maltreatment in cases of suspected abuse and neglect. Since the state does not mandate which cases should be referred to a CAP center, we were interested in studying factors that may influence workers' decisions to consult a CAP. We used a mixed methods study design consisting of a focus group followed by a survey. The focus group identified multiple factors that impact workers' decision-making, including several that involve medical providers. Responses from 436 completed surveys were compared to employees' number of years of employment and to the state region in which they worked. Focus group findings and survey responses revealed frustration among many workers when dealing with medical providers, and moderate levels of confidence in workers' abilities to make accurate determinations in cases involving medical information. Workers were more likely to refer cases involving serious physical injury than other types of cases. Among workers who reported prior interactions with a CAP, experiences and attitudes regarding CAPs were typically positive. The survey also revealed significant variability in referral practices by state region. Our results suggest that standard guidelines regarding CAP referrals may help workers who deal with cases involving medical information. Future research and quality improvement efforts to improve transfers of information and to better understand the qualities that CPS workers appreciate in CAP teams should improve CAP-CPS coordination. Copyright © 2017 Elsevier Ltd. All rights reserved.

[The male genital in legal medicine].

PubMed

Albrecht, K; Schultheiss, D

2006-02-01

Pathomorphological findings for the male genital are an exception among forensic cases. In earlier publications they were usually published as individual cases. A significant percentage are the so-called fertility- and potency medical certificates, which are usually commissioned for doubtful paternity cases. Old forensic writings about genital injuries distinguish--apart from the necessity of a complete dissection--between "deadly as such" and "accidentally deadly" injuries. Another group consists of reports about self-inflicted genital mutilation, e.g. among prison inmates or soldiers of the last world wars to become an invalid. When it was necessary to identify a corpse, e.g. in cases of progressive decomposition, Merkel recommended in 1945 the representation of the so-called "Schnepfenkopf" (snipe head; colliculus seminalis) in the lesser pelvis. In this article a medical and forensic review of forensically relevant findings of the male genital is presented and illustrated with historical cases.

Proceedings of the 2004 Workshop on CFD Validation of Synthetic Jets and Turbulent Separation Control

NASA Technical Reports Server (NTRS)

Rumsey, Christopher L. (Compiler)

2007-01-01

The papers presented here are from the Langley Research Center Workshop on Computational Fluid Dynamics (CFD) Validation of Synthetic Jets and Turbulent Separation Control (nicknamed "CFDVAL2004"), held March 2004 in Williamsburg, Virginia. The goal of the workshop was to bring together an international group of CFD practitioners to assess the current capabilities of different classes of turbulent flow solution methodologies to predict flow fields induced by synthetic jets and separation control geometries. The workshop consisted of three flow-control test cases of varying complexity, and participants could contribute to any number of the cases. Along with their workshop submissions, each participant included a short write-up describing their method for computing the particular case(s). These write-ups are presented as received from the authors with no editing. Descriptions of each of the test cases and experiments are also included.

Treatment of femoral Ewing's sarcoma.

PubMed

Terek, R M; Brien, E W; Marcove, R C; Meyers, P A; Lane, J M; Healey, J H

1996-07-01

The treatment of Ewing's sarcoma consists of chemotherapy for systemic and local disease. However, the role of radiation therapy, and/or surgical resection for definitive local treatment has yet to be determined. A retrospective review of 32 patients (24 males and 8 females) treated for femoral Ewing's sarcoma between 1970 and 1985 was performed. Patients were divided into 3 treatment groups: chemotherapy and radiotherapy (CR) (10); chemotherapy and surgery (CS) (9); and chemotherapy, surgery, and radiotherapy (CSR) (13). Patients in the CR group received a mean of 5320 centigray (cGy) of radiation and patients in the CSR group received a mean of 3590 cGy. Multiagent cyclophosphamide/doxorubicin based chemotherapy was used in all cases. Surgery consisted of wide resection or amputation. Patients in the CR group had a higher risk of local recurrence than patients in the CS and CSR groups (P=0.02, log rank). The combination of local recurrences and treatment complications necessitated surgery for 7 of 10 CR patients, whereas 1 of 9 and 4 of 13 in the CS and CSR groups required additional surgery. The median survival for the entire group was 39 months. Minimum follow-up for surviving patients was 45 months. Five-year survival consisted of 1 of 10 patients in the CR group, 2 of 9 in the CS group, and 7 of 13 in the CSR group. There were no statistically significant differences among the three survival curves. Tumor location within the femur was a significant prognostic variable. Distal femoral location had a survival advantage compared with proximal and mid-femur locations (P = 0.049, log rank). Femoral Ewing's sarcoma remains a disease with a poor prognosis. Radiation alone for local treatment results in a high rate of local recurrence and complications. Our current local treatment strategy for femoral Ewing's sarcoma includes surgery in all and adjuvant radiotherapy in many of the patients.

[Treatment of Occipital Neuralgia by Electroacupuncture Combined with Neural Mobilization].

PubMed

Wang, Yan; Guo, Zi-Nan; Yang, Zhen; Wang, Shun

2018-03-25

To observe the effect of electroacupuncture (EA) combined with neural mobilization (NM) in the treatment of occipital neuralgia. A total of 62 occipital neuralgia patients were randomized into EA group (19 cases), NM group (22 cases) and EA＋NM group (21 cases). EA was applied at acupoint-pairs as Yuzhen (BL 9)- Tianzhu (BL 10), Fengchi (GB 20)- Wangu (GB 12), etc. NM intervention consisted of occipital muscle group mobilization, C 2 spinous process mobilization, cervical joint passive movement management mobilization, etc., was performed at the impaired cervical spine segment. The two methods were used in combination for patients in the EA＋NM group. All the treatment was given once a day for 2 weeks. Before and after treatment, the visual analogue scale (VAS) and the 6-point (1－6 points) behavioral rating scale (BRS-6) of headache were used to assess the severity of pain. The therapeutic effect was evaluated according to the "Criteria for Diagnosis and Cure-Improvement of Clinical Conditions" formulated by State Administration of Traditional Chinese Medicine of the People's Republic of China in 1994. After treatment, both VAS and BRS-6 scores were significantly lower than those before treatment in each of the three groups ( P <0.05), and were significantly lower in the EA＋NM group than in the simple EA and simple NM groups ( P <0.01, P <0.05). The total effective rates were 78.95% (15/19) in the EA group, 68.18% (15/22) in the NM group, and 90.48% (19/21) in the EA＋NM group, with an obviously better therapeutic effect being in the EA＋NM group relevant to each of the other two treatment groups ( P <0.05). EA, NM and EA combined with NM can improve symptoms of patients with occipital neuralgia, and EA＋NM has a synergic analgesic effect for occipital neuralgia.

[Development of nursing pratice in family medecine groups].

PubMed

D'Amour, Danielle; Goudreau, Johanne; Hudon, Eveline; Beaulieu, Marie-Dominique; Lamothe, Lise; Jobin, Guy; Gilbert, Frédéric

2008-01-01

The purpose of the study was to analyze the development of nursing practice in family medicine groups (FMGs). The two-year case study consisted of 73 semi-directed interviews ofnurses, physicians and managers in five FMGs. The findings led to three main observations: nursing practice varies considerably from one FMG to another, the development of nurses' practice seems to be associated with the development of a collaborative relationship, and the satisfaction of the professionals in the FMG, nurses in particular, depends on the type of practice. It is important to implement measures to encourage the optimal use ofnurses' skills in a FMG.

Uncompacted myelin lamellae in peripheral nerve biopsy.

PubMed

Vital, Claude; Vital, Anne; Bouillot, Sandrine; Favereaux, Alexandre; Lagueny, Alain; Ferrer, Xavier; Brechenmacher, Christiane; Petry, Klaus G

2003-01-01

Since 1979, the authors have studied 49 peripheral nerve biopsies presenting uncompacted myelin lamellae (UML). Based on the ultrastructural pattern of UML they propose a 3-category classification. The first category includes cases displaying regular UML, which was observed in 43 cases; it was more frequent in 9 cases with polyneuropathy organomegaly endocrinopathy m-protein skin changes (POEMS) syndrome as well as in 1 case of Charcot-Marie-Tooth 1B with a novel point mutation in the P0 gene. The second category consists of cases showing irregular UML, observed in 4 cases with IgM monoclonal gammopathy and anti-myelin-associated glycoprotein (MAG) activity. This group included 1 benign case and 3 B-cell malignant lymphomas. The third category is complex UML, which was present in 2 unrelated patients with an Arg 98 His missense mutation in the P0 protein gene. Irregular and complex UML are respectively related to MAG and P0, which play a crucial role in myelin lamellae compaction and adhesion.

Visual memory effects on intraoperator study design: determining a minimum time gap between case reviews to reduce recall bias.

PubMed

Campbell, W Scott; Talmon, Geoffrey A; Foster, Kirk W; Baker, John J; Smith, Lynette M; Hinrichs, Steven H

2015-03-01

The objective of this research was to determine test intervals between intraoperator case reviews to minimize the impact of recall. Three pathologists were presented with a group of 120 slides and subsequently challenged with a study set of 120 slides after 2-week and 4-week intervals. The challenge set consisted of 60 slides seen during the initial review and 60 slides previously unseen within the study. Pathologists rendered a diagnosis for each slide and indicated whether they recalled seeing the slide previously (yes/no). Two weeks after having been shown 60 cases from a challenge set of 120 cases, the pathologists correctly remembered 26, 22, and 24 cases or 40% overall. After 4 weeks, the pathologists correctly recalled 31% of cases previously seen. Pathologists were capable of recalling from memory cases seen previously at 2 and 4 weeks. Recall rates may be sufficiently high to affect intraobserver study design. Copyright© by the American Society for Clinical Pathology.

Association Between Androgenetic Alopecia and Coronary Artery Disease in Young Male Patients

PubMed Central

Sharma, Kamal H; Jindal, Anchal

2014-01-01

Background: Several studies have demonstrated an association between androgenetic alopecia (AGA) and cardiovascular disease. Still controversies exist regarding the association. Are they truly associated? Objective: The purpose of the present study was to assess the prevalence of AGA and establish its association in young (<45 years) Asian Indian Gujarati male patients having coronary artery disease (CAD). Materials and Methods: Case-control prospective multicentric study was carried out on 424 men. Case group consisted of 212 male subjects having CAD (Group 1) and another 212, either sibling or first degree male relative of the case subjects (having no evidence of CAD) were considered as the control group (Group 2). Age, total cholesterol, incidence of diabetes mellitus, and hypertension were similar in both groups. The degree of alopecia was assessed using the Norwood-Hamilton scale for men. Statistical analysis was performed using Chi-square test. Results: AGA was found in 80 (37.73%) young CAD patients (Group 1), whereas 44 (20.7%) of patients had alopecia in the control group (Group 2). There was statistically significant association between male AGA and CAD (P = 0.001). Odds ratio was 2.70 (95% confidence interval [CI], 1.72 ± 4.26). Statistically significant association was found between high grade baldness (Grades IV-VII) and CAD in young men (P < 0.05). Odds ratio = 2.36 (95% CI, 1.108 ± 5.033). There is statistically significant association of AGA in young Asian Gujarati male with CAD and the prevalence of AGA in young CAD patient is 37.73%. Conclusion: This study implies early onset AGA in male is independently associated with CAD, though mechanisms need to be investigated. PMID:25114445

Use of an online curriculum to teach delirium to fourth-year medical students: a comparison with lecture format.

PubMed

Chao, Serena H; Brett, Belle; Wiecha, John M; Norton, Lisa E; Levine, Sharon A

2012-07-01

Web-based learning methods are being used increasingly to teach core curriculum in medical school clerkships, but few studies have compared the effectiveness of online methods with that of live lectures in teaching the same topics to students. Boston University School of Medicine has implemented an online, case-based, interactive curriculum using videos and text to teach delirium to fourth-year medical students during their required 1-month Geriatrics and Home Medical Care clerkship. A control group of 56 students who received a 1-hour live delirium lecture only was compared with 111 intervention group students who completed the online delirium curriculum only. Evaluation consisted of a short-answer test with two cases given as a pre- and posttest to both groups. The total possible maximum test score was 34 points, and the lowest possible score was -8 points. Mean pre- and posttest scores were 10.5 ± 4.0 and 12.7 ± 4.4, respectively, in the intervention group and 9.9 ± 3.5 and 11.2 ± 4.5, respectively, in the control group. The intervention group had statistically significant improvement between the pre- and posttest scores (2.21-point difference; P < .001), as did the control group (1.36-point difference; P = .03); the difference in test score improvement between the two groups was not statistically significant. An interactive case-based online curriculum in delirium is as effective as a live lecture in teaching delirium, although neither of these educational methods alone produces robust increases in knowledge. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

European framework for tuberculosis control and elimination in countries with a low incidence. Recommendations of the World Health Organization (WHO), International Union Against Tuberculosis and Lung Disease (IUATLD) and Royal Netherlands Tuberculosis Association (KNCV) Working Group.

PubMed

Broekmans, J F; Migliori, G B; Rieder, H L; Lees, J; Ruutu, P; Loddenkemper, R; Raviglione, M C

2002-04-01

As countries approach the elimination phase of tuberculosis, specific problems and challenges emerge, due to the steadily declining incidence in the native population, the gradually increasing importance of the importation of latent tuberculosis infection and tuberculosis from other countries and the emergence of groups at particularly high risk of tuberculosis. Therefore, a Working Group of the World Health Organization (WHO), the International Union Against Tuberculosis and Lung Disease (IUATLD) and the Royal Netherlands Tuberculosis Association (KNCV) have developed a new framework for low incidence countries based on concepts and definitions consistent with those of previous recommendations from WHO/IUATLD Working Groups. In low-incidence countries, a broader spectrum of interventions is available and feasible, including: 1) a general approach to tuberculosis which ensures rapid detection and treatment of all the cases and prevention of unnecessary deaths; 2) an overall control strategy aimed at reducing the incidence of tuberculosis infection (risk-group management and prevention of transmission of infection in institutional settings) and 3) a tuberculosis elimination strategy aimed at reducing the prevalence of tuberculosis infection (outbreak management and provision of preventive therapy for specified groups and individuals). Government and private sector commitment towards elimination, effective case detection among symptomatic individuals together with active case finding in special groups, standard treatment of disease and infection, access to tuberculosis diagnostic and treatment services, prevention (e.g. through screening and bacille Calmette-Guéria immunization in specified groups), surveillance and treatment outcome monitoring are prerequisites to implementing the policy package recommended in this new framework document.

The Effect of Group Play Therapy on Social-Emotional Skills in Pre-School Children

PubMed Central

Chinekesh, Ahdieh; Kamalian, Mehrnoush; Eltemasi, Masoumeh; Chinekesh, Shirin; Alavi, Manijeh

2014-01-01

Background: Childhood is important and critical period in human life. The foundation of ego is shaped in childhood. Play therapy is one of the successful strategies to help children with inner conflicts problems. This method of psychotherapy is base on the normal learning processes of children, provides solutions to relieve feelings of stress, and expands self-expression. Group play therapy can enhance the self-awareness, self- regulation, social communication, empathy and adoptability in children. Methods: Present study investigated the effects of play therapy on relational and emotional skills of pre-school children. For this purpose, the total numbers of 372 pre-school children were randomly selected, and divided into two equal groups (case and control). In next step, the BUSSE-SR methodology was used for evaluation and comparison of self-awareness, self-regulation, social interaction, empathy, adoptability, and control groups. Pre-test were performed for both groups and case group was involved in-group play therapy. According to the results of post-test, correlation of variables between case-control groups was examined by multivariate analysis of covariance. Results: Frequency of boys and girls in our sample were 51.3 and 48.7 percent, respectively. The mean age of children was 5.1±0.6 year. According to the results of present study, play therapy significantly enhanced the social-emotional skills (P< 0.001). Our findings are consistent with the results of previous studies in other nations with different environmental and cultural properties. In conclusion, it seems that play therapy can be used in pre-school centers to help children learn problem-solving skills and communicate with others. PMID:24576376

[Mexidol in treatment of children with generalized epilepsy and febrile seizures].

PubMed

Natriashvili, G; Natriashvili, S; Kapanadze, N

2005-05-01

The aim of our study was to estimate the role of Mexidol in ceasing of epileptic fits and improving electroencephalographic (EEG) pathological patterns in children. 120 patients with generalized epilepsy (from 4 to 16 years old) were investigated. All patients were treated by Depakin chrono 30 mg/kg. Children were divided into 2 groups: 1st--study group consisted of 60 children with combined treatment with Depakin and Mexidol (5 mg/kg). In the control group (60 children) treatment was performed only by Depakin. 100 children with the first episode of febrile seizures (from 6 months to 4 years old) were investigated. 50 children composed the study group with monotheraphy by Mexidol and 50 patients--the control group, without any treatment. The EEG examination was done by computer EEG Topography "Brain Surveyor Saico". Using Depakin in combination with Mexidol in the study group of patients with generalized epilepsy, improvement of clinical picture of disease and normalization of EEG patterns in 93% of cases has been observed. In the study group of patients with febrile seizures, normalization of EEG pathological patterns was observed in 82% cases and in 18% its improvement was seen. The relapse of seizures at high temperature was observed in 3 patients. In control group EEG patterns were improved only in 20%, in 48% no positive effect was observed and in 41% the worsening of EEG findings was seen. The relapse of febrile seizures was observed in 26 cases. Mexidol titrated to the target doze of 5mg/kg may be effective in combination with Depakin for treatment of patients with generalized epilepsy and as monotherapy in patients with first episode of febrile seizures.

Hepatitis A in Korea from 2011 to 2013: Current Epidemiologic Status and Regional Distribution.

PubMed

Moon, Shinje; Han, Jun Hee; Bae, Geun-Ryang; Cho, Enhi; Kim, Bongyoung

2016-01-01

The hepatitis A virus (HAV) has been the leading cause of viral hepatitis in Korea since the 2000s. We aimed to describe the current status and regional differences in hepatitis A incidence. We studied the total number of hepatitis A cases reported to the Korea Centers for Disease Control and Prevention through the National Infectious Diseases Surveillance System between 2011 and 2013. Additionally, National Health Insurance Review and Assessment Service data and national population data from Statistics Korea were used. In total, 7,585 hepatitis A cases were reported; 5,521 (10.9 cases per 100,000 populations), 1,197 (2.3 cases per 100,000 populations), and 867 (1.7 cases per 100,000 populations) in 2011, 2012, and 2013, respectively. Fifty-eight patients were infected outside of the country and 7,527 patients represented autochthonous HAV infection cases. Autochthonous HAV infection occurred more frequently among men than women (4,619 cases, 6.1 cases per 100,000 population vs. 2,908 cases, 3.9 cases per 100,000 population). The incidence rate was higher in the 20-29 yr-old group (2,309 cases, 11.6 cases per 100,000 populations) and 30-39 yr-old group (3,306 cases, 13.6 cases per 100,000 populations). The majority of cases were reported from March to June (53.6%, 4,038/7,527). Geographic analyses revealed a consistently high relative risk (RR) of HAV infection in mid-western regions (2011, RR, 1.25, P=0.019; 2012, RR, 2.53, P<0.001; 2013, RR, 1.86, P<0.001). In summary, we report that hepatitis A incidence has been decreasing gradually from 2011 to 2013 and that some regions show the highest prevalence rates of HAV infection in Korea.

Employing crisis postcards with case management in Kaohsiung, Taiwan: 6-month outcomes of a randomised controlled trial for suicide attempters.

PubMed

Chen, Wei-Jen; Ho, Chi-Kung; Shyu, Shi-Sen; Chen, Cheng-Chung; Lin, Guei-Ging; Chou, Li-Shiu; Fang, Yun-Ju; Yeh, Pin-Yang; Chung, Tieh-Chi; Chou, Frank Huang-Chih

2013-07-17

Suicide attempts constitute a serious clinical problem and have important implications for healthcare resources. The aim of the present study was to evaluate the effectiveness of case management using crisis postcards over a 6-month follow-up period. A randomised controlled trial was conducted in Kaohsiung, Taiwan. Prevention of further suicide attempts was compared between two groups with and without the postcard intervention. The intervention group consisted of 373 participants (139 males, 234 females; age: 39.8 ± 14.0 yrs.). The control group consisted of 388 participants (113 males, 275 females; age: 40.0 ± 16.0 yrs.). A survival analysis was used to test the effectiveness of the crisis postcard intervention for the prevention of suicide reattempts. Per-protocol and intention-to-treat analyses were conducted. The intention-to-treat analysis indicated that the crisis postcard had no effect (hazard ratio = 0.84; 95% CI = 0.56 - 1.29), whereas the per-protocol analysis showed a strong benefit for the crisis postcard (hazard ratio = 0.39; 95% CI = 0.21 - 0.72). Although the results of the present study indicated that the postcard intervention did not reduce subsequent suicide behaviour, our study provides an alteration to the postcard intervention. Further studies need to be conducted to clarify whether this type of intervention can reduce subsequent suicidal behaviour, with a particular focus on reducing the rate of loss to follow-up.

Investigation of effective strategies for developing creative science thinking

NASA Astrophysics Data System (ADS)

Yang, Kuay-Keng; Lee, Ling; Hong, Zuway-R.; Lin, Huann-shyang

2016-09-01

The purpose of this study was to explore the effectiveness of the creative inquiry-based science teaching on students' creative science thinking and science inquiry performance. A quasi-experimental design consisting one experimental group (N = 20) and one comparison group (N = 24) with pretest and post-test was conducted. The framework of the intervention focused on potential strategies such as promoting divergent and convergent thinking and providing an open, inquiry-based learning environment that are recommended by the literature. Results revealed that the experimental group students outperformed their counterparts in the comparison group on the performances of science inquiry and convergent thinking. Additional qualitative data analyses from classroom observations and case teacher interviews identified supportive teaching strategies (e.g. facilitating associative thinking, sharing impressive ideas, encouraging evidence-based conclusions, and reviewing and commenting on group presentations) for developing students' creative science thinking.

Snake poisoning in rural Zimbabwe--a prospective study.

PubMed

Nhachi, C F; Kasilo, O M

1994-01-01

Over a period of 2 years (January 1991 to December 1992) 274 cases of snake bite were admitted to hospital in the eight provinces of Zimbabwe. Of these patients, 54% were males and 88% belonged to the 6-40-year age group. Five deaths (1.8% of the total cases) were reported. The majority of snake bites (63%) occurred at night (between 6.30 p.m. and midnight) and over 74% took place during the hot rainy season, i.e. between November and April. In over 58% of the cases the victim accidentally stepped on the snake, the snake being cobra in 37%, puff adder in 20% and the black and green mamba in 18% of the cases. Most of the bites occurred on the leg, below the knee. Treatment of snake envenomation consisted mainly of the administration of antibiotics (151 cases), analgesics (144 cases), antivenom tropical snake polyvalent (ATT) (89 cases), antitoxoid tetanus (TT) (61 cases), antihistamines (47 cases) and traditional medicines (43 cases). This study indicates that snake envenomation in rural Zimbabwe is common but fatalities are relatively rare.

[Variability of nutritional status and of the parameters of lipid metabolism in gluten-free diet].

PubMed

Ozkan, Mircan; Trandafir, Laura; Mîndru, Elena; Moraru, Evelina

2012-01-01

Celiac disease is one of the most common forms of food intolerance in children, being an autoimmune enteropathy occurring in genetically susceptible individuals. The only treatment of celiac disease consists in a lifelong strict gluten-free diet. After gluten free diet patients with normal weight or growth failure risk become obese on the one hand because of recovery intestinal absorption and, on the other hand, nutritionally unbalanced diet, high in fat and protein. The aim of this study was to assess the nutritional status and the presence and prevalence of various changes dyslipidemia in gluten free diet. The trial was formed by 92 patients (mean age at diagnosis 88,5 months) diagnosed with CD between January 2008 - December 2010 in 2nd and 3rd Pediatric Clinics of "Sf. Maria" Hospital Iaşi. Patients were divided into two groups: group I included 36 patients younger than 2 years and group II included 52 patients aged over 2 years at time of diagnosis of celiac disease. All patients received gluten free diet. Were evaluated periodically anthropometric indices (weight, height, body mass index and Z scores in children over 2 years and weight and nutritional index in children under 2 years) and lipid profile (total lipids, total cholesterol, HDL cholesterol, triglycerides). Assessing food intake was achieved by interviewing parents and children on dietary habits and daily food ration. Assessment of nutritional status: group I:--after 24 months of gluten free diet 5 cases presented overweight; group II: after 24 months of gluten free diet obesity (BMI > 30) was found in 16.07% of cases (9 patients) and overweight (BMI > 25) was found in 28.57% of cases (16 patients). Food intake: in all cases was observed increased calorie intake by an excess of lipids and carbohydrates in the diet. Investigation of lipid metabolism: in group II high values of cholesterol were found in 12 cases (21,42 of cases). In conclusions, in celiac disease gluten free diet should be balanced caloric, fat and protein to ensure an optimal nutritional status and prevent long-term complications.

Histopathology findings in patients presenting with menorrhagia: A study of 100 hysterectomy specimen

PubMed Central

Sawke, Nilima G.; Sawke, Gopal Krishna; Jain, Hanisha

2015-01-01

Background: Menorrhagia, by definition, is heavy cyclical blood loss in excess of 80 ml/month of menstrual period lasting longer than 7 days. There are many possible causes of heavy menstrual bleeding which include hormonal imbalance, fibroids, miscarriage or ectopic pregnancy, nonhormonal intrauterine device, adenomyosis, pelvic inflammatory disease, and rarely uterine, ovarian, or cervical cancer. Treatment depends on the causes of the menorrhagia. Hysterectomy is one of the several surgical procedures as definitive treatment. Objective: To determine the histopathologic spectrum of lesions associated with menorrhagia in different age groups. Study Design: This prospective descriptive study was conducted at the Department of Pathology, People's College of Medical Sciences and Research Centre, Bhopal. During the study period, 100 hysterectomy specimens were taken which were performed for the treatment of menorrhagia. Patients with menorrhagia in the age group of 30-50 years were selected after detailed history and fulfilling the inclusion criteria. Result: In our study, it was observed that maximum number of cases were in the age group of 41-50 years (n = 35) followed by the age group of 31-40 (n = 30). Out of 100 cases, 31% cases (n = 31) showed adenomyosis followed by leiomyomas 25% (n = 25), endometrial hyperplasia 23% (n = 23), and endometrial polyp 4% (n = 4). 11% cases (n = 11) showed dual pathology consisting of both adenomyosis and endometrial hyperplasia and 6% cases (n = 6) of leiomyoma with adenomyosis. Conclusion: Uterine adenomyosis and leiomyoma are the most common benign conditions found in hysterectomy specimens with peak incidence at 31-50 years. Patients having menorrhagia above 40 years should be screened for any endometrial pathology. Histopathology is mandatory for confirming diagnosis and the key to effective therapy and optimal outcome. PMID:26903755

Management of birth brachial plexus palsy.

PubMed

O'Brien, Donncha F; Park, T S; Noetzel, Michael J; Weatherly, Trisha

2006-02-01

The indications for surgical repair of congenital brachial plexus palsy are controversial. Our objective was to determine the results of early brachial plexus surgery following obstetric-induced brachial plexus palsy. We performed a retrospective analysis of the outcome of 58 cases of brachial plexus surgery. The indication for operation consisted of the presence of less than antigravity strength in the biceps, triceps, and deltoid muscle groups at 6 months of age. Data gathered prospectively, previously, showed the likelihood of improvement with less than antigravity strength in these cases to be poor. Follow-up data were obtained on 52 of the 58 cases. Overall mean follow-up was 2 years. Twelve patients had more than 3 years follow-up (mean 5.5 years, range 3-11.5 years). Significant improvement was seen in all injury patterns i.e., C5-C6, C5-C7, and C5-C8, T1. Greater than antigravity strength in the biceps, triceps, and deltoid muscle groups was seen in the majority of cases at follow-up. Repair of obstetrical brachial plexus palsy in children at 6 months of age that is based on less than antigravity strength in the biceps, triceps, and deltoid muscle groups produces improvement in functional capabilities. Children with obstetrical brachial plexus palsy should be referred soon after birth to a center that specializes in the treatment of this type of palsy.

Association of influenza vaccination and reduced risk of stroke hospitalization among the elderly: a population-based case-control study.

PubMed

Lin, Hui-Chen; Chiu, Hui-Fen; Ho, Shu-Chen; Yang, Chun-Yuh

2014-04-02

The aim of this study was to investigate the effect of influenza vaccination (and annual revaccination) on the risk of stroke admissions. We conducted a population-based case-control study in Taiwan. Cases consisted of patients >65 years of age who had a first-time diagnosis of stroke during the influenza seasons from 2006 to 2009. Controls were selected by matching age, sex, and index date to cases. Multiple logistic regression analysis was used to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Ever vaccinated individuals in the current vaccination season were associated with a reduced risk of ischemic stroke admissions (OR = 0.76, 95% CI = 0.60-0.97). Compared with individuals never vaccinated against influenza during the past 5 years, the adjusted ORs were 0.92 (95% CI = 0.68-1.23) for the group with 1 or 2 vaccinations, 0.73 (95% CI = 0.54-1.00) for the group with 3 or 4 vaccinations, and 0.56 (95% CI = 0.38-0.83) for the group with 5 vaccinations. There was a significant trend of decreasing risk of ischemic stroke admissions with an increasing number of vaccinations. This study provides evidence that vaccination against influenza may reduce the risk of hospitalization for ischemic stroke and that annual revaccination provides greater protection.

Cost-effectiveness of 'Program We Care' for patients with chronic obstructive pulmonary disease: A case-control study.

PubMed

Wong, Eliza Mi Ling; Lo, Shuk Man; Ng, Ying Chu; Lee, Larry Lap Yip; Yuen, T M Y; Chan, Jimmy Tak Shing; Chair, Sek Ying

2016-07-01

To evaluate the effectiveness of a discharge program for patients with chronic obstructive pulmonary disease (COPD) patients on discharge from an emergency medical ward on discharge home rate, hospital length of stay (LOS), inpatient admission rate and cost. Frequent visits to the emergency department (ED) and subsequent hospital admission are common among patients with COPD, which adds a burden to ED and hospital care. A discharge program was implemented in an ED emergency medical ward. The program consisted of multidisciplinary care, discharge planning, discharge health education on disease management, and continued support from the community nursing services. A retrospective case-control study was used. Data were retrieved and compared between 478 COPD program cases and 478 COPD non-program cases. No significant difference was found in age, gender, and triage category, LOS in ED, and readmission rate between the program and non-program groups. The program group demonstrated a significantly higher discharge home rate from the ED (33.89% vs. 20.08%) and fewer medical admissions (40.59% vs. 55.02%) compared with the non-program group, resulting in lower total medical costs after the program was implemented. The program provides insight on the strategic planning for discharge care in a short stay unit of emergency department. Copyright © 2015 Elsevier Ltd. All rights reserved.

Working memory, reasoning, and expertise in medicine-insights into their relationship using functional neuroimaging.

PubMed

Hruska, Pam; Krigolson, Olav; Coderre, Sylvain; McLaughlin, Kevin; Cortese, Filomeno; Doig, Christopher; Beran, Tanya; Wright, Bruce; Hecker, Kent G

2016-12-01

Clinical reasoning is dependent upon working memory (WM). More precisely, during the clinical reasoning process stored information within long-term memory is brought into WM to facilitate the internal deliberation that affords a clinician the ability to reason through a case. In the present study, we examined the relationship between clinical reasoning and WM while participants read clinical cases with functional magnetic resonance imaging (fMRI). More specifically, we examined the impact of clinical case difficulty (easy, hard) and clinician level of expertise (2nd year medical students, senior gastroenterologists) on neural activity within regions of cortex associated with WM (i.e., the prefrontal cortex) during the reasoning process. fMRI was used to scan ten second-year medical students and ten practicing gastroenterologists while they reasoned through sixteen clinical cases [eight straight forward (easy) and eight complex (hard)] during a single 1-h scanning session. Within-group analyses contrasted the easy and hard cases which were then subsequently utilized for a between-group analysis to examine effects of expertise (novice > expert, expert > novice). Reading clinical cases evoked multiple neural activations in occipital, prefrontal, parietal, and temporal cortical regions in both groups. Importantly, increased activation in the prefrontal cortex in novices for both easy and hard clinical cases suggests novices utilize WM more so than experts during clinical reasoning. We found that clinician level of expertise elicited differential activation of regions of the human prefrontal cortex associated with WM during clinical reasoning. This suggests there is an important relationship between clinical reasoning and human WM. As such, we suggest future models of clinical reasoning take into account that the use of WM is not consistent throughout all clinical reasoning tasks, and that memory structure may be utilized differently based on level of expertise.

