Real-Life Case Studies for Teachers.

ERIC Educational Resources Information Center

Hayes, William

Case studies described in this book reflect conditions present in today's public schools. Situations described in these case studies are intended to introduce education students to the variety of problems existing in today's schools. The 38 case studies highlight: student cheating; teacher's observation by administrator; inclusion; contract…

A rare case of acute pancreatitis and life-threatening hemolytic anemia associated with Epstein-Barr virus infection in a young healthy adult.

PubMed

Singh, Sukhchain; Khosla, Pam

2016-01-01

Epstein-Barr virus (EBV) is a common infection that affects 95% of adults worldwide at some point during life. It is usually asymptomatic or causes a self-limiting clinical syndrome known as infectious mononucleosis. It rarely causes complications. Here, we present a case of a healthy 21-year-old female college student who suffered from severe pancreatitis and life-threatening autoimmune hemolytic anemia in association with EBV infection, and we also discuss the common presentation of EBV infection and the diagnosis and treatment of simple and complicated EBV infection. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Ethics at the End of Life: A Teaching Tool

ERIC Educational Resources Information Center

Wallace, Cara L.; Thielman, Kara J.; Cimino, Andrea N.; Rueda, Heidi L. Adams

2017-01-01

Social workers rarely receive education and training in the areas of grief, bereavement, and death and dying, which may lead to difficulties in compassionately and ethically addressing concerns in end-of-life or grief-related contexts. This article presents actual and potential outcomes from three challenging end-of-life case studies using…

Endovascular treatment of arterio-ureteral fistulae with covered stents: Case series and review of the literature.

PubMed

Patel, Dhruv; Kumar, Abhishek; Ranganath, Praveen; Contractor, Sohail

2014-01-01

Arterio-ureteral fistulae are abnormal connections between an artery and the ureter and carry a high mortality. We present two cases of arterio-ureteral fistulae that presented with life-threatening hematuria. Both patients were treated with endovascular covered stent placement.

Endovascular treatment of arterio-ureteral fistulae with covered stents: Case series and review of the literature

PubMed Central

Patel, Dhruv; Ranganath, Praveen; Contractor, Sohail

2014-01-01

Arterio-ureteral fistulae are abnormal connections between an artery and the ureter and carry a high mortality. We present two cases of arterio-ureteral fistulae that presented with life-threatening hematuria. Both patients were treated with endovascular covered stent placement. PMID:27489652

Persistent hyperphagia in acquired brain injury; an observational case study of patients receiving inpatient rehabilitation.

PubMed

Rowell, Arleen M; Faruqui, Rafey A

2010-01-01

Morbid hunger or persistent hyperphagia is a relatively rare but potentially life threatening complication of acquired brain injury (ABI). This paper presents findings from an observational case study of patients with hyperphagia receiving inpatient neurobehavioural rehabilitation following their acquired brain injury. The case study has utilized dietetic and medical records of identified patients to confirm the persistent and serious nature of this presentation in order to extract important management principles. The findings confirmed that hyperphagia or morbid hunger posed potentially life-threatening health risks to the patient, primarily around weight control and fluid balance, and risks of aggression towards professional and family carers. Pharmacological or behaviour modification interventions were only partially successful in management of this presentation. The study identified a high need for environmental and cue exposure control in management of this condition.

Life cycle design metrics for energy generation technologies: Method, data, and case study

NASA Astrophysics Data System (ADS)

Cooper, Joyce; Lee, Seung-Jin; Elter, John; Boussu, Jeff; Boman, Sarah

A method to assist in the rapid preparation of Life Cycle Assessments of emerging energy generation technologies is presented and applied to distributed proton exchange membrane fuel cell systems. The method develops life cycle environmental design metrics and allows variations in hardware materials, transportation scenarios, assembly energy use, operating performance and consumables, and fuels and fuel production scenarios to be modeled and comparisons to competing systems to be made. Data and results are based on publicly available U.S. Life Cycle Assessment data sources and are formulated to allow the environmental impact weighting scheme to be specified. A case study evaluates improvements in efficiency and in materials recycling and compares distributed proton exchange membrane fuel cell systems to other distributed generation options. The results reveal the importance of sensitivity analysis and system efficiency in interpreting case studies.

Family planning and tradition: a view from northern Cameroon.

PubMed

Einterz, E M

1994-01-01

Sometimes efforts to improve the quality of life can hasten the destruction of a whole way of life, in which case the "beneficiaries" can lose much more than they gain. This presents health workers and planners with difficult choices.

End-of-life practices at a Lebanese hospital: courage or knowledge?

PubMed

Gebara, Jouhayna; Tashjian, Hera

2006-10-01

End-of-life care requires knowledgeable and culturally sensitive clinicians to assist patients and families dealing with the difficult journey of death. The authors present important end-of-life considerations for health care providers dealing with culturally diversified patients. A case study approach is used illustrating two case vignettes derived from the practice of an intensive care setting of a tertiary teaching facility in a large urban area in Lebanon. In a multidisciplinary fashion, practices of end of life were explored and a protocol developed to guide health care providers. Special cultural values were identified such as importance of family involvement and religious beliefs. Implications for practice are described.

Thrombus in Transit: A Potentially Life-threatening Complication of Cerebral Sinus Thrombosis.

PubMed

Petracca, Martina; Calandrelli, Rosalinda; Broccolini, Aldobrando; Caliandro, Pietro; Della Marca, Giacomo; Frisullo, Giovanni; Morosetti, Roberta; Profice, Paolo; Lamendola, Priscilla; Pennestrì, Faustino; Pilato, Fabio

2017-01-01

We report the case of a 41-year-old, 7-weeks-pregnant patient, presenting with headache and generalized seizure due to cerebral venous thrombosis complicated by jugular thrombosis and thrombus dislocation into right cardiac cavities. The patient was treated with intravenous heparin, and underwent embolectomy in extracorporeal circulation. This case illustrates the variability of cerebral venous thrombosis progression and a potentially life-threatening condition even during anticoagulant therapy.

Bartter syndrome type III and congenital anomalies of the kidney and urinary tract: an antenatal presentation.

PubMed

Westland, Rik; Hack, Wilfried W; van der Horst, Henricus J R; Uittenbogaard, Lukas B; van Hagen, Johanna M; van der Valk, Paul; Kamsteeg, Erik J; van den Heuvel, Lambert P; van Wijk, Joanna A E

2012-12-01

Bartter syndrome encompasses a variety of inheritable renal tubular transport disorders characterized by hypokalemia and hypochloremic metabolic alkalosis. Bartter syndrome Type III is caused by genetic alterations in the chloride channel kidney B (CLCNKB) gene and often presents in the first 2 years of life, known as classic Bartter syndrome. However, in rare cases Bartter syndrome Type III has an antenatal presentation with polyhydramnios, premature delivery and severe dehydration in the first weeks of life. Associations between congenital anomalies of the kidney and urinary tract and Bartter syndrome are extremely rare. This case report presents a girl with Bartter syndrome Type III due to a homozygous CLCNKB mutation and bilateral congenital anomalies of the kidney and urinary tract. In addition, we describe the antenatal presentation as well as its perinatal management.

The neuropsychiatric aspect of Addison's disease: a case report.

PubMed

Abdel-Motleb, Mohamed

2012-10-01

Chronic adrenal insufficiency, known as Addison's disease, presents with a constellation of symptoms and signs. The neuropsychiatric aspect of this condition is not fully understood and not much has been documented about it in the English literature. This article presents a case of a 41-year old male patient who presented initially with depression after a recent life stressor. After his condition escalated and therapy continued to fail, the medical team revised its diagnosis to Addison's disease. Neuropsychiatric symptoms could be the first presentation of Addison's disease, and thus should be kept in mind whenever such a case presents to the physician.

Primary gastric Burkitt lymphoma: a rare cause of life-threatening haematemesis.

PubMed

Ayoub, Fares; Forde, Justin J; Patel, Niraj; Markham, Merry

2017-08-22

Lymphomas are the second most common gastric malignancy following gastric adenocarcinoma. The majority of gastric lymphomas are either mucosa-associated lymphoid tissue lymphomas or diffuse large B-cell lymphomas. Primary gastric Burkitt lymphoma is a subtype of non-Hodgkin's lymphoma and represents an aggressive and rare malignancy with only a small number of cases reported worldwide. Clinical and radiological presentation is non-specific and mimics other gastric lymphomas. Diagnosis is established with pathological evaluation. Due to the paucity of cases, treatment of this condition is not well studied and is extrapolated from paediatric and adult literature of Burkitt lymphoma not isolated to the stomach. We present the case of a male patient with primary gastric Burkitt lymphoma who initially presented with life-threatening haematemesis, later achieving complete remission with treatment. We discuss the epidemiology, presentation and management of gastric Burkitt lymphoma. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The family and work connect: A case for relationship-focused family life education

PubMed Central

Henry, Jane; Parthasarathy, R.

2010-01-01

The article presents the premises for the need to develop a relationship-focused family life education program for young adult employees. The article explores the changing trends in the Indian family unit and their impact on the workforce. The author also presents the findings from interviews with family-intervention experts and their recommendations for the contents of such a program. PMID:20808662

Rupture of an ascending and descending thoracic aortic aneurysm causing tension hemothorax: a case report.

PubMed

Pizon, Anthony; Bissell, Brad J; Gilmore, Nathan

2012-10-01

A ruptured thoracic aortic aneurysm is a life-threatening condition and can lead to a tension hemothorax. To describe the presentation and management of a case of a tension hemothorax. An 84-year-old woman presented in respiratory distress and was found to have a tension hemothorax. The cause was the rupture of an ascending and descending thoracic aortic aneurysm. She was managed with intubation, mechanical ventilation, and chest tube placement with stabilization. Definitive operative repair was deferred due to the patient's comorbidities and wishes of the family. A tension hemothorax can result from an ascending and descending thoracic aneurysm, as this case describes. Emergent therapy is necessary as this is a life-threatening condition. Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical Case Studies: Science-Society "Bonding."

ERIC Educational Resources Information Center

Hofstein, Avi; Nae, Nehemia

1981-01-01

Describes a unit designed to illustrate the "science-society-technology connection," in which three case studies of the chemical industry in Israel are presented to high school chemistry students. Chosen for the unit are case studies on copper production in Timna, on plastics, and on life from the Dead Sea. (CS)

Electroconvulsive therapy (ECT) for catatonia in a patient with schizophrenia and synthetic cannabinoid abuse: a case report.

PubMed

Leibu, Evan; Garakani, Amir; McGonigle, Daniel P; Liebman, Lauren S; Loh, Daniella; Bryson, Ethan O; Kellner, Charles H

2013-12-01

We present the case of a young man with a long-standing history of schizophrenia who presented with severe and life-threatening catatonia in the setting of synthetic cannabis use who was successfully treated with electroconvulsive therapy. To our knowledge, this is the first reported case of severe and persistent catatonia in the setting of synthetic cannabis use and the first documented successful treatment.

Breast cancer, psychological distress and life events among young women

PubMed Central

Peled, Ronit; Carmil, Devora; Siboni-Samocha, Orly; Shoham-Vardi, Ilana

2008-01-01

Since 1983, studies have suggested an interaction between the severe life events, psychological distress and the etiology of Cancer. However, these associations are still under dispute. The aim of the present study was to examine the relationship between life events, psychological distress and Breast Cancer (BC) among young women. Methods A case control study. The study population included 622 women, under the age of 45 years. 255 were diagnosed for BC, and 367 were healthy women. A validated Brief Symptom Inventory (BSI) and Life Event Questionnaire were used. Results The cases presented significantly higher scores of depression compared to the controls and significant lower scores of happiness and optimism. A significant difference was found when comparing the groups according to the cumulative number of life events (two or more events). A multivariate analysis suggest that exposure to more than one life event is positively associated with BC [Odds Ratio(OR) :1.62 95% Confidence Interval (CI): 1.09–2.40], and that a general feeling of happiness and optimism has a "protective effect" on the etiology of BC. (OR-0.75, 95% CI:0.64–0.86). Conclusion Young women who were exposed to a number of life events, should be considered as a risk group for BC and treated accordingly. PMID:18721454

Life Cycle Assessment Perspectives on Delivering an Infant in the US

PubMed Central

Campion, Nicole; Thiel, Cassandra L.; DeBlois, Justin; Woods, Noe C.; Landis, Amy E.; Bilec, Melissa M.

2012-01-01

This study introduces life cycle assessment as a tool to analyze one aspect of sustainability in healthcare: the birth of a baby. The process life cycle assessment case study presented evaluates two common procedures in a hospital, a cesarean section and a vaginal birth. This case study was conducted at Magee-Womens Hospital of the University of Pittsburgh Medical Center, which delivers over 10,000 infants per year. The results show that heating, ventilation, and air conditioning (HVAC), waste disposal, and the production of the disposable custom packs comprise a large percentage of the environmental impacts. Applying the life cycle assessment tool to medical procedures allows hospital decision makers to target and guide efforts to reduce the environmental impacts of healthcare procedures. PMID:22482785

Severe progressive scoliosis in an adult female possibly secondary thoracic surgery in childhood treated with scoliosis specific Schroth physiotherapy: Case presentation.

PubMed

Lebel, Andrea; Lebel, Victoria Ashley

2016-01-01

Scoliosis is a complex three-dimensional (3D) spinal deformity. Acquired scoliosis in early childhood may progress into adulthood and pose an increased risk of health problems and reduction in quality of life. In Canada, patients with scoliosis are not referred for physiotherapeutic scoliosis-specific exercises (PSSE) despite the fact that Schroth physiotherapy, a scoliosis-specific 3D posture training and exercise program, can be effective in reducing pain and improving scoliosis curves, vital capacity, and overall quality of life in scoliosis patients. This case presentation shows that indeed adult curve progression can be stopped and even reversed with scoliosis specific Schroth physiotherapy (SSSPT) in an adult patient with scoliosis. This is a retrospective case presentation involving a 23-year-old female scoliosis patient who began an outpatient Schroth physiotherapy exercise program and was initially monitored monthly and then annually for improvement in measurements of angle of trunk rotation (ATR) and chest expansion and improvement in vital capacity measured with incentive spirometry. Photos were taken to document body image periodically throughout Schroth physiotherapy treatment. Additionally, the patient completed SRS-22 quality of life questionnaires every 2 years to evaluate daily function, pain, self-imagine, mental health, and scoliosis management satisfaction. Within one month of beginning SSSPT, the patient reported no more back pain and within 2 months, reported improved breathing. The patient also benefitted from improved chest expansion, reduced scoliosis curve angles (measured in Cobb degrees), increased vital capacity, decreased ATR, and higher SRS-22 scores. She became more active and resumed all athletic activity within 8 months of beginning Schroth physiotherapy. Adult scoliosis patients are not routinely referred for PSSE in Canada, even though Schroth physiotherapy, a form of PSSE, is shown to be effective in this case presentation. The patient in this case presentation was successfully treated with Schroth physiotherapy. Long-term comprehensive Schroth physiotherapy, to help correct and maintain proper posture in all aspects of daily living, should be part of scoliosis management for adult scoliosis patients in Canada to stop and reverse curve progression and to improve overall quality of life.

