The Effects of the Davis Symbol Mastery System to Assist a Fourth Grader with Dyslexia in Spelling: A Case Report

ERIC Educational Resources Information Center

Amsberry, Gianna; McLaughlin, T. F.; Derby, K. Mark; Waco, Teresa

2012-01-01

The purpose of this study was to determine the effectiveness of using the Davis Symbol Mastery Procedure for Words (Davis, 1994) for improving spelling skills. The participant was a fourth-grade male diagnosed with a significant learning disability. The intervention consisted of having the participant write each word, its definition, the word in a…

A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses.

PubMed

Nasreldin, Magda H A; Ibrahim, Eman A; Saad El-Din, Somaia A

2016-01-01

Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a clinical diagnosis suggestive of malignant thyroid tumor with metastasis to the cervical lymph nodes. Histopathological examination revealed that it was compatible with third/fourth branchial pouch-derived anomaly composed of mature cartilage and thymic and parathyroid tissues for clinical and radiological correlations.

A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses

PubMed Central

Nasreldin, Magda H. A.; Ibrahim, Eman A.; Saad El-Din, Somaia A.

2016-01-01

Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a clinical diagnosis suggestive of malignant thyroid tumor with metastasis to the cervical lymph nodes. Histopathological examination revealed that it was compatible with third/fourth branchial pouch-derived anomaly composed of mature cartilage and thymic and parathyroid tissues for clinical and radiological correlations. PMID:26819565

Dandy-Walker syndrome with duplex kidney abnormalities in trisomy 18 - A rare case report.

PubMed

Wang, Tun-Jun; Li, Yi-Ying; Wu, Wan-Ju; Lin, Chi-Kang; Wang, Chun-Kai; Wang, Chen-Yu; Hwang, Kwei-Shuai; Su, Her-Young

2017-10-01

Trisomy 18 is one of the major numerical chromosomal disorders. The incidence of trisomy 18 is approximately one in 6000 live births. Dandy-Walker malformation (DWM) is the most common congenital malformation of the cerebellum, with an incidence of about one in 5000 live births. The incidence of trisomy 18 associated with DWM is rare and long-term survival rate is very low. A case involving a 39-year-old pregnant female with a case of trisomy 18 associated with DWM. The incidence of trisomy 18 associated with DWM is rare, and our report presents an unusual case that supplements our knowledge of this condition. We report a case involving a 39-year-old pregnant female with a case of trisomy 18 associated with Dandy-Walker malformation (DWM). Fetal ultrasonography showed hypoplasia of the cerebellar vermis and dilatation of the fourth ventricle and was characterized by an enlarged posterior fossa. Fetal magnetic resonance imaging showed inferior vermian hypoplasia and a large posterior fossa cyst communicating with the fourth ventricle causing high insertion of the torcular herophili, which was compatible with DWM. Furthermore, the karyotyping report revealed trisomy 18. The incidence of trisomy 18 associated with DWM is rare, and our report presents an unusual case that supplements our knowledge of this condition. Copyright © 2017. Published by Elsevier B.V.

Nasopharyngeal teratoma, congenital diaphragmatic hernia and Dandy-Walker malformation - a yet uncharacterized syndrome.

PubMed

Gupta, N; Shastri, S; Singh, P K; Jana, M; Mridha, A; Verma, G; Kabra, M

2016-11-01

An association of congenital diaphragmatic hernia, dandy walker malformation and nasopharyngeal teratoma is very rare. Here, we report a fourth case with this association where chromosomal microarray and whole exome sequencing (WES) was performed to understand the underlying genetic basis. Findings of few variants especially a novel variation in HIRA provided some insights. An association of congenital diaphragmatic hernia, dandy walker malformation and nasopharyngeal teratoma is very rare. Here, we report a fourth case with this association where chromosomal microarray and whole exome sequencing (WES) was performed to understand the underlying genetic basis. Findings of few variants especially a novel variation in HIRA provided some insights. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Branchial anomalies in children: A report of 105 surgical cases.

PubMed

Li, Wanpeng; Xu, Hongming; Zhao, Liming; Li, Xiaoyan

2018-01-01

Branchial anomalies (BAs) account for 20% of all congenital masses in children. We sought to review the incidence of involvement of individual anomalies, diagnostic methods, surgical treatment, and complications of BAs in children. In addition, we also classified our study and analyzed a congenital lower neck cutaneous fistula near the sternoclavicular joint that was thought to be the skin-side remnant of the fourth BAs. We conducted a retrospective analysis of 105 children who were referred to our hospital from June 2009 to December 2016 for the treatment of BAs. In this series, there were 51 males and 54 females. The age at the time of operation varied from 19 days to 13 years, and the mean age was 4.5 years. A total of 33 (31.4%) cases presented with first BAs, 13 (12.4%) presented with second BAs, and 59 (56.2%) presented with third and fourth BAs, including 6 cases of congenital lower neck cutaneous fistula. Fistulectomy under general anesthesia was performed on all of them. For postoperative complications, 2 cases had temporary facial paralysis, 1 case had permanent facial paralysis, 4 cases had temporary recurrent laryngeal nerve injury. Recurrence occurred in 2 patients with first BAs after medium follow-up time of 3.6 years (6 months-8 years). BAs are common congenital head and neck lesions in children, and there are four distinct types (first, second, third and fourth anomalies). The incidence of third and fourth BAs in Asia maybe higher when compared with literature reports, second BAs seem rare in this population, but more research is needed to confirm this perspective. Diagnosis is not difficult with a proper knowledge of the anatomy of the BAs. The surgical procedures should be tailored depending on the various types, and complete excision of the fistula is the key to prevent recurrence. Copyright © 2017 Elsevier B.V. All rights reserved.

OD in Schools: The State of the Art. Vol. IV: Case Studies. Final Report.

ERIC Educational Resources Information Center

Fullan, Michael; And Others

This volume, the fourth of a five-volume series, contains three onsite case studies of organization development (OD) selected from a sample of 76 school districts. The purpose of the case studies was to analyze in detail different types of OD programs and their use. Each case study represents a different OD focus: case study A involves a survey…

Theory Building and Modeling in a Sinking and Floating Unit: A Case Study of Third and Fourth Grade Students' Developing Epistemologies of Science. Research Report

ERIC Educational Resources Information Center

Kawasaki, Keiko; Herrenkohl, Leslie Rupert; Yeary, Sherry A.

2004-01-01

The purpose of this paper is to carefully examine the evolution of students' theory building and modeling, critical components of scientific epistemologies, over a unit of study on sinking and floating in one third/fourth grade classroom. The study described in this paper follows in the tradition of Design Experiments (Brown 1992, Collins 1990)…

[Report of a case with Joubert syndrome and literature review].

PubMed

Yi, Ya-hui; Li, Gang; Lu, Zhong-lie; Zhou, Jian-sheng; Yao, Zhen-wei; Wang, Peng-fei; Yao, Jin-xiang

2011-12-01

To explore the clinical feature, imaging and their diagnostic value for Joubert syndrome (JS). The clinical data, imaging feature, and 31 references from China Biomedical literature database (CBMdise) were reviewed and analyzed. The age of onset of 32 patients including male 20 and female 12 ranged from 3 days to 6 years (mean 2.2 years). All the 32 patients with Joubert syndrome showed "slow growth" and "reduced muscle tension", 26 cases (81.3%) showed "gasp for breath", 26 cases (81.3%) showed "unusual motion of eyeball", 2 cases (6.3%) showed additional fingers (toes), 6 cases (18.8%) showed stretching tongue with agape. The typical imaging features of Joubert syndrome included "molar tooth sign", "midline cleavage" between cerebellar hemispheres and "bat-wing" like fourth ventricle, all the 32 patients with Joubert syndrome showed "midline cleavage", "molar tooth sign" was present in 29 cases (90.1%), and "bat-wing" like fourth ventricle in 30 cases (93.8%). Joubert syndrome is a rare congenital brain malformation. The typical clinical manifestations included "gasp for breath", "reduced tension of muscle", "slow growth" and "unusual motion of eyeball", and at the same time the patients had the following typical imaging features of brain: "molar tooth sign", "midline cleavage" and "bat-wing" like fourth ventricle.

The Multi-Disciplinary Graduate Program in Educational Research. Final Report, Part IV; The Utilization of Sociological Ideas in Organizational Planning: A Case Study.

ERIC Educational Resources Information Center

Lazarsfeld, Paul F., Ed.

This document, the fourth in the final report on the Multi-Disciplinary Graduate Program in Educational Research, is a qualitative case study designed to show the form of sociological contributions to and the role of sociologists in policy formulation at an American Educational Research Association (AERA) colloquium. Discussions at the conference…

P16.30 4th ventricle glioblastoma

PubMed Central

Unal, E.; Isik, S.; Gurbuz, M.; Kilic, K.

2017-01-01

Abstract Introduction: We present the 2nd case ever known in English literature describing a glioblastoma of the fourth ventricle originating from cerebellar peduncle. CASE DESCIPTION: A 66 years old woman was admitted to hospital with dizziness and nausea for four months. An MRI scan showed fourth ventricle mass. First impression was an ependymoma due to MRI scan characteristics. Results: A surgery was performed and histopathology revealed Grade IV glial tumor. Radiotherapy was done. CONCLUSION: This report suggests that GBM can mimic every tumor in the CNS. Surgery is the best option for these tumors not only for aggressive behaviour of glioblastoma but also to prevent hydrocephalus and associated symptoms.

Resolution of precocious puberty following resection of fourth ventricular medulloblastoma: case report.

PubMed

Medina, Renata G; Dempsher, David P; Gauvain, Karen M; Geller, Thomas J; Elbabaa, Samer K

2015-09-01

Medulloblastoma is a malignant embryonal tumor that arises in the cerebellum and invades the fourth ventricle, often resulting in obstructive hydrocephalus. Patients typically present with symptoms related to increased intracranial pressure and cerebellar dysfunction. The authors report a rare case of classic medulloblastoma with central precocious puberty (CPP) as its only presenting symptom. A 7-year-old boy with no prior history of medulloblastoma presented with Tanner Stage IV testicular enlargement and a 4-month history of acne and pubic hair. Laboratory tests of blood samples demonstrated highly elevated luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone. Admission MRI of the brain revealed a mass in the posterior fossa, which bordered and compressed the fourth ventricle. The patient also exhibited mild lateral and third ventriculomegaly. Surgical options were discussed with the neurosurgical department. A suboccipital craniotomy and C-1 laminectomy were performed. A large mass was seen arising from the inferior surface of the vermis, and lying within the fourth ventricle. Gross-total microsurgical resection of the mass was performed. Histopathological investigation characterized the tumor as classic medulloblastoma. Follow-up laboratory tests of blood samples demonstrated a reduction of LH, FSH, and testosterone back to prepubertal levels. The patient then began radiation and chemotherapy. This report demonstrates that mild obstructive hydrocephalus due to a posterior fossa tumor may present with unexpected symptoms, such as CPP. To the authors' knowledge, precocious puberty has not yet been associated with medulloblastoma, although it has been found with other posterior fossa tumors. Extensive imaging of the CNS for patients presenting with CPP is recommended.

Adult manifestation of the Dandy-Walker syndrome. Report of two cases with review of the literature.

PubMed

Unsgaard, G; Sand, T; Støvring, J; Ringkjøb, R

1987-01-01

Two cases of Dandy-Walker syndrome that became manifest in adult life are reported. A review of the literature of Dandy-Walker syndrome revealed 13 additional cases with onset in adult life and three cases that could not be differentiated from arachnoid cysts. While shunting is the primary treatment in infantile Dandy-Walker, the usual treatment of adult Dandy-Walker has been excision of the membrane covering the enlarged fourth ventricle. The outcome of our two cases treated with membrane excision indicates that primary shunting should also be tried in adult Dandy-Walker.

Trigeminal neuralgia due to Dandy-Walker syndrome.

PubMed

Zhang, Wenhao; Chen, Minjie; Zhang, Weijie

2013-07-01

Trigeminal neuralgia (TN) is a common pain in the orofacial region. Dandy-Walker syndrome (DWS) is a congenital malformation of the cerebellar and the fourth ventricle foramina atresia. Dandy-Walker syndrome is rarely found in patients with TN. This article presents a 36-year-old man with the symptoms of typical TN. His physical examination was entirely normal. An enhanced magnetic resonance imaging was taken. Magnetic resonance imaging revealed the bilateral lateral ventricle, the fourth and third ventricle significantly enlarged with severe obstructive hydrocephalus, a huge posterior fossa cyst connected with the fourth ventricle, and hypoplastic vermis. The pain was controlled by Tegretol. The reported case suggests that DWS is an unusual cause of TN.

Pernicious anaemia in triplets. A case report and literature review.

PubMed

Masnou, Helena; Domènech, Eugeni; Navarro-Llavat, Mercè; Zabana, Yamile; Mañosa, Míriam; García-Planella, Esther; Gassull, Miquel A

2007-12-01

Pernicious anemia is the most common cause of vitamin B12 deficiency in adults. This entity is associated with chronic atrophic gastritis. We report a case of pernicious anaemia in triplets. We also report a fourth case of cobalamin deficiency with antibodies against intrinsic factor and anti parietal cell antigen negative antibodies in a sibling. The present article reviews the pediatric presentation of pernicious anemia and highlights the possible existence of familial aggregation. Furthermore, the need for systematic familial screening and the usefulness of an endoscopic follow-up program in patients with pernicious anemia are evaluated.

Intravenous human immunoglobulin for treatment of folliculitis decalvans.

PubMed

Ismail, Nuriah; Ralph, Nicola; Murphy, Gillian

2015-10-01

We report a case of folliculitis decalvans (FD) successfully treated with intravenous human immunoglobulin (HIG). Many conventional treatments with topical agents and oral antibiotics had failed to achieve disease remission, treatment with HIG at a dose of 2 g/kg for the first month, reduced to 1 g/kg for second to fourth months was therefore started, which resulted in rapid improvement and ultimately complete resolution of FD. Clinical improvement was noted after the first infusion of HIG and remission of inflammation was achieved after the fourth infusion. Disease remission was sustained for six months following the last HIG infusion. The exact mechanism of action of HIG is poorly understood. However, it is thought to act as an immunomodulatory agent by altering different components of immune functions. To our knowledge, this is the first case reported in the literature of FD successfully treated with intravenous HIG.

Radiologically occult medulloblastoma with hydrocephalus: case report.

PubMed

Honma, Hirokuni; Ogiwara, Hideki

2017-09-01

There have been no reports of occult medulloblastoma nor noncommunicating hydrocephalus due to radiologically occult brain tumors. Herein, we report radiologically occult medulloblastoma with noncommunicating hydrocephalus. A 3-year-old boy presented with macrocephaly, visual field constriction, and papilledema. Neuroimagings showed enlargement of the ventricles without any mass lesions. The CT cisternography did not show influx of the contrast into the ventricles, which suggested local cerebrospinal fluid (CSF) circulatory disturbance at the outlet of the fourth ventricle. Due to possible obstructive nature of hydrocephalus, endoscopic third ventriculostomy (ETV) was performed. Three months after the ETV, he presented with repeated vomiting. Neuroimagings showed a 3-cm fourth ventricular mass with progressive hydrocephalus. Surgical resection was performed, which revealed the pathology was medulloblastoma. We report the case of radiologically occult medulloblastoma which was demonstrated radiologically in the follow-up period of ETV for noncommunicating hydrocephalus of uncertain etiology. This is the first description of a radiologically occult medulloblastoma and also the first description of an occult brain tumor with noncommunicating hydrocephalus. The occult brain tumor may be included in the etiology of hydrocephalus.

Gender Bias in the Diagnosis of a Geriatric Standardized Patient: A Potential Confounding Variable

ERIC Educational Resources Information Center

Lewis, Roya; Lamdan, Ruth M.; Wald, David; Curtis, Michael

2006-01-01

Background: Gender bias has been reported in the diagnosis and treatment of patients with a variety of illnesses. In the context of our 10-station fourth year Objective Structured Clinical Evaluation, we queried whether this could influence diagnosis in a geriatric case. Case writers hypothesized that, due to this bias, the female standardized…

Rare association between cystic fibrosis, Chiari I malformation, and hydrocephalus in a baby: a case report and review of the literature

PubMed Central

2011-01-01

Introduction Cystic fibrosis, an epithelial cell transport disorder caused by mutations of the cystic fibrosis transmembrane conductance regulator gene, is not generally associated with malformations of the central nervous system. We review eight previously published reports detailing an infrequent association between cystic fibrosis and Chiari I malformation. Case presentation To the best of our knowledge, our report describes only the ninth case of a baby presenting with a new diagnosis of cystic fibrosis and Chiari I malformation, in this case in a 10-month-old, full-term Caucasian baby boy from the United States of America. Neurosurgical consultation was obtained for associated developmental delay, macrocephaly, bulging anterior fontanel, and papilledema. An MRI scan demonstrated an extensive Chiari I malformation with effacement of the fourth ventricle, obliteration of the outlets of the fourth ventricle and triventricular hydrocephalus without aqueductal stenosis. Our patient was taken to the operating room for ventriculoperitoneal shunt placement. Conclusions It is possible that the cystic fibrosis transmembrane conductance regulator gene may play a previously unrecognized role in central nervous system development; alternatively, this central nervous system abnormality may have been acquired due to constant valsalva from recurrent coughing or wheezing or metabolic and electrolyte imbalances that occur characteristically in cystic fibrosis. PMID:21838874

Oral Pyogenic Granuloma Associated With a Dental Implant Treated With an Er:YAG Laser: A Case Report.

PubMed

Kaya, Alper; Ugurlu, Faysal; Basel, Bilal; Sener, Cem B

2015-12-01

A pyogenic granuloma is a tumorlike proliferation that occurs slightly more often in females, frequently involving the gingiva in the maxillary region. Clinically, it presents as a sessile or pedunculated exophytic mass with a smooth or lobulated surface, which tends to bleed easily. Its color can range from pink to dark red. The most common treatment is surgical excision. This case report presents a pyogenic granuloma that formed around an implant 7 years after its insertion. Pyogenic granulomas associated with dental implants are extremely rare; this is the fourth reported case and the first case of pyogenic granuloma to be treated with an Er:YAG laser.

Methodological Issues in Comparative Educational Studies: The Case of the IEA Reading Literacy Study.

ERIC Educational Resources Information Center

Binkley, Marilyn, Ed.; And Others

This report discusses various methodological issues confronted in the Reading Literacy Study conducted under the auspices of the International Association for the Evaluation of Educational Achievement (IEA) and issues relating to analysis of the data. The study analyzed in the report involved fourth- and ninth-grade students (9-year-olds and…

The Effects of CLIL on Oral Comprehension and Production: A Longitudinal Case Study

ERIC Educational Resources Information Center

Pérez Cañado, María Luisa; Lancaster, Nina Karen

2017-01-01

This article reports on the outcomes of a longitudinal case study to gauge the impact of content and language integrated learning (CLIL) on two of the least researched language skills: oral comprehension and production. It worked with 24 students in the fourth grade of Compulsory Secondary Education in a public school in Andalusia (southern Spain)…

Ainhum - A Rare Case Report.

PubMed

Prabhu, Ravi; Kannan, Narayanasamy Subbaraju; Vinoth, Sundaresan; Praveen, Chinnappan Balasubramanian

2016-04-01

The term 'AINHUM' is derived from the African word meaning 'to saw or cut'. True ainhum otherwise called dactylolysis spontanea is a condition involving soft tissue or digits with constricting rings commonly presenting in fifth toes, usually bilateral. It is to be differentiated from Pseudo-ainhum that occurs secondary to some hereditary and nonhereditary diseases that lead to annular constriction of digits. We report a rare case of true ainhum involving the left fourth toe only. It is a very rare case and a very few were reported worldwide. The highest incidence of ainhum has been reported in South Africa and South America. It is rarely reported in India. Ainhum when diagnosed and treated in early stages can be prevented from progressing to mutilating deformities.

An Interesting Case of Tolosa-Hunt Syndrome in a Young Male.

PubMed

Murtaza, Ghulam; Konowitz, Nicholas; Lu, Hannah; Faqah, Anadil; Kuruvilla, Aneesh

2017-01-01

Tolosa-Hunt syndrome is a rare disease with a limited number of cases reported in the literature. It typically presents with orbital pain associated with palsy of the third, fourth, or sixth cranial nerve. We present an interesting case of Tolosa-Hunt syndrome in a young male who responded well to high-dose steroids and in a few days had significant improvement in his retro-orbital pain and ocular movements.

Assessment of knowledge and attitudes of dental students in regard to child abuse in Turkey.

PubMed

Hazar Bodrumlu, E; Avşar, A; Arslan, S

2018-02-01

Child abuse is a serious public problem. Signs of abuse are often present in the oro-facial region and dentists are in a strategic position to recognise and report suspected cases. The aim of this study was to investigate dental students' knowledge about and attitudes towards child abuse. This study was performed at the Faculty of Dentistry of the Ondokuz Mayis University. The data were collected through a self-report questionnaire administered to dental students (137 female/111 male) in three different dental classes (third, fourth and fifth study years) and grouped by considering those students who have been training in the school year of 2013. The definition of physical and social indicators of abuse, awareness regarding legal and ethical responsibilities, students' experience and requests made by students were evaluated by the students' response to questions put in the questionnaire. Descriptive statistics and chi-square tests were performed to analyse the questionnaire data. The questionnaire completion rate was 100%. About 67.74% of the third year, 40.71% of the fourth year and 16.67% of the fifth year believed that they could detect child abuse cases. However, results indicated a major lack of knowledge of social indicators, signs of physical abuse and reporting procedure amongst all respondents. The assessment of the total correct answers exhibited significant differences amongst third-, fourth- and fifth-year students' answers. Fifth-year students had the highest rate of correct responses (P < 0.05). Most students wanted to receive more knowledge about this topic. Dental students in Turkey are not sufficiently prepared for their role in diagnosing suspected cases of child abuse. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Case of Community-Acquired Pneumonia Due to Legionella pneumophila Serogroup 9 Wherein Initial Treatment with Single-Dose Oral Azithromycin Appeared Useful.

PubMed

Ito, Akihiro; Ishida, Tadashi; Tachibana, Hiromasa; Ito, Yuhei; Takaiwa, Takuya; Fujii, Hiroyuki; Hashimoto, Toru; Nakajima, Hiroshi; Amemura-Maekawa, Junko

2017-11-22

Legionella species are important causative pathogens for severe community-acquired pneumonia (CAP). Most cases of Legionella pneumonia are due to Legionella pneumophila serogroup 1, and CAP due to L. pneumophila serogroup 9 is rare. A fourth case of CAP due to L. pneumophila serogroup 9 has been reported, and initial treatment using single-dose oral azithromycin appeared useful. Azithromycin or fluoroquinolone injection is usually recommended for the treatment of Legionella pneumonia, and no previous reports have shown the effectiveness of single-dose oral azithromycin. This case report is therefore valuable from the perspective of possible treatment for mild to moderate Legionella pneumonia using single-dose oral azithromycin.

Delayed management of traumatic bilateral cervical facet dislocation: surgical strategy. Report of three cases.

PubMed

Bartels, Ronald H M A; Donk, Roland

2002-10-01

Postinjury cervical spine instability typically requires surgical treatment in the acute or semiacute stage. The authors, however, report on three patients with older (> 8 weeks) untreated bilateral cervical facet dislocation. In two patients they attempted a classic anterior-posterior-anterior approach but failed. The misalignment in the second stage of the procedure could not be corrected, and they had to add a fourth, posterior, stage. To avoid the fourth stage, thereby reducing operating time and risk of neurological damage while turning the patient, they propose the following sequence: 1) a posterior approach to perform a complete facetectomy bilaterally with no attempt to reduce the dislocation; 2) an anterior microscopic discectomy with reduction of the dislocation and anterior fixation; and 3) posterior fixation. This sequence of procedures was successfully performed in the third patient. Based on this experience, they suggest that in cases of nonacute bilateral cervical facet dislocations the operating sequence should be posterior-anterior-posterior.

A Case of Duplicated Right Vertebral Artery.

PubMed

Motomura, Mayuko; Watanabe, Koichi; Tabira, Yoko; Iwanaga, Joe; Matsuuchi, Wakako; Yoshida, Daichi; Saga, Tsuyoshi; Yamaki, Koh-Ichi

2018-04-27

We encountered a case of duplicated right vertebral artery during an anatomical dissection course for medical students in 2015. Two vertebral arteries were found in the right neck of a 91-year-old female cadaver. The proximal leg of the arteries arose from the area between the right subclavian artery and the right common carotid artery that diverged from the brachiocephalic artery. The distal leg arose from the right subclavian artery as expected. The proximal leg entered the transverse foramen of the fourth cervical vertebra and the distal leg entered the transverse foramen of the sixth cervical vertebra. The two right vertebral arteries joined to form one artery just after the origin of the right vertebral artery of the brachiocephalic artery entered the transverse foramen of the fourth cervical vertebra. This artery then traveled up in the transverse foramina and became the basilar artery, joining with the left vertebral artery. We discuss the embryological origin of this case and review previously reported cases.

Learning to Mean in Spanish Writing: A Case Study of a Genre-Based Pedagogy for Standards-Based Writing Instruction

ERIC Educational Resources Information Center

Troyan, Francis J.

2016-01-01

This case study reports the results of a genre-based approach, which was used to explicitly teach the touristic landmark description to fourth-grade students of Spanish as a foreign language. The instructional model and unit of instruction were informed by the pedagogies of the Sydney School of Linguistics and an instructional model for…

The Effects of an Intervention Combining Peer Tutoring with Story Mapping on the Text Comprehension of Struggling Readers: A Case Report

ERIC Educational Resources Information Center

Grünke, Matthias; Leidig, Tatjana

2017-01-01

This single-case study tested a peer tutoring model using a visualizing strategy (story mapping) to teach struggling students better text comprehension. Three teams each consisting of a tutor and a tutee attending a fourth-grade general education classroom participated in the experiment. A short series of observations was carried out before and…

Giant cemento-ossifying fibroma of the mandible

PubMed Central

Naik, Raghavendra Mahadev; Guruprasad, Yadavalli; Sujatha, D; Gurudath, Shubha; Pai, Anuradha; Suresh, KV

2014-01-01

Cemento-ossifying fibroma (COF) is classified as a fibro-osseous neoplasm and included among the non-odontogenic tumors derived from the mesenchymal blast cells of the periodontal ligament, with a potential for forming fibrous tissue, cementum and bone, or a combination of such elements. These are slow-growing lesions, and are more frequent in women between the third and fourth decades of life. Case reports of massive expansile COF, measuring more than 10 cm are rarely reported in the literature. We report a case of giant cemento-ossifying fibroma of the mandible in a 34 year old female patient. PMID:24678226

Giant cemento-ossifying fibroma of the mandible.

PubMed

Naik, Raghavendra Mahadev; Guruprasad, Yadavalli; Sujatha, D; Gurudath, Shubha; Pai, Anuradha; Suresh, Kv

2014-01-01

Cemento-ossifying fibroma (COF) is classified as a fibro-osseous neoplasm and included among the non-odontogenic tumors derived from the mesenchymal blast cells of the periodontal ligament, with a potential for forming fibrous tissue, cementum and bone, or a combination of such elements. These are slow-growing lesions, and are more frequent in women between the third and fourth decades of life. Case reports of massive expansile COF, measuring more than 10 cm are rarely reported in the literature. We report a case of giant cemento-ossifying fibroma of the mandible in a 34 year old female patient.

Fourth-line rescue therapy with rifabutin in patients with three Helicobacter pylori eradication failures.

PubMed

Gisbert, J P; Castro-Fernandez, M; Perez-Aisa, A; Cosme, A; Molina-Infante, J; Rodrigo, L; Modolell, I; Cabriada, J L; Gisbert, J L; Lamas, E; Marcos, E; Calvet, X

2012-04-01

In some cases, Helicobacter pylori infection persists even after three eradication treatments. To evaluate the efficacy of an empirical fourth-line rescue regimen with rifabutin in patients with three eradication failures. Multicentre, prospective study. In whom the following three treatments had consecutively failed: first (PPI + clarithromycin + amoxicillin); second (PPI + bismuth + tetracycline + metronidazole); third (PPI + amoxicillin + levofloxacin). A fourth regimen with rifabutin (150 mg b.d.), amoxicillin (1 g b.d.) and a PPI (standard dose b.d.) was prescribed for 10 days. Eradication was confirmed by (13) C-urea breath test 4-8 weeks after therapy. Compliance and tolerance: Compliance was determined through questioning and recovery of empty medication envelopes. Adverse effects were evaluated using a questionnaire. One-hundred patients (mean age 50 years, 39% men, 31% peptic ulcer/69% functional dyspepsia) were included. Eight patients did not take the medication correctly (in six cases due to adverse effects). Per-protocol and intention-to-treat eradication rates were 52% (95% CI = 41-63%) and 50% (40-60%). Adverse effects were reported in 30 (30%) patients: nausea/vomiting (13 patients), asthenia/anorexia (8), abdominal pain (7), diarrhoea (5), fever (4), metallic taste (4), myalgia (4), hypertransaminasemia (2), leucopenia (<1,500 neutrophils) (2), thrombopenia (<150,000 platelets) (2), headache (1) and aphthous stomatitis (1). Myelotoxicity resolved spontaneously in all cases. Even after three previous H. pylori eradication failures, an empirical fourth-line rescue treatment with rifabutin may be effective in approximately 50% of the cases. Therefore, rifabutin-based rescue therapy constitutes a valid strategy after multiple previous eradication failures with key antibiotics, such as clarithromycin, metronidazole, tetracycline and levofloxacin. © 2012 Blackwell Publishing Ltd.

Short fourth and fifth metacarpals in a case of idiopathic primary hypoparathyroidism

PubMed Central

Valizadeh, Neda; Mehdizadeh, Alireza; Nazarbaghi, Surena

2013-01-01

Shortening of metacarpals is a useful diagnostic marker in patients with pseudohypoparathyroidism type Ia (PHP-Ia) with Albright's hereditary osteodystrophy (AHO) phenotype or pseudopseudohypoparathyroidism (PPHP). There are very rare reports of metacarpals shortening in idiopathic primary hypoparathyroidism (IPH) cases in the literature. Here we described a young woman with IPH who presented with hypocalcaemia and generalized tonic-clonic seizure. She had shortening of forth and fifth metacarpals which was prominent in her right hand. Based on our finding and other previous case reports we conclude that metarpals shortening is not a specific finding of PHP-Ia or PPHP and it may be found in IPH cases. PMID:24083181

Childhood headache attributed to airplane travel: a case report.

PubMed

Rogers, Kirsty; Rafiq, Nadia; Prabhakar, Prab; Ahmed, Mas

2015-05-01

Headache attributed to airplane flights is a rare form of headache disorder. This case study describes an 11-year-old girl with recurrent, severe, frontal headaches occurring during airplane travel. The episodes were associated with dizziness and facial pallor but no additional symptoms and showed spontaneous resolution on landing. Blood tests and imaging revealed no abnormalities. The present case fulfils the criteria for airplane headache recently included in the revised edition of the International Classification of Headache Disorders (ICHD-III Beta). Only a few cases of airplane headache have been reported in children. To our knowledge, this is the fourth case. We review the current literature on this rare syndrome and discuss various proposed pathophysiological mechanisms. © The Author(s) 2014.

Reasons for Vocabulary Attrition: Revisiting the State of the Art

ERIC Educational Resources Information Center

Alharthi, Thamer

2015-01-01

This paper reports on a one year, mixed-methods longitudinal case study investigating the neglected area of the perceived reasons why participants forget vocabulary knowledge. The participants were 43 fourth year male Saudi EFL majors at King Abdulaziz University KAU, Saudi Arabia. Quantitative and qualitative data including self-reported…

Compensatory Education: Case Study

ERIC Educational Resources Information Center

Bateman, David F.

2007-01-01

Anna is a 13-year-old student who has a learning disability and is eligible for special education and related services. Anna's parents enrolled her in the Private Academy for fifth grade; her frustration, inappropriate behaviors, and inattention had increased during fourth grade. In its year-end report, the Private Academy described Anna's…

An unusual variety of simultaneous fracture dislocation pattern: medial swivel dislocation of talonavicular joint with displaced fractures of the fourth and fifth metatarsals.

PubMed

Inal, Sermet; Inal, Canan

2013-01-01

In published studies, a very rare, special type of Chopart dislocation termed a swivel dislocation has been reported. This injury is characterized by dislocation of the talonavicular joint, but the calcaneocuboid joint remains intact. The foot creates a typical rotational movement without inversion or eversion. The axis of rotation is the interosseous talocalcaneal ligament, which remains intact. We report the case of an 18-year-old male who had experienced a medial swivel dislocation of the talonavicular joint associated with displaced fractures of the fourth and fifth metatarsals. The occurrence, features, and method of treatment of this rare injury are presented. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Management of Foramen Magnum Meningioma During Pregnancy: Literature Review and Case Report.

PubMed

Casabella, Amanda M; Urakov, Timur M; Basil, Gregory; Morcos, Jacques J

2017-01-01

Foramen magnum meningiomas are very rare and challenging lesions. Their presentation in women during pregnancy tremendously complicates the course of gestation. Conservative management is always the first option, but in cases of a deteriorating clinical picture, there are currently no clear guidelines on best management. A woman presents in the 30th week of pregnancy with pain and progressive numbness in right posterior aspect of neck and right arm. Foramen magnum meningioma was diagnosed and successful surgical resection was performed with intraoperative fetal hearth monitoring and three fourths prone position of the patient. We believe a three fourths prone position of a pregnant patient is safe and adequate for the far-lateral exposure of craniocervical lesions. Rapid growing of tumor can be precipitated by steroids management during pregnancy. Published by Elsevier Inc.

Space Shuttle propulsion parameter estimation using optimal estimation techniques

NASA Technical Reports Server (NTRS)

1983-01-01

This fourth monthly progress report again contains corrections and additions to the previously submitted reports. The additions include a simplified SRB model that is directly incorporated into the estimation algorithm and provides the required partial derivatives. The resulting partial derivatives are analytical rather than numerical as would be the case using the SOBER routines. The filter and smoother routine developments have continued. These routines are being checked out.

Traumatic ipsilateral multiple open metatarsal and calcaneal fractures with first metatarsophalangeal joint dislocation: a case report.

PubMed

Ozkan, Namik Kemal; Unay, Koray; Cift, Hakan; Eceviz, Engin; Ozkan, Korhan

2010-06-01

A 17-year-old man fell from a height of 10 m onto his right forefoot and sustained ipsilateral calcaneal, comminuted cuboid, and second, third, and fourth metatarsal neck fractures and first metatarsophalangeal joint open dislocation. This report discusses this rare injury. The authors believe that initial debridement with immediate surgical fixation and reduction with appropriate antibiotic treatment saved the patient's extremity.

Occupational Asthma in Antibiotic Manufacturing Workers: Case Reports and Systematic Review

PubMed Central

Díaz Angulo, Sara; Szram, Joanna; Welch, Jenny; Cannon, Julie; Cullinan, Paul

2011-01-01

Background. The risks of occupational asthma (OA) from antibiotics are uncertain. We report 4 new cases and a systematic review of the literature. Methods. Cases were identified through a specialist clinic, each underwent specific provocation testing (SPT). We subsequently reviewed the published literature. Results. The patients were employed in the manufacture of antibiotics; penicillins were implicated in three cases, in the fourth erythromycin, not previously reported to cause OA. In two, there was evidence of specific IgE sensitisation. At SPT each developed a late asthmatic reaction and increased bronchial hyperresponsiveness. 36 case reports have been previously published, 26 (citing penicillins or cephalosporins). Seven cross-sectional workplace-based surveys found prevalences of 5–8%. Conclusions. OA in antibiotic manufacturers may be more common than is generally recognised. Its pathogenesis remains unclear; immunological tests are of uncertain value and potential cases require confirmation with SPT. Further study of its frequency, mechanisms, and diagnosis is required. PMID:21603168

Foundations for Success: Case Studies of How Urban School Systems Improve Student Achievement [and] Abstract.

ERIC Educational Resources Information Center

Snipes, Jason; Doolittle, Fred; Herlihy, Corinne

This report examines the experiences of three large urban school districts (and part of a fourth) that raised academic performance for their districts as a whole, while also reducing racial differences in achievement. Educational challenges included low achievement, political conflict, inexperienced teachers, low expectations, and lack of…

Modelling Impacts of Climate Change: Case Studies using the New Generation of Erosion Models

USDA-ARS?s Scientific Manuscript database

Climate change is expected to impact upon a number of soil erosion drivers and processes, which should be taken into account when designing a modelling strategy. The fourth assessment report of the Intergovernmental Panel for Climate Change (IPCC) (Parry et al., 2007; Solomon et al., 2007) reviews a...

Investigating Fourth Amendment Judicial Outcomes across Contrasting Minority School Settings: Subjectivity in Disciplinary Decision Making in Diverse Settings?

ERIC Educational Resources Information Center

Torres, Mario S., Jr.; Callahan, Jamie L.

2008-01-01

This study explores the court system's treatment of students' Fourth Amendment rights in cases emerging from contrasting minority school settings and whether discrepancies exist in case outcomes between these extremes. From virtually every search and seizure case that occurred between the 1985 U.S. Supreme Court case in "New Jersey v.…

Fourth Marine Division Operations Report - Tinian, 24 July to 1 August 1944

DTIC Science & Technology

1944-08-01

and 2 and Beach :Red. 3. All LCVPs - witn liht vehicles and. equiprment - from desi.gnted areas on Beaches Gre n 1 and. 2. In all cases , drivers and...Headquarters was landed - 19 - ti~~~~~ -· . M . a-.>g. ; fDXXX4XffV,- ,4 an v ;..............f 1 4 SECTION III - SHOi .01 TO HOYiC OPiATIO -i on Ji--cayr...SPECIAL &ACTIO1> REPORT, T’INTIAN. AddBd to this -;aere many small miiscellaneous units such as airbase and construction units. Ass had betn the case on

Streptococcus suis meningoencephalitis with seizure from raw pork ingestion: a case report.

PubMed

Wongjittraporn, Suwarat; Teerasukjinda, Ornusa; Yee, Melvin; Chung, Heath H

2014-09-01

Streptococcus suis meningoencephalitis is a rare but increasingly important condition. Good history taking will give clues to the diagnosis. This is the fourth case report in the United States. A 52-year-old Filipino man who recently returned from a trip to the Philippines was admitted with classic symptoms of bacterial meningitis. His cerebrospinal fluid culture grew Streptococcus suis. His clinical course was complicated by seizures, hearing loss, and permanent tinnitus. Clinicians should be aware of this emerging disease especially in patients with recent travel history to endemic areas. Early recognition and appropriate management could potentially prevent complications.

Presentation of renal cell carcinoma as cervical polyp metastasis.

PubMed

Godfrey, Gwendolyn J; Moore, Grace; Alatassi, Houda

2010-10-01

Secondary cervical adenocarcinomas are most commonly seen owing to the extension of a primary endometrial adenocarcinoma. Metastatic tumors from other sites are rather uncommon and, when seen, are most frequently from the ovaries, gastrointestinal tract, or breast. We report a case of metastatic renal cell carcinoma, clear cell variant, to the cervix, which presented as a cervical polyp in a postmenopausal female. To our knowledge, this is the fourth reported case of renal cell carcinoma metastatic to the cervix. This case is only the third in which the cervical metastasis was the presenting sign of renal cell carcinoma and the first in which the clinical presentation was as a cervical polyp.

Sexsomnia: A case of sleep masturbation documented by video-polysomnography in a young adult male with sleepwalking.

PubMed

Yeh, Shih-Bin; Schenck, Carlos H

2016-01-01

The first case of video-polysomnography (vPSG) documented sleep masturbation in a male is reported, and the second reported case of shift work induced sexsomnia. A 20 y.o. soldier with childhood sleepwalking (SW) developed sleep masturbation and SW triggered by military shift work. vPSG documented two episodes of sleep masturbation from N2 sleep in the fourth sleep cycle and from N3 sleep during the fifth sleep cycle. There was no sleep-disordered breathing nor periodic limb movements. vPSG thus confirmed confusional arousals from NREM sleep as the cause of the masturbation. Bedtime clonazepam therapy controlled the SW but not the masturbation.

A case report of pornography addiction with dhat syndrome

PubMed Central

Darshan, M. S.; Sathyanarayana Rao, T. S.; Manickam, Sam; Tandon, Abhinav; Ram, Dushad

2014-01-01

A case of pornography addiction with dhat syndrome was diagnosed applying the existing criteria for substance dependence in International Classification for Diseases-10 and Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision. There is a lack of clear-cut criteria for identifying and defining such behavioural addictions and also lack of medical documents on pornography addiction. An applied strategy in lines with any substance addiction is used, and we found it helped our patient to gradually deaddict and then completely quit watching pornography. This is one of the few cases being reported scientifically, and we hope more work will be carried out in this ever increasing pornography addiction problem. PMID:25568482

77 FR 31849 - Information Collections Being Submitted for Review and Approval to the Office of Management and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-30

... Broadcast Translator Stations, Fourth Report and Order and Third Order on Reconsideration (``Fourth Report... than 4 pending translator applications) to request the dismissal of applications to comply with these... Eligibility Rules for FM Broadcast Translator Stations, Fourth Report and Order and Third Order on...

Potential Protective Effects of Probiotics and Prebiotics Against Colorectal Cancer

NASA Astrophysics Data System (ADS)

Allsopp, Philip; Rowland, Ian

Colorectal cancer (CRC) is the fourth most frequent cause of cancer related mortality in the world. Approximately 944,000 new cases were diagnosed globally in 2000 and this accounts for 9.2% of all new cancer cases (IARC, 2000). In Western societies namely Europe, North America and Australasia, it is the second most prevalent cancer after lung/breast (Boyle and Langman, 2000). About 363,000 new cases were reported in Europe in 2000 and it affects 6% of men and women by age 75, in almost equal proportion.

Colloid cyst and multiple meningiomata in Gorlin syndrome.

PubMed

Li, Yan-Lin; Kwok, Stephen Kai-Yan; Shiu, Kenneth Chun-Kit

2018-01-01

A middle-aged man presented with syncope and confusion. Neuroimaging revealed a third ventricular mass with obstructive hydrocephalus and bilateral convexity meningiomata. The masses were excised and pathology showed a colloid cyst and WHO grade 1 meningiomata respectively. Multisystem workup confirmed Gorlin syndrome. To our knowledge, this is the fourth reported case of Gorlin syndrome associated with colloid cyst, and the first case where multiple meningiomata are also present. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Sirenomelia Sequence: A Case History

PubMed Central

Fadhlaoui, Anis; Khrouf, Mohamed; Gaigi, Soumaya; Zhioua, Fethi; Chaker, Anis

2010-01-01

We report a case of sirenomelia sequence observed in an incident of preterm labor during the 29th gestational week. According to some authors, this syndrome should be classified separately from caudal regression syndrome and is likely to be the result of an abnormality taking place during the fourth gestational week, causing developmental abnormalities in the lower extremities, pelvis, genitalia, urinary tract and digestive organs. Despite recent progress in pathology, the etiopathogenesis of sirenomelia is still debated. PMID:21769253

Search and Seizure of Students in Public Schools: 2002 Update of Fourth Amendment Cases.

ERIC Educational Resources Information Center

Stefkovich, Jacqueline A.

This paper presents court cases for the purpose of updating current knowledge on search and seizure of students in the school setting. These cases focus on the balance and interplay between students' Fourth Amendment rights and school administrators' obligations to maintain order and discipline in the schools. Part of this obligation implies…

Quadruple cancer including Bowen's disease after arsenic injections 40 years earlier: report of a case.

PubMed

Murata, K; Iwazawa, T; Takayama, T; Yamashita, K; Okagawa, K

1994-01-01

This report describes the successful treatment of quadruple cancer including Bowen's disease in a 71-year-old man who had been given injections of salvarsan, an arsenic compound, for syphilis more than 40 years earlier. Resection of a skin lesion on his chest subsequently confirmed a diagnosis of Bowen's disease, 3 years after which he was operated on for concurrent gastric cancer and sigmoid colon cancer. A fourth cancer was discovered on his left vocal cord 2 weeks after this operation; it was resected 2 years later. A discussion of multiple malignant neoplasms and the possible relationship between arsenic and cancer is presented following this case report.

