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Sample records for con aceleradores medicos

  1. Evaluating medico-legal decisional competency criteria.

    PubMed

    Whiting, Demian

    2015-06-01

    In this paper I get clearer on the considerations that ought to inform the evaluation and development of medico-legal competency criteria-where this is taken to be a question regarding the abilities that ought to be needed for a patient to be found competent in medico-legal contexts. In the "Decisional Competency in Medico-Legal Contexts" section I explore how the question regarding the abilities that ought to be needed for decisional competence is to be interpreted. I begin by considering an interpretation that takes the question to be asking about the abilities needed to satisfy an idealized view of competent decision-making, according to which decisional competency is a matter of possessing those abilities or attributes that are needed to engage in good or effective or, perhaps, substantially autonomous or rational decision-making. The view has some plausibility-it accords with the way decisional competency is understood in a number of everyday contexts-but fails as an interpretation of the question regarding the abilities that should be needed for decisional competence in medico-legal contexts. Nevertheless, consideration of why it is mistaken suggests a more accurate interpretation and points the way in which the question regarding the evaluation of medico-legal competency criteria is to be answered. Building on other scholarly work in the area, I outline in the "Primary and Secondary Requirements" section several requirements that decisional competence criteria ought to satisfy. Then, in the "Applying the Framework" section, I say something about the extent to which medico-legal competency criteria, as well as some models of decisional competency proposed in the academic literature, fulfil those requirements.

  2. [Medico-legal assessment of systemic sclerosis].

    PubMed

    Graninger, M

    2007-10-01

    Diagnosis and management of the rare disease systemic sclerosis (scleroderma) is a challenge for the physician, not least due to the possible multitude of organ systems involved. The medico-legal assessment is important for the patient claiming insurance benefits or applying for early retirement due to scleroderma. Both the specialist for sclerosis and the impartial medico-legal assessor have to cooperate and understand the respective partner's requirements and terminology. Evaluations of individual organ impairments, handicaps and disabilities have to be taken into account when assessing the degree of impairment of occupational activity.

  3. Pharmacogenetics in medico-legal context.

    PubMed

    Sajantila, A; Palo, J U; Ojanperä, I; Davis, C; Budowle, B

    2010-12-15

    Medico-legal autopsy is the primary method in determining the cause and manner of death when the death is suspected to be unnatural. In some of these autopsies, the death remains ambiguous, even after a complete autopsy including histological investigation and toxicological screenings. In cases where there are no morphological abnormalities, medico-legal genetics may offer additional means to provide knowledge of possible genetic mutations, which may have initiated the process or predisposed the individual to stress risk conditions leading to death. One class of ambiguous deaths consists of drug-related deaths where the interpretation of the toxicological results are not clear. In such situations post mortem genotyping and the analysis of metabolite rations may provide an insight to the findings. A few cases demonstrating the potential strength of pharmacogenetics in medico-legal context has been published. However, there is a paramount need for serious scientific studies before the field of post mortem pharmacogenetics can be utilized in routine medico-legal analyses casework and brought routinely into courtroom.

  4. [Cancer screening: medico-legal aspects].

    PubMed

    Buzzi, F

    2003-01-01

    The cancer screening programmes need a particular considerations for their medico-legal implications: above all in order to the information toward the persons recruited, those must be aware about their diagnostic limits and about the ineluctable recurrence of false positive and false negative results.

  5. Medico-historical review of drug Kustha.

    PubMed

    Prasad, P V V; Subhaktha, P K J P

    2002-01-01

    Kustha is well known for its cures since ancient times. Atharvaveda considers this as a potent plant next to Soma (a divine plant) in curing several diseases. It is also called Takmanashana (which cures fevers) in Atharvaveda. It grows in Himalayas and Kasmir. In Ayurveda, root of Kustha is used for fevers, skin diseases, headache etc. Almost all Nighantus carry the description of Kustha with several synonyms. Some scholars consider two varieties of Kustha i.e. sweetish and bitter, but one with bitter taste is the real Kustha. Pushkarmool (Inula recemosa Hook.f.) is available in the market as sweet variety of Kustha. Thus its medico-historical importance and other details have been presented in this article.

  6. [Medico-economic evaluation of abciximab].

    PubMed

    Le Pen, C; Bonastre, J; Pinton, P

    1999-01-01

    Abciximab (RéoPro) is a chimeric monoclonal antibody directed against platelet glycoprotein IIb-IIIa. It reduces the frequency of major cardiac ischaemic events after percutaneous transluminal coronary angioplasty (PTCA). This treatment is more expensive than the commonly used treatment (aspirin and heparin). However, a treatment can only be validly assessed in term of its cost-benefit ratio. The authors present the results of a medico-economic evaluation of abciximab in the French institutional context, based on the three-year clinical results of the EPIC study (Evaluation of abciximab for the Prevention of Ischemic Complications). The efficacy of treatment was expressed by means of two quantitative indicators: the number of patients with no major ischaemic event (MIE) and the number of years of life without myocardial infarction or revascularization. According to French good practice recommendations for economic evaluation of therapeutic strategies, major ischaemic events were assessed by using the complete cost of the corresponding homogeneous groups of diseases (GHM). Medico-economic evaluation of abciximab showed that the net excess cost per patient for national health insurance was 395 Francs, while the cost of the product is 5,300 Francs. The incremental cost per additional patient with no major ischaemic event is 6,585 Francs and the incremental cost per additional year of life without myocardial infarction or revascularization is 2,469 F. From a public health point of view, abciximab administered by bolus injection plus a 12-hour infusion, presents a good cost-effectiveness ratio in the prevention of cardiac ischaemic complications in high-risk patients after PTCA.

  7. Phytol in a pharma-medico-stance.

    PubMed

    Islam, Md Torequl; de Alencar, Marcus Vinícius Oliveira Barros; da Conceição Machado, Katia; da Conceição Machado, Keylla; de Carvalho Melo-Cavalcante, Ana Amélia; de Sousa, Damiao Pergentino; de Freitas, Rivelilson Mendes

    2015-10-05

    This study aims to review phytol (PYT), through published articles, periodicals, magazines and patents, which were retrieved from the PM, SD, WS, SP; DII, WIPO, CIPO, USPTO and INPI databases. Among the 149 articles and 62 patents, 27.52% articles and 87.09% patients were found on the searched topic, PYT and its sources and synthesis and metabolism; then followed by 15.44% and 14.77% articles on PYT in cytotoxicity/cancer/mutagenicity/teratogenicity and PYT in neurological diseases, respectively. In the pharma-medico viewpoint, PYT and its derivatives have been evident to have antimicrobial, cytotoxic, antitumorous, antimutagenic, anti-teratogenic, antibiotic-chemotherapeutic, antidiabetic, lipid lowering, antispasmodic, anticonvulsant, antinociceptive, antioxidant, anti-inflammatory, anxiolytic, antidepressant, immunoadjuvancy, hair growth facilitator, hair fall defense and antidandruff activities. Otherwise, the important biometebolite of PYT is phytanic acid (PA). Evidence shows PA to have cytotoxic, anticancer, antidiabetic, lipid lowering and aniteratogenic activities. In addition, it may be considered as an important biomarker for some diseases such as Refsum's Disease (RD), Sjögren Larsson syndrome (SLS), rhizomelic chondrodysplasia punctata (RZCP), chronic polyneuropathy (CP), Zellweger's disease hyperpipecolic academia (ZDHA) and related diseases. Thus, phytol may be considered as a new drug candidate.

  8. Contemporary medico-legal dental radiology.

    PubMed

    Wright, Brad

    2012-03-01

    The advent of extraoral radiology in general dental practice has become more widespread since 2000, particularly with digital systems. With this comes a range of medico-legal risks for dentists not adverted to previously. These risks include a higher than expected radiation dose for some surveys, and the risk of a 'loss of a chance' for a patient whereby the images may disclose pathology not diagnosed by general dental practitioners using OPG and CBVT radiology. Practitioners need to apply relevant legal principles in deciding which surveys to order and record, and also need to explain to patients the dosages of the radiation that they will likely receive. Practitioners also need to assess whether the resultant survey ought to be interpreted by a radiologist to diagnose any wider pathology with which a general practitioner may not be familiar. Extra caution needs to be used in ordering high dose radiology in paediatric patients. Dentists should not assume patients fully understand the nature of CBVT and MCT, and its risks and benefits. Consideration ought to be given to the volume of CBVT ordered dependent on factors such as patient age, symptoms, history and procedural intent. © 2012 Australian Dental Association.

  9. Current medico-legal death investigation system in China.

    PubMed

    Chang, Lin; Zhang, Baosheng; Yan, Ping; Fowler, David; Li, Ling

    2011-07-01

    Medico-legal death investigation in China has a long history that can be traced back to the Chhin era in the third century BC. We conducted a national study on the current medico-legal death investigation system in China. Our study showed that, at present, medico-legal death investigations in China are conducted by c. 12,000 forensic medical experts mainly within five relatively independent agencies: the police organizations, the prosecutors' offices, the departments/divisions of forensic medicine/science in medical colleges and universities, the Institute of Forensic Science in the Ministry of Justice, and the government or private forensic societies. Owing to China's large population and area, the medico-legal death investigation is largely based on the administrative divisions. There is a wide variation in the scope, extent, and quality of investigations among the agencies and at the different levels of county/district, municipal, and provincial governments. This article gives a general overview of medicolegal death investigation in modern China.

  10. [Relevant factors in medico-legal prognosis of whiplash injury].

    PubMed

    Pujol, Amadeo; Puig, Luisa; Mansilla, Joaquina; Idiaquez, Itziar

    2003-07-12

    Whiplash injury (WI) is commonly evaluated in medico-legal practice. With the aim of knowing the determining factors of WI's medico-legal prognosis, a prospective and observational study was carried out. One hundred and twenty consecutive patients who were clinically observed and evaluated in the Medico-Legal Clinic of Barcelona were studied. Socio-demographic, clinical, radiographic and evolutive factors were analyzed. We included 120 patients with a mean age of 35.6 (14) years (range, 4-74), with a homogeneous male/female distribution. An earlier cervical pathology was detected in 10% of patients; none of them had previous psychiatric pathology. 95% corresponded to road-traffic accident cases and there were 5 aggression cases. Over 50% of cases involved a rear-end collision. All patients had neck pain, almost 25% had headache and 13% had paresthesia. According to the Whiplash Association Disorders clinical classification, distribution in grades (G) was: G I 51%, G II 32% and G III 17%. Patients reported recovery within a mean time of 71.6 (46) days (range, 4-244), with 51,2 (45) no working days (range, 0-180 days). The 52% of the patients rest with complains. According to the recovery time, the following medico-legal prognostic factors were identified: age (p < 0.001), being female (p = 0.001), clinical grade (p < 0.001) and abnormal cervical MRI exploration (p < 0.001). Patients with previous cervical pathology reported more complaints (p = 0.001). In our study, WI affected young people of both sex mainly during rear-end collision. Worst medico-legal prognostic factors were age, being females, severity of initial clinical symptoms, previous cervical pathology and abnormal cervical MRI/CT.

  11. Recent developments of the 1 MV AMS facility at the Centro Nacional de Aceleradores

    NASA Astrophysics Data System (ADS)

    Scognamiglio, G.; Chamizo, E.; López-Gutiérrez, J. M.; Müller, A. M.; Padilla, S.; Santos, F. J.; López-Lora, M.; Vivo-Vilches, C.; García-León, M.

    2016-05-01

    The Centro Nacional de Aceleradores (CNA) hosts a 1 MV accelerator mass spectrometry (AMS) apparatus since September 2005. In order to improve its overall performance, several updates have been made on the existing facility during the last 10 years of operation. In this paper, two modifications conducted in 2015 will be described. To increase the transmission of the ions through the accelerator, the stripping gas on the 1 MV CNA machine was changed from Ar to He. The measured maximum transmission for almost every isotope results to be higher, especially for heavy masses: for instance, in the case of uranium in the 3+ charge state, the transmission increased from 11% with Ar gas to about 38% with He gas. The second advance consisted of the substitution of the existing gas ionization chamber with a new one provided by ETH Zurich. The ETH detector features with its miniaturized design and is optimized for low energy AMS (i.e. very low electronic noise and efficient charge collection). As the electronic noise is the most important contribution to the resolution for light ions, the total energy resolution has been reduced by 15% in the case of 10Be, allowing a better discrimination against its isobar, 10B. For the heaviest radionuclides where the quality of the spectra is determined by the charge carrier production in the gas, the resolution for 2.7 MeV uranium ions was improved by 30%, probably due to a more efficient charge collection.

  12. Status of the compact 1 MV AMS facility at the Centro Nacional de Aceleradores (Spain)

    NASA Astrophysics Data System (ADS)

    Chamizo, E.; López-Gutiérrez, J. M.; Ruiz-Gómez, A.; Santos, F. J.; García-León, M.; Maden, C.; Alfimov, V.

    2008-05-01

    Since February 2006, the new 1 MV multielement compact AMS facility SARA (Spanish Accelerator for Radionuclides Analyses) at the Centro Nacional de Aceleradores (CNA) in Sevilla (Spain) is fully operative. During the first one and a half year of operation, the viability of the system for the measurement of 10Be, 14C, 129I and plutonium isotopes, 239Pu and 240Pu, has been evaluated. First results have demonstrated that, in terms of precision and detection limits, the performance of the device compares to other compact AMS facilities, although some progress can still be done in order to optimize its capacities. At this moment, background levels are in the order of 10-14 for 10Be/9Be, 10-13 for 129I/127I, 10-15 for 14C/12C (processed and unprocessed blank) and about 106 atoms for plutonium isotopes: 239Pu, 240Pu and 242Pu. In this work, the current status of the AMS measurements at CNA for the above mentioned radionuclides is described.

  13. Plutonium measurements on the 1 MV AMS system at the Centro Nacional de Aceleradores (CNA)

    NASA Astrophysics Data System (ADS)

    Chamizo, Elena; Enamorado, Santiago Miguel; García-León, Manuel; Suter, Martin; Wacker, Lukas

    2008-11-01

    Plutonium isotopes have been recently added to the list of radionuclides that can be measured with the new generation of compact AMS facilities. In this paper we present first experimental results concerning the development of the plutonium AMS technique at 680 kV on the 1 MV AMS system at the Centro Nacional de Aceleradores (CNA) in Sevilla, Spain. This is the first compact AMS machine designed and manufactured by High Voltage Engineering Europa. As we demonstrate, the obtained backgrounds for 239,240Pu, of about 10 6 atoms, and the 239Pu/ 238U mass suppression factor, in the range of 10 -9, compare to the ones achieved on other AMS facilities. With the measurement of reference materials provided by the International Atomic Energy Agency (IAEA-375, IAEA-Soil-6, IAEA-381) and samples already studied on the 600 kV compact ETH/PSI AMS system at Zürich, we show that the CNA system can be perfectly used for the routine measurement of plutonium isotopes at environmental levels.

  14. [The victim as object of the medico-legal intervention].

    PubMed

    Magalhães, Teresa

    2005-01-01

    We present a reflection about the victim as the object of the medico-legal intervention, that opens perspectives not only to the evidence research (as a techno-scientific contribute to support Justice in what concerns bio-psycho-social questions), but also to the support of victims which, in a last analysis, is no more than another aspect of this the social contribution of this science to ensure the best interest of the victim. This reflection aims to contribute to a better knowledge of the victim in his/her various perspectives. Accordingly, during the exposition, we refer some contributes of Victimology towards the understanding of the victims' behaviour's. Afterwards, we focus on the problems related to the aetiologies (with a particular reference to trauma), levels and consequences (physical, psychological and socio-economical) of victimization, as well as the methodologies of victims approach, medico-legal evaluation and reparation. Considering victims as being not only those who suffer directly the consequences of the victimizing phenomena, but also those that suffer from it indirectly and even secondarily, we shall approach the topic regarding both perspectives. We highlight the importance of understanding the victim as a person, not just understanding him/her confined to the organic aspect (as it used to be until recently in certain fields of medico-legal intervention, and as it still happens due to some legal obligations, for instance in the Labour Law), but considering the person in a global way (body, capacities, life situations and subjectivity). In conclusion, we highlight the importance of this topic to the medico-legal mission, while taking part in various multidisciplinary interventions and being involved in strategies and measures which purpose is to prevent violence, promote safety, avoid secondary victimization and revictimization as well as guarantee the victims' protection and reintegration, in a work attitude that should happen, even more and

  15. [Mandatory or voluntary vaccinations? Juridical and medico-legal aspects].

    PubMed

    Molendini, L O; Zanetti, A; Buzzi, F

    2003-01-01

    The Italian juridical and legislative aspects of vaccination based on a compulsory system are presented considering the medico-legal questions. The prospective of a voluntary system, as anticipated by many normatives and other official documents, is examined. The experience of some local health authorities on cases of in observance of the vaccinal obligation are detailed Finally professional risks for vaccinal operators are examined and the need of specific guidelines for parents' consent to compulsory vaccination during infancy is prospected.

  16. Khadira (Acasia Catechu Linn.) - A medico-historical review.

    PubMed

    Narayana, A

    1996-01-01

    Indigenous Medical wisdom in India known as Ayurveda goes back to a hoary past. We find references in Vedas not only to medical science but to various drugs also. The medico-historical review of Khadira (Acasia Catechu linn.) including the historical perspectives, identity, varieties, formulae and therapeutic usage etc. is presented here, based on the classical treatises, medical lexicons, commentaries and other compilations, covering the from Vedic period to present times.

  17. [[Medico-historical findings of (neuro-) prosthetics: an online survey].

    PubMed

    Ohnemus, Dirk; Otte, Andreas

    2014-01-01

    This article presents an online survey on medico-historical (neuro-)prostheses. Important findings of the past 3000 years are outlined: toe prostheses from ancient Egypt, the Capua leg prosthesis, Götz von Berlichingen's artificial hands and Sauerbruch's prosthetic arm. These historical examples are compared with modern neuroprosthetics. It is also shown that historical prostheses were in no way primitive and, even more, that ancient people already used first intelligent medical engineering approaches.

  18. [Organization of medico-genetic counseling for hereditary hearing impairment].

    PubMed

    Markova, T G

    2009-01-01

    High frequency of hereditary pathologies resulting in congenital and prelingual auditory inefficiency necessitates organization of readily available medico-genetic counseling services based at specialized centres and an integrated dispensary system for the observation of families at risk of hereditary hearing impairment and identification of high-risk groups among the general population. Correct clinical diagnosis provides a basis for the strategy of molecular-genetic examination of a given patient and members of his (her) family. Results of the examination can be used for family planning and the choice of measures for the prevention of recurrent cases. The objective of the present work was to draw up the main lines of cooperative activities of deafness specialists and geneticists, propose indications for medico-genetic counseling, and distinguish groups at high risk of development of hereditary hearing impairment among the affected subjects and in the general population. It is shown that the efficiency of measures for the prevention of hereditary hearing loss is directly related to the availability of medico-genetic aid and the degree of involvement of risk groups in the examination.

  19. Imaging of body packing: errors and medico-legal issues.

    PubMed

    Reginelli, Alfonso; Russo, Anna; Urraro, Fabrizio; Maresca, Duilia; Martiniello, Ciro; D'Andrea, Alfredo; Brunese, Luca; Pinto, Antonio

    2015-10-01

    Body packing is the ingestion or insertion in the human body of packed illicit substances. Over the last 20 years, drug smuggling has increased global and new means of transport of narcotics have emerged. Among these, the most frequent one is the gastrointestinal tract: from mouth to anus, vagina, and ears. Cocaine is one of the most traded drugs, followed by heroin. Condoms, latex gloves, and balloons are typically used as drug packets for retention in the body. There are different radiologic modalities to detect illicit drugs in body packing: Plain radiography, computed tomography (CT), ultrasound, and magnetic resonance. Current protocols recommend the use of radiography to confirm packet retention and, in case of doubt, the use of abdominal CT scan with reduced mAs. In case of packet rupture, catastrophic effects can occur. Management of patients carrying packets of drugs is a recurrent medico-legal problem. To improve diagnostic accuracy and prevent hazardous complications, radiologists and emergency physicians should be familiar with radiologic features of body packing. The radiologist plays both a social and a medico-legal role in their assessment, and it should not be limited only to the identification of the packages but must also provide accurate information about their number and their exact location. In this review, we focus on diagnostic errors and medico-legal issues related to the radiological assessment of body packers.

  20. The importance of medico-legal evaluation in a case with intraabdominal gossypiboma.

    PubMed

    Uluçay, Tarik; Dizdar, Mustafa Gökhan; SunayYavuz, Mehmet; Aşirdizer, Mahmut

    2010-05-20

    Data concerning the incidence of gossypiboma tend to fluctuate and is difficult to estimate because of a low reporting rate lest medico-legal implication. Gossypiboma is frequently located in the abdominal and pelvic cavities after gynecologic and upper abdominal surgical operations but can also follow thoracic, orthopedic, and urological and neurosurgical procedures. In medical literature, there are few articles about the medico-legal evaluation of gossypiboma although it is typically subjected to a medico-legal process. In this article, we reported a 22-year-old female case with intraabdominal gossypiboma following a cesarean procedure and discussed the importance of medico-legal evaluation of gossypiboma.

  1. The medico-legal aspects of prescribing vitamin D

    PubMed Central

    Davies, John S; Poole, Chris D; Feldschreiber, Peter

    2014-01-01

    Vitamin D is a particularly important sterol hormone and its effects beyond bone are increasingly recognized. Over the last decade clinical interest has grown in vitamin D, with increased recognition of deficiency and hence increased prescribing of vitamin D products. However, the increased prescription of vitamin D has generally been met with unlicensed vitamin D products which potentially expose the patient to clinical risk. This review discusses the issues relating to the clinical use of unlicensed vitamin D products, safety concerns that may arise from this, as well as discussing the medico-legal responsibilities of the prescriber and dispenser. PMID:25047693

  2. Doctor Zander's Medico-Mechanical Institute in Opatija.

    PubMed

    Fischinger, Janez; Fischinger, Ales; Fischinger, Dusa

    2009-01-01

    At the beginning of the 20th century, there were different kinds of medical institutions in the health and seaside spa resort Abbazia (nowadays Opatija). The Opatija Guidebooks (1904-1914) praised the three sanatoriums and Zander's Medico-Mechanical Institute, which was owned by Dr. Isor Stein. Dr. Zander, who is not well-known today, has been the main topic of the authors' research. The authors have found out that Dr. Gustav Zander (1835-1920) worked as a teacher of gymnastics, a physician, and a university lecturer about the remedial gymnastics at the University of Stockholm. He constructed several devices which enabled constant and regular movement of individual parts of the human body, as well as certain devices that replaced the manual massage. Zander started his first institute in Stockholm in 1865. People could do exercise using his apparatus. He gained international fame by exhibiting his devices at the International Exhibitions in Brussels and Philadelphia in 1876 and in Paris in 1878. Several Zander's medico-mechanical institutes were established around the world and they were all named after him. There were two hundred and two Zander's Institutes in 1911 when his success and fame reached its peak. Zander's Institute in Opatija was constructed already in 1904 and it was located on the ground floor of Stein's mansion, known as Vila Stein, nowadays Vila Dora. The First World War changed the fundamental role of Zander's Institutes and the Great Depression in 1929 destroyed them. It seems the Institute in Opatija closed down at that time too, even thought we have not found out the precise date. The modern fitness studios started to emerge in Europe in the 1950s, a few decades after Zander's medico-mechanical institutes ceased to exist. Many modern professional fitness devices are basically derived from the apparatus that was recommended, constructed and launched into the society already by Dr. Gustav Zander. The authors of this article presume that it was Dr

  3. [Past, present and future development of the project of manned space medico-engineering in China].

    PubMed

    Su, Shuang-ning

    2003-01-01

    Based on the research work of manned space medico-engineering at different stages of its development in China, the formation and development of the subject was summarized. The relations among the main fields of space medico-engineering, that is, depend on each other for existence, influence, co-operation and infiltration in the system, were discussed. Considering the ongoing tasks of manned space flight in China, directions and contents of research work of manned space medico-engineering were pointed out. And to make the ongoing tasks more successful, methods of development of the subject were put forward, namely, teaching, research and project should promote each other and develop together.

  4. Medico legal investigations into sudden sniffing deaths linked with trichloroethylene.

    PubMed

    Da Broi, Ugo; Colatutto, Antonio; Sala, Pierguido; Desinan, Lorenzo

    2015-08-01

    Sudden deaths attributed to sniffing trichloroethylene are caused by the abuse of this solvent which produces pleasant inebriating effects with rapid dissipation. In the event of repeated cycles of inhalation, a dangerous and uncontrolled systemic accumulation of trichloroethylene may occur, followed by central nervous system depression, coma and lethal cardiorespiratory arrest. Sometimes death occurs outside the hospital environment, without medical intervention or witnesses and without specific necroscopic signs. Medico legal investigations into sudden sniffing deaths associated with trichloroethylene demand careful analysis of the death scene and related circumstances, a detailed understanding of the deceased's medical history and background of substance abuse and an accurate evaluation of all autopsy and laboratory data, with close cooperation between the judiciary, coroners and toxicologists.

  5. Ethno – Medico – Botany of Chenchus of Mahaboobnagar District, Andhra Pradesh

    PubMed Central

    Kumar, T. Dharmachandra; Pullaiah, T.

    1999-01-01

    The present paper deals with the ethno-medico-botany of Chenchus of Mahaboobnagar district, Andhra Pradesh. About fourty four plants are enumerated with knowledge of the tribals for their medicinal uses in curing different diseases and ailments. PMID:22556915

  6. Necessity of including medico-legal autopsy data in epidemiological surveys of individuals with major trauma.

    PubMed

    Bagher, A; Wingren, C J; Ottosson, A; Andersson, L; Wangefjord, S; Acosta, S

    2015-08-01

    It is rare that epidemiological surveys of patients with major trauma include both those admitted to the emergency department and those sent for medico-legal autopsy. The main aim of the present population-based study of major trauma was to examine the importance of medico-legal autopsy data. A new injury severity score (NISS)>15 or lethal outcome was used as criteria for major trauma and to identify patients at the emergency, anaesthesiology and forensic departments and/or being within the jurisdiction of the Malmö police authority and subjected to a medico-legal autopsy between 2011 and 2013. According to Swedish legislation all trauma related deaths should be reported to the police who refer these cases for medico-legal autopsy. Among the 174 individuals included, 92 (53%) died and 81 (47%) underwent medico-legal autopsy. One hundred twenty-six patients were primarily admitted to hospital and 48 died before admission to hospital and were sent directly for medico-legal autopsy. Forty-four in-hospital deaths occurred, of whom 33 (75%) were sent to medico-legal autopsy. In those sent directly to the department of forensic medicine the proportion of accidents was lower (p<0.001), self-inflicted injuries higher (p<0.001) and gunshot wounds higher (p=0.002) in comparison with those sent to hospital. The most prevalent drugs detected by forensic toxicology screening in the 81 fatalities were ethanol (20%), sedatives (16%), anti-depressives (15%) and illicit narcotics (9%). Forty-four cases (54%) were positive for at least one drug, and twenty-eight cases (35%) were positive for two or more drugs. Factors associated with a lower rate of medico-legal autopsies among trauma-related deaths at hospital were high age (p<0.001), lower NISS (p<0.001), a longer duration between trauma and death (p<0.001), falls (p=0.030) and trauma-related infections (p<0.001). This population based study covering clinical and forensic data shows that more than half of the individuals

  7. Medico - historical study of "Visŭcikă" (Cholera).

    PubMed

    Prasad, P V V

    2005-01-01

    The Sanskrit word Visŭcikă refers to a condition in which vitiated văta dŏşa causes pain like pricking with a needle over the body. It occurs in a person suffering with ajĭrna (indigestion) and its detailed description is available in Ayurvedic literature. This disease has its existence in India since ancient times; it has also been referred in Mahăhărata and Tripitikas. Its etiology, signs, symptoms, complications, prognosis and treatment etc. as described in Ayurveda may be correlated with the disease Cholera, which is commonly known as "Haiza" in Hindi. In Greek language, the word Cholera means a flow of bile or the bilious disease. Cholera is an acute infectious diarrheal disease, caused by comma bacillus or vibrio cholerae sero groups 01 or 0139. Aretaetus, Benjamin Rush, Chadwick, John Snow, Robert Koch, etc. were some of the pioneers in Cholera research. Medico- historical importance of Cholera, its transmission, description and references from Ayurvedic texts etc., are being presented in this article.

  8. Preventing medico-legal issues in clinical practice.

    PubMed

    Raveesh, Bevinahalli N; Nayak, Ragavendra B; Kumbar, Shivakumar F

    2016-10-01

    The medical profession is considered to be one of the noblest professions in the world. The practice of medicine is capable of rendering noble service to humanity provided due care, sincerity, efficiency, and professional skill is observed by the doctors. However, today, the patient-doctor relationship has almost diminished its fiduciary character and has become more formal and structured. Doctors are no longer regarded as infallible and beyond questioning. Corporatization of health care has made it like any other business, and the medical profession is increasingly being guided by the profit motive rather than that of service. On the other hand, a well-publicized malpractice case can ruin the doctor's career and practice. The law, like medicine, is an inexact science. One cannot predict with certainty an outcome of cases many a time. It depends on the particular facts and circumstances of the case, and also the personal notions of the judge concerned who is hearing the case. The axiom "you learn from your mistakes" is too little honored in healthcare. The best way to handle medico-legal issues is by preventing them, and this article tries to enumerate the preventive measures in safeguarding the doctor against negligence suit.

  9. Eruption Pattern of Dentition and Its Medico-legal Significance.

    PubMed

    Karki, R K

    2016-01-01

    Background The eruption pattern of temporary and permanent teeth are fairly constant with the growing age. So the age determination of an individual by examination of teeth is one of the accepted methods in legal system. A review of the literature shows there are differences in eruption pattern between different populations mainly due to variations in the constitutions and environment, so highlighting the importance of this study to the Nepalese population. Objective To assess the eruption age of temporary and permanent teeth in Nepalese population and compared the eruption age with other groups. Method This cross-sectional study, included 450 subjects, aged between six months to 25 years selected by simple random sampling method. The determinant variable such as age and number of teeth was recorded. Result Eruption of temporary and permanent teeth is slightly delayed in Nepalese population compared with others. First temporary tooth to erupt is lower central Incisor at around eight months and last to erupt is second molar at around 28 months. For permanent tooth, first molar erupts at around seven years and second molar erupts by 14 years. Eruption of third molar (wisdom tooth) varies from 18 to 25 years. Conclusion This study provides a model data on eruption age of teeth which is first study of its kind in Nepal. The findings of this study will help as a reference data for optimal use in clinical, academic and research activities especially in Nepalese population. Medico legally it helps in estimation of age along with other parameters.

  10. Preventing medico-legal issues in clinical practice

    PubMed Central

    Raveesh, Bevinahalli N.; Nayak, Ragavendra B.; Kumbar, Shivakumar F.

    2016-01-01

    The medical profession is considered to be one of the noblest professions in the world. The practice of medicine is capable of rendering noble service to humanity provided due care, sincerity, efficiency, and professional skill is observed by the doctors. However, today, the patient–doctor relationship has almost diminished its fiduciary character and has become more formal and structured. Doctors are no longer regarded as infallible and beyond questioning. Corporatization of health care has made it like any other business, and the medical profession is increasingly being guided by the profit motive rather than that of service. On the other hand, a well-publicized malpractice case can ruin the doctor's career and practice. The law, like medicine, is an inexact science. One cannot predict with certainty an outcome of cases many a time. It depends on the particular facts and circumstances of the case, and also the personal notions of the judge concerned who is hearing the case. The axiom “you learn from your mistakes” is too little honored in healthcare. The best way to handle medico-legal issues is by preventing them, and this article tries to enumerate the preventive measures in safeguarding the doctor against negligence suit. PMID:27891020

  11. Measurement of 236U on the 1 MV AMS system at the Centro Nacional de Aceleradores (CNA)

    NASA Astrophysics Data System (ADS)

    Chamizo, E.; Christl, M.; Fifield, L. K.

    2015-09-01

    In this paper we present the first comprehensive analysis of the 1 MV AMS system at the Centro Nacional de Aceleradores (CNA, Seville, Spain) for 236U studies in environmental samples. In the last years, this radionuclide has become key in the AMS community, due to the very demanding 236U/238U abundance sensitivities required for general applications. As we demonstrate, the AMS system at the CNA is able to achieve sensitivity for the 236U/238U ratio of about 3 × 10-11 despite its compact design. The use of "239Pu"/238U ratio as a proxy for "236U"/235U background correction is proposed and tested with natural samples that were also studied on the 600 kV Tandy AMS system at the ETH Zürich. This correction is significant in the CNA case, due to the low mass resolving power of the low-energy spectrometer and to the lack of a third filter on the high-energy side. With the measurement of reference solutions supplied by the Institute for Reference Materials and Methods (IRMM-075), and reference natural matrixes provided by the International Atomic Energy Agency (IAEA-Soil-6, IAEA-375; 384; 386 and IAEA-RGU), we show that the 1 MV AMS system at the CNA can be routinely used for determinations of anthropogenic 236U at environmental levels.

  12. On the measurement of 10Be on the 1 MV compact AMS system at the Centro Nacional de Aceleradores (Spain)

    NASA Astrophysics Data System (ADS)

    Ruiz-Gómez, A.; Chamizo-Calvo, E.; López-Gutierrez, J. M.; García-León, M.; Müller, A. M.; Christl, M.

    2010-04-01

    In this work we present the most recent improvements performed by our group on 10Be measurements on the 1 MV AMS system recently set up at the CNA (Centro Nacional de Aceleradores), in Seville (Spain). Our efforts have been focused on the study of the viability of our system for BeO and BeF - measurements. To achieve this, different standard materials have been measured to demonstrate the reliability of the system for BeO measurements in a wide 10Be/ 9Be atomic ratio range and several environmental samples have been studied both at the 1 MV AMS CNA facility and at the 6 MV AMS ETH-PSI facility of Zurich to validate our measurements. The results show a good agreement between laboratories. New experiments also have been carried out selecting 1+ and 2+ charge states at the exit of the accelerator and inserting Si 3N 3.1 foils with different thicknesses to separate 10Be from its isobar, 10B. The influence of each foil on the overall transmission (detected 10Be compared to BeO - injected into the accelerator) and background level was also assessed. In addition some tests were also done to assess the viability of BeF 2 and BaBeF 4 measurements at our system. Several metal matrices and cathode preparation procedures for BeO samples were investigated to maximize current and cathode lifetime.

  13. The medico-legal scene in Dubai: 2002-2007.

    PubMed

    Benomran, Fawzi A

    2009-08-01

    Various characteristics of the medico-legal scene in Dubai are described, along with an overview of all cases examined over a period of 6 years. During the period of study, a total of 17,683 cases were examined in the Department of Forensic Medicine of Dubai Police General Headquarters. This constituted a yearly average of (2947.16). The average annual increment was 11.13%, the percentage of increase between 2002 and 2007 being 68.96%. Of these 10,165 (57.48%) were clinical cases of injuries, 5404 (30.56%) postmortem examinations, 1525 (8.62%) clinical cases of sexual crimes, 409 (2.3%) age estimations, 58 (0.32%) medical responsibility, 20 (0.11%) criminal abortion, 61 (0.34%) civil actions and 38 (0.21%) miscellaneous cases. Of postmortem examinations, 4846 (89.7%) of them were males and 558 (10.3%) females. The age ranged from (0-90) years, with a mean age of 40.5 years. The peak incidence was in the age group (20-50) years, where the extremes of age were least represented (Fig. 1). Only in 361 cases (6.68% of the grand total) the deceased was a local citizen. Autopsies amounted to 394 cases, which constituted 7.29% of the total deaths examined. The four manners of death in descending order of frequency were natural 3003 (55.57%), accidental 1727 (32%), suicidal 498 (9.2%), homicidal 164 (3%). The manner was undetermined in 12 (0.22%) of the cases over the 6 year period.

  14. [Prevention of medico-legal conflicts in medical practice].

    PubMed

    Minossi, José Guilherme

    2009-02-01

    Generally, medico-legal conflicts which occur in surgical and medical practice are a source of worry for both the medical profession and the society as a whole, because on one hand, they could cause high emotional stress for doctors, and on the other hand, patients could be rejected. Once consolidated, defensive medicine increases treatment costs and the doctor-patient relationship could transform into a tragedy. There are many causes for this, including non-treatment factors, such as an unsupported and disorganized health system, lack of participation from society and the doctor in improving this system, the training machine which launches a large number of young unprepared doctors to practice in this noble profession, along with a lack of continuing training, as there are few public or private institutions providing preparation, or further medical training. The related treatment factors are generally, a deficient doctor-patient relationship, poor work condition, power abuse by the doctor, a lack of clear agreement, and poor medical record keeping. These conflicts cannot be solved by simple creating legislation, or by denying the existence of medical error, which occurs at higher frequency than the actual conflicts. It is very important to improve the doctor-patient relationship because an effective fraternal relationship reduces the chance of a judicial demand. The doctor still needs to fully understand his/her conduct obligations and mainly to avoid power abuse. Doctors must also professionally link themselves with politicians who fight for the individual's rights against the system. Society must also understand that health is not just an issue exclusive for doctors, and people must fight to improve living conditions. Society must seriously show its frustration with the increasing disparity between scientific possibilities and actual wellbeing. The training machine needs immediate profound changes to produce professionals with the highest qualifications equipped

  15. Medico-ecological zoning of the territory of the Russian Federation

    NASA Astrophysics Data System (ADS)

    Lyubovtseva, Yu. S.; Kagan, A. I.; Pyatigina, O. O.; Voronova, E. V.

    2015-12-01

    The medico-ecological state of Russian regions has been analyzed on the basis of statistical data. It is found that the incidence of different groups of diseases varies significantly in different regions. The regions of Russia are classified according to their medico-ecological parameters; the zones of maximal health risk caused by environmental pollutions, including air, water and soil pollution, are determined. The proposed methods for zoning by health level and the estimate of medico-ecological conditions in different administrative units provide the basis for the development of measures for the adaptation of population. These data can be used for the control of sanitary measures planned by regional organizations for the social-ecological protection of the population.

  16. Relatives' attitudes towards medico-legal investigation and forensic autopsy: a study from South Delhi.

    PubMed

    Behera, C; Rautji, R; Dogra, T D

    2008-04-01

    Relatives of deceased persons on whose bodies a medico-legal autopsy had been performed at the All India Institute of Medical Sciences, New Delhi, India were personally asked to complete a questionnaire. The aim of study was to determine surviving family members' attitudes towards medico-legal investigation and forensic autopsy. The majority of the relatives showed a positive attitude towards forensic autopsy but were not aware of the detailed procedure of the autopsy. They wanted sufficient information to be provided before the autopsy. They showed a great interest in autopsy results i.e. the cause of death. It was concluded that sufficient relevant explanations given before the autopsy improves the relatives' acceptance and helps alleviate the suffering of the bereaved. The experience and opinions of relatives may help an autopsy surgeon in more effective management of medico-legal cases.

  17. Forensic medicine experts' opinion on medico-legal autopsies in hospital deaths: a questionnaire survey.

    PubMed

    D'Souza, Deepak Herald; Pant, Sadip; Menezes, Ritesh George

    2013-10-01

    Medico-legal autopsy is conducted routinely in some countries and selectively in others in hospital deaths. This study was conducted to evaluate the views of the forensic medicine experts regarding this matter. A questionnaire pro forma was sent to sixty-five forensic medicine experts practicing in different medical institutions all around India. Designations and experiences of the participants were noted by requests in the same questionnaire. Their specific experience in conducting medico-legal autopsy in hospital deaths was also requested for. Responses were charted in frequency distribution tables and analyzed using SPSS, version 17.0. One-third of the participants felt that a medico-legal autopsy was necessary in all the hospital death cases as defined in the present study. Ten percent of the participants opined that a medico-legal autopsy was unnecessary in hospital deaths. The majority of the experts mentioned finding the cause of death, followed by finding the manner of death and collecting the evidentiary materials, as the reasons for medico-legal autopsy in hospital deaths. Twenty percent of the participants felt that internal findings at autopsy poorly matched with the case records. All the experts agreed that external autopsy findings matched with the hospital case records. Nearly two-third of the participants felt that it was difficult in some cases to interpret the autopsy findings without case records from the hospital where the deceased was treated. Our findings suggest that the exercise of carrying out medico-legal autopsy routinely in every hospital death as evident in the Indian framework is often unnecessary as per the experts' opinion. Autopsy findings in hospital deaths often correlate with hospital case records.

  18. The shifting sands of medico-legal intra-partum Ctg (I-P Ctg) monitoring.

    PubMed

    Buttigieg, George G

    2016-03-01

    Intra-partum (IP) surveillance of the unborn child by cardiotacography (CTG) monitoring is the commonest obstetric procedure in the developed world.(1) It is also the most medico-legally contested obstetric procedure in labour. In 2011, 'birth asphyxia' comprised 50% of the UK National Health Service (NHS) litigation costs,(2) and in the 2000-2010 decade, the same NHS paid out £3.1 billion for maternity medico-legal claims (the highest of any speciality), mostly involving cerebral palsy and CTG misinterpretation.(3) This article looks at a number of characteristics of IP CTG monitoring which argue for its questionable solidity of base in court proceedings.

  19. The medico-legal investigation of abandoned fetuses and newborns--a review of cases admitted to the Pretoria Medico-Legal Laboratory, South Africa.

    PubMed

    du Toit-Prinsloo, L; Pickles, C; Smith, Z; Jordaan, J; Saayman, G

    2016-03-01

    There is a dearth of literature on the extent of fetal or newborn abandonment or "dumping" and the medico-legal investigation procedures these cases require. This is despite the fact that these occurrences are a worldwide phenomenon and by definition involve criminal law concerns such as illegal abortion, concealment of birth, murder, or neonaticide, depending on the country concerned. This article contributes to current literature in both respects and provides a retrospective case audit for the period 2004-2008 pertaining to all abandoned newborns and fetuses admitted to the Pretoria Medico-Legal Laboratory (PMLL) in South Africa. Demographic details, scope, and nature of the medico-legal investigation as well as formulation of cause of death were recorded. A total of 289 cases were identified for inclusion in this study, 57% of which were considered to have been non-viable fetuses, while 45 of the viable fetuses were deemed to have been stillborn. These instances involve the crimes of concealment of birth and at times illegal abortion, yet prosecution of these cases are relatively unheard of. Signs of live birth were identified in 38 of the cases in the study. Of these infants, 9 were deemed to have died from injuries they have sustained, and in a further 9 cases, no anatomical cause of death could be identified. Homicidal cases should be brought in cases where death ensued as a result of abandonment; however, it is not known how many cases were prosecuted. A comparatively large number of cases were found to have been admitted to the Pretoria Medico-Legal Laboratory. This is alarming because South African abortion laws are liberal and services are free at point of access in the public health care sector. A substantial percentage of cases of abandoned infants were found to have shown signs of life after birth implying a homicidal manner of death or death by abandonment, but it seems these cases are merely shelved.

  20. The Effectiveness of Weights and Links in Automatic Indexing. Project MEDICO Second Progress Report.

    ERIC Educational Resources Information Center

    Artandi, Susan; Wolf, Edward H.

    This report describes work concerned with the statistical evaluation of the output of MEDICO automatic indexing procedure. The statistical tests were designed to examine the validity of the assumptions which formed the bases of the indexing algorithms with primary emphasis on the algorithm development for the computation of weights and links. Some…

  1. Death and AIDS: A Review of the Medico-Legal Literature.

    ERIC Educational Resources Information Center

    Huber, Jeffrey T.

    1993-01-01

    Notes that diagnosis of Acquired Immune Deficiency Syndrome (AIDS) continues to denote death sentence. Contends that AIDS is unique terminal illness in that no other single disease in history of American legal system has generated more litigation than AIDS. Examines medico-legal issues associated with AIDS-related death: estate planning,…

  2. [The use of the spectral analysis techniques for the medico-criminalistic identification of the speaker].

    PubMed

    Kir'yanov, P A; Kaganov, A Sh

    2016-01-01

    The objective of the present article is to discuss the theoretical foundations and the methodological basis for the use of the apparatus of spectral analysis for the purpose of medico-criminalistic personality identification from the characteristics of the subject's voice and sounding speech. The article is based on the review of the literature sources and the methodological approaches developed by the author.

  3. Death and AIDS: A Review of the Medico-Legal Literature.

    ERIC Educational Resources Information Center

    Huber, Jeffrey T.

    1993-01-01

    Notes that diagnosis of Acquired Immune Deficiency Syndrome (AIDS) continues to denote death sentence. Contends that AIDS is unique terminal illness in that no other single disease in history of American legal system has generated more litigation than AIDS. Examines medico-legal issues associated with AIDS-related death: estate planning,…

  4. Documentation of torture victims, assessment of the start procedure for medico-legal documentation.

    PubMed

    Mandel, Lene; Worm, Lise

    2007-01-01

    A Pilot Study was performed at the Rehabilitation and Research Centre for Torture Victims (RCT) in Copenhagen in order to explore the possibilities for adding a medico-legal documentation component to the rehabilitation of torture victims already taking place. It describes the process and results on implementing medico-legal documentation in a rehabilitative setting. A modified version of the Guidelines in the Istanbul Protocol was developed on the basis of the review of literature and current practices described in "Documentation of torture victims, implementation of medico-legal protocols". The modified guidelines were tested on five clients. The aim was twofold: 1) To assess the client's attitude towards the idea of adding a documentation component to the rehabilitation process and: 2) To assess the practical circumstances of implementing the Istanbul Protocol in the everyday life of a rehabilitation centre. Results show that all five clients were positive towards the project and found comfort in being able to contribute to the fight against impunity. Also, the Pilot Study demonstrated that a large part of the medico-legal documentation was already obtained in the rehabilitation process. It was however not accessible due to lack of systematization and a data registering system. There are thus important synergies in collecting data for rehabilitation and documentation but a joint database system is necessary to realize these synergies.

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

    PubMed

    Mont, Janice Du; White, Deborah

    2013-09-01

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

  6. Medico-legal investigations of the Airbus, A320 crash upon Mount Ste-Odile, France.

    PubMed

    Ludes, B; Tracqui, A; Pfitzinger, H; Kintz, P; Levy, F; Disteldorf, M; Hutt, J M; Kaess, B; Haag, R; Memheld, B

    1994-09-01

    The authors present the medico-legal investigations and identification after the aircrash of the Airbus A320 upon the Mount Sainte-Odile (France). The identification team comprising investigators from the gendarmerie, forensic pathologists, odontologists, and scientists of the Institute from Legal Medecine rapidly retrieved and identified 85 of the 87 victims, with 17 being identified through DNA typing, three through fingerprints and the remaining through dental records and specific physical or X-ray findings. Full autopsies were performed on all fatalities to determine patterns of injury and cause of death. Results lead us to point out the importance of a multidisciplinary team of forensic practitioners especially trained for managing medico-legal investigation in mass disaster and the ability of DNA technology to solve complex identification problems.

  7. [Continuous target of China's manned space project and research direction of space medico-engineering].

    PubMed

    Shen, Li-ping

    2003-01-01

    The subject of space medico-engineering which takes manned space flight as its own task, played an important role in China's manned space project, and developed rapidly. According to China's next three manned space objectives: 1) to develop the technology of extra-vehicle activity (EVA) and test the astronauts' performance ability of EVA; 2) to develop the technology of docking with other object spacecraft in space; 3) to found a relatively large space lab, the research directions and key technology of space medico-engineering have been given, including astronaut's selection and training; requirements and evaluation of medicine and ergonomics of the space lab design; the researches of fields in astronauts' medical monitoring and space medicine; technology of environmental control and life support system in space module; technology of EVA or docking; and technology of simulation of astronaut's training.

  8. [MEDICO-SOCIAL CHARACTERISTIC OF HIV-INFECTED PATIENTS RECEIVING ANTIRETROVIRAL THERAPY].

    PubMed

    Rostova, N B; Ivanova, E S; Ivanova, Yu N

    2015-01-01

    The aim of the study was medico-social characteristic of HIV-infected patients receiving antiretroviral therapy in 2006-2012 based on the logical and comparative analysis of medical cards with the use of systemic informational approach. The study yielded the medico-social characteristic of HIV-infected patients suggesting the presence of concomitant disorders requiring prescription of several medications to be used either simultaneously or alternatively (in case of poor efficiency or side effects of primary treatment). The data obtained indicate the necessity of optimization of the choice and prescription of pharmacotherapy taking account of its effects and safety based on the analysis of the potential and cost-effectiveness of different therapeutic modalities. The results of the study can be used to develop organizational measures for the improvement of public drug supply.

  9. Sudden unexpected death in epilepsy: some approaches for its prevention and medico-legal consideration.

    PubMed

    Verma, Archana; Kumar, Alok

    2015-09-01

    Worldwide, mortality associated with epilepsy is a matter of grave concern. The mortality rate in epileptic population is two to three times more than that of the general population. Sudden unexplained death in epilepsy, better known as sudden unexpected death in epilepsy (SUDEP), is a mysterious and rare condition, in which typically young or middle-aged people with epilepsy die without a clearly defined cause. At times, this may raise a strong suspicion of foul play and raise several medico-legal issues. There may be several different underlying mechanisms but most research has focused on seizure-related cerebral and respiratory depression, cardiac arrhythmia and autonomic dysfunction. In recent years, some significant risk factors have been recognized and strategies have been suggested that could be useful in prevention of SUDEP. Present communication provides some of the updates on new advances in prevention of SUDEP as well as highlights related medico-legal issues.

  10. The clinical management of diabetic foot in the elderly and medico-legal implications.

    PubMed

    Terranova, Claudio; Bruttocao, Andrea

    2013-10-01

    Diabetic foot is a complex and challenging pathological state, characterized by high complexity of management, morbidity and mortality. The elderly present peculiar problems which interfere on one hand with the patient's compliance and on the other with their diagnostic-therapeutic management. Difficult clinical management may result in medico-legal problems, with criminal and civil consequences. In this context, the authors present a review of the literature, analysing aspects concerning the diagnosis and treatment of diabetic foot in the elderly which may turn out to be a source of professional responsibility. Analysis of these aspects provides an opportunity to discuss elements important not only for clinicians and medical workers but also experts (judges, lawyers, medico-legal experts) who must evaluate hypotheses of professional responsibility concerning diabetic foot in the elderly.

  11. Functional and symptomatic assessment of medico-legal claims after upper limb injuries.

    PubMed

    Belcher, Hjcr

    2016-10-04

    A consecutive group of 250 patients underwent medico-legal assessment at a mean of 24 (±13) months following upper limb injuries. Each had completed questionnaires to assess function (Quick-DASH) and cold intolerance (CIQ36) before clinical assessment following which their whole limb impairment percentage was calculated. The mean(±SD) whole limb impairment, QDASH and CIQ36 scores were 9(±14)%, 43(±24) and 17(±10), respectively. There was a significant correlation between whole limb impairment and QDASH, although some patients reported surprisingly high disability levels despite minimal or no objective functional impairment. Whilst useful qualitative information can be obtained from questionnaires, the correlation between subjective and objective scores is weak albeit statistically significant. Individual patients can show marked discrepancies between objective and subjective functional scores. The results of questionnaires in individual medico-legal patients should be treated with caution.

  12. [Anxiety and anxiety disorders--differential diagnosis, etiology and medico-legal assessment].

    PubMed

    Licha, Christina; Stevens, Andreas

    2012-06-01

    Psychiatric disorders including anxiety disorders, are becoming more and more important in medico-legal assessment. Anxiety disorders are frequent in the general population. However, they may not be reliably diagnosed even by psychiatric experts because the disorders' symptoms may fail to manifest themselves during the examination. Functional impairments related to anxiety disorders are similarly problematic to assess. Finally, given the existence of effective therapies, it is hard to explain why patients with anxiety disorders have to be assessed at all. This report discusses the various and quite heterogeneous concepts associated with the word "anxiety". Anxiety disorder as a disease is differentiated from anxiety as a physiological emotion. Evidence concerning the etiology of anxiety disorders is compiled and strategies for medico-legal assessment, including the efficacy of therapies, are presented.

  13. Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications.

    PubMed

    Vassalini, Marzia; Verzeletti, Andrea; De Ferrari, Francesco

    2016-06-22

    Concerning recent Italian laws and jurisprudential statements, guidelines application involves several difficulties in clinical practice, regarding prevention, diagnosis and therapy of venous thromboembolism. International scientific community systematically developed statements about this disease in order to optimize the available resources in prophylaxis, diagnosis and therapy. Incongruous prevention, missed or delayed diagnosis and/or inadequate treatment of this disease can frequently give rise to medico-legal litigation.

  14. [School for patients with chronic obstructive bronchitis as a method of medico-social rehabilitation].

    PubMed

    Gnezdilova, E V

    2001-01-01

    The results of investigation of 282 patients with chronic obstructive bronchitis (COB) gave the basis for design of a cycle of lectures in the school for COB patients. The curricula of the school include positive information about the disease, psychological correction (different for men and women), recommendations on the methods of enhancing social activity. Medico-social rehabilitation of COB patients must be continuous. This becomes possible only if the patient takes an active part in the process of rehabilitation.

  15. Medico-legal perspectives on sudden cardiac death in young athletes.

    PubMed

    Oliva, Antonio; Grassi, Vincenzo M; Campuzano, Oscar; Brion, Maria; Arena, Vincenzo; Partemi, Sara; Coll, Monica; Pascali, Vincenzo L; Brugada, Josep; Carracedo, Angel; Brugada, Ramon

    2017-03-01

    Sudden cardiac death (SCD) in a young athlete represents a dramatic event, and an increasing number of medico-legal cases have addressed this topic. In addition to representing an ethical and medico-legal responsibility, prevention of SCD is directly correlated with accurate eligibility/disqualification decisions, with an inappropriate pronouncement in either direction potentially leading to legal controversy. This review summarizes the common causes of SCD in young athletes, divided into structural (hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, congenital coronary artery anomalies, etc.), electrical (Brugada, congenital LQT, Wolf-Parkinson-White syndrome, etc.), and acquired cardiac abnormalities (myocarditis, etc.). In addition, the roles of hereditary cardiac anomalies in SCD in athletes and the effects of a positive result on them and their families are discussed. The medico-legal relevance of pre-participation screening is analyzed, and recommendations from the American Heart Association and European Society of Cardiology are compared. Finally, the main issues concerning the differentiation between physiologic cardiac adaptation in athletes and pathologic findings and, thereby, definition of the so-called gray zone, which is based on exact knowledge of the mechanism of cardiac remodeling including structural or functional adaptions, will be addressed.

  16. Iatrogenic splenic injury: review of the literature and medico-legal issues

    PubMed Central

    Feola, Alessandro; Niola, Massimo; Conti, Adelaide; Delbon, Paola; Graziano, Vincenzo; Pietra, Bruno Della

    2016-01-01

    Abstract Introduction: Iatrogenic splenic injury is a recognized complication in abdominal surgery. The aim of this paper is to understand the medico-legal issues of iatrogenic splenic injuries. We performed a literature review on PubMed and Scopus using iatrogenic splenic or spleen injury and iatrogenic splenic rupture as keywords. Iatrogenic splenic injury cases were identified. Most cases were related to colonoscopy, but we also identified cases related to upper gastrointestinal procedures, colonic surgery, ERCP, left nephrectomy and/or adrenalectomy, percutaneous nephrolithotomy, vascular operations involving the abdominal aorta, gynecological operation, left lung biopsy, chest drain, very rarely spinal surgery and even cardiopulmonary resuscitation. There are several surgical procedures that can lead to a splenic injury. However, from a medico-legal point of view, it is important to assess whether the cause can be attributed to a technical error of the operator rather than being an unpredictable and unpreventable complication. It is important for the medico-legal expert to have great knowledge on iatrogenic splenic injuries because it is important to evaluate every step of the first procedure performed, how a splenic injury is produced, and whether the correct treatment for the splenic injury was administered in a judgment. PMID:28352813

  17. Medico-legal education: a pilot curriculum to fill the identified knowledge gap.

    PubMed

    Evans, Adele; Refrow-Rutala, Donna

    2010-12-01

    We sought to determine if a medico-legal educational curriculum designed to increase physicians' familiarity with the legal system in a nonthreatening environment-a didactic and interactive educational seminar-would positively influence learners' knowledge base and self-awareness. Because neither the Accreditation Council for Graduate Medical Education nor its Residency Review Committees specifically addresses medico-legal liability education, we designed a 2-day intensive medico-legal educational curriculum and piloted it in 2007 and 2008 at a large academic tertiary-referral medical center. Postcurriculum evaluations and precurriculum and postcurriculum testing were used to identify areas of common and/or persisting knowledge deficit. A total of 50 graduating residents, fellows, and community practitioners participated in the course. Common areas of knowledge deficit were "privilege," "discovery," statutes of limitations, and basic legal procedure. Discordance in physician interpretation of patient perspective and misunderstanding among physicians of the impact of the legal suit were evident. Concentrated legal education at selected times during medical training may support physicians' motivations to improve the assurance of quality and continuity of care. We continue to revise the curriculum to address issues of lecturer style, lecture content, and overall attitudinal values related to clinical practice, legal education, long-term impact on practice patterns, job satisfaction and its effect on attention to quality and continuity-of-care issues, and health care provider attitudes about the provider's role within the legal system and the community. We plan to conduct follow-up of participants to assess retention and subsequent use of this knowledge.

  18. Medico-Legal Education: A Pilot Curriculum to Fill the Identified Knowledge Gap

    PubMed Central

    Evans, Adele; Refrow-Rutala, Donna

    2010-01-01

    Purpose We sought to determine if a medico-legal educational curriculum designed to increase physicians' familiarity with the legal system in a nonthreatening environment—a didactic and interactive educational seminar—would positively influence learners' knowledge base and self-awareness. Methods Because neither the Accreditation Council for Graduate Medical Education nor its Residency Review Committees specifically addresses medico-legal liability education, we designed a 2-day intensive medico-legal educational curriculum and piloted it in 2007 and 2008 at a large academic tertiary-referral medical center. Postcurriculum evaluations and precurriculum and postcurriculum testing were used to identify areas of common and/or persisting knowledge deficit. Results A total of 50 graduating residents, fellows, and community practitioners participated in the course. Common areas of knowledge deficit were “privilege,” “discovery,” statutes of limitations, and basic legal procedure. Discordance in physician interpretation of patient perspective and misunderstanding among physicians of the impact of the legal suit were evident. Conclusions Concentrated legal education at selected times during medical training may support physicians' motivations to improve the assurance of quality and continuity of care. We continue to revise the curriculum to address issues of lecturer style, lecture content, and overall attitudinal values related to clinical practice, legal education, long-term impact on practice patterns, job satisfaction and its effect on attention to quality and continuity-of-care issues, and health care provider attitudes about the provider's role within the legal system and the community. We plan to conduct follow-up of participants to assess retention and subsequent use of this knowledge. PMID:22132284

  19. Using existing information from medico-legal death investigations to improve care of older people in residential aged care services.

    PubMed

    Ibrahim, Joseph Elias; Bugeja, Lyndal; Ranson, David

    2013-12-01

    The care of older people in residential aged care services could be improved by optimising the use of existing information gathered for medico-legal death investigations. The authors address three myths contributing to underuse of this information: deaths are not preventable; public health gains are too small; and it is someone else's charter or responsibility A significant proportion of deaths are preventable, specifically those occurring prematurely from natural causes or due to injury and trauma. By addressing these preventable deaths, significant public health cost savings and better health outcomes for our growing ageing population can be achieved. Despite substantive monitoring of the provision of aged care, no single entity is explicitly responsible for systematically analysing medico-legal death information. The data and skills for using information from medico-legal death investigations currently exist. Dispelling the myths removes one impediment to investing in this area of public health.

  20. Ethics and Medico Legal Aspects of “Not for Resuscitation”

    PubMed Central

    Salins, Naveen Sulakshan; Pai, Sachin Gopalakrishna; Vidyasagar, MS; Sobhana, Manikkath

    2010-01-01

    Not for resuscitation in India still remains an abstract concept with no clear guidelines or legal frame work. Cardiopulmonary resuscitation is a complex medical intervention which is often used inappropriately in hospitalized patients and usually guided by medical decision making rather than patient-directed choices. Patient autonomy still remains a weak concept and relatives are expected to make this big decision in a short time and at a time of great emotional distress. This article outlines concepts around ethics and medico legal aspects of not for resuscitation, especially in Indian setting. PMID:21811350

  1. E-suicide note: A newer trend and its medico-legal implications in India.

    PubMed

    Behera, C; Karthik, Krishna; Dogra, Td; Lalwani, S; Millo, T; Singh, Sr

    2014-06-01

    Rapid advancements of information and communication technology in the form of electronic mails, mobile phones, social networking sites, etc have an increasing impact on people's day to day life. It has been observed that these readily available applications are used frequently to express suicidal intentions. There are many studies on conventional handwritten suicide notes but suicide note in electronic format is an emerging issue and an under-researched phenomena. The authors have termed it as "E-suicide note" and discuss its medico-legal implications in India with examples from their observations.

  2. Suicide pact by drowning with bound wrists: a case of medico-legal importance.

    PubMed

    Behera, C; Karthik, Krishna; Singh, Hansraj; Deepak, Prakash; Jhamad, Akhilesh R; Bhardwaj, D N

    2014-03-01

    Suicide pacts are uncommon and mainly committed by male-female pairs in a consortial relationship. The victims frequently choose methods such as hanging, poisoning, using a firearm, etc; however, a case of a suicide pact by drowning is rare in forensic literature. We report a case where a male and a female, both young adults, in a relationship of adopted "brother of convenience" were found drowned in a river. The victims were bound together at their wrists which helped with our conclusion this was a suicide pact. The medico-legal importance of wrist binding in drowning cases is also discussed in this article.

  3. Tuberculous abdominal aortic aneurysm with alimentary tract hemorrhage: a case report with medico-legal implications.

    PubMed

    Xie, Dan; Xie, Kai; Li, Pei; Peng, Yu-Long; Yang, Xiang; Yang, Li-Ying; Cai, Ji-Feng

    2014-04-01

    An autopsy case of sudden death induced by alimentary tract hemorrhage was presented, which was caused by the unexpected rupture of clinically unrecognized tuberculous abdominal aortic aneurysm (TAAA). The initial diagnosis was made of the syndrome of coronary heart disease and hypertensive disease. The detailed autopsy showed that the alimentary tract hemorrhage was caused by a sudden rupture of the mass after posture changing was ascertained as the cause of death. The diagnosis of TAAA was determined by the autopsy findings. Analysis for the medical dispute of TAAA was described, and the difficulty of the diagnosis and medico-legal implications were also discussed.

  4. [Clinical practice guidelines: juridical and medico legal issues in health care malpractice liability].

    PubMed

    Moreschi, Carlo; Broi, Ugo Da

    2014-01-01

    Clinical Practice Guidelines are clinical tools addressed to medical and health professionals and are normally employed to improve quality and safety of diagnostic and therapeutical procedures but may sometimes limit the autonomy of medical and other health care professionals. The adherence to Clinical Practice Guidelines should not be an exclusive step to evaluate the liability and respect of standards of care in case of medico-legal investigations being each clinical case very specific. Medical liability and respect of standards of care should be evaluated with the support of Clinical Practice Guidelines and the extensive examination of all specific features, professional background and experience requested to treat each single patient.

  5. Trivial trauma, heart disease and medico-legal interpretation of death.

    PubMed

    Kohli, Anil; Mishra, Kiran

    2008-01-01

    Forensic experts are often required to give an opinion on the cause of death and its medico-legal interpretation in cases where an individual dies after receiving non-fatal injuries and at autopsy is discovered to have had a natural disease that alone could have caused death. The significance of this varies in different countries depending on the local laws relating to death in cases of trivial trauma associated with natural disease. This paper discusses this issue from an Indian perspective with the help of an illustrative case report and highlights the importance of the forensic pathologist in such cases.

  6. [Behavioral disorders in Parkinson's disease. Genetic, pharmacological and medico-legal aspects].

    PubMed

    Sobrido, M J; Dias-Silva, J J; Quintáns, B

    2009-01-23

    Patients with Parkinson's disease (PD) may present neuropsychiatric and conduct disorders at different stages of the development of the disease that make treatment even more difficult. The neurologist must be on the lookout for the possible appearance of alterations affecting impulse control, even from the early stages of the disease, so as to be able to prevent them or to plan a suitable adjustment of treatment. Some of the most common impulsivity disorders include hypersexuality, compulsive gambling and other addictive behaviours which, if left undetected and untreated, can end up having a destructive effect on the patient's socio-familial surroundings. Psychotic disorders (hallucinations, delusions) are often associated to advanced phases of PD and to the effect of dopamine therapy, and they are associated to a higher morbidity and mortality rate. Factors of a genetic or pharmacogenetic nature or a gene-environment interaction may account for the different individual susceptibility to disorders in the neuropsychiatric realm among patients with PD. It is wise to bear in mind the possible medico-legal implications that may stem from behavioral disorders, both for the patient and his or her family and for the physician, because situations could arise that trigger conflicts between confidentiality and preventing third parties from being harmed, as well as harm that can be attributed to the side effects of medicines. The specialist must be familiar with, foresee and propose suitable treatment for behavioral and neuropsychiatric disorders in PD with potential medico-legal implications.

  7. Medico-legal litigation in Obstetrics: a characterization analysis of a decade in Portugal.

    PubMed

    Domingues, Ana Patrícia Rodrigues; Belo, Adriana; Moura, Paulo; Vieira, Duarte Nuno

    2015-05-01

    It was to analyse the most critical areas in Obstetrics and to suggest measures to reduce or avoid the situations most often involved in these disputes. Obstetrics cases submitted to the Medico-legal Council since the creation of the National Institute of Legal Medicine and Forensic Sciences in 2001 until 2011 were evaluated. A comprehensive characterization, determination of absolute/relative frequencies, hypothesis of a linear trend over the years and the association between each parameter was done. The analysis has shown no significantly linear trend. The most common reasons for disputes were perinatal asphyxia (50%), traumatic injuries of the newborn (24%), maternal sequelae (19%) and issues related to prenatal diagnosis and/or obstetric ultrasound (5.4%). Perinatal asphyxia showed no significantly linear trend (p=0.58) and was usually related to perinatal deaths or permanent neurologic sequelae in newborn children. Traumatic injuries of the newborn, mostly related to instrumented deliveries, shoulder dystocia or vaginal delivery in breech presentation, has shown a significantly increased linear trend (p<0.001), especially related to instrumented deliveries. The delay/absence of cesarean section was the clinical procedure questioned in a significantly higher number of cases of perinatal asphyxia (68.7%) and of traumatic lesions of the newborn due to instrumented deliveries (20.5%). It is important to improve and correct theoretical/practical daily clinical performance in these highlighted areas, in order to reduce or even avoid situations that could end up in medico-legal litigations.

  8. [Medico-legal features of early discharge in acute myocardial infarction and chest pain].

    PubMed

    Montisci, M; Ruscazio, M; Snenghi, R; Nalin, S; Montisci, R; Iliceto, S; Ferrara, S D

    2001-06-01

    The authors' aim is to outline some of the main medico-legal problems in cardiology, especially those regarding the premature hospital discharge of patients with undefined chest pain and/or with acute myocardial infarction. After a brief overview on the etiology and clinical definition of chest pain and myocardial infarction, premature hospital discharge is defined and the incidental medico-legal risks that physicians operating in such situations are exposed to are pointed out. Next, the profiles regarding both the positive and negative views of professional medical responsibility are described. In the negative frame, the authors outline the most frequent civil and penal aspects of the unpremeditated responsibility. Then the physician's error, in both qualitative (generic or specific guilt) and quantitative (degree) terms, is considered; particularly, negligence, imprudence and inexperience, as qualitatively accepted meanings of generic guilt, are dealt with by adopting illustrative cases settled in the light of the right legal interpretation. The phases of the diagnostic or prognostic error are evaluated, and clinical protocols, as a reference parameter for the identification of error, are considered. Lastly, the problem of causality, essential condition for the judgment about the professional responsibility, and the problem of the patient's consent, including an evaluation of the legal capability or incapability about the declaration of consent, are examined closely.