Quality of School Work Life of Public School Teachers: Cases from Turkey and Pakistan

ERIC Educational Resources Information Center

Akram, Muhammad; Ilgan, Abdurrahman; Ozu, Oyku; Shah, Ashfaque Ahmad

2017-01-01

The Quality of Work life (QWL) is the employees' feeling or perception of being comfortable with their work. The objective of the present study was to compare Quality of School Work Life (QSWL) of public school teachers from Turkey and Pakistan. A QSWL scale developed by Ilgan, Ata, Zepeda and Ozu-Cengiz (2014) having 30 items was used as the…

Astronomy and religion (1780-1915). Four case studies involving ideas of extraterrestrial life

NASA Astrophysics Data System (ADS)

Crowe, Michael J.

The present essay discusses four examples of interactions, two from the eighteenth century and two from the nineteenth. All four cases concern the relations between religion and the astronomical claim that intelligent beings exist elsewhere in space. In each of these four cases religious claims influenced astronomy. Cases 3 and 4 share a feature not usually encountered in studies on the interactions of astronomy and religion in that they are instances where not just theistic belief but in fact core doctrines of a specific religion, Christianity, influenced astronomy. I begin by surveying the interactions between religion and the idea of extraterrestrial intelligent life in the early modern period.

Exploring the Counselor's Role in "Right to Die" Decisions.

ERIC Educational Resources Information Center

Farrugia, David

1993-01-01

Explores issues related to "right to die." Makes case for counselors to assist clients and families with concerns related to refusal or withdrawal of medical treatment in cases of terminal illness or in cases where quality of life is severely impaired such as permanent comatose state. Presents historical, ethical, and legal perspectives.…

Peace Pilgrim, Exemplar of Level V

ERIC Educational Resources Information Center

Piechowski, Michael

2009-01-01

Cases of secondary integration (Level V), the most advanced level of development through positive disintegration, are easily found within the religious sphere. To find a secular case of secondary integration presents a greater challenge. The life of Peace Pilgrim (1908-1981), known personally to a great many people, appears to be such a case. The…

Microperforated Hymen Presenting Spontaneous Pregnancy with Cesarean Delivery and Hymenotomy Surgery: A Case Report

PubMed Central

Elshani, Brikene; Arifi, Heroid; Daci, Armond

2018-01-01

BACKGROUND: Female genital tract anomalies including imperforate hymen affect sexual life and fertility. CASE PRESENTATION: In the present case, we describe a pregnant woman diagnosed with imperforate hymen which never had penetrative vaginal sex. A 27–year-old married patient with 2 months of amenorrhea presented in a clinic without any other complications. Her history of difficult intercourse and prolonged menstrual flow were reported, and subsequent vaginal examination confirmed the diagnosis of imperforate hymen even though she claims to made pinhole surgery in hymen during puberty. Her urine pregnancy test was positive, and an ultrasound examination revealed 8.3 weeks pregnant. The pregnancy was followed up to 39.5 weeks when she entered in cesarean delivery in urgency. Due to perioperative complications in our study, a concomitant hymenotomy was successfully performed. The patient was discharged with the baby, and vaginal anatomy was restored. CONCLUSIONS: This case study suggests that even though as microperforated hymen surgery in puberty can permit pregnancy and intervention with cesarean section and hymenotomy is a good option to reduce the resulting perioperative complications which indirectly affect the increase of the fertilisation and improvement of later sexual life. PMID:29610613

Plasmodium falciparum-induced severe malaria with acute kidney injury and jaundice: a case report

NASA Astrophysics Data System (ADS)

Baswin, A.; Siregar, M. L.; Jamil, K. F.

2018-03-01

P. falciparum-induced severe malaria with life-threatening complications like acute kidney injury (AKI), jaundice, cerebral malaria, severe anemia, acidosis, and acute respiratory distress syndrome (ARDS). A 31-year-old soldier man who works in Aceh Singkil, Indonesia which is an endemic malaria area presented with a paroxysm of fever, shaking chills and sweats over four days, headache, arthralgia, abdominal pain, pale, jaundice, and oliguria. Urinalysis showed hemoglobinuria. Blood examination showed hemolytic anemia, thrombocytopenia, and hyperbilirubinemia. Falciparum malaria was then confirmed by peripheral blood smear, antimalarial medications were initiated, and hemodialysis was performed for eight times. The patient’s condition and laboratory results were quickly normalized. We report a case of P. falciparum-induced severe malaria with AKI and jaundice. The present case suggests that P. falciparum may induce severe malaria with life-threatening complications, early diagnosis and treatment is important to improve the quality of life of patients. Physicians must be alert for correct diagnosis and proper management of imported tropical malaria when patients have travel history in endemic areas.

Late-life homicide-suicide: a national case series in New Zealand.

PubMed

Cheung, Gary; Hatters Friedman, Susan; Sundram, Frederick

2016-01-01

Homicide-suicide is a rare event, but it has a significant impact on the family and community of the perpetrator and victim(s). The phenomenon of late-life homicide-suicide has not been previously studied in New Zealand, and there is only limited data in the international literature. The aim of this study is to systematically review coroners' records of late-life homicide-suicides in New Zealand. After ethics approval was granted, the Coronial Services of New Zealand was approached to provide records of all closed cases with a suicide verdict (age 65+) over a five-year period (July 2007-December 2012). Of the 225 suicides, 4 cases of homicide-suicide were identified (an estimated incidence of 0.12 per 100,000 per persons year). All four perpetrators were men; three had been farmers. Their ages ranged from 65 to 82. One case occurred in the context of an underlying psychiatric illness (psychotic depression in bipolar disorder). Firearms were used in three cases. Two cases were categorized as spousal/consortial subtype, one case as filicide-suicide, and one case as siblicide-suicide. The prospect of major social upheaval in the form of losing their homes was present in all four cases. The findings of this case series were consistent with the limited existing literature on homicide-suicide. Age-related biopsychosocial issues were highlighted in this case series of late-life homicide-suicide. Additionally, evaluating firearm licences in high-risk groups may represent a prevention strategy. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Advance care planning: challenges and approaches for pediatricians.

PubMed

Heckford, Emma; Beringer, Antonia Jane

2014-09-01

There is increasing recognition of the value of advance care planning for children with life-limiting conditions. It is important that we acknowledge and reflect on the challenges that this work presents in order to optimize practice. Our aim was to review advance care planning for children with life-threatening or life-limiting conditions (LTLLCs) in our local area. We conducted a retrospective case note review. Study subjects were from two National Health Service (NHS) Trusts in Bristol in the United Kingdom. Cases were identified from Child Death Overview Panel data. Forty-two sets of case notes were reviewed in relation to 20 children. Measurements included quantitative and qualitative review of advance care planning in relation to standards set by The Association for Children's Palliative Care (ACT). In 25% of cases there was no documented discussion with families about the approach to end of life (EOL). In 25% of cases there was no evidence of an advance care plan, and the content and accessibility of those that did exist was variable. Forty-five percent of families were not offered a choice with regard to location of care (LOC) in the last months of life and 50% were not offered a choice about location of death (LOD). We hope that acknowledgement of some of the challenges, alongside recognition of the clear benefits, of planning will help pediatricians to deliver this important area of care.

Life-threatening haemothorax: a rare presentation of pulmonary arteriovenous malformation.

PubMed

Kundu, Somenath; Mitra, Subhra; Mukherjee, Shubhasis; Chakravorty, Anushree

2010-11-01

Arteriovenous malformations of the lung are rare pulmonary vascular disorders which can suddenly lead to life threatening complications. Haemothorax due to rupture of a pulmonary arteriovenous malformation (PAVM) is very rare. We report here a case of a 39 year-old lady who presented with an acute onset of shortness of breath due to right-sided massive haemothorax and was subsequently detected to have pulmonary as well as cerebral arteriovenous malformation (CAVM).

Failures in Hybrid Microcircuits During Environmental Testing. History Cases

NASA Technical Reports Server (NTRS)

Teverovsky, Alexander

2008-01-01

This purpose of this viewgraph presentation is to discuss failures in hermetic hybrids observed at the GSFC PA Lab during environmental stress testing. The cases discussed are: Case I. Substrate metallization failures during Thermal cycling (TC). Case II. Flex lid-induced failure. Case Ill. Hermeticity failures during TC. Case IV. Die metallization cracking during TC. and how many test cycles and parts is necessary? Case V. Wire Bond failures after life test. Case VI. Failures caused by Au/In IMC growth.

Ensuring pain relief for children at the end of life

PubMed Central

Grégoire, Marie-Claude; Frager, Gerri

2006-01-01

Pain management in the context of pediatric palliative care can be challenging. The present article reviews, through a case-based presentation, the nonpharmacological and pharmacological methods used to ensure adequate pain control in children facing end of life. Details on the impressive range of opioid dosages required and routes of administration are highlighted from published literature and clinical experience. Where available, evidence-based recommendations are provided. Potential side effects of pain medication and barriers to good pain control are discussed. Novel analgesics and innovative delivery methods are presented as future tools enhancing pain relief at the end of life. Some challenges to ethically grounded research in this important context of care are reviewed. PMID:16960633

Primary Bladder Neurofibroma: A Rare Case with Clinical Implications and Diagnostic Challenges.

PubMed

Umakanthan, Srikanth; Naik, Ramadas; Bukelo, Maryann Margaret; Rai, Sharada; Prabhu, Laxman

2015-09-01

Neurofibroma of the genito-urinary tract is rare. Urinary bladder is the commonest organ involved in cases of urinary tract involvement. Patients present early in life and there is male preponderance. We discuss here a case of primary neurofibroma of the urinary bladder in a 52-year-male presenting with haematuria, irritative bladder symptoms and pelvic mass. Cystoscopy showed a swelling in the left lateral wall. A transurethral biopsy revealed neurofibroma of the urinary bladder. Immunohistochemical studies confirmed the diagnosis.

Primary Bladder Neurofibroma: A Rare Case with Clinical Implications and Diagnostic Challenges

PubMed Central

Naik, Ramadas; Bukelo, Maryann Margaret; Rai, Sharada; Prabhu, Laxman

2015-01-01

Neurofibroma of the genito-urinary tract is rare. Urinary bladder is the commonest organ involved in cases of urinary tract involvement. Patients present early in life and there is male preponderance. We discuss here a case of primary neurofibroma of the urinary bladder in a 52-year-male presenting with haematuria, irritative bladder symptoms and pelvic mass. Cystoscopy showed a swelling in the left lateral wall. A transurethral biopsy revealed neurofibroma of the urinary bladder. Immunohistochemical studies confirmed the diagnosis. PMID:26500913

Clinical Holistic Medicine: The Case Story of Anna. III. Rehabilitation of Philosophy of Life During Holistic Existential Therapy for Childhood Sexual Abuse

PubMed Central

Ventegodt, Søren; Clausen, Birgitte; Merrick, Joav

2006-01-01

When we experience life events with overwhelming emotional pain, we can escape this pain by making decisions (in our mind) that transfer responsibility from our existence to the surrounding world. By doing this, we slowly destroy the essence of our being, health, quality of life, and ability to function. The case of Anna is an excellent example of such a systematic destruction of self, done to survive the extreme pressure from childhood abuse and sexual abuse. The case study shows that the damage done to us by traumatic events is not on our body or soul, but rather our philosophy of life. The important consequence is that we can heal our existence by letting go of the negative decisions taken in the past painful and traumatic situations. By letting go of the life-denying sentences, we come back to life and take responsibility for our own life and existence. The healing of Annas existence was done by existential holistic therapy. Although the processing did not always run smoothly, as she projected very charged material on the therapists on several occasions, the process resulted in full health and a good quality of life due to her own will to recover and heal completely. The case illustrates the inner logic and complexity of intensive holistic therapy at the most difficult moment, where only a combination of intensive medical, psychiatric, and sexological treatment could set her free. In the paper, we also present a meta-perspective on intensive holistic therapy and its most characteristic phases. PMID:17370004

Clinical holistic medicine: the case story of Anna. III. Rehabilitation of philosophy of life during holistic existential therapy for childhood sexual abuse.

PubMed

Ventegodt, Søren; Clausen, Birgitte; Merrick, Joav

2006-03-07

When we experience life events with overwhelming emotional pain, we can escape this pain by making decisions (in our mind) that transfer responsibility from our existence to the surrounding world. By doing this, we slowly destroy the essence of our being, health, quality of life, and ability to function. The case of Anna is an excellent example of such a systematic destruction of self, done to survive the extreme pressure from childhood abuse and sexual abuse. The case study shows that the damage done to us by traumatic events is not on our body or soul, but rather our philosophy of life. The important consequence is that we can heal our existence by letting go of the negative decisions taken in the past painful and traumatic situations. By letting go of the life-denying sentences, we come back to life and take responsibility for our own life and existence. The healing of Anna's existence was done by existential holistic therapy. Although the processing did not always run smoothly, as she projected very charged material on the therapists on several occasions, the process resulted in full health and a good quality of life due to her own will to recover and heal completely. The case illustrates the inner logic and complexity of intensive holistic therapy at the most difficult moment, where only a combination of intensive medical, psychiatric, and sexological treatment could set her free. In the paper, we also present a meta-perspective on intensive holistic therapy and its most characteristic phases.

Atypically presenting kaposiform hemangioendothelioma of the knee: ultrasound findings.

PubMed

Erdem Toslak, Iclal; Stegman, Matthew; Reiter, Michael P; Barkan, Güliz A; Borys, Dariusz; Lim-Dunham, Jennifer E

2018-04-10

Kaposiform hemangioendothelioma (KHE) is a rare vascular tumor of early childhood and infancy. Kasabach-Merritt phenomenon, a common complication of KHE, is characterized by life-threatening thrombocytopenia, hemolytic anemia, and consumption coagulopathy. There may be atypical cases that do not present with Kasabach-Merritt phenomenon and do have atypical imaging findings. Knowledge of atypical imaging features may assist radiologists in identifying KHE. In this report, we present a 4-year-old case of KHE with atypical ultrasound findings.

Monitoring and Fostering Elementary School Students' Life Satisfaction: A Case Study

ERIC Educational Resources Information Center

Wingate, Emily J.; Suldo, Shannon M.; Peterson, Rebekah K. S.

2018-01-01

Research on the importance of complete mental health has led to increased focus on students' subjective well-being (i.e., happiness and life satisfaction) coupled with the traditional attention to psychopathology. Although screeners for psychopathology abound, the present project is novel in applying best practices in universal screening to grade…

The Life Cycle of Academic Management Fads. ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Birnbaum, Robert

This study reviewed the literature to trace the evolution and life cycles of seven management techniques related to higher education. The seven case studies involved analysis of a selected sample of periodical, monograph, and technical literature from 1960 to the present. The literature base on each management technique was reviewed in reference…

Science gateways for semantic-web-based life science applications.