What Form of Mathematics Are Assessments Assessing? The Case of Multiplication and Division in Fourth Grade NAEP Items

ERIC Educational Resources Information Center

Kosko Karl W.; Singh, Rashmi

2018-01-01

Multiplicative reasoning is a key concept in elementary school mathematics. Item statistics reported by the National Assessment of Educational Progress (NAEP) assessment provide the best current indicator for how well elementary students across the U.S. understand this, and other concepts. However, beyond expert reviews and statistical analysis,…

State Actions To Restructure Schools: First Steps. Results in Education Series.

ERIC Educational Resources Information Center

David, Jane L.; And Others

The widening mismatch between the skills of the work force and the skill demands of the work place underlie the need for school restructuring. Fourth in a series, this document builds on and extends the issues discussed in the National Governors' Association's (NGA) previous publications and reports on case studies of early restructuring efforts…

Structure and Flow: Toward an Organic Approach to Critical Multiliteracies in a Writing Workshop

ERIC Educational Resources Information Center

Schaenen, Inda

2010-01-01

This qualitative case study reports on a three-year writing enrichment program among second, third, and fourth graders at a public urban elementary school in a medium-sized midwestern city. Designed as teacher research, the inquiry is a phenomenological examination of the experience of the workshop for its participants, including more than one…

Supernumerary maxillary and Mandibular Fourth Molars.

DTIC Science & Technology

1981-09-23

9-109, 1963. 11. Gorlin, R.J.; Pindborg, J.J.; and Cohen, M.M., Jr.: Syndromes of the Head and Neck , 2nd ed., New York, 1976, McGraw-Hill Book...Hyperdontia:Report of case. JADA 79: 1191-1192, 1969. 5. Sicher, H. (ed.): Orban’s Oral Histology and Embryology , ed. 5, St. Louis, 1962, The C.V. Mosby Co

Melorheostosis of the hand with complicating bony spur formation and bursal inflammation: diagnosis and treatment.

PubMed

Ameen, S; Nagy, L; Gerich, U; Anderson, S E

2002-08-01

A 37-year old woman presented with intolerable pain associated with a slowly growing mass on the dorsum of the right hand. The radiographs were characteristic of melorheostosis involving the third and fourth metacarpals, with a cortical bony projection extending from the base of the third metacarpal eroding slightly into the fourth metacarpal, associated with bursal formation. Magnetic resonance imaging (MRI) demonstrated an inflamed bursal collection adjacent to the spur. This region corresponded to the patient's severe clinical, focal pain. To our knowledge, this is the first case report in which melorheostosis of the hand has been associated with bony spur formation and complicated by an inflamed bursa.

Takotsubo cardiomyopathy associated with cardiac arrest following cardiac surgery: new variants of an unusual syndrome.

PubMed

Vernick, William J; Hargrove, W Clark; Augoustides, John G; Horak, Jiri

2010-11-01

Takotsubo cardiomyopathy is increasingly being recognized in the perioperative period. To date, there have been only three previous cases involving cardiac surgery reported and this represents the fourth case. The precise mechanism remains elusive, and there is no definitive management strategy. It appears that the syndromes course in cardiac surgical patients is self-limited. This syndrome must now be considered in the differential diagnosis of postcardiotomy cardiac failure. © 2010 Wiley Periodicals, Inc.

Building America Case Study: Side-by-Side Testing of Water Heating Systems: Results from 2013-2014 Evaluation Final Report, Cocoa, FL

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

Rothgeb, Stacey K; Colon, C.; Martin, E.

The Florida Solar Energy Center (FSEC) has completed a fourth year-long evaluation on residential hot water heating systems in a laboratory environment (east central Florida, hot-humid climate). This report contains a summary of research activities regarding the evaluation of two residential electric heat pump water heaters (HPWHs), a solar thermal system utilizing a polymer glazed absorber and a high efficiency natural gas system.

Building America Case Study: Side-by-Side Testing of Water Heating Systems: Results from the 2013–2014 Evaluation Final Report

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

C. Colon and E. Martin

The Florida Solar Energy Center (FSEC) has completed a fourth year-long evaluation on residential hot water heating systems in a laboratory environment (east central Florida, hot-humid climate). This report contains a summary of research activities regarding the evaluation of two residential electric heat pump water heaters (HPWHs), a solar thermal system utilizing a polymer glazed absorber and a high efficiency natural gas system.

Simultaneous bilateral distal biceps tendon rupture during a preacher curl exercise: a case report.

PubMed

Rokito, Andrew S; lofin, Ilya

2008-01-01

Complete rupture of the distal biceps tendon is a rare injury, the overwhelming majority occurring in the dominant arm of males during the fourth to sixth decades of life. Simultaneous bilateral rupture of the distal biceps tendon is an extremely rare occurrence, with only three cases reported in the literature. This unusual injury occurred in a recreational weightlifter during a preacher curl exercise. In this particular case, a 6-week delay in presentation necessitated a staged procedure in which a primary repair was feasible in one elbow, while reconstruction using allograft tissue was required in the contralateral elbow. Satisfactory results for both elbows were achieved, with return to weightlifting by one year following surgery.

Giant cemento-ossifying fibroma of the mandible: a rare case.

PubMed

Sujatha, D; Shubha, Gurudath; Anuradha, Pai; Ragavendra, Mahadev Naik

2013-01-01

The World Health Organization classifies cemento-ossifying fibroma (COF) as a fibro-osseous neoplasm included among the nonodontogenic tumors derived from the mesenchymal blast cells of the periodontal ligament, with a potential for forming fibrous tissue, cementum and bone, or a combination of such elements. These are slow-growing lesions, and are more frequent in women, between the third and fourth decades of life. Case reports of massive expansile COFs (measuring more than 10 cm) are rarely reported in the literature. This article aims to describe a case of giant cemento-ossifying fibroma with radiographic and 3D CT features in a 34 year old female patient, who came with the complaint of progressive swelling of the face which had started 6 years earlier.

A case series of 12 patients with incidental asymptomatic Dandy-Walker syndrome and management.

PubMed

Jha, Vikas Chandra; Kumar, Raj; Srivastav, Arun Kumar; Mehrotra, Anant; Sahu, Rabi Narayan

2012-06-01

Incidentally detected asymptomatic Dandy-Walker syndrome (DWS) is sparsely reported in literature at extremes of age (from 1 to 75 years) in association with different diseases. Precipitating factors causing DWS in these cases to manifest in late adulthood are still unidentified. We tried to hypothesize the aetiology and the natural course of disease based on review of literature Twelve cases of asymptomatic DWS were selected retrospectively in this study while being treated for some unrelated disease over a period of 15 years. All the cases had vermian hypoplasia with sizeable fourth ventricular cyst (more than 3 cm), large posterior fossa and with no or borderline ventriculomegaly on CT/MRI. The age ranged from 1 to 65 years. Five cases presented with head injury and four cases presented with enlarged head size with suboccipital protuberance (noticed in children more than 5 years). Remaining cases presented with either occipital encephalocele or right trigeminal neuralgia or fixed atlantoaxial dislocation. They were asymptomatic for DWS following treatment of the presenting complaints on follow-up of average duration of 4.5 years. Presentation at extremes of age signifies that slow degenerative changes in communicating channels between fourth ventricular cyst and surrounding basal cisterns may cause asymptomatic DWS to manifest, but cases having good communication between these structures can remain asymptomatic throughout their life.

The "fourth disease" of childhood: reevaluation of a nonexistent disease.

PubMed

Morens, D M; Katz, A R

1991-09-15

Observed and described between 1884 and 1900, "fourth disease" (Dukes disease) followed measles, scarlet fever, and rubella as the fourth clinically characterized childhood exanthem. Like rubella ("third disease") and erythema infectiosum ("fifth disease"), accepted by the medical community at about the same time, the existence of fourth disease was initially controversial. Over the following decades descriptions of hundreds of cases, outbreaks, and laboratory studies were published in the indexed medical literature. Unlike rubella and fifth disease, however, fourth disease was not subsequently proven to exist by either epidemiologic criteria or isolation of an etiologic agent. By the 1930s, it was infrequently recognized and by the 1960s had been dropped from textbooks. In this study, the authors use epidemiologic methods to reevaluate published data on English schoolchildren from 1892 to 1900 upon which the original fourth disease claim of Dukes was based. The authors conclude that fourth disease never existed. Reinterpretation of the original data suggests that cases can be completely explained as misdiagnosed rubella and scarlet fever. Misidentification of fourth disease is attributed to failures in the critical abilities of the medical and scientific communities at the time. The implications of erroneously identifying a nonexistent disease suggest that modern scientific approaches to disease identification are sound.

Loeffler's syndrome: an interesting case report.

PubMed

Ekin, Selami; Sertogullarindan, Bunyamin; Gunbatar, Hulya; Arisoy, Ahmet; Yildiz, Hanifi

2016-01-01

Loeffler's syndrome is an acute pneumonia with an unclear cause. One fourth of Loeffler's syndrome patients are idiopathic, although the most common etiologic causes include parasites. Asymptomatic form is usually a reversible, self-limited disease, which does not require a specific treatment regimen. We presented a 17-year-old young man with diagnosis of Loeffler syndrome. © 2014 John Wiley & Sons Ltd.

Fourth branchial cleft anomaly: management strategy in acute presentation.

PubMed

Carta, Filippo; Sionis, Sara; Mascia, Luigi; Puxeddu, Roberto

2014-09-01

Branchial malformations are common congenital head and neck lesions usually diagnosed in childhood during the first decade of life. Acute presentation is usually managed with conservative protocols before a definitive surgical procedure although the risk of life-treating septic complications may influence the physician's decision. Surgery is the treatment of choice with the removal of the lesion alone, nevertheless more aggressive approaches must be considered in complicated cases. Selective neck dissection including the removal of part of the thyroid lobe with the congenital lesion should be considered as the "ultima ratio" treatment to avoid recurrence. We reviewed literature and report our experience concerning two patients with fourth branchial cleft sinus. A three-year-old child with a clinical history of recurrent neck abscess was referred to our department after several drainages performed in another centre. A three-year-old child referred to our department for a left side lower primary neck abscess. In both cases the diagnosis of a complicated fourth cleft remnant was confirmed by rigid endoscopic visualization of the mucosal orifice of the sinus in the pyriform fossa. Surgical management during acute presentation was challenging; in one patient the early fasciitis required an emergency procedure to remove the infected sinus that were strictly adherent to the deep vascular-nervous axis. Surgery was the definitive treatment in both cases and at 12 and 25 months follow-up respectively no recurrences were observed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Dandy-Walker syndrome with psychotic symptoms: a case report.

PubMed

Buonaguro, Elisabetta F; Cimmarosa, Sara; de Bartolomeis, Andrea

2014-01-01

Here we report the case of a patient with psychotic symptoms apparently resistant to antipsychotic treatments. Since the last admission in a psychiatric division the patient was diagnosed with Bipolar Disorder type I and then referred to our Outpatients Unit of Treatment Resistant Psychosis, where she was subsequently re-diagnosed with Dandy-Walker Syndrome. The Dandy Walker Complex is a congenital brain malformation involving the fourth ventricle and the cerebellum. We investigated the cognitive impairment of the patient and found deficits prominently in executive functions. This report may add further evidence on the importance of a correct diagnosis prior to defining a patient as treatment resistant and highlights cerebellar dysfunctions that may contribute to neuropsychiatric symptoms and cognitive impairment.

Exploring the Causes of Underachievement of African American Boys: A Qualitative Descriptive Case Study

ERIC Educational Resources Information Center

Ennis, Rosetta

2017-01-01

The qualitative descriptive case study explores the underachievement phenomenon of fourth-grade African American boys in New York City public elementary schools. Numerous studies have been conducted at the middle school through college levels. However, very little is known about the underachievement phenomenon of fourth-grade African American…

A Unique Instrumental Malfunction during Robotic Prostatectomy

PubMed Central

Park, Sung Yul; Ahn, Jenny Jin-Kyung; Jeong, Wooju; Ham, Won Sik

2010-01-01

Over the past decade, the introduction of robotics in the field of medicine has provided a new approach to patients requiring surgery, and both its advantages and disadvantages are currently under study by many groups worldwide. The use of robotics has especially been considered by the urological community as a treatment option in radical prostatectomy. The current case report is one in which the da Vinci Surgical System™, with fourth arm use was employed in radical prostatectomy. This case presents a unique occurrence in which a bolt of the Prograsper forcep became loose during an operation, leading to diminished device functionality and later impedance of its removal. A circumstance such as this has not previously been reported, so we introduce for other robotic surgeons our unique instrumental malfunction case during a robotic prostatectomy. PMID:20046531

Long survival in a 69,XXX triploid infant in Greece.

PubMed

Iliopoulos, Dimitrios; Vassiliou, Georgia; Sekerli, Eleni; Sidiropoulou, Vasiliki; Tsiga, Alexandra; Dimopoulou, Despina; Voyiatzis, Nikolaos

2005-12-30

The live birth of a triploidy infant is a very rare event and death usually occurs within the first hours of life. Triploid cases with a survival of more than two months are infrequent. We report on an infant with a 69,XXX chromosome constitution who survived 164 days. Chromosomal analysis demonstrated a 69,XXX karyotype with no evidence of mosaicism. This is the longest survival reported for this condition to date in Greece and the fourth longest worldwide. The infant was admitted to our clinic several times due to respiratory problems, and supplementary oxygen was required. The improved survival of our case was possibly due to better management of respiratory illness and prematurity, and these are essential factors that physicians should consider carefully with such rare cases.

Renal manifestations of human brucellosis: First report of minimal change disease.

PubMed

Sabanis, Nikolaos; Gavriilaki, Eleni; Paschou, Eleni; Tsotsiou, Eleni; Kalaitzoglou, Asterios; Kavlakoudis, Christos; Vasileiou, Sotirios

2016-05-01

Human brucellosis is considered a great example of the complexity of clinical manifestations possibly affecting multiple organs or systems. Renal manifestations of human brucellosis have been documented in few case reports and one case series. Herein, we present a case of Nephrotic syndrome (NS) due to minimal change disease in the course of acute brucellosis. A 53-year-old male farmer was admitted to our department with acute brucellosis and NS. Renal biopsy revealed minimal change disease. Combined treatment with prednisone (1 mg/kg), rifampicin (600 mg/day), and doxycycline (200 mg/day) was initiated. Complete remission of NS was achieved at the end of the fourth week. One year later, the patient remained in complete remission of NS without any sign of relapse of brucellosis.

Gastrointestinal tract metastasis from tubulolobular carcinoma of the breast: a case report and review of the literature.

PubMed

Wang, Guixin; Wang, Tingjiang; Jiang, Jian; Zhou, Luyao; Zhao, Haidong

2014-01-01

Metastasis of breast cancer into the gastrointestinal tract happens rarely. The diagnosis of this kind of disease is difficult because of the nonspecific symptoms and the long interval between primary manifestations and recurrence. Awareness of this condition may lead to an accurate diagnosis and an earlier initiation of systemic treatment, thus avoiding unnecessary surgical intervention. In this paper, we report a rare case of a patient with tubulolobular carcinoma metastases to the colon, presenting with abdominal pain, discomfort, and weight loss. The patient underwent radical mastectomy and received postoperative radiotherapy and chemotherapy. Ten years later, she presented with gastrointestinal tract symptoms. Surgery combined with systemic treatment was chosen for the colon lesion. Immunohistochemical staining suggested a breast origin. The patient was still living 24 months after the diagnosis of the metastasis. This is the fourth case report in our literature review.

ICASE Semiannual Report, October 1, 1992 through March 31, 1993

DTIC Science & Technology

1993-06-01

NUMERICAL MATHEMATICS Saul Abarbanel Further results have been obtained regarding long time integration of high order compact finite difference schemes...overall accuracy. These problems are common to all numerical methods: finite differences , finite elements and spectral methods. It should be noted that...fourth order finite difference scheme. * In the same case, the D6 wavelets provide a sixth order finite difference , noncompact formula. * The wavelets

Wolfram Syndrome presenting with optic atrophy and diabetes mellitus: two case reports

PubMed Central

2009-01-01

Wolfram syndrome is the constellation of juvenile onset diabetes mellitus and optic atrophy, known as DIDMOAD (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy, and Deafness). Patients demonstrate diabetes mellitus followed by optic atrophy in the first decade, diabetes insipidus and sensorineural deafness in the second decade, dilated renal outflow tracts early in the third decade, and multiple neurological abnormalities early in the fourth decade. This study reports two siblings with late diagnosed wolfram syndrome with diabetes insipidus, diabetes mellitus, optic atrophy, deafness and severe urological abnormalities. In conclusion, cases having early onset insulin-dependent diabetes mellitus and optic atrophy together need to be evaluated with respect to Wolfram. PMID:20062605

Aggressive Angiomyxoma of the Vulva Mimicking Clitoromegaly in a Young Child.

PubMed

Kawamura, Masataka; Matsumoto, Fumi; Matsui, Futoshi; Yazawa, Koji; Shimada, Kenji

2017-03-01

Aggressive angiomyxoma (AAM) is a rare soft tissue tumor of mesenchymal origin that chiefly involves the vulvar and perineal region. In 90% of cases, AAM presents in women of reproductive age with a peak incidence in the fourth decade of life. To date, AAM of the vulva in young children and infancy has never been reported. We present a case of AAM of the vulva that was initially interpreted as clitoromegaly in a 3-year-old girl. Copyright © 2016 Elsevier Inc. All rights reserved.

Twenty-fourth Semiannual Report of the Commission to the Congress, July 1958

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

Strauss, Lewis L.; McCone, John A.

1958-07-31

The document represents the twenty-fourth semiannual Atomic Energy Commission (AEC) report to Congress. The report sums up the major activities and developments in the national atomic energy program covering the period January - June 1958.

[Ischemic cholangiopathy induced by extended burns].

PubMed

Cohen, Laurence; Angot, Emilie; Goria, Odile; Koning, Edith; François, Arnaud; Sabourin, Jean-Christophe

2013-04-01

Ischemic cholangiopathy is a recently described entity occurring mainly after hepatic grafts. Very few cases after intensive care unit (ICU) for extended burn injury were reported. We report the case of a 73-year-old woman consulting in an hepatology unit, for a jaundice appearing during a hospitalisation in an intensive care unit and increasing from her leaving from ICU, where she was treated for an extended burn injury. She had no pre-existing biological features of biliary disease. Biological tests were normal. Magnetic resonance imaging acquisitions of biliary tracts pointed out severe stenosing lesions of diffuse cholangiopathy concerning intrahepatic biliary tract, mainly peri-hilar. Biopsie from the liver confirmed the diagnosis, showing a biliary cirrhosis with bile infarcts. This case is the fourth case of ischemic cholangiopathy after extended burn injury, concerning a patient without a prior history of hepatic or biliary illness and appearing after hospitalisation in intensive care unit. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Domestic airlines fares consumer report. Second report : fourth quarter 1996 passenger and fare information

DOT National Transportation Integrated Search

1997-08-01

In response to an increasing number of inquires about domestic airline prices, the Department of Transportation decided to release a quarterly fare report. This is the second report and is based on data for the fourth quarter of 1996. For each market...

Domestic airlines fares consumer report. Fourth report : second quarter 1997 passenger and fare information

DOT National Transportation Integrated Search

1998-01-01

In response to an increasing number of inquires about domestic airline prices, the Department of Transportation decided to release a quarterly fare report. This is the fourth report and is based on data for the second quarter of 1997. For each market...

Fourth Ventriculostomy in Occlusion of the Foramen of Magendie Associated with Chiari Malformation and Syringomyelia

PubMed Central

Orakdogen, Metin; Emon, Selin Tural; Erdogan, Baris; Somay, Hakan

2015-01-01

We present four cases of hydrocephalus caused by occlusion of foramen of Magendie associated with Chiari Type I malformation and syringomyelia. The aim of this study is to evaluate the results of surgical treatment via fourth ventriculostomy with catheter from the fourth ventricle to the upper cervical subarachnoid space. Obstructive tetraventricular hydrocephalus due to occlusion of the foramina of Luschka and Magendie can be treated with cerebrospinal fluid shunting, opening the membranes with suboccipital craniotomy, placement of a catheter, endoscopic third ventriculostomy, and endoscopic fourth ventriculostomy. Our aim was to solve all the pathologies such as Chiari malformation, hydrocephalus, and syringomyelia in one approach. Thus, the treatment consisted of posterior fossa decompression and exploration. All the patients were treated with suboccipital craniectomy and C1 laminectomy with excision of the membrane obstructing the foramen of Magendie. Fourth ventriculostomy with cathetering from fourth ventricle to upper cervical subarachnoid space was performed. The postoperative period was uneventful in all the patients. Neurological status of all the patients improved. Tetraventricular hydrocephalus and syrinx were reduced in the control cranial magnetic resonance imaging. Complications such as infection and catheter migration were not observed during the follow-up period. Treatment with fourth ventriculostomy using a catheter from fourth ventricle to upper cervical subarachnoid space could be a treatment of choice in cases with hydrocephalus caused by occlusion of the foramina of Magendie, with associated Chiari Type I malformation and syringomyelia. PMID:28663969

Case Report: A Rosette-forming Glioneuronal Tumor in the Tectal Plate in a Patient with Neurofibromatosis Type I.

PubMed

Sieg, Emily P; Payne, Russell; Langan, Sara; Specht, Charles S

2016-11-01

We report the case of a 41-year-old female with neurofibromatosis Type 1 (NF1) who developed a rosette-forming glioneuronal tumor (RGNT) in the tectal plate. This tumor was diagnosed in 2002 when the patient presented with obstructive hydrocephalus, which was subsequently treated with a ventriculoperitoneal shunt and then an endoscopic third ventriculostomy. Initially thought to be a pilocytic astrocytoma, it was followed with serial magnetic resonance imaging (MRI) until tumor progression and development of a large fourth ventricular cystic component prompted resection via suboccipital craniotomy. Histological examination demonstrated an RGNT, a WHO Grade 1 tumor, with neurocytic rosettes, perivascular pseudorosettes, and elements resembling a pilocytic astrocytoma. Initially, the patient did well after her craniotomy, but postoperative complications set in that eventually led to her death. In this case report, we describe a relatively rare tumor that, despite its benign nature, leads to frequent complications and deficits due to its surgically challenging location. Along with previously reported examples, this cases raises the possibility of a causal relationship between NF1 and RGNT.

Dandy-Walker Malformation Presenting with Affective Symptoms.

PubMed

Batmaz, Mert; Balçik, Zeynep Ezgi; Özer, Ürün; Hamurişçi Yalçin, Burcu; Özen, Şakir

2017-09-01

Dandy-Walker malformation is defined by enlarged posterior fossa, cystic dilatation of the fourth ventricle, and cerebellar hypoplasia. Although developmental delay and mental retardation are common in Dandy-Walker malformation cases, other comorbid psychiatric conditions have been rarely reported. There are limited numbers of case reports about comorbidity of bipolar disorder with Dandy-Walker malformation in the literature. Herein, a Dandy-Walker malformation case presenting affective symptoms is reported, and psychiatric symptoms which might be seen in this rare malformation are discussed along with diagnosis, treatment, and follow-up processes. A 27-year-old male patient, hospitalized for compulsory treatment, had been diagnosed with Dandy-Walker malformation in childhood. First complaints were attention deficiency, behavioral problems, learning difficulties; and manic and depressive episodes have occurred during follow-ups. He recently complained of decreased need for sleep, irritability, and increased speed of thought, and psychiatric examination was consistent with manic episode. Cranial computed tomography (CT) revealed bilateral ventriculomegaly, enlarged third and fourth ventricles with posterior fossa cyst, and cerebellar hypoplasia. His treatment included 30 mg/day aripiprazole, 1000 mg/day valproic acid, 200 mg/day quetiapine, 4 mg/day biperiden, and 100 mg/month paliperidone palmitate. Beside its traditional role in the regulation of coordination and motor functions, cerebellum is increasingly emphasized for its involvement in the mood regulation. Thus, as seen in Dandy-Walker malformation, cerebellar anomalies are suggested to play a role in the pathophysiology of mood disorders. Further studies are needed to better understand the relationship between mood disorders and cerebellum. Moreover, treatment options should be considered carefully in terms of resistance to treatment and potential side effects, for psychiatric disorders occurring in these cases; and detailed examinations, including cranial imaging, would be beneficial in bipolar cases with early onset, unresponsiveness to treatment, presenting atypical symptoms, mental retardation, and developmental delay as well as neurological symptoms and signs.

Dandy-Walker Malformation Presenting with Affective Symptoms

PubMed Central

BATMAZ, Mert; BALÇIK, Zeynep Ezgi; ÖZER, Ürün; HAMURİŞÇİ YALÇIN, Burcu; ÖZEN, Şakir

2017-01-01

Dandy-Walker malformation is defined by enlarged posterior fossa, cystic dilatation of the fourth ventricle, and cerebellar hypoplasia. Although developmental delay and mental retardation are common in Dandy-Walker malformation cases, other comorbid psychiatric conditions have been rarely reported. There are limited numbers of case reports about comorbidity of bipolar disorder with Dandy-Walker malformation in the literature. Herein, a Dandy-Walker malformation case presenting affective symptoms is reported, and psychiatric symptoms which might be seen in this rare malformation are discussed along with diagnosis, treatment, and follow-up processes. A 27-year-old male patient, hospitalized for compulsory treatment, had been diagnosed with Dandy-Walker malformation in childhood. First complaints were attention deficiency, behavioral problems, learning difficulties; and manic and depressive episodes have occurred during follow-ups. He recently complained of decreased need for sleep, irritability, and increased speed of thought, and psychiatric examination was consistent with manic episode. Cranial computed tomography (CT) revealed bilateral ventriculomegaly, enlarged third and fourth ventricles with posterior fossa cyst, and cerebellar hypoplasia. His treatment included 30 mg/day aripiprazole, 1000 mg/day valproic acid, 200 mg/day quetiapine, 4 mg/day biperiden, and 100 mg/month paliperidone palmitate. Beside its traditional role in the regulation of coordination and motor functions, cerebellum is increasingly emphasized for its involvement in the mood regulation. Thus, as seen in Dandy-Walker malformation, cerebellar anomalies are suggested to play a role in the pathophysiology of mood disorders. Further studies are needed to better understand the relationship between mood disorders and cerebellum. Moreover, treatment options should be considered carefully in terms of resistance to treatment and potential side effects, for psychiatric disorders occurring in these cases; and detailed examinations, including cranial imaging, would be beneficial in bipolar cases with early onset, unresponsiveness to treatment, presenting atypical symptoms, mental retardation, and developmental delay as well as neurological symptoms and signs. PMID:29033643

Sjogren’s syndrome: a case report

NASA Astrophysics Data System (ADS)

Sunata, A.; Marpaung, B.

2018-03-01

The incidence of Sjogren’s Syndrome was estimated 4 in 100.000 of these cases with the prevalence is 0.2% to 2.7% of the population. Predominant sex female/male ratio is approximately 10:1 with peak incidence is in the fourth and fifth decade. A 29-year-old woman had dry eyes and recurrent sensation of sand in the eyes for two years. Schimmer’s test was positive ≤5mm in 5 minutes both, and the autoantibodies SSA and SSB were positive. Without history head or neck radiation and the result of laboratory examination hepatitis C and HIV negative. Until now there is no satisfying therapy for Sjogren Syndrome, only supportive specific to symptomatic can be treated. We reported a case of Sjogren Syndrome with dry eyes symptom, polyathralgia, and fatigue. Muscarinic agonist pilocarpine 5mg PO qid and hydroxychloroquine were given.

Open and Endoscopic Management of Fourth Branchial Pouch Sinus – Our Experience

PubMed Central

Arunachalam, Pavai; Vaidyanathan, Venkatraman; Sengottan, Palaninathan

2015-01-01

Introduction Acute suppurative neck infections associated with third or fourth branchial arch fistulas are frequently recurrent. Third and fourth branchial arch anomalies are much less common and usually present with recurrent left thyroid lobe abscesses. Objectives The authors present their experience in treating such cases that were observed exclusively in children. Methods The study involved performing a retrospective review of five cases in PSG Institute of Medical Sciences & Research. All cases were evaluated radiologically and with Direct Rigid hypopharyngoscopy. Definitive surgery was performed, including hemithyroidectomy. Results The patients consisted of five children, two boys and three girls. All of them presented with recurrent episodes of neck infection. Investigations performed included computed tomography (CT) fistulography, rigid hypopharyngoscopy and ultrasound, which were useful in preoperatively delineating pyriform sinus fistulous tract. All patients underwent neck exploration with excision of the fistulous tract and hemithyroidectomy. Upon follow-up, all patients are asymptomatic. Conclusions Recurrent neck abscesses in a child should alert the clinician to the possibility of a fourth branchial arch anomaly; therefore, children with this condition require a complete evaluation so the anomaly can be ruled out. PMID:26491476

Open and Endoscopic Management of Fourth Branchial Pouch Sinus - Our Experience.

PubMed

Arunachalam, Pavai; Vaidyanathan, Venkatraman; Sengottan, Palaninathan

2015-10-01

Introduction Acute suppurative neck infections associated with third or fourth branchial arch fistulas are frequently recurrent. Third and fourth branchial arch anomalies are much less common and usually present with recurrent left thyroid lobe abscesses. Objectives The authors present their experience in treating such cases that were observed exclusively in children. Methods The study involved performing a retrospective review of five cases in PSG Institute of Medical Sciences & Research. All cases were evaluated radiologically and with Direct Rigid hypopharyngoscopy. Definitive surgery was performed, including hemithyroidectomy. Results The patients consisted of five children, two boys and three girls. All of them presented with recurrent episodes of neck infection. Investigations performed included computed tomography (CT) fistulography, rigid hypopharyngoscopy and ultrasound, which were useful in preoperatively delineating pyriform sinus fistulous tract. All patients underwent neck exploration with excision of the fistulous tract and hemithyroidectomy. Upon follow-up, all patients are asymptomatic. Conclusions Recurrent neck abscesses in a child should alert the clinician to the possibility of a fourth branchial arch anomaly; therefore, children with this condition require a complete evaluation so the anomaly can be ruled out.

Eosinophilic folliculitis occurring after stem cell transplant for acute lymphoblastic leukemia: a case report and review.

PubMed

Zitelli, Kristine; Fernandes, Neil; Adams, Brian B

2015-07-01

Eosinophilic folliculitis (EF) comprises classic eosinophilic pustular folliculitis (EPF), human immunodeficiency virus (HIV)-related EF, and infantile EPF subtypes. A fourth proposed subtype describes EF associated with hematologic malignancy. Recently, EF has occurred after bone marrow or stem cell transplantation (SCT). We report a unique case of EF after haploidentical allogeneic SCT for acute lymphoblastic leukemia (ALL) and review the literature for similar cases. A 56-year-old, HIV-negative ALL patient presented with an intensely pruritic papulopustular eruption. He had undergone haploidentical allogeneic SCT 65 days earlier, which he had tolerated well. Histopathology revealed a moderately dense perifollicular and perivascular lymphocytic infiltrate with many eosinophils extending from the superficial dermis to the subcutaneous fat. Fungal stains were negative. These findings were highly consistent with EF. Therapy with a class II topical corticosteroid ointment, oral doxepin, and emollients achieved near-resolution of the lesions within eight weeks. Transition to topical tacrolimus 0.1% ointment applied twice daily to residual lesions yielded complete clearance by 12 weeks with mild post-inflammatory hyperpigmentation. The patient's ALL remains in remission. A fourth proposed subtype of EF is associated with HIV-negative hematologic disease. This subtype is distinguished by a predictable timeframe to presentation and a relatively rapid response to therapy. Although EF is an important consideration in all patients with hematologic malignancy, clinically heightened suspicion is warranted during the 2-3 months after transplant. © 2014 The International Society of Dermatology.

Successful nonoperative treatment of a three-column thoracic fracture in a patient with ankylosing spondylitis: existence and clinical significance of the fourth column of the spine.

PubMed

Shen, Francis H; Samartzis, Dino

2007-07-01

A case report. To report the successful nonoperative management of a patient with progressive ankylosing spondylitis who sustained a three-column flexion-distraction injury of the upper thoracic spine with an intact sternal-rib complex, thereby emphasizing the existence and clinical relevance of the fourth-column concept in such patients. Three-column injuries of the cervical and lumbar spine are typically unstable and require surgical stabilization. Patients with ankylosing spondylitis are at an increase risk to sustain three-column injuries of the spine due to their progressive inflammatory disease, a state that renders the spine brittle and alters its biomechanical function. A fourth-column model of the thoracic spine has been proposed and incorporates the sternal-rib complex; however, such a model has rarely been addressed in the literature and its role regarding three-column upper thoracic spine injury with an intact sternal-rib complex in patients with ankylosing spondylitis is unknown. METHODS.: A 68-year-old white man with ankylosing spondylitis and Pickwickian body habitus sustained a three-column flexion-distraction injury at T5 following a ground-level fall. The patient complained of midthoracic back pain; however, he was neurologically intact and ambulated without aids. Because of the patient's numerous active medical issues that substantially increased his perioperative risks combined with symptomatic improvement of his pain, the patient refused surgical stabilization. In addition, because of the patient's body habitus and pulmonary issues, external brace immobilization was not tolerated. At 17 months of follow-up, the patient remained neurologically intact, ambulated well, his midthoracic back pain had subsided, and no progressive kyphosis was noted. This case confirms the existence and clinical relevance of the fourth column of the thoracic spine and its role in providing added spinal stability in the patient with ankylosing spondylitis. As such, it is still possible to achieve a favorable clinical outcome in a select subpopulation of patients with ankylosing spondylitis that sustain three-column flexion-distraction injuries who are neurologically intact and are not candidates for surgical stabilization.

Improvements in chronic diseases with a comprehensive natural medicine approach: a review and case series.

PubMed

Nader, T; Rothenberg, S; Averbach, R; Charles, B; Fields, J Z; Schneider, R H

2000-01-01

Approximately 40% of the US population report using complementary and alternative medicine, including Maharishi Vedic Medicine (MVM), a traditional, comprehensive system of natural medicine, for relief from chronic and other disorders. Although many reports suggest health benefits from individual MVM techniques, reports on integrated holistic approaches are rare. This case series, designed to investigate the effectiveness of an integrated, multimodality MVM program in an ideal clinical setting, describes the outcomes in four patients: one with sarcoidosis; one with Parkinson's disease; a third with renal hypertension; and a fourth with diabetes/essential hypertension/anxiety disorder. Standard symptom reports and objective markers of disease were evaluated before, during, and after the treatment period. Results suggested substantial improvements as indicated by reductions in major signs, symptoms, and use of conventional medications in the four patients during the 3-week in-residence treatment phase and continuing through the home follow-up program.

Improvements in Chronic Diseases With a Comprehensive Natural Medicine Approach: A Review and Case Series

PubMed Central

Nader, Tony; Rothenberg, Stuart; Averbach, Richard; Charles, Barry; Fields, Jeremy Z.; Schneider, Robert H.

2008-01-01

Approximately 40% of the US population report using complementary and alternative medicine, including Maharishi Vedic Medicine (MVM), a traditional, comprehensive system of natural medicine, for relief from chronic and other disorders. Although many reports suggest health benefits from individual MVM techniques, reports on integrated holistic approaches are rare. This case series, designed to investigate the effectiveness of an integrated, multi-modality MVM program in an ideal clinical setting, describes the outcomes in four patients: one with sarcoidosis; one with Parkinson’s disease; a third with renal hypertension; and a fourth with diabetes/essential hypertension/anxiety disorder. Standard symptom reports and objective markers of disease were evaluated before, during, and after the treatment period. Results suggested substantial improvements as indicated by reductions in major signs, symptoms, and use of conventional medications in the four patients during the 3-week in-residence treatment phase and continuing through the home follow-up program. PMID:10971882

The fourth national anti-tuberculosis drug resistance survey in Viet Nam.

PubMed

Nhung, N V; Hoa, N B; Sy, D N; Hennig, C M; Dean, A S

2015-06-01

Viet Nam's Fourth National Anti-Tuberculosis Drug Resistance Survey was conducted in 2011. To determine the prevalence of resistance to the four main first-line anti-tuberculosis drugs in Viet Nam. Eighty clusters were selected using a probability proportion to size approach. Drug susceptibility testing (DST) against the four main first-line anti-tuberculosis drugs was performed. A total of 1629 smear-positive tuberculosis (TB) patients were eligible for culture. Of these, DST results were available for 1312 patients, including 1105 new TB cases, 195 previously treated TB cases and 12 cases with an unknown treatment history. The proportion of cases with resistance to any drug was 32.7% (95%CI 29.1-36.5) among new cases and 54.2% (95%CI 44.3-63.7) among previously treated cases. The proportion of multidrug-resistant TB (MDR-TB) cases was 4.0% (95%CI 2.5-5.4) in new cases and 23.3 (95%CI 16.7-29.9) in previously treated cases. The fourth drug resistance survey in Viet Nam found that the proportion of MDR-TB among new and previously treated cases was not significantly different from that in the 2005 survey. The National TB Programme should prioritise the detection and treatment of MDR-TB to reduce transmission of MDR-TB in the community.

An Unusual Presentation of Neurocysticercosis: A Space-Occupying Lesion in the Fourth Ventricle Associated with Progressive Cognitive Decline.

PubMed

Kurz, Carolin; Schmidt, Veronika; Poppert, Holger; Wilkins, Patricia; Noh, John; Poppert, Sven; Schlegel, Jürgen; Delbridge, Claire; da Costa, Clarissa Prazeres; Winkler, Andrea S

2016-01-01

We communicate a case of a middle-aged Brazilian patient with an unusual presentation of fourth ventricular neurocysticercosis: occurrence of two intraventricular cysts at different locations in the brain within 2 years and cognitive decline as the only neurological symptom. Neurocysticercosis was confirmed by magnetic resonance imaging, serology, histology, and genetic analysis. Neurocysticercosis should be considered as a differential diagnosis in cases with atypical neurologic or psychiatric symptoms, atypical neuroimaging and travel history. Especially, fourth ventricular cysts carry the risk of obstructive hydrocephalus and brainstem compression and therefore should be extirpated completely. If complete removal of the cystic structures cannot be proven in cases with surgically treated neurocysticercosis, anthelminthic therapy and thorough follow-up examinations should be conducted. © The American Society of Tropical Medicine and Hygiene.

[Teratoma and medulloblastoma of the cerebellum: a case].

PubMed

Boudawara, T; Boudawara, M Z; Sellami, M H; Ben Mansour, H; Jlidi, R

1999-01-01

The majority of intracranial teratoma are localized in pineal and sellar regions. In cerebellum, the teratoma is quite rare, the association with medulloblastoma is exceptional and was differentiated from medullomyoblastoma. We report one case of 5 years old boy with intracranial hypertension for 3 months. The cerebral computed tomography showed a tumor in the fourth ventricle. The histologic study of surgical specimens found a proliferation of component of medulloblastoma adjacent to mature teratoma with smooth and striated muscles, chondroid component, adipose tissue and epithelial elements. Our objective is to discuss the diagnosis, the hitogenesis and the prognosis of this tumor.

Acoustic Studies of New Materials: Quasicrystals, Low-Loss Glasses, and High Tc Superconductors

DTIC Science & Technology

1990-08-01

REFEREED JOURNALS TECHNICAL REPORTS PUBLISHED 1. NSF Final Progress Report 2. Tania Slawecki M.S. Thesis "Measuring fourth sound in silica aerogel " 3...Pennsylvania State University The Graduate School Department of Physics Measuring Fourth Sound in Silica Aerogel A Thesis in Physics by Tania Maria...Slawecki Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science December 1989 Abstract Measuring Fourth Sound in Silica

Statistics Report on TEQSA Registered Higher Education Providers, 2017

ERIC Educational Resources Information Center

Australian Government Tertiary Education Quality and Standards Agency, 2017

2017-01-01

The "Statistics Report on TEQSA Registered Higher Education Providers" ("the Statistics Report") is the fourth release of selected higher education sector data held by is the fourth release of selected higher education sector data held by the Australian Government Tertiary Education Quality and Standards Agency (TEQSA) for its…

Environmental Quality, the Fourth Annual Report of the Council on Environmental Quality.

ERIC Educational Resources Information Center

Council on Environmental Quality, Washington, DC.

The state of the environment and efforts to improve it are reported upon in this Fourth Annual Report of the Council on Environmental Quality. Broad in scope, the report covers federal and state activities during the past year, the urban environment, economics and environmental management, the law and land use regulation, environmental quality,…

Primary Total Hip Arthroplasty With Fourth-Generation Ceramic-on-Ceramic: Analysis of Complications in 939 Consecutive Cases Followed for 2-10 Years.

PubMed

Buttaro, Martin A; Zanotti, Gerardo; Comba, Fernando M; Piccaluga, Francisco

2017-02-01

Delta ceramics may be the bearing of choice for younger and active patients due to its improved toughness and wear characteristics, provided there is no risk of fracture. However, ceramic fracture is the most serious complication related to this type of bearing. Although millions of Delta ceramics have been implanted worldwide, short to midterm results have been scarcely reported in the literature. The purpose of this study was to report the complication rate at short to midterm follow-up associated with the bearing surface used in a series of primary total hip arthroplasties with Delta ceramic-on-ceramic bearings performed in a single institution. A total of 939 cases (880 patients) undergoing primary total hip arthroplasty with fourth-generation Delta ceramic-on-ceramic bearings were retrospectively reviewed. They were followed for an average of 5.3 years (2-10 years). One hip experienced a liner fracture, 2 cups presented early loosening due to friction between the acetabular screw and the backside of the liner, one femoral ball head had a fracture; one case of squeaking was reported, which is impending revision. Considering revision or impending revision in relationship with the bearing surface as the end point, the mean survival rate was 99.3% (confidence interval 95%, 98.3%-99.7%) at 2-10 years. This study showed a low rate of ceramic fracture compared with others; however, it was much higher than the complication rate presented by the manufacturers. The complications observed were directly related to technical errors that surgeons should avoid when using this type of surface. Copyright © 2016 Elsevier Inc. All rights reserved.

A descriptive study of work aggravated asthma.

PubMed

Goe, S K; Henneberger, P K; Reilly, M J; Rosenman, K D; Schill, D P; Valiante, D; Flattery, J; Harrison, R; Reinisch, F; Tumpowsky, C; Filios, M S

2004-06-01

Work related asthma (WRA) is one of the most frequently reported occupational lung diseases in a number of industrialised countries. A better understanding of work aggravated asthma (WAA), as well as work related new onset asthma (NOA), is needed to aid in prevention efforts. WAA and NOA in the United States were compared using cases reported to the National Institute for Occupational Safety and Health (NIOSH) from four state Sentinel Event Notification Systems for Occupational Risks (SENSOR) surveillance programmes for 1993-95. A total of 210 WAA cases and 891 NOA cases were reported. WAA cases reported mineral and inorganic dusts as the most common exposure agent, as opposed to NOA cases, in which diisocyanates were reported most frequently. A similar percentage of WAA and NOA cases still experienced breathing problems at the time of the interview or had visited a hospital or emergency room for work related breathing problems. NOA cases were twice as likely to have applied for workers' compensation compared with WAA cases. However, among those who had applied for worker compensation, approximately three-fourths of both WAA and NOA cases had received awards. The services and manufacturing industrial categories together accounted for the majority of both WAA (62%) and NOA (75%) cases. The risk of WAA, measured by average annual rate, was clearly the highest in the public administration (14.2 cases/10(5)) industrial category, while the risk of NOA was increased in both the manufacturing (3.2 cases/10(5)) and public administration (2.9 cases/10(5)) categories. WAA cases reported many of the same adverse consequences as NOA cases. Certain industries were identified as potential targets for prevention efforts based on either the number of cases or the risk of WAA and NOA.

Detention of American Citizens as Enemy Combatants

DTIC Science & Technology

2005-03-31

Padilla a limited right to meet with his attorney under government monitoring and appealed the decision to the Supreme Court, which heard the case on...an individual is an enemy combatant is conclusive, so long as it is supported by some evidence.182 In the first interlocutory appeal , the Fourth...a hearing to determine the status of those captured during hostilities. See CRS Report RL31367. 186 See Government’s Motion for Interlocutory Appeal

Dandy–Walker malformation: An incidental finding

PubMed Central

Tadakamadla, Jyothi; Kumar, Santhosh; Mamatha, G. P.