  9. Witnesses of the body: medico-legal cases in seventeenth-century Rome.

    PubMed

    De Renzi, Silvia

    2002-06-01

    Studying early modern medico-legal testimonies can enrich our understanding of witnessing, the focus of much research in the history of science. Expert testimonies were well established in the Roman Cannon law, but the sphere of competence of expert witnesses - one of the grounds on which seventeenth-century physicians claimed social and intellectual authority- troubled contemporary jurists. By reconstructing these debates in Counter Reformation Rome, and by placing in them the testimonies given by Poalo Zacchia, one of the founding fathers of legal medicine, this article discusses the epistemological and social issues surrounding the definition of expertise about the body in court. It shows how a high-ranking expert witness would define his competence versus the legal authority on the one hand, lower-status expert witnesses on the other. But it also explores the interactions between specific legal constraints, for example about eye witnessing, and the ways in which different kinds of witnesses would use the body as a source of evidence for testimony. While engaging with medico-legal issues including the ambiguous signs of childbirth and the (in)visibility of pain, the article examines their meanings within Counter Reformation social controversies, including control over sexuality, imposition of discipline and the social status of physicians. Copyright 2002 Elsevier Science Ltd. All rights reserved.

  10. Maxillofacial Surgeon as Fact Witness for Medico-Legal Cases: Indian Scenario.

    PubMed

    Kedarnath, N S; Shruthi, R

    2015-12-01

    An Oral and Maxillofacial surgeon at any time during the practice will encounter medicolegal cases (MLC). There are lacunae in the knowledge and understanding of the correct method of dealing with such cases. Many of the practitioners are apprehensive and anxious as they have to interact with individuals and systems outside the normal realm of practice. In today's arena, it is of utmost importance to be aware of legal system and law of the land. An OMF surgeon needs to have thorough understanding in recording and maintenance of the details of all MLCs and presenting the same in the court. Professional guidelines for expert witness are often not well recognised as those relating to the clinical practice. Surgeon has an obligation to conduct him/herself to highest ethical standards. This article provides insight into the details of registration of MLC, examination and recording of injuries, collecting medico-legal evidences and writing a medico legal report. Also discusses the court proceedings and possible questions that may be faced by the surgeon in the court.

  11. Alcohol in a series of medico-legally autopsied deaths in northern Norway 1973-1992.

    PubMed

    Nordrum, I; Eide, T J; JŁrgensen, L

    2000-05-15

    It is well established that use of alcohol increases the risk of fatal injuries. The presence of blood alcohol in autopsied deaths is regularly encountered in medico-legal practices. The aim of this study was to investigate the prevalence and concentration of alcohol in 1539 medico-legal autopsies in two counties in northern Norway in the period 1973-1992, and the reporting of acute alcohol influence among these deaths to the official cause-of-death statistics. Blood alcohol concentration (BAC) >/=0.5 per thousand (50 mg/100 ml) was found in 47.6% (n=456) of violent deaths tested, and in 93% (n=426) of these the BAC was >/=1.0 per thousand. In 17.4% (n=55) of tested natural deaths the BAC was >/=0.5 per thousand. Acute alcohol-influenced violent deaths were under-reported to the cause-of-death statistics. Deaths by motor vehicle traffic accidents did not differ from other violent deaths in this respect. The under-reporting among violent deaths was 41% in cases with BAC >/=0. 5 per thousand and 37% where the BAC was >/=1.0 per thousand during the whole period. It is concluded that post-mortem BAC >/=0.5 per thousand, should be regarded as a possible contributory cause in all violent deaths, and reported accordingly.

  12. [Medico-legal opinionating in cases of insobriety in medical personnel].

    PubMed

    Jurek, Tomasz; Swiatek, Barbara; Drozd, Radosław

    2009-01-01

    The authors analyzed the medico-legal opinions in cases of insobriety in medical personnel. The studies were based on the results of 157 medico-legal evaluations in criminal cases performed in the years 2005-2007. Expert appraisals included: correctness of medical management, degree of exposure to direct danger of death or grave detriment to health associated with alcohol intoxication of a physician, regardless of his activities being correct in their merits, as well as influence of insobriety on personnel behavior. Penal responsibility is implemented in case of exposing the patient to direct danger to life or severe detriment to health. The necessary analysis should include activities that have been or should have been performed by a physician with respect to his patients, their health status (degree of danged to life or health) and the effect of the physician's alcohol intoxication on his abilities to perceive and assess the reality, make decisions and perform his duties. The Polish law in force lacking the equivalent of Article 147 found in the Polish penal code of 1969 causes problems in penalization of insobriety in medical personnel.

  13. Clinical photography in dermatology: ethical and medico-legal considerations in the age of digital and smartphone technology.

    PubMed

    Kunde, Lauren; McMeniman, Erin; Parker, Malcolm

    2013-08-01

    Clinical photography has long been an important aspect in the management of dermatological pathology and has many applications in contemporary dermatology practice. With the continuous evolution of digital and smartphone technology, clinicians must maintain ethical and medico-legal standards. This article reviews how dermatology trainees are utilising this technology in their clinical practice and what procedures they follow when taking photos of patients. We review the ethical and legal considerations of clinical photography in dermatology and present a hypothetical medico-legal scenario. Dermatology registrars were surveyed on their use of personal smartphones and digital equipment for photographing patients in their clinical practice. Numerous medico-legal providers were approached to provide medico-legal advice about a hypothetical scenario. We found that the use of these technologies is prevalent among dermatology registrars and all respondents reported regular use. Clinicians should routinely obtain and document adequate patient consent in relation to clinical photography, utilise strict privacy settings on smartphones and other digital devices and ensure that the images are stored on these devices for minimal periods. Express consent documentation in the clinical file puts the clinician in a more defensible position if a complaint is made to the medical board or privacy commissioner. © 2013 The Authors. Australasian Journal of Dermatology © 2013 The Australasian College of Dermatologists.

  14. [Brazil-Medico and the contributions of medical-hygienist thought to the scientific bases of Brazilian physical education].

    PubMed

    Mendes, Maria Isabel Brandão de Souza; da Nóbrega, Terezinha Petrucia

    2008-01-01

    The end of the nineteenth century and beginning of the twentieth were emblematic in the 'scientifization' of physical education in Brazil. This examination of the journal Brazil-Medico during 1887-1923 seeks to identify views of the body and health as well as contributions to the scientific bases of physical education in Brazil.

  15. [The auditory analysis in the context of the problem of medico-criminalistic identification of the speaker].

    PubMed

    Kaganov, A Sh

    2016-01-01

    This article was designed to discuss the theoretical foundations and methodological basis of the auditory component of the comprehensive medico-criminalistic study aimed at the identification of the speaker from his (her) voice and speech. The article is based on the literature data and the materials of forensic and criminalistic examination carried out by the author.

  16. When range of motion is not enough: towards an evidence-based approach to medico-legal reporting in whiplash injury.

    PubMed

    Worsfold, Christian

    2014-07-01

    Whiplash injury medico-legal reporting has traditionally been focused upon identifying restrictions in range of motion and identifying the presence of tender areas in the cervical spine in an effort both to diagnose the condition and to offer a prognosis. There have been considerable advances in this field over the last decade however that calls into question such a diminutive approach. This paper reviews the contemporary evidence base for the medico-legal assessment of whiplash injury and identifies a body of literature that strongly implicates a Claimant's physiological and psychological stress response as a key medico-legal marker in predicting prognosis following whiplash injury.

  17. Educational level and pseudohypacusis in medico-legal compensation claims: a retrospective study.

    PubMed

    Mahdavi, Mohammad-Ebrahim; Mokari, Nooshin; Amiri, Zohreh

    2011-01-01

    Pseudohypacusis or the intentional feigning of hearing loss is a challenging situation in the medicolegal evaluation of hearing levels. Few studies have been performed on predisposing factors that make compensation claims susceptible to malingering. The goal of this study was to investigate the relationship between educational level and frequency of pseudohypacusis in a group of medico-legal clients. Retrospectively, we studied the files of subjects (n=421) referred to the audiology clinic of a government hospital during a 12 month period. Educational levels of the individuals with and without pseudohypacusis were compared by the Chi-square test. The results show that individuals with pseudohypacusis have lower educational levels than cooperative clients. The relative frequency of individuals with pseudohypacusis among illiterates (43.5%) was clearly higher than individuals with higher educational levels (17.5%). The education level of a person filing a compensation claim may alert an examiner in detecting pseudohypacusis.

  18. Theories About Blood Coagulation in the Writings of Ancient Greek Medico-philosophers.

    PubMed

    Tsoucalas, Gregory; Karamanou, Marianna; Papaioannou, Theodoros G; Sgantzos, Markos

    2017-01-01

    Anaxagoras and Empedocles both established during the Presocratic era a pioneering theory for the creation of everything in the universe. Macrocosmos' impact through the "Four Elements Theory" explained the conglomeration of the blood inside the vessels. Hippocrates, who instituted the "Four Humours theory", clearly understood blood's coagulation and introduced the term "thrombus". Plato, Aristotle and Galen, all engaged with the clotting phenomenon trying to interpret it. After eons of inquiry, it was the innovative thinking of the ancient Greek medico philosophers that set the scientific bases towards the understanding of a process that had been analyzing until our era. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  19. Chemical Construction of Polyfunctional Nanocomposites and Nanorobots for Medico-biological Applications

    NASA Astrophysics Data System (ADS)

    Gorbyk, P. P.; Dubrovin, I. V.; Petranovska, A. L.; Abramov, M. V.; Usov, D. G.; Storozhuk, L. P.; Turanska, S. P.; Turelyk, M. P.; Chekhun, V. F.; Lukyanova, N. Yu.; Shpak, A. P.; Korduban, O. M.

    A method for preparation of magnetosensitive nanocomposites on the basis of surface-modified magnetite carrying immobilized cisplatin and monoclonal antibody CD 95 (a medico-biological nanorobot model) was developed. Adsorption and covalent immobilization of monoclonal antibody CD 95 and human normal immunoglobulin on nanocomposites comprising magnetite coated with poly(acryl amide) and γ-aminopropylsiloxane was studied. Isotherms of covalent attachment of oxidized immunoglobulin via formation of Schiff bases and non-specific (physical) adsorption of the normal immunoglobulin were compared. Kinetics of release of the immunoglobulin to a model environment was studied. Interaction of the prepared models of nanorobots with the cell line MCF-7 was studied. It was shown that use of magnetically driven nanocomposites carrying the anti-tumour drug and the monoclonal antibody CD 95 causes a synergic cytotoxic effect which exceeds the influence of the control doses up to 50%.

  20. From medico-administrative databases analysis to care trajectories analytics: an example with the French SNDS.

    PubMed

    Drezen, Erwan; Guyet, Thomas; Happe, André

    2017-09-16

    Medico-administrative data like SNDS (Système National de Données de Santé) are not collected initially for epidemiological purposes. Moreover, the data model and the tools proposed to SNDS users make their in-depth exploitation difficult. We propose a data model, called the ePEPS model, based on health care trajectories to provide a medical view of raw data. A data abstraction process enables the clinician to have an intuitive medical view of raw data and to design a study-specific view. This view is based on a generic model of care trajectory, i.e. a sequence of timestamped medical events for a given patient. This model is combined with tools to manipulate care trajectories efficiently. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  1. Occupational fatalities in the construction sector: A medico-legal viewpoint.

    PubMed

    Das, Siddhartha

    2015-06-01

    Occupational fatalities are those that occur during the course of a person's occupation. They can occur in any industry or sector. Studies have shown that the construction sector is more dangerous for workers than the industrial sector, and there are more deaths both in the developed and developing countries. The construction sector has seen a boom in countries like India over the past few years and with it an increase in the number of occupational fatalities. Three different types of occupational fatalities pertaining to construction sector are presented here to increase awareness of the different types of occupational fatalities that may occur. The circumstances leading to them are discussed from a medico-legal viewpoint. Specific acts of negligence have been highlighted and suggestions offered with a view to decreasing fatalities.

  2. The assessment of grip strength after upper limb injuries in medico-legal practice.

    PubMed

    Belcher, Hjcr

    2017-03-01

    Four hundred adult claimants underwent medico-legal assessment following upper limb injuries. Dynamometry was performed on each using the Jamar five handle-position test. Injury causes loss of power and there is a significant relationship between the percentage loss of power and the measured whole limb impairment. This paper presents a new approach for the analysis of the tests. The normal physiological length-tension pattern of muscle is maintained in the majority of claimants albeit with modifications due to the specific effects of injury on hand function. This paper provides normative data for the analysis of dynamometry in this population and makes recommendations for parameters that suggest that a test is a true reflection of capacity and thus useable in court.

  3. Danger points, complications and medico-legal aspects in endoscopic sinus surgery.

    PubMed

    Hosemann, W; Draf, C

    2013-12-13

    Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5-1%. A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education.

  4. Medico-legal autopsy of abandoned foetuses and newborns in India.

    PubMed

    Behera, C; Sikary, Asit Kumar; Krishna, Karthik; Garg, Aayushi; Chopra, Saurav; Gupta, S K

    2016-06-01

    Foeticide and the abandonment of newborns are important, albeit frequently neglected, issues. Concealment of childbirth is often seen in the setting of unwanted pregnancy which has been recognised as one of the most important factors in both cases. This study highlights the medico-legal autopsy findings of 238 abandoned foetuses and newborns over a period of 17 years (1996-2012) from the region of South Delhi, India. There was no sex predilection. The majority of the cases were full term. Nearly 35% of the foetuses were still born, about 29% were live born and the remainder were non-viable. Among the live born, death by homicide was more common than a natural death and most were left by the roadside. The abandoning and killing of newborns needs urgent attention, and strict measures are needed to save thousands of innocent lives.

  5. Quantitative elementary analysis of medico-biological specimens using a laser mass spectrometer

    SciTech Connect

    Aref'ev, I.M.; Benyaev, N.E.; Komleva, A.A.; Ramendik, G.I.; Tyurin, D.A.

    1986-06-01

    The present work is devoted to an investigation of the dependence of the value of the relative sensitivity coefficient (RSC) on the influence oflaser radiation on medico-biological specimens in order to develop a standardless quantitative analysis. The objects of the investigation were dried tissues of organs of the animals, whole blood and its components. It was shown that the values of the RSC are close to one in the range of 20% error at laser radiation flux densities of 5.10/sup 8/-1.10/sup 9/ W/cm/sup 2/. A decrease or increase in the flux density in comparison with the optimum leads to the appearance of discrimination, in the first case during atomization where the RSC depends on the thermophysical parameters of the investigated elements, and, in the second case, during ionization where the RSC depends on the ionization potentials of the elements.

  6. Chemical Construction of Polyfunctional Nanocomposites and Nanorobots for Medico-biological Applications

    NASA Astrophysics Data System (ADS)

    Gorbyk, P. P.; Dubrovin, I. V.; Petranovska, A. L.; Abramov, M. V.; Usov, D. G.; Storozhuk, L. P.; Turanska, S. P.; Turelyk, M. P.; Chekhun, V. F.; Lukyanova, N. Yu.; Shpak, A. P.; Korduban, O. M.

    A method for preparation of magnetosensitive nanocomposites on the basis of surface-modified magnetite carrying immobilized cisplatin and monoclonal antibody CD 95 (a medico-biological nanorobot model) was developed. Adsorption and covalent immobilization of monoclonal antibody CD 95 and human normal immunoglobulin on nanocomposites comprising magnetite coated with poly(acryl amide) and γ-aminopropylsiloxane was studied. Isotherms of covalent attachment of oxidized immunoglobulin via formation of Schiff bases and non-specific (physical) adsorption of the normal immunoglobulin were compared. Kinetics of release of the immunoglobulin to a model environment was studied. Interaction of the prepared models of nanorobots with the cell line MCF-7 was studied. It was shown that use of magnetically driven nanocomposites carrying the anti-tumour drug and the monoclonal antibody CD 95 causes a synergic cytotoxic effect which exceeds the influence of the control doses up to 50%.

  7. Responsible use of cone beam computed tomography: minimising medico-legal risks.

    PubMed

    Noffke, C E E; Farman, A G; Van der Linde, A; Nel, S

    2013-07-01

    This communication highlights some of the ethical and possible legal responsibilities which pertain to the taking, reading, reporting, and communication of findings from cone-beam computed tomography (CBCT) scans. The importance of knowledge of head and neck anatomy and pathology to reduce the likelihood of incorrect interpretation is emphasised. Failure to detect critical findings in any diagnostic image can potentially result in medico-legal consequences. CBCT is no exception to this rule. Dental schools are advised to include CBCT imaging as a diagnostic tool in their under- and postgraduate curricula thereby equipping graduates to use 3D imaging in general and CBCT in particular. Existing dental practitioners are advised to seek continuing education on 3D imaging as part of their required lifelong learning.

  8. A medico-legal evaluation of the use of assisted reproductive technologies in Turkey.

    PubMed

    Pelin, S S

    1997-01-01

    In Turkey, as possibly in the case of several or even many other countries, infertility is generally regarded as a negative phenomenon in women. Assisted Reproductive Technologies (ARTs), which provide certain childless couples with the possibility of having a baby, are being applied more and more frequently in this country, apparently as has been the case in the world at large. From a medicolegal point of view, the related applications in Turkey can only be realized in the case of married couples. Other forms of application in this area, on the other hand, such as sperm banks or surrogate motherhood, are not allowed legally. A text which was called "Guidelines Regarding the Centers of In Vitro Fertilization and Embryo Transfer" was prepared in 1987 by the Ministry of Health. The aim of these Guidelines is to find solutions to the medico-legal problems created by the application of ARTs in this country.

  9. Danger points, complications and medico-legal aspects in endoscopic sinus surgery

    PubMed Central

    Hosemann, W.; Draf, C.

    2013-01-01

    Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5–1%. A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education. PMID:24403974

  10. Osler and the "medico-chirurgical neurologists": Horsley, Cushing, and Penfield.

    PubMed

    Feindel, William

    2003-07-01

    Sir Victor Horsley's lecture "On the Technique of Operations on the Central Nervous System," delivered in Toronto in 1906, set the stage for an appraisal of Sir William Osler as a protagonist for the emerging specialty of neurosurgery. During his time at McGill University from 1871 to 1884, Osler performed more than 1000 autopsies. Hispathological reports covered the topics of cerebral aneurysm, apoplectic hemorrhage, vascular infarction, subdural hematoma, meningitis, multiple sclerosis, cerebral abscess, and brain tumor. He wrote about cerebral localization and anatomy and the relationships between the morphological characteristics of the brain and intelligence and criminality. During his continuing career at Philadelphia and Baltimore, Osler published widely on problems in clinical neurology, including monographs on cerebral palsies and chorea as well as chapters on disorders of the nervous system in the first five editions of his popular textbook, The Principles and Practice of Medicine. He became familiar with many of the outstanding figures in medical neurology of his time. Regarding neurosurgery, Osler commended the pioneer operation for a brain tumor in 1884 by Rickman Godlee and the surgery for epilepsy in 1886 by Horsley. In 1907, in discussing the state of brain surgery as reviewed by Horsley, William Macewen, and others, Osler made a plea for "medico-chirurgical neurologists, properly trained in the anatomical, physiological, clinical and surgical aspects of the subject." He played a significant role as a referring physician, mentor, and friend to his young colleague Harvey Cushing (later to become Osler's Boswell), who was breaking new ground in neurosurgery at Johns Hopkins Hospital. Beyond that Osler became an inspiring hero figure for his Oxford student Wilder Penfield, who a few decades later would establish a neurological institute at McGill University where medico-chirurgical neurology would flourish.

  11. The effectiveness of clinical problem-based learning model of medico-jurisprudence education on general law knowledge for Obstetrics/Gynecological interns.

    PubMed

    Chang, Hui-Chin; Wang, Ning-Yen; Ko, Wen-Ru; Yu, You-Tsz; Lin, Long-Yau; Tsai, Hui-Fang

    2017-06-01

    The effective education method of medico-jurisprudence for medical students is unclear. The study was designed to evaluate the effectiveness of problem-based learning (PBL) model teaching medico-jurisprudence in clinical setting on General Law Knowledge (GLK) for medical students. Senior medical students attending either campus-based law curriculum or Obstetrics/Gynecology (Ob/Gyn) clinical setting morning meeting from February to July in 2015 were enrolled. A validated questionnaire comprising 45 questions were completed before and after the law education. The interns attending clinical setting small group improvisation medico-jurisprudence problem-based learning education had significantly better GLK scores than the GLK of students attending campus-based medical law education course after the period studied. PBL teaching model of medico-jurisprudence is an ideal alternative pedagogy model in medical law education curriculum. Copyright © 2017. Published by Elsevier B.V.

  12. "Against all hushing up and stamping down": the Medico-Psychological Clinic of London and the novelist May Sinclair.

    PubMed

    Martindale, Philippa

    2004-01-01

    May Sinclair (1863-1946) was one of the first modern novelists to appropriate psychoanalytic theories in her works. She was an early reader of the new psychoanalytic techniques but, rather than embracing its theories wholeheartedly and unquestioningly, she synthesized those that appealed to her own psychology of womanhood. Moreover, Sinclair's position was a unique one. As well as a highly acclaimed novelist with a respected public voice, she was closely associated with the setting up of one of the first psychotherapeutic centres in Britain, the Medico-Psychological Clinic of London. In this paper, I argue that the eclectic psychoanalytic situations in which Sinclair places her literary heroines mirror the eclectic and potentially feminist endeavours of the medico-Psychological Clinic. I draw upon archival material, hitherto unexamined by literary critics and medical historians, to reflect upon the turbulent lifespan of the Clinic and the attempts to curtail its controversial practices.

  13. [Medico-legal opinions in penal cases provided by clinicians and forensic medicine specialists--comparative analysis].

    PubMed

    Chowaniec, Czesław; Chowaniec, Małgorzata; Nowak, Agnieszka

    2005-01-01

    From the practice of the Forensic Medicine Department, Medical University of Silesia, Katowice it appears that in criminal cases the level of medico-legal opinions provided by experts appointed by the district court or 'ad hoc' is very low. The analysis of the chosen files shoved a divergence of opinions given to the adopted motions as well as numerous offences to regulations in the nature of a consultative error. In the paper the authors have made an attempt to appraise causes of the above mentioned problems such as: 1. the lack of medico-legal knowledge and experience in court experts. 2. excessive ease of registration to the panel of court experts and the lack of processes which verify the qualifications of experts. 3. the lack of judicial control over expert's opinions and common acceptance of their work. 4. ignorance of the obligatory penal law. 5. ignorance of the basic rules for giving medico-legal opinions (legal consequences, casual nexus). 6. excessive but groundless self-confidence in experts. 7. the lack of a correct way of thinking and conclusion making. The aim of the paper was to pay close attention to the absolute need of verification of court experts' qualifications and work.

  14. To err is human: Quality management practices in surgical oral pathology, a safety net for medico-legal complications.

    PubMed

    Venkatraman, Narayan T; Bhadranna, Abhishek; Shenoy, Sadhana; Mohanty, Leeky

    2013-05-01

    Reading a slide and rendering a diagnosis is not only a science but also requires us to appreciate the constant artifact that is introduced in a controlled manner by tissue processing and obtaining a stained tissue section. There are a number of steps involved in getting the final stained tissue section and all these procedures if not performed properly have the potential to give rise to erroneous picture on the slide. Simple errors in judgments can lead to wrong diagnosis and unwarranted treatment. Such mistakes can put us at risk for Medico-Legal problems. The subject of Medico-Legal issues and practice of pathology has been neglected and amount of information available to the practicing professional in India is scarce. This paper focuses on standardized procedures for the various histopathology laboratory exercises. The paper highlights the importance of proper record maintenance with reporting protocols. A list of do's and don'ts for an Oral Pathologist is provided to help him/her in reducing the probable Medico-Legal issues. It does not in any way address the issue of individual competence and diagnostic abilities: That is an aspect for each individual to introspect upon and take remedial action.

  15. Humans in Space: Summarizing the Medico-Biological Results of the Space Shuttle Program

    NASA Technical Reports Server (NTRS)

    Risin, Diana; Stepaniak, P. C.; Grounds, D. J.

    2011-01-01

    As we celebrate the 50th anniversary of Gagarin's flight that opened the era of Humans in Space we also commemorate the 30th anniversary of the Space Shuttle Program (SSP) which was triumphantly completed by the flight of STS-135 on July 21, 2011. These were great milestones in the history of Human Space Exploration. Many important questions regarding the ability of humans to adapt and function in space were answered for the past 50 years and many lessons have been learned. Significant contribution to answering these questions was made by the SSP. To ensure the availability of the Shuttle Program experiences to the international space community NASA has made a decision to summarize the medico-biological results of the SSP in a fundamental edition that is scheduled to be completed by the end of 2011 beginning 2012. The goal of this edition is to define the normal responses of the major physiological systems to short-duration space flights and provide a comprehensive source of information for planning, ensuring successful operational activities and for management of potential medical problems that might arise during future long-term space missions. The book includes the following sections: 1. History of Shuttle Biomedical Research and Operations; 2. Medical Operations Overview Systems, Monitoring, and Care; 3. Biomedical Research Overview; 4. System-specific Adaptations/Responses, Issues, and Countermeasures; 5. Multisystem Issues and Countermeasures. In addition, selected operational documents will be presented in the appendices. The chapters are written by well-recognized experts in appropriate fields, peer reviewed, and edited by physicians and scientists with extensive expertise in space medical operations and space-related biomedical research. As Space Exploration continues the major question whether humans are capable of adapting to long term presence and adequate functioning in space habitats remains to be answered We expect that the comprehensive review of

  16. Urologia: aspetti medico-legali. Cosa l'urologo non può non sapere.

    PubMed

    Rizzotto, Antonio

    2014-12-03

    Medico-legal notes in urologyIn recent years, claims for damages for medical liability have significantly increased. This implies that urologists need to know at least some basic concepts and updates regarding Forensic Medicine. Hence it is mandatory that, beyond the requirements of the law, every physician is covered by insurance liability for medical professionals. With the aim to protect and help the urologist in response to a claim for damages, the Italian Society of Urology has established and activated a "urological first aid", which any member can turn to in a moment of need. In the case of an accident, urologists can contact the "urological first aid" otherwise they can send a letter within 3 days to his/her insurance company, which will analyze the complaint and prepare a brief statement of defence and choose a civil lawyer specializing in medical professional liability. In this paper we will deal with some concepts of forensic medicine, distinguishing between public-liability and penal setting.

  17. Ejection in hostile environments: medico-psychological aspects for the fighter pilot.

    PubMed

    Daudin, Marianne; Renard, Magali-Diane; Louzon, Virginie; Chollet, Sabine; Colas, Marie-Dominique

    2013-08-01

    In the French Air Force, commitment of fighter squadrons in Afghanistan revives the fear among pilots of being ejected in a hostile environment, along with the prospect of being captured. Although ejection in a hostile environment is an exceptional event, it is what flight crews fear most strongly over enemy territory. Since the widespread use of ejection seats in fighter aircraft in the 1950s, ejection has become a means of protecting the crews' lives. Ejection is a breaking point when the pilot suddenly passes from an intense activity to a passive position in which he (or she) is often helpless and sometimes exposed to the hostility of the environment where he lands. It is always important to analyze the circumstances surrounding an ejection. Some clinical observations allow us to understand the psycho-traumatic potential of this brutal experience. In a hostile environment, ejection quite rapidly becomes a question of survival. The pilot is technically and physically prepared during training. He (or she) regularly trains for the use of the ejection seat and the equipment to protect himself, to report, and ensure his survival until his recovery. Because it is always a singular event, on a case-by-case basis, no psychological reaction to such a situation can be modeled with a view to predicting psycho-traumatic disorders. Since 2007, there has been a medico-psychological supporting device, organized by the French Air Force, to be used after this type of event.

  18. The medico-artistic phenomenon and its implications for medical education.

    PubMed

    Weisz, G M; Albury, W R

    2010-01-01

    A better understanding of the relationship between medicine and art could have significant implications for the role of the creative arts in medical education. This study seeks to contribute to that understanding by providing an overview of the involvement of medical practitioners in artistic creation from the Renaissance to the present--based on historical material, statements published by medico-artists in professional journals, and an informal survey of members of a Medical Art Society. Our findings support the hypothesis that there are close links between medical practice and artistic creativity, and that individuals who engage in both forms of activity find the interaction beneficial. The implications of this hypothesis are that the inclusion of practical art training in the medical curriculum would not only enrich the experience of medical students during their education, but would also enhance their later wellbeing, both while they are engaged in medical practice and after they have retired. Although this study is preliminary, we believe that we have identified a consistent relationship which, if established, would have significant implications for medical education, and which therefore merits further investigation by psychological, sociological and educational researchers. The article concludes with some suggestions for further research.

  19. Student perceptions of medico-legal autopsy demonstrations in a student-centred curriculum.

    PubMed

    McNamee, Lakshini S; O'Brien, Frances Y; Botha, Julia H

    2009-01-01

    Teaching autopsies in undergraduate medicine, although traditionally considered valuable by both educators and students, have been marginalised in modern curricula. This study explored medical students' experiences of the medico-legal autopsy demonstrations which formed part of their training in forensic medicine. In this phenomenological study, qualitative data obtained by interviewing 10 Year 4 medical students from various socio-cultural backgrounds were interpretively examined. One-to-one, semi-structured interviews were tape-recorded and transcribed. The data were thematically organised and then analysed using a theoretical framework of three dimensions of learning, namely, cognitive, emotional and societal. Students still perceive autopsies as essential even in the context of self-directed learning. They identified a better understanding of anatomy and traumatology as the main cognitive benefits. At an emotional level students felt they had developed a degree of clinical detachment and would be better equipped to deal with issues surrounding death. Although socialisation influenced students' feelings about the autopsy, it did not detract from their appreciation of the educational value of the experience. The results support previous findings from both students, prior to curriculum reform, and medical educators who were canvassed for their opinions in relation to a modern curriculum. Besides the obvious cognitive advantages, educators should be mindful of the hidden curriculum that emanates from autopsies because it impacts on the development of professionalism and ethical behaviours of future medical practitioners.

  20. Forensic Odontology: A Boon to Community in Medico-legal Affairs.

    PubMed

    Chidambaram, R

    2016-01-01

    Forensic odontology is a sub-discipline of dental science which involves the relationship between dentistry and the law. The specialty of forensic odontology is applied in radiographic investigation, human bite marks analysis, anthropologic examination and during mass disasters. Besides the fact that radiographs require pretentious laboratory, it is still claimed to be a facile, rapid, non-invasive method of age identification in the deceased. The budding DNA technology has conquered the traditional procedures and currently being contemplated as chief investigating tool in revealing the hidden mysteries of victims and suspects, especially in hopeless circumstances. Forensic odontology has played a chief role in solving cold cases and proved to be strong evidence in the court of law. Systematic collection of dental records and preservation of the same would marshal the legal officials in identification of the deceased. To serve the forensic operation and legal authorities, dental professionals need to be familiar with the basics of forensic odontology, which would create a consciousness to preserve the dental data. The aim of this paper is to emphasize the vital applications of forensic odontology in medico-legal issues. Conjointly the recent advancements applied in forensic human identification have been updated.

  1. [Medico-economic analysis of a neurosurgery department at a university hospital].

    PubMed

    Lemaire, J-J; Delom, C; Coste, A; Khalil, T; Jourdy, J-C; Pontier, B; Gabrillargues, J; Sinardet, D; Chabanne, A; Achim, V; Sakka, L; Coste, J; Chazal, J; Salagnac, A; Coll, G; Irthum, B

    2015-02-01

    Economic and societal constraints require to take into account the economic dimension and medical performance of hospital departments. We carried out a self-assessment study, which we thought could be useful to share with the neurosurgical community. Care and research activities were assessed from 2009 to 2013. We used institutional and assessment-body parameters in order to describe activities and perform a financial evaluation. It was a retrospective descriptive study based on the guidelines of the DHOS/O4 circular No. 2007/390 of October 29, 2007. The average annual, analytic income statement was +1.39 millions euros, for 63 beds with a 92% occupancy rate, including 6.7 full-time equivalent neurosurgeons (and assistants), for 2553 patients and 1975 surgeries. The average mortality rate was 2.74%. The annual mean length of stay was 6.82 days. Per year, on average 15.6% of patients were admitted in emergency and 76.9% returned home. The annual, act-related-pricing and publication-related incomes represented 77% and 0.6%, respectively of the total funding. Difficulties to find downstream beds for the most severe patients induced 1401 "waiting days" in 2012. Medico-economic analysis of a neurosurgery department at a university hospital was useful in order to take into account the care, teaching and research activities, as well as its related financial value. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Fatal Clostridium perfringens septicemia suggested by postmortem computed tomography: A medico-legal autopsy case report.

    PubMed

    Yamaguchi, Rutsuko; Makino, Yohsuke; Chiba, Fumiko; Motomura, Ayumi; Inokuchi, Go; Yajima, Daisuke; Iwase, Hirotatro

    2015-08-01

    We report a fatal case of suspected Clostridium (Cl.) perfringens septicemia in a previously healthy woman in her eighties. At first, she presented at the hospital complaining of upper abdominal discomfort and vomiting, and was discharged the next day after ruling out any fatal conditions. However, her condition deteriorated approximately 10h after discharge and she died shortly after. The postmortem computed tomography (PMCT) performed 29h postmortem revealed an excessive systemic gas accumulation compared with the postmortem external appearance and time elapsed since her death, which suggested the presence of a gas-forming infection. Histopathological examination showed diffuse proliferation of Gram-positive bacilli in almost all the organ tissues, especially in blood vessels. Along with these findings, hyperthermia 3h postmortem, and severe anemia and thrombocytopenia without an obvious site of hemorrhage suggested hemolysis due to Cl. perfringens septicemia. These findings suggested the diagnosis before performing the conventional autopsy. To the best of our knowledge, this is the first case report to describe PMCT findings of gas-forming infection and septicemia in contrast with the external appearance and histopathological findings in a medico-legal autopsy setting. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. [Medico-economic evaluation of treatment of inguinal hernia: Shouldice vs. laparoscopy].

    PubMed

    Damamme, A; Samama, G; D'Alche-Gautier, M J; Chanavel, N; Bréfort, J L; Le Roux, Y

    1998-01-01

    Between May 1994 and September 1995, 64 men were included in a randomized prospective study comparing conventional Shouldice repair (S group) and transperitoneal laparoscopic repair with polypropylene mesh (L group). Cost evaluation was divided into distinct parts: drugs, non usable surgical materials, medico-technical procedures food and employees costs. In group S, mean operating time was 56', total cost was 3,922 FF in the case of unilateral hernia and 4,808 FF and respectively 77' in the case of bilateral hernia. In group L, mean operative time was 89', total cost 8,949 FF (disposable trocars) and 7,136 FF (non-disposable trocars) in the case of unilateral hernia and 116', 9,570 FF and 7,763 FF in case of bilateral hernia. Postoperative stay was 4.2 days in group S and 4 days in group L. Return to work was 28.6 days in group L and 35.5 days in group S (ns). In conclusion laparoscopic hernia repair does not decrease post operative pain, hospital stay and return to work, but is twice as expensive.

  4. Quality of Life and Medico-Legal Implications Following Iatrogenic Bile Duct Injuries.

    PubMed

    Hariharan, Deepak; Psaltis, Emmanouil; Scholefield, John H; Lobo, Dileep N

    2017-01-01

    In this review we aimed to evaluate quality of life after bile duct injury and the consequent medico-legal implications. A comprehensive English language literature search was performed on MEDLINE, Embase, Science Citation Index and Google™ Scholar databases for articles published between January 2000 and April 2016. The last date of search was 11 April 2016. Key search words included bile duct injury, iatrogenic, cholecystectomy, prevention, risks, outcomes, quality of life, litigation and were used in combination with the Boolean operators AND, OR and NOT. Long-term survival after bile duct injury is significantly impaired (all-cause long-term mortality approximately 21 %) along with the quality of life (especially psychological/mental state remains affected). Bile duct injury is associated with high rates of litigation. Monetary compensation varied from £2500 to £216,000 in the UK, €9826-€55,301 in the Netherlands and $628,138-$2,891,421 in the USA. Bile duct injuries have profound implications for patients, medical personnel and healthcare providers as they cause significant morbidity and mortality, high rates of litigation and raised healthcare expenditure.

  5. The role of fillers in aesthetic medicine: medico-legal aspects.

    PubMed

    Marinelli, E; Montanari Vergallo, G; Reale, G; di Luca, A; Catarinozzi, I; Napoletano, S; Zaami, S

    2016-11-01

    In recent years there has been an exponential increase of fillers use in aesthetic medicine. The popularity of this anti-wrinkle product is based on their capacity to offer significant improvement in the aesthetic field, particularly to skin rejuvenating processes with non-invasive and less expensive techniques, if compared to the surgical methods (i.e. surgical lifting). The great number of fillers on the market is composed of a large heterogenic number of biomaterials. The aim of this review was to provide an overview and a classification of the filling materials that are most commonly used. A synthesis of the literature concerning fillers and related side effects was also reported. The law decree no. 23 of 1998, converted in the law no. 94 of 1998 and the principal judgments of the Italian Court of Cassation have been examined with the medico-legal issues related to fillers use in medicine. With respect to their degradation, filler materials may be classified as temporary (degradable), semi-permanent and permanent (not degradable). The temporary fillers such as hyaluronic acid and collagen are completely degraded by the surrounding tissue in a few months. The permanent fillers, such as the ones derived from silicon oil and minerals are not biodegradable and may cause serious and irreversible side effects. Their use requires a physician with a high level of specialization to perform the treatment, a deep knowledge of face anatomy and a great degree of experience.

  6. Diptera of Medico-Legal Importance Associated With Pig Carrion in a Tropical Dry Forest.

    PubMed

    Vasconcelos, S D; Salgado, R L; Barbosa, T M; Souza, J R B

    2016-06-20

    The diversity of necrophagous Diptera is largely unknown in seasonally dry tropical forests, despite their medical, veterinary, and forensic relevance. We performed a study in the dry Caatinga forest exclusive to Brazil in order to assess the diversity and temporal pattern of Diptera species using pig carcasses as substrates. Adults were collected daily until complete skeletonization. We collected 17,142 adults from 18 families, 10 of which comprise species with known necrophagous habits. The most abundant families were Calliphoridae (47.3% of specimens), Sarcophagidae (20.8%), and Muscidae (15.5%), whereas Sarcophagidae stood out in terms of richness with 21 species. The native Cochliomyia macellaria (F.) (Diptera: Calliphoridae) and the invasive Chrysomya albiceps (Wiedmann) (Calliphoridae) were the dominant species. A total of 18 species reached the carcass during the first 48 h postdeath. The bloated and active decay stages had the highest richness and abundance of dipterans. From a forensic standpoint, C. macellaria and C. albiceps are likely to aid in establishing postmortem interval due to their early arrival and high abundance on the carcass. Despite harsh environmental conditions, the Caatinga harbors a rich assemblage of dipterans that play a key role in carrion decomposition. Their medico-veterinary importance is strengthened by the poor local sanitary conditions.

  7. The use of a medico economic database as a part of French apheresis registry.

    PubMed

    Kanouni, T; Aubas, P; Heshmati, F

    2017-02-01

    An apheresis registry is a part of each learned apheresis society. The interest in this is obvious, in terms of knowledge of the practice of apheresis, adverse events, and technical issues. However, because of the weight of data entry it could never be exhaustive and some data will be missing. While continuing our registry efforts and our efforts to match with other existing registries, we decided to extend the data collection to a medico-economic database that is available in France, the Programme de Médicalisation du Système d'Information (PMSI) that has covered reimbursement information for each public or private hospital since 2007. It contains almost all apheresis procedures in all apheresis fields, demographic patient data, and primary and related diagnoses, among other data. Although this data does not include technical apheresis issues or other complications of the procedures, its interest is great and it is complementary to the registry. From 2003-2014, we have recorded 250,585 apheresis procedures, for 48,428 patients. We showed that the data are reliable and exhaustive. The information shows a perfect real life practice in apheresis, regarding indications, the rhythm and the duration of apheresis treatment. This prospective data collection is sustainable and allows us to assess the impact of healthcare guidelines. Our objective is to extend the data collection and match it to other existing databases; this will allow us to conduct, for example, a cohort study specifically for ECP.

  8. Deaths on board ships assisted by the Centro Internazionale Radio Medico in the last 25 years.

    PubMed

    Grappasonni, Iolanda; Petrelli, Fabio; Amenta, Francesco

    2012-07-01

    Data on occupational diseases of seafarers and of causes of death during their career are sparse. The causes of deaths on board ships assisted by Centro Internazionale Radio Medico (CIRM), the Italian Telemedical Maritime Assistance Service (TMAS) were reviewed by examining 29,146 files of patients treated from 1986 to 2010. In the 25 years, 383 deaths occurred (1.31%). Diseases of the circulation were the most frequent, followed by external causes such as accidents and violence, infectious and parasitic diseases, alcohol and drug addiction, respiratory system diseases. Cardiovascular and external causes were the principal causes of deaths among seafarers. This investigation is the first study on the causes of death on board ships obtained from data of a maritime telemedical centre, that has assisted seafarers when they were alive or immediately after their death. The fact that diseases of the circulatory system are the first cause of death of sailing seafarers deserves specific initiatives. They should include campaigns for adequate lifestyles and the availability on ships of medical devices useful for diagnostic purposes, resuscitation as well as for verification of death. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Characteristics of victims of violence admitted to a specialized medico-legal unit in Switzerland.

    PubMed

    Hofner, Marie-Claude; Burquier, Raphaelle; Huissoud, Thérèse; Romain, Nathalie; Graz, Bertrand; Mangin, Patrice

    2009-07-01

    To improve care and services to victims of interpersonal violence, a medico-legal consultation unit was set up at the Lausanne University Hospital, Switzerland in 2006. Adult victims of violence are referred to the consultation by the emergency department. Patients are received by forensic nurses for support, forensic examination and community orientation. A descriptive study of medical reports filled for the 2006 population was conducted in 2007 with the aim to explore characteristics of this specific population and to better orient prevention. Among the 422 patients in 2006, 57% were men and 43% women, with a median age of 31 years old. Violent episodes took place in a public place for 90% of male victims and at home for 70% of female victims. The perpetrators were mostly unknown to male victims (62% of all men victims) and mostly known (usually the partner or a former partner) to female victims (90% of all women victims). For 80% of the women and 47% of the men, the violent event which brought them to the consultation, was not the first one. Because 90% of all patients under study were victimized by men., not only is it necessary to target prevention program to match the potential victims, prevention messages must also focus on potential offenders, especially on young men.

  10. [The possibility of medico-legal opinionating on medical error in cases of waived postmortem examination].

    PubMed

    Kunz, Jerzy

    2008-01-01

    For several years now, with the introduction of the health care sector reform we have been observing a considerable drop in the number of postmortem examinations performed in patients who died in hospitals. The decrease amounts to as much as 50 to 70%. This is undoubtedly a consequence of financial restrictions imposed on the management of these inpatient facilities. On the other hand, Departments of Forensic Medicine established to evaluate the so-called medical errors are swamped with an increasing avalanche of complaints concerning the appropriateness of therapeutic management. This leads to a growing number of orders from penal prosecution and jurisdiction agencies with requests for assessment whether a medical error has been committed in a particular case. The result of a postmortem examination is practically the only basis for a factual evaluation of a given case. When no autopsy has been performed, the experts are virtually helpless, and in the majority of such instances, they are forced to refuse passing an expert opinion. The report presents basic principles of medico-legal opinionating in criminal cases (including proceedings pertaining to medical errors), the rules governing the medical error assessment, as well as problems encountered in evaluating the appropriate course of treatment when a post mortem examination has been waived.

  11. [Medico-legal opinionating in cases of medical errors in declaration of death].

    PubMed

    Jurek, Tomasz; Swiatek, Barbara; Drozd, Radosław

    2007-01-01

    Declaration of death is a diagnosis and it has legal consequences. While declaring death, there is a possibility of committing a medical error. The majority of irregularities in declaring an individual dead occur in emergency situations. When a physician declares death, he is released from the professional obligation of saving the individual's life. The studies were based on the results of medico-legal evaluations in criminal cases in medical errors. In case death is erroneously declared, we may face a situation of squandering the chance of saving the life of a human being. Exposure to loss of life or to severe detriment to health are possible charges here, along with failure to offer medical assistance, although a deliberate character of the offence according to article 162 of the Polish penal code renders such a legal qualification dubious in case of medical errors. In both cases verification is needed whether an interest protected by law was still in existence, i.e. whether the individual was still alive when the physician incorrectly declared him dead.

  12. Accidents on board merchant ships. Suggestions based on Centro Internazionale Radio Medico (CIRM) experience.

    PubMed

    Napoleone, Paolo

    2016-01-01

    This statistical study was performed to find out the occurrence of accidents on board ships assisted by Centro Internazionale Radio Medico (CIRM) during the years 2010-2015, with the aim of providing suggestions in accident prevention, based on such a wide experience. The case histories of CIRM in the years 2010-2015 were examined. The total number of accidents per year was calculated and compared as a percentage with the total number of cases assisted by CIRM per year. The incidence of accidents on board in these years ranged between 14.4% and 18.4% of total cases assisted per year, which is constantly increasing. The most common injuries on board among cases treated by CIRM were contusions and wounds. Also burns and eye injuries were significantly represented. Multiple injuries and head injuries were found to be the most frequent cause of death on board due to an accident. More information on the occurrence and type of accidents and on the body injured areas should represent the basis for developing strategies and campaigns for their prevention.

  13. [Selected medico-legal problems in cases of poisoning with substances of abuse].

    PubMed

    Kłys, M; Klementowicz, W; Trela, F

    1997-01-01

    In toxicological examinations of substances of abuse with respect to medico-legal purposes many problems have been discussed. A selection of biological material and proper analytical methods in confrontation with interpretation of results in reference to the subject in question seems to be a central toxicological issue. Blood and urine samples are usually used in cases of human. The problem is more complicated if it concerns dead subjects on the account of postmortem processes in a body. From this point of view, in fatal cases of poisonings experience proves, besides blood and urine also other body fluids such as: cerebrospinal fluid, vitreous humor, perilymph and bile turned out to be usefull for examinations of various xenobiotics. The analytical methods (FPIA, HPLC, GC-MS) have been used for qualitative and quantitative evaluation in wide range of xenobiotic concentration in biological matrix. Interpretation of the results including such problems as toxic interaction, metabolism, data base has been discussed in the study on the basis of intoxication cases with substances of abuse.

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

    PubMed Central

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

    2009-01-01

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

  15. An algorithm to identify patients with treated type 2 diabetes using medico-administrative data

    PubMed Central

    2011-01-01

    Background National authorities have to follow the evolution of diabetes to implement public health policies. An algorithm was developed to identify patients with treated type 2 diabetes and estimate its annual prevalence in Luxembourg using health insurance claims when no diagnosis code is available. Methods The DIABECOLUX algorithm was based on patients' age as well as type and number of hypoglycemic agents reimbursed between 1995 and 2006. Algorithm validation was performed using the results of a national study based on medical data. Sensitivity, specificity and predictive values were estimated. Results The sensitivity of the DIABECOLUX algorithm was found superior to 98.2%. Between 2000 and 2006, 22,178 patients were treated for diabetes in Luxembourg, among whom 21,068 for type 2 diabetes (95%). The prevalence was estimated at 3.79% in 2006 and followed an increasing linear trend during the period. In 2005, the prevalence was low for young age classes and increased rapidly from 40 to 70 for male and 80 for female, reaching a peak of, respectively 17.0% and 14.3% before decreasing. Conclusions The DIABECOLUX algorithm is relevant to identify treated type 2 diabetes patients. It is reproducible and should be transferable to every country using medico-administrative databases not including diagnosis codes. Although undiagnosed patients and others with lifestyle recommendations only were not considered in this study, this algorithm is a cheap and easy-to-use tool to inform health authorities. Further studies will use this tool with the aim of improving the quality of health care dedicated to diabetic patients in Luxembourg. PMID:21492480

  16. [Sudden death secondary to acute aortic syndromes in the North of Portugal: medico-legal study].

    PubMed

    Moreira, Pedro Costa; Santos, Agostinho

    2013-01-01

    An evaluation is presented on the clinical, pathological and sociodemographic characteristics of a sample of sudden death victims secondary to an Acute Aortic Syndrome (AAS) in the north of Portugal, submitted to medico-legal autopsy, during the period between January 2008 and December 2012. Autopsy reports were analyzed in which, through necropsy and histological examination, the confirmed cause of death was an Acute Aortic Syndrome. From the studied cases, 70.3% of the victims were male. The median age was 65,19 ± 14,35 years (minimum of 27 years and maximum of 88 years). Death occurred mainly at home (40,5%) and during the normal activities of daily living (43,1%). There was an history of prodromes in 64,9% of the cases, mainly syncope and pain or respiratory symptoms. In 62,2% of the cases no pain history was reported. In the internal examination three presentation forms were identified: cardiac tamponade (51,4%); hemotorax (16,2%) and intra-abdominal bleeding (32,4%). The occurence of an Acute Aortic Syndrome was related to an aneurysmatic formation in 81% of the cases. Atherosclerotic plaques were identified in 51,4% of the cases and left ventricular hypertrophy was identified in 54,1%. None of the victims had a family history of aortic pathology and 54,1% of them presented a history of arterial hypertension. Necropsy data analysis of sudden death victims allows a better understanding of the AAS presentation, thus complementing the existent clinical studies. This work reveals how forensic medicine can be a privileged medium for articulation with clinical practice.

  17. Resins and Gums in Historical Iatrosophia Texts from Cyprus - A Botanical and Medico-pharmacological Approach.

    PubMed

    Lardos, Andreas; Prieto-Garcia, José; Heinrich, Michael

    2011-01-01

    This study explores historical iatrosophia texts from Cyprus from a botanical and medico-pharmacological point of view focusing on remedies containing resins and gums. The iatrosophia are a genre of Greek medical literature of Byzantine origin and can be described as medicine handbooks which serve as therapeutic repositories containing recipes or advice. To extract and analyze information on plant usage in such sources - which are largely unedited texts and so far have not been translated - we investigate (i) the relationship of the iatrosophia to Dioscorides' De Materia Medica as well as historic pharmaceutical books or standard texts on modern phytotherapy and (ii) the validity of the remedies by comparing them to modern scientific data on reported biological activities. In the six texts investigated 27 substances incorporating plant exudates are mentioned. They are obtained from over 43 taxa of higher plants and in particular are used to treat dermatological, gastrointestinal, and respiratory tract conditions. The comparison to historic pharmaceutical books and phytotherapy texts reflects the gradual decline of the use of plant exudates in Western medicine. While remarkable parallels to Dioscorides' text exist, the non-Dioscoridean influence suggests a complex pattern of knowledge exchange. Overall, this resulted in an integration of knowledge from so far poorly understood sources. The comparison with bioscientific data reveals a fragmentary picture and highlights the potential of these unexplored substances and their uses. Where relevant bioscientific data are available, we generally found a confirmation. This points to a largely rational use of the associated remedies. Taken together, the iatrosophia are a valuable resource for ethnopharmacological and natural product research. Most importantly they contribute to the understanding of the development of herbal medicines in the (Eastern) Mediterranean and Europe.

  18. Medico-economic study of the management of hepatocellular carcinoma by chemo-embolization.

    PubMed

    Clouet, J; Audureau, D; Lefranc, B; Maillard, N; Guilé, R; Frampas, E; Perret, C; Grimandi, G

    2014-04-01

    This study has two aims. The first is to compare conventional lipiodol chemo-embolization (Trans Arterial Chemo-Embolization - TACE) to one using pre-loaded particles (Trans Arterial Chemo-Embolisation-Drug Eluted Bead - TACE-DEB) using a cost minimization study. The second is to define the fundable nature of TACE-DEB and the conditions under which it is cost-effective. Retrospective study of patients treated by chemo-embolization (n=31: TACE; n=32: TACE-DEB) during the year 2010. The cost minimization study was conducted from the hospital perspective. Direct medical costs were calculated and compared using the readjusted ENCC (National Studies of Costs by Common Methodology) method. The affordability of the two techniques and definition of a cost-effective hypothesis (break-even point) were also established. All DRGs combined, lengths of stay (TACE: 4.90 ± 3.36; TACE-DEB: 5.03 ± 3.36) does not change significantly. An average upper mean cost for TACE-DEB is described (TACE: 2869.05 €; TACE-DEB: 3960.10 €). The affordability calculations in the study show that, overall, TACE-DEB can be funded regardless of DRG. A ratio of 1.3 procedures using the conventional (TACE) method would enable TACE-DEB procedures to be funded. This medico-economic analysis demonstrates that the TACE-DEB procedure is fundable. Copyright © 2013 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  19. Impact of medico-legal findings on charge filing in cases of rape in adult women.

    PubMed

    Hagemann, Cecilie T; Stene, Lise E; Myhre, Arne K; Ormstad, Kari; Schei, Berit

    2011-11-01

    To assess the impact of the medical documentation and biological trace evidence in rape cases on the legal process. Retrospective descriptive study. Police-reported cases of rape of women ≥16 years old in the Norwegian county of Sør-Trøndelag from January 1997 to June 2003. Police data were merged with data from the Sexual Assault Center at St Olav's Hospital. Charged and non-charged cases were compared. Medico-legal findings and legal outcome. A total of 185 police-reported cases were identified. Of the 101 cases examined at Sexual Assault Center, charges were filed in 18 cases. Extragenital injuries were documented in 49 women; five were life threatening. Anogenital injuries were documented in 14 women; eight had multiple anogenital injuries. Documentation of injuries was not associated with charge filing. In only 33% of the cases were swabs collected from women's genitals used as trace evidence by the police. When used, this increased the likelihood for charge filing. A DNA profile matching the suspect was identified in four of the 18 charged cases and in only one among the 54 non-charged cases. Half of the women had one or more documented injury. Only one-third of the trace evidence kits collected from the women's anogenital area were analyzed. The analysis of swabs was associated with charge filing, regardless of test results. Increased use of such medical evidence, especially in cases of stranger rape, may ensure women's rights and increase available information to the legal system. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

  20. Identification of Muscidae (Diptera) of medico-legal importance by means of wing measurements.

    PubMed

    Grzywacz, Andrzej; Ogiela, Jakub; Tofilski, Adam

    2017-03-16

    Cadavers attract numerous species and genera of Muscidae, both regular elements of carrion insect assemblages, and accidental visitors. Identification of adult Muscidae may be considered difficult, particularly by non-experts. Since species identification is a vital first step in the analysis of entomological material in any forensic entomology orientated experiment and real cases, various alternative methods of species identification have been proposed. We investigated possibility of semiautomated identification by means of wing measurements as an alternative for classic morphology and DNA-based approaches. We examined genus-level identification success for 790 specimens representing 13 genera of the most common European cadavers visiting Muscidae. We found 99.8% of examined specimens correctly identified to the genus-level. Without error, the following were identified: Azelia, Eudasyphora, Graphomya, Hydrotaea, Musca, Muscina, Mydaea, Neomyia, Polietes, Stomoxys and Thricops. Genus-level misidentifications were found only in Helina and Phaonia. Discrimination of examined material on the species level within Hydrotaea (318 specimens representing eight species) and Muscina (163 specimens representing four species) showed lower, yet still high average identification success, 97.2 and 98.8%, respectively. Our results revealed relatively high success in both genus and species identification of Muscidae of medico-legal importance. Semiautomated identification by means of wing measurements can be used by non-experts and does not require sophisticated equipment. This method will facilitate the identification of forensically relevant muscids in comparison to more difficult and more time-consuming identification approaches based on taxonomic keys or DNA-based methods. However, for unambiguous identification of some taxa, we recommend complementary use of identification keys.

  1. [Medico-legal opinions in cases for annulment of testament. Part I. Characteristics of investigative material. Characteristics of testators].

    PubMed

    Marcinkowski, Jerzy T; Klimberg, Aneta

    2007-01-01

    A very important issue in preparing medico-legal opinions is the establishment whether the devisor had the ability to bequeath at the date of preparing a testament. The subsequent loss of the ability of bequeathing does not have any impact on execution of the previously prepared testament. Experts who pass opinions in testament cases evaluate: 1) the testament itself and the circumstances of its preparation, excluding, however, the reliability of records, 2) statements obtained while interrogating witnesses (descriptions of daily life, motivation to bequeath), 3) medical records (files, case histories, discharge records). The investigative material consisted of judicial files in 73 testament cases referred to the Chair and Department of Forensic Medicine (CDFM), University of Medical Sciences, Poznań, by courts from all over Poland in the period 1990-2005 for formulation of medico-legal opinions based on these documents. In 63.0% of cases, CDFM in Poznań was the first opinionating institution; in the remaining instances, previous medico-legal opinions had been given elsewhere; in six cases they were antagonistic. The investigative material included a predominant percentage (75.2%) of ordinary testaments (made before a notary and oligraphic) as opposed to 22% of informal testaments (oral only). Although in the majority of cases (67.2%) only one testament was drawn up, there were also instances (2.7%) where the devisor prepared as many as five testaments. The length of devisors survival following the drawing up of the final testament was generally short. In total, testaments not only in the oral form, but also made before a notary, were prepared by chronically ill individuals presenting with marked clinical symptoms, what was perceived by their family and caregivers as a sign of the imminent death. Hence, the testaments were often drawn up in a hospital room or in a notary office where the patient was taken between consecutive hospitalizations.

  2. [Medico-geographical analysis of the territory: the experience of research in the European North of Russia].

    PubMed

    Dushkova, D O

    2013-01-01

    Detailed analysis of medical-geographical peculiarities in the regions of the European North of Russia is presented Medico-geographical characteristics were revealed to impose certain restrictions on the economic development of the region and serve as prerequisites for the occurrence regional pathologies. The importance of such research to identify spatial patterns in changes in health indices in connection with the regional features and landscape-epidemiological situation has been shown. The main factors contributing to the occurrence and development of natural focal diseases caused by feral herd infections in the investigated area have been described

  3. Drug-related deaths with evidences of body packing: Two case reports and medico-legal issues.

    PubMed

    Cappelletti, Simone; Aromatario, Mariarosaria; Bottoni, Edoardo; Fiore, Paola Antonella; Straccamore, Marco; Umani Ronchi, Federica; De Mari, Guido Maria; Ciallella, Costantino

    2016-05-01

    Body packing is a general term used to indicate the internal transportation of drug packages, mainly cocaine, heroin, amphetamines, and methamphetamine, within the gastrointestinal tract. We described two cases of accidental drug intoxication, observed over the last year period, with evidence of intracorporeal drug concealment. The first case concerned a body packer transporting 69 drug packages of heroin adulterated with piracetam. The second body packer transported 16 drug packages of cocaine adulterated with levamisole. For both cases, forensic examination and toxicological analysis of drug packages and biological samples were carried out. Authors also wants to highlight the main medico-legal issues that commonly arise in cases of suspected or ascertained body packers.

  4. [Total permanent or major permanent inability to work in profession. Remarks about the possibility of criteria verification in medico-legal opinionating in criminal cases].

    PubMed

    Nowak, Agnieszka; Chowaniec, Czesław; Chowaniec, Małgorzata; Rygol, Krystian

    2008-01-01

    Despite the fact that some criteria of medico-legal certification in criminal proceedings have been established, there are still some areas that--parallel to changes occurring in contemporary society--have started to be controversial. This phenomenon has prompted the authors to attempt establishing new criteria for certification in total/major permanent inability to work in profession. This work is a continuation of a cycle devoted to interpretation of article 156 of the Penal Code to meet the needs of medico-legal opinionating.

  5. [Prevalence of enteral patients with suboptimal feeding at Centro Medico Lic. Adolfo Lopez Mateos].

    PubMed

    Baca Molina, Giovanna Paola; Peña Corona, Maribel

    2015-04-01

    Antecedentes y Objetivo: En México, el 64% de los pacientes hospitalizados sufren de desnutrición hospitalaria y hasta un 100% en adultos mayores, se han estudiado las causas, entre ellas se destacan: la sub-alimentación, el tiempo de hospitalización, el catabolismo presente en diversas patologías, falta de interés o tiempo del personal que labora en los hospitales entre otras. El objetivo del presente trabajo fue obtener la prevalencia de sub-alimentación en los pacientes hospitalizados con soporte enteral, en el Centro Médico “Lic. Adolfo López Mateos” (CMLALM) durante el periodo Agosto – Octubre 2014. Metodología: Se diseñó un estudio observacional, transversal, descriptivo; con una población de 52 pacientes con soporte enteral en el que se analizó la prevalencia de pacientes con sub-alimentación a partir de la ministración de la dieta enteral y la prescripción nutricional calórica establecida, durante el periodo de Agosto – Octubre 2014. Resultados: Se realizaron medidas de tendencia central para obtener el porcentaje de pacientes con sub-alimentación calórica. La prevalencia de pacientes con sub-alimentación fue del 71%, con mayor predominio el sexo masculino (70%) y en un rango de edad entre 51 años y 61 años (43%). El servicio médico de hospitalización donde se encontró la mayor prevalencia de pacientes con sub-alimentación fue medicina interna afectando a 14 pacientes (38%), seguido de neurocirugía con 7 pacientes (19%) y unidad de cuidados intensivos (UCI) con 7 pacientes (19%); siendo el turno nocturno donde se presentó en mayor predominio la sub-alimentación. Conclusiones: La sub-alimentación afectó a 37 pacientes con soporte enteral los cuales representan el 71% de la población estudiada, esta cifra coincide con otros estudios similares. La causa principal de la sub-alimentación fue el incumplimiento en la ministración de la dieta enteral.

  6. The medico-legal observation of an aggressive urogenital fibromatosis with isolated development not related to any traumatic event.

    PubMed

    Muccino, Enrico; Gentile, Guendalina; Mantero, Stefano; Marchesi, Matteo; Rancati, Alessandra; Zoja, Riccardo

    2016-03-01

    Desmoid tumor is a fibroproliferative neoplasm with an intermediate malignancy and it can be localized in every bodily district: some locations are considered exceptional, like the urogenital localization. The Author point out a rare case of giant idiopathic scrotal fibromatosis that was found during an autopsy. A widower, that lived alone in poor hygienic conditions, was found dead in his house. The Judicial Authority ordered the autopsy, that was performed two days later at the Medico-Legal Section of Milan University. External examinations revealed only the considerable dimension of the scrotum (cm 24 × 41). The cause of death was fixed in a cardiac tamponade due to a natural heart laceration localized in correspondence of a transmural infarction. The toxicological exam resulted negative, while the histopathological and immunohistochemical analysis qualify the scrotal mass as a desmoids tumor. Due to the absence of predisposing conditions and of fibroproliferative infiltration in bladder and retroperitoneal space, the neoplasm was configured as an idiopathic desmoid tumor. The presented case gives the reason for the discussion concerning medico-legal aspects that are typical of rare neoplasms. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. [Remarks about the position of the medico-legal expert in imperative regulations in the Penal and Civil Codes].

    PubMed

    Chowaniec, Czesław; Nowak, Agnieszka; Chowaniec, Małgorzata; Kobek, Mariusz

    2005-01-01

    In the monograph 'Medico-legal opinions--essays on theory', prof. K. Jaegermann wrote that 'the use of an expert requires theoretical or fairly clear knowledge about the mutual relationship between judge and expert'. In his opinion knowledge of this kind plays a significant role in estimating the usefulness of so-called expert evidence. Practical knowledge about the relationship between the judge and expert is necessary but not a decisive condition not only for a lawyer to be a judge but also for a physician to be a medico-legal expert. An expert can be not only a person appointed by the court but must also possess proper knowledge in a particular field, namely, the required professional and specialist qualifications and must also considered to be impartial. On the basis of the analysis of law in force and imperative regulations in Penal and Civil Codes, the authors have presented remarks relating to the expert's status as well as the lack of judicial control over the activity of experts appointed by court. Verification of professional qualifications in court experts and a reduction of those appointed 'ad hoc' are suggested. In the authors opinion co-operation between lawyers and experts should be improved. It is also essential to introduce statutory legal protection of court experts as well as to undertake activities leading to equaling the status of Polish court experts to that of other European countries.

  8. A retrospective analysis of alcohol in medico-legal autopsied deaths in Pretoria over a 1 year period.

    PubMed

    Ehmke, Ursula; Toit-Prinsloo, Lorraine du; Saayman, Gert

    2014-12-01

    The misuse of alcohol has a particularly detrimental effect and is one of the most significant public health problems in South Africa and it also has an impact on the criminal justice system with evidence of association between high levels of alcohol and risk-taking behaviour, committing crimes, or being a victim of crime. A global trend has been set worldwide with alcohol being one of the most common drugs found in post mortem specimens and especially with regard to cases admitted for medico-legal autopsies. The influence of alcohol on the cause of death is either a contributory or an underlying factor in a substantial number of violent deaths. We retrospectively reviewed 1455 cases, in which alcohol was taken, of 2344 medico-legal autopsies done in 2009. We found that 47% of the cases tested positive for alcohol, with the reported blood alcohol concentrations varying from 0.01 to 0.95g per 100ml (mean=0.16±0.11g per 100ml) with the highest proportion being in the 0.10-0.19g per 100ml range. A breakdown of the results showed that road traffic accidents, assaults and firearm-related deaths predominated the alcohol-positive cases. The results showed that there was a definite correlation between alcohol consumption and the incidence of other that natural deaths.

  9. General practitioners' preferences with regard to colorectal cancer screening organisation Colon cancer screening medico-legal aspects.

    PubMed

    Papin-Lefebvre, Frédérique; Guillaume, Elodie; Moutel, Grégoire; Launoy, Guy; Berchi, Célia

    2017-09-06

    French health authorities put general practitioners at the heart of the colorectal cancer screening. This position raises organisational issues and poses medico-legal problems for the professionals and institutions involved in these campaigns, related to the key concepts of medical decisions and suitability of standards. The objective of our study is to reveal the preferences of general practitioners related to colorectal cancer screening organisation with regard to the medico-legal risk METHODS: A discrete choice questionnaire presenting hypothetical screening scenarios was mailed to 2114 physicians from 20 French different areas. The preferences of 358 general practitioners were analysed using logistic regression models. The factors that have significant impact on the preferences of general practitioners are the capacity of the primary care professional in the procedure, the manner in which pre-screening information is given to patients, the manner in which screening results are given to patients, the number of reminders sent to patients who test positive and who do not undergo a colonoscopy and the remuneration of the attending physician. Our results reveals that current colorectal cancer screening organisation is not adapted to general practitioners preferences. This work offers the public authorities avenues for reflection on possible developments in order to optimize the involvement of general practitioners in the promotion of cancer screening programme. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Using medico-legal data to investigate fatal older road user crash circumstances and risk factors.