PubMed

Ardizzone, Valeria; Bruno, Riccardo; Calanducci, Antonio; Carrubba, Carla; Fargetta, Marco; Ingrà, Elisa; Inserra, Giuseppina; La Rocca, Giuseppe; Monforte, Salvatore; Pistagna, Fabrizio; Ricceri, Rita; Rotondo, Riccardo; Scardaci, Diego; Barbera, Roberto

2012-01-01

In this paper we present the architecture of a framework for building Science Gateways supporting official standards both for user authentication and authorization and for middleware-independent job and data management. Two use cases of the customization of the Science Gateway framework for Semantic-Web-based life science applications are also described.

[Palliative care in Primary Care: presentation of a case].

PubMed

Álvarez-Cordovés, M M; Mirpuri-Mirpuri, P G; Gonzalez-Losada, J; Chávez-Díaz, B

2013-10-01

We present a case of a patient diagnosed with glioblastoma multiforme refractory to treatment. Glioblastoma multiforme is the most common primary brain tumour and unfortunately the most aggressive, with an estimated mortality of about 90% in the first year after diagnosis. In our case the patient had reached a stage of life where quality of life was importsnt, with palliative care being the only recourse. The family is the mainstay in the provision of care of terminally ill patients, and without their active participation it would be difficult to achieve the objectives in patient care. We must also consider the family of the terminally ill in our care aim, as its members will experience a series of changes that will affect multiple areas where we should take action. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Life-threatening heat stroke presenting with ST elevations: a report of consecutive cases during the heat wave in Austria in July 2013.

PubMed

Lassnig, Elisabeth; Dinkhauser, Patrick; Maurer, Edwin; Eber, Bernd

2014-08-01

Heat stroke is a life-threatening condition due to an acute thermoregulatory failure during exposure to high environmental temperatures. We report a series of four cases (three exertional, one classic heat stroke) during the heat wave of July 2013 in Austria. All of them presented with a core temperature > 41 °C, central nervous dysfunction, acute respiratory and renal failure, disseminated intravascular coagulation, rhabdomyolysis, and severe electrocardiographic changes, two cases even mimicking ST-elevation myocardial infarction. The patients were cooled to normal temperature with the "Arctic sun" external cooling system within hours. Electrocardiographic changes resolved quickly. All patients primarily recovered from multiple organ dysfunction and could be discharged from intensive care unit. Unfortunately, the two elder patients died 1 week and 5 weeks later because of late complications.

[The sequential traumatisation of a Sinti-child Holocaust-survivor].

PubMed

Purucker, Michael

2004-05-01

The subject of this case-report is the life-history, nosogenesis and history of compensation claims of a 64-years old Sinti-woman, who survived Nazi-persecution and WWII as a child. She and her mother spent 3 years in a concentration camp. At the end of the war she witnessed her mothers death. Her life is characterised by psychosomatic symptoms, disorders of psychosexual development, including infertility, and a chronic Post Traumatic Stress Disorder. The non-treated course of the Holocaust survivor syndrom, described by Niederland, which was mostly denied in Germany, could be now shown by detailed exploration and the reanalysis of former expert reports of her symptoms. Furthermore, this case report presents the internationally described characteristics of long-term effects in children that have survived the Holocaust. These symptoms are typical of cases that were not been treated throughout life. The former lack of acceptance in Germany of these long-term effects has - like in this and other cases - lead to development into a chronic disorder.

Spondylocostal Dysostosis: A Literature Review and Case Report with Long-Term Follow-Up of a Conservatively Managed Patient

PubMed Central

Crawford, Alvin H.

2018-01-01

Introduction Patients with spondylocostal dysostosis (SCD) have congenital spine and rib deformities associated with frequently severe thoracic insufficiency and respiratory compromise. The literature is largely composed of case reports and small cohorts, and there is little information regarding adults with this condition. In this report, we describe the natural history of a conservatively treated patient and include quality-of-life issues such as childbearing, athletic participation, and occupational selection. Case Presentation We present a patient with SCD who was conservatively treated by a single physician from birth for 31 years. Our patient was capable of a reasonably good quality of life through adulthood, including participation in gymnastics and employment. At age 18, she became pregnant and subsequently terminated the pregnancy due to obstetrical concerns for compromised respiration. She has had intermittent respiratory complaints and occasionally experiences dyspnea with exertion, but this only has limited her during certain activities in the past three years. Currently, she takes naproxen for chronic back pain with periodic exacerbations. Discussion Other cases in the literature have described adult SCD patients who have received nonoperative treatment and achieved a wide range of functional outcomes. This provides some limited evidence to suggest that select patients with SCD may be treated conservatively and achieve a reasonable quality of life. However, close clinical follow-up with these patients is recommended, particularly early on, considering the high rates of infant morbidity and mortality. Chest physiotherapy and early pulmonary care have been associated with favorable outcomes in infancy. Surgery to increase thoracic volume and correct scoliosis has been shown in some cases to improve respiratory function. Treatment depends on the degree of thoracic insufficiency and quality of life. The natural history of SCD remains largely unknown, but some patients are capable of relatively favorable life spans, employment, and participation in athletics. PMID:29765785

[Quality of life in patients with urinary incontinence].

PubMed

Córcoles, Martínez B; Sánchez, Salinas A S; Bachs, Giménez J M; Moreno, Donate M J; Navarro, Pastor H; Rodríguez, Virseda J A

2008-02-01

To assess the quality of life of female patients with urinary stress incontinence (USI) who were attended at the urology department of the University Hospital at Albacete. Between November 2001 and December 2005, 126 patients with USI were surveyed in our hospital using the King's Health Questionnaire (KHQ), which is a specific instrument to measure the quality of life among female patients with urinary incontinence (UI). The mean age of patients was 57.09 años (SD: 9.57) and the mean BMI was 28.14 Kg/m2 (SD: 4.66). The mean evolution of UI was 114.48 months, with a median of 96 months. During the last week of the study period, a total of 73 women (57.94%) had more than 10 urine leaks a day. As regards the number of sanitary towels used a day, 82.5% (104 cases) stated they used less than 6. The urodynamic diagnosis was described as normal in 8 cases (6.3%), 16 cases (12.7%) were diagnosed as mixed urinary incontinence and, finally, 102 cases (81%) suffered genuine USI. The best scores were presented in the Personal Relationships scale with a mean score of 26.8, whereas the worse scores were noted in that of Impact of Urinary Incontinence, whose mean score was 82.96. Generally, the lowest scores (better quality of life) were obtained in the youngest age groups. Scores in the scales of General Health, Impact on daily activities, Impact on physical activity, Impact on social activity and Emotions, were significantly higher in patients who had undergone a histerectomy. Patients whose evolution of urinary incontinence was longer presented lower scores in the Personal Relationships scale (r=0.179; p=0.045). The quality of life of female patients with U.I. is affected, which limits both their physical activity and image. Their quality of life worsens with age, a greater extent of incontinence, greater urinary symptomatology and when episodes of urinary infection are associated.

Registry on acute cardiovascular events during endurance running races: the prospective RACE Paris registry.

PubMed

Gerardin, Benoît; Collet, Jean-Philippe; Mustafic, Hazrije; Bellemain-Appaix, Anne; Benamer, Hakim; Monsegu, Jacques; Teiger, Emmanuel; Livarek, Bernard; Jaffry, Murielle; Lamhaut, Lionel; Fleischel, Catherine; Aubry, Pierre

2016-08-21

Long distance running races are associated with a low risk of life-threatening events much often attributed to hypertrophic cardiomyopathy. However, retrospective analyses of aetiology lack consistency. Incidence and aetiology of life-threatening/fatal events were assessed in long distance races in the prospective Registre des Accidents Cardiaques lors des courses d'Endurance (RACE Paris Registry) from October 2006 to September 2012. Characteristics of life-threatening/fatal events were analysed by interviewing survivors and reviewing medical records including post-mortem data of each case. Seventeen life-threatening events were identified of 511 880 runners of which two were fatal. The vast majority were cardiovascular events (13/17) occurring in experienced male runners [mean (±SD) age 43 ± 10 years], with infrequent cardiovascular risk factors, atypical warning symptoms prior to the race or negative treadmill test when performed. Acute myocardial ischaemia was the predominant aetiology (8 of 13) and led to immediate myocardial revascularization. All cases with initial shockable rhythm survived. There was no difference in event rate according to marathons vs. half-marathons and events were clustered at the end of the race. A meta-analysis of all available studies including the RACE Paris registry (n = 6) demonstrated a low prevalence of life-threatening events (0.75/100 000) and that presentation with non-shockable rhythm [OR = 29.9; 95% CI (4.0-222.5), P = 0.001] or non-ischaemic aetiology [OR = 6.4; 95% CI (1.4-28.8), P = 0.015] were associated with case-fatality. Life-threatening/fatal events during long distance races are rare, most often unpredictable and mainly due to acute myocardial ischaemia. Presentation with non-shockable rhythm and non-ischaemic aetiology are the major determinant of case fatality. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Acral peeling skin syndrome in two East-African siblings: case report

PubMed Central

2012-01-01

Background Acral peeling skin syndrome is a rare autosomal recessive genodermatosis due to a missense mutation in transglutaminase 5. The skin peeling occurs at the separation of the stratum corneum from the stratum granulosum. Case presentation We present a case of two siblings who developed continuous peeling of the palms and soles from the first year of life. This peeling was more severe on the soles than palms and on younger sibling than elder sibling. Peeling is worsened by occlusion and sweating. Conclusions Sporadic cases of Acral Peeling Skin Syndrome occur in African population. There is variability in time of presentation and clinical severity even within families. PMID:22429841

Conceptual Framework To Extend Life Cycle Assessment ...

EPA Pesticide Factsheets

Life Cycle Assessment (LCA) is a decision-making tool that accounts for multiple impacts across the life cycle of a product or service. This paper presents a conceptual framework to integrate human health impact assessment with risk screening approaches to extend LCA to include near-field chemical sources (e.g., those originating from consumer products and building materials) that have traditionally been excluded from LCA. A new generation of rapid human exposure modeling and high-throughput toxicity testing is transforming chemical risk prioritization and provides an opportunity for integration of screening-level risk assessment (RA) with LCA. The combined LCA and RA approach considers environmental impacts of products alongside risks to human health, which is consistent with regulatory frameworks addressing RA within a sustainability mindset. A case study is presented to juxtapose LCA and risk screening approaches for a chemical used in a consumer product. The case study demonstrates how these new risk screening tools can be used to inform toxicity impact estimates in LCA and highlights needs for future research. The framework provides a basis for developing tools and methods to support decision making on the use of chemicals in products. This paper presents a conceptual framework for including near-field exposures into Life Cycle Assessment using advanced human exposure modeling and high-throughput tools

An Exceptional Case of Diabetic Ketoacidosis.

PubMed

Van de Vyver, Celine; Damen, Jorn; Haentjens, Carl; Ballaux, Dominique; Bouts, Benoit

2017-01-01

We present a case of diabetic ketoacidosis, known as one of the most serious metabolic complications of diabetes. We were confronted with rapid neurological deterioration and unseen glycaemic values, which reached almost 110 mmol/L, subsequently resulting in hyperkalaemia and life-threatening dysrhythmias. This is the first reported live case with such high values of blood glucose and a favourable outcome.

The problem of resonance in technology usage

NASA Technical Reports Server (NTRS)

Sayani, H. H.; Svoboda, C. P.

1981-01-01

Various information system tools and techniques are analyzed. A case study is presented which draws together the issues raised in three distinct cases. This case study shows a typical progression from the selection of an analysis methodology, to the adoption of an automated tool for specification and documentation, and the difficulty of fitting these into an existing life cycle development methodology.

Motor neurone disease presenting as polycythaemia.

PubMed

Santana-Vaz, Natasha; Bwika, Jumaa; Morley, Kirstie; Mukherjee, Rahul

2014-04-28

Motor neurone disease (MND) is a chronic, progressive and currently incurable neurodegenerative disorder. This case report discusses an instance of MND presenting initially as polycythaemia, caused via insidious respiratory failure through ventilatory insufficiency. This case aims to improve clinicians' awareness of this atypical presentation and highlights the need for a high index of suspicion of respiratory failure in any patient with polycythaemia. Finally it demonstrates an improvement in quality of life associated with the use of non-invasive ventilation (NIV) in a patient with MND.

Point-of-care ultrasound leads to diagnostic shifts in patients with undifferentiated hypotension.

PubMed

Shokoohi, Hamid; Boniface, Keith S; Zaragoza, Michelle; Pourmand, Ali; Earls, James P

2017-12-01

To assess the impact of an ultrasound hypotension protocol in identifying life-threatening diagnoses that were missed in the initial evaluation of patients with hypotension and shock. A subset of cases from a previously published prospective study of hypotensive patients who presented at the Emergency Department in a single, academic tertiary care hospital is described. An ultrasound-trained emergency physician performed an ultrasound on each patient using a standardized hypotension protocol. In each case, the differential diagnosis and management plan was solicited from the treating physician immediately before and after the ultrasound. This is a case series of patients with missed diagnoses in whom ultrasound led to a dramatic shift in diagnosis and management by detecting life threatening pathologies. Following a published prospective study of the effect on an ultrasound protocol in 118 hypotensive patients, we identified a series of cases that ultrasound protocol unexpectedly determined serious life threatening diagnoses such as Takotsubo cardiomyopathy, pulmonary embolism, pericardial effusion with tamponade physiology, abdominal aortic aneurysm and perforated viscus resulting in proper diagnoses and management. These hypotensive patients had completely unsuspected but critical diagnoses explaining their hypotension, who in every case had their management altered to target the newly identified life-threatening condition. A hypotension protocol is an optimal use of ultrasound that exemplifies "right time, right place", and impacts decision-making at the bedside. In cases with undifferentiated hypotension, ultrasound is often the most readily available option to ensure that the most immediate life-threatening conditions are quickly identified and addressed in the order of their risk potential. Copyright © 2017 Elsevier Inc. All rights reserved.

Successful use of recombinant factor VIIa in a preterm infant with life-threatening haematuria.

PubMed

Faust, Kirstin; Tröger, Birthe; Kahl, Fritz; Schumacher, Marius; Göpel, Wolfgang; Härtel, Christoph

2009-10-01

We report the case of a preterm male infant with a gestational age of 28 + 1 weeks and birth weight of 715 g who presented with life-threatening haematuria on day 28 of life. The haematuria was unresponsive to administration of platelet concentrates and fresh frozen plasma, but then successfully treated with recombinant factor VIIa. The resulting obstructive uropathy was managed by continuous bladder irrigation through suprapubic and urethral catheters. No other adverse affects were noted, and the boy was discharged from the hospital on day 108 of life.