2010-01-01

Dandy–Walker malformation (DWM) is a rare intracranial congenital abnormality that affects the cerebellum and some of its components; particularly cerebellar vermis, fourth ventricle and is characterized by an enlarged posterior fossa. Although there is an extensive list of signs attributed to DWM, final diagnosis is solely dependent on imaging techniques as there are no signs that are characteristic of DWM. This article reports a case with DWM who was diagnosed by magnetic resonance imaging. PMID:20838490

[Type I Chiari malformation associated with cerebellar atrophy. Case report].

PubMed

Moscote-Salazar, Luis Rafael; Calderón-Miranda, Willem Guillermo; Alvis-Miranda, Hernando Raphael; Lee-Aguirre, Ángel; Alcalá-Cerra, Gabriel

2017-01-01

Chiari malformation is characterized by caudal displacement of the cerebellar tonsils that penetrate into the spinal canal through the foramen magnum, achieving reach the atlas or axis. trunk and any drop of the fourth ventricle is observed. Typically is seen in young adults. In some cases scoliosis and Syringomyelic cavities may occur. The authors present (as far as they know) the first case in the literature with long term follow-up, of a caucasian woman with an unusual form of cerebellar atrophy and Chiari Type I malformation, suffering from weakness in his upper and lower extremities with rapidly progression. The patient was successfully treated with suboccipital decompression and C1 laminectomy.

[Intramedullary spinal cord metastasis from gastric adenocarcinoma: Case report and review of literature].

PubMed

Pérez-Suárez, Javier; Barrio-Fernández, Patricia; Ibáñez-Plágaro, Francisco Javier; Ribas-Ariño, Teresa; Calvo-Calleja, Pablo; Mostaza-Saavedra, Antonio Luis

2016-01-01

Intramedullary spinal cord metastases are very rare and usually associated with lung or breast cancer, with gastric origin being exceptional. Their clinical onset tends to be faster than that of primary intramedullary tumours. The most common early symptoms of intramedullary spinal cord metastasis are motor deficit in one or more limbs, pain, sensory loss, and sphincter disturbances. The appearance of a rapidly progressive Brown-Séquard syndrome in an oncology patient should orientate the diagnosis of this condition. The prognosis is very poor, with a median survival of 4 months. However, recent research has shown that surgery could offer a slight benefit in survival and functionality. The case is reported of a 61-year-old man with an intramedullary spinal cord metastasis from a gastric carcinoma, as well as a literature review of this topic. It has been found that this case is the fourth one reported in the literature. Copyright © 2015. Published by Elsevier España.

[Colon transverse volvulus; a case report].

PubMed

Ramírez-Wiella-Schwuchow, G; Villanueva-Sáenz, E; Bolaños-Badillo, L E; García-Hernández, L A

2009-01-01

Colon transverse volvulus is an uncommon pathology which is associate with alterations of the colonic motility, mental disorders and congenital anomalies of the fixation of the colon sistem. Up to 1994, 72 cases has been reported in world-wide literature. To report a case of colon transverse volvulus and the treatment. A female 46 years old who show intense abdominal pain 2 days of evolution. The physical exploration show important abdominal distension and pain in left inferior quadrant. The Rx of abdomen with gas absence in rectal descendent colon and ampula with level and important distension of proximal colon. Colonoscopic study with impossibility to advance endoscopy throw colon transverse by zone of stenosis, wasn't made a contrast study, underwent laparotomy of urgency, it was done right hemicolectomy and ileocoloanastomosis with good evolution and given of discharge fourth postsurgical day. This possibility is due to have in mind diagnoses, the treatment is surgical secondary to a high index of recidivate, nevertheless recommends the colonoscopy study accomplishment in order to discard obstructive injuries mainly cancer.

A branchial cyst of the pyriform fossa transoral laser resection: a case report.

PubMed

Abdelfattah, Hesham Mostafa; Ahmed, Mohammed Elrabie; Ahmed, Mona El-Rabie; Ahmed, Mohamed Abd El-Kader; Moussa, Abd-Elmateen

2016-02-01

Pyriform sinus malformations represent rare third and fourth branchial anomalies. Fistulae at the latter site were initially described and make up less than 1 % of all brachial anomalies. They may be discovered incidentally, or may present as a neck mass with recurrent infection, dysphagia, or airway compromise, and can be an unusual cause of dysphonia in infant and children. Here, we present a case of third branchial cyst located in pharyngeal wall of the left pyriform sinus which presented with dysphonia since birth in a 6-year-old girl. Transoral CO2 laser excision was carried out successfully with no communicating tract. The patient's dysphonia showed progressive regression at 1-year follow-up. Third branchial cyst in the left pyriform sinus (Bailey's type IV) is an unusual cause of dysphonia in pediatric. Our present case report is the first brachial cyst to be reported in the pyriform fossa and the second branchial anomalies to be excised transorally with CO2 laser.

Perivascular epithelioid cell tumor (PEComa) of the urinary bladder: report of 3 cases and review of the literature.

PubMed

Sukov, William R; Cheville, John C; Amin, Mahul B; Gupta, Ruta; Folpe, Andrew L

2009-02-01

The perivascular epithelioid cell family of tumors (PEComas) includes familiar lesions such as angiomyolipoma, lymphangioleiomyoma, and clear-cell "sugar" tumors of the lung. Less frequently, PEComas arise in various other locations throughout the body including soft tissue, bone, and visceral organs. We report 3 cases of PEComa arising in the urinary bladder in 2 men in their fourth decade, and 1 woman in her third decade. All 3 tumors showed histologic features characteristic of PEComa including spindled and epithelioid cell morphology with variable clear cell change, and all coexpressed melanocytic and smooth muscle associated markers by immunohistochemistry. Follow-up demonstrated an indolent course for 2 patients with no evidence of disease at 10 and 21 months, respectively, and the third case was recently diagnosed. We also provide a review of the 4 previously reported PEComas occurring in the bladder. PEComas of the urinary bladder should be carefully distinguished from a variety of histologically similar, but clinically dissimilar entities.

Looking Very Old Age in the Eye: A Nuanced Approach to the Fourth Age in Contemporary Irish Fiction: A Case Study.

PubMed

Zamorano Llena, Carmen

2018-04-21

Associations of young-old age with successful aging have contributed to relegating negatively perceived aspects of aging to very old age. This has prompted the formation of the social imaginary of the fourth age. Re-examinations of the fourth age foreground the diversity of aging experiences among the oldest old. In this sense, literature is in a privileged position to contribute individual narratives of aging to this field. The main aim of this article is to analyze Irish writer Jennifer Johnston's later fiction and how particularly two of her later fictional works contribute a nuanced re-examination of the fourth age through the narrativization of individual aging experiences of the oldest old in the contemporary Irish context. The work of sociologists and social theorists on re-examinations of the fourth age functions as the framework to analyze the selected fictional texts. The analysis of the oldest old characters in Truth or Fiction and Naming the Stars shows the contribution of literary texts to rethinking the fourth age as a time characterized by the inextricable combination of gains and losses, with emphasis on the diversity of the aging experiences of the oldest old and on the importance of sociocultural influence on individual aging. Combining longitudinal analyses with case studies, such as the ones suggested by these fictional texts, can provide a more accurate knowledge of the experience of advanced old age and the fourth age.

National survey of drinking and driving attitudes and behavior : 1997

DOT National Transportation Integrated Search

1998-11-01

This report represents the fourth in a series of biennial national surveys undertaken by the National Highway Traffic Safety Administration (NHTSA) starting in 1991, and reports data from this fourth administration as well as those of the first three...

Short-Term Acceptability of the Woman's Condom among Married Couples in Shanghai

PubMed Central

Wu, Junqing; Huang, Zirong

2016-01-01

Background. The Woman's Condom, a second-generation female condom designed for acceptability, is poised for introduction in China. Method. This single-arm study was conducted among 60 couples in China in 2010 to assess acceptability of the Woman's Condom. Results. Male participants reported that ease of handling, inserting, and removing the device improved significantly from first to fourth use. Female and male participants reported that comfort during insertion, feel of lubricant during insertion, comfort/fit of outer ring during use, and overall comfort improved significantly from first to fourth use. Further, at fourth use, female participants reported significant improvement in the comfort of the feel of the condom material and lubricant. Female and male participants reported that satisfaction with stability and sensation during sex and ability to achieve orgasm improved significantly from first to fourth use. At fourth use, female participants reported statistically significant improvement in sensation compared to using nothing. A majority of participants (78%) stated that they would use the Woman's Condom in the future, primarily due to its dual protection profile. Conclusion. This study has shown that, in China, the Woman's Condom appears to be acceptable to married couples. User experience contributes to improvement in many aspects of device acceptability. PMID:27547481

Intussusception: a rare complication in a patient with acute leukaemia after consolidation chemotherapy.

PubMed

Qasrawi, Ayman; Abu Ghanimeh, Mouhanna; Abughanimeh, Omar; Qasem, Abdulraheem

2017-02-28

Intussusception is telescoping of one segment of the gastrointestinal tract into an adjacent one. It is more common in children than adults. When it occurs in adults, it is usually associated with a lead point. Intussusception is very rare in acute leukaemia and has only been reported in few cases. We present a case of an adult woman who presented with intussusception after a cycle of consolidation chemotherapy with high-dose cytarabine for acute myeloid leukaemia. Other causes of acute abdominal pain were excluded, and the diagnosis was established by CT scan of the abdomen and barium enema. No pathological lead points were found intraoperatively. She underwent a right-sided hemicolectomy with complete recovery. To the best of our knowledge, this is only the fourth case of intussusception that has been reported in an adult patient with acute myeloid leukaemia. 2017 BMJ Publishing Group Ltd.

Metastasizing leiomyoma to heart.

PubMed

Consamus, Erin N; Reardon, Michael J; Ayala, Alberto G; Schwartz, Mary R; Ro, Jae Y

2014-01-01

Cardiac smooth muscle tumors are rare. Three different clinical settings for these tumors have been reported, including benign metastasizing leiomyoma from the uterus, primary cardiac leiomyoma and leiomyosarcoma, and intravenous cardiac extension of pelvic leiomyoma, which is the most common. We present a case of a 55-year-old woman with a benign metastasizing leiomyoma to the heart 17 years after hysterectomy and 16 years after metastasis to the lung. Immunohistochemical stains for smooth muscle actin, desmin, and estrogen and progesterone receptors were positive, indicating a smooth muscle tumor of uterine origin. To our knowledge, this is only the fourth reported case of benign metastasizing leiomyoma to the heart and the first case of long-delayed cardiac metastasis after successful treatment of pulmonary metastasis. It illustrates that benign metastasizing leiomyoma should be included in the differential diagnosis of cardiac tumors in patients with a history of uterine leiomyoma, especially when associated with pulmonary metastasis.

Cutaneous Emergence of Eustrongylides in Two Persons from South Sudan

PubMed Central

Eberhard, Mark L.; Ruiz-Tiben, Ernesto

2014-01-01

Two large, living worms were collected as they emerged from the lower limb of each of two persons in South Sudan. The worms were observed by staff of the South Sudan Guinea Worm Eradication Program during surveillance activities in communities at-risk for cases of Guinea worm disease (dracunculiasis). The worms measured 7 and 8 cm in length and were identified as fourth-stage larvae of Eustrongylides. This is the first report of such worms emerging from the skin; all five previous reports of human infection involved surgical removal of worms from the peritoneal cavity. PMID:24379241

Preventing lower cranial nerve injuries during fourth ventricle tumor resection by utilizing intraoperative neurophysiological monitoring.

PubMed

Jahangiri, Faisal R; Minhas, Mazhar; Jane, John

2012-12-01

We present two cases illustrating the benefit of utilizing intraoperative neurophysiological monitoring (IONM) for prevention of injuries to the lower cranial nerves during fourth ventricle tumor resection surgeries. Multiple cranial nerve nuclei are located on the floor of the fourth ventricle with a high risk of permanent damage. Two male patients (ages 8 and 10 years) presented to the emergency department and had brain magnetic resonance imaging (MRI) scans showing brainstem/fourth ventricle tumors. During surgery, bilateral posterior tibial and median nerve somatosensory evoked potentials (SSEPs); four-limb and cranial nerves transcranial electrical motor evoked potentials (TCeMEPs); brainstem auditory evoked responses (BAERs); and spontaneous electromyography (s-EMG) were recorded. Electromyography (EMG) was monitored bilaterally from cranial nerves V VII, IX, X, XI, and XII. Total intravenous anesthesia was used. Neuromuscular blockade was used only for initial intubation. Pre-incision baselines were obtained with good morphology of waveforms. After exposure the floor of the fourth ventricle was mapped by triggered-EMG (t-EMG) using 0.4 to 1.0 mA. In both patients the tumor was entangled with cranial nerves VII to XII on the floor of the fourth ventricle. The surgeon made the decision not to resect the tumor in one case and limited the resection to 70% of the tumor in the second case on the basis of neurophysiological monitoring. This decision was made to minimize any post-operative neurological deficits due to surgical manipulation of the tumor involving the lower cranial nerves. Intraoperative spontaneous and triggered EMG was effectively utilized in preventing injuries to cranial nerves during surgical procedures. All signals remained stable during the surgical procedure. Postoperatively both patients were well with no additional cranial nerve weakness. At three months follow-up, the patients continued to have no deficits.

Primary intestinal lymphangiectasia successfully treated by segmental resections of small bowel.

PubMed

Kim, Na Rae; Lee, Suk-Koo; Suh, Yeon-Lim

2009-10-01

Primary intestinal lymphangiectasia is a rare cause of protein-losing enteropathy and usually presents with intermittent diarrhea or malnutrition. Diagnosis depends largely on its pathologic condition demonstrating greatly dilated lymphatics mainly in the lamina propria of the mucosa. We report a case of primary intestinal lymphangiectasia, of the diffuse type, presenting with abdominal pain and voluminous diarrhea in a previously healthy 8-year-old boy. He had periumbilical pain for 3 months before presentation. He was managed by segmental bowel resections and end-to-end anastomoses. The histopathologic condition of the resected small intestine showed lymphatic dilation limited mainly to the subserosa and mesentery but was not prominent in the mucosa. Abdominal pain and diarrhea subsided postoperatively. The present case is the fourth report describing a response to operative resection.

Mesothelioma associated with the shipbuilding industry in coastal Virginia.

PubMed

Tagnon, I; Blot, W J; Stroube, R B; Day, N E; Morris, L E; Peace, B B; Fraumeni, J F

1980-11-01

A case-control study was undertaken to clarify reasons for a four-fold increased incidence of mesothelioma discovered among white males in coastal Tidewater, Va., from 1972 to 1978. Sixty-one cases were identified. Interviews with next of kin revealed that the excess was linked to employment in area shipyards. Three-fourths of the cases had been employed in the shipbuilding industry, nearly all beginning employment prior to 1950. Most were career employees, but an increased risk was also found among those who worked only temporarily, mainly during World War II, and were reportedly exposed to asbestos. More of the cases than controls were pipecoverers or pipefitters, but cases were reported to work in a variety of shipyard trades. Few of the mesothelioma cases were heavy smokers, a trend that may be related in part to the competing risks for fatal diseases caused by the interactions of smoking and asbestos exposure. Information obtained by interview for five of the six white females diagnosed with mesothelioma revealed that the husband of four had been employed in the shipbuilding industry.

Multiple stress fractures in a young female runner.

PubMed

Dusek, T; Pećina, M; Loncar-Dusek, M; Bojanic, I

2004-01-01

The effect of exercise on female's bone metabolism has received much attention in recent years. We report on unusual case of a female runner with low body mass and amenorrhea, who suffered 4 stress fractures. Three of the stress fractures occurred during her sports career, and the fourth occurred 7 years after the cessation of sports activities. It seems that exercise-induced amenorrhea together with food restriction in the young age may cause long-term consequences on bone metabolism.

Apatinib treatment combined with chemotherapy for advanced epithelial ovarian cancer: a case report.

PubMed

Deng, Linghui; Wang, Yue; Lu, Wenbin; Liu, Qian; Wu, Jie; Jin, Jianhua

2017-01-01

Apatinib is a novel oral tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor-2, which has been proved by clinical trials to be effective and safe for patients with chemotherapy-refractory gastric cancer. To date, there is no study or case report on apatinib treatment for patients with ovarian cancer. Here, we present the case of a 50-year-old Chinese woman with advanced ovarian cancer, who received apatinib at a daily dose of 500 mg for 28 days per cycle after failure of fourth-line chemotherapy. Favorable oncologic outcome was achieved in this case after treatment with apatinib. The patient's progression-free survival is now 11.3 months, and she is taking apatinib and capecitabine as maintenance treatment. The common side effect of apatinib was fatigue; however, the toxicity of apatinib was controllable and tolerable. Thus, apatinib may be an option for chemotherapy-refractory advanced epithelial ovarian cancer, but this still warrants further investigation.

Primary intraosseous Kaposi's sarcoma presenting as an asymptomatic periapical radiolucency: a case report.

PubMed

Noel, Kenson E; Mardirossian, George; Schneider, Lawrence

2007-05-01

Kaposi's sarcoma (KS) is a common mucocutaneous manifestation of acquired immunodeficiency syndrome (AIDS). Primary bone lesions have been reported but are rare. A 38-year-old African-American male who was human immunodeficiency virus (HIV)-positive appeared for the evaluation of an asymptomatic well-defined radiolucency of the mandibular midline discovered on routine radiographic examination. The adjacent central incisors were asymptomatic, nonmobile, and vital. The overlying mucosa and cortical plate were intact. Excision of the lesion revealed a fleshy, pink-red soft tissue mass with a uniform consistency. Histological examination showed a malignant spindle cell neoplasm containing numerous extravasated erythrocytes. The tumor cells exhibited positive immunohistochemical staining for CD31, CD34, and human herpesvirus 8. One year after surgical procedure, the surgical defect showed radiographic evidence of repair and there was no sign of recurrent tumor. This case represents the fourth reported instance of primary intraosseous involvement of the jaws with KS.

Novel presentation of a fourth branchial cleft anomaly in a male infant.

PubMed

Evans, Seth H; Marinello, Mark; Dodson, Kelley M

2010-01-01

Fourth branchial cleft anomalies are rare congenital disorders of the neck. We describe a case involving a unique presentation of this entity as well as a review of the literature concerning its management. Copyright (c) 2010 Elsevier Inc. All rights reserved.

A Novel Approach to Medical Student Peer-assisted Learning Through Case-based Simulations

PubMed Central

Jauregui, Joshua; Bright, Steven; Strote, Jared; Shandro, Jamie

2018-01-01

Introduction Peer-assisted learning (PAL) is the development of new knowledge and skills through active learning support from peers. Benefits of PAL include introduction of teaching skills for students, creation of a safe learning environment, and efficient use of faculty time. We present a novel approach to PAL in an emergency medicine (EM) clerkship curriculum using an inexpensive, tablet-based app for students to cooperatively present and perform low-fidelity, case-based simulations that promotes accountability for student learning, fosters teaching skills, and economizes faculty presence. Methods We developed five clinical cases in the style of EM oral boards. Fourth-year medical students were each assigned a unique case one week in advance. Students also received an instructional document and a video example detailing how to lead a case. During the 90-minute session, students were placed in small groups of 3–5 students and rotated between facilitating their assigned cases and participating as a team for the cases presented by their fellow students. Cases were supplemented with a half-mannequin that can be intubated, airway supplies, and a tablet-based app (SimMon, $22.99) to remotely display and update vital signs. One faculty member rotated among groups to provide additional assistance and clarification. Three EM faculty members iteratively developed a survey, based on the literature and pilot tested it with fourth-year medical students, to evaluate the course. Results 135 medical students completed the course and course evaluation survey. Learner satisfaction was high with an overall score of 4.6 on a 5-point Likert scale. In written comments, students reported that small groups with minimal faculty involvement provided a safe learning environment and a unique opportunity to lead a group of peers. They felt that PAL was more effective than traditional simulations for learning. Faculty reported that students remained engaged and required minimal oversight. Conclusion Unlike other simulations, our combination of brief, student-assisted cases using low-fidelity simulation provides a cost-, resource- and time-effective way to implement a medical student clerkship educational experience. PMID:29383080

A Novel Approach to Medical Student Peer-assisted Learning Through Case-based Simulations.

PubMed

Jauregui, Joshua; Bright, Steven; Strote, Jared; Shandro, Jamie

2018-01-01

Peer-assisted learning (PAL) is the development of new knowledge and skills through active learning support from peers. Benefits of PAL include introduction of teaching skills for students, creation of a safe learning environment, and efficient use of faculty time. We present a novel approach to PAL in an emergency medicine (EM) clerkship curriculum using an inexpensive, tablet-based app for students to cooperatively present and perform low-fidelity, case-based simulations that promotes accountability for student learning, fosters teaching skills, and economizes faculty presence. We developed five clinical cases in the style of EM oral boards. Fourth-year medical students were each assigned a unique case one week in advance. Students also received an instructional document and a video example detailing how to lead a case. During the 90-minute session, students were placed in small groups of 3-5 students and rotated between facilitating their assigned cases and participating as a team for the cases presented by their fellow students. Cases were supplemented with a half-mannequin that can be intubated, airway supplies, and a tablet-based app (SimMon, $22.99) to remotely display and update vital signs. One faculty member rotated among groups to provide additional assistance and clarification. Three EM faculty members iteratively developed a survey, based on the literature and pilot tested it with fourth-year medical students, to evaluate the course. 135 medical students completed the course and course evaluation survey. Learner satisfaction was high with an overall score of 4.6 on a 5-point Likert scale. In written comments, students reported that small groups with minimal faculty involvement provided a safe learning environment and a unique opportunity to lead a group of peers. They felt that PAL was more effective than traditional simulations for learning. Faculty reported that students remained engaged and required minimal oversight. Unlike other simulations, our combination of brief, student-assisted cases using low-fidelity simulation provides a cost-, resource- and time-effective way to implement a medical student clerkship educational experience.

First-trimester visualization of the fourth ventricle in fetuses with and without spina bifida.

PubMed

Solt, Ido; Acuna, Joann G; Adeniji, Beni A; Mirocha, James; Kim, Matthew J; Rotmensch, Siegfried

2011-12-01

The purpose of this study was to examine the efficacy of nonvisualization of the fourth ventricle for first-trimester detection of spina bifida. A total of 250 digitally stored sonographic examinations at gestational ages of 11 weeks to 13 weeks 6 days (245 normal and 5 randomly interspersed spina bifida cases) were retrospectively analyzed by 4 blinded reviewers for the presence or absence of the fourth ventricle followed by an anteroposterior ventricular dimension measurement. The ventricle size was related to the crown-rump length and gestational age by linear regression analysis and Pearson correlation. The fourth ventricle was identified in 971 of 1000 image readings (97.1%). False-negative and false-positive readings occurred in 11 of 20 (55.0%) and 20 of 980 (2.0%) cases, respectively (sensitivity, 0.45; specificity, 0.98.). False-negative and false-positive readings were evenly distributed throughout the gestational age range. When the ventricular size was measurable, its mean dimensions increased linearly with gestational age and were below the fifth percentile in 10 of 245 (4.0%) normal and 0 of 4 spina bifida cases, respectively. Intraclass correlation coefficient estimates were calculated based on the 2-way analysis of variance model and found to be 0.30 for a single rater and 0.64 for the mean of 4 raters. Nonvisualization of the first-trimester fourth ventricle is a less robust screening parameter for spina bifida than previously published.

Solitary thyroid metastasis from colon cancer: fine-needle aspiration cytology and molecular biology approach.

PubMed

Onorati, M; Uboldi, P; Bianchi, C L; Nicola, M; Corradini, G M; Veronese, S; Fascì, A I; Di Nuovo, F

2015-01-01

Thyroid gland is one of the most vascularized organs of the body, nevertheless clinical and surgical series report an incidence of secondary malignancies in this gland of only 3%. Colorectal carcinoma metastatic to the thyroid gland is not as uncommon as previously believed, infact the number of cases seems to be increased in recent years due to the more frequent use of fine-needle aspiration cytology (FNAC) guided by ultrasonography. Although kidney, breast and lung metastases to the thyroid are frequent, metastasis from colon cancer is clinically rare with 52 cases reported in the literature in the last 5 decades and three cases described as solitary thyroid metastasis from the colon cancer without any other visceral metastases. To the best of our knowledge, we report the fourth case of solitary, asymptomatic thyroid metastasis from colon cancer without involvement of other organs. We discuss the importance of FNAC to detect metastatazing process as a compulsory step of the diagnostic and therapeutic management algorithm, combined with a molecular biology approach. A review of the last 5 decades literature, to update the number of cases described to date, is also included.

Ectopic craniopharyngioma of the fourth ventricle in a patient with Gardner syndrome.

PubMed

Pena, Andres H; Chaudhry, Ammar; Seidman, Roberta J; Peyster, Robert; Bangiyev, Lev

2016-01-01

Ectopic craniopharyngioma is uncommon and a craniopharyngioma confined purely within the fourth ventricle is extremely rare. We report a craniopharyngioma of the fourth ventricle in a 20-year-old man with Gardner syndrome. Imaging characteristics of craniopharyngiomas and fourth ventricle lesions are discussed with a review of the literature regarding the pathogenesis of craniopharyngiomas and the possible association with Gardner syndrome. Copyright © 2015 Elsevier Inc. All rights reserved.

Freon injection injury to the hand. A report of four cases

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

Goetting, A.T.; Carson, J.; Burton, B.T.

1992-08-01

During a 6-month period, the poison center was consulted on three occasions for advice regarding accidental injection of hexafluorethane (Freon) used in the manufacturing process of athletic shoes. A fourth case was later identified after consulting physicians near the manufacturing facility. Little information exists in the medical literature concerning injection of freon or other volatile substances. In each of these cases, workers inadvertently injected concentrated hexafluorethane into a finger while holding the shoe component and attempting to inject hexafluorethane. Each case presented with edema, limitation of motion, and crepitation. Hand roentgenogram revealed subcutaneous gas. Treatment was nonsurgical, consisting of splinting,more » tetanus immunization, and antibiotics. Rapid resolution of symptoms occurred in all four cases. Hexafluorethane is relatively inert when injected and has low toxicity. However, potential rapid expansion warrants observation for pressure injury.« less

Possible role of hypercoagulability in calciphylaxis: review of the literature.

PubMed

Harris, Ryan Jeffrey; Cropley, Thomas George

2011-02-01

The role of a hypercoagulable state in the pathogenesis of calciphylaxis has yet to be determined. We sought to find evidence of an association between hypercoagulability and calciphylaxis. We reviewed the primary literature for review articles, studies, and case reports that discussed or demonstrated a possible relationship between calciphylaxis and a hypercoagulable state. Review of the primary literature showed that in cases of calciphylaxis with reported levels of protein C and S, 38% of the patients had decreased protein C levels and 43% had decreased levels of protein S. From review of case reports, 3 cases of improvement of skin lesions with low molecular weight heparin treatment, and a fourth case of healing of skin lesions with tissue plasminogen activator treatment, were found. Calciphylaxis was also found in a patient with antiphospholipid antibody syndrome, and a patient with cryofibrinogenemia had clinical and histologic findings consistent with possible calciphylaxis. A limited number of reports were available for review. Our review of the literature found sufficient evidence to suggest a possible role of a hypercoagulable state in the pathogenesis of calciphylaxis. A prospective study with serial testing of all relevant clotting factors in patients with calciphylaxis is needed to more definitively establish this role. Copyright © 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Central tarsal bone fracture in the border collie.

PubMed

Guilliard, M

2007-07-01

Fracture of the plantar process of the central tarsal bone together with a dorsomedial displacement of the body of the bone was seen in six border collies. All injuries occurred during free exercise, with no extrinsic trauma. Three dogs had concomitant tarsal fractures. Primary treatment was by lag screwing the central tarsal bone to the fourth tarsal bone. All cases eventually made an excellent recovery. The superficial radiographic appearance was of a luxation of the bone as reported in a previous series, but appraisal of the radiographs showed evidence of fracture in all cases. A cadaver study to assess the mechanism of luxation showed that it is unlikely to occur naturally.

[The case of completed pregnancy of the patient with Dandy-Walker malformation].

PubMed

Beliaeva, E V; Lapshina, L V; Shaposhnikova, E V; Molgachev, A A

2018-01-01

Dandy-Walker malformation is a rare disease of the central nervous system pathology (congenital malformations of the fossa cranii posterior). The key features of this syndrome are an enlargement of the fourth ventricle; complete absence of the cerebellar vermis, the posterior midline area of cerebellar cortex responsible for coordination of the axial musculature; and cyst formation near the internal base of the skull. Pregnant patients with Dandy-Walker malformation are at high risk and are managed by multidisciplinary teams including neurologists and obstetricians. We present a case report of full-term pregnancy and uncomplicated delivery in a women with Dandy-Walker malformation.

[A case report: anomaly of the fourth branchial pouch with recurring cervical abscesses. Cauterization with trichloroacetic acid closed the fistula opening and cured the patient].

PubMed

Stenquist, Monika; Juhlin, Claes; Aström, Gunnar; Friberg, Ulla

2003-04-24

A fourth branchial pouch sinus is a rare congenital anomaly, which in a 13-year-old girl presented clinically as recurrent deep cervical abscesses. The location of the majority of these anomalies is the left side of the neck (90%). Radiological and endoscopic investigations verified the diagnosis. The internal orifice located at the apex of the pyriform sinus could facilitate contamination by infectious pharyngeal secretions and lead to abscess recurrence. Traditionally, the recommended treatment is radical surgery. It can, however, be technically difficult to excise the whole fistula tract. In this patient we used a non-invasive treatment modality; chemocauterization with 40% trichloroacetic acid (TCA). After three treatments the fistula was closed. To date (month no. 15) there has been no abscess recurrence. TCA chemocauterization seems to be a safe first-line treatment for patients with pyriform sinus fistulas.

Dandy-Walker variant associated with bipolar affective disorder

PubMed Central

Lingeswaran, Anand; Barathi, Deepak; Sharma, Gyaneswahr

2009-01-01

The Dandy-Walker malformation is a congenital brain malformation, typically involving the fourth ventricle and the cerebellum. To date, the Dandy-Walker syndrome has not been described in association with bipolar disorder type I mania, and therefore we briefly report the case of a Dandy-Walker variant associated with acute mania. A 10-year-old boy was brought by his mother to the outpatient clinic of the Department of Psychiatry of a tertiary care hospital, with symptoms of mania. The MRI brain of the patient showed a posterior fossa cystic lesion, a giant cisterna magna communicating with the fourth ventricle and mild hypoplasia of the cerebellar vermis, with the rest of the structures being normal and no signs of hydrocephalus. These findings showed that the patient had a Dandy-Walker variant. He responded partially to valproate and olanzepine, which controlled the acute manic symptoms in the ward. PMID:21887198

Histologic analysis of a failing three-part dental implant: a human case report.

PubMed

Landi, Luca; Manicone, Paolo Francesco; Piccinelli, Stefano; Raia, Roberto

2005-12-01

Two failing implants were removed for prosthetic reasons from the maxilla of a 60-year-old woman. The implants were clinically immobile but presented clear signs of peri-implant mucositis and bone destruction. One of the two implants was harvested together with the surrounding bone and analyzed histologically. The implant was threaded and consisted of three distinct components screwed together in a telescopic fashion. Histologically, bone loss reached the fourth thread, while apical to the fourth thread, osseointegration between the host bone and the implant surface was recognizable. The implant parts were not completely seated into each other, and the resulting gap was colonized by host bone. Newly formed alveolar bone penetrated deep into the implant body cavity and appeared similar in nature to the alveolar bone surrounding the implant. Histologic findings are discussed in reference to the ability of such an implant to withstand biomechanical loading over time.

The Nation's Report Card Mathematics 2013 State Snapshot Report. Oregon. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth-and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and for…

The Nation's Report Card Reading 2013 State Snapshot Report. Oregon. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Minnesota. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth-and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and for…

The Nation's Report Card Reading 2013 State Snapshot Report. Minnesota. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Minnesota. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Idaho. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth-and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and for…

The Nation's Report Card Mathematics 2013 State Snapshot Report. New Hampshire. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth-and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and for…

The Nation's Report Card Reading 2013 State Snapshot Report. New Hampshire. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Hawaii. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Hawaii. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth-and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and for…

The Nation's Report Card Reading 2013 State Snapshot Report. Wisconsin. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Wisconsin. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Wisconsin. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth-and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and for…

The Nation's Report Card Mathematics 2013 State Snapshot Report. DoDEA. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth-and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and for…

The Nation's Report Card Reading 2013 State Snapshot Report. DoDEA. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Oregon. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Iowa. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Iowa. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Arkansas. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Colorado. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth-and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and for…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Michigan. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Virginia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. New York. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. DoDEA. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Nevada. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Illinois. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Florida. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Arizona. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. New Hampshire. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Alabama. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Tennessee. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Arizona. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. South Carolina. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Kansas. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Mississippi. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Alaska. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Maryland. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Minnesota. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Colorado. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Utah. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. New Jersey. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Hawaii. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Colorado. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Florida. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Alabama. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Texas. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. California. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. California. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth-and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and for…

The Nation's Report Card Reading 2013 State Snapshot Report. Maine. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Oregon. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Maryland. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Vermont. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. West Virginia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. North Dakota. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. California. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Louisiana. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Rhode Island. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Arizona. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Oklahoma. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Montana. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. New Mexico. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Wisconsin. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Arkansas. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Colorado. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Ohio. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Delaware. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Idaho. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Ohio. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. New Mexico. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. District of Columbia. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. North Carolina. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Delaware. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Alaska. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Kentucky. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Virginia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Connecticut. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Nebraska. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Hawaii. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Connecticut. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Idaho. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Kentucky. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Alaska. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Pennsylvania. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Rhode Island. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. South Carolina. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Kansas. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Wyoming. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Missouri. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Louisiana. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Georgia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. District of Columbia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. DoDEA. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Maine. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. North Dakota. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. South Dakota. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Indiana. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Ohio. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Indiana. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Tennessee. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. New Hampshire. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Delaware. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Georgia. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Alaska. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth-and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and for…

The Nation's Report Card Reading 2013 State Snapshot Report. Iowa. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Washington. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Tennessee. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Idaho. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Massachusetts. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Connecticut. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Alabama. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth-and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and for…

The Nation's Report Card Reading 2013 State Snapshot Report. Massachusetts. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Mississippi. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Mathematics 2013 State Snapshot Report. Georgia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Arkansas. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Washington. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. Washington. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

The Nation's Report Card Reading 2013 State Snapshot Report. District of Columbia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2013

2013-01-01

Results from the 2013 NAEP assessments show fourth- and eighth-graders making progress in mathematics and reading. Nationally representative samples of more than 376,000 fourth-graders and 341,000 eighth-graders were assessed in either mathematics or reading in 2013. Results are reported for public and private school students in the nation, and…

Bullying Prevention in the Elementary Classroom Using Social Skills

ERIC Educational Resources Information Center

Anderson, Stacie; Swiatowy, Colleen

2008-01-01

Our action research project report provided students with social skills training to effectively handle bullying situations in the fourth grade. Our study involved 70 fourth-grade students and began Monday, January 14, 2008 and concluded Friday, May 2, 2008. The behaviors documented from the fourth grade students were name calling, exclusion,…

Examining Variations in Fourth-Grade Children's Participation in School Breakfast and Lunch Programs by Student and Program Demographics

ERIC Educational Resources Information Center

Guinn, Caroline H.; Baxter, Suzanne Domel; Finney, Christopher J.; Hitchcock, David B.

2013-01-01

Purpose/Objectives: Analyses were conducted to examine variations in fourth-grade children's participation in school-breakfast and school-lunch programs by weekday, month, socioeconomic status, absenteeism, gender, and school-breakfast location. Methods: Fourth-grade children were participants in a dietary-reporting validation study during either…

A boy with 46,X,+mar presenting gynecomastia and short stature.

PubMed

Kim, Ki Eun; Kim, Ye Jin; Jung, Mo Kyoung; Chae, Hyun-Wook; Kwon, Ah Reum; Lee, Woo Jung; Kim, Duk-Hee; Kim, Ho-Seong

2017-12-01

A 15-year-old boy was referred due to gynecomastia and short stature. He was overweight and showed the knuckle-dimple sign on the left hand, a short fourth toe on the left foot, and male external genitalia with a small phallus. His levels of estradiol and follicle-stimulating hormone were increased, and his testosterone concentration was normal. Other hormonal tests were within the normal range. Radiographs showed short fourth and fifth metacarpals and fourth metatarsal bones. The karyotype was reported as 46,X,+mar, and the marker chromosome was shown to originate from the Y chromosome, which was identified by fluorescence in situ hybridization. Polymerase chain reaction and direct sequencing were used to clarify the deleted loci of the Y chromosome by making use of Y-specific sequence-tagged sites (STSs). The sex-determining region Y and centromere were verified, and there were microdeletions on the long arm of the Y chromosome. The azoospermia factor (AZF) b region was partially deleted, and AZFa and AZFc were completely deleted. Two STS probes of sY143 and the Y chromosome RNA recognition motif in AZFb showed positive signals corresponding to Yq11.223. The karyotype of the patient was interpreted as 46,X,der(Y)del(Y)(q11.21q11.222)del(Y)(q11.23qter). Herein, we report a rare case of a boy presenting with gynecomastia and short stature with 46, X, +mar, which originated from the Y chromosome, which was identified to have Yq microdeletions.

A fourth-order box method for solving the boundary layer equations

NASA Technical Reports Server (NTRS)

Wornom, S. F.

1977-01-01

A fourth order box method for calculating high accuracy numerical solutions to parabolic, partial differential equations in two variables or ordinary differential equations is presented. The method is the natural extension of the second order Keller Box scheme to fourth order and is demonstrated with application to the incompressible, laminar and turbulent boundary layer equations. Numerical results for high accuracy test cases show the method to be significantly faster than other higher order and second order methods.

77 FR 17476 - Information Collections Being Reviewed by the Federal Communications Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-26

... Rules for FM Broadcast Translator Stations, Fourth Report and Order and Third Order on Reconsideration... more than 4 pending translator applications) to request the dismissal of applications to comply with... Service and Eligibility Rules for FM Broadcast Translator Stations, Fourth Report and Order and Third...

Slowing of the HIV Epidemic in Ukraine: Evidence from Case Reporting and Key Population Surveys, 2005–2012

PubMed Central

Vitek, Charles R.; Čakalo, Jurja-Ivana; Kruglov, Yuri V.; Dumchev, Konstantin V.; Salyuk, Tetyana O.; Božičević, Ivana; Baughman, Andrew L.; Spindler, Hilary H.; Martsynovska, Violetta A.; Kobyshcha, Yuri V.; Abdul-Quader, Abu S.; Rutherford, George W.

2014-01-01

Background Ukraine developed Europe's most severe HIV epidemic due to widespread transmission among persons who inject drugs (PWID). Since 2004, prevention has focused on key populations; antiretroviral therapy (ART) coverage has increased. Recent data show increases in reported HIV cases through 2011, especially attributed to sexual transmission, but also signs of potential epidemic slowing. We conducted a data triangulation exercise to better analyze available data and inform program implementation. Methods and Findings We reviewed data for 2005 to 2012 from multiple sources, primarily national HIV case reporting and integrated biobehavioral surveillance (IBBS) studies among key populations. Annually reported HIV cases increased at a progressively slower rate through 2011 with recent increases only among older, more immunosuppressed individuals; cases decreased 2.7% in 2012. Among women <25 years of age, cases attributed to heterosexual transmission and HIV prevalence in antenatal screening declined after 2008. Reported cases among young PWID declined by three-fourths. In 2011, integrated biobehavioral surveillance demonstrated decreased HIV prevalence among young members of key populations compared with 2009. HIV infection among female sex workers (FSW) remains strongly associated with a personal history of injecting drug use (IDU). Conclusions This analysis suggests that Ukraine's HIV epidemic has slowed, with decreasing reported cases and older cases predominating among those diagnosed. Recent decreases in cases and in prevalence support decreased incidence among young PWID and women. Trends among heterosexual men and men who have sex with men (MSM) are less clear; further study and enhanced MSM prevention are needed. FSW appear to have stable prevalence with risk strongly associated with IDU. Current trends suggest the Ukrainian epidemic can be contained with enhanced prevention among key populations and increased treatment access. PMID:25251080

Situational Interest of Fourth-Grade Children in Music at School

ERIC Educational Resources Information Center

Roberts, J. Christopher

2015-01-01

The purpose of this study was to identify the characteristics of common elementary music class activities that elicit situational interest, the short-term interest that emerges spontaneously in learners when faced with environmental factors in an educational experience. An instrumental case study approach was employed, with 24 fourth-grade…

Provision of oral hygiene services as a potential method for preventing periodontal disease and control hypertension and diabetes in a community health centre in Korea.

PubMed

Kim, Nam-Hee; Lee, Ga-Yeong; Park, Su-Kyung; Kim, Yeun-Ju; Lee, Min-Young; Kim, Chun-Bae

2018-05-01

This study aimed to evaluate the effects of a community-based oral hygiene service on general and periodontal health indicators of patients with hypertension and type 2 diabetes mellitus visiting a community health centre in Korea. The study used a one-group pretest-posttest and interrupted time-series design. A total of 151 participants (45% male), with a mean age of 63 ± 8.4 years, were included in the study; these included patients with hypertension (62%), diabetes (12%) and both hypertension and diabetes (26%). Two dental hygienists dedicated 2 days per week to this project, providing oral hygiene services to 10-13 participants per day. Four oral hygiene service sessions were provided per patient. The objective oral hygiene status and subjective self-reported periodontal status were compared before and after the service. The changes in blood pressure and glycosylated haemoglobin levels were also assessed. A lower frequency of subjective swelling was reported at the fourth session (37.9%) compared to the first (55.6%) session. Further, significantly fewer cases of calculus and bleeding were observed (p < .05), and significantly more patients reported having no gum problems at the fourth session (43.1% vs. 27.2%; p < .05) than at the first session. Finally, the participants maintained stable blood pressures at each of the four sessions, and their glycosylated haemoglobin levels were significantly lower at the fourth session. In conclusion, the findings of this study suggest that community oral hygiene services provided by dental hygienists can promote objective oral hygiene and subjective periodontal status in the local community, and may help in the control of hypertension and diabetes. © 2017 John Wiley & Sons Ltd.

The State of the Cities, 2000: Megaforces Shaping the Future of the Nation's Cities. Fourth Annual Report.

ERIC Educational Resources Information Center

Department of Housing and Urban Development, Washington, DC.

This report, fourth in a series, recounts the most recent data on indicators of the social and economic vitality of U.S. cities and positions the Administration's urban policy agenda to address challenges confronting cities. This year the report identifies four megaforces that are shaping the future of U.S. cities and presents findings showing…

[Successful Prophylactic Minocycline Treatment for Recurrent Helicobacter Cinaedi Sepsis during Chemotherapy in a Patient with Follicular Lymphoma].

PubMed

Aota, Yasuo; Gotoh, Akihiko; Nakamura, Itaru; Motoya, Kazuki; Okuda, Yuko; Hanyu, Naofumi; Honma, Toshihiro; Udou, Ryutaro; Yokoyama, Tomohisa; Kitagawa, Naoyuki; Komatsu, Norio

2017-05-01

A 63-year-old man with follicular lymphoma was administered standard R-CHOP chemotherapy. Six days after the second course of chemotherapy, the patient developed fever and chills. Blood cultures yielded rod-shaped gram-negative bacteria, but no further identification was obtained. High fever and chills returned on the fifth and sixth days after the third and fourth courses of R-CHOP, respectively. These blood cultures were also positive. Since we detected spiral-shaped gram-negative rods, we performed a prolonged culture during the febrile period after the fourth course of R-CHOP. This revealed the formation of characteristic film-like colonies, and Helicobacter cinaedi(H. cinaedi)bacteria was identified. After final identification, the patient was administered prophylactic minocycline treatment. Subsequent blood cultures were negative, fever did not recur, and we were able to complete 6 courses of R-CHOP. Although H. cinaedi has been reported to be a cause of sepsis in immunocompromised patients, standard correlation has not been established. Our case suggests that H. cinaedi should be considered when recurrent fever is observed after chemotherapy. Prophylactic antibiotic treatment with minocycline may prevent sepsis, as observed in our case.

Computer simulation results for bounds on the effective conductivity of composite media

NASA Astrophysics Data System (ADS)

Smith, P. A.; Torquato, S.