    PubMed

    Koppel, Sjaan; Bugeja, Lyndal; Smith, Daisy; Lamb, Ashne; Dwyer, Jeremy; Fitzharris, Michael; Newstead, Stuart; D'Elia, Angelo; Charlton, Judith

    2017-07-31

    This study used medico-legal data to investigate fatal older road user (ORU, aged 65 years and older) crash circumstances and risk factors relating to 4 key components of the Safe System approach (e.g., roads and roadsides, vehicles, road users, and speeds) to identify areas of priority for targeted prevention activity. The Coroners' Court of Victoria's (CCOV) Surveillance Database was searched to identify and describe the frequency and rate per 100,000 population of fatal ORU crashes in the Australian state of Victoria for 2013-2014. Information relating to the deceased ORU, crash characteristics and circumstances, and risk factors was extracted and analyzed. One hundred and thirty-eight unintentional fatal ORU crashes were identified in the CCOV Surveillance Database. Of these fatal ORU crashes, most involved older drivers (44%), followed by older pedestrians (32%), older passengers (17%), older pedal cyclists (4%), older motorcyclists (1%), and older mobility scooter users (1%). The average annual rate of fatal ORU crashes per 100,000 population was 8.1 (95% confidence interval [CI], 6.0-10.2). In terms of the crash characteristics and circumstances, most fatal ORU crashes involved a counterpart (98%), of which the majority were passenger cars (50%) or fixed/stationary objects (25%), including trees (46%) or embankments (23%). In addition, most fatal ORU crashes occurred close to home (73%), on-road (87%), on roads that were paved (94%), on roads with light traffic volume (37%), and during low-risk conditions: between 12 p.m. and 6 p.m. (44%), on weekdays (80%), during daylight (75%), and under dry/clear conditions (81%). Road user (RU) error was identified by the police and/or the coroner for the majority of fatal crashes (55%), with a significant proportion of deceased ORUs deemed to have failed to yield (54%) or misjudged (41%). RU error was the most significant factor identified in fatal ORU crashes, which suggests that there is a limited capacity of the

  11. [Specific medico-social supports for drug-resistant partial epilepsies].

    PubMed

    Gonnaud, P-M

    2004-06-01

    While employment appears to be among major concerns for epileptic patients, these are confronted with a very high rate of unemployment, especially when epilepsy is pharmacoresistant. However, the persistence of seizures is not the only factor bearing on vocational training or employment; other factors may intervene as well: cognitive dysfunctions, psychological/behavioral disturbances, impact of AEDs, education, vocational training, family members and relatives' attitude, school teams' attitude, employers' attitude, occupational physicians' attitude. Educational level is lower when epilepsy started at school-age; persisting seizures together with other problems may lead the epileptic child or teenager to attend specialized schools. In France, there are few institutions dedicated to children or teenagers with severe epilepsy, and these are very unevenly distributed over the French territory. The main social measures regarding children with epilepsy in France are mentioned. Besides being seizure-free and able to drive, work is one major expectation of patients from epilepsy surgery. The results of epilepsy surgery regarding employment are somewhat controversial; in some studies, temporal lobe surgery may not raise the employment rate; other studies point out that operated-on patients need a long time (up to 6 years) to find a job after surgery. The vocational level or the previous work experiences appear to be as important factors for further employment as being seizure-free, a condition which may not be met in all favourable work outcomes. The medico-social support to patients with pharmacoresistant partial epilepsies has to deal with all the factors mentioned previously; the opportunity for epilepsy surgery may have to be considered early in order to try and prevent the detrimental impact of pharmacoresistant epilepsy on school achievement and vocational training; adult patients with pharmacoresistant epilepsy often cumulate a low qualification level, an absence of

  12. Medico-economic evaluation of health products in the context of the Social Security Financing Act for 2012.

    PubMed

    Dervaux, Benoît; Baseilhac, Eric; Fagon, Jean-Yves; Ameye, Véronique; Angot, Pierre; Audry, Antoine; Becquemont, Laurent; Borel, Thomas; Cazeneuve, Béatrice; Courtois, Jocelyn; Detournay, Bruno; Favre, Pascal; Granger, Muriel; Josseran, Anne; Lassale, Catherine; Louvet, Olivier; Pinson, Jean; de Pouvourville, Gérard; Rochaix, Lise; Rumeau-Pichon, Catherine; de Saab, Rima; Schwarzinger, Mickaël; Sun, Aristide

    2013-01-01

    The participants in round table 6 of the Giens Workshops 2012 drafted recommendations based on the collective interpretation of important elements of the decree concerning the medico-economic evaluation of health products published a few days earlier (02 October 2012). The medico-economic evaluation (MEE), becomes an additional determinant for fixing the prices of health products by the Health products economic committee (Comité économique des produits de santé, CEPS) via the hierarchisation of treatment strategies, and thus modifies the market access conditions. Limiting the analysis to medicinal products and medical devices for which a major, important or moderate improvement in the medical service rendered (ASMR) or of the expected service (ASA) has been requested and presenting a significant budget impact on the Social Security expenses, excludes health products with ASMR or ASA with a lower level requested which often create complex price fixing problems and often have a major budget impact. This latter concept remains to be defined in detail. The MEE envisaged for the first registration must include the need to confirm or refute the initial hypotheses especially concerning the actual position in the therapeutic strategy at the time of renewal of the registration. For the first registration, the conventional reference to European prices guaranteeing a minimum price to innovative medicinal products, the medico-economic models submitted by the industry to the French Drug Authority (Haute autorité de santé, HAS) must be used to guide the compilation of new data to be requested at the time of the registration renewal and to negotiate the level of the discounts in the framework of a price-volume agreement, if applicable. The MEE will allow comparing the result of the analysis to the model hypothesis at the time of the renewal of the registration, which may contribute to the renegotiation (either up or down) of the price of health goods. The costs related to

  13. Risk management in clinical practice. Part 6b. Identifying and avoiding medico-legal risks in removable dentures.

    PubMed

    Stilwell, C

    2010-10-09

    The most likely cause of complaint with prosthodontics is a denture that in some way fails to be accepted. A denture that does not perform as the patient expects can give rise to great disappointment and anger. The problem is that acceptance of a denture is not just a technical issue. Success depends on the individual's ability to tolerate and adapt to the denture. It is therefore essential to make the right assessment for the patient from the outset. This includes discovering the patient's priorities and establishing realistic expectations. With the aim of assisting the dental profession in identifying and avoiding medico-legal risks in removable dentures, this article sets out a systematic, diagnostic and collaborative approach to complete and partial denture assessment and treatment.

  14. [Disturbance of the health--an attempt at interpreting the term. Part II--problems in medico-legal opinionating].

    PubMed

    Jurek, Tomasz; Swiatek, Barbara

    2006-01-01

    Interpretative problems are caused by the semantic definition of the term "disturbance of the health" and its usage in the law system context. Judicial decisions show that this term is employed to denote a functional, as well as mental detriment to the health that exceeds the individual's adaptative abilities. A review of medico-legal literature demonstrates various interpretations of the term, starting from general systemic disturbances to definitions allowing for objectivization of the injured person's complaints. The deliberations constitute an attempt at quantification of "disturbance of the health" and defining the upper and lower limits of the medium and slight detriment to the health. The results of the analysis allow for adopting a definition that permits to judge objectively the injured person's complaints and to determine the limits of the compensatory ability of his body.

  15. Analysis of 756 cases of sexual assault in Tours (France): medico-legal findings and judicial outcomes.

    PubMed

    Saint-Martin, Pauline; Bouyssy, Marie; O'Byrne, Patrick

    2007-10-01

    We describe the medico-legal findings in a population of sexual assault cases assessed in an urban French referral centre, analyse the subsequent legal dispositions in each case and determine whether the characteristics of the assault and the medico-legal findings were associated with conviction of the assailant. We performed a retrospective study of medicolegal reports in all the sexual assault cases reported in Tours (France) during a seven-year period. We defined two groups of victims: children under 15 years old and victims aged 15 years or more. Legal outcomes were obtained from courtroom proceedings. The relationship between the outcomes and the circumstances of the case was analyzed by logistic regression. We enrolled a total of 756 cases during the study period. The mean age of the study population was 16.5 years and 68.3% of the cases involved children under 15 years old. In 57% of these cases, the assailant was a family member. 31.7% of all the victims were aged 15 years or more. The assailant was an acquaintance of the victim in 62.2% of the cases. Drug-facilitated assault was suspected in 2.9% of the cases. In 46.2% of the cases, formal criminal charges were not filed due to insufficient evidence; 36.3% of the assailants were convicted. Examination at the request of the police authorities and previous acquaintance of the assailant by the victim were significantly associated with conviction. Allegations of penetration, the presence of general body trauma and the presence of genital trauma were not necessarily associated with conviction. Medical examiners need to be circumspect when they record non-medical variables. Physical evidence of trauma was neither predictive nor essential for conviction. Successful prosecution depends on the quality of the testimony provided by the victim.

  16. Visualizing sexual assault: an exploration of the use of optical technologies in the medico-legal context.

    PubMed

    White, Deborah; Du Mont, Janice

    2009-01-01

    This article is an exploration of the visualization of sexual assault in the context of adult women. In investigating the production of visual evidence, we outline the evolution of the specialized knowledge of medico-legal experts and describe the optical technologies involved in medical forensic examinations. We theorize that the principles and practices characterizing medicine, science and the law are mirrored in the medico-legal response to sexual assault. More specifically, we suggest that the demand for visual proof underpins the positivist approach taken in the pursuit of legal truth and that the generation of such evidence is based on producing discrete and decontextualized empirical facts through what are perceived to be objective technologies. Drawing on interview and focus group data with 14 sexual assault nurse examiners (SANEs) in Ontario, Canada, we examine perceptions and experiences of the role of the visual in sexual assault. Certain of their comments appear to lend support to our theoretical assumptions, indicating a sense of the institutional overemphasis placed on physical damage to sexually assaulted women's bodies and the drive towards the increased technologization of visual evidence documentation. They also noted that physical injuries are frequently absent and that those observed through more refined tools of microvisualization such as colposcopes may be explained away as having resulted from either vigorous consensual sex or a "trivial" sexual assault. Concerns were expressed regarding the possibly problematic ways in which either the lack or particular nature of visual evidence may play out in the legal context. The process of documenting external and internal injuries created for some an uncomfortable sense of fragmenting and objectifying the bodies of those women they must simultaneously care for. We point to the need for further research to enhance our understanding of this issue.

  17. Medico-legal assessment of methamphetamine and amphetamine serum concentrations-what can we learn from survived intoxications?

    PubMed

    Weber, Marco; Lessig, Rüdiger; Richter, Carolin; Ritter, Axel P; Weiß, Ilona

    2017-05-16

    Medico-legal experts are increasingly enlisted to assess the methamphetamine and amphetamine serum concentrations after a criminal offense. However, since criminal users rarely provide useful information to medico-legal experts regarding the substances abused, when the substance(s) was/were used, dose of ingestion tools are needed to interpret the analytical data, which can be used as objective evidence in such cases. A comparative series of methamphetamine and amphetamine serum concentrations were used to analyze the frequency of concentrations, to determine methamphetamine/amphetamine concentration ratios, and prove them as a tool to distinguish pure methamphetamine from mixed amphetamine/methamphetamine ingestion. Additionally, two cases of survived accidental methamphetamine intoxication, resulting from ingestion smuggling which was longitudinally monitored, and pharmacokinetic parameters were assessed. In a series of 628 samples where the most frequent concentration of methamphetamine exceeded the therapeutic level, there was a strong correlation suggesting pure methamphetamine consumption, when the ratios of methamphetamine/amphetamine concentrations were within the range between 3 and 10. In the two cases of methamphetamine bodypacking, the relevant serum concentrations of methamphetamine and amphetamine, which could be measured up to 9 days after ingestion, indicated a decrease of the methamphetamine/amphetamine ratios in an exponential manner. However, the ratios were not always within the range between 3 and 10. Lastly, the course of the serum concentrations suggested an increase of the apparent elimination half-life of methamphetamine. In terms of the objective evidence required in criminal law, calculating methamphetamine/amphetamine concentration ratio is not a suitable to means to distinguish pure methamphetamine intake and that of mixed amphetamine/methamphetamine abuse in an individual case. Instead, methamphetamine high serum concentrations and

  18. Padova Charter on personal injury and damage under civil-tort law : Medico-legal guidelines on methods of ascertainment and criteria of evaluation.

    PubMed

    Ferrara, Santo Davide; Baccino, Eric; Boscolo-Berto, Rafael; Comandè, Giovanni; Domenici, Ranieri; Hernandez-Cueto, Claudio; Gulmen, Mete Korkut; Mendelson, George; Montisci, Massimo; Norelli, Gian Aristide; Pinchi, Vilma; Ranavaya, Mohammed; Shokry, Dina A; Sterzik, Vera; Vermylen, Yvo; Vieira, Duarte Nuno; Viel, Guido; Zoja, Riccardo

    2016-01-01

    Compensation for personal damage, defined as any pecuniary or non-pecuniary loss causally related to a personal injury under civil-tort law, is strictly based on the local jurisdiction and therefore varies significantly across the world. This manuscript presents the first "International Guidelines on Medico-Legal Methods of Ascertainment and Criteria of Evaluation of Personal Injury and Damage under Civil-Tort Law". This consensus document, which includes a step-by-step illustrated explanation of flow charts articulated in eight sequential steps and a comprehensive description of the ascertainment methodology and the criteria of evaluation, has been developed by an International Working Group composed of juridical and medico-legal experts and adopted as Guidelines by the International Academy of Legal Medicine (IALM).

  19. Cone beam computed tomography (CBCT) as a tool for the analysis of nonhuman skeletal remains in a medico-legal setting.

    PubMed

    Lucena, Joaquin; Mora, Esther; Rodriguez, Lucia; Muñoz, Mariela; Cantin, Mario G; Fonseca, Gabriel M

    2016-09-01

    To confirm the nature and forensic significance of questioned skeletal material submitted a medico-legal setting is a relatively common procedure, although not without difficulties when the remains are fragmented or burned. Different methodologies have been described for this purpose, many of them invasive, time and money consuming or dependent on the availability of the analytical instrument. We present a case in which skeletal material with unusual conditions of preservation and curious discovery was sent to a medico-legal setting to determine its human/nonhuman origin. A combined strategy of imagenological procedures (macroscopic, radiographic and cone beam computed tomography - CBCT-technology) was performed as non-invasive and rapid methods to assess the nonhuman nature of the material, specifically of pig (Sus scrofa) origin. This hypothesis was later confirmed by DNA analysis. CBCT data sets provide accurate three-dimensional reconstructions, which demonstrate its reliable use as a forensic tool.

  20. A clinical analysis of 500 medico-legal claims evaluating the causes and assessing the potential benefit of alternative dispute resolution.

    PubMed

    B-Lynch, C; Coker, A; Dua, J A

    1996-12-01

    1. To evaluate the common causes of medico-legal dispute in obstetrics and gynaecology. 2. To assess the potential benefit of early alternative dispute resolution. A prospective analysis of over 500 cases submitted from over 100 solicitors between 1984 and 1994 for medical expert opinion on potential medico-legal claims. Five hundred consecutive cases that met the inclusion criteria: 488 from the United Kingdom and 12 from abroad (Hong Kong, Republic of Ireland). The main principles underlining medico-legal disputes and causes of such claims. Analysis of 500 claims show 46% were misguided allegations, 19% incompetent care, 12% error of judgement, 9% lack of expertise, 7% failure of communication, 6% poor supervision and 1% inadequate staffing. Of the misguided allegations 119/225 cases (59%) were obstetric and 111/275 (40%) cases were gynaecological. The most common cause of obstetric dispute was "cerebral palsy' (22%), while the commonest cause of gynaecological dispute was failed sterilisation (19%). Settled claims were under-reported by solicitors. Because of the high percentage (46%) of misguided allegations, an alternative course of dispute resolution must be a realistic way forward. This course of action, combined with improved communication, could result in a major reduction in the costs of potential medical litigation. Early alternative dispute resolution should be considered in an attempt to reduce the escalating quantum of damages and costs. We recommend recruiting independent, experienced and unbiased consultants in active practice within the appropriate specialty to review such cases at the level of hospital complaints management as an in house review procedure, particularly for small and moderate-sized claims, as a means whereby doctors can retain control of medico-legal disputes, in contrast to control by the legal profession.

  1. [Clinical justification of medico-psychological care to the victims of technogenic accidents and catastrophes with prevalence of anxious and depressive symptoms of non-psychotic register].

    PubMed

    Volobuev, V V

    2014-01-01

    In the article the clinical justification of medico-psychological care to the victims of technogenic accidents and catastrophes with prevalence of anxious and depressive symptoms of non-psychotic register is described. The necessity of differentiated approach is analyzed in accomplishing of psychotherapy of this contingent of patients taking into account the high level of anxiety, emotional stress, decreased mood, low levels of the quality of life in the remote period of strong stressful factor's action.

  2. Severe acute hemorrhagic pancreatitis secondary to cholelithiasis as a rare cause of sudden unexpected death in medico-legal case: A case report.

    PubMed

    Srettabunjong, Supawon; Limgitisupasin, Wiratchaya

    2016-08-01

    Acute pancreatitis (AP) is an uncommon disease with a wide clinical course varying from mild and self-limiting to severe with eventual death. However, death caused by AP is rare. Most cases of AP reported in the English-language literature are based on clinical data; few are medico-legal studies. The author recently experienced a case of sudden unexpected death in a young man caused by extensive severe hemorrhagic AP secondary to cholelithiasis, not chronic alcoholism, which is a much more prominent etiology of AP in medico-legal perspectives. The deceased had complained of dizziness, nausea, and fatigue without significant abdominal pain for about 1 week and received some home medications for symptomatic treatment including an antibiotic drug from a clinic just 2 days prior to his death. He had complained of lower extremity weakness, intense thirst, and subsequently collapsed and was brought to a nearby hospital where he was pronounced dead shortly after his admission following unsuccessful advanced cardiopulmonary resuscitation attempts. This case is herein reported with an extensive review of the pertinent literature to highlight the findings of the case and raise awareness within the medico-legal profession and also the medical profession.

  3. [The role, objectives and usefulness of medico-legal determinations in post-accidental procedures in traumatic deaths in hard coal-mining industry].

    PubMed

    Skowronek, Rafał; Chowaniec, Czesław

    2009-01-01

    The underground hard coal-mining sector demonstrates one of the highest rates of fatal accidents, in spite of a decline in coal-mining over the last few years. Post-accidental investigations, including forensic medical expertise, continue to present a significant problem. The objective of the research was to evaluate the role, tasks and usefulness of medico-legal determinations in post-accidental procedures in traumatic deaths in hard coal-mining industry. The study was carried out retrospectively by investigating files and autopsy reports, with attention focusing on the scope of necessary activities and medico-legal examinations in order to determine the cause and manner of death, and on identification of fatalities, especially in the cases of collective occupational accidents. Complex medico-legal determinations (identification, autopsy), supplemented by additional investigations (toxicology, histopathology and hemogenetics) provide a valuable source of evidence for legal authorities and post-accidental commissions. Mutual cooperation of the experts representing various branches of science is the basis of executing appropriate procedures after a traumatic death in the coal mine.

  4. Analysis of 236U and plutonium isotopes, 239,240Pu, on the 1 MV AMS system at the Centro Nacional de Aceleradores, as a potential tool in oceanography

    NASA Astrophysics Data System (ADS)

    Chamizo, Elena; López-Lora, Mercedes; Villa, María; Casacuberta, Núria; López-Gutiérrez, José María; Pham, Mai Khanh

    2015-10-01

    The performance of the 1 MV AMS system at the CNA (Centro Nacional de Aceleradores, Seville, Spain) for 236U and 239,240Pu measurements has been extensively investigated. A very promising 236U/238U abundance sensitivity of about 3 × 10-11 has been recently achieved, and background figures for 239Pu of about 106 atoms were reported in the past. These promising results lead to the use of conventional low energy AMS systems for the analysis of 236U and 239Pu and its further application in environmental studies. First 236U results obtained on our AMS system for marine samples (sediments and water) are presented here. Results of two new IAEA reference materials (IAEA-410 and IAEA-412, marine sediments from Pacific Ocean) are reported. The obtained 236U/239Pu atom ratios, of 0.12 and 0.022, respectively, show a dependency with the contamination source (i.e. local fallout from the US tests performed at the Bikini Atoll and general fallout). The results obtained for a third IAEA reference material (IAEA-381, seawater from the Irish Sea), are also presented. In the following, the uranium and plutonium isotopic compositions obtained on a set of 5 intercomparison seawater samples from the Arctic Ocean provided by the ETH Zürich are discussed. By comparing them with the obtained results on the 600 kV AMS facility Tandy at the ETH Zürich, we demonstrate the solidity of the CNA technique for 236U/238U determinations at, at least, 7 × 10-10 level. Finally, these results are discussed in their environmental context.

  5. [Algorithms based on medico-administrative data in the field of endocrine, nutritional and metabolic diseases, especially diabetes].

    PubMed

    Fosse-Edorh, S; Rigou, A; Morin, S; Fezeu, L; Mandereau-Bruno, L; Fagot-Campagna, A

    2017-10-01

    Medico-administrative databases represent a very interesting source of information in the field of endocrine, nutritional and metabolic diseases. The objective of this article is to describe the early works of the Redsiam working group in this field. Algorithms developed in France in the field of diabetes, the treatment of dyslipidemia, precocious puberty, and bariatric surgery based on the National Inter-schema Information System on Health Insurance (SNIIRAM) data were identified and described. Three algorithms for identifying people with diabetes are available in France. These algorithms are based either on full insurance coverage for diabetes or on claims of diabetes treatments, or on the combination of these two methods associated with hospitalizations related to diabetes. Each of these algorithms has a different purpose, and the choice should depend on the goal of the study. Algorithms for identifying people treated for dyslipidemia or precocious puberty or who underwent bariatric surgery are also available. Early work from the Redsiam working group in the field of endocrine, nutritional and metabolic diseases produced an inventory of existing algorithms in France, linked with their goals, together with a presentation of their limitations and advantages, providing useful information for the scientific community. This work will continue with discussions about algorithms on the incidence of diabetes in children, thyroidectomy for thyroid nodules, hypothyroidism, hypoparathyroidism, and amyloidosis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Remaking the medico-legal scene: a social history of the late-Victorian coroner in Oxford.

    PubMed

    Hurren, Elizabeth T

    2010-04-01

    There have been wide-ranging debates about medicine and the law encapsulated in the figure of the coroner in Victorian England. Recently the historical literature on coroners has been enriched by macro-studies. Despite this important research, the social lives of coroners and their daily interactions remain relatively neglected in standard historical accounts. This article redresses that issue by examining the working life of the coroner for Oxford during the late-Victorian era. Edward Law Hussey kept very detailed records of his time in office as coroner. New research material makes it feasible to trace his professional background, from doctor of the sick poor, to hospital house surgeon and then busy coroner. His career trajectory, personal interactions, and professional disputes, provide an important historical prism illuminating contemporary debates that occupied coroners in their working lives. Hussey tried to improve his medico-legal reach and the public image of his coroner's office by reducing infanticide rates, converting a public mortuary, and acquiring a proper coroner's court. His campaigns had limited success because the social scene in which he worked was complicated by the dominance of health and welfare agencies that resented his role as an expanding arm of the Victorian information state.

  7. Sudden perinatal death due to rupture of congenital cardiac diverticulum. Pathological findings and medico-legal investigations in malpractice charge.

    PubMed

    Marchesi, Matteo; Boracchi, Michele; Gentile, Guendalina; Maghin, Francesca; Zoja, Riccardo

    2017-09-01

    Congenital diverticula of the left ventricle, very rare malformations, are determined by an abnormal embryonic development of the ventricular wall and can be isolated or associated to other cardiac anomalies. In most of the cases, these pathologies are not symptomatic and in some patients can be associated to ventricular arrhythmia, cardiac rupture with tamponade and sudden death. Authors are presenting the case of a sudden death in an 8-weeks-old newborn due to rupture of a cardiac congenital diverticulum of the left ventricle, discovered only at the moment of the autopsic examination. The parents of the victim pressed charges against the medical staff that was appointed to the cares, blaming them with malpractice. The missed diagnosis of a cardiac congenital diverticulum of the left ventricle, a rare pathology, reflects the trickiness of the medical management that can lead to medico-legal controversies and, even though such rare conditions must be always taken into consideration when investigating possible dysfunction causing the death, diagnostic difficulties, in the case in exam, justify the missed diagnosis intra-vitam of cardiac ventricular diverticulum. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. [Alcohol and work: ethical-deontological and medico-legal remark upon the recent set of rules].

    PubMed

    Chiaravalli, M; Guzzetti, Laura; Tavani, M

    2007-01-01

    The Disposition of the Permanent Conference for the relation among the State, the Regions and the Autonomous Provinces of Trento and Bolzano, published in Gazzetta Ufficiale n. 75 on the 30th March 2006 the list of high-risk occupations under the influence of alcohol, activating de facto a previous law (Legge n. 125, 3017 march 2001, "Legge quadro in materia di alcol e di problemi alcolcorrelati"). We here present some ethical-deontological and medical-juridical profiles on the contents of this law and some consideration about its application. Particular attention is dedicated to deontological aspects about industrial safety rules and to medico-legal aspects about occupation under the influence of alcohol, with references to complex relations among worker's discretion right, employer's right to the protection of his own interests and qualified doctor's (or someone to him comparable) right to the respect for the deontological code, with regard to benefit recipient information before the medical treatment. Authors'purpose is to evidence critical points and interpretative ambiguities of a regulation lacking in its practical applications, to provide further proposals of consideration, available to revalue a thematic rich in questions and with a significant social impact.

  9. European Council of Legal Medicine (ECLM) principles for on-site forensic and medico-legal scene and corpse investigation.

    PubMed

    Cusack, D; Ferrara, S D; Keller, E; Ludes, B; Mangin, P; Väli, M; Vieira, N

    2017-07-01

    Forensic medical practitioners need to define the general principles governing procedures to be used for the on-site examination of a body where the death has occurred in unnatural, violent or suspicious circumstances. These principles should be followed whenever a medical expert is required to perform an on-site corpse inspection and should be utilised as a set of general guidelines to be adapted to the specific situation in hand and interpreted using common sense and scientific knowledge of the relevant procedures and facts of the case. The aim of these principles is to ensure that forensic evidence at the scene of a death is properly observed and assessed and all necessary relevant evidence gathered in order to ensure that a comprehensive report is available to the judicial authority (investigating judge or coroner) in the justice system. The on-site corpse inspection by a forensic practitioner is a mandatory and essential stage of the forensic and medico-legal autopsy, as it may provide important information for subsequent investigation stages.

  10. Multidisciplinary cancer care in Australia: a national audit highlights gaps in care and medico-legal risk for clinicians.

    PubMed

    Wilcoxon, Heidi; Luxford, Karen; Saunders, Christobel; Peterson, Janice; Zorbas, Helen

    2011-03-01

    Multidisciplinary care (MDC) is accepted as best practice in cancer treatment planning and care. Despite recognition of the importance of a team approach, limited data are available about the extent to which MDC has been implemented in Australia. The aim of the audit was to investigate the implementation of MDC for five main cancer types across Australia in line with best practice. A sample of 155 hospitals was surveyed to investigate the status of MDC for cancer treatment planning in Australia across five cancer types (breast, gynecological, lung, prostate and colorectal). The survey investigated team structure, meetings, patient consent, documentation of team recommendations and communication with the patient. Two-thirds of hospitals surveyed did not have a multidisciplinary team. Of those with such a team; in one-third patients were not informed their case would be discussed by the team, in half patient consent was not sought for all cases discussed by the team, in one-quarter the team's recommended treatment plan was not noted in the patient record. Less than 1% of teams reported routine attendance by the tumour-specific minimum core team. MDC is not being implemented in line with best practice or applied consistently across Australia. This audit has highlighted gaps in care delivery, despite national recommendations about MDC. Areas being neglected can affect the quality of care provided and may put clinicians at medico-legal risk. Recommendations to improve uptake and effectiveness of MDC are provided. © 2011 Blackwell Publishing Asia Pty Ltd.

  11. An Appraisal of Decomposition Cases Received at the Johannesburg Forensic Pathology Service Medico-legal Mortuary During 2010-2011.

    PubMed

    Keyes, Craig A; Hill, Lawrence; Gordon, Guinevere M

    2016-03-01

    Decomposed bodies pose many questions for researchers regarding environmental effects, cause of death, and patterns. This study aimed to observe the factors associated with decomposed bodies autopsied at the Johannesburg Forensic Pathology Service Medico-legal Mortuary. A total of 4876 autopsies were conducted from 2010 to 2011, of which 109 were decomposed. Black individuals made up the largest proportion (67%) followed by White (26%). Males comprised 86.2%, while 12.8% were female. The mean age was 42.78 years. Most cases were in the early stages of decomposition (49.5%), with 32.1% bloated, 11.9% in active decay, 2.8% in advanced decay, and 3.7% were skeletal. Insect activity was identified in 25.7% of decomposition cases. Cause of death was determined in 48.6% of cases. Of all the cases, 64% were found indoors and 23% outdoors, while 23% had insufficient information regarding the location. Of considerable interest was the number of cases from hospitals and clinics.

  12. Trends in domestic animal medico-legal pathology cases submitted to a veterinary diagnostic laboratory 1998-2010.

    PubMed

    McEwen, Beverly J

    2012-09-01

    Pathologists at veterinary diagnostic laboratories receive medico-legal cases from a variety of animal species for postmortem examination. A search of computerized records of the Animal Health Laboratory, University of Guelph, Guelph, Ontario, Canada from 1998 to 2010 identified 1706 medicolegal cases. These were categorized according to the history as criminal investigations, anesthetic-related deaths, insurance, litigation, malpractice cases, and regulatory cases. Statistically significant linear trends in the proportion of medicolegal cases for all animals and criminal cases for companion animals were identified over the 12 year period. Companion animals had significantly greater odds of being a medicolegal case in all categories except for insurance and regulatory cases, compared to noncompanion animals. Based on pathology reports for the 271 criminal cases, 43.1% were consistent with neglect, 29.2% were compatible with non-accidental injury, 4.80% were poisonings, 10.7% were deemed to be due to natural disease, and 11.43% were inconclusive. © 2012 American Academy of Forensic Sciences.

  13. [Pharmacological, toxicological, deontologic, and medico-legal aspects of the use of appetite suppressant agents in "weight-loss cures"].

    PubMed

    Carolei, L; Ermio, G; Accorinti, N; Meo, G; Lamberti, V; De Sarro, G

    1997-01-01

    The pharmacological, deontologic and medico-legal aspects in the use of appetite suppressant drugs have been evaluated. Appetite suppressant drugs used in the treatment of obesity are divided into 2 broad pharmacological categories: those acting via brain catecholamine pathways and those acting via serotonin pathways. Of the former group, amphetamines and phenimetrazines are no longer used because of their stimulant properties and addictive potential. The remaining drugs of this group have some sympathomimetic and stimulant properties. Anorectic drugs which promote serotonin neurotransmission have no such stimulant or sympathomimetic properties. They reduce appetite and food intake and are effective in the treatment of obesity. If they are not used appropriately, appetite suppressants can be of no therapeutic benefit and cause marked health risks. As regards to anorectic drugs, the 13/4/1995 act "Rules and limits in preparing drugs containing anorectic substances", precisely defines rules about selling and use of those substances. Behavior of health care personnel neglecting observance of the rule, could be interpreted as "imprudence", "negligence" and "inexpertness" in designing and managing a fat-reducing diet, that may imply, in case of damage to the patient, a professional fault.

  14. Validity of medico-administrative data related to amyotrophic lateral sclerosis in France: A population-based study.

    PubMed

    Vasta, Rosario; Boumédiene, Farid; Couratier, Philippe; Nicol, Marie; Nicoletti, Alessandra; Preux, Pierre-Marie; Marin, Benoit

    2017-02-01

    The accuracy of French medico-administrative data concerning amyotrophic lateral sclerosis (ALS) is to date unknown. We aimed to assess the validity of hospital discharge data (HDD) and health insurance data (HID) related to ALS. A retrospective population-based study was performed. The French register of ALS in Limousin (FRALim) was used as gold standard (2000-2013 period). All patients discharged from the regional hospitals with a 'G12.2' code in their HDD (according to the International Classification of Disease-10th version) or having a G12 HID code were considered. In the study period, the register included a total of 322 incident ALS patients. Among 451 subjects identified through HDD, 290 were true incident ALS cases, corresponding to 90.1% (95% CI 86.3-93.1) sensitivity and 64.3% (95% CI 59.7-68.7) positive predictive value (PPV). A total of 184 subjects were identified through HID, 142 of which were true ALS cases. This corresponded to 44.1% (95% CI 38.6-49.7) sensitivity and 75.5% (95% CI 68.7-81.5) PPV. The combination of both HDD and HID led to 93.8% (95% CI 90.6-96.2) sensitivity and 60.8% (95% CI 56.3-65.1) PPV. This study shows that French HDD and HID, even if combined, are not per se suitable for accurate and exhaustive direct identification of ALS cases.

  15. Interpersonal violence in road rage. Cases from the Medico-Legal Center for Victims of Violence in Hamburg.

    PubMed

    Pfeiffer, Joost-Levin; Pueschel, Klaus; Seifert, Dragana

    2016-04-01

    Aggressive behavior in traffic is a widespread phenomenon. Up to 90% of the population are involved in mild forms such as shouting or gesturing. More dramatic cases with injury to individuals affect at least 1100 people in the US annually. Certain factors such as a male sex, a young age and an urban residency have been identified to contribute to the likelihood of road rage. Central to this analysis is the determination of specific features regarding the conflicting parties, the crime scene and the injury pattern in violent offenses related to traffic. In a retrospective study spanning 10 years, cases of road rage-linked injuries were identified amongst patients at the Medico-Legal Center of the Institute of Legal Medicine in Hamburg, Germany. The data were digitized and then analyzed using descriptive statistics via SPSS. There are disproportionately large numbers of males (85.7%) and motorists (61.2%) amongst road rage perpetrators. Usually the conflicting parties have no prior relationship (89.7%). In 68.1% of the cases, the violence applied was exclusively physical. Objects were utilized in 31.0% of all cases, and in more than half (55.6%) of these cases the vehicle was used as a weapon. The resulting trauma in road rage is mostly blunt and applied to the face and the extremities. There are characteristic features regarding the demographics, time and place of incident, as well as severity and pattern of injury in road rage associated offenses. Identifying these factors may lead to appropriate measures in the reduction of road rage.

  16. Resins and Gums in Historical Iatrosophia Texts from Cyprus – A Botanical and Medico-pharmacological Approach

    PubMed Central

    Lardos, Andreas; Prieto-Garcia, José; Heinrich, Michael

    2011-01-01

    This study explores historical iatrosophia texts from Cyprus from a botanical and medico-pharmacological point of view focusing on remedies containing resins and gums. The iatrosophia are a genre of Greek medical literature of Byzantine origin and can be described as medicine handbooks which serve as therapeutic repositories containing recipes or advice. To extract and analyze information on plant usage in such sources – which are largely unedited texts and so far have not been translated – we investigate (i) the relationship of the iatrosophia to Dioscorides’ De Materia Medica as well as historic pharmaceutical books or standard texts on modern phytotherapy and (ii) the validity of the remedies by comparing them to modern scientific data on reported biological activities. In the six texts investigated 27 substances incorporating plant exudates are mentioned. They are obtained from over 43 taxa of higher plants and in particular are used to treat dermatological, gastrointestinal, and respiratory tract conditions. The comparison to historic pharmaceutical books and phytotherapy texts reflects the gradual decline of the use of plant exudates in Western medicine. While remarkable parallels to Dioscorides’ text exist, the non-Dioscoridean influence suggests a complex pattern of knowledge exchange. Overall, this resulted in an integration of knowledge from so far poorly understood sources. The comparison with bioscientific data reveals a fragmentary picture and highlights the potential of these unexplored substances and their uses. Where relevant bioscientific data are available, we generally found a confirmation. This points to a largely rational use of the associated remedies. Taken together, the iatrosophia are a valuable resource for ethnopharmacological and natural product research. Most importantly they contribute to the understanding of the development of herbal medicines in the (Eastern) Mediterranean and Europe. PMID:21772820

  17. Opium alcaloids in toxicological medico-legal practice of Department of Forensic Medicine, Jagiellonian University Medical College

    PubMed

    Kłys, Małgorzata; Rojek, Sebastian; Maciów-Głab, Martyna; Kula, Karol

    2013-01-01

    Most likely, opium was the first narcotic substance discovered at the dawn of mankind. Contemporary drug abuse predominantly poses a social and clinical problem and encompasses among other aspects emergency procedures in cases of intoxication and treatment of addictions. On the other hand, this is also a problem of the judicial system, which implements the rule of apt punishment in criminal cases (rapes, robberies, drivers, production and trade in narcotic substances) and of the necessity of monitoring drug-associates deaths. In all drug-associated cases, investigative capabilities have increased with the introduction of extremely sensitive and specific analytical methods (GC-MS, LC/MS, HPLC/DAD) allowing for detection and identification of multi-component mixtures of xenobiotics found at low concentration levels in complex biological matrices. The history of the Krakow Department of Forensic Medicine dates back to the year 1877, since archival materials have been kept since that time. Isolated deaths resulting from morphine poisoning, mostly involving individuals employed in the health care sector, constituted the subject of medico-legal expert opinions starting at the beginning of the 20th century, but only the eighties did bring the need for multidirectional toxicological examinations of opiates and their metabolites in diversified biological and non-biological materials. The present report, in addition to the historical background of opiate addiction, discusses selected problems derived from published by Department reports on opiates, including cases of fatal intoxication, hair analysis of drug addicts in its various aspects, interactions in cases of poisoning and others.

  18. Comparison of injuries due to lethal weapons during and after civil strife in Sri Lanka: A medico-legal study

    PubMed Central

    Vidanapathirana, Muditha; Ruwanpura, Rohan P; Amararatne, Sriyantha RRG; Ratnaweera, Ajith RHI

    2016-01-01

    Background and Aims: “Injuries due to lethal weapons” has emerged as a subject of public discussion in Sri Lanka. This study was conducted to describe the nature and characteristics of injuries due to lethal weapons during civil strife and to compare those with injuries after civil strife. Methods: A cross-sectional study was conducted on patients reported with injuries caused by lethal weapons from 2004 to 2014. Periods before and after May 19, 2009 were considered as during and after civil strife periods, respectively. A total of 21,210 medico-legal examination forms were studied. Results: There were 358 (1.7%) injuries caused by lethal weapons. Of them, 41% (n = 148) were during and 59% (n = 210) were after the civil strife. During civil strife, 63% occurred during daytime (P < 0.05). Types of lethal weapons that caused injuries were sharp weapons (n = 282), explosives (n = 49), and firearms (n = 27). Of them, 32% of during and 01% of after civil strife were explosive injuries (P < 0.01). Regarding severity, 73% of during and 57% of after civil strife injuries were severe (P < 0.05). During civil strife, 34% injuries were in lower limbs (P < 0.01) and after civil strife, 37% were in upper limbs (P < 0.05). Conclusions: The presence of many similarities indicated that both groups learnt their basis in a society that breeds violence. During civil strife, more injuries occurred during daytime, to lower limbs by explosive weapons and after the civil strife during nighttime, to upper limbs by nonexplosive weapons. Nonexplosive lethal weapon use after civil strife needs further investigation to develop evidence-based interventions. PMID:27127743

  19. Comparison of injuries due to lethal weapons during and after civil strife in Sri Lanka: A medico-legal study.

    PubMed

    Vidanapathirana, Muditha; Ruwanpura, Rohan P; Amararatne, Sriyantha Rrg; Ratnaweera, Ajith Rhi

    2016-01-01

    "Injuries due to lethal weapons" has emerged as a subject of public discussion in Sri Lanka. This study was conducted to describe the nature and characteristics of injuries due to lethal weapons during civil strife and to compare those with injuries after civil strife. A cross-sectional study was conducted on patients reported with injuries caused by lethal weapons from 2004 to 2014. Periods before and after May 19, 2009 were considered as during and after civil strife periods, respectively. A total of 21,210 medico-legal examination forms were studied. There were 358 (1.7%) injuries caused by lethal weapons. Of them, 41% (n = 148) were during and 59% (n = 210) were after the civil strife. During civil strife, 63% occurred during daytime (P < 0.05). Types of lethal weapons that caused injuries were sharp weapons (n = 282), explosives (n = 49), and firearms (n = 27). Of them, 32% of during and 01% of after civil strife were explosive injuries (P < 0.01). Regarding severity, 73% of during and 57% of after civil strife injuries were severe (P < 0.05). During civil strife, 34% injuries were in lower limbs (P < 0.01) and after civil strife, 37% were in upper limbs (P < 0.05). The presence of many similarities indicated that both groups learnt their basis in a society that breeds violence. During civil strife, more injuries occurred during daytime, to lower limbs by explosive weapons and after the civil strife during nighttime, to upper limbs by nonexplosive weapons. Nonexplosive lethal weapon use after civil strife needs further investigation to develop evidence-based interventions.

  20. Do medico-legal truths have more power than war lies? About the conflicts in the former Yugoslavia and in Kosovo.

    PubMed

    de la Grandmaison, G L; Durigon, M

    2001-10-01

    War crimes perpetrated during the conflicts in the former Yugoslavia and in Kosovo prompted medicolegal investigations of mass graves as required by the International Criminal Tribunal (ICT). In spite of natural and methodological boundaries, these investigations were able to help to identify the victims and to discover the clues and evidence that are likely to support objectively the indictments brought by the ICT. However, the medico-legal data cannot explain everything. They should be exploited very carefully in order to avoid any error of interpretation.

  1. [Changes of medico-pharmaceutical profession and private practice from the late 19th century to the early 20th century: ebb and flow of western pharmacies and clinics attached to pharmacy].

    PubMed

    Lee, Heung-Ki

    2010-12-31

    This article examined i) how traditional medico-pharmaceutical custom from the late 19th century influenced such changes, ii) how medical laws of Daehan Empire and early colonial period influenced the differentiation of medico-pharmaceutical profession, and iii) what the responses of medico-pharmaceutical professionals were like, and arrived at following conclusions. First, in late Chosun, there was a nationwide spread of pharmacies (medicine room, medicine store) as general medical institutions in charge of prescription and medication as well as diagnosis. Therefore, Koreans' perception of Western medicine was not very different from that of traditional pharmacy. Second, Western pharmacies were established by various entities including oriental doctors, Western doctors and drug manufacturers.Their business ranged from medical consultation, prescription, medication and drug manufacture. This was in a way the extension of traditional medico-pharmaceutical custom, which did not draw a sharp line between medical and pharmaceutical practices. Also, regulations on medical and pharmaceutical business of Daehan Empire did not distinguish oriental and Western medicine. Third, clinics attached to pharmacy began to emerge after 1908, as some Western pharmacies that had grown their business based on selling medicine began to hire doctors trained in Western medicine. This trend resulted from Government General's control over medico-pharmaceutical business that began in 1908, following a large-scale dismissal of army surgeons trained in medical schools in 1907. Fourth, as specialization increased within medico-pharmaceutical business following the colonial medical law in early 1910s, such comprehensive business practices as Western pharmacy disappeared and existing businesses were differentiated into dealers of medical ingredients, drug manufacturer, patent medicine businessmen and herbalists. And private practice gradually became the general trend by establishment of medical

  2. [Medico-legal assessment of the injuries of fatal victims of building collapse at Katowice International Fair in Katowice/Chorzów on January 28, 2006].

    PubMed

    Chowaniec, Czesław; Kobek, Mariusz; Chowaniec, Małgorzata; Rygol, Krystian; Kabiesz-Neniczka, Stanisława; Skowronek, Rafał

    2011-01-01

    On January 28, 2006, during an exhibition of carrier pigeons, the roof of one of the buildings at Katowice International Fair collapsed. At the time of accident, there were 700 people in the building--65 died and 171 were injured. It was the biggest building disaster in the history of modern Poland. The aim of this study was to present the type (character) of the observed injuries, the cause of death of 48 fatal victims and the range of activities and medico-legal examinations performed in the Department of Forensic Medicine, Medical University of Silesia in Katowice. In the period of January 29-February 1, 2006, on February 14, 2006, and February 17, 2006, post-mortem examinations of the 48 deceased were carried out, and in some cases additional dissecting techniques were employed. During autopsies, numerous specimens for various additional examinations (histopathological, toxicological) were collected. For identification purposes, photographic material and specimens, necessary for genetic identification, were secured. Additionally, the bodies were identified by families. The post-mortem procedures eventually allowed for establishing the cause of death of all the victims. The authors emphasize the range of necessary medico-legal procedures and examinations that should be carried out in a Department of Forensic Medicine in case of a building collapse with a large number of fatalities in order to determine the type of injuries, cause and mechanism of death and to identify the deceased.

  3. A contextual analysis of nervous force in medico-scientific and literary writings in English of the nineteenth and early-twentieth centuries.

    PubMed

    Lazar, J Wayne

    2015-01-01

    This study concerns the context of use of the term "nervous force," as it appears in scientific and literary publications in English over the course of the nineteenth century and the first two decades of the twentieth century. The context of use, loss, or waste of nervous force and the context of nervous force as an expression of an attribute are analyzed in 189 scientific and 105 literary writings. Both contexts appeared in literary writings, where nervous force expresses the attributes of strength, forcefulness, vigor, or energy and use, loss or waste of nervous force explains such nonmorbid conditions as why someone is tired or needs rest. Only the context of use-loss-waste appeared in the medico-scientific literature, but here it explained both nonmorbid conditions (for example, effects of old age) and morbid conditions (like epilepsy). Changes in the number of these references give insights into the medico-scientific and the literary disciplines. Discussions include why nervous force is associated with explanation of disease, the persistence of its use in this capacity, and its influence on a similar use in literary writings.

  4. Organ retention and communication of research use following medico-legal autopsy: a pilot survey of university forensic medicine departments in Japan.

    PubMed

    Tsujimura-Ito, Takako; Inoue, Yusuke; Yoshida, Ken-ichi

    2014-09-01

    This study investigated the circumstances and problems that departments of forensic medicine encounter with bereaved families regarding samples obtained from medico-legal autopsies. A questionnaire was posted to all 76 departments of forensic medicine performing medico-legal autopsies in Japan, and responses were received from 48 (63.2%). Of the respondents, 12.8% had approached and communicated with bereaved families about collecting samples from the deceased person during an autopsy and the storage of the samples. In addition, 23.4% of these had informed families that samples might be used in research. Eighteen departments had received enquiries and requests from families about the samples, with most requests concerning their return. The response to such requests varied according to the department. Few departments interacted with the bereaved families regarding the procedure for obtaining autopsy samples, and their methods for handling family concerns differed depending on the person within the department authorised to contact the family. Moreover, the procedures for engaging in such communication have long been unclear, and no legal or ethical consensus or agreement with the general public has been established. It is important for researchers to further discuss the correct way for forensic medicine departments to communicate with bereaved families. 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.

  5. Child soldiers as zones of violence in The Democratic Republic of Congo: three cases of medico-legal evidence of torture.

    PubMed

    Guy, Kitwe Mulunda

    2009-01-01

    This article sets medico legal light on torture of three former child soldiers by comparing torture methods, consequences of torture and medical observations. It is focused on these child soldiers as representatives of the many abuses of children as soldiers in armed groups. The three persons were child soldiers during 12 years in The Democratic Republic of Congo (DRC) as members of three different armed groups. They were exposed to armed conflict events, experienced torture, and participated in atrocities, sexual abuse and traditional rituals during their role in armed conflict. They were psychologically distressed with unhealthy physical and mental states. The principles for working with child soldiers are described. The model addresses basic items: The confluence of the dimensions of the items will determine the specifics of medico legal evidence of torture in child soldiers, taking into consideration inputs that are required at the macro, community and individual levels. A primary goal is to prevent violence from occurring in child soldiers. Thus, much more deliberate effort is made to address the underlying causes of recruitment of children in armed groups in DRC and to invest more resources in conflict resolution before there is an outbreak of violence. Peace education tends to be introduced too late and does little to alleviate the use of children in armed conflict in DRC.

  6. [Epidemiologic and medico-clinical aspects of the cholera outbreak in the Littoral department of Benin in 2008].

    PubMed

    Gbary, A R; Dossou, J P; Sossou, R A; Mongbo, V; Massougbodji, A

    2011-04-01

    The purpose of this study was to determine epidemiological and medico-clinical features of the cholera outbreak that occurred in the Littoral department of Benin in 2008. This cross-sectional descriptive analytic study was based on review of a total of 404 patient files. Study data included patient identity, clinical and therapeutic features and treatment outcome. Ten randomly selected patients participated in a focus group discussion. Decision-makers in charge of managing the outbreak and medical personnel that provided care were thoroughly debriefed and 10 affected areas were visited. Data were analyzed using EPI INFO 3.3.2 and EXCEL 2007. The outbreak started in Cotonou on 26 July 2008 and lasted for 21 weeks. Mean patient age was 23.72 +/- 14.80 years. Attack rates per district ranged from 15.86 to 172.98 per 100.000. Attack rates in Agbodjèdo, Hlacomey and Enagnon districts were significantly higher (p<10(-4)) than in other districts. The case fatality rate was 0.24 per 100. Crowded living conditions along the banks of the Cotonou lagoon along with poor sanitation and inadequate drinking water supply explain the endemicity of cholera in Cotonou. Vibrio cholerae O:1 was detected in 19 out of 36 stool samples. All strains were sensitive to ciprofloxacine but resistant to cotrimoxazole. Diarrhea was a consistent feature in all patients, along with vomiting in 88.11% and severe dehydration in 39.35%. Treatment involved oral rehydration, parenteral rehydration and antibiotherapy in 99.50%, 85% and 97.77% patients respectively. Antibiotherapy consisted of doxycycline for adult cases and amoxicilline for pregnant women and children. The duration of stay at the treatment center was significantly longer for patients with severe dehydration (p<10(-4)). Enhancing basic sanitation and access to drinking water and intensifying information campaigns on the need for healthy living behavior especially in districts located near the banks of Cotonou lagoon are needed to

  7. ConSCRIPT

    PubMed Central

    Mottarella, Scott E.; Rosa, Mario; Bangura, Abdul; Bernstein, Herbert J.; Craig, Paul A.

    2011-01-01

    The aim of the Structural Biology Extensible Visualization Scripting Language (SBEVSL) project is to allow users who are experts in one scripting language to use that language in a second molecular visualization environment without requiring the user to learn a new scripting language. ConSCRIPT, the first SBEVSL release, is a plug-in for PyMOL that accepts RasMol scripting commands either as premade scripts or as line-by-line entries from PyMOL's own command line. The plug-in is available for download at http://sourceforge.net/projects/sbevsl/files in the ConSCRIPT folder. PMID:21567873

  8. From stack-firing to pyromania: medico-legal concepts of insane arson in British, US and European contexts, c.1800–1913. Part 2

    PubMed Central

    Andrews, Jonathan

    2014-01-01

    The second part of this paper1 explores deepening doubts about pyromania as a special insanity, British debates post-1890, and pyromania’s supplanting with the broader diagnostic category of insane incendiarism. It assesses the conceptual importance of revenge and morbid-motivations for arson, and the relationship of Victorian and Edwardian concepts of arson to more modern psychiatric research. The main objective is to ascertain the extent to which Victorian and Edwardian medico-psychologists and medical legists arrived at meaningful and workable definitions of criminal insanity linked to arson. It concludes by emphasizing the limitations, contentiousness and inconsistencies in the use of technical terms such as ‘pyromania’, contrasted with the qualified success of authorities in arriving at more viable and broadly acceptable explanations of insane firesetting. PMID:21877418

  9. Medico-economic evaluation of healthcare products. Methodology for defining a significant impact on French health insurance costs and selection of benchmarks for interpreting results.

    PubMed

    Dervaux, Benoît; Baseilhac, Eric; Fagon, Jean-Yves; Biot, Claire; Blachier, Corinne; Braun, Eric; Debroucker, Frédérique; Detournay, Bruno; Ferretti, Carine; Granger, Muriel; Jouan-Flahault, Chrystel; Lussier, Marie-Dominique; Meyer, Arlette; Muller, Sophie; Pigeon, Martine; De Sahb, Rima; Sannié, Thomas; Sapède, Claudine; Vray, Muriel

    2014-01-01

    Decree No. 2012-1116 of 2 October 2012 on medico-economic assignments of the French National Authority for Health (Haute autorité de santé, HAS) significantly alters the conditions for accessing the health products market in France. This paper presents a theoretical framework for interpreting the results of the economic evaluation of health technologies and summarises the facts available in France for developing benchmarks that will be used to interpret incremental cost-effectiveness ratios. This literature review shows that it is difficult to determine a threshold value but it is also difficult to interpret then incremental cost effectiveness ratio (ICER) results without a threshold value. In this context, round table participants favour a pragmatic approach based on "benchmarks" as opposed to a threshold value, based on an interpretative and normative perspective, i.e. benchmarks that can change over time based on feedback.

  10. Medico-Artistic Complicities on Swedish Stages: The Boys in the Band and the Regulation of Gay Male Representation in the Welfare State.

    PubMed

    Gindt, Dirk

    2016-01-01

    Seeking to understand the highly unfavorable conditions for the development of gay male theater in Sweden, this essay engages in a historical study of the national opening of Mart Crowley's The Boys in the Band at Malmö City Theatre in 1970. Propelled by a Foucauldian-inspired theoretical approach, it identifies the subtle, yet highly effective, measures of control that the, at the time, social democratic welfare state exercised over representations of homosexuality on stage. State representatives, who complied with the official political and medical doctrine that homosexuality was a mental illness and posed a potential threat to social stability, interfered at various levels of the production, including the rehearsal process and post-performance talks between cast members and audiences. This alliance between Swedish theaters and members of the medical, psychological, and sexological professions constituted a medico-artistic complicity that supervised and regulated early attempts of gay representation on stage.

  11. Unusual suicide in Italy: criminological and medico-legal observations-a proposed definition of "atypical suicide" suitable for international application.

    PubMed

    Massaro, Luca

    2015-05-01

    This work is the result of a kind of categorization of suicidal conduct based on an empirical-phenomenological approach, with integrated assessment of certain criteria, such as the dynamics, correlation of types of injury and how they were produced, evidence gathered during official inspections in loco, and case history findings about "suicide." This categorization is an attempt to provide a nosographic definition of atypical suicide, that is, cases in which the parameters of "typical" suicide are missing. Case studies are described, taken from a systematic exploration mainly of the Italian specialized literature of the 20th century, supplemented by earlier references when deemed significant. In-depth analysis of atypical suicide can supply additional interpretations of the problem of differential diagnosis of suicide, homicide, and accidental death, that is, the real punctum dolens in overall medico-legal determination of the cause of death in scenarios in which death cannot be definitely traced to a deliberate act.

  12. A medico-legal review of cases involving quadriplegia following cervical spine surgery: Is there an argument for a no-fault compensation system?

    PubMed

    Epstein, Nancy E

    2010-04-07

    To determine whether patients who become quadriplegic following cervical spine surgery are adequately compensated by our present medico-legal system. The outcomes of malpractice suits obtained from Verdict Search (East Islip, NY, USA), a medico-legal journal, were evaluated over a 20-year period. Although the present malpractice system generously rewards many quadriplegic patients with substantial settlements/ Plaintiffs' verdicts, a subset receive lesser reimbursements (verdicts/settlements], while others with defense verdicts receive no compensatory damages. Utilizing Verdict Search, 54 cases involving quadriplegia following cervical spine surgery were reviewed for a 20-year interval (1988-2008). The reason(s) for the suit, the defendants, the legal outcome, and the time to outcome were identified. Operations included 25 anterior cervical procedures, 22 posterior cervical operations, 1 circumferential cervical procedure, and 6 cases in which the cervical operations were not defined. The four most prominent legal allegations for suits included negligent surgery (47 cases), lack of informed consent (23 cases), failure to diagnose/treat (33 cases), and failure to brace (15 cases). Forty-four of the 54 suits included spine surgeons. There were 19 Plaintiffs' verdicts (average US $5.9 million, range US $540,000-US $18.4 million), and 20 settlements (average US $2.8 million, range US $66,500-US $12.0 million). Fifteen quadriplegic patients with defense verdicts received no compensatory damages. The average time to verdicts/settlements was 4.3 years. For 54 patients who were quadriplegic following cervical spine surgery, 15 (28%) with defense verdicts received no compensatory damages. Under a No-Fault system, quadriplegic patients would qualify for a "reasonable" level of compensation over a "shorter" time frame.

  13. The Con Test

    ERIC Educational Resources Information Center

    Fletcher, Michael

    2009-01-01

    In this article, the author describes the format of the Con Test, an Australian television game show which followed the same general rules and game play as the UK show PokerFace. At the end of each round a contestant needs to decide whether or not he or she should fold. A contestant needs to know how likely it is that he or she is in last place.…

  14. Nam Con Son Basin

    SciTech Connect

    Tin, N.T.; Ty, N.D.; Hung, L.T.

    1994-07-01

    The Nam Con Son basin is the largest oil and gas bearing basin in Vietnam, and has a number of producing fields. The history of studies in the basin can be divided into four periods: Pre-1975, 1976-1980, 1981-1989, and 1990-present. A number of oil companies have carried out geological and geophysical studies and conducted drilling activities in the basin. These include ONGC, Enterprise Oil, BP, Shell, Petro-Canada, IPL, Lasmo, etc. Pre-Tertiary formations comprise quartz diorites, granodiorites, and metamorphic rocks of Mesozoic age. Cenozoic rocks include those of the Cau Formation (Oligocene and older), Dua Formation (lower Miocene), Thong-Mang Cau Formation (middle Miocene), Nam Con Son Formation (upper Miocene) and Bien Dong Formation (Pliocene-Quaternary). The basement is composed of pre-Cenozoic formations. Three fault systems are evident in the basin: north-south fault system, northeast-southwest fault system, and east-west fault system. Four tectonic zones can also be distinguished: western differentiated zone, northern differentiated zone, Dua-Natuna high zone, and eastern trough zone.

  15. [Medico-legal assessment in neurological malpractice based on casework material collected at the Department of Forensic Medicine, Medical University of Białystok].

    PubMed

    Ptaszyńska-Sarosiek, Iwona; Niemcunowicz-Janica, Anna; Janica, Jerzy; Dopierała, Tomasz; Załuski, Janusz; Wardaszka, Zofia

    2007-01-01

    Medical malpractice results from inadequate professional knowledge, incompliance to the present state of medical knowledge or negligence and inattention. The aim of the paper was the analysis of medical malpractice cases based on material in the field of neurology. The cases were assessed according to the number and type in 32 medico-legal opinions issued by specialist teams of forensic medicine and neurology in the Department of Forensic Medicine, Medical University of Białystok in the years 2001-2006. In 11 cases (34%) medical malpractice was concluded with reference to improper treatment after head injury or brain pathology, inadequate care at neurology unit, lacked or delayed diagnostics of head pathology and injury, non-referral to hospital by neurologists. In the material analysed diagnostic errors predominated. Majority of them originated from the open health care system. Incompetence of neurologists with regard to differential diagnostics resulting in misdiagnosis and improper therapy was noted. In one third of the overall cases medical malpractice was concluded. The most common causes included misinterpretation of disease signs and symptoms, misapplication of available diagnostic potential and unjustified delay before commencing diagnostics.

  16. [Application of hair analysis of selected psychoactive substances for medico-legal purposes. Part I. Segmental hair analysis in cases of fatal opioids and amphetamines poisoning].

    PubMed

    Rojek, Sebastian; Kłys, Małgorzata; Konopka, Tomasz

    2009-01-01

    The present experimental investigations were inspired by the necessity of standardizing the procedures and analytical methods employed in hair analysis aiming at a retrospective evaluation of ingestion of various xenobiotics. Thus, in keeping with the principal premises, the main objective of the study was development of unique, novel chemico-toxicological procedures for analyzing hair content of psychoactive substances in two basic groups of substances of abuse: opioids (morphine, 6-monoacetylmorphine, codeine) and amphetamines (amphetamine, methamphetamine, MDA, MDMA, MDEA) by HPLC-APCI-MS-MS, followed by verification of the thus worked out procedures in medico-legal practice through opinionating in selected group of patients deceased due to fatal psychoactive substance poisoning (cause of death determination). Determinations of opioids and amphetamines in the hair biological matrix were performed using high performance liquid chromatography - atmospheric pressure chemical ionization - tandem mass spectrometry (HPLC-APCI-MS-MS). In the group of fatal poisonings by ,,Polish heroine", hair segmental analysis confirmed the abuse profile of the opiate or mixed (opiate-amphetamine) type, which to some measure is characteristic of Polish drug addiction, indicating the presence of these xenobiotics in the investigating hair samples in the premortem period.

  17. Medico-legal considerations of canine leishmaniosis in Italy: an overview of an emerging disease with reference to the buying and selling of dogs.

    PubMed

    Passantino, A

    2006-12-01

    Leishmaniosis is a common infection in the canine population. Domestic dogs are the main reservoir hosts for zoonotic human visceral leishmaniosis in both the Old and New Worlds. In fact, canine leishmaniosis is not just a veterinary problem. In the light of some recent advances in the field of diagnosis, the author evaluated the medico-legal aspects of buying and selling dogs that are potentially affected by leishmaniosis. This paper clarifies why it is impossible to attribute redhibitory vice (an essential defect in a product which renders it useless or so diminishes its usefulness or value that it must be presumed that, if he had been aware of it, the buyer would not have bought it, or would have paid a lesser price) to this disease and highlights the necessity to improve Sicilian regional law no. 15 of 3 July 2000 concerning the creation of a dog register by giving every animal a health book. With this aim in mind, the author suggests that leishmaniosis be included in the list of notifiable diseases that appears in article 1 of the Italian Veterinary Police Regulations so as to reduce the possibilities of fraudulent trade in dogs known to be infected before purchase.

  18. [Permanent essential defacement--remarks on the possibilities of verification of the accepted criteria in medico-legal certification in criminal and civil law proceedings].

    PubMed

    Chowaniec, Czesław; Nowak, Agnieszka; Jabłoński, Christian; Neniczka, Stanisława

    2007-01-01

    Despite the fact that some criteria of medico-legal certification in criminal and civil proceedings have been established, there are still some topics which are controversial and thus require modification. This is also true of the notion of "permanent essential defacement". In the opinion of the authors, changes in social conventions that are occurring nowadays, as well as a highly diversified, subjective perception of esthetic values indicate the need for discussing a possible modification of the presently obligatory criteria. Apart from the assessment of posttraumatic changes, an important problem is posed by defining the notion of "a part of the body customarily open to the view ". Additionally, the authors bring up for discussion the issue of experts taking into consideration the age and sex of the victims while assessing damages. A separate problem lies in difficulties in assessing the degree of detriment to health because of defacement due to the fact that official tables for evaluating permanent or long-term detriment to health do not include relevant information.

  19. Social isolation and delayed discovery of bodies in houses: the value of forensic pathology, anthropology, odontology and entomology in the medico-legal investigation.

    PubMed

    Archer, M S; Bassed, R B; Briggs, C A; Lynch, M J

    2005-07-16

    The bodies of socially isolated people may remain undiscovered in their own houses for prolonged periods. Occasionally the body is in situ for sufficient time to become skeletonised, or partially so. Medico-legal investigation of these cases is complicated by degradation and contamination of evidence. Thus, a multidisciplinary forensic investigation is recommended. The potential contributions of forensic pathology, anthropology, odontology and entomology are outlined here with reference to two cases that occurred in Victoria, Australia, in 2003. Forensic pathologists are often unable to determine the cause of death in skeletonised bodies, however, they may find evidence to support either a natural or unnatural mode of death, and they may describe skeletal pathology or trauma, and identify skeletal features to support radiological identification of the deceased. Anthropologists can provide supplementary evidence of skeletal trauma. Additionally, they can assess age, sex, stature and racial affiliation from skeletal remains. Odontologists can identify individuals through comparison with ante-mortem dental records; however, potential difficulties exist in identifying the treating dentist of a socially isolated person. Odontologists may also examine the teeth and oro-facial skeleton for trauma. Entomologists may estimate minimum death time and/or season of death. Entomological examination of insect remains may also confirm that a body has lain in situ for a considerable period.

  20. The utility of medico-legal databases for public health research: a systematic review of peer-reviewed publications using the National Coronial Information System.

    PubMed

    Bugeja, Lyndal; Ibrahim, Joseph E; Ferrah, Noha; Murphy, Briony; Willoughby, Melissa; Ranson, David

    2016-04-12

    Medico-legal death investigations are a recognised data source for public health endeavours and its accessibility has increased following the development of electronic data systems. Despite time and cost savings, the strengths and limitations of this method and impact on research findings remain untested. This study examines this issue using the National Coronial Information System (NCIS). PubMed, ProQuest and Informit were searched to identify publications where the NCIS was used as a data source for research published during the period 2000-2014. A descriptive analysis was performed to describe the frequency and characteristics of the publications identified. A content analysis was performed to identify the nature and impact of strengths and limitations of the NCIS as reported by researchers. Of the 106 publications included, 30 reported strengths and limitations, 37 reported limitations only, seven reported strengths only and 32 reported neither. The impact of the reported strengths of the NCIS was described in 14 publications, whilst 46 publications discussed the impacts of limitations. The NCIS was reported to be a reliable source of quality, detailed information with comprehensive coverage of deaths of interest, making it a powerful injury surveillance tool. Despite these strengths, researchers reported that open cases and missing information created the potential for selection and reporting biases and may preclude the identification and control of confounders. To ensure research results are valid and inform health policy, it is essential to consider and seek to overcome the limitations of data sources that may have an impact on results.

  1. David Murray Morton: father figure of surgery at St Vincent's Hospital, bush lawyer and thwarted reformer of the medico-legal system.

    PubMed

    Vellar, Ivo D

    2002-08-01

    When the first Golden Age of surgery at St Vincent's Hospital Melbourne (a period covering the first 25 years of the twentieth century) is discussed, the names that spring to mind are usually those of Sir Thomas Dunhill, Sir Hugh Devine, Sir Douglas Shields and Julian Smith. A name which is often overlooked, and by now almost forgotten, is that of David Murray Morton. Murray -Morton's career both as a medical student, general practitioner, anaesthetist and surgeon coincided with a revolution in the practice of medicine. He witnessed the progression from Listerian antisepsis to asepsis in surgical practice, the improvements in anaesthesia, the introduction of antibiotics and, before he died in 1959, the beginnings of organ transplants and open heart surgery. Morton was fond of saying that he grew up with the hospital. From the time of his first appointment as an anaesthetist in l896 to the time of his retirement from St Vincent's as senior surgeon in 1931, Morton, admired by all as a highly competent surgeon and a man of incorruptible probity, can rightly be described as the father figure of surgery during the formative years of St Vincent's Hospital. His innate sense of justice and fair play formed the basis of his distinguished tenure of the Presidency of the Medical Defence Association of Victoria, where his constructive attempts at reform of the medico-legal system were only thwarted by the predictable opposition of the legal profession and politicians.