You and Technology, A High School Case Study Text.

ERIC Educational Resources Information Center

Damaskos, Nickander J., Ed.; Smyth, Michael P., Ed.

This second draft of a manuscript for a high school engineering and technology course uses case studies as its format. The principles associated with various engineering problems are presented along with their effects on daily life. Topics include the computer, the automotive power system, satellite communications, the petroleum industry, water…

The effect of life skills training on emotional intelligence of the medical sciences students in iran.

PubMed

Lolaty, Hamideh A; Ghahari, Sharbanoo; Tirgari, Abdolhakim; Fard, Jabbar Heydari

2012-10-01

Emotional intelligence has a major role in mental health and life skills training, and could be viewed as a bridge relating to emotional intelligence and mental health. The present study is aimed at determining the effect of life skills training on the emotional intelligence among the first year students of Mazandaran University of Medical Sciences. MATERIALS AND METHODS: IN THIS EXPERIMENTAL STUDY, THE SUBJECTS WERE SELECTED BY RANDOM SAMPLING AND ALLOCATED INTO TWO GROUPS: Case group (n=20) and control group (n=19); they matched for gender, experience of stressful life events in the past six months, level of interest in the field of study, and level of emotional intelligence. The two groups responded to Bar-on Emotional Quotient Inventory before starting the experiment. Subsequently, the case group underwent life skills training. After the training, Bar-on Emotional Quotient Inventory was responded by the case and control groups again. The data was analyzed using descriptive statistics including Chi-square test, paired and independent t-tests, using SPSS software version 15. In the case group, the scores of emotional intelligence after life skills training were significantly improved (t=11.703 df=19 P=0.001), while no significant difference was observed in the control group (t=0.683 df =18 P=0.503). By performing programs such as life skills training, the levels of emotional intelligence of the students could be increased, which itself could lead to academic success, reduced substance abuse, and increased stress tolerance in the students.

Dream Work in Grief Therapy

PubMed Central

Noronha, Konrad Joseph

2014-01-01

Working with dreams is useful with grief and loss clients who present with dreams. Adlerian dream analysis is one-way of exploring dreams. It incorporates the life-style of the client. This case report demonstrates how Adlerian dream analysis was used with a client. Progress was noted in improved life-style once the client began to talk about her dream. PMID:25035561

A Case of Post Myocardial Infarction Papillary Muscle Rupture.

PubMed

Anuwatworn, Amornpol; Milnes, Christopher; Kumar, Vishesh; Raizada, Amol; Nykamp, Verlyn; Stys, Adam

2016-06-01

Papillary muscle rupture is a rare, life-threatening post myocardial infarction mechanical complication. Without surgical intervention, prognosis is very poor. Clinicians need to recognize this complication early, as prompt therapy is crucial. We present a case of inferior ST elevation myocardial infarction complicated by posteromedial papillary muscle rupture resulting in severe acute mitral regurgitation (flail anterior mitral leaflet), acute pulmonary edema and cardiogenic shock. In our patient, a new mitral regurgitation murmur suggested this mechanical complication. Complete disruption of papillary muscle was visualized by transesophageal echocardiography. This case illustrates the importance of good physical examination for early diagnosis of papillary muscle rupture, so that life-saving treatment can be administered without delay.

Chronic brain damage in sickle cell disease and its relation with quality of life.

PubMed

Cela, Elena; Vélez, Ana G; Aguado, Alejandra; Medín, Gabriela; Bellón, José M; Beléndez, Cristina

2016-12-16

Sickle cell anaemia causes progressive organ damage. The objective is to describe school performance of patients with sickle cell anaemia and their clinical parameters and quality of life that may have an influence. The hypothesis is that if school alterations occur without other objective data, additional factors must be present besides the disease itself. Transversal study performed in November 2015 considering analytical variables, complications and neuroradiological images of children with sickle cell anaemia, and family survey on school performance and quality of life. Median age was 6.8 years and 78% were diagnosed at birth. Sixty patients were included. School performance was altered in 51% of cases and was related to nocturnal hypoxemia. Acute stroke incidence was 6.7%. Transcranial ultrasound was abnormal in 4% of cases and magnetic resonance imaging in 16% of cases. Quality of life showed pathological findings in all areas and the low values increased proportionally in older ages. The stroke affected the physical and social sphere, and lung disease affected the physical and emotional spheres. Poor school performance affects half of the patients and it is related to nocturnal hypoxemia, although other socio-cultural factors may have an influence. Quality of life is affected in most of these cases independently of academic results. The absence of alterations in neuroimaging or the apparent lack of severe clinical parameters do not mean that quality of life and schooling are normal. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Adenoid cystic carcinoma: An unusual presentation.

PubMed

Pushpanjali, M; Sujata, D Naga; Subramanyam, S Bala; Jyothsna, M

2014-05-01

The adenoid cystic carcinoma is a relatively rare epithelial tumor of the major and minor salivary glands, accounting for about 1% of all malignant tumor of the oral and maxillofacial regions. Peak incidence occurs between the 5(th) and 6(th) decades of life. The clinical and pathological findings typical of this tumor include slow growth, peri-neural invasion, multiple local recurrences and distant metastasis. Herein, we report a case of adenoid cystic carcinoma of oropharynx with unusual clinical presentation. The diagnosis of this case and importance of cytology in diagnosing such cases is discussed.

Adenoid cystic carcinoma: An unusual presentation

PubMed Central

Pushpanjali, M; Sujata, D Naga; Subramanyam, S Bala; Jyothsna, M

2014-01-01

The adenoid cystic carcinoma is a relatively rare epithelial tumor of the major and minor salivary glands, accounting for about 1% of all malignant tumor of the oral and maxillofacial regions. Peak incidence occurs between the 5th and 6th decades of life. The clinical and pathological findings typical of this tumor include slow growth, peri-neural invasion, multiple local recurrences and distant metastasis. Herein, we report a case of adenoid cystic carcinoma of oropharynx with unusual clinical presentation. The diagnosis of this case and importance of cytology in diagnosing such cases is discussed. PMID:25328314

End-of-life decisions in Dutch neonatal intensive care units.

PubMed

Verhagen, A A Eduard; Dorscheidt, Jozef H H M; Engels, Bernadette; Hubben, Joep H; Sauer, Pieter J

2009-10-01

To clarify the practice of end-of-life decision making in severely ill newborns. Retrospective descriptive study with face-to-face interviews. The 10 neonatal intensive care units in the Netherlands from October 2005 to September 2006. All 367 newborn infants who died in the first 2 months of life in Dutch neonatal intensive care units. Adequate documentation was available in 359 deaths. Presence of end-of-life decisions, classification of deaths in 3 groups, and physicians' considerations leading to end-of-life decisions. An end-of-life decision preceded death in 95% of cases, and in 5% treatment was continued until death. Of all of the deaths, 58% were classified as having no chance of survival and 42% were stabilized newborns with poor prognoses. Withdrawal of life-sustaining therapy was the main mode of death in both groups. One case of deliberate ending of life was found. In 92% of newborns with poor prognoses, end-of-life decisions were based on patients' future quality of life and mainly concerned future suffering. Considerations regarding the infant's present state were made in 44% of infants. Virtually all deaths in Dutch neonatal intensive care units are preceded by the decision to withdraw life-sustaining treatment and many decisions are based on future quality of life. The decision to deliberately end the life of a newborn may occur less frequently than was previously assumed.

Leiomyoma of Urinary Bladder Presenting with Febrile Urinary Tract Infection: A Case Report.

PubMed

Haddad, Ra'ed Ghassan; Murshidi, Mujalli Mhailan; Abu Shahin, Nisreen; Murshidi, Muayyad Mujalli

2016-01-01

Leiomyomas of urinary bladder constitute only about 0.43% of all bladder tumors. Only about 250 cases were reported in English literature. This is the first reported case of bladder leiomyoma to present with febrile urinary tract infection. We report a case of a 37- year old male who presented with febrile urinary tract infection. Imaging showed a bladder lesion. This lesion was managed by transurethral resection. Pathologic diagnosis was bladder leiomyoma. Although bladder leiomyomas are benign, they can cause serious sequelae, including serious urinary tract infections as the case we present here shows. This is why it is important to early diagnose and treat this condition. This case highlights the importance of early introduction of imaging in patients presenting with severe urinary tract infections. Failure to diagnose this lesion as the underlying cause of infection may have easily led to recurrence of similar severe life-threatening infections. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Chest wall resection for local recurrence of breast cancer. Presented at the 99th Meeting of the Royal Belgium Society of Obstetrics and Gynecology, Brussels May 9th 1998, Belgium.

PubMed

Tjalma, W; Van Schil, P; Verbist, A M; Buytaert, P; van Dam, P

1999-05-01

We present three cases of chest wall resection for locally recurrent breast cancer and a Medline review of the current literature. In selected cases full thickness resection of the chest wall may be used as a salvage procedure to improve the quality of life and prolong the survival at low morbidity and mortality.

The accountant as triage master: an economist's perspective on voluntary euthanasia and the value of life debate.

PubMed

Richardson, J

1987-07-01

The author, an economist, rebuts the contention that human life cannot and should not be economically evaluated and argues that such evaluations are made implicitly and inconsistently, resulting in a reduction of human welfare. He presents an economic framework for the analysis of costs and benefits in which the focal point, as in most value systems, is the tradeoff between life and quality of life. Therefore, as the quality of life decreases, society's efforts to preserve life should decrease. If the valuation of life includes self evaluation, then there should be less effort to preserve the life of an individual who wishes to die. Richardson concludes that voluntary euthanasia is a limiting case in which society accepts the individual's valuation of life.

Pheochromocytoma presenting with rhabdomyolysis and acute renal failure: a case report.

PubMed

Celik, Huseyin; Celik, Ozlem; Guldiken, Sibel; Inal, Volkan; Puyan, Fulya Oz; Tugrul, Armagan

2014-02-01

Rhabdomyolysis ranges from an asymptomatic illness with elevated creatine kinase levels to a life-threatening condition associated with extreme elevations in creatine kinase, electrolyte imbalances, acute renal failure, and disseminated intravascular coagulation. The most common causes are crush injury, overexertion, alcohol abuse, certain medicines, and toxic substances. A number of electrolyte abnormalities and endocrinopathies, including hypothyroidism, thyrotoxicosis, diabetic ketoacidosis, nonketotic hyperosmolar state, and hyperaldosteronism, cause rhabdomyolysis. Rhabdomyolysis and acute renal failure are unusual manifestations of pheochromocytoma. There are a few case reports with pheochromocytoma presenting rhabdomyolysis and acute renal failure. Herein, we report a case with pheochromocytoma crisis presenting with rhabdomyolysis and acute renal failure.

The use of hypnosis in therapy to increase happiness.

PubMed

Ruysschaert, Nicole

2014-01-01

In their journey through life, most people are looking for happiness. Definitions of happiness and the concepts of a pleasant, good, meaningful, and a full life are reviewed. Next, Seligman's (2002) concept of "authentic happiness" and a happiness formula, S+C+V (Set + Circumstances + Variables), are discussed. An integration of happiness, as a goal, and hypnosis, as a facilitative approach, are presented. Hypnotic techniques with case examples are given. Hypnosis is presented as an efficient companion intervention to work on these variables in a creative way and to pave the way to a happy and full life. The following results are presented: (1) hypnosis allows for increased executive attention with control of emotions, (2) focusing on positive imagery contributes to strengthening "happy pathways," and (3) emotions about the past, present, and future are subject to change.

An autochthonous case of cystic echinococcosis in Finland, 2015.

PubMed

Hämäläinen, Sari; Kantele, Anu; Arvonen, Miika; Hakala, Tapio; Karhukorpi, Jari; Heikkinen, Jukka; Berg, Ensio; Vanamo, Kari; Tyrväinen, Erja; Heiskanen-Kosma, Tarja; Oksanen, Antti; Lavikainen, Antti

2015-01-01

We report a case of pulmonary cystic echinococcosis in a child from eastern Finland with no history of travelling abroad. The cyst was surgically removed and the organism molecularly identified as Echinococcus canadensis genotype G10. This parasite is maintained in eastern Finland in a sylvatic life cycle involving wolves and moose; in the present case, the infection was presumably transmitted by hunting dogs.

Simpson's Paradox: A Data Set and Discrimination Case Study Exercise

ERIC Educational Resources Information Center

Taylor, Stanley A.; Mickel, Amy E.

2014-01-01

In this article, we present a data set and case study exercise that can be used by educators to teach a range of statistical concepts including Simpson's paradox. The data set and case study are based on a real-life scenario where there was a claim of discrimination based on ethnicity. The exercise highlights the importance of performing…

Mystery of the Toxic Flea Dip: An Interactive Approach to Teaching Aerobic Cellular Respiration

ERIC Educational Resources Information Center

Baines, A. T.; McVey, M.; Rybarczyk, B.; Thompson, J. T.; Wilkins, H. R.

2004-01-01

We designed an interrupted case study to teach aerobic cellular respiration to major and nonmajor biology students. The case is based loosely on a real-life incident of rotenone poisoning. It places students in the role of a coroner who must determine the cause of death of the victim. The case is presented to the students in four parts. Each part…

Hypocalcaemia-induced tetany secondary to total thyroidectomy: a nursing case review.

PubMed

Bakon, Shannon; Craft, Judy; Christensen, Martin

2017-07-05

Presentations to the emergency department with a diagnosis of hypocalcaemia-induced tetany secondary to total thyroidectomy are rare. A patient presented to the emergency department of a regional Australian hospital with hypocalcaemia-induced tetany. A case study was employed to reflect on the care provided and identify knowledge practice deficits within this unusual patient presentation. Calcium plays a central role within the nervous system and is vital for both cardiac and muscular contraction. The clinical manifestations of electrolyte disturbances such as hypocalcaemia can be life threatening, and therefore, appropriate assessment, monitoring and management are essential to ensure positive patient outcomes. Understanding the importance of calcium imbalance for the emergency and critical care nurse is paramount in preventing complications associated with cardiac conduction and muscle tone, especially the potential for airway compromise. Education is central to this and may include clinical case reviews, the application of pathophysiological presentations of electrolyte imbalance and a review of electrolyte administration guidelines. Understanding the role of calcium within the body will assist emergency and critical care nurses to assess, monitor and intervene appropriately, thereby preventing the life-threatening manifestations of hypocalcaemia. © 2017 British Association of Critical Care Nurses.

Purpura, petechiae, and bullae as first signs of juvenile granulomatosis with polyangiitis.