1989-02-01

This paper studies the determination of third- and fourth-order bounds on the effective conductivity σe of a composite material composed of aligned, infinitely long, identical, partially penetrable, circular cylinders of conductivity σ2 randomly distributed throughout a matrix of conductivity σ1. Both bounds involve the microstructural parameter ζ2 which is a multifold integral that depends upon S3, the three-point probability function of the composite. This key integral ζ2 is computed (for the possible range of cylinder volume fraction φ2) using a Monte Carlo simulation technique for the penetrable-concentric-shell model in which cylinders are distributed with an arbitrary degree of impenetrability λ, 0≤λ≤1. Results for the limiting cases λ=0 (``fully penetrable'' or randomly centered cylinders) and λ=1 (``totally impenetrable'' cylinders) compare very favorably with theoretical predictions made by Torquato and Beasley [Int. J. Eng. Sci. 24, 415 (1986)] and by Torquato and Lado [Proc. R. Soc. London Ser. A 417, 59 (1988)], respectively. Results are also reported for intermediate values of λ: cases which heretofore have not been examined. For a wide range of α=σ2/σ1 (conductivity ratio) and φ2, the third-order bounds on σe significantly improve upon second-order bounds which just depend upon φ2. The fourth-order bounds are, in turn, narrower than the third-order bounds. Moreover, when the cylinders are highly conducting (α≫1), the fourth-order lower bound provides an excellent estimate of the effective conductivity for a wide range of volume fractions.

The effect of apatinib in the treatment of metastatic renal cell carcinoma: a case report and review of the literature.

PubMed

Bi, Jinling; Liu, Haiyuan; Huang, Yong

2017-01-01

The aim of this study was to explore the effect of apatinib in the treatment of metastatic renal cell carcinoma (mRCC) and related adverse events. A case of mRCC was reported which recurred after surgery and roferon treatment. The patient was treated with apatinib at a dose of 500 mg orally, twice daily, 28 days/cycle. The metastatic lesions improved based on computed tomography after apatinib administration in the fourth and eighth month. The progression-free survival of the patient had increased almost to 8 months. The patient showed a good tolerance with only an adverse effect of mild-to-moderate hand-foot syndrome which was managed well. Apatinib is an option for mRCC after previous treatment. However, more and larger trials are still needed.

Annual Report of the Oklahoma State Advisory Council Vocational-Technical Education (Fourth).

ERIC Educational Resources Information Center

Oklahoma State Advisory Council for Vocational-Technical Education, Oklahoma City.

The fourth annual report of the Oklahoma Advisory Council for Vocational-Technical Education presents detailed evaluative comments on programs carried out under the Oklahoma State Plan for Vocational Education for the academic year 1971-72. Following last year's recommendations, health occupations programs continued to have first priority. A…

Case series: Endoscopic management of fourth branchial arch anomalies.

PubMed

Watson, G J; Nichani, J R; Rothera, M P; Bruce, I A

2013-05-01

Fourth branchial arch anomalies represent <1% of all branchial anomalies and present as recurrent neck infections or suppurative thyroiditis. Traditionally, management has consisted of treatment of the acute infection followed by hemithyroidectomy, surgical excision of the tract and obliteration of the opening in the pyriform fossa. Recently, it has been suggested that endoscopic obliteration of the sinus tract alone using laser, chemo or electrocautery is a viable alternative to open surgery. To determine the results of endoscopic obliteration of fourth branchial arch fistulae in children in our institute. Retrospective case note review of all children undergoing endoscopic treatment of fourth branchial arch anomalies in the last 7 years at the Royal Manchester Children's Hospital. Patient demographics, presenting symptoms, investigations and surgical technique were analysed. The primary and secondary outcome measures were resolution of recurrent infections and incidence of surgical complications, respectively. In total 5 cases were identified (4 females and 1 male) aged between 3 and 12 years. All presented with recurrent left sided neck abscesses. All children underwent a diagnostic laryngo-tracheo-bronchoscopy which identified a sinus in the apex of the left pyriform fossa. This was obliterated using electrocautery in 1 patient, CO₂ laser/Silver Nitrate chemocautery in 2 patients and Silver Nitrate chemocautery in a further 2 patients. There were no complications and no recurrences over a mean follow-up period of 25 months (range 11-41 months). Endoscopic obliteration of pyriform fossa sinus is a safe method for treating fourth branchial arch anomalies with no recurrence. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Pseudohypoparathyroidism with Hashimoto's thyroiditis and Turner syndrome: a case report.

PubMed

Zeng, Wen-Heng; Xu, Jiao-Jun; Jia, Min-Yue; Ren, Yue-Zhong

2014-10-01

To report the case of an individual with PHP, Turner syndrome and Hashimoto's thyroiditis. A 16-year-old girl was referred to our hospital with chief complaint of short stature. She presented with round chubby facies, short neck, obesity and short stature. Radiography indicated short metatarsals and metacarpals, which mainly affected the second, third and fourth digits. Biochemistry revealed hyperphosphatemia, increased serum concentrations of parathyroid hormone and thyroid stimulating hormone, elevated levels of follicular-stimulating hormone and prolactin, and increased thyroid peroxidase antibody and thyroglobulin antibody. Radiographic examination revealed delayed bone age and pelvic ultrasonography demonstrated an immature uterus. Karyotype analysis showed 46,X,i(Xq10), while molecular analysis revealed a same sense mutation in exon 5 of GNAS (ATC → ATT, Ile).The specific diagnosis was made of Turner syndrome in the presence of Hashimoto's thyroiditis and PHP. She was treated with calcium supplementation, calcitriol and thyroxine. This is the first case report to describe a combination of Turner syndrome with these other clinical entities, and their co-existence should be considered and further investigated.

Administration of the Small Public Library. Fourth Edition.

ERIC Educational Resources Information Center

Weingand, Darlene E.

Since the publication of its first edition in 1965, this book has been a standard resource for setting up and managing cutting-edge small public library facilities. Completely revised and updated, this fourth edition continues that tradition with many more figures (28 in this edition), case studies and sample policies, and new content on grant…

Manifestations of gastrointestinal plasmablastic lymphoma: a case series with literature review.

PubMed

Luria, Lynette; Nguyen, Johnny; Zhou, Jun; Jaglal, Michael; Sokol, Lubomir; Messina, Jane L; Coppola, Domenico; Zhang, Ling

2014-09-07

Plasmablastic lymphoma (PBL) rarely occurs in the gastrointestinal (GI) tract with limited studies reported. We reviewed the clinical histories and pathology of four patients with GI PBL at our institute and similar case reports published in peer-reviewed journals. In our first case, a 40 year-old human immunodeficiency virus positive male presented with a hemorrhoid-like sensation, and was diagnosed with PBL via biopsy of a rectal mass. The second case involves a 65 year-old healthy male with bloody diarrhea who was found to have PBL in a resected sigmoid mass. The third patient was a 41 year-old male with a history of Crohn's disease who presented with abdominal pain, diarrhea, and weight loss. A small intestinal mass (PBL) was removed. The fourth patient was a 65-year-old male who was found PBL after surgical resection of bowel for his florid Crohn's disease. He later developed secondary acute myeloid leukemia. Clinical outcome was very poor in 3 out of 4 patients as reported in the literature. One patient survived chemotherapy followed by autologous transplant. The prototypical clinical presentation and variations of PBL can help create a more comprehensive differential diagnosis for GI tumors and establish an appropriate therapeutic guideline.

Procedural and interpretive skills of medical students: experiences and attitudes of fourth-year students.

PubMed

Wu, Edward H; Elnicki, D Michael; Alper, Eric J; Bost, James E; Corbett, Eugene C; Fagan, Mark J; Mechaber, Alex J; Ogden, Paul E; Sebastian, James L; Torre, Dario M

2008-10-01

Recent data do not exist regarding fourth-year medical students' performance of and attitudes toward procedural and interpretive skills, and how these differ from third-year students'. Cross-sectional survey conducted in February 2006 of 122 fourth-year students from seven U.S. medical schools, compared with their responses in summer 2005. Students estimated their cumulative performance of 22 skills and reported self-confidence and perceived importance using a five-point Likert-type scale. The response rate was 79% (96/122). A majority reported never having performed cardioversion, thoracentesis, cardiopulmonary resuscitation, blood culture, purified protein derivative placement, or paracentesis. One fifth of students had never performed peripheral intravenous catheter insertion, phlebotomy, or arterial blood sampling. Students reported increased cumulative performance of 17 skills, increased self-confidence in five skills, and decreased perceived importance in three skills (two-sided P < .05). A majority of fourth-year medical students still have never performed important procedures, and a substantial minority have not performed basic procedures.

39 CFR 242.2 - Change of site-fourth-class offices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Change of site-fourth-class offices. 242.2 Section 242.2 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION CHANGE OF SITE § 242.2 Change of site—fourth-class offices. Report by memorandum to chief, organization and management branch, when change in site is necessary....

Eigenvalues of the Wentzell-Laplace operator and of the fourth order Steklov problems

NASA Astrophysics Data System (ADS)

Xia, Changyu; Wang, Qiaoling

2018-05-01

We prove a sharp upper bound and a lower bound for the first nonzero eigenvalue of the Wentzell-Laplace operator on compact manifolds with boundary and an isoperimetric inequality for the same eigenvalue in the case where the manifold is a bounded domain in a Euclidean space. We study some fourth order Steklov problems and obtain isoperimetric upper bound for the first eigenvalue of them. We also find all the eigenvalues and eigenfunctions for two kind of fourth order Steklov problems on a Euclidean ball.

[Fourth evaluation of the law on the review of termination of life on request and assisted suicide (Euthanasia Act)].

PubMed

van der Heide, A; Onwuteaka-Philipsen, B D; van Delden, J J M; Gevers, J K M; van der Maas, P J; van der Wal, G

2005-09-24

This fall, an extensive study will start to evaluate the Dutch Euthanasia Act. This law was enacted in 2002. According to this law, physicians must report cases of euthanasia and physician-assisted suicide. The cases are then judged by regional euthanasia review committees consisting of a lawyer, a physician and an ethicist. Only if they conclude that the case does not meet the requirements for prudent practice, it will be sent to the public prosecutor. The study will be focused on the practice of medical end-of-life decision-making, the functioning and effects of the Euthanasia Act, and opinions of physicians about the scope of the law and the demarcation between different end-of-life decisions. The study will comprise 4 sub-studies: a judicial evaluation, a death certificate study, a survey among physicians and a panel study among physicians, nurses, members of euthanasia review committees, lawyers and ethicists. This study is the fourth in a row of nationwide studies into end-of-life practices that have been performed since 1990. The previous studies contributed to the public debate about medical care at the end of life and to the development of policy in this field. It is expected that this study, by providing up-to-date information on and insight into end-of-life care in the Netherlands, will do the same.

[Contraception with levonorgestrel (Norplant) subcutaneous implants. African experience in Burkina Faso].

PubMed

Koné, B; Lankoandé, J; Ouédraogo, C M; Ouédraogo, A; Bonané, B; Dao, B; Sanou, J

1999-02-01

The subcutaneous implants from the levonorgestrel (Norplant) has been introduced in Burkina Faso in September 1992 within the context of a project assisted by a non-governmental organization (the Population Council). The aim was to reinforce the family planning programme in Burkina Faso by increasing the number of family planning methods available for the clients. 4 years after its introduction, we propose to make a report of our experience in terms of the contraception through subcutaneous implants in order to better set up an IEC campaign on this method. Within 4 years, 1,660 users benefitted from that contraceptive method. They were housewives in 65% of the cases. The age-group of 30-34 years old most used this method with 28.6%. Multipares most benefitted from this method with 64.3%. In 72% of the cases, the insertion was made during the premenstrual period. On the whole, 247 withdrawals have been made before the fourth years for various reasons. Among those reasons are cycle disorders (60 withdrawals), medical reasons (53 withdrawals), personal conveniences (47 withdrawals), weight gaining (14 withdrawals), failures (2 withdrawals). Regarding the side effects, they were mainly represented by the menstrual cycle disorders such as amenorrhoea, spotting, hypermenorrhoea in 51% of the cases. A good information and sensitization campaign should reduce the number of implants withdrawals before the fourth year of use. Moreover, a perfect knowledge of contraindications is indispensable before any prescription.

The Fourth Revolution

ERIC Educational Resources Information Center

Abelson, Philip H.

1972-01-01

Comments on the conclusions of the Carnegie Commission on Higher Education's report, The Fourth Revolution: Instructional Technology in Higher Education,'' and advocates effort in exploiting the new technology and in assessing the possible adverse effects. (AL)

Harnessing Social Networks along with Consumer-Driven Electronic Communication Technologies to Identify and Engage Members of 'Hard-to-Reach' Populations: A Methodological Case Report

PubMed Central

2010-01-01

Background Sampling in the absence of accurate or comprehensive information routinely poses logistical, ethical, and resource allocation challenges in social science, clinical, epidemiological, health service and population health research. These challenges are compounded if few members of a target population know each other or regularly interact. This paper reports on the sampling methods adopted in ethnographic case study research with a 'hard-to-reach' population. Methods To identify and engage a small yet diverse sample of people who met an unusual set of criteria (i.e., pet owners who had been treating cats or dogs for diabetes), four sampling strategies were used. First, copies of a recruitment letter were posted in pet-friendly places. Second, information about the study was diffused throughout the study period via word of mouth. Third, the lead investigator personally sent the recruitment letter via email to a pet owner, who then circulated the information to others, and so on. Fourth, veterinarians were enlisted to refer people who had diabetic pets. The second, third and fourth strategies rely on social networks and represent forms of chain referral sampling. Results Chain referral sampling via email proved to be the most efficient and effective, yielding a small yet diverse group of respondents within one month, and at negligible cost. Conclusions The widespread popularity of electronic communication technologies offers new methodological opportunities for researchers seeking to recruit from hard-to-reach populations. PMID:20089187

Harnessing social networks along with consumer-driven electronic communication technologies to identify and engage members of 'hard-to-reach' populations: a methodological case report.

PubMed

Rock, Melanie J

2010-01-20

Sampling in the absence of accurate or comprehensive information routinely poses logistical, ethical, and resource allocation challenges in social science, clinical, epidemiological, health service and population health research. These challenges are compounded if few members of a target population know each other or regularly interact. This paper reports on the sampling methods adopted in ethnographic case study research with a 'hard-to-reach' population. To identify and engage a small yet diverse sample of people who met an unusual set of criteria (i.e., pet owners who had been treating cats or dogs for diabetes), four sampling strategies were used. First, copies of a recruitment letter were posted in pet-friendly places. Second, information about the study was diffused throughout the study period via word of mouth. Third, the lead investigator personally sent the recruitment letter via email to a pet owner, who then circulated the information to others, and so on. Fourth, veterinarians were enlisted to refer people who had diabetic pets. The second, third and fourth strategies rely on social networks and represent forms of chain referral sampling. Chain referral sampling via email proved to be the most efficient and effective, yielding a small yet diverse group of respondents within one month, and at negligible cost. The widespread popularity of electronic communication technologies offers new methodological opportunities for researchers seeking to recruit from hard-to-reach populations.

Imaging in the diagnosis of cemento-ossifying fibroma: a case series.

PubMed

Mithra, R; Baskaran, Pavitra; Sathyakumar, M

2012-01-01

Cemento-ossifying fibroma is a benign fibro-osseous lesion belonging to the same category as fibrous dysplasia and cementifying dysplasia. These are slow-growing lesions that are seen in the third and fourth decades of life. Both the ossifying fibroma and cemento-ossifying fibroma represent two extremes of the same disease process since histologically both contain bone and cementum. However, the term cemento-ossifying fibroma is justified on the basis of clinical and radiological correlation. Radiographs have become an essential tool in the diagnosis of lesions in the jaw, where the anatomy is complex. Nowadays, CT provides information for diagnosis as well as treatment planning. In this case series, we report three cases of cemento-ossifying fibroma that were histologically confirmed and discuss the imaging findings.

Imaging in the Diagnosis of Cemento-Ossifying Fibroma: A Case Series

PubMed Central

Mithra, R; Baskaran, Pavitra; Sathyakumar, M

2012-01-01

Cemento-ossifying fibroma is a benign fibro-osseous lesion belonging to the same category as fibrous dysplasia and cementifying dysplasia. These are slow-growing lesions that are seen in the third and fourth decades of life. Both the ossifying fibroma and cemento-ossifying fibroma represent two extremes of the same disease process since histologically both contain bone and cementum. However, the term cemento-ossifying fibroma is justified on the basis of clinical and radiological correlation. Radiographs have become an essential tool in the diagnosis of lesions in the jaw, where the anatomy is complex. Nowadays, CT provides information for diagnosis as well as treatment planning. In this case series, we report three cases of cemento-ossifying fibroma that were histologically confirmed and discuss the imaging findings. PMID:23029635

Recurrent neck infection with branchial arch fistula in children.

PubMed

Madana, J; Yolmo, Deeke; Kalaiarasi, R; Gopalakrishnan, S; Saxena, S K; Krishnapriya, S

2011-09-01

Acute suppurative neck infections associated with third or fourth branchial arch fistulas are frequently recurrent. Third and fourth branchial arch anomalies are much less common than those of second arch and usually present with left thyroid lobe inflammation. The authors present their experience with 15 cases of pyriform sinus fistulae (PSF) of third branchial arch origin and 3 cases of fourth arch origin, all of which presented as recurrent neck infection mainly on the left side. A retrospective review of 18 cases of third and fourth arch fistulae treated at JIPMER from 2005 to 2010. This study includes 18 patients with PSF diagnosed by the existence of fistulous tract radiologically and intraoperatively with pathological correlation. Neck exploration with excision of tract and left hemithyroidectomy was performed in all cases. The patients consisted of 7 males and 11 females, and the ages ranged from 3 to 15 years. All of them presented with recurrent episodes of neck infection. Investigations performed include computed tomography (CT) fistulography, barium swallow and ultrasound which were useful in delineating pyriform sinus fistulous tract preoperatively. All cases were on the left side and the fistula was identified by barium swallow in 14 cases (80%), while intraoperative and pathologic confirmation of the tract was possible in all cases (100%). Neck exploration with an emphasis on complete exposure of the recurrent laryngeal nerve and exposure of the pyriform sinus opening to facilitate complete fistulous tract excision with left hemithyroidectomy was successful in all patients. A follow up period of 1-3 years showed no recurrence. Recurrent neck infection in a child should alert the physician to the possibility of an underlying pyriform sinus fistula of branchial origin and CT fistulography should be performed after the resolution of the neck infection to delineate the tract anatomically. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.

Report for Colorado: Background & Visuals, Math 2005. The Nation's Report Card

ERIC Educational Resources Information Center

Sandoval, Pam A.

2005-01-01

The National Assessment of Educational Progress (NAEP) 2005 assessment was administered to a stratified random sample of fourth-, eighth-, and twelfth-graders at the national level and to a stratified random sample of fourth- and eighth-graders at the state level. The Mathematics Framework for NAEP was revised in 1996 and again in 2005. The new…

76 FR 48073 - Hazardous Waste Management System: Identification and Listing of Hazardous Waste: Carbon Dioxide...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

... Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change [Solomon, S., D. Qin, M. Manning, Z. Chen, M. Marquis, K.B. Averyt, M. Tignor... Vulnerability. Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel...

FLORIDA MIGRANT HEALTH PROJECT. FOURTH ANNUAL PROGRESS REPORT, 1966-1967.

ERIC Educational Resources Information Center

Florida State Board of Health, Jacksonville.

THE FOURTH ANNUAL PROGRESS REPORT OF THE FLORIDA MIGRANT HEALTH PROJECT INDICATES THAT IN 1966-67 THERE WAS AN APPRECIABLE INCREASE IN THE AMOUNT AND VARIETY OF MIGRANT HEALTH SERVICES RENDERED, THE NUMBER OF MIGRANTS CONTACTED, AND THE ACTIVITIES PERFORMED BY PROJECT PERSONNEL. MIGRANT HEALTH SERVICE REFERRALS INCREASED BY 1,222 OVER THE SAME…

Renewable Energy Finance Tracking Initiative (REFTI): Snapshot of Recent Geothermal Financing Terms, Fourth Quarter 2009 - Second Half 2011

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

Lowder, T.; Hubbell, R.; Mendelsohn, M.

This report is a review of geothermal project financial terms as reported in the National Renewable Energy Laboratory's Renewable Energy Finance Tracking Initiative (REFTI). The data were collected over seven analysis periods from the fourth quarter (Q4) of 2009 to the second half (2H) of 2011.

Simulation study of the ROMPS robot control system

NASA Technical Reports Server (NTRS)

Nguyen, Charles C.; Liu, HUI-I.

1994-01-01

This is a report presenting the progress of a research grant funded by NASA for work performed from June 1, 1993 to August 1, 1993. The report deals with the Robot Operated Material Processing System (ROMPS). It presents results of a computer simulation study conducted to investigate the performance of the control systems controlling the azimuth, elevation, and radial axes of the ROMPS and its gripper. Four study cases are conducted. The first case investigates the control of free motion of the three areas. In the second case, the compliant motion in the elevation axis with the wrist compliant device is studied in terms of position accuracy and impact forces. The third case focuses on the behavior of the control system in controlling the robot motion along the radial axis when pulling the pallet out of the rack. In the fourth case, the compliant motion of the gripper grasping a solid object under the effect of the gripper passive compliance is studied in terms of position accuracy and contact forces. For each of the above cases, a set of PIR gains will be selected to optimize the controller performance and computer simulation results will be presented and discussed.

Competency to stand trial evaluations in a multicultural population: Associations between psychiatric, demographic, and legal factors.

PubMed

Paradis, Cheryl M; Owen, Elizabeth; Solomon, Linda Z; Lane, Benjamin; Gulrajani, Chinmoy; Fullar, Michael; Perry, Alan; Rai, Sasha; Lavy, Tamar; McCullough, Gene

2016-01-01

Data were examined from an archival sample of Competency to Stand Trial (CST) reports of 200 consecutive New York City pre-trial defendants evaluated over a five-month period. Approximately a fourth of defendants in the present study were immigrants; many required the assistance of interpreters. The examiners conducting the CST evaluation diagnosed approximately half of the defendants with a primary diagnosis of a psychotic disorder and deemed over half not competent. Examiners reached the same conclusion about competency in 96% of cases, about the presence of a psychotic disorder in 91% of cases, and affective disorder in 85% of cases. No significant differences between psychologists and psychiatrists were found for rates of competency/incompetency opinions. Compared to those deemed competent, defendants deemed not competent had significantly higher rates of prior psychiatric hospitalization and diagnosis of psychotic illness at the time of the CST evaluation but lower rates of reported substance abuse. Copyright © 2016 Elsevier Ltd. All rights reserved.

Notes from the Field: Chlorination Strategies for Drinking Water During a Cholera Epidemic - Tanzania, 2016.

PubMed

Wang, Alice; Hardy, Colleen; Rajasingham, Anangu; Martinsen, Andrea; Templin, Lindsay; Kamwaga, Stanislaus; Sebunya, Kiwe; Jhuthi, Brenda; Habtu, Michael; Kiberiti, Stephen; Massa, Khalid; Quick, Rob; Mulungu, Jane; Eidex, Rachel; Handzel, Thomas

2016-10-21

Since August 2015, the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) of Tanzania has been leading the response to a widespread cholera outbreak. As of June 9, 2016, cholera had affected 23 of 25 regions in Tanzania, with 21,750 cumulative cases and 341 deaths reported (Ally Nyanga, MoHCDGEC Emergency Operations Center, personal communication, June 2016). Approximately one fourth of all cases occurred in the Dar es Salaam region on the east coast. Regions surrounding Lake Victoria, in the north, also reported high case counts, including Mwanza with 9% (Ally Nyanga, MoHCDGEC Emergency Operations Center, personal communication, June 2016). Since the start of the outbreak, MoHCDGEC and the Ministry of Water (MOW) have collaborated with the Tanzania Red Cross Society, United Nations Children's Fund (UNICEF), World Health Organization (WHO), and CDC to enhance the water, sanitation, and hygiene (WASH) response to prevent the further spread of cholera.

Florida's tuberculosis epidemic. Public health response.

PubMed

Witte, J J; Bigler, W J

1994-03-01

Florida ranked fourth in the nation with 1,707 tuberculosis cases reported in 1992 for a rate of 12.7 per 100,000 population. Thirteen percent of these patients had AIDS. Recent cases in prisons, shelters, hospitals and schools have stimulated interest and media coverage. Resurgence of strains of multiple-drug resistant tuberculosis is a serious concern. The Florida Department of Health and Rehabilitative Services, in collaboration with allied agencies, has utilized several initiatives in response. The most significant, Tuberculosis Epidemic Containment Plan, details intervention strategies needed to eliminate TB in the state by the year 2010. Successful implementation depends upon local TB prevention and control coalitions that include private and public sector providers.

Cemento-ossifying fibroma of mandible: An unusual case report and review of literature.

PubMed

Mohapatra, Mounabati; Banushree, C S; Nagarajan, K; Pati, Debashish

2015-01-01

The term ossifying fibroma (OF) has recently been included under fibro-osseous lesions. Cemento-OF (COF) is a benign neoplasm that arises from the periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone and fibrous tissue. These tumors occur in the third and fourth decades of life with a predilection for women. The mandible is more commonly involved than the maxilla. This lesion has caused considerable controversy regarding the use of terminology, origin and diagnostic criteria. This article describes an unusual case of COF presenting as unilocular lytic lesion of mandible in a 38-year-old male patient with review of literature.

Cemento-ossifying fibroma of mandible: An unusual case report and review of literature

PubMed Central

Mohapatra, Mounabati; Banushree, CS; Nagarajan, K; Pati, Debashish

2015-01-01

The term ossifying fibroma (OF) has recently been included under fibro-osseous lesions. Cemento-OF (COF) is a benign neoplasm that arises from the periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone and fibrous tissue. These tumors occur in the third and fourth decades of life with a predilection for women. The mandible is more commonly involved than the maxilla. This lesion has caused considerable controversy regarding the use of terminology, origin and diagnostic criteria. This article describes an unusual case of COF presenting as unilocular lytic lesion of mandible in a 38-year-old male patient with review of literature. PMID:26980975

Hydrocephalus secondary to obstruction of the lateral apertures in two dogs.

PubMed

Kent, M; Glass, E N; Haley, A C; Shaikh, L S; Sequel, M; Blas-Machado, U; Bishop, T M; Holmes, S P; Platt, S R

2016-11-01

Traditionally, hydrocephalus is divided into communicating or non-communicating (obstructive) based on the identification of a blockage of cerebrospinal fluid (CSF) flow through the ventricular system. Hydrocephalus ex vacuo refers to ventricular enlargement as a consequence of neuroparenchymal loss. Hydrocephalus related to obstruction of the lateral apertures of the fourth ventricles has rarely been described. The clinicopathologic findings in two dogs with hydrocephalus secondary to obstruction of the lateral apertures of the fourth ventricle are reported. Signs were associated with a caudal cervical spinal cord lesion in one dog and a caudal brain stem lesion in the other dog. Magnetic resonance imaging (MRI) disclosed dilation of the ventricular system, including the lateral recesses of the fourth ventricle. In one dog, postmortem ventriculography confirmed obstruction of the lateral apertures. Microscopic changes were identified in the choroid plexus in both dogs, yet a definitive cause of the obstructions was not identified. The MRI findings in both dogs are similar to membranous occlusion of the lateral and median apertures in human patients. MRI detection of dilation of the entire ventricular system in the absence of an identifiable cause should prompt consideration of an obstruction of the lateral apertures. In future cases, therapeutic interventions aimed at re-establishing CSF flow or ventriculoperitoneal catheterisation should be considered. © 2016 Australian Veterinary Association.

Rural Development: Part 1. Information and Technical Assistance Delivered by the Department of Agriculture in Fiscal Year 1973. Fourth Annual Report to the Congress.

ERIC Educational Resources Information Center

Department of Agriculture, Washington, DC.

As part 1 of a four part report to the U.S. Congress pursuant to Title IX, Section 901 of the Agricultural Act of 1970, this fourth annual report is limited to rural development activities of the U.S. Department of Agriculture (USDA) delivery system (the USDA National Rural Development Committee, State Rural Development Committee, and county…

Rare case of tibial hemimelia, preaxial polydactyly, and club foot

PubMed Central

Granite, Guinevere; Herzenberg, John E; Wade, Ronald

2016-01-01

A seven-month old female presented with left tibial hemimelia (or congenital tibial aplasia; Weber type VIIb, Jones et al type 1a), seven-toed preaxial polydactyly, and severe club foot (congenital talipes equinovarus). Definitive amputation surgery disarticulated the lower limb at the knee. This case report describes the anatomical findings of a systematic post-amputation examination of the lower limb’s superficial dissection, X-rays, and computed tomography (CT) scans. From the X-rays and CT scans, we found curved and overlapping preaxial supernumerary toes, hypoplastic first metatarsal, lack of middle and distal phalanges in one supernumerary toe, three tarsal bones, hypoplastic middle phalanx and no distal phalanx for fourth toe, and no middle or distal phalanges for fifth toe. The fibula articulated with the anteromedial calcaneus and the tibia was completely absent. We identified numerous muscles and nerves in the superficial dissection that are described in the results section of the case report. Due to the rarity of this combination of anatomical findings, descriptions of such cases are very infrequent in the literature. PMID:28035313

Rare case of tibial hemimelia, preaxial polydactyly, and club foot.

PubMed

Granite, Guinevere; Herzenberg, John E; Wade, Ronald

2016-12-16

A seven-month old female presented with left tibial hemimelia (or congenital tibial aplasia; Weber type VIIb, Jones et al type 1a), seven-toed preaxial polydactyly, and severe club foot (congenital talipes equinovarus). Definitive amputation surgery disarticulated the lower limb at the knee. This case report describes the anatomical findings of a systematic post-amputation examination of the lower limb's superficial dissection, X-rays, and computed tomography (CT) scans. From the X-rays and CT scans, we found curved and overlapping preaxial supernumerary toes, hypoplastic first metatarsal, lack of middle and distal phalanges in one supernumerary toe, three tarsal bones, hypoplastic middle phalanx and no distal phalanx for fourth toe, and no middle or distal phalanges for fifth toe. The fibula articulated with the anteromedial calcaneus and the tibia was completely absent. We identified numerous muscles and nerves in the superficial dissection that are described in the results section of the case report. Due to the rarity of this combination of anatomical findings, descriptions of such cases are very infrequent in the literature.

The rapid disintegration of projections: the West Antarctic Ice Sheet and the intergovernmental panel on climate change.

PubMed

O'Reilly, Jessica; Oreskes, Naomi; Oppenheimer, Michael

2012-10-01

How and why did the scientific consensus about sea level rise due to the disintegration of the West Antarctic Ice Sheet (WAIS), expressed in the third Intergovernmental Panel on Climate Change (IPCC) assessment, disintegrate on the road to the fourth? Using ethnographic interviews and analysis of IPCC documents, we trace the abrupt disintegration of the WAIS consensus. First, we provide a brief historical overview of scientific assessments of the WAIS. Second, we provide a detailed case study of the decision not to provide a WAIS prediction in the Fourth Assessment Report. Third, we discuss the implications of this outcome for the general issue of scientists and policymakers working in assessment organizations to make projections. IPCC authors were less certain about potential WAIS futures than in previous assessment reports in part because of new information, but also because of the outcome of cultural processes within the IPCC, including how people were selected for and worked together within their writing groups. It became too difficult for IPCC assessors to project the range of possible futures for WAIS due to shifts in scientific knowledge as well as in the institutions that facilitated the interpretations of this knowledge.

The fourth Minnesota forest inventory: area.

Treesearch

Pamela J. Jakes

1980-01-01

In 1977 the fourth Minnesota Forest Inventory found 13.7 million acres of commercial forest land, down 11% from that reported in 1962. This bulletin analyzes finding from the inventory and presents detailed tables of forest area.

Serum betaine but not choline is inversely associated with breast cancer risk: a case-control study in China.

PubMed

Du, Yu-Feng; Lin, Fang-Yu; Long, Wei-Qing; Luo, Wei-Ping; Yan, Bo; Xu, Ming; Mo, Xiong-Fei; Zhang, Cai-Xia

2017-04-01

Choline and betaine are important for DNA methylation and synthesis, and may affect tumor carcinogenesis. To our knowledge, no previous study has examined the association between serum choline and betaine and breast cancer risk. This study aimed to examine whether serum choline and betaine were inversely associated with breast cancer risk among Chinese women. This hospital-based case-control study consecutively recruited 510 breast cancer cases and 518 frequency-matched (age and residence) controls, and blood samples were available for 500 cases and 500 controls. Serum choline and betaine were assayed by high-performance liquid chromatography-tandem mass spectrometry. Multiple unconditional logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs). An inverse association with breast cancer risk was observed for serum betaine (fourth vs first quartile adjusted OR 0.68, 95 % CI 0.47-0.97) and for the ratio of serum betaine to choline (fourth vs first quartile adjusted OR 0.70, 95 % CI 0.48-1.00), but not for serum choline (fourth vs first quartile adjusted OR 0.80, 95 % CI 0.56-1.15). Serum betaine was inversely associated with breast cancer risk in subjects with below-median dietary folate intake (fourth vs first quartile adjusted OR 0.48, 95 % CI 0.30-0.77). This study suggested that serum betaine but not choline was inversely associated with breast cancer risk. This result needed to be further confirmed by the prospective studies.

Spindle Cell Rhabdomyosarcoma of Bone with FUS-TFCP2 Fusion: Confirmation of a Very Recently Described Rhabdomyosarcoma Subtype.

PubMed

Dashti, Nooshin K; Wehrs, Rebecca N; Thomas, Brittany C; Nair, Asha; Davila, Jaime; Buckner, Jan C; Martinez, Anthony P; Sukov, William R; Halling, Kevin C; Howe, Benjamin M; Folpe, Andrew L

2018-05-14

Rhabdomyosarcomas of bone are extremely rare, with fewer than 10 reported cases. A very rare subtype of spindle cell/sclerosing rhabdomyosarcoma harboring a FUS-TFCP2 fusion and involving both soft tissue and bone locations has very recently been reported. We report only the fourth case of this unusual, clinically aggressive rhabdomyosarcoma. A previously-well 72-year old male presented with a destructive lesion of the mandible. Morphological and immunohistochemical study of a needle biopsy and the subsequent resection showed a spindle cell rhabdomyosarcoma. RNA-seq, RT-PCR and FISH confirmed the presence of the FUS-TFCP2 fusion. Spindle cell rhabdomyosarcomas carrying the FUS-TFCP2 fusion are very rare rhabdomyosarcoma variants with osseous predilection. The classification and differential diagnosis of this unusual molecular variant of spindle cell/ sclerosing rhabdomyosarcoma are discussed. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

High-grade soft tissue sarcoma arising in a desmoid tumor: case report and review of the literature.

PubMed

Bertucci, François; Faure, Marjorie; Ghigna, Maria-Rosa; Chetaille, Bruno; Guiramand, Jérôme; Moureau-Zabotto, Laurence; Sarran, Anthony; Perrot, Delphine

2015-01-01

Desmoid tumors are rare benign monoclonal fibroblastic tumors. Their aggressiveness is local with no potential for metastasis or dedifferentiation. Here we report on a 61-year-old patient who presented a locally advanced breast desmoid tumor diagnosed 20 years after post-operative radiotherapy for breast carcinoma. After 2 years of medical treatment, a high-grade undifferentiated pleomorphic soft tissue sarcoma arose within the desmoid tumor. Despite extensive surgery removing both tumors, the patient showed locoregional relapse by the sarcoma, followed by multimetastatic progression, then death 25 months after the surgery. The arising of a soft tissue sarcoma in a desmoid tumor is an exceptional event since our case is the fourth one reported so far in literature. It reinforces the need for timely and accurate diagnosis when a new mass develops in the region of a preexisting desmoid tumor, and more generally when a desmoid tumor modifies its clinical or radiological aspect.

Effects of Healthy Life Practice Education on Reported Health Behaviors among Fourth-Grade Elementary School Students in South Korea

ERIC Educational Resources Information Center

Kim, Shin-Jeong; Cho, Haeryun; Baek, Seong-Sook

2016-01-01

The purpose of this study was to test the effects of healthy life practice (HLP) education on reported health behaviors, including health promotion, disease prevention, and safety among fourth-grade elementary school students. A quasi-experimental, pretest/posttest design was used. The 101 recruited participants from two schools were assigned to…

Mt. Druitt Early Childhood Project. Third, Fourth, and Fifth Annual Reports to Bernard Van Leer Foundation.

ERIC Educational Resources Information Center

Macquarie Univ., North Ryde (Australia). School of Education.

This series of the third, fourth, and fifth annual reports to the Bernard Van Leer Foundation on the Mt. Druitt Early Childhood Project of Macquarie University, Australia, describes the general activities, program developments, and research activities of the project for the period 1977-1979. The main objective of the project is to develop,…

Neurocutaneous melanosis in association with Dandy-Walker malformation: case report and literature review.

PubMed

Schreml, S; Gruendobler, B; Schreml, J; Bayer, M; Ladoyanni, E; Prantl, L; Eichelberg, G

2008-08-01

Neurocutaneous melanosis (NCM) is a rare congenital noninheritable phacomatosis characterized by large and/or numerous cutaneous congenital melanocytic naevi (CMN) in combination with melanocytic leptomeningeal tumours. Dandy-Walker malformation (DWM) consists of a cystic dilatation of the fourth ventricle communicating with the posterior fossa, and a high insertion of the tentorium and hypoplasia/aplasia of the cerebellar vermis (partially caused by Zic1(+/-)Zic 4(+/-) on 3q2). An association of NCM and DWM is very rare, with only 15 previously reported cases to our knowledge. We present an 8-year-old girl with multiple CMN and DWM. A ventriculoperitoneal shunt operation was performed when she was 1 day old. Her neurological symptoms to date comprise headaches, nausea and vomiting as a result of ventriculoperitoneal shunt dislocation at the age of 4 years. The diagnosis is provisional asymptomatic multiple CMN-type NCM in association with DWM.

Human Phaeohyphomycotic Osteomyelitis Caused by the Coelomycete Phomopsis Saccardo 1905: Criteria for Identification, Case History, and Therapy

PubMed Central

Sutton, Deanna A.; Timm, William D.; Morgan-Jones, Gareth; Rinaldi, Michael G.

1999-01-01

The Sphaeropsidales, coelomycetous fungi producing asexual conidia within enclosed conidiomata (pycnidia), are saprobic on numerous vascular plants. Despite their ubiquitous nature, only a limited number of genera have been documented as causing human disease. We report what we believe to be the first human case of osteomyelitis due to a Phomopsis species in a chronically immunosuppressed female. The patient developed a subcutaneous abscess on the distal phalanx of the right fourth finger complicated by osteomyelitis. Operative specimens revealed fungal hyphae and a pure culture of mould. The patient was treated with a 6-month course of itraconazole. At 16 months of follow-up, she remained free of recurrence. Phomopsis species differ from the similar, more frequently reported Phoma species by having immersed, thick-walled, multiloculate conidiomata and by the production of alpha (short, ellipsoidal) and beta (long, filamentous) conidia. PMID:9986861

School Hygiene: A Report of the Fourth International Congress of School Hygiene, Held at Buffalo, New York, August 25-30, 1913. Bulletin, 1913, No. 48. Whole Number 559

ERIC Educational Resources Information Center

Ryan, W. Carson, Jr.

1913-01-01

The Fourth International Congress of School Hygiene, held at Buffalo, New York, August 25-30, was a notable event in the progress of health supervision as a part of public education. Because of its importance, the author was detailed to attend this conference and prepare a report of it. This report contains three parts: (1) An introduction giving…

Immediate reaction to lidocaine with periorbital edema during upper blepharoplasty

PubMed Central

Presman, Benjamin; Vindigni, Vincenzo; Tocco-Tussardi, Ilaria

2016-01-01

Introduction Blepharoplasty is the fourth most commonly performed cosmetic surgery in the US, with 207,000 operations in 2014. Lidocaine is the preferred anesthetic agent for blepharoplasty. Presentation of case We describe the unusual case of acute periorbital edema following local anesthesia with lidocaine for upper blepharoplasty. At present, only two other reports of periorbital reactions to lidocaine are present in the literature. The reactions observed are significant palpebral swelling and erythema with scaling of the cheek. Fortunately the swelling, although marked, is transient in nature and resolves almost spontaneously without affecting the visual acuity. Discussion Patients reporting adverse reactions should be screened for allergy according to the standard protocols, but skin testing has only been reported to be positive in less than 10% of all cases and allergy confirmation with IgE is even more rare. Conclusion In clinical practice, we recommend that patient should be informed about the possibility of recurrence of an adverse reaction in case of re-exposure to lidocaine, even in the vast majority of cases where true allergy could not be proven. In case of further need for local anesthesia with history of an adverse event, a different agent may be chosen even from the same class (another amide) as cross-reactions in the amide group are rare. Otherwise, an anesthetic from the ester group can also be safely used. PMID:26785079

Dysphagia: An Unusual Presentation of Metastatic Uterine Cervical Carcinoma.

PubMed

Hameed, Anam; Dekovich, Alexander A; Lum, Phillip J; Shafi, Mehnaz A

2017-03-01

Worldwide, cervical cancer is the third most common cancer among women and the fourth leading cause of death from cancer. The most common sites of metastasis are the pelvic lymph nodes, vagina, and the pelvic sidewalls. Distant metastases are uncommon but can involve the bone, lung, and liver. Characteristics associated with increased rate of distant metastasis include bulky tumor, endometrial extension, lymph node involvement, and advanced disease. We report the case of a woman with stage II cervical carcinoma, who presented with dysphagia due to cervical cancer metastases to the mediastinum.

SCALS: a fourth-generation study of assisted living technologies in their organisational, social, political and policy context

PubMed Central

Greenhalgh, Trisha; Shaw, Sara; Wherton, Joe; Hughes, Gemma; Lynch, Jenni; A'Court, Christine; Hinder, Sue; Fahy, Nick; Byrne, Emma; Finlayson, Alexander; Sorell, Tom; Procter, Rob; Stones, Rob

2016-01-01

Introduction Research to date into assisted living technologies broadly consists of 3 generations: technical design, experimental trials and qualitative studies of the patient experience. We describe a fourth-generation paradigm: studies of assisted living technologies in their organisational, social, political and policy context. Fourth-generation studies are necessarily organic and emergent; they view technology as part of a dynamic, networked and potentially unstable system. They use co-design methods to generate and stabilise local solutions, taking account of context. Methods and analysis SCALS (Studies in Co-creating Assisted Living Solutions) consists (currently) of 5 organisational case studies, each an English health or social care organisation striving to introduce technology-supported services to support independent living in people with health and/or social care needs. Treating these cases as complex systems, we seek to explore interdependencies, emergence and conflict. We employ a co-design approach informed by the principles of action research to help participating organisations establish, refine and evaluate their service. To that end, we are conducting in-depth ethnographic studies of people's experience of assisted living technologies (micro level), embedded in evolving organisational case studies that use interviews, ethnography and document analysis (meso level), and exploring the wider national and international context for assisted living technologies and policy (macro level). Data will be analysed using a sociotechnical framework developed from structuration theory. Ethics and dissemination Research ethics approval for the first 4 case studies has been granted. An important outcome will be lessons learned from individual co-design case studies. We will document the studies’ credibility and rigour, and assess the transferability of findings to other settings while also recognising unique aspects of the contexts in which they were generated. Academic outputs will include a cross-case analysis and progress in theory and method of fourth-generation assisted living technology research. We will produce practical guidance for organisations, policymakers, designers and service users. PMID:26880671

Metatarsal lengthening by callotasis in adults with first brachymetatarsia.

PubMed

Hwang, So-Min; Song, Jennifer Kim; Kim, Hui-Taek

2012-12-01

Brachymetatarsia is a rare clinical entity that presents a challenging problem for surgeons. One-stage lengthening with an autologous bone graft has been preferred for metatarsals that require a limited lengthening. With a gradual lengthening of metatarsals, callus distraction (callotasis) can achieve a greater length gain and a concomitant lengthening of the soft tissue. This article presents results of callotasis for adults with first brachymetatarsia. The outcomes of nine cases of first brachymetatarsia in five adult patients who underwent metatarsal lengthening by callotasis between March 1999 and February 2005 were retrospectively reviewed and analyzed. The average length gain was 16.4 mm and the average lengthening percentage was 43.7%. In addition, the average healing index was calculated as 3.8 months/cm, which was higher than that reported previously in the fourth brachymetatarsia. It was concluded that the period of bony consolidation following callotasis is longer in the first brachymetatarsia than in the fourth brachymetatarsia. Presumably, this might be because of the anatomically larger osteotomized cut surface and its weight-bearing function.