  2. Medico-economic impact of MSKCC non-sentinel node prediction nomogram for ER-positive HER2-negative breast cancers

    PubMed Central

    Guillot, Eugénie; Feron, Jean-Guillaume; Fourchotte, Virginie; Alran, Séverine; Pierga, Jean-Yves; Cottu, Paul; Lerebours, Florence; Stevens, Denise; Vincent-Salomon, Anne; Sigal-Zafrani, Brigitte; Campana, François; Rouzier, Roman; Reyal, Fabien

    2017-01-01

    Background Avoiding axillary lymph node dissection (ALND) for invasive breast cancers with isolated tumor cells or micrometastatic sentinel node biopsy (SNB) could decrease morbidity with minimal clinical significance. Purpose The aim of this study is to simulate the medico-economic impact of the routine use of the MSKCC non-sentinel node (NSN) prediction nomogram for ER+ HER2- breast cancer patients. Methods We studied 1036 ER+ HER2- breast cancer patients with a metastatic SNB. All had a complementary ALND. For each patient, we calculated the probability of the NSN positivity using the MSKCC nomogram. After validation of this nomogram in the population, we described how the patients’ characteristics spread as the threshold value changed. Then, we performed an economic simulation study to estimate the total cost of caring for patients treated according to the MSKCC predictive nomogram results. Results A 0.3 threshold discriminate the type of sentinel node (SN) metastases: 98.8% of patients with pN0(i+) and 91.6% of patients with pN1(mic) had a MSKCC score under 0.3 (false negative rate = 6.4%). If we use the 0.3 threshold for economic simulation, 43% of ALND could be avoided, reducing the costs of caring by 1 051 980 EUROS among the 1036 patients. Conclusion We demonstrated the cost-effectiveness of using the MSKCC NSN prediction nomogram by avoiding ALND for the pN0(i+) or pN1(mic) ER+ HER2- breast cancer patients with a MSKCC score of less than or equal to 0.3. PMID:28241044

  3. [Werner Leibbrand, Annemarie Wettley and controversies on "euthanasia" the background of medico-historical and ethical debates in the Post World War II era].

    PubMed

    Wiesinger, Christine; Frewer, Andreas

    2014-01-01

    Psychiatrists and medical historians Werner Leibbrand (1896 - 1974) and Annemarie Wettley (1913 - 1996) are amongst the most striking figures in the field of history of medicine. Leibbrand was appointed director of the "Heil- und Pflegeanstalt" in Erlangen shortly after the war. Fuelled by his own experiences of suppression and persecution during the Nazi era he promised to unearth the crimes and atrocities which had happened under watch of the Nazi regime. He was joined by Annemarie Wettley, who worked as a physician at the hospital and had developed an increasing interest in the history of medicine. In 1946 they published "Um die Menschenrechte der Geisteskranken" ("Human Rights of the Mentally Ill") about the "euthanasia" campaign of the Nazi regime. Although a number of substantial works followed, Leibbrand and Wettley failed to inform in more depth on crimes and atrocities, for instance killings of patients and forced malnutrition. Doubts and charges against Wettley regarding her role in dietary programmes at the Erlangen hospital and against Leibbrand regarding special expert's reports--both had a short-term arrest warrant--might have contributed to stagnation in their efforts. In 1953 Leibbrand accepted the offer of a chair at the University in Munich, Wettley followed and habilitated in history of medicine; in the year 1962 they married. Contacts and exchange amongst medico-historical experts shed light on developments during the post-war era; still, a critical and fundamental review of the crimes within the medical system of the Nazi regime did not take place during this time.

  4. Selective culturing and genus-specific PCR detection for identification of Aeromonas in tissue samples to assist the medico-legal diagnosis of death by drowning.

    PubMed

    Huys, Geert; Coopman, Vera; Van Varenbergh, Dirk; Cordonnier, Jan

    2012-09-10

    The detection of autochthonous aquatic bacteria in tissue samples from drowning cases is increasingly considered as an alternative approach to assist the medico-legal diagnosis of death by drowning. Bacteria belonging to the genus Aeromonas may be suitable candidates for this application as they are ubiquitous in natural aquatic environments but are generally not part of the human microbiota. The research aims of this study were (i) to develop a sensitive, specific and rapid screening and confirmation method for Aeromonas species in tissue samples and (ii) to evaluate aseptic sternal puncture as a post-mortem sample technique and bone marrow as an alternative matrix to provide evidence of death by drowning. The presence of Aeromonas in tissue samples was verified by cultivation using the selective media Ampicillin Dextrin Agar (ADA) and Ryan's Aeromonas Medium. The use of ADA medium was found most optimal for the sensitive, inexpensive and quick detection of aeromonads in human tissue samples. Positive culture plates were confirmed by harvesting all colonies for DNA extraction and subsequent PCR amplification using Aeromonas genus-specific primers. Aeromonads were detected in lung swab, blood and bone marrow of drowned bodies (n=3), but were negative in these three matrices for all negative controls (n=90) tested. Bone marrow proved to be a suitable alternative matrix and can be sampled post-mortem by an aseptic sternal puncture. In conclusion, this study confirms previous indications that aeromonads in cultures from blood of water bodies can be considered a potential marker for drowning. Given the fact that the number of immersed bodies (drowned and non-drowned) included in this study is statistically not significant, however, more tissue samples need to be investigated to confirm the validity of these methods to aid the diagnosis of death by wet drowning.

  5. Patterns of abuse amongst Sri Lankan women returning home after working as domestic maids in the Middle East: An exploratory study of medico-legal referrals.

    PubMed

    Wickramage, Kolitha; De Silva, Malintha; Peiris, Sharika

    2017-01-01

    Migrant worker abuse is well recognised, but poorly characterised within the scientific literature. This study aimed to explore patterns of abuse amongst Sri Lankan women returning home after working as domestic maids. Sri Lanka has over 2 million of its citizens employed overseas as international labor migrants. A cross-sectional study was conducted on Sri Lankan female domestic maids returning from the Middle East region who were referred for medico-legal opinion. A total of 20 women were included in the study. Average length of their employment overseas was 14 months. Complaints of physical violence directed mainly through their employers were made by 60% of women. Upon physical examination, two-thirds had evidence of injuries, with a third being subjected to repetitive/systematic violence. Eighty percent suffered some form of psychological trauma. Personal identity papers and travel documents had been confiscated by the employer in 85% of cases, with two thirds indicating they were prevented and/or restricted from leaving their place of work/residence. Our study demonstrates that female domestic maid abuse manifests through multiple pathways. Violence against such workers span the full spectrum of physical, financial, verbal, emotional abuse and neglect, as defined by the World Health Organization. Findings from this exploratory study cannot be generalized to the large volume of migrant worker outflows. Further research is needed to determine incidence and define patterns in other migrant worker categories such as low-skilled male workers. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  6. [Medico-legal opinions in cases for annulment of testament. Part II. Final conclusions of opinions. Quality of medical documentation. Evaluation of witnesses' testimonies].

    PubMed

    Marcinkowski, Jerzy T; Klimberg, Aneta

    2007-01-01

    The percentage of cases, in which devisors were unable to devise properly was high, what was mostly associated with the frequent drawing up of testaments by chronically ill individuals immediately before death. Grounds for pronouncing the devisor lacking in testamentary capacity were observed in 46.6% of cases, while 39.7% of devisors were found to lack free expression of will. Medical records were available in all the cases, including psychiatric records in 20.5% of cases and neurological records in 20.5%. In the majority of instances, the low quality of medical records hindered formulating expert opinions. The fact that in the majority of cases, the testimonies of witnesses were highly divergent indicated that they were either unable to assess the mental state of the devisor or else were themselves interested in the settlement of the case. Frequently, attending physicians from non-psychiatric wards were unable to answer questions on the mental state of the devisor, what resulted from their focusing on the somatic cause of hospitalization and the fact that their contact with the patient was very limited in time. Problems with certification on the basis of medical records were mainly associated with lacking psychiatric or neurological consults performed at the time the testament was drawn up; in some instances, the entire medical records from that period were missing. For this reason, individuals desiring to prepare a last will should be advised to undergo voluntary psychiatric assessment in this period. Medico-legal opinions in testament cases are difficult and time-consuming, but pleading one's case before the court is even more tedious and difficult.

  7. [Cognitive research about the use of virtual worlds among the students enrolled to the faculty of medicine and surgery "Campus Bio-Medico University" in Rome].

    PubMed

    Tambone, V; Alessi, A; Macchi, I; Milighetti, S; Muzii, L

    2009-01-01

    The main difference between a virtual reality and a generic representation is to be directly involved into the action you are performing. As a matter of fact, within the shift from real to virtual world, our biological physique does not mutate but is amplified and connected to the virtual world by technological interfaces. Training using a virtual reality simulator is an option to supplement (or replace) standard training. One of the two main goals of our study is to test, at first, how much students enrolled to the Faculty of Medicine at "University Campus Bio-Medico of Rome" are familiar with synthetic worlds, how long they have been using them and how they would like their Avatar to look like. Moreover, the second aim is to collect students' opinion about the use of virtual, interactive environments to enable learning and participation in dynamic, problem based, clinical, virtual simulations. Simulations might be used to allow learners to make mistakes safely in lieu of real life situations, learn from those mistakes and ultimately to improve performances by subsequent avoidance of those mistakes. The selected approach to the study is based on a semi-structured questionnaire made of 14 questions administered to all the medical students. Most of the students appear not to be very confident with virtual worlds mostly because of a lack of interest. However, a large majority of them are likely to use a virtual world for fun or escaping from reality. Students would select and customize their Avatar by giving her/him the same sexual identity, same figure, same social class but different employment. It is important to notice that a wide majority of the students is interested in practicing on a virtual world in order to manage new experiences and being able to face them; their willing is to get benefits from the ability to make mistakes in a safe environment as well as to record a positive impact on their understanding.

  8. For mothers and sisters: care of the reproductive female body in the medico-ritual world of early and medieval Japan.

    PubMed

    Triplett, Katja

    2014-01-01

    While married female members of the Japanese aristocracy followed the ideal of bearing children, female Buddhist novices and ordained women, often belonging to the aristocracy themselves, had to abstain from sexual activity and reproduction in accordance with the ordination rules. Infertility was considered with disdain by the first group, whereas not bearing children was the utmost expression of leading a virtuous life for the second group. However, both groups were concerned with keeping their physical bodies healthy: some to become mothers, the others to live as nuns or religious sisters. Focusing on the early medieval period, this paper examines various sources to illuminate the ways in which women were cared for and the kind of views and ideas that informed this care. Instead of looking at the ancient methods of treatment through a modern "scientific" lens and sorting them into "proto-scientific" and "superstitious" categories, medico-ritual and religious views on the female body are explored as facets of the worldview prevalent in the period under consideration. Special attention is paid to relevant chapters of the first medical work produced in Japan, the Ishinpō, compiled by a court physician, Tanba no Yasuyori, in the late 10th century CE. The investigation of other sources, such as Buddhist legends and doctrinal texts, suggests that women were recommended to seek to overcome their femaleness altogether by transforming their female bodies into male bodies in order to reach ultimate "healing" in terms of salvation. In lay circles, however, the Buddhist divinities and other powerful deities were worshipped to ensure this-worldly "healing" in terms of successful procreation and continuation of the family line.

  9. Do drug users use less alcohol than non-drug users? A comparison of ethyl glucuronide concentrations in hair between the two groups in medico-legal cases.

    PubMed

    Paul, Richard; Kingston, Robert; Tsanaclis, Lolita; Berry, Anthony; Guwy, Alan

    2008-03-21

    Two groups were selected from the remainder of hair samples that had been tested for drugs at TrichoTech for medico-legal cases: samples that tested negative (drug-negative group; N=42, age 33.4+/-7.2 years) and samples that tested positive for drugs (drug-positive group; N=57, age 32.5+/-8.8 years). A rapid, simple method to detect the ethanol metabolite, ethyl glucuronide (EtG) in hair has been developed. The hair samples were sectioned, and then submitted to overnight sonication in water. Samples then underwent SPE using anion exchange cartridges, followed by derivatisation with N,O-bis[trimethylsilyl]trifluoroacetamide (BSTFA), before confirmation by GC-MS/MS. The assay produced excellent linearity and sensitivity over the calibration range 0.02-1.0 ng/mg, assuming a 10 mg hair sample. The mean age of the two groups was not statistically different (p=0.575, Student t-test), indicating a homogeneous group. Twelve of the 57 (21.0%) hair samples of the drug-positive group tested positive for EtG, and 17 of the 42 (40.5%) hair samples of the drug-negative group tested positive for EtG. The mean concentration of EtG in the drug-positive group was 0.011 ng/mg compared to 0.107 ng/mg in the drug-negative group. When the full results of this study were subjected to statistical analysis it was shown that EtG levels in the drug-negative group were statistically higher than those found in the drug-positive group (p<0.05). This preliminary finding may be of use in the study of addiction and adds valuable data to previous studies regarding the use of EtG as a valuable marker for alcohol levels in hair.

  10. Project MEDICO Third Progress Report.

    ERIC Educational Resources Information Center

    Artandi, Susan; Baxendale, Stanley

    This report describes the searching methods and the search program for the automatic indexing method which was developed and implemented in an earlie r phase of the project. The indexing method generates index tags automatically from English language text and creates a machine searchable file of index records for the document being processed.…

  11. Tuberculosis: Medico-Legal Aspects

    PubMed Central

    Vetrugno, G.; De-Giorgio, F.; D’Alessandro, F.; Scafetta, I.; Berloco, F.; Buonsenso, D.; Abbate, F.; Scalise, G.; Pascali, V.L.; Valentini, P

    2014-01-01

    Tuberculosis is a diffusive infectious disease whose typical behaviour differentiates it from other infectious diseases spread by human-to-human transmission (flu, chicken pox, cholera, etc.) that follow a classic epidemic pattern. Indeed, in the presence of a known source of Koch bacilli that is capable of spreading the bacteria by air, not all exposed individuals inhale the bacteria, not all those who inhale them absorb them, not all those who absorb the bacteria are unable to eliminate them, not all who are able to eliminate them do so using delayed hypersensitivity, not all those who react with delayed hypersensitivity suffer lasting tissue damage (among other things, minor), not all who suffer tissue damage have anatomical sequelae, and not all those who have anatomical sequelae, however minimal, become carriers of bacilli in the latent period. The vast majority (90–95%) of the latter – which are in any case a portion, not the totality of those exposed – remain asymptomatic throughout their lives and never develop active tuberculosis. Based on these biological characteristics and the legal concepts of “epidemic” and “disease,” it becomes highly problematic, if not impossible, to assert both that tuberculosis can cause events of sufficient magnitude to be associated with the crime of “epidemic,” and that the mere diagnosis of a latent tuberculosis infection is sufficient to assume the presence of an illness legally prosecutable in criminal proceedings or a disability prosecutable in civil proceedings. Furthermore, clinically apparent tuberculosis is a temporarily—and in some cases permanently—disabling condition, and in certain work environments, even with the difficulties caused by the lack of available effective diagnostic tools and the insidious behaviour of the disease in the early stages, targeted monitoring to identify other persons who may become ill is appropriate. PMID:24804006

  12. [Problem of exposure to direct danger of death or grave detriment to health of a child breast-fed by an alcohol-abusing mother in medico-legal opinions].

    PubMed

    Swiderski, Paweł; Zaba, Czesław; Tezyk, Artur; Wachowiak, Roman

    2011-01-01

    In the last few years, the authors have noted an increasing amount of cases submitted for analysis in the Chair and Department of Forensic Medicine, Poznan University of Medical Sciences, and addressing alcohol abuse by breast-feeding mothers. A question about the exposure to direct danger of death or grave detriment to health of a child by a breast-feeding mother under the influence of alcohol is posed by prosecution or the court, and the expectation is obtaining answers from forensic experts as to whether the situation fulfills the meaning of article 160 of the penal code, which would result in the mother bearing criminal liability. Difficulties that have arisen during the analysis of such cases have prompted the authors to analyze the problem of alcohol abuse by breast-feeding mothers in terms of medico-legal opinions.

  13. Mincle Signaling Promotes Con A Hepatitis.

    PubMed

    Greco, Stephanie H; Torres-Hernandez, Alejandro; Kalabin, Aleksandr; Whiteman, Clint; Rokosh, Rae; Ravirala, Sushma; Ochi, Atsuo; Gutierrez, Johana; Salyana, Muhammad Atif; Mani, Vishnu R; Nagaraj, Savitha V; Deutsch, Michael; Seifert, Lena; Daley, Donnele; Barilla, Rocky; Hundeyin, Mautin; Nikifrov, Yuriy; Tejada, Karla; Gelb, Bruce E; Katz, Steven C; Miller, George

    2016-10-01

    Con A hepatitis is regarded as a T cell-mediated model of acute liver injury. Mincle is a C-type lectin receptor that is critical in the immune response to mycobacteria and fungi but does not have a well-defined role in preclinical models of non-pathogen-mediated inflammation. Because Mincle can ligate the cell death ligand SAP130, we postulated that Mincle signaling drives intrahepatic inflammation and liver injury in Con A hepatitis. Acute liver injury was assessed in the murine Con A hepatitis model using C57BL/6, Mincle(-/-), and Dectin-1(-/-) mice. The role of C/EBPβ and hypoxia-inducible factor-1α (HIF-1α) signaling was assessed using selective inhibitors. We found that Mincle was highly expressed in hepatic innate inflammatory cells and endothelial cells in both mice and humans. Furthermore, sterile Mincle ligands and Mincle signaling intermediates were increased in the murine liver in Con A hepatitis. Most significantly, Mincle deletion or blockade protected against Con A hepatitis, whereas Mincle ligation exacerbated disease. Bone marrow chimeric and adoptive transfer experiments suggested that Mincle signaling in infiltrating myeloid cells dictates disease phenotype. Conversely, signaling via other C-type lectin receptors did not alter disease course. Mechanistically, we found that Mincle blockade decreased the NF-κβ-related signaling intermediates C/EBPβ and HIF-1α, both of which are necessary in macrophage-mediated inflammatory responses. Accordingly, Mincle deletion lowered production of nitrites in Con A hepatitis and inhibition of both C/EBPβ and HIF-1α reduced the severity of liver disease. Our work implicates a novel innate immune driver of Con A hepatitis and, more broadly, suggests a potential role for Mincle in diseases governed by sterile inflammation.

  14. Mincle Signaling Promotes Con-A Hepatitis

    PubMed Central

    Greco, Stephanie H.; Torres-Hernandez, Alejandro; Kalabin, Aleksandr; Whiteman, Clint; Rokosh, Rae; Ravirala, Sushma; Ochi, Atsuo; Gutierrez, Johana; Salyana, Muhammad Atif; Mani, Vishnu R.; Nagaraj, Savitha V.; Deutsch, Michael; Seifert, Lena; Daley, Donnele; Barilla, Rocky; Hundeyin, Mautin; Nikifrov, Yuriy; Tejada, Karla; Gelb, Bruce E.; Katz, Steven C.; Miller, George

    2016-01-01

    Concanavalin-A (Con-A) hepatitis is regarded as a T cell-mediated model of acute liver injury. Mincle is a C-type lectin receptor (CLR) that is critical in the immune response to mycobacteria and fungi, but does not have a well-defined role in pre-clinical models of non-pathogen mediated inflammation. Since Mincle can ligate the cell death ligand SAP130, we postulated that Mincle signaling drives intrahepatic inflammation and liver injury in Con-A hepatitis. Acute liver injury was assessed in the murine Con-A hepatitis model using C57BL/6, Mincle−/−, and Dectin-1−/− mice. The role of C/EBPβ and HIF-1α signaling was assessed using selective inhibitors. We found that Mincle was highly expressed in hepatic innate inflammatory cells and endothelial cells in both mice and humans. Furthermore, sterile Mincle ligands and Mincle signaling intermediates were increased in the murine liver in Con-A hepatitis. Most significantly, Mincle deletion or blockade protected against Con-A hepatitis whereas Mincle ligation exacerbated disease. Bone marrow chimeric and adoptive transfer experiments suggested that Mincle signaling in infiltrating myeloid cells dictates disease phenotype. Conversely, signaling via other CLRs did not alter disease course. Mechanistically, we found that Mincle blockade decreased the NF-κβ related signaling intermediates, C/EBPβ and HIF-1α, both of which are necessary in macrophage-mediated inflammatory responses. Accordingly, Mincle deletion lowered production of nitrites in Con-A hepatitis and inhibition of both C/EBPβ and HIF1-α reduced the severity of liver disease. Our work implicates a novel innate immune driver of Con-A hepatitis and, more broadly, suggests a potential role for Mincle in diseases governed by sterile inflammation. PMID:27559045

  15. Galaxias australes con núcleo doble

    NASA Astrophysics Data System (ADS)

    Gimeno, G.; Díaz, R.; Carranza, G.

    Se estudia una muestra de galaxias australes con núcleo doble a partir de una búsqueda extensiva en la literatura. Se analizan las características morfológicas, fotométricas y espectroscópicas de la muestra. Para algunas galaxias se han realizado observaciones con el espectrógrafo multifunción (EMF) de la Estación Astrofísica de Bosque Alegre a partir de las cuales se determinaron parámetros cinemáticos.

  16. GeConT: gene context analysis.

    PubMed

    Ciria, R; Abreu-Goodger, C; Morett, E; Merino, E

    2004-09-22

    The fact that adjacent genes in bacteria are often functionally related is widely known. GeConT (Gene Context Tool) is a web interface designed to visualize genome context of a gene or a group of genes and their orthologs in all the completely sequenced genomes. The graphical information of GeConT can be used to analyze genome annotation, functional ortholog identification or to verify the genomic context congruence of any set of genes that share a common property. http://www.ibt.unam.mx/biocomputo/gecont.html

  17. InterCon Travel Health: Case B

    ERIC Educational Resources Information Center

    Truman, Gregory E.; Pachamanova, Dessislava A.; Goldstein, Michael A.

    2010-01-01

    InterCon provides services to health insurers of foreign tourists who travel to the United States and Canada. Management wants to implement a new information system that will deal with several operational problems, but it is having difficulty securing the capital resources to fund the system's development. After an initial failure, the chief…

  18. InterCon Travel Health: Case B

    ERIC Educational Resources Information Center

    Truman, Gregory E.; Pachamanova, Dessislava A.; Goldstein, Michael A.

    2010-01-01

    InterCon provides services to health insurers of foreign tourists who travel to the United States and Canada. Management wants to implement a new information system that will deal with several operational problems, but it is having difficulty securing the capital resources to fund the system's development. After an initial failure, the chief…

  19. Ependimoma myxopapilar sacro gigante con osteolisis

    PubMed Central

    Ajler, Pablo; Landriel, Federico; Goldschmidt, Ezequiel; Campero, Álvaro; Yampolsky, Claudio

    2014-01-01

    Objetivo: la presentación de un caso de una paciente con un ependimoma sacro con extensa infiltración y destrucción ósea local. Descripción del caso: una mujer de 53 años acudió a la consulta por dolor lumbosacro y alteraciones sensitivas perineales y esfinterianas. La imágenes por Resonancia Magnética (IRM) y la Tomografía Axial Computada (TAC) mostraron una lesión expansiva gigante a nivel S2-S4 con extensa osteólisis e invasión de tejidos adyacentes. Se realizó una exéresis tumoral completa con mejoría del estatus funcional. La anatomía patológica informó ependimoma mixopapilar. Discusión: la extensión de la resección quirúrgica es el mejor predictor de buen pronóstico. El tratamiento radiante se reserva como opción adyuvante para las resecciones incompletas y recidiva tumoral. La quimioterapia sólo debería utilizarse en casos en que la cirugía y la radioterapia estén contraindicadas. Conclusión: Los ependimomas mixopapilares sacros con destrucción ósea y presentación intra y extradural son muy infrecuentes y deben ser tenidos en cuenta entre los diagnósticos diferenciales preoperatorios. Su resección total, siempre que sea posible, es la mejor alternativa terapéutica. PMID:25165615

  20. Conserva a Puerto Rico con bosques maderables

    Treesearch

    Frank H. Wadsworth

    2009-01-01

    [article in Spanish] Puerto Rico consume muchos productos forestales costosos de importar. También tiene bosques extensos con maderas explotables. Además, existen condiciones físicas favorables para la producción de madera útil. No obstante, hoy día no se utiliza la madera de los bosques actuales ocurre la deforestación para cualquier fin. Los Bosques productivos de...

  1. Somatic cell nuclear transfer: pros and cons.

    PubMed

    Sumer, Huseyin; Liu, Jun; Tat, Pollyanna; Heffernan, Corey; Jones, Karen L; Verma, Paul J

    2009-01-01

    Even though the technique of mammalian SCNT is just over a decade old it has already resulted in numerous significant advances. Despite the recent advances in the reprogramming field, SCNT remains the bench-mark for the generation of both genetically unmodified autologous pluripotent stem cells for transplantation and for the production of cloned animals. In this review we will discuss the pros and cons of SCNT, drawing comparisons with other reprogramming methods.

  2. 9 CFR 319.301 - Chili con carne with beans.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Chili con carne with beans. 319.301 Section 319.301 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Dehydrated Meat Food Products § 319.301 Chili con carne with beans. Chili con carne with beans shall contain...

  3. 9 CFR 319.301 - Chili con carne with beans.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Chili con carne with beans. 319.301 Section 319.301 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Dehydrated Meat Food Products § 319.301 Chili con carne with beans. Chili con carne with beans shall contain...

  4. 9 CFR 319.301 - Chili con carne with beans.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Chili con carne with beans. 319.301 Section 319.301 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Dehydrated Meat Food Products § 319.301 Chili con carne with beans. Chili con carne with beans shall contain...

  5. 9 CFR 319.301 - Chili con carne with beans.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Chili con carne with beans. 319.301 Section 319.301 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Dehydrated Meat Food Products § 319.301 Chili con carne with beans. Chili con carne with beans shall contain...

  6. 9 CFR 319.300 - Chili con carne.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Chili con carne. 319.300 Section 319.300 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... Products § 319.300 Chili con carne. “Chili con carne” shall contain not less than 40 percent of meat...

  7. 9 CFR 319.301 - Chili con carne with beans.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Chili con carne with beans. 319.301 Section 319.301 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Dehydrated Meat Food Products § 319.301 Chili con carne with beans. Chili con carne with beans shall...

  8. 9 CFR 319.300 - Chili con carne.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Chili con carne. 319.300 Section 319.300 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... Products § 319.300 Chili con carne. “Chili con carne” shall contain not less than 40 percent of...

  9. 9 CFR 319.300 - Chili con carne.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Chili con carne. 319.300 Section 319.300 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... Products § 319.300 Chili con carne. “Chili con carne” shall contain not less than 40 percent of...

  10. 9 CFR 319.300 - Chili con carne.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Chili con carne. 319.300 Section 319.300 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... Products § 319.300 Chili con carne. “Chili con carne” shall contain not less than 40 percent of...

  11. 9 CFR 319.300 - Chili con carne.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Chili con carne. 319.300 Section 319.300 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY... Products § 319.300 Chili con carne. “Chili con carne” shall contain not less than 40 percent of...

  12. Vandhyatva--a medico historical study.

    PubMed

    Babu, G; Babu, Anitha; Bhuyan, G C; Prasad, G P; Swamy, G K

    2006-01-01

    As per Ayurvĕda, important factors for conception are considered as rtu (fertile period), Kşĕtra (uterus and reproductive organs), Ambu (Proper nutrient fluid) and Bĭja (sukra-sŏnita) and also normalcy of Hŗdaya (Psychology). Abnormality of properly functioning Văyu and Satbhavăs (mătŗja, pitŗja, atma, satva, sătmaya and Rasa), any one of these causes infertility (Vandhyatva). From the time immemorial the phenomenon of infertility was prevalent through out the world and this may persist till the human race exists. Every human being has inherent, intense desire to continue his (one's) own race; to become a mother is one of the most cherished desires of every woman. Failure to achieve conception by a couple of mature age, having normal coitus during appropriate period of menstrual cycle regularly, at least for one year of their conjugal is termed as infertility. The historical importance of strĭ vandhyatva and a comparative study regarding its Nidăna, Samprăpti, Lakşaņa, Chikitsă etc compiled from various Granthăs are being presented in this paper.

  13. Plastination: ethical and medico-legal considerations

    PubMed Central

    Conti, Adelaide; Buccelli, Claudio; Addeo, Giuseppe; Capasso, Emanuele; Piras, Mauro

    2016-01-01

    Abstract The international plastination phenomenon has proved to be immensely popular with audiences world-wide. Never before has the human body been exposed to public gaze in such an accessible manner. The exhibitions have perplexed many, included anatomists, some of whom find the display of human bodies unethical. The objective of this study is to review the attention on the use of plastination and exhibition of entire human bodies for non-educational or commercial purposes. The nature of these exhibitions and the uneasy balance between entertainment and education has caused heated debate. The possible legitimacy of the expression of one’s will as far as exhibition purposes isn’t considered sufficient for the indiscriminate use of a corpse despite the ethical necessity of respecting the wishes of individuals based on respect for the deceased. The informed consent of an individual represents only the most basic and minimal prerequisite for the use of the deceased’s body for exhibition purposes, and is absolutely not enough on its own to justify its use in entertainment exhibitions or for the commercialization of the death PMID:28352850

  14. A medico-historical review of Arjuna

    PubMed

    Narayana, A; Kumaraswamy, R

    1996-01-01

    Ancient Indian Medical knowledge known as Ayurveda goes back to a immemorial past. The Vedas and Puranas refer various materials of medical importance including herbs, plants and trees etc. The ancient medical scientists have mentioned the properties of the Arjuna, and recommended mainly for the management of Hirta/Rudhira vikaras, Vrana, Prameha, Visa Vikaras, Asrugdhara, Kshetriya/Shukra dosha etc. The modern medical/Botanical scientists have also carried out so many researches on Arjuna and do not find any difference with the ancestery knowledge.

  15. Consent--its medico legal aspects.

    PubMed

    Yadwad, B S; Gouda, H

    2005-10-01

    One of the duties of a doctor towards his patients is to obtain consent before any medical examination. Any such examination without prior consent amounts to an assault on the patient. Consent is defined under Indian Contract Act (because Doctor Patient relationship isa contract) as "two or more persons are said to consent when they agree to the same thing in the same sense." Consent may be implied, expressed or informed depending upon the circumstances. But the consent of the patient is not required in situations like medical emergency, for vaccination etc. If the patient is not medically or legally competent to give consent, the consent of the parents or guardians or any person present at the time with the patient can be taken. Any research on a potential subject, removal of organs for transplantation, publication of information obtained during medical examination also require consent of the concerned person.

  16. Energy Star program benefits Con Edison

    SciTech Connect

    1995-05-01

    Impressed with savings in energy costs achieved after upgrading the lighting and air conditioning systems at its Manhattan headquarters, Home Box Office (HBO) wanted to do more, James Flock, vice president for computer and office systems, contacted Con Edison Co. of New York in March 1991 to determine what the company could do to save money by reducing energy consumed by personal computers. Arthur Kressner, Con Edison Research and Development manager contacted industry organizations and manufacturers for advice, but was told only to shut off computers at night and on weekends. Kressner arranged a series of meetings with IBM and the Electric Power Research Institute (EPRI) to discuss the issue, then approached the U.S. Environmental Protection Agency (EPA), which was designing a program to promote the introduction and use of energy-efficient office equipment. In 1992, the EPA announced the Energy Star program for PCs, enabling manufacturers to display the Energy Star logo on machines meeting program criteria, including the ability to enter a sleep mode in which neither the computer nor monitor consume more than 30 W or electricity. Industry experts estimate national energy consumption by office equipment could double by the year 2000, but Energy Star equipment is expected to improve efficiency and help maintain electric loads.

  17. Cervical disc arthroplasty: Pros and cons

    PubMed Central

    Moatz, Bradley; Tortolani, P. Justin

    2012-01-01

    Background: Cervical disc arthroplasty has emerged as a promising potential alternative to anterior cervical discectomy and fusion (ACDF) in appropriately selected patients. Despite a history of excellent outcomes after ACDF, the question as to whether a fusion leads to adjacent segment degeneration remains unanswered. Numerous US investigational device exemption trials comparing cervical arthroplasty to fusion have been conducted to answer this question. Methods: This study reviews the current research regarding cervical athroplasty, and emphasizes both the pros and cons of arthroplasty as compared with ACDF. Results: Early clinical outcomes show that cervical arthroplasty is as effective as the standard ACDF. However, this new technology is also associated with an expanding list of novel complications. Conclusion: Although there is no definitive evidence that cervical disc replacement reduces the incidence of adjacent segment degeneration, it does show other advantages; for example, faster return to work, and reduced need for postoperative bracing. PMID:22905327

  18. Pros and cons of phage therapy

    PubMed Central

    Loc-Carrillo, Catherine

    2011-01-01

    Many publications list advantages and disadvantages associated with phage therapy, which is the use of bacterial viruses to combat populations of nuisance or pathogenic bacteria. The goal of this commentary is to discuss many of those issues in a single location. In terms of “Pros,” for example, phages can be bactericidal, can increase in number over the course of treatment, tend to only minimally disrupt normal flora, are equally effective against antibiotic-sensitive and antibiotic-resistant bacteria, often are easily discovered, seem to be capable of disrupting bacterial biofilms, and can have low inherent toxicities. In addition to these assets, we consider aspects of phage therapy that can contribute to its safety, economics, or convenience, but in ways that are perhaps less essential to the phage potential to combat bacteria. For example, autonomous phage transfer between animals during veterinary application could provide convenience or economic advantages by decreasing the need for repeated phage application, but is not necessarily crucial to therapeutic success. We also consider possible disadvantages to phage use as antibacterial agents. These “Cons,” however, tend to be relatively minor. PMID:22334867

  19. Games Con Men Play: The Semiosis of Deceptive Interaction.

    ERIC Educational Resources Information Center

    Hankiss, Agnes

    1980-01-01

    Analyzes some of the most frequent deceptive interactions as rendered through case histories of male con artists and their victims taken from police records. Discusses the recurrent elements in both the con-games strategies and victims' way of interpreting those strategies. (JMF)

  20. Breath Analysis Science at PittCon 2012, Orlando, Florida

    EPA Science Inventory

    Breath analysis science was featured in three organized sessions at this year’s Pittsburgh Conference and Exposition, or ‘PittCon 2012’ (http://www.pittcon.org/). As described in previous meeting reports, PittCon is one of the largest international conferences for analytical chem...

  1. Trazando la materia oscura con cúmulos globulares

    NASA Astrophysics Data System (ADS)

    Forte, J. C.

    Se describe la estrategia adoptada para mapear la distribución de materia oscura y bariónica en galaxias elípticas cuyos cúmulos globulares están siendo observados con los telescopios VLT y Gemini. Se ejemplifican los resultados con los datos obtenidos en el cúmulo de Fornax.

  2. Breath Analysis Science at PittCon 2012, Orlando, Florida

    EPA Science Inventory

    Breath analysis science was featured in three organized sessions at this year’s Pittsburgh Conference and Exposition, or ‘PittCon 2012’ (http://www.pittcon.org/). As described in previous meeting reports, PittCon is one of the largest international conferences for analytical chem...

  3. RoboCon: A general purpose telerobotic control center

    SciTech Connect

    Draper, J.V.; Noakes, M.W.; Schempf, H.; Blair, L.M.

    1997-02-01

    This report describes human factors issues involved in the design of RoboCon, a multi-purpose control center for use in US Department of Energy remote handling applications. RoboCon is intended to be a flexible, modular control center capable of supporting a wide variety of robotic devices.

  4. Pro/con a precessional geodynamo

    NASA Astrophysics Data System (ADS)

    Vanyo, J.

    2003-04-01

    The modest amount of research that exists on the ability, or lack of ability, of mantle precession to power a geodynamo developed mostly during the last half of the 1900s. Papers by Roberts and Stewartson (1965) and by Busse (1968) studied precession generally without a pro/con conclusion. Malkus in the late 1960s attempted to advance a positive role for precession through experiments and analysis. His experiments have survived criticism, but his analyses were discounted, especially by Rochester, Jacobs, Smylie, and Chong (1975) and by Loper (1975). Rochester, et al. critiqued existing analyses of precession, including those of Malkus, but did not reach a strong position either pro or con a precessional geodynamo. Loper argued emphatically that precession was not capable of powering the geodynamo. Explicit analyses that either critique or support Loper’s arguments have yet to appear in the literature. During the 1970s, Vanyo and associates studied energy dissipation during precession of satellite liquid fuels and its effect on satellite attitude stability. Engineers and scientists in every country that has launched satellites completed similar research. Some is published in the aerospace literature, more is available in company and government reports. Beginning in 1981, Vanyo and associates applied this knowledge to the very similar problem of energy dissipation and flow patterns in precessing mechanical models scaled geometrically and dynamically to the Earth’s liquid core. Energy experiments indicate massive amounts of mechanical energy are dissipated at the CMB, and flow experiments show complex motions within the boundary layer and axial flows with helicity throughout the interior. Analysis of Earth core precession also advanced, especially in several papers by Kerswell and by Tilgner in the late 1990s. Detail numerical models have yet to appear. Although progress in understanding the role of precession in Earth core motions has advanced, there remains a

  5. Psychopathology and neoplastic disease: medico-social and medico-legal considerations.

    PubMed

    Massoni, F; Ricci, P; Crusco, M; Onofri, E; Petrone, L; Sacco, C; Ricci, L; Ricciardi, M; Archer, T; Ricci, S

    2017-01-01

    The cognitive disability associated with stress in patients presenting cancer disease may exert a significant impact on the psychological health of the individual and even deteriorate the clinical diagnosis. The present study consists of a review of the available literature and an analysis of the association between psychopathologic disease and cancer by selecting useful contributions to the medicosocial discussion of the topic. Interesting considerations have emerged on the epidemiology and pathogenesis of the association between psychopathology and cancer that initiated possibilities towards a greater accuracy in the assessment of the patient that is not only limited to oncologic problems and outcomes.

  6. [Cement augmentation of pedicle screws : Pros and cons].

    PubMed

    Schnake, K J; Blattert, T R; Liljenqvist, U

    2016-09-01

    Cement augmentation of pedicle screws biomechanically increases screw purchase in the bone. However, clinical complications may occur. The pros and cons of the technique are discussed from different clinical perspectives.

  7. Planificación Neuroquirúrgica con Software Osirix

    PubMed Central

    Jaimovich, Sebastián Gastón; Guevara, Martin; Pampin, Sergio; Jaimovich, Roberto; Gardella, Javier Luis

    2014-01-01

    Introducción: La individualidad anatómica es clave para reducir el trauma quirúrgico y obtener un mejor resultado. Actualmente, el avance en las neuroimágenes ha permitido objetivar esa individualidad anatómica, permitiendo planificar la intervención quirúrgica. Con este objetivo, presentamos nuestra experiencia con el software Osirix. Descripción de la técnica: Se presentan 3 casos ejemplificadores de 40 realizados. Caso 1: Paciente con meningioma de la convexidad parasagital izquierda en área premotora; Caso 2: Paciente con macroadenoma hipofisario, operada previamente por vía transeptoesfenoidal en otra institución con una resección parcial; Caso 3: Paciente con lesiones en pedúnculo cerebeloso medio bilateral. Se realizó la planificación prequirúrgica con el software OsiriX, fusionando y reconstruyendo en 3D las imágenes de TC e IRM, para analizar relaciones anatómicas, medir distancias, coordenadas y trayectorias, entre otras funciones. Discusión: El software OsiriX de acceso libre y gratuito permite al cirujano, mediante la fusión y reconstrucción en 3D de imágenes, analizar la anatomía individual del paciente y planificar de forma rápida, simple, segura y económica cirugías de alta complejidad. En el Caso 1 se pudo analizar las relaciones del tumor con las estructuras adyacentes para minimizar el abordaje. En el Caso 2 permitió comprender la anatomía post-operatoria previa del paciente, para determinar la trayectoria del abordaje transnasal endoscópico y la necesidad de ampliar su exposición, logrando la resección tumoral completa. En el Caso 3 permitió obtener las coordenadas estereotáxicas y trayectoria de una lesión sin representación tomográfica. Conclusión: En casos de no contar con costosos sistemas de neuronavegación o estereotáxia el software OsiriX es una alternativa a la hora de planificar la cirugía, con el objetivo de disminuir el trauma y la morbilidad operatoria. PMID:25165617

  8. Detail of conning tower atop the submarine. Note the wire ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Detail of conning tower atop the submarine. Note the wire rope wrapped around the base of the tower, which may have been used in an attempt to pull the submarine offshore. - Sub Marine Explorer, Located along the beach of Isla San Telmo, Pearl Islands, Isla San Telmo, Former Panama Canal Zone, CZ

  9. Canceling Some d-CON Mouse and Rat Control Products

    EPA Pesticide Factsheets

    EPA has reached agreement with the manufacturer, to cancel 12 d-CON products that do not meet our testing protocols that better protect children, pets and non-target wildlife from accidental exposure to the pesticide. These products will be phased out.

  10. Providers debate pros and cons of pneumonia vaccination at discharge.

    PubMed

    2001-02-01

    When to vaccinate against pneumonia? Does it makes sense when patients are in the hospital? Or should patients wait for the first post-op visit with the PCP? Office-based and hospital-based physicians weigh the pros and cons of each.

  11. Three dimensional boundary layers on submarine conning towers and rudders

    NASA Astrophysics Data System (ADS)

    Gleyzes, C.

    1988-01-01

    Solutions for the definition of grids adapted to the calculation of three-dimensional boundary layers on submarine conning towers and on submarine rudders and fins are described. The particular geometry of such bodies (oblique shaped hull, curved fins) required special adaptations. The grids were verified on examples from a test basin.

  12. Utilice en forma segura los productos con cebo para roedores

    EPA Pesticide Factsheets

    Si se usan de manera inadecuada, los productos con veneno para ratas y ratones podrían hacerle daño a usted, a sus hijos o a sus mascotas. Siempre que use pesticidas lea la etiqueta del producto y siga todas las indicaciones.

  13. Teaching after Retirement: The Pros and the Cons

    ERIC Educational Resources Information Center

    Sommer, Robert

    2014-01-01

    Having enjoyed teaching during my active career, I continued to teach summer school following retirement. Self-observed sensory and cognitive impairments, although not mentioned by students in their evaluations, induced me to consider the pros and cons of continuing to teach. My hope is that this list of benefits and problems will be of assistance…

  14. Opioid analgesics in the substance abuser: pros and cons.

    PubMed

    Ineck, Joseph R; Rule, Ann M

    2006-01-01

    The pros and cons of using opioid analgesics to help manage pain in patient with a history of substance abuse are presented. Topics discussed include ethical constructs, efficacy, and safety relating to the use of opioids in patients with substance abuse histories.

  15. Teaching after Retirement: The Pros and the Cons

    ERIC Educational Resources Information Center

    Sommer, Robert

    2014-01-01

    Having enjoyed teaching during my active career, I continued to teach summer school following retirement. Self-observed sensory and cognitive impairments, although not mentioned by students in their evaluations, induced me to consider the pros and cons of continuing to teach. My hope is that this list of benefits and problems will be of assistance…

  16. LunGradCon: The Lunar Graduate Conference

    NASA Astrophysics Data System (ADS)

    Dove, A.; Poppe, A.; Neish, C.; Fagan, A.; Fuqua, H.; Kramer, G. Y.; Horanyi, M.

    2011-12-01

    Members of the Colorado Center for Lunar Dust and Atmospheric Studies (CCLDAS) initiated the Lunar Graduate Conference (LunGradCon), modeled after the highly successful Astrobiology Graduate Conference (AbGradCon). The purpose of this conference is to enhance the professional development of graduate students and early postdoctoral researchers by providing an opportunity to present and discuss scientific research in an environment of their peers. For the first two years, LunGradCon has been held as a one-day conference in conjunction with the NASA Lunar Science Institue's (NLSI) Lunar Science Forum at the NASA Ames Research Center. Activities include an invited overview talk on each of the NASA Lunar Science Institute's three main research areas (OF the Moon, ON the Moon, and FROM the Moon), submitted oral presentations from graduate students and postdoctoral researchers, and networking opportunities with established member of the lunar science community and the NLSI. In each of the first two years of LunGradCon, there have been 20-25 attendees, with about 15 of those presenting submitted talks. Each speaker received feedback forms from the other participants in order to improve on their presentation techniques. Participants also provided feedback on the conference as a whole in order to evaluate the content and provide suggestions for improvement in following years. Overall, the feedback has been extremely positive. This talk will summarize the achievements of past LunGradCons and plans for expansion of the conference to ensure a long-term positive impact on the early careers of future lunar, planetary and space science researchers.

  17. ConStrains identifies microbial strains in metagenomic datasets.

    PubMed

    Luo, Chengwei; Knight, Rob; Siljander, Heli; Knip, Mikael; Xavier, Ramnik J; Gevers, Dirk

    2015-10-01

    An important fraction of microbial diversity is harbored in strain individuality, so identification of conspecific bacterial strains is imperative for improved understanding of microbial community functions. Limitations in bioinformatics and sequencing technologies have to date precluded strain identification owing to difficulties in phasing short reads to faithfully recover the original strain-level genotypes, which have highly similar sequences. We present ConStrains, an open-source algorithm that identifies conspecific strains from metagenomic sequence data and reconstructs the phylogeny of these strains in microbial communities. The algorithm uses single-nucleotide polymorphism (SNP) patterns in a set of universal genes to infer within-species structures that represent strains. Applying ConStrains to simulated and host-derived datasets provides insights into microbial community dynamics.

  18. Tailoring a ConOps for NASA LSP Integrated Operations

    NASA Technical Reports Server (NTRS)

    Owens, Skip Clark V., III

    2017-01-01

    An integral part of the Systems Engineering process is the creation of a Concept of Operations (ConOps) for a given system, with the ConOps initially established early in the system design process and evolved as the system definition and design matures. As Integration Engineers in NASA's Launch Services Program (LSP) at Kennedy Space Center (KSC), our job is to manage the interface requirements for all the robotic space missions that come to our Program for a Launch Service. LSP procures and manages a launch service from one of our many commercial Launch Vehicle Contractors (LVCs) and these commercial companies are then responsible for developing the Interface Control Document (ICD), the verification of the requirements in that document, and all the services pertaining to integrating the spacecraft and launching it into orbit. However, one of the systems engineering tools that have not been employed within LSP to date is a Concept of Operations. The goal of this paper is to research the format and content that goes into these various aerospace industry ConOps and tailor the format and content into template form, so the template may be used as an engineering tool for spacecraft integration with future LSP procured launch services. This tailoring effort was performed as the authors final Masters Project in the Spring of 2016 for the Stevens Institute of Technology and modified for publication with INCOSE (Owens, 2016).

  19. A complex photoreceptor system mediates the regulation by light of the conidiation genes con-10 and con-6 in Neurospora crassa.

    PubMed

    Olmedo, María; Ruger-Herreros, Carmen; Luque, Eva M; Corrochano, Luis M

    2010-04-01

    Genes con-10 and con-6 in Neurospora crassa are activated during conidiation or after illumination of vegetative mycelia. Light activation requires the white-collar complex (WCC), a transcription factor complex composed of the photoreceptor WC-1 and its partner WC-2. We have characterized the photoactivation of con-10 and con-6, and we have identified 300bp required for photoactivation in the con-10 promoter. A complex stimulus-response relationship for con-10 and con-6 photoactivation suggested the activity of a complex photoreceptor system. The WCC is the key element for con-10 activation by light, but we suggest that other photoreceptors, the cryptochrome CRY-1, the rhodopsin NOP-1, and the phytochrome PHY-2, modify the activity of the WCC for con-10 photoactivation, presumably through a repressor. In addition we show that the regulatory protein VE-1 is required for full photocarotenogenesis. We propose that these proteins may modulate the WCC in a gene-specific way.

  20. Status report of the 1 MV AMS facility at the Centro Nacional de Aceleradores

    NASA Astrophysics Data System (ADS)

    Calvo, Elena Chamizo; Santos, Francisco Javier; López-Gutiérrez, José María; Padilla, Santiago; García-León, Manuel; Heinemeier, Jan; Schnabel, Christoph; Scognamiglio, Grazia

    2015-10-01

    SARA (Spanish Accelerator for Radionuclides Analysis) was the first multielemental AMS facility installed in Spain in 2005. Since then it has been dedicated to the routine analysis of several radionuclides, such as 10Be, 14C, 26Al, 129I and Pu isotopes. Tests have been carried out with other isotopes, such as 41Ca, 236U and 237Np, and several changes have been made to the original facility to improve performance. First, an upgraded version of the ion source SO-110 has allowed us more stable measurement conditions for volatile elements (i.e. iodine), and a better general performance. Besides, changes in the target geometry have improved the ionization efficiency and long-term stability of the source output. Moreover, different software upgrades have been introduced to meet our routine operational needs. Finally, changing the movable Faraday-cup associated electronics now allows the measurement of smaller currents (in the range of pA), which has been key for the study of 236U/238U atomic ratio in environmental samples. Apart from these modifications it has to be noted that routine radiocarbon measurements have been moved to a Micadas system (200 kV) installed at CNA in 2012. In this paper we will illustrate the evolution of the facility up to now, and our future prospects will be introduced.

  1. Molecular diagnostics: Molecular Med Tri-Con 2013.

    PubMed

    Klein, Roger D

    2013-07-01

    The 20th annual Molecular Med Tri-Con conference, sponsored by Cambridge Health Institute (MA, USA), consisted of over 250 presentations within five parallel 'channels': 'Diagnostics, Therapeutics, Clinical, Informatics and Cancer', along with five preliminary symposia, 15 short courses, a plenary keynote session entitled 'Personalized Oncology - Fulfilling the Promise for Today's Patients' and a keynote panel entitled, 'Emerging Technologies and Industry Perspectives'. Over 3000 individuals from academia, clinical laboratories and industry were in attendance. This article will focus on the Keynote Session of 'Molecular Diagnostics' track within the Diagnostics Channel.

  2. Apoyo a Estudios Geodinamicos con GPS en Guatemala

    NASA Astrophysics Data System (ADS)

    Robles, V. R.

    2013-05-01

    El Instituto Geografico Nacional de Guatemala implemento 17 estaciones GNSS en el año 2009, como un proyecto de credito mixto de donacion de equipamiento del Gobierno de Suiza, el cual, este equipamiento de estaciones CORS GNSS es un sistema de recepción y transmisión de datos crudos GPS RInex que utiliza la tecnologia Spider Web de Leica, asi mismo este sistema esta sirviendo para el espablecimiento de un marco geodesico nacional de coordenadas geodesicas oficiales, el cual se calculan u obtienen las velocidades en tiempos temporales programados de las 17 Estaciones CORS. La infraestructura del marco geodesico de Guatemala esta sirviendo de base para las aplicaciones de estudios geodinamicos como el monitoreo de del desplazamiento de las placas tectonicas por medio de un estudio que se inicio en el año de 1999, llamado medicion con GPS el sistema de Fallas de los rios Polochic Motagua de Guatemala, tambien para un estudio que se implemento para deformación de corteza terrestre local en un Volcan Activo de Guatemala llamado Pacaya. Para el estudio de medicion con GPS en el sistema de falla de los Rios del polochic Motagua se implementaron 16 puntos para medir con GPS de dos frecuencias en el año de 1999, el cual, tres puntos son estaciones geodesicas CORS IGS llamados GUAT, ELEN y HUEH, despues en el año de 2003 se hizo otra medicion en un total de 20 puntos, que permitió calcular las velocidades de desplazamieinto de los puntos en mención, usando como referencia el modelo NUVEL 1A de DeMets de la placa de Norteamerica. Este estudio fue en cooperación internacional por la universidad de Nice de Francia y el IGNde Francia. Para el estudio del monitoreo con GPS del volcan activo de Guatemala, se implementaron cuatro puntos al rededor del volcan, el cual, se realizan cuatro mediciones al año, que permiten determinar axialmente la distancias entre los puntos, y rebisar estadisticamente cual es el comportamiento de las distancias en funcion del tiempo, si

  3. Caffe con Troll: Shallow Ideas to Speed Up Deep Learning.

    PubMed

    Hadjis, Stefan; Abuzaid, Firas; Zhang, Ce; Ré, Christopher

    2015-01-01

    We present Caffe con Troll (CcT), a fully compatible end-to-end version of the popular framework Caffe with rebuilt internals. We built CcT to examine the performance characteristics of training and deploying general-purpose convolutional neural networks across different hardware architectures. We find that, by employing standard batching optimizations for CPU training, we achieve a 4.5× throughput improvement over Caffe on popular networks like CaffeNet. Moreover, with these improvements, the end-to-end training time for CNNs is directly proportional to the FLOPS delivered by the CPU, which enables us to efficiently train hybrid CPU-GPU systems for CNNs.

  4. Conning the conmen: Intelligence and female desire in Dedh Ishqiya.

    PubMed

    Singh, Shailendra Kumar

    2017-04-11

    This article investigates the ostensibly paradoxical relationship that exists between the theme of excessive love, as suggested by the title of Abhishek Chaubey's film Dedh Ishqiya (2014), and the actual representation of it in the movie, which is not only restrained and disproportionate, but is also looked at with suspicion and contempt. It examines the logic of this seeming contradiction through the other two related themes that Chaubey's chef-d'œuvre foregrounds, namely that of intelligence and female desire. The quest for financial autonomy that the female protagonists of the movie are involved in-a necessary pre-condition for leading independent lives-is so inextricably intertwined with manipulation, dexterity, and subterfuge, that any overt expression of homoerotic female desire can only jeopardize their existing possibilities of self-aggrandizement. The heteronormative arrangements of Begum Para's palace thus constitute the elaborate mise en scène, behind which female desire is enacted through a politics of intelligence, resourcefulness, discretion, and anonymity. Through this strategic negotiation, which is also a tactical necessity, the female protagonists are not only able to con the con men in the movie, but also imagine alternative subject positions that recognize the need for both pragmatism and expediency as well as deconstructing heteropatriarchal economies of desire.

  5. Postoperative Analgesia in Abdominal Surgery: a Medico-economic Study

    ClinicalTrials.gov

    2014-08-13

    Extended Ileal Resection Under Laparotomy; Total Proctocolectomy Under Laparotomy; Colectomy Left/Right/Total Under Laparotomy; Rectosigmoidal Resection Under Laparotomy; Anterior Resection of Rectum Under Laparotomy; Abdomino-perineal Amputation Under Laparotomy

  6. Medico-legal claims against English radiologists: 1995–2006

    PubMed Central

    Halpin, S F S

    2009-01-01

    A list of claims against radiologists from 1995–2006 was obtained from the NHS Litigation Authority. It shows a total of 440 claims. The largest number of claims (199) related to delayed or missed diagnoses of cancer, and 73 claims related to breast radiology. There is a trend for a mild increase in the number of claims each year. 30 claims were made after a false-positive diagnosis of cancer. Just under £8.5 million has so far been paid in damages, with a further £5 million in legal fees. A claim for multiple missed diagnoses of breast cancer led to a pay-out of £464 000 (£673 000 after legal fees); the largest sum awarded following a delay in the diagnosis of an individual cancer was £300 000. The subtle legal distinction between error and negligence is reviewed here. The reason why breast radiologists are more likely to be sued than any other type of British radiologist is also discussed, along with the implications for UK radiological practice, particularly in light of the recent Chief Medical Officer's report on revalidation. A method is proposed that may protect radiologists from allegations of clinical negligence in the future. PMID:19470570

  7. [Regenerative medicine: orthopaedical applications and medico legal questions].

    PubMed

    Ricci, S; Ricci, O; Tucci, C E; Massoni, F; Sarra, M V; Ricci, S

    2012-01-01

    Over the last decades, the increase in the global population's mean age has implied a corresponding increase in degenerative disease affecting various anatomical areas and tissues, including bones and cartilages, thus provoking a rising number of disabilities and a wider usage of drugs, mostly anti-inflammatory and cortisone. New developments in technologic and biomedical fields gave birth to new subjects, such as tissue engineering, cell therapy, gene therapy that, by and large, create a knowledge network falling under the concept of Regenerative Medicine. This science is essentially based on the usage of stem cells that can replicate and renovate themselves originating, if adequately stimulated, a number of cell types. Inter alia, in orthopaedic field a particular type of adult stem cells is used, the mesenchymal stem cells (MSCs). If combined with synthetic material produced in laboratories, the usage of these cells has provided inspiration for new study interests; today, it can be applied in various degenerative and post-traumatic pathologies, with great therapeutic benefits for the patient. Actually, many studies write about an improvement in patients' life quality. In this sense appear significant reflections on legal medicine, both in accidents and insurance, of this innovative therapeutic alternative and is hopefully an equally valid process of improvement of regulatory and case law.

  8. [Medico-legal risks of human voluntary sterilization].

    PubMed

    Le Quinquis, P; Chevrant-Breton, O

    1986-01-01

    There has been no legislation in France explicitly authorizing voluntary sterilization, so that a practitioner carrying out a voluntary surgical sterilization runs a theoretical risk of lawsuit. Concern about the legal status of voluntary sterilization stems from 2 articles in the French penal code, article 16 which forbids the crime of castration, defined as the intentional complete and definitive amputation or removal of an organ necessary for procreation; and article 309 which forbids voluntary assault and battery resulting in death or inability to work for 8 days, or a lesser incapacity if the violence was premeditated. Vasectomy and tubal ligation differ from castration in that they do not involve removal or mutilation of the genital organs. Article 309 has been applied to a sterilization case only once. The criminal chamber of the Court of Cassation, France's highest appeals court, ruled in 1937 that the consent of the victim had no effect on penal responsibility, since individuals have no right to violate on their own persons the rules of public order by undergoing corporal injuries unjustified by medical need. There has been no penal judgment since 1937 in a voluntary sterilization case. In a 1983 judgment, the Court of Cassation upheld the responsibility of a surgeon for not informing a 28-year-old mother of 5 of the possibility of failure of the sterilization operation he performed on her. The patient found herself pregnant once again less than 1 month after the operation. Had she been informed of the possibility of pregnancy, she might have taken further precautions to avoid it. The court established a causal link between the problems created by the pregnancy and the fault of the physician in not providing adequate information. The court's decision was of interest because it included tubal ligation among surgical interventions condoned by the common law of medical responsibility, thereby implying acceptance of voluntary sterilization. The plaintiff brought the action in civil rather than criminal court, and the question of the legal status of the operation was not raised even though the operation was not performed to remedy any pathological condition. The Court of Cassation was careful to specify that the surgeon had an obligation to use appropriate techniques according to state of the art procedures to obtain sterilization. The surgeon's error was not failure of the operation but failure to warn the patient of the possibility of pregnancy.

  9. [Valorisation of brachytherapy and medico-economic considerations].

    PubMed

    Pommier, P; Morelle, M; Millet-Lagarde, F; Peiffert, D; Gomez, F; Perrier, L

    2013-04-01

    Economic data in the literature for brachytherapy are still sparse and heterogeneous, with few controlled prospective studies and a perspective most often limited to those of the provider (health insurances). Moreover, these observation and conclusions are difficult to generalize in France. The prospective health economic studies performed in France in the framework of a national program to sustain innovative and costly therapies (STIC program) launched by the French cancer national institute are therefore of most importance. With the exception of prostate brachytherapy with permanent seeds, the valorisation of the brachytherapy activity by the French national health insurance does not take into account the degree of complexity and the real costs supported by health institutions (i.e. no specific valorisation for 3D image-based treatment planning and dose optimization and for the use of pulsed dose rate brachytherapy).

  10. India's Medico-Pharmaceutical Inheritance from the Colonial Period.

    PubMed

    Singh, Harkishan

    2014-01-01

    The development of pharmacy in India did not make sufficient headway during the British colonial period. The status of the pharmaceutical inheritance from the colonial era may be summarized as follows: There were around one hundred qualified pharmacists. The Health Survey and Development Committee (1943-45) put the number at 75. The number of compounders was nearly 27,000. They were inadequately qualified and were not counted as pharmacists. A large number of them worked in governmental hospitals. But for some missionary hospitals there was hardly any institutionalized pharmacy else-where. The drug distribution was in the hands of chemists and druggists who were not professionally qualified. The provision of drugs largely remained a trade. The drug industry was in its infancy. The yearly turnover was just 100 million rupees for a country as vast as India. The Drugs Rules 1945 under the Drug Act 1940 had been formulated but their implementation was yet to be effected. Some groundwork had been done on legislation for the control of pharmacy but the bill had yet to be enacted. There were three pharmacy degree-awarding institutions. The Banaras Hindu University and the Panjab University had instituted B. Pharm. courses in 1937 and 1944, with yearly intake of 20 and 5 students, respectively. The L. M. College of Pharmacy at Ahmedabad, then with the Bombay University, had their first admissions in 1947. Two diploma-level pharmacy courses existed at the Madras Medical College and the Medical College, Vishakapatnam, in the Madras Presidency; the yearly intake was very small. The country's entire pharmaceutical legacy from the colonial rule portrays the poor state of pharmacy practice that came with independence. The higher status of pharmacy as seen today is the result of sustained efforts made over the last fifty years. The chemists and druggists of the earlier period were not a qualified group--they were more concerned with protecting their trade interests and lacked the professional component. Thus the development of the profession constituted a formidable task. Once it became evident that inadequate attention had been paid to the pharmaceutical component of the new health care system during the colonial period--within pharmaceutical circles during the early part of the twentieth century--change began to take place, with the establishment of the Drugs Enquiry Committee recognized as the most significant event of the time. The Report was submitted by the Committee in 1931, laying the foundation of the drugs and pharmacy statutes and development of the pharmacy profession in general. It was a coincidence that the year 1931 also witnessed an occurrence of potential significance; that was, the entry of Mahadeva Lal Schroff, a man with an indomitable spirit, into the pharmaceutical arena to lead and direct the making of modern pharmacy in India.

  11. Medico-Legal Employability Assessment: Myths, Mistakes and Misconceptions

    ERIC Educational Resources Information Center

    Pryor, Robert G. L.; Hawkins, Trevor K.

    2009-01-01

    The onset of injury and disability can have a significant negative effect on individuals' social, interpersonal and vocational participation. This in turn impacts on individuals' current and future earning capacity. An objective assessment of post-injury work capacity is often sought through legal processes to determine the extent of this…

  12. Otolaryngology and Irish literature: an important medico-literary alliance.

    PubMed

    Cashman, Emma C

    2010-12-01

    For a comparatively small island, Ireland has made a disproportionately large contribution to world literature in all its aspects. The literary lineage of those who pursue medicine and also write is long and well established. The Irish contribution to world literature in all its aspects is well documented. Less explored, however, is the prominent influence of Dublin-based otolaryngologists in the Irish literary movement at the turn of the last century. Here, we examine two such figures, Sir William Wilde and Oliver St. John Gogarty, and their pivotal roles both professionally and in establishing Ireland on the world's literary stage. During the early part of the 1800s, otology was perceived as a defunct subspecialty that could be adequately managed, without much expertise, in the primary care setting. It was through the efforts of William Wilde and others that otology gained clinical and scientific credence during the latter half of the 19th century. Copyright © 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

  13. The Medici syndrome: a medico-historical puzzle.

    PubMed

    Weisz, George M; Matucci-Cerinic, Marco; Albury, William R; Lippi, Donatella

    2010-05-01

    The historical significance of the Medici family of Florence is widely recognised, but the diseases which afflicted leading members of this family have only been scientifically studied in recent decades. Paleopathological findings on exhumed skeletons, supplemented by medical descriptions in historical documents, have permitted a retrospective diagnosis of a triple pathological syndrome in the senior branch of the Medici family. Peripheral joint and spinal conditions, with the presence of skin disease, are identified in several generations of the family in the 15th century and are presented as the 'Medici syndrome'. Radiological findings are compared with macro- and microscopical descriptions in the diagnosis of the peripheral joint disease and spinal ankylosis/stenosis within the syndrome.

  14. Medico-Legal Employability Assessment: Myths, Mistakes and Misconceptions

    ERIC Educational Resources Information Center

    Pryor, Robert G. L.; Hawkins, Trevor K.

    2009-01-01

    The onset of injury and disability can have a significant negative effect on individuals' social, interpersonal and vocational participation. This in turn impacts on individuals' current and future earning capacity. An objective assessment of post-injury work capacity is often sought through legal processes to determine the extent of this…

  15. Ensino Medico e Desenvolvimento (Secondary Education and Development).

    ERIC Educational Resources Information Center

    Gouveia, Aparecida Joly; Havinghurst, Robert J.

    This document is an English-language abstract (approximately 1,500 words) of a study about secondary education with particular reference to students; it essentially treats the relationship between economics and education in the context of Brazilian society. From the sociological point of view; the study is characterized by concentration on certain…

  16. Examination of the placenta: medico-legal implications.

    PubMed

    Chang, Kenneth Tou-En

    2014-10-01

    Formal examination of the placenta may provide valuable information to the clinicians, family, and court of law in cases of adverse pregnancy outcome when litigation is initiated. Placental examination contributes towards the identification of specific intrinsic or secondary placental lesions, and understanding the nature of the intrauterine environment. This article provides an update of important placental pathologies that may contribute towards neurologic injury of the newborn child, and describes the role of placental findings in the adjudication of cases of adverse neonatal outcome.

  17. Automatic Indexing of Drug Information. Project MEDICO Final Report.

    ERIC Educational Resources Information Center

    Artandi, Susan

    The broad objective of this investigation was to explore the potential and applicability of automatic methods for the indexing of drug-related information appearing in English natural language text and to find out what can be learned about automatic indexing in general from the experience. More specific objectives were the development,…

  18. The irresponsible criminal in Norwegian medico-legal discourse.

    PubMed

    Skålevåg, Svein Atle

    2014-01-01

    This article discusses discourses on criminal responsibility in Norway in the 19th and 20th centuries, in light of Michel Foucault's regimes of power and knowledge: the apparatuses of law, discipline and security. The passing of two criminal codes, in 1842 and 1902 marks a development from neo-classical law to a law influenced by positivist criminology. In these consecutive ways of thinking law, the figure of the irresponsible criminal constituted a contentious issue. From being a figure marking the limits of the law, the irresponsible criminal became an object to be disciplined and a security threat. This redefinition of criminal responsibility created or was created by new groups of experts speaking from positions increasingly close to the criminals. The most important professional group was of course the psychiatrists, that emerged in Norway as a distinct professional group in the second half of the 19th century, and whose influence in the legislative process culminated in the 1920s.

  19. Medico-legal implications of acute subdural haematoma in boxing.

    PubMed

    Ng'walali, P M; Muraoka, N; Honjyo, K; Hamada, K; Kibayashi, K; Tsunenari, S

    2000-09-01

    A 16-year-old male high school student with a history of fever (38-39 degrees C) for 4 days lost consciousness following the end of a three round boxing match. He was transferred to a neurosurgical unit located 48 km away 1 h 36 min after injury. Clinical assessment at the unit revealed a comatose patient with a left acute subdural haematoma, but because of advanced brain oedema surgical management was deemed futile. At autopsy an acute subdural haematoma and a severe brain oedema were confirmed. Evaluation of physical conditions before the fight should have been more rigorous in our patient. The observations in our case support the published literature that boxing matches should be held only where neurosurgical expertise is readily available.

  20. [The relativity and geodiversity of medico-economic realities].

    PubMed

    Piérard, G E

    1998-05-01

    The economic gestion of health care is difficult to handle. It covers several aspects which cannot pride to be accurate sciences. It strikes difficulties such as the geodiversity of problems to be solved and the nuances in the application of principles of social equity and medical ethics. The health-care analysis is also exposed to some politician interpretations biased by doctrinal a priori. Most often, a confrontation ensues between the political cenacle and the professionals directly involved in health-care.

  1. [Depression --the most pragmatic diagnosis in medico-legal opinionating].

    PubMed

    Kowalski, Piotr; Skupień, Elzbieta

    2007-01-01

    As it follows from the expertise practice of the authors, broadly understood "depression syndrome" is the most common diagnosis occurring in sick-leave certificates provided for legal procedures to the court. This problem is encountered in penal, civil and insurance cases. At the same time, in a significant percentage of cases, the patient's self-presentation does not correspond with the provided diagnosis. A particular legal situation of a person stigmatized with such a diagnosis clearly indicates its pragmatic character. Hence, several questions emerge: (1) Why does such a particular diagnosis prevail? (2) Is there another disease entity in psychiatry, which has such a broadly reactive background? On the basis of a particular case the authors formulate the problem of the appropriately understood interest of the patient. Does the current protection against broadly understood legal consequences cause the patient to fixate on the defense mechanisms and -- in consequence -- degradation of his functioning?