Effect of C-G (Hithiol capsule) on radiotoxemia (in Japanese)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huruta, A.; Nakada, J.

1973-03-01

C-G capsule was administered to the patients treated with a large quantity of remote cobalt irradiation, and its effect on symptoms of radiotoxemia was examined. One capsule of C-G containing 80 mg of cysteine and 120 mg of glucose within one capsule were administered three times a day and one capsule out of three was administered between meals. Symptoms of radiotoxemia such as total fatigue, nausea and vomiting, and anorexia were observed. Blood examination was carried out before irradiation, and after irradiation it was carried out once a week. The reported cases consist of 10 cases of breast cancer andmore » its metastasis, four of brain neoplasms, three of penis neoplasms, two of uterus cancer (cervical uterus), two of larynx cancer, and one case each of maxilla cancer, tonsil cancer, parotid gland cancer, lung cancer, ovarian tumor, malignant lympadenoma, and chondrosarcoma. Six control subjects were used. Out of 28 cases, a dramatic response of the patients was recognized in five cases, an effective response in 19 cases, and an ineffective response in four cases. Two cases out of five that were treated with other preventives against radiotoxemia showed an ineffective response, and three cases showed effects thought to be potentiation. Especially, decrease of leukocytes was mild with prompt recovery. In the case of the chest and abdomen irradiation, four control subjects showed strong general radiotoxemia and marked decrease of leukocytes, and in the group administered C-G, one case discontinued irradiation. Moreover, symptoms, radiotherapy, radiotoxemia, and blood findings of the group administered C-G were also explained. (JA)« less

Benefit of an operating vehicle preventing peritonitis in peritoneal dialysis patients: a retrospective, case-controlled study.

PubMed

Fang, Pan; Lu, Jia; Liu, Ying-Hong; Deng, Hong-Mei; Zhang, Lei; Zhang, Hong-Qing

2018-06-01

Peritonitis, which is one of the leading complications of peritoneal dialysis (PD) worldwide, severely affected morbidity and mortality of the PD patients. Although many efforts have been made to prevent PD-related peritonitis, it seems impossible to prevent it completely. Many causes have been reported to lead to peritonitis, and contamination during bag exchange is one of the important risk factors for peritonitis. Here, we introduce an operating vehicle, which we invented to provide a sterile and safe space for bag exchange. A single-center, retrospective, case-control study was undertaken to determine whether this operating vehicle has a protective role in preventing peritonitis. In total, 462 continuous ambulatory peritoneal dialysis patients were included in this study from October 2014 to March 2017. According to their personal will, these patients chose to use operating vehicle or traditional method during their bag exchange. The demographic, clinical and laboratory data of these patients in the two groups were collected, analyzed and compared. Of 462 patients with home dialysis, operating vehicle group consisted of 61 patients, and control group consisted of 401 patients. In the control group, over 677 patient-years, peritonitis occurred in 69 of 401 patients (17.2%), while in the operating vehicle group, over 60 patient-years, only 4 of 61 patients (6.6%) had episodes of peritonitis. The number of patients suffered from peritonitis was significantly decreased in the operating vehicle group (P = 0.034). Besides, there were a total of 99 episodes of peritonitis, and the rate was 1 episode every 7.2 patient-years in control group and 1 episode every 12 patient-years in the operating vehicle group. There was significant difference between the two groups (0.013). Positive dialysate cultures were obtained in majority of the peritonitis episodes (60.6%). Operating vehicle might help to reduce PD-related peritonitis by preventing contamination during bag exchange. Further studies are still needed to demonstrate the protective role of the operating vehicle in preventing peritonitis.

Rectal bleeding in patients with haemorrhoids. Coincidental findings in colon and rectum.

PubMed

Koning, M V; Loffeld, R J L F

2010-06-01

Rectal bleeding is a very common clinical sign. It is often caused by haemorrhoids. However, it can be a symptom of other pathology in the rectum or colon. There are little data coincidental pathology in patients with haemorrhoids and rectal bleeding. To examine coincidental pathology in patients with rectal bleeding and haemorrhoids, especially with respect to age. Prospectively, 290 consecutive patients presenting with bleeding and haemorrhoids were analysed. All patients had an endoscopic examination. All significant endoscopic findings (diverticuli, polyps, cancer, angiodysplasia and varices or colitis) were recorded. The patients were divided into two groups. Group 1 consisted of patients with only haemorrhoids (n = 129, % male: 41.1, mean age: 53.6 +/- 12.7 years). Group 2 consisted of patients with haemorrhoids and coincidental pathology (n = 161, % male: 46.6, mean age: 67.3 +/- 13.7 years). There was no difference in gender or in the type of endoscopy. However, patients in Group 2 were significantly older. It can be concluded that in cases of rectal bleeding and haemorrhoids, coincidental pathology occurs in a large proportion of patients, especially the elderly. Omitting endoscopy in these patients can lead to major doctors delay.

Risk of intrapartum cervical lacerations in women with cerclage.

PubMed

Seravalli, Viola; Potti, Sushma; Berghella, Vincenzo

2013-02-01

The aim of our study was to estimate whether the placement of cerclage in pregnancy to prevent preterm birth (PTB) is associated with higher incidence of intrapartum cervical lacerations. A retrospective cohort study was conducted on singleton pregnancies with risk factors for PTB. The study group consisted of women with either a history- or ultrasound-indicated cerclage placed between 12 and 24 weeks of gestation, while the control group consisted of women with similar risk factors for PTB but who did not receive a cerclage. Primary outcome was the incidence of intrapartum cervical lacerations. A sample size calculation was performed on the basis of the results of previous studies on cervical lacerations. We identified 134 women who had a cerclage placed in pregnancy. They were compared with 236 controls with no cerclage. Cases and controls had similar risk factors for cervical lacerations. Cervical lacerations occurred with similar frequencies in the cerclage and no-cerclage group (2.2 vs 1.3%, p = 0.78). There was no significant difference between the two groups for the risk of cervical lacerations (RR 1.76, 95% CI: 0.36-8.60). Cerclage placement during pregnancy is not associated with an increased risk of intrapartum cervical lacerations.

Cryotherapy and ankle motion in chronic venous disorders

PubMed Central

Kelechi, Teresa J.; Mueller, Martina; Zapka, Jane G.; King, Dana E.

2013-01-01

This study compared ankle range of motion (AROM) including dorsiflexion, plantar flexion, inversion and eversion, and venous refill time (VRT) in leg skin inflamed by venous disorders, before and after a new cryotherapy ulcer prevention treatment. Fifty-seven-individuals participated in the randomized clinical trial; 28 in the experimental group and 29 received usual care only. Results revealed no statistically significant differences between the experimental and usual care groups although AROM measures in the experimental group showed a consistent, non-clinically relevant decrease compared to the usual care group except for dorsiflexion. Within treatment group comparisons of VRT results showed a statistically significant increase in both dorsiflexion and plantar flexion for patients with severe VRT in the experimental group (6.9 ± 6.8; p = 0.002 and 5.8 ± 12.6; p = 0.02, respectively). Cryotherapy did not further restrict already compromised AROM, and in some cases, there were minor improvements. PMID:23516043

Rapid assessment of agents of biological terrorism: defining the differential diagnosis of inhalational anthrax using electronic communication in a practice-based research network.

PubMed

Temte, Jonathan L; Anderson, Anna Lisa

2004-01-01

Early detection of bioterrorism requires assessment of diagnoses assigned to cases of rare diseases with which clinicians have little experience. In this study, we evaluated the process of defining the differential diagnosis for inhalational anthrax using electronic communication within a practice-based research network (PBRN) and compared the results with those obtained from a nationwide random sample of family physicians with a mailed instrument. We distributed survey instruments by e-mail to 55 physician members of the Wisconsin Research Network (WReN), a regional PBRN. The instruments consisted of 3 case vignettes randomly drawn from a set describing 11 patients with inhalational anthrax, 2 with influenza A, and 1 with Legionella pneumonia. Physicians provided their most likely nonanthrax diagnosis, along with their responses to 4 yes-or-no management questions for each case. Physicians who had not responded at 1 week received a second e-mail with the survey instrument. The comparison group consisted of the nationwide sample of physicians who completed mailed survey instruments. Primary outcome measures were response rate, median response time, and frequencies of diagnostic categories assigned to cases of inhalational anthrax. The PBRN response rate compared favorably with that of the national sample (47.3% vs 37.0%; P = not significant). The median response time for the PBRN was significantly shorter than that for the national sample (2 vs 28 days; P < .001). No significant differences were found between the PBRN and the Midwest subset of the national sample in the frequencies of major diagnostic categories or in case management. Electronic means of creating differential diagnoses for rare infectious diseases of national significance is feasible within PBRNs. Information is much more rapidly acquired and is consistent with that obtained by conventional methods.

Chemokine (C-C motif) ligand 3 detection in the serum of persons exposed to asbestos: A patient-based study

PubMed Central

Xu, Jiegou; Alexander, David B; Iigo, Masaaki; Hamano, Hirokazu; Takahashi, Satoru; Yokoyama, Takako; Kato, Munehiro; Usami, Ikuji; Tokuyama, Takeshi; Tsutsumi, Masahiro; Tamura, Mouka; Oguri, Tetsuya; Niimi, Akio; Hayashi, Yoshimitsu; Yokoyama, Yoshifumi; Tonegawa, Ken; Fukamachi, Katsumi; Futakuchi, Mitsuru; Sakai, Yuto; Suzui, Masumi; Kamijima, Michihiro; Hisanaga, Naomi; Omori, Toyonori; Nakae, Dai; Hirose, Akihiko; Kanno, Jun; Tsuda, Hiroyuki

2015-01-01

Exposure to asbestos results in serious risk of developing lung and mesothelial diseases. Currently, there are no biomarkers that can be used to diagnose asbestos exposure. The purpose of the present study was to determine whether the levels or detection rate of chemokine (C-C motif) ligand 3 (CCL3) in the serum are elevated in persons exposed to asbestos. The primary study group consisted of 76 healthy subjects not exposed to asbestos and 172 healthy subjects possibly exposed to asbestos. The secondary study group consisted of 535 subjects possibly exposed to asbestos and diagnosed with pleural plaque (412), benign hydrothorax (10), asbestosis (86), lung cancer (17), and malignant mesothelioma (10). All study subjects who were possibly exposed to asbestos had a certificate of asbestos exposure issued by the Japanese Ministry of Health, Labour and Welfare. For the primary study group, levels of serum CCL3 did not differ between the two groups. However, the detection rate of CCL3 in the serum of healthy subjects possibly exposed to asbestos (30.2%) was significantly higher (P < 0.001) than for the control group (6.6%). The pleural plaque, benign hydrothorax, asbestosis, and lung cancer groups had serum CCL3 levels and detection rates similar to that of healthy subjects possibly exposed to asbestos. The CCL3 chemokine was detected in the serum of 9 of the 10 patients diagnosed with malignant mesothelioma. Three of the patients with malignant mesothelioma had exceptionally high CCL3 levels. Malignant mesothelioma cells from four biopsy cases and an autopsy case were positive for CCL3, possibly identifying the source of the CCL3 in the three malignant mesothelioma patients with exceptionally high serum CCL3 levels. In conclusion, a significantly higher percentage of healthy persons possibly exposed to asbestos had detectable levels of serum CCL3 compared to healthy unexposed control subjects. PMID:25940505

Clinical usefulness of free subcutaneous fat pad for reduction of intraoperative air leakage during thoracoscopic pulmonary resection in lung cancer cases.

PubMed

Shintani, Yasushi; Inoue, Masayoshi; Funaki, Soichiro; Kawamura, Tomohiro; Minami, Masato; Okumura, Meinoshin

2015-10-01

Intraoperative alveolar air leaks remain a significant problem in thoracoscopic surgery (TS) cases. We examined the usefulness of covering damaged lung tissue with a subcutaneous fat pad for preventing postoperative air leakage in patients with non-small cell lung cancer (NSCLC). Patients with NSCLC underwent a thoracoscopic lobectomy or segmentectomy. When alveolar air leakage from the superficial pulmonary parenchyma was found, fibrin glue in combination with an absorbable mesh sheet was applied (S group; n = 100). When leakage originated from deep within the pulmonary parenchyma, a subcutaneous fat pad about 2 × 2 cm in size was harvested from the utility incision and placed on the damaged lung tissue with fibrin glue and sutures (F group; n = 66). Patient characteristics, air leak duration, and chest-tube removal time were analyzed. The homogeneity of each group was consistent, with no statistical differences for age, respiratory function, surgical procedures, pathologic stage, and histological type. The air leak duration was significantly shorter (p = 0.015), and the chest tube was removed significantly earlier (p = 0.002) in patients in the F group. Use of a free subcutaneous fat pad during pulmonary resection for TS patients with NSCLC reduced the duration of air leakage and chest tube drainage. The present method is easy, safe, and effective for repairing an air leak from remaining lung tissues in such cases.

Association of oral breathing with dental malocclusions and general health in children.

PubMed

Jiménez, Emilio L; Barrios, Rocío; Calvo, Juan C; de la Rosa, Maria T; Campillo, José S; Bayona, José C; Bravo, Manuel

2017-06-01

The aims of this study were to analyze the association of oral breathing with dental malocclusions and aspects of general health such as acute illnesses, oxygen saturation in blood and its possible implication in the process of nutrition. A prevalence analytic study was carried out. Five dentists explored to children between 6 and 12 years and measured their oxygen saturation. Parents completed a questionnaire of 11 items about general health (colds, ear infections, tonsillitis and taking antibiotics) and the food preferences of their children. At the end, children were classified in oral breathing group (prevalence cases) or nasal breathing group (controls). There were statistical differences between cases (452 children) and controls (752 children) in the facial morphometric measurements. Oral breathing children had statistically less percentage of oxygen saturation than controls (92.3±3.3% versus 96.5±2.3%), took less time to have lunch and preferred less consistent and sugary food. Cases had had more prevalence of pathologies in the last year and of taking the antibiotics. This group also had higher prevalence of allergies compared with controls group (P<0.001). Oral breathing is significantly associated with specific dental malocclusions and important aspects of general health such as oxygen saturation and the nutrition. On the same line, oral breathing is related to a significantly higher prevalence of allergies and a significantly more likely getting sick and taking medication.

PERIAPICAL LESIONS OF THE JAWS: A REVIEW OF 104 CASES IN IBADAN

PubMed Central

Akinyamoju, AO; Gbadebo, SO; Adeyemi, BF

2014-01-01

Background: Periapical lesions (PLs) occur as a result of pulpal inflammation and may rarely be seen in the absence of pulpal diseases. They are the most common pathological lesions affecting the alveolar bone. Objective: This study aims to describe the clinicopathological features of PLs of the jaws with emphasis on the two most common types. Methods: Histopathology records of PLs diagnosed from January 1990 to December 2012 at the Department of Oral Pathology, University College Hospital Ibadan, were examined and categorized into periapical cysts (PCs); periapical granuloma (PGs) and others. Clinical data and histopathological features of these PLs were reviewed and analyzed. Results: One hundred and four lesions met the criteria for this study and consisted of PGs with 71 (68.3%) cases and PCs with 31 (29.8%) cases and one case each of apical scar and pleomorphic adenoma. Age range of cases was 9 to 80 years (mean=35.6 ± 15.8years) with a peak at age group of 20-29 years. Females were more frequently affected with 51.9% of cases. PLs were most frequently diagnosed in the anterior maxillary region with 58 (56.9%) cases, while the most frequently involved tooth was the left maxillary central incisor with 23 (22.1%) cases. Conclusion: Findings in this study are consistent with those of previous studies. It is important for all periapical pathological specimens to be submitted for histological examination to establish an accurate diagnosis and aid in the identification of sinister lesions that may present in the Periradicular region of teeth. PMID:25960702

Innovation Networks to Stimulate Public and Private Sector Collaboration for Advisory Services Innovation and Coordination: The Case of Pasture Performance Issues in the New Zealand Dairy Industry

ERIC Educational Resources Information Center

Rijswijk, K.; Brazendale, R.

2017-01-01

Purpose: An innovation network, called the Pasture Improvement Leadership Group (PILG), was formed to improve the quality and consistency of advice provided to dairy farmers in New Zealand, after they expressed dissatisfaction with their pastures. The aim of this paper is to better understand the challenges of forming and maintaining networks to…

Trans advanced surface laser ablation (TransPRK) outcomes using SmartPulseTechnology.

PubMed

Aslanides, Ioannis M; Kymionis, George D

2017-02-01

To evaluate early visual rehabilitation, post-operative pain, epithelial healing and haze after transepithelial photorefractive keratectomy (TransPRK) using the SmartPulseTechnology (SPT) of Schwind Amaris (Schwind eye-tech-solutions GmbH, Kleinostheim, Germany). This was a retrospective comparative evaluation of a cohort of myopic patients undergoing TransPRK with SPT (group 1), with one matched control group that underwent conventional TransPRK (group 2). All cases had a 6-month post-operative follow-up including visual acuity and slit-lamp examination. Subjective evaluation of pain was recorded post-operatively. 49 eyes of 25 patients in group 1 and 40 eyes of 20 patients in group 2 were enrolled. The patients' visual rehabilitation was significantly faster in group 1, one day and one week post-operatively (P<0.05). From one month onward there was no significant difference between the groups. The epithelial defect size was significantly smaller on post-operative days 1 and 2 for group 1 (P<0.05 in both cases). The pain score was also significantly less in group 1 (P<0.05). The haze level had no significant difference between the groups at any post-operative point (P>0.05). TransPRK using SPT provides promising results in the early post-operative period. Visual rehabilitation, re-epithelialization and pain were faster in the early post-operative period in group 1 in comparison with group 2. Haze formation was not significantly different between the two groups; however, it was consistently less in group 1. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Nevus Lipomatosus Cutaneous Superficialis With Perifollicular Fibromas.

PubMed

Anzai, Alessandra; Halpern, Ilana; Rivitti-Machado, Maria Cecília

2015-09-01

Nevus lipomatosus cutaneous superficialis (NLCS) is a rare cutaneous hamartoma characterized by groups of mature fat cells in the dermis. The authors report a case of a dark-skinnned, 6-year-old, Brazilian girl with 1 lesion in the right upper chest, extending to the neck, since 1 year of age. The dermatological examination consisted of skin-colored and yellowish follicular papules, isolated and grouped into a papillomatous plaque. The biopsy revealed ectopic mature adipose tissue in the dermis, compatible with NLCS, perifollicular well-circumscribed fibroblast and collagen proliferation, and decreased elastic fibers in the papillary and upper reticular dermis. The finding of perifollicular fibrosis in NLCS is not common, having been first described in 2003. The perifollicular fibrosis is characteristic of other rare hamartoma, the perifollicular fibroma, but is also present in fibrofolliculomas or trichodiscomas, angiofibromas, and fibrotic papules on the face of tuberous sclerosis and postinflammatory fibrosis. This case is very similar to the first described case of NLCS with perifollicular fibrosis, and the authors believe that this is the second case of this entity, but they propose to name it NCLS with perifollicular fibromas, which better describes the nature of this lesion.

Timing of entry to care by newly diagnosed HIV cases before and after the 2010 New York State HIV testing law.

PubMed

Gordon, Daniel E; Bian, Fuqin; Anderson, Bridget J; Smith, Lou C

2015-01-01

Prompt entry to care after HIV diagnosis benefits the infected individual and reduces the likelihood of further transmission of the virus. The New York State HIV Testing Law of 2010 requires diagnosing providers to refer persons newly diagnosed with HIV to follow-up medical care. This study used routinely collected HIV-related laboratory data from the New York State HIV surveillance system to assess whether the fraction of newly diagnosed cases entering care within 90 days of diagnosis increased after the implementation of the law. Laboratory data on 23,302 newly diagnosed cases showed that entry to care within 90 days rose steadily from 72.0% in 2007 to 85.4% in 2012. The rise was observed across all race/ethnic groups, ages, transmission risk groups, sexes, and regions of residence. Logistic regression analyses of entry to care pre-law and post-law, controlling for demographic characteristics, transmission risk, and geographic area, indicate that percentage of newly diagnosed cases entering care within 90 days grew more rapidly in the post-law period. This is consistent with a positive effect of the law on entry to care.

Diagnostic criteria for selenium toxicosis in aquatic birds: histologic lesions

USGS Publications Warehouse

Green, D.E.; Albers, P.H.

1997-01-01

Chronic selenium toxicosis was induced in 1-year-old male mallard ducks (Anas platyrhynchos) by feeding selenium, as seleno-DL-methionine, in amounts of 0, 10, 20, 40, and 80 parts per million (ppm) to five groups of 21 ducks each for 16 wk during March to July 1988. All mallards in the 80 ppm group, three in the 40 ppm group, and one in the 20 ppm group died. Histologic lesions in mallards that died of selenosis were hepatocellular vacuolar degeneration progressing to centrolobular and panlobular necrosis, nephrosis, apoptosis of pancreatic exocrine cells, hypermaturity and avascularity of contour feathers of the head with atrophy of feather follicles, lymphocytic necrosis and atrophy of lymphoid organs (spleen, gut-associated lymphoid tissue, and lumbar lymph nodes), and severe atrophy and degeneration of fat. Histologic lesions in surviving mallards in the 40 ppm group, which had tissue residues of selenium comparable to mallards that died, were fewer and much milder than mallards that died; lesions consisted of atrophy of lymphoid tissue, hyalinogranular swelling of hepatocytes, atrophy of seminiferous tubules, and senescence of feathers. No significant histologic lesions were detected in euthanized mallards in the 0, 10 and 20 ppm groups. Based on tissue residues and histologic findings, primarily in the liver, there was a threshold of selenium accumulation above which pathophysiologic changes were rapid and fatal. Pathognomonic histologic lesions of fatal and nonfatal selenosis were not detected. Criteria for diagnosis of fatal selenosis in aquatic birds include consistent histologic lesions in the liver, kidneys, and organs of the immune system. Although histologic changes were present in cases of chronic non-fatal selenosis, these were inconsistent. Consistent features of fatal and non-fatal chronic selenosis were marked weight loss and elevated concentrations of selenium in organs.

Does a SLAP lesion affect shoulder muscle recruitment as measured by EMG activity during a rugby tackle?

PubMed Central

2010-01-01

Background The study objective was to assess the influence of a SLAP lesion on onset of EMG activity in shoulder muscles during a front on rugby football tackle within professional rugby players. Methods Mixed cross-sectional study evaluating between and within group differences in EMG onset times. Testing was carried out within the physiotherapy department of a university sports medicine clinic. The test group consisted of 7 players with clinically diagnosed SLAP lesions, later verified on arthroscopy. The reference group consisted of 15 uninjured and full time professional rugby players from within the same playing squad. Controlled tackles were performed against a tackle dummy. Onset of EMG activity was assessed from surface EMG of Pectorialis Major, Biceps Brachii, Latissimus Dorsi, Serratus Anterior and Infraspinatus muscles relative to time of impact. Analysis of differences in activation timing between muscles and limbs (injured versus non-injured side and non injured side versus matched reference group). Results Serratus Anterior was activated prior to all other muscles in all (P = 0.001-0.03) subjects. In the SLAP injured shoulder Biceps was activated later than in the non-injured side. Onset times of all muscles of the non-injured shoulder in the injured player were consistently earlier compared with the reference group. Whereas, within the injured shoulder, all muscle activation timings were later than in the reference group. Conclusions This study shows that in shoulders with a SLAP lesion there is a trend towards delay in activation time of Biceps and other muscles with the exception of an associated earlier onset of activation of Serratus anterior, possibly due to a coping strategy to protect glenohumeral stability and thoraco-scapular stability. This trend was not statistically significant in all cases PMID:20184752

Safety of audiology direct access for medicare patients complaining of impaired hearing.

PubMed

Zapala, David A; Stamper, Greta C; Shelfer, Janet S; Walker, David A; Karatayli-Ozgursoy, Selmin; Ozgursoy, Ozan B; Hawkins, David B

2010-06-01

Allowing Medicare beneficiaries to self-refer to audiologists for evaluation of hearing loss has been advocated as a cost-effective service delivery model. Resistance to audiology direct access is based, in part, on the concern that audiologists might miss significant otologic conditions. To evaluate the relative safety of audiology direct access by comparing the treatment plans of audiologists and otolaryngologists in a large group of Medicare-eligible patients seeking hearing evaluation. Retrospective chart review study comparing assessment and treatment plans developed by audiologists and otolaryngologists. 1550 records comprising all Medicare eligible patients referred to the Audiology Section of the Mayo Clinic Florida in 2007 with a primary complaint of hearing impairment. Assessment and treatment plans were compiled from the electronic medical record and placed in a secured database. Records of patients seen jointly by audiology and otolaryngology practitioners (Group 1: 352 cases) were reviewed by four blinded reviewers, two otolaryngologists and two audiologists, who judged whether the audiologist treatment plan, if followed, would have missed conditions identified and addressed in the otolaryngologist's treatment plan. Records of patients seen by audiology but not otolaryngology (Group 2: 1198 cases) were evaluated by a neurotologist who judged whether the patient should have seen an otolaryngologist based on the audiologist's documentation and test results. Additionally, the audiologist and reviewing neurotologist judgments about hearing asymmetry were compared to two mathematical measures of hearing asymmetry (Charing Cross and AAO-HNS [American Academy of Otolaryngology-Head and Neck Surgery] calculations). In the analysis of Group 1 records, the jury of four judges found no audiology discrepant treatment plans in over 95% of cases. In no case where a judge identified a discrepancy in treatment plans did the audiologist plan risk missing conditions associated with significant mortality or morbidity that were subsequently identified by the otolaryngologist. In the analysis of Group 2 records, the neurotologist judged that audiology services alone were all that was required in 78% of cases. An additional 9% of cases were referred for subsequent medical evaluation. The majority of remaining patients had hearing asymmetries. Some were evaluated by otolaryngology for hearing asymmetry in the past with no interval changes, and others were consistent with noise exposure history. In 0.33% of cases, unexplained hearing asymmetry was potentially missed by the audiologist. Audiologists and the neurotologist demonstrated comparable accuracy in identifying Charing Cross and AAO-HNS pure-tone asymmetries. Of study patients evaluated for hearing problems in the one-year period of this study, the majority (95%) ultimately required audiological services, and in most of these cases, audiological services were the only hearing health-care services that were needed. Audiologist treatment plans did not differ substantially from otolaryngologist plans for the same condition; there was no convincing evidence that audiologists missed significant symptoms of otologic disease; and there was strong evidence that audiologists referred to otolaryngology when appropriate. These findings are consistent with the premise that audiology direct access would not pose a safety risk to Medicare beneficiaries complaining of hearing impairment. American Academy of Audiology.

Evaluation of Informed Choice for contraceptive methods among women attending a family planning program: conceptual development; a case study in Chile.

PubMed

Valdés, Patricio R; Alarcon, Ana M; Munoz, Sergio R

2013-03-01

To generate and validate a scale to measure the Informed Choice of contraceptive methods among women attending a family health care service in Chile. The study follows a multimethod design that combined expert opinions from 13 physicians, 3 focus groups of 21 women each, and a sample survey of 1,446 women. Data analysis consisted of a qualitative text analysis of group interviews, a factor analysis for construct validity, and kappa statistic and Cronbach alpha to assess scale reliability. The instrument comprises 25 items grouped into six categories: information and orientation, quality of treatment, communication, participation in decision making, expression of reproductive rights, and method access and availability. Internal consistency measured with Cronbach alpha ranged from 0.75 to 0.89 for all subscales (kappa, 0.62; standard deviation, 0.06), and construct validity was demonstrated from the testing of several hypotheses. The use of mixed methods contributed to developing a scale of Informed Choice that was culturally appropriate for assessing the women who participated in the family planning program. Copyright © 2013 Elsevier Inc. All rights reserved.

Bioactive glass in cavitary bone defects: a comparative experimental study in rabbits

PubMed Central

Camargo, André Ferrari de França; Baptista, André Mathias; Natalino, Renato; de Camargo, Olavo Pires

2015-01-01

OBJECTIVES: To compare bioactive glass and autograft regarding their histomorphometric characteristics. METHODS: The authors conducted a prospective case-control experimental study on animals in order to compare the histomorphometric characteristics of bioactive glass versus autograft. Eight rabbits underwent surgery in which a cavitary defect was created in both proximal femurs. One side was filled with bioactive glass granules and the other, with autograft grafted from the contralateral side. The sides were randomized. Fourteen days after surgery, the animals were euthanized. RESULTS: Histologic analysis revealed that bone neoformation was equivalent among the two groups and the osteoblasts cell-count was higher in the femurs treated with bioactive glass. The osteocytes cell-count, however, was lower. The similarity in bone formation between both groups was consistent to literature findings. CONCLUSION: Bioactive glass is similar to autograft regarding bone neoformation in this animal model of cavitary bone defects. Level of Evidence III, Case-Control Study. PMID:26327802

Biochemical diagnosis of phaeochromocytoma: two instructive case reports.

PubMed Central

Stewart, M F; Reed, P; Weinkove, C; Moriarty, K J; Ralston, A J

1993-01-01

The biochemical features of two patients with phaeochromocytomas illustrate the inadvisability of depending on a single group of analytes for the diagnosis. The first case presented as a surgical emergency with retroperitoneal haemorrhage. Biochemical diagnosis was difficult since total 24 hour urinary free catecholamine excretion was within normal limits in two out of three samples, and only marginally raised in the third with an atypical preponderance of adrenaline. Plasma catecholamine concentrations were also normal. But urinary excretion of the catecholamine metabolites, metadrenaline and 4-hydroxy-3-methoxy mandelic acid (HMMA), was consistently raised. In contrast, the second patient presenting with headache and labile hypertension showed normal metabolite excretion in the face of grossly increased free noradrenaline excretion and raised plasma noradrenaline concentrations. It is therefore recommend that, as well as urinary free catecholamines, one group of their main metabolites, the 3-methoxy amines (normetadrenaline and metadrenaline) or HMMA, should routinely be measured whenever a phaeochromocytoma is suspected. PMID:8463426

Associations between biosecurity and outbreaks of canine distemper on Danish mink farms in 2012-2013.

PubMed

Gregers-Jensen, Louise; Agger, Jens Frederik; Hammer, Anne Sofie Vedsted; Andresen, Lars; Chrièl, Mariann; Hagberg, Emma; Jensen, Mette Kragh; Hansen, Mette Sif; Hjulsager, Charlotte Kristiane; Struve, Tina

2015-09-30

During 8 months from July 2012 to February 2013, a major outbreak of canine distemper involving 64 mink farms occurred on the Danish peninsula of Jutland. The canine distemper outbreak was associated with exposure of farmed mink to infected wild carnivores and could represent a deficit in biosecurity on the mink farms. The aim of this study was to investigate the extent and association of specific biosecurity measures with the outbreak. The study was carried out in an epidemiological case-control design. The case group consisted of the 61 farms, which had a confirmed outbreak of canine distemper from July 2012 to February 2013. The control group included 54 farms without an outbreak of canine distemper in 2012 or 2013, selected as the closest geographical neighbour to a case farm. The results showed that significantly more control than case farms had vaccinated their mink against canine distemper virus. Mortality was only assessed on the case farms, and there was a non-significantly lower mortality on vaccinated farms than on the non-vaccinated farms. Furthermore, the proportion of farms with observations of wild red foxes (Vulpes vulpes) inside the farm enclosures were larger for case farms, indicating that the control farms had a better biosecurity or were not equally exposed to canine distemper virus. Generally, all farms had very few specific precautions at the gate entrance in respect to human visitors as well as animals. The use of biosecurity measures was very variable in both case and control farms. Not using plastic boot covers, presence of dogs and cats, presence of demarcated area for changing clothes when entering and leaving the farm area and presence of hand washing facilities significantly lowered the odds of the farm having a canine distemper virus outbreak. The results of the study indicate that consistent use of correct vaccination strategies, implementation of biosecurity measures and limiting human and animal access to the mink farm can be important factors in reducing the risk for canine distemper outbreaks.