Fluoroquinolone Treatment and Susceptibility of Isolates From Bacterial Keratitis

PubMed Central

Ray, Kathryn J.; Prajna, Lalitha; Srinivasan, Muthiah; Geetha, Manoharan; Karpagam, Rajarathinam; Glidden, David; Oldenburg, Catherine E.; Sun, Catherine Q.; McLeod, Stephen D.; Acharya, Nisha R.; Lietman, Thomas M.

2013-01-01

Objective To analyze the relationship between fluoroquinolone use at presentation and minimum inhibitory concentration in bacterial keratitis. Methods The Steroids for Corneal Ulcers Trial was a randomized, double-masked, placebo-controlled trial assessing the effect of adjunctive topical corticosteroid treatment on outcomes in bacterial keratitis. After presentation, all patients were treated with moxifloxacin hydrochloride, 0.5%. We compare antibiotic use at presentation with minimum inhibitory concentration against moxifloxacin for all isolates. Separate analyses accounted for organism species and fluoroquinolone generation. Results Topical fluoroquinolone use at presentation was reported in 92 of 480 cases (19.2%). Causative organisms in the 480 cases included Streptococcus pneumoniae (247 cases [51.5%]), Pseudomonas aeruginosa (109 cases [22.7%]), and Nocardia species (55 cases [11.5%]). Isolates from patients who reported fluoroquinolone use at presentation had a 2.01-fold–higher minimum inhibitory concentration (95% CI, 1.39-fold to 2.91-fold; P <.001). Fourth-generation fluoroquinolones were associated with a 3.48-fold–higher minimum inhibitory concentration than those isolates that were not exposed to pretreatment at enrollment (95% CI, 1.99-fold to 6.06-fold; P <.001). Conclusion This study provides evidence that prior use of fluoroquinolones is associated with antibiotic resistance. PMID:23307105

Fluoroquinolone treatment and susceptibility of isolates from bacterial keratitis.

PubMed

Ray, Kathryn J; Prajna, Lalitha; Srinivasan, Muthiah; Geetha, Manoharan; Karpagam, Rajarathinam; Glidden, David; Oldenburg, Catherine E; Sun, Catherine Q; McLeod, Stephen D; Acharya, Nisha R; Lietman, Thomas M

2013-03-01

To analyze the relationship between fluoroquinolone use at presentation and minimum inhibitory concentration in bacterial keratitis. The Steroids for Corneal Ulcers Trial was a randomized, double-masked, placebo-controlled trial assessing the effect of adjunctive topical corticosteroid treatment on outcomes in bacterial keratitis. After presentation, all patients were treated with moxifloxacin hydrochloride, 0.5%. We compare antibiotic use at presentation with minimum inhibitory concentration against moxifloxacin for all isolates. Separate analyses accounted for organism species and fluoroquinolone generation. Topical fluoroquinolone use at presentation was reported in 92 of 480 cases (19.2%). Causative organisms in the 480 cases included Streptococcus pneumoniae (247 cases [51.5%]), Pseudomonas aeruginosa (109 cases [22.7%]), and Nocardia species (55 cases [11.5%]). Isolates from patients who reported fluoroquinolone use at presentation had a 2.01-fold-higher minimum inhibitory concentration (95% CI, 1.39-fold to 2.91-fold; P < .001). Fourth-generation fluoroquinolones were associated with a 3.48-fold-higher minimum inhibitory concentration than those isolates that were not exposed to pretreatment at enrollment (95% CI, 1.99-fold to 6.06-fold; P < .001). This study provides evidence that prior use of fluoroquinolones is associated with antibiotic resistance. clinicaltrials.gov Identifier: NCT00324168.

Myasthenia gravis and autoimmune Addison disease in a patient with thymoma.

PubMed

Seker, Mesut; Gozu, Hulya Iliksu; Oven Ustaalioğlu, Bala Basak; Sonmez, Berkant; Erkal, Fatih Yavuz; Kocak, Mihriban; Barisik, Nagehan Ozdemir; Orbay, Ekrem; Sargin, Mehmet; Sargin, Haluk; Boru, Ulku Turk; Yaylaci, Mustafa

2009-09-01

The association of thymoma with myasthenia gravis has been well documented. However, the relationship between these two syndromes and Addison disease are very rarely encountered in clinical practice. We report on a 32-year-old man who underwent a resection for thymoma 48 months ago. The diagnosis of Addison disease was made followed by a diagnosis of myasthenia gravis on the basis of a high titer of acetylcholine receptor levels. The treatment of oral prednisolone 7.5 mg/day and oral prostigmine 180 mg/day was initiated. His symptoms and physical signs were improved after this treatment. To our knowledge, this is the fourth reported case of thymoma synchronously associated with myasthenia gravis and Addison disease.

Multifocal epithelioid hemangioendothelioma of the foot and ankle: a case report.

PubMed

Bisbinas, Ilias; Karabouta, Zacharoula; Georgiannos, Dimitrios; Lampridis, Vasileios; Badekas, Athanasios

2014-04-01

We report on a 41-year-old man with multiple epithelioid hemangioendothelioma of the left foot and ankle. The patient was treated with curettage and fixation with 2 separate plates, but later developed local infection. Owing to the potential for malignancy, below-knee amputation was suggested, but the patient declined and was treated symptomatically with close monitoring. The patient underwent removal of the plates, excision of the distal fourth of the fibula, intralesional curettage of all lesions, and fusion of the ankle and subtalar joints with a retrograde intramedullary nail. After 5.5 years, the patient had recovered well and had no evidence of malignancy. The tumour was considered definitively benign.

Schizophrenia-Like Psychosis and Dandy-Walker Variant Comorbidity: Case Report

PubMed Central

Kıvılcım, Yiğit; İzci, Filiz; Semiz, Umit Basar

2014-01-01

Dandy-Walker variant is a developmental malformation consisting of cerebellar hypoplasia and cystic dilatation of the fourth ventricle. Previous research has proposed a possible role for the cerebellum in cognition and in schizophrenia. In this paper we report a schizophrenia-like psychotic disorder in a 30 year-old woman with Dandy-Walker variant. The patient was treated with risperidone 6 mg/day, biperiden 4 mg/day and risperidone depot 50 mg injections fortnightly, and most of the symptoms were ameliorated within 2 months. The similar cognitive profile to populations with cerebellar pathology and rarity of the condition strongly suggests that there may be direct relationship between cerebellar pathology and appearence of psychotic symptoms. PMID:24605131

Infestation of a bird and two cats by larvae of Plodia interpunctella (Lepidoptera: Pyralidae).

PubMed

Pinckney, R D; Kanton, K; Foster, C N; Steinberg, H; Pellitteri, P

2001-09-01

The larvae of Plodia interpunctella (Hübner), commonly known as the Indian meal moth, often cause enormous losses in stored food supplies. We present three clinical case reports of accidental infestation by P. interpunctella larvae in two domestic cats and one parakeet. A larva gained entry into the avian host and subsequently migrated to the brain. It was alive, covered with "silk-like" fibers and confirmed to be a fourth instar. Plodia interpunctella larvae were excised with forceps from the subcutaneous tissues of the ear and neck of two cats in a different household. Previous reports of infestation by P. interpunctella larvae in vertebrates are unknown.

Obesity May Be Protective against Severe Perineal Lacerations

PubMed Central

Garretto, Diana; Lin, Brian B.; Syn, Helen L.; Judge, Nancy; Beckerman, Karen; Atallah, Fouad; Friedman, Arnold; Brodman, Michael; Bernstein, Peter S.

2016-01-01

Objective. To determine if there is an association between BMI and 3rd- or 4th-degree perineal lacerations in normal spontaneous and operative vaginal deliveries. Study Design. We performed a retrospective case control study using a large obstetric quality improvement database over a six-year period. Cases were identified as singleton gestations with third- and fourth-degree lacerations. Controls were obtained randomly from the database of patients without third- or fourth-degree lacerations in a 1 : 1 ratio. Univariate and multivariate logistic regression analyses were performed. Results. Of 32,607 deliveries, 22,011 (67.5%) charts with BMI documented were identified. Third- or fourth-degree lacerations occurred in 2.74% (n = 605) of patients. 37% (n = 223) were identified in operative vaginal deliveries. In the univariate analysis, obesity, older maternal age, non-Asian race, and birth weight <4000 g were all protective against 3rd- and 4th-degree lacerations. After controlling for age, race, mode of vaginal delivery, and birth weight, obesity remained significant. Conclusion. Being obese may protect against third- and fourth-degree lacerations independent of parity, race, birth weight, and mode of delivery. PMID:27274869

Submucosal reconstructive hemorrhoidectomy (Parks' operation): a 20-year experience.

PubMed

Rosa, G; Lolli, P; Piccinelli, D; Vicenzi, L; Ballarin, A; Bonomo, S; Mazzola, F

2005-12-01

Submucosal reconstructive hemorrhoidectomy has never been a popular operation due to its difficulty and duration, the amount of blood loss, and the risk of incontinence. The main indication for hemorrhoidectomy according to Parks is fourth-degree hemorrhoids with prolapse of the dentate line outside the anus and with simultaneous presence of external hemorrhoids. We report our experience in the treatment of hemorrhoids using submucosal reconstructive hemorrhoidectomy according to Parks. A total of 640 patients (381 men and 259 women) of median age 42 years (range, 18-81) were treated between 1983 and 2002; 80% of patients had fourth-degree, 19% third-degree and 1% second- degree hemorrhoids. All patients underwent rectosigmoidoscopic examination before surgery; patients over 35 years of age or with a suspected inflammatory or neoplastic disease underwent colonoscopy or barium enema. All patients underwent anorectal manometry before operation, to measure anal resting pressure, maximal squeeze and sphincter length, with the purpose of determining if an internal sphincterotomy was also necessary (in case of high anal resting tone). One-third of the patients also had an internal sphincterotomy to correct anal hypertonia. Postoperative bleeding occurred in 19 patients (2.9%), 0.9% requiring a reintervention. Severe pain was reported by 9 patients (1.4%); fecal impaction occurred in 3 cases (0.5%) and suture disruption in 2 patients (0.3%). In 74 patients (11.6%), bladder catheterization was needed due to urinary retention. Of 550 patients who had a minimum follow-up of 3 years and were sent a postal questionnaire, 374 patients responded, with a median 7.3-year follow- up; 176 patients (32%) were lost to follow-up. Eleven patients (2.9% of 374 cases) reported pain during defecation, 6 (1.6%) developed skin tags or recurrence, 3 (0.8%) reported gas incontinence, 2 (0.5%) developed anal fistula and 1 (0.3%) had anal stricture. Submucosal reconstructive hemorrhoidectomy according to Parks still represents a good choice for the treatment of high-degree hemorrhoids with prolapse of the dentate line outside the anus and external circumferential hemorrhoids.

Angiomyofibroblastoma of the vulva: a case report of a pedunculated variant and review of the literature.

PubMed

Sims, Shireen Madani; Stinson, Kathryn; McLean, Frederick W; Davis, John D; Wilkinson, Edward J

2012-04-01

Angiomyofibroblastoma (AMF) is a benign mesenchymal tumor usually found in the vulva. We reviewed 70 cases of vulvar AMF that have been reported in the English-language literature and report 1 case of a pedunculated variant. Our case brings the total reported to 71 and is only the fourth pedunculated variant reported. This 50-year-old woman presented to our gynecology clinic with a 1-year history of a left labial mass. It began as pea-sized, and rapidly grew to 12 cm in diameter. Physical examination demonstrated a 12-cm pedunculated soft mass arising from the left labia majora. The clinical diagnosis was aggressive angiomyxoma, and a simple excision was performed. The final pathology demonstrated AMF. The patient remains free from tumor at 4 years of follow-up. Seventy-one cases were summarized. The mean age at presentation was 45 years. The lesions were equally distributed between the left (52%) and right (48%). The most common clinical diagnosis was a Bartholin gland cyst (46%) or lipoma (15%). The mean duration of the lesion before seeking treatment was 29 months, and the mean diameter at presentation was 5.9 cm. All of the patients were treated with simple excision. The mean duration of follow-up was 37 months. There was 1 report of sarcomatous transformation 2 years after initial treatment. Angiomyofibroblastoma is a rare benign tumor that most often occurs in the vulva. Differential diagnosis may include aggressive angiomyxoma, Bartholin cyst, or lipoma. The treatment of choice is simple total excision, which is usually curative.

Development of an Applied Fisheries Science Program for Native Alaskans at Sheldon Jackson College (Sitka, Alaska). Fourth Progress Report, 1 July 1976.

ERIC Educational Resources Information Center

Seifert, Mel

Covering the period January 1 through June 30, 1976, this fourth and final semi-annual report of the first two-year grant for the Applied Fishery Science Program operating at Sheldon Jackson College in Sitka, Alaska presents the following information; Background (program objectives, advisory committee, and program staff); Program Progress…

[Fourth branchial cleft deformity with skin orifice: a series of 10 cases].

PubMed

Huang, S L; Zhang, B; Chen, L S; Liang, L; Luo, X N; Lu, Z M; Zhang, S Y

2016-10-07

Objective: To report rare cases of congenital neck cutaneous sinus with an orifice near the sternoclavicular joint and to investigate their origins and managements. Methods: A total of ten patients with congenital neck cutaneous sinus having an orifice near the sternoclavicular joint treated in the Guangdong General Hospital from January 2010 to June 2015 were retrospectively analyzed. Results: There four boys and six girls, aging from 11 months to 96 months with an average of 33.4 months, and they had a common feature showing a congenital cutaneous sinus with an orifice near sternoclavicular joint. Discharge of pus from the orifice or abscess formation was commonly seen soon after infection. With bacteriological study, staphylococcus aureus was positive in five cases and klebsiella pneumonia in a case. Another orifice of fistula/sinus was not depicted in pyriform with barium swallow X-ray in five cases Ultrasound studies of three cases demonstrated anechoic (i.e., nearly black) and solid-cystic lesion near sternoclavicular joint with posterior acoustic enhancement. Magnetic resonance imaging (MRI) showed isointensity of the lesion on T1 and T2 weighted images with heterogeneous enhancement and a close relationship with sternoclavicular joint. All patients underwent laryngoscopic examination, which showed no orifice of sinus in pyriform at same side. Surgical resection of fistula/sinus was performed in all cases. The lengths of the fistula varied from 5 mm to 22 mm with an average of 11 mm. Postoperative pathological examination showed all specimens were accordance with fistula. No complications were noticed. Recurrence was not observed in the cases by following-up of 6 months to 70 months (median: 33 months). Conclusion: Congenital neck cutaneous sinus with orifice near the sternoclavicular joint maybe a special clinical phenotype of the fourth branchial cleft sinus with skin orifice in cervicothoracic junction. Differential diagnoses between low cervical diseases are required. The curative treatment is a complete excision during inflammatory quiescent period.

"Acquired" Dandy-Walker malformation and cerebellar hemorrhage: Usefulness of serial MRI.

PubMed

Pichiecchio, Anna; Decio, Alice; Di Perri, Carol; Parazzini, Cecilia; Rossi, Andrea; Signorini, Sabrina

2016-01-01

Neuroimaging plays a fundamental role in the diagnosis of Dandy Walker malformation (DWM), a posterior fossa anomaly that is usually associated with genetic abnormalities, but may rarely be ascribed to acquired causes. Here, we report the clinical history and neuroimaging studies of a child with a complex cardiac malformation, developmental delay, and oculomotor anomalies whose neuroimaging findings were consistent with an acquired form of DWM. Fetal MRI at gestational weeks 27 and 31 showed cerebellar and vermis hypoplasia and fourth ventricle enlargement, together with hemosiderin deposits on the cerebellar hemispheric surface, but without significant vermian rotation. Postnatal MRIs at 5 days and 13 months revealed progressive counter-clockwise rotation of the hypoplastic cerebellar vermis with cystic dilation of the fourth ventricle, eventually leading to a full-blown DWM. This case strengthens the opinion that DWM is a heterogeneous condition, and may support the hypothesis that acquired meningeal abnormalities in the form of cortico-pial hemosiderosis may play a role in the development of DWM. This case also demonstrates that serial neuroimaging plays a key role in the correct diagnosis of posterior fossa malformations, whose prognosis is difficult to establish on second trimester fetal MRI and requires longer clinical follow-up. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Collapsing glomerulopathy, the Saudi Arabian scenario

PubMed Central

Husain, Sufia

2017-01-01

Objectives: To compare the clinico-pathological features of collapsing glomerulopathy (CG) at a tertiary hospital in Saudi Arabia with the world literature. Methods: In a retrospective study, all biopsy-diagnosed cases of CG between 2004-2015 were identified and analyzed, at King Khalid University Hospital, King Saud University, Riyadh. The clinico-pathological findings along with prognosis were reviewed and compared with the reported literature. Results: Thirty-one CG patients were identified, most were adult males. All the CG cases were idiopathic, all Arabs, none HIV positive, none of African descent, and none with a history of drug abuse. The number of glomeruli with collapsing lesions per biopsy ranged from 1 to 9. Other types of FSGS lesions (not otherwise specified and perihilar) were also noted. There was extensive podocyte effacement. Upon treatment, remission (complete/partial) was noted in almost half the patients; around one fourth did not respond to treatment; and one fourth progressed to end stage kidney disease (ESKD). The median time taken to develop ESKD from the time of biopsy diagnosis was 23 months. Conclusion: The clinico-pathological and prognostic correlates of CG in Saudi Arabia are comparable with that of the world literature. The management protocol at our center is the same as that practiced in different parts of the world, and the prognosis is overall poor. PMID:28439601

Role of the husband's knowledge and behaviour in postnatal depression: a case study of an immigrant Pakistani woman.

PubMed

Khan, Tahir M; Arif, Noor Hayati B; Tahir, Humera; Anwar, Mudassir

2009-12-01

Objective This study aims to highlight the subjective experience of an immigrant Pakistani woman during postnatal depression (PND), with a special emphasis on the husband's knowledge and behaviour towards PND.Methods A face-to-face interview was conducted with a woman reporting symptoms of depression on the fourth day after delivery. She was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV)(1) and the Edinburgh Postnatal Depression Rating Scale (EPDRS).(2) The evaluations were completed by a qualified psychiatrist. The demographic information, personal and family medical history and attitude towards the child were the principal issues recorded. In addition, five items were used to evaluate the husband's knowledge about PND. The EPDRS differences before and after counselling were evaluated using a student t-test.Results The patient was 32 years old and this was her first experience of delivery by Caesarean section. The evaluation for depression confirmed the diagnosis of PND and she scored 16 on the EPDRS. The husband's knowledge of PND was poor.Conclusion This case study suggests that lack of social support and understanding appear to play a vital role in the persistence of symptoms of PND among new mothers. Therefore, counselling of couples may be an effective additional tool in treating PND.

Social Security Disability: Demographic and Economic Characteristics of New Beneficiaries.

DTIC Science & Technology

1988-01-01

to do any work at all because of their health, they said. Almost one-fourth reported being either bedridden or wheelchair-bound. 2 FAM % rN9wrW TI...work for pay, they reported. Almost one-fourth reported being either bedridden or wheelchair-bound. Given 12 major categories of health conditions such...Total survey population 224,874 100 Unable to do work at all 193,398 86 Bedridden 29,556 13 Wheelchair-bound 22,832 10 Had a heart attack or stroke 81,026

Escalating placenta invasiveness: repeated placenta accreta at the limit of viability

PubMed Central

Greenbaum, Shirley; Khashper, Alla; Leron, Elad; Ohana, Eric; Meirovitz, Mihai; Hershkovitz, Reli; Erez, Offer

2016-01-01

Placenta percreta is an obstetric condition in which the placenta invades through the myometrium. This is the most severe form of placenta accreta and may result in spontaneous uterine rupture, a rare complication that threatens the life of both mother and fetus. In this case report, we describe a 32-year-old woman in her fourth pregnancy, diagnosed with repeated placenta accreta, which was eventually complicated by spontaneous uterine rupture at 24 weeks’ gestation. This patient had a history of abnormal placentation in prior pregnancies and previous uterine injuries. This case demonstrates a pattern of escalating placental invasiveness, and raises questions regarding the process of abnormal placentation and the manifestation of uterine rupture in scarred uteri. PMID:27143953

An aggressive vertebral hemangioma in pregnancy: a case report

PubMed Central

2014-01-01

Introduction Pregnancy-related compressive myelopathy secondary to vertebral hemangioma is a rare occurrence and its treatment antepartum is rare. Case presentation A 19-year-old North African woman in her 38th week of pregnancy presented with paraplegia that progressed within 2 days after a rapidly progressive weakness of her lower limbs. Magnetic resonance imaging studies showed compression of her spinal cord in front of the fourth thoracic vertebra for suspected tuberculous spondylitis. A Caesarean section was done followed by corpectomy with a bone graft because we intraoperatively discovered a vertebral hemangioma. Pathology showed an aggressive hemangioma. Conclusion At any term of pregnancy, extensive neurological involvement which is rapidly progressive due to compression should be considered for immediate decompression. PMID:24943121

D-2-hydroxyglutaric aciduria: a case with an intermediate phenotype and prenatal diagnosis of two affected fetuses.

PubMed

Clarke, Nigel F; Andrews, Ian; Carpenter, Kevin; Jakobs, Cornelis; van der Knaap, Marjo S; Kirk, Edwin P

2003-08-01

D-2-hydroxyglutaric aciduria (D2HGA) is a rare autosomal recessive disorder with variable clinical expression. The biochemical defect is unknown at present. Previously reported cases have either followed a severe clinical course characterized by neonatal epileptic encephalopathy, cortical blindness, and profound developmental delay, or a mild course characterized by mild developmental delay, manageable epilepsy, and mild hypotonia. To date there has been a clear distinction between these two groups. We report the second case of a child with D2HGA who has followed an intermediate course. She presented in infancy with hypotonia, manageable epilepsy and developed moderate to severe developmental delay, and cortical visual impairment. The proposita had a coarse facial appearance, flat face, broad nasal bridge, up-turned nose, and simple, anteverted ears. These facial anomalies have been noted in other children with D2HGA and this case strengthens the proposed association between this facial phenotype and D2HGA. We also report the third and fourth instances of prenatal diagnosis for D2HGA. At each prenatal diagnosis, an affected fetus was diagnosed on the basis of markedly increased levels of D-2-hydroxyglutaric acid in amniotic fluid. Copyright 2003 Wiley-Liss, Inc.

A case report of gastric lymphocytic phlebitis, a rare mimic for malignancy.

PubMed

Chan, Daniel L; Ravindran, Praveen; Chua, Dorothy; Smith, Jason D; Wong, King S; Ghusn, Michael A

2017-01-01

Lymphocytic phlebitis is a benign condition characterised by inflammation of the veins and rarely affects the gastrointestinal tract. Reported cases present as acute abdomen and involve the colon or small intestine. We report the fourth case of gastric lymphocytic phlebitis in the literature. A 74-year-old female presented with eight weeks of abdominal pain. Findings at endoscopy were suggestive of a malignant ulcer on the greater curvature of antrum, while biopsies showed chronic gastritis without malignancy. Appearance at diagnostic laparoscopy was consistent with a malignant gastric ulcer with serosal changes. Due to persistent pain and the macroscopic appearance, she proceeded to have an open subtotal gastrectomy and D2 lymph node clearance. Despite macroscopic appearance, the microscopic examination demonstrated no malignancy, and was consistent with lymphocytic phlebitis with overlying ulceration. This case was a mimic for gastric malignancy, with the benign diagnosis only being made after surgical resection. Gastric lymphocytic phlebitis is a rare differential diagnosis for gastric ulcers when biopsies are negative, although preoperative diagnosis is difficult given the lesions do not involve the mucosa. If clinical history and endoscopic findings are suspicious for malignancy, despite normal biopsies, an aggressive surgical resection remains reasonable given the rarity gastric lymphocytic phlebitis. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Smoking-related Attitudes and Behaviors of Parents of Fourth Grade Students.

ERIC Educational Resources Information Center

Gordon, Leonard V.; Haynes, Donald K.

1981-01-01

A study was done to determine the smoking habits and attitudes of parents of fourth grade students. The results indicate that cigarette smoking parents who participated in the school-home smoker education program reported smoking fewer cigarettes. (JN)

Rabies Vaccine Hesitancy and Deaths Among Pregnant and Breastfeeding Women - Vietnam, 2015-2016.

PubMed

Nguyen, Huong T T; Tran, Cuc H; Dang, Anh D; Tran, Huong G T; Vu, Thiem D; Pham, Thach N; Nguyen, Hoang V; Nguyen, Anh N K; Pieracci, Emily G; Tran, Duong N

2018-03-02

Human rabies deaths are preventable through prompt administration of postexposure prophylaxis (PEP) with rabies immune globulin and rabies vaccine after exposure to a rabid animal (1); there are no known contraindications to receiving PEP (1,2). Despite widespread availability of PEP in Vietnam, in 2015 the Ministry of Health (MoH) received reports of pregnant and breastfeeding women with clinically diagnosed rabies. MoH investigated factors associated with these rabies cases. MoH found that, during 2015-2016, among 169 cases reported in Vietnam, two probable cases of rabies were reported in breastfeeding mothers and four in pregnant women, all of whom had been bitten by dogs. All six patients died. Three of the four pregnant women had cesarean deliveries. One of the three newborns died from complications believed to be unrelated to rabies; the fourth pregnant woman contracted rabies too early in pregnancy for the fetus to be viable. Two of the patients sought care from a medical provider or traditional healer; however, none sought PEP after being bitten. In each case, families reported the patient's fear of risk to the fetus or breastfed child as the primary barrier to receiving PEP. These findings highlight the need for public health messaging about the safety and effectiveness of PEP in preventing rabies among all persons with exposures, including pregnant and breastfeeding women.

Assessment of the calibration of periodontal diagnosis and treatment planning among dental students at three dental schools.

PubMed

Lane, Brittany A; Luepke, Paul; Chaves, Eros; Maupome, Gerardo; Eckert, George J; Blanchard, Steven; John, Vanchit

2015-01-01

Calibration in diagnosis and treatment planning is difficult to achieve due to variations that exist in clinical interpretation. To determine if dental faculty members are consistent in teaching how to diagnose and treat periodontal disease, variations among dental students can be evaluated. A previous study reported high variability in diagnoses and treatment plans of periodontal cases at Indiana University School of Dentistry. This study aimed to build on that one by extending the research to two additional schools: Marquette University School of Dentistry and West Virginia University School of Dentistry. Diagnosis and treatment planning by 40 third- and fourth-year dental students were assessed at each of the schools. Students were asked to select the diagnosis and treatment plans on a questionnaire pertaining to 11 cases. Their responses were compared using chi-square tests, and multirater kappa statistics were used to assess agreement between classes and between schools. Logistic regression models were used to evaluate the effects of school, class year, prior experience, and GPA/class rank on correct responses. One case had a statistically significant difference in responses between third- and fourth-year dental students. Kappas for school agreement and class agreement were low. The students from Indiana University had higher diagnosis and treatment agreements than the Marquette University students, and the Marquette students fared better than the West Virginia University students. This study can help restructure future periodontal courses for a better understanding of periodontal diagnosis and treatment planning.

The fourth branchial complex anomaly: a rare clinical entity.

PubMed

Patel, Alpen B; Hinni, Michael L

2011-01-01

Fourth branchial pouch anomalies are rare congenital disorders of the neck and are a consequence of abnormal development of the branchial apparatus during embryogenesis. Failure to appropriately recognize these anomalies may result in misdiagnosis, insufficient treatment, and continued recurrence. Here, we present an unique presentation of two cases, describe their diagnosis, clinical course, and management, and review the literature regarding these interesting anomalies.

The Fourth Branchial Complex Anomaly: A Rare Clinical Entity

PubMed Central

Patel, Alpen B.; Hinni, Michael L.

2011-01-01

Fourth branchial pouch anomalies are rare congenital disorders of the neck and are a consequence of abnormal development of the branchial apparatus during embryogenesis. Failure to appropriately recognize these anomalies may result in misdiagnosis, insufficient treatment, and continued recurrence. Here, we present an unique presentation of two cases, describe their diagnosis, clinical course, and management, and review the literature regarding these interesting anomalies. PMID:22937376

Performance Indicators of California Higher Education, 1997. The Fourth Annual Report to California's Governor, Legislature, and Citizens in Response to Assembly Bill 1808 (Chapter 741, Statutes of 1991).

ERIC Educational Resources Information Center

California State Postsecondary Education Commission, Sacramento.

This fourth annual report presents background information on the development of performance indicators for California higher education, describes the scope of the current set of indicators, identifies highlights of recent trends, delineates some recent developments and future plans, and includes data on the full set of 75 performance indicators.…

Audit of Violence against Asian Pacific Americans, 1996: The Violent Impact on a Growing Community. Fourth Annual Report.

ERIC Educational Resources Information Center

Hui, Elsie V.; Hwang, Victor; Ma, Jacinta S.; OuYang, Elizabeth R.; Su, Julie A.

This audit, fourth in an annual series, tracks incidents of violence against Asian Pacific Americans in 1996 using data from a variety of sources. There was an increase of 17% in reported anti-Asian incidents in 1996, raising the total of suspected and confirmed incidents to 534. Although data were difficult to obtain, harassment increased by 161%…

Equal Educational Opportunity Scoreboard: The Status of Black Americans in Higher Education, 1970-1979. Fourth ISEP Status Report, Part I.

ERIC Educational Resources Information Center

Morris, Lorenzo; And Others

This fourth report of the Institute for the Study of Educational Policy examines the status of black Americans in higher education from 1970 to 1979, with special consideration to a discussion of a basis of parity which takes into account the rapid growth of the black population and to enrollment patterns in traditionally black institutions of…

For Profit Organizations Showing Signs of Turnaround: Twenty-Fourth Annual Status Report on for Profit Child Care

ERIC Educational Resources Information Center

Neugebauer, Roger; Hartzell, Debra

2011-01-01

The year 2010 will not be remembered as a banner year for large for profit child care organizations. But it appears that heading into 2011, optimism has returned. This article presents the twenty-fourth annual status report on for profit child care organizations. In 2010, the total capacity of the three largest for profit chains in North America,…

High-risk human papillomavirus infection in Bowen's disease of the nail unit: report of three cases and review of the literature.

PubMed

Grundmeier, Natalie; Hamm, Henning; Weissbrich, Benedikt; Lang, Sabrina Christine; Bröcker, Eva-Bettina; Kerstan, Andreas

2011-01-01

Bowen's disease (BD) of the nail unit is associated with human papillomavirus (HPV) infection. This study aimed to investigate the frequency of high-risk HPV infection, gender, age and digital distribution in this condition. Biopsy specimens of 3 consecutive cases with periungual BD were investigated for the presence of HPV DNA by in situ hybridization and by polymerase chain reaction (PCR). Furthermore, 74 cases of ungual BD conducted with HPV genotyping as reported in the literature were reviewed. PCR of biopsy specimens revealed in 2 cases infection with HPV-16 and in 1 case with HPV-73. Additionally, in 1 HPV-16-positive case HPV-31/33 was detected by in situ hybridization. In line, review of the literature demonstrated a clear association of HPV-positive BD with high-risk HPV types. Interestingly, age at diagnosis was significantly lower in women. Whereas in both genders the second to fourth fingers on both hands were commonly diseased, only in men the thumbs were also prominently affected. Infection with high-risk HPV types is common in BD of the nail unit suggesting the aetiological cause. Therefore, patients and partners should be closely followed up for digital and genital HPV-associated lesions. Copyright © 2012 S. Karger AG, Basel.

Economic Cost and Burden of Dengue in the Philippines

PubMed Central

Edillo, Frances E.; Halasa, Yara A.; Largo, Francisco M.; Erasmo, Jonathan Neil V.; Amoin, Naomi B.; Alera, Maria Theresa P.; Yoon, In-Kyu; Alcantara, Arturo C.; Shepard, Donald S.

2015-01-01

Dengue, the world's most important mosquito-borne viral disease, is endemic in the Philippines. During 2008–2012, the country's Department of Health reported an annual average of 117,065 dengue cases, placing the country fourth in dengue burden in southeast Asia. This study estimates the country's annual number of dengue episodes and their economic cost. Our comparison of cases between active and passive surveillance in Punta Princesa, Cebu City yielded an expansion factor of 7.2, close to the predicted value (7.0) based on the country's health system. We estimated an annual average of 842,867 clinically diagnosed dengue cases, with direct medical costs (in 2012 US dollars) of $345 million ($3.26 per capita). This is 54% higher than an earlier estimate without Philippines-specific costs. Ambulatory settings treated 35% of cases (representing 10% of direct costs), whereas inpatient hospitals served 65% of cases (representing 90% of direct costs). The economic burden of dengue in the Philippines is substantial. PMID:25510723

Economic cost and burden of dengue in the Philippines.

PubMed

Edillo, Frances E; Halasa, Yara A; Largo, Francisco M; Erasmo, Jonathan Neil V; Amoin, Naomi B; Alera, Maria Theresa P; Yoon, In-Kyu; Alcantara, Arturo C; Shepard, Donald S

2015-02-01

Dengue, the world's most important mosquito-borne viral disease, is endemic in the Philippines. During 2008-2012, the country's Department of Health reported an annual average of 117,065 dengue cases, placing the country fourth in dengue burden in southeast Asia. This study estimates the country's annual number of dengue episodes and their economic cost. Our comparison of cases between active and passive surveillance in Punta Princesa, Cebu City yielded an expansion factor of 7.2, close to the predicted value (7.0) based on the country's health system. We estimated an annual average of 842,867 clinically diagnosed dengue cases, with direct medical costs (in 2012 US dollars) of $345 million ($3.26 per capita). This is 54% higher than an earlier estimate without Philippines-specific costs. Ambulatory settings treated 35% of cases (representing 10% of direct costs), whereas inpatient hospitals served 65% of cases (representing 90% of direct costs). The economic burden of dengue in the Philippines is substantial. © The American Society of Tropical Medicine and Hygiene.

Immediate reaction to lidocaine with periorbital edema during upper blepharoplasty.

PubMed

Presman, Benjamin; Vindigni, Vincenzo; Tocco-Tussardi, Ilaria

2016-01-01

Blepharoplasty is the fourth most commonly performed cosmetic surgery in the US, with 207,000 operations in 2014. Lidocaine is the preferred anesthetic agent for blepharoplasty. We describe the unusual case of acute periorbital edema following local anesthesia with lidocaine for upper blepharoplasty. At present, only two other reports of periorbital reactions to lidocaine are present in the literature. The reactions observed are significant palpebral swelling and erythema with scaling of the cheek. Fortunately the swelling, although marked, is transient in nature and resolves almost spontaneously without affecting the visual acuity. Patients reporting adverse reactions should be screened for allergy according to the standard protocols, but skin testing has only been reported to be positive in less than 10% of all cases and allergy confirmation with IgE is even more rare. In clinical practice, we recommend that patient should be informed about the possibility of recurrence of an adverse reaction in case of re-exposure to lidocaine, even in the vast majority of cases where true allergy could not be proven. In case of further need for local anesthesia with history of an adverse event, a different agent may be chosen even from the same class (another amide) as cross-reactions in the amide group are rare. Otherwise, an anesthetic from the ester group can also be safely used. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Acoustic Studies of New Materials: Quasicrystals, Low-Loss Glasses, and High Tc Superconductors

DTIC Science & Technology

1991-12-18

Progress Report, 1989 2. Tania Slawecki, M.S. Thesis Measuring fourth sound in silica aerogel 3. Chang Yu, Ph.D. Thesis A high Q resonant photoacoustic...Pennsylvania State University The Graduate School Department of Physics Measuring Fourth Sound in Silica Aerogel A Thesis in Physics by Tania Maria...Slawecki Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science December 1989 Abstract Measuring Fourth Sound in Silica

Familial cardiofaciocutaneous syndrome in a father and a son with a novel MEK2 mutation.

PubMed

Karaer, Kadri; Lissewski, Christina; Zenker, Martin

2015-02-01

Cardiofaciocutaneous (CFC) syndrome is a rare genetic disorder belonging to the group of RASopathies. It is typically characterized by congenital heart defects, short stature, dysmorphic craniofacial features, intellectual disability, failure to thrive, and ectodermal abnormalities such as hyperkeratosis and sparse, brittle, curly hair. CFC syndrome is caused by dominant mutations in one of the four genes BRAF, MEK1, MEK2, and KRAS. Only three familial cases of CFC syndrome have been reported to date, whereas the vast majorities are sporadic cases due to de novo mutations. We report on a fourth familial case with transmission of CFC syndrome from father to son due to a novel heterozygous sequence change c.376A>G (p.N126D) in exon 3 of MEK2 gene. This observation further documents the possibility of vertical transmission of CFC syndrome, which appears to be associated with rare mutations and relatively mild intellectual disability in affected individual. The hypomorphic effect of specific mutations particularly regarding neurocognitive issues may be related to the variable fertility of affected individuals. © 2014 Wiley Periodicals, Inc.

Stress fractures of the ribs in elite competitive rowers: a report of nine cases.

PubMed

Dragoni, S; Giombini, A; Di Cesare, A; Ripani, M; Magliani, G

2007-10-01

The objective was to report the clinical and imaging patterns of nine cases of stress fractures of the rib diagnosed in Italian Olympic rowers. Nine patients with stress fractures of the rib detected from 103 (8.7%) Italian team rowers competing between May 2000 and May 2006 were identified based on the database of a sports medicine institute. All athletes were male. They were aged between 17 and 31 years (mean: 24.4). Patient weight, fracture location, rowing side and imaging methods employed were noted. The diagnosis was made based on history, clinical examination and Tc-99m MDP bone scintigraphy. Eight of the 9 fractures were located anterolaterally between the fourth and ninth rib. In 1 of the 5 athletes with standard radiographs, a fracture line was visible and in 4 there was callus formation. In 2 athletes sonography was performed, which detected discontinuity of the rib surface and callus formation (1 case each). Stress fractures of the ribs are relatively common in competitive rowers. They are characterized by increasing lateral chest pain and typical scintigraphic, radiographic and sonographic findings.

Appendicitis with appendicular atresia: a rare presentation

PubMed Central

Masood, Irfan; Majid, Zain; Rafiq, Ali; Fatima, Saba; Siddiqui, Osama Bin Zia

2015-01-01

Acute appendicitis is the most common acute surgical condition; making appendectomy the most commonly performed emergency surgical procedure in the world. Anomalies of the appendix are relatively uncommon. However, their presence may alter the course of pre-operative diagnosis and the surgical treatment provided, leading to medico-legal issues in certain cases as well. We hereby present the case of a 17 year-old female who had the suggestive signs, symptoms and investigations of appendicular lump. She was managed according to the Ochsner-Sherren regimen and then underwent interval open appendectomy 6 weeks later. During the procedure, the findings of a 5 cm long appendix were noted. The base of the appendix was attached to the caecum, however there was complete mucosal discontinuity between the base and the remaining portion of the appendix. A fibrous strand connected the two blind ending parts together. After thorough literature search, the authors concluded that this is only the fourth reported case of appendicular atresia ever to have been reported. Considering the rarity of this finding we feel this could be of valuable interest to surgeons and readers alike PMID:26090015

Propagation of Sound in Matter.

DTIC Science & Technology

1982-03-01

Attenuation in Liquid Helium at 1 GHz; Technical Report No. 28, April 1969. 2. Kriss, Michael A., Size Effects in Liquid Helium II as Measured by Fourth...Helium, Technical Report No. 30, October 1969. 4. Scott, Stephen A., A Specific Heat and Fourth Sound Measurement of Size Effects in Liquid Helium...Rudnick, Superfluid Helmholtz Resonators, Phys. Rev. 174, No. 1, 326 (October 1968). 2. E. Guyon and I. Rudnick, Size Effects in Superfluid Helium II, Le

Applied Meteorology Unit (AMU) Quarterly Report Fourth Quarter FY-04

NASA Technical Reports Server (NTRS)

Bauman, William; Wheeler, Mark; Lambert, Winifred; Case, Jonathan; Short, David

2004-01-01

This report summarizes the Applied Meteorology Unit (A MU) activities for the fourth quarter of Fiscal Year 2004 (July -Sept 2004). Tasks covered are: (1) Objective Lightning Probability Forecast: Phase I, (2) Severe Weather Forecast Decision Aid, (3) Hail Index, (4) Shuttle Ascent Camera Cloud Obstruction Forecast, (5) Advanced Regional Prediction System (ARPS) Optimization and Training Extension and (5) User Control Interface for ARPS Data Analysis System (ADAS) Data Ingest.

Powassan virus infection: case series and literature review from a single institution.

PubMed

Raval, Mihir; Singhal, Mayank; Guerrero, Dubert; Alonto, Augusto

2012-10-30

Powassan virus is a flavivirus related to eastern hemisphere's tick-borne encephalitis viruses. It can cause a rare but potentially life-threatening disease including encephalitis. We report four cases of POWV infection in Minnesota and North Dakota with known exposure to tick bites in 2011. Our first case was an 18-year-old male who dramatically presented with seizure and headache with positive serum analysis for Powassan virus immunoglobulin M. The second case was a 60 year old gentleman with intraparenchymal hemorrhage and was diagnosed via cerebrospinal fluid analysis. Thirdly, a 61 year old male developed altered mental status and encephalitis. Our fourth patient was a 69 year old male who had headache and non-focal weakness who was diagnosed with serum analysis. Symptoms of Powassan virus infection ranged from headaches to seizures and severe neurological symptoms. This study serves to highlight the increased detection of Powassan virus infection in the central north United States. This report focuses on the increasing incidence that can lead to increasing efforts for raising awareness regarding this infection. There is a need for clinician vigilance and public attention due to its increasing detection, westward progression and varied clinical presentations.

Molecular diagnosis of Pseudoterranova decipiens s.s in human, France.

PubMed

Brunet, Julie; Pesson, Bernard; Royant, Maude; Lemoine, Jean-Philippe; Pfaff, Alexander W; Abou-Bacar, Ahmed; Yera, Hélène; Fréalle, Emilie; Dupouy-Camet, Jean; Merino-Espinosa, Gema; Gómez-Mateos, Magdalena; Martin-Sanchez, Joaquina; Candolfi, Ermanno

2017-06-06

Anisakis and Pseudoterranova are the main genera involved in human infections caused by nematodes of the Anisakidae family. Species identification is complicated due to the lack of differential morphological characteristics at the larval stage, thus requiring molecular differentiation. Pseudoterranova larvae ingested through raw fish are spontaneously eliminated in most cases, but mechanical removal by means of endoscopy might be required. To date, only very few cases of Pseudoterranova infection have been reported in France. A 19-year-old woman from Northeastern France detected, while brushing her teeth, a larva exiting through her mouth. The patient who presented with headache, diarrhea, and abdominal cramps reported having eaten baked cod. The worm was a fourth-stage larva with a size of 22 × 0.9 mm, and molecular biology identified it as Pseudoterranova decipiens sensu stricto (s. s.). In a second P. decipiens infection case, occurring a few months later, a worm exited through the patient's nose after she had eaten raw sea bream. These two cases demonstrate that Pseudoterranova infection is not uncommon among French patients. Therefore, molecular techniques should be more widely applied for a better characterization of anisakidosis epidemiology in France.

Herpes simplex virus type 2 (Mollaret's) meningitis: a case report.