  2. Medico-legal analysis of a case of mass shooting.

    PubMed

    Kuruc, R; Šidlo, J; Zummerová, A; Šikuta, J; Baloghová, A

    Despite the existence of organised crime in Slovakia, no case has ever been monitored in which one individual used a firearm against several people, as happens in the U.S. or in Western Europe. The aim of this work is to demonstrate a "unique" case in the history of Slovak criminality, when six members of one family were killed and some other accidental victims were wounded or even killed by one perpetrator using a firearm.

  3. [Medico-biological effect of natural electromagnetic variations].

    PubMed

    Oraevskiĭ, V N; Kuleshova, V P; Gurfinkel', Iu F; Guseva, A V; Rapoport, S I

    1998-01-01

    Emergency ambulance statistical data accumulated in Moscow during March 1983-October 1984 have been analyzed. Diurnal numbers of urgent hospitalization of patients in connection with suicides, mental disorders, myocardial infarction, defects of cerebrum vessels and arterial and venous diseases have been examined. Intensity and duration of planetary geomagnetic storms were used as magnetic activity indices. Comparison of geomagnetic and medical data rows has shown that at least 75% of magnetic storms caused increase in hospitalization of patients with the above-mentioned diseases on 30-80% at average. The dependence of the value of biotropic effect on the duration of effect and intensity of magnetic storm is observed.

  4. Medico-legal aspect of amphetamine-related deaths.

    PubMed

    Kula, K; Rojek, S; Maciów-Głąb, M; Kopacz, P; Kłys, M

    The subject of the work included 41 cases of death in which amphetamine was involved as the direct or indirect cause. Identification and determination of xenobiotics in blood samples collected from post-mortem cases were performed by high-performance liquid chromatography coupled with tandem mass spectrometry with electrospray ionisation (HPLC-ESI-MS-MS). Only for two cases was the cause of death amphetamine poisoning. In most of the investigated cases the death was caused by poisoning due to complex amphetamine and other psychoactive substances (e.g. opiates, benzodiazepines, cocaine). In other cases, multi-organ damage (fall from a height, traffic accident), a puncture wound and wound incised, drowning, or asphyxiation by hanging were reported. It can be explained as risky, murderous, or suicidal actions of people who were under the influence of amphetamines. The presented paper focuses on the interpretation of amphetamine concentration in blood samples from the perspective of direct or indirect cause of death.

  5. Medico-legal claims against English radiologists: 1995-2006.

    PubMed

    Halpin, S F S

    2009-12-01

    A list of claims against radiologists from 1995-2006 was obtained from the NHS Litigation Authority. It shows a total of 440 claims. The largest number of claims (199) related to delayed or missed diagnoses of cancer, and 73 claims related to breast radiology. There is a trend for a mild increase in the number of claims each year. 30 claims were made after a false-positive diagnosis of cancer. Just under pound8.5 million has so far been paid in damages, with a further pound5 million in legal fees. A claim for multiple missed diagnoses of breast cancer led to a pay-out of pound464 000 ( pound673 000 after legal fees); the largest sum awarded following a delay in the diagnosis of an individual cancer was pound300 000. The subtle legal distinction between error and negligence is reviewed here. The reason why breast radiologists are more likely to be sued than any other type of British radiologist is also discussed, along with the implications for UK radiological practice, particularly in light of the recent Chief Medical Officer's report on revalidation. A method is proposed that may protect radiologists from allegations of clinical negligence in the future.

  6. Importation of mycobacteriosis with ornamental fish: Medico-legal implications.

    PubMed

    Passantino, A; Macrì, D; Coluccio, P; Foti, F; Marino, F

    2008-07-01

    Mycobacterium fortuitum, as well as Mycobacterium marinum and Mycobacterium chelonae, are the etiological agents of fish Mycobacterioses. Mycobacteriosis has been reported to affect a wide range of freshwater and marine fish species, suggesting an ubiquitous distribution, and can cause zoonotic infections (known as "fish tank granuloma" or "swimming pool granuloma") in humans exposed to fish and contaminated water. Infection in human consists of nodular cutaneous lesions that can progress to tenosynovitis, arthritis, and osteomyelitis, depending on the immunological status. Authors describe some cases observed during routinary diagnostic activity in aquarium fish. Fish were sampled and histopathological, microbiological, and biomolecular exams were carried out. Histopathology showed systemic granulomatosis. Microbiological and biomolecular exams allowed us to identify the M. fortuitum as a main species. Finally, some considerations on the legal aspects of such disease are discussed.

  7. Cannabinoids and cancer: pros and cons of an antitumour strategy

    PubMed Central

    Bifulco, Maurizio; Laezza, Chiara; Pisanti, Simona; Gazzerro, Patrizia

    2006-01-01

    In the last two decades, research has dramatically increased the knowledge of cannabinoids biology and pharmacology. In mammals, compounds with properties similar to active components of Cannabis sativa, the so called ‘endocannabinoids', have been shown to modulate key cell-signalling pathways involved in cancer cell growth, invasion and metastasis. To date, cannabinoids have been licensed for clinical use as palliative treatment of chemotherapy, but increased evidences showed direct antiproliferative actions of cannabinoid agonists on several tumour cells in vitro and in animal models. In this article, we will review the principal molecular pathways modulated by cannabinoids on cancer and summarize pros and cons evidence on the possible future use of endocannabinoid-based drugs in cancer therapy. PMID:16501583

  8. Balancing Ethical Pros and Cons of Stem Cell Derived Gametes.

    PubMed

    Segers, Seppe; Mertes, Heidi; de Wert, Guido; Dondorp, Wybo; Pennings, Guido

    2017-07-01

    In this review we aim to provide an overview of the most important ethical pros and cons of stem cell derived gametes (SCD-gametes), as a contribution to the debate about reproductive tissue engineering. Derivation of gametes from stem cells holds promising applications both for research and for clinical use in assisted reproduction. We explore the ethical issues connected to gametes derived from embryonic stem cells (both patient specific and non-patient specific) as well as those related to gametes derived from induced pluripotent stem cells. The technology of SCD-gametes raises moral concerns of how reproductive autonomy relates to issues of embryo destruction, safety, access, and applications beyond clinical infertility.

  9. Endoscopic scoring systems for inflammatory bowel disease: pros and cons.

    PubMed

    Tontini, Gian Eugenio; Bisschops, Raf; Neumann, Helmut

    2014-07-01

    Endoscopy plays a pivotal role for diagnosis and assessment of disease activity and extent in patients with inflammatory bowel diseases. International guidelines recommend the use of endoscopic scoring systems for evaluation of the prognosis and efficacy of medical treatments. Ideal scoring systems are easy to use, reproducible, reliable, responsive to changes, and validated in different clinical settings in order to guide therapeutic strategies. However, currently available endoscopic scoring systems often appear as complex for routine endoscopy and suffer from insufficient interobserver agreement and lack of formal validation which often limit their use in clinical trials. Here, we describe the role of endoscopic scoring systems in inflammatory bowel diseases focusing on pros and cons in the era of advanced endoscopic imaging and mucosal healing.

  10. Gradient Optimization for Analytic conTrols - GOAT

    NASA Astrophysics Data System (ADS)

    Assémat, Elie; Machnes, Shai; Tannor, David; Wilhelm-Mauch, Frank

    Quantum optimal control becomes a necessary step in a number of studies in the quantum realm. Recent experimental advances showed that superconducting qubits can be controlled with an impressive accuracy. However, most of the standard optimal control algorithms are not designed to manage such high accuracy. To tackle this issue, a novel quantum optimal control algorithm have been introduced: the Gradient Optimization for Analytic conTrols (GOAT). It avoids the piecewise constant approximation of the control pulse used by standard algorithms. This allows an efficient implementation of very high accuracy optimization. It also includes a novel method to compute the gradient that provides many advantages, e.g. the absence of backpropagation or the natural route to optimize the robustness of the control pulses. This talk will present the GOAT algorithm and a few applications to transmons systems.

  11. RoboCon: Operator interface for robotic applications

    SciTech Connect

    Schempf, H.; Warwick, J.; Fung, M.; Chemel, B.; Blackwell, M.

    1996-12-31

    Carnegie Mellon U. and ORNL`s Robotics and Process Systems Division are developing a state-of-the-art robot operator control station (RoboCon) with standardized hardware and software control interfaces to be adaptable to a variety of remote and robotic equipment currently funded by DOE`s Office of Science & Technology Robotics Technology Development Program. The human operation and telerobotic and supervisory control of sophisticated and remote and robotic systems is a complex, tiring, and non-intuitive activity. Since decontamination & decommissioning, selective equipment removal, mixed waste operations, and in-tank cleanup are going to be a major future activity in DOE environmental restoration and waste management cleanup agenda, it seems necessary to utilize an operator control station and interface which maximizes operator comfort and productivity.

  12. Caffe con Troll: Shallow Ideas to Speed Up Deep Learning

    PubMed Central

    Hadjis, Stefan; Abuzaid, Firas; Zhang, Ce; Ré, Christopher

    2016-01-01

    We present Caffe con Troll (CcT), a fully compatible end-to-end version of the popular framework Caffe with rebuilt internals. We built CcT to examine the performance characteristics of training and deploying general-purpose convolutional neural networks across different hardware architectures. We find that, by employing standard batching optimizations for CPU training, we achieve a 4.5× throughput improvement over Caffe on popular networks like CaffeNet. Moreover, with these improvements, the end-to-end training time for CNNs is directly proportional to the FLOPS delivered by the CPU, which enables us to efficiently train hybrid CPU-GPU systems for CNNs. PMID:27314106

  13. [Modern tribology in total hip arthroplasty: pros and cons].

    PubMed

    Gómez-García, F

    2014-01-01

    The wear products and adverse reactions that occur on bearing surfaces represent one of the greatest challenges in prosthetic replacements, as the latter experience increasing demands due to the large number of young and older adult patients that have a long life expectancy and remarkable activity. The purpose of this review is to analyze the pros and cons of the new advances in the bearing components of the articular surfaces of current total hip arthroplasties. We also discuss the strategies used historically, their problems, results and the surgeon's role in prescribing the tribologic couple that best fits each patient's needs. We conclude with practical recommendations for the prescription and management of the latest articular couples for total hip arthroplasty.

  14. Cannabinoids and cancer: pros and cons of an antitumour strategy.

    PubMed

    Bifulco, Maurizio; Laezza, Chiara; Pisanti, Simona; Gazzerro, Patrizia

    2006-05-01

    In the last two decades, research has dramatically increased the knowledge of cannabinoids biology and pharmacology. In mammals, compounds with properties similar to active components of Cannabis sativa, the so called 'endocannabinoids', have been shown to modulate key cell-signalling pathways involved in cancer cell growth, invasion and metastasis. To date, cannabinoids have been licensed for clinical use as palliative treatment of chemotherapy, but increased evidences showed direct antiproliferative actions of cannabinoid agonists on several tumour cells in vitro and in animal models. In this article, we will review the principal molecular pathways modulated by cannabinoids on cancer and summarize pros and cons evidence on the possible future use of endocannabinoid-based drugs in cancer therapy.

  15. Neogene sequence stratigraphy, Nam Con Son Basin, offshore Vietnam

    SciTech Connect

    McMillen, K.J. ); Do Van Luu; Lee, E.K.; Hong, S.S. )

    1996-01-01

    An integrated well log, biostratigraphic, and seismic stratigraphic study of Miocene to Recent deltaic sediments deposited in the Nam Con Son Basin offshore from southern Vietnam shows the influence of eustacy and tectonics on sequence development. Sediments consist of Oligocene non-marine rift-basin fill (Cau Formation), early to middle Miocene tide-dominated delta plain to delta front sediments (TB 1.5 to TB 2.5, Due and Thong Formations), and late Miocene to Recent marine shelf sediments (TB. 2.6 to TB 3.1 0, Mang Cau, Nam Con Son, and Bien Dong Formations). Eustacy controlled the timing of key surfaces and sand distribution in the tectonically-quiet early Miocene. Tectonic effects on middle to late Miocene sequence development consist of thick transgressive systems tracts due to basin-wide subsidence and transgression, sand distribution in the basin center, and carbonate sedimentation on isolated fault blocks within the basin. Third-order sequence boundaries (SB) are identified by spore peaks, sand stacking patterns, and channel incision. In the basin center, widespread shale beds with coal occur above sequence boundaries followed by transgressive sandstone units. These TST sandstones merge toward the basin margin where they lie on older HST sandstones. Maximum flooding surfaces (MFS) have abundant marine microfossils and mangrove pollen, a change in sand stacking pattern, and often a strong seismic reflection with downlap. Fourth-order genetic-type sequences are also interpreted. The MFS is the easiest marker to identify and correlate on well logs. Fourth-order SB occur within these genetic units but are harder to identify and correlate.

  16. Neogene sequence stratigraphy, Nam Con Son Basin, offshore Vietnam

    SciTech Connect

    McMillen, K.J.; Do Van Luu; Lee, E.K.; Hong, S.S.

    1996-12-31

    An integrated well log, biostratigraphic, and seismic stratigraphic study of Miocene to Recent deltaic sediments deposited in the Nam Con Son Basin offshore from southern Vietnam shows the influence of eustacy and tectonics on sequence development. Sediments consist of Oligocene non-marine rift-basin fill (Cau Formation), early to middle Miocene tide-dominated delta plain to delta front sediments (TB 1.5 to TB 2.5, Due and Thong Formations), and late Miocene to Recent marine shelf sediments (TB. 2.6 to TB 3.1 0, Mang Cau, Nam Con Son, and Bien Dong Formations). Eustacy controlled the timing of key surfaces and sand distribution in the tectonically-quiet early Miocene. Tectonic effects on middle to late Miocene sequence development consist of thick transgressive systems tracts due to basin-wide subsidence and transgression, sand distribution in the basin center, and carbonate sedimentation on isolated fault blocks within the basin. Third-order sequence boundaries (SB) are identified by spore peaks, sand stacking patterns, and channel incision. In the basin center, widespread shale beds with coal occur above sequence boundaries followed by transgressive sandstone units. These TST sandstones merge toward the basin margin where they lie on older HST sandstones. Maximum flooding surfaces (MFS) have abundant marine microfossils and mangrove pollen, a change in sand stacking pattern, and often a strong seismic reflection with downlap. Fourth-order genetic-type sequences are also interpreted. The MFS is the easiest marker to identify and correlate on well logs. Fourth-order SB occur within these genetic units but are harder to identify and correlate.

  17. Modulation of ConA-induced inflammatory ascites by histamine - short communication.

    PubMed

    Baintner, Károly

    2015-03-01

    The early phase of the ConA-induced inflammatory ascites was studied, with special reference to histamine. Concanavalin A (ConA), a cell-surface binding lectin was injected i.p. (25 mg/kg bw) to mice. After 1 h the animals were killed, the ascitic fluid collected and measured. Other agents were injected s.c., 10 min before the ConA-challenge. Exogenous histamine markedly inhibited the ConA-induced ascites. Release of endogenous vasoactive agents from the mast cells by Compound 48/80 had a similar, but slight effect. Cromolyn, a mast cell stabilizing agent, and chloropyramine, a histamine H1 receptor antagonist was ineffective. Although histamine increases endothelial permeability, it did not enhance the formation of ascitic fluid, on the contrary, it inhibited the ConA-induced ascites, presumably due to its known hypotonic effect. It is concluded that ConA-induced ascites is not mediated by mast cell histamine.

  18. Cardiac CON Regulations and the Availability and Use of Revascularization Services

    PubMed Central

    Ho, Vivian; Ross, Joseph S.; Nallamothu, Brahmajee K.; Krumholz, Harlan M.

    2007-01-01

    Background Many states enforce Certificate of Need (CON) regulations for cardiac procedures, but little is known about how CON affects utilization. We assessed the association between cardiac CON regulations, availability of revascularization facilities, and revascularization rates. Methods We determined when state cardiac CON regulations were active and obtained data for Medicare beneficiaries ages 65 and older who received coronary artery bypass graft surgery (CABG) or a percutaneous coronary intervention (PCI) between 1989 and 2002. We compared the number of hospitals performing revascularization and patient utilization in states with and without CON regulations, and in states which discontinued CON regulations during 1989-2002. Results Each year, the per capita number of hospitals performing CABG and PCI was higher in states without CON (3.7 per 100,000 elderly for CABG, 4.5 for PCI in 2002), compared with CON states (2.5 for CABG, 3.0 for PCI in 2002). Multivariate regressions that adjusted for market and population characteristics found no difference in CABG utilization rates between states with and without CON (p=.7). However, CON was associated with 19.2 percent fewer PCIs per 1,000 elderly (p=.01), equivalent to 322,526 fewer PCIs for 1989-2002. Among most states that discontinued CON, the number of hospitals performing PCI rose in the mid 1990s, but there were no consistent trends in the number of hospitals performing CABG or in PCIs or CABGs per capita. Conclusions CON restricts the number of cardiac facilities, but its effect on utilization rates may vary by procedure. PMID:17893007

  19. Laparoscopy for inflammatory bowel disease: pros and cons.

    PubMed

    Sardinha, T C; Wexner, S D

    1998-04-01

    The role of laparoscopic surgery in the treatment of colorectal malignancies is still under investigation, although it can offer significant benefits to many patients with inflammatory bowel disease (IBD). The aim of this study was to assess the pros and cons of the laparoscopic management of IBD. Data were obtained from a review of the literature published since 1992, when the first report of laparoscopic surgery for IBD appeared in print. From 1992 to 1997 several series of laparoscopic colorectal surgery for the management of IBD have been reported. A close evaluation of these studies revealed that laparoscopy in patients with terminal ileal Crohn's disease or anal Crohn's disease in need of fecal diversion offers significant advantages compared to laparotomy, including decreased pain, length of hospitalization, and disability. An additional bonus is improved cosmesis and a reduction in symptomatic postoperative adhesions. These many benefits can be achieved without any increase in morbidity or expense. Conversely, the use of this technology for restorative proctocolectomy in patients with mucosal ulcerative colitis is associated with a longer operative time and an increased incidence of both intra- and postoperative complications compared to laparotomy. Laparoscopic colorectal surgery can thus be advantageous for treatment of terminal ileal Crohn's disease but cannot be routinely justified for the treatment of mucosal ulcerative colitis.

  20. Pros and cons of circumcision: an evidence-based overview.

    PubMed

    Friedman, B; Khoury, J; Petersiel, N; Yahalomi, T; Paul, M; Neuberger, A

    2016-09-01

    Based on three large randomized controlled trials (RCTs) conducted in Africa, it can clearly be stated that circumcision lowers the risk of infection with the human immunodeficiency virus (HIV) and some sexually transmitted infections (STIs) among males in settings of high HIV and STI endemicity. Similar effects on STI risk may exist for females, although this may result from an indirect effect of decreasing risk of infection among male partners. It is unknown whether circumcision prevents HIV acquisition in men who have sex with men (MSM), although there might be a protective effect for men who engage mainly in insertive anal intercourse. When the effects of adult circumcision on sexual function and satisfaction of men are examined, high-quality evidence strongly supports lack of harm. Whether circumcision alters sexual satisfaction of female partners is not known as fewer and smaller studies reported conflicting results. Circumcision rarely causes serious complications if practiced by trained practitioners, in a sterile setting, and with a proper follow-up. These conclusions are limited by the lack of high-quality data from areas outside of Africa. RCTs have not been conducted to assess the effects of circumcising infants or MSM. Circumcision has well-proven benefits for people residing in areas with high prevalence of STIs, including HIV, and is not unethical for those who choose to be circumcised or have their children circumcised on religious, social, or cultural grounds. For many others, a definite pro or con recommendation, based on a risk-benefit ratio, cannot be made.

  1. Percutaneous coronary intervention in nonagenarians: pros and cons

    PubMed Central

    Biondi Zoccai, Giuseppe; Abbate, Antonio; D'Ascenzo, Fabrizio; Presutti, Davide; Peruzzi, Mariangela; Cavarretta, Elena; Marullo, Antonino G.M.; Lotrionte, Marzia; Frati, Giacomo

    2013-01-01

    Percutaneous coronary intervention is a mainstay in the management of symptomatic or high-risk coronary artery disease. The bulk of clinical evidence and experience underlying this fact relies, however, on relatively young patients. Indeed, few data of very limited quality are available which adequately define the risk-benefit and cost-benefit profile of coronary angioplasty and stenting in very old subjects, such as those of 90 years of age or older (i.e., nonagenarians). The aim of this review is to provide a concise, yet practical, synthesis of the available evidence on percutaneous coronary revascularization in the very elderly. The main arguments elaborated upon are to what extent we can extrapolate findings from studies including younger patients to nonagenarians, whether we should provide higher priority to prognosis or quality of life in such patients, and whether we can afford to allocate vast resources to care for such subjects in an era of financial constraints. Our review of 18 studies and 1082 patients suggest that percutaneous coronary intervention is feasible and associated with acceptable short- and long-term results in this population, which is nonetheless fraught with a high mortality risk irrespective of the revascularization procedure. Accordingly, the pros and cons of percutaneous coronary intervention should be carefully weighed when considering this treatment in nonagenarians. PMID:23610578

  2. Immune cascades in human intervertebral disc: the pros and cons

    PubMed Central

    Sun, Zhen; Zhang, Ming; Zhao, Xu-Hong; Liu, Zhi-Heng; Gao, Yang; Samartzis, Dino; Wang, Hai-Qiang; Luo, Zhuo-Jing

    2013-01-01

    The unique structural hallmark of the intervertebral disc has made its central composition, the nucleus pulposus (NP), excluded from the immunologic tolerance. Consequently, the intervertebral disc is identified as an immune-privileged organ. Traditionally, local detrimental immune activities caused by NP at the lesion sites of the disc are noted as a significant factor contributing to disc degeneration. However, given the beneficial activities of immune cells in other immune-privileged sites on basis of current evidence, the degenerate disc might need the assistance of a subpopulation of immune cells to restore its structure and lessen inflammation. In addition, the beneficial impact of immune cells can be seen in the absorption of the herniated NP, which is an important factor causes the mechanical compression of nerve roots. Consequently, a modulated immune network in degenerate disc is essential for the restoration of this immune-privileged organ. Until now, the understandings of immune response in disc degeneration still rest on the harmful aspect. Further studies are needed to explore its beneficial influence. Accordingly, there are no absolutely the pros and cons in terms of immune reactions caused by NP. PMID:23696917

  3. Immune cascades in human intervertebral disc: the pros and cons.

    PubMed

    Sun, Zhen; Zhang, Ming; Zhao, Xu-Hong; Liu, Zhi-Heng; Gao, Yang; Samartzis, Dino; Wang, Hai-Qiang; Luo, Zhuo-Jing

    2013-01-01

    The unique structural hallmark of the intervertebral disc has made its central composition, the nucleus pulposus (NP), excluded from the immunologic tolerance. Consequently, the intervertebral disc is identified as an immune-privileged organ. Traditionally, local detrimental immune activities caused by NP at the lesion sites of the disc are noted as a significant factor contributing to disc degeneration. However, given the beneficial activities of immune cells in other immune-privileged sites on basis of current evidence, the degenerate disc might need the assistance of a subpopulation of immune cells to restore its structure and lessen inflammation. In addition, the beneficial impact of immune cells can be seen in the absorption of the herniated NP, which is an important factor causes the mechanical compression of nerve roots. Consequently, a modulated immune network in degenerate disc is essential for the restoration of this immune-privileged organ. Until now, the understandings of immune response in disc degeneration still rest on the harmful aspect. Further studies are needed to explore its beneficial influence. Accordingly, there are no absolutely the pros and cons in terms of immune reactions caused by NP.

  4. Pros and cons of screening for occult Cushing syndrome.

    PubMed

    Tabarin, Antoine; Perez, Paul

    2011-03-22

    Systematic screening studies performed mainly in patients with diabetes mellitus have revealed an unexpectedly high prevalence of occult Cushing syndrome. Such studies may provide a rationale for systematically screening obese patients with type 2 diabetes mellitus. However, a screening strategy is only justified if it is supported by enough evidence of its efficacy and if the benefits will outweigh drawbacks. To date, the natural history of occult Cushing syndrome and its possible effect on long-term morbidity are unknown. The clinical spectrum of occult Cushing syndrome and its relatively low prevalence may potentially negatively affect the performance of endocrine tests used to diagnose overt Cushing syndrome and generate false positives. Whether the cure of occult Cushing syndrome favorably influences clinical outcomes and is more beneficial than treatment of diabetes mellitus and cardiovascular risk factors with currently available pharmacological tools remains to be demonstrated. Last, the acceptability of a screening program by professionals and the health-care system in terms of workload and costs is highly questionable. Thus, an assessment of the indications for and against screening for occult Cushing syndrome on the basis of currently available data suggests that, to date, the cons surpass the pros.

  5. Pros and Cons of Medical Management of Ulcerative Colitis

    PubMed Central

    Navaneethan, Udayakumar; Shen, Bo

    2010-01-01

    Ulcerative colitis (UC) is a chronic inflammatory disease characterized by diffuse mucosal inflammation limited to the colon and rectum. Although a complete medical cure may not be possible, UC can be treated with medications that induce and maintain remission. The medical management of this disease continues to evolve with a goal to avoid colectomy and ultimately alter the natural history of UC. Emergence of antitumor necrosis factor-α (TNF-α) agents has expanded the medical armamentarium. 5-Aminosalicylates continue to be used in mild to moderate UC and corticosteroids are mainly used for induction of remission with immunomodulators (6-mercaptopurine/azathiopurine/methotrexate) being applied as steroid-sparing agents for maintenance therapy. Infliximab has been approved by the U.S. Food and Drug Administration and used in the treatment of moderate to severe UC; nevertheless, its use may be associated with significant adverse effects and have a negative impact on the postoperative course should the patients undergo restorative proctocolectomy. In addition, there is always a concern about patients' compliance to medical therapy, cost of medications, and risk for UC-associated dysplasia. The authors discuss the pros and cons of medications used in the treatment of UC. PMID:22131893

  6. Pros, Cons, and Alternatives to Weight Based Cost Estimating

    NASA Technical Reports Server (NTRS)

    Joyner, Claude R.; Lauriem, Jonathan R.; Levack, Daniel H.; Zapata, Edgar

    2011-01-01

    Many cost estimating tools use weight as a major parameter in projecting the cost. This is often combined with modifying factors such as complexity, technical maturity of design, environment of operation, etc. to increase the fidelity of the estimate. For a set of conceptual designs, all meeting the same requirements, increased weight can be a major driver in increased cost. However, once a design is fixed, increased weight generally decreases cost, while decreased weight generally increases cost - and the relationship is not linear. Alternative approaches to estimating cost without using weight (except perhaps for materials costs) have been attempted to try to produce a tool usable throughout the design process - from concept studies through development. This paper will address the pros and cons of using weight based models for cost estimating, using liquid rocket engines as the example. It will then examine approaches that minimize the impct of weight based cost estimating. The Rocket Engine- Cost Model (RECM) is an attribute based model developed internally by Pratt & Whitney Rocketdyne for NASA. RECM will be presented primarily to show a successful method to use design and programmatic parameters instead of weight to estimate both design and development costs and production costs. An operations model developed by KSC, the Launch and Landing Effects Ground Operations model (LLEGO), will also be discussed.

  7. Meeting Report: Breath Biomarkers Networking Sessions at PittCon 2010, Orlando, Florida

    EPA Science Inventory

    The Pittsburgh Conference and Exposition, or "PittCon" (www.pittcon.org/), is one of the largest international conferences for analytical chemistry and instrumentation typically attracting about 25,000 attendees and 1,000 commercial exhibitors. PittCon began in 1950 as a small sp...

  8. Gestational surrogacy: could be a way to be a way to reproduction? Pros and cons.

    PubMed

    Clementina, Peris

    2011-06-01

    The aim of this article was to address pros and cons of gestational surrogacy, the social and psychological issues involved in surrogate motherhood triads. Pros and cons of surrogacy, the possible insurgence of a hematologic disease in the fetus, hemolytic disease of the newborn, naturally acquired microchimerism in surrogacy cases, ethical, medical, psychologic, legal and religious issues of a problem are discussed.

  9. Meeting Report: Breath Biomarkers Networking Sessions at PittCon 2010, Orlando, Florida

    EPA Science Inventory

    The Pittsburgh Conference and Exposition, or "PittCon" (www.pittcon.org/), is one of the largest international conferences for analytical chemistry and instrumentation typically attracting about 25,000 attendees and 1,000 commercial exhibitors. PittCon began in 1950 as a small sp...

  10. ConSearch: An Electronic Document Research and Retrieval Utility for Windows from Management Information Technologies.

    ERIC Educational Resources Information Center

    Combs, Joseph, Jr.

    1995-01-01

    Reviews ConSearch 3.0, a product that provides flexible searching of electronic files, allowing the location of related meanings as well as exact matches. ConSearch 3.0 differs from other file retrieval approaches by relating words in search phrases of questions to the "meaning" of the words, which are stored in a "conceptual…

  11. Self-Exfoliated Guanidinium-Based Ionic Covalent Organic Nanosheets (iCONs).

    PubMed

    Mitra, Shouvik; Kandambeth, Sharath; Biswal, Bishnu P; Khayum M, Abdul; Choudhury, Chandan K; Mehta, Mihir; Kaur, Gagandeep; Banerjee, Subhrashis; Prabhune, Asmita; Verma, Sandeep; Roy, Sudip; Kharul, Ulhas K; Banerjee, Rahul

    2016-03-02

    Covalent organic nanosheets (CONs) have emerged as functional two-dimensional materials for versatile applications. Although π-π stacking between layers, hydrolytic instability, possible restacking prevents their exfoliation on to few thin layered CONs from crystalline porous polymers. We anticipated rational designing of a structure by intrinsic ionic linker could be the solution to produce self-exfoliated CONs without external stimuli. In an attempt to address this issue, we have synthesized three self-exfoliated guanidinium halide based ionic covalent organic nanosheets (iCONs) with antimicrobial property. Self-exfoliation phenomenon has been supported by molecular dynamics (MD) simulation as well. Intrinsic ionic guanidinium unit plays the pivotal role for both self-exfoliation and antibacterial property against both Gram-positive and Gram-negative bacteria. Using such iCONs, we have devised a mixed matrix membrane which could be useful for antimicrobial coatings with plausible medical benefits.

  12. Surgical animal models of neuropathic pain: Pros and Cons.

    PubMed

    Challa, Siva Reddy

    2015-03-01

    One of the biggest challenges for discovering more efficacious drugs for the control of neuropathic pain has been the diversity of chronic pain states in humans. It is now acceptable that different mechanisms contribute to normal physiologic pain, pain arising from tissue damage and pain arising from injury to the nervous system. To study pain transmission, spot novel pain targets and characterize the potential analgesic profile of new chemical entities, numerous experimental animal pain models have been developed that attempt to simulate the many human pain conditions. Among the neuropathic pain models, surgical models have paramount importance in the induction of pain states. Many surgical animal models exist, like the chronic constriction injury (CCI) to the sciatic nerve, partial sciatic nerve ligation (pSNL), spinal nerve ligation (SNL), spared nerve injury (SNI), brachial plexus avulsion (BPA), sciatic nerve transaction (SNT) and sciatic nerve trisection. Most of these models induce responses similar to those found in causalgia, a syndrome of sustained burning pain often seen in the distal extremity after partial peripheral nerve injury in humans. Researchers most commonly use these surgical models in both rats and mice during drug discovery to screen new chemical entities for efficacy in the area of neuropathic pain. However, there is scant literature that provides a comparative discussion of all these surgical models. Each surgical model has its own benefits and limitations. It is very difficult for a researcher to choose a suitable surgical animal model to suit their experimental set-up. Therefore, particular attention has been given in this review to comparatively provide the pros and cons of each model of surgically induced neuropathic pain.

  13. Synergistic hemolysins of coagulase-negative staphylococci (CoNS).

    PubMed

    Różalska, Małgorzata; Derczyńska, Anna; Maszewska, Agnieszka

    2015-01-01

    A total of 104 coagulase negative staphylococci, belonging to S. capitis, S. hominis, S. haemolyticus and S. warneri, originating from the collection of the Department of Pharmaceutical Microbiology (ZMF), Medical University of Lodz, Poland, were tested for their synergistic hemolytic activity. 83% of strains produced δ-hemolysin, however, the percentage of positive strains of S. haemolyticus, S. warneri, S. capitis and S. hominis was different - 98%, 78%, 75% and 68%, respectively. Highly pure hemolysins were obtained from culture supernatants by protein precipitation with ammonium sulphate (0-70% of saturation) and extraction by using a mixture of organic solvents. The purity and molecular mass of hemolysins was determined by TRIS/Tricine PAGE. All CoNS hemolysins were small peptides with a molar mass of about 3.5 kDa; they possessed cytotoxic activity against the line of human foreskin fibroblasts ATCC Hs27 and lysed red cells from different mammalian species, however, the highest activity was observed when guinea pig, dog and human red blood cells were used. The cytotoxic effect on fibroblasts occurred within 30 minutes. The S. cohnii ssp. urealyticus strain was used as a control. The antimicrobial activity was examined using hemolysins of S. capitis, S. hominis, S. cohnii ssp. cohnii and S. cohnii ssp. urealyticus. Hemolysins of the two S. cohnii subspecies did not demonstrate antimicrobial activity. Cytolysins of S. capitis and S. hominis had a very narrow spectrum of action; out of 37 examined strains, the growth of only Micrococcus luteus, Corynebacterium diphtheriae and Pasteurella multocida was inhibited.

  14. Antibiotic susceptibility of coagulase-negative staphylococci (CoNS): emergence of teicoplanin-non-susceptible CoNS strains with inducible resistance to vancomycin.

    PubMed

    Ma, Xiao Xue; Wang, En Hua; Liu, Yong; Luo, En Jie

    2011-11-01

    Coagulase-negative staphylococci (CoNS) have become increasingly recognized as important agents of nosocomial infection. One of the characteristics of CoNS is their resistance to multiple antimicrobial agents commonly used for the treatment of staphylococcal infections. CoNS strains (n = 745) isolated from a university teaching hospital in China between 2004 and 2009 were tested for antibiotic resistance. The antibiotics were placed into three categories based on resistance levels of the CoNS strains to these antibiotics: high resistance (resistance rate >70 %), including penicillin G, oxacillin and erythromycin; medium resistance (resistance rate between 30 and 70 %), including tetracycline, clindamycin, ciprofloxacin, trimethoprim/sulfamethoxazole and chloramphenicol; and low resistance (resistance rate <30 %), including rifampicin, ceftizoxime and gentamicin. We also found that the prevalence of strains non-susceptible to teicoplanin increased from 4.5 to 6.7 % between 2008 and 2009. A one-step vancomycin agar selection experiment and subsequent population analysis revealed potentially vancomycin-resistant subpopulations that have been selected from the teicoplanin-non-susceptible strains. Vigilant surveillance of nosocomial isolates of CoNS is needed to determine their resistance to glycopeptides.

  15. Project "Convective Wind Gusts" (ConWinG)

    NASA Astrophysics Data System (ADS)

    Mohr, Susanna; Richter, Alexandra; Kunz, Michael; Ruck, Bodo

    2017-04-01

    Convectively-driven strong winds usually associated with thunderstorms frequently cause substantial damage to buildings and other structures in many parts of the world. Decisive for the high damage potential are the short-term wind speed maxima with duration of a few seconds, termed as gusts. Several studies have shown that convectively-driven gusts can reach even higher wind speeds compared to turbulent gusts associated with synoptic-scale weather systems. Due to the small-scale and non-stationary nature of convective wind gusts, there is a considerable lack of knowledge regarding their characteristics and statistics. Furthermore, their interaction with urban structures and their influence on buildings is not yet fully understood. For these two reasons, convective wind events are not included in the present wind load standards of buildings and structures, which so far have been based solely on the characteristics of synoptically-driven wind gusts in the near-surface boundary layer (e. g., DIN EN 1991-1-4:2010-12; ASCE7). However, convective and turbulent gusts differ considerably, e.g. concerning vertical wind-speed profiles, gust factors (i.e., maximum to mean wind speed), or exceedance probability curves. In an effort to remedy this situation, the overarching objective of the DFG-project "Convective Wind Gusts" (ConWinG) is to investigate the characteristics and statistics of convective gusts as well as their interaction with urban structures. Based on a set of 110 climate stations of the German Weather Service (DWD) between 1992 and 2014, we analyzed the temporal and spatial distribution, intensity, and occurrence probability of convective gusts. Similar to thunderstorm activity, the frequency of convective gusts decreases gradually from South to North Germany. A relation between gust intensity/probability to orography or climate conditions cannot be identified. Rather, high wind speeds, e.g., above 30 m/s, can be expected everywhere in Germany with almost

  16. Targeted Drug Delivery in Covalent Organic Nanosheets (CONs) via Sequential Postsynthetic Modification.

    PubMed

    Mitra, Shouvik; Sasmal, Himadri Sekhar; Kundu, Tanay; Kandambeth, Sharath; Illath, Kavya; Díaz Díaz, David; Banerjee, Rahul

    2017-03-29

    Covalent organic nanosheets (CONs) have emerged as a new class of functional two-dimensional (2D) porous organic polymeric materials with a high accessible surface, diverse functionality, and chemical stability. They could become versatile candidates for targeted drug delivery. Despite their many advantages, there are limitations to their use for target specific drug delivery. We anticipated that these drawbacks could be overturned by judicious postsynthetic modification steps to use CONs for targeted drug delivery. The postsynthetic modification would not only produce the desired functionality, it would also help to exfoliate to CONs as well. In order to meet this requirement, we have developed a facile, salt-mediated synthesis of covalent organic frameworks (COFs) in the presence of p-toluenesulfonic acid (PTSA). The COFs were subjected to sequential postsynthetic modifications to yield functionalized targeted CONs for targeted delivery of 5-fluorouracil to breast cancer cells. This postsynthetic modification resulted in simultaneous chemical delamination and functionalization to targeted CONs. Targeted CONs showed sustained release of the drug to the cancer cells through receptor-mediated endocytosis, which led to cancer cell death via apoptosis. Considering the easy and facile COF synthesis, functionality based postsynthetic modifications, and chemical delamination to CONs for potential advantageous targeted drug delivery, this process can have a significant impact in biomedical applications.

  17. Analyses of muscular dystrophy and Con A deficiency traits in testcross progeny of chickens.

    PubMed

    Kline, K; Sanders, B G

    1984-01-01

    Hereditary muscular dystrophic chickens of the Storrs strain possess two genetic disorders, muscular dystrophy (MD) and a deficient concanavalin A (Con A), a T-cell mitogen, mediated splenic lymphocyte blastogenic response. A possible amelioration of the MD phenotype in MD chickens expressing normal Con A was postulated on the basis of progeny segregating for these two traits in F2 genetic analyses. To test this possibility, testcross progeny were examined for segregation of MD and Con A deficiency traits, and for the degree of muscle destruction and Con A deficiency. The data show both traits to be inherited independently as autosomal recessive traits, and do not support any phenotypic modifications occurring in chickens expressing MD with normal Con A. In the testcross progeny, the Con A deficiency disorder is equally deficient in normal and MD progeny, and the degree of muscle destruction as measured by serum creatine phosphokinase levels is equally great in MD chickens with or without the Con A deficiency trait. The reduced numbers of MD chickens in the testcross progeny can be accounted for by chance and probably reflect losses during in ovo development.

  18. Abundancias químicas de estrellas de Mercurio-Manganeso obtenidas con espectros EBASIM

    NASA Astrophysics Data System (ADS)

    Pintado, O. I.; Adelman, S. J.

    Se determinan las abundancias químicas de estrellas de HgMn usando espectros obtenidos con EBASIM en CASLEO en un rango de longitud de onda comprendido entre los 400 y 890 nm. Los valores iniciales de temperatura efectiva y gravedad superficial se calculan con la fotometría uvbyβ. Las abundancias se calculan usando WIDTH9 y SYNTHE. Los resultados se comparan análisis realizados por los autores usando espectros obtenidos con el espectrógrado REOSC del CASLEO, el espectrógrafo echelle del Telescopio Anglo-Australiano y el espectrógrafo Coudé del Dominion Astrophysical Observatory.

  19. Photoelectron spectroscopy and density functional theory study of ConO- (n = 1-3)

    NASA Astrophysics Data System (ADS)

    Li, Ren-Zhong; Liang, Jun; Xu, Xi-Ling; Xu, Hong-Guang; Zheng, Wei-Jun

    2013-06-01

    ConO- (n = 1-3) clusters were investigated with photoelectron spectroscopy and density functional calculations. The vertical detachment energies (VDEs) of ConO- (n = 1-3) were measured to be 1.54 ± 0.04, 1.43 ± 0.08, and 1.42 ± 0.08 eV respectively from their photoelectron spectra. The electron affinity and term energy of CoO were determined to be 1.54 ± 0.04 eV and 0.31 ± 0.04 eV respectively based on the vibrationally resolved photoelectron spectrum of CoO- and theoretical calculations. The structures of ConO- (n = 1-3) were determined by comparison of photoelectron experiments and calculations. The analysis of molecular orbitals shows that the HOMOs of ConO- (n = 1-3) cluster anions are mainly localized on the Co atoms.

  20. The International Consortium for the Investigation of Renal Malignancies (I-ConFIRM)

    Cancer.gov

    The International Consortium for the Investigation of Renal Malignancies (I-ConFIRM) was formed to promote international, multidisciplinary collaborations to advance our understanding of the etiology and outcomes of kidney cancer.

  1. iCon-TMA for control and quantitation of immunohistochemistry and in situ molecular pathology analysis.

    PubMed

    Petersen, Iver; Blind, Christiane; Koepenik, Axel; Dietel, Manfred; Krenn, Veit

    2007-01-01

    Reliable assessment of in situ pathology analyses like immunohistochemistry, RNA in situ hybridization, and FISH are critically important in diagnosis and treatment decisions. We describe the development of small tissue microarrays (TMA) for the internal control and quantitation of these techniques, the iCon-TMA. In its simple variant, these iCon-TMA (abbreviated from internal control TMA) consist of 2 tissue cylinders, one being clearly positive and the other clearly negative for a specific marker. In its more elaborate format, the iCon-TMAs carry additional tissue spots providing a scale for quantitatively assessable markers, e.g. representing scores of negative, weak, moderate, or strong positivity. The specimen with the yet unknown reactivity is then applied to the iCon-TMA section, and both are simultaneously processed and analyzed, thus providing a convenient measure for in situ quality control and quantitation.

  2. Characterization of the effector cells in Con A-induced cytotoxicity against HEp 2 tumour targets.

    PubMed

    Pócsik, E; González-Cabello, R; Benedek, K; Perl, A; Láng, I; Gergely, P

    1983-01-01

    Con A-induced cytotoxic activity of human lymphocyte subpopulations obtained by cell fractionation procedures was studied in a test system using human epipharynx carcinoma cells (HEp 2) as targets. Only T lymphocytes were cytotoxic, non-T cells exerted no cytotoxic activity, but enhanced the adherence of the tumour cells. Tnon-G lymphocytes (Fc-receptor negative T cells) were more active than TG cells (Fc-receptor-positive T cells) in mediating the Con A-induced cytotoxic reaction.

  3. SLUDGE PARTICLE SEPAPATION EFFICIENCIES DURING SETTLER TANK RETRIEVAL INTO SCS-CON-230

    SciTech Connect

    DEARING JI; EPSTEIN M; PLYS MG

    2009-07-16

    The purpose of this document is to release, into the Hanford Document Control System, FA1/0991, Sludge Particle Separation Efficiencies for the Rectangular SCS-CON-230 Container, by M. Epstein and M. G. Plys, Fauske & Associates, LLC, June 2009. The Sludge Treatment Project (STP) will retrieve sludge from the 105-K West Integrated Water Treatment System (IWTS) Settler Tanks and transfer it to container SCS-CON-230 using the Settler Tank Retrieval System (STRS). The sludge will enter the container through two distributors. The container will have a filtration system that is designed to minimize the overflow of sludge fines from the container to the basin. FAI/09-91 was performed to quantify the effect of the STRS on sludge distribution inside of and overflow out of SCS-CON-230. Selected results of the analysis and a system description are discussed. The principal result of the analysis is that the STRS filtration system reduces the overflow of sludge from SCS-CON-230 to the basin by roughly a factor of 10. Some turbidity can be expected in the center bay where the container is located. The exact amount of overflow and subsequent turbidity is dependent on the density of the sludge (which will vary with location in the Settler Tanks) and the thermal gradient between the SCS-CON-230 and the basin. Attachment A presents the full analytical results. These results are applicable specifically to SCS-CON-230 and the STRS filtration system's expected operating duty cycles.

  4. Sport Concussion Management Using Facebook: A Feasibility Study of an Innovative Adjunct "iCon".

    PubMed

    Ahmed, Osman Hassan; Schneiders, Anthony G; McCrory, Paul R; Sullivan, S John

    2017-04-01

      Sport concussion is currently the focus of much international attention. Innovative methods to assist athletic trainers in facilitating management after this injury need to be investigated.   To investigate the feasibility of using a Facebook concussion-management program termed iCon (interactive concussion management) to facilitate the safe return to play (RTP) of young persons after sport concussion.   Observational study.   Facebook group containing interactive elements, with moderation and support from trained health care professionals.   Eleven participants (n = 9 men, n = 2 women; range, 18 to 28 years old) completed the study.   The study was conducted over a 3-month period, with participant questionnaires administered preintervention and postintervention. The primary focus was on the qualitative experiences of the participants and the effect of iCon on their RTP. Usage data were also collected.   At the completion of the study, all participants (100%) stated that they would recommend an intervention such as iCon to others. Their supporting quotes all indicated that iCon has the potential to improve the management of concussion among this cohort. Most participants (n = 9, 82%) stated they were better informed with regard to their RTP due to participating in iCon.   This interactive adjunct to traditional concussion management was appreciated among this participant group, which indicates the feasibility of a future, larger study of iCon. Athletic trainers should consider the role that multimedia technologies may play in assisting with the management of sport concussion.

  5. Pros and cons: prospective predictors of marijuana use on a college campus.

    PubMed

    Elliott, Jennifer C; Carey, Kate B

    2013-03-01

    Marijuana use on college campuses is prevalent and associated with high rates of abuse and dependence. The Marijuana Decisional Balance (MDB) scales measure perceived pros and cons toward marijuana use. Evidence supports reliability and concurrent validity of these scales, but the predictive validity has not yet been assessed. The current study evaluated the prospective predictive validity of pros and cons scales for marijuana use, as well as explored predictive validity for marijuana problem indicators. Secondary analyses included test-retest reliability and internal consistency, to provide additional evidence of psychometric properties. A total of 149 college students (57% recent marijuana users, 77% lifetime users) participated in a baseline survey, then completed a second survey one month later. All provided data on marijuana pros and cons, as well as use status in the past month. Users at each time point reported on use frequency, problems, and disorder symptoms. In the month between assessments, 55% of the students used marijuana. Both pros and cons subscales prospectively predicted use status in the subsequent month, but not use frequency. Pros prospectively predicted marijuana problems and dependence symptoms at follow-up, and remained a significant predictor of later dependence symptoms even after controlling for baseline dependence symptoms. In contrast, pros only marginally predicted abuse. Cons did not predict problems, abuse, or dependence symptoms. Pros and cons showed strong test-retest reliability (rs = 0.80-0.85) and internal consistency (alphas = 0.92-0.95). In a college sample, pros and cons of marijuana use demonstrated stability over one month, and prospectively predicted use. Pros may also have utility in predicting problems and dependence potential on college campuses.

  6. SubCons: a new ensemble method for improved human subcellular localization predictions.

    PubMed

    Salvatore, M; Warholm, P; Shu, N; Basile, W; Elofsson, A

    2017-08-15

    Knowledge of the correct protein subcellular localization is necessary for understanding the function of a protein. Unfortunately large-scale experimental studies are limited in their accuracy. Therefore, the development of prediction methods has been limited by the amount of accurate experimental data. However, recently large-scale experimental studies have provided new data that can be used to evaluate the accuracy of subcellular predictions in human cells. Using this data we examined the performance of state of the art methods and developed SubCons, an ensemble method that combines four predictors using a Random Forest classifier. SubCons outperforms earlier methods in a dataset of proteins where two independent methods confirm the subcellular localization. Given nine subcellular localizations, SubCons achieves an F1-Score of 0.79 compared to 0.70 of the second best method. Furthermore, at a FPR of 1% the true positive rate (TPR) is over 58% for SubCons compared to less than 50% for the best individual predictor. SubCons is freely available as a webserver (http://subcons.bioinfo.se) and source code from https://bitbucket.org/salvatore_marco/subcons-web-server. The golden dataset as well is available from http://subcons.bioinfo.se/pred/download. arne@bioinfo.se. Supplementary data are available at Bioinformatics online.

  7. ConA-based glucose sensing using the long-lifetime azadioxatriangulenium fluorophore

    NASA Astrophysics Data System (ADS)

    Cummins, Brian; Simpson, Jonathan; Gryczynski, Zygmunt; Sørensen, Thomas Just; Laursen, Bo W.; Graham, Duncan; Birch, David; Coté, Gerard

    2014-02-01

    Fluorescent glucose sensing technologies have been identified as possible alternatives to current continuous glucose monitoring approaches. We have recently introduced a new, smart fluorescent ligand to overcome the traditional problems of ConA-based glucose sensors. For this assay to be translated into a continuous glucose monitoring device where both components are free in solution, the molecular weight of the smart fluorescent ligand must be increased. We have identified ovalbumin as a naturally-occurring glycoprotein that could serve as the core-component of a 2nd generation smart fluorescent ligand. It has a single asparagine residue that is capable of displaying an N-linked glycan and a similar isoelectric point to ConA. Thus, binding between ConA and ovalbumin can potentially be monovalent and sugar specific. This work is the preliminary implementation of fluorescently-labeled ovalbumin in the ConA-based assay. We conjugate the red-emitting, long-lifetime azadioxatriangulenium (ADOTA+) dye to ovalbumin, as ADOTA have many advantageous properties to track the equilibrium binding of the assay. The ADOTA-labeled ovalbumin is paired with Alexa Fluor 647-labeled ConA to create a Förster Resonance Energy Transfer (FRET) assay that is glucose dependent. The assay responds across the physiologically relevant glucose range (0-500 mg/dL) with increasing intensity from the ADOTA-ovalbumin, showing that the strategy may allow for the translation of the smart fluorescent ligand concept into a continuous glucose monitoring device.

  8. ConsPred: a rule-based (re-)annotation framework for prokaryotic genomes.

    PubMed

    Weinmaier, Thomas; Platzer, Alexander; Frank, Jeroen; Hellinger, Hans-Jörg; Tischler, Patrick; Rattei, Thomas

    2016-11-01

    The rapidly growing number of available prokaryotic genome sequences requires fully automated and high-quality software solutions for their initial and re-annotation. Here we present ConsPred, a prokaryotic genome annotation framework that performs intrinsic gene predictions, homology searches, predictions of non-coding genes as well as CRISPR repeats and integrates all evidence into a consensus annotation. ConsPred achieves comprehensive, high-quality annotations based on rules and priorities, similar to decision-making in manual curation and avoids conflicting predictions. Parameters controlling the annotation process are configurable by the user. ConsPred has been used in the institutions of the authors for longer than 5 years and can easily be extended and adapted to specific needs. The ConsPred algorithm for producing a consensus from the varying scores of multiple gene prediction programs approaches manual curation in accuracy. Its rule-based approach for choosing final predictions avoids overriding previous manual curations. ConsPred is implemented in Java, Perl and Shell and is freely available under the Creative Commons license as a stand-alone in-house pipeline or as an Amazon Machine Image for cloud computing, see https://sourceforge.net/projects/conspred/. thomas.rattei@univie.ac.atSupplementary information: Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. ConTour: Data-Driven Exploration of Multi-Relational Datasets for Drug Discovery.

    PubMed

    Partl, Christian; Lex, Alexander; Streit, Marc; Strobelt, Hendrik; Wassermann, Anne-Mai; Pfister, Hanspeter; Schmalstieg, Dieter

    2014-12-01

    Large scale data analysis is nowadays a crucial part of drug discovery. Biologists and chemists need to quickly explore and evaluate potentially effective yet safe compounds based on many datasets that are in relationship with each other. However, there is a lack of tools that support them in these processes. To remedy this, we developed ConTour, an interactive visual analytics technique that enables the exploration of these complex, multi-relational datasets. At its core ConTour lists all items of each dataset in a column. Relationships between the columns are revealed through interaction: selecting one or multiple items in one column highlights and re-sorts the items in other columns. Filters based on relationships enable drilling down into the large data space. To identify interesting items in the first place, ConTour employs advanced sorting strategies, including strategies based on connectivity strength and uniqueness, as well as sorting based on item attributes. ConTour also introduces interactive nesting of columns, a powerful method to show the related items of a child column for each item in the parent column. Within the columns, ConTour shows rich attribute data about the items as well as information about the connection strengths to other datasets. Finally, ConTour provides a number of detail views, which can show items from multiple datasets and their associated data at the same time. We demonstrate the utility of our system in case studies conducted with a team of chemical biologists, who investigate the effects of chemical compounds on cells and need to understand the underlying mechanisms.

  10. A Con A- purified hydatid glycoprotein fraction effectively diagnoses human hydatidosis.

    PubMed

    Kamel, Manal M; Maher, Kesmat M; Rabia, Ibrahim; Helmy, Ahmed H; El-Adawi, Azza I; Mousa, Mousa A; Mahgoub, Abeer M

    2006-12-01

    Diagnosis and quantification of Echinococcus granulosus infection in man and animal hosts are centralized to feasible control. This study included 93 serum samples, 25 sure positive hydatid cases confirmed surgically, 7 suspected cases diagnosed by indirect haemagglutination IHA and 41 cases other parasitic infections (15 S. mansoni, 8 Fasciola, 7 Ascaris, 5 H. nana & 6 Ancylostoma) diagnosed by microscopic examination and were negative by ELISA and/or IHA for anti-hydatid antibody. Twenty negative serum samples served as healthy controls. Six types of hydatid fluid antigens (crude, host-free & Con-A purified) of human and camel origin were subjected to electrophoretic separation (SDS-PAGE) and immunoblotting (EITB). The anti-hydatid IgG was detected in sera of the different groups for evaluation of sensitivity, specificity and diagnostic efficacy of each type of antigens. Detection of circulating hydatid antigen (CAg) was performed using anti rabbit hyperimmune sera raised against Con-A purified either human or camel hydatid antigen. SDS-PAGE revealed several bands ranging from 55-185 kDa with 10 kDa band shared by all antigens. The specific bands revealed by EITB for Con-A purified camel and human antigens were at 80, 110 & 55, 110 kDa respectively. ELISA highest sensitivity (96.9%) was by using host-free Con-A purified glycoprotein fraction of human hydatid antigen. Highest specificity (98.4%) was recorded upon use of either Con-A purified camel or human antigen with 94.5% & 97.7% diagnostic efficacy respectively. Detection of circulating antigen by polyclonal antibodies against Con-A purified human hydatid antigen revealed 91.8% specificity.

  11. Physician Preparation for the American Board of Emergency Medicine ConCert Examination.

    PubMed

    Marco, Catherine A; Wahl, Robert P; Counselman, Francis L; Heller, Barry N; Kowalenko, Terry; Harvey, Anne L; Joldersma, Kevin B; Reisdorff, Earl J

    2016-02-01

    To maintain certification by the American Board of Emergency Medicine (ABEM), physicians are required to pass the Continuous Certification (ConCert) examination at least every 10 years. On the 2014 ConCert postexamination survey, ABEM sought to understand the manner in which ABEM diplomates prepared for the test and to identify associations between test preparation approaches and performance on the ConCert examination. This was a cross-sectional survey study. The survey was administered at the end of the 2014 ConCert examination. Analyses included chi-square and linear regression to determine the association of preparation methods with performance. Of the 2,431 on-time test-takers, 2,338 (96.2%) were included. The most commonly used study approach was the review of written materials designed for test preparation (1,585; 67.8%), followed by an online training course (1,006; 43.0%). There were 758 (32.4%) physicians who took a single onsite board review course, while 41 (1.8%) took two or more onsite courses. Most physicians (1,611; 68.9%) spent over 35 hours preparing for the ConCert examination. The study method that was most associated with favorable test scores was the review of written materials designed for test preparation (p < 0.001). Attending an onsite preparation course was associated with poorer performance (p < 0.001). There was a significant association between no additional preparation and failing the examination (chi-square with Yates correction; p = 0.001). A substantial majority (97.8%) of physicians taking the 2014 ABEM ConCert examination prepared for it. The majority of physicians used written materials specifically designed for test preparation. Reviewing written materials designed for test preparation was associated with the highest performance. © 2016 by the Society for Academic Emergency Medicine.

  12. Soluciones analiticas AL problema de jets con velocidad de eyeccion variable EN EL tiempo.

    NASA Astrophysics Data System (ADS)

    Canto, J.; Raga, A. C.; D'Alessio, P.

    1998-11-01

    Se presenta un nuevo metodo que permite resolver de manera exacta y analitica las ecuaciones que describen un jet hipersonico con velocidad de eyeccion variable en el tiempo. El metodo se basa en consideraciones sencillas de conservacion de momento para las superficies de trabajo que se forman en el interior del jet. Como ejemplo, se presentan soluciones para jets con variacion sinusoidal en la velocidad de eyeccion, y tambien para el caso de un incremento lineal en el tiempo. Estas soluciones analiticas tienen una clara aplicacion en la interpretacion de las observaciones de jets asociados a objetos Herbig-Haro.

  13. GeConT 2: gene context analysis for orthologous proteins, conserved domains and metabolic pathways.

    PubMed

    Martinez-Guerrero, C E; Ciria, R; Abreu-Goodger, C; Moreno-Hagelsieb, G; Merino, E

    2008-07-01

    The Gene Context Tool (GeConT) allows users to visualize the genomic context of a gene or a group of genes and their orthologous relationships within fully sequenced bacterial genomes. The new version of the server incorporates information from the COG, Pfam and KEGG databases, allowing users to have an integrated graphical representation of the function of genes at multiple levels, their phylogenetic distribution and their genomic context. The sequence of any of the genes can be easily retrieved, as well as the 5' or 3' regulatory regions, greatly facilitating further types of analysis. GeConT 2 is available at: http://bioinfo.ibt.unam.mx/gecont.

  14. Reversible hydrogen adsorption on Co/N4 cluster embedded in graphene: The role of charge manipulation

    NASA Astrophysics Data System (ADS)

    Omidvar, Akbar

    2017-08-01

    Electrical charging of Co/N4 cluster embedded in graphene (Co/N4/G) is proposed as an approach for electrocatalytically switchable hydrogen adsorption. Using density functional theory, we found that the H2 molecule is weakly adsorbed on the uncharged Co/N4/G cluster. Our results show that the adsorption energy of hydrogen molecule on Co/N4/G cluster is significantly increased by introducing extra positive charges into the cluster. Once the charges are removed, H2 molecule spontaneously desorb from the Co/N4/G absorbent. Therefore, this approach promises both facile reversibility and tunable kinetics without the need of specific catalysts. Our study indicates that the Co/N4/G nanomaterial is excellent absorbent for controllable and reversible adsorption and release of H2.

  15. 129I measurements on the 1MV AMS facility at the Centro Nacional de Aceleradores (CNA, Spain).

    PubMed

    Gómez-Guzmán, J M; López-Gutiérrez, J M; Pinto-Gómez, A R; Holm, E

    2012-01-01

    The AMS system at CNA has been the first 1MV compact AMS system designed and manufactured by HVE. In this paper we present the experimental set-up for (129)I measurements in this facility. Charge state +3 has been selected at high-energy side and an optimum stripper pressure of 6×10(-3)mbar of argon (mass thickness of about 0.15μgcm(-2)) has been reached to obtain lowest blank values ((129)I/(127)I≅3×10(-13)). The measurements of the reference materials provided by the IAEA have demonstrated the viability of this facility to make routine measurements of (129)I at environmental levels. This blank value obtained is enough for the measurement of most environmental samples and comparable with other reported backgrounds obtained in facilities working at higher energies and higher charge states.

  16. Impact of the ConRed program on different cyberbulling roles.

    PubMed

    Del Rey, Rosario; Casas, José A; Ortega, Rosario

    2016-01-01

    This article presents results from an evaluation of the ConRed cyberbullying intervention program. The program's impacts were separately determined for the different roles within cyberbullying that students can take, i.e., cyber-victims, cyber-bullies, cyber-bully/victims, and bystanders. The ConRed program is a theory-driven program designed to prevent cyberbullying and improve cyberbullying coping skills. It involves students, teachers, and families. During a 3-month period, external experts conducted eight training sessions with students, two with teachers and one with families. ConRed was evaluated through a quasi-experimental design, in which students from three secondary schools were separated into experimental and control groups. The sample comprised 875 students, aged between 11 and 19 years. More students (n = 586) were allocated to the experimental groups at the specific insistence of the management of all schools; the remainder (n = 289) formed the control. Repeated measures MANOVA showed that cyber victims, cyber aggressors and cyberbully/victims reduced their involvement in cyberbullying. Moreover, cyber-victims and bystanders adjusted their perceptions about their control of personal information on the Internet, and cyber aggressors and bystanders reduced their Internet dependence. The ConRed program had stronger effects on male participants, especially in heightening their affective empathy. © 2015 Wiley Periodicals, Inc.

  17. Mandated Mental Health Insurance: A Complex Case of Pros and Cons. Human Resources Series.

    ERIC Educational Resources Information Center

    Paterson, Andrea

    1986-01-01

    The pros and cons of state laws mandating mental health insurance are discussed in this report. The history of a 1985 Supreme Court case which held that states could mandate mental health benefits introduces the report. In an overview of the issue, the long-standing argument between the insurance industry and the mental health establishment is…

  18. [(Con)natal teeth: a role for maternity care and dental care].

    PubMed

    Gambon, D L

    2014-02-01

    A baby was referred to a dentist by an obstetrician 18 days after birth in connection with the presence of 2 teeth in the mandibula which resembled incisors. It appeared to be a case of 2 (con)natal teeth with a high degree of mobility. Dental treatment in the form of 2 extractions was necessary.

  19. Non Invasive Biomedical Analysis - Breath Networking Session at PittCon 2011, Atlanta, Georgia

    EPA Science Inventory

    This was the second year that our breath colleagues organized a networking session at the Pittsburgh Conference and Exposition or ''PittCon'' (http://www.pincon.org/).This time it was called "Non-invasive Biomedical Analysis" to broaden the scope a bit, but the primary focus rema...

  20. Silence, Metaperformance, and Communication in Pedro Almodóvar's "Hable con ella"

    ERIC Educational Resources Information Center

    Fellie, Maria C.

    2016-01-01

    Many scenes in Pedro Almodóvar's "Hable con ella" (2002) include shots of metaperformances such as silent films, dances, television shows, concerts, and bullfights. Spectators often observe passive characters who are in turn observing. By presenting these performances within cinematic performance, Almodóvar highlights our role as viewers…

  1. Wilderness for science: pros and cons of using wilderness areas for biological research

    Treesearch

    Diana L. Six; Paul Alaback; Robert A. Winfree; Delia Snyder; Anne Hagele

    2000-01-01

    Research is one of the intended purposes of wilderness. The Wilderness Act states that “wilderness may contain ecological, geological, or other features of scientific, educational, scenic, or historical value.” This session specifically focuses on the pros and cons of conducting research in wilderness.

  2. Are You Ready to Go Digital?: The Pros and Cons of Electronic Portfolio Development

    ERIC Educational Resources Information Center

    Heath, Marilyn

    2005-01-01

    There is an increasing need for educators to have professional portfolios, which are considered to be authentic tools for evaluating the knowledge, skill, beliefs and attitudes of prospective educators. Electronic portfolios are gaining in popularity and their relative pros and cons are examined.

  3. Silence, Metaperformance, and Communication in Pedro Almodóvar's "Hable con ella"

    ERIC Educational Resources Information Center

    Fellie, Maria C.

    2016-01-01

    Many scenes in Pedro Almodóvar's "Hable con ella" (2002) include shots of metaperformances such as silent films, dances, television shows, concerts, and bullfights. Spectators often observe passive characters who are in turn observing. By presenting these performances within cinematic performance, Almodóvar highlights our role as viewers…

  4. Non Invasive Biomedical Analysis - Breath Networking Session at PittCon 2011, Atlanta, Georgia

    EPA Science Inventory

    This was the second year that our breath colleagues organized a networking session at the Pittsburgh Conference and Exposition or ''PittCon'' (http://www.pincon.org/).This time it was called "Non-invasive Biomedical Analysis" to broaden the scope a bit, but the primary focus rema...

  5. End-User Use of Data Base Query Language: Pros and Cons.

    ERIC Educational Resources Information Center

    Nicholes, Walter

    1988-01-01

    Man-machine interface, the concept of a computer "query," a review of database technology, and a description of the use of query languages at Brigham Young University are discussed. The pros and cons of end-user use of database query languages are explored. (Author/MLW)

  6. Mandated Mental Health Insurance: A Complex Case of Pros and Cons. Human Resources Series.

    ERIC Educational Resources Information Center

    Paterson, Andrea

    1986-01-01

    The pros and cons of state laws mandating mental health insurance are discussed in this report. The history of a 1985 Supreme Court case which held that states could mandate mental health benefits introduces the report. In an overview of the issue, the long-standing argument between the insurance industry and the mental health establishment is…

  7. Are You Ready to Go Digital?: The Pros and Cons of Electronic Portfolio Development

    ERIC Educational Resources Information Center

    Heath, Marilyn

    2005-01-01

    There is an increasing need for educators to have professional portfolios, which are considered to be authentic tools for evaluating the knowledge, skill, beliefs and attitudes of prospective educators. Electronic portfolios are gaining in popularity and their relative pros and cons are examined.

  8. CHILES Con Pol: An ultra-deep JVLA survey probing galaxy evolution and cosmic magnetism

    NASA Astrophysics Data System (ADS)

    Hales, Christopher A.; Momjian, Emmanuel; van Gorkom, Jacqueline; Rupen, Michael P.; Greiner, Maksim; Ensslin, Torsten A.; Bonzini, Margherita; Padovani, Paolo; Harrison, Ian; Brown, Michael L.; Gim, Hansung; Yun, Min S.; Maddox, Natasha; Stewart, Adam; Fender, Rob P.; Tremou, Evangelia; Chomiuk, Laura; Peters, Charee; Wilcots, Eric M.; Lazio, Joseph

    2015-08-01

    We are undertaking a 1000 hour campaign with the Karl G. Jansky VLA to survey 0.2 square degrees of the COSMOS field in full polarization continuum at 1.4 GHz. Our observations are part of a joint program with the spectral line COSMOS HI Large Extragalactic Survey (CHILES). When complete, we expect our CHILES Continuum Polarization (CHILES Con Pol) survey to reach an SKA-era sensitivity of 500 nJy per 4 arcsecond resolving beam, the deepest view of the radio sky yet. CHILES Con Pol will open new and fertile parameter space, with sensitivity to star formation rates of 10 Msun per year out to an unprecedented redshift of z=2, and ultra-luminous infrared galaxies and sub-millimeter galaxies out to redshifts of z=8 and beyond. This rich resource will extend the utility of radio band studies beyond the usual radio quasar and radio galaxy populations, opening sensitivity to the starforming and radio-quiet AGN populations that form the bulk of extragalactic sources detected in the optical, X-ray, and infrared bands. In this talk I will outline the key science of CHILES Con Pol, including galaxy evolution and novel measurements of intergalactic magnetic fields. I will present initial results from the first 180 hours of the survey and describe our forthcoming Data Release 1. I invite the astronomical community to consider unique science that can be pursued with CHILES Con Pol radio data.