Value of MRI in diagnosing injuries after ankle sprains in children.

PubMed

Endele, Dominick; Jung, Christian; Bauer, Gerhard; Mauch, Frieder

2012-12-01

To our knowledge, there are only a few prospective studies on the use of magnetic resonance imaging (MRI) to diagnose injuries associated with ankle sprains in children. We hypothesized that MRI examinations of acute ankle sprains in growing children would show relevant injuries that may have been overlooked by conventional clinical, radiological, and ultrasound examinations. Thirty children with acute inversion injury of the ankle were subjected to an MRI examination of the ankle joint, in addition to conventional radiographic procedures. All data were recorded prospectively. Depending on the severity of the clinical symptoms, the children were divided into three different groups. Children with little soft-tissue swelling and who were still able to walk were assigned to Group I (n = 10), Group II consisted of children who were only partially able to walk and had moderate soft-tissue swelling (n = 12), while Group III consisted of the children who were not able to walk and had pronounced soft-tissue swelling (n = 8). Regular followup examinations were carried out. At the final followup examination, on average 8 months after injury, the children in Groups II and III were again examined by MRI. The clinical results were compared and correlated with the results of the MRI examinations. Altogether, torn ligaments could be verified in 23 out of 30 of the cases; bony avulsions were found in 10% of these. Three of 30 patients had a Salter I injury. Bone bruising was found in 18 out of 30 (60%). Bone bruising was most commonly found near the medial talus. MRI examination of the patients in Group I showed no more ruptures than the clinical examination; here, only four patients were found to have partial ruptures of the ATL. In Group II, torn ligaments were found in six out of 12 (50%) of the cases; similarly, Salter I injuries were found in three out of 12 cases. The patients in Group III also showed serious injuries on the MRI examination. Bone bruising, torn ligaments, or bony avulsions were found in eight out of eight (100%) cases. The recorded clinical results showed only weak correlation to the injury patterns diagnosed using MRI. Only the bone bruises correlated with clinical results. Children with more pronounced swelling and less ability to walk were more commonly diagnosed with bone bruises. No differences were found between groups with regard to pain, instability, or limitations of mobility in the followup examinations or the final MRI examination 8 months after injury. The injury patterns diagnosed through MRI examination did not correlate with clinical findings. With adequate progressive rehabilitation, the pathological changes diagnosed with MRI healed without further complications. MRI examinations of acute ankle distortion injuries in children did not result in any additional therapeutic value. Therefore, we believe conventional clinical, radiological, and ultrasound diagnostic methods are sufficient for the primary diagnosis of ankle fractures and ankle ligament injuries in children.

The Computational Fluid Dynamics Rupture Challenge 2013—Phase I: prediction of rupture status in intracranial aneurysms.

PubMed

Janiga, G; Berg, P; Sugiyama, S; Kono, K; Steinman, D A

2015-03-01

Rupture risk assessment for intracranial aneurysms remains challenging, and risk factors, including wall shear stress, are discussed controversially. The primary purpose of the presented challenge was to determine how consistently aneurysm rupture status and rupture site could be identified on the basis of computational fluid dynamics. Two geometrically similar MCA aneurysms were selected, 1 ruptured, 1 unruptured. Participating computational fluid dynamics groups were blinded as to which case was ruptured. Participants were provided with digitally segmented lumen geometries and, for this phase of the challenge, were free to choose their own flow rates, blood rheologies, and so forth. Participants were asked to report which case had ruptured and the likely site of rupture. In parallel, lumen geometries were provided to a group of neurosurgeons for their predictions of rupture status and site. Of 26 participating computational fluid dynamics groups, 21 (81%) correctly identified the ruptured case. Although the known rupture site was associated with low and oscillatory wall shear stress, most groups identified other sites, some of which also experienced low and oscillatory shear. Of the 43 participating neurosurgeons, 39 (91%) identified the ruptured case. None correctly identified the rupture site. Geometric or hemodynamic considerations favor identification of rupture status; however, retrospective identification of the rupture site remains a challenge for both engineers and clinicians. A more precise understanding of the hemodynamic factors involved in aneurysm wall pathology is likely required for computational fluid dynamics to add value to current clinical decision-making regarding rupture risk. © 2015 by American Journal of Neuroradiology.

The effects of a nurse case manager and a community health worker team on diabetic control, emergency department visits, and hospitalizations among urban African Americans with type 2 diabetes mellitus: a randomized controlled trial.

PubMed

Gary, Tiffany L; Batts-Turner, Marian; Yeh, Hsin-Chieh; Hill-Briggs, Felicia; Bone, Lee R; Wang, Nae-Yuh; Levine, David M; Powe, Neil R; Saudek, Christopher D; Hill, Martha N; McGuire, Maura; Brancati, Frederick L

2009-10-26

Although African American adults bear a disproportionate burden from diabetes mellitus (DM), few randomized controlled trials have tested culturally appropriate interventions to improve DM care. We randomly assigned 542 African Americans with type 2 DM enrolled in an urban managed care organization to either an intensive or minimal intervention group. The intensive intervention group consisted of all components of the minimal intervention plus individualized, culturally tailored care provided by a nurse case manager (NCM) and a community health worker (CHW), using evidence-based clinical algorithms with feedback to primary care providers (eg, physicians, nurse practitioners, or physician assistants). The minimal intervention consisted of mailings and telephone calls every 6 months to remind participants about preventive screenings. Data on diabetic control were collected at baseline and at 24 months by blind observers; data emergency department (ER) visits and hospitalizations were assessed using administrative data. At baseline, participants had a mean age of 58 years, 73% were women, and 50% were living in poverty. At 24 months, compared with the minimal intervention group, those in the intensive intervention group were 23% less likely to have ER visits (rate difference [RD], -14.5; adjusted rate ratio [RR], 0.77; 95% confidence interval [CI], 0.59-1.00). In on-treatment analyses, the rate reduction was strongest for patients who received the most NCM and CHW visits (RD, -31.0; adjusted RR, 0.66; 95% CI, 0.43-1.00; rate reduction downward arrow 34%). These data suggest that a culturally tailored intervention conducted by an NCM/CHW team reduced ER visits in urban African Americans with type 2 DM. clinicaltrials.gov Identifier: NCT00022750.

The Effects of a Nurse Case Manager and a Community Health Worker Team on Diabetic Control, Emergency Department Visits, and Hospitalizations Among Urban African Americans With Type 2 Diabetes Mellitus

PubMed Central

Gary, Tiffany L.; Batts-Turner, Marian; Yeh, Hsin-Chieh; Hill-Briggs, Felicia; Bone, Lee R.; Wang, Nae-Yuh; Levine, David M.; Powe, Neil R.; Saudek, Christopher D.; Hill, Martha N.; McGuire, Maura; Brancati, Frederick L.

2017-01-01

Background Although African American adults bear a disproportionate burden from diabetes mellitus (DM), few randomized controlled trials have tested culturally appropriate interventions to improve DM care. Methods We randomly assigned 542 African Americans with type 2 DM enrolled in an urban managed care organization to either an intensive or minimal intervention group. The intensive intervention group consisted of all components of the minimal intervention plus individualized, culturally tailored care provided by a nurse case manager (NCM) and a community health worker (CHW), using evidence-based clinical algorithms with feedback to primary care providers (eg, physicians, nurse practitioners, or physician assistants). The minimal intervention consisted of mailings and telephone calls every 6 months to remind participants about preventive screenings. Data on diabetic control were collected at baseline and at 24 months by blind observers; data emergency department (ER) visits and hospitalizations were assessed using administrative data. Results At baseline, participants had a mean age of 58 years, 73% were women, and 50% were living in poverty. At 24 months, compared with the minimal intervention group, those in the intensive intervention group were 23% less likely to have ER visits (rate difference [RD], −14.5; adjusted rate ratio [RR], 0.77; 95% confidence interval [CI], 0.59-1.00). In on-treatment analyses, the rate reduction was strongest for patients who received the most NCM and CHW visits (RD, −31.0; adjusted RR, 0.66; 95% CI, 0.43–1.00; rate reduction ↓ 34%). Conclusion These data suggest that a culturally tailored intervention conducted by an NCM/CHW team reduced ER visits in urban African Americans with type 2 DM. PMID:19858437

Potential Psychosocial Risk Factors for Chronic TMD: Descriptive Data and Empirically Identified Domains from the OPPERA Case-Control Study

PubMed Central

Fillingim, Roger B.; Ohrbach, Richard; Greenspan, Joel D.; Knott, Charles; Dubner, Ronald; Bair, Eric; Baraian, Cristina; Slade, Gary D.; Maixner, William

2011-01-01

Case-control studies have consistently associated psychosocial factors with chronic pain in general, and with temporomandibular disorders (TMD) specifically. Moreover, a handful of prospective studies suggest that pre-existing psychosocial characteristics represent risk factors for new onset TMD. The current study presents psychosocial findings from the baseline case-control study of the Orofacial Pain Prospective Evaluation and Risk Assessment (OPPERA) cooperative agreement. For this study, 1,633 TMD-free controls and 185 TMD cases completed a battery of psychosocial instruments assessing general psychosocial adjustment and personality, affective distress, psychosocial stress, somatic awareness, and pain coping and catastrophizing. In bivariate and demographically-adjusted analyses, odds of TMD were associated with higher levels of psychosocial symptoms, affective distress, somatic awareness, and pain catastrophizing. Among controls, significant gender and ethnic group differences in psychosocial measures were observed, consistent with previous findings. Principal component analysis was undertaken to identify latent constructs revealing four components: stress and negative affectivity, global psychosocial symptoms, passive pain coping, and active pain coping. These findings provide further evidence of associations between psychosocial factors and TMD. Future prospective analyses in the OPPERA cohort will determine if the premorbid presence of these psychosocial factors predicts increased risk for developing new-onset TMD. PMID:22074752

Melanoma with rhabdomyosarcomatous differentiation.

PubMed

Kuwadekar, Aditya; Allard, Justin; Dardik, Michael; Smith, Franz

2018-06-06

Melanoma with rhabdomyosarcomatous differentiation is an extremely rare observation with a review of the literature revealing fewer than 15 previously identified cases. The authors describe a case of a 72-year-old man with a cutaneous lesion of the left scalp that was diagnosed as malignant melanoma on biopsy and wide excision. One month later, a punch biopsy of the excisional area revealed rhabdomyosarcomatous proliferation. Re-examination of the wide-excision specimen with muscle markers revealed areas of neoplastic melanoma cells consistent with rhabdomyosarcomatous differentiation. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Case-control study on uveal melanoma (RIFA): rational and design

PubMed Central

Schmidt-Pokrzywniak, Andrea; Jöckel, Karl-Heinz; Bornfeld, Norbert; Stang, Andreas

2004-01-01

Background Although a rare disease, uveal melanoma is the most common primary intraocular malignancy in adults, with an incidence rate of up to 1.0 per 100,000 persons per year in Europe. Only a few consistent risk factors have been identified for this disease. We present the study design of an ongoing incident case-control study on uveal melanoma (acronym: RIFA study) that focuses on radiofrequency radiation as transmitted by radio sets and wireless telephones, occupational risk factors, phenotypical characteristics, and UV radiation. Methods/Design We conduct a case-control study to identify the role of different exposures in the development of uveal melanoma. The cases of uveal melanoma were identified at the Division of Ophthalmology, University of Essen, a referral centre for tumours of the eye. We recruit three control groups: population controls, controls sampled from those ophthalmologists who referred cases to the Division of Ophthalmology, University of Duisburg-Essen, and sibling controls. For each case the controls are matched on sex and age (five year groups), except for sibling controls. The data are collected from the study participants by short self-administered questionnaire and by telephone interview. During and at the end of the field phase, the data are quality-checked. To estimate the effect of exposures on uveal melanoma risk, we will use conditional logistic regression that accounts for the matching factors and allows to control for potential confounding. PMID:15318944

Medicare intensive care unit use: analysis of incidence, cost, and payment.

PubMed

Cooper, Liesl M; Linde-Zwirble, Walter T

2004-11-01

To determine the incidence, cost, and payment for intensive care unit services among Medicare beneficiaries. Retrospective observational database cohort study. All nonfederal hospitals with intensive care unit beds (n = 5003) paid through the inpatient prospective payment system (IPPS). We used all fiscal year 2000 Medicare IPPS hospitalizations with consistent payment information (n = 10,657,587). None. We examined the distribution of cost and payments overall, by hospital type, and by diagnosis related group. Intensive care was used in 2,353,208 cases (21.1%). The overall incidence was 59.8 cases per thousand beneficiaries in the aged (65+) population, increasing with age from 36.2 (65-69) to 91.6 (85+). Intensive care unit patients cost nearly three times floor patients (4,135 dollars vs. 5,571 dollars), with two thirds of costs associated with the intensive care unit portion of the stay, 2,278 dollars per intensive care unit day. However, intensive care unit cases were paid at a rate only twice floor cases (11,704 dollars vs. 5,835 dollars). Only 83% of costs were paid for intensive care unit patients, compared with 105% for floor patients, generating a 5.8 billion dollars loss to hospitals when intensive care unit care is required. There was a linear association between the percent intensive care unit in a diagnosis related group and the percent paid, with payment >90% of cost only in diagnosis related groups with >/=60% intensive care unit cases. We found that teaching hospitals were better paid than nonteaching hospitals (87% vs. 78% of costs, respectively), but this was only due to indirect medical education payments. Intensive care is common, expensive, and poorly paid in the Medicare population. Few diagnosis related groups have a large enough intensive care unit population to ensure adequate payment. Additional diagnosis related groups for conditions common to the intensive care unit would improve payment and enable incentives for efficiency.

[Which one is more important, raw materials or productive technology?--a case study for quality consistency control of Gegen Qinlian decoction].

PubMed

Zhong, Wen; Chen, Sha; Zhang, Jun; Wang, Yu-Sheng; Liu, An

2016-03-01

To investigate the effect of Chinese medicine raw materials and production technology on quality consistency of Chinese patent medicines with Gegen Qinlian decoction as an example, and establish a suitable method for the quality consistency control of Chinese patent medicines. The results showed that the effect of production technology on the quality consistency was generally not more than 5%, while the effect of raw materials was even more than 30%, indicating that the effect of raw materials was much greater than that of the production technology. In this study, blend technology was used to improve the quality consistency of raw materials. As a result, the difference between the product produced by raw materials and reference groups was less than 5%, thus increasing the quality consistence of finished products. The results showed that under the current circumstances, the main factor affecting the quality consistency of Chinese patent medicines was raw materials, so we shall pay more attention to the quality of Chinese medicine's raw materials. Finally, a blend technology can improve the quality consistency of Chinese patent medicines. Copyright© by the Chinese Pharmaceutical Association.

Prediction of Disease Case Severity Level To Determine INA CBGs Rate

NASA Astrophysics Data System (ADS)

Puspitorini, Sukma; Kusumadewi, Sri; Rosita, Linda

2017-03-01

Indonesian Case-Based Groups (INA CBGs) is case-mix payment system using software grouper application. INA CBGs consisting of four digits code where the last digits indicating the severity level of disease cases. Severity level influence by secondary diagnosis (complications and co-morbidity) related to resource intensity level. It is medical resources used to treat a hospitalized patient. Objectives of this research is developing decision support system to predict severity level of disease cases and illustrate INA CBGs rate by using data mining decision tree classification model. Primary diagnosis (DU), first secondary diagnosis (DS 1), and second secondary diagnosis (DS 2) are attributes that used as input of severity level. The training process using C4.5 algorithm and the rules will represent in the IF-THEN form. Credibility of the system analyzed through testing process and confusion matrix present the results. Outcome of this research shows that first secondary diagnosis influence significant to form severity level predicting rules from new disease cases and INA CBGs rate illustration.

CT and MR Protocol Standardization Across a Large Health System: Providing a Consistent Radiologist, Patient, and Referring Provider Experience.

PubMed

Sachs, Peter B; Hunt, Kelly; Mansoubi, Fabien; Borgstede, James

2017-02-01

Building and maintaining a comprehensive yet simple set of standardized protocols for a cross-sectional image can be a daunting task. A single department may have difficulty preventing "protocol creep," which almost inevitably occurs when an organized "playbook" of protocols does not exist and individual radiologists and technologists alter protocols at will and on a case-by-case basis. When multiple departments or groups function in a large health system, the lack of uniformity of protocols can increase exponentially. In 2012, the University of Colorado Hospital formed a large health system (UCHealth) and became a 5-hospital provider network. CT and MR imaging studies are conducted at multiple locations by different radiology groups. To facilitate consistency in ordering, acquisition, and appearance of a given study, regardless of location, we minimized the number of protocols across all scanners and sites of practice with a clinical indication-driven protocol selection and standardization process. Here we review the steps utilized to perform this process improvement task and insure its stability over time. Actions included creation of a standardized protocol template, which allowed for changes in electronic storage and management of protocols, designing a change request form, and formation of a governance structure. We utilized rapid improvement events (1 day for CT, 2 days for MR) and reduced 248 CT protocols into 97 standardized protocols and 168 MR protocols to 66. Additional steps are underway to further standardize output and reporting of imaging interpretation. This will result in an improved, consistent radiologist, patient, and provider experience across the system.

Prophylaxis versus pre-emptive antibiotics in third molar surgery: a randomised control study.

PubMed

Olusanya, A A; Arotiba, J T; Fasola, O A; Akadiri, A O

2011-06-01

This study was carried out to compare the efficacy of preoperative single bolus antibiotics with a 5 day- postoperative antibiotic regimen in reducing pain, swelling, and trismus, surgical site infection (SSI) and alveolar osteitis (AO) after third molar surgery. A randomised experiment was done involving eighty-four patients. The patients were divided into two groups consisting of 42 patients each. A preoperative group was given an oral bolus of 2g amoxycillin capsules and 1g metronidazole tablets one hour before extraction, while those in the postoperative group were given a five-day regimen oral 500mg amoxycillin capsules thrice daily and 400mg metronidazole tablets thrice daily. The occurrence of postoperative pain, swelling, trismus, SSI and AO were compared between the groups. Seventy-nine patients completed the study; 38 patients in the preoperative group and 41 patients in the postoperative group. There was no difference between the groups in respect of the inflammatory complications. The four cases of AO occurred in the preoperative group. Single bolus antibiotic prophylaxis should be adequate for most cases of third molar surgery as the degree of degree of postoperative pain, swelling and trismus was similar in both groups. The use of single bolus antibiotic prophylaxis would also help reduce the cost of treatment in developing countries as well as reduce the risk of development of resistant strains. However, a five-day postoperative antibiotic regimen is advised in patient with risk factors for AO.

Deaths among women of reproductive age: a forensic autopsy study.

PubMed

Padubidri, Jagadish Rao; Menezes, Ritesh G; Pant, Sadip; Shetty, Soumya B

2013-08-01

Unnatural deaths in women of reproductive age (range 12-49 years) have a serious psychological and social impact on the family and community. Deaths among women of reproductive age reported as medico-legal cases were investigated to see the trend in terms of cause and manner of death. The study group consisted of a series of 328 consecutive forensic autopsies on women in the reproductive age group, performed between 2009 and 2011 at the Government Wenlock District Hospital, Mangalore, India by qualified specialist forensic medicine experts. Unnatural deaths formed 93.6% of the cohort. The top three causes of death included burns, poisoning and hanging forming 69.5% of the cases. The manner of death was suicide in 45.4% cases, accident in 43.6% cases and homicide in 4.6% cases. The circumstances of death were related to alleged medical negligence in 2.4% cases. Death in 4% cases was natural mannered with a disease being the cause of death. Three-fourths of the victims were married. Married women formed 63.1% of the suicidal victims. Homicidal deaths were not reported among unmarried women. The preponderant method of suicide was by poisoning at 42.3% (63 cases), followed by hanging (34.9%), burns (11.4%) and drowning (9.4%). These four methods comprised 98% of the total suicidal deaths in this study cohort. Accidental deaths were predominantly caused by burns (62.2%) and road traffic accident (23.1%). Two-thirds of the homicidal deaths were due to assault caused by blunt-force trauma, ligature strangulation and sharp-force trauma. One-third of the homicidal victims died due to burns. With a clear understanding of the cause and manner of death, it may be possible to predict, and hopefully prevent, future cases of unnatural deaths in women of reproductive age who form a very important group of society. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Novel sonographic clues for diagnosis of antral gastritis and Helicobacter pylori infection: a clinical study.

PubMed

Cakmakci, Emin; Ucan, Berna; Colak, Bayram; Cinar, Hasibe Gokçe

2014-09-01

The purpose of this study was to find out whether transabdominal sonography may have a predictive role for detection of antral gastritis and Helicobacter pylori infection in the antrum. A total of 108 patients and 54 control participants were allocated into 3 groups: group 1, controls without any symptoms or findings of antral gastritis and H pylori infection; group 2, patients with symptoms and endoscopic findings consistent with gastritis in the absence of documented H pylori infection; and group 3, patients with symptoms and endoscopic findings consistent with gastritis and documented H pylori infection. These groups were compared in terms of demographics, antral wall thickness, mucosal layer (together with muscularis mucosa) thickness, and mucosal layer-to-antral wall thickness ratio. The groups had no statistically significant differences with respect to age, sex, body mass index, and smoking habits. However, it turned out that both antral walls and muscularis mucosa layers were thicker and the mucosal layer-to-antral wall thickness ratio was higher in groups 2 and 3 compared to group 1 (P > .001). In addition, group 3 had statistically significantly thicker antral walls and muscularis mucosa layers and a significantly increased mucosal layer-to-antral wall thickness ratio than group 2 (P < .001). Our results suggest that antral gastritis caused by H pylori infection is associated with characteristic features such as thickening of antral walls and mucosal layers on sonography. These novel clues may be useful in the diagnosis of gastritis, and unnecessary interventions and measures can be avoided in some cases. © 2014 by the American Institute of Ultrasound in Medicine.

Mechanical and interfacial characterization of laser welded Co-Cr alloy with different joint configurations

PubMed Central

Kokolis, John; Chakmakchi, Makdad; Theocharopoulos, Antonios; Prombonas, Anthony

2015-01-01

PURPOSE The mechanical and interfacial characterization of laser welded Co-Cr alloy with two different joint designs. MATERIALS AND METHODS Dumbbell cast specimens (n=30) were divided into 3 groups (R, I, K, n=10). Group R consisted of intact specimens, group I of specimens sectioned with a straight cut, and group K of specimens with a 45° bevel made at the one welding edge. The microstructure and the elemental distributions of alloy and welding regions were examined by an SEM/EDX analysis and then specimens were loaded in tension up to fracture. The tensile strength (TS) and elongation (ε) were determined and statistically compared among groups employing 1-way ANOVA, SNK multiple comparison test (α=.05) and Weibull analysis where Weibull modulus m and characteristic strength σο were identified. Fractured surfaces were imaged by a SEM. RESULTS SEM/EDX analysis showed that cast alloy consists of two phases with differences in mean atomic number contrast, while no mean atomic number was identified for welded regions. EDX analysis revealed an increased Cr and Mo content at the alloy-joint interface. All mechanical properties of group I (TS, ε, m and σο) were found inferior to R while group K showed intermediated values without significant differences to R and I, apart from elongation with group R. The fractured surfaces of all groups showed extensive dendritic pattern although with a finer structure in the case of welded groups. CONCLUSION The K shape joint configuration should be preferred over the I, as it demonstrates improved mechanical strength and survival probability. PMID:25722836

The effect of group bibliotherapy on the self-esteem of female students living in dormitory.

PubMed

Salimi, Sepideh; Zare-Farashbandi, Firoozeh; Papi, Ahmad; Samouei, Rahele; Hassanzadeh, Akbar

2014-01-01

Bibliotherapy is a supplement, simple, inexpensive and readily available method to treat the diseases that is performed with cooperation of librarians and psychologists or doctors. The aim of this study is the investigation of group bibliotherapy's effect on the self-esteem of the female students of Isfahan University of Medical Sciences Living in Dormitory in 2012. The present study is an interventional semi-experimental study with pre test and post test and control group. The statistical population of study consisted of 32 female students who reside in Isfahan University of Medical Sciences dormitories which control and case groups and the students were divided randomly between these two groups. Data was collected by Cooper Smith Self-esteem questionnaire scale (Cronbach's alpha: 0.85). Two groups were examined by the questionnaire in pre test. Case group received group bibliotherapy for 2 month (8 sessions of 2 hours), while the control group received no training at all. Then, 2 groups were assessed in post test after 1 month. Descriptive statistics (means and frequencies distribution) and inferential statistics (independent t- test, paired t- test and mann whitney) were used and data was analyzed by SPSS20 software. The findings showed that group bibliotherapy had positive and significant effect on general, family, professional and total self esteem of female students living in dormitories, but it had no effect on their social self esteem. Group bibliotherapy can increase female students' self-esteem levels. On the other hand, conducting these studies not only can improve mental health of people, but can also improve their reading habits.

The development and preliminary effectiveness of a nursing case management e-learning program.

PubMed

Liu, Wen-I; Chu, Kuo-Chung; Chen, Shing-Chia

2014-07-01

The purpose of this article was to describe the development and preliminary effectiveness of a digital case management education program. The e-learning program was built through the collaboration of a nurse educator and an informatics professor. The program was then developed according to the following steps: (1) building a visual interface, (2) scripting each unit, (3) preparing the course material and assessment tests, (4) using teaching software to record audio and video courses, (5) editing the audio recordings, (6) using instructional media or hyperlinks to finalize the interactions, (7) creating the assessment and obtaining feedback, and (8) testing the overall operation. The digital program consisted of five learning modules, self-assessment questions, learning cases, sharing experiences, and learning resources. Forty nurses participated in this study and fully completed the questionnaires both before and after the program. The knowledge and confidence levels in the experimental group were significantly higher over time than those of the comparison group. The results supported the use of educational technology to provide a more flexible and effective presentation method for continuing education programs.

[Trans-obturator urethral sling for surgical correction of female stress urinary incontinence: Outside-in (Monarc) versus inside-out (TVT-O). Are both ways safe?].

PubMed

Debodinance, P

2006-10-01

The originally described outside-in procedure for the trans-obturator route was later turned inside-out. We wanted to demonstrate the safety of the two techniques through personal and published experience. Non-randomized, prospective, observational, open-label, longitudinal study of 100 female patients (50 TVT-O and 50 Monarc). All the female patients presented with isolated stress urinary incontinence. Only 4 patients presented with mixed incontinence in the Monarc (MON) group. Sphincter incompetence was observed 4 times in the MON group and 3 times in the TVT-O group. All the patients underwent surgery under assisted local anesthesia in a day-hospital setting. Only those patients presenting with patent established urinary incontinence, corrected by the TVT test, underwent surgery. Post-operative control was conducted at 3 months and 1 year. The duration of hospitalization was 10 h for 48 patients in the MON group and 49 in the TVTO group. The only per-operative complication was a vaginal perforation in the lateral angle of the vagina for a MON patient. Early post-operative complications were observed in the MON group: 3 cases of urinary tract infection, 1 of transient urine retention, 3 of pain in the thighs spontaneously resolving within 4 days and 1 of permanent pain in one leg at time 1 year, which remained bearable. For the TVTO group the post-operative complications consisted in: 1 case of urinary tract infection, 1 of transient retention and 4 of pain in the thigh. No hematoma was reported in either group. Among the late complications, the de novo symptoms included 1 case of imperious urges to urinate in the TVTO group and objective dysuria in 2 cases in the MON group vs. 7 in the TVTO group. There was no statistically significant between-group difference in the complications. No tape exposure was observed. Overall, the recovery rate was 90% at 1 year for MON vs. 94% for TVTO (p = NS) with 2 cases of recurrence between 3 months and 1 year in that series. Mixed incontinence was corrected at time point 1 year in 75% of cases for MON, with 1 case of recurrence in the year. For the patients presenting with sphincter incompetence, competence was maintained at 3 months and 1 year in all cases in the MON group. The 3 TVT-O were cured at 3 months, but 2 recurrences were observed at 1 year. All patients, except one, were satisfied at time point 1 year and those who had sexual relations (54%) did not report any disorder at time point 1 year. The cadaveric studies by advocates of the outside-in technique show a vascular and nervous risk which has received little attention in terms of complications in the literature. Post-operative leg pain is encountered with both techniques and usually is transient. Our experience, like that reported in the literature, shows that the two trans-obturator access routes are equally safe. The clinical results would appear to be equivalent, in terms of recovery, to the rates obtained with retropubic TVT.

Control of Aedes aegypti Breeding: A Novel Intervention for Prevention and Control of Dengue in an Endemic Zone of Delhi, India

PubMed Central

Nagpal, B. N.; Gupta, Sanjeev Kumar; Shamim, Arshad; Vikram, Kumar; Srivastava, Aruna; Tuli, N. R.; Saxena, Rekha; Singh, Himmat; Singh, V. P.; Bhagat, V. N.; Yadav, N. K.; Valecha, Neena

2016-01-01

Background and objective The study is based on hypothesis that whether continuous entomological surveillance of Ae. aegypti and simultaneous appropriate interventions in key containers during non-transmission (December–May) months would have any impact on breeding of Aedes and dengue cases during the following transmission months (June–November). The impact of the surveillance and intervention measures undertaken during non-transmission months were assessed by entomological indicators namely container index (CI), house index (HI), pupal index (PI) and breteau index (BI). Methods A total of 28 localities of West Zone of Delhi with persistent dengue endemicity were selected for the study. Out of these localities, 20 were included in study group while other 8 localities were in control group. IEC and various Aedes breeding control activities were carried out in study group in both non-transmission and transmission season whereas control group did not have any such interventions during non-transmission months as per guidelines of MCD. These activities were undertaken by a team of investigators from NIMR and SDMC, Delhi. In control group, investigators from NIMR carried out surveillance activity to monitor the breeding of Aedes mosquito in localities. Results Comparison of baseline data revealed that all indices in control and study group of localities were comparable and statistically non-significant (p>0.05). In both study and control groups, indices were calculated after pooling data on seasonal basis, i.e., transmission and non-transmission months for both years. The test of significance conducted on all the four indices, i.e., HI, PI, CI, and BI, revealed a significant difference (p<0.05) between the study group and control group during transmission and non-transmission months except in HI. Due to consistent intervention measures undertaken in non-transmission months in study group, reduction in CI, HI, BI and PI was observed 63%, 62%, 64% and 99% respectively during transmission months as compared to control group where increase of 59%, 102%, 73% and 71% respectively. As a result of reduction in larval indices, no dengue case (except one NS1) was observed in study group, whereas 38 dengue cases were observed in control group. Conclusion Through this pilot study, it is concluded that proper intervention in non-transmission season reduces vector density and subsequently dengue cases in transmission season. PMID:27918577

Control of Aedes aegypti Breeding: A Novel Intervention for Prevention and Control of Dengue in an Endemic Zone of Delhi, India.