PubMed

Abu Khattab, Mohammed; Al Soub, Hussam; Al Maslamani, Mona; Al Khuwaiter, Jameela; El Deeb, Yasser

2009-11-01

Mollaret's meningitis is an unusual and under-appreciated syndrome of benign, recurrent aseptic meningitis. The available literature indicates that the causative agent is herpes simplex virus type 2 (HSV-2) in the majority of cases and much less frequently herpes simplex virus type 1 (HSV-1). We report the case of a 49-year-old Indian female who had four attacks of recurrent lymphocytic meningitis (Mollaret's meningitis) occurring over a 7-year period. The diagnosis of herpes simplex meningitis was made at the time of the fourth episode by a positive PCR for herpes simplex virus infection in the cerebrospinal fluid. During the first three episodes, the patient was treated with anti-tuberculous drugs and antibiotics for bacterial meningitis; however for the last episode, once the diagnosis of herpes simplex meningitis was confirmed, only symptomatic treatment was given. No long-term suppressive therapy was given and no recurrence has been experienced so far. Mollaret's meningitis should be suspected in all cases of recurrent lymphocytic meningitis. Early diagnosis may prevent prolonged hospital admissions, unnecessary investigations, and exposure to unnecessary medications, with the associated considerable costs. Treatment with acyclovir may be beneficial in decreasing the severity and duration of attacks and in preventing further episodes. [Au?1].

The existence of a real pole-free solution of the fourth order analogue of the Painlevé I equation

NASA Astrophysics Data System (ADS)

Claeys, T.; Vanlessen, M.

2007-05-01

We establish the existence of a real solution y(x, T) with no poles on the real line of the following fourth order analogue of the Painlevé I equation: \\[ \\begin{equation*}x=Ty-\\left(\\case 1 6 y^3+\\case{1}{24} (y_x^2+2yy_{xx}) +\\case {1}{240} y_{xxxx}\\right).\\end{equation*} \\] This proves the existence part of a conjecture posed by Dubrovin. We obtain our result by proving the solvability of an associated Riemann-Hilbert problem through the approach of a vanishing lemma. In addition, by applying the Deift/Zhou steepest-descent method to this Riemann-Hilbert problem, we obtain the asymptotics for y(x, T) as x → ±∞.

Simple resection arthroplasty for treatment of 4th and 5th tarsometatarsal joint problems. A technical tip and a small case series.

PubMed

Koenis, M J J; Louwerens, J W K

2015-03-01

Osteoarthritis, primary or secondary, of the fourth and/or fifth tarsometatarsal (TMT) joint is a rare condition. When conservative treatment fails or proves to be unacceptable for the patient, operative treatment is an option. In this article the technique of resection arthroplasty is described and a retrospective case series of 6 patients is presented. Three patients underwent tendon interposition arthroplasty after resection of the two joints and in the last three cases no interposition at all was performed. Results suggest that resection arthroplasty without interposition may be as effective as other operative treatment options for patients with fourth and fifth TMT pathology. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Successful treatment of Dandy-Walker syndrome by endoscopic third ventriculostomy in a 6-month-old girl with progressive hydrocephalus: a case report and literature review.

PubMed

Hu, Chih-Fen; Fan, Hueng-Chuen; Chang, Cheng-Fu; Wang, Chih-Chien; Chen, Shyi-Jou

2011-02-01

Dandy-Walker syndrome (DWS) is a congenital brain malformation involving the cerebellum and fourth ventricle. We report a 6-month-old girl with DWS presenting an initially normal ventricular system and mild cyst-like lesion over the posterior fossa as assessed by postnatal brain sonography. However, symptoms and signs of increased intracranial cerebral pressure in terms of frequent vomiting and tense anterior fontanel developed, and these were associated with mild hypotonia and poor neck support, and upward-gaze palsy at the age of 6 months. Magnetic resonance imaging revealed a huge cystic lesion of the fourth ventricle, which filled the posterior fossa and ventricular dilatation. The tentorium was progressively displaced upward by the cyst. A nearly complete agenesis of the cerebellar vermis was also confirmed. After a successful endoscopic third ventriculostomy, a series of brain magnetic resonance imaging scans, taken during a follow-up survey, showed normal lateral and third ventricles. Consequently, symptoms of intracranial cerebral pressure resolved, and a developmental milestone was achieved. In conclusion, DWS can be confirmed postpartum, and endoscopic third ventriculostomy was found to be a preferential operative procedure for DWS with hydrocephalus. It may be effective for patients younger than 1 year. Copyright © 2011. Published by Elsevier B.V.

Applied Meteorology Unit (AMU) Quarterly Report - Fourth Quarter FY-09

NASA Technical Reports Server (NTRS)

Bauman, William; Crawford, Winifred; Barrett, Joe; Watson, Leela; Wheeler, Mark

2009-01-01

This report summarizes the Applied Meteorology Unit (AMU) activities for the fourth quarter of Fiscal Year 2009 (July - September 2009). Tasks reports include: (1) Peak Wind Tool for User Launch Commit Criteria (LCC), (2) Objective Lightning Probability Tool. Phase III, (3) Peak Wind Tool for General Forecasting. Phase II, (4) Update and Maintain Advanced Regional Prediction System (ARPS) Data Analysis System (ADAS), (5) Verify MesoNAM Performance (6) develop a Graphical User Interface to update selected parameters for the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLlT)

Theory Building and Modeling in a Sinking and Floating Unit: A Case Study of Third and Fourth Grade Students' Developing Epistemologies of Science

ERIC Educational Resources Information Center

Kawasaki, Keiko; Rupert Herrenkohl, Leslie; Yeary, Sherry

2004-01-01

The purpose of this paper is to carefully examine the evolution of students' theory building and modeling, critical components of scientific epistemologies, over a unit of study on sinking and floating in one third/fourth grade classroom. The study described in this paper follows in the tradition of Design Experiments ( Brown 1992 , Collins 1990 )…

Academic Growth Trajectories of ELLs in NAEP Data: The Case of Fourth- and Eighth-Grade ELLs and Non-ELLs on Mathematics and Reading Tests

ERIC Educational Resources Information Center

Polat, Nihat; Zarecky-Hodge, Ashley; Schreiber, James B.

2016-01-01

Utilizing the National Assessment of Educational Progress (NAEP) data, this study examined (1) how fourth and eighth-grade ELLs' mathematics and reading scores on national tests compared to their non-ELL peers' scores over the testing period between 2003 and 2011, and (2) if gender and ethnicity contributed to variation in the growth patterns…

Subependymomas: a clinicopathological study of 6 symptomatic cases.

PubMed

Limaïem, F; Bellil, S B H; Bellil, K; Chelly, I; Jemel, H; Haouet, S; Khaldi, M; Zitouna, M; Kchir, N

2008-10-01

Subependymomas are rare, slow-growing, ependymal neoplasms that commonly occur in the fourth or lateral ventricles. A retrospective study of 6 histologically proven subependymomas was undertaken to analyse their clinicopathological characteristics. There were five male and one female patients ranging in age from 11 to 50 years (mean 35.8 years). All patients were symptomatic at diagnosis. The most common clinical presentations included headache (n=6) and vomiting (n=3). Tumours were located in the lateral ventricle in five cases and in the fourth ventricle in one case. Magnetic resonance imaging detected obstructive hydrocephalus in all cases. Five patients underwent gross total resection and one patient had subtotal excision of the tumour. Histologically, all tumours were characterised by clustering of isomorphic cells arranged against a fibrillary background. Focal cystic degeneration was seen in 5 tumours. During the follow-up period, which ranged between 2 months and 10 years, all patients were symptom-free with no evidence of recurrence.

Case report: microcephaly associated with Zika virus infection, Colombia.

PubMed

Mattar, Salim; Ojeda, Carolina; Arboleda, Janna; Arrieta, German; Bosch, Irene; Botia, Ingrid; Alvis-Guzman, Nelson; Perez-Yepes, Carlos; Gerhke, Lee; Montero, German

2017-06-13

Recently there has been a large outbreak of Zika virus infections in Colombia, South America. The epidemic began in September 2015 and continued to April 2017, for the total number of Zika cases reported of 107,870. For those confirmed Zika cases, there were nearly 20,000 (18.5%) suspected to be pregnant women, resulting in 157 confirmed cases of microcephaly in newborns reported by their health government agency. There is a clear under-estimation of the total number of cases and in addition no prior publications have been published to demonstrate the clinical aspects of the Zika infection in Colombia. We characterized one Zika presentation to be able to compare and contrast with other cases of Zika infection already reported in the literature. In this case report, we demonstrate congenital microcephaly at week 19 of gestation in a 34-year-old mother who showed symptoms compatible with Zika virus infection from Sincelejo, State of Sucre, in the Colombian Caribbean. Zika virus RNA was detected in the placenta using real-time reverse transcriptase polymerase chain reaction (RT-PCR). At week 25, the fetus weigh estimate was 770 g, had a cephalic perimeter of 20.2 cm (5th percentile), ventriculomegaly on the right side and dilatation of the fourth ventricle. At week 32, the microcephaly was confirmed with a cephalic perimeter of 22 cm, dilatation of the posterior atrium to 13 mm, an abnormally small cerebellum (29 mm), and an augmented cisterna magna. At birth (39 weeks by cesarean section), the head circumference was 27.5 cm, and computerized axial tomography (Siemens Corp, 32-slides) confirmed microcephaly with calcifications. We report a first case of maternal Zika virus infection associated with fetal microcephaly in Colombia and confirmed similar presentation to those observed previous in Brazil, 2015-2016.

Fourth Year Status Report. Computerized Training Systems Project. Project ABACUS.

DTIC Science & Technology

1976-08-01

in 7 9. PERFORMING ORGANIZATION NAME AND ADOMEN ,,, 10. PROGRAM ELEMENT. PROJECT , TASK US Army Tra ining Support Center A R E A S WORK UNIT NUMBERS...transp ired during the fourth year of Project ABACUS, the A rmy ’s program for the development of a Computerized Training System. It inc l udes a...have transpired durlnq the fourth year of Project ABACUS, the Army ’s program for the developmen t o~ aprototype Computer i zed Training System. It

Concussion assessment and management knowledge among chiropractic fourth year interns and residents

PubMed Central

Kazemi, Mohsen; Pichini, Alessandro; Scappaticci, Steven; Savic, Mitchell

2016-01-01

Objectives: To investigate the degree of knowledge chiropractic fourth year interns and post-graduate chiropractic residents have in regard to concussion diagnosis and management. Methods: A survey modified from a study conducted by Boggild and Tator (2012), was administered to fourth year chiropractic interns and post-graduate residents via SurveyMonkey.com. Results: Chiropractic fourth year interns and postgraduate chiropractic specialty college residents scored 5.2 and 5.25 out of 9 respectively, which compares well with Bogglid and Tator’s reports on medical students and residents. Several knowledge gaps were identified in the sample population. Conclusion: The results from this survey show that the concussion knowledge among Canadian fourth year chiropractic interns and specialty college residents compares favorably with the knowledge of fourth year medical students and residents in diagnosing and managing concussions. Chiropractors appear to possess the skills and knowledge to diagnose and manage concussion equal to their medical counterparts. However, knowledge gaps regarding concussion diagnosis and management were found among chiropractic students and residents. PMID:28065987

Concussion assessment and management knowledge among chiropractic fourth year interns and residents.

PubMed

Kazemi, Mohsen; Pichini, Alessandro; Scappaticci, Steven; Savic, Mitchell

2016-12-01

To investigate the degree of knowledge chiropractic fourth year interns and post-graduate chiropractic residents have in regard to concussion diagnosis and management. A survey modified from a study conducted by Boggild and Tator (2012), was administered to fourth year chiropractic interns and post-graduate residents via SurveyMonkey.com. Chiropractic fourth year interns and postgraduate chiropractic specialty college residents scored 5.2 and 5.25 out of 9 respectively, which compares well with Bogglid and Tator's reports on medical students and residents. Several knowledge gaps were identified in the sample population. The results from this survey show that the concussion knowledge among Canadian fourth year chiropractic interns and specialty college residents compares favorably with the knowledge of fourth year medical students and residents in diagnosing and managing concussions. Chiropractors appear to possess the skills and knowledge to diagnose and manage concussion equal to their medical counterparts. However, knowledge gaps regarding concussion diagnosis and management were found among chiropractic students and residents.

Laparoscopic duodenal-jejunal bypass for the treatment of duodenal obstruction caused by annular pancreas: description of a surgical technique.

PubMed

Zilberstein, Bruno; Sorbello, Mauricio P; Orso, Ivan R B; Cecconello, Ivan

2011-04-01

Annular pancreas is a rare congenital anomaly, which is only surgically treated in symptomatic cases. Surgical treatment consists of bypassing the duodenal transit by gastrojejunal or duodenal-jejunal anastomosis. In the absolute majority of published cases, laparotomy is the most widely used access technique. The aim of this article is to report a case of an annular pancreas and describe the technical steps involved in carrying out a laparoscopic duodenal-jejunal anastomosis, for correction of the duodenal obstruction. The patient's recovery was uneventful; she was discharged on the fourth postoperative day and remained asymptomatic for the 2-year, outpatient follow-up period. Laparoscopic duodenal-jejunal bypass is shown to be feasible and safe, and produce less surgical trauma, when carried out by an experienced surgeon who is duly trained and familiar with the laparoscopic technique.

Primary Intraosseous Adenoid Cystic Carcinoma of the Mandible: A Comprehensive Review With Analysis of 2 Additional Cases.

PubMed

Hu, Hong Ying; Liu, Yuan Yuan; Wang, Hu; Jiang, Meng

2017-08-01

Primary intraosseous adenoid cystic carcinoma (IACC) of the mandible is poorly understood because of its rarity. This study performed a comprehensive literature review on IACC of the mandible. Forty-five cases of IACC reported in the literature and 2 additional cases in the authors' hospital were reviewed. IACC of the mandible generally occurred in the fourth to sixth decades, with no meaningful gender predilection. Pain and swelling were the most common clinical manifestations. Radical surgery combined with postsurgical radiotherapy was recommended as the best treatment. The diagnosis of IACC should be based on clinical, radiologic, and pathologic examinations. Radical surgery combined with postsurgical radiotherapy seems to be the best treatment. In addition, the histologic subtype of the tumor is an important prognostic factor in patients with IACC. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Inner ear abnormalities in patients with Goldenhar syndrome.

PubMed

Bisdas, Sotirios; Lenarz, Minoo; Lenarz, Thomas; Becker, Hartmut

2005-05-01

The objective of this study is to investigate the inner ear malformations in patients with Goldenhar syndrome and to hypothesize the potential embryopathogenesis of these malformations. Retrospective case review. Tertiary referral center. Fourteen patients with Goldenhar syndrome. Each patient underwent hearing tests and high-resolution computed tomography (CT) of the temporal bone. In six patients, magnetic resonance imaging of the temporal bone also was performed. Among the 14 patients with Goldenhar syndrome, 13 had outer and middle ear anomalies and 5 (36%) had inner ear malformations, including one case of common cavity. Our observations regarding inner ear anomalies in Goldenhar syndrome correlate with the reported cases in the literature and may help to hypothesize the embryological origin of these malformations, which can caused by an early developmental arrest in the fourth gestational week. Specialists evaluating patients with Goldenhar syndrome should be aware of the possibility of inner ear malformations, which could be diagnosed earlier with appropriate imaging studies.

Laparoscopic Sleeve Gastrectomy in the Postpartum Period: Increased Risk of Bleeding, a Challenging Situation.

PubMed

Abouzahr, Omar; Garofalo, Fabio; Garneau, Pierre Y

2016-06-01

The female population represents three-fourths of patients undergoing a bariatric procedure and could be scheduled for surgery in their postpartum period. We report a difficult case of a female patient who underwent a laparoscopic sleeve gastrectomy 6 weeks postpartum. The postpartum period is accompanied by pronounced vasodilatation with transient portal hypertension. Most of the hemodynamic alterations occurring during pregnancy return to baseline within 6-8 weeks after delivery. Bariatric surgery in the postpartum period should be avoided in order for the cardiovascular system to regain its normality.

The Observed Properties of Liquid Helium at the Saturated Vapor Pressure

NASA Astrophysics Data System (ADS)

Donnelly, Russell J.; Barenghi, Carlo F.

1998-11-01

The equilibrium and transport properties of liquid 4He are deduced from experimental observations at the saturated vapor pressure. In each case, the bibliography lists all known measurements. Quantities reported here include density, thermal expansion coefficient, dielectric constant, superfluid and normal fluid densities, first, second, third, and fourth sound velocities, specific heat, enthalpy, entropy, surface tension, ion mobilities, mutual friction, viscosity and kinematic viscosity, dispersion curve, structure factor, thermal conductivity, latent heat, saturated vapor pressure, thermal diffusivity and Prandtl number of helium I, and displacement length and vortex core parameter in helium II.

Recurrent infarctions due to a dome-shaped pannus above the mitral valve prosthesis.

PubMed

Kasahara, Hirofumi; Inoue, Yoshito; Suzuki, Satoru

2016-01-01

This report describes a unique case of a 56-year-old female who suffered from recurrent stroke after double mechanical valve replacement. During the four years after the surgery, she remained in normal sinus rhythm, received adequate anticoagulation therapy, and no apparent left atrial thrombus was detected. She underwent redo surgery to prevent further stroke after fourth instance of cerebral infarction. Intraoperative findings revealed a 'dome-shaped' pannus formation covering the sewing ring of the mitral prosthesis circumferentially, probably leading to clot formation and repeated infarctions. She has been stroke free for three years after pannus resection.

Future mobility demand in megaregions : a national study with a focus on the Gulf Coast.

DOT National Transportation Integrated Search

2013-09-01

About three fourth of national population and wealth are concentered in the 11 megaregional areas that occupy one fourth of the land areas in the US. NHTS reveal that megaregions also concentrate current and future mobility demand. This report presen...

Comparison of case-based and lecture-based learning in dental education using the SOLO taxonomy.

PubMed

Ilgüy, Mehmet; Ilgüy, Dilhan; Fişekçioğlu, Erdoğan; Oktay, Inci

2014-11-01

The aim of this study was to compare the impact of case-based learning (CBL) and lecture-based learning (LBL) on fourth-year dental students' clinical decision making by using the Structure of Observed Learning Outcome (SOLO) taxonomy. Participants in the study were fourth-year dental students (n=55) in academic year 2012-13 taught in a large-group LBL context and fourth-year dental students (n=54) in academic year 2013-14 taught with the CBL methodology; both took place in the oral diseases course at Yeditepe University Faculty of Dentistry, Istanbul, Turkey. All eligible students participated, for a 100 percent response rate. A real case was presented to the students in both groups to assess their clinical decision making on the topic of oral diseases. Their performance was evaluated with the SOLO taxonomy. Student t-test was used for statistical evaluation, and significance was set at the p<0.05 level. A statistically significant difference was found between the mean scores of the relational and extended abstract categories of the CBL and LBL groups (p<0.05). Students who were taught with CBL had higher scores at the top two levels of the SOLO taxonomy than students taught with LBL. These findings suggest that an integrated case-based curriculum may be effective in promoting students' deep learning and it holds promise for better integration of clinical cases likely to be encountered during independent practice.

Oral findings and dental treatment in a patient with Dandy-Walker syndrome: a case report.

PubMed

Kusumoto, Yasuka; Shinozuka, Osamu

2014-01-01

Dandy-Walker syndrome (DWS) is congenital disease characterized by hypoplasia of the cerebellum, the formation of cysts that communicate with the fourth ventricle of the posterior cranial fossa, and hydrocephalus. In addition to various other complications, cleft lip/palate, facial retrognathia, a high-arched palate, and maldentition occur at an increased frequency in patients with DWS. However, few studies have reported the dental manifestations of DWS. Herein, we report the clinical manifestations, oral findings, and dental management of a DWS patient who was treated under general anesthesia. Poor oral hygiene, gingivitis, and several congenital dental abnormalities (e.g., generalized microdontia, conical tooth, transposition, and congenitally missing teeth) were observed. This report is the first to describe the oral findings and dental treatment of DWS. Our findings emphasize the importance of a multidisciplinary approach in the diagnosis and treatment of DWS. © 2013 Special Care Dentistry Association and Wiley Periodicals, Inc.

Pulmonary and cardiac pathology in sudden unexpected death in epilepsy (SUDEP).

PubMed

Nascimento, Fábio A; Tseng, Zian H; Palmiere, Cristian; Maleszewski, Joseph J; Shiomi, Takayuki; McCrillis, Aileen; Devinsky, Orrin

2017-08-01

To review studies on structural pulmonary and cardiac changes in SUDEP cases as well as studies showing pulmonary or cardiac structural changes in living epilepsy patients. We conducted electronic literature searches using the PubMed database for articles published in English, regardless of publication year, that included data on cardiac and/or pulmonary structural abnormalities in SUDEP cases or in living epilepsy patients during the postictal period. Fourteen postmortem studies reported pulmonary findings in SUDEP cases. Two focused mainly on assessing lung weights in SUDEP cases versus controls; no group difference was found. The other 12 reported descriptive autopsy findings. Among all SUDEP cases with available descriptive postmortem pulmonary examination, 72% had pulmonary changes, most often pulmonary edema/congestion, and, less frequently, intraalveolar hemorrhage. Eleven studies reported on cardiac pathology in SUDEP. Cardiac abnormalities were found in approximately one-fourth of cases. The most common findings were myocyte hypertrophy and myocardial fibrosis of various degrees. Among living epilepsy patients, postictal pulmonary pathology was the most commonly reported pulmonary abnormality and the most common postictal cardiac abnormality was transient left ventricular dysfunction - Takotsubo or neurogenic stunned myocardium. Cardiac and pulmonary pathological abnormalities are frequent among SUDEP cases, most commonly pulmonary edema/congestion and focal interstitial myocardial fibrosis. Most findings are not quantified, with subjective elements and undefined interobserver reliability, and lack of controls such as matched epilepsy patients who died from other causes. Further, studies have not systematically evaluated potential confounding factors, including postmortem interval to autopsy, paramedic resuscitation and IV fluids administration, underlying heart/lung disease, and risk factors for cardiac or pulmonary disease. Prospective studies with controls are needed to define the heart and lung changes in SUDEP and understand their potential relationship to mechanisms of death in SUDEP. Copyright © 2017 Elsevier Inc. All rights reserved.

Uses of chitosan for treating different forms of serious obstetrics hemorrhages.

PubMed

Carles, G; Dabiri, C; Mchirgui, A; Saoudi, E O; Hcini, N; Pouget, K; Seve, B; de Matteis, B

2017-11-01

Postpartum hemorrhage is a major cause of maternal death worldwide. Many therapeutic strategies have been developed to reduce maternal morbidity and mortality like oxytocin, prostaglandin, and uterine balloons. A new member of the therapeutic arsenal has recently emerged, the chitosan (Celox ® ), used since several years by military doctors to stop bleeding of combat wounds. In 2012, a first study was reported with the successful use of chitosan-coated gauze to treat severe postpartum hemorrhage. We report here four cases of the use of chitosan to treat life-threatening obstetric bleeding. In the first case, a pelvic packing with chitosan gauze after hemostatic hysterectomy with persistent bleeding. In the second case, the use of chitosan powder in a case of severe bleeding from multiple vaginal tears. In the third case, the use of chitosan gauze in uterine packing for postpartum hemorrhage by atonia. In the fourth case, the use of chitosan powder for stop bleeding during a hemorrhagic cesarean section. Postpartum hemorrhage of uterine origin resistant to treatment with prostaglandins can be treated with chitosan-coated gauze. This treatment requires no training and its costs are one fifth those of a Bakri ® intrauterine balloon. Using these two forms of chitosan, powder and gauze, we have a new therapeutic method at our disposal for dealing with the most serious cases of bleeding. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

SCALS: a fourth-generation study of assisted living technologies in their organisational, social, political and policy context.

PubMed

Greenhalgh, Trisha; Shaw, Sara; Wherton, Joe; Hughes, Gemma; Lynch, Jenni; A'Court, Christine; Hinder, Sue; Fahy, Nick; Byrne, Emma; Finlayson, Alexander; Sorell, Tom; Procter, Rob; Stones, Rob

2016-02-15

Research to date into assisted living technologies broadly consists of 3 generations: technical design, experimental trials and qualitative studies of the patient experience. We describe a fourth-generation paradigm: studies of assisted living technologies in their organisational, social, political and policy context. Fourth-generation studies are necessarily organic and emergent; they view technology as part of a dynamic, networked and potentially unstable system. They use co-design methods to generate and stabilise local solutions, taking account of context. SCALS (Studies in Co-creating Assisted Living Solutions) consists (currently) of 5 organisational case studies, each an English health or social care organisation striving to introduce technology-supported services to support independent living in people with health and/or social care needs. Treating these cases as complex systems, we seek to explore interdependencies, emergence and conflict. We employ a co-design approach informed by the principles of action research to help participating organisations establish, refine and evaluate their service. To that end, we are conducting in-depth ethnographic studies of people's experience of assisted living technologies (micro level), embedded in evolving organisational case studies that use interviews, ethnography and document analysis (meso level), and exploring the wider national and international context for assisted living technologies and policy (macro level). Data will be analysed using a sociotechnical framework developed from structuration theory. Research ethics approval for the first 4 case studies has been granted. An important outcome will be lessons learned from individual co-design case studies. We will document the studies' credibility and rigour, and assess the transferability of findings to other settings while also recognising unique aspects of the contexts in which they were generated. Academic outputs will include a cross-case analysis and progress in theory and method of fourth-generation assisted living technology research. We will produce practical guidance for organisations, policymakers, designers and service users. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Powassan virus infection: case series and literature review from a single institution

PubMed Central

2012-01-01

Background Powassan virus is a flavivirus related to eastern hemisphere’s tick-borne encephalitis viruses. It can cause a rare but potentially life-threatening disease including encephalitis. Case presentation We report four cases of POWV infection in Minnesota and North Dakota with known exposure to tick bites in 2011. Our first case was an 18-year-old male who dramatically presented with seizure and headache with positive serum analysis for Powassan virus immunoglobulin M. The second case was a 60 year old gentleman with intraparenchymal hemorrhage and was diagnosed via cerebrospinal fluid analysis. Thirdly, a 61 year old male developed altered mental status and encephalitis. Our fourth patient was a 69 year old male who had headache and non-focal weakness who was diagnosed with serum analysis. Conclusion Symptoms of Powassan virus infection ranged from headaches to seizures and severe neurological symptoms. This study serves to highlight the increased detection of Powassan virus infection in the central north United States. This report focuses on the increasing incidence that can lead to increasing efforts for raising awareness regarding this infection. There is a need for clinician vigilance and public attention due to its increasing detection, westward progression and varied clinical presentations. PMID:23111001

Posterior Fossa Craniotomy for Adherent Fourth Ventricle Neurocysticercosis.

PubMed

Franko, Lynze R; Pandian, Balaji; Gupta, Avneesh; Savastano, Luis E; Chen, Kevin S; Riddell, James; Orringer, Daniel A

2018-06-14

Neurocysticercosis (NCC) is an infectious helminthic disease often presenting in patients who have immigration or travel history from areas where NCC is endemic. Fourth ventricle cysts from NCC pose a unique treatment challenge, as there is little consensus on the best treatment. This case study describes the treatment of a patient with fourth ventricle neurocysticercosis (FVNCC), examines the therapeutic decision-making, and provides a video of a posterior fossa craniotomy (PFC) resection of a degenerative cyst. The patient presented with headache, dizziness, nausea, and memory difficulties. A fourth ventricle cyst consistent with NCC was found on magnetic resonance imaging, and serum enzyme-linked immunosorbent assay (ELISA) confirmed the diagnosis. The cyst was removed utilizing an open PFC followed by antihelminthic therapy and corticosteroids. There was resolution of symptoms at 9 mo postoperatively. Several treatment modalities have been proposed for isolated cysts in the fourth ventricle, including medication, ventriculoperitoneal shunt, endoscopic removal, and PFC. The treatment decision is complex, and there is little guidance on the best treatment choices. In this article, we describe treatment via PFC for an adherent FVNCC cyst.

Successful fifth metatarsal bulk autograft reconstruction of thermal necrosis post intramedullary fixation.

PubMed

Veljkovic, Andrea; Le, Vu; Escudero, Mario; Salat, Peter; Wing, Kevin; Penner, Murray; Younger, Alastair

2018-03-21

Reamed intramedullary (IM) screw fixation for proximal fifth metatarsal fractures is technically challenging with potentially devastating complications if basic principles are not followed. A case of an iatrogenic fourth-degree burn after elective reamed IM screw fixation of a proximal fifth metatarsal fracture in a high-level athlete is reported. The case was complicated by postoperative osteomyelitis with third-degree soft-tissue defect. This was successfully treated with staged autologous bone graft reconstruction, tendon reconstruction, and local bi-pedicle flap coverage. The patient returned to competitive-level sports, avoiding the need for fifth ray amputation. Critical points of the IM screw technique and definitive reconstruction are discussed. Bulk autograft reconstruction is a safe and effective alternative to ray amputation in segmental defects of the fifth metatarsal.Level of evidence V.

Exploring a fourth dimension: spirituality as a resource for the couple therapist.

PubMed

Anderson, D A; Worthen, D

1997-01-01

This article explores ways in which the therapist's own spirituality can serve as a resource in couple therapy. Spirituality is defined as subjective engagement with a fourth, transcendent dimension of human experience. This engagement enhances human life and evokes corresponding behavior. Spiritually based therapy may be influenced by three assumptions: that God or a Divine Being exists, that human-kind yearns innately for connection with this Being, and that this Being is interested in humans and acts upon and within their relationships to promote beneficial change. In therapy these assumptions affect how the therapist listens and responds throughout sessions. The authors incorporate a case example illustrating the application of this fourth dimension in couple therapy.

Business Management for Independent Schools. Fourth Edition.

ERIC Educational Resources Information Center

National Association of Independent Schools, Boston, MA.

This fourth edition of a guide for independent school business managers has been produced in looseleaf format so that changes may be made promptly as decisions of regulatory bodies require modifications in current practice. Fourteen chapters are organized under three broad topic headings. Chapters in part 1, Accounting and Financial Reporting,…

Doing Your Thing: Fourth Grade.

ERIC Educational Resources Information Center

Potter, Beverly

The fourth grade instructional unit, part of a grade school level career education series, is designed to assist learners in relating present experiences to past and future ones. Before the main body of the lessons is described, field testing results are reported, and key items are presented: the concepts, the estimated instructional time, the…

THE SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION PROGRAM: PROGRESS AND ACCOMPLISHMENTS - FISCAL YEAR 1990 A FOURTH REPORT TO CONGRESS

EPA Science Inventory

The SITE Program was the first major program for demonstrating and evaluating fullscale innovative treatment technologies at hazardous waste sites. Having concluded its fourth year, the SITE Program is recognized as a leading advocate of innovative technology development and comm...

Understanding Chronically Reported Families

PubMed Central

Jonson-Reid, Melissa; Emery, Clifton R.; Drake, Brett; Stahlschmidt, Mary Jo

2013-01-01

Although a strong literature on child maltreatment re-reporting exists, much of that literature stops at the first re-report. The literature on chronic re-reporting, meaning reports beyond the second report, is scant. The authors follow Loman’s lead in focusing on reports beyond the first two to determine what factors predict these “downstream” report stages. Cross-sector, longitudinal administrative data are used. The authors analyze predictors at each of the first four recurrences (first to second report, second to third report, third to fourth report, and fourth to fifth report). Findings demonstrate that some factors (e.g., tract poverty) which predict initial recurrence lose their predictive value at later stages, whereas others (e.g., aid to families with dependent children history) remain predictive across stages. In-home child welfare services and mental health treatment emerged as consistent predictors of reduced recurrence. PMID:20941889

[With the fourth sentence of the First Chamber on wrongful birth: is it possible to start talking about "jurisprudence"?].

PubMed

de Angel Yágüez, Ricardo

2005-01-01

Chamber number 1 of the Spanish Supreme Court of Justice has announced its fourth wrongful birth case decision dated December 18, 2003. The issue is whether we can state that with these four rulings there is a genuine law of precedent, that is, reiterated doctrine of the Supreme Court of Justice on this matter (Article 1.6 of the Civil Code).

The Impact of the Use of One-to-One Netbooks on Student Achievement, Teacher Practice, and Perceptions of Technology in a Fourth-Grade Bilingual Class

ERIC Educational Resources Information Center

Bukofser, J. Holly

2013-01-01

This research involved a 14-month qualitative case study of a fourth-grade bilingual class embarking on a one-to-one netbook computer initiative. Students in this program had unlimited use of the netbooks during the school day. The main foci of the data collected were student achievement, teacher instruction, and student and teacher perceptions of…

Pseudoaneurysm following laparoscopic cholecystectomy.

PubMed

Madanur, Mansoor Ahmed; Battula, Narendra; Sethi, Harsheet; Deshpande, Rahul; Heaton, Nigel; Rela, Mohamed

2007-06-01

Laparoscopic cholecystectomy (LC) is the operation of choice for removal of the gallbladder. Unrecognized bile duct injuries present with biliary peritonitis and systemic sepsis. Bile has been shown to cause damage to the vascular wall and therefore delay the healing of injured arteries leading to pseudoaneurysm formation. Failure to deal with bile leak and secondary infection may result in pseudoaneurysm formation. This study was to report the incidence and outcomes of pseudoaneurysm in patients with bile leak following LC referred to our hospital. A retrospective analysis of our prospectively maintained liver database using key words pseudoaneurysm, bile leak and bile duct injury following laparoscopic cholecystectomy from January 2000 to December 2005 was performed. A total of 86 cases were referred with bile duct injury and bile leak following LC and of these, 4 patients (4.5%) developed hepatic artery pseudoaneurysm (HAP) presenting with haemobilia in 3 and massive intra-abdominal bleed in 1. Selective visceral angiography confirmed pseudoaneurysm of the right hepatic artery in 2 cases, cystic artery stump in one and an intact but ectatic hepatic artery with surgical clips closely applied to the right hepatic artery at the origin of the cystic artery in the fourth case. Effective hemostasis was achieved in 3 patients with coil embolization and the fourth patient required emergency laparotomy for severe bleeding and hemodynamic instability due to a ruptured right hepatic artery. Of the 3 patients treated with coil embolization, 2 developed late strictures of the common hepatic duct (CHD) requiring hepatico-jejunostomy and one developed a stricture of left hepatic duct. All the 4 patients are alive at a median follow up of 17 months (range 1 to 65) with normal liver function tests. HAP is a rare and potentially life-threatening complication of LC. Biloma and subsequent infection are reported to be associated with pseudoaneurysm formation. Late duct stricture is common either due to unrecognized injury at LC or secondary to ischemia after embolization.

Sudden deterioration due to intra-tumoral hemorrhage of ependymoma of the fourth ventricle in a child during a flight: a case report.

PubMed

Mahdavi, Ali; Baradaran, Nima; Nejat, Farideh; El Khashab, Mostafa; Monajemzadeh, Maryam

2010-05-20

To the best of our knowledge, the association between air travel and intra-tumoral hemorrhage in pediatric populations has never been described previously. We report the case of a two-and-a-half-year-old Caucasian, Iranian boy with a hemorrhaging brain tumor. He had a posterior fossa midline mass and severe hydrocephalus. He had been shunted for hydrocephalus four weeks earlier and was subsequently referred to our center for further treatment. The hemorrhage occurred in an infra-tentorial ependymoma, precipitated by an approximately 700-mile air journey at a maximum altitude of 25,000 feet. A pre-existing intra-cranial mass lesion diminishes the ability of the brain to accommodate the mild environmental disturbances caused by hypercarbia, increased venous pressure and reduced cerebral blood flow during long air journeys. This is supported by a literature review, based on our current knowledge of physiological changes during air travel.

Donnai–Barrow Syndrome (DBS/FOAR) in a Child With a Homozygous LRP2 Mutation Due to Complete Chromosome 2 Paternal Isodisomy

PubMed Central

Kantarci, Sibel; Ragge, Nicola K.; Thomas, N. Simon; Robinson, David O.; Noonan, Kristin M.; Russell, Meaghan K.; Donnai, Dian; Raymond, F. Lucy; Walsh, Christopher A.; Donahoe, Patricia K.; Pober, Barbara R.

2010-01-01

Donnai–Barrow syndrome [Faciooculoacousticorenal (FOAR) syndrome; DBS/FOAR] is a rare autosomal recessive disorder resulting from mutations in the LRP2 gene located on chromosome 2q31.1. We report a unique DBS/FOAR patient homozygous for a 4-bp LRP2 deletion secondary to paternal uniparental isodisomy for chromosome 2. The propositus inherited the mutation from his heterozygous carrier father, whereas the mother carried only wild-type LRP2 alleles. This is the first case of DBS/FOAR resulting from uniparental disomy (UPD) and the fourth published case of any paternal UPD 2 ascertained through unmasking of an autosomal recessive disorder. The absence of clinical symptoms above and beyond the classical phenotype in this and the other disorders suggests that paternal chromosome 2 is unlikely to contain imprinted genes notably affecting either growth or development. This report highlights the importance of parental genotyping in order to give accurate genetic counseling for autosomal recessive disorders. PMID:18553518

Perivascular epithelioid cell neoplasm (PEComa) of the uterus: A systematic review.

PubMed

Musella, Angela; De Felice, Francesca; Kyriacou, A Kyriacos; Barletta, Francesco; Di Matteo, Filippo Maria; Marchetti, Claudia; Izzo, Luciano; Monti, Marco; Benedetti Panici, Pierluigi; Redler, Adriano; D'Andrea, Vito

2015-07-01

Perivascular epithelioid cell neoplasm (PEComa) is a rare mesenchymal tumor. Gynecological PEComas account for just over one-fourth of the overall PEComa cases reported in the literature. Surgery is the most recommended primary treatment while adjuvant therapy is generally reserved for high-risk cases. However, the best management of this neoplasia has not been well established, primarily because of the paucity of cases described to date. The aim of this systematic review is to summarize what is known thus far regarding the etiopathogenesis, clinical and pathologic features of PEComas, focusing also on the most valid treatment options for uterine cases. Pubmed articles on PEComas published in various journals over the past 70 years were analyzed. Although the optimal treatment of gynecological PEComas is controversial, surgical resection remains the cornerstone. The use of adjuvant treatment is warranted in high risk patients to increase disease control. A multidisciplinary approach should be key in treatment decision-making regarding gynecological PEComas. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Pediatric oncology in Turkey.

PubMed

Kebudi, Rejin

2012-03-01

The survival of children with cancer has increased dramatically in the last decades, as a result of advances in diagnosis, treatment and supportive care. Each year in Turkey, 2500-3000 new childhood cancer cases are expected. According to the Turkish Pediatric Oncology Group and Turkish Pediatric Hematology Societies Registry, about 2000 new pediatric cancer cases are reported each year. The population in Turkey is relatively young. One fourth of the population is younger than 15 years of age. According to childhood mortality, cancer is the fourth cause of death (7.2%) after infections, cardiac deaths and accidents. The major cancers in children in Turkey are leukemia (31%), lymphoma (19%), central nervous system (CNS) neoplasms (13%), neuroblastomas (7%), bone tumors (6.1%), soft tissue sarcomas (6%), followed by renal tumors, germ cell tumors, retinoblastoma, carcinomas-epithelial neoplasms, hepatic tumors and others. Lymphomas rank second in frequency as in many developing countries in contrast to West Europe or USA, where CNS neoplasms rank second in frequency. The seven-year survival rate in children with malignancies in Turkey is 65.8%. The history of modern Pediatric Oncology in Turkey dates back to the 1970's. Pediatric Oncology has been accepted as a subspecialty in Turkey since 1983. Pediatric Oncologists are all well trained and dedicated. All costs for the diagnosis and treatment of children with cancer is covered by the government. Education and infrastructure for palliative care needs improvement.

Recurrent thyroid abscess - Is it a fourth branchial archanomaly?

PubMed

Desai, A A; Pandya, V K; Chougule, Sachin; Nair, Unnikrishnnan

2006-04-01

Branchial fistulae are of congenital origin(6) and consists of skin lined tract opening internally at junction of cartilaginous and bony meatus in case of 1(st) arch anomaly, tonsillar fossa in case of 2(nd) arch, while 3(rd) and 4(th) arch sinuses have internal opening at level of pyriform sinus or below. A complete tract of 3(rd) or 4(th) arch fistulae is yet to be described. Fourth arch fistulae(1) have a distinct clinical pattern of internal opening at pyriform apex, are left sided and associated with suppurative thyroiditis(3), they manifest at a younger age and treatment involves excision of tract with ipsilateral thyroid lobectomy.

Dark Coulomb binding of heavy neutrinos of fourth family

NASA Astrophysics Data System (ADS)

Belotsky, K. M.; Esipova, E. A.; Khlopov, M. Yu.; Laletin, M. N.

2015-11-01

Direct dark matter searches put severe constraints on the weakly interacting massive particles (WIMPs). These constraints cause serious troubles for the model of stable neutrino of fourth generation with mass around 50GeV. Though the calculations of primordial abundance of these particles make them in the charge symmetric case a sparse subdominant component of the modern dark matter, their presence in the universe would exceed the current upper limits by several orders of the magnitude. However, if quarks and leptons of fourth generation possess their own Coulomb-like y-interaction, recombination of pairs of heavy neutrinos and antineutrinos and their annihilation in the “neutrinium” atoms can play important role in their cosmological evolution, reducing their modern abundance far below the experimental upper limits. The model of stable fourth generation assumes that the dominant part of dark matter is explained by excessive Ū antiquarks, forming (ŪŪŪ)-- charged clusters, bound with primordial helium in nuclear-interacting O-helium (OHe) dark atoms. The y charge conservation implies generation of the same excess of fourth generation neutrinos, potentially dangerous WIMP component of this scenario. We show that due to y-interaction recombination of fourth neutrinos with OHe hides these WIMPs from direct WIMP searches, leaving the negligible fraction of free neutrinos, what makes their existence compatible with the experimental constraints.

Radiative Forcing by Well-Mixed Greenhouse Gases: Estimates from Climate Models in the Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report (AR4)

NASA Technical Reports Server (NTRS)

Collins, W. D.; Ramaswamy, V.; Schwarzkopf, M. D.; Sun, Y.; Portmann, R. W.; Fu, Q.; Casanova, S. E. B.; Dufresne, J.-L.; Fillmore, D. W.; Forster, P. M. D.;

Bilinear, trilinear forms, and exact solution of certain fourth order integrable difference equations

NASA Astrophysics Data System (ADS)

Sahadevan, R.; Rajakumar, S.

2008-03-01

A systematic investigation of finding bilinear or trilinear representations of fourth order autonomous ordinary difference equation, x(n +4)=F(x(n),x(n+1),x(n+2),x(n+3)) or xn +4=F(xn,xn +1,xn +2,xn +3), is made. As an illustration, we consider fourth order symplectic integrable difference equations reported by [Capel and Sahadevan, Physica A 289, 86 (2001)] and derived their bilinear or trilinear forms. Also, it is shown that the obtained bilinear representations admit exact solution of rational form.

Students teaching students: evaluation of a "near-peer" teaching experience.

PubMed

Naeger, David M; Conrad, Miles; Nguyen, Janet; Kohi, Maureen P; Webb, Emily M

2013-09-01

Teaching is an important skill. Academic physicians teach on a daily basis, and nearly all physicians occasionally teach colleagues and patients. There are generally few opportunities for medical students to learn teaching skills. We developed a novel "near-peer" teaching program in which fourth-year students cotaught first-year students. Eighteen fourth-year students enrolled in our institution's primary senior radiology elective learned the basics of ultrasound through a series of lectures and hands-on scanning sessions. Each fourth-year student, paired with a radiology resident or attending, then cotaught a first-year anatomy small group session. After instruction, voluntary surveys were administered to assess the perceived value of the "near-peer" teaching experience. Seventeen of 18 (94%) and 104 of 120 (87%) administered surveys were returned by fourth- and first-year students, respectively. Sixteen (94%) and 99 (95%) of the fourth- and first-year students reported they "enjoyed" or "really enjoyed" the near-peer teaching experience. Fourteen (82%) of the fourth years perceived improvement in their teaching skills and an increase in their knowledge. Only 8 (47%) of the fourth years thought they were "helpful" or "very helpful," though 92 (88%) of the first years identified their fourth-year co-instructors as "helpful" or "very helpful." We piloted a novel "near-peer" program. Both senior and freshman students enjoyed the experience, and fourth years thought the session was educational for them as well. Although most fourth years did not judge themselves as helpful, first-year students overwhelmingly considered them a useful addition to the session. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

Student-Described Engagement with Text: Insights Are Discovered from Fourth Graders

ERIC Educational Resources Information Center

Weih, Timothy G.

2014-01-01

This article reports on a research study investigating student-described engagement with self-selected text in a classroom where a core reading program (in the context of this study meaning instruction based primarily on manuals and commercial textbooks) comprised the majority of their literacy instruction. Fourth grade students were invited to…

Relations of Friends' Activities to Friendship Quality

ERIC Educational Resources Information Center

Mathur, Ravisha; Berndt, Thomas J.