  9. Pros & Cons of Using Blackboard Collaborate for Blended Learning on Students' Learning Outcomes

    ERIC Educational Resources Information Center

    Hamad, Mona M.

    2017-01-01

    Blackboard Collaborate was introduced to King Khalid University recently in the last decade; instructors and students were trained to use it in an effective way. The objective of this study is to find pros and cons of using Blackboard Collaborate for Blended Learning and its effect on students' learning outcomes. The researcher used the…

  10. "Con todo mi corazón": Mentoring Latinas in Educational Leadership Doctoral Programs

    ERIC Educational Resources Information Center

    Rodríguez, Mariela A.

    2016-01-01

    Personal narrative essays were used to analyze the experiences of four Latina doctoral students who completed their first year in an educational leadership doctoral program in a Hispanic-Serving Institution (HSI) in the southwestern U.S. Four themes emerged from their "testimonios" 1) "Con todo el corazón"; 2) "Somos como…

  11. "Con todo mi corazón": Mentoring Latinas in Educational Leadership Doctoral Programs

    ERIC Educational Resources Information Center

    Rodríguez, Mariela A.

    2016-01-01

    Personal narrative essays were used to analyze the experiences of four Latina doctoral students who completed their first year in an educational leadership doctoral program in a Hispanic-Serving Institution (HSI) in the southwestern U.S. Four themes emerged from their "testimonios" 1) "Con todo el corazón"; 2) "Somos como…

  12. The Con Edison Emergency Child Care Plan for Management Employees: Summary Plan Description.

    ERIC Educational Resources Information Center

    Consolidated Edison Co., Brooklyn, NY.

    This summary plan description offers guidelines for participation in a pilot program that provides short-term emergency care for children of Con Edison managers who are under 13 years old. The plan offers professional, in-home child care that can be used when usual arrangements have collapsed. The summary plan description addresses the following…

  13. ConMap: Investigating New Computer-Based Approaches to Assessing Conceptual Knowledge Structure in Physics.

    ERIC Educational Resources Information Center

    Beatty, Ian D.

    There is a growing consensus among educational researchers that traditional problem-based assessments are not effective tools for diagnosing a student's knowledge state and for guiding pedagogical intervention, and that new tools grounded in the results of cognitive science research are needed. The ConMap ("Conceptual Mapping") project, described…

  14. Optimizing Electrospray Interfaces Using Slowly Diverging Conical Duct (ConDuct) Electrodes

    PubMed Central

    Krutchinsky, Andrew N.; Padovan, Júlio C.; Cohen, Herbert; Chait, Brian T.

    2015-01-01

    We demonstrate that the efficiency of ion transmission from atmosphere to vacuum through stainless steel electrodes that contain slowly divergent conical duct (ConDuct) channels can be close to 100%. Here, we explore the properties of 2.5 cm long electrodes with angles of divergence of 0°, 1°, 2°, 3°, 5°, 8°, 13°, and 21°, respectively. The ion transmission efficiency was observed to jump from 10–20% for the 0° (straight) channels to 90–95% for channels with an angle of divergence as small as 1°. Furthermore, the 2–3° ConDuct electrodes produced extraordinarily low divergence ion beams that propagated in a laser-like fashion over long distances in vacuum. To take advantage of these newly discovered properties, we constructed a novel atmosphere-to-vacuum ion interface utilizing a 2° ConDuct as an inlet electrode and compared its ion transmission efficiency with that of the interface used in the commercial (Thermo) Velos Orbitrap and Q Exactive mass spectrometers. We observed that the ConDuct interface transmitted up to 17 times more ions than the commercial reference interface and also yielded improved signal-to-noise mass spectra of peptides. We infer from these results that the performance of many current atmosphere-tovacuum interfaces utilizing metal capillaries can be substantially improved by replacing them with 1° or 2° metal ConDuct electrodes, which should preserve the convenience of supplying ion desolvation energy by heating the electrode while greatly increasing the efficiency of ion transmission into the mass spectrometer. PMID:25667060

  15. Optimizing Electrospray Interfaces Using Slowly Diverging Conical Duct (ConDuct) Electrodes

    NASA Astrophysics Data System (ADS)

    Krutchinsky, Andrew N.; Padovan, Júlio C.; Cohen, Herbert; Chait, Brian T.

    2015-04-01

    We demonstrate that the efficiency of ion transmission from atmosphere to vacuum through stainless steel electrodes that contain slowly divergent conical duct (ConDuct) channels can be close to 100%. Here, we explore the properties of 2.5-cm-long electrodes with angles of divergence of 0°, 1°, 2°, 3°, 5°, 8°, 13°, and 21°, respectively. The ion transmission efficiency was observed to jump from 10-20% for the 0° (straight) channels to 90-95% for channels with an angle of divergence as small as 1°. Furthermore, the 2-3° ConDuct electrodes produced extraordinarily low divergence ion beams that propagated in a laser-like fashion over long distances in vacuum. To take advantage of these newly discovered properties, we constructed a novel atmosphere-to-vacuum ion interface utilizing a 2° ConDuct as an inlet electrode and compared its ion transmission efficiency with that of the interface used in the commercial (Thermo Fisher Scientific, San Jose, CA, USA) Velos Orbitrap and Q Exactive mass spectrometers. We observed that the ConDuct interface transmitted up to 17 times more ions than the commercial reference interface and also yielded improved signal-to-noise mass spectra of peptides. We infer from these results that the performance of many current atmosphere-to-vacuum interfaces utilizing metal capillaries can be substantially improved by replacing them with 1° or 2° metal ConDuct electrodes, which should preserve the convenience of supplying ion desolvation energy by heating the electrode while greatly increasing the efficiency of ion transmission into the mass spectrometer.

  16. ConMap - a new spatial data mining framework for terrain based digital soil mapping

    NASA Astrophysics Data System (ADS)

    Behrens, T.; Schmidt, K.; Scholten, T.

    2009-04-01

    In this talk, we present a new digital terrain analysis framework for digital soil mapping based on spatial data mining, referred to as the contextual elevation mapping (ConMap). Aiming at integrating different scales, which can be important at landscape scale level due to interrelations of topo- and climofunctions, it comprises local surface function approximations in terms of standard local terrain attributes as well as the incorporation of geomorphic arrangements within larger neighborhoods. In contrast to common digital terrain analysis of deriving multiple terrain attributes, ConMap is based on elevation differences from the center pixel to each pixel in a local neighborhood. These differences are then used as predictors in machine learning approaches such as Random Forests. Thus, it is not necessary to choose a specific set of terrain attributes. Additionally, possibly unknown surface functions can be taken into account, as well as larger geomorphic settings. We applied and validated the framework by predicting topsoil silt content for an area of 1150 km2 in Rhineland-Palatinate and Hesse, Germany, based on 342 samples, a 20 m resolution DEM, and neighborhood sizes up to 12 km. Cross-validation R2 values increase from 0.15 for standard digital terrain analysis to 0.61 using ConMap. This effect is due to a spatial trend in the data. As ConMap is able to map this trend and as it is based on the pedological concept of integrating scales it can be seen as a new entry to spatial prediction approaches such as Kriging or Geographically Weighted Regression. We conclude that ConMap shows a great potential for future digital soil mapping studies.

  17. BeadCons: detection of nucleic acid sequences by flow cytometry.

    PubMed

    Horejsh, Douglas; Martini, Federico; Capobianchi, Maria Rosaria

    2005-11-01

    Molecular beacons are single-stranded nucleic acid structures with a terminal fluorophore and a distal, terminal quencher. These molecules are typically used in real-time PCR assays, but have also been conjugated with solid matrices. This unit describes protocols related to molecular beacon-conjugated beads (BeadCons), whose specific hybridization with complementary target sequences can be resolved by cytometry. Assay sensitivity is achieved through the concentration of fluorescence signal on discrete particles. By using molecular beacons with different fluorophores and microspheres of different sizes, it is possible to construct a fluid array system with each bead corresponding to a specific target nucleic acid. Methods are presented for the design, construction, and use of BeadCons for the specific, multiplexed detection of unlabeled nucleic acids in solution. The use of bead-based detection methods will likely lead to the design of new multiplex molecular diagnostic tools.

  18. GenomeCons: a web server for manipulating multiple genome sequence alignments and their consensus sequences.

    PubMed

    Sato, Tetsuya; Suyama, Mikita

    2015-04-15

    Genome sequence alignments provide valuable information on many aspects of molecular biological processes. In this study, we developed a web server, GenomeCons, for manipulating multiple genome sequence alignments and their consensus sequences for high-throughput genome sequence analyses. This server facilitates the visual inspection of multiple genome sequence alignments for a set of genomic intervals at a time. This allows the user to examine how these sites are evolutionarily conserved over time for their functional importance. The server also reports consensus sequences for the input genomic intervals, which can be applied to downstream analyses such as the identification of common motifs in the regions determined by ChIP-seq experiments. GenomeCons is freely accessible at http://bioinfo.sls.kyushu-u.ac.jp/genomecons/ mikita@bioreg.kyushu-u.ac.jp. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Air Traffic Management Technology Demonstration-1 Concept of Operations (ATD-1 ConOps)

    NASA Technical Reports Server (NTRS)

    Baxley, Brian T.; Johnson, William C.; Swenson, Harry; Robinson, John E.; Prevot, Thomas; Callantine, Todd; Scardina, John; Greene, Michael

    2012-01-01

    The operational goal of the ATD-1 ConOps is to enable aircraft, using their onboard FMS capabilities, to fly Optimized Profile Descents (OPDs) from cruise to the runway threshold at a high-density airport, at a high throughput rate, using primarily speed control to maintain in-trail separation and the arrival schedule. The three technologies in the ATD-1 ConOps achieve this by calculating a precise arrival schedule, using controller decision support tools to provide terminal controllers with speeds for aircraft to fly to meet times at a particular meter points, and onboard software providing flight crews with speeds for the aircraft to fly to achieve a particular spacing behind preceding aircraft.

  20. GeConT 2: gene context analysis for orthologous proteins, conserved domains and metabolic pathways

    PubMed Central

    Martinez-Guerrero, C. E.; Ciria, R.; Abreu-Goodger, C.; Moreno-Hagelsieb, G.; Merino, E.

    2008-01-01

    The Gene Context Tool (GeConT) allows users to visualize the genomic context of a gene or a group of genes and their orthologous relationships within fully sequenced bacterial genomes. The new version of the server incorporates information from the COG, Pfam and KEGG databases, allowing users to have an integrated graphical representation of the function of genes at multiple levels, their phylogenetic distribution and their genomic context. The sequence of any of the genes can be easily retrieved, as well as the 5′ or 3′ regulatory regions, greatly facilitating further types of analysis. GeConT 2 is available at: http://bioinfo.ibt.unam.mx/gecont. PMID:18511460

  1. Propiedades biomecánicas de la membrana limitante interna tras recibir tratamiento intravítreo con ocriplasmina.

    PubMed

    Vielmuth, Franziska; Schumann, Ricarda G; Spindler, Volker; Wolf, Armin; Scheler, Renate; Mayer, Wolfgang J; Henrich, Paul B; Haritoglou, Christos

    2017-01-01

    Objetivo: Evaluar la rigidez de la membrana limitante interna (MLI) humana y evaluar los posibles cambios de las propiedades mecánicas tras administrar una inyección intravítrea de ocriplasmina para tratar la tracción vitreomacular. Métodos: Este estudio se compone de una serie de casos intervencionales y comparativos de 12 muestras de MLI extraídas mediante cirugía y obtenidas de forma consecutiva de 9 ojos de 9 pacientes después de someterse sin éxito a vitreólisis farmacológica con ocriplasmina. Durante el mismo periodo de tiempo, 16 muestras de otros 13 ojos sin tratamiento con ocriplasmina se obtuvieron mediante vitrectomía y sirvieron como controles. Todos los pacientes presentaron agujeros maculares o tracción vitreomacular y se sometieron a vitrectomía con disección de la MLI tanto con tinción con azul brillante (AB) como sin ella. Todas las muestras se analizaron con un microscopio de fuerza atómica con imágenes de las regiones de 25 × 25 μm. En todas las muestras, se analizaron tanto la parte de la retina como la del vítreo de la MLI. Resultados: La microscopia de fuerza atómica no reveló diferencias significativas en cuanto a elasticidad de las muestras de MLI extraídas de ojos con o sin tratamiento con ocriplasmina. Las áreas onduladas de la parte de la retina presentaron una mayor rigidez que la parte del vítreo de la MLI. La cartografía topográfica tanto de la parte del vítreo como de la retina de la MLI no mostró ninguna alteración aparente de la morfología en ojos tratados con ocriplasmina en comparación con los ojos no tratados. La tinción con azul brillante conllevó un aumento de la rigidez tisular. Conclusiones: Las inyecciones intravítreas de ocriplasmina no varían las propiedades biomecánicas de la MLI humana. No existen pruebas de un posible efecto enzimático que interfiera con la rigidez de esta membrana basal. © 2017 S. Karger AG, Basel.

  2. Extreme lateral lumbar interbody fusion: Do the cons outweigh the pros?

    PubMed Central

    Epstein, Nancy E.

    2016-01-01

    Background: Major factors prompted the development of minimally invasive (MIS) extreme lateral interbody fusion (XLIF; NuVasive Inc., San Diego, CA, USE) for the thoracic/lumbar spine. These include providing interbody stabilization and indirect neural decompression while avoiding major visceral/vessel injury as seen with anterior lumbar interbody fusion (ALIF), and to avert trauma to paraspinal muscles/facet joints found with transforaminal lumbar interbody fusion (TLIF), posterior lumbar interbody fusion (PLIF), and posterior-lateral fusion techniques (PLF). Although anticipated pros of MIS XLIF included reduced blood loss, operative time, and length of stay (LOS), they also included, higher fusion, and lower infection rates. Unanticipated cons, however, included increased morbidity/mortality rates. Methods: We assessed the pros and cons (e.g., risks, complications, comparable value/superiority/inferiority, morbidity/mortality) of MIS XLIF vs. ALIF, TLIF, PLIF, and PLF. Results: Pros of XLIF included various biomechanical and technical surgical advantages, along with multiple cons vs. ALIF, TLIF, PLIF, and PLF. For example, XLIF correlated with a considerably higher frequency of major neurological deficits vs. other constructs; plexus injuries 13.28%, sensory deficits 0–75% (permanent in 62.5%), motor deficits 0.7–33.6%, and anterior thigh pain 12.5–25%. XLIF also disproportionately contributed to other major morbidity/mortality; sympathectomy, major vascular injuries (some life-ending others life-threatening), bowel perforations, and seromas. Furthermore, multiple studies documented no superiority, and the potential inferiority of XLIF vs. ALIF, TLIF, PLIF, and PLF. Conclusion: Reviewing the pros of XLIF (e.g. radiographic, technical, biomechanical) vs. the cons (inferiority, increased morbidity/mortality) vs. ALIF, TLIF, PLIF, and PLF, we question whether XLIF should remain part of the lumbar spinal surgical armamentarium. PMID:27843688

  3. Simulaciones numéricas hidrodinámicas con formación estelar

    NASA Astrophysics Data System (ADS)

    Volpe, M. G.; Merchan, M.; García Lambas, D.

    Se realizan simulaciones numéricas cosmológicas utilizando el código HYDRA modificado para incluir formación estelar. A partir de éstas, se estiman diferentes parámetros observacionales como la relación Tully- Fisher, función de luminosidad y la tasa de formación estelar en función del redshift. Estos resultados son comparados con datos observacionales de diferentes autores.

  4. The pros and cons of endovascular and open surgical treatments for patients with acute limb ischemia.

    PubMed

    Branco, B C; Montero-Baker, M F; Mills, J L

    2015-06-01

    The present review addresses the pros and cons of the current, wide variety of therapeutic options available for the treatment of acute limb ischemia (ALI). Despite five prospective randomized controlled trials comparing catheter directed thrombolysis and open surgical revascularization, no single treatment strategy can yet be considered optimal for patients with ALI. This report includes 20 years of published data to evaluate the efficacy and safety profile of thrombolytic agents and adjunctive endovascular techniques when compared to open surgical revascularization.

  5. Precisión de las velocidades radiales obtenidas con el REOSC

    NASA Astrophysics Data System (ADS)

    González, J. F.; Lapasset, E.

    Complementando una línea de trabajo iniciada con anterioridad discutimos la estabilidad del espectrógrafo REOSC de CASLEO en DC para la medición de velocidades radiales en base al análisis de observaciones realizadas en enero y abril de 1997. En esas oportunidades obtuvimos 26 espectros de estrellas patrones y 27 espectros de 3 estrellas usadas como estrellas de referencia en nuestro programa de cúmulos abiertos. Además tomamos 26 espectros de crepúsculo con el telescopio en posiciones cubriendo el rango H=-4,+4 y δ =-90,+30. Mediante correlaciones cruzadas derivamos la velocidad de 19 órdenes en cada uno de estos espectros. En base a un análisis estadístico de los datos obtenidos discutimos la contribución de los distintos factores que afectan a la dispersión de lectura observada. En particular, la flexión del instrumento no introduciría errores significativos cuando se observa con masas de aire menores que 2.0. La dispersión de los valores de velocidad medidos para espectros de alta relación S/N de una misma estrella resultó del orden de 0.5 km/s. La comparación con los valores de velocidad publicados por distintos autores para las estrellas patrones no permite distinguir ninguna diferencia sistemática apreciable de las velocidades de CASLEO, siendo la media cuadrática de los residuos del orden de 1.0 km/s.

  6. NASA KSC/AFRL Reusable Booster System (RBS) Concept of Operations (ConOps)

    NASA Technical Reports Server (NTRS)

    Zeno, Dnany; Mosteller, Ted; McCleskey, Carey; Jhnson, Robert; Hopkins, Jason; Miller, Thomas

    2010-01-01

    This slide presentation reviews the study and findings of the study on the Concept of Operations (ConOps) for Reusable Booster System (RBS) centering on rapid turnaround and launch of a two-stage partially reusable payload delivery system (i.e., 8 hours between launches). The study was to develop rapid ground processing (aircraft like concepts) and identify areas for follow-on study, technology needs, and proof-of-concept demonstrations.

  7. Nuevas observaciones de 3C10 con el VLA*: estudio de la expansión

    NASA Astrophysics Data System (ADS)

    Reynoso, E. M.; Moffett, D. A.:; Dubner, G. M.; Giacani, E. B.; Reynolds, S. P.; Goss, W. M.; Dickel, J.

    Se presentan nuevos resultados sobre la expansión del remanente de la supernova de Tycho a lo largo de un intervalo de 10.9 años, comparando nuevas observaciones tomadas con el VLA a 1375 y 1635 MHz durante 1994 y 1995, con observaciones previas realizadas entre 1983 y 1984 (Dickel y col. ~1991 AJ 101, 2151), usando las mismas configuraciones, anchos de banda, calibradores y tiempos de integración. El coeficiente de expansión se calcula para sectores radiales de 4o de ancho cada uno, ajustando la correlación cruzada de las derivadas de los perfiles promedio para cada época. A partir de la expansión medida, se estima el índice (parámetro de expansión) de la ley potencial R∝ tm como m≡ d ln R/d ln t . Este valor se compara con coeficientes teóricos para diferentes fases evolutivas de remanentes de supernova.

  8. ConTrack: Finding the most likely pathways between brain regions using diffusion tractography

    PubMed Central

    Sherbondy, Anthony J.; Dougherty, Robert F.; Ben-Shachar, Michal; Napel, Sandy; Wandell, Brian A.

    2009-01-01

    Magnetic resonance diffusion-weighted imaging coupled with fiber tractography (DFT) is the only non-invasive method for measuring white matter pathways in the living human brain. DFT is often used to discover new pathways. But there are also many applications, particularly in visual neuroscience, in which we are confident that two brain regions are connected, and we wish to find the most likely pathway forming the connection. In several cases, current DFT algorithms fail to find these candidate pathways. To overcome this limitation, we have developed a probabilistic DFT algorithm (ConTrack) that identifies the most likely pathways between two regions. We introduce the algorithm in three parts: a sampler to generate a large set of potential pathways, a scoring algorithm that measures the likelihood of a pathway, and an inferential step to identify the most likely pathways connecting two regions. In a series of experiments using human data, we show that ConTrack estimates known pathways at positions that are consistent with those found using a high quality deterministic algorithm. Further we show that separating sampling and scoring enables ConTrack to identify valid pathways, known to exist, that are missed by other deterministic and probabilistic DFT algorithms. PMID:18831651

  9. ConSurf 2016: an improved methodology to estimate and visualize evolutionary conservation in macromolecules.

    PubMed

    Ashkenazy, Haim; Abadi, Shiran; Martz, Eric; Chay, Ofer; Mayrose, Itay; Pupko, Tal; Ben-Tal, Nir

    2016-07-08

    The degree of evolutionary conservation of an amino acid in a protein or a nucleic acid in DNA/RNA reflects a balance between its natural tendency to mutate and the overall need to retain the structural integrity and function of the macromolecule. The ConSurf web server (http://consurf.tau.ac.il), established over 15 years ago, analyses the evolutionary pattern of the amino/nucleic acids of the macromolecule to reveal regions that are important for structure and/or function. Starting from a query sequence or structure, the server automatically collects homologues, infers their multiple sequence alignment and reconstructs a phylogenetic tree that reflects their evolutionary relations. These data are then used, within a probabilistic framework, to estimate the evolutionary rates of each sequence position. Here we introduce several new features into ConSurf, including automatic selection of the best evolutionary model used to infer the rates, the ability to homology-model query proteins, prediction of the secondary structure of query RNA molecules from sequence, the ability to view the biological assembly of a query (in addition to the single chain), mapping of the conservation grades onto 2D RNA models and an advanced view of the phylogenetic tree that enables interactively rerunning ConSurf with the taxa of a sub-tree. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  10. What are the pros and cons of electronically monitoring inhaler use in asthma? A multistakeholder perspective

    PubMed Central

    Howard, Sam; Lang, Alexandra; Sharples, Sarah; Shaw, Dominick

    2016-01-01

    Introduction Electronic monitoring devices (EMDs) are the optimal method for collecting objective data on inhaler use in asthma. Recent research has investigated the attitudes of patients with asthma towards these devices. However, no research to date has formally considered the opinions of stakeholders and decision-makers in asthma care. These individuals have important clinical requirements that need to be taken into account if EMDs are to be successfully provisioned, making collecting their opinions on the key barriers facing these devices a valuable process. Methods Three rounds of surveys in a Delphi format were used to assess the most important pros and cons of EMDs for asthma care in a sample of 31 stakeholders which included healthcare professionals and members of clinical commissioning groups. Results The respondents identified 29 pros and 32 cons. Pros that were rated as most important included new visual evidence to aid clinical discussions with a patient and an increase in patient involvement and motivation. The cons that were rated as most important included a need for more clinical evidence of the effectiveness of EMDs, as well as better clarity over who has responsibilities in managing, interpreting and discussing data with a patient. Conclusions The research provides a guide for EMD developers by highlighting where these devices may provide the most benefit as well as prioritising the key issues that need addressing if they are to be used effectively in everyday asthma care. PMID:27933181

  11. Mound-ACT*DE*CON{sup SM} feasibility study. Phase 2: Final report

    SciTech Connect

    1994-12-01

    A portion of the abandoned Miami-Erie Canal paralleling the Greater Miami River receives the runoff and storm-water discharge from Mound Laboratory. In 1969, a low-level plutonium leak contaminated sediment as far away as 1.5 mi from the Mound site along the old canal system. An estimated one million cubic feet of sediment requires remediation. The technology being evaluated for the remediation of the low-level plutonium-238 contamination of the sediment involves two processes: washing the sediments with ACT*DE*CON{sup SM} solution to dissolve the contaminant, followed by extraction of the solution and processing with the MAG*SEP{sup SM} process to concentrate the contaminant and allow reuse of the ACT*DE*CON{sup SM} solution. The processes are being optimized for pilot-scale and field demonstration. Phase 2 of the project primarily involved identification at the laboratory scale of the optimal ACT*DE*CON{sup SM} formulation, identification of the ion-exchanger and MAG*SEP{sup SM} particles, verification of the plutonium mobility in the treated soil, and evaluation of other process parameters according to a series of tasks.

  12. ConA and UEA-I lectin histochemistry of parotid gland mucoepidermoid carcinoma.

    PubMed

    Sobral, Ana Paula V; Rego, Moacyr J B M; Cavalacanti, Carmelita L B; Carvalho, Luiz B; Beltrão, Eduardo I C

    2010-03-01

    Mucoepidermoid carcinoma (MEC) corresponds to 5-12% of all salivary gland tumours, and is classified as low, intermediate or high grade. Traditionally, immunohistochemistry was considered as the complementary tool for diagnosis of salivary gland neoplasia. Lectin histochemistry has also been increasingly used in recent years. In this work, lectins were used as histochemical markers for normal and transformed parotid glands. Biopsy specimens of 15 cases diagnosed as MEC (low, intermediate and high grade) of the parotid gland were trypsin- and methanol-H(2)O(2)-treated and incubated with horseradish peroxidase (HRP)-conjugated lectins, Concanavalin A (Con A-HRP) and Ulex europeus I (UEA-I-HRP). Con A stained the neoplasic cells of MEC (all grades). In high and intermediate cases, ductal cells were weakly stained by Con A. UEA-I weakly stained normal cells of the excretory duct and neoplasic cells in high grade. Neoplasic cells in intermediate grade were moderately stained and in low grade, the cell membrane was intensely stained with UEA-I. Stroma presented a direct relation between malignancy and staining intensity for UEA-I. The results indicated that lectin histochemistry distinguished the cell biology among histological grades of MEC.

  13. Salud mental en desastres naturales: estrategias interventivas con adultos mayores en sectores rurales de Chile.

    PubMed

    Osorio-Parraguez, Paulina; Espinoza, Adriana

    2016-06-01

    En el presente artículo se da a conocer una estrategia de intervención llevada a cabo con adultos mayores en la comuna de Paredones, sexta región de Chile, con posterioridad al terremoto y tsunami del 27 de febrero 2010 en Chile, en el contexto de una investigación sobre fortalezas y vulnerabilidades desplegadas por este grupo etario, con posterioridad a un desastre natural. Se presenta una descripción del desarrollo metodológico de la intervención y de los sustentos teóricos y conceptuales en los que se basa. Como resultado de este proceso, se propone una estrategia que trabaje a través de la identificación de las propias experiencias y fortalezas de los sujetos. De tal forma se minimizan los efectos negativos de los determinantes sociales de la salud (como la edad y el lugar de residencia) en contexto de crisis; permitiendo a los adultos mayores fortalecer sus recursos individuales y colectivos, en pro de su bienestar psicosocial.

  14. Structure, stratigraphy and petroleum geology of the south east Nam Con Son Basin, offshore Vietnam

    SciTech Connect

    Fraser, A.J.; Matthews, S.J.; Lowe, S.; Todd, S.P.; Simon, P. Peel, F.J. )

    1996-01-01

    Recent exploration of the south east Nam Con Son Basin, offshore Vietnam, by BP in alliance with Statoil has involved acquisition of new seismic and well data. These new data have allowed re-evaluation of the tectono-stratigraphic development and petroleum geology, and have provided additional constraints on the regional tectonic evolution. The offshore Vietnamese basins have evolved in response to the complex relative motions of Indochina, Peninsular Malaysia, Borneo and the South China Sea during the Cenozoic. On the regional scale these motions have been accommodated by strike-slip fault development, rifting and contraction. In the Nam Con Son Basin these motions have interacted in different ways from the Palaeogene to recent. Two rifting episodes are recognized; a Palaeogene phase dominated by E-W trending extensional faults, and a Miocene phase dominated by N-S to NE-SW trending faults. The structural evolution is complicated by a pulse of mild contraction during the Middle Miocene. The sedimentary fill of the basin evolves from continental fluvio-lacustrine in the Palaeogene through to fully marine following the second phase of rifting in the Miocene. This pulsed structural and stratigraphic evolution has resulted in basinwide deposition of source, reservoir and seal facies, and produced a variety of potential trapping styles. This paper describes the hydrocarbon habitat of the south east Nam Con Son Basin within the context of the regional tectono-stratigraphic model.

  15. Structure, stratigraphy and petroleum geology of the south east Nam Con Son Basin, offshore Vietnam

    SciTech Connect

    Fraser, A.J.; Matthews, S.J.; Lowe, S.; Todd, S.P.; Simon, P. Peel, F.J.

    1996-12-31

    Recent exploration of the south east Nam Con Son Basin, offshore Vietnam, by BP in alliance with Statoil has involved acquisition of new seismic and well data. These new data have allowed re-evaluation of the tectono-stratigraphic development and petroleum geology, and have provided additional constraints on the regional tectonic evolution. The offshore Vietnamese basins have evolved in response to the complex relative motions of Indochina, Peninsular Malaysia, Borneo and the South China Sea during the Cenozoic. On the regional scale these motions have been accommodated by strike-slip fault development, rifting and contraction. In the Nam Con Son Basin these motions have interacted in different ways from the Palaeogene to recent. Two rifting episodes are recognized; a Palaeogene phase dominated by E-W trending extensional faults, and a Miocene phase dominated by N-S to NE-SW trending faults. The structural evolution is complicated by a pulse of mild contraction during the Middle Miocene. The sedimentary fill of the basin evolves from continental fluvio-lacustrine in the Palaeogene through to fully marine following the second phase of rifting in the Miocene. This pulsed structural and stratigraphic evolution has resulted in basinwide deposition of source, reservoir and seal facies, and produced a variety of potential trapping styles. This paper describes the hydrocarbon habitat of the south east Nam Con Son Basin within the context of the regional tectono-stratigraphic model.

  16. Equilibrium geometries, electronic structure and magnetic properties of ConSn (n = 1-12) clusters from density functional calculations

    NASA Astrophysics Data System (ADS)

    Zhang, Jing Ya; Lv, Jin

    2017-05-01

    Equilibrium geometries, relative stabilities, electronic stabilities and magnetic properties of ConSn (n = 1-12) clusters have been systematically investigated by using relativistic all-electron density functional theory with generalized gradient approximation. The results indicated that the lowest-energy structures of ConSn (n = 1-5, 7, 9 and 10) clusters are similar to those of corresponding Con+1 clusters. As for Co6Sn, Co8Sn, Co11Sn and Co12Sn clusters, the most stable structures give rise to a geometry reconstruction. In the low-lying structures of ConSn (n = 1-12) clusters, tin impurity prefers to occupy the external site. The second-order difference energy of the ground-state ConSn (n = 1-12) clusters shows a pronounced odd-even oscillation with the number of Co atoms, and the clusters exhibit higher stability at n = 5. Compared with corresponding pure Con+1 clusters, the total magnetic moment of the ConSn clusters reduces with 1, 3 and 5 μB, respectively. The different magnetic changes of the tin doped Co clusters are analyzed in detail based on the magnetism coupling, density of state and hybridization between cobalt and tin atoms.

  17. The Transcription Factor Con7-1 Is a Master Regulator of Morphogenesis and Virulence in Fusarium oxysporum.

    PubMed

    Ruiz-Roldán, Carmen; Pareja-Jaime, Yolanda; González-Reyes, José Antonio; Roncero, M Isabel G

    2015-01-01

    Previous studies have demonstrated the essential role of morphogenetic regulation in Fusarium oxysporum pathogenesis, including processes such as cell-wall biogenesis, cell division, and differentiation of infection-like structures. We identified three F. oxysporum genes encoding predicted transcription factors showing significant identities to Magnaporthe oryzae Con7p, Con7-1, plus two identical copies of Con7-2. Targeted deletion of con7-1 produced nonpathogenic mutants with altered morphogenesis, including defects in cell wall structure, polar growth, hyphal branching, and conidiation. By contrast, simultaneous inactivation of both con7-2 copies caused no detectable defects in the resulting mutants. Comparative microarray-based gene expression analysis indicated that Con7-1 modulates the expression of a large number of genes involved in different biological functions, including host-pathogen interactions, morphogenesis and development, signal perception and transduction, transcriptional regulation, and primary and secondary metabolism. Taken together, our results point to Con7-1 as general regulator of morphogenesis and virulence in F. oxysporum.

  18. Con_A-carbone nanotube conjugate with short wave near-infrared laser ablation for tumor therapy

    NASA Astrophysics Data System (ADS)

    Lei, Huan-Yao; Peng, Ching-An; Tang, Ming-Jer; Reindhart, Kit; Szu, Harold H.

    2009-04-01

    Using the characteristics of T cell mitogen called lectin protein from the jack-beam Canavalia ensiformis Concanavalin A (Con_A) with dual activities, cytotoxicity and immunomodulation, we have shown it has a therapeutic effect on hepatoma. Injection of Con_A can eradicate the established malign tumor, because Con_A can induce tumor cell autophagic, cell-programmed death, as well as activate the effector T cells. Combined, in this paper, with the absorption exceeding the Carbon NanoTube (CNT) band-gap (ɛbg=~1/CNT diameter) with an active short wave near-infrared (SWIR) (1.2~1.5 micron wavelengths), which happened to be translucent to the irradiation upon animal skin, similar to that used in hospital fingertip-clamped Pulse Oxymetry. Once the Con_ACNT is guided to hepatoma cells, it is bonded and internalized into the mitochondria (MC) compartment, the cellular energy factory. Con_A has the higher specificity for tumor cells useful for targeting because of the abnormal glycosylation on tumor cells. When CNT hitch hike with Con_A, they can t together like a laser-denotable chemical missile surgically targeting at the tumor cells precisely by Con_A-guidance. We switch on SWIR laser, when the Con_A-CNT conjugated complex has been bonded and internalized to MC of malign cells and already commenced cellular programmed death. Thus, it might appear to casual readers that we have initiated an overkill, chemical drugged autophage followed with physical laser ablation, but what if we can eradicate hepatoma totally if no blue print is left behind inadvertently in case of a partial failure. We conclude that using Con_A-CNT conjugated complex targeting specifically at malign tumor cells is a novel targeted-laser-radiation therapy for tumors in mice.

  19. Wildland Fire Induced Heating of Dome 375 Perma-Con®

    SciTech Connect

    Flores, Eugene Michael

    2016-08-09

    AET-1 was tasked by ADEM with determining the temperature rise in the drum contents of drums stored in the Dome 375 Perma-Con® at TA-54 given a wildland fire. The wildland fire causes radiative and convective heating on the Perma-Con® exterior. The wildland fire time histories for the radiative and convective heating environment were provided to AET-1 by EES-16. If the calculated temperature rise results in a drum content temperature over 40 °C, then ADEM desires a design solution to ensure the peak temperature remains below 40 °C. An axi-symmetric FE simulation was completed to determine the peak temperature of the contents of a drum stored in the Dome 375 Perma-Con® during a wildland fire event. Three wildland fire time histories for the radiative and convective heat transfer were provided by EES-16 and were inputs for the FE simulation. The maximum drum content temperature reached was found to be 110 °C while using inputs from the SiteG_2ms_4ign_wind_from_west.xlsx time history input and not including the SWB in the model. Including the SWB in the results in a peak drum content temperature of 61 °C for the SiteG_2ms_4ign_wind_from_west.xlsx inputs. EES-16 decided that by using fuel mitigation efforts, such as mowing the grass and shrubs near the Perma-Con® they could reduce the shrub/grass fuel loading near the Perma-Con® from 1.46 kg/m2 to 0.146 kg/m2 and by using a less conservative fuel loading for the debris field inside the Dome 375 perimeter, reducing it from 0.58 kg/m2 to 0.058 kg/m2 in their model. They also greatly increased the resolution of their radiation model and increased the accuracy of their model’s required convergence value. Using this refined input the maximum drum content temperature was found to be 28 °C with no SWB present in the model. Additionally, this refined input model was modified to include worst case emissivity values for the concrete, drum and Perma-Con® interior, along with adding a

  20. El efecto de la panfotocoagulación con láser en edema macular diabético con el fotocoagulador Pascal® versus el láser de argón convencional.

    PubMed

    Mahgoub, Mohamed M; Macky, Tamer A

    2017-07-11

    Objetivo: El objetivo de este estudio fue comparar el efecto de la panfotocoagulación (PFC) en el edema macular diabético (EMD) en pacientes con retinopatía diabética proliferativa (RDP) con el fotocoagulador Pascal® (FP) vs. un fotocoagulador con láser de argón convencional (FLAC). Métodos: Se aleatorizó el uso de FP o FLAC en ochenta ojos con RDP y EMD con afectación central de la mácula. Ambos grupos tuvieron una evaluación de base de mejor agudeza visual corregida y fueron examinados con tomografía de coherencia óptica y angiografía con fluoresceína. Resultados: El número medio de disparos de láser en los grupos de FP y FLAC fue 1.726,10 y 752,00 en la sesión 1 y 1.589,00 y 830,00 (p < 0,001) en la sesión 2, respectivamente. El grosor foveal central (GFC) medio antes de comenzar el estudio fue 306 ± 100 y 314 ± 98 en los grupos de FP y FLAC, respectivamente. A las 8 semanas, el GFC medio fue 332 ± 116 y 347 ± 111 en los grupos de FP y FLAC, respectivamente (p > 0,05). La MAVC media fue similar durante el periodo de estudio y no hubo ninguna diferencia significativa entre los grupos (p > 0,05). Conclusiones: El FP y el FLAC mostraron efectos similares en el EMD en ojos con RDP y fueron igualmente seguros sin un aumento significativo del GFC. © 2017 S. Karger AG, Basel.

  1. Lectin-dependent cell-mediated cytotoxicity in an invertebrate model: Con A does not act as a bridge.

    PubMed Central

    Boswell, C A; Bayne, C J

    1986-01-01

    The plant lectin concanavalin A (Con A) has been used in an invertebrate model of lectin-dependent cell-mediated cytotoxicity (LDCC). Macrophage-like cells from the susceptible host snail Biomphalaria glabrata become cytotoxic effectors when they encounter sporocysts of the parasitic trematode Schistosoma mansoni that have been treated with Con A. The sugar alpha-methyl mannoside and rabbit anti-Con A antibodies fail to block this LDCC. Con A is effective only when the target, not the effector cell, has been exposed to it. These results constitute evidence against the molecular bridging hypothesis and support the notion that surface modulation of the target may be the stimulus that provokes cytotoxicity. Results from this invertebrate model are discussed in the context of murine T lymphocyte LDCC. PMID:3949370

  2. A phase 2 trial of long-acting TransCon growth hormone in adult GH deficiency.

    PubMed

    Höybye, Charlotte; Pfeiffer, Andreas F H; Ferone, Diego; Christiansen, Jens Sandahl; Gilfoyle, David; Christoffersen, Eva Dam; Mortensen, Eva; Leff, Jonathan A; Beckert, Michael

    2017-04-01

    TransCon growth hormone is a sustained-release human growth hormone prodrug under development in which unmodified growth hormone is transiently linked to a carrier molecule. It is intended as an alternative to daily growth hormone in the treatment of growth hormone deficiency. This was a multi-center, randomized, open-label, active-controlled trial designed to compare the safety (including tolerability and immunogenicity), pharmacokinetics and pharmacodynamics of three doses of weekly TransCon GH to daily growth hormone (Omnitrope). Thirty-seven adult males and females diagnosed with adult growth hormone deficiency and stable on growth hormone replacement therapy for at least 3 months were, following a wash-out period, randomized (regardless of their pre-study dose) to one of three TransCon GH doses (0.02, 0.04 and 0.08 mg GH/kg/week) or Omnitrope 0.04 mg GH/kg/week (divided into 7 equal daily doses) for 4 weeks. Main outcomes evaluated were adverse events, immunogenicity and growth hormone and insulin-like growth factor 1 levels. TransCon GH was well tolerated; fatigue and headache were the most frequent drug-related adverse events and reported in all groups. No lipoatrophy or nodule formation was reported. No anti-growth hormone-binding antibodies were detected. TransCon GH demonstrated a linear, dose-dependent increase in growth hormone exposure without accumulation. Growth hormone maximum serum concentration and insulin-like growth factor 1 exposure were similar after TransCon GH or Omnitrope administered at comparable doses. The results suggest that long-acting TransCon GH has a profile similar to daily growth hormone but with a more convenient dosing regimen. These findings support further TransCon GH development. © 2017 The authors.

  3. Segundo Catálogo Estelar del Hemisferio Sur con Astrolabio Fotoeléctrico PAII

    NASA Astrophysics Data System (ADS)

    Manrique, W. T.; Podestá, R. C.; Alonso, E.; Actis, E. V.; Pacheco, A. M.; Bustos, G.; Lizhi, L.; Zezhi, W.; Fanmiao, Z.; Hongqi, W.; Perdomo, R.

    Recordamos que entre el Observatorio Astronómico ``Félix Aguilar'', el Observatorio Astronómico de Beijing y el Observatorio Astronómico de La Plata, se ha convenido en desarrollar un Proyecto de Investigación conjunto, para la observación sistemática de estrellas en el Hemisferio Sur, con el objeto de la elaboración de un Catálogo Estelar Global utilizando un Astrolabio Fotoeléctrico PAII del Observatorio de Beijing, que ha sido usado con éxito en la República de China. En este trabajo se presenta el Segundo Catálogo Estelar del Hemisferio Sur, derivado de las observaciones realizadas con el PAII instalado en el OAFA, durante el períiodo Febrero de 1992 a Marzo de 1997. En este lapso se han observado mas de 400000 pasajes estelares, obteniéndose las correcciones Δ α y Δ δ de 5241 estrellas del FK4, FK5, FK5 Ext., SRS, CAMC y GC. Las precisiones medias son del orden de ± 3,2 ms en ascensión recta y ±0."057 en declinación. Rango de magnitudes : 2,0 a 11,5 Rango de declinaciones : -3o a -60o Epoca Media : 1994.9 Se analizan los residuos en función de la magnitud y tipo espectral, correcciones de grupo y frecuencia de distribución Δ α y Δ δ.

  4. Soy-Based Therapeutic Baby Formulas: Testable Hypotheses Regarding the Pros and Cons

    PubMed Central

    Westmark, Cara J.

    2017-01-01

    Soy-based infant formulas have been consumed in the United States since 1909, and currently constitute a significant portion of the infant formula market. There are efforts underway to generate genetically modified soybeans that produce therapeutic agents of interest with the intent to deliver those agents in a soy-based infant formula platform. The threefold purpose of this review article is to first discuss the pros and cons of soy-based infant formulas, then present testable hypotheses to discern the suitability of a soy platform for drug delivery in babies, and finally start a discussion to inform public policy on this important area of infant nutrition. PMID:28149839

  5. Confrontando teorías físicas con la Cosmología

    NASA Astrophysics Data System (ADS)

    Vucetich, H.

    Hay numerosas teorías físicas que no pueden contrastarse con el experimento en laboratorio y eso las hace poco interesantes como descripción de la naturaleza. Sin embargo, algunas de estas teorías tienen consecuencias cosmológicas observables y se abre la posibilidad de contrastación a través de la observación. Se discuten las observaciones capaces de poner a prueba tales teorías y se examinan ejemplos de teorías limitadas por la observación.

  6. On application of optimal control to SEIR normalized models: Pros and cons.

    PubMed

    de Pinho, Maria do Rosario; Nogueira, Filipa Nunes

    2017-02-01

    In this work we normalize a SEIR model that incorporates exponential natural birth and death, as well as disease-caused death. We use optimal control to control by vaccination the spread of a generic infectious disease described by a normalized model with L1 cost. We discuss the pros and cons of SEIR normalized models when compared with classical models when optimal control with L1 costs are considered. Our discussion highlights the role of the cost. Additionally, we partially validate our numerical solutions for our optimal control problem with normalized models using the Maximum Principle.

  7. Soy-Based Therapeutic Baby Formulas: Testable Hypotheses Regarding the Pros and Cons.

    PubMed

    Westmark, Cara J

    2016-01-01

    Soy-based infant formulas have been consumed in the United States since 1909, and currently constitute a significant portion of the infant formula market. There are efforts underway to generate genetically modified soybeans that produce therapeutic agents of interest with the intent to deliver those agents in a soy-based infant formula platform. The threefold purpose of this review article is to first discuss the pros and cons of soy-based infant formulas, then present testable hypotheses to discern the suitability of a soy platform for drug delivery in babies, and finally start a discussion to inform public policy on this important area of infant nutrition.

  8. The pros and cons about the digital recording of Intangible Cultural Heritage and some strategies

    NASA Astrophysics Data System (ADS)

    Yang, H.

    2015-08-01

    Intangible Cultural Heritage (referred to as ICH), whose fundamental nature different from the tangible cultural heritage is "Intangible", and the related physical presence of the heritage is not the core content. Digital means have irreplaceable advantages in recording intangible and dynamic ICH resources, while it also needs flexible and rigorous recording means as a support, thus striving to maximize resources recording and protection. This article will focus on the pros and cons about the digital recording of ICH, and preliminarily discuss some strategies used in the process of recording.

  9. La interacción de estrellas WN con el medio circundante

    NASA Astrophysics Data System (ADS)

    Arnal, M.; Cappa, C.; Rizzo, J. R.; Cichovolski, S.

    Se presentan resultados preliminares de un estudio de la distribución del hidrógeno neutro en los alrededores de estrellas WR de la serie del nitrógeno. Los datos observacionales de la línea de 21 cm provienen de un relevamineto de baja resolución angular (36'), así como de observaciones de resolución angular intermedia (9') tomadas con el radiotelescopio de Effelsberg. Este análisis ha permitido detectar cavidades y envolturas de H I en expansión vinculadas a las estrellas que componen la muestra.

  10. Nano anti-cancer drugs: pros and cons and future perspectives.

    PubMed

    Ali, Imran

    2011-02-01

    For last one decade, scientists are working for developing nano anti-cancer drugs with claim of ideal ones due to their targeted chemotherapic nature. These drugs have many beneficial properties such as targeted drug delivery and gene therapy modalities with minimum side effects. This article describes pros and cons and future perspectives of nano anti-cancer drugs. Efforts have been made to address importance, special features, toxicities (general, blood identities, immune system and environmental) and future perspectives of nano anti-cancer drugs. It was concluded that nano anti-cancer drugs may be magic bullet drugs for cancer treatment leading to bright future of the whole world.

  11. Perceived pros and cons of smoking and quitting in hard-core smokers: a focus group study.

    PubMed

    Bommelé, Jeroen; Schoenmakers, Tim M; Kleinjan, Marloes; van Straaten, Barbara; Wits, Elske; Snelleman, Michelle; van de Mheen, Dike

    2014-02-18

    In the last decade, so-called hard-core smokers have received increasing interest in research literature. For smokers in general, the study of perceived costs and benefits (or 'pros and cons') of smoking and quitting is of particular importance in predicting motivation to quit and actual quitting attempts. Therefore, this study aims to gain insight into the perceived pros and cons of smoking and quitting in hard-core smokers. We conducted 11 focus group interviews among current hard-core smokers (n = 32) and former hard-core smokers (n = 31) in the Netherlands. Subsequently, each participant listed his or her main pros and cons in a questionnaire. We used a structural procedure to analyse the data obtained from the group interviews and from the questionnaires. Using the qualitative data of both the questionnaires and the transcripts, the perceived pros and cons of smoking and smoking cessation were grouped into 6 main categories: Finance, Health, Intrapersonal Processes, Social Environment, Physical Environment and Food and Weight. Although the perceived pros and cons of smoking in hard-core smokers largely mirror the perceived pros and cons of quitting, there are some major differences with respect to weight, social integration, health of children and stress reduction, that should be taken into account in clinical settings and when developing interventions. Based on these findings we propose the 'Distorted Mirror Hypothesis'.

  12. Establishing confidence in the output of qualitative research synthesis: the ConQual approach.

    PubMed

    Munn, Zachary; Porritt, Kylie; Lockwood, Craig; Aromataris, Edoardo; Pearson, Alan

    2014-09-20

    The importance of findings derived from syntheses of qualitative research has been increasingly acknowledged. Findings that arise from qualitative syntheses inform questions of practice and policy in their own right and are commonly used to complement findings from quantitative research syntheses. The GRADE approach has been widely adopted by international organisations to rate the quality and confidence of the findings of quantitative systematic reviews. To date, there has been no widely accepted corresponding approach to assist health care professionals and policy makers in establishing confidence in the synthesised findings of qualitative systematic reviews. A methodological group was formed develop a process to assess the confidence in synthesised qualitative research findings and develop a Summary of Findings tables for meta-aggregative qualitative systematic reviews. Dependability and credibility are two elements considered by the methodological group to influence the confidence of qualitative synthesised findings. A set of critical appraisal questions are proposed to establish dependability, whilst credibility can be ranked according to the goodness of fit between the author's interpretation and the original data. By following the processes outlined in this article, an overall ranking can be assigned to rate the confidence of synthesised qualitative findings, a system we have labelled ConQual. The development and use of the ConQual approach will assist users of qualitative systematic reviews to establish confidence in the evidence produced in these types of reviews and can serve as a practical tool to assist in decision making.

  13. Avoided costs associated with cogeneration: a case study of Con Ed

    SciTech Connect

    Bright, R.; Davitian, H.; Martorella, J.

    1980-08-01

    The potential impact of cogeneration in office and apartment buildings in New York City on the Consolidated Edison Company (Con Ed) has been investigated using a method of utility cost and fuel use analysis developed at Brookhaven National Laboratory. This method computes a utility's long run marginal costs and long run marginal fuel consumption associated with load modifications due to the introduction of on-site energy producing technologies. The principal findings of this study show that Con Ed's long run average cost is more likely to go down than up due to cogeneration in office and apartment building; the utility's avoided costs (i.e., its long run marginal savings) associated with the gross power output of the cogeneration systems are 10.5 cents/KWh for the office building and 6.4 cents/KWh for the apartment buildings; the utility's marginal savings include a component for avoided capacity costs; and there are net savings in the use of oil due to cogeneration (assuming the building used oil for its boilers before it switched and diesel fuel in its cogenerators afterwards).

  14. Reliability of knee extension and flexion measurements using the Con-Trex isokinetic dynamometer.

    PubMed

    Maffiuletti, Nicola A; Bizzini, Mario; Desbrosses, Kevin; Babault, Nicolas; Munzinger, Urs

    2007-11-01

    The aim of this study was to evaluate the reliability of isokinetic and isometric assessments of the knee extensor and the flexor muscle function using the Con-Trex isokinetic dynamometer. Thirty healthy subjects (15 males, 15 females) were tested and retested 7 days later for maximal strength (isokinetic peak torque, work, power and angle of peak torque as well as isometric maximal voluntary contraction torque and rate of torque development) and fatigue (per cent loss and linear slope of torque and work across a series of 20 contractions). For both the knee extensor and the flexor muscle groups, all strength data - except angle of peak torque - demonstrated moderate-to-high reliability, with intraclass correlation coefficients (ICC) higher than 0.86. The highest reliability was observed for concentric peak torque of the knee extensor muscles (ICC = 0.99). Test-retest reliability of fatigue variables was moderate for the knee extensor (ICC range 0.84-0.89) and insufficient-to-moderate for the knee flexor muscles (ICC range 0.78-0.81). The more reliable index of muscle fatigue was the linear slope of the decline in work output. These findings establish the reliability of isokinetic and isometric measurements using the Con-Trex machine.

  15. Quick fix or long-term cure? Pros and cons of bariatric surgery

    PubMed Central

    Madura, James A.

    2012-01-01

    The past decade has seen an enormous increase in the number of bariatric, or weight loss, operations performed. This trend is likely to continue, mirroring the epidemic of obesity around the world and its rising prevalence among children. Bariatric surgery is considered by many to be the most effective treatment for obesity in terms of maintenance of long-term weight loss and improvement in obesity-related comorbid conditions. Although overly simplified, the primary mechanisms of the surgical interventions currently utilized to treat obesity are the creation of a restrictive or malabsorptive bowel anatomy. Operations based on these mechanisms include the laparoscopic adjustable gastric band and laparoscopic vertical sleeve gastrectomy (considered primarily restrictive operations), the laparoscopic biliopancreatic diversion with or without a duodenal switch (primarily malabsorptive operation), and the laparoscopic Roux-en-Y gastric bypass (considered a combination restrictive and selective malabsorptive procedure). Each operation has pros and cons. Important considerations, for the patient and surgeon alike, in the decision to proceed with bariatric surgery include the technical aspects of the operation, postoperative complications including long-term nutritional problems, magnitude of initial and sustained weight loss desired, and correction of obesity-related comorbidities. Herein, the pros and cons of the contemporary laparoscopic bariatric operations are reviewed and ongoing controversies relating to bariatric surgery are discussed: appropriate patient selection, appropriate operation selection for an individual patient, surgeon selection, and how to measure success after surgery. PMID:23091563

  16. RETOS EN LA INTERVENCIÓN CON ADOLESCENTES PUERTORRIQUEÑOS/AS QUE MANIFIESTAN COMPORTAMIENTO SUICIDA*

    PubMed Central

    Vélez, Yovanska Duarté; Dávila, Paloma Torres; Hernández, Samariz Laboy

    2015-01-01

    Presentamos un estudio de caso de una adolescente puertorriqueña con comportamiento suicida. Esta comenzó una Terapia Socio Cognitivo-Conductual para el Comportamiento Suicida (TSCC-CS) de tipo ambulatorio luego de una hospitalización por intento suicida. La TSCC-CS incorpora una perspectiva ecológica y de desarrollo a la terapia cognitivo-conductual. Inicialmente mostró baja autoestima y severos síntomas depresivos y de ansiedad. Al finalizar el tratamiento, manifestó un cambio significativo en su sintomatología clínica y evidenció una mejoría en sus destrezas de manejo. No presentó ideas suicidas durante meses previos, ni durante el seguimiento. El análisis de este caso permitió realizar cambios en el protocolo de tratamiento, particularmente en las sesiones de familia y de comunicación con el fin de aumentar la viabilidad del tratamiento. PMID:26702337

  17. Uso de Sustancias en Mujeres con Desventaja Social: Riesgo para el Contagio de VIH/SIDA

    PubMed Central

    Cianelli, R.; Ferrer, L; Bernales, M.; Miner, S.; Irarrázabal, L.; Molina, Y.

    2009-01-01

    Antecedentes La caracterización epidemiológica en Chile apunta a feminización, pauperización y heterosexualización de la epidemia del VIH, lo que implica un mayor riesgo para las mujeres en desventaja social. Si a esto se suma la utilización de sustancias, la vulnerabilidad de este grupo frente al VIH/SIDA aumenta. Objetivo Describir el uso de sustancias en mujeres con desventaja social e identificar factores de riesgo de contagio de VIH, asociados a este consumo. Material y Método 52 mujeres fueron entrevistadas como parte del proyecto “Testeando una intervención en prevención de VIH/SIDA en mujeres chilenas” GRANT # RO1 TW 006977. Se describen variables sociodemográficas y de consumo de sustancias a través de estadísticas descriptivas y se analiza la relación entre variables a través de pruebas de correlación. Resultados Los resultados indican un perfil sociodemográfico que sitúa a las mujeres en situación de vulnerabilidad frente al contagio de VIH/SIDA, con alto índice de uso de sustancias que acentúa el riesgo. Conclusiones Los hallazgos apuntan a la necesidad de considerar intervenciones que se enfoquen en la prevención de VIH en mujeres, abordando los riesgos asociados al consumo de sustancias. PMID:21197380

  18. Targeting of proConA to the plant vacuole depends on its nine amino-acid C-terminal propeptide.

    PubMed

    Saint-Jore-Dupas, Claude; Claude, Saint-Jore-Dupas; Gilbert, Marie-Agnès; Marie-Agnès, Gilbert; Ramis, Catalina; Catalina, Ramis; Paris, Nadine; Nadine, Paris; Kiefer-Meyer, Marie-Christine; Marie-Christine, Kiefer-Meyer; Neuhaus, Jean-Marc; Jean-Marc, Neuhaus; Faye, Loïc; Loïc, Faye; Gomord, Véronique; Véronique, Gomord

    2005-10-01

    Concanavalin A (ConA) is a well characterized and extensively used lectin accumulated in the protein bodies of jack bean cotyledons. ConA is synthesized as an inactive precursor proConA. The maturation of inactive proConA into biologically active ConA is a complex process including the removal of an internal glycopeptide and a C-terminal propeptide (CTPP), followed by a head-to-tail ligation of the two largest polypeptides. The cDNA encoding proConA was cloned and expressed in tobacco BY-2 cells. ProConA was slowly transported to the vacuole where its maturation into ConA was similar to that in jack bean cotyledons, apart from an incomplete final ligation. To investigate the role of the nine amino acid CTPP, a truncated form lacking the propeptide (proConADelta9) was expressed in BY-2 cells. In contrast to proConA, proConADelta9 was rapidly chased out of the endoplasmic reticulum (ER) and secreted into the culture medium. The CTPP was then fused to the C-terminal end of a secreted form of green fluorescent protein (secGFP). When expressed in tobacco BY-2 cells and leaf protoplasts, the chimaeric protein was located in the vacuole whereas secGFP was located in the culture medium and in the vacuole. Altogether, our results show we have isolated a new C-terminal vacuolar sorting determinant.

  19. Overcoming the aggregation problem: A new type of fluorescent ligand for ConA-based glucose sensing

    PubMed Central

    Cummins, Brian M.; Li, Mingchien; Locke, Andrea K.; Birch, David J.S.; Vigh, Gyula; Coté, Gerard L.

    2016-01-01

    Competitive binding assays based on the lectin Concanavalin A (ConA) have displayed significant potential to serve in continuous glucose monitoring applications. However, to date, this type of fluorescent, affinity-based assay has yet to show the stable, glucose predictive capabilities that are required for such an application. This instability has been associated with the extensive crosslinking between traditionally-used fluorescent ligands (presenting multiple low-affinity moieties) and ConA (presenting multiple binding sites) in free solution. The work herein introduces the design and synthesis of a new type of fluorescent ligand that can avoid this aggregation and allow the assay to be sensitive across the physiologically relevant glucose concentration range. This fluorescent ligand (APTS–MT) presents a single high-affinity trimannose moiety that is recognized by ConA’s full binding site and a fluorophore that can effectively track the ligand’s equilibrium binding via fluorescent anisotropy. This is confirmed by comparing its measured fluorescent lifetime to experimentally-determined rotational correlation lifetimes of the free and bound populations. Using an assay comprised of 200 nM APTS–MT and 1 μM ConA, the fluorescence anisotropy capably tracks the concentration of monosaccharides that are known to bind to ConA’s primary binding site, and the assay displays a MARD of 6.5% across physiologically relevant glucose concentrations. Ultimately, this rationally-designed fluorescent ligand can facilitate the realization of the full potential of ConA-based glucose sensing assays and provide the basis for a new set of competing ligands to be paired with ConA. PMID:25058939

  20. Cue-based assertion classification for Swedish clinical text--developing a lexicon for pyConTextSwe.

    PubMed

    Velupillai, Sumithra; Skeppstedt, Maria; Kvist, Maria; Mowery, Danielle; Chapman, Brian E; Dalianis, Hercules; Chapman, Wendy W

    2014-07-01

    The ability of a cue-based system to accurately assert whether a disorder is affirmed, negated, or uncertain is dependent, in part, on its cue lexicon. In this paper, we continue our study of porting an assertion system (pyConTextNLP) from English to Swedish (pyConTextSwe) by creating an optimized assertion lexicon for clinical Swedish. We integrated cues from four external lexicons, along with generated inflections and combinations. We used subsets of a clinical corpus in Swedish. We applied four assertion classes (definite existence, probable existence, probable negated existence and definite negated existence) and two binary classes (existence yes/no and uncertainty yes/no) to pyConTextSwe. We compared pyConTextSwe's performance with and without the added cues on a development set, and improved the lexicon further after an error analysis. On a separate evaluation set, we calculated the system's final performance. Following integration steps, we added 454 cues to pyConTextSwe. The optimized lexicon developed after an error analysis resulted in statistically significant improvements on the development set (83% F-score, overall). The system's final F-scores on an evaluation set were 81% (overall). For the individual assertion classes, F-score results were 88% (definite existence), 81% (probable existence), 55% (probable negated existence), and 63% (definite negated existence). For the binary classifications existence yes/no and uncertainty yes/no, final system performance was 97%/87% and 78%/86% F-score, respectively. We have successfully ported pyConTextNLP to Swedish (pyConTextSwe). We have created an extensive and useful assertion lexicon for Swedish clinical text, which could form a valuable resource for similar studies, and which is publicly available. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Overcoming the aggregation problem: a new type of fluorescent ligand for ConA-based glucose sensing.

    PubMed

    Cummins, Brian M; Li, Mingchien; Locke, Andrea K; Birch, David J S; Vigh, Gyula; Coté, Gerard L

    2015-01-15

    Competitive binding assays based on the lectin Concanavalin A (ConA) have displayed significant potential to serve in continuous glucose monitoring applications. However, to date, this type of fluorescent, affinity-based assay has yet to show the stable, glucose predictive capabilities that are required for such an application. This instability has been associated with the extensive crosslinking between traditionally-used fluorescent ligands (presenting multiple low-affinity moieties) and ConA (presenting multiple binding sites) in free solution. The work herein introduces the design and synthesis of a new type of fluorescent ligand that can avoid this aggregation and allow the assay to be sensitive across the physiologically relevant glucose concentration range. This fluorescent ligand (APTS-MT) presents a single high-affinity trimannose moiety that is recognized by ConA's full binding site and a fluorophore that can effectively track the ligand's equilibrium binding via fluorescent anisotropy. This is confirmed by comparing its measured fluorescent lifetime to experimentally-determined rotational correlation lifetimes of the free and bound populations. Using an assay comprised of 200 nM APTS-MT and 1 µM ConA, the fluorescence anisotropy capably tracks the concentration of monosaccharides that are known to bind to ConA's primary binding site, and the assay displays a MARD of 6.5% across physiologically relevant glucose concentrations. Ultimately, this rationally-designed fluorescent ligand can facilitate the realization of the full potential of ConA-based glucose sensing assays and provide the basis for a new set of competing ligands to be paired with ConA.

  2. Comparison of phenotypic methods in predicting methicillin resistance in coagulase-negative Staphylococcus (CoNS) from animals.

    PubMed

    Zhang, Yifan; Wang, Xiaogang; LeJeune, Jeffrey T; Zervos, Marcus; Bhargava, Kanika

    2011-02-01

    Phenotypic detection of methicillin resistance in coagulase-negative Staphylococcus (CoNS) of animal origin has been challenging due to the heterogeneous expression of mecA. To compare different phenotypic methods in predicting the mecA presence in CoNS, a total of 87 CoNS isolates from agricultural animals were analyzed in this study by agar dilution, disk diffusion, and broth microdilution. mecA was present in 81 CoNS isolates. Broth microdilution demonstrated the highest sensitivity of 100% in predicting the mecA presence, followed by 72.8% by agar dilution and 70.4% by disk diffusion. The results indicate that broth microdilution may be more suitable for predicting the presence of mecA in CoNS from animals than the other two methods, although staphylococcal species may also be a factor affecting the sensitivities of the methods as the top three staphylococcal species in this study were Staphylococcus lentus, Staphylococcus sciuri, and Staphylococcus xylosus (a total of 75 of 87).

  3. Contribution of the Kallikrein/Kinin System to the Mediation of ConA-Induced Inflammatory Ascites.

    PubMed

    Baintner, Károly

    2016-03-01

    Intraperitoneal administration of concanavalin A (ConA, 25 mg/kg b.w.), a cell-binding plant lectin was used for inducing inflammatory ascites, and potential inhibitors were tested in 1 h and 2.5 h experiments, i.e. still before the major influx of leucocytes. At the end of the experiment the peritoneal fluid was collected and measured. The ConA-induced ascites was significantly (p<0.01) and dose-dependently inhibited by icatibant (HOE-140), a synthetic polypeptide antagonist of bradykinin receptors. Aprotinin, a kallikrein inhibitor protein also had significant (p<0.01), but less marked inhibitory effect. L-NAME, an inhibitor of NO synthesis, and atropine methylnitrate, an anticholinergic compound, were ineffective. It is concluded, that the kallikrein/kinin system contributes to the mediation of the ConA-induced ascites by increasing subperitoneal vascular permeability, independent of the eventual vasodilation produced by NO. It is known, that membrane glycoproteins are aggregated by the tetravalent ConA and the resulting distortion of membrane structure may explain the activation of the labile prekallikrein. Complete inhibition of the ConA-induced ascites could not be achieved by aprotinin or icatibant, which indicates the involvement of additional mediators.

  4. Is ACPA positivity the main driver for rheumatoid arthritis treatment? Pros and cons.

    PubMed

    Alivernini, Stefano; Galeazzi, Mauro; Peleg, Hagit; Tolusso, Barbara; Gremese, Elisa; Ferraccioli, Gianfranco; Naparstek, Yaakov

    2017-09-09

    Rheumatoid Arthritis (RA) is an autoimmune chronic disease that is characterized by the positivity of various antibodies, the most specific being autoantibodies against citrullinated antigens (ACPA). Despite ACPA are not arthritogenic by themselves, ACPA positive individuals have high risk of RA development and ACPA positivity is associated with severe erosive phenotype and higher mortality rate compared to seronegative RA. Moreover, ACPA status is associated with favorable response to biologics targeting pathways involving autoantibody producing cells as B lymphocytes. In the current review we have discussed the pros and cons on the available scientific evidences, regarding the diagnostic, prognostic and management implications of ACPAs in RA. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. The new human papillomavirus (HPV) vaccine: pros and cons for pediatric and adolescent health.

    PubMed

    Thomas, Tami L

    2008-01-01

    The new human papillomavirus (HPV) vaccine is a research breakthrough for pediatric/adolescent health to prevent cervical cancer and related morbidity. The annual heath care cost for the treatment of cervical cancer and genital warts is estimated to be more than three billion dollars a year. The new HPV vaccine has incredible potential to improve reproductive health promotion, reduce health care costs, and close health care disparity gaps. However, issues both for and against the new HPV vaccine, including mandating vaccination, high cost of the vaccine, the short duration of protection offered, and the perceived promotion of sexual activity, cause confusion. Pediatric nurses, including those in advanced practice, benefit by understanding the pros and cons of these issues in advocating for their patients.

  6. Multipotent (adult) and pluripotent stem cells for heart regeneration: what are the pros and cons?

    PubMed

    Liao, Song-Yan; Tse, Hung-Fat

    2013-12-24

    Heart failure after myocardial infarction is the leading cause of mortality and morbidity worldwide. Existing medical and interventional therapies can only reduce the loss of cardiomyocytes during myocardial infarction but are unable to replenish the permanent loss of cardiomyocytes after the insult, which contributes to progressive pathological left ventricular remodeling and progressive heart failure. As a result, cell-based therapies using multipotent (adult) stem cells and pluripotent stem cells (embryonic stem cells or induced pluripotent stem cells) have been explored as potential therapeutic approaches to restore cardiac function in heart failure. Nevertheless, the optimal cell type with the best therapeutic efficacy and safety for heart regeneration is still unknown. In this review, the potential pros and cons of different types of multipotent (adult) stem cells and pluripotent stem cells that have been investigated in preclinical and clinical studies are reviewed, and the future perspective of stem cell-based therapy for heart regeneration is discussed.