PubMed

Nagpal, B N; Gupta, Sanjeev Kumar; Shamim, Arshad; Vikram, Kumar; Srivastava, Aruna; Tuli, N R; Saxena, Rekha; Singh, Himmat; Singh, V P; Bhagat, V N; Yadav, N K; Valecha, Neena

2016-01-01

The study is based on hypothesis that whether continuous entomological surveillance of Ae. aegypti and simultaneous appropriate interventions in key containers during non-transmission (December-May) months would have any impact on breeding of Aedes and dengue cases during the following transmission months (June-November). The impact of the surveillance and intervention measures undertaken during non-transmission months were assessed by entomological indicators namely container index (CI), house index (HI), pupal index (PI) and breteau index (BI). A total of 28 localities of West Zone of Delhi with persistent dengue endemicity were selected for the study. Out of these localities, 20 were included in study group while other 8 localities were in control group. IEC and various Aedes breeding control activities were carried out in study group in both non-transmission and transmission season whereas control group did not have any such interventions during non-transmission months as per guidelines of MCD. These activities were undertaken by a team of investigators from NIMR and SDMC, Delhi. In control group, investigators from NIMR carried out surveillance activity to monitor the breeding of Aedes mosquito in localities. Comparison of baseline data revealed that all indices in control and study group of localities were comparable and statistically non-significant (p>0.05). In both study and control groups, indices were calculated after pooling data on seasonal basis, i.e., transmission and non-transmission months for both years. The test of significance conducted on all the four indices, i.e., HI, PI, CI, and BI, revealed a significant difference (p<0.05) between the study group and control group during transmission and non-transmission months except in HI. Due to consistent intervention measures undertaken in non-transmission months in study group, reduction in CI, HI, BI and PI was observed 63%, 62%, 64% and 99% respectively during transmission months as compared to control group where increase of 59%, 102%, 73% and 71% respectively. As a result of reduction in larval indices, no dengue case (except one NS1) was observed in study group, whereas 38 dengue cases were observed in control group. Through this pilot study, it is concluded that proper intervention in non-transmission season reduces vector density and subsequently dengue cases in transmission season.

Differentiation of constrictive pericarditis from restrictive cardiomyopathy: the case for high-resolution dynamic tomographic imaging

NASA Astrophysics Data System (ADS)

Weiss, Robert M.; Otoadese, Eramosele A.; Oren, Ron M.

1995-05-01

The syndrome of constrictive pericarditis (CP) presents a diagnostic challenge to the clinician. This study was undertaken to determine whether cine computed tomography (CT), a cardiac imaging technique with excellent temporal and spatial resolution, can reliably demonstrate the unique abnormalities of pericardial anatomy and ventricular physiology present in patients with this condition. A second goal of this study was to determine whether the presence of diseased thickened pericardium, by itself, imparts cardiac impairment due to abnormalities of ventricular diastolic function. Methods: Twelve patients with CP suspected clinically, in whom invasive hemodynamic study was consistent with the diagnosis of CP, underwent cine CT. They were subdivided into Group 1 (CP, N equals 5) and Group 2 (No CP, N equals 7) based on histopathologic evaluation of tissue obtained at the time of surgery or autopsy. A third group consisted of asymptomatic patients with incidentally discovered thickened pericardium at the time of cine CT scanning: Group 3 (ThP, N equals 7). Group 4 (Nl, N equals 7) consisted of healthy volunteer subjects. Results: Pericardial thickness measurements with cine CT clearly distinguished Group 1 (mean equals 10 +/- 2 mm) from Group 2 (mean equals 2 +/- 1 mm), with diagnostic accuracy of 100% compared to histopathological findings. In addition, patients in Group 1 had significantly more brisk early diastolic filling of both left and right ventricles than those in Group 2, which clearly distinguished all patients with, from all patients without CP. Patients in Group 3 had pericardial thicknesses similar to those in Group 1 (mean equals 9 +/- 1 mm, p equals NS), but had patterns of diastolic ventricular filling that were nearly identical to Group 4 (Nl). Conclusions: The abnormalities of anatomy and ventricular function present in the syndrome of constrictive pericarditis are clearly and decisively identified by cine CT. This allows a reliable distinction between patients with constrictive pericarditis and those with cardiomyopathy. The presence of diseased thickened pericardium does not by itself impart impairment of ventricular diastolic function. Thus, definitive diagnosis of constrictive pericarditis requires demonstration of both abnormal anatomy and physiology.

Comparison of the Efficacy of Carboxymethylcellulose 0.5%, Hydroxypropyl-guar Containing Polyethylene Glycol 400/Propylene Glycol, and Hydroxypropyl Methyl Cellulose 0.3% Tear Substitutes in Improving Ocular Surface Disease Index in Cases of Dry Eye.

PubMed

Maharana, Prafulla K; Raghuwanshi, Sapna; Chauhan, Ashish K; Rai, Vaishali G; Pattebahadur, Rajesh

2017-01-01

To compare the efficacy of carboxymethylcellulose 0.5% (CMC), hydroxypropyl-guar containing polyethylene glycol 400/propylene glycol (PEG/PG), and hydroxypropyl methylcellulose 0.3% (HPMC) as tear substitutes in patients with dry eye. A retrospective evaluation of cases presenting with symptoms of dry eye from July 2014 to June 2015 was done. Patients with Ocular Surface Disease Index (OSDI) scoring >12 were included in the study. Parameters such as age, gender, Schirmer test (ST), and tear film breakup time (TBUT) were recorded on day 0, week 1, and week 4. For analysis, cases were divided into three groups; Group 1 - CMC, Group 2 - PEG/PG, and Group 3 - HPMC. Overall, 120 patients were included in the study. Demographic data and baseline characteristics were comparable among the groups. Group 2 had significant improvement in percentage change in OSDI (weeks 0-1, 0-4, and 1-4, P = 0.00), TBUT (weeks 0-1, P = 0.01; 0-4, P = 0.006; and 1-4, P = 0.007), and in ST (weeks 0-1, P = 0.02; 0-4, P = 0.002; and 1-4, P = 0.008) compared to Group 1 at all follow-ups. Group 3 had improvements similar to Group 2, but it was not at all follow-ups (improvement in percentage change OSDI [weeks 0-1, 0-4, and 1-4, P = 0.00], TBUT [weeks 0-1, P = 0.10; 0-4, P = 0.03; and 1-4, P = 0.04], and in ST [weeks 0-1, P = 0.007; 0-4, P = 0.03; and 1-4, P = 0.12]). No significant difference was found between Groups 2 and 3. Hydroxypropyl-guar containing PEG/PG and HPMC as tear substitutes are better than CMC. While HPMC was comparable to PEG/PG in subjective improvement, the objective improvement was not consistent.

THE VELOCITY DISTRIBUTION OF NEARBY STARS FROM HIPPARCOS DATA. II. THE NATURE OF THE LOW-VELOCITY MOVING GROUPS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bovy, Jo; Hogg, David W., E-mail: jo.bovy@nyu.ed

2010-07-10

The velocity distribution of nearby stars ({approx}<100 pc) contains many overdensities or 'moving groups', clumps of comoving stars, that are inconsistent with the standard assumption of an axisymmetric, time-independent, and steady-state Galaxy. We study the age and metallicity properties of the low-velocity moving groups based on the reconstruction of the local velocity distribution in Paper I of this series. We perform stringent, conservative hypothesis testing to establish for each of these moving groups whether it could conceivably consist of a coeval population of stars. We conclude that they do not: the moving groups are neither trivially associated with their eponymousmore » open clusters nor with any other inhomogeneous star formation event. Concerning a possible dynamical origin of the moving groups, we test whether any of the moving groups has a higher or lower metallicity than the background population of thin disk stars, as would generically be the case if the moving groups are associated with resonances of the bar or spiral structure. We find clear evidence that the Hyades moving group has higher than average metallicity and weak evidence that the Sirius moving group has lower than average metallicity, which could indicate that these two groups are related to the inner Lindblad resonance of the spiral structure. Further, we find weak evidence that the Hercules moving group has higher than average metallicity, as would be the case if it is associated with the bar's outer Lindblad resonance. The Pleiades moving group shows no clear metallicity anomaly, arguing against a common dynamical origin for the Hyades and Pleiades groups. Overall, however, the moving groups are barely distinguishable from the background population of stars, raising the likelihood that the moving groups are associated with transient perturbations.« less

Intergroup cannibalism in the European Early Pleistocene: the range expansion and imbalance of power hypotheses.

PubMed

Saladié, Palmira; Huguet, Rosa; Rodríguez-Hidalgo, Antonio; Cáceres, Isabel; Esteban-Nadal, Montserrat; Arsuaga, Juan Luis; Bermúdez de Castro, José María; Carbonell, Eudald

2012-11-01

In this paper, we compare cannibalism in chimpanzees, modern humans, and in archaeological cases with cannibalism inferred from evidence from the Early Pleistocene assemblage of level TD6 of Gran Dolina (Sierra de Atapuerca, Spain). The cannibalism documented in level TD6 mainly involves the consumption of infants and other immature individuals. The human induced modifications on Homo antecessor and deer remains suggest that butchering processes were similar for both taxa, and the remains were discarded on the living floor in the same way. This finding implies that a group of hominins that used the Gran Dolina cave periodically hunted and consumed individuals from another group. However, the age distribution of the cannibalized hominins in the TD6 assemblage is not consistent with that from other cases of exo-cannibalism by human/hominin groups. Instead, it is similar to the age profiles seen in cannibalism associated with intergroup aggression in chimpanzees. For this reason, we use an analogy with chimpanzees to propose that the TD6 hominins mounted low-risk attacks on members of other groups to defend access to resources within their own territories and to try and expand their territories at the expense of neighboring groups. Copyright © 2012 Elsevier Ltd. All rights reserved.

Oral Rehabilitation of a Severe Periodontally Involved Patient with Mucous Membrane Pemphigoid: A 15-Year Follow-Up Case Report.

PubMed

Megarbane, Jean-Marie; Freiha, Cécile; Mokbel, Nadim

Mucous membrane pemphigoid (MMP) refers to a group of chronic autoimmune subepithelial diseases distinguished by erosive lesions of the mucous membranes and skin. Its treatment consists of inhibition of the inflammatory reaction by means of corticosteroids and symptomatic medication. This is a report of a patient suffering from a combination of MMP and severe generalized chronic periodontitis. The patient has been treated with oral corticosteroids, initial phase therapy, extraction with immediate implant placement, and periodontal surgery where the prognosis was questionable. The case has been followed up for 15 years. Periodontal therapy with immediate implant placement was determined to be a viable modality to achieve a total rehabilitation of a case suffering from MMP combined with severe generalized chronic periodontitis.

[Cyclic vomiting with ketosis as a cause of acute kidney dysfunction: own clinical experience].

PubMed

Ostrowska-Nawarycz, L; Rapacka, E; Baszczyński, J; Górski, P; Czajka, J; Makowski, M; Kudzin, A

2000-04-01

The aim of the study was to evaluate renal activity during cyclic vomiting with ketosis. The clinical material was obtained from 50 cases of children hospitalized in Department of Pediatrics Military Medical University within 1993-1999 what makes about 1% of all patients. The examined group consisted of 26 boys (52%) and 24 girls (48%). Three of the children were repeatedly hospitalized (3 to 8 times) because of acetonemic vomiting. The special attention during the laboratory studies was paid to evaluation of renal activity. Vomiting with ketosis were associated with temporary kidneys acute dysfunction in 46% of cases. In 98% of cases the parenteral hydration was necessary. Ketonemic vomiting with kidneys dysfunction was observed mainly with the children in pre-school age.

Perceptions in the Mind Maps of Turkish Children Living in England at Primary Education Level about Their Home Country Turkey and the World

ERIC Educational Resources Information Center

Aydin, Gülnur; Baysan, Sultan; Aydogan, Selcen

2017-01-01

This research was conducted to determine the perceptions of Turkish children in their mind maps at the primary educational level living in the UK and parental views on these perceptions about the children's home country Turkey and the world. For this purpose, case study approach in qualitative research is preferred. The study group consists of 36…

Lung cancer in heavy equipment operators and truck drivers with diesel exhaust exposure in the construction industry.

PubMed

Järvholm, B; Silverman, D

2003-07-01

Several studies indicate that truck drivers have an increased risk of lung cancer, but few studies have examined lung cancer risk in heavy equipment operators. Workers in both occupations are exposed to diesel exhaust. To examine the incidence and mortality from lung cancer among truck drivers and among drivers of heavy vehicles. A computerised register of Swedish construction workers participating in health examinations between 1971 and 1992 was used. Male truck drivers (n = 6364) and drivers of heavy construction vehicles (n = 14 364) were selected as index groups; carpenters/electricians constituted the reference group (n = 119 984). Operators of heavy construction equipment experienced no increased risk of lung cancer compared to risk among the carpenter/electrician referents (61 cases v 70.1 expected). However, a significant inverse trend risk with increasing use of cabins was apparent. Truck drivers had increased risks of cancer of the lung (61 cases v 47.3 expected) and prostate (124 cases v 99.7 expected), although only mortality for lung cancer was significantly increased. Comparisons with the general population showed similar results. Results are consistent with those of previous studies suggesting that heavy equipment operators with potential exposure to diesel exhaust may have little or no increased risk of lung cancer, although the use of cabins seemed to decrease the risk of lung cancer. The results for truck drivers are also consistent with previous reports of increased lung cancer risk among truck drivers exposed to diesel exhaust, as well as recent reports linking diesel exhaust exposure to prostate cancer.

The continuum of fetal alcohol spectrum disorders in a community in South Africa: Prevalence and characteristics in a fifth sample.

PubMed

May, Philip A; Marais, Anna-Susan; de Vries, Marlene M; Kalberg, Wendy O; Buckley, David; Hasken, Julie M; Adnams, Colleen M; Barnard, Ronel; Joubert, Belinda; Cloete, Marise; Tabachnick, Barbara; Robinson, Luther K; Manning, Melanie A; Jones, Kenneth Lyons; Bezuidenhout, Heidre; Seedat, Soraya; Parry, Charles D H; Hoyme, H Eugene

2016-11-01

The prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in a fifth sample in a South African community. An active case ascertainment approach was employed among all first grade learners in this community (n=862). Following individual examination by clinical geneticists/dysmorphologists, cognitive/behavioral testing, and maternal interviews, final diagnoses were made in multidisciplinary case conferences. Physical measurements, cardinal facial features of FAS, and total dysmorphology scores clearly differentiated diagnostic categories in a consistent, linear fashion, from severe to mild. Neurodevelopmental delays and behavioral problems were significantly worse for each of the FASD diagnostic categories, although not as consistently linear across diagnostic groups. Alcohol use was documented by direct report from the mother in 71% to 100% of cases in specific diagnostic groups. Significant distal maternal risk factors in this population are: advanced maternal age at pregnancy; low height, weight, and body mass index (BMI); small head circumference; low education; low income; and rural residence. Even when controlling for socioeconomic status, prenatal drinking correlates significantly with total dysmorphology score, head circumference, and five cognitive and behavioral measures. In this community, FAS occurs in 59-79 per 1,000 children, and total FASD in 170-233 per 1,000 children, or 17% to 23%. Very high rates of FASD continue in this community where entrenched practices of regular binge drinking co-exist with challenging conditions for childbearing and child development in a significant portion of the population. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

THE CONTINUUM OF FETAL ALCOHOL SPECTRUM DISORDERS IN A COMMUNITY IN SOUTH AFRICA: PREVALENCE AND CHARACTERISTICS IN A FIFTH SAMPLE

PubMed Central

May, Philip A.; Marais, Anna-Susan; de Vries, Marlene M.; Kalberg, Wendy O.; Buckley, David; Hasken, Julie M.; Adnams, Colleen M.; Barnard, Ronel; Joubert, Belinda; Cloete, Marise; Tabachnick, Barbara; Robinson, Luther K.; Manning, Melanie A.; Jones, Kenneth Lyons; Bezuidenhout, Heidre; Seedat, Soraya; Parry, Charles D.H.; Hoyme, H. Eugene

2016-01-01

Background The prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in a fifth sample in a South African community. Methods An active case ascertainment approach was employed among all first grade learners in this community (n=862). Following individual examination by clinical geneticists/ dysmorphologists, cognitive/behavioral testing, and maternal interviews, final diagnoses were made in multidisciplinary case conferences. Results Physical measurements, cardinal facial features of FAS, and total dysmorphology scores clearly differentiated diagnostic categories in a consistent, linear fashion, from severe to mild. Neurodevelopmental delays and behavioral problems were significantly worse for each of the FASD diagnostic categories, although not as consistently linear across diagnostic groups. Alcohol use was documented by direct report from the mother in 71% to 100% of cases in specific diagnostic groups. Significant distal maternal risk factors in this population are: advanced maternal age at pregnancy; low height, weight, and body mass index (BMI); small head circumference; low education; low income; and rural residence. Even when controlling for socioeconomic status, prenatal drinking correlates significantly with total dysmorphology score, head circumference, and five cognitive and behavioral measures. In this community, FAS occurs in 59 – 79 per 1,000 children, and total FASD in 170 – 233 per 1,000 children, or 17% to 23%. Conclusions Very high rates of FASD continue in this community where entrenched practices of regular binge drinking co-exist with challenging conditions for childbearing and child development in a significant portion of the population. PMID:27736681

[Diagnostic imaging and interventional therapy in hepatocarcinoma. Multicenter study of 290 cases].

PubMed

Dalla Palma, L; Pozzi Mucelli, R; Sponza, M; Bartolozzi, C; Lencioni, R; Florio, F; De Santis, M; Gandini, G; Matricardi, L; Rossi, C; Simonetti, G; Pocek, M

1997-01-01

We report the results of a multicenter study on the diagnosis and interventional therapy of hepatocellular carcinoma (HCC). The first aim--diagnosis--was to evaluate the sensitivity of 4 imaging techniques, namely ultrasonography (US), Computed Tomography (CT), digital arteriography (DSA) and Lipiodol CT (LCT), in HCC detection. The accuracy of these techniques was also investigated in tumor staging, which is important for treatment planning. Two hundred ninety patients underwent this imaging protocol. The patients were classified by tumor spread into three groups, namely group 1 (single HCCs < 5 cm), group 2 (multifocal HCCs with max. 3 nodules or tumor volume < 80 cc), group 3 (multifocal HCCs with more than 3 nodules and/or tumor volume > 80 cc). US and CT diagnosed more cases as group 1 and fewer cases as group 3 than DSA and LCT; the latter two techniques gave a similar classification. With LCT as the gold standard, US and CT understaged 27.9% and 26.5% of cases, respectively. Even though LCT is known to have 53% sensitivity, it is currently the most sensitive preoperative investigation and therefore the best tool for treatment planning. In surgical patients, however, intraoperative US, with its nearly 100% sensitivity, is suggested. The second aim--treatment--consisted in assessing the therapeutic efficacy of intraarterial chemoembolization (CEAT) versus percutaneous ethanol injection (PEI) in non advanced HCC and of CEAT versus no treatment (NT) in advanced HCC. Treatment efficacy was evaluated with the following randomized protocols: PEI versus CEAT in group 1, PEI versus CEAT in group 2 and CEAT versus NT in group 3. The data were analyzed relative to 215 patients for 6 to 30 months. The Kaplan-Meier method was used to calculate survival rates, which were, at 24 and 30 months, 72% and 72% for PEI and 72% and 52% for CEAT in group 1, 52% and 28% for PEI and 70% and 50% for CEAT in group 2 and finally 30% and 20% for NT and 45% and 30% for CEAT in group 3. In group 1, PEI appeared markedly superior to CEAT. In group 2, the difference between PEI and CEAT was not statistically significant; the results in this group indicate that CEAT should be considered when three nodules are present because of PEI invasiveness in these cases. In group 3, CEAT results were definitely better in the first two years, but there was no difference with NT patients at the end of the third year. Therefore, CEAT is indicated in advanced HCC because it improves the survival rate in the first 24 months. After this period, the survival time is not modified by treatment.

[Evaluation of the acceptability of a formula for children with diarrhea in a marginal community].

PubMed

Hernández Ramírez, B D; Guerra, M J

1995-01-01

Evaluated the acceptability of a nutrition formula consisting of pumpkin-rice chicken and oils; in a marginal community to children between the ages of 7 months to 5 years old when acute diarrhea was present. The acceptability was also evaluated in the mothers, who indicated that they liked food very little. Nevertheless, they admitted that they would give the product to their children. During the period of study 26 cases of diarrhea were reported of the 26 children, 6 children consumed all the food offered, 16 children showed variable acceptance and only 4 children reject the food completely. By age-groups, the acceptability was 75.69% for children between the ages of 7 months to one year. 72.90% acceptability for ages between 13 months to 2 years and 78.28% for ages between 25 months to 5 years old. The total acceptability was 75.66%. All cases presented marked decreased in diarrhea and an increased in the consistency of the feces with the third dose.

An interesting case of cryptogenic stroke in a young man due to left ventricular non-compaction: role of cardiac MRI in the accurate diagnosis.

PubMed

Kannan, Arun; Das, Anindita; Janardhanan, Rajesh

2014-06-24

A 28-year-old man arrived for an outpatient cardiac MRI (CMR) study to evaluate cardiac structure. At the age of 24 the patient presented with acute onset expressive aphasia and was diagnosed with ischaemic stroke. Echocardiography at that time was reported as 'apical wall thickening consistent with apical hypertrophic cardiomyopathy'. CMR revealed a moderately dilated left ventricle with abnormal appearance of the left ventricular (LV) apical segments. Further evaluation was consistent with a diagnosis of LV non-compaction (LVNC) cardiomyopathy with a ratio of non-compacted to compacted myocardium measuring 3. There was extensive delayed hyperenhancement signal involving multiple segments representing a significant myocardial scar which is shown to have a prognostic role. Our patient, with no significant cerebrovascular risk factors, would likely have had an embolic stroke. This case demonstrates the role of CMR in accurately diagnosing LVNC in a patient with young stroke where prior echocardiography was non-diagnostic. 2014 BMJ Publishing Group Ltd.

Decoding noises in HIV computational genotyping.

PubMed

Jia, MingRui; Shaw, Timothy; Zhang, Xing; Liu, Dong; Shen, Ye; Ezeamama, Amara E; Yang, Chunfu; Zhang, Ming

2017-11-01

Lack of a consistent and reliable genotyping system can critically impede HIV genomic research on pathogenesis, fitness, virulence, drug resistance, and genomic-based healthcare and treatment. At present, mis-genotyping, i.e., background noises in molecular genotyping, and its impact on epidemic surveillance is unknown. For the first time, we present a comprehensive assessment of HIV genotyping quality. HIV sequence data were retrieved from worldwide published records, and subjected to a systematic genotyping assessment pipeline. Results showed that mis-genotyped cases occurred at 4.6% globally, with some regional and high-risk population heterogeneities. Results also revealed a consistent mis-genotyping pattern in gp120 in all studied populations except the group of men who have sex with men. Our study also suggests novel virus diversities in the mis-genotyped cases. Finally, this study reemphasizes the importance of implementing a standardized genotyping pipeline to avoid genotyping disparity and to advance our understanding of virus evolution in various epidemiological settings. Copyright © 2017 Elsevier Inc. All rights reserved.

Do effects of common case-mix adjusters on patient experiences vary across patient groups?

PubMed

de Boer, Dolf; van der Hoek, Lucas; Rademakers, Jany; Delnoij, Diana; van den Berg, Michael

2017-11-22

Many survey studies in health care adjust for demographic characteristics such as age, gender, educational attainment and general health when performing statistical analyses. Whether the effects of these demographic characteristics are consistent between patient groups remains to be determined. This is important as the rationale for adjustment is often that demographic sub-groups differ in their so-called 'response tendency'. This rationale may be less convincing if the effects of response tendencies vary across patient groups. The present paper examines whether the impact of these characteristics on patients' global rating of care varies across patient groups. Secondary analyses using multi-level regression models were performed on a dataset including 32 different patient groups and 145,578 observations. For each demographic variable, the 95% expected range of case-mix coefficients across patient groups is presented. In addition, we report whether the variance of coefficients for demographic variables across patient groups is significant. Overall, men, elderly, lower educated people and people in good health tend to give higher global ratings. However, these effects varied significantly across patient groups and included the possibility of no effect or an opposite effect in some patient groups. The response tendency attributed to demographic characteristics - such as older respondents being milder, or higher educated respondents being more critical - is not general or universal. As such, the mechanism linking demographic characteristics to survey results on patient experiences with quality of care is more complicated than a general response tendency. It is possible that the response tendency interacts with patient group, but it is also possible that other mechanisms are at play.

What is the Effect of Case-Based Learning on the Academic Achievement of Students on the Topic of "Biochemical Oxygen Demand?"

NASA Astrophysics Data System (ADS)

Günter, Tuğçe; Alpat, Sibel Kılınç

2017-11-01

The purpose of this study was to investigate the effect of the case-based learning (CBL) method used in "biochemical oxygen demand (BOD)," which is a topic taught in the environmental chemistry course, at Dokuz Eylul University, on the academic achievement and opinions of students. The research had a quasi-experimental design and the study group consisted of 4th and 5th grade students (N = 18) attending the Chemistry Teaching Program in a university in Izmir. The "Biochemical Oxygen Demand Achievement Test (BODAT)" and the structured interview form were used as data collection tools. The results of BODAT post-test showed the higher increase in the achievement scores of the experimental group may be an indication of the effectiveness of the CBL method in improving academic achievement in the relevant topic. In addition, the experimental and control group students had positive opinions regarding the method, the scenario, and the material. The students found the method, the scenario, and the material to be interesting, understandable/instructional, relatable with everyday life, suitable for the topic, and enhancing active participation.

The function of credibility in information processing for risk perception.

PubMed

Trumbo, Craig W; McComas, Katherine A

2003-04-01

This study examines how credibility affects the way people process information and how they subsequently perceive risk. Three conceptual areas are brought together in this analysis: the psychometric model of risk perception, Eagly and Chaiken's heuristic-systematic information processing model, and Meyer's credibility index. Data come from a study of risk communication in the circumstance of state health department investigations of suspected cancer clusters (five cases, N = 696). Credibility is assessed for three information sources: state health departments, citizen groups, and industries involved in each case. Higher credibility for industry and the state directly predicts lower risk perception, whereas high credibility for citizen groups predicts greater risk perception. A path model shows that perceiving high credibility for industry and state-and perceiving low credibility for citizen groups-promotes heuristic processing, which in turn is a strong predictor of lower risk perception. Alternately, perceiving industry and the state to have low credibility also promotes greater systematic processing, which consistently leads to perception of greater risk. Between a one-fifth and one-third of the effect of credibility on risk perception is shown to be indirectly transmitted through information processing.

Identifying Etiological Agents Causing Diarrhea in Low Income Ecuadorian Communities

PubMed Central

Vasco, Gabriela; Trueba, Gabriel; Atherton, Richard; Calvopiña, Manuel; Cevallos, William; Andrade, Thamara; Eguiguren, Martha; Eisenberg, Joseph N. S.

2014-01-01

Continued success in decreasing diarrheal disease burden requires targeted interventions. To develop such interventions, it is crucial to understand which pathogens cause diarrhea. Using a case-control design we tested stool samples, collected in both rural and urban Ecuador, for 15 pathogenic microorganisms. Pathogens were present in 51% of case and 27% of control samples from the urban community, and 62% of case and 18% of control samples collected from the rural community. Rotavirus and Shigellae were associated with diarrhea in the urban community; co-infections were more pathogenic than single infection; Campylobacter and Entamoeba histolytica were found in large numbers in cases and controls; and non-typhi Salmonella and enteropathogenic Escherichia coli were not found in any samples. Consistent with the Global Enteric Multicenter Study, focused in south Asia and sub-Saharan Africa, we found that in Ecuador a small group of pathogens accounted for a significant amount of the diarrheal disease burden. PMID:25048373

Investigating the purpose of an online discussion group for health professionals: a case example from forensic occupational therapy

PubMed Central

2013-01-01

Background Thousands of health-related online discussion groups are active world-wide however, very little is known about the purpose and usefulness of such groups. In 2003 an online discussion group called ‘forensic occupational therapy’ was established in the United Kingdom. This group was examined to gain an understanding of the purpose and use of online discussion groups for health professionals who may be practically and geographically isolated from others in similar areas of practice. Methods Following a case study design, descriptive characteristics on members’ locations and number of posts were collected from the forensic occupational therapy online discussion group. Eight years of posts (2003–2011) were examined using a theoretical thematic analysis process to identify and describe the purposes for which members were using the group. Results Members from 20 countries contributed to the discussion group; the vast majority of posts being from members in the United Kingdom. Activity within the group was consistently high for the first five years however, activity within the group declined in the final three years. Six purposes for which members use the online discussion group were identified: seeking and giving advice, networking, requesting and sharing material resources, service development, defining the role of occupational therapists, and student learning. Conclusions Findings suggest that health professionals in specialized and often isolated areas of practice are keen to connect with colleagues and learn from each other’s experiences. The main purposes for which the online discussion group was used could be summarized as communication, information sharing and networking; though activity within the group declined significantly during the last three years of the data collection period. This raises questions about the sustainability of online discussion groups within the rapidly developing social media environment. PMID:23822895

Investigating the purpose of an online discussion group for health professionals: a case example from forensic occupational therapy.

PubMed

Dieleman, Crystal; Duncan, Edward A S

2013-07-03

Thousands of health-related online discussion groups are active world-wide however, very little is known about the purpose and usefulness of such groups. In 2003 an online discussion group called 'forensic occupational therapy' was established in the United Kingdom. This group was examined to gain an understanding of the purpose and use of online discussion groups for health professionals who may be practically and geographically isolated from others in similar areas of practice. Following a case study design, descriptive characteristics on members' locations and number of posts were collected from the forensic occupational therapy online discussion group. Eight years of posts (2003-2011) were examined using a theoretical thematic analysis process to identify and describe the purposes for which members were using the group. Members from 20 countries contributed to the discussion group; the vast majority of posts being from members in the United Kingdom. Activity within the group was consistently high for the first five years however, activity within the group declined in the final three years. Six purposes for which members use the online discussion group were identified: seeking and giving advice, networking, requesting and sharing material resources, service development, defining the role of occupational therapists, and student learning. Findings suggest that health professionals in specialized and often isolated areas of practice are keen to connect with colleagues and learn from each other's experiences. The main purposes for which the online discussion group was used could be summarized as communication, information sharing and networking; though activity within the group declined significantly during the last three years of the data collection period. This raises questions about the sustainability of online discussion groups within the rapidly developing social media environment.

Variance of foot biomechanical parameters across age groups for the elderly people in Romania

NASA Astrophysics Data System (ADS)

Deselnicu, D. C.; Vasilescu, A. M.; Militaru, G.

2017-10-01

The paper presents the results of a fieldwork study conducted in order to analyze major causal factors that influence the foot deformities and pathologies of elderly women in Romania. The study has an exploratory and descriptive nature and uses quantitative methodology. The sample consisted of 100 elderly women from Romania, ranging from 55 to over 75 years of age. The collected data was analyzed on multiple dimensions using a statistic analysis software program. The analysis of variance demonstrated significant differences across age groups in terms of several biomechanical parameters such as travel speed, toe off phase and support phase in the case of elderly women.

[Drug-induced extrapyramidal disorders].

PubMed

Horga, J F; Navarro, M; Peiró, V; Hernández, M

1995-01-01

We analyze 402 drug-adverse events consisting of movement disorders or aggravation of parkinsonisms, submitted to Sistema Español de Farmacovigilancia until 1994. Our aim is to know patient characteristics and the drugs related with these submissions. Most of them (64) belong to calcium-entry blocker group (31%) and benzamides (27%). Case age intervals more frequent were 11-30 and 60-80 years-old and the events affect predominantly females. The percentage of serious adverse events were near 80%. We think that drug-related parkinsonisms have high prevalence rate and that the role of calcium-entry blockers in these events should be considered at the moment to prescribe groups.

DOE Office of Scientific and Technical Information (OSTI.GOV)

King, W.A.; Kubas, G.J.

The present invention provides: a composition of the formula M{sup +x}(Ga(Y){sub 4}{sup {minus}}){sub x} where M is a metal selected from the group consisting of lithium, sodium, potassium, cesium, calcium, strontium, thallium, and silver, x is an integer selected from the group consisting of 1 or 2, each Y is a ligand selected from the group consisting of aryl, alkyl, hydride and halide with the proviso that at least one Y is a ligand selected from the group consisting of aryl, alkyl and halide; a composition of the formula (R){sub x}Q{sup +}Ga(Y){sub 4}{sup {minus}} where Q is selected from themore » group consisting of carbon, nitrogen, sulfur, phosphorus and oxygen, each R is a ligand selected from the group consisting of alkyl, aryl, and hydrogen, x is an integer selected from the group consisting of 3 and 4 depending upon Q, and each Y is a ligand selected from the group consisting of aryl, alkyl, hydride and halide with the proviso that at least one Y is a ligand selected from the group consisting of aryl, alkyl and halide; an ionic polymerization catalyst composition including an active cationic portion and a gallium based weakly coordinating anion; and bridged anion species of the formula M{sup +x}{sub y}[X(GaY{sub 3}){sub z}]{sup {minus}y}{sub x} where M is a metal selected from the group consisting of lithium, sodium, potassium, magnesium, cesium, calcium, strontium, thallium, and silver, x is an integer selected from the group consisting of 1 or 2, X is a bridging group between two gallium atoms, y is an integer selected from the group consisting 1 and 2, z is an integer of at least 2, each Y is a ligand selected from the group consisting of aryl, alkyl, hydride and halide with the proviso that at least one Y is a ligand selected from the group consisting of aryl, alkyl and halide.« less

Gallium based low-interaction anions

DOEpatents

King, Wayne A.; Kubas, Gregory J.

2000-01-01

The present invention provides: a composition of the formula M.sup.+x (Ga(Y).sub.4.sup.-).sub.x where M is a metal selected from the group consisting of lithium, sodium, potassium, cesium, calcium, strontium, thallium, and silver, x is an integer selected from the group consisting of 1 or 2, each Y is a ligand selected from the group consisting of aryl, alkyl, hydride and halide with the proviso that at least one Y is a ligand selected from the group consisting of aryl, alkyl and halide; a composition of the formula (R).sub.x Q.sup.+ Ga(Y).sub.4.sup.- where Q is selected from the group consisting of carbon, nitrogen, sulfur, phosphorus and oxygen, each R is a ligand selected from the group consisting of alkyl, aryl, and hydrogen, x is an integer selected from the group consisting of 3 and 4 depending upon Q, and each Y is a ligand selected from the group consisting of aryl, alkyl, hydride and halide with the proviso that at least one Y is a ligand selected from the group consisting of aryl, alkyl and halide; an ionic polymerization catalyst composition including an active cationic portion and a gallium based weakly coordinating anion; and bridged anion species of the formula M.sup.+x.sub.y [X(Ga(Y.sub.3).sub.z ].sup.-y.sub.x where M is a metal selected from the group consisting of lithium, sodium, potassium, magnesium, cesium, calcium, strontium, thallium, and silver, x is an integer selected from the group consisting of 1 or 2, X is a bridging group between two gallium atoms, y is an integer selected from the group consisting 1 and 2, z is an integer of at least 2, each Y is a ligand selected from the group consisting of aryl, alkyl, hydride and halide with the proviso that at least one Y is a ligand selected from the group consisting of aryl, alkyl and halide.

Guided implant surgery with modification of the technique involving the raising of a semicircular miniflap: A preliminary study

PubMed Central

Viña, José; Maestre, Laura; Peñarrocha, David; Balaguer, José

2012-01-01

Objective: An evaluation is made of pain, swelling and peri-implant attached mucosal width after implant-based rehabilitation involving guided surgery and a modification of the technique with the raising of a semicircular miniflap, in single and partial replacements. Study design: A case-control study was carried out. The study group consisted of 12 patients with the placement of 19 implants using a guided surgery and miniflap technique. The control group consisted of 12 patients with the placement of 22 implants using the conventional technique. Each patient scored postoperative swelling and pain by means of a visual analog scale (VAS). Attached vestibular mucosa width was evaluated 12 weeks after implant placement. Results: Twelve operations were carried out in each group. Immediate aesthetics were established for all implants of the study group. One implant failed in each group. Maximum pain was recorded after 6 hours in both groups (mean VAS score 4 and 4.9 in the study and control group, respectively). Maximum swelling was recorded after 24 hours (mean VAS score 2.5) in the study group and on the second day (mean VAS score 3.4) in the control group. The mean attached vestibular mucosa width was 2.9 mm in the study group and 3.2 mm in the control group. Conclusion: In this preliminary study, guided implant surgery with a semicircular miniflap in single and partial replacements resulted in slightly less postoperative pain and swelling than with the conventional implant technique. The attached vestibular mucosa width was greater in the control group, though the differences were very small. Key words:Guided surgery, flapless surgery, miniflap, peri-implant mucosa. PMID:22549666

The essential tension between leadership and power: when leaders sacrifice group goals for the sake of self-interest.

PubMed

Maner, Jon K; Mead, Nicole L

2010-09-01

Throughout human history, leaders have been responsible for helping groups attain important goals. Ideally, leaders use their power to steer groups toward desired outcomes. However, leaders can also use their power in the service of self-interest rather than effective leadership. Five experiments identified factors within both the person and the social context that determine whether leaders wield their power to promote group goals versus self-interest. In most cases, leaders behaved in a manner consistent with group goals. However, when their power was tenuous due to instability within the hierarchy, leaders high (but not low) in dominance motivation prioritized their own power over group goals: They withheld valuable information from the group, excluded a highly skilled group member, and prevented a proficient group member from having any influence over a group task. These self-interested actions were eliminated when the group was competing against a rival outgroup. Findings provide important insight into factors that influence the way leaders navigate the essential tension between leadership and power. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Outcomes of Video-Assisted Teaching for Latching in Postpartum Women: A Randomized Controlled Trial.

PubMed

Sroiwatana, Suttikamon; Puapornpong, Pawin

2018-04-25

Latching is an important process of breastfeeding and should be taught and practiced by the postpartum mother. The objective is to compare latching outcomes between video-assisted and routine teaching methods among postpartum women. A randomized controlled trial was conducted. Postpartum women who had deliveries without complications were randomized into two groups: 14 cases in the video-assisted teaching group and 14 cases in a routine teaching group. In the first group, the mothers were taught breastfeeding benefits, latching methods, and breastfeeding positions and practiced breastfeeding in a controlled setting for a 30-minute period and watched a 6-minute video with consistent content. In the second group, the mothers were taught a normal 30-minute period and then practiced breastfeeding. In both groups, Latching on, Audible swallowing, the Type of nipples, Comfort, and Help (LATCH) scores were assessed at 24-32 and 48-56 hours after the breastfeeding teaching modals. Demographic data and LATCH scores were collected and analyzed. There were no statistically significant differences in the mothers' ages, occupations, marital status, religion, education, income, infants' gestational age, body mass index, nipple length, route of delivery, and time to first latching between the video-assisted and routine breastfeeding teaching groups. First and second LATCH score assessments had shown no significant differences between both breastfeeding teaching groups. The video-assisted breastfeeding teaching did not improve latching outcomes when it was compared with routine teaching.

Collective motion of groups of self-propelled particles following interacting leaders

NASA Astrophysics Data System (ADS)

Ferdinandy, B.; Ozogány, K.; Vicsek, T.

2017-08-01

In order to keep their cohesiveness during locomotion gregarious animals must make collective decisions. Many species boast complex societies with multiple levels of communities. A common case is when two dominant levels exist, one corresponding to leaders and the other consisting of followers. In this paper we study the collective motion of such two-level assemblies of self-propelled particles. We present a model adapted from one originally proposed to describe the movement of cells resulting in a smoothly varying coherent motion. We shall use the terminology corresponding to large groups of some mammals where leaders and followers form a group called a harem. We study the emergence (self-organization) of sub-groups within a herd during locomotion by computer simulations. The resulting processes are compared with our prior observations of a Przewalski horse herd (Hortobágy, Hungary) which we use as results from a published case study. We find that the model reproduces key features of a herd composed of harems moving on open ground, including fights for followers between leaders and bachelor groups (group of leaders without followers). One of our findings, however, does not agree with the observations. While in our model the emerging group size distribution is normal, the group size distribution of the observed herd based on historical data have been found to follow lognormal distribution. We argue that this indicates that the formation (and the size) of the harems must involve a more complex social topology than simple spatial-distance based interactions.

[Latent factors aggravating airway allergic symptom in urban population: the involvement of urban living environments].

PubMed

Azuma, E; Nakajima, T; Hashimoto, M; Toyoshima, K; Hayashida, M; Komachi, Y

1999-03-01

The involvement of urban living environments in IgE-increase (atopy) and ECP-increase (enhanced eosinophil activity), the inter-relationship of IgE-increase and ECP-increase, and their involvement in developing airway allergic symptoms were studied on a population of adult nonsmoking women, in order to elucidate the latent factors aggravating airway allergic symptoms in an urban population. In our earlier study on child asthma in 1994, we examined the relationship between living environments and mite proliferation in asthma and non-asthma groups and the involvement of mite proliferation in developing atopy in the non-asthma group. The asthma group consisted of 190 children under 12 years old who had been recently diagnosed as having bronchial asthma and under the care of Osaka Prefectural Habikino Hospital. The non-asthma group consisted of 78 children under 12 years old who had been under care at Osaka Prefectural Hospital but had no present history of allergic symptom. The adult woman group consisted of 423 non-smoking women who had been diagnosed as having no allergic disease by the medical examination done at Yao City, Osaka, each March from 1995 to 1997. Individual living environments such as housing and heating styles were surveyed by questionnaire. Also, the amount of mite allergen (Dp: Dermatophagoides pteronyssinus, Df: Dermatophagoides farinae) in room and bedding dust (only in the case of children) and the concentration of continine in urine were examined as objective indicators for the load of environmental allergen and the indoor air pollution by tobacco smoke, respectively. Atopy was diagnosed according to whether Dp-specific immunoglobulin E (Dp-IgE) was present/absent (positive/negative), and ECP-increase was defined as serum ECP concentration over 10 ng/ml. The results were as follows: 1. An environment of higher humidity (dampness) causing a room to become moldy appeared to enhance mite proliferation, while heating only with an electric heater or kotatsu appeared to suppress it. 2. Living environments were involved in the development of atopy in children and adult women through the effects on mite proliferation. In the case of children, heating with oil or gas heater appeared to have a positive effect while reinforced concrete housing a negative effect, probably by effects on the immune system. However, in the case of adult women, such modification was not observed. 3. Passive smoking in adult women was related to ECP-increase. 4. IgE-increase and ECP-increase appeared to be involved in each other. 5. Among airway allergic symptoms such as cough, sputum and wheeze, atopy was involved in wheeze, and ECP-increase in cough.

Initial Clinical Experience with an Endoluminal Spiral Prosthesis for Treating Complicated Venous Thrombosis and Preventing Pulmonary Embolism

PubMed Central

Jakob, H.; Oelert, H.; Schmiedt, W.; Teusch, P.; Iversen, S.; Hake, U.; Schild, H.; Maass, D.

1989-01-01

Fourteen patients with complicated venous thrombosis or recurrent pulmonary embolism were treated by implantation of an endoluminal spiral prosthesis subsequent to balloon angioplasty, surgical thrombectomy or embolectomy, a combination of these, or, in 2 cases, no other treatment. The patients were divided into 2 groups, based on their primary diagnosis and the purpose of the prosthesis. Group I included 8 patients with extensive iliofemoral or caval thrombosis, caused by congenital caval stenosis (1 case) or extravascular compression or retraction (7 cases); 7 of these patients had had previous operations, and the remaining patient had undergone thrombolysis, which failed. The current treatment consisted of balloon angioplasty and surgical thrombectomy or embolectomy, and implantation of an endoluminal spiral stent to prevent elastic recoil of the vessel. In 4 cases, an arteriovenous fistula was constructed and was taken down 3 months later; in 1 additional patient, a bilateral arteriovenous fistula was created. Group II comprised 6 patients with recurrent pulmonary embolism (4 cases), massive pulmonary embolism (1 case), or paradoxical bilateral carotid artery embolism (1 case). Four of these patients underwent surgical thrombectomy or embolectomy, while 2 had no treatment other than filter implantation. All 6 underwent transluminal implantation of a helix caval filter (a modification of the endoluminal spiral stent). All but 1 implantation was accomplished by means of either a transfemoral or a transjugular cutdown; the remaining implantation was performed transatrially after a pulmonary embolectomy. The only device-related complication was a retroperitoneal hematoma in Group I, resulting from perforation of the inferior vena cava by the guidewire during device implantation. This complication necessitated an emergency laparotomy and takedown of the arteriovenous fistula, which resulted in rethrombosis of the left iliofemoral vein. The other 7 stented veins were patent at early phlebographic follow-up, as were all 5 of those studied later. One Group-I patient died 4 months after surgery, due to tumor progression and without signs of caval restenosis. Twelve months postoperatively, 1 Group-II patient died of urosepsis without a recurrence of pulmonary embolism. Four of the 6 Group-II patients were studied late postoperatively, and all of their stented vessels were patent. There was no operative mortality or postoperative embolism. On the basis of these results, we conclude that endoluminal stenting with an expandable spiral prosthesis is a promising method for remote venous reconstruction. Moreover, it appears that the modified stent, or helix caval filter, compares favorably with commercially available filters. (Texas Heart Institute Journal 1989;16:87-94) Images PMID:15227219

Estimation of the probability of exposure to metalworking fluids in a population-based case-control study

PubMed Central

Park, Dong-Uk; Colt, Joanne S.; Baris, Dalsu; Schwenn, Molly; Karagas, Margaret R.; Armenti, Karla R.; Johnson, Alison; Silverman, Debra T; Stewart, Patricia A

2014-01-01

We describe here an approach for estimating the probability that study subjects were exposed to metalworking fluids (MWFs) in a population-based case-control study of bladder cancer. Study subject reports on the frequency of machining and use of specific MWFs (straight, soluble, and synthetic/semi-synthetic) were used to estimate exposure probability when available. Those reports also were used to develop estimates for job groups, which were then applied to jobs without MWF reports. Estimates using both cases and controls and controls only were developed. The prevalence of machining varied substantially across job groups (10-90%), with the greatest percentage of jobs that machined being reported by machinists and tool and die workers. Reports of straight and soluble MWF use were fairly consistent across job groups (generally, 50-70%). Synthetic MWF use was lower (13-45%). There was little difference in reports by cases and controls vs. controls only. Approximately, 1% of the entire study population was assessed as definitely exposed to straight or soluble fluids in contrast to 0.2% definitely exposed to synthetic/semi-synthetics. A comparison between the reported use of the MWFs and the US production levels by decade found high correlations (r generally >0.7). Overall, the method described here is likely to have provided a systematic and reliable ranking that better reflects the variability of exposure to three types of MWFs than approaches applied in the past. PMID:25256317

[Infective endocarditis in intensive cardiac care unit - clinical and biochemical differences of blood-culture negative infective endocarditis].

PubMed

Kaziród-Wolski, Karol; Sielski, Janusz; Ciuraszkiewicz, Katarzyna

2017-01-23

Diagnosis and treatment of infective endocarditis (IE) is still a challenge for physicians. Group of patients with the worst prognosis is treated in Intensive Cardiac Care Unit (ICCU). Etiologic agent can not be identified in a substantial number of patients. The aim of study is to find differences between patients with blood culture negative infective endocarditis (BCNIE) and blood culture positive infective endocarditis (BCPIE) treated in ICCU by comparing their clinical course and laboratory parameters. Retrospective analysis of 30 patients with IE hospitalized in ICCU Swietokrzyskie Cardiac Centre between 2010 and 2016. This group consist of 26 men (86,67%) and 4 women (13,3%). Mean age was 58 years ±13. Most of the cases were new disease, recurrence of the disease was observed in 2 cases (6,7%). 8 patients (26,7%) required artificial ventilation, 11 (36,7%) received inotropes and 6 (20%) vasopresors. In 14 (46,7%) cases blood cultures was negative (BCNIE), the rest of patients (16, 53,3%) was blood cultures - positive infective endocarditis (BCIE). Both of the groups were clinically similar. There were no statistically significant differences in incidence of cardiac implants, localization of bacterial vegetations, administered catecholamines, antibiotic therapy, artificial ventilation, surgical treatment, complication and in-hospital mortality. Incidence of cardiac complications in all of BCNIE cases and in 81,3% cases of BCPIE draws attention, but it is not statistically significant difference (p=0,08). There was statistically significant difference in mean BNP blood concentration (3005,17 ng/ml ±2045,2 vs 1013,42 ng/ml ±1087,6; p=0,01), but there were no statistically significant differences in rest of laboratory parameters. BCNIE group has got higher mean BNP blood concentration than BCPIE group. There were no statistically significant differences between these groups in others laboratory parameters, clinical course and administered antibiotic therapy. In our endemic region major cause of BCNIE seems to be early antibiotic therapy prior to collection of blood samples, but further studies are necessary.

Do serum BDNF levels vary in self-harm behavior among adolescents and are they correlated with traumatic experiences?

PubMed

Kavurma, Canem; Varol Tas, Fatma; Serim Demirgoren, Burcu; Demirci, Ferhat; Akan, Pınar; Eyuboglu, Damla; Guvenir, Taner

2017-12-01

The aim of this study was to compare serum brain-derived neurotrophic factor (BDNF) levels between adolescents that harm themselves, those that receive psychiatric treatment but do not harm themselves, healthy adolescents, and childhood traumas and to investigate the relationship between traumatic experiences and serum BDNF levels. The cases were divided into two groups of 40 adolescents exhibiting self-harm behavior (self-harm/diagnosed group) and 30 adolescents receiving psychiatric treatment but not exhibiting self-harm behaviors (non self-harm/diagnosed group). The control group (healthy control group) consisted of 35 healthy adolescents with no psychiatric disorders or self-harm behaviors. The adolescents were asked to fill in the Inventory of Statements About Self Injury (ISAS) and Childhood Trauma Questionnaire (CTQ). For BDNF measurement, blood samples were taken from the cases and controls. The serum BDNF level of self-harming adolescents who used the self-cutting method was significantly lower than that of other groups, and serum BDNF levels decreased with the increase in the emotional neglect and abuse severity of self-harming adolescents during childhood. In our study, serum BDNF levels decreased with the increase in emotional abuse in self-harming adolescents. This finding may indicate that neuroplasticity can be affected by a negative emotional environment during the early period. Copyright © 2017 Elsevier B.V. All rights reserved.

Outcomes of endothelial keratoplasty in pseudophakic corneal oedema: with or without Descemet's membrane stripping.

PubMed

Mohamed, Ashik; Ks, Anil Raj; Chaurasia, Sunita; Ramappa, Muralidhar

2016-06-01

To evaluate and compare outcomes of Descemet's stripping endothelial keratoplasty (DSEK) with non-DSEK (nDSEK) in pseudophakic corneal oedema (PCE). The study was a prospective, non-consecutive, comparative, interventional case series. Twenty-six patients with PCE were randomised into two groups. Group 1 comprised of those cases that had undergone conventional DSEK, and group 2 consisted of those that had nDSEK for PCE between 2010 and 2012. The data on demographics and clinical characteristics were collected from all patients. Any intraoperative and early and late postoperative complications were also noted. The primary outcome measure was postoperative functional success. Graft survival and complications were analysed as secondary outcomes. The median best-corrected visual acuities at 6 months postoperatively in groups 1 and 2 were 0.18 (IQR 0.10-0.30) and 0.44 (IQR 0.18-0.51), respectively (p=0.11). Corneal oedema cleared in all patients. During the early postoperative period, a patient in group 2 had lenticule detachment managed by rebubbling. nDSEK has outcomes similar to DSEK in PCE with advantages of decreased surgical time and avoidance of inadvertent pull on the posterior stromal fibres that may occur during Descemet's stripping. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Study of lung cancer risk in the electroplating industry in Lombardy based on the OCCAM method].

PubMed

Panizza, C; Bai, E; Oddone, E; Scaburri, Alessandra; Massari, Stefania; Modonesi, C; Crosignani, P

2011-01-01

The OCCAM method consists of case-control studies aimed at estimating occupational risks by cancer site, by area and by economic sector, using available archives to identify cases and controls; for exposure definition each subject is assigned to the category code of the economic sector or company where he/she worked the longest, obtained by automatic link with the Social Security Institute (INPS) files. The reference category (unexposed) consists of service industry workers. The economic sector is given by the ATECO category that INPS assigns to each firm. In the Lombardy Region, lung cancer risk evaluated for the "metal treatment" industry as a whole was 1.32 (90% CI 1.33-3.10, 67 cases) for males and 1.33 (90% CI 0.51-3.59, 10 cases) for females. The aim of the study was to estimate lung cancer risk among metal electroplating workers only. The metal electroplating firms were identified according to the detailed description of production, data which was also contained in INPS files, instead of using the "metal treatment" ATECO code. Lung cancer risk was evaluated using 2001-2008 incident cases identified from hospital discharge records of residents in the Lombardy Region. Controls were a sample from National Health Service files. For the group of firms identified as metal electroplating industries the risk was 2.03 (90% CI 1.69-8.32, 18 cases) for males and 3.75 (90% CI 1.38-9.03, 4 cases) for females. Focusing on the true electroplating firms increased the risk estimates. Even though these risk were due to past exposures, case histories and recent acute effects indicate that, at least in some factories, a carcinogenic hazard still exists.

Prospective memory performance of patients with Parkinson's disease depends on shifting aptitude: evidence from cognitive rehabilitation.

PubMed

Costa, Alberto; Peppe, Antonella; Serafini, Francesca; Zabberoni, Silvia; Barban, Francesco; Caltagirone, Carlo; Carlesimo, Giovanni Augusto

2014-08-01

This study investigated the effect of cognitive training aimed at improving shifting ability on Parkinson's disease (PD) patients' performance of prospective memory (PM) tasks. Using a double-blind protocol, 17 PD patients were randomly assigned to two experimental arms. In the first arm (n=9) shifting training was administered, and in the second (placebo) arm (n=8), language and respiratory exercises. Both treatments consisted of 12 sessions executed over 4 weeks. PM and shifting measures (i.e., Trail Making Test and Alternate Fluency Test) were administered at T0 (before treatment) and T1 (immediately after treatment). A mixed analysis of variance was applied to the data. To evaluate the effects of treatment, the key effect was the interaction between Group (experimental vs. placebo) and Time of Assessment (T0 vs. T1). This interaction was significant for the accuracy indices of the PM procedure (p<.05) and for the performance parameters of the shifting tasks (p ≤.05). Tukey's HSD tests showed that in all cases passing from T0 to T1 performance significantly improved in the experimental group (in all cases p ≤.02) but remained unchanged in the placebo group (all p consistently>.10). The performance change passing from T0 to T1 on the Alternate Fluency test and the PM procedure was significantly correlated (p<.05). Results show that the cognitive training significantly improved PD patients' event-based PM performance and suggest that their poor PM functioning might be related to reduced shifting abilities.

Anti-Mullerian hormone and insulin resistance in classic phenotype lean PCOS.

PubMed

Caglar, Gamze Sinem; Kahyaoglu, Inci; Pabuccu, Recai; Demirtas, Selda; Seker, Rabia

2013-10-01

This study is designed to explore the correlation between AMH levels and IR in normal weight PCOS women. This prospective study was conducted on 55 patients, who were admitted to obstetrics and gynecology department of a university clinic. Study group was consisted of 34 patients diagnosed as polycystic ovary syndrome (PCOS) according to the Rotterdam Criteria, whereas control group was consisted of 21 healthy volunteers without any features of clinical or biochemical hyperandrogenism, who had regular menstrual cycles. BMI ≥ 25 kg/m(2) were considered overweight and obese and excluded. Blood samples were obtained during days 2-3 after spontaneous menses or progesterone-induced withdrawal bleeding after overnight fasting for at least 12 h. The weight, height, hip and waist circumferences of the patients were measured. Fasting insulin and glucose (FPG) levels were used for calculating different insulin resistance indexes (Homeostatic Model Assessment (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI)). No significant difference was found between PCOS and control groups regarding the mean age, BMI, waist to hip ratio (WHR), mean values of FPG, FPG/insulin ratio and HOMA B (p > 0.05). AMH values were significantly higher in PCOS cases when compared with controls (4.7 vs. 3.4 ng/mL) (p < 0.05).The mean values of HOMA-IR and QUICKI indexes were significantly higher among PCOS cases when compared with controls. E2 levels were significantly lower and Total-T were significantly higher in PCOS patients. When PCOS cases are categorized according to the existence of IR, no difference in Total-T and AMH levels between both groups. Although not statistically significant, a negative correlation of AMH with HOMA-IR and a positive correlation with QUICKI index were found. Among the hormone parameters, AMH was found to be positively correlated with Total-T (r = 0.332, p = 0.013). Although the relation between AMH and androgen production is supported by current evidence, the mechanism underlying the relation between AMH and insulin resistance is not clear yet.

Correlation between aerosol therapy in early childhood and Molar Incisor Hypomineralisation.

PubMed

Loli, D; Costacurta, M; Maturo, P; Docimo, R

2015-03-01

To evaluate the correlation between the use of aerosol therapy in early childhood and the presence of Molar Incisor Hypomineralisation (MIH). a retrospective case-control study in which a group (cases) consisted of children from 6 to 13 years with MIH visited at the unit of Pediatric Dentistry of the Policlinico Tor Vergata (Rome, Italy), and a group (controls) consisted of an equal number of children of the same age without MIH. Data about the aerosol therapy and the presence of MIH were obtained respectively by medical history and intraoral clinical examination. Collected data underwent statistical analysis using mainly non-parametric tests (p < 0.05). In the study were included 182 patients, of which 91 (46 males, 51%) were children with MIH (cases), and 91 (46 males, 51%) were children without MIH (controls). In the group of patients with MIH, in the early childhood, 12 (13.1%) never had aerosol therapy, 6 (6.6%) underwent aerosol therapy less than 7 days per year, 22 (24.2%) from 8 to 15 days per year, 22 (24.2%) from 16 to 45 days a year, and 29 (31.9%) more than 45 days per year. In the control group, in the early childhood, 9 (9.9%) never had aerosol therapy, 29 (31.9%) underwent aerosol therapy less than 7 days per year, 26 (28.6%) from 8 to 15 days per year, 20 (22.0%) from 16 to 45 days a year and 7 (7.6%) more than 45 days per year. the risk of developing MIH in children undergoing intensive use of aerosol therapy with respect to those receiving a less intensive use resulted in an odds ratio of 3.19 (p <0.001) in the general population, 4.83 (p < 0.001) in males and was not statistically significant in females (p = 0.132). The Spearman correlation between aerosol therapy and MIH was 0.278 (p < 0.001) in the general population, 0.372 (p < 0.001) in male, and it was not statistically significant (p = 0.08) in female subjects. Aerosol therapy carried out in early childhood appears to be a risk factor for the development of MIH, particularly in male subjects.

Tension pneumocephalus following suboccipital sitting craniotomy in the pediatric population.

PubMed

Daszkiewicz, P; Dziedzic, D

Sitting craniotomy often results in entrapment of air in fluid-filled intracranial cavities. Gas under pressure exerts a deleterious effect on adjacent nervous tissue, resulting in clinical deterioration. To assess the incidence of tension pneumocephalus (TP) and to define risk factors associated therewith. Analysis included 100 consecutive patients (57 boys, 43 girls, mean age 9.7 y) undergoing suboccipital sitting craniotomy since 2012 to 2014. In our material (n=100) TP was seen in 7 cases, asymptomatic pneumocephalus (AP) in 77 and no pneumocephalus (NP) in 16. Tumor types encountered were typical for pediatric population. In the TP group (n=7) the ratio of low-grade to high-grade tumors was 5:2, in the AP group (n=77) 2:1 and in the NP group (n=16) 1:1. Preoperative hydrocephalus was present in 21 cases (21%, mean incidence), thereof 3 in the TP group (3/7; 42.8%), 12 in AP group (12/77; 15.5%) and 6 in the NP group (6/16; 37.5%). All TP patients received an emergency external drainage, thereof 4 required a permanent ventriculo-peritoneal shunt (57.1%), while AP and NP patients combined (n=93) required a permanent shunt in 4 cases only (4.3%). TP-associated morbidity (n=2) consisted in a significant deterioration of neurological condition. TP is a relatively rare but potentially serious complication of suboccipital sitting craniotomy. Risk factors for TP are low-grade tumor and pre-existing long-standing hydrocephalus. TP requires emergency decompression by temporary external drainage. TP patients significantly more often require a permanent CSF shunt. Copyright © 2017. Published by Elsevier Urban & Partner Sp. z o.o.

Adjunctive effect of chlorhexidine antiseptics in mechanical periodontal treatment: first results of a preliminary case series.

PubMed

Calderini, A; Pantaleo, G; Rossi, A; Gazzolo, D; Polizzi, E

2013-08-01

The aim of the present case series was to evaluate the clinical and microbiological effects of a single session of mechanical and manual scaling and root planing (SRP) combined with the use of two different chlorhexidine formulations in the treatment for generalized chronic periodontitis. Ten patients affected by chronic periodontal disease with periodontal probing depth (PPD) ≥ 5 mm were treated with SRP plus local chlorhexidine. In each patient, similar teeth, treated with SRP with the adjunctive use of chlorhexidine digluconate and dihydrochloride or chlorhexidine gluconate, respectively, were selected and assigned to a test and a control group. In both groups, PPD, bleeding on probing (BOP) parameters, total bacterial counts (TBC) and quality of periodontal bacteria at time 0 and 6 weeks after treatment were measured. PPD significantly decreased over time both in the test and in the control group; however, no significant differences between the two groups were observed. BOP and TBC were significantly lower in the test than in the control group 6 weeks after treatment. In the post-treatment revaluation, a significant decrease both in the treatment and in the control group, for each of the single periodontal pathogens, was observed. In this study--a preliminary case series with small sample size and short follow-up--the adjunctive use of chlorhexidine (CHX) to SRP resulted in clinical and microbiological benefits in the treatment for generalized chronic periodontitis. A CHX gel formulation consisting of CHX digluconate and CHX dihydrochloride seems to lead some additional benefits over SRP plus CHX gluconate in the short term. Additional investigations are needed to evaluate the effectiveness of this antiseptic therapy. © 2012 John Wiley & Sons A/S.

Effect of Ginger and Chamomile on Nausea and Vomiting Caused by Chemotherapy in Iranian Women with Breast Cancer.

PubMed

Sanaati, Fateme; Najafi, Safa; Kashaninia, Zahra; Sadeghi, Masoud

2016-01-01

Chemotherapy-induced nausea and vomiting (CINV) places a significant burden on the patient. Herbal agents are the most commonly complementary therapies used among the public. This study was done to determine the effect of ginger and chamomile capsules on nausea and vomiting in cases undergoing chemotherapy for breast cancer (BC). In a randomized, double-blind and clinical trial study, 65 women with BC undergoing chemotherapy were referred to Breast Cancer Research Center, Tehran, Iran, between May 2013 to June 2014. Regimen for ginger group for 5 days before and 5 days after chemotherapy was: 2 times a day and 500 mg capsules of powdered ginger root in addition to a routine antiemetic regimen consisting of dexamethasone, metoclopramide and aprepitant (DMA) capsules. Chamomile group similarly was: 2 times a day and 500 mg capsules of Matricaria chamomilla extract in addition to a routine antiemetic regimen consisting of DMA capsules. Control group, routine antiemetic regimen consisting of DMA capsules. There were no significant differences between the ginger, chamomile and control groups regarding age. Drugs used for chemotherapy were identical and duration of disease was also matched (1-4 months). Ginger and chamomile were both significantly effective for reducing the frequency of vomiting, there being no significant difference between the ginger and chamomile groups. Moreover, unlike the chamomile, ginger significantly influenced the frequency of nausea. According to the findings of this study, it should be declared that taking ginger capsules (1 g/day) might relieve CINV safely. Nurses dealing directly with cancer patients should be responsible for providing educational programs for patients and their families about how to deal with their drug regimens and associated side effects.

Frequency of cancer in children residing in Mexico City and treated in the hospitals of the Instituto Mexicano del Seguro Social (1996–2001)

PubMed Central

Juárez-Ocaña, Servando; González-Miranda, Guadalupe; Mejía-Aranguré, Juan Manuel; Rendón-Macías, Mario Enrique; Martínez-García, María del Carmen; Fajardo-Gutiérrez, Arturo

2004-01-01

Background The objective of this article is to present the frequency of cancer in Mexican children who were treated in the hospitals of the Instituto Mexicano del Seguro Social in Mexico City (IMSS-MC) in the period 1996–2001. Methods The Registry of Cancer in Children, started in 1996 in the IMSS-MC, is an on-going, prospective register. The data from 1996 through 2001 were analyzed and the different types of cancer were grouped according to the International Classification for Cancer in Children (ICCC). From this analysis, the general and specific frequencies by age and by sex were obtained for the different groups of neoplasms. Also, the frequency of the stage of the disease that had been diagnosed in cases of children with solid tumors was obtained. Results A total of 1,702 new cases of children with cancer were registered, with the male/female ratio at 1.1/1. Leukemias had the highest frequency with 784 cases (46.1%) and, of these, acute lymphoblastic leukemias were the most prevalent with 614 cases (78.3%). Thereafter, in descending order of frequency, were tumors of the central nervous system (CNST) with 197 cases (11.6%), lymphomas with 194 cases (11.4%), germinal cell tumors with 110 cases (6.5%), and bone tumors with 97 cases (5.7%). The highest frequency of cancer was found in the group of one to four year-olds that had 627 cases (36.8%). In all the age groups, leukemias were the most frequent. In the present work, the frequency of Hodgkin's disease (~4%) was found to be lower than that (~10%) in previous studies and the frequency of tumors of the sympathetic nervous system was low (2.3%). Of those cases of solid tumors for which the stage of the disease had been determined, 66.9% were diagnosed as being Stage III or IV. Conclusions The principal cancers in the children treated in the IMSS-MC were leukemias, CNST, and lymphomas, consistent with those reported by developed countries. A 2.5-fold reduction in the frequency of Hodgkin's disease was found. Of the children, the stage of whose disease had been determined, two thirds were diagnosed as having advanced stages of the disease. PMID:15310396

Regression Rates Following the Treatment of Aggressive Posterior Retinopathy of Prematurity with Bevacizumab Versus Laser: 8-Year Retrospective Analysis

PubMed Central

Nicoară, Simona D.; Ştefănuţ, Anne C.; Nascutzy, Constanta; Zaharie, Gabriela C.; Toader, Laura E.; Drugan, Tudor C.

2016-01-01

Background Retinopathy is a serious complication related to prematurity and a leading cause of childhood blindness. The aggressive posterior form of retinopathy of prematurity (APROP) has a worse anatomical and functional outcome following laser therapy, as compared with the classic form of the disease. The main outcome measures are the APROP regression rate, structural outcomes, and complications associated with intravitreal bevacizumab (IVB) versus laser photocoagulation in APROP. Material/Methods This is a retrospective case series that includes infants with APROP who received either IVB or laser photocoagulation and had a follow-up of at least 60 weeks (for the laser photocoagulation group) and 80 weeks (for the IVB group). In the first group, laser photocoagulation of the retina was carried out and in the second group, 1 bevacizumab injection was administered intravitreally. The following parameters were analyzed in each group: sex, gestational age, birth weight, postnatal age and postmenstrual age at treatment, APROP regression, sequelae, and complications. Statistical analysis was performed using Microsoft Excel and IBM SPSS (version 23.0). Results The laser photocoagulation group consisted of 6 premature infants (12 eyes) and the IVB group consisted of 17 premature infants (34 eyes). Within the laser photocoagulation group, the evolution was favorable in 9 eyes (75%) and unfavorable in 3 eyes (25%). Within the IVB group, APROP regressed in 29 eyes (85.29%) and failed to regress in 5 eyes (14.71%). These differences are statistically significant, as proved by the McNemar test (P<0.001). Conclusions The IVB group had a statistically significant better outcome compared with the laser photocoagulation group, in APROP in our series. PMID:27062023

The Effect of Chronic Alcoholism on the Conjunctival Flora.

PubMed

Gunduz, Göksel; Gunduz, Abuzer; Polat, Nihat; Cumurcu, Birgul Elbozan; Yakupogulları, Yusuf

2016-06-01

We aimed to investigate the effect of alcohol abuse on the conjunctival flora. The cases were evaluated as two groups. The study group consisted of 55 heavy-drinking males diagnosed with alcohol abuse, while the control group consisted of 55 males without a history of alcohol abuse. Samples were taken from the inferior fornix conjunctiva with sterile cotton-tipped swabs (Amies transport medium) for culture. The samples were inoculated into blood agar, chocolate agar, eosine methylene blue agar and Saboraud-Dextrose agar (Oxoid/UK) with the dilution method. The microorganisms that grew in study group subjects were Coagulase Negative Staphylococcus (CNS) in 30 (54.5%), Staphylococcus aureus in 14 (25.5%), Moraxella spp. in 3 (5.5%), Streptococcus spp. in 3 (5.5), Bacillus spp. in 3 (5.5%), Corynebacterium spp. in 3 (5.5%), Candida spp. in 3 (5.5%), Haemophilus spp. in 2 (3.6%), Acinetobacter spp. in 2 (3.6%), Neisseria spp. in 1 (1.8%) and Micrococcus spp. in 1 (1.8%). The results for control group were CNS in 31 (56.4%), Bacillus spp. in 7 (12.7%), S. aureus in 5 (9.1%), and Corynebacterium spp. in 2 (3.6%). Moraxella spp., Streptococcus spp., Candida spp., Haemophilus spp., Acinetobacter spp., Neisseria spp. and Micrococcus spp. microorganisms grew in the conjunctival flora samples of the study group but not in the control group. S. aureus colonization was significantly higher in the study group than the control group (p < 0.05). The S. aureus colonization rate was statistically significantly higher in the study group. Some microorganisms only grew in the conjunctival flora samples of the study group. These findings indicate that the conjunctival flora in persons with chronic alcoholism is different than the normal population.

A Retrospective Analysis of Dental Implants Replacing Failed Implants in Grafted Maxillary Sinus: A Case Series.

PubMed

Manor, Yifat; Chaushu, Gavriel; Lorean, Adi; Mijiritzky, Eithan

2015-01-01

To evaluate the survival rate of dental implants replacing failed implants in grafted maxillary sinuses using the lateral approach vs nongrafted posterior maxillae. A retrospective analysis was conducted to study the survival of secondary dental implants inserted in the posterior maxilla in previously failed implant sites between the years 2000 and 2010. The study group consisted of patients who had also undergone maxillary sinus augmentation, and the control group consisted of patients in whom implants in the posterior maxilla had failed. Clinical and demographic data were analyzed using a structured form. Seventy-five patients with a total of 75 replaced implants were included in the study. The study group comprised 40 patients and the control group, 35 patients. None of the replaced implants in the study group failed, resulting in an overall survival of 100%; three replaced implants in the control group failed (92% survival). The main reason for the primary implant removal was lack of osseointegration (35 [87.5%] of 40 study group implants and 23 [65.7%] of 35 control group implants [P = .027]). The difference between the groups with regard to the timing of primary implant failure was statistically significant. The study group had more early failures of the primary implant than did the control group (77% vs 62%; P = .038). Dental implants replaced in the posterior maxilla had a high survival rate. A higher rate of survival was found in augmented maxillary sinus sites. Within the limits of the present study, it can be concluded that previous implant failures in the grafted maxillary sinus should not discourage practitioners from a second attempt.

[Surgical treatment of pain in chronic pancreatitis].

PubMed

Stefanović, Dejan; Knezević, Srbislav; Djordjević, Zoran; Kerkez, Mirko; Bulajić, Predrag; Marković, Ljiljana

2006-01-01

The principal indication for surgical intervention in chronic pancreatitis is intractable pain. Depending upon the presence of dilated pancreatic ductal system, pancreatic duct drainage procedures and different kinds of pancreatic resections are applied. The objective of the study was to show the most appropriate procedure to gain the most possible benefits in dependence of type of pathohistological process in chronic pancreatitis. Our study included 58 patients with intractable pain caused by chronic pancreatitis of alcoholic genesis. The first group consisted of 30 patients with dilated pancreatic ductal system more than 10 mm. The second group involved 28 patients without dilated pancreatic ductal system. Pain relief, weight gain and glucose tolerance were monitored. All patients of Group I (30) underwent latero-lateral pancreaticojejunal--Puestow operation. 80% of patients had no pain after 6 month, 13.6% had rare pain and 2 patients, i.e. 6.4%, who continued to consume alcohol, had strong pain. Group II consisting of 28 patients was without dilated pancreatic ductal system. This group was subjected to various types of pancreatic resections. Whipple procedure (W) was done in 6 patients, pylorus preserving Whipple (PPW) in 7 cases, and duodenum preserving cephalic pancreatectomy (DPCP) was performed in 15 patients. Generally, 89.2% of patients had no pain 6 month after the operation. An average weight gain was 1.9 kg in W group, 2.8 kg in PPW group and 4.1 kg in DPCP group. Insulin-dependent diabetes was recorded in 66.6% in W group, 57.1% in PPW group and 0% in DPCP group. According to our opinion, DPCP may be considered the procedure of choice for surgical treatment of pain in chronic pancreatitis in patients without dilatation of pancreas ductal system because of no serious postoperative metabolic consequences.

[Perinatal complications in patients with chronic renal insufficiency on hemodialysis].

PubMed

Vázquez-Rodríguez, Juan Gustavo; del Angel-García, Guadalupe

2010-09-01

Pregnant patients with chronic renal insufficiency treated with hemodialysis experience adverse perinatal results. To compare perinatal complications of patients with chronic renal insufficiency undergoing hemodialysis who become pregnant vs. the complications of women with chronic renal insufficiency not undergoing dialysis but who then require dialysis during gestation. Transversal and retrospective study that included three patients with chronic renal insufficiency on chronic hemodialysis who became pregnant (group A) and three patients with chronic renal insufficiency without hemodialysis at the time of conception but who required dialysis during gestation (group B). Perinatal results were compared. Statistical analysis was performed with measures of central tendency and dispersion and Student t-test. Group A had 25 sessions vs. group B with 29 hemodialysis sessions (p = 0.88). Maternal complications were anemia 100% (six cases), Cesarean delivery 83.3% (group A 2 cases vs. group B 2 cases), preeclampsia 50% (group A 2 cases vs. group B 1 case), uncontrolled hypertension 50% (group A 2 cases vs. group B 1 case), preterm delivery 50% (group A 2 cases vs. group B 1 case), transfusion 33.3% (group A 2 cases), polyhydramnios 33.3% (group A 1 case vs. group B 1 case) and abortion 16.6% (group A 1 case). Fetal complications included fetal loss 16.6% (group A 1 case), neonatal mortality 33.3% (group A 1 cases vs. group B 1 case), prematurity 50% (group A2 cases vs. group B 1 case), fetal distress 50% (group A 1 case vs. group B 2 cases), respiratory failure 33.3% (group A 2 cases) and fetal growth restriction 16.6% (group A 1 case). Frequency of perinatal complications is elevated in both groups.

Case Finding of Mild Cognitive Impairment and Dementia and Subsequent Care; Results of a Cluster RCT in Primary Care.

PubMed

van den Dungen, Pim; Moll van Charante, Eric P; van de Ven, Peter M; van Marwijk, Harm W J; van der Horst, Henriëtte E; van Hout, Hein P J

2016-01-01

Despite a call for earlier diagnosis of dementia, the diagnostic yield of case finding and its impact on the mental health of patients and relatives are unclear. This study assessed the effect of a two-component intervention of case finding and subsequent care on these outcomes. In a cluster RCT we assessed whether education of family physicians (FPs; trial stage 1) resulted in more mild cognitive impairment (MCI) and dementia diagnoses among older persons in whom FPs suspected cognitive decline and whether case finding by a practice nurse and the FP (trial stage 2) added to this number of diagnoses. In addition, we assessed mental health effects of case finding and subsequent care (trial stage 2). FPs of 15 primary care practices (PCPs = clusters) judged the cognitive status of all persons ≥ 65 years. The primary outcome, new MCI and dementia diagnoses by FPs after 12 months as indicated on a list, was assessed among all persons in whom FPs suspected cognitive impairment but without a formal diagnosis of dementia. The secondary outcome, mental health of patients and their relatives, was assessed among persons consenting to participate in trial stage 2. Trial stage 1 consisted of either intervention component 1: training FPs to diagnose MCI and dementia, or control: no training. Trial stage 2 consisted of either intervention component 2: case finding of MCI and dementia and care by a trained nurse and the FP, or control: care as usual. Seven PCPs were randomized to the intervention; eight to the control condition. MCI or dementia was diagnosed in 42.3% (138/326) of persons in the intervention, and in 30.5% (98/321) in the control group (estimated difference GEE: 10.8%, OR: 1.51, 95%-CI 0.60-3.76). Among patients and relatives who consented to stage 2 of the trial (n = 145; 25%), there were no differences in mental health between the intervention and control group. We found a non-significant increase in the number of new MCI diagnoses. As we cannot exclude a clinically relevant effect, a larger study is warranted to replicate ours. Nederlands Trial Register NTR3389.

Gestational Trophoblastic Disease - Clinicopathological Study at Tertiary Care Hospital

PubMed Central

Aher, Vidhya; Gadhiya, Suchi; Jagtap, Swati Sunil

2017-01-01

Introduction Gestational Trophoblastic Disease (GTD) is a term used for a group of pregnancy-related tumours. These consist of various tumours and tumour like lesions characterized by proliferation of trophoblastic tissue. Amongst GTD, hydatidiform moles are the most common form. These lesions sometimes may develop into invasive moles, or, in rare cases, into choriocarcinoma. Aim To study the clinicopathologic characteristics and prevalence of different forms of gestational trophoblastic disease in a tertiary care hospital. Materials and Methods The present study was descriptive, observational, analytical type done in Department of Pathology at tertiary care hospital from May 2012 to April 2016. All cases clinically suspected of GTD were included and confirmation was done by histopathological study on H&E stained slides. The cases of GTD were classified according to WHO classification. Detailed histomorphological features and beta human Chorionic Gonadotropin (hCG) levels were correlated. Results During study period, 18345 deliveries were reported; out of which 77 cases were diagnosed as GTD. Almost 97.40% cases were of hydatidiform moles, 1.30% cases of choriocarcinoma and 1.30% cases of Placental Site Trophoblastic Tumour (PSTT). Among the cases of hydatidiform mole 57.34% were complete mole and 41.33% cases were of partial mole. The common clinical presentation was per vaginal bleeding and amenorrhea. The blood group A was most commonly observed in patient (49.35%). In majority of cases beta hCG levels were between 50,000 to 100000 mIU/ml. The correlation between beta hCG level and GTD were done. Conclusion Pregnant females clinically presenting with abnormal vaginal bleeding must be evaluated for GTD. Histopathological examination is helpful for confirmatory diagnosis. Follow up of such patients is essential for early detection of malignant trophoblastic tumours. PMID:28969138

Diabetes mellitus in classical trigeminal neuralgia: A predisposing factor for its development.

PubMed

Xu, Zhenq; Zhang, Ping; Long, Li; He, Huiy; Zhang, Jianch; Sun, Shup

2016-12-01

A higher prevalence of diabetes mellitus in classical trigeminal neuralgia patients was observed in few pilot surveys. The study was aimed to investigate whether diabetes mellitus is a predisposing factor for developing trigeminal neuralgia. Patients with classical trigeminal neuralgia were enrolled in the case study group. The control group consisted of the same number of age- and gender-matched, randomly sampled subjects without trigeminal neuralgia. Characteristics of classical trigeminal neuralgia cases were analyzed. The prevalence of diabetes mellitus in the cases and controls was calculated using the Chi-square test. The onset age ranged from 31 to 93 in 256 patients affected classical trigeminal neuralgia (162 females; 94 males) with a peak age between the fifth and seventh decade; right-side involvement and mandibular branch affliction occurred at a greater frequency. 21.9% patients in the study group was affected by diabetes mellitus compared to 12.9% of controls. The increased prevalence of diabetes mellitus in the trigeminal neuralgia group was statistically significant (P=0.01). Diabetes is a risk factor to the development of classical trigeminal neuralgia, and nerve damage duing to hyperglycemia might be the linkage to the two diseases. More works should be done to consolidate the correlation and to clarify the underlying mechanism for the positive association which would provide new insight into the pathogenesis of trigeminal neuralgia and may open new therapeutic perspectives. Copyright © 2016 Elsevier B.V. All rights reserved.

Characteristics and outcomes of paracetamol poisoning cases at a general hospital in Northern Malaysia.

PubMed

Mohd Zain, Z; Fathelrahman, A I; Ab Rahman, A F

2006-02-01

Paracetamol is available as an over-the-counter medication in many countries including Malaysia. This drug has been implicated in many poisoning cases admitted to hospitals throughout the country. We conducted a three-year retrospective review of 165 medical records of patients admitted to the Penang General Hospital for acute paracetamol poisoning. Cases were identified according to the discharge diagnosis documented in their medical records. Acute paracetamol poisoning occurred in all major ethnic groups. About 70 percent of our patients were female. There was minimal involvement of children. Admissions were more likely to be due to deliberate ingestions rather than accidental poisoning. In most cases, serum concentrations data plotted on the Rumack-Matthew nomogram predicted the majority of cases to be unlikely to be hepatotoxic, which were consistent with their mild clinical courses. Patients who acutely ingested more than 140 mg/kg or predicted to be hepatotoxic, based on their serum concentrations, had a significantly longer hospital stay. Although acute paracetamol poisoning was common, the outcome was generally good.

Application of CD56, P63 and CK19 immunohistochemistry in the diagnosis of papillary carcinoma of the thyroid

PubMed Central

El Demellawy, Dina; Nasr, Ahmed; Alowami, Salem

2008-01-01

Papillary carcinoma of the thyroid (PTC) is the commonest thyroid cancer. In the recent decades an obvious increase in the incidence of PTC has occurred. The pathological diagnosis of PTC is usually an easy diagnosis in the majority of cases. However since the introduction of follicular variant of PTC and the wide threshold range in interpretation of the clearly set pathological criteria for diagnosis of PTC, between pathologists including experts, the diagnosis in some cases became quite difficult. Unfortunately some cases are unjustifiably over-called as follicular variant of PTC as a result of the wide inter observable variability between pathologists, including thyroid pathologists. Ancillary studies such as immmunohistochemistry may be helpful, but till now there is no 100% consistent marker(s), that distinct between PTC and other follicular thyroid lesions and tumors. We assessed expression of antibodies against CD56, CK19, P63 and E-Cadherin in PTC and other follicular thyroid lesions and neoplasms. A total of 175 cases were studied. The neoplastic cases included 75 carcinomas (72 papillary, 2 follicular, 1 Hurthle cell) and 35 adenomas (32 follicular and 3 Hurthle cell). The non-neoplastic thyroids included 65 cases, (25 nodular hyperplasia, 5 thyrotoxic hyperplasia (Grave's disease), 19 lymphocytic thyroiditis and 6 Hashimoto's thyroiditis). All cases were evaluated by immunohistochemistry for the expression of the above mentioned markers. The markers' patterns and intensities of staining were scored. Positive expression of the markers equal or >10% of the follicular epithelium within the tumor or lesional cells was considered positive. An expression of <10% was considered to be negative. Our results showed CD56 positive in all the lesions and tumors except for PTC in all cases (100%). CD56 was negative in all PTC cases (100%). CK 19 showed positive expression in PTC accounting for 85% of cases and in 26% of non PTC lesions/tumors. P63 showed selective focal positivity in PTC cases, in contrast to other non PTC lesions/tumors. P63 expression was in 70% of cases of PTC and was consistently absent in all the non PTC cases. E-Cadherin showed consistent non discriminatory expression in all cases included in the study. We concluded that a panel consisted of CD56, CK19 and P63 is of value in distinction of PTC from other thyroid follicular lesion. P63 is a specific but less sensitive marker for PTC than CK19. CD56 is more specific and sensitive marker than CK19, however it is a negative rather than a positive marker for PTC. E-Cadherin is of no value in the diagnosis of thyroid follicular lesions/tumors. We recommend application of a panel composed of CK19, P63 and CD56 by a group of expert thyroid pathologists on a large series of follicular malignant thyroid neoplasms of uncertain malignant. PMID:18254952

Recognition as a patient-centered medical home: fundamental or incidental?

PubMed

Dohan, Daniel; McCuistion, Mary Honodel; Frosch, Dominick L; Hung, Dorothy Y; Tai-Seale, Ming

2013-01-01

Little is known about reasons why a medical group would seek recognition as a patient-centered medical home (PCMH). We examined the motivations for seeking recognition in one group and assessed why the group allowed recognition to lapse 3 years later. As part of a larger mixed methods case study, we conducted 38 key informant interviews with executives, clinicians, and front-line staff. Interviews were conducted according to a guide that evolved during the project and were audio-recorded and fully transcribed. Transcripts were analyzed and thematically coded. PCMH principles were consistent with the organization's culture and mission, which valued innovation and putting patients first. Motivations for implementing specific PCMH components varied; some components were seen as part of the organization's patient-centered culture, whereas others helped the practice compete in its local market. Informants consistently reported that National Committee for Quality Assurance recognition arose incidentally because of a 1-time incentive from a local group of large employers and because the organization decided to allocate some organizational resources to respond to the complex reporting requirements for about one-half of its clinics. Becoming patient centered and seeking recognition as such ran along separate but parallel tracks within this organization. As the Affordable Care Act continues to focus attention on primary care redesign, this apparent disconnect should be borne in mind.

A two-year follow-up case of chronic fatigue syndrome: substantial improvement in personality following a yoga-based lifestyle intervention.

PubMed

Yadav, Raj Kumar; Sarvottam, Kumar; Magan, Dipti; Yadav, Rashmi

2015-04-01

Chronic Fatigue Syndrome (CFS) is characterized by excessive fatigue after minimal physical or mental exertion, muscle and joint pain, poor concentration, dizziness, and sleep disturbances. We report here the effect of a yoga-based lifestyle intervention in a 30-year old male patient with a documented diagnosis of CFS with compromised quality of life (QoL) and altered personality. The patient initially attended a short-term yoga-based lifestyle intervention program that consisted of yoga-postures, breathing exercises (pranayama), meditation, group discussions, and individualized advice on stress management, diet and physical activity besides group support. Thereafter, patient attended 5 more such programs. There was a notable and consistent improvement in his clinical profile, positive aspects of personality and subjective well-being, and reduction in anxiety following this yoga-based lifestyle intervention. Overall, the results suggest that lifestyle intervention may improve clinical condition and personality in patients with CFS.

Developmental trajectories of bullying and social dominance in youth.

PubMed

Reijntjes, Albert; Vermande, Marjolijn; Goossens, Frits A; Olthof, Tjeert; van de Schoot, Rens; Aleva, Liesbeth; van der Meulen, Matty

2013-04-01

Bullying is increasingly conceptualized as strategic behavior motivated by a desire to gain social dominance in the peer group. Cross-sectional research has shown that relative to their peers bullies are higher in social dominance as indexed by resource control, and are often perceived as powerful and "cool." However, research examining the developmental relationship between bullying and resource control is lacking. The present longitudinal study fills this gap in the literature. Using a three wave design, participants (N=394) were followed from late childhood into early adolescence. Joint trajectory analyses were used to test whether groups with distinct developmental trajectories of bullying and resource control can be identified, and how these trajectories are related. For both bullying and resource control three groups emerged (high, medium, and low), indicating that bullies and social dominants do not constitute one homogeneous group. More intense bullying is associated with higher levels of social dominance. Being consistently high in bullying is almost synonymous with being consistently high in resource control, whereas the reverse is not the case. Findings suggest that high bullying leads to the attainment of high social dominance, and do not support the view that children high in social dominance engage in bullying to maintain their dominant position. This study further underscores the need for interventions targeting mechanisms by which the peer group assigns social dominance to bullies. Copyright © 2012 Elsevier Ltd. All rights reserved.

Sinonasal extramedullary plasmacytoma: a population-based incidence and survival analysis.

PubMed

Patel, Tapan D; Vázquez, Alejandro; Choudhary, Moaz M; Kam, David; Baredes, Soly; Eloy, Jean Anderson

2015-09-01

Sinonasal extramedullary plasmacytoma (SN-EMP) is a rare plasma cell neoplasm. Published literature on this tumor largely consists of case reports and case-series with small sample sizes. This study analyzed population-based data on SN-EMP patients to understand demographic and clinical features as well as incidence and survival trends. The Surveillance, Epidemiology, and End Results (SEER) database was queried for SN-EMP and other head and neck EMP (HN-EMP) cases from 1973 to 2011. Cases were analyzed to determine patient demographics, initial treatment modality, and survival outcomes. Of 778 patients identified with EMP in the head and neck region, 367 patients had SN-EMP and 411 had other HN-EMP. There was a strong male predilection found, with a male-to-female ratio of 3.65:1 in the SN-EMP group and 1.87:1 in the other HN-EMP group. The majority of the patients presented with localized disease in both SN-EMP (84.4%) and other HN-EMP (81.0%) groups. The most common treatment modality reported in this database was surgery with adjuvant radiotherapy in both SN-EMP (46.3%) and other HN-EMP (38.9%) groups, followed by radiotherapy alone (SN-EMP: 40.7%; other HN-EMP: 34.2%). Five-year and 10-year disease-specific survival rates were comparable between SN-EMP (88.2% and 83.3%, respectively) and other HN-EMP (90.0% and 87.4%, respectively) (p = 0.6016 and p = 0.4015, respectively). This study analyzed the largest cohort of SN-EMP patients to date. There was no statistically significant survival advantage found for any 1 particular treatment modality over other treatment modalities in both SN-EMP and other HN-EMP. © 2015 ARS-AAOA, LLC.

[Prevention of neonatal group B streptococcal sepsis in Hungary in 2012. Preliminary data of a nation-wide survey].

PubMed

Sziller, István; Szabó, Miklós; Valek, Andrea; Rigó, Barbara; Ács, Nándor

2014-07-20

At present, there is no obligatory guideline for the prevention of early-onset neonatal group B streptococcal disease in Hungary. The aim of the present study was to gain insight into the spontaneously developed preventive strategy of the domestic obstetric divisions and departments in Hungary. Standardized questionnaire was sent out to each of the 71 obstetric divisions and departments in Hungary. Overall, 20 (27.4%) of the chairpersons replied, and thus, 39.9% of the total number of live births in Hungary were included in the study. Despite missing public health guidelines, each of the divisions and departments developed their own strategy to prevent neonatal group B streptococcal disease. In 95% of cases, bacterial culture of the lower vagina was the method of identifying pregnant women at risk. In 5% of the cases intrapartum antibiotic prophylaxis was based on risk assessment only. Of the departments using culture-based prophylaxis, 58% departments sampled women after completion of 36th gestational weeks. Antibiotic of choice was penicillin or ampicillin in 100% of cases. Of the study participants, 80% reported on multiple administration of colonized pregnant women after onset of labor or rupture of the membranes. The authors concluded that the rate of participation in the study was low. However, prevention of early-onset neonatal group B streptococcal infection is a priority of obstetric care in Hungary. Lack of a nation-wide public health policy did not prevent obstetric institutions in this country to develop their own prevention strategy. In the majority of cases and institutions, the policy is consistent with the widely accepted international standards.

TDP-43 pathology in primary progressive aphasia and frontotemporal dementia with pathologic Alzheimer disease

PubMed Central

Mishra, Manjari; Hatanpaa, Kimmo J.; White, Charles L.; Johnson, Nancy; Rademaker, Alfred; Weitner, Bing Bing; Deng, Han-Xiang; Dubner, Steven D.; Weintraub, Sandra; Mesulam, Marsel

2010-01-01

The clinical syndrome of primary progressive aphasia (PPA) can be associated with a variety of neuropathologic diagnoses at autopsy. Thirty percent of cases have Alzheimer disease (AD) pathology, most often in the usual distribution, which defies principles of brain–behavior organization, in that aphasia is not symptomatic of limbic disease. The present study investigated whether concomitant TDP-43 pathology could resolve the lack of clinicoanatomic concordance. In this paper, 16 cases of clinical PPA and 10 cases of primarily non-aphasic frontotemporal dementia (FTD), all with AD pathology, were investigated to determine whether their atypical clinical phenotypes reflected the presence of additional TDP-43 pathology. A comparison group consisted of 27 cases of pathologic AD with the typical amnestic clinical phenotype of probable AD. Concomitant TDP-43 pathology was discovered in only three of the FTD and PPA but in more than half of the typical amnestic clinical phenotypes. Hippocampal sclerosis (HS) was closely associated with TDP-43 pathology when all groups were combined for analysis. Therefore, the clinical phenotypes of PPA and FTD in cases with pathologic AD are only rarely associated with TDP-43 proteinopathy. Furthermore, medial temporal TDP-43 pathology is more tightly linked to HS than to clinical phenotype. These findings challenge the current notions about clinicopathologic correlation, especially about the role of multiple pathologies. PMID:20361198

Can instruction in engineering ethics change students' feelings about professional responsibility?

PubMed

Hashemian, Golnaz; Loui, Michael C

2010-03-01

How can a course on engineering ethics affect an undergraduate student's feelings of responsibility about moral problems? In this study, three groups of students were interviewed: six students who had completed a specific course on engineering ethics, six who had registered for the course but had not yet started it, and six who had not taken or registered for the course. Students were asked what they would do as the central character, an engineer, in each of two short cases that posed moral problems. For each case, the role of the engineer was successively changed and the student was asked how each change altered his or her decisions about the case. Students who had completed the ethics course considered more options before making a decision, and they responded consistently despite changes in the cases. For both cases, even when they were not directly involved, they were more likely to feel responsible and take corrective action. Students who were less successful in the ethics course gave answers similar to students who had not taken the course. This latter group of students seemed to have weaker feelings of responsibility: they would say that a problem was "not my business." It appears that instruction in ethics can increase awareness of responsibility, knowledge about how to handle a difficult situation, and confidence in taking action.

Rotating shift work and menstrual characteristics in a cohort of Chinese nurses.

PubMed

Wang, Yizi; Gu, Fang; Deng, Mingfen; Guo, Lan; Lu, Ciyong; Zhou, Canquan; Chen, Shouzhen; Xu, Yanwen

2016-05-04

Shift work disrupts the circadian rhythm and may cause menstruation disorders. This study assessed the impact of shift work on menstrual cycle in a population of Chinese nurses. Questionnaires on menstrual characteristics and shift schedules were sent to female nurses of the First Affiliated Hospital of Sun Yat-sen University (FAHSYSU) and Guanghua Hospital of Stomatology (GHHS), affiliated to Sun Yat-sen University. Part I was a cross-sectional study and included 139 nurses in GHHS who had regular 8:00-17:30 working (non-shift group), and 334 nurses from FAHSYSU who worked shifts, a response rate of 67.5 % and 59.6 %, respectively (age ≤ 50 years). Menstrual patterns were compared and age-adjusted relative risks of shift work were analyzed. Part II was a nested case-control study. Cases were nurses in Part I who had regular cycle with mean cycle length (MCL) of 25-31 days and but at least 3 days variation in MCL after starting shift work (n = 45). Controls consisted of 67 nurses with matching shift patterns and age, but no MCL changes. A control non-shift age-matched group consisted of 30 GHHS nurses with no MCL changes. A follow-up second questionnaire was sent 2 years later. In Part I, the shift group had a significantly higher proportion of nurses with menstrual cycle irregularity. The proportion of nurses with a cycle of 25-31 days decreased from 81.7 to 67.8 % after changing to shift work. Logistic regression analysis showed that night shift frequency was the only risk factor associated with cycle shortening. After adjusting for age, MCL was shorter when night work was performed > 7 times per month. In Part II, the mean change in MCL in the case group, including prolongation or shortening, was 4.115 ± 2.084 days after shift working. In the 2 years' follow-up, the MCL of the study group did not recover to the original length. Rotating shift work can increase the prevalence of menstrual cycle irregularity. Night shift frequency was the only risk factor associated with cycle reduced. Changes in MCL did not show recovery over a follow-up period of 2 years.

A note on local BRST cohomology of Yang-Mills type theories with free Abelian factors

NASA Astrophysics Data System (ADS)

Barnich, Glenn; Boulanger, Nicolas

2018-05-01

We extend previous work on antifield dependent local Becchi-Rouet-Stora-Tyutin (BRST) cohomology for matter coupled gauge theories of Yang-Mills type to the case of gauge groups that involve free Abelian factors. More precisely, we first investigate in a model independent way how the dynamics enters the computation of the cohomology for a general class of Lagrangians in general spacetime dimensions. We then discuss explicit solutions in the case of specific models. Our analysis has implications for the structure of characteristic cohomology and for consistent deformations of the classical models, as well as for divergences/counterterms and for gauge anomalies that may appear during perturbative quantization.

Continued follow-up study of 120 persons born after refusal of application for therapeutic abortion.

PubMed

Forssman, H; Thuwe, I

1981-08-01

An investigation material consisting of 120 persons who were born after refusal of an application for therapeutic abortion, with the same number of controls, has previously been followed up by the writers to the age of 21 years. This follow-up study has now been extended to completion of the 35th year. It is found that in social-psychiatric respects the index cases as a group are still somewhat worse situated than the control cases. However, the differences have to a certain extent levelled out and during the later part of the observation period no statistically significant differences can be demonstrated for any single variable.

Renormalization group invariant of lepton Yukawa couplings

NASA Astrophysics Data System (ADS)

Tsuyuki, Takanao

2015-04-01

By using quark Yukawa matrices only, we can construct renormalization invariants that are exact at the one-loop level in the standard model. One of them, Iq, is accidentally consistent with unity, even though quark masses are strongly hierarchical. We calculate a lepton version of the invariant Il for Dirac and Majorana neutrino cases and find that Il can also be close to unity. For the Dirac neutrino and inverted hierarchy case, if the lightest neutrino mass is 3.0 meV to 8.8 meV, an equality Iq=Il can be satisfied. These invariants are not changed even if new particles couple to the standard model particles, as long as those couplings are generation independent.

Optimizing content for pre-exposure prophylaxis (PrEP) counseling for men who have sex with men: Perspectives of PrEP users and high-risk PrEP naïve men.

PubMed

Wade Taylor, S; Mayer, Kenneth H; Elsesser, Steven M; Mimiaga, Matthew J; O'Cleirigh, Conall; Safren, Steven A

2014-05-01

Existing trials of antiretroviral (ARV) medication as chemoprophylaxis against HIV reveal that the degree of protection is primarily dependent on product adherence. However, there is a lack of data on targets for behavioral interventions to improve adherence to ARV as prevention. Information from individuals who have used ARV as pre-exposure prophylaxis (PrEP) can inform behavioral intervention development. Thirty-nine HIV-uninfected MSM at high risk for HIV acquisition participated in one of four semi-structured focus groups. Two of the focus groups consisted of MSM who had been prescribed and used PrEP in the context of a clinical trial; the other two consisted of high-risk MSM who had not previously used PrEP. An in-depth, within-case/across-case content analysis resulted in six descriptive themes potentially salient for a PrEP adherence behavioral intervention: (1) motivations to use PrEP, (2) barriers to PrEP use, (3) facilitators to PrEP use, (4) sexual decision-making in the context of PrEP, (5) prospective PrEP education content, and, (6) perceived effective characteristics of PrEP delivery personnel. Addressing these themes in behavioral interventions in the context of prescribing PrEP may result in the optimal "packaging" public health programs that implement PrEP for high-risk MSM.

Preeclampsia with and without intrauterine growth restriction-Two pathogenetically different entities?

PubMed

Milosevic-Stevanovic, Jelena; Krstic, Miljan; Radovic-Janosevic, Dragana; Stefanovic, Milan; Antic, Vladimir; Djordjevic, Ivana

2016-11-01

The objective of this study is to determine the differences in histopathological features of basal decidua and placenta in cases of preeclampsia with or without fetal intrauterine growth restriction (IUGR). A prospective case-control study included a study group consisting of 30 pregnant women with preeclampsia completed by cesarean section (CS), in 19 of whom preeclampsia was associated with IUGR, and in 11 it was not. The control group consisted of 20 healthy pregnant women delivered by elective CS. Placentas and samples of placental bed obtained during CS were histopathologically (HP) analyzed after hematoxylin-eosin staining and immunohistochemical labeling of Cytokeratin 7 (CK7) trophoblastic cells in decidua. Regarding the HP changes in the spiral arteries in preeclampsia, the most frequent features were inadequate transformation of spiral arteries with poor trophoblastic invasion (70.0%) and fibrinoid necrosis of the media (66.7%), and rarely acute atherosis (33.3%) and thrombosis (30.0%). Villous hypermaturity was more frequently found in placentas of patients with preeclampsia with IUGR (p < 0.05), while there were no differences between subgroups of preeclampsia with and without IUGR regarding some of HP alterations of placental bed. Alterations of the placental bed in terms of decidual vasculopathy are more the characteristics of the preeclampsia itself than IUGR, while changes in placental villi primarily follow the presence of IUGR, which could indicate that preeclampsia with and without IUGR are two pathogenetically different entities.

[Analysis of protective effect of using chickenpox live attenuated vaccine among 4-17 years old children in Minhang district, Shanghai].

PubMed

Du, Yan; Yu, Feng; Zhang, Liping; Wang, Xi; Jin, Baofang; Wang, Ye; Mei, Kewen; Lu, Jia; Jiang, Lufang

2014-12-01

To survey on the vaccination of varicella live attenuated vaccine among 4-17 children in Minhang District, and analyze the protective effect against varicella. We collected outbreak chickenpox cases reported from infectious disease report system and surveillance units in Minhang district from 1st May in 2012 to 30th Apr in 2013. The 1: 3 matched case-control study was conducted to questionnaire the legal guardian of the cases and control group, and calculate the protective effect and effective term of protection. The survey included vaccination, chickenpox exposure history, previous history of varicella illness, suffering from the symptoms of chickenpox, the vaccinations brand, etc. The criteria of accepted case were those healthy students who were in the same class with those chickenpox cases. The accepted matched controlling data were those children who were from the same class with outbreak chickenpox cases without varicelliform eruption, similar live condition, the closest house, the same gender, the closest age. This study investigated 390 cases of patients and the control group included 1 170 cases. Chi-square test was used to compare the vaccination of cases and controls, as well as the incidence of chickenpox vaccination different brands VarV, Mantel-Haenzel chi-square test was applied to compare the protective effect of the two groups. VarV overall vaccination rate was 68.3% (1 065/1 560), among them, the case group coverage was 45.1% (176/390), significantly lower than the control group (76.0% (889/1 170)) (χ² = 128.55, P < 0.01). The coverage in children of 4-10 years old group was 88.4% (375/424), significantly higher than the 11-17 years old group (60.7% (690/1 136)) (χ² = 109.40, P < 0.01). The overall protective effect of VarV was 78.10% (71.82%-82.98%).Vaccinated group incidence ratio was 16.5% (176/1 065), significantly lower than the unvaccinated group (43.2% (214/495)) (χ² = 128.55, P < 0.01). The chickenpox risk of the children who were vaccinated was lower than those who were not, and the OR (95%CI) was 0.22(0.17-0.28) . Proportion of the fever and the typical symptoms of varicella zoster were 26.1% (46/176), 8.0% (14/176) in the children vaccinated VarV, significantly lower than children without VarV vaccination history (54.7% (117/214) , 18.2% (39/214) ) (χ² values were 32.33 and 8.67, respectively. P values both <0.01). The varicella incidence was 17.4% (139/797) in children vaccinated domestic VarV, and it was 13.8% (37/268) in the group of imported VarV (χ² = 1.92, P = 0.184) . The average duration of effective protection period for domestic and imported VarV was (6.2 ± 2.7), (6.3 ± 3.4) years (F = 2.24, P = 0.136). The risk of varicella incidence and the proportion of fever or typical varicella zoster were lower in the one dose of VarV vaccinated; Effective protective effect was consistent in the children with domestic or imported VarV vaccination.

[Modification of pertussis vaccination schedule in Chile, immunization of special groups and control strategies: Commentary from the Consultive Committee of Immunizations of The Chilean Society of Infectious Diseases].

PubMed

Potin, Marcela; Cerda, Jaime; Contreras, Lily; Muñoz, Alma; Ripoll, Erna; Vergara, Rodrigo

2012-06-01

In Chile, an increased number of notifications of cases of whooping cough was detected at the beginning of October 2010, and maintained through 2012. Accumulated cases during 2011 were 2,581 (15.0 per 100,000), which is greater than the number of cases registered during the period 2008-2010 (2,460 cases). On the other hand, the local sanitary authority introduced a modification of pertussis vaccination schedule (starting 2012), which consists in the replacement of the second booster of pertussis vaccine (DTwP, administered to 4-year-old children) as well as diphtheria-tetanus toxoid (dT, administered to second grade scholars) for an acellular pertussis vaccine with reduced antigenic content (dTpa), which will be administrated to first grade scholars. The Consultive Committee of Immunizations considers that the modification is adequate, since it extends the age of protection, reducing at least in theory the infection in older scholars and adolescents -who are significant sources of transmission of Bordetella pertussis to infants- using an adequate vaccine formulation (acellular pertussis vaccine). The available evidence regarding vaccination in special groups (adolescents and adults, health-care workers and pregnant women) and cocooning strategy are commented.

Change and Continuity in Vaping and Smoking by Young People: A Qualitative Case Study of A Friendship Group

PubMed Central

McKeganey, Neil; Barnard, Marina

2018-01-01

This paper reports a qualitative case study of a small friendship group (n = 8) in Glasgow, Scotland. Interviewed twice at six months apart, these 16 to 17 year olds reported a substantial change in their use of and attitudes towards e-cigarettes and tobacco. At time 1, vaping generated much excitement and interest, with six out of eight individuals having their own vape device. At time 2, only two young people still vaped, with the others no longer professing any interest in continued vaping. The two regular smokers, who had been smoking before they first vaped, now only vaped privately and to reduce their tobacco intake. This small case study illustrates plasticity in the use of these devices; just as young people can move into their use, so too can they move away from them. This small study underscores the importance of differentiating between long-term, frequent, consistent use and more episodic, experimental and infrequent use by young people and for undertaking a measurement of actual e-cigarette use at multiple time points in both quantitative and qualitative studies. In addition, the case study illustrates the powerful impact which peers can have on teenagers use of e-cigarettes. PMID:29772812

Change and Continuity in Vaping and Smoking by Young People: A Qualitative Case Study of A Friendship Group.

PubMed

McKeganey, Neil; Barnard, Marina

2018-05-17

This paper reports a qualitative case study of a small friendship group ( n = 8) in Glasgow, Scotland. Interviewed twice at six months apart, these 16 to 17 year olds reported a substantial change in their use of and attitudes towards e-cigarettes and tobacco. At time 1, vaping generated much excitement and interest, with six out of eight individuals having their own vape device. At time 2, only two young people still vaped, with the others no longer professing any interest in continued vaping. The two regular smokers, who had been smoking before they first vaped, now only vaped privately and to reduce their tobacco intake. This small case study illustrates plasticity in the use of these devices; just as young people can move into their use, so too can they move away from them. This small study underscores the importance of differentiating between long-term, frequent, consistent use and more episodic, experimental and infrequent use by young people and for undertaking a measurement of actual e-cigarette use at multiple time points in both quantitative and qualitative studies. In addition, the case study illustrates the powerful impact which peers can have on teenagers use of e-cigarettes.

Case managers and the use of Medicare, Part D.

PubMed

Hensley, Melissa Anne

2011-01-01

The purpose of this study was to examine the experiences and opinions of community-based mental health case managers with the Medicare prescription drug benefit. A qualitative approach, consisting of analysis of data from 3 case manager focus groups, was used to achieve an understanding of the role that case managers played in beneficiaries' access to and use of prescription medicines. Two urban nonprofit community-based mental health agencies. Adults who are disabled by mental illness depend on case managers for information about their prescription drug insurance, help with formulary and plan switching information, and assistance with tasks related to medication adherence in the community. Common themes in the case managers' discussion were managing beneficiary problems, stress for beneficiaries, information and paperwork issues, and cynicism regarding health care reform. The critical role of case managers in the use of Medicare Part D is not well understood or appreciated. Case managers need to be informed about Medicare Part D and ready to advocate for their clients in the community. In addition, it is important for case managers to understand how Medicare Part D affects not only older adults, but also adults living with serious and persistent mental illness.

Computing Galois Groups of Eisenstein Polynomials Over P-adic Fields

NASA Astrophysics Data System (ADS)

Milstead, Jonathan

The most efficient algorithms for computing Galois groups of polynomials over global fields are based on Stauduhar's relative resolvent method. These methods are not directly generalizable to the local field case, since they require a field that contains the global field in which all roots of the polynomial can be approximated. We present splitting field-independent methods for computing the Galois group of an Eisenstein polynomial over a p-adic field. Our approach is to combine information from different disciplines. We primarily, make use of the ramification polygon of the polynomial, which is the Newton polygon of a related polynomial. This allows us to quickly calculate several invariants that serve to reduce the number of possible Galois groups. Algorithms by Greve and Pauli very efficiently return the Galois group of polynomials where the ramification polygon consists of one segment as well as information about the subfields of the stem field. Second, we look at the factorization of linear absolute resolvents to further narrow the pool of possible groups.

Femtosecond Laser in situ Keratomileusis Flap Creation in Narrow Palpebral Fissure Eyes without Suction.

PubMed

Chang, John S M; Law, Antony K P; Ng, Jack C M; Cheng, May S Y

2017-01-01

To evaluate a surgical technique used in eyes with narrow palpebral fissure undergoing femtosecond laser flap creation without suction during laser in situ keratomileusis (LASIK). All data of 2 patient groups were collected through chart review. Group 1 consisted of 6 eyes with narrow palpebral fissure in which the suction ring was manually fixated and femtosecond laser was applied accordingly. Thirty comparison cases were randomly drawn from among eyes that underwent a standard LASIK procedure matched for age and preoperative refraction (group 2). Only 1 eye of each patient was selected to compare the refractive and visual outcomes between groups. In all group 1 eyes, the flaps were created successfully with manual fixation of the suction ring without suction. No eyes lost 2 or more lines of vision. No significant difference was found in the safety and refractive outcomes between groups. Manual fixation of the suction ring in eyes with narrow palpebral fissure without suction was feasible for flap creation during LASIK.

Femtosecond Laser in situ Keratomileusis Flap Creation in Narrow Palpebral Fissure Eyes without Suction

PubMed Central

Chang, John S.M.; Law, Antony K.P.; Ng, Jack C.M.; Cheng, May S.Y.

2017-01-01

Purpose To evaluate a surgical technique used in eyes with narrow palpebral fissure undergoing femtosecond laser flap creation without suction during laser in situ keratomileusis (LASIK). Methods All data of 2 patient groups were collected through chart review. Group 1 consisted of 6 eyes with narrow palpebral fissure in which the suction ring was manually fixated and femtosecond laser was applied accordingly. Thirty comparison cases were randomly drawn from among eyes that underwent a standard LASIK procedure matched for age and preoperative refraction (group 2). Only 1 eye of each patient was selected to compare the refractive and visual outcomes between groups. Results In all group 1 eyes, the flaps were created successfully with manual fixation of the suction ring without suction. No eyes lost 2 or more lines of vision. No significant difference was found in the safety and refractive outcomes between groups. Conclusion Manual fixation of the suction ring in eyes with narrow palpebral fissure without suction was feasible for flap creation during LASIK. PMID:28690535

Mucinous Cystic Neoplasms Lined by Abundant Mucinous Epithelium Frequently Involve KRAS Mutations and Malignant Progression.

PubMed

Shibata, Hideki; Ohike, Nobuyuki; Norose, Tomoko; Isobe, Tomohide; Suzuki, Reika; Imai, Hideyuki; Shiokawa, Akira; Aoki, Takeshi; Murakami, Masahiko; Mizukami, Hiroki; Tanaka, Jun-Ichi; Takimoto, Masafumi

2017-12-01

Pancreatic and hepatic mucinous cyst neoplasms (MCNs) have a malignant potential, but indolent MCNs are not uncommon. The pathological and genetic characteristics of resected MCNs (n=15) categorized by the amount of mucin of the lining epithelium were investigated. MCNs were divided into two groups: (i) a rich (r)-MCN group (n=6), in which more than half of the epithelium was lined by abundant mucinous epithelium; and (ii) a poor (p)-MCN group (n=9), which consisted of the remaining cases. Three patients in the r-MCN group showed invasive carcinoma or high-grade dysplasia, whereas all patients in the p-MCN group showed low-grade dysplasia. Mutations of Kirsten rat sarcoma viral oncogene homolog (KRAS) were more frequent in the r-MCN group (83%) (p-MCN; 11%, p<0.05). Mucinous MCNs more frequently have KRAS mutations and higher risk of malignant progression. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Empathic skills and theory of mind in female adolescents with conduct disorder.

PubMed

Arango Tobón, Olber E; Olivera-La Rosa, Antonio; Restrepo Tamayo, Viviana; Puerta Lopera, Isabel C

2018-01-01

Most studies on conduct disorder (CD) have focused on male adolescents, disregarding analysis of this psychopathology in women. The purpose of this study was to identify differences in empathy and theory of mind (ToM) in a group of adolescent women with CD and a control group. Thirty-six adolescent women were selected from an initial sample of 239 adolescents (CD group = 18, control group = 18). Empathy and ToM were evaluated through objective instruments. Mean comparisons and multivariate analysis were performed to ascertain differences between cases and controls and to propose a prediction model based on clinical status. Significant differences in empathic abilities and ToM were found between the groups. The model that differentiated both groups was composed of eye-reading ability, perspective taking, and personal distress. These findings are consistent with previous studies. Capacity to take the other's perspective and the recognition of emotions in the face are protective factors against CD in women.

[Intraoperative fluid therapy during esophagectomy followed by repair].

PubMed

Sizov, V A; Raevskaya, M B; Kovalerova, N B; Ruchkin, D V; Subbotin, V V; Kazennov, V V; Ilyin, S A

To optimize fluid therapy in transhiatal eshophagectomy by using of goal-oriented infusion therapy based on stroke volume variation. Our trial enrolled 30 patients who underwent transhiatal esophagectomy followed by repair for the period 2011-2014. Patients were divided into 2 groups. The first group (LT) included 16 patients with liberal fluid therapy. The second group (GDT) consisted of 14 patients in whom goal-oriented fluid therapy was performed. Goal-oriented fluid therapy was implemented via stroke volume variation (SVV). Infusion rate was 6.7 ml/kg/h and 11.5 ml/kg/h in the main and control groups, respectively. Morbidity rate was 28.6% (n=4) and 62.5% (n=10) in the main and control groups respectively. Clavien-Dindo IV complications were lung atelectasis (n=2, 14%), pneumonia (n=1, 7%). Hydrothorax required puncture was noted in 1 (7%) case. Acute respiratory failure as complication IVa was in 1 (9%) patient. In the control group complications were registered in 10 (62.5%) patients. Complications I-II degree included lung atelectasis (n=4, 25%), cervical anastomosis failure (n=1, 6%); complications IVa were observed in 8 cases (50%). It was significant respiratory failure with reduced PO2/FiO2<300. Patients of the main group required less time for postoperative mechanical ventilation (120 [90-300] vs. 315 [215-810] min (p=0.02) and ICU-stay (0.83 [0.7-0.8] vs. 1.75 [1.25-2.75] (p=0.0022).

The effect of group bibliotherapy on the self-esteem of female students living in dormitory

PubMed Central

Salimi, Sepideh; Zare-Farashbandi, Firoozeh; Papi, Ahmad; Samouei, Rahele; Hassanzadeh, Akbar

2014-01-01

Introduction: Bibliotherapy is a supplement, simple, inexpensive and readily available method to treat the diseases that is performed with cooperation of librarians and psychologists or doctors. The aim of this study is the investigation of group bibliotherapy's effect on the self-esteem of the female students of Isfahan University of Medical Sciences Living in Dormitory in 2012. Materials and Methods: The present study is an interventional semi-experimental study with pre test and post test and control group. The statistical population of study consisted of 32 female students who reside in Isfahan University of Medical Sciences dormitories which control and case groups and the students were divided randomly between these two groups. Data was collected by Cooper Smith Self-esteem questionnaire scale (Cronbach's alpha: 0.85). Two groups were examined by the questionnaire in pre test. Case group received group bibliotherapy for 2 month (8 sessions of 2 hours), while the control group received no training at all. Then, 2 groups were assessed in post test after 1 month. Descriptive statistics (means and frequencies distribution) and inferential statistics (independent t- test, paired t- test and mann whitney) were used and data was analyzed by SPSS20 software. Results: The findings showed that group bibliotherapy had positive and significant effect on general, family, professional and total self esteem of female students living in dormitories, but it had no effect on their social self esteem. Conclusion: Group bibliotherapy can increase female students’ self-esteem levels. On the other hand, conducting these studies not only can improve mental health of people, but can also improve their reading habits. PMID:25250355

Three-dimensional cell groups with disordered nuclei and cellular discohesion (3DDD) are associated with high sensitivity and specificity for cystoscopic urine cytopathological diagnosis of low-grade urothelial neoplasia.

PubMed

Mai, Kien T; Ball, Christopher G; Kos, Zuzana; Belanger, Eric C; Islam, Shahidul; Sekhon, Harman

2014-07-01

Cystoscopic urine obtained before the resection of low-grade urothelial carcinoma (LGUC), with adequate cytological sampling of the tumor, frequently revealed the presence of three-dimensional cell groups with disordered nuclei and cellular discohesion (3DDD). 936 cystoscopic urine specimens were categorized into five groups: Group 1 (80 specimens) with biopsy-proven LGUC within 6 months of cytologic examination, Group 2 (23 specimens) with biopsy proven LGUC within 6 to 36 months of cytologic examination, Group 3 (527 specimens) with a history of LGUC but no tumor for a period of greater than 3 years, Group 4 (300 specimens) with no association with LGUC, and Group 5 (6 specimens) with urinary lithiasis. Specimens with scant cellularity accounted for 20% of those in Group 1. For 3DDD in detecting LGUC in adequate cystoscopic urine, the sensitivity was 70%, specificity was 94%. Two- or three-dimensional cell groups with ordered nuclei and/or cellular non-discohesion were often seen in specimens from Groups 4 or 5. The 3DDD was present in a significant number of cases with concurrent negative cystoscopic findings but also positive LGUC in ensuing follow-up. In these cases, 3DDD with or without tumor identified at concurrent cystoscopy were found to be morphologically similar. Furthermore, the presence of 3DDD in 8% of Group 3 likely represents urothelial dysplasia that is not cystoscopically detectable. The high specificity and sensitivity of 3DDD is demonstrated. These findings are consistent with the decreased cell adhesion and disordered nuclear arrangement of low grade urothelial neoplasia. © 2013 Wiley Periodicals, Inc.

Pathology of ochratoxin A-induced nephrotoxicity in Japanese quail and its protection by sea buckthorn (Hippophae rhamnoides L.).

PubMed

Patial, V; Asrani, R K; Patil, R D; Ledoux, D R; Rottinghaus, G E

2013-12-01

The present study was designed to study the protective effect of sea buckthorn (SBT) against renal damage induced by ochratoxin A (OTA) in Japanese quail. Day-old quail chicks were divided into six groups and fed a basal quail chick mash containing 2% SBT leaf powder (group SX), OTA at a dietary level of 3 ppm (group OX), 25 ppm L-beta-phenylalanine (Phe) plus 3 ppm OTA (group OP), 2% dietary level of SBT leaf powder plus 3 ppm OTA (group OS), SBT leaf extract at a level of 10%/L of drinking water plus 3 ppm OTA (group OSS), and a standard toxin-free feed (group CX, control) for 21 days. OTA at 3 ppm level in diet grossly revealed mild to moderate renal swelling in OX birds, and the severity was less in the case of OS, OSS, and OP birds. Microscopically, degenerative, necrotic, and inflammatory changes were observed in OX birds, but the changes were less severe in OS, OSS, and OP birds. Ultrastructural studies revealed remarkable and consistent changes in the proximal convoluted tubules (PCTs), with severe damage of mitochondria and endoplasmic reticulum in OX birds, whereas SBT-treated birds (groups OS, OSS) had mild changes in mitochondria. A moderate to marked increase in number of peroxisomes in the cytoplasm of PCTs was a consistent finding in the Phe- and SBT-treated groups kept on OTA in comparison to the group fed OTA alone. In conclusion, the inclusion of 2% SBT leaf powder in feed and SBT leaf extract in water provided partial protection against OTA-induced nephropathy in Japanese quail.

Predictors for delayed encephalopathy following acute carbon monoxide poisoning.

PubMed

Kudo, Kaoru; Otsuka, Kotaro; Yagi, Junko; Sanjo, Katsumi; Koizumi, Noritaka; Koeda, Atsuhiko; Umetsu, Miki Yokota; Yoshioka, Yasuhito; Mizugai, Ayumi; Mita, Toshinari; Shiga, Yu; Koizumi, Fumito; Nakamura, Hikaru; Sakai, Akio

2014-01-31

In Japan, many carbon monoxide (CO) poisoning cases are transported to emergency settings, making treatment and prognostic assessment an urgent task. However, there is currently no reliable means to predict whether "delayed neuropsychiatric sequelae (DNS)" will develop after acute CO poisoning. This study is intended to find out risk factors for the development of DNS and to characterize the clinical course following the development of DNS in acute CO poisoning cases. This is a retrospective cohort study of 79 consecutive patients treated at a single institution for CO poisoning. This study included 79 cases of acute CO poisoning admitted to our emergency department after attempted suicide, who were divided into two groups consisting of 13 cases who developed DNS and 66 cases who did not. The two groups were compared and analyzed in terms of clinical symptoms, laboratory findings, etc. Predictors for the development of DNS following acute CO poisoning included: serious consciousness disturbance at emergency admission; head CT findings indicating hypoxic encephalopathy; hematology findings including high creatine kinase, creatine kinase-MB and lactate dehydrogenase levels; and low Global Assessment Scale scores. The clinical course of the DNS-developing cases was characterized by prolonged hospital stay and a larger number of hyperbaric oxygen (HBO) therapy sessions. In patients with the characteristics identified in this study, administration of HBO therapy should be proactively considered after informing their family, at initial stage, of the risk of developing DNS, and at least 5 weeks' follow-up to watch for the development of DNS is considered necessary.

Identification of a current hot spot of HIV type 1 transmission in Mongolia by molecular epidemiological analysis.

PubMed

Davaalkham, Jagdagsuren; Unenchimeg, Puntsag; Baigalmaa, Chultem; Erdenetuya, Gombo; Nyamkhuu, Dulmaa; Shiino, Teiichiro; Tsuchiya, Kiyoto; Hayashida, Tsunefusa; Gatanaga, Hiroyuki; Oka, Shinichi

2011-10-01

We investigated the current molecular epidemiological status of HIV-1 in Mongolia, a country with very low incidence of HIV-1 though with rapid expansion in recent years. HIV-1 pol (1065 nt) and env (447 nt) genes were sequenced to construct phylogenetic trees. The evolutionary rates, molecular clock phylogenies, and other evolutionary parameters were estimated from heterochronous genomic sequences of HIV-1 subtype B by the Bayesian Markov chain Monte Carlo method. We obtained 41 sera from 56 reported HIV-1-positive cases as of May 2009. The main route of infection was men who have sex with men (MSM). Dominant subtypes were subtype B in 32 cases (78%) followed by subtype CRF02_AG (9.8%). The phylogenetic analysis of the pol gene identified two clusters in subtype B sequences. Cluster 1 consisted of 21 cases including MSM and other routes of infection, and cluster 2 consisted of eight MSM cases. The tree analyses demonstrated very short branch lengths in cluster 1, suggesting a surprisingly active expansion of HIV-1 transmission during a short period with the same ancestor virus. Evolutionary analysis indicated that the outbreak started around the early 2000s. This study identified a current hot spot of HIV-1 transmission and potential seed of the epidemic in Mongolia. Comprehensive preventive measures targeting this group are urgently needed.

Red cell glucose-6-phosphate dehydrogenase phenotypes in Iraq.

PubMed

Hilmi, F A; Al-Allawi, N A; Rassam, M; Al-Shamma, G; Al-Hashimi, A

2002-01-01

We attempted to characterize biochemically glucose-6-phosphate dehydrogenase (G6PD) variants in Iraqi individuals. Thus 758 healthy Iraqi males aged 18-60 years were randomly selected and 46 (6.1%) were G6PD deficient. Although the predominant non-deficient G6PD phenotype was G6PD B (92.6%), G6PD A+ was found in polymorphic frequency (1.3%). In the deficient group, 31 cases were fully characterized, including 17 cases with features consistent with G6PD Mediterranean variant, while 12 had other biochemical features and were labelled as non-Mediterranean variant. The remaining two deficient cases were characterized as G6PD A- variant. The presence of a significant number of non-Mediterranean variant was unexpected and may be related to the more heterogeneous background of the Iraqi people.

[Analysis of interappointment flare-ups after root canal preparation with Mtwo NiTi rotary system].

PubMed

Han, Jun-li; He, Hong; Zhu, Ya-qin

2011-08-01

To study the interappointment flare-ups after root canal preparation with Mtwo NiTi rotary system and explore the influence factors. Ninty-seven pulp cases caused by caries or invisible cracks which consisted of 37 males and 60 females,16 to 62 years old were selected and divided into 2 groups randomly. One group was treated with Mtwo NiTi rotary system while the other was treated with K file, the interappointment flare-ups after root canal preparation was compared between the 2 groups. The data were subjected to Mann-Whitney U test and X(2) test with SPSS13.0 software package. Less flare-ups occurred in the group of root canal preparation with NiTi rotary system, the difference was statistically significant (P=0.027). Root canal preparation with Mtwo NiTi rotary system could decrease the flare-ups after root canal therapy.

The relationship between functional ovarian cysts and vitamin A, vitamin E, and folate intake.

PubMed

Tafazoli, Mahin; Fazeli, Elham; Nematy, Mohsen; Bahri, Narjes; Dadgar, Salmeh

2017-02-01

This study aimed to clarify the relationship between functional ovarian cysts and vitamin A, vitamin E, and folate intake. This case-control study evaluated 265 women of reproductive age who presented at gynaecology clinics of three hospitals in Mashhad, Iran. While women in the ovarian cyst group [n = 132] had functional ovarian cysts, control group [n = 133] consisted of women without functional ovarian cysts. The participants' vitamin A, vitamin E, and folate intake was assessed using the Food Frequency Questionnaire. Results showed that folate intake was significantly higher in the ovarian cyst group [p = .040]. No significant differences in vitamin A and vitamin E intake were observed between the two groups [p = .950 and .230, respectively]. It is concluded that women with functional ovarian cysts had significantly higher folate intake. Vitamin A and vitamin E intake had no significant effects on the incidence of these cysts.

Cluster randomised controlled trial to examine medical mask use as source control for people with respiratory illness.

PubMed

MacIntyre, Chandini Raina; Zhang, Yi; Chughtai, Abrar Ahmad; Seale, Holly; Zhang, Daitao; Chu, Yanhui; Zhang, Haiyan; Rahman, Bayzidur; Wang, Quanyi

2016-12-30

Medical masks are commonly used by sick individuals with influenza-like illness (ILI) to prevent spread of infections to others, but clinical efficacy data are absent. Determine whether medical mask use by sick individuals with ILI protects well contacts from related respiratory infections. 6 major hospitals in 2 districts of Beijing, China. Cluster randomised controlled trial. 245 index cases with ILI. Index cases with ILI were randomly allocated to medical mask (n=123) and control arms (n=122). Since 43 index cases in the control arm also used a mask during the study period, an as-treated post hoc analysis was performed by comparing outcomes among household members of index cases who used a mask (mask group) with household members of index cases who did not use a mask (no-mask group). Primary outcomes measured in household members were clinical respiratory illness, ILI and laboratory-confirmed viral respiratory infection. In an intention-to-treat analysis, rates of clinical respiratory illness (relative risk (RR) 0.61, 95% CI 0.18 to 2.13), ILI (RR 0.32, 95% CI 0.03 to 3.13) and laboratory-confirmed viral infections (RR 0.97, 95% CI 0.06 to 15.54) were consistently lower in the mask arm compared with control, although not statistically significant. A post hoc comparison between the mask versus no-mask groups showed a protective effect against clinical respiratory illness, but not against ILI and laboratory-confirmed viral respiratory infections. The study indicates a potential benefit of medical masks for source control, but is limited by small sample size and low secondary attack rates. Larger trials are needed to confirm efficacy of medical masks as source control. ACTRN12613000852752; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Associations between tongue movement pattern consistency and formant movement pattern consistency in response to speech behavioral modificationsa)

PubMed Central

Mefferd, Antje S.

2016-01-01

The degree of speech movement pattern consistency can provide information about speech motor control. Although tongue motor control is particularly important because of the tongue's primary contribution to the speech acoustic signal, capturing tongue movements during speech remains difficult and costly. This study sought to determine if formant movements could be used to estimate tongue movement pattern consistency indirectly. Two age groups (seven young adults and seven older adults) and six speech conditions (typical, slow, loud, clear, fast, bite block speech) were selected to elicit an age- and task-dependent performance range in tongue movement pattern consistency. Kinematic and acoustic spatiotemporal indexes (STI) were calculated based on sentence-length tongue movement and formant movement signals, respectively. Kinematic and acoustic STI values showed strong associations across talkers and moderate to strong associations for each talker across speech tasks; although, in cases where task-related tongue motor performance changes were relatively small, the acoustic STI values were poorly associated with kinematic STI values. These findings suggest that, depending on the sensitivity needs, formant movement pattern consistency could be used in lieu of direct kinematic analysis to indirectly examine speech motor control. PMID:27908069

Introduction of high risk pregnancy care in rural Cameroon: health service research approach.

PubMed

Leke, R J; Nasah, B T; Mtango, F D

1988-05-01

A 3-year study (1982-1985) in Cameroon showed that high-risk pregnancy identification and care could successfully be introduced in rural communities through inexpensive training and supervision of local nurses, particularly when motivation for use of antenatal clinics (ANCs) was provided by the local Community Women's Organization (CWO). 11 communities, all rural except Tsinga, were randomly allocated to Groups I (control) or II. A retrospective baseline survey of ANCs showed that high-risk pregnancy detection had been nonexistent. For both groups, nurses were given 2-week training courses on high-risk identification and family planning. The registers for recording prenatal consultations and deliveries were modified to include recording of risk factors. Special forms were created for reporting on each high-risk case thus identified. These forms proved more difficult for the nurses to complete than the registers. For Group II communities, CWO leaders were recruited to urge women to attend ANCs. 2548 cases of high-risk pregnancy (21.9% of pregnancies) were identified on the special forms, although the number of cases identified in clinic registers was consistently higher. Posttest attendance at ANCs was higher than pretest and significantly higher in areas where CWO motivation had been used. Major risk factors in the identified cases were grand multiparity, teenage pregnancy and previous complicated obstetrics history, although semiurban Tsinga had less grand multiparity and teenage pregnancy and more obesity, diabetes, hypertension and preclampsia. Only 23.4% of the identified cases delivered in the clinics, showing the need for more comprehensive maternal service programs. Since only 5% of the high-risk pregnancy population accepted modern contraceptives after delivery, research is needed on the determinants.

Validation of a noninvasive test routinely used in otology for the diagnosis of cerebrospinal fluid shunt malfunction in patients with normal pressure hydrocephalus.

PubMed

Sakka, Laurent; Chomicki, Alexandre; Gabrillargues, Jean; Khalil, Toufic; Chazal, Jean; Avan, Paul

2016-02-01

Ventriculoperitoneal shunting is the first-line treatment for normal pressure hydrocephalus. Noninvasive auditory tests based on recorded otoacoustic emissions were assessed, as currently used for universal neonatal hearing screenings, for the diagnosis of cerebrospinal fluid shunt malfunction. The test was designed based on previous works, which demonstrated that an intracranial pressure change induces a proportional, characteristic, otoacoustic-emission phase shift. Forty-four patients with normal pressure hydrocephalus (23 idiopathic and 21 secondary cases) were included in this prospective observational study. The male:female sex ratio was 1.44, the age range was 21-87 years (mean age 64.3 years), and the range of the follow-up period was 1-3 years (mean 20 months). Patients were implanted with a Sophy SU8 adjustable-pressure valve as the ventriculoperitoneal shunt. The phase shifts of otoacoustic emissions in response to body tilt were measured preoperatively, immediately postoperatively, and at 3-6 months, 7-15 months, 16-24 months, and more than 24 months postoperatively. Three groups were enrolled: Group 1, 19 patients who required no valve opening-pressure adjustment; Group 2, 18 patients who required valve opening-pressure adjustments; and Group 3, 7 patients who required valve replacement. In Group 1, phase shift, which was positive before surgery, became steadily negative after surgery and during the follow-up. In Group 2, phase shift, which was positive before surgery, became negative immediately after surgery and increasingly negative after a decrease in the valve-opening pressure. In Group 3, phase shift was positive in 6 cases and slightly negative in 1 case before revision, but after revision phase shift became significantly negative in all cases. Otoacoustic emissions noninvasively reflect cerebrospinal fluid shunt function and are impacted by valve-opening pressure adjustments. Otoacoustic emissions consistently diagnosed shunt malfunction and predicted the need for surgical revision. The authors' diagnostic test, which can be repeated without risk or discomfort by an unskilled operator, may address the crucial need of detecting valve dysfunction in patients with poor clinical outcome after shunt surgery.

[Can venous iron and tranexamic acid reduce the transfusion need? Report on a non randomized, case control study].

PubMed

Essola, L; Kouégnigan Rérambiah, L; Obame, R; Issembè, H; Sima Zué, A

2017-06-01

To evaluate if the association of injectable iron and tranexamic acid allows a significant saving in transfusion, in cases of myomectomies and hysterectomies. This is a prospective, non randomized study done over 8 months (from January 2013 to August 2013). Were included, patients undergoing hysterectomy or myomectomy who had a hemoglobin level greater than or equal to 8g/dl and less than 12g/dl. Two groups were compared: group A consisting of patients for whom a pack red cells was ordered and the group B which patients received intravenous iron preoperatively and tranexamic acid perioperatively. The level of hemoglobin, pre- and postoperative, the average number of blood units per patient and estimated blood loss was compared. The transfusion economy was evaluated. During this period, 87 patients with a mean age of 40±9 years (range: 23 and 70years) were included according to our criteria: 44 patients in group A and 43 patients in group B. Initial mean hemoglobin in both groups was 9.1±0.7g/dl. In group B, after iron administration, the mean hemoglobin was 11.3±0.7g/dl. The average number of red blood cells received intraoperative patient in group A was 1.54±0.51. The estimated blood loss was significant greater (P=0.0002) in group A (571.6±237.1ml) than in group B (213.7±131.7ml). No transfusion was performed in group B. The association intravenous iron and tranexamic acid resulted in the reduction of transfusion requirements in our setting. It could be integrated in the strategy for sparing blood transfusion in scheduled surgery with hemorrhagic risks. Copyright © 2017. Published by Elsevier SAS.

[GP medication prioritisation in older patients with multiple comorbidities recently discharged from hospital: a case-based bottom-up approach].

PubMed

Herrmann, M L H; von Waldegg, G H; Kip, M; Lehmann, B; Andrusch, S; Straub, H; Robra, B-P

2015-01-01

After the hospital discharge of older patients with multiple morbidities, GPs are often faced with the task of prioritising the patients' drug regimens so as to reduce the risk of overmedication. How do GPs prioritise such medications in multimorbid elderly patients at the transition between inpatient and home care? The experience by the GPs is documented in typical case vignettes. 44 GPs in Sachsen-Anhalt were recruited--they were engaged in focus group discussions and interviewed using semi-standardised questionnaires. Typical case vignettes were developed, relevant to the everyday care that elderly patients would typically receive from their GPs with respect to their drug optimisation. According to the results of the focus groups, the following issues affect GPs' decisions: drug and patient safety, their own competence in the health system, patient health literacy, evidence base, communication between secondary and primary care (and their respective influences on each other). When considering individual cases, patient safety, patient wishes, and quality of life were central. This is demonstrated by the drug dispositions of one exemplary case vignette. GPs do prioritise drug regimens with rational criteria. Initial problem delineation, process documentation and the design of a transferable product are interlinking steps in the development of case vignettes. Care issues of drug therapy in elderly patients with multiple morbidities should be investigated further with larger representative samples in order to clarify whether the criteria used here are applied contextually or consistently. Embedding case vignettes into further education concepts is also likely to be useful. © Georg Thieme Verlag KG Stuttgart · New York.

Analysis of Parasitic Diseases Diagnosed by Tissue Biopsy Specimens at KyungHee Medical Center (1984-2005) in Seoul, Korea

PubMed Central

Chu, Jong-Phil; Jiang, Meihua; Lee, Yun-Sik; Kim, Bum-Shik; Kim, Deog-Gon; Park, Yong-Koo

2010-01-01

We analyzed parasitic diseases diagnosed by tissue biopsy specimens at KyungHee Medical Center (KMC) from 1984 to 2005. The total number of parasite infection cases was 150 (0.07%) out of the total 211,859 biopsy specimens submitted for histopathological examinations. They consisted of 62 cysticercosis, 23 sparganosis, 16 paragonimiasis, 15 amebiasis, 11 anisakiasis, 11 clonorchiasis, 3 ascariasis, 2 scabies, 2 enterobiasis, 2 trichuriasis, 1 leishmaniasis, 1 taeniasis, and 1 thelaziasis. Out of 62 cysticercosis cases, 55 were detected in subcutaneous tissues or the central nerve system. Eighteen out of 23 sparganosis cases were involved in muscular and subcutaneous tissues. In most anisakiasis cases, the involved organ was the stomach. The lung and the pleura were the most common site of paragonimiasis. The incidence of parasitic diseases during the first 5 years (1984-1988) was the highest of all observed periods. After 1989, similar incidences were shown throughout the period. Whereas cysticercosis was diagnosed in 34 cases during 1984-1988, no case has been diagnosed since 2000. In the case of sparganosis, the chronological incidence was almost uniform throughout the period 1984-2005. Paragonimiasis showed a similar tendency to cysticercosis. In gender and age distribution of parasitic diseases, men showed higher incidence rates than females, and the age groups of the 40s or older indicated higher infection frequencies than other age groups. Therefore, these results are a significant report to appear the tendency of human parasitic disease diagnosed by tissue biopsy in association with parasitosis at KMC in Seoul. PMID:20333293

[Lung and heart-lung transplantation in respiratory tract diseases. Evaluation and development of the indications based on our first 15 cases].

PubMed

Couraud, L; Baudet, E; Martigne, C; Roques, X; Velly, J F; Laborde, N; Clerc, P

1989-01-01

Since January 1988, the Bordeaux group has performed 15 transplantations for lung disease: 9 heart-lung transplants, 1 heart + left lung, 1 double lung, 2 right lungs and 2 left lungs. The transplantations were performed for pulmonary emphysema (10 cases), pulmonary artery hypertension (2 cases), cystic fibrosis (1 case), pulmonary fibrosis (2 cases). Cardiopulmonary transplantation was not always performed because of associated heart failure but sometimes because of large intrahilar adenopathy or intractable bronchial infection. Pulmonary transplantation is recommended on the right side in cases of pulmonary fibrosis. One patient died postoperatively (ischaemia of the transplant). Four others died during the 2nd and 3rd months from poorly defined but probably infectious pulmonary syndromes. The tracheobronchial patency of the 10 survivors was 80% or 100% of the predicted value. The respiratory functional result was excellent in the short and intermediate term. Specific difficulties essentially consisted of pleural symphyses, hilar adenopathy, bronchial infection, steroid dependence of certain subjects, the difficulty of identifying the cause and treating lung opacities during the 2nd and 3rd months.

Guidelines for the public health management of typhoid and paratyphoid in England: practice guidelines from the National Typhoid and Paratyphoid Reference Group.

PubMed

Balasegaram, S; Potter, A L; Grynszpan, D; Barlow, S; Behrens, R H; Lighton, L; Booth, L; Inamdar, L; Neal, K; Nye, K; Lawrence, J; Jones, J; Gray, I; Tolley, D; Lane, C; Adak, B; Cummins, A; Addiman, S

2012-09-01

The Typhoid and Paratyphoid Reference Group (TPRG) was convened by the Health Protection Agency (HPA) and the Chartered Institute of Environmental Health (CIEH) to revise guidelines for public health management of enteric fever. This paper presents the new guidelines for England and their rationale. Methods include literature reviews including grey literature such as audit data and case studies; analysis of enhanced surveillance data from England, Wales and Northern Ireland; review of clearance and screening schedules in use in other non-endemic areas; and expert consensus. The evidence and principles underpinning the new guidance are summarised. Significant changes from previous guidance include: • Algorithms to guide risk assessment and management, based on risk group and travel history; • Outline of investigation of non-travel cases; • Simplified microbiological clearance schedules for cases and contacts; • Targeted co-traveller screening and a "warn and inform" approach for contacts; • Management of convalescent and chronic carriers. The guidelines were launched in February 2012. Feedback has been positive: the guidelines are reported to be clear, systematic, practical and risk-based. An evaluation of the guidelines is outlined and will add to the evidence base. There is potential for simplification and consistency between international guidelines. Copyright © 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

[Clinical diagnosis and drug therapy of elderly patients with schizophrenia : A restrospective analysis of data in a department of old age psychiatry].

PubMed

Jagsch, Christian; Dietmaier, Gabriele; Jagsch, Maximilian; Kurz, Martin

2016-06-01

The objective of this study was to survey the consistency of the clinical diagnostics and the psychopharmacological treatment of schizophrenia and delusional disorders suffered by older persons. A further aspect was to record significant clinical differences and also similarities between the patient groups in care, matching with the criteria of ICD 10 for schizophrenia (F20), persistent delusional disorders (F22) and schizoaffective disorder (F25). Retrospective analysis with reference to the manually and electronically recorded patient medical records of an acute case care ward for geriatric psychiatry and psychotherapy. During the assessment period 210 patients over the age of 65 years were included consecutively in the study (F20 - 64 patients, F22 - 78 patients, F25 - 64 patients, 4 patients died). Ignoring the fact that many of the patients were admitted without a diagnosis, the diagnostic classification of the referring doctor, above all those made by general practitioners, proved to be very consistent for the groups F20 and F25. In the group F22 diagnoses, however, up to almost one half of the referred patients were incorrectly admitted with an F20 diagnosis. The patients included in group F22 formed a heterogeneous group, or a melting pot for various sub-groups, with the common shared characteristic of being comprised of persons suffering from a delusional disorder. These differed from the other two groups in the following attributes: the patients were either older or very old persons, they were mostly receiving inpatient treatment for the first time and subsequently had fewer re-admissions. They also suffered more frequently from both psychiatric and somatic comorbidities; furthermore they included elderly people who had suffered from learning deficiencies or borderline intellectual deficiencies throughout their earlier lives. The patients in groups F20 and F25 differed primarily only in terms of their psychiatric medication, with significantly more mood stabilizer prescribed in the F25 group. Patients in all three groups frequently received tranquilisers during the day and sedatives in the evening, atypical antipsychotics were prescribed in the great majority of cases. The referral diagnoses of patients suffering from many years of schizophrenic type illnesses were largely in compliance with the diagnostic criteria, a much more difficult issue for the referring doctors was the allocation of patients with a first occurrence of delusional symptoms. Those patients who were allocated to the diagnostic group schizophrenia differed significantly from patients from the group with delusional disorders.

Efficacy of Intracameral Moxifloxacin Endophthalmitis Prophylaxis at Aravind Eye Hospital.

PubMed

Haripriya, Aravind; Chang, David F; Namburar, Sathvik; Smita, Anand; Ravindran, Ravilla D

2016-02-01

To compare the rate of postoperative endophthalmitis before and after initiation of intracameral (IC) moxifloxacin for endophthalmitis prophylaxis in patients undergoing cataract surgery. Retrospective, clinical registry. All charity and private patients (116 714 eyes) who underwent cataract surgery between February 15, 2014, and April 15, 2015, at the Madurai Aravind Eye Hospital were included. Group 1 consisted of 37 777 eyes of charity patients who did not receive IC moxifloxacin, group 2 consisted of 38 160 eyes of charity patients who received IC moxifloxacin prophylaxis, and group 3 consisted of 40 777 eyes of private patients who did not receive IC moxifloxacin. The electronic health record data for each of the 3 groups were analyzed, and the postoperative endophthalmitis rates were statistically compared. The cost of endophthalmitis treatment (groups 1 and 2) and the cost of IC moxifloxacin prophylaxis (group 2) were calculated. Postoperative endophthalmitis rate before and after initiation of IC moxifloxacin endophthalmitis treatment cost. Manual, sutureless, small incision cataract surgery (M-SICS) accounted for approximately all of the 75 937 cataract surgeries in the charity population (97%), but only a minority of the 40 777 private surgeries (21% M-SICS; 79% phacoemulsification). Thirty eyes in group 1 (0.08%) and 6 eyes in group 2 (0.02%) were diagnosed with postoperative endophthalmitis (P < 0.0001). The group 3 endophthalmitis rate was 0.07% (29 eyes), which was also higher than the second group's rate (P < 0.0001). There were no adverse events attributed to IC moxifloxacin in group 2. The total cost of treating the 30 patients with endophthalmitis in group 1 was virtually identical to the total combined cost in group 2 of routine IC moxifloxacin prophylaxis and treatment of the 6 endophthalmitis cases. Routine IC moxifloxacin prophylaxis achieved a highly significant, 4-fold reduction in postoperative endophthalmitis in patients undergoing M-SICS. Compared with previous studies, having such a high volume of patients undergoing surgery during a relatively short 14-month time period strengthens the conclusion. This study provides further evidence that moxifloxacin is an effective IC prophylactic antibiotic and suggests that IC antibiotics should be considered for M-SICS and phacoemulsification. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Assessment of Root Resorption and Root Shape by Periapical and Panoramic Radiographs: A Comparative Study.

PubMed

Ahuja, Puneeta D; Mhaske, Sheetal P; Mishra, Gaurav; Bhardwaj, Atul; Dwivedi, Ruby; Mangalekar, Sachin B

2017-06-01

One of the common findings encountered by the clinician at the end of orthodontic treatment is the apical root resorption. Root resorption occurs to various degrees. A severe form of root resorption is characterized by shortening of root for more than 4 mm or more than one-third of the total tooth length. A low incidence rate of resorption is observed based on radiographic findings for the diagnosis of root resorption, panoramic radiography, and periapical radiography. Hence, we evaluated the accuracy of panoramic radiographic films for assessing the root resorption in comparison with the periapical films. This study included the assessment of all the cases in which pre- and post-treatment radiographs were available for analysis of the assessment of the amount of root resorption. Complete records of 80 patients were analyzed. Examination of a total of 900 teeth was done. Mean age of the patients in this study was 21 years ranging from 11 to 38 years. The majority of the patients in the present study were females. All the treatments were carried out by registered experienced orthodontists having minimum experience of more than 10 years. All the cases were divided into two study groups. Group I comprised panoramic radiographic findings, while group II consisted of periapical radiographic findings. For the measurement of crown portion, root portion, and the complete root length, magnification loops of over 100 powers with parallax correction with inbuilt grids were used. Assessment of the tooth length and the crown length was done by the same observers. All the results were analyzed by Statistical Package for the Social Sciences software version 6.0. Maximum amount of root resorption was observed in case of maxillary central incisors and canines among group I and II cases respectively. However, nonsignificant difference was obtained while comparing the mean root resorption in relation to maxillary incisors and canines among the two study groups. While comparing the overall value of root resorption among the two study groups, a significant difference was obtained. The maximum value of tooth length in both the groups was observed in cases of maxillary canines. Significant differences were observed while comparing the tooth length of various teeth among the two study groups. Among the deviated forms of root shape, dilacera-tion was the most common form of root shape detected in both the study groups. Periapical radiographs are more efficient in the assessment of the shape and resorption of the root. Thorough evaluation of periapical radiographs is necessary for detection of even minute levels of root resorption.

The role of nailfold capillaroscopy in interstitial lung diseases - can it differentiate idiopathic cases from collagen tissue disease associated interstitial lung diseases?

PubMed

Çakmakçı Karadoğan, Dilek; Balkarlı, Ayşe; Önal, Özgür; Altınışık, Göksel; Çobankara, Veli

2015-01-01

Nailfold capillaroscopy (NFC) is a non-invasive diagnostic test that is mostly used for early diagnosis of collagen tissue diseases (CTDs). We aimed to evaluate whether NFC findings could be a clue for discriminating idiopathic interstitial lung diseases (ILD) from CTD associated ILDs (CTD-ILD). Additionally it was aimed to determine whether NFC could be helpful in discriminating usual interstitial pneumonia (UIP) pattern from non-specific interstitial pneumonia (NSIP) pattern. We grouped patients into three main groups: 15 CTD-ILD, 18 idiopathic ILD, and 17 patients in the control group. The CTD-ILD group was split into two subgroups: 8 patients with Sjögren's syndrome (SJS)-associated ILD and 7 with rheumatoid arthritis (RA)-associated ILD. The idiopathic-ILD group consisted of 10 idiopathic NSIP and 8 IPF patients. The control group consisted of 10 SJS and 7 RA patients without lung disease. None of the patients were on acute exacerbation at the time of examination, and none had Reynaud's phenomenon. Mean capillary density was significantly reduced only in the CTD-ILD group as compared to the control group (p= 0.006). In subgroup analysis, it was determined that RA-ILD, IPF, and SJS-ILD subgroups had more severe capillaroscopic abnormalities. Mean capillary density in patients with the UIP pattern was reduced compared to patients with the NSIP pattern and those in the control group; p values were 0.008 and < 0.001, respectively. This study is to be the first describing and comparing the nailfold capillaroscopic findings of patients with NSIP and UIP patterns. NFC findings can be helpful in discriminating UIP patterns from NSIP patterns. But to show its role in differentiating idiopathic disease, more studies with more patients are needed.

Multiparametric flow cytometry in the diagnosis and characterization of low-grade pulmonary mucosa-associated lymphoid tissue lymphomas.

PubMed

Zaer, F S; Braylan, R C; Zander, D S; Iturraspe, J A; Almasri, N M

1998-06-01

Primary mucosa associated lymphoid tissue (MALT) lymphomas are rare neoplasms that seem to have a better prognosis than nodal lymphomas. Morphologic diagnosis of these lesions may be difficult because of features that overlap with those of benign lymphoid infiltrates. In this study, we assessed the contribution of multi-parametric flow cytometry in demonstrating clonality and further characterizing pulmonary MALT lymphomas. Based on a clinical or pathologic suspicion of MALT-lymphoma, 3 transbronchial biopsies, 4 fine needle aspirates, 1 core needle biopsy, and 13 wedge excisions of lung were submitted fresh (unfixed) to our laboratory for evaluation. Among the 13 cases diagnosed as MALT lymphomas, B-cell monoclonality was established by identifying expression of a single immunoglobulin light chain on CD20 or CD19-positive cells in 12 cases. One case lacked expression of both light chains on B-cells. Of 11 lymphoma cases in which CD5 and CD10 surface antigens were assessed, no cases expressed CD10, and 1 case demonstrated weak CD5 expression. Nine of 10 cases studied were diploid and 1 case was hyperdiploid. All of the lymphomas displayed low (< or = 3%) S-phase fractions consistent with low grade processes. In 10 patients with short follow-up, none died of their disease and the majority had no evidence of lymphoma dissemination. In seven of the remaining eight cases, B-cells were polyclonal consistent with reactive processes. In one morphologically reactive case, flow cytometric analysis was unsuccessful because of poor cell viability. The pulmonary MALT lymphomas in this study represent a group of B-cell tumors with distinctive morphologic, immunophenotypic, and cell kinetic characteristics. Multi-parametric flow cytometry is useful for confirming B-cell monoclonality and illustrating an antigenic profile compatible with this diagnosis. Flow cytometry can be particularly helpful when working with small biopsies and cytologic samples with limited diagnostic material and may abrogate the need for more aggressive surgical procedures.

The relationship between crystal structure and methyl and t-butyl group dynamics in van der Waals organic solids

NASA Astrophysics Data System (ADS)

Beckmann, Peter A.; Paty, Carol; Allocco, Elizabeth; Herd, Maria; Kuranz, Carolyn; Rheingold, Arnold L.

2004-03-01

We report x-ray diffractometry in a single crystal of 2-t-butyl-4-methylphenol (TMP) and low-frequency solid state nuclear magnetic resonance (NMR) proton relaxometry in a polycrystalline sample of TMP. The x-ray data show TMP to have a monoclinic, P21/c, structure with eight molecules per unit cell and two crystallographically inequivalent t-butyl group (C(CH3)3) sites. The proton spin-lattice relaxation rates were measured between 90 and 310 K at NMR frequencies of 8.50, 22.5, and 53.0 MHz. The relaxometry data is fitted with two models characterizing the dynamics of the t-butyl groups and their constituent methyl groups, both of which are consistent with the determined x-ray structure. In addition to presenting results for TMP, we review previously reported x-ray diffractometry and low-frequency NMR relaxometry in two other van der Waals solids which have a simpler structure. In both cases, a unique model for the reorientational dynamics was found. Finally, we review a similar previously reported analysis in a van der Waals solid with a very complex structure in which case fitting the NMR relaxometry requires very many parameters and serves mainly as a flag for a careful x-ray diffraction study.

Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea.

PubMed

Oliveira, Luciana Almeida Moreira da Paz; Fontes, Luiz Henrique de Souza; Cahali, Michel Burihan

2015-01-01

Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing. To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia. This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing. The dysphagia group consisted of 17 patients (77.3%) in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n=15; 68.2%) and/or in the questionnaire (n=7; 31.8%). The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea. Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Does peer learning or higher levels of e-learning improve learning abilities? A randomized controlled trial

PubMed Central

Worm, Bjarne Skjødt; Jensen, Kenneth

2013-01-01

Background and aims The fast development of e-learning and social forums demands us to update our understanding of e-learning and peer learning. We aimed to investigate if higher, pre-defined levels of e-learning or social interaction in web forums improved students’ learning ability. Methods One hundred and twenty Danish medical students were randomized to six groups all with 20 students (eCases level 1, eCases level 2, eCases level 2+, eTextbook level 1, eTextbook level 2, and eTextbook level 2+). All students participated in a pre-test, Group 1 participated in an interactive case-based e-learning program, while Group 2 was presented with textbook material electronically. The 2+ groups were able to discuss the material between themselves in a web forum. The subject was head injury and associated treatment and observation guidelines in the emergency room. Following the e-learning, all students completed a post-test. Pre- and post-tests both consisted of 25 questions randomly chosen from a pool of 50 different questions. Results All students concluded the study with comparable pre-test results. Students at Level 2 (in both groups) improved statistically significant compared to students at level 1 (p>0.05). There was no statistically significant difference between level 2 and level 2+. However, level 2+ was associated with statistically significant greater student's satisfaction than the rest of the students (p>0.05). Conclusions This study applies a new way of comparing different types of e-learning using a pre-defined level division and the possibility of peer learning. Our findings show that higher levels of e-learning does in fact provide better results when compared with the same type of e-learning at lower levels. While social interaction in web forums increase student satisfaction, learning ability does not seem to change. Both findings are relevant when designing new e-learning materials. PMID:24229729

Does peer learning or higher levels of e-learning improve learning abilities? A randomized controlled trial.

PubMed

Worm, Bjarne Skjødt; Jensen, Kenneth

2013-01-01

Background and aims The fast development of e-learning and social forums demands us to update our understanding of e-learning and peer learning. We aimed to investigate if higher, pre-defined levels of e-learning or social interaction in web forums improved students' learning ability. Methods One hundred and twenty Danish medical students were randomized to six groups all with 20 students (eCases level 1, eCases level 2, eCases level 2+, eTextbook level 1, eTextbook level 2, and eTextbook level 2+). All students participated in a pre-test, Group 1 participated in an interactive case-based e-learning program, while Group 2 was presented with textbook material electronically. The 2+ groups were able to discuss the material between themselves in a web forum. The subject was head injury and associated treatment and observation guidelines in the emergency room. Following the e-learning, all students completed a post-test. Pre- and post-tests both consisted of 25 questions randomly chosen from a pool of 50 different questions. Results All students concluded the study with comparable pre-test results. Students at Level 2 (in both groups) improved statistically significant compared to students at level 1 (p>0.05). There was no statistically significant difference between level 2 and level 2+. However, level 2+ was associated with statistically significant greater student's satisfaction than the rest of the students (p>0.05). Conclusions This study applies a new way of comparing different types of e-learning using a pre-defined level division and the possibility of peer learning. Our findings show that higher levels of e-learning does in fact provide better results when compared with the same type of e-learning at lower levels. While social interaction in web forums increase student satisfaction, learning ability does not seem to change. Both findings are relevant when designing new e-learning materials.

Intrapartum fetal heart rate patterns of trisomy 21 fetuses: A case-control study.

PubMed

Koren, Inbal; Michaelson-Cohen, Rachel; Chen, Daniela; Michaeli, Jennia; Schimmel, Michael; Tsafrir, Avi; Shen, Ori

2016-01-01

To determine whether there are specific characteristic intrapartum heart rate patterns for fetuses with trisomy 21(T21). Intrapartum fetal heart rate (FHR) tracings of T21 fetuses were compared to those of euploid fetuses in a retrospective, observational, matched, case-control study. The study group consisted of 42 fetuses with T21 and 42 matched euploid controls. Matching was designed to accommodate possible confounders. The sign test and McNemar's test were used for categorical variables. The paired t test was used for comparison between quantitative variables. Intrapartum baseline FHR of fetuses with T21 was found to be slightly decreased compared to controls (122.5 vs 129.05 beats per minute, p=0.028). No differences were detected in the presence of periodic changes, or FHR variability between the groups. When evaluating intrapartum FHR of fetuses with T21, decreased baseline FHR can be expected. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effect of Occupant and Impact Factors on Forces within Neck: II. Analysis of Specific Subsets

NASA Astrophysics Data System (ADS)

Shaibani, Saami J.

2000-03-01

The forces generated in the cervical spine were evaluated for a substantial number of motor-vehicle occupants in an associated study.[1] Correlation between these forces and various occupant- and impact-related parameters was generally not high for the broad groupings of the population considered at that time. In this research, smaller subsets with more elements in common were extracted from the data to try to detect any underlying relationships that might exist for the neck force. Although correlation coefficients for these subsets were higher than those for the previous groupings in more than three-quarters of the matches undertaken, the values still did not indicate consistently good fits. This suggests that there is no simple relationship for the force within the cervical spine and this, in turn, means that the potential for neck injury has to be evaluated on a case-by-case basis. 1. Effect of Occupant and Impact Factors on Forces within Neck: I. Overview of Large Population, Bull. Am. Phys. Soc. in press (2000).

Don't wait to incubate: immediate versus delayed incubation in divergent thinking.

PubMed

Gilhooly, Kenneth J; Georgiou, George J; Garrison, Jane; Reston, Jon D; Sirota, Miroslav

2012-08-01

Previous evidence for the effectiveness of immediate incubation in divergent creative tasks has been weak, because earlier studies exhibited a range of methodological problems. This issue is theoretically important, as a demonstration of the effects of immediate incubation would strengthen the case for the involvement of unconscious work in incubation effects. For the present experiment, we used a creative divergent-thinking task (alternative uses) in which separate experimental groups had incubation periods that were either delayed or immediate and that consisted of either spatial or verbal tasks. Control groups were tested without incubation periods, and we carried out checks for intermittent conscious work on the target task during the incubation periods. The results showed significant incubation effects that were stronger for immediate than for delayed incubation. Performance was not different between the verbal and spatial incubation conditions, and we found no evidence for intermittent conscious working during the incubation periods. These results support a role for unconscious work in creative divergent thinking, particularly in the case of immediate incubation.