2006-01-01

Two studies were conducted to examine age and sex differences in friends' activities and relations of participation in these activities to perceived friendship quality. In Study 1, 52 fourth and eighth graders were asked open-ended questions about activities they do with their best friends. In Study 2, 105 fourth and eighth graders reported both…

Die Stimmhaftigkeitskorrelation der deutschen Verschlusslautphoneme (The Voiced Correlation of the German Stop Phoneme)

ERIC Educational Resources Information Center

Ezawa, Kennosuke

1973-01-01

Article based on the author's report, Sprachnorm und Sprechnorm,'' presented at the Sixth International Congress of Phonetic Sciences, September 1967, Prague, Czechoslovakia. Present version read at the Fourth Czechoslovakia. Present version read at the Fourth Annual Conference of the Societas Linguistica Europaea, October 9-11, 1970, Prague,…

UNDERSTANDING THE FOURTH GRADE SLUMP IN CREATIVE THINKING. FINAL REPORT.

ERIC Educational Resources Information Center

TORRANCE, E. PAUL

STUDIES OF CREATIVITY AND OF PSYCHOLOGICAL DISTURBANCES IN CHILDREN HAVE SUGGESTED THE PRESENCE OF SLUMPS (OR INVERSIONS) WHICH MAY BE CORRELATED WITH DEVELOPMENTAL TRANSITIONS. THE MOST NOTABLE OF THESE OCCURS AT ABOUT THE FOURTH GRADE AND IS THE OBJECT OF THIS STUDY. THREE SETS OF INVESTIGATIONS WERE UNDERTAKEN--(1) A STUDY OF CREATIVE…

Multi-scale Eulerian model within the new National Environmental Modeling System

NASA Astrophysics Data System (ADS)

Janjic, Zavisa; Janjic, Tijana; Vasic, Ratko

2010-05-01

The unified Non-hydrostatic Multi-scale Model on the Arakawa B grid (NMMB) is being developed at NCEP within the National Environmental Modeling System (NEMS). The finite-volume horizontal differencing employed in the model preserves important properties of differential operators and conserves a variety of basic and derived dynamical and quadratic quantities. Among these, conservation of energy and enstrophy improves the accuracy of nonlinear dynamics of the model. Within further model development, advection schemes of fourth order of formal accuracy have been developed. It is argued that higher order advection schemes should not be used in the thermodynamic equation in order to preserve consistency with the second order scheme used for computation of the pressure gradient force. Thus, the fourth order scheme is applied only to momentum advection. Three sophisticated second order schemes were considered for upgrade. Two of them, proposed in Janjic(1984), conserve energy and enstrophy, but with enstrophy calculated differently. One of them conserves enstrophy as computed by the most accurate second order Laplacian operating on stream function. The other scheme conserves enstrophy as computed from the B grid velocity. The third scheme (Arakawa 1972) is arithmetic mean of the former two. It does not conserve enstrophy strictly, but it conserves other quadratic quantities that control the nonlinear energy cascade. Linearization of all three schemes leads to the same second order linear advection scheme. The second order term of the truncation error of the linear advection scheme has a special form so that it can be eliminated by simply preconditioning the advected quantity. Tests with linear advection of a cone confirm the advantage of the fourth order scheme. However, if a localized, large amplitude and high wave-number pattern is present in initial conditions, the clear advantage of the fourth order scheme disappears. In real data runs, problems with noisy data may appear due to mountains. Thus, accuracy and formal accuracy may not be synonymous. The nonlinear fourth order schemes are quadratic conservative and reduce to the Arakawa Jacobian in case of non-divergent flow. In case of general flow the conservation properties of the new momentum advection schemes impose stricter constraint on the nonlinear cascade than the original second order schemes. However, for non-divergent flow, the conservation properties of the fourth order schemes cannot be proven in the same way as those of the original second order schemes. Therefore, nonlinear tests were carried out in order to check how well the fourth order schemes control the nonlinear energy cascade. In the tests nonlinear shallow water equations are solved in a rotating rectangular domain (Janjic, 1984). The domain is covered with only 17 x 17 grid points. A diagnostic quantity is used to monitor qualitative changes in the spectrum over 116 days of simulated time. All schemes maintained meaningful solutions throughout the test. Among the second order schemes, the best result was obtained with the scheme that conserved enstrophy as computed by the second order Laplacian of the stream function. It was closely followed by the Arakawa (1972) scheme, while the remaining scheme was distant third. The fourth order schemes ranked in the same order, and were competitive throughout the experiments with their second order counterparts in preventing accumulation of energy at small scales. Finally, the impact was examined of the fourth order momentum advection on global medium range forecasts. The 500 mb anomaly correlation coefficient is used as a measure of success of the forecasts. Arakawa, A., 1972: Design of the UCLA general circulation model. Tech. Report No. 7, Department of Meteorology, University of California, Los Angeles, 116 pp. Janjic, Z. I., 1984: Non-linear advection schemes and energy cascade on semi-staggered grids. Monthly Weather Review, 112, 1234-1245.

Skin thickening as unique pathologic sign of an inflammatory breast cancer: a case report and review of the literature.

PubMed

Ballesio, L; D'Ambrosio, I; Ravazzolo, N; Angeletti, M; Di Pastena, F; Tardioli, S; Lodise, P; Marini, M

2011-01-01

We report the case of a 42-year-old woman with inflammatory cancer of the right breast treated with neoadjuvant chemotherapy, surgery, additional chemotherapy, and consolidative radiotherapy (RT), that has metastatized to the chest wall and presented a resumption of disease on the contralateral breast. Magnetic Resonance (MR), performed after the second phase's fourth round of additional chemotherapy, showed a modest reduction of scar metastases on the right and a contralateral anomalous skin thickening with high signal intensity in T2 weighted images (WI) with multiple mass-like enhancements located in a wide area of the central region at the union of higher quadrants. These findings were suggestive for resumption of contralateral disease; the biopsy confirmed an inflammatory breast cancer (IBC) infiltrating lobular type with high mitotic rate. A retrospective evaluation of the previous MR exam, performed 5 months before, was conducted: on the left side only a modest skin thickening was found as an early sign. A careful review of the literature has confirmed that skin thickening, increased density and clinical signs of inflammation are the most common findings in inflammatory cancer. We report the case of a patient affected by IBC whose unique early sign of resumption on the contralateral breast was skin thickening.

Paracentric inversion-associated t(8;21) variant in de novo acute myelogenous leukemia: characteristic patterns of conventional cytogenetics, FISH, and multicolor banding analysis.

PubMed

Park, Tae Sung; Song, Jaewoo; Lee, Kyung-A; Min, Yoo Hong; Lee, Sang-Guk; Park, Yongjung; Kim, Juwon; Lee, Eun Yup; Choi, Jong Rak

2008-05-01

Acute myelogenous leukemia (AML) with t(8;21)(q22;q22) demonstrates unique clinico-pathologic disease entity in patients with hematologic malignancies. The t(8;21), which results in fusion of the AML1 gene on 21q22 and the ETO gene on 8q22 on a molecular level, is one of the most common nonrandom chromosomal changes, and it is found in about 5-12% of patients with AML. Among these cases, complex variants involving chromosomes 8 and 21, as well as a third or fourth chromosome, account for approximately 6-10% of patients with an AML1/ETO chimeric gene, and about 100 variant cases with AML1/ETO fusion transcript have been reported in the literature. Here, we describe a rare case report of reciprocal paracentric inversion-associated t(8;21) variant in a 28-year old male patient with de novo AML. The abnormal results of conventional cytogenetics and interphase fluorescent in situ hybridization in this patient drove us to perform further studies and a literature review. This report emphasizes the value of "conventional" cytogenetics, as well as "newly developed" molecular cytogenetic methods in the diagnosis of rare complex t(8;21) variant in patients with AML. Copyright 2008 Elsevier Inc.

Neoadjuvant chemotherapy for atypical teratoid rhabdoid tumors: case report.

PubMed

Thatikunta, Meena; Mutchnick, Ian; Elster, Jennifer; Thompson, Matthew P; Huang, Michael A; Spalding, Aaron C; Moriarty, Thomas

2017-05-01

Atypical teratoid rhabdoid tumors (ATRTs) are a rare pediatric brain tumor with high mortality rate. Several large series have reported achieving gross-total resection (GTR) in less than 50% of patients due to the lesions' large size, vascularity, and limited blood volume in young patients. While neoadjuvant chemotherapy for choroid plexus carcinomas in pediatric patients has become widely accepted, it has not been used as widely for other pediatric brain tumors. To the best of the authors' knowledge, there are only 3 published cases of neoadjuvant chemotherapy for ATRTs. In the present report, the authors present a fourth case of neoadjuvant chemotherapy for ATRT and review the available literature on this strategy. A 17-month-old child presented with a left ventricular ATRT for which imaging raised concern for a highly vascularized tumor. The authors undertook neoadjuvant chemotherapy with 2 cycles of Head Start II therapy, which reduced the size of the ventricular tumor by 35% and decreased the vascularity of the lesion on imaging. The estimated blood loss during resection was 425 ml and GTR was achieved. The patient continued with postoperative chemotherapy but suffered an on-therapy recurrence. While higher-quality data are necessary, available evidence suggests that neoadjuvant chemotherapy can reduce the size and vascularity of ATRTs and facilitate a surgical avenue for large or "inoperable" tumors.

‘IMPULSIVE PICA’: A NEW DIAGNOSTIC CATEGORY?

PubMed Central

Chowdhury, A.N.; Basu, Saikat

2002-01-01

Pica is an interesting psychiatric entity that merits special clinical attention. This report describes three cases of pica and calls for its separate nosological placement in clinical psychiatry. In the Diagnostic and statistical manual of mental disorders fourth edition (DSM-IV), pica is described as persistent eating of nonutritive substances for a period of at least 1 month which is inappropriate to the developmental level and not part of a culturally sanctioned practice (American Psychiatric Association, 1994). On the other hand, impulse-control disorders not elsewhere classified is defined as failure to resist an impulse, drive or temptation to perform an act that is harmful to the person or to others, feeling of an increasing sense of tension or arousal before committing the act and pleasure, gratification or relief at the time of committing the act or shortly thereafter (American Psychiatric Association, 1994). Regarding the aetiologies of Pica most contemporary literatures have cited various causative factors, e.g. normal exploratory orality of children, pregnancy, stress and conflicts, cultural beliefs, mental retardation, psychotic disorders and even nutritional deficiencies (Chatoor, 2000; Popper & West, 2001). Here, we report 3 atypical cases of Pica, attending outpatient department of the Institute of Psychiatry, Calcutta. These reported cases are unique in their time of onset, phenomenological progression and therapeutic responsiveness. PMID:21206603

Acute pancreatitis with saw palmetto use: a case report

PubMed Central

2011-01-01

Introduction Saw palmetto is a phytotherapeutic agent commercially marketed for the treatment of benign prostatic hyperplasia. Evidence suggests that saw palmetto is a safe product, and mild gastrointestinal adverse effects have been reported with its use. We report a case of acute pancreatitis, possibly secondary to the use of saw palmetto. Case presentation A 61-year-old Caucasian man with a history of benign prostatic hyperplasia and gastroesophageal reflux disease developed epigastric pain associated with nausea 36 hours prior to presentation. He denied drinking alcohol prior to the development of his symptoms. His home medications included saw palmetto, lansoprazole and multivitamins. Laboratory results revealed elevated lipase and amylase levels. An abdominal ultrasound demonstrated a nondilated common bile duct, without choledocholithiasis. Computed tomography of his abdomen showed the pancreatic tail with peripancreatic inflammatory changes, consistent with acute pancreatitis. Our patient's condition improved with intravenous fluids and pain management. On the fourth day of hospitalization his pancreatic enzymes were within normal limits: he was discharged home and advised to avoid taking saw palmetto. Conclusion It is our opinion that a relationship between saw palmetto and the onset of acute pancreatitis is plausible, and prescribers and users of saw palmetto should be alert to the possibility of such adverse reactions. PMID:21867545

[Clinical characteristics and surgical management in patients with third and fourth branchial anomalies].

PubMed

Li, Y X; He, X G; Wang, Y; Yang, X

2016-08-05

Objective: To analysize the clinical characteristics as well as the effect and methods of the surgical treatment in patiets with the third and fourth branchial anomalies. Method: The clinical data of 25 patients diagnosed as third and fourth branchial cleft fistula by pathological method were analyzed retrospectively.Two of 25 patients had undergone fistulectomy simply.Based on the embryologicc and anatomic features of branchial anomalies,23 of 25 patients had received different types of selective neck dissection.All of lesions were confirmed as branchial cleft fistula by pathology.All patients were received the examinations of Esophagus myelography,MRI and CT preoperatively. Result: The features of the third and the fourth bianchial fistula were as following:most patients suffered from recurrent neck abscess and had undergone incision and drainage. Esophagus myelography and CT were important auxiliary examination for branchial anomalies.No recurrent and complications were found in all patients by using treatment of selective neck dissection (23/25 cases) and fistulectomy simply(2/25 cases) within 12 to 36 months following-up,postoperatively. Conclusion: Branchial anomalies is characterized by recurrent acute abscess,acute thyroiditis or fistula secretion inferior to neck.Complete removal of branchial lesions and inflammatory granuloma using selective neck dissection is a safty and effective treatment for recurrent branchial anomalies. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Fourth order difference methods for hyperbolic IBVP's

NASA Technical Reports Server (NTRS)

Gustafsson, Bertil; Olsson, Pelle

1994-01-01

Fourth order difference approximations of initial-boundary value problems for hyperbolic partial differential equations are considered. We use the method of lines approach with both explicit and compact implicit difference operators in space. The explicit operator satisfies an energy estimate leading to strict stability. For the implicit operator we develop boundary conditions and give a complete proof of strong stability using the Laplace transform technique. We also present numerical experiments for the linear advection equation and Burgers' equation with discontinuities in the solution or in its derivative. The first equation is used for modeling contact discontinuities in fluid dynamics, the second one for modeling shocks and rarefaction waves. The time discretization is done with a third order Runge-Kutta TVD method. For solutions with discontinuities in the solution itself we add a filter based on second order viscosity. In case of the non-linear Burger's equation we use a flux splitting technique that results in an energy estimate for certain different approximations, in which case also an entropy condition is fulfilled. In particular we shall demonstrate that the unsplit conservative form produces a non-physical shock instead of the physically correct rarefaction wave. In the numerical experiments we compare our fourth order methods with a standard second order one and with a third order TVD-method. The results show that the fourth order methods are the only ones that give good results for all the considered test problems.

Beckwith-Wiedemann syndrome and Chiari I malformation--a case-based review of central nervous system involvement in hemihypertrophy syndromes.

PubMed

Udayakumaran, Suhas; Onyia, Chiazor U

2015-05-01

Beckwith-Wiedemann syndrome (BWS) is an unusual complex of abnormalities that includes mainly omphalocele, macroglossia, gigantism, visceromegaly, and neonatal hypoglycemia. Type I Chiari malformation, on the other hand, is defined as ectopia of the cerebellar tonsils below the plane of the foramen magnum. Only one case of association of BWS with Chiari I malformation has been previously reported in the literature. Several conditions involving congenital hemihypertrophy have been previously reported in association with Type I Chiari malformation. The pathophysiological mechanism for most of these associations is thought to be quite complex and still remains unclear. However, the presence of tonsillar herniation in BWS has been explained by Tubbs and Oakes in the only one existing case report of BWS with Type I Chiari malformation in the literature, to be due to associated hemihypertrophy of the skull base. We additionally suggest that cerebellar hypertrophy may also contribute to the tonsillar herniation and fourth ventricular outlet obstruction. We now report our recent experience on this association following a review of the literature on association of other hemihypertrophy syndromes with the central nervous system anomalies. We believe that a common pathogenesis of Type I Chiari malformation occurs in conditions of hemihypertrophy including BWS, probably secondary to dysmorphology involving the posterior cranial fossa, and is not just an associated finding.

Intracranial translucency as a sonographic marker for detecting open spina bifida at 11-13+6 weeks scan: Our experience.

PubMed

Teegala, Madhavi L; Vinayak, Dhamangaonkar G

2017-01-01

The fourth ventricle, seen as intracranial translucency (IT) at 11-13 +6 weeks, has been reported to be obliterated in cases of open spina bifida (OSB). Our aim was to assess its role in detecting OSB at 11-13 +6 weeks. This prospective study was conducted at foetal medicine unit from January 2014 to June 2015. All women who underwent both first and mid-trimester scan in our unit were included in the study. IT was categorized as normal, obliterated or not clear. Spine was examined during both scans. Totally, 341 cases were included in the study. IT was found to be obliterated in four cases and not clear in one case. There was demonstrable OSB at 11-13 +6 weeks in two cases, at 15-16 weeks in two cases and at 24 weeks in one case. In the remaining 336 cases with normal IT, spine was found to be normal at target scan. Mid-sagittal view of face that is routinely used to measure nuchal translucency (NT) can also be used to detect OSB. It is feasible to integrate IT into the routine 11-13 +6 weeks scan.

Anatomic variants in Dandy-Walker complex.

PubMed

Jurcă, Maria Claudia; Kozma, Kinga; Petcheşi, CodruŢa Diana; Bembea, Marius; Pop, Ovidiu Laurean; MuŢiu, Gabriela; Coroi, Mihaela Cristiana; Jurcă, Alexandru Daniel; Dobjanschi, Luciana

2017-01-01

Dandy-Walker complex (DWC) is a malformative association of the central nervous system. DWC includes four different types: Dandy-Walker malformation (vermis agenesis or hypoplasia, cystic dilatation of the fourth ventricle and a large posterior fossa); Dandy-Walker variant (vermis hypoplasia, cystic dilatation of the fourth ventricle, normal posterior fossa); mega cysterna magna (large posterior fossa, normal vermis and fourth ventricle) and posterior fossa arachnoid cyst. We present and discuss four cases with different morphological and clinical forms of the Dandy-Walker complex. In all four cases, diagnosis was reached by incorporation of clinical (macrocephaly, seizures) and imaging [X-ray, computed tomography (CT), magnetic resonance imaging (MRI)] data. Two patients were diagnosed with Dandy-Walker complex, one patient was diagnosed with Dandy-Walker variant in a rare association with neurofibromatosis and one patient was diagnosed with a posterior fossa arachnoid cyst associated with left-sided Claude Bernard-Horner syndrome, congenital heart disease (coarctation of the aorta, mitral stenosis) and gastroesophageal reflux. In all forms of DWC, the clinical, radiological and functional manifestations are variable and require adequate diagnostic and therapeutic measures.

Age and Race Differences in Racial Stereotype Awareness and Endorsement

PubMed Central

Copping, Kristine E.; Kurtz-Costes, Beth; Rowley, Stephanie J.; Wood, Dana

2012-01-01

Age and race differences in race stereotype awareness and endorsement were examined in 382 Black and White fourth, sixth, and eighth graders. Youth reported their own beliefs and their perceptions of adults’ beliefs about racial differences in ability in two domains: academics and sports. Children’s own endorsement of race stereotypes was highly correlated with their perceptions of adults’ race stereotypes. Blacks reported stronger traditional sports stereotypes than Whites, and fourth- and sixth-grade Blacks reported roughly egalitarian academic stereotypes. At every grade level, Whites reported academic stereotypes that favored Whites, and sixth and eighth grade Whites reported sports stereotypes that favored Blacks. Results support the tenets of status theory and have implications for identity development and achievement motivation in adolescents. PMID:23729837

Determination of HIV Status in African Adults With Discordant HIV Rapid Tests.

PubMed

Fogel, Jessica M; Piwowar-Manning, Estelle; Donohue, Kelsey; Cummings, Vanessa; Marzinke, Mark A; Clarke, William; Breaud, Autumn; Fiamma, Agnès; Donnell, Deborah; Kulich, Michal; Mbwambo, Jessie K K; Richter, Linda; Gray, Glenda; Sweat, Michael; Coates, Thomas J; Eshleman, Susan H

2015-08-01

In resource-limited settings, HIV infection is often diagnosed using 2 rapid tests. If the results are discordant, a third tie-breaker test is often used to determine HIV status. This study characterized samples with discordant rapid tests and compared different testing strategies for determining HIV status in these cases. Samples were previously collected from 173 African adults in a population-based survey who had discordant rapid test results. Samples were classified as HIV positive or HIV negative using a rigorous testing algorithm that included two fourth-generation tests, a discriminatory test, and 2 HIV RNA tests. Tie-breaker tests were evaluated, including rapid tests (1 performed in-country), a third-generation enzyme immunoassay, and two fourth-generation tests. Selected samples were further characterized using additional assays. Twenty-nine samples (16.8%) were classified as HIV positive and 24 of those samples (82.8%) had undetectable HIV RNA. Antiretroviral drugs were detected in 1 sample. Sensitivity was 8.3%-43% for the rapid tests; 24.1% for the third-generation enzyme immunoassay; 95.8% and 96.6% for the fourth-generation tests. Specificity was lower for the fourth-generation tests than the other tests. Accuracy ranged from 79.5% to 91.3%. In this population-based survey, most HIV-infected adults with discordant rapid tests were virally suppressed without antiretroviral drugs. Use of individual assays as tie-breaker tests was not a reliable method for determining HIV status in these individuals. More extensive testing algorithms that use a fourth-generation screening test with a discriminatory test and HIV RNA test are preferable for determining HIV status in these cases.

Anatomical reconstruction of the fourth brachymetatarsia with one-stage iliac bone and cartilage cap grafting.

PubMed

Woo, Sang Hyun; Bang, Chi Young; Ahn, Hee-Chan; Kim, Sung-Jung; Choi, Jun-Young

2017-05-01

We present a one-stage procedure for lengthening the fourth brachymetatarsia with autogenous iliac bone and cartilage cap grafting for the anatomical reconstruction of the metatarsophalangeal (MTP) joint METHODS: During the last 8 years, 56 feet in 41 patients with congenital brachymetatarsia of the fourth toe were corrected with a one-stage operation to reposition the articular cartilage cap to the distal part of interpositional iliac bone graft at the metatarsal epiphysis. The length of the harvested iliac bone graft was 22.9 mm on average. The mean fixation period was 58.5 days, and the mean gain in length and percentage increase was 20.9 mm and 39%, respectively. MRI showed a stable MTP joint over viable cartilage cap in 83.3% of the cases. Mean postoperative American Orthopedic Foot and Ankle Society lesser MTP-interphalangeal score was 82.0. Neither neurovascular impairment nor recurrence of brachymetatarsia occurred in the mean follow-up period of 43.6 months. All patients were satisfied with the postoperative cosmetic results. Thirteen patients (23.2%) complained of limited active dorsiflexion of the fourth toe, and extensor adhesion was released by extensor tenolysis in only one patient. In a single case of nonunion at the bone graft site, additional surgery was not necessary. Anatomical reconstruction of the fourth brachymetatarsia with one-stage interpositional iliac bone and cartilage cap grafting resulted in excellent cosmetic results and a physiologic MTP joint, providing the benefits of one-stage lengthening with a low complication rate. Therapeutic, IV. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Dandy-Walker malformation: a rare association with hypoparathyroidism.

PubMed

Coban, Dilek; Akin, Mustafa Ali; Kurtoglu, Selim; Oktem, Suat; Yikilmaz, Ali

2010-12-01

Dandy-Walker malformation is characterized by cystic dilatation of the fourth ventricle and an enlarged posterior cranial fossa with upward displacement of the tentorium, lateral sinuses, and torcular, with agenesis or hypoplasia of the cerebellar vermis. Dandy-Walker malformation occurs in approximately the 4th week of gestation and is associated with various abnormalities involving the cardiac, skeletal, genitourinary, and gastrointestinal systems. The parathyroid gland also forms in the 3rd and 4th gestational weeks. Reported here is the case of a male infant with Dandy-Walker malformation with ventricular and atrial septal defect, unilateral renal agenesis, and hypoparathyroidism. To our knowledge, this rare association with neural crest events during the development of Dandy-Walker malformation has not been reported previously. Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved.

Japanese family with congenital factor VII deficiency.

PubMed

Sakakibara, Kanae; Okayama, Yoshiki; Fukushima, Kenji; Kaji, Shunsaku; Muraoka, Michiko; Arao, Yujiro; Shimada, Akira

2015-10-01

Congenital factor VII (FVII) deficiency is a rare bleeding disorder with autosomal recessive inheritance. The present female patient was diagnosed with congenital FVII deficiency because of low hepaplastin test (HPT), although vitamin K was given. Heterozygous p.A191T mutation was detected in the peripheral blood, and the same mutation was also found in the mother and sister. To the best of our knowledge, this is the fourth reported case of p.A191T mutation of FVII in the literature and the first to be reported in Japan. FVII coagulation activity (FVII:C) in asymptomatic heterozygous carriers is mildly reduced. Therefore, some patients may not be accurately diagnosed with congenital FVII deficiency. In infants with low HPT without vitamin K deficiency, congenital FVII deficiency should be considered. © 2015 Japan Pediatric Society.

Learning from Multiple Cases: A New Paradigm for Investigating the Effects of Clinical Experience on Knowledge Restructuring and Knowledge Acquisition.

ERIC Educational Resources Information Center

Boshuizen, Henny P. A.; Bongaerts, Maureen Machiels; van de Wiel, Margaretha W. J.; Schmidt, Henk G.

The effects of experience with a series of similar cases on the knowledge restructuring and learning from text were studied in a longitudinal design. Two groups of fourth-year medical students were confronted with a series of cases, part of them having the same underlying disease. The cases were interspersed with fillers, and each set of cases had…

Case Management and Rehabilitation Counseling: Procedures and Techniques. Fourth Edition

ERIC Educational Resources Information Center

Roessler, Richard T.; Rubin, Stanford E.

2006-01-01

"Case Management and Rehabilitation Counseling" discusses procedures that are useful to rehabilitation professionals working in many settings. Specifically, this book reviews the finer points relating to diagnosing, arranging services, monitoring program outcomes, arranging for placement, planning for accommodations, ethical decision making,…

Successful liver transplantation from donor with Plesiomonas shigelloides sepsis after freshwater drowning: case report and review of literature on gram-negative bacterial aspiration during drowning and utilization of organs from bacteremic donors.

PubMed

Bonatti, Hugo; Sifri, Costi; Sawyer, Robert G

2012-04-01

Plesiomonas shigelloides is a freshwater, non-fermentative gram-negative bacillus associated with diarrheal disease. Rare cases of invasive infection in human beings usually involve immunosuppressed individuals. We report a patient who underwent successful liver transplantation (LT) using a graft from a 14-year-old boy who had drowned in a freshwater lake. PUBMED was searched for both reported drowning victims with sepsis and outcomes of LT using organs from infected donors. Our patient received prophylactic piperacillin-tazobactam, which was switched to cefepime one day after transplantation when gram-negative bacteria grew in blood cultures of the donor. The next day, the organism was identified as P. shigelloides resistant to third- and fourth-generation cephalosporins; ciprofloxacin was given for seven days, and surveillance cultures remained negative. After an uneventful course the patient was discharged on day 10 after LT without signs of infection and is alive with a well-functioning graft. Literature review revealed one case of P. shigelloides in a potential allograft, in which the organism was isolated from heart valves of a drowning victim; the organs were discarded. Reports of freshwater drowning show that bacteremia is universally found post-mortem. Isolated pathogens correspond to specimens from the drowning site, with Aeromonas spp. being the most common and many other microorganisms described anecdotally. Livers from infected donors have been used, in most cases with good results if the recipient and, when possible, donor were treated appropriately; however, cases of fatal pathogen transmission have been reported. This is the first reported case of a LT using a graft from a donor with P. shigelloides sepsis. Drowning victims should be considered potentially infected with rare pathogens and therefore represent extended-criteria donors.

Online virtual-patient cases versus traditional problem-based learning in advanced pharmacy practice experiences.

PubMed

Al-Dahir, Sara; Bryant, Kendrea; Kennedy, Kathleen B; Robinson, Donna S

2014-05-15

To evaluate the efficacy of faculty-led problem-based learning (PBL) vs online simulated-patient case in fourth-year (P4) pharmacy students. Fourth-year pharmacy students were randomly assigned to participate in either online branched-case learning using a virtual simulation platform or a small-group discussion. Preexperience and postexperience student assessments and a survey instrument were completed. While there were no significant differences in the preexperience test scores between the groups, there was a significant increase in scores in both the virtual-patient group and the PBL group between the preexperience and postexperience tests. The PBL group had higher postexperience test scores (74.8±11.7) than did the virtual-patient group (66.5±13.6) (p=0.001). The PBL method demonstrated significantly greater improvement in postexperience test scores than did the virtual-patient method. Both were successful learning methods, suggesting that a diverse approach to simulated patient cases may reach more student learning styles.

Case Studies in a Physiology Course on the Autonomic Nervous System: Design, Implementation, and Evaluation

ERIC Educational Resources Information Center

Zimmermann, Martina

2010-01-01

The introduction of case studies on the autonomic nervous system in a fourth-semester physiology course unit for Pharmacy students is described in this article. This article considers how these case studies were developed and presents their content. Moreover, it reflects on their implementation and, finally, the reception of such a transformation…

Leadership Effectiveness and Instructional Supervision: The Case of the Failing Twin

ERIC Educational Resources Information Center

Bloom, Collette Madeleine

2011-01-01

This case study examines the leadership practices of an effective versus an ineffective elementary school principal. The background of this case involves two fourth grade teachers, each teaching one of a set of identical twins. Discrepancies in teaching and grading practices result in one twin failing. The decision-making choices of the principal…

Microbiology of third and fourth branchial pouch cysts.

PubMed

Pahlavan, Shane; Haque, Waqar; Pereira, Kevin; Larrier, Deidre; Valdez, Tulio A

2010-03-01

To identify the most common pathogens involved in infections of third and fourth branchial pouch cysts. Third and fourth branchial pouch cyst infections are an uncommon cause of anterior neck abscesses often confused with other entities, such as thyroglossal duct cysts and thyroid abscesses leading to misdiagnosis, recurrence, and increased morbidity related to a delay in diagnosis and appropriate treatment. Retrospective chart and literature review. Retrospective chart review case series of patients presenting to the Bobby R. Alford Department of Otolaryngology at Texas Children's Hospital from July 2004 to July 2008 with third and fourth branchial pouch cysts. A total of 11 patients were identified. All patients had left-sided lesions. Eikenella corrodens was found in 60% of cultures and was the most common organism identified in our patient group. Furthermore, 56% of the organisms isolated were anaerobic. All organisms with the exception of Staphylococcus aureus were identified as oral cavity flora. Third and fourth branchial pouch cysts provide a communication between the neck and the oral cavity through pyriform sinus tracts. The presence of oral cavity flora in a left anterior neck abscess should raise the suspicion of a branchial pouch anomaly, and subsequently alter therapeutic management.

[Diagnosis and surgical operation for fourth branchial cleft anomalies].

PubMed

Zhu, Ting; Hua, Qingquan

2011-11-01

To explore diagnosis and surgical operation through analyzing clinical features of the fourth branchial cleft anomalies. Clinical materials of 10 patients with the fourth branchial cleft anomalies were retrospectively analyzed, and literatures were studied to explore the diagnosis, differential diagnosis and treatment methods of surgical operation; lesions of 10 patients were completely removed by surgical operation, and internal sinus was properly handled. All 10 cases were cured, no recurrence were observed during a follow-up of 1-3 years. 1 patient appeared low voice, and drinking cough, back to normality after 2 weeks; 1 patient appeared paralysis of left hypoglossal nerves, back to normality after 3 months. Recurrent deep neck abscess and chronic sinus infections of anterior area in the lower part of neck should be considered with the diagnosis of the fourth branchial cleft anomalies. Enhanced neck CT scan and barium sulfate meal examination aid to diagnosis, pathological examination can be confirmed. Complete surgical removal of lesions is an effective treatment of fourth branchial cleft anomalies, knowing of the courses of internal sinus and spread of infection, and use of principle of selective neck dissection is the key to ensure complete removal of lesions.

Case Studies for Management Development in Bangladesh. Fourth Book. Parepared for the World Bank/Bangladesh Management Education and Training Project.

ERIC Educational Resources Information Center

McLean, Gary N.

This document contains five case studies of management and finance situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. One to four discussion questions follow each case study. The titles and authors of the case studies on management are: "Azir Ahmed & Co.,…

Cytological Diagnosis of Primary Thyroid Tuberculosis.

PubMed

Goyal, P; Mittal, D; Ghosh, S; Agrawal, D; Sehgal, S; Singh, S

2015-01-01

Primary thyroid tuberculosis is an extremely rare disease, even in countries where other forms of tuberculosis are abundant. TT has no age bar but usually affects women in fourth and fifth decade. Hereby, we report a case of 16-years-old girl presented with complaint of progressively increasing, painful thyroid swelling. Diagnosis of TT was made on cytology and there was no evidence of involvement of any other organ by tuberculosis. Despite of its rarity, TT is usually misdiagnosed. So, a clinician should always consider this entity in the differential diagnosis of thyroid swelling. Fine needle aspiration cytology is the best diagnostic method and can result in the avoidance of unnecessary thyroid surgeries.

Endoscopic transaqueductal placement of a single-catheter cyst-ventriculoperitoneal shunt in a neonate with Dandy-Walker malformation-associated hydrocephalus: case report.

PubMed

Morigaki, Ryoma; Pooh, Kyong-Hon; Nakagawa, Yoshinobu

2011-01-01

A neonate with hydrocephalus associated with Dandy-Walker malformation was successfully treated with an endoscopic placement of a transaqueductal ventricular single catheter. The modified catheter was provided with additional fenestration on its proximal side to allow simultaneous drainage from both the supra- and infratentorial compartments. This technique is well known for isolated fourth ventricles, but has not been applied to hydrocephalus associated with Dandy-Walker malformation. The cyst-ventriculoperitoneal shunt effectively drained both compartments. The patient was doing well 18 months after the surgical procedure. Endoscopic transaqueductal shunt placement can be considered, especially in patients with aqueductal patency.

Recurrent infarctions due to a dome-shaped pannus above the mitral valve prosthesis

PubMed Central

Inoue, Yoshito; Suzuki, Satoru

2016-01-01

This report describes a unique case of a 56-year-old female who suffered from recurrent stroke after double mechanical valve replacement. During the four years after the surgery, she remained in normal sinus rhythm, received adequate anticoagulation therapy, and no apparent left atrial thrombus was detected. She underwent redo surgery to prevent further stroke after fourth instance of cerebral infarction. Intraoperative findings revealed a ‘dome-shaped’ pannus formation covering the sewing ring of the mitral prosthesis circumferentially, probably leading to clot formation and repeated infarctions. She has been stroke free for three years after pannus resection. PMID:26904241

Eosinophilic Pustular Folliculitis in Children after Stem Cell Transplantation: An Eruption Distinct from Graft-Versus-Host Disease.

PubMed

Theiler, Martin; Oza, Vikash S; Mathes, Erin F; Dvorak, Christopher C; McCalmont, Timothy H; Yeh, Iwei; Sidbury, Robert; Cordoro, Kelly M

2017-05-01

Eosinophilic pustular folliculitis (EPF) is a rare cutaneous disorder that typically occurs in three clinical contexts: men, individuals who are immunosuppressed or have human immunodeficiency virus, and infants. A fourth subtype occurring 2 to 3 months after hematopoietic stem cell transplantation (HSCT) has recently been described in several adults. We report two cases of EPF arising in children after HSCT. It is important to recognize this form of EPF after HSCT and differentiate it from graft-versus-host disease since it responds readily to topical steroids and appears to have an excellent prognosis. © 2017 Wiley Periodicals, Inc.

The atmospheric effects of stratospheric aircraft: A fourth program report

NASA Technical Reports Server (NTRS)

Stolarski, Richard S. (Editor); Wesoky, Howard L. (Editor); Wofsy, Steven C.; Ravishankara, A. R.; Rodriguez, Jose M.; Grose, William L.

1995-01-01

This document presents the fourth report from the Atmospheric Effects of Stratospheric Aircraft (AESA) component of NASA's High-Speed Research Program (HSRP). Market and technology considerations continue to provide an impetus for high-speed civil transport research. A recent AESA interim assessment report and a review of that report have shown that considerable uncertainty still exists about the possible impact of aircraft on the atmosphere. The AESA has been designed to develop the body of scientific knowledge necessary for the evaluation of the impact of stratospheric aircraft on the atmosphere. The first Program report presented the basic objectives and plans for AESA. This fourth report comes after the interim assessment and sets forth directions for the 1995 assessment at the end of AESA Phase 1. It also sets forth the goals and directions for AESA Phase 2, as reported at the 1994 Atmospheric Effects of Aviation Project (AEAP) annual meeting held in June. The focus of the Phase 2 effort is to obtain the best possible closure on the outstanding problems identified in the interim assessment and NASA/NRC review. Topics discussed in this report include how high-speed civil transports (HSCT) might affect stratospheric ozone, emissions scenarios and databases to assess potential atmospheric effects from HSCT's, calculated results from 2-D zonal mean models using emissions data, engine trace constituent measurements.

Bully Prevention in Positive Behavior Support: Preliminary Evaluation of Third-, Fourth-, and Fifth-Grade Attitudes toward Bullying

ERIC Educational Resources Information Center

Ross, Scott W.; Horner, Robert H.

2014-01-01

The current pilot study demonstrates the potential of adding simple and efficient bully prevention strategies to already established School-Wide Positive Behavior Interventions and Supports. The self-report surveys of third-, fourth-, and fifth-grade students from three elementary schools evaluated the relationship between the implementation of…

Fourth Five-Year Plan, 1969-1974. Draft.

ERIC Educational Resources Information Center

Planning Commission, New Delhi (India).

This document is an English language abstract (approximately 1,500 words) of the Fourth Indian Five Year Plan Report, Chapter 15, which deals with Education and Manpower. India's tasks in providing educational facilities for children in the 6-14 age group are immense. Only about 60% of that age group are in school today. The Plan refers to this…

Embedding EfS in Teacher Education through a Multi-Level Systems Approach: Lessons from Queensland

ERIC Educational Resources Information Center

Evans, Neus; Ferreira, Jo-Anne; Davis, Julie; Stevenson, Robert B.

2016-01-01

This article reports on the fourth stage of an evolving study to develop a systems model for embedding education for sustainability (EfS) into preservice teacher education. The fourth stage trialled the extension of the model to a comprehensive state-wide systems approach involving representatives from all eight Queensland teacher education…

Substance Use by Fourth-Year Students at 13 U.S. Medical Schools.

ERIC Educational Resources Information Center

Conard, Scott; And Others

1988-01-01

A study investigated drug use by fourth-year medical students in 13 schools and compared drug use patterns with those of an age- and sex-matched cohort. Medical students reported less use of marijuana, cocaine, cigarettes, LSD, barbiturates, and amphetamines, similar use of opiates, and slightly more use of tranquilizers and alcohol. (MSE)

Fourth-order acoustic torque in intense sound fields

NASA Technical Reports Server (NTRS)

Wang, T. G.; Kanber, H.; Olli, E. E.

1978-01-01

The observation of a fourth-order acoustic torque in intense sound fields is reported. The torque was determined by measuring the acoustically induced angular deflection of a polished cylinder suspended by a torsion fiber. This torque was measured in a sound field of amplitude greater than that in which first-order acoustic torque has been observed.

Income and Expenditures of Families with a Baby.

ERIC Educational Resources Information Center

Lino, Mark

1991-01-01

Studies real household income after the birth of a baby reporting median child care expenses were zero in first and $6 in fourth quarter; mean expenses in fourth quarter were $210. Fertility rate of women aged 18-44 without high school education who had baby in 1988 was 87, compared to 63 for women with college degree. (LB)

Hawaii State Senior Center. Fourth Annual Report, July 1, 1972 to June 30, 1973.

ERIC Educational Resources Information Center

Hawaii State Senior Center, Honolulu.

The activities of the Hawaii State Senior Center during its fourth year of operation are discussed. The center, which is sponsored by the Honolulu Community College, provides health services, counseling, adult education, community service, and recreation and leisure-time activities. Enrolled membership of the center is 1,776. This annual report…

A rare case of hepatic duct injury from blunt abdominal trauma.

PubMed

Hasaniya, Nahidh W; Premaratne, Shyamal; Premaratne, Ishani D; McNamara, J Judson

2013-01-01

A 25 year-old male was brought to the emergency room following an apparent suicide attempt by jumping from the fourth floor. Patient had a large abdominal laceration in the right upper quadrant (RUQ). CT scan showed a sub-scapular hematoma of the liver. Due to the repeated episodes of hypotension, a laporotomy was performed and the left hepatic artery was ligated while the ductal injury was managed with a Roux-en-Y left hepatic jejunostomy and stent. Bile leakage was resolved post-operatively by day 5 and the patient was discharged home on day 13 after clearance from psychiatry. While non-iatrogenic extrahepatic biliary trauma is rare, a high degree of suspicion is essential, especially in cases like the one discussed in this report. Diagnosis can be difficult in patients undergoing observation.

Unusual presentation of pheochromocytoma: thirteen years of anxiety requiring psychiatric treatment.

PubMed

Alguire, Catherine; Chbat, Jessica; Forest, Isabelle; Godbout, Ariane; Bourdeau, Isabelle

2018-01-01

Pheochromocytoma is a rare tumor of the adrenal gland. It often presents with the classic triad of headache, palpitations and generalized sweating. Although not described as a typical symptom of pheochromocytoma, anxiety is the fourth most common symptom reported by patients suffering of pheochromocytoma. We report the case of a 64 year old man who had severe anxiety and panic disorder as presenting symptoms of pheochromocytoma. After 13 years of psychiatric follow-up, the patient was diagnosed with malignant pheochromocytoma. After surgical resection of his pheochromocytoma and his hepatic metastases, the major panic attacks completely disappeared, the anxiety symptoms improved significantly and the psychiatric medications were stopped except for a very low maintenance dose of venlafaxine. We found in our cohort of 160 patients with pheochromocytoma 2 others cases of apparently benign tumors with severe anxiety that resolved after pheochromocytoma resection. These cases highlight that pheochromocytoma should be included in the differential diagnosis of refractory anxiety disorder. Anxiety and panic disorder may be the main presenting symptoms of pheochromocytoma.The diagnosis of pheochromocytoma should be excluded in cases of long-term panic disorder refractory to medications since the anxiety may be secondary to a catecholamine-secreting tumor.Surgical treatment of pheochromocytoma leads to significant improvement of anxiety disorders.

The Savannah River Site`s Groundwater Monitoring Program. Fourth quarter, 1989

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

Not Available

1989-12-31

The Environmental Monitoring Section of the Environmental and Health Protection (EHP) Department administers the Savannah River Site`s Groundwater Monitoring Program. During fourth quarter 1989 (October--December), EHP conducted routine sampling of monitoring wells and drinking water locations. EHP collected the drinking water samples from Savannah River Site (SRS) drinking water systems supplied by wells. EHP established two sets of flagging criteria in 1986 to assist in the management of sample results. The flagging criteria aid personnel in sample scheduling, interpretation of data, and trend identification. An explanation of flagging criteria for the fourth quarter is presented in the Flagging Criteria sectionmore » of this document. All analytical results from fourth quarter 1989 are listed in this report, which is distributed to all waste-site custodians.« less

Bilateral Abducent Nerve Palsy After Neck Trauma: A Case Report

PubMed Central

Aminiahidashti, Hamed; Shafiee, Sajad; Sazegar, Mohammad; Nosrati, Nazanin

2016-01-01

Introduction The abducent nucleus is located in the upper part of the rhomboid fossa beneath the fourth ventricle in the caudal portion of the pons. The abducent nerve courses from its nucleus, to innervate the lateral rectus muscle. This nerve has the longest subarachnoid course of all the cranial nerves, it is the cranial nerve most vulnerable to trauma. It has been reported that 1% to 2.7% of all head injuries are followed by unilateral abducent palsy, but bilateral abducent nerve palsy is extremely rare. Case Presentation A 65-year-old woman presented to the emergency department following a motor vehicle accident. A neurological assessment showed the patient’s Glascow coma scale (GCS) to be 15. She complained of double vision, and we found lateral gaze palsy in both eyes. A hangman fracture type IIA (C2 fracture with posterior ligamentous C1 - C2 distraction) was found on the cervical CT scan. A three-month follow-up of the patient showed complete recovery of the abducent nerve. Conclusions Conservative treatment is usually recommended for traumatic bilateral abducent nerve palsy. Our patient recovered from this condition after three months without any remaining neurological deficit, a very rare outcome in a rare case. PMID:27218062

Lightning and transportation.