PubMed

Rawn, Saara; Miettunen, Paivi; Brown, Holly A; Schmeling, Heinrike

2014-12-01

We present a case of a 14-year-old girl who had a severe form of granulomatosis with polyangiitis (GPA) with extensive dermatological involvement, whose initial presentation was nonspecific leading to diagnostic confusion and initial consideration of infectious and other vasculitis causes. The patient presented with fever, congestion, malaise, and sinus pain. She was diagnosed with bacterial sinusitis and treated with antibiotics. Within weeks, she developed abdominal pain, hematuria, migratory arthritis, and palpable purpura and was diagnosed with Henoch-Schonlein purpura. She went on to develop hemoptysis and progression of the rash into erosive bullae. Investigations revealed that she was ANCA positive and had pauci-immune glomerulonephritis. Given her upper airway, pulmonary and renal involvement, and antineutrophil cytoplasmic antibodies positivity, a definitive diagnosis of a severe form of GPA was made. GPA is a chronic relapsing, life threatening vasculitis that predominantly affects small vessels. Our case demonstrates that GPA can present initially with nonspecific symptoms, including extensive dermatological involvement, leading to diagnostic confusion, and delays in treatment. In the case of a severe peripheral rash in the juvenile population and/or resistant upper airway symptoms, it is vital to consider a diagnosis of GPA to avoid serious organ or life threatening consequences.

Prevalence of pulmonary artery hypertension in patients of chronic obstructive pulmonary disease and its correlation with stages of chronic obstructive pulmonary disease, exercising capacity, and quality of life.

PubMed

Gupta, Kamlesh Kumar; Roy, Bidyut; Chaudhary, Shyam Chand; Mishra, Arvind; Patel, M L; Singh, Jitendra; Kumar, Vivek

2018-01-01

Pulmonary arterial hypertension (PAH) is a complication of chronic obstructive pulmonary disease (COPD) in advance stages, and its presence indicates poor prognosis. The present study was design to know the prevalence of PAH in patients with COPD and its correlation with stages of COPD, exercising capacity, and quality of life. It is a cross-sectional prevalence study over a period of 1 year from August 2015 to July 2016. The study included 109 COPD patients, diagnosed by spirometry, and severity was determined according Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification criteria. Screening two-dimensional echocardiography was done to determine pulmonary arterial hypertension and exercising capacity assessed by 6 min walk test (6MWT) while the quality of life was assessed by St George respiratory Questionnaire for COPD (SGRQ-C) Questionnaires. Out of 109 patients, PAH was present in 68 (62.4%) cases consisting of mild grade 41 (37.6%), moderate grade 11 (10.1%), and severe grade 16 (14.7%). In GOLD A stage, there were 20 cases of mild PAH and Stage B included 18 cases of mild and 3 cases of moderate PAH. Stage C had 3 cases of mild and 8 cases of moderate PAH while Stage D had 16 cases of severe PAH. In 6MWT, patients with severe grade PAH fail to perform the test while patients with mild to moderate PAH walked short distance. In SGRQ-C Questionnaires symptom, activity, impact, and total score were high with the severity of PAH. The prevalence of PAH in COPD was significant. Therefore, every COPD patient should be evaluated for PAH.

Prevalence of pulmonary artery hypertension in patients of chronic obstructive pulmonary disease and its correlation with stages of chronic obstructive pulmonary disease, exercising capacity, and quality of life

PubMed Central

Gupta, Kamlesh Kumar; Roy, Bidyut; Chaudhary, Shyam Chand; Mishra, Arvind; Patel, M. L.; Singh, Jitendra; Kumar, Vivek

2018-01-01

Background: Pulmonary arterial hypertension (PAH) is a complication of chronic obstructive pulmonary disease (COPD) in advance stages, and its presence indicates poor prognosis. Aims and Objective: The present study was design to know the prevalence of PAH in patients with COPD and its correlation with stages of COPD, exercising capacity, and quality of life. Materials and Methods: It is a cross-sectional prevalence study over a period of 1 year from August 2015 to July 2016. The study included 109 COPD patients, diagnosed by spirometry, and severity was determined according Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification criteria. Screening two-dimensional echocardiography was done to determine pulmonary arterial hypertension and exercising capacity assessed by 6 min walk test (6MWT) while the quality of life was assessed by St George respiratory Questionnaire for COPD (SGRQ-C) Questionnaires. Results: Out of 109 patients, PAH was present in 68 (62.4%) cases consisting of mild grade 41 (37.6%), moderate grade 11 (10.1%), and severe grade 16 (14.7%). In GOLD A stage, there were 20 cases of mild PAH and Stage B included 18 cases of mild and 3 cases of moderate PAH. Stage C had 3 cases of mild and 8 cases of moderate PAH while Stage D had 16 cases of severe PAH. In 6MWT, patients with severe grade PAH fail to perform the test while patients with mild to moderate PAH walked short distance. In SGRQ-C Questionnaires symptom, activity, impact, and total score were high with the severity of PAH. Conclusion: The prevalence of PAH in COPD was significant. Therefore, every COPD patient should be evaluated for PAH. PMID:29915733

[Individual medical relevance of headaches. Comorbidities and quality of life].

PubMed

Haag, G

2014-08-01

In a multitude of cases, very frequent primary headaches lead to a clear deterioration in quality of life. Particularly in patients with chronic migraine, chronic tension headache, and cluster headache, quality of life is limited. This contradicts the preconception still encountered today that headaches are not a serious illness. Comorbidities with somatic and above all mental disorders are also very frequently observed in headache patients. In the foreground are the cardiovascular diseases of arterial hypertension, stroke, and coronary heart disease, as well as the mental disorders of depression, anxiety disorders, posttraumatic stress disorders, and sleep disorders. When such comorbidities are present, the quality of life of the sufferers is significantly reduced. Therefore, headache disorders should be taken seriously and sufferers should be provided with a consistent therapy. In cases of severe types of headache and in the presence of comorbidities, it is imperative that therapy is also prophylactic and multimodal in nature.

Sepsis and acute respiratory distress syndrome requiring extracorporeal life support in an adolescent with mild cystic fibrosis.

PubMed

Faricy, Lauren Elizabeth; Church, Gwynne

2017-01-01

Outcomes for invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO) to treat acute respiratory failure in patients with mild cystic fibrosis (CF) lung disease are not known. We present a case of the successful use of ECMO to treat acute respiratory failure secondary to staphylococcal sepsis in an adolescent CF patient with previously normal lung function. Her post-ECMO course was notable for severe airflow obstruction, hypoxemia, deconditioning, and growth failure. She had significantly improved at six months follow-up, though she continued to have moderate airflow obstruction on pulmonary function testing. This case illustrates that ECMO and prolonged intubation can prolong life in CF patients with mild lung disease who present with potentially reversible acute respiratory failure, though they are associated with significant morbidity.

Giant Hepatic Aneurysm Presenting With Hematemesis Successfully Treated With an Endovascular Technique.

PubMed

Abdallah, Feras F; Serracino-Inglott, Ferdinand; Ananthakrishnan, Ganapathy

2017-07-01

Hepatic artery aneurysms are uncommon visceral aneurysms that are usually found incidentally on imaging. We present a case of large common hepatic aneurysm presenting with life-threatening hematemesis due to duodenal erosion, in a 66-year-old man, treated by embolization with Onyx and coils while preserving hepatic perfusion.

Making Public the Private Life of Plants: The Contribution of Informal Learning Environments

ERIC Educational Resources Information Center

Sanders, Dawn L.

2007-01-01

Plants are essential to life on Earth and yet are often deemed invisible by the human populace. Botanic gardens are an under-researched educational context and, as such, have occupied a peripheral arena in biology education discussions. This article seeks to readdress this absence and present the case for a more sustained use of informal learning…

A Winding Road--Professional Trajectories from Higher Education to Working Life: A Case Study of Political Science and Psychology Graduates

ERIC Educational Resources Information Center

Nystrom, Sofia; Dahlgren, Madeleine Abrandt; Dahlgren, Lars Owe

2008-01-01

This qualitative and longitudinal study focuses on graduate employment and the development of graduate employment paths. The aim of this article is to explore the present professional trajectory from higher education to working life, with particular reference to graduates from two different study programmes at Linkoping University in Sweden:…

School Crisis Management: A Model of Dynamic Responsiveness to Crisis Life Cycle

ERIC Educational Resources Information Center

Liou, Yi-Hwa

2015-01-01

Purpose: This study aims to analyze a school's crisis management and explore emerging aspects of its response to a school crisis. Traditional linear modes of analysis often fail to address complex crisis situations. The present study applied a dynamic crisis life cycle model that draws on chaos and complexity theory to a crisis management case,…

Starting Life Over--Working with the Head Injured: The Case of Randall.

ERIC Educational Resources Information Center

Bostwick, Tracy

1993-01-01

Presents case of engineering college student who, after automobile accident, three months in coma, and four years of rehabilitation therapy, is seeking career counseling due to his frustrations with obtaining full-time professional employment. Notes that client had difficulty remembering new information; was physically slow; was mentally slower…

Insects Affecting Man. MP-21.

ERIC Educational Resources Information Center

Lawson, Fred A.; Spackman, Everett

The insects discussed in this document are those which have a direct effect upon humans either through a permanent association, as with lice, or a temporary association in the case of flies, bees, wasps, and spiders. In each case, life cycles and identifying characteristics are presented with remarks about the specific effect incurred by man. (CS)

Increasing Unit Effectiveness in a Dynamic Environment by Implementing a Leadership Mathematical Model

DTIC Science & Technology

2011-06-10

research . For example, Creswell presents five types of qualitative research : narrative , phenomenological , grounded theory , ethnographic research , and... case study (2007, 53). According to Denzin and Lincoln (2005) there are six research directions: case study , ethnography , grounded theory , life 32...commanders. A method could be a kind of theory . Hence, grounded

Constructing increment-decrement life tables.

PubMed

Schoen, R

1975-05-01

A life table model which can recognize increments (or entrants) as well as decrements has proven to be of considerable value in the analysis of marital status patterns, labor force participation patterns, and other areas of substantive interest. Nonetheless, relatively little work has been done on the methodology of increment-decrement (or combined) life tables. The present paper reviews the general, recursive solution of Schoen and Nelson (1974), develops explicit solutions for three cases of particular interest, and compares alternative approaches to the construction of increment-decrement tables.

Discharge diagnoses in infants with apparent life-threatening event.

PubMed

Okada, Kazuko; Miyako, Motoko; Honma, Satoshi; Wakabayashi, Yasuko; Sugihara, Shigetaka; Osawa, Makiko

2003-10-01

There are various identifiable diseases or conditions that can be associated with an apparent life-threatening event (ALTE) in infancy. The present study was carried out to investigate the etiology of ALTE based on the discharge diagnoses. A protocol for the complete work-up used to examine the cause of ALTE was designed, and was carried out for 69 infants with ALTE. Gastroesophageal reflux disease (GERD) was demonstrated in 38 cases, and chronic gastric volvulus (CGV) was diagnosed in 21 (associated with GERD in 13 infants). Four cases of pertussis and two cases each of sepsis, laryngomalacia, respiratory immaturity, and premature ventricular contractions were found. Others cases presented with pneumonia, meningitis, intussuception, food allergy, epilepsy, and adenoid vegetations. In 12 of the 69 infants with ALTE, no abnormalities were found in any of the studies performed, including two patients with breath-holding spells. In 17 cases, two or more possibly contributing findings were diagnosed. It is important to recognize that gastroesophageal impairments such as GERD or CGV could be responsible for many incidences of ALTE in infancy. The authors recommend a trial be established to investigate the causes of ALTE, including gastroesophageal evaluations in all infants with ALTE.

The effectiveness of osteopathic manipulative treatment in an abnormal uterine bleeding related pain and health related quality of life (HR-QoL) - A case report.

PubMed

Goyal, Kanu; Goyal, Manu; Narkeesh, Kanimozhi; John Samuel, Asir; Sharma, Sorabh; Chatterjee, Subhasish; Arumugam, Narkeesh

2017-07-01

Abnormal uterine bleeding is characterized by painful and/or excessive menorrhea, chronic pelvic pain due to the endometriosis (Em). Osteopathic treatment is commonly used in the gynecological dysfunctions. The aim of the present case study was to explore the effect of osteopathic treatment (OT) for a woman with abnormal uterine bleeding related pain and quality of life (QoL). We reported a case of 29 year old female who presented with chief complaints of increased flow during periods, lower abdominal pain, leukorrhoea, lower back pain and with occasional constipation for the last 3 years. Patient is a mother of 6 years old male child born with normal delivery. On diagnostic ultrasonography the uterus was found bulky with insignificant endometriosis and no other abnormality was detected. She did not have any relevant past medical and surgical history. The pre and post osteopathic treatment measurements were measured using Visual Analog Scale (VAS) and the health related quality of life (HR-QoL) questionnaire called short form Endometriosis Health Profile Questionnaire (EHP) - 5. In the present case the pain due to the endometriosis was treated with the osteopathic treatment consists of all the major diaphragms' release (release of pelvic diaphragm, abdominal diaphragm, thoracic outlet release and hyoid diaphragm) during the first session and in the second session gastro-esophageal (GE) junction release, sigmoid colon release, cranial therapy to the occiput, sacral release and dural tube rocking. Following that improvement of pain from VAS 8.3/10 to 3.9/10 and QoL improvement from EHP-5, 72/100 to 26/100 was noted. Osteopathic manipulative approach (OMA) in the patient with Em might improve the abnormal uterine bleeding related pain and health related quality of life (HR-QoL). Copyright © 2016 Elsevier Ltd. All rights reserved.

Substance abuse as a way of life in marginalized gender identity disorder: a case report with review of Indian literature.

PubMed

Goyal, Shrigopal; Deb, Koushik Sinha; Elawadhi, Deeksha; Kaw, Nanaji

2014-12-01

Persons suffering from gender identity disorder (GID) are often severely marginalized in India and mostly live outside the society as a part of a minority community called the Hijras. Although substance abuse is considered a way of life in them, such patients rarely seek treatment because of the stigma and fear of discrimination. We report a case of GID presenting to tertiary care centre for treatment of multiple substance use dependence (SUD). The case is the first to highlight the use and dependence of multiple substances in the Hijra community of India. Further, the case emphasizes that SUD treatment might be a worthwhile intervention to bring such marginalized population under treatment, when further complicated issues on gender identity can be addressed. Copyright © 2014. Published by Elsevier B.V.

Metabolism, body size and life span: a case study in evolutionarily divergent populations of the garter snake (Thamnophis elegans).

PubMed

Bronikowski, Anne; Vleck, David

2010-11-01

We present a case study of metabolism, life history and aging in the western terrestrial garter snake (Thamnophis elegans). Early research in the field supported the rate-of-living hypothesis as an explanation of aging, which was based on an apparent negative relationship between mass-specific metabolic rate and lifespan in endotherms. This hypothesis in its original form has not withstood additional tests and comparisons between the two main lineages of endotherms-birds and mammals, but there is still much to be discovered of the causative links among rate of oxygen consumption, physiology and life history, particularly in ectothermic reptiles. We present data that show adult short-lived snakes, from naturally occurring ecotypes of garter snakes, have higher mass-specific resting metabolic rates at any given body mass (metabolic intensity) across a series of normal activity temperatures (15-32°C). The short-lived ecotype in this geographic region reaches a larger body size, and has life-history traits that place it at the fast end of a pace-of-life continuum (fast growth, early maturation, high reproductive output) relative to individuals of the small-bodied long-lived ecotype. The difference between ecotypes in metabolic intensity, even after acclimation to identical conditions, may reflect evolutionary divergence and genetic differences between ecotypes. The difference in metabolic intensity is not, however, present at birth, so an alternative is that developmental environment may permanently influence metabolic rate and life history. Such developmental canalization could lead to altered gene expression via environmental influences on the epigenome and result in altered metabolic trajectories in the snakes' natural habitats.

Evaluation and management of priapism in a newborn: A case report and review of the literature

PubMed Central

Dust, Nicholas; Daboval, Thierry; Guerra, Luis

2011-01-01

Idiopathic neonatal priapism is a rare and poorly understood phenomenon. The case of an otherwise healthy premature male newborn who was noted to have a persistent penile erection on the first day of life is presented. A Doppler ultrasound of the penis was performed, along with the first-ever cavernous blood gas analysis reported in a newborn. These investigations indicated that the presentation was consistent with nonischemic (arterial or high-flow) priapism. The patient was managed conservatively and the erection resolved fully on the sixth day of life. A review of the existing literature identified polycythemia as the most common identifiable cause of priapism in newborns, but the majority of cases are idiopathic. In most instances, observation alone is appropriate and spontaneous detumescence occurs. There are no published reports of erectile impairment following neonatal priapism, which suggests that this condition is relatively benign in the absence of other disease states. PMID:22211080

The Lavelle Affair: An Air Force Case Study in Ethics

DTIC Science & Technology

2016-06-01

THE LAVELLE AFFAIR: AN AIR FORCE CASE STUDY IN ETHICS BY KRISTINA ELLIS A THESIS PRESENTED TO THE FACULTY OF THE SCHOOL OF... ethical transgressions. As such, the story of General Lavelle’s wartime command experiences became a case study in ethics and integrity within Air...1 1 THE LIFE AND CAREER OF GENERAL LAVELLE 8 1 VIETNAM 14 2 CIVIL-MILITARY RELATIONS 25 2 ETHICAL

Modelling in Action. Examining How Students Approach Modelling Real Life Situations. Three Case Studies. Model of the Movement of an Elevator

ERIC Educational Resources Information Center

Rivas, Eugenia Marmolejo

2015-01-01

By means of three case studies, we will present two mathematical modelling activities that are suitable for students enrolled in senior high school and the first year of mathematics at university level. The activities have been designed to enrich the learning process and promote the formation of vital modelling skills. In case studies one and two,…

Fatal coma in a young adult due to late-onset urea cycle deficiency presenting with a prolonged seizure: a case report.

PubMed

Alameri, Majid; Shakra, Mustafa; Alsaadi, Taoufik

2015-11-23

Unexplained hyperammonemic coma in adults can be a medical dilemma in the absence of triggering factors and known comorbidities. Ornithine transcarbamylase deficiency presents most commonly with hyperammonemic coma. Although a rare disorder, ornithine transcarbamylase deficiency is the most common of the urea cycle disorders, which can occur both in children, and less commonly, in adults. The urea cycle disorder is usually acquired as an X-linked trait, and very rarely, similar to our reported case, may be acquired as a "new" mutation. Mutations that lead to later-onset presentations may lead to life-threatening disease and may be unrecognized, particularly when the first clinical symptoms occur in adulthood. We report the case of a previously healthy 17-year-old white man who developed a prolonged seizure and a rapid decline in mental status leading to coma over a 3-day period. Analysis of the OTC gene showed a 119G variant, which was identified in exon 2 of the OTC gene by sequencing. A diagnosis of ornithine transcarbamylase deficiency should be considered in adult patients who present with unexplained hyperammonemic coma and for all adult patients presenting with cryptogenic new-onset seizure and laboratory finding of elevated blood ammonia levels. This reported case highlights the importance of early recognition of this potentially reversible cause of life-threatening encephalopathy, as timely recognition and appropriate treatment can be lifesaving.

Case Reports of Five Cancer Patients with Unusual Course.

PubMed

Payrhuber, Dietmar; Thieves, Karin; Sangaletti, Piero; Muehlmann, Josef; Frass, Michael

2018-06-16

 The analysis of the periodic table of elements by Jan Scholten opened the way for a new kind of classification and repertorisation of homeopathic remedies. Thereby, group analysis (resorting to series and stages) makes precise prescriptions possible. This approach appears to yield striking results, even in severe cases. Whereas Hahnemann stressed the emotional state ('Gemüthssymptome', Organon § 210) when choosing a remedy, Scholten 200 years later investigated the mental picture that represents a life conflict or even a life theme that may maintain the disease process. The person's environment, emotional traumas or a conflict drives him or her to suppress and dissect painful emotions. Such compensations can become subconscious and so strong that they can no longer be controlled; they then influence the patient with a highly destructive energy.  We present five case reports, each dealing with an unusual clinical course of severe cancer associated with homeopathic treatment using the Scholten method.  By presenting these cases, we consider how the constitution (lifelong signs and symptoms of the patient) and the mental state are interwoven and, as a complex mechanism, might provoke disease.  The appropriate homeopathic remedy, reflecting the Scholten approach, seemed to have beneficial impact on the disease process of the five individuals presented. The Faculty of Homeopathy.

Actinic Prurigo Cheilitis: A Clinicopathologic Review of 75 Cases.

PubMed

Plaza, Jose A; Toussaint, Sonia; Prieto, Victor G; Mercadillo, Patricia; Diez de Medina, Juan C; Lourenco, Silvia; Batdorf, Bjorn; Sangueza, Martin

2016-06-01

Actinic prurigo (AP) is a chronic idiopathic photodermatosis that primarily affects American Indians in the United States and Mestizos in Latin American countries. Clinically, the onset of the disease is usually in the first decade of life but may appear initially in adult life, and it is characterized by symmetric involvement of sun-exposed areas of the skin, particularly areas of the face, resulting in polymorphic erythematous papules, macules, and plaques in different stages of evolution. Lower lip involvement includes swelling, scaling, fissures, hyperpigmentation, and ulcerations of the vermilion border. and in some cases could represent the only manifestation of the disease. The histopathologic features of AP have been studied; however, there is a controversy regarding whether AP cheilitis has distinct histopathologic features that could allow accurate separation from other specific and nonspecific forms of cheilitis. The diagnosis can be challenging, mainly when lip lesions are the only manifestation of the disease. In this study, the authors investigate the clinicopathologic features of 75 cases of AP cheilitis to provide further criteria for its diagnosis and classification. All 75 patients presented with lip lesions. Thirty-three cases were diagnosed as AP cheilitis with cutaneous lesions and 42 cases were diagnosed as AP cheilitis without cutaneous lesions (only lip lesions). Histologically, of the 33 cases with AP cheilitis with cutaneous lesions, 17 (52%) cases showed follicular cheilitis, and of the 42 cases that had only lip lesions, 18 (43%) cases showed follicular cheilitis. Histologically, AP cheilitis can present as follicular cheilitis; thus, supporting the diagnosis. Also, our findings confirm that lip lesions can present as the only manifestation of the disease, showing typical histological and clinical features. This form of cheilitis has not being well described in the dermatologic and dermatopathologic literature.

Laryngeal Involvement of Rhabdomyosarcoma in an Adult

PubMed Central

Abali, Hüseyin; Aksoy, Sercan; Sungur, Arzu; Yalçin, Suayib

2003-01-01

Background Although initial presentation of sarcomas in the head and neck region is relatively common, involvements of the larynx by rhabdomyosarcoma either primary or metastatic have been reported rarely. Case report A case of rhabdomyosarcoma in the right thigh, which involved laryngeal structures three years after the diagnosis, is presented. Conclusions The laryngeal involvement by primary and metastatic rhabdosarcomas is very rare, however when it occurs it can result in life treating upper airway obstruction. After emergency intervention, radiotherapy and / or chemotherapy must be undertaken for long-term benefit and surgery may be helpful only in selected cases. PMID:14556654

Case studies in medical futility.

PubMed

Mains, Douglas A; Coustasse, Alberto; Lurie, Sue G

2007-01-01

Technology has provided means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient. This study presents two case histories, compiled from historical patient charts, staff notes and observations, that illustrate the variety of ethical issues involved and the role culture plays in the decision making process related to possible futile medical treatment. Ethical and cultural issues related to the cases are discussed and processes are presented that can help hospitals to avoid, or decrease the level of, medically futile care, and improve the cultural appropriateness of medical care and relationships with patients.

Your (Flex) Time May Come

ERIC Educational Resources Information Center

Morgan, Frank T.

1977-01-01

After citing reasons for the use of flextime, a case study is presented which indicates positive effects of flextime scheduling for employees--work satisfaction, better performance, and more personal life--and the company. (SH)

Role of Echocardiograghy in Treating a Case of Double Chamber Right Ventricle with Delayed Presentation.

PubMed

Barik, Ramachandra

2017-01-01

The clinical diagnosis of double chamber right ventricle (DCRV) is not straightforward. Clinical history, clinical examination, 12-lead electrocardiogram, chest X-ray, and Echocardiography (echo) contribute to morphological diagnosis. Cardiac catheterization is essential for hemodynamic evaluation. A thorough presurgical workup helps the cardiac surgeon to choose the appropriate surgical approach and timing of surgery in an individual case. We present a case of a DCRV who presented to us in the fifth decade of life. Echo confirmed the morphological diagnosis and cardiac catheterization complemented the exact pull back gradient across the obstruction in the right ventricle. This patient was suggested muscle bundle resection and ventricular septal defect closure using right atrial approach.

Determining system boundaries on commercial broiler chicken production system using ISO 14040/14044 guideline: A case Study

NASA Astrophysics Data System (ADS)

Sidek, ‘A. A.; Suffian, S. A.; Al-Hazza, M. H. F.; Yusof, H. M.

2018-01-01

The demand of poultry product in Malaysia market shows an escalation throughout the year and expected to increase in the future. The expansion of poultry production has led to environmental concern in relation to their operational impact to environmentAt present, assessment of waste management of poultry production in Malaysia is lacking. A case study research was conducted in a commercial broiler farm to identify and assess the system boundaries in the lifecycle supply chain of broiler chicken production using ISO 14040/44 guidelines. ISO 14040/44 standard includes Life Cycle Assessment (LCA) framework guidelines to evaluate environmental influence associated with a product/process throughout its life span. All attributes associated with broiler operation is defined and the system boundaries is determined to identify possible inputs and outputs in the case study. This paper discuss the initial stage in the LCA process, which set the context of the research and prepare for the stage of Life Cycle Inventory.

Surgical correction of the snout suffocation syndrome.

PubMed

Keipper, V L; Chikes, P G

1990-04-01

Two nursing home patients with difficulty breathing because of occlusion of the mouth and nares by an involuntary snout reflex-like mannerism have previously been described. In both cases advanced dementia, edentia, and a downward-angled nasal base were present. Life-threatening hypoxia occurred intermittently in one case, and after becoming severe, was corrected by the surgical procedure described.

The Case for Group Counseling as the Means for Eliminating Erroneous Zones.

ERIC Educational Resources Information Center

Dyer, Wayne W.

1979-01-01

Presents a case for group counseling, a curricular intervention that aids young people in learning how to make decisions, take charge of their emotions and reorder their thinking, and focus on themselves as human beings. They learn to shed their erroneous zones and to opt for a neurosis-free, self-actualized life. (Author/BEF)

Life in the Cloud: A WorldShare Management Services Case Study

ERIC Educational Resources Information Center

Hartman, Robin R.

2012-01-01

A small, private academic library took the risk of moving from a traditional integrated library system to adopting a system "in the cloud." This case study presents the setting, history, and local needs of the library, including staffing challenges, and explains the decision-making rationale and process. A description of the library's transition…

Isolation of sochi virus from a fatal case of hantavirus disease with fulminant clinical course.

PubMed

Dzagurova, Tamara K; Witkowski, Peter T; Tkachenko, Evgeniy A; Klempa, Boris; Morozov, Vyacheslav G; Auste, Brita; Zavora, Dmitriy L; Iunicheva, Iulia V; Mutnih, Elena S; Kruger, Detlev H

2012-01-01

Sochi virus, a novel genetic variant of Dobrava-Belgrade virus, was isolated in cell culture from a fulminant lethal case of hantavirus disease presenting with shock and combined kidney and lung failure. Sochi virus is transmitted to humans from host reservoir Apodemus ponticus and must be considered a life-threatening emerging agent.

The Fish Kill Mystery: Learning about Aquatic Communities

ERIC Educational Resources Information Center

Kosal, Erica F.

2004-01-01

This paper presents a case where students can learn about aquatic communities. In this case, students speculate on what may have caused a major fish kill in an estuary in North Carolina. In the process, they explore how land runoff and excess nutrients affect aquatic communities. They also learn about the complex life cycle of the dinoflagellate…

The Importance of Decision Making: A Gifted Case Report

ERIC Educational Resources Information Center

Nauta, Noks; Ronner, Sieuwke; Groeneveld, Benno

2009-01-01

In this article the story of a fictional young university-educated woman is presented who struggles with making choices in her career and in her life. In this case report background information on gifted people at work is provided. In addition to that jobs and companies which are appropriate for highly gifted are mentioned. Besides that…

Implementing Problem-Based Learning in an Undergraduate Psychology Course

ERIC Educational Resources Information Center

Searight, H. Russell; Searight, Barbara K.

2009-01-01

Problem-based learning (PBL) is a small-group pedagogical technique widely used in fields such as business, medicine, engineering, and architecture. In PBL, pre-written cases are used to teach core course content. PBL advocates state that course material is more likely to be retained and applied when presented as cases reflecting "real life"…

Institutionalizing China's Research University through Academic Mobility: The Case of PKU

ERIC Educational Resources Information Center

Xiaoguang, Shi

2015-01-01

Academic mobility is becoming a tread in academic life and a professional development globally, regionally and nationally. This article makes use of a case university--Peking University (PKU)--as an analytical approach to explore how and why academic mobility can happen in China's research universities. The author first presents an overview of the…

Beneficial effects of physical activity in an HIV-infected woman with lipodystrophy: a case report

PubMed Central

2011-01-01

Introduction Lipodystrophy is common in patients infected with human immunodeficiency virus receiving highly active antiretroviral therapy, and presents with morphologic changes and metabolic alterations that are associated with depressive behavior and reduced quality of life. We examined the effects of exercise training on morphological changes, lipid profile and quality of life in a woman with human immunodeficiency virus presenting with lipodystrophy. Case presentation A 31-year-old Latin-American Caucasian woman infected with human immunodeficiency virus participated in a 12-week progressive resistance exercise training program with an aerobic component. Her weight, height, skinfold thickness, body circumferences, femur and humerus diameter, blood lipid profile, maximal oxygen uptake volume, exercise duration, strength and quality of life were assessed pre-exercise and post-exercise training. After 12 weeks, she exhibited reductions in her total subcutaneous fat (18.5%), central subcutaneous fat (21.0%), peripheral subcutaneous fat (10.7%), waist circumference (WC) (4.5%), triglycerides (9.9%), total cholesterol (12.0%) and low-density lipoprotein cholesterol (8.6%). She had increased body mass (4.6%), body mass index (4.37%), humerus and femur diameter (3.0% and 2.3%, respectively), high-density lipoprotein cholesterol (16.7%), maximal oxygen uptake volume (33.3%), exercise duration (37.5%) and strength (65.5%). Quality of life measures improved mainly for psychological and physical measures, independence and social relationships. Conclusions These findings suggest that supervised progressive resistance exercise training is a safe and effective treatment for evolving morphologic and metabolic disorders in adults infected with HIV receiving highly active antiretroviral therapy, and improves their quality of life. PMID:21892961

Minneapolis Multi-Ethnic Curriculum Project--Acculturation Unit.

ERIC Educational Resources Information Center

Skjervold, Christian K.; And Others

The student booklet presents short case studies illustrating the acculturation unit of the Minneapolis Multi-Ethnic Curriculum Project for secondary schools. It is presented in nine chapters. Chapter I provides background information on immigration and points out ways acculturation takes place. Chapter II, "Barrio Boy," tells of life in…

Quality of life in women with urinary incontinence.

PubMed

Mladenović Segedi, Ljiljana; Segedi, Dimitrije; Parezanović Ilić, Katarina

2011-08-01

To determine the characteristics of urinary incontinence and its impact on the quality of life in adult women with urinary incontinence who presented to a tertiary care clinic of Vojvodina from September 2008 to May 2009 for treatment We used a prospective case-control study. Cases were defined as patients (47) with urinary incontinence symptoms. Controls (50) were defined as patients without urinary incontinence who presented to a tertiary care gynecology clinic for other reasons. Both, cases and controls, completed two questionnaires recommended for the evaluation of symptoms, The Urinary Distress Inventory, and quality of life impact The Urinary Impact Questionnaire. There was a significant correlation between aging (r=0.614; p<0.01), body mass index (r=0.357; p<0.01) and menopause (r= -0.572; p<0.01) and urinary incontinence. All patients had symptoms of stress incontinence, 61.7% had urge incontinence symptoms, 21.3% voiding difficulty and 85.1% dysuria. Ninety-four patients believed that urinary incontinence impaired their quality of life: 50% of patients reported an impaired ability to do household activities, 59.1% avoided social activities, 70.4% reported an impaired ability to travel more than 30 minutes by car or bus, 88.6% avoided leisure activities, 45.5% of patients had impaired emotional health and 34% felt frustrated. The dominant type of urinary incontinence in more than half of the respondents was a mixed type, with moderate to very severe problems. Symptoms of urinary incontinence interfere with the performance of everyday household and social activities, causing the appearance of anxiety, depression and frustration, and in more than 50% of women leads to reduced quality of life.

The Interrelationship between Language and Culture.

ERIC Educational Resources Information Center

Chang, Hsiu-Chen

2002-01-01

Significant, real-life instances of cross-cultural miscommunication or conflict are presented and categorized into verbal and non-verbal parts. each case is discussed and analyzed for the possible causes and feasible solutions. (Author/VWL)

Odorous vaginal discharge - a case study for thorough investigation.

PubMed

Cernat, Geta; Leung, Lawrence

2011-08-01

Odorous vaginal discharge is a common presentation to general practitioners, and a frequent presentation for bacterial infections and sexually transmissible diseases. Busy GPs may be tempted to make a diagnosis from the clinical history and symptoms, and prescribe antibiotics as a first line treatment. This case highlights an unusual cause of persistent odorous vaginal discharge. If a thorough examination had not been conducted, the cause would have been overlooked, first line antibiotics would most likely have been ineffective, and potentially life threatening consequences may have occurred.

Effective nutrition support programs for college athletes.

PubMed

Vinci, D M

1998-09-01

This paper presents an overview of the Husky Sport Nutrition Program at the University of Washington. This program is a component of the Department of Intercollegiate Athletics Total Student-Athlete Program, an NCAA-sponsored CHAMPS/Life Skills Program that provides life skills assistance to student-athletes. Successful integration of a sport nutrition program requires an understanding of the athletic culture, physiological milestones, and life stressors faced by college athletes. The sport nutritionist functions as an educator, counselor, and administrator. Team presentations and individual nutrition counseling provide athletes with accurate information on healthy eating behaviors for optimal performance. For women's sports, a multidisciplinary team including the sport nutritionist, team physician, clinical psychologist, and athletic trainer work to prevent and treat eating disorders. Case studies are presented illustrating the breadth of nutrition-related issues faced by a sport nutritionist working with college athletes.

Risk factors and treatment for steroid-related mood and behavior symptoms in preschool children with leukemia: A case series.

PubMed

Samsel, Chase; Muriel, Anna C

2017-02-01

Treatment of pediatric acute lymphoblastic leukemia (ALL) relies on systemic corticosteroids for remission; however, they can cause significant mood and behavior changes that interfere with quality of life and may increase risk for injury. This case series reports on preschool children with preexisting developmental and psychiatric risk factors who presented with behavioral side effects that required intervention. Identification of these vulnerable children may provide opportunities for early intervention, anticipatory guidance, and effective treatment to minimize behavioral side effects and improve quality of life and safety during ALL treatment. © 2016 Wiley Periodicals, Inc.

Anomalous origin of the left coronary artery from the pulmonary artery in adults: a comprehensive review of 151 adult cases and a new diagnosis in a 53-year-old woman.

PubMed

Yau, James M; Singh, Rajiv; Halpern, Ethan J; Fischman, David

2011-04-01

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality associated with early infant mortality and adult sudden death. As it predominantly presents in the first year of life, diagnosis in living adults is extremely rare. Current management is based on limited case series or extrapolated from pediatric cases. Modern advances in noninvasive cardiac imaging have substantially increased the number of diagnoses, uncovering a large adult population that has not been reviewed. The availability of newer diagnostic modalities correlates with an increasing incidence in an older cohort, and true association between sudden death and ALCAPA may be lower, especially among older patients. A comprehensive literature search was performed for all case reports of ALCAPA on MEDLINE and PubMed using the keywords ALCAPA, Bland-White-Garland, and coronary anomaly; and augmented by references from published case reports from 1908 to 2008. All adult cases, defined by age 18 years and older, were reviewed for this article. One hundred fifty-one adult cases of ALCAPA are described, in addition to the case of an asymptomatic 53-year-old woman. The average reported age was 41 years old with the oldest being 83. Sixty-six percent of the patients presented with symptoms of angina, dyspnea, palpitations, or fatigue; 17% presented with ventricular arrhythmia, syncope, or sudden death; and 14% were asymptomatic. Twelve percent were diagnosed at autopsy. The majority had some form of surgical correction during their clinical course. ALCAPA is a rare and life-threatening condition in adults. The availability of newer, less invasive diagnostic modalities has resulted in more frequent identification of this condition in an older cohort. © 2011 Wiley Periodicals, Inc.

Microperforated Hymen Presenting Spontaneous Pregnancy with Cesarean Delivery and Hymenotomy Surgery: A Case Report.

PubMed

Elshani, Brikene; Arifi, Heroid; Daci, Armond

2018-03-15

Female genital tract anomalies including imperforate hymen affect sexual life and fertility. In the present case, we describe a pregnant woman diagnosed with imperforate hymen which never had penetrative vaginal sex. A 27-year-old married patient with 2 months of amenorrhea presented in a clinic without any other complications. Her history of difficult intercourse and prolonged menstrual flow were reported, and subsequent vaginal examination confirmed the diagnosis of imperforate hymen even though she claims to made pinhole surgery in hymen during puberty. Her urine pregnancy test was positive, and an ultrasound examination revealed 8.3 weeks pregnant. The pregnancy was followed up to 39.5 weeks when she entered in cesarean delivery in urgency. Due to perioperative complications in our study, a concomitant hymenotomy was successfully performed. The patient was discharged with the baby, and vaginal anatomy was restored. This case study suggests that even though as microperforated hymen surgery in puberty can permit pregnancy and intervention with cesarean section and hymenotomy is a good option to reduce the resulting perioperative complications which indirectly affect the increase of the fertilisation and improvement of later sexual life.

Human placental lactogen and color Doppler in predicting expulsion of retained adherent placenta: a new clinical observation.

PubMed

Zepiridis, L; Zafrakas, M; Theodoridis, T D; Assimakopoulos, E; Tzevelekis, P; Athanatos, D; Bontis, J N; Tarlatzis, B C

2009-12-01

To present a new clinical observation made in three cases of retained adherent placenta, a rare obstetrical complication, associated with potentially life-threatening hemorrhage. Three consecutive cases of retained adherent placenta are presented. Diagnosis of placenta increta in two and placenta percreta in one case was established with ultrasound and MRI. Methotrexate 50 mg i.v. (300 mg total dose) and follinic acid 0.1 mg/kg were administered on alternating days, over 12 days. On follow-up, placental perfusion on color Doppler was present up to the point when circulating hPL levels were no longer detectable; this was followed in all cases by spontaneous placental expulsion within 10 days. The observation that both color Doppler and human placental lactogen can be used to monitor response to therapy and predict placental expulsion should be evaluated in future cases of retained adherent placenta.

Ewings Sarcoma: A Case of Respiratory Distress and Opacification That Was not Pneumonia.

PubMed

Wells, Jordee M; Spencer, Sandra P

2018-05-01

The Ewing sarcoma family of tumors typically appears in the second decade of life with regional pain and swelling of a long bone. The following case presents a pediatric patient, aged 4 years, given a diagnosis of Ewing sarcoma of the rib with the initial presentation of respiratory distress, hypoxia, and pleural effusion. Respiratory distress accounts for a large majority of emergency department visits annually, so it is the distinct responsibility of the emergency department physician to avoid premature closure in attributing the most common diagnoses to account for the presenting symptoms. In this case, the careful study of the initial radiographic findings led to further identification and characterization of the mass through thoracic computed tomography to suggest Ewing sarcoma, despite the patient's unlikely demographics and presentation.

Cervical abscess: a life-threatening complication of infectious mononucleosis.

PubMed

Westmore, G A

1990-04-01

The former view of infectious mononucleosis as an invariably benign disease has been modified in recent years by reports of life-threatening complications. A case is presented of a deep cervical abscess complicating infectious mononucleosis which came close to a fatal conclusion. The implications for the management of the illness are discussed in the light of this rare event, no exactly similar instance of which has been recorded.

Invasive rhino-orbito-cerebral mucormycosis in a diabetic patient – the need for prompt treatment

PubMed Central

Chow, Vanessa; Khan, Sheema; Balogun, Adeola; Mitchell, David; Mühlschlegel, Fritz A.

2014-01-01

Mucormycosis is a rare life threatening fungal infection predominately seen in immunocompromised or diabetic patients. The following case is of a known type II diabetic patient who presented with sepsis and sudden unilateral loss of vision secondary to infective rhino-orbito-cerebral mucormycosis. Treatment of the condition required extensive surgical intervention and medical management for a life saving outcome. PMID:25750854

Bilateral Central Retinal Vein Occlusion as Presenting Feature of Chronic Myeloid Leukemia

PubMed Central

Narang, Subina; Gupta, Panchmi; Sharma, Anuj; Sood, Sunandan; Palta, Anshu; Goyal, Shilpa

2016-01-01

Central retinal vein occlusion (CRVO) is a common pathology of the retinal vasculature. Patients with CRVO usually present with a drop in visual acuity. The condition bears no specific therapy; treatment is aimed at the management of potentially blinding complications, of which there are many. With majority of cases being unilateral, bilateral CRVO is usually associated with an underlying systemic illness such as a hyperviscosity syndrome. Here, we present a case of a patient, who presented with a bilateral drop in vision diagnosed as bilateral CRVO on ophthalmic evaluation. Systemic workup revealed the presence of an underlying undiagnosed chronic myeloid leukemia. An initial presentation to the ophthalmologist is a rare occurrence in leukemic patients. This case report highlights the role of the ophthalmologist in diagnosing a potentially life-threatening hematological illness. PMID:27555710

An unusual presentation of an unusual complication of infectious mononucleosis: haematemesis and melaena.

PubMed

Koay, C B; Norval, C

1995-04-01

Tonsillar haemorrhage is a rare complication of infectious mononucleosis. We present a case of life-threatening tonsillar haemorrhage secondary to infectious mononucleosis in a young man whose predominant symptoms at presentation were haematemesis and melaena. The origin of the haemorrhage was not obvious until the patient was examined under anaesthesia. The bleeding was controlled by emergency tonsillectomy.

[Verrucose epidermal nevus with belated grow and pregnancy. Case report].

PubMed

Aguilera Martínez, Verónica; Cervantes Villarreal, Gustavo Enrique; Ramos Garibay, Alberto; Ruiz Mondragón, María Eugenia

2007-10-01

Verrucose epidermal nevus is a benign and congenital hyperplasia of the superficial epidermis and annexes. It expresses itself during the firs year of life, grows during childhood and in adolescence reaches its largest size. It can appear everywhere in skin surface. We present a case of late verrucose epidermal nevus with genital onset. Differential diagnosis was done with acuminated condylomas.

Pseudoaneurysm of the internal maxillary artery secondary to subcondylar fracture: case report and literature review.

PubMed

Moro, Alessandro; Todaro, Mattia; Pedicelli, Alessandro; Alexandre, Andrea; Pelo, Sandro; Doneddu, Piero; Gasparini, Giulio; Garagiola, Umberto; D'Amato, Giuseppe; Saponaro, Gianmarco

2018-04-01

Pseudoaneurysms are an uncommon complication of mandibular condylar-subcondylar fractures; however, if present, their recognition and management is mandatory to avoid life-threatening situations. The authors report a case of internal maxillary artery pseudoaneurysm rupture that occurred after an open reduction and internal fixation of a mandibular subcondylar fracture, along with a review of the literature.

ELECTRO CONVULSIVE THERAPY IN PRE-PUBERTAL CATATONIA: A CASE STUDY

PubMed Central

Thakur, Anupam; Dutta, S.; Jagadheesan, K.; Sinha, Vinod Kumar

2001-01-01

Depression in prepubertal age group is a relatively rare condition. The presence of life threatening catatonic features call for aggressive treatment. Electro convulsive therapy (ECT) has been described to be effective in these circumstances; however, doubts have been raised about its safety profile. This present case study illustrates the efficacy and safety of ECT in prepubertal catatonia. PMID:21407888

THREE GENERATIONS, CASE MATERIALS IN LOW INCOME URBAN LIVING.

ERIC Educational Resources Information Center

JEFFERS, CAMILLE

ONE IN A SERIES OF STUDIES OF THE CHILD REARING STUDY (CRS) OF LOW-INCOME FAMILIES IN WASHINGTON, D.C., THIS BOOKLET PRESENTS CASE MATERIALS TO ILLUSTRATE THE CRS THESIS THAT THERE IS A WIDE VARIABILITY IN BEHAVIOR AND OUTLOOK AMONG THE URBAN POOR, AND SUGGESTS SOME OF THE IMPLICATIONS OF THE CRS FINDINGS FOR PARENT AND FAMILY LIFE EDUCATION.…

Case report: Survival after deliberate strychnine self-poisoning, with toxicokinetic data

PubMed Central

Wood, David Michael; Webster, Emma; Martinez, Daniel; Dargan, Paul Ivor; Jones, Alison Linda

2002-01-01

Introduction Strychnine poisoning is uncommon, and in most severe cases, the patient dies before reaching hospital. The management of strychnine poisoning is well documented, although there are few data on the kinetics of elimination of strychnine after overdose. Case report A 42-year-old man presented shortly after ingestion of an unknown quantity of strychnine powder. After a respiratory arrest, with intensive supportive management requiring admission to an intensive care unit, he survived. Eight serum samples were taken over the first 5 days and analysed subsequently for strychnine concentrations. Results The initial concentration at 1.5 hours after ingestion was 4.73 mg/l, falling to 0.38 mg/l at 74 hours postingestion. Serum concentrations followed a monoexponential elimination curve with a calculated elimination half-life of 12 hours. Discussion and conclusion Strychnine poisoning presents with classical features, and with early diagnosis and supportive management, the patient can survive. The initial serum concentration of 4.73 mg/l is the highest reported concentration in a patient who has survived. Previous reports of the elimination half-life have suggested it is between 10 and 16 hours, which conforms to the elimination data in our case. PMID:12398788

Neuropsychological functioning in Wernicke's encephalopathy

PubMed Central

Behura, Sushree Sangita; Swain, Sarada Prasanna

2015-01-01

Context: Wernicke's encephalopathy (WE) is caused by thiamine (Vitamin B1) deficiency and most commonly found in chronic alcoholism and malnutrition. Clinically, the key features are mental status disturbances (global confusion), oculomotor abnormalities, and gait disturbances (ataxia). Apart from these clinical features, we can find deficits in neuropsychological functioning in patients with WE, which is more prominent after the improvement in the physical conditions. Neuropsychological functioning includes both basic cognitive processes (i.e., attention-concentration) as well as higher order cognitive processes (i.e., memory, executive functioning, reasoning), which is much vital for the maintenance of quality of life of an individual. However, unfortunately, in most of the cases, neuropsychological functioning is ignored by the clinicians. Materials and Methods: In this study four case reports of WE have been presented. The patients were taken from the outdoor department of Mental Health Institute, S.C.B. Medical College, Cuttack, Odisha. Neuropsychological functioning was measured by administration of PGIBBD and Quality of Life was measured by WHO-QOL BREF Odia Version. Discussion: As described in the literature, among the three cardinal signs (global confusion, ataxia, and ocular sings), the first two were present in all cases, but nystagmus was present in only two cases. Memory dysfunction was so disabling that the persons were unable to maintain a good Quality of Life and occupational impairment was prominent. There are disturbances in recent, remote memory, immediate recall, delayed recall, and attention and concentration, ultimately creating both physical and mental disability. PGI-BBD findings also suggest the overall impairment in neuropsychological functioning other than memory, that is, executive functioning, visual acuity, and depth perception. Findings of WHO-QOL BREF suggest the impairment of four domains of QOL in all the cases, but the severity level varies from person to person. Conclusion: Like the three cardinal features, neuropsychological dysfunction in WE should be given importance, which is a most vital component for the maintenance of QOL. As a result, the disability produced by this condition can be well managed. PMID:26257495

Typhoid ulcer causing life-threatening bleeding from Dieulafoy's lesion of the ileum in a seven-year-old child: a case report

PubMed Central

2010-01-01

Introduction We describe a case of rare complication of typhoid fever in a seven-year-old child and review the literature with regard to other rare causes of bleeding per rectum. Dieulafoy's lesion is an uncommon but important cause of recurrent gastrointestinal bleeding. Dieulafoy's lesion located extragastrically is rare. We report a case of typhoid ulcer with Dieulafoy's lesion of the ileum causing severe life-threatening bleeding and discuss the management of this extremely uncommon entity. Case presentation As a complication of typhoid fever, a seven-year-old Kurdish girl from Northern Iraq developed massive fresh bleeding per rectum. During colonoscopy and laparotomy, she was discovered to have multiple bleeding ulcers within the Dieulafoy's lesion in the terminal ileum and ileocecal region. Conclusion Although there is no practical way of predicting the occurrence of such rare complications, we emphasize in this case report the wide array of pathologies that can result from typhoid fever. PMID:20525295

“I tried so many diets, now I want to do it differently”—A single case study on coaching for weight loss

PubMed Central

Stelter, Reinhard

2015-01-01

In this single case study, the author presented an in-depth description and analysis of a coaching intervention with focus on weight loss, conducted over 10 sessions in the course of 17 months. The client was a well-educated woman in her late 30s, who had tried many different forms of dieting over the years—with little and no lasting effect. In his coaching approach, the author went beyond a pure behavioural change model, that is, based on the Health Belief Model, and tried to take a whole-life perspective, where the client learned to link specific events and habits in her work life and everyday life with specific eating habits. In their collaborative practice, coach and coachee initiated changes both in regard to diet, physical activity, and healthy life style, in general. In a theoretical section, the change in understanding with regard to overeating was presented. Finally, an intra-active model—viewing the client as a self-reflective individual—was used as theoretical basis. A narrative analysis of the first session and a cross-session examination was presented to show, analyse, and understand the procedure of the coaching approach. Finally, the voice of the coachee was heard in regard to her personal experiences during the process. The data material was based on audio recordings of selected sessions, notes written by the coach from every session, and final written reflections by the coachee. PMID:26282867

The Two-Year Post-Secondary College Student and Life Span Development.

ERIC Educational Resources Information Center

Morgan, Don A., Ed.

This monograph presents the papers and addresses of the Sixth Rochester Institute, an annual joint staff development effort of Rochester Community College and the University of Minnesota. W. Wesley Tennyson and Sharon Strom present a case for career development education to be used as a fulcrum to swing education further towards humanistic…

Pacemaker failure resulting from radiation damage

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

Quertermous, T.; Megahy, M.S.; Das Gupta, D.S.

1983-07-01

The authors present a case of radiation-induced pacemaker failure. After 2000 rad (20 Gy) of photon irradiation for metastatic bronchogenic carcinoma, the pulse generator circuitry failed, producing a runaway rhythm. This suggests that present pacemaker circuitry may be more susceptible to irradiation than previously believed, and that even modest radiation doses can induce life-threatening arrhythmias.

Role of Echocardiograghy in Treating a Case of Double Chamber Right Ventricle with Delayed Presentation

PubMed Central

Barik, Ramachandra

2017-01-01

The clinical diagnosis of double chamber right ventricle (DCRV) is not straightforward. Clinical history, clinical examination, 12-lead electrocardiogram, chest X-ray, and Echocardiography (echo) contribute to morphological diagnosis. Cardiac catheterization is essential for hemodynamic evaluation. A thorough presurgical workup helps the cardiac surgeon to choose the appropriate surgical approach and timing of surgery in an individual case. We present a case of a DCRV who presented to us in the fifth decade of life. Echo confirmed the morphological diagnosis and cardiac catheterization complemented the exact pull back gradient across the obstruction in the right ventricle. This patient was suggested muscle bundle resection and ventricular septal defect closure using right atrial approach. PMID:28465983

The variable presentations and broadening geographic distribution of hepatic fascioliasis.

PubMed

Rowan, Sarah E; Levi, Marilyn E; Youngwerth, Jean M; Brauer, Brian; Everson, Gregory T; Johnson, Steven C

2012-06-01

We report 2 unrelated cases of hepatic fascioliasis in travelers returning to the United States from Africa and the Middle East. The first case presented with acute infection. Prominent clinical features included abdominal pain, elevated liver transaminases, serpiginous hepatic lesions, pericapsular hematoma, and marked peripheral eosinophilia. The second case was diagnosed in the chronic stage of infection and presented with right upper quadrant abdominal pain, cystic hepatic lesions, and an adult fluke in the common bile duct. We review the life cycle of Fasciola species, the corresponding clinical features during the stages of human infection, diagnostic methods, and the evolving understanding of the epidemiology of human fascioliasis, particularly emphasizing fascioliasis in African countries. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

A case of a brain stem abscess with a favorable outcome

PubMed Central

Bulthuis, Vincent J.; Gubler, Felix S.; Teernstra, Onno P. M.; Temel, Yasin

2015-01-01

Background: A brain stem abscess is a rare and severe medical condition. Here, we present a rare case of a brain stem abscess in a young pregnant woman, requiring acute stereotactic intervention. Case Description: A 36-year-old woman presented with a headache, nausea, and vomiting, and computed tomography showed a space-occupying lesion in the brain stem. She became shortly after comatose, and we decided to perform an acute stereotactic aspiration of the abscess. Soon after surgery, her neurological condition improved dramatically. Conclusion: A brainstem abscess is a life-threatening condition with a potentially good outcome if treated adequately. PMID:26543670

Acral peeling skin syndrome in two East-African siblings: case report.

PubMed

Kiprono, Samson K; Chaula, Baraka M; Naafs, Bernard; Masenga, John E

2012-03-19

Acral peeling skin syndrome is a rare autosomal recessive genodermatosis due to a missense mutation in transglutaminase 5. The skin peeling occurs at the separation of the stratum corneum from the stratum granulosum. We present a case of two siblings who developed continuous peeling of the palms and soles from the first year of life. This peeling was more severe on the soles than palms and on younger sibling than elder sibling. Peeling is worsened by occlusion and sweating. Sporadic cases of Acral Peeling Skin Syndrome occur in African population. There is variability in time of presentation and clinical severity even within families.

Infant botulism, type F, presenting at 54 hours of life.

PubMed

Keet, Corinne A; Fox, Christine K; Margeta, Marta; Marco, Elysa; Shane, Andi L; Dearmond, Stephen J; Strober, Jonathan B; Miller, Steven P

2005-03-01

We report a case of botulism in a 54-hour-old infant with rapidly progressive fulminant paralysis and rapid spontaneous recovery atypical for infant botulism. Clostridium baratii and type F botulinum neurotoxin were isolated from the patient's stool. This unique presentation with rapid recovery is consistent with pharmacokinetics of type F botulinum neurotoxin. Interestingly, a muscle biopsy also revealed pathologic changes early in the disease course. This article reports the youngest known case of infant botulism and only the third reported case of this disease caused by type F neurotoxin. Botulism should be considered in patients of any age with subacute or acute neuromuscular weakness.

Solitary pancreatic head metastasis from tibial adamantinoma: a rare indication to pancreaticoduodenectomy

PubMed Central

Silvestri, S; Sandrucci, S; Comandone, A; Molinaro, L; Chiusa, L; Fronda, G R; Franchello, A

2018-01-01

Abstract Pancreatic metastases are rare, <2% of all pancreatic neoplasia. This is the first case of pancreatic metastasis from adamantinoma, a rare, low grade and slow growing tumor which is frequently localized in long bones. We describe a case of a 45-year-old woman presenting with increased bilirubin level. Computed tomography and ecoendoscopic ultra sonography revealed a pancreatic head mass. Fine-needle aspiration biopsy was consistent with metastatic adamantinoma. The patient was submitted to a standard pancreaticoduodenectomy. As in the case presented, standard pancreatic resections are safe and feasible options to treat non-pancreatic primary tumor improving patient’s survival and quality of life. PMID:29479415

Two case reports of orofacial paraesthesia demonstrating the role of the general dental practitioner in identifying patients with intracranial tumours.

PubMed

Barber, Andrew J; Lawson, David D A; Field, E Anne

2009-04-01

The following case reports describe the clinical features, diagnosis and management of two patients who presented to their general dental practitioner with a complaint of orofacial paraesthesia. After appropriate investigations, both patients were diagnosed as having benign intracranial tumours and were managed by a neurosurgeon. These cases illustrate the important role the general dental practitioner has in the early recognition of potentially life-threatening conditions.

Presence of voltage-gated potassium channel complex antibody in a case of genetic prion disease

PubMed Central

Jammoul, Adham; Lederman, Richard J; Tavee, Jinny; Li, Yuebing

2014-01-01

Voltage-gated potassium channel (VGKC) complex antibody-mediated encephalitis is a recently recognised entity which has been reported to mimic the clinical presentation of Creutzfeldt-Jakob disease (CJD). Testing for the presence of this neuronal surface autoantibody in patients presenting with subacute encephalopathy is therefore crucial as it may both revoke the bleak diagnosis of prion disease and allow institution of potentially life-saving immunotherapy. Tempering this optimistic view is the rare instance when a positive VGKC complex antibody titre occurs in a definite case of prion disease. We present a pathologically and genetically confirmed case of CJD with elevated serum VGKC complex antibody titres. This case highlights the importance of interpreting the result of a positive VGKC complex antibody with caution and in the context of the overall clinical manifestation. PMID:24903967

Presence of voltage-gated potassium channel complex antibody in a case of genetic prion disease.

PubMed

Jammoul, Adham; Lederman, Richard J; Tavee, Jinny; Li, Yuebing

2014-06-05

Voltage-gated potassium channel (VGKC) complex antibody-mediated encephalitis is a recently recognised entity which has been reported to mimic the clinical presentation of Creutzfeldt-Jakob disease (CJD). Testing for the presence of this neuronal surface autoantibody in patients presenting with subacute encephalopathy is therefore crucial as it may both revoke the bleak diagnosis of prion disease and allow institution of potentially life-saving immunotherapy. Tempering this optimistic view is the rare instance when a positive VGKC complex antibody titre occurs in a definite case of prion disease. We present a pathologically and genetically confirmed case of CJD with elevated serum VGKC complex antibody titres. This case highlights the importance of interpreting the result of a positive VGKC complex antibody with caution and in the context of the overall clinical manifestation. 2014 BMJ Publishing Group Ltd.

Phenotypic manifestation of congenital transverse amputation of autopod in Pakistani subjects

PubMed Central

Riaz, Hafiza Fizzah; Lal, Karmoon; Ullah, Saif; Bhatti, Nadeem Ahmad; Ullah, Waheed; Malik, Sajid

2016-01-01

Terminal transverse deficiency of forearm is a very rare limb malformation. Most of the cases have traumatic etiology and congenital presentation is less common. A series of six individuals with transverse deficiency through the