  7. From in vitro Experiments to in vivo and Clinical Studies; Pros and Cons.

    PubMed

    Saeidnia, Soodabeh; Manayi, Azadeh; Abdollahi, Mohammad

    2015-01-01

    Biomedical investigators use different methods including experimental animals, tissue, and cell cultures as well as computational simulations and clinical studies finding the ways to treat human diseases and disorders. All the mentioned procedures have their own advantages and disadvantages. For instance although animal models provide some drawbacks like difference in biokinetics parameters or extrapolation of results to human, they are more reliable than in vitro tests. The disadvantage of the in vitro procedures is that they are mostly performed on cancerous cell lines that have a substantially abnormal function. Furthermore, although in vitro models are fruitfully used in biological fields, finding an end point, the initial aim of chemical attack, and extrapolation of the effects to the human are some real weaknesses. Absence of biokinetics in in vitro methods may lead to a misinterpretation of the data. The present review has criticized the pros and cons of both methods, especially in the fields of pharmacology, toxicology, and medical sciences.

  8. What to consider when regulating electronic cigarettes: Pros, cons and unintended consequences.

    PubMed

    Caponnetto, Pasquale; Saitta, Daniela; Sweanor, David; Polosa, Riccardo

    2015-06-01

    Many public health experts, medical research societies, large health organizations and policy makers have expressed concerns about the increased popularity of electronic cigarettes and have pushed for more restrictive measures ranging from complete bans to tight regulations of these products either as medicines or as tobacco products. But these concerns have never been adequately qualified nor quantified. Without judicious assessment and thorough evaluation, regulations may have unintended consequences that can do more damage than good in public health terms. In this article, we will appraise the existing prominent regulatory frameworks for e-cigarettes, namely, general consumer product, medicinal product and tobacco product regulation, to highlight their pros and cons. Moreover, we provide concrete examples of the unintended consequences which may arise from inappropriate regulatory action.

  9. Multipotent (adult) and pluripotent stem cells for heart regeneration: what are the pros and cons?

    PubMed Central

    2013-01-01

    Heart failure after myocardial infarction is the leading cause of mortality and morbidity worldwide. Existing medical and interventional therapies can only reduce the loss of cardiomyocytes during myocardial infarction but are unable to replenish the permanent loss of cardiomyocytes after the insult, which contributes to progressive pathological left ventricular remodeling and progressive heart failure. As a result, cell-based therapies using multipotent (adult) stem cells and pluripotent stem cells (embryonic stem cells or induced pluripotent stem cells) have been explored as potential therapeutic approaches to restore cardiac function in heart failure. Nevertheless, the optimal cell type with the best therapeutic efficacy and safety for heart regeneration is still unknown. In this review, the potential pros and cons of different types of multipotent (adult) stem cells and pluripotent stem cells that have been investigated in preclinical and clinical studies are reviewed, and the future perspective of stem cell-based therapy for heart regeneration is discussed. PMID:24476362

  10. Pros and cons of healthcare information technology implementation: the pros win.

    PubMed

    Maffei, Roxana

    2006-01-01

    Countless studies and investigations have been performed siding either for or against the implementation of technology in the healthcare setting. This article presents both sides of this debate, with an obvious conclusion that the pros of this debate win. The practice of information technology in the medical domain lags behind its knowledge and discovery by at least 7 years. The key to closing this gap is to show, through various studies, how information technology systems provide decision support to users at the point in time when decisions are needed. What the reader will obtain from this article is that the pros for information technology implementation in healthcare settings weigh much more and have a greater effect than the cons.

  11. Space and terrestrial media for military communications - Technical pros and cons

    NASA Astrophysics Data System (ADS)

    Dharamsi, Manoj T.; Reilly, James F.; Hawrylko, Warren P.

    Technical pros and cons are presented for space and terrestrial media for defense-wide long-haul military communications. Defense-wide military space communications include use of leased commercial satellite capability in addition to the government-owned Defense Satellite Communications System (DSCS). The terrestrial communications include use of troposcatter, HF radios, line-of-sight microwave, and metallic and fiber-optic cables. The current usage, capacity, cost, and other attributes of these media are examined. Current trends and future uses of the space and terrestrial media for military communications are discussed. It is concluded that military communications can continue best by using a mix of both space and terrestrial media.

  12. DESAFÍOS ÉTICOS DE LA INVESTIGACIÓN CON ANIMALES, MANIPULACIÓN GENÉTICA

    PubMed Central

    Yunta, Eduardo Rodríguez

    2012-01-01

    En la investigación con animales existen cuestionamientos éticos tanto en el uso como modelos de enfermedades humanas y requisito previo para ensayos en humanos como en la introducción de modificaciones genéticas. Algunos de estos cuestionamientos son: no representar exactamente la condición humana como modelos, realizar pruebas de toxicidad con grave daño para los animales, alterar su naturaleza mediante modificaciones genéticas, riesgos de la introducción de organismos genéticamente modificados. El uso de animales en investigación para beneficio humano, impone al ser humano la responsabilidad moral de respetarlo, no haciéndoles sufrir innecesariamente, al estar trabajando con seres vivientes y sentientes. PMID:23338641

  13. Formación estelar en NGC 6357: viendo a través del polvo con Gemini

    NASA Astrophysics Data System (ADS)

    Bosch, G.; Morrell, N.; Barbá, R.

    Presentamos aquí los primeros resultados de fotometría JHKs obtenidos con Flamingos I en el telescopio Gemini Sur. El mosaico comprendido por tres posiciones adyacentes tomadas a lo largo de varios semestres nos permite caracterizar la población estelar en la zona que presenta una interacción más importante entre las estrellas masivas y la nube molecular que les dió origen. Los diagramas color-magnitud nos permiten identificar numerosas fuentes con exceso infrarrojo, la mayoría de ellas imposible de detectarse en el rango óptico debido a la fuerte absorción del polvo presente en la región. Es altamente probable que la mayoría de estas fuentes con exceso sean protoestrellas, aunque es necesario realizar espectroscopía infrarroja de las mismas para confirmar su naturaleza.

  14. La salud en personas con discapacidad intelectual en España: estudio europeo POMONA-II

    PubMed Central

    Martínez-Leal, Rafael; Salvador-Carulla, Luis; Gutiérrez-Colosía, Mencía Ruiz; Nadal, Margarida; Novell-Alsina, Ramón; Martorell, Almudena; González-Gordón, Rodrigo G.; Mérida-Gutiérrez, M. Reyes; Ángel, Silvia; Milagrosa-Tejonero, Luisa; Rodríguez, Alicia; García-Gutiérrez, Juan C.; Pérez-Vicente, Amado; García-Ibáñez, José; Aguilera-Inés, Francisco

    2011-01-01

    Introducción Estudios internacionales demuestran que existe un patrón diferenciado de salud y una disparidad en la atención sanitaria entre personas con discapacidad intelectual (DI) y población general. Objetivo Obtener datos sobre el estado de salud de las personas con DI y compararlos con datos de población general. Pacientes y métodos Se utilizó el conjunto de indicadores de salud P15 en una muestra de 111 sujetos con DI. Los datos de salud encontrados se compararon según el tipo de residencia de los sujetos y se utilizó la Encuesta Nacional de Salud 2006 para comparar estos datos con los de la población general. Resultados La muestra con DI presentó 25 veces más casos de epilepsia y el doble de obesidad. Un 20% presentó dolor bucal, y existió una alta presencia de problemas sensoriales, de movilidad y psicosis. Sin embargo, encontramos una baja presencia de patologías como la diabetes, la hipertensión, la osteoartritis y la osteoporosis. También presentaron una menor participación en programas de prevención y promoción de la salud, un mayor número de ingresos hospitalarios y un uso menor de los servicios de urgencia. Conclusiones El patrón de salud de las personas con DI difiere del de la población general, y éstas realizan un uso distinto de los servicios sanitarios. Es importante el desarrollo de programas de promoción de salud y de formación profesional específicamente diseñados para la atención de personas con DI, así como la implementación de encuestas de salud que incluyan datos sobre esta población. PMID:21948011

  15. Self-efficacy, pros, and cons as variables associated with adjacent stages of change for regular exercise in Japanese college students.

    PubMed

    Horiuchi, Satoshi; Tsuda, Akira; Kobayashi, Hisanori; Fallon, Elizabeth A; Sakano, Yuji

    2016-01-18

    This study examined self-efficacy (confidence to exercise), pros (exercise's advantages), and cons (exercise's disadvantages) as variables associated across the transtheoretical model's six stages of change in 403 Japanese college students. A series of logistic regression analyses were conducted. Results showed that higher pros and lower cons were associated with being in contemplation compared to precontemplation. Lower cons were associated with being in preparation compared to contemplation. Higher self-efficacy was associated with being in action compared to preparation as well as being in maintenance compared to action. Lower cons were associated with being in termination compared to maintenance.

  16. Prevalence and antimicrobial susceptibility pattern of coagulase-negative staphylococci (CoNS) isolated from clinical specimens in Northern of Jordan.

    PubMed

    Al Tayyar, Ibrahim Ali; Al-Zoubi, Mazhar Salim; Hussein, Emad; Khudairat, Salih; Sarosiekf, Konrad

    2015-12-01

    Coagulase negative Staphylococci (CoNS) are one of the most common bacteria found on human skin and on mucous membranes as a component of normal flora. The presence of CoNS in clinical specimens is frequently associated with an infectious aetiology or contamination. We aimed to evaluate CoNS species distribution and susceptibility patterns in specimens obtained from clinics and hospitals in the Northern area of Jordan. Standard identification methods showed the presence of CoNS in 223 specimens at different local hospitals. Susceptibility testing was performed using 18 antibiotics in accordance with the Clinical and Laboratory Standards Institute (CLSI) recommendations. Staphylococcus epidermidis and S. haemolyticus were found to be the most common species isolated from all specimens representing 122 (54.7%) and 52 (23.4%) of all CoNS species, respectively. Antibiotic susceptibility testing of CoNS species revealed their sensitivity to vancomycin, linozolid, rifampin and nitrofurantin, while showing a highly resistant pattern to ampicillin, penicillin, ceftriaxone, cefazolin, amoxicillin-clavulanic acid and erythromycin. Some variation of the susceptibility pattern of CoNS species were identified in specimens isolated from the ICU and paediatric hospital wards as well as from clinical specimens of urine, blood and catheter tips. The most common CoNS isolates were found to be S. epidermidis and S. haemolyticus with variable percentages according to the specimen source. Moreover, a high susceptibility CoNS to vancomycin, rifampin, and linezolid showed resistance to amoxicillin and penicillin.

  17. Economic and Ethical Consequences of Natural Hazards in Alpine Valleys (EE-Con)

    NASA Astrophysics Data System (ADS)

    Ortner, Florian; Brantl, Dirk; Meyer, Lukas; Steininger, Karl; Sass, Oliver

    2015-04-01

    The Alps and their population are particularly vulnerable to geomorphological and hydrological hazards and this problem might be amplified by ongoing climate change. Natural disasters cause severe monetary damage which often leads to the difficult question whether it socially pays to protect settlements at high costs or whether alternatively settlement areas should better be abandoned. By investigations in the Johnsbachtal and the Kleinsölktal (Styria), the interdisciplinary project "Economic and Ethical Consequences of Natural Hazards in Alpine Valleys" (EE-Con), funded by the Austrian Academy of Sciences, seeks to answer the following questions: (1) Are natural hazards and associated damages in fact increasing, and is this due to meteorological triggers, to anthropogenic factors or to internal process dynamics? (2) What is the perception and knowledge of local people, how is risk and risk prevention communicated? (3) What is the respective cost ratio between protection infrastructure, soft measures of adaptation and other options (e.g. reduction of settlement area)? (4) What legitimate claims to compensation do people have, how far does societal responsibility go and where does individual responsibility start if parts of the settlement area had to be abandoned? These questions will be tackled in an interdisciplinary cooperation between geography, economics and normative theory (philosophy). EE-Con will follow broadly the path of risk analysis and risk assessment, focusing on the temporal dimension (past - present - future) with the aim to unravel the history of natural hazards in the areas and to analyse the economic values involved. In the following, natural hazard scenarios for the future (2050 and 2100) will be developed considering the economic consequences. Besides this, the project deals with local knowledge, risk perception and risk communication, which will be investigated via group interviews and stakeholder workshops and be integrated into a human

  18. Future of clip-on weapon sights: pros and cons from an applications perspective

    NASA Astrophysics Data System (ADS)

    Knight, C. Reed; Greenslade, Ken; Francisco, Glen

    2015-05-01

    US Domestic, International, allied Foreign National Warfighters and Para-Military First Responders (Police, SWAT, Special Operations, Law Enforcement, Government, Security and more) are put in harm's way all the time. To successfully complete their missions and return home safely are the primary goals of these professionals. Tactical product improvements that affect mission effectiveness and solider survivability are pivotal to understanding the past, present and future of Clip-On in-line weapon sights. Clip-On Weapon Sight (WS) technology was deemed an interim solution by the US Government for use until integrated and fused (day/night multi-sensor) Weapon Sights (WSs) were developed/fielded. Clip-On has now become the solution of choice by Users, Warriors, Soldiers and the US Government. SWaP-C (size, weight and power -cost) has been improved through progressive advances in Clip-On Image Intensified (I2), passive thermal, LL-CMOS and fused technology. Clip-On Weapon Sights are now no longer mounting position sensitive. Now they maintain aim point boresight, so they can be used for longer ranges with increased capabilities while utilizing the existing zeroed weapon and daysight optic. Active illuminated low-light level (both analog I2 and digital LL-CMOS) imaging is rightfully a real-world technology, proven to deliver daytime and low-light level identification confidence. Passive thermal imaging is also a real-world technology, proven to deliver daytime, nighttime and all-weather (including dirty battlefield) target detection confidence. Image processing detection algorithms with intelligent analytics provide documented promise to improve confidence by reducing Users, Warriors and Soldiers' work-loads and improving overall system engagement solution outcomes. In order to understand the future of Clip-On in-line weapon sights, addressing pros and cons, this paper starts with an overview of historical weapon sight applications, technologies and stakeholder decisions

  19. iPathCons and iPathDB: an improved insect pathway construction tool and the database

    PubMed Central

    Zhang, Zan; Yin, Chuanlin; Liu, Ying; Jie, Wencai; Lei, Wenjie; Li, Fei

    2014-01-01

    Insects are one of the most successful animal groups on earth. Some insects, such as the silkworm and honeybee, are beneficial to humans, whereas others are notorious pests of crops. At present, the genomes of 38 insects have been sequenced and made publically available. In addition, the transcriptomes of dozens of insects have been sequenced. As gene data rapidly accumulate, constructing the pathway of molecular interactions becomes increasingly important for entomological research. Here, we developed an improved tool, iPathCons, for knowledge-based construction of pathways from the transcriptomes or the official gene sets of genomes. Considering the high evolution diversity in insects, iPathCons uses a voting system for Kyoto Encyclopedia of Genes and Genomes Orthology assignment. Both stand-alone software and a web server of iPathCons are provided. Using iPathCons, we constructed the pathways of molecular interactions of 52 insects, including 37 genome-sequenced and 15 transcriptome-sequenced ones. These pathways are available in the iPathDB, which provides searches, web server, data downloads, etc. This database will be highly useful for the insect research community. Database URL: http://ento.njau.edu.cn/ipath/ PMID:25388589

  20. Air Traffic Management Technology Demonstration-1 Concept of Operations (ATD-1 ConOps), Version 3.0

    NASA Technical Reports Server (NTRS)

    Baxley, Brian T.; Johnson, William C.; Scardina, John; Shay, Richard F.

    2016-01-01

    This document describes the goals, benefits, technologies, and procedures of the Concept of Operations (ConOps) for the Air Traffic Management (ATM) Technology Demonstration #1 (ATD-1), and provides an update to the previous versions of the document [ref 1 and ref 2].

  1. Treatment of plutonium contaminated soil/sediment from the Mound site using the ACT*DE*CON{sup SM} process

    SciTech Connect

    Negri, M.C.; Swift, N.A.; North, J.P.

    1996-10-01

    The removal and/or treatment of contaminated soil is a major problem facing the US DOE. The EG&G Mound Applied Technologies site in Miamisburg, Ohio, has an estimated 1.5 million cubic feet of soils from past disposal and waste burial practices awaiting remediation from plutonium contamination. This amount includes sediment from the Miami-Erie Canal that was contaminated in 1969 following a pipe- rupture accident. Conventional soil washing techniques that use particle separation would generate too large a waste volume to be economically feasible. Therefore, innovative technologies are needed for the cleanup. The ACT*DE*CON process was developed by SELENTEC for washing soils to selectively dissolve and remove heavy metals and radionuclides. ACT*DE*CON chemically dissolves and removes heavy metals and radionuclides from soils and sediments into an aqueous medium. The ACT*DE*CON process uses oxidative carbonate/chelant chemistry to dissolve the contaminant from the sediment and hold the contaminant in solution. The objective of recent work was to document the proves conditions necessary to achieve the Mound-site and regulatory-cleanup goals using the ACT*DE*CON technology.

  2. Donation of the body for scientific purposes in Italy: ethical and medico-legal considerations.

    PubMed

    Bin, Paola; Delbon, Paola; Piras, Mauro; Paternoster, Mariano; Di Lorenzo, Pierpaolo; Conti, Adelaide

    2016-01-01

    In recent years in Italy (and in the other European Countries) a new debated topic involves anatomists and the scientific world: donation of the body after death for scientific purposes. The aim of our analysis is to analyze the issue of voluntary body donation in Italy focusing first of all, on key principles of the disciplines of donation. Considering the rise of exhibitions and events in which death is spectacularized, the debate is focus on will, on respect and overall on the purpose for which the body is donated. Anatomical dissection is considered necessary in the direct learning of the human body, of surgical practices and new scientific techniques but the scarcity of programmes and regulations regarding the donation of bodies for study and research make it an uncommon practice. After discussing what are the constitutional principles underlying the issue we want to emphasize the need of a more effective and updated regulation to set limits and methods of a practice still essential for scientific progress.

  3. [Medico-legal study on crashes of fighter planes of the National People's Army].

    PubMed

    Lignitz, Eberhard; Kopetz, Bernd; Wirth, Ingo

    2009-01-01

    In the years 1974 to 1990, 39 pilots died in 34 crashes of fighter planes of the National People's Army; 32 victims were examined forensically. For the present study all autopsy protocols and examination reports available in the German Federal Military Archives in Freiburg could be evaluated. Both officer cadets and experienced pilots of high military ranks were among the victims. The majority of the crashes (24 out of 34) was caused by human failure. Health problems or the use of alcohol and medications did not play a role in the aircraft accidents. All killed pilots were identified. The injury patterns after fatal ejection are different from the patterns seen after impact with a plane. Such patterns of findings are meaningful in the reconstruction of unknown sequences of events leading to the accidents and for the assessment of the pilots' capacity to act at the moment of the incident

  4. [Medico-statistical characteristics of the cholelithiasis in the Udmurt Republic].

    PubMed

    Vakhrushev, Ia M; Kudrina, E A; Gorbunov, A Iu; Khokhlachev, N A; Suchkova, E V

    2011-01-01

    THE AIM OF OUR INVESTIGATION: siuay me level or moroiaity or cnolelimiasis and its dynamic in adult and children population of Udmurt Republic. We used the materials of state statistic registration documentation. We took into account the average population of Udmurt Republic, data of cholrlithiasis morbidity and the quantity of registrated cases of disease. To reveal tendency of cholelithiasis morbidity we spent the regressive analysis with using of trend models. We found that during analyzing period (2005-2009) common morbidity of cholelithiasis in Udmurt Republic exceeds the same data in Russian Federation. Morbidity of adult urban population is significantly higher than in rural population. The cholelithiasis morbidity increases at the age of 41-60 years. In children population we marked significant raising of primary cholelithiasis morbidity. CONCLUSION. It was revealed that cholelithiasis morbidity in Udmurt Republic remains high. Due to this information we have possibility to determine medical and prophylactic measures.

  5. THE MEDICO-SCIENTIFIC MARGINALISATION OF HOMEOPATHY: INTERNATIONAL LEGAL AND REGULATORY DEVELOPMENTS.

    PubMed

    Freckelton, Ian

    2015-09-01

    The 2010 report of the United Kingdom Science and Technology Committee of the House of Commons and the 2015 report of the Australian National Health and Medical Research Council have overtaken in significance the uncritical Swiss report of 2012 and have gone a long way to changing the environment of tolerance toward proselytising claims of efficacy in respect of homeopathy. The inquiry being undertaken in the United States by the Food and Drug Administration during 2015 may accelerate this trend. An outcome of the reports and inquiries has been a series of decisions from advertising regulators and by courts rejecting medically unjustifiable claims in respect of the efficacy of homeopathy. Class actions have also been initiated in North America against manufacturers of homeopathic products. The changing legal and regulatory environment is generating an increasingly scientifically marginalised existence for homeopathy. That new environment is starting to provide effective inhibition of assertions on behalf of homeopathy and other health modalities whose claims to therapeutic efficacy cannot be justified by reference to the principles of evidence-based health care. This has the potential to reduce the financial support that is provided by insurers and governments toward homeopathy and to result in serious liability exposure for practitioners, manufacturers and those who purvey homeopathic products, potentially including pharmacists. In addition, it may give a fillip to a form of regulation of homeopaths if law reform to regulate unregistered health practitioners gathers momentum, as is taking place in Australia.

  6. Current trends for medico-legal disputes related to functional nasal surgery in Italy.

    PubMed

    Motta, S; Nappi, S

    2014-06-01

    The problem of professional liability in case of adverse outcomes or failures secondary to surgery is very sensitive in many countries of the European Community. In Italy, a recent sentence of the Supreme Court concerning a patient who underwent septoplasty raised considerable doubts in relation to the guidance to be followed in disputes related to an alleged professional liability, further exacerbating the juridical orientation of recent years in this context. This ruling involves any surgery, as well as rhinologic surgery, and calls into question most regulatory and legal principles that have traditionally been adopted by the Italian Civil Law. The sentence states that the plaintiff is only required to document the failure of surgical treatment, but not the breach of the duty of care by the surgeon, thus shifting the burden of proof to the physician-debtor. It also considers that, in assessing the degree of negligence, reference should be made to the qualifications of the surgeon, according to principles that are not covered by current regulations, denying that in general surgery (i.e., not with aesthetic purposes) the surgeon must only to act with diligence and need not guarantee a favourable outcome. This series of statements, complementing one another and evolving more unfavourably towards physicians, facilitate legal disputes for speculative purposes through complainants, with obvious health and socio-economic implications.

  7. Traumatic dental injuries during anaesthesia. Part II: medico-legal evaluation and liability.

    PubMed

    Gaudio, Rosa Maria; Barbieri, Stefania; Feltracco, Paolo; Tiano, Letizia; Galligioni, Helmut; Uberti, Manuela; Ori, Carlo; Avato, Francesco Maria

    2011-02-01

    Claims for tooth damage following intubation are increasing. An anaesthetic chart (AC) has been proposed to describe patient's pre-existent dental diseases and any possible lesions caused during intubation and extubation. We conducted a retrospective study of 235 cases of dental lesions reported in litigation files from January 2000 to June 2009. Based on preoperative oral inspection the anaesthetist decided whether or not to use a protective aid. Two different tooth protectors were applied: (i) a standard mouthguard and (ii) silicone impression putty. The study population consisted of 110 female (age 6-88 years) and 125 male patients (11-90 years) patients. In 66% of cases greater risk of perianesthetic dental injury was reported in the AC due to pre-existing poor dentition. In intubation procedures without protective devices dental subluxation/luxation occurred in 55% of patients, dental avulsion in 43%, exfoliation in 2%, and soft tissue damage in five patients. One patient suffered from transient facial nerve paralysis. The costs of treatments and of impression materials, as well as the total value of compensation for injuries are reported. Definition and demonstrability of damages on the AC is important in order to separate the cases worthy of compensation from the non-compensable ones, as to evaluate the possibility of solving the litigation by extrajudicial channels. There are cases in which, based on AC reporting and device adoption the damage resulted to be compensable, but the costs were defined on different estimates of lesions. The use of a protective device makes it possible to down-modulate the damage compensation. The analysis of litigation records and 'incident reports' has suggested that the choice of accurate proceeding and the use of protection aids could reduce the number of claims, insurance premiums and the costs of litigation process, thus improving physician-patient relationship. © 2011 John Wiley & Sons A/S.

  8. [Medico-legal assessment in the sequelae of burns (1st part)].

    PubMed

    Costagliola, R; Cantaloube, D; Costagliola, M; Foyatier, J-L

    2011-10-01

    The assessment of physical injury in after-effects of burns is very specific. Indeed, the evolution of burn scars is particular compared to the scarring process in general. The expert needs to know these specific aspects in order to objectively assess the after-effects due to burns, in order to compensate for the loss of autonomy in major burn victims. The assessment has to analyze all the effects, functional and aesthetic, of the after-effects due to burns and has to particularly specify: the mending, which can never be set before one year, the pressure test allowing to check the complete maturation of the scars; the functional disability which results from skin retractions (due to after-effects) on the limbs mobility but which also must consider the burnt skin surface; the aesthetic damage, often important, with a discrimination between hypertrophic and keloid scars; the suffering, always significant in view of specialized and prolonged therapeutics; the sexual damage, often unrecognized in this type of injured people. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  9. [Diffculties in medico-social management of tuberculosis in Pneumology Departement of Fann University Teaching Hospital].

    PubMed

    Ndiaye, M W; Preira, A; Ndir, M; Ba, O; Cissokho, S; Diop Dia, D; Kandji, M; Diatta, A; Toure, N O; Niang, A; Dia, Y; Sylla, O; Hane, A A

    2004-01-01

    This prospective study included all the patients who, during the month of September 1995, were admitted for pulmonary baclliferous tuberculosis to the Pneumology Clinic of the Fann University Hospital, Dakar. The patient's escorts and the health personnel were also included in this study. The aim of the study was to find the different socio-economic and health factors impeding the hospitalization of tuberculosis patients in the Pneumology Clinic of Fann University Hospital. 22 members of the health team, 209 patients aged between 15 and 65 years and 209 escorts were interviewed. Out of the 10% of tuberculosis patients with HIV seropositivity, 80% admitted not to have informed their spouses of their infection. The decision to be admitted was made by the patient himself in 54.4% of cases and by his family in 45.5% of cases. Late admittance with regards to the beginning of symptoms was due to the recourse to traditional medicine in 43.7% of cases, wrong diagnosis in 24%, ignorance in 19.3% and, in 13% of cases, due to inappropiate anti tuberculosis treatment. Despite the fact that anti tuberculosis medicine was free of charge, each patient or his family spent an average sum of 87,500 CFA F (US dollar 175) for a month's admission (the minimal salary (SMIG) in Senegal is 32,000 CFA F (US dollar 64), and 40% of the patients and escorts had difficulties making this payment. 9 patients were judged to be poor by 25.7% of the patients and 8.7% found relations with the health personnel difficult. The escorts deplored the lack of toilets (only 1 out of 4 was functional), the time worn facilities, the overcrowding as well as the irregularity and poor quality of the hospital meals. The entire health team deplored the lack of adequate personnel and 30% of them deplored the lack of hygiene of some patients and escorts. Taking financial charge of tuberculosis patients at the Pneumology Clinic of the Fann University Hospital requires an increased financial effort from the State (rehabilitation of the facilities, recruitment of medical and paramedical personnel, improved meals) harmonisation on a national scale of anti tuberculosis therapeutic protocoles and an Information-Education-Communication (IEC) programme on tuberculosis and hygiene.

  10. Abortion laws and medical developments: a medico-legal anomaly in Queensland.

    PubMed

    Petersen, Kerry

    2011-03-01

    In October 2010 the District Court sitting in Cairns, Queensland, found Tegan Leach not guilty of attempting to procure her own abortion and Sergie Brennan not guilty of supplying Leach with the drugs Mifepristone and Misoprostol to procure an abortion. Brennan obtained the drugs from his sister in the Ukraine through the regular postal system. R v Brennan and Leach was the first case in Queensland's history where a woman was charged with procuring her own abortion. The drugs are accepted by the medical profession worldwide for medical abortions. A prosecution witness gave evidence that Mifepristone is not harmful or injurious to the health of a woman and it is listed as an essential medicine by the World Health Organisation and approved for use by the Australian Therapeutic Goods Administration. The jury found the defendants not guilty because they were not satisfied beyond reasonable doubt that the combination of the drugs Mifepristone and Misoprostol was a "noxious" substance under the Criminal Code (Old). This article concludes that there is no regulatory miracle which will stop the traffic of Mifepristone and Misoprostol into Australia and therefore an intelligent regulatory response is required which would make it unnecessary for women to seek Mifepristone and Misoprostol from overseas networks and the internet. Among other things, this would include the repeal of confusing, inappropriate and ineffective abortion laws.

  11. Nobel Prize for Physical Therapy? Rise, Fall, and Revival of Medico-Mechanical Institutes.

    PubMed

    Hansson, Nils; Ottosson, Anders

    2015-08-01

    This historical vignette explores the considerations of the Nobel Prize Committee for Physiology or Medicine by vetting the Nobel Prize chances of Dr Gustaf Zander (1835-1920). His way to stardom started 150 years ago when he began mechanizing the passive and active movements that physical therapists manually used to treat diseases. A glance at his machines shows that they parallel surprisingly well what can be found in modern fitness studios. By combining files from the Nobel Prize Archive and sources from the first physical therapists, this vignette pieces together why Zander was considered one of the best candidates for the Nobel Prize in 1916. By providing this glimpse of history, questions about the origin of physical therapy concepts and the profession of the physical therapist are raised.

  12. [Medico-ecological approaches to the integrated management of water resources].

    PubMed

    El'piner, L I

    2012-01-01

    The necessity of taking into account the interests of public health care informing and implementing solutions for water management has been substantiated. Scientific frameworks and regulatory sanitary legislative documents relating to various areas of water management have been considered. The possibilities and the importance of performing complex territory medical ecological forecasts of effects of changes in hydrological situation have been demonstrated.

  13. [Giant recurrent trochanteric pressure sore: A complex medico-surgical care].

    PubMed

    Pesenti, S; Ciceron, C; Toledano, E; Niddam, J; Tournebise, H

    2016-12-01

    Pressure sores are a frequent complication in spinal injured people. Their treatment is often long and complex. We report the case of a 60-year-old man affected with complete paraplegia who developed a right trochanteric pressure ulcer complicated with osteoarthritis of the coxofemoral joint. The treatment was done in three steps. First, a large excision of necrotic tissues and a femoral head-neck resection is performed. Then, the defect is partly covered with a Gluteus Maximus and a Biceps Femoris myocutaneous flaps. Finally, the residual defect is covered with a cutaneous pedicled groin flap called McGregor's flap. Later, the patient showed a right para-scrotal pressure sore on a heterotopic ossification of the ischial tuberosity. McGregor's flap is rarely employed for treating trochanteric pressure sores. It was here the only pedicled flap available. It was necessary to autonomize it in order to get enough length and to place a hip external fixation. The para-scrotal pressure sore illustrates the fact that bone resection surgery lifts the weight-bearing zones and can lead to pressure sores in unusual locations. The surgical treatment of these "giant" pressure sores requires a perfect collaboration between teams of rehabilitation and several surgical areas. Without a good adherence of the patient, the treatment is doomed to fail. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Medico-legal implications of mobbing. A false accusation of psychological harassment at the workplace.

    PubMed

    Jarreta, Begoña Martínez; García-Campayo, Javier; Gascón, Santiago; Bolea, Miguel

    2004-12-02

    Mobbing, or psychological harassment at the workplace, is usually defined as a situation in which a person or a group of people engage in extreme psychological violence against another person. In Spain, the number of reports for mobbing has increased extraordinarily in the last years. The reports are increasing dramatically not only before the Labour Courts, but also before the Civil Courts, with claims for damages, and before the Penal Court for offences causing physical or moral injury, etc., since at the present time this figure is not typified as an offence in the Spanish Penal Code. The high degree of complexity of this situation has given rise to frequent misuse of the term and to a number of false accusations of mobbing. A recent European Parliament Resolution on harassment at the workplace addressed the devastating consequences of false accusations. In this paper we present a case in which the "false" victim was mentally ill (paranoia) but succeed in generating an extreme dangerous environment of great harassment against the "false" assailants that were "falsely" accused of mobbing. Forensic diagnosis of the psychiatric disorder suffered by the "false" victim was essential to clarify the issue at the Penal Court.

  15. A case of stillbirth: the importance of placental investigation in medico-legal practice.

    PubMed

    Marchetti, Daniela; Belviso, Maura; Fulcheri, Ezio

    2009-03-01

    The authors present a case of stillbirth in which histologic examination of the placenta provides the opportunity to make a definitive diagnosis of a death due to fetal thrombotic vasculopathy (FTV). Establishing the etiology in cases of stillbirth may avoid medical malpractice litigation. The better knowledge of the cause of stillbirths also helped obstetricians to recognize factors that could have prejudiced future pregnancies.

  16. Detectability and medico-legal value of the gunshot residues in the intracorporeal channel.

    PubMed

    Migliorini, Arnaldo Stanislao; Andreola, Salvatore; Battistini, Alessio; Gentile, Guendalina; Muccino, Enrico; Vancheri, Giulia; Zoja, Riccardo

    2015-11-01

    The application of the histochemical stain of sodium rhodizonate to the entrance wound for the detection of the lead (Pb) residues coming from the gunshot may be affected by false positive cases due to the contamination of the environmental Pb. The aim of the Authors is to histochemically search the Pb of GSR in a region which should be more protected by the contamination: the intracorporeal channel. Two hundreds and eighteen serial histological specimens of the intracorporeal channels coming from 25 subjects (dead due to gunshots and being autopsied at the Section of Legal Medicine of the Milan University, in the years 2013-2014) were stained with the sodium rhodizonate and sodium rhodizonate in acid environment (HCl 5%), and then observed by the microscope. The sodium rhodizonate showed a positivity for the Pb residues in the intracorporeal channel, with the detection of the particles within the first 2 cm beyond the entrance wound in 6 cases over the total number of 25 (24%). Victims were characterized by common features: short-barreled weapon; contact shots or short-distance shots; involvement of regions that were not covered by clothing; preservation of the microscopic structure of organs interested by the intracorporeal channel. The searching of GSR in the intracorporeal channel, even in conditions securing a high sensitivity, could represent an important test for the discrimination between an environmental contamination of Pb and the presence of Pb residues by GSR: once confirmed the presence of GSR in the intracorporeal channel by the histochemical analysis, the diagnostic process should require the application of the SEM-EDX for the confirmation of the results. Although not yet studied, this combination could be applied to cadavers exposed to the environment, with advanced post-mortal phenomena permitting at least the suspects of the existence of gunshot wounds at the macroscopic autopsy evaluation. Indeed, in some cases, the putrefaction is so advanced that no suspect of gunshot injuries could be derived from the soft tissue. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  17. [The issue of medico-legal assessment of noise induced hearing loss: comparison of methods].

    PubMed

    Bosio, D; Coggiola, M; Baracco, A; Andreis, P; Perrelli, F

    2011-01-01

    Audiogram classification is crucial for hearing protection of workers occupationally exposed to noise. The methods that have been proposed are based on two principles: the morphological evaluation of the audiometric curve (eg. Merluzzi-Pira-Bosio--MPB) or the average hearing loss on different frequencies (eg. Albera-Beatrice--AB). The purpose of this study was to classify audiograms compatible with chronic acoustic trauma performed at the Occupational Medicine Outpatient Clinic of CTO Hospital in Turin from 2004 to 2011 with the methods outlined in Guidelines published by SIMLII. A substantial agreement among the methods was observed. While MPB is the most appropriate method for secondary prevention, the AB would seem more appropriate for the verification of a permanent weakening that has to be reported to the competent legal authorities.

  18. Breakdowns in communication of radiological findings: an ethical and medico-legal conundrum

    PubMed Central

    Murphy, Daniel R.; Singh, Hardeep

    2016-01-01

    Communication problems in diagnostic testing have increased in both number and importance in recent years. The medical and legal impact of failure of communication is dramatic. Over the past decades, the courts have expanded and strengthened the duty imposed on radiologists to timely communicate radiologic abnormalities to referring physicians and perhaps the patients themselves in certain situations. The need to communicate these findings goes beyond strict legal requirements: there is a moral imperative as well. The Code of Medical Ethics of the American Medical Association points out that “Ethical values and legal principles are usually closely related, but ethical obligations typically exceed legal duties.” Thus, from the perspective of the law, radiologists are required to communicate important unexpected findings to referring physicians in a timely fashion, or alternatively to the patients themselves. From a moral perspective, radiologists should want to effect such communications. Practice standards, moral values, and ethical statements from professional medical societies call for full disclosure of medical errors to patients affected by them. Surveys of radiologists and non-radiologic physicians reveal that only few would divulge all aspects of the error to the patient. In order to encourage physicians to disclose errors to patients and assist in protecting them in some manner if malpractice litigation follows, more than 35 states have passed laws that do not allow a physician’s admission of an error and apologetic statements to be revealed in the courtroom. Whether such disclosure increases or decreases the likelihood of a medical malpractice lawsuit is unclear, but ethical and moral considerations enjoin physicians to disclose errors and offer apologies. PMID:27006891

  19. Medico-historical review of Nyagrŏdha (Ficus bengalensis Linn.).

    PubMed

    Varanasi, Subhose; Narayana, A

    2007-01-01

    Nyagrŏdha the Banyan tree (Ficus bengalensis Linn.) is a sacred medicinal plant since Vedic times. The English name Banyan is given by the Britishers to this tree because under the tree Banias i.e., the Hindu merchants used to assemble for business. The triad Ganges, the Himalayas and the Banyan tree are symbolise the images of India, hence it is considered as National Tree. Ficus means fig and bengalensis means belonging to or is of Bengal. To the most of Indians it is Sacred and symbolizes all three Gods of Hindus. The bark represents Lord Visnu, Brahma the roots and Siva the branches. Since Vedic times its small branches are used in Yajña (a sacrificial rite) and known for its giant structure. Alexander the Great is said to have camped under a banyan tree, which was big enough to shelter his whole army of 7,000 men. As per Vĕda it checks the environmental pollution and one of the source of Lăksă (Lac). Its medicinal importance is well documented in Ayurvĕda literature. However, more research needs for understanding the medicinal properties of this symbolic tree.

  20. [Medico legal considerations on prosthesis surgery of the erectile dysfunction in a La Peyronie disease case].

    PubMed

    Ricci, S; Massoni, F; Simeone, C; Letizia, P; Alei, G

    2013-04-01

    Peyronie's disease is characterized by the presence of an inelastic fibrous plaque of the penile tunica albuginea affecting 3-10% of the male population. The fibrous scar causes the curvature of the erect penis, which prevents the penetration. In the stabilization phase the plaque can cause a variable degree of erectile dysfunction (20-54%). In the treatment of the chronic disease, surgery is the gold standard and in case of concomitant erectile dysfunction the placement of a penile prosthesis is indicated. This surgery is loaded with an increase of the variables which can affect the outcome, such as individual clinical features and functionality of the device. The present case concerns a patient suffering from erectile dysfunction associated with Peyronie's disease who underwent surgery for implantation of hydraulic three-component penile prosthesis. After surgery a malfunction of the prosthesis was detected, which required unloading measures under sedation and a surgical revision of the scrotal pump. The latter was followed by the displacement of the prosthesis' cylinder and by a new surgical treatment for the reintegration of the prosthesis and the repair of the left corpus cavernosum. After two months a wrong positioning of the two cylinders inserted into the corpora cavernosa, with the left cranial extreme positioned 2 cm below the contralateral, was detected. In this case the failure of surgical treatment highlights a negligent behavior and the responsibility of the doctors by failing to examine adequately the variables, both clinical and not clinical, that might affect the outcome of the intervention.

  1. Los torturadores medicos: medical collusion with human rights abuses in Argentina, 1976-1983.

    PubMed

    Perechocky, Andrew

    2014-12-01

    Medical collaboration with authoritarian regimes historically has served to facilitate the use of torture as a tool of repression and to justify atrocities with the language of public health. Because scholarship on medicalized killing and biomedicalist rhetoric and ideology is heavily focused on Nazi Germany, this article seeks to expand the discourse to include other periods in which medicalized torture occurred, specifically in Argentina from 1976 to 1983, when the country was ruled by the Proceso de Reorganización Nacional military regime. The extent to which medical personnel embedded themselves within the Proceso regime's killing apparatus has escaped full recognition by both scholars and human rights activists. This article reconstructs the narrative of the Proceso's human rights abuses to argue that health professionals knowingly and often enthusiastically facilitated, oversaw, and participated in every phase of the "disappearance," torture, and mass murder process.

  2. [Medico-legal autopsy--selected legal issues: the autopsy protocol].

    PubMed

    Gaszczyk-Ozarowski, Zbigniew; Chowaniec, Czesław

    2010-01-01

    The majority of experts in the field of forensic medicine maintain that the minutes of the medicolegal autopsy should be taken by the forensic pathologist. The authors argue that it is the public prosecutor who is obliged to draw up the minutes, whereas the forensic pathologist issues the expert opinion. To support their stance, the authors make frequent references to several provisions of the Criminal Procedure Code of 1997. The authors also imply that due to organizational reasons and the ratio legis of the aforementioned code, the forensic pathologist should not be assigned the role of the minutes-taker, despite the lack of a specific exclusion rule governing such a case. Possible consequences caused by the lack of the properly drawn up minutes are briefly discussed as well.

  3. Legal update: a roadmap of the recent changes to the medico-legal landscape.

    PubMed

    Plotzker, S R

    2001-01-01

    This article provides an overview of recent changes to federal law that physicians should be aware of The Final Compliance Program Guidance for Individual and Small Group Practices, the HIPAA privacy regulations, and the Fraud and Abuse Safe Harbors are discussed specifically. Also addressed are miscellaneous tax changes and the lapse of the Advisory Opinions.

  4. [The vermillion border of the lips as the object of medico-criminalistics expertise].

    PubMed

    Zviagin, V N; Galitskaia, O I; Fomina, E E

    2013-01-01

    The objective of the present work was to study biometric characteristics of the vermillion border of the lips and estimate the possibility of their use for personality identification. Photographs of the lips obtained from the archive of the Department of Forensic Medical Personality Identification, Russian Centre of Forensic Medical Expertise, were analysed with the use of the specially developed ALips 2.0 software. Verification of the hypothesis of normal sign distribution allowed the values of the signs to be split into intervals. Category limits of each sign were calculated for both men and women, the categories were compared in the automatic regime with the help of the ALips 2.0 software. The diagnostic value of the described system is thus far rather low. A number of calculation procedures allowing to identify the object of interest were performed at the concluding stage of the study. The results of experiments suggest the high identification significance of the signs under consideration while the number of the objects similar to the one being identified does not exceed five which confirms that the groups are fairly well distinguished.

  5. [Legal and medico-legal assessment of medical errors in obstetrics].

    PubMed

    Jurek, Tomasz; Swiatek, Barbara; Rorat, Marta; Drozd, Radosław

    2011-01-01

    The authors review the doctrine of criminal law and the jurisdiction of the Supreme Court in search of a starting point for the legal protection of human life and health. In cases of medical errors in obstetrics concerning a fetus, an act of a perpetrator can be classified as manslaughter or exposure to direct danger of loss of life or great bodily injury depending on whether the fetus is recognized as "a human being". The authors criticize the doctrinal criteria of the beginning of legal protection: spatial, physiological, obstetric, and developmental, pointing to the possibilities of decriminalization of medical errors of omission. A solution to this situation is the presented evolution of the jurisdiction of the Supreme Court. It moves towards establishing the beginning of legal and criminal protection of life and health at the "moment of emergence of objective grounds to necessitate delivery".

  6. Donation of the body for scientific purposes in Italy: ethical and medico-legal considerations

    PubMed Central

    Bin, Paola; Delbon, Paola; Piras, Mauro; Di Lorenzo, Pierpaolo; Conti, Adelaide

    2016-01-01

    Abstract In recent years in Italy (and in the other European Countries) a new debated topic involves anatomists and the scientific world: donation of the body after death for scientific purposes. The aim of our analysis is to analyze the issue of voluntary body donation in Italy focusing first of all, on key principles of the disciplines of donation. Considering the rise of exhibitions and events in which death is spectacularized, the debate is focus on will, on respect and overall on the purpose for which the body is donated. Anatomical dissection is considered necessary in the direct learning of the human body, of surgical practices and new scientific techniques but the scarcity of programmes and regulations regarding the donation of bodies for study and research make it an uncommon practice. After discussing what are the constitutional principles underlying the issue we want to emphasize the need of a more effective and updated regulation to set limits and methods of a practice still essential for scientific progress. PMID:28352814

  7. Fetal laceration during caesarean section and its medico-legal sequelae.

    PubMed

    Esposito, Ciro; Escolino, Maria; Paternoster, Mariano; Buccelli, Claudio; Graziano, Vincenzo; Falco, Marianna; Alicchio, Francesca; Cerulo, Mariapina; Settimi, Alessandro; Savanelli, Antonio

    2015-04-01

    Fetal laceration is a recognized complication of caesarean delivery. The aim of this study was to investigate the incidence, type, location, risk factors and long-term consequences of accidental fetal incised wounds during caesarean delivery. During a five-year period, we observed 25 cases of fetal lacerations caused by the scalpel during hysterotomy. In 20 of these cases, we observed these lesions as consultants for the Neonatologic Care Unit; the other five cases came under our care after an insurance claim for damages against the gynaecologist. All the infants had a lesion located to the head. In only 5 of the 25 cases the lesion was reported in the operative summary, and only 16 of the 25 mothers had signed an informed consent before surgery. With regard to the 20 cases diagnosed at the Neonatologic Care Unit, the lesion was closed using single stitches in nine cases, and with biological glue in 11 cases. Concerning the five cases that underwent legal proceedings against the gynaecologist, a clinical examination was performed by an expert in Public Health and Social Security in collaboration with a paediatric surgeon to evaluate the degree of biological damage. In all five cases, the result of the legal challenge was monetary compensation for the physical and moral damage caused by the gynaecologists to the patients and their parents. Accidental fetal lesions may occur during caesarean delivery; the incidence is significantly higher during emergency caesarean delivery compared to elective procedures. Patients should sign an informed consent in which they should be informed about the risk of the occurrence of fetal lacerations during caesarean delivery in order to avoid legal complications. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  8. Intimate partner violence against women in Spain: A medico-legal and criminological study.

    PubMed

    Regueira-Diéguez, Antía; Pérez-Rivas, Natalia; Muñoz-Barús, José Ignacio; Vázquez-Portomeñe, Fernando; Rodríguez-Calvo, María Sol

    2015-08-01

    Intimate partner violence (IPV) is a significant worldwide problem whose magnitude and risk factors vary across different settings and cultures. Nowadays, it is a priority to improve the knowledge on this issue in order to formulate better evidence-based policy responses. This study aims to contribute to a better understanding of non-fatal IPV against women in Spain. A retrospective analysis of IPV cases with a final judicial decision was carried out. The period under study extended from January 2005 to December 2012, with a total of 582 files included in the investigation. Most IPV victims were young adult women of Spanish origin, either married or single, with children, unemployed and with a low family income level. The majority of alleged perpetrators were young adults, employed, with a middle-low income level, a history of alcohol consumption/abuse, but no criminal records. Most victims had previous history of IPV, were engaged in a long-term relationship with their abuser and lived with him at the time of assault. The combination of psychological and physical abuse was the most frequent form of violence. The most common mechanisms of assault consisted in minor acts of physical violence, which resulted in mild injuries, most of them in the upper limbs and face. Nearly half of women sought medical care, but physician's injury report was only made in about a quarter of these cases, even though it is mandatory for health professionals. The majority of criminal proceedings were initiated by the victim's report and ended in conviction, most of them being considered occasional mistreatment. This study confirms the heterogeneity of the phenomenon of intimate partner violence. The importance of adopting standard IPV concepts and promoting the recognition and assessment of this form of violence amongst health care professionals, criminal investigators and forensic personnel is emphasized.

  9. Paranormal experience in a medico-swimming rescue: a case study.

    PubMed

    Avramidis, Stathis

    2013-06-01

    This study looks at the case of a 20-year-old fisherman, who was speared in the head, the spear entering at his jaw and protruding from the top of his scull, while he was swimming unaccompanied; he was rescued, admitted to the intensive care unit for an operation, remained in a coma for a few days and then had a full recovery. About 10 days before the rescue, he had visited a monk who, intuited and functioning as channel of the divine spirit, had told him that he 'should not be afraid of anything', rubbing the top of his scull and his jaw exactly at the points through which the 40-inch spear passed. After the incident, the monk prescience again the exact day on which he would recover from the coma. It is concluded that the survival of the fisherman can be attributed to a paranormal event. The monk's prescience permit the assumption that a divine spirit was pervasive throughout the universe and present in this life-threatening situation, endeavouring to assist the lifeguard, the neurosurgeons and the young fisherman.

  10. Mycetoma caused by Madurella mycetomatis: a completely neglected medico-social dilemma.

    PubMed

    van Belkum, Alex; Fahal, Ahmed; van de Sande, Wendy W J

    2013-01-01

    Mycetoma is a debilitating disease with a highly particular geographical distribution. The mycetoma belt circles the entire world just above the equator and defines the region with the highest prevalence and incidence. Although the disease is seen in Central America, India and all across Africa, Sudan seems to be the homeland of mycetoma. Mycetoma is an infectious disease caused either by bacteria (actinomycetoma) or true fungi (eumycetoma). In Sudan most cases are caused by the fungal species Madurella mycetomatis. The precise natural habitat of this fungus is still an enigma, but its DNA can easily be found in soil and plant samples in endemic areas. Although the entire human population in these areas are in regular contact with the fungus, most individuals are unaffected. Thus mycetoma is an ideal clinical and experimental model system for the study of host-pathogen interactions. Also, given its relative importance locally, improvements in clinical and laboratory diagnostics and knowledge of the epidemiology of the disease are badly needed. This chapter describes the current state of affairs in the field of eumycetoma caused by M. mycetomatis. The value of laboratory research on this disease and future perspective for control and prevention of the infection are discussed.

  11. A study of homicidal deaths in medico-legal autopsies at UMMC, Kuala Lumpur.

    PubMed

    Kumar, Virendra; Li, Adeline Khaw Mae; Zanial, Ahmad Zaid; Lee, Ding Ai; Salleh, Syahrul Anuar

    2005-10-01

    The main aim of this study was to determine the causes and epidemiological aspects of homicidal deaths. Data were collected on 217 homicidal victims from the total number of 2762 autopsies performed in UMMC, Kuala Lumpur over a five-year period, from year 1999 to 2003. There were 194 male victims and 23 female victims. The largest number of victims (63.6%) were in the age group of 20-39 years. Indians comprised the maximum proportion of victims (28.1%). Approximately 71.9% of victims came from the semiskilled and unskilled group. A majority of victims were married (47%). Injuries caused by sharp weapons (41%) were the most common cause of death, followed by blunt trauma and firearm injuries.

  12. A Management Guide to Asbestos: Medico-Legal, Regulatory, and Hazard Abatement Considerations

    DTIC Science & Technology

    1986-08-01

    1935 between Sumner Simpson, then president of Raybestos-Manhattan, and Vandiver Brown, then general counsel of Johns - Manville , discussing how they...damage suits is skyrocketing. The nation’s largest asbestos producer, the Denver-based Manville Corporation (formerly Johns - Manville ), chose a unique...company that provided coverage at anytime in between? 2 0 In 1947, Johns - Manville signed the first of a series of policies It would hold with Travelers

  13. Whiplash-Associated Disorders : Clinical and medico-legal guidelines on the methods of ascertainment.

    PubMed

    Ferrara, S D; Ananian, V; Baccino, E; Banczerowski, P; Bordignon, D; Boscolo-Berto, R; Domenici, R; Gorriz Quevedo, J; Graw, M; Hell, W; Hernandez Cueto, C; Knudsen, P J T; Masiero, S; Montisci, M; Norelli, G A; Pinchi, V; Raudys, R; Raul, J S; Sterzik, V; Tessitore, E; Tuusov, J; Vanezis, P; Vermylen, Y; Vieira, D N; Viel, G; Viero, A; Villanueva, E; Zoia, R

    2016-01-01

    The manuscript presents the International Guidelines developed by the Working Group on Personal Injury and Damage under the patronage of the International Academy of Legal Medicine (IALM) regarding the Methods of Ascertainment of any suspected Whiplash-Associated Disorders (WAD).The document includes a detailed description of the logical and methodological steps of the ascertainment process as well as a synoptic diagram in the form of Flow Chart.

  14. Exorcising excision: medico-legal issues arising from male and female genital surgery in Australia.

    PubMed

    Mason, C

    2001-08-01

    Genital surgery is one of the most controversial and contested practices, yet it is frequently described and referred to with little or no attention to cultural and social context. This article examines the practice, performed on both men and women, and the extent to which it clashes with issues of consent and capacity, as well as multicultural concepts of toleration for minority group practices. It then questions why female genital surgery, unlike male genital surgery, is legally prohibited in Australia. It argues that such legal gender bias stems from a liberal conception of "tolerance" and the limits of consent in Australia, placing female genital surgery in an "unacceptable" category and male genital surgery in an "acceptable" category.

  15. Phenazepam: A review of medico-legal deaths in South Scotland between 2010 and 2014.

    PubMed

    Shearer, K; Bryce, C; Parsons, M; Torrance, H

    2015-09-01

    Phenazepam is a long acting benzodiazepine that is not prescribed in the United Kingdom. In Scotland it has been detected in a large number of post mortem cases, but very little data has been published looking at post mortem concentrations of this drug and indeed concentrations that may be associated with causing death. We looked at all post mortem cases between 2010 and 2014 where phenazepam was found in blood and correlated these with the given cause of death. The data collected shows the variability in reporting of phenazepam deaths and will provide a useful tool for those deciding when phenazepam should or should not be included as a cause of death. Cases discussed include drug related deaths with phenazepam as the sole cause of death (as is), drug related death when the cause of death was noted as being from a combination of phenazepam plus one or more other drugs (range <0.005-0.9mg/L, median 0.10mg/L) and causes of death in non-drug related deaths where phenazepam was detected (hangings range <0.05-0.39mg/L, median 0.09mg/L and deaths due to ischaemic heart disease range 0.05-0.1mg/L, median 0.04mg/L).

  16. Project MEDICO; Model Experiment in Drug Indexing by Computer. First Progress Report.

    ERIC Educational Resources Information Center

    Artandi, Susan; Baxendale, Stanley

    This report describes Phase 1 of a research project with the over-all objective of exploring the applicability of automatic methods in the indexing of drug information appearing in English natural language text. Two major phases of the research have been completed: (1) development of the automatic indexing method and its implementation on the test…

  17. Treatment of Liver Metastases From Colorectal Cancer: Medico-Surgical Strategies

    PubMed Central

    Essadi, Ismail; Sbitti, Yassir; Fetohi, Mohamed; Slimani, Khaoula Alaoui; Essadi, Meryam; Tazi, Elmehdi; Ichou, Mohamed; Errihani, Hassan

    2011-01-01

    Background The management of hepatic metastases from colorectal cancer can be understood only as part of a multidisciplinary strategy. Progress experienced by medical treatment, surgical techniques and ways of imaging, has improved the prognosis of patients with liver metastases of colorectal cancers. This work displays the experience of Medical Oncology unit at the Military training hospital in Rabat. Methods From January 2007 to December 2009, 60 patients with liver metastases from colorectal cancer, synchronous or metachronous were supported in the Medical Oncology unit at the Military training hospital in Rabat. Results Liver metastases were synchronous in 41 (68%) patients and metachronous in 19 (32%). Patients were classified into 3 categories according to their resectability: 14 (22%) were resectable at the outset, 28 (47%) were unresectable and 18 (31%) were considered uncertain resectability. Thirty-five patients (58%) received neoadjuvant chemotherapy before surgical gesture, 25 (42%) received chemotherapy after resection of primary tumor. This chemotherapy enabled the resection of liver metastases in 5 patients initially deemed uncertain resectability. The average objective responses to chemotherapy were in the range of 59% with 4 complete responses and one confirmed histologically. Twenty-three patients (38%) underwent surgery including 15 liver resections with R0 (25%). The median progression-free survival in this series was 15.5 months. Some minor side effects were noted, which have not entered the prognosis of patients. Conclusions Hepatic resection remains the only potentially curative treatment of liver metastases of colorectal cancers. Perioperative chemotherapy is a promising standard, which has improved the prognosis of patients historically associated with a poor prognosis. PMID:27942326

  18. Medico legal and epidemiological aspects of femicide in a judicial district of north eastern Italy.

    PubMed

    Moreschi, Carlo; Da Broi, Ugo; Zamai, Valentina; Palese, Francesca

    2016-04-01

    Femicide is the intentional killing of a woman because she is female, and often occurs when there are pre-existing relations, intimate or otherwise, between the victim and the murderer. A retrospective epidemiological study was made of 34 female homicides recorded in a university departmental register of post-mortems, pertaining to a judicial district of about 700,000 inhabitants in north eastern Italy, during a 21-year period from January 1st 1993 to December 31st 2013. The temporal trend, the socio-demographic characteristics of victims and perpetrators, the circumstances surrounding the crime and the risk factors for femicide were studied with the aim of identifying and developing preventive strategies.

  19. [Medico-economic impact of an innovative management of CHF by HF unit].

    PubMed

    Baudouin, C; Groshens, S; Gueneau, P; Rousseau, M; Saura, M; Hryschyschyn, N; Hillani, A; Dagorn, J; Pitthan, E; Jourdain, P

    2015-11-01

    Chronic heart failure remains a frequent, severe and costly disease. Despite encouraging data from different countries, heart failure clinics are scarce in France. We have analyzed the impact of a heart failure clinic (UTIC of Pontoise) in terms of reduction of rehospitalizations and in hospitalization costs in 4855 consecutive patients. In our study, heart failure clinic management dramatically reduces HF related hospitalizations (RRR: -28 %, P=0.001) and HF related costs (55% reduction, P<0.001) regardless of comorbidities or disease severity. HF clinics have to be developed in France in order to optimize management of CHF and reduce the HF related costs.

  20. Morphological changes in genesial system of men: medico-legal aspects.

    PubMed

    Dmitrieva, Olga Anatolievna

    2003-03-01

    With the purpose of perfection of examination the character of structural changes in testicles and prostate is investigated; the comparative qualitative and quantitative analysis of cellular reactions of persons with chronic somatopathies (rheumatic disease, idiopathic hypertensia) and chronic household intoxications (alcoholic illness, narcomania) is carried out. The work is carried out on 50 corpses of male persons, 18-35 years old, who died of chronic drunkenness (13 observations), narcomania (20), idiopathic hypertensia (9), and rheumatic disease (8). The suppression of testicles was characterized by disturbances of spermatogenesis at a level of the cell population, characteristic for a zero and first degree of spermatogenesis activity especially expressed in chronic narcotic intoxication. The damage to a prostate was stacked in a picture of a chronic relapsing prostatitis and chronic indurative prostatitis with the outcome of cirrhosis of prostata, being most typical for chronic alcohol intoxication. Morpho-functional investigation of a prostate and testicles affected by chronic somatopathies and chronic household intoxications, both qualitative and quantitative, testify to reduction of function of activity of these organs (hormonal imbalances, mail sterility, sex frustration). Thus, the persons suspected of violent actions of a sexual nature should be examined in order to reveal both erectile dysfunctions and disruption of spermatogenesis.

  1. Survey of medico-legal investigation of homicide in the region of Epirus (Northwest Greece).

    PubMed

    Fragkouli, Kleio; Boumba, Vassiliki; Vougiouklakis, Theodore

    2016-01-01

    This study analyzed the forensic features of homicides in North-West Greece (Epirus) from 1998 to 2013, a borderland area between Greece and Albania. Although Greece is critically influenced by both the increasing flow of refugees and the current socioeconomic crisis, very little information has been published regarding the patterns of homicide in the country. Fifty-eight autopsied victims (36 males; 22 females) were investigated. The median age was 37 years old. The average annual homicide rate was 0.85 per 100,000 inhabitants and showed remarkable fluctuation, with largest increase during Greek financial downturn. Sixteen victims were not Greek citizens. The most common method of commitment was the use of firearm (40%). The main motives were economical causes (26%) and passion (14%). Four cases were categorized as matricide (7%), 3 as homicide-suicide (5%), 2 as patricide (3%) and 1 as infanticide (2%). Toxicological analysis proved negative for ethanol and other psychotropic substances in the majority of the victims (50%). There is an urgent need for public actions both in Epirus and in Greece, with the application of effective strategies against criminality.

  2. [Crohn disease. Medico-surgical experience. A 10-year retrospective study].

    PubMed

    Pérez Torres, E; Sobrino Cossío, S; García Guerrero, V A; Abdo Francis, M; Murguía Domínguez, D; Bernal Sahagún, F

    1992-01-01

    Crohn's disease is rare in Mexico. The regarding of this pathology at Gastrointestinal Unit of the General Hospital of Mexico city, between january 1980 and december 1989, is presented. There were six cases of Crohn's disease, two women (33%) and four men (66%). The definitive diagnosis was done preoperatively only in one case, the other were diagnosed postoperatively. In all, intestinal obstruction was the surgical indication. A patient died (16.6%), three cases were followed for 12 months, only two patients are still under surveillance after 15 months.

  3. Readiness for legally literate medical practice? Student perceptions of their undergraduate medico-legal education.

    PubMed

    Preston-Shoot, Michael; McKimm, Judy; Kong, Wing May; Smith, Sue

    2011-10-01

    Medical councils increasingly require graduates to understand law and to practise medicine mindful of the legal rules. In the UK a revised curriculum for medical law and ethics has been published. However, coverage of law in medical education remains variable and doubts exist about how far students acquire legal knowledge and skills in its implementation. This survey of students in two UK medical schools measured their law learning and their confidence in using this knowledge. Concept maps and a self-audit questionnaire were used to capture students' understanding and perceptions of this knowledge domain and self-assessments of their legal knowledge and skills. A large sample was achieved across first, second and final year students. Students agree that a sound understanding of law is essential to being a good doctor. Their perceptions of law are generally positive but the interface between the legal rules and codes of medical ethics creates difficulty. In some areas students offer relatively confident self-assessments of their legal knowledge and skills for practising law. However, levels of confidence in other areas of their law learning raise doubts about the degree to which they can advocate for and protect their patients. Conclusions are drawn about the effectiveness of students' law learning and recommendations made for further research.

  4. [Li-Fraumeni syndrome: clinico-molecular diagnostics and medico-genetic counseling].

    PubMed

    Liubchenko, L N

    2011-01-01

    Li-Fraumeni syndrome (sarcoma family syndrome, OMIM 151623) is a rare clinically and genetically hetergoeneous autosomal dominant disorder characterized by the evolvement and accumulation of soft-tissue osteogenic sarcomas in members of a family, as well as uni- and bilateral breast cancer in young women, brain tumours, adrenocortical cancer, and lymphoproliferative diseases. Germinal mutations of the TP53 gene constitute the etiological genetic basis of Li-Fraumeni syndrome. American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network developed recommendations for genetic testing and observation of carriers of TP53 mutations. In vitro and in vivo studies demonstrated correlation between the TP53-mutant genotype and resistance to standard therapeutic modalities. This finding gave impetus to the development of new genotherapeutic approaches to the treatment of TP53-associated tumours in patients with Li-Fraumeni syndrome.

  5. Medico-Science and School Hygiene: A Contribution to a History of the Senses in Schooling

    ERIC Educational Resources Information Center

    Milewski, Patrice

    2014-01-01

    This article takes as its inspiration Ian Grosvenor's conjectural essay presented for the symposium "Historiography of the Future: Looking Back to the Future" held at the International Standing Conference for History of Education (ISCHE) 33 in July 2011 in San Luis Potosi, Mexico. It contributes to a sensory history of schooling by…

  6. Ethno- medico - botanical studies of Badaga population In the Nilgiri district of Tamilnadu, South India

    PubMed Central

    Manikandan, P. N. Arul

    2008-01-01

    The study grains to explore ethno-medicobotany of Badaga population in the Nilgiri hills of Tamilnadu, South India. Ethno botanical field survey and personal discussion methods have been adopted in the collection of data. A list of 71 flowering plants belonging to 42 families, 67 genera and 70 species are employed by the Badaga popu-lation in their native system of medicine for therapeutic purposes. In reviewing ethnomedical information, data on folk herbal remedies and their various methods of applications for treating a wide range of ailments have been furnished. A brief description of plants, their habitat, family and local Badaga names are outlined here. PMID:22557279

  7. Khat induced psychosis and its medico-legal implication: a case report.

    PubMed

    Alem, A; Shibre, T

    1997-04-01

    It has been established that khat plant leaves (Catha edulis forsk) contain an active psychostimulant substance known as Cathinone that is similar in structure and pharmacological activity to amphetamine. There have been no previously reported cases of khat induced psychosis in Ethiopia despite heavy consumption of khat in most parts of the country. We report here a case of brief and episodic psychosis attributed to heavy khat chewing. We maintain that khat leaf is a substance of abuse and that Khat chewing has the potential to complicate psychiatric conditions and forensic events.

  8. Medico-legal aspects of congenital heart diseases in buying and selling of pets

    PubMed Central

    Passantino, Annamaria; Pugliese, Michela; Quartarone, Valeria; Russo, Natalia; Bussadori, Roberto; Guercio, Bartolomeo

    2017-01-01

    Aim: The veterinarian should be able to assess congenital and inherited malformations such as heart defects because they may be object of legal disputes. In this study, the authors report some cases of congenital heart defects in pets (dogs and cats) to clarify whether or not they may be considered a redhibitory defect. Materials and Methods: A total of 28 medical records of pets referred with suspected congenital heart disease were examined. All patients aged between 3 and 24 months underwent clinical examination, chest X-ray examination, electrocardiogram, and echocardiography and angiocardiography when necessary. Results: Congenital heart diseases or associated cardiac malformations were confirmed. Considering the above congenital diseases as redhibitory defect and the rights of the owners from a strictly legal viewpoint, 9 owners demanded an estimatory action and 11 a redhibitory action; 1 owner decided to demand the reimbursement of veterinary expenses because the animal died; 7 owners took no legal action but requested surgical intervention. Conclusions: Until more appropriate and detailed legislation on the buying and selling of pet animals is put in place; the authors propose to include in the contract a temporal extension of the guarantee relating to congenital heart disease, which can often become evident later. PMID:28246457

  9. Paulus aegineta: review of spine-related chapters in "Epitomoe medicoe libri septem".

    PubMed

    Er, Uygur; Naderi, Sait

    2013-04-15

    Analysis of chapters related to spinal fractures and dislocations of an important medical book from medieval age. A historical study. To present the sections on spinal fractures and dislocations in the treatise of Paulus Aegineta or Paul of Aegina, and to discuss their relationship with preceding and subsequent literature. Paul of Aegina was influenced by precedent great authors and provided a significant link in the transmission of the surgical knowledge to present day via the prominent physicians of Islamic golden age. The edition on which this study is based was translated from Greek into English by Francis Adams and was published in 1846 by The Sydenham Society in London in 3 volumes. The related sections were examined and compared with the treatises of earlier and subsequent writers. Although Paul of Aegina was influenced by Hippocrates, Celsus, and Galen, he also put forward his own opinions. The most prominent representatives of the Islamic Golden Age, Rhazes, Albucasis, Avicenna, and Haly Abas were influenced by Paul of Aegina. Paul of Aegina, who was the last representative of the Byzantine School, compiled approximately 1000 years of medical knowledge up to his own era. By taking on this task, he provided a significant link in the transmission of ancient knowledge to later generations. He is also considered as a bridge between Western and Eastern medicines as he conveyed medical knowledge of the ancient era to Islamic authors.

  10. Use of sensorineural tests in a large volume of medico-legal compensation claims for HAVS.

    PubMed

    McGeoch, K L; Lawson, I J; Burke, F; Proud, G; Miles, J

    2004-12-01

    The Department of Trade and Industry set up a contract to examine miners and ex-miners claiming compensation for hand-arm vibration syndrome (HAVS). They had been exposed to hand-transmitted vibration. Over 100,000 have now been examined using sensorineural tests as part of that process. The purpose of this paper was to examine the internal consistency of the vibrotactile threshold test (VTT) and the thermal aesthesiometry test (TA). In 18 centres across the UK, nurses were trained to perform the measurement of VTT and TA in a controlled standardized manner. These tests were to aid the staging of the neurological component of the Stockholm Workshop Scales. The staging of this component was modified by dividing stage 2SN into 2SN (early) and 2SN (late). The test results and an automatic neurological staging were presented to the examining doctor following the clinical examination. The results of these sensorineural tests were held on a central database. The results and analysis of the first 57,000 tests are reported. The correlations within the VTT and TA scores were consistent with reliable measures. However, these correlations were not of such strength as to allow reliance on the results of a single test when making an assessment of the severity of neurological damage. Different end organs and nerve fibres should be tested when making an assessment of damage in the sensorineural component of HAVS. The correlations demonstrated for the VTT and TA suggest that they are of value in assessing these claimants and would be for other vibration exposed workers.

  11. Medico-legal analysis of legal complaints in bariatric surgery: a 15-year retrospective study.

    PubMed

    Tuchtan, Lucile; Kassir, Radwan; Sastre, Bernard; Gouillat, Christian; Piercecchi-Marti, Marie-Dominique; Bartoli, Christophe

    2016-05-01

    Bariatric surgery for severe obesity has become an effective and accepted treatment for sustained weight loss. The aim of our study was to analyze the complications and issues raised by the experts on which jury or judges' decisions were made for the different types of bariatric surgery. University Hospital, France. We have carried out a retrospective study of 59 expert review dossiers over a period of 15 years (1999-2014) on the different types of bariatric surgery (laparoscopic adjustable gastric band [LAGB], sleeve gastrectomy [SG], Roux-en-Y gastric bypass [RYGB], vertical banded gastroplasty [VBG], and gastric plication [GP]). Of the cases, 81% were women and the average age was 39 years old (range 19 to 68 years). Among the procedures giving rise to the complaints, 40% were for LAGB, 28% for RYGB, and 23% for SG. The most common initial complications were perforations (30%), fistulae (27%), bowel obstruction (14%), vascular injuries (9.5%), and infections (peritonitis, pleurisy, abscesses, and so forth) (8%). Revision surgery was required in 78% of patients, and perioperative complications accounted for 28.5% of dossiers. The experts concluded that fault had occurred in 40% of case. Negligence arising from an error deemed to be an act of negligence was found in 30% of cases, 67% of which were because of delayed diagnosis. Major long-term complications accounted for 8% of dossiers and minor long-term complications for 22%. Forty-seven percent of patients completely recovered. Delayed diagnosis was the main error established by the experts. Surgeons should remain vigilant postoperatively after every bariatric surgical procedure. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  12. [Resistant starches. Part II. Physico-chemical and technological aspects solution medico-biological problems].

    PubMed

    Iur'ev, V P; Gapparov, M M; Vasserman, L A; Genkina, N K

    2006-01-01

    This paper is a review of the recent literature data related to structure, composition and physico-chemical properties of starches as well as the special methods of processing of the starch containing raw sources producing the food products with increasing content of resistant starches. The prognosis is made about usefulness of such resistant starches for control of some metabolic disorder in human organism and for prophylactic aims.

  13. [Medico-social and administrative aspects of optimization of thoracoabdominal aortic aneurism surgical treatment].

    PubMed

    Belov, Iu V; Komarov, R N

    2008-01-01

    Improvement of diagnostics, availability and quality of surgical help for patients with thoracoabdominal aneurisms is necessary. Cardiosurgical hospitals should be supplied with modern equipment, new technologies should be wider introduced to practice. Establishing departments of aortic surgery with the concentration of patients in the single center together with the risin the level of surgical skills are crucial.

  14. MEDICO-BOTANY OF ANDAMAN AND NICOBAR ISLANDS – III AYURVEDIC DRUGS – I

    PubMed Central

    Nair, K.V.; Yoganarasimhan, S.N.; Murthy, K.R. Kesava; Shantha, T.R.

    1984-01-01

    Ayurveda is not exploited to the maximum extent in the islands. In order to provide a basic data for establishing Ayurvedic and allied pharmaceutical based industries, information of on fortyfour drugs available in the islands are provided in this first paper of the series PMID:22557452

  15. MEDICO – BOTANY OF ANDAMAN AND NICOBAR ISLANDS – IV (AYURVEDIC DRUGS – 2)

    PubMed Central

    Nair, K. Vasudevan; Gopakumar, K.; Yoganarasimhan, S. N.; Shantha, T. R.; Keshavamurthy, K. R.

    1986-01-01

    Details on 33 plants / drugs belonging to 30 genera and 22 families are provided in this paper; ayurvedic drug name, botanical sources in the island, short description of the species occurring in the islands, chemical constituents, ayurvedic preparations and therapeutic properties are elucidated. PMID:22557524

  16. HANNIBAL REVISITED: ANTISOCIAL PERSONALITY DISORDER VERSUS PSYCHOPATHY--MEDICO-LEGAL PERSPECTIVES FROM SOUTH AFRICA.

    PubMed

    Stevens, Philip

    2014-07-01

    Psychopathy and its relation to criminal behaviour has been the focus of clinical research for many years. Within the context of South African criminal law, the impact of psychopathy on criminal liability has been addressed in numerous decisions with varying outcomes all indicative of the reality that psychopathy will at most serve as a factor in mitigation of sentence, but will not exonerate an accused of criminal responsibility. In this contribution, the author reflects on the diagnostic entities of psychopathy and antisocial personality disorder against the backdrop of South African criminal law cases in terms of which either of these entities were raised in support of mitigation of sentence and/or as extenuating circumstances.

  17. [Medico-prophylactic foundations of the safety of information and communication technologies used in educational institutions].

    PubMed

    Baranov, A A; Kuchma, V R; Sukhareva, L M; Stepanova, M I; Teksheva, L M

    2011-01-01

    The problems pertaining to the safety of information and communication technologies used in the spheres of education and leisure activities of children and adolescents are discussed. The relevant risk factors are identified. Results of physiological and hygienic studies for substantiating regulations of continuous work with a personal computer are presented taking into account the children's age and hygienic requirements to electronic teaching aids.

  18. [Medico-economic assessment of two methods for implementing thyroid testing guidelines].

    PubMed

    Saillour-Glénisson, F; Michel, P; Daucourt, V

    2005-09-01

    To compare independent and combined effectiveness and cost-effectiveness of two implementation interventions of guidelines for ordering thyroid function tests. The two implementation interventions were a Memorandum Pocket Card (MPC) and a Test Request Form (TRF). Intervention groups were wards. The study used an experimental 2*2 factorial design with matching hospitals according to size and activity and wards according to pre-intervention appropriateness for test ordering. Four ward groups were established: the dual intervention group, the order form group, the pocket card group and the control group. Physicians in all groups received guidelines and were invited to a local information meeting. The main outcome measure of effectiveness was the Guideline Conformity Rate (GCR). The cost-effectiveness ratio was the cost difference between the tested intervention and the control intervention upon effectiveness difference between the tested intervention and the control intervention. Six hospitals participated in the study (two middle-sized hospitals, two small-sized hospitals and two psychiatric hospitals). A total of 1412 orders for thyroid function tests were collected. GCR was 78% in the dual intervention group, 83% in the order form group, 73% in the pocket card group and 62% in the control group. The interaction between TRF and MPC was not significant (B=-0.70, p=0.21). Compared to simple information, TRF was effective in increasing GCR (OR=2.65, 95% Confidence Interval [CI]: 1.52-4.62), unlike MPC (OR=1.28, CI: 0.75-2.19). TRF was the less expensive and the most effective intervention. Using a robust design, our study shows a greater effectiveness of TRF than MPC and their association in implementing thyroid function test guidelines. The development of clinical practice improvement projects through the second procedure of accreditation in France is a good opportunity to develop a guidelines implementation research project.

  19. [Medico-criminal examination of damages to clothes in flight accidents].

    PubMed

    Zviagin, V N; Alpatov, I M

    2005-01-01

    Examination of cloths is a permanent sphere in the practice of forensic-medical expert and an indispensable expertise stage providing for decision-making on the key issues set before the expert. Although, the examination of cloth in forensic-medical expertise has been productive, research in this field slowed down during the recent decades; definition of new sets of evident informative signs has been also suspended. The methodological potentialities of examination of cloths items were demonstrated by examples of aviation incidents because such incidents reflect the principle variations of impacts, i.e. blow, explosion, fire, compression and chemical factors etc., which are subject to examination in the forensic-medical practice. Identification of mechanism causing damage and other signs on cloths helps a lot the forensic-medical expert in solving quite a number of issues related with circumstances of an incident and with a nature of an impact encountered by a person.

  20. Medico-Science and School Hygiene: A Contribution to a History of the Senses in Schooling

    ERIC Educational Resources Information Center

    Milewski, Patrice

    2014-01-01

    This article takes as its inspiration Ian Grosvenor's conjectural essay presented for the symposium "Historiography of the Future: Looking Back to the Future" held at the International Standing Conference for History of Education (ISCHE) 33 in July 2011 in San Luis Potosi, Mexico. It contributes to a sensory history of schooling by…

  1. Pharmacodynamics of vancomycin for CoNS infection: experimental basis for optimal use of vancomycin in neonates.

    PubMed

    Ramos-Martín, V; Johnson, A; Livermore, J; McEntee, L; Goodwin, J; Whalley, S; Docobo-Pérez, F; Felton, T W; Zhao, W; Jacqz-Aigrain, E; Sharland, M; Turner, M A; Hope, W W

    2016-04-01

    CoNS are the most common cause of neonatal late-onset sepsis. Information on the vancomycin pharmacokinetics/pharmacodynamics against CoNS is limited. The aim of this study was to characterize vancomycin pharmacokinetic/pharmacodynamic relationships for CoNS and investigate neonatal optimal dosage regimens. A hollow fibre and a novel rabbit model of neonatal central line-associated bloodstream CoNS infections were developed. The results were then bridged to neonates by use of population pharmacokinetic techniques and Monte Carlo simulations. There was a dose-dependent reduction in the total bacterial population and C-reactive protein levels. The AUC/MIC and Cmax/MIC ratios were strongly linked with total and mutant resistant cell kill. Maximal amplification of resistance was observed in vitro at an fAUC/MIC of 200 mg · h/L. Simulations predicted that neonates <29 weeks post-menstrual age are underdosed with standard regimens with respect to older age groups. The AUC/MIC and Cmax/MIC ratios are the pharmacodynamic indices that best explain total and resistant cell kill in CoNS infection. This suggests that less-fractionated regimens are appropriate for clinical use and continuous infusions may be associated with increased risk of emergence of antimicrobial resistance. This study has provided the pharmacodynamic evidence to inform an optimized neonatal dosage regimen to take into a randomized controlled trial. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Prevalencia y tamizaje del Trastorno por Déficit de Atención con Hiperactividad en Costa Rica

    PubMed Central

    Weiss, Nicholas T.; Schuler, Jovita; Monge, Silvia; McGough, James J.; Chavira, Denise; Bagnarello, Monica; Herrera, Luis Diego; Mathews, Carol A.

    2015-01-01

    Resumen La investigación tuvo como propósito estimar la prevalencia del Trastorno por Déficit de Atención con Hiperactividad (TDAH) en Costa Rica y determinar si la versión en español del cuestionario Swanson Nolan and Pelham Scale IV (SNAP-IV) es un instrumento de tamizaje útil en una población de niños y niñas escolares costarricenses. El instrumento fue entregado a padres y maestros de 425 niños entre 5 y 13 años de edad (promedio = 8.8). Todos fueron evaluados con el instrumento Swanson, Kotkin, Agler, M-Flynn and Pelham Scale (SKAMP). Su diagnóstico fue confirmado con una entrevista clínica. La sensibilidad y la especificidad del SNAP-IV fueron evaluadas como predictores de criterios de diagnóstico según el DSM-IV. La prevalencia puntual en la muestra del TDAH fue del 5%. El tamizaje más preciso lo hizo el SNAP-IV completado por el maestro en un corte de 20%, con una sensibilidad de 96% y una especificidad de un 82%. La sensibilidad de los instrumentos completados por los padres fue más baja que aquella de los maestros. El SNAP-IV completado por las maestras con un corte aislando el 20% de los mayores puntajes categorizó correctamente a un 87% de los sujetos. PMID:22432094

  3. Synthesis of colloidal metal nanocrystals in droplet reactors: the pros and cons of interfacial adsorption.

    PubMed

    Zhang, Lei; Wang, Yi; Tong, Limin; Xia, Younan

    2014-07-09

    Droplet reactors have received considerable attention in recent years as an alternative route to the synthesis and potentially high-volume production of colloidal metal nanocrystals. Interfacial adsorption will immediately become an important issue to address when one seeks to translate a nanocrystal synthesis from batch reactors to droplet reactors due to the involvement of higher surface-to-volume ratios for the droplets and the fact that nanocrystals tend to be concentrated at the water-oil interface. Here we report a systematic study to compare the pros and cons of interfacial adsorption of metal nanocrystals during their synthesis in droplet reactors. On the one hand, interfacial adsorption can be used to generate nanocrystals with asymmetric shapes or structures, including one-sixth-truncated Ag octahedra and Au-Ag nanocups. On the other hand, interfacial adsorption has to be mitigated to obtain nanocrystals with uniform sizes and controlled shapes. We confirmed that Triton X-100, a nonionic surfactant, could effectively alleviate interfacial adsorption while imposing no impact on the capping agent typically needed for a shape-controlled synthesis. With the introduction of a proper surfactant, droplet reactors offer an attractive platform for the continuous production of colloidal metal nanocrystals.

  4. Thromboprophylaxis in carriers of antiphospholipid antibodies (APL) without previous thrombosis: "Pros" and "Cons".

    PubMed

    Ceccarelli, Fulvia; Chighizola, Cecilia; Finazzi, Guido; Meroni, Pier Luigi; Valesini, Guido

    2012-06-01

    The presence of anti-phospholipid (aPL) is necessary but not sufficient to induce a thrombotic event. The "second hit" hypothesis suggested that an additional trigger may be needed to develop a vascular event in aPL carriers. In this article, pro and con of primary thromboprophylaxis in aPL carriers is deeply discussed, concluding that univocal data are not available, due to conflicting results of available clinical trials. However, in clinical practice the primary thromboprophylaxis is not indicated in all unselected asymptomatic aPL carriers, and the best strategy begin with the assessment of the peculiar risk profile of the subject. Thus, it is mandatory to eliminate modifiable prothrombotic risk factors (i.e. smoking, oral contraceptive), to treat the irreversible risk factors (i.e. hypertension, diabetes) and to introduce an aggressive prophylaxis with subcutaneous LMWH in high-risk situations (i.e. surgical procedures with prolonged immobilization). A different evaluation should be addressed to aPL carriers with a concomitant autoimmune disease that are considered as an additional pro-thrombotic risk factor. Similarly, concomitant positivity for more than one anti-phospholipid test confer a stronger risk of developing the thrombotic manifestations. Specific trials with larger cohorts of patients are needed to better clarify this issue.

  5. Carbon dioxide rebreathing with the anaesthetic conserving device, AnaConDa®.

    PubMed

    Sturesson, L W; Malmkvist, G; Bodelsson, M; Niklason, L; Jonson, B

    2012-08-01

    The anaesthetic conserving device (ACD) AnaConDa(®) was developed to allow the reduced use of inhaled agents by conserving exhaled agent and allowing rebreathing. Elevated has been observed in patients when using this ACD, despite tidal volume compensation for the larger apparatus dead space. The aim of the present study was to determine whether CO(2), like inhaled anaesthetics, adsorbs to the ACD during expiration and returns to a test lung during the following inspiration. The ACD was attached to an experimental test lung. Apparent dead space by the single-breath test for CO(2) and the amount of CO(2) adsorbed to the carbon filter of the ACD was measured with infrared spectrometry. Apparent dead space was 230 ml larger using the ACD compared with a conventional heat and moisture exchanger (internal volumes 100 and 50 ml, respectively). Varying CO(2) flux to the test lung (85-375 ml min(-1)) did not change the measured dead space nor did varying respiratory rate (12-24 bpm). The ACD contained 3.3 times more CO(2) than the predicted amount present in its internal volume of 100 ml. Our measurements show a CO(2) reservoir effect of 180 ml in excess of the ACD internal volume. This is due to adsorption of CO(2) in the ACD during expiration and return of CO(2) during the following inspiration.

  6. Assessing ComSciCon 2013: A science communication workshop for STEM graduate students (Invited)

    NASA Astrophysics Data System (ADS)

    Kohler, S.; Ranjan, S.; Sanders, N.; Morey, S.

    2013-12-01

    We report on the efficacy of Communicating Science 2013, a science communication workshop for graduate students. Effective science communication is imperative for the sharing of scientific ideas, continued funding and support from policy makers, and education of the public. Science graduate students are a prime group to target for communication training, as they will be our future scientists, educators, and EPO professionals. To this end, Communicating Science 2013 (ComSciCon), a workshop organized by and for STEM graduate students, was held in June of this year. This workshop taught graduate students from around the nation to effectively communicate science to both their peers and the public. To learn about grad students' attitudes toward science communication and establish the workshop's efficacy, we surveyed the participants both before and after the workshop. This assessment probed topics such as communication preparation the participants have already received, how science communication is perceived in their home department, and what participants gained from the workshop. We report the results here.

  7. Pros and cons of BCG vaccination in countries with low incidence of tuberculosis.

    PubMed

    Tala, E O; Tala-Heikkilä, M M

    1994-07-01

    Preventive bacille Calmette-Guérin (BCG) vaccination, together with case finding and effective chemotherapy, has formed an integral part of the tuberculosis (TB) control program in most countries. In some low-incidence countries the balance of prevention has been more on the side of chemoprophylaxis than of BCG vaccination. The time clearly has come when the strategy of mass BCG vaccination no longer is indicated medically, nor is it cost-effective. The pros and cons of the programs need to be critically evaluated against the present epidemiological background, taking into account the facts that TB, the killer disease, is recovering strength, human immunodeficiency virus infection is on the increase, and multidrug-resistant TB has changed the outcome of this previously fully curable disease. Although no longer appropriate for mass programs, BCG vaccination still should be considered for the protection of selected risk groups in low-incidence countries. The overall efficacy may be of the order 50% to 80%, but the variation is great. Therefore, further research urgently is needed on the effectiveness of BCG as an intervention in local TB programs.

  8. Leveling data in geochemical mapping: scope of application, pros and cons of existing methods

    NASA Astrophysics Data System (ADS)

    Pereira, Benoît; Vandeuren, Aubry; Sonnet, Philippe

    2017-04-01

    Geochemical mapping successfully met a range of needs from mineral exploration to environmental management. In Europe and around the world numerous geochemical datasets already exist. These datasets may originate from geochemical mapping projects or from the collection of sample analyses requested by environmental protection regulatory bodies. Combining datasets can be highly beneficial for establishing geochemical maps with increased resolution and/or coverage area. However this practice requires assessing the equivalence between datasets and, if needed, applying data leveling to remove possible biases between datasets. In the literature, several procedures for assessing dataset equivalence and leveling data are proposed. Daneshfar & Cameron (1998) proposed a method for the leveling of two adjacent datasets while Pereira et al. (2016) proposed two methods for the leveling of datasets that contain records located within the same geographical area. Each discussed method requires its own set of assumptions (underlying populations of data, spatial distribution of data, etc.). Here we propose to discuss the scope of application, pros, cons and practical recommendations for each method. This work is illustrated with several case studies in Wallonia (Southern Belgium) and in Europe involving trace element geochemical datasets. References: Daneshfar, B. & Cameron, E. (1998), Leveling geochemical data between map sheets, Journal of Geochemical Exploration 63(3), 189-201. Pereira, B.; Vandeuren, A.; Govaerts, B. B. & Sonnet, P. (2016), Assessing dataset equivalence and leveling data in geochemical mapping, Journal of Geochemical Exploration 168, 36-48.

  9. Evaluation of the Arthritis Foundation's Camine Con Gusto Program for Hispanic Adults With Arthritis.

    PubMed

    Callahan, Leigh F; Rivadeneira, Alfredo; Altpeter, Mary; Vilen, Leigha; Cleveland, Rebecca J; Sepulveda, Victoria E; Hackney, Betsy; Reuland, Daniel S; Rojas, Claudia

    2016-09-01

    Camine Con Gusto (CCG) is the Hispanic version of an evidence-based walking program for people with arthritis. This study examined CCG outcomes, feasibility, tolerability, safety, and acceptability and potential tailoring. A pre and post 6-week evaluation was conducted in Hispanic people with arthritis. Outcomes included pain, stiffness, fatigue, functional capacity, helplessness, and self-efficacy. A formative evaluation with program participants and key stakeholders explored program tailoring. Participants' mean age was 46.9 years, 44.4% had a high school degree or less, 2.5% were born in United States, 60.1% spoke only Spanish, and 74.7% were female. Moderate effect sizes were found: 0.50 for pain, 0.75 for fatigue, 0.49 for stiffness, 0.33 for function, 0.26 for helplessness, and 0.24 for self-efficacy. There were 285 participants recruited with an 82% 6-week retention (feasibility), no adverse events were reported (safety), and 98% reported program satisfaction (acceptability). Recommended adaptations included simpler language, more pictures and content addressing nutrition and chronic conditions, shortened materials, and inclusion of motivational strategies. CCG showed improvement in outcomes in Hispanic individuals comparable to those noted in non-Hispanic White and Black individuals with arthritis. © The Author(s) 2016.

  10. Nonalcoholic Fatty Liver Disease: Pros and Cons of Histologic Systems of Evaluation.

    PubMed

    Brunt, Elizabeth M

    2016-01-13

    The diagnostic phenotype of nonalcoholic fatty liver disease (NAFLD)--in particular, the most significant form in terms of prognosis, nonalcoholic steatohepatitis (NASH)--continues to rely on liver tissue evaluation, in spite of remarkable advances in non-invasive algorithms developed from serum-based tests and imaging-based or sonographically-based tests for fibrosis or liver stiffness. The most common tissue evaluation remains percutaneous liver biopsy; considerations given to the needle size and the location of the biopsy have the potential to yield the most representative tissue for evaluation. The pathologist's efforts are directed to not only global diagnosis, but also assessment of severity of injury. Just as in other forms of chronic liver disease, these assessments can be divided into necroinflammatory activity, and fibrosis with parenchymal remodeling, in order to separately analyze potentially reversible (grade) and non-reversible (stage) lesions. These concepts formed the bases for current methods of evaluating the lesions that collectively comprise the phenotypic spectra of NAFLD. Four extant methods have specific applications; there are pros and cons to each, and this forms the basis of the review.

  11. Pros and cons in endocrine practice: pre-surgical treatment with somatostatin analogues in acromegaly.

    PubMed

    Losa, Marco; Bollerslev, Jens

    2016-06-01

    The aim of this commentary is to balance the pros and cons for pre-surgical SSA treatment in a modern perspective ending up with a pragmatic recommendation for treatment based on the current evidence and expertise of the authors. Even though prospective and randomized studies in this particular area are hampered by obvious limitations, the interpretation of the four published trials has in general been in favor of pre-treatment with SSA, showing a better outcome following surgery. However, major drawbacks of these studies, such as non-optimal diagnostic criteria for cure, potential selection bias, and timing of the postoperative evaluation in SSA pre-treated patients, limit their overall interpretation. Three matched-controlled studies showed remarkably similar results with no apparent beneficial effect of SSA pre-treatment on surgical outcome. Both prospective, randomized studies and retrospective studies did not find any significant difference in the rate of endocrine and non-endocrine complications related to surgery, despite the beneficial clinical effects of SSA treatment in most acromegalic patients. The newly diagnosed patient with acromegaly should be carefully evaluated in the trans-disciplinary neuroendocrine team and treatment individualized accordingly. The issue of SSA pre-treatment to improve surgical outcome is yet to be settled and further methodologically sound studies are probably necessary to clarify this point.

  12. Arab-American Hookah Smokers: Initiation, and Pros and Cons of Hookah Use.

    PubMed

    Kassem, Nada O F; Kassem, Noura O; Jackson, Sheila R; Daffa, Reem M; Liles, Sandy; Hovell, Melbourne F

    2015-09-01

    To examine initiation, pros and cons of hookah tobacco smoking among Arab Americans. In this descriptive cross-sectional study, we recruited a community-based convenience sample of 458 adult Arab-American hookah smokers, mean age 28.4 years, who completed self-administered questionnaires. Irrespective of sex, most participants initiated hookah tobacco use by young adulthood in private homes or hookah lounges influenced by friends and family. Women initiated hookah use later than men. Ever dual smokers (hookah smokers who ever smoked a cigarette) initiated hookah use later than cigarettes; however, early hookah initiators < 18 years initiated hookah and cigarettes concurrently. Participants enjoyed the flavors of hookah tobacco, and complained about coughing, dizziness, and headaches. Early and late initiation of hookah tobacco use warrant prevention programs targeting the youth and older adults in communities, colleges, and middle and high schools that include health education campaigns, and encouragement of voluntary smokefree home rules. Tobacco control policies aimed to prevent initiation of hookah use should include regulation of hookah tobacco flavors, and should target the physical environments in neighborhoods, especially around schools and colleges, to reduce the proliferation of hookah lounges. Dual hookah tobacco and cigarette use warrant continuous monitoring.

  13. Pros and cons of condom use among gay and bisexual men as explored via the Internet.

    PubMed

    Gullette, Donna L; Turner, Joan G

    2003-01-01

    The purpose of this study was to conduct a survey utilizing Internet technology related to gay and bisexual men's condom use behavior as an expression of safer sexual practices. A total of 241 self-identified gay and bisexual men responded to the questionnaire in a 3-month period of time. Confidentiality was assured by utilizing an electronic system whereby the respondents e-mail address was eliminated. The study was conceptually guided by the use of the Transtheoretical Model of Behavioral Change (TMC) and the pros and cons of condom of use were explored. Fifty-six percent of the participants reported that one advantage (pro) of using condoms with casual partners was that it would make them safer from disease. About half of the respondents (n = 119, 49%) reported a history of one or more sexually transmitted diseases. There were 14 variables found to be significantly associated with using a condom with primary and casual partners among gay and bisexual men. Essentially, findings from this study corresponded to results obtained by more traditional data collection methods. Therefore, the authors conclude that electronic data collection may well be an alternative means for collecting sensitive data such as those collected in this study.

  14. Pros and cons of the liposome platform in cancer drug targeting.

    PubMed

    Gabizon, Alberto A; Shmeeda, Hilary; Zalipsky, Samuel

    2006-01-01

    Coating of liposomes with polyethylene-glycol (PEG) by incorporation in the liposome bilayer of PEG-derivatized lipids results in inhibition of liposome uptake by the reticulo-endothelial system and significant prolongation of liposome residence time in the blood stream. Parallel developments in drug loading technology have improved the efficiency and stability of drug entrapment in liposomes, particularly with regard to cationic amphiphiles such as anthracyclines. An example of this new generation of liposomes is a formulation of pegylated liposomal doxorubicin known as Doxil or Caelyx, whose clinical pharmacokinetic profile is characterized by slow plasma clearance and small volume of distribution. A hallmark of these long-circulating liposomal drug carriers is their enhanced accumulation in tumors. The mechanism underlying this passive targeting effect is the phenomenon known as enhanced permeability and retention (EPR) which has been described in a broad variety of experimental tumor types. Further to the passive targeting effect, the liposome drug delivery platform offers the possibility of grafting tumor-specific ligands on the liposome membrane for active targeting to tumor cells, and potentially intracellular drug delivery. The pros and cons of the liposome platform in cancer targeting are discussed vis-à-vis nontargeted drugs, using as an example a liposome drug delivery system targeted to the folate receptor.

  15. CON4EI: Evaluation of QSAR models for hazard identification and labelling of eye irritating chemicals.

    PubMed

    Geerts, L; Adriaens, E; Alépée, N; Guest, R; Willoughby, J A; Kandarova, H; Drzewiecka, A; Fochtman, P; Verstraelen, S; Van Rompay, A R

    2017-09-20

    Assessment of ocular irritation is a regulatory requirement in safety evaluation of industrial and consumer products. Although a number of in vitro ocular irritation assays exist, none are capable of fully categorizing chemicals as stand-alone assays. Therefore, the CEFIC-LRI-AIMT6-VITO CON4EI (CONsortium for in vitro Eye Irritation testing strategy) project was developed to assess the reliability of eight in vitro test methods and computational models as well as establishing an optimal tiered-testing strategy. For three computational models (Toxtree, and Case Ultra EYE_DRAIZE and EYE_IRR) performance parameters were calculated. Coverage ranged from 15 to 58%. Coverage was 2 to 3.4 times higher for liquids than for solids. The lowest number of false positives (5%) was reached with EYE_IRR; this model however also gave a high number of false negatives (46%). The lowest number of false negatives (25%) was seen with Toxtree; for liquids Toxtree predicted the lowest number of false negatives (11%), for solids EYE_DRAIZE did ((78%).It can be concluded that the training sets should be enlarged with high quality data. The tested models are not yet sufficiently powerful for stand-alone evaluations, but that they can surely become of value in an integrated weight-of-evidence approach in hazard assessment. Copyright © 2017. Published by Elsevier Ltd.

  16. Structural and magnetic properties of N doped Fe_mCon superlattices: First principles calculations.

    NASA Astrophysics Data System (ADS)

    Kim, Miyoung; Freeman, A. J.

    2001-03-01

    Magnetic alloys and multilayers have been widely investigated because of their potential for magnetic device applications. In this, materials exhibiting high magnetization as well as good soft magnetic properties are desirable. We investigated the magnetic and structural properties of Fe_mCon superlattices with various compositions via first principles local density full potential linearized augmented plane wave (FLAPW) method^(1) calculations. For the 25% Co composition which showed the maximum magnetic moments, we inserted N atoms to make (Fe_3Co)_4N_2, in order to examine the possible magnetic enhancement by N, which has drawn much attention since the first report (in 1972) of a giant magnetic moment for the quasi-stable α-Fe_16N_2. The structural optimization was fully accomplished by total energy and atomic force calculations. Despite the lattice expansion due to the N insertion, the magnetic moment of (Fe_3Co)_4N2 was found to be reduced from the value of the Fe_3Co superlattice by the strong hybridization of N with Fe and Co. (1) E. Wimmer, H. Krakauer, M. Weinert and A. J. Freeman, Phys. Rev. B 24, 864 (1981).

  17. A new millimeter-wave observation of the weakly bound CO-N2 complex

    NASA Astrophysics Data System (ADS)

    Surin, L. A.; Potapov, A.; Müller, H. S. P.; Schlemmer, S.

    2015-01-01

    New millimeter-wave transitions of the CO-N2 van der Waals complex have been observed using the intracavity OROTRON jet spectrometer in the frequency range of 103-159 GHz. For the less abundant form, CO-paraN2, a total of 37 rotational transitions were assigned to three K = 0-0, 0-1, 2-1 subbands connecting the (jCO, jN2) = (1, 1) and (jCO, jN2) = (0, 1) internal rotor states. The upper K = 0 and K = 2 "stacks" of rotational levels were probed for the first time here by millimeter-wave spectroscopy following a recent infrared study by Rezaei et al. (2013). The observation of new subbands fixes with higher precision not only these upper K = 0 and K = 2 but also lower K = 1(f) levels, not linked with other stacks in earlier rotational studies. For the more abundant form, CO-orthoN2, five new P-branch rotational transitions of the K = 0-0 "CO bending" subband are reported, thus extending previous measurements. Nuclear quadrupole hyperfine structure due to the presence of two equivalent 14N nuclei was partly resolved and analyzed to give additional information about the angular orientation of the N2 molecule in the complex.

  18. Ground and lowest-lying electronic states of CoN. A multiconfigurational study.

    PubMed

    Gobbo, João Paulo; Borin, Antonio Carlos

    2006-12-28

    The lowest-lying X1Sigma+, a3Phi, b3II, c5Delta, A1Phi, and B1II electronic states of CoN have been investigated at the ab initio MRCI and MS-CASPT2 levels, with extended atomic basis sets and inclusion of scalar relativistic effects. Among the singlet states, the A1Phi and B1II states have been described for the first time. Potential energy curves, excitation energies, spectroscopic constants, and bonding character for all states are reported. Comparison with other early transition-metal nitrides (ScN, TiN, VN, and CrN), isoelectronic (NiC) and isovalent (RhN and IrN) species has been made, besides analyzing the B1II <=> X1+ electronic transition in terms of Franck-Condon factors, Einstein coefficients, and radiative lifetimes. At both levels of theory, the following energetic order has been obtained: X1Sigma+, a3Phi, b3II, c5Delta, A1Phi, and B1II, with good agreement with experimental results. In contrast, previous DFT and MRCI calculations predicted the ground state to be the 5Delta state.

  19. Autophagic Mechanism in Anti-Cancer Immunity: Its Pros and Cons for Cancer Therapy

    PubMed Central

    Li, Ying-Ying; Feun, Lynn G.; Thongkum, Angkana; Tu, Chiao-Hui; Chen, Shu-Mei; Wangpaichitr, Medhi; Wu, Chunjing; Kuo, Macus T.; Savaraj, Niramol

    2017-01-01

    Autophagy, a self-eating machinery, has been reported as an adaptive response to maintain metabolic homeostasis when cancer cells encounter stress. It has been appreciated that autophagy acts as a double-edge sword to decide the fate of cancer cells upon stress factors, molecular subtypes, and microenvironmental conditions. Currently, the majority of evidence support that autophagy in cancer cells is a vital mechanism bringing on resistance to current and prospective treatments, yet whether autophagy affects the anticancer immune response remains unclear and controversial. Accumulated studies have demonstrated that triggering autophagy is able to facilitate anticancer immunity due to an increase in immunogenicity, whereas other studies suggested that autophagy is likely to disarm anticancer immunity mediated by cytotoxic T cells and nature killer (NK) cells. Hence, this contradiction needs to be elucidated. In this review, we discuss the role of autophagy in cancer cells per se and in cancer microenvironment as well as its dual regulatory roles in immune surveillance through modulating presentation of tumor antigens, development of immune cells, and expression of immune checkpoints. We further focus on emerging roles of autophagy induced by current treatments and its impact on anticancer immune response, and illustrate the pros and cons of utilizing autophagy in cancer immunotherapy based on preclinical references. PMID:28629173

  20. Pro/Con debate: Is occupational asthma induced by isocyanates an immunoglobulin E-mediated disease?

    PubMed

    Wisnewski, A V; Jones, M

    2010-08-01

    Isocyanates, low-molecular weight chemicals essential to polyurethane production, are one of the most common causes of occupational asthma, yet the mechanisms by which exposure leads to disease remain unclear. While isocyanate asthma closely mirrors other Type I Immune Hypersensitivity (Allergic) disorders, one important characteristic of hypersensitivity ('allergen'-specific IgE) is reportedly absent in a large portion of affected individuals. This variation from common environmental asthma (which typically is induced by high-molecular weight allergens) is important for two reasons. (1) Allergen-specific IgE is an important mediator of many of the symptoms of bronchial hyper-reactivity in 'allergic asthma'. Lack of allergen-specific IgE in isocyanate hypersensitive individuals suggests differences in pathogenic mechanisms, with potentially unique targets for prevention and therapy. (2) Allergen-specific IgE forms the basis of the most commonly used diagnostic tests for hypersensitivity (skin prick and RAST). Without allergen-specific IgE, isocyanates may go unrecognized as the cause of asthma. In hypersensitive individuals, chronic exposure can lead to bronchial hyperreactivity that persists years after exposure ceases. Thus, the question of whether or not isocyanate asthma is an IgE-mediated disease, has important implications for disease screening/surveillance, diagnosis, treatment and prevention. The present Pro/Con Debate, addresses contemporary, controversial issues regarding IgE in isocyanate asthma.

  1. Angio-OCT de la zona avascular foveal en ojos con oclusión venosa de la retina.

    PubMed

    Wons, Juliana; Pfau, Maximilian; Wirth, Magdalena A; Freiberg, Florentina J; Becker, Matthias D; Michels, Stephan

    2017-07-11

    Objetivo: El objetivo del estudio comprendía visualizar y cuantificar las alteraciones patológicas de la zona avascular foveal (ZAF) mediante angio-OCT en ojos con oclusión venosa de la retina (OVR) en comparación con el ojo contralateral sano. Procedimientos: La angio-OCT se llevó a cabo mediante el sistema Avanti® RTVue 100 XR (Optovue Inc., Fremont, Calif., EE. UU.). Los bordes de la capa vascular superficial (CVS) se definieron como 3 μm por debajo de la membrana limitante interna y 15 μm por debajo de la capa plexiforme interna y, para la capa vascular profunda (CVP), como 15 y 70 μm por debajo de la membrana limitante interna y de la capa plexiforme interna, respectivamente. La longitud de la ZAF horizontal, vertical y máxima de la CVS y la CVP en cada ojo se midió de forma manual. Además, se midió el ángulo entre el diámetro máximo de la ZAF y el plano papilomacular. Resultados: La angio-OCT representó los defectos dentro de la vasculatura en el área perifoveal en ojos con oclusión de rama venosa de la retina (ORVR; n = 11) y con oclusión de la vena central de la retina (OVCR; n = 8). Esto resultó en un crecimiento del diámetro máximo de la ZAF en ojos con OVR (n = 19) en comparación con el ojo contralateral (n = 19; 921 ± 213 frente a 724 ± 145 µm; p = 0,008). Además, se observó una correlación significativa entre la mejor agudeza visual corregida (MAVC) y el diámetro máximo de la ZAF en la CVP (ρ de Spearman = -0,423, p < 0,01). Por último, en los ojos con OVR, el ángulo entre el plano papilomacular y el diámetro máximo de la ZAF se dio tan solo en el 21,05% (CVS) y en el 15,79% (CVP) de los casos a 0 ± 15 ó 90 ± 15°, respectivamente. En ojos sanos, estos ángulos (que supuestamente representan una configuración de la ZAF regular) fueron más prevalentes (CVS 68,42 frente a 21,05%, p = 0,003; CVP 73,68 frente a 15,79%, p < 0,001). Conclusiones: La angio-OCT muestra alteraciones morfológicas de la ZAF en ojos con

  2. 40 CFR 180.1213 - Coniothyrium minitans strain CON/M/91-08; exemption from the requirement of a tolerance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Coniothyrium minitans strain CON/M/91... PESTICIDE CHEMICAL RESIDUES IN FOOD Exemptions From Tolerances § 180.1213 Coniothyrium minitans strain CON/M... tolerance is established for residues of the microbial pesticide Coniothyrium minitans strain...

  3. 40 CFR 180.1213 - Coniothyrium minitans strain CON/M/91-08; exemption from the requirement of a tolerance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Coniothyrium minitans strain CON/M/91... PESTICIDE CHEMICAL RESIDUES IN FOOD Exemptions From Tolerances § 180.1213 Coniothyrium minitans strain CON/M... tolerance is established for residues of the microbial pesticide Coniothyrium minitans strain...

  4. Single step purification of concanavalin A (Con A) and bio-sugar production from jack bean using glucosylated magnetic nano matrix.

    PubMed

    Kim, Ho Myeong; Cho, Eun Jin; Bae, Hyeun-Jong

    2016-08-01

    Jack bean (JB, Canavalia ensiformis) is the source of bio-based products, such as proteins and bio-sugars that contribute to modern molecular biology and biomedical research. In this study, the use of jack bean was evaluated as a source for concanavalin A (Con A) and bio-sugar production. A novel method for purifying Con A from JBs was successfully developed using a glucosylated magnetic nano matrix (GMNM) as a physical support, which facilitated easy separation and purification of Con A. In addition, the enzymatic conversion rate of 2% (w/v) Con A extracted residue to bio-sugar was 98.4%. Therefore, this new approach for the production of Con A and bio-sugar is potentially useful for obtaining bio-based products from jack bean.

  5. Outreach Opportunities for Early Career Scientists at the Phoenix ComiCon

    NASA Astrophysics Data System (ADS)

    Horodyskyj, L.; Walker, S. I.; Forrester, J. H.

    2014-12-01

    The Phoenix ComiCon (PCC) is a rapidly growing annual four-day pop culture event, featuring guests, costuming, exhibits, and discussion panels for popular sci-fi, fantasy, horror, and anime franchises. In 2013, PCC began experimenting with science discussion panels. The popularity of the science programming resulted in an expansion of the track for 2014, which Horodyskyj was responsible for coordinating. Thirty hours of programming were scheduled, including 25 discussion panels, NASA's FameLab, and a Mars room. Panelists included industry specialists, established scientists, STEM outreach enthusiasts, and early career scientists. The majority of the panelists were early career scientists recruited from planetary sciences and biology departments at ASU and UA. Panel topics included cosmology, biotechnology, artificial intelligence, space exploration, astrobiology, and the cross-linkages of each with pop culture. Formats consisted of Q&A, presentations, and interactive game shows. Although most panels were aimed at the general audience, some panels were more specialized. PCC 2014 attracted 77,818 attendees. The science programming received rave reviews from the audience, the PCC management, and the panelists themselves. Many panel rooms were filled to capacity and required crowd control to limit attendance. We observed the formation of science "groupies" who sought out the science panels exclusively and requested more information on other science public events in the Phoenix area. We distributed surveys to several select sessions to evaluate audience reasons for attending the science panels and their opinion of the scientists they observed. We will present the results of these surveys. As the PCC continues to grow at an exponential rate, the science programming will continue to expand. We will discuss ideas for continued expansion of the PCC science programming both to serve the public and as a unique public outreach opportunity for early career scientists.

  6. (Con)text-specific effects of visual dysfunction on reading in posterior cortical atrophy.

    PubMed

    Yong, Keir X X; Shakespeare, Timothy J; Cash, Dave; Henley, Susie M D; Warren, Jason D; Crutch, Sebastian J

    2014-08-01

    Reading deficits are a common early feature of the degenerative syndrome posterior cortical atrophy (PCA) but are poorly understood even at the single word level. The current study evaluated the reading accuracy and speed of 26 PCA patients, 17 typical Alzheimer's disease (tAD) patients and 14 healthy controls on a corpus of 192 single words in which the following perceptual properties were manipulated systematically: inter-letter spacing, font size, length, font type, case and confusability. PCA reading was significantly less accurate and slower than tAD patients and controls, with performance significantly adversely affected by increased letter spacing, size, length and font (cursive < non-cursive), and characterised by visual errors (69% of all error responses). By contrast, tAD and control accuracy rates were at or near ceiling, letter spacing was the only perceptual factor to influence reading speed in the same direction as controls, and, in contrast to PCA patients, control reading was faster for larger font sizes. The inverse size effect in PCA (less accurate reading of large than small font size print) was associated with lower grey matter volume in the right superior parietal lobule. Reading accuracy was associated with impairments of early visual (especially crowding), visuoperceptual and visuospatial processes. However, these deficits were not causally related to a universal impairment of reading as some patients showed preserved reading for small, unspaced words despite grave visual deficits. Rather, the impact of specific types of visual dysfunction on reading was found to be (con)text specific, being particularly evident for large, spaced, lengthy words. These findings improve the characterisation of dyslexia in PCA, shed light on the causative and associative factors, and provide clear direction for the development of reading aids and strategies to maximise and sustain reading ability in the early stages of disease. Copyright © 2014. Published by

  7. (Con)text-specific effects of visual dysfunction on reading in posterior cortical atrophy

    PubMed Central

    Yong, Keir X.X.; Shakespeare, Timothy J.; Cash, Dave; Henley, Susie M.D.; Warren, Jason D.; Crutch, Sebastian J.

    2014-01-01

    Reading deficits are a common early feature of the degenerative syndrome posterior cortical atrophy (PCA) but are poorly understood even at the single word level. The current study evaluated the reading accuracy and speed of 26 PCA patients, 17 typical Alzheimer's disease (tAD) patients and 14 healthy controls on a corpus of 192 single words in which the following perceptual properties were manipulated systematically: inter-letter spacing, font size, length, font type, case and confusability. PCA reading was significantly less accurate and slower than tAD patients and controls, with performance significantly adversely affected by increased letter spacing, size, length and font (cursive < non-cursive), and characterised by visual errors (69% of all error responses). By contrast, tAD and control accuracy rates were at or near ceiling, letter spacing was the only perceptual factor to influence reading speed in the same direction as controls, and, in contrast to PCA patients, control reading was faster for larger font sizes. The inverse size effect in PCA (less accurate reading of large than small font size print) was associated with lower grey matter volume in the right superior parietal lobule. Reading accuracy was associated with impairments of early visual (especially crowding), visuoperceptual and visuospatial processes. However, these deficits were not causally related to a universal impairment of reading as some patients showed preserved reading for small, unspaced words despite grave visual deficits. Rather, the impact of specific types of visual dysfunction on reading was found to be (con)text specific, being particularly evident for large, spaced, lengthy words. These findings improve the characterisation of dyslexia in PCA, shed light on the causative and associative factors, and provide clear direction for the development of reading aids and strategies to maximise and sustain reading ability in the early stages of disease. PMID:24841985

  8. Iliac crest autograft versus alternative constructs for anterior cervical spine surgery: Pros, cons, and costs

    PubMed Central

    Epstein, Nancy E.

    2012-01-01

    Background: Grafting choices available for performing anterior cervical diskectomy/fusion (ACDF) procedures have become a major concern for spinal surgeons, and their institutions. The “gold standard”, iliac crest autograft, may still be the best and least expensive grafting option; it deserves to be reassessed along with the pros, cons, and costs for alternative grafts/spacers. Methods: Although single or multilevel ACDF have utilized iliac crest autograft for decades, the implant industry now offers multiple alternative grafting and spacer devices; (allografts, cages, polyether-etherketone (PEEK) amongst others). While most studies have focused on fusion rates and clinical outcomes following ACDF, few have analyzed the “value-added” of these various constructs (e.g. safety/efficacy, risks/complications, costs). Results: The majority of studies document 95%-100% fusion rates when iliac crest autograft is utilized to perform single level ACDF (X-ray or CT confirmed at 6-12 postoperative months). Although many allograft studies similarly quote 90%-100% fusion rates (X-ray alone confirmed at 6-12 postoperative months), a recent “post hoc analysis of data from a prospective multicenter trial” (Riew KD et. al., CSRS Abstract Dec. 2011; unpublished) revealed a much higher delayed fusion rate using allografts at one year 55.7%, 2 years 87%, and four years 92%. Conclusion: Iliac crest autograft utilized for single or multilevel ACDF is associated with the highest fusion, lowest complication rates, and significantly lower costs compared with allograft, cages, PEEK, or other grafts. As spinal surgeons and institutions become more cost conscious, we will have to account for the “value added” of these increasingly expensive graft constructs. PMID:22905321

  9. Pros and cons of intraperitoneal chemotherapy in the treatment of epithelial ovarian cancer.

    PubMed

    Zeimet, Alain G; Reimer, Daniel; Radl, Alice C; Reinthaller, Alexander; Schauer, Christian; Petru, Edgar; Concin, Nicole; Braun, Stephan; Marth, Christian

    2009-07-01

    Development of the pros and cons of intraperitoneal (IP) chemotherapy in the treatment of epithelial ovarian cancer based on the most prominent data published on the evolution of IP chemotherapy and on experience with this therapeutic strategy in clinical routine. The literature published on IP chemotherapy in ovarian cancer between 1970 and 2008 was identified systematically by computer-based searches in MEDLINE and the Cochrane Library. Furthermore, a preliminary analysis of data recorded during an observational nationwide multicenter study of the Austrian AGO on IP-IV chemotherapy using the GOG-172 treatment regimen was performed. The literature review unequivocally revealed a significantly greater toxicity for IP than for intravenous (IV) cisplatin-based chemotherapy. However, according to a Cochrane meta-analysis, IP-IV administration of chemotherapy is associated with a 21.6% decrease in the risk for death. In agreement with earlier reports, the most frequently mentioned side-effects in the Austria-wide observational study were long-lasting neurotoxicity, abdominal pain, fatigue, gastrointestinal and metabolic toxicities, and catheter-related complications. Most of these toxicities were identified as mirroring the toxicity profile of high-dose IV cisplatin (>or=100 mg/m(2)). In some patients, the classic IP-IV regimen with cisplatin/paclitaxel was changed to an alternative schedule comprising carboplatin AUC 5 (d1) and weekly paclitaxel 60 mg/m(2) (d1, 8, 15) completely administered via the IP route. This treatment was better tolerated and quality of life was significantly less compromised. However, neutropenia and thrombocytopenia were the limiting side-effects of this IP regimen. In cases where optimal cytoreduction with residual disease

  10. "Pros and cons" of total hip arthroplasty with metaphyseal Proxima endoprosthesis.

    PubMed

    Wraźen, Waldemar; Golec, Edward B; Tomaszewski, Krzysztof A; Golec, Piotr; Jaworowski, Michał de Lubicz; Dudkiewicz, Zbigniew

    2015-01-01

    The authors present their own experience concerning total hip arthroplasty with the metaphyseal prosthesis Proxima. Proxima, a metaphyseal prosthesis, provides an innovative supplement to total hip arthroplasty. In this study, the authors present their own experience using Proxima in patients with hip osteoarthritis. This study was performed between 2008 to 2013 and comprised of 62 patients, of which 38 were male (61.3%) and 24 female (38.7%). All patients were operated on due to hip osteoarthritis using total hip arthroplasty with the metaphyseal prosthesis Proxima. The age of patients included into the study ranged from 23 years to 62 years with the mean age of 46 years. The authors paid close attention to the "pros and cons" of surgical techniques and assessed clinical and radiological results in both the short and long-term observation periods. The clinical evaluation was based on the Harris Hip Score and radiological assessment of fixation of the acetabular cup of the endoprosthesis was based on Pradhan's criteria. The endoprosthesis Proxima stem was positioned using the manufacturer's recommended method, evaluating the direction, scope and duration of the displacement in the marrow cavity of the proximal stump of the femur. According to the authors' analysis, the surgery gives good functional and radiological results both in the short- and long-term observation periods. The effectiveness depends on precise qualification for surgery, proper surgical techniques and specific anatomical conditions of the proximal femur stump. The most common reasons for primary and secondary dislocations of the metaphyseal endoprosthesis Proxima stem occur during the first three months post surgery. This is due to incorrect surgical techniques, which disregard the importance of specific anatomical conditions of the proximal femoral stump, which affects Proxima implantation, and cause deviations towards a varus or valgus orientation.

  11. Characterization Data Package for Containerized Sludge Samples Collected from Engineered Container SCS-CON-210

    SciTech Connect

    Fountain, Matthew S.; Fiskum, Sandra K.; Baldwin, David L.; Daniel, Richard C.; Bos, Stanley J.; Burns, Carolyn A.; Carlson, Clark D.; Coffey, Deborah S.; Delegard, Calvin H.; Edwards, Matthew K.; Greenwood, Lawrence R.; Neiner, Doinita; Oliver, Brian M.; Pool, Karl N.; Schmidt, Andrew J.; Shimskey, Rick W.; Sinkov, Sergey I.; Snow, Lanee A.; Soderquist, Chuck Z.; Thompson, Christopher J.; Trang-Le, Truc LT; Urie, Michael W.

    2013-09-10

    This data package contains the K Basin sludge characterization results obtained by Pacific Northwest National Laboratory during processing and analysis of four sludge core samples collected from Engineered Container SCS-CON-210 in 2010 as requested by CH2M Hill Plateau Remediation Company. Sample processing requirements, analytes of interest, detection limits, and quality control sample requirements are defined in the KBC-33786, Rev. 2. The core processing scope included reconstitution of a sludge core sample distributed among four to six 4-L polypropylene bottles into a single container. The reconstituted core sample was then mixed and subsampled to support a variety of characterization activities. Additional core sludge subsamples were combined to prepare a container composite. The container composite was fractionated by wet sieving through a 2,000 micron mesh and a 500-micron mesh sieve. Each sieve fraction was sampled to support a suite of analyses. The core composite analysis scope included density determination, radioisotope analysis, and metals analysis, including the Waste Isolation Pilot Plant Hazardous Waste Facility Permit metals (with the exception of mercury). The container composite analysis included most of the core composite analysis scope plus particle size distribution, particle density, rheology, and crystalline phase identification. A summary of the received samples, core sample reconstitution and subsampling activities, container composite preparation and subsampling activities, physical properties, and analytical results are presented. Supporting data and documentation are provided in the appendices. There were no cases of sample or data loss and all of the available samples and data are reported as required by the Quality Assurance Project Plan/Sampling and Analysis Plan.

  12. Best Practice in Research: Consensus Statement on Ethnopharmacological Field Studies - ConSEFS.

    PubMed

    Heinrich, Michael; Lardos, Andreas; Leonti, Marco; Weckerle, Caroline; Willcox, Merlin

    2017-08-14

    Ethnopharmacological research aims at gathering information on local and traditional uses of plants and other natural substances. However, the approaches used and the methods employed vary, and while such a variability is desirable in terms of scientific diversity, research must adhere to well defined quality standards and reproducible methods OBJECTIVES: With ConSEFS (the Consensus Statement on Ethnopharmacological Field Studies) we want to define best-practice in developing, conducting and reporting field studies focusing on local and traditional uses of medicinal and food plants, including studies using a historical approach. After first developing an initial draft the core group invited community-wide feedback from researchers both through a web-based consultation and a series of workshops at conferences during 2017. The consultation resulted in a large number of responses. Feedback was received via a weblink on the Journal of Ethnopharmacology's website (ca. 100 responses), other oral and written responses (ca. 50) and discussions with stakeholders at four conferences. The main outcome is a checklist, covering best practice for designing, implementing and recording ethnopharmacological field studies and historical studies. Prior to starting ethnopharmacological field research, it is essential that the authors are fully aware of the best practice in the field. For the first time in the field of ethnopharmacology a community-wide document defines guidelines for best practice on how to conduct and report such studies. It will need to be updated and further developed. While the feedback has been based on responses by many experienced researchers, there is a need to test it in practice by using it both in implementing and reporting field studies (or historical studies), and peer-review. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  13. Perfiles de luminosidad en galaxias con núcleo tipo Seyfert 1

    NASA Astrophysics Data System (ADS)

    Boris, N.; Rodriguez-Ardilla, A. A.; Pastoriza, M. G.

    Presentamos imágenes CCD en los filtros BVI y Hα de una muestra de 10 galaxias Seyfert 1 y Narrow Line Seyfert 1. Recientes observaciones muestran que hay una diferencia significante en el índice espectral óptico entre NLS1s y Sy1 normales, siendo para las primeras del orden de 2. Otra característica importante es que la mayor parte de las NLS1s muestran tasas de FeII/Hβ mayores que las observadas en otras Sy1s. Desde el punto de vista fotométrico, estas galaxias no tienenningún tipo de estudio previo. Presentamos magnitudes totales, perfiles de luminosidad y mapas de color junto con un detallado análisis de la formación estelar en estos objetos. Encontramos que la descomposición en bulbo + disco representa adecuadamente los perfiles de luminosidad de las galaxias de la muestra. Sin embargo, en todos los casos es necesario que el disco tenga un agujero en su centro. El radio de este agujero va desde los 3 a los 9 kpc. Si bien no tenemos aún una explicación para este hecho, los agujeros parecen estar asociados a anillos circumnucleares de alto oscurecimiento E(B-V) ~1. Los perfiles presentan también un fuerte gradiente de color, siendo notablemente más azules hacia la región nuclear. Los objetos de la muestra cubren todo el rango de tipos morfológicos, no obstante, no encontramos regiones de formación estelar en las regiones exteriores de las galaxias. La formación estelar está confinada a la región nuclear y se data en alrededor de 5 x 107 años.

  14. Strain Rate into South American Plate by SIRGAS-CON Geodetic Observations

    NASA Astrophysics Data System (ADS)

    Marotta, G. S.; Franca, G. S.; Monico, J. G.; Fuck, R. A.

    2013-05-01

    In this study were investigated the surface strain rates computed from the direction variations and velocity values estimated from the coordinates of the continuous monitoring geodetic network called SIRGAS-CON. That investigation was done using points located in the South American plate. The determination of the strain rate was based on the Finite Element method using points defined by Delaunay triangulation (sub-networks). Each one of sub-networks was considered as an homogeneous solid body. Using these methods was possible to separate the strain from the plate movement. The results showed that there are differences of strain rate along the South American plate. From the results were suggest that near to the west board of the plate, the strain is more significant, as expected, because this region is near to one area where Nazca Plate subduct South American Plate. It was detected that the contraction region founded in this area coincides whit the region where occurs most of earthquakes of greater magnitude. Far from the board, there are some areas with anomalies of significant strain of extension and contraction that can be originated by differences of stress aligned with different geological composites. By the results, It may be concluded that large surface movements occur in regions with more heterogeneous geological structures and multiple event of rupture, that large earthquakes arising from large tectonic activity into South American Plate are concentrated in areas with contraction strain rates predominantly oriented towards northeast-southwest, that significant amounts of elastic strain can be accumulated over geological structures away from fault plate boundary and that the behavior of contractions and extensions are similar to that found by different researches involving geophysical studies. Dilation and principal components of strain rate

  15. Estereotipos Sexuales y su Relación con Conductas Sexuales Riesgosas1,2,3

    PubMed Central

    Pérez-Jiménez, David; Orengo-Aguayo, Rosaura E.

    2012-01-01

    Resumen Los estereotipos sexuales son creencias generalmente aceptadas y poco cuestionadas que podrían contribuir a cómo los hombres y las mujeres debemos expresar nuestra sexualidad. Los objetivos de este estudio eran identificar cuántos hombres y mujeres heterosexuales en Puerto Rico endosaban ciertos estereotipos acerca de la sexualidad masculina y femenina y explorar la relación entre el endoso de estos estereotipos sexuales y las actitudes hacia el condón masculino y su uso en relaciones sexuales vaginales Llevamos a cabo un estudio descriptivo-correlacional mediante el cual le administramos dos escalas, una sobre sexualidad masculina y otra sobre sexualidad femenina a un grupo de 429 personas heterosexuales. Encontramos que los hombres endosaron estereotipos sexuales masculinos y femeninos más que las mujeres y que estos tienden a tener una visión más conservadora respecto a la sexualidad femenina que la que tienen sobre su propia sexualidad. Las mujeres, por otra parte, tienden a ver su propia sexualidad y la sexualidad masculina en términos menos estereotipados y más equitativos. También encontramos que a mayor endoso de creencias tradicionales sobre la sexualidad masculina y femenina, peor la actitud hacia el uso del condón masculino. Sin embargo, el endosar estereotipos sexuales masculinos y/o femeninos no se relacionó con el uso del condón. Estos hallazgos contradicen la literatura que sugiere que estos estereotipos sexuales y de género resultan en conductas sexuales de alto riesgo, lo cual tiene implicaciones importantes para el desarrollo e implementación de programas de prevención. PMID:24575164

  16. Molecular detection of pathogens in water--the pros and cons of molecular techniques.

    PubMed

    Girones, Rosina; Ferrús, Maria Antonia; Alonso, José Luis; Rodriguez-Manzano, Jesus; Calgua, Byron; Corrêa, Adriana de Abreu; Hundesa, Ayalkibet; Carratala, Anna; Bofill-Mas, Sílvia

    2010-08-01

    Pollution of water by sewage and run-off from farms produces a serious public health problem in many countries. Viruses, along with bacteria and protozoa in the intestine or in urine are shed and transported through the sewer system. Even in highly industrialized countries, pathogens, including viruses, are prevalent throughout the environment. Molecular methods are used to monitor viral, bacterial, and protozoan pathogens, and to track pathogen- and source-specific markers in the environment. Molecular techniques, specifically polymerase chain reaction-based methods, provide sensitive, rapid, and quantitative analytical tools with which to study such pathogens, including new or emerging strains. These techniques are used to evaluate the microbiological quality of food and water, and to assess the efficiency of virus removal in drinking and wastewater treatment plants. The range of methods available for the application of molecular techniques has increased, and the costs involved have fallen. These developments have allowed the potential standardization and automation of certain techniques. In some cases they facilitate the identification, genotyping, enumeration, viability assessment, and source-tracking of human and animal contamination. Additionally, recent improvements in detection technologies have allowed the simultaneous detection of multiple targets in a single assay. However, the molecular techniques available today and those under development require further refinement in order to be standardized and applicable to a diversity of matrices. Water disinfection treatments may have an effect on the viability of pathogens and the numbers obtained by molecular techniques may overestimate the quantification of infectious microorganisms. The pros and cons of molecular techniques for the detection and quantification of pathogens in water are discussed. (c) 2010 Elsevier Ltd. All rights reserved.

  17. Operating on a suspicious lung mass without a preoperative tissue diagnosis: pros and cons.

    PubMed

    Sihoe, Alan D L; Hiranandani, Raj; Wong, Henry; Yeung, Enoch S L

    2013-08-01

    Patients with a suspicious lung mass sometimes receive surgery with no preoperative tissue diagnosis despite-and sometimes in lieu of-modern medical investigations. The pros and cons of doing so have rarely been studied. Pulmonary surgery was performed in 443 consecutive adult patients with a lung mass confirmed or suspected to be an early stage primary lung cancer. No diagnosis was confirmed preoperatively in 206 (46.5%) patients. Whether to take a core biopsy or wedge excision biopsy for frozen section assessment intraoperatively was decided at the surgeon's discretion. Patients without preoperative diagnosis were on average younger than those with a diagnosis (61 vs 66 years, P < 0.01), but were otherwise similar to those who had a preoperative diagnosis confirmed. In all patients operated on without a preoperative diagnosis, there was no mortality or major complication, and the perioperative minor morbidity rate was 9.7%. Among patients ultimately found to have lung cancer and who received a lobectomy, performing a frozen section intraoperatively did not increase mean operation time or morbidity. Among those patients with no preoperative tissue diagnosis, 97 (47.1%) proceeded to surgery without attempts at preoperative diagnosis, and 109 (52.9%), after attempts at preoperative diagnosis failed to yield a positive diagnosis. After surgery, benign disease was found in 16 (7.8%) patients without preoperative diagnosis. A significantly lower proportion of patients without preoperative diagnosis waited an interval of over 28 days between presentation and being accepted for thoracic surgery (42.2 vs 54.9%, P < 0.01). However, they were not more likely to have Stage I disease and did not have better recurrence-free survival rates on survival analysis. Proceeding to surgery without preoperative diagnosis in selected patients with a suspicious lung mass is safe and can potentially reduce the interval between presentation and surgical management. However, the shortened

  18. 40Ar/39Ar laserprobe study of the Day Nui Con Voi Metamorphic Complex, Vietnam

    NASA Astrophysics Data System (ADS)

    Wu, C.; Lo, C.; Yeh, M.; Chung, S.; Lee, T.

    2009-12-01

    The garnet bearing gneiss within the Day Nui Con Voi (DNCV) Metamorphic Complex along the Red River Shear Zone (RRSZ) in North Vietnam, recorded a long tectonothermal history since the Indosinian orogeny. In-situ 40Ar/39Ar laserprobe study of biotite inclusions within garnet porphyroblasts and matrix biotites, combining with microstructural and scanning electron microscopy (SEM) studies, deciphered the timing and duration of thermal events. Biotites from two matrix fabrics from different deformation events show approximately similar 40Ar/39Ar age ranges in 19-24Ma, depending grain size. These matrix biotite ages are best interpreted to record a rapid cooling event associating with the left-lateral shearing event of the RRSZ. Whereas, all biotite inclusions exhibit age zoning patterns with 40Ar/39Ar ages gradually increase from 17 Ma to more than 28 Ma according to their diffusion pathways. These age variations may have resultant from a combination effect of argon retention by garnet shielding, which provides a best recorder to the metamorphic event, and argon diffusion loss along the deformed cracks during the shearing event of the RRSZ. Diffusion modeling of these age zoning indicated that the total duration of argon diffusion loss may have lasted for nearly 9 Myr and argon diffusion may have occurred sometime around 24.5Ma. These results are generally in good agreement with previous interpretation, but provide better resolution of 40Ar/39Ar age data for deciphering the history of thermal event in the DNCV Metamorphic Complex and the left-lateral shearing event of the RRSZ in Vietnam, as well.

  19. Exploring the pros and cons of mechanistic case diagrams for problem-based learning

    PubMed Central

    2017-01-01

    Purpose Mechanistic case diagram (MCD) was recommended for increasing the depth of understanding of disease, but with few articles on its specific methods. We address the experience of making MCD in the fullest depth to identify the pros and cons of using MCDs in such ways. Methods During problem-based learning, we gave guidelines of MCD for its mechanistic exploration from subcellular processes to clinical features, being laid out in as much detail as possible. To understand the students’ attitudes and depth of study using MCDs, we analyzed the results of a questionnaire in an open format about experiencing MCDs and examined the resulting products. Results Through the responses to questionnaire, we found several favorable outcomes, major of which was deeper insight and comprehensive understanding of disease facilitated by the process of making well-organized diagram. The main disadvantages of these guidelines were the feeling of too much workload and difficulty of finding mechanisms. Students gave suggestions to overcome these problems: cautious reading of comprehensive texts, additional guidance from staff about depth and focus of mechanisms, and cooperative group work. From the analysis of maps, we recognized there should be allowance of diversities in the appearance of maps and many hypothetical connections, which could be related to an insufficient understanding of mechanisms in nature. Conclusion The more detailed an MCD task is, the better students can become acquainted with deep knowledges. However, this advantage should be balanced by the results that there are many ensuing difficulties for the work and deliberate help plans should be prepared. PMID:28870018

  20. [Patient safety: prescription of drugs that prolong the QT interval].

    PubMed

    Hernández-Arroyo, María Jesús; Díaz-Madero, Alfonso; Menacho-Miguel, David

    2015-09-01

    Objetivo: conocer la prescripcion de farmacos con riesgo conocido de prolongar el intervalo QT en un area de salud, informar a los medicos responsables de los factores de riesgo asociados a su aparicion y mejorar la seguridad del paciente. Métodos: estudio descriptivo transversal y observacional de prevalencia. Se incluyeron 4.964 pacientes de un area de salud en tratamiento con farmacos con riesgo conocido en un mes. Se identificaron farmacos de riesgo, interacciones y factores predisponentes. Se proporciono a cada medico los pacientes con farmacos con riesgo conocido, las recomendaciones y la encuesta para conocer mas factores de riesgo, su utilidad y su actitud clinica. Se realizo un analisis estadistico descriptivo. Resultados: el 3,2% de los pacientes del area estaban tratados con farmacos con riesgo conocido. El 64,0% eran mujeres, 57,5% mayores de 65 anos, y el 39,6% presentaban interacciones. El numero medio de factores de riesgo por paciente fue 1,78. Los farmacos con riesgo conocido mas frecuentes fueron antidepresivos (41,2%) y antibioticos (40,4%). El 25,4% de los medicos devolvio la encuesta informando de la actitud clinica en 1.073 pacientes: se retiro el farmaco con riesgo conocido en 289, se redujo la dosis en 113 y se realizo electrocardiograma en 398. Los medicos identificaron otros factores de riesgo: problema cardiaco (17,9%) e hiper/hipotiroidismo (8,8%). Conclusiones: la prevalencia detectada en la prescripcion de farmacos que prolongan el intervalo QT es relevante teniendo en cuenta que los pacientes tenian ademas otros factores de riesgo. Su identificacion permite mejorar la calidad de la atencion y la seguridad del paciente.