PubMed

Cherington, M

1995-12-01

It is a little-known fact that lightning casualties often involve travel or transportation. López and colleagues, in their studies on the epidemiology of lightning injuries, have reported that 10% of lightning injuries are categorized under transportation. In the majority of their cases, victims were struck while standing outside or near their vehicles during a thunderstorm. During my review of the neurologic complications of lightning injuries, I was impressed by the number of case reports in which the victim was struck while either in or near a vehicle, airplane or vessel. In this article, I shall put forth information on four aspects of lightning that relate to the danger to people traveling in vehicles, boats, and airplanes. First, I shall deal with lightning safety on ships and boats. People who enjoy recreational sailing, including the "weekend sailor" and those who enjoy fishing from a boat, should be fortified with knowledge about lightning protection. Second, I shall consider the matter of lightning strikes to aircraft. In the third section, I shall discuss the question of lightning safety in automobiles. Fourth, I shall review those cases found in my literature review in which the victim was struck while in or near a vehicle, boat, or airplane.

Contemporary occurrence of hydrocephalus and Chiari I malformation in sagittal craniosynostosis. Case report and review of the literature.

PubMed

Sgulò, Francesco Giovanni; Spennato, Pietro; Aliberti, Ferdinando; Di Martino, Giuliana; Cascone, Daniele; Cinalli, Giuseppe

2017-01-01

Chiari malformation type I (CM-I) and hydrocephalus are often associated with complex craniosynostosis. On the contrary, their simultaneous occurrence in monosutural synostosis is extremely rare. The pathophysiological hypothesis is that they may alter posterior fossa growth and lead to cerebellar tonsil herniation also without skull base primary involvement. Hydrocephalus is multifactorial and may be secondary to fourth ventricle outlet obstruction. The management of these cases is quite complex and not well defined. Cranial vault remodeling should be the only treatment when CM-I is asymptomatic and not related to syringomyelia. Suboccipital decompression should be reserved only in complicated CM-I, usually as a second surgical step following the correction of the supratentorial deformity. In our opinion, the associated hydrocephalus should be treated first in order to normalize intracranial hypertension before opening the cranial sutures. We report the case of a 26-month-old child that presented with sagittal craniosynostosis, hydrocephalus, and CM-I. He was managed by performing endoscopic third ventriculostomy (ETV) first and cranial vault remodeling thereafter. Clinico-radiological outcome was very satisfying. Concerning literature is reviewed; physiopathology and surgical management are discussed.

Juvenile xanthogranuloma: a case report and review of the literature

PubMed Central

2014-01-01

Background Juvenile xanthogranuloma is a rare disorder which may be present at birth, or appears in infancy. It can also occur in adults of all ages; appears with lesions that may be solitary or multiple nodules several millimeters in diameter. The predilection sites are head and neck, but it may occur on the extremities and trunk also. There can also be involved internal organs such as lung, kidney, gastrointestinal tract, etc. The most frequent extracutaneous location is the eye. Case presentation We report a case of juvenile xanthogranuloma in a male child with onset in the fourth month of life. He presented with a nodule 8 millimeters in diameter, tan-orange in color, ulcerated in the centre, located on the left corner of the left eye. A biopsy without total excision was performed. After the biopsy, the nodule enlarged to 1.5 cm in diameter and became haemorrhagic. The histologic evaluation and immunohistochemistry analysis resulted in the diagnosis of juvenile xanthogranuloma. For aesthetic reasons the nodule was removed by surgical resection. Conclusion Juvenile xanthogranuloma is on a spectrum of histiocytic disorders, which is necessary to differentiate from maligniances in childhood by biopsy. PMID:24666806

Symmetries and integrability of a fourth-order Euler-Bernoulli beam equation

NASA Astrophysics Data System (ADS)

Bokhari, Ashfaque H.; Mahomed, F. M.; Zaman, F. D.

2010-05-01

The complete symmetry group classification of the fourth-order Euler-Bernoulli ordinary differential equation, where the elastic modulus and the area moment of inertia are constants and the applied load is a function of the normal displacement, is obtained. We perform the Lie and Noether symmetry analysis of this problem. In the Lie analysis, the principal Lie algebra which is one dimensional extends in four cases, viz. the linear, exponential, general power law, and a negative fractional power law. It is further shown that two cases arise in the Noether classification with respect to the standard Lagrangian. That is, the linear case for which the Noether algebra dimension is one less than the Lie algebra dimension as well as the negative fractional power law. In the latter case the Noether algebra is three dimensional and is isomorphic to the Lie algebra which is sl(2,R). This exceptional case, although admitting the nonsolvable algebra sl(2,R), remarkably allows for a two-parameter family of exact solutions via the Noether integrals. The Lie reduction gives a second-order ordinary differential equation which has nonlocal symmetry.

Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case

DTIC Science & Technology

1992-10-01

Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case. This study... management information system to automate manual Naval aviation maintenance tasks-NALCOMIS. With the use of a fourth-generation programming language

Dorsal slab fracture of the fourth carpal bone in a racing greyhound.

PubMed

Rutherford, Scott; Ness, Malcolm G

2012-11-01

To report the diagnosis and surgical management of a dorsal slab fracture of the fourth carpal bone in a racing greyhound. Clinical report. Three-year-old, male racing Greyhound. The fracture was not visible on orthogonal radiographs and the diagnosis was made by computed tomography. Open reduction and internal fixation with 2 countersunk 2.0-mm screws inserted in lag fashion was performed via a dorsal approach. Outcome was analyzed objectively by comparing preinjury and postsurgery racing performances. Internal fixation resulted in fracture healing and the dog returned to racing recording times similar to those before injury. Fractures of the fourth carpal bone may not be visible on standard orthogonal radiographic views and cross-sectional imaging may be required for more accurate identification. Surgical management was successful with the dog returning to preinjury levels of competition. © Copyright 2012 by The American College of Veterinary Surgeons.

Congenital Tracheobronchomegaly (Mounier-Kuhn Syndrome) in a Woman with Human Immunodeficiency Virus: A Case Report.

PubMed

Fletcher, Amanda; Stowell, Justin; Jamoulis, Socrates

2017-04-04

Congenital tracheobronchomegaly (Mounier-Kuhn Syndrome, MKS) is a rare idiopathic disorder characterized by dilation of the central airways, including the trachea and first through fourth order bronchi. MKS disproportionately affects men and results in chronic respiratory tract infections. The diagnosis is made through the synthesis of clinical and radiological data. Here we report a unique case of MKS in a patient with human immunodeficiency virus (HIV) infection. A 45-year-old African American woman with a past medical history of HIV, tobacco and recreational drug abuse, chronic obstructive pulmonary disease, sleep apnea, and a 15-year history of recurrent respiratory infections presented with dyspnea, wheezing, a productive cough, increased yellow-green sputum production, and subjective fevers. Computerized tomography (CT) of the chest revealed striking dilation of the trachea and central bronchi. Fiberoptic bronchoscopy demonstrated a dilated trachea and bronchial tree with complete collapse of the trachea and bilateral mainstem bronchi during expiration. Serial imaging over 14 years allowed the radiologist to confidently diagnose her underlying disorder and recommend appropriate clinical management, which included mucolytics, chest physiotherapy, prophylactic vaccinations, and antibiotics during infectious exacerbations. To the best of our knowledge, there is only one reported case of MKS in the setting of HIV in the English literature. We report the second such case and outline the clinical presentation, diagnostic criteria, and management of MKS with the hope that increased awareness will prevent delayed or misdiagnosis for patients with MKS. This case highlights the common diagnostic delay for MKS and the need to include MKS in the differential diagnosis of recurrent respiratory tract infections.

Autoerotic deaths: four cases.

PubMed

Cooke, C T; Cadden, G A; Margolius, K A

1994-07-01

We describe the circumstances and post mortem medical findings of 4 unusual fatalities where death occurred during autoerotic practice. Three cases occurred in young to middle-aged men--hanging, electrocution and inhalation of a zucchini. The manner of death in each was accidental. The fourth case was an elderly man who died of ischemic heart disease, apparently whilst masturbating with a vacuum cleaner and a hair dryer.

A Failure To Reproduce the Intermediate Effect in Clinical Case Recall.

ERIC Educational Resources Information Center

van de Wiel, Margaretha W. J.; And Others

In an attempt to replicate an earlier study by H. G. Schmidt, H. P. A. Boshuizen, and P. P. M. Hobus (1988), 96 students and physicians at the University of Limburg (Netherlands) studied 4 clinical cases, produced a diagnosis, and recalled each case. Subjects were 24 second-year, 24 fourth-year, and 24 sixth-year medical students and 24 internists…

A Research Study to Determine the Effects of Early Keyboard Use upon Student Development in Occupational Keyboarding. Final Report of Research.

ERIC Educational Resources Information Center

Warwood, Byrdeen; And Others

Before students can use microcomputers effectively, they need keyboarding skills. A project was conducted in Montana to teach keyboarding to fourth-grade children using computer-assisted instruction. Two fourth-grade classes at Hawthorne Elementary School, Bozeman, Montana, participated in an 8-week, 32-session elementary keyboarding pilot…

The Relationships between Indonesian Fourth Graders' Difficulties in Fractions and the Opportunity to Learn Fractions: A Snapshot of TIMSS Results

ERIC Educational Resources Information Center

Wijaya, Ariyadi

2017-01-01

This paper reports an exploration into Indonesian fourth graders' difficulties in fractions and their relation to the opportunity to learn fractions students got at schools. The concept of "opportunity to learn" is often considered as a framework to investigate possible reasons for students' difficulties. The data for this study was…

Research Reports from the Fourth and Fifth National Conferences on Diagnostic and Prescriptive Mathematics. 1980 Research Monograph. Revised Third Edition.

ERIC Educational Resources Information Center

Romberg, Thomas A., Ed.

This document contains 15 research papers presented at the Fourth and Fifth Annual Conferences of the Research Council for Diagnostic and Prescriptive Mathematics. The papers are organized into four sections. In part I, four position papers by Romberg, Engelhardt, Ashlock, and Heddens reflect research ideas which underlie the Council. Part II…

Simultaneous and sequential hemorrhage of multiple cerebral cavernous malformations: a case report.

PubMed

Louis, Nundia; Marsh, Robert

2016-02-09

The etiology of cerebral cavernous malformation hemorrhage is not well understood. Causative physiologic parameters preceding hemorrhagic cavernous malformation events are often not reported. We present a case of an individual with sequential simultaneous hemorrhages in multiple cerebral cavernous malformations with a new onset diagnosis of hypertension. A 42-year-old white man was admitted to our facility with worsening headache, left facial and tongue numbness, dizziness, diplopia, and elevated blood pressure. His past medical history was significant for new onset diagnosis of hypertension and chronic seasonal allergies. Serial imaging over the ensuing 8 days revealed sequential hemorrhagic lesions. He underwent suboccipital craniotomy for resection of the lesions located in the fourth ventricle and right cerebellum. One month after surgery, he had near complete resolution of his symptoms with mild residual vertigo but symptomatic chronic hypertension. Many studies have focused on genetic and inflammatory mechanisms contributing to cerebral cavernous malformation rupture, but few have reported on the potential of hemodynamic changes contributing to cerebral cavernous malformation rupture. Systemic blood pressure changes clearly have an effect on angioma pressures. When considering the histopathological features of cerebral cavernous malformation architecture, changes in arterial pressure could cause meaningful alterations in hemorrhage propensity and patterns.

Acute pancreatitis with saw palmetto use: a case report.

PubMed

Bruminhent, Jackrapong; Carrera, Perliveh; Li, Zhongzhen; Amankona, Raymond; Roberts, Ingram M

2011-08-25

Saw palmetto is a phytotherapeutic agent commercially marketed for the treatment of benign prostatic hyperplasia. Evidence suggests that saw palmetto is a safe product, and mild gastrointestinal adverse effects have been reported with its use. We report a case of acute pancreatitis, possibly secondary to the use of saw palmetto. A 61-year-old Caucasian man with a history of benign prostatic hyperplasia and gastroesophageal reflux disease developed epigastric pain associated with nausea 36 hours prior to presentation. He denied drinking alcohol prior to the development of his symptoms. His home medications included saw palmetto, lansoprazole and multivitamins. Laboratory results revealed elevated lipase and amylase levels. An abdominal ultrasound demonstrated a nondilated common bile duct, without choledocholithiasis. Computed tomography of his abdomen showed the pancreatic tail with peripancreatic inflammatory changes, consistent with acute pancreatitis. Our patient's condition improved with intravenous fluids and pain management. On the fourth day of hospitalization his pancreatic enzymes were within normal limits: he was discharged home and advised to avoid taking saw palmetto. It is our opinion that a relationship between saw palmetto and the onset of acute pancreatitis is plausible, and prescribers and users of saw palmetto should be alert to the possibility of such adverse reactions.

The Dandy-Walker malformation. A review of 40 cases.

PubMed

Hirsch, J F; Pierre-Kahn, A; Renier, D; Sainte-Rose, C; Hoppe-Hirsch, E

1984-09-01

Forty cases of Dandy-Walker malformation referred to the Hôpital Necker Enfants-Malades between 1969 and 1982 have been reviewed. The incidence of the malformation in hydrocephalus was 2.4%. There was a slight, statistically insignificant, female prevalence. Hydrocephalus should not be included in the definition of the syndrome. In 80% of the cases, it was actually a post-natal complication of the malformation and most often developed within 3 months after birth. In 80% of the cases, a communication, although insufficient, was found between the dilated 4th ventricle and the subarachnoid space. Since this communication is probably established through the foramina of Luschka, the definition of the Dandy-Walker malformation should only include atresia of the foramen of Magendie. Associated brain and systemic malformations were numerous. Among facial anomalies, facial angiomas were found in 10% of our cases. The association of facial and cardiovascular anomalies favors the hypothesis that the onset of the malformation occurs between the formation and the migration of the cells of the neural crest (that is, between the 3rd and the 4th post-ovulatory week, earlier than previously thought). Except in selected patients, membrane excision has a high rate of failure and should be abandoned. Cyst-peritoneal shunting avoids the risk of an entrapped fourth ventricle and is presently the best surgical procedure. The overall mortality in this series was 12.5%. Intelligence quotients were over 80 in 60% of the patients. Other studies will be necessary to understand why the communication between the fourth ventricle and the subarachnoid spaces, sufficient in utero, usually becomes insufficient for a normal cerebrospinal fluid (CSF) circulation in the first months following birth. Two hypotheses are discussed: a change in CSF circulation, or bleeding in the dilated fourth ventricle during delivery.

Treatment of Leptomeningeal Carcinomatosis in a Patient with Metastatic Pancreatic Cancer: A Case Report and Review of the Literature

PubMed Central

Johnson, William Rainey; Theeler, Brett J.; Van Echo, David; Young, Patrick; Kwok, Mary

2018-01-01

Pancreatic cancer is the fourth leading cause of cancer-related death with a median survival of 3–11 months when metastatic. We present a patient with metastatic pancreatic cancer and an exceptional response to initial systemic chemotherapy with FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin). Despite evidence of disease control on body imaging, he developed symptomatic leptomeningeal disease and brain metastases 29 months into treatment. He received aggressive treatment with capecitabine and irinotecan, intrathecal topotecan, and eventually bevacizumab. He did well for 36 weeks on this regimen until developing sepsis. This patient significantly outlived his expected survival and, moreover, did so with very good quality of life. This case demonstrates the natural history of pancreatic cancer progressing to involve the central nervous system when systemic disease is otherwise responsive to chemotherapy. It is the first case to demonstrate the potential effectiveness of intrathecal topotecan in combination with systemic chemotherapy for the treatment of leptomeningeal metastases of pancreatic cancer. PMID:29867436

Virological and serological analysis of a recent Middle East respiratory syndrome coronavirus infection case on a triple combination antiviral regimen.

PubMed

Spanakis, Nikolaos; Tsiodras, Sotirios; Haagmans, Bart L; Raj, V Stalin; Pontikis, Kostantinos; Koutsoukou, Antonia; Koulouris, Nikolaos G; Osterhaus, Albert D M E; Koopmans, Marion P G; Tsakris, Athanassios

2014-12-01

Serological, molecular and phylogenetic analyses of a recently imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) in Greece are reported. Although MERS-CoV remained detectable in the respiratory tract secretions of the patient until the fourth week of illness, viraemia was last detected 2 days after initiation of triple combination therapy with pegylated interferon, ribavirin and lopinavir/ritonavir, administered from Day 13 of illness. Phylogenetic analysis of the virus showed close similarity with other human MERS-CoVs from the recent Jeddah outbreak in Saudi Arabia. Immunoglobulin G (IgG) titres peaked 3 weeks after the onset of illness, whilst IgM levels remained constantly elevated during the follow-up period (second to fifth week of illness). Serological testing confirmed by virus neutralisation assay detected an additional case that was a close contact of the patient. Copyright © 2014. Published by Elsevier B.V.

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE); a rare association with phyllodes tumour of breast.

PubMed

Sarkar, R N; Phaujdar, Sibaji; Banerjee, Siwalik; Siddhanta, Sattik; De, Dibyendu; Bhattachary, Kuntal; Pal, Hare Krishna

2012-04-01

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare entity mainly found in elderly males. It is characterized by pitting edema mainly of dorsum of both hands giving a "boxing glove hand" appearance; rarely involving feet also, acute in onset, negative rheumatoid factor and a good response to low dose corticosteroid therapy. Clinically it almost resembles a case of polymyalgia rheumatica, late onset rheumatoid arthritis or other seronegative spondyloarthropathy.Though there are multiple underlying factors causing this rare entity but it has very close associations with many malignancies.So far its association with solid tumours and hematological malignancies has been reported. Phyllodes tumour of breast shows wide spectrum of activity from a benign condition to a locally aggressive and sometimes metastatic tumour.One fourth of the cases recur after definitive treatment.Our case represent an unusual association with recurrent phyllodes tumour of breast with RS3PE.

[New toxicity of fotemustine: diffuse interstitial lung disease].

PubMed

Bertrand, M; Wémeau-Stervinou, L; Gauthier, S; Auffret, M; Mortier, L

2012-04-01

Fotemustine is an alkylating cytostatic drug belonging to the nitrosourea family and is used in particular in the treatment of disseminated malignant melanoma. Herein, we report a case of interstitial lung disease associated with fotemustine. An 81-year-old man treated with fotemustine for metastatic melanoma presented acute interstitial lung disease 20 days after a fourth course of fotemustine monotherapy. The condition regressed spontaneously, with the patient returning to the clinical, radiological and blood gas status that had preceded fotemustine treatment. After other potential aetiologies had been ruled out, acute fotemustine-induced lung toxicity was considered and this treatment was definitively withdrawn. Other cytostatic agents belonging to the nitrosourea family can cause similar pictures, with a number of cases of interstitial lung disease thus being ascribed to fotemustine and dacarbazine. To our knowledge, this is the first case of interstitial lung disease induced by fotemustine monotherapy. This diagnosis should be considered where respiratory signs appear in melanoma patients undergoing fotemustine treatment. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

De novo development of a cerebral arteriovenous malformation following radiation therapy: Case report and an update to classical arteriovenous malformation nomenclature.

PubMed

Koch, Matthew J; Agarwalla, Pankaj K; Stapleton, Christopher J; Ogilvy, Christopher S; Loeffler, Jay S

2016-06-01

Cerebral arteriovenous malformations (AVM) are traditionally considered primary congenital lesions that result from embryological aberrations in vasculogenesis. Recent insights, however, suggest that these lesions may be secondary to a vascular insult such as ischemia or trauma. Herein, the authors present a rare case of a secondary cerebral AVM, occurring in a young girl who received prior cranial radiation therapy. At age 3years, she underwent surgical resection, chemotherapy, and photon radiation therapy for treatment of a fourth ventricular ependymoma. At age 19years, she developed new onset seizures and was found to have a left medial temporal lobe AVM. Her seizures were managed successfully with anti-epileptic medications and the AVM was treated with proton radiation therapy. This case highlights a rare but possible vascular sequela of radiation therapy and adds to the growing body of evidence that cerebral AVM may arise as secondary lesions. Copyright © 2015 Elsevier Ltd. All rights reserved.

SRM attrition rate study of the aft motor case segments due to water impact cavity collapse loading

NASA Technical Reports Server (NTRS)

Crockett, C. D.

1976-01-01

The attrition assessment of the aft segments of Solid Rocket Motor due to water impact requires the establishment of a correlation between loading occurrences and structural capability. Each discrete load case, as identified by the water impact velocities and angle, varies longitudinally and radially in magnitude and distribution of the external pressure. The distributions are further required to be shifted forward or aft one-fourth the vehicle diameter to assure minimization of the effect of test instrumentation location for the load determinations. The asymmetrical load distributions result in large geometric nonlinearities in structural response. The critical structural response is progressive buckling of the case. Discrete stiffeners have been added to these aft segments to aid in gaining maximum structural capability for minimum weight addition for resisting these loads. This report presents the development of the attrition assessment of the aft segments and includes the rationale for eliminating all assessable conservatisms from this assessment.

Congenital band syndrome with pseudarthrosis of the radius and ulna and impending vascular compromise: a case report.

PubMed

Ho, Christine A; Richards, B Stephens; Ezaki, Marybeth

2014-09-01

Although amniotic band syndrome is relatively rare, reports of pseudarthrosis in conjunction with amniotic band syndrome are even rarer, as are reports of impending vascular compromise in the neonatal period. Careful serial examinations and timely surgical intervention can successfully avoid the catastrophic event of limb loss. We report on a case of upper extremity amniotic band syndrome with pseudarthrosis of the radius and ulna that was complicated by vascular compromise in a neonate. Chart and radiographic data for this single case were reviewed and reported retrospectively. A 1-day-old neonate born at 28 3/7 weeks of gestational age was transferred to our institution for increased swelling to the forearm distal to a congenital band associated with an underlying radius and ulna pseudarthrosis. Although the forearm and hand were soft and viable initially, severe edema and swelling occurred after fluid resuscitation, and on the fourth day of life, the patient underwent simple band releases at bedside with 2 longitudinal incisions over the radius and ulna. Circulation was restored, and the pseudarthrosis healed with no further surgical intervention. Successful delayed reconstruction of the band with Z-plasties was performed when the baby was 7 months of age. In this case, a relatively simple, straightforward procedure that is familiar to most pediatric orthopaedists salvaged a compromised neonatal limb with amniotic band syndrome and allowed healing of a pseudarthrosis, allowing more complex reconstruction to be performed in a delayed, elective manner. Careful observation is necessary in the neonatal period of the baby with a severe band; a viable, well-perfused, compressible extremity may still be at risk.

Adult-Onset Acral Peeling Skin Syndrome in a Non-Identical Twin: A Case Report in South Africa

PubMed Central

Mathew, Reshmi; Omole, Olufemi B.; Rigby, Jonathan; Grayson, Wayne

2014-01-01

Patient: Female, 44 Final Diagnosis: Acral peeeling skin syndrome Symptoms: Recurrent skin exfoliation Medication: — Clinical Procedure: Skin biopsy Specialty: Dermatology Objective: Rare disease Background: Acral peeling skin syndrome is a rare autosomal recessive disorder in which skin exfoliation is limited to the hands and feet. While it typically manifests from early childhood, in this first reported case from South Africa, the patient did not manifest clinically until the fourth decade of life. Case Report: A 44-year-old woman of African descent, 1 of a set of non-identical twins, presented with recurrent episodes of skin peeling of the upper and lower limbs. The first episode occurred 4 years prior, followed by perennial skin peeling during the spring seasons. She was not on treatment for any chronic disease and reported no exposure to chemicals or other irritants. The family, including the non-identical twin sister, has no history of skin disorders and the patient’s HIV antibody test was negative. At presentation, physical examination revealed ongoing exfoliation with new skin formation on the palms and soles. The mucous membranes and nails were spared. Other systems were normal. Skin biopsy taken from the palms confirmed peeling skin syndrome. The patient was managed with topical aqueous cream and analgesics. She was briefly counseled on the nature and prognosis of the disease, and referred for genetic testing and counseling. On follow-up, she continues to have skin peeling once or twice a year. Conclusions: This first reported case of this rare disease in South Africa contributes to the growing body of literature on the disease and highlights the need for clinicians to be aware of its variable clinical onset. PMID:25549719

Test-Retest Reliability of the National Health and Nutrition Examination Survey’s 5-Question Food Insecurity Survey Completed by Fourth-Grade Children

PubMed Central

Baxter, Suzanne D.; Smith, Albert F.; Hitchcock, David B.; Collins, Kathleen L.; Guinn, Caroline H.; Finney, Christopher J.; Royer, Julie A.; Miller, Patricia H.

2015-01-01

Objective To examine test-retest reliability and internal consistency of a 5-question food insecurity survey used in the National Health and Nutrition Examination Survey. Methods Researchers administered the National Health and Nutrition Examination Survey in the classroom to 92 fourth-grade children (74 African American; 48 girls) in 2 sessions 27–30 days apart in spring, 2011. Each classroom administration lasted 5–10 minutes. Results Test-retest reliability was 0.66 (Kendall tau), which is modest. Internal consistency (Cronbach alpha) was .67 and .70 for respective administrations. Food insecurity scores were related to gender (adjusted P = .05) and academic achievement (adjusted P = .004) but not to socioeconomic status or body mass index percentile (binomial regression). On average, boys reported higher food insecurity than girls. Children with lower academic achievement scores reported higher food insecurity than children with higher academic achievement scores. Conclusions and Implications The National Health and Nutrition Examination 5-question survey may be group administered to assess food insecurity efficiently as reported by individual fourth-grade children. PMID:26363937

Report of the Fourth International Workshop on human X chromosome mapping 1993

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

Schlessinger, D.; Mandel, J.L.; Monaco, A.P.

1993-12-31

Vigorous interactive efforts by the X chromosome community have led to accelerated mapping in the last six months. Seventy-five participants from 12 countries around the globe contributed progress reports to the Fourth International X Chromosome Workshop, at St. Louis, MO, May 9-12, 1993. It became clear that well over half the chromosome is now covered by YAC contigs that are being extended, verified, and aligned by their content of STSs and other markers placed by cytogenetic or linkage mapping techniques. The major aim of the workshop was to assemble the consensus map that appears in this report, summarizing both consensusmore » order and YAC contig information.« less

Dandy-Walker malformation and neurocutaneous melanosis in a three-month-old infant

PubMed Central

Mahgoub, Shaza Mohamed; Yassin, Rehab Omer; Osman, Atika Mohamed

2013-01-01

Dandy-Walker Malformation (DWM) is a rare congenital malformation of the brain. It is characterized by cystic enlargement of the fourth ventricle which is communicating with an enlarged posterior fossa, cerebellar dysgenesis, high tentorial insertion and hydrocephalus. Neurocutaneous Melanosis (NCM) is a congenital neurocutaneous syndrome characterized by large or multiple melanocytic nevi and benign or malignant melanocytic tumors of the leptomeninges. We report three months old boy who presented with projectile vomiting associated with a noticeable increase in head size. Several congenital nevi were seen all over his body with evident signs of hydrocephalus. The association of DWM and NCM is a rare complex, and to our knowledge, this is the eleventh case to be reported in the literature. In this article, we discuss the proposed pathogenesis, classification and management of the condition. PMID:27493376

Florid papillomatosis of the nipple: a rare presentation and review of the literature.

PubMed

Salemis, Nikolaos S

2015-01-01

Florid papillomatosis (FP) of the nipple, or nipple adenoma, is a rare benign proliferative lesion originating from the lactiferous ducts of the nipple. It most commonly affects women in their fourth and fifth decades of life. Clinically, in most cases FP presents with serous or serosanguinous nipple discharge while in many cases an erythematoid or eroded lesion, a nodule or a swelling of the nipple may coexist thus resembling Paget's disease. We describe a case of FP with a very unusual clinical presentation. Diagnostic evaluation and management of the patient are discussed along with a review of the relevant literature. We conclude that FP should be always considered in the differential diagnosis of patients presenting with a rapidly enlarging nipple nodule even in the absence of any skin lesions or nipple discharge. Early diagnosis and prompt treatment are essential. Simple complete excision in order to eliminate the risk of recurrence is the treatment of choice for FP. Although in rare cases a coincidental ipsilateral or contralateral breast cancer has been reported, FP is considered as an entirely benign clinical entity associated with excellent prognosis.

Fibularis tertius: revisiting the anatomy.

PubMed

Rourke, K; Dafydd, H; Parkin, I G

2007-11-01

Fibularis tertius (FT) may be used during reconstructive surgery and muscle transposition with retention of function. The muscle was examined in both lower limbs of 41 cadavers. Measurements were made of muscle belly length and width, tendon length and width, and the size of the origin on the fibula. Tendon insertion, nerve and blood supplies were also examined. FT was absent in five (6.1%) lower limbs of three (7.3%) subjects. The size of its origin demonstrated inter- and intra-individual variation. FT arose from the distal fibula and on average occupied (28.4 +/- 9.1)% (mean +/- S. D.) of the total shaft length. In all cases the tendon inserted into the dorsal surface of the shafts of both the fourth and fifth metatarsals. A small nerve branch consistently arose from the deep fibular nerve near the origin of extensor digitorum longus. The nerve ran parallel to the length of this muscle, between it and extensor hallucis longus, before piercing FT. Anatomy textbooks describe FT as inserting into the fifth metatarsal only. This study, supported by data from previous reports, suggests that the "textbook" accounts of FT should be updated to record that most commonly its tendon reaches both the fourth and fifth metatarsals.

Juvenile xanthogranuloma: a case report and review of the literature.

PubMed

Pajaziti, Laura; Hapçiu, Syzana Rexhepi; Pajaziti, Artina

2014-03-26

Juvenile xanthogranuloma is a rare disorder which may be present at birth, or appears in infancy. It can also occur in adults of all ages; appears with lesions that may be solitary or multiple nodules several millimeters in diameter. The predilection sites are head and neck, but it may occur on the extremities and trunk also. There can also be involved internal organs such as lung, kidney, gastrointestinal tract, etc. The most frequent extracutaneous location is the eye. We report a case of juvenile xanthogranuloma in a male child with onset in the fourth month of life. He presented with a nodule 8 millimeters in diameter, tan-orange in color, ulcerated in the centre, located on the left corner of the left eye. A biopsy without total excision was performed. After the biopsy, the nodule enlarged to 1.5 cm in diameter and became haemorrhagic. The histologic evaluation and immunohistochemistry analysis resulted in the diagnosis of juvenile xanthogranuloma. For aesthetic reasons the nodule was removed by surgical resection. Juvenile xanthogranuloma is on a spectrum of histiocytic disorders, which is necessary to differentiate from maligniances in childhood by biopsy.

Stonefish "Okoze" envenomation during food preparation.

PubMed

Yamamoto, Ryo; Suzuki, Masaru; Hori, Shingo; Aikawa, Naoki

2010-01-01

Stonefish is a dangerous and venomous fish commonly found in the shallow waters of the Pacific region. Its envenomation is reported worldwide with increasing frequency. Although envenomation usually occurs in those engaged in marine sports, chefs may suffer envenomation during cutting stonefish, which is eaten either sliced raw, boiled, or deep-fried by Japanese. Since many people cook and eat Japanese food, it is important to know that cutting a stonefish for cooking carries the risk of envenomation. However, most primary and emergency physicians have not encountered cases of envenomation during food preparation. Here we describe a case of envenomation occurring while cooking. The patient was a healthy 33-year-old man working as a chef in a Japanese restaurant. He was presented to an academic emergency department after suddenly developing severe pain in his right fourth finger while cutting a stonefish. The finger was reddish, swollen, and tender. The pain reduce d after immersing his hand in hot water, and disappeared within 18 h without any complication. In this report, we describe the history of stonefish envenomation and provide a brief review of the literature related to this form of envenomation.

In vitro fertilization surrogate pregnancy in a patient who underwent radical hysterectomy followed by ovarian transposition, lower abdominal wall radiotherapy, and chemotherapy.

PubMed

Steigrad, Stephen; Hacker, Neville F; Kolb, Bradford

2005-05-01

To describe an IVF surrogate pregnancy from a patient who had a radical hysterectomy followed by excision of a laparoscopic port site implantation with ovarian transposition followed by abdominal wall irradiation and chemotherapy, which resulted in premature ovarian failure from which there was partial recovery. Case report. Tertiary referral university women's hospital in Sydney, Australia and private reproductive medicine clinic in California. A 34-year-old woman who underwent laparoscopy for pelvic pain, shortly afterward followed by radical hysterectomy and pelvic lymph node dissection, who subsequently developed a laparoscopic port site recurrence, which was excised in association with ovarian transposition before abdominal wall irradiation and chemotherapy. Modified IVF treatment, transabdominal oocyte retrieval, embryo cryopreservation in Australia, and transfer to a surrogate mother in the United States. Pregnancy. Miscarriage in the second cycle and a twin pregnancy in the fourth cycle. This is the first case report of ovarian stimulation and oocyte retrieval performed on transposed ovaries after a patient developed premature ovarian failure after radiotherapy and chemotherapy with subsequent partial ovarian recovery.

Fourth-order convergence of a compact scheme for the one-dimensional biharmonic equation

NASA Astrophysics Data System (ADS)

Fishelov, D.; Ben-Artzi, M.; Croisille, J.-P.

2012-09-01

The convergence of a fourth-order compact scheme to the one-dimensional biharmonic problem is established in the case of general Dirichlet boundary conditions. The compact scheme invokes value of the unknown function as well as Pade approximations of its first-order derivative. Using the Pade approximation allows us to approximate the first-order derivative within fourth-order accuracy. However, although the truncation error of the discrete biharmonic scheme is of fourth-order at interior point, the truncation error drops to first-order at near-boundary points. Nonetheless, we prove that the scheme retains its fourth-order (optimal) accuracy. This is done by a careful inspection of the matrix elements of the discrete biharmonic operator. A number of numerical examples corroborate this effect. We also present a study of the eigenvalue problem uxxxx = νu. We compute and display the eigenvalues and the eigenfunctions related to the continuous and the discrete problems. By the positivity of the eigenvalues, one can deduce the stability of of the related time-dependent problem ut = -uxxxx. In addition, we study the eigenvalue problem uxxxx = νuxx. This is related to the stability of the linear time-dependent equation uxxt = νuxxxx. Its continuous and discrete eigenvalues and eigenfunction (or eigenvectors) are computed and displayed graphically.

Intracranial translucency as a sonographic marker for detecting open spina bifida at 11–13+6 weeks scan: Our experience

PubMed Central

Teegala, Madhavi L; Vinayak, Dhamangaonkar G

2017-01-01

Aims and Objectives: The fourth ventricle, seen as intracranial translucency (IT) at 11–13+6 weeks, has been reported to be obliterated in cases of open spina bifida (OSB). Our aim was to assess its role in detecting OSB at 11–13+6 weeks. Materials and Methods: This prospective study was conducted at foetal medicine unit from January 2014 to June 2015. All women who underwent both first and mid-trimester scan in our unit were included in the study. IT was categorized as normal, obliterated or not clear. Spine was examined during both scans. Results: Totally, 341 cases were included in the study. IT was found to be obliterated in four cases and not clear in one case. There was demonstrable OSB at 11–13+6 weeks in two cases, at 15–16 weeks in two cases and at 24 weeks in one case. In the remaining 336 cases with normal IT, spine was found to be normal at target scan. Conclusion: Mid-sagittal view of face that is routinely used to measure nuchal translucency (NT) can also be used to detect OSB. It is feasible to integrate IT into the routine 11–13+6 weeks scan. PMID:29379237

Challenges of the Future in Postsecondary Occupational Education. Fourth Conference on New Horizons in Community College Occupational-Technical Education (4th, Blacksburg, Virginia, October 31, November 1-2, 1976).

ERIC Educational Resources Information Center

Hoerner, James L., Ed.

Approximately 135 instructors, counselors, division directors, deans, presidents, university personnel, and graduate students from ten states participated in a fourth annual conference on New Horizons in Community College Occupational-Technical Education reported in this document. The general purpose of the conference was to examine current views…

EXPLORATORY STUDY AND PLANNING FOR A FOURTH-YEAR, PAID INTERNSHIP TEACHER EDUCATION PROGRAM FOR BOTH ELEMENTARY AND SECONDARY TEACHERS. FINAL REPORT.

ERIC Educational Resources Information Center

RYERSON, NORMAN E.

THROUGH THE DEVELOPMENT OF A COOPERATIVE COLLEGE-UNIVERSITY GRADUATE STUDY PROGRAM, THE AUGMENTATION OF A PAID FOURTH-YEAR INTERNSHIP APPROACH IN A TEACHER TRAINING PROGRAM WAS EXPLORED. STEPS INCLUDED--(1) INVOLVEMENT OF THE FACULTY IN AN EVALUATION OF THE TEACHER EDUCATION PROGRAM AND THE COLLEGE CURRICULUM, (2) CHANGING WEEKLY SCHEDULES AND THE…

WAIS-IV and WISC-IV Structural Validity: Alternate Methods, Alternate Results. Commentary on Weiss et al. (2013a) and Weiss et al. (2013b)

ERIC Educational Resources Information Center

Canivez, Gary L.; Kush, Joseph C.

2013-01-01

Weiss, Keith, Zhu, and Chen (2013a) and Weiss, Keith, Zhu, and Chen (2013b), this issue, report examinations of the factor structure of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), respectively; comparing Wechsler Hierarchical Model (W-HM) and…

An Investigation of Two Instructional Settings in the Use of Semantic Mapping with Poor Readers. Program Report 85-4.

ERIC Educational Resources Information Center

Pittelman, Susan D.; And Others

A study investigated whether semantic mapping is more effective for poor readers instructed in a small group of poor readers or in a class of students with mixed reading abilities. Students in five fourth-grade classes served as the control, receiving no semantic mapping instruction. Subjects, 39 fourth-grade poor readers, were presented semantic…

Project CHECO Southeast Asia Report. The Fourth Offensive

DTIC Science & Technology

1969-10-01

DPL .... .......... 4 (e) CSH ............ . .. 1 f. AFLC (f) DOTEC ............ 5 (g) DE .... ........... 1 (1) HEADQUARTERS(h) DM. .............. .1(a...who performed politi- cal , economic, and military functions. In support of military operations, the VCI operated a vigorous recruiting net to provide...against Allied outposts rather than areas that were heavily de - fended by friendly forces. The enemy tactics of the Fourth Offensive strongly suggested that

JPRS Report, Proliferation Issues

DTIC Science & Technology

1991-08-08

from its processing plant at Valindaba, and fuel-fabrication plants at Valindaba and Pelindaba. where fuel rods for use at the Koeberg nuclear-power...construction of the fourth one. The pulsed reactor uses special elements of nuclear fuel The site of the proposed fourth nuclear power plant can enabling...chemical, and biological weapons, including delivery systems and the transfer of weapons-relevant technologies.] AFRICA SOUTH AFRICA Civilian Uses for

Spondylocostal dysostosis associated with right-sided polythelia, right-sided rib deformity and meningocoele: Case report with review of literature.

PubMed

Rai, Narendra; Thakur, Neha; Khan, Naheed Zin; Dwivedi, Akhilesh Dutt

2015-01-01

Spondylocostal dysostosis (SCD) is a rare anomaly of axial skeleton due to flawed embryological development. A newborn baby boy with right-sided polythelia, meningocoele, fan-like configuration of third and fourth rib, fused fifth and sixth rib and third thoracic hemivertebra was delivered to a second gravid mother by elective caesarean section. Baby was active, cried immediately after birth, had normal muscle tone and reflexes. He passed urine and meconium within 24 h of birth. Based on clinical examination and radiological picture, a diagnosis of SCD with meningocele with right-sided polythelia was made. Our case is the first SCD with polythelia and meningocele in newborn. SCD with right-sided polythelia and rib deformity with neural tube defect (NTD) may be due to a genetic defect with the culprit genes missing. Further genetic and embryological studies might find a link between right-sided rib defects, polythelia and NTD.

Spontaneous rupture of a giant non parasitic hepatic cyst presenting as an acute surgical abdomen.

PubMed

Salemis, Nikolaos S; Georgoulis, Epameinondas; Gourgiotis, Stavros; Tsohataridis, Efstathios

2007-01-01

Spontaneous rupture of a non parasitic hepatic cyst is an extremely rare occurrence. A 50 -year- old male, was admitted with typical clinical manifestations of acute surgical abdomen. At exploratory laparotomy, a giant ruptured non parasitic cyst occupying the entire left liver lobe was found, along with a large amount of free intraperitoneal fluid. The cyst was widely unroofed very close to the liver parenchyma. The patient had an uneventful postoperative course and was discharged six days later. The clinical presentation, diagnostic evaluation and surgical management of this extremely rare clinical entity are discussed, along with a review of the literature. This case, which according to our best knowledge is the fourth reported in the literature, highlights the considerable risk of serious complications associated with the presence of a large symptomatic nonparasitic hepatic cyst. Prophylactic treatment should be considered in all these cases.

Idiopathic Non-traumatic Facial Nerve Palsy (Bell's Palsy) in Neonates; An Atypical Age and Management Dilemma.

PubMed

Khair, Abdulhafeez M; Ibrahim, Khalid

2018-01-01

Idiopathic (Bell's) palsy is the commonest cause of unilateral facial paralysis in children. Although being idiopathic by definition, possible infectious, inflammatory, and ischemic triggers have been suggested. Bell's palsy is thought to be responsible for up to three-fourths of cases of acute unilateral facial paralysis worldwide. The diagnosis has to be reached after other causes of acute peripheral palsy have been excluded. However, it is rarely described in neonates and young infants. Steroids may have some role in treatment, but antiviral therapies have doubtful evidence of benefit. Prognosis is good, though residual dysfunction is occasionally encountered. We report the case of a two-week-old neonate with no prior illnesses who presented with acute left facial palsy. Clinical findings and normal brain imaging were consistent with the diagnosis of Bell's palsy. The patient had a good response to oral steroids.

Idiopathic Non-traumatic Facial Nerve Palsy (Bell’s Palsy) in Neonates; An Atypical Age and Management Dilemma

PubMed Central

Khair, Abdulhafeez M.; Ibrahim, Khalid

2018-01-01

Idiopathic (Bell’s) palsy is the commonest cause of unilateral facial paralysis in children. Although being idiopathic by definition, possible infectious, inflammatory, and ischemic triggers have been suggested. Bell’s palsy is thought to be responsible for up to three-fourths of cases of acute unilateral facial paralysis worldwide. The diagnosis has to be reached after other causes of acute peripheral palsy have been excluded. However, it is rarely described in neonates and young infants. Steroids may have some role in treatment, but antiviral therapies have doubtful evidence of benefit. Prognosis is good, though residual dysfunction is occasionally encountered. We report the case of a two-week-old neonate with no prior illnesses who presented with acute left facial palsy. Clinical findings and normal brain imaging were consistent with the diagnosis of Bell’s palsy. The patient had a good response to oral steroids. PMID:29468002

[Congenital generalized lipodystrophy in a patient with Dandy Walker anomaly].

PubMed

Luna, Cecilia Inés; Fernández Cordero, Marisa; Escruela, Romina; Sierra, Valeria; Córdoba, Antonela; Goñi, Ignacio María; Berridi, Ricardo

2014-10-01

The objective of this study is to describe the unexpected association between the congenital generalized lipodystrophy (CGL) and Dandy Walker anomaly. We report the case of a 1-year-old infant who was hospitalized at her fourth month of life with Dandy Walker anomaly diagnosis and an increased social risk. During her hospitalization, she developed progressively: acromegaloid aspect, triangular fascia, hirsutism, lipoatrophy, muscle hypertrophy, clitoromegaly, abdominal distention, progressive hepatomegaly, and hypertriglyceridemia. This led to the clinical diagnosis of congenital generalized lipodystrophy. Importance should be given to the examination of clinical aspects as well as the interdisciplinary follow-up for proper detection of insulin resistance and diabetes, early puberty, cardiomyopathy, among others. In case of Dandy Walker anomaly, it should be checked the evolution to search intracranial hypertension signs. Due to its autosomal recessive nature, it is important to provide genetic counseling to the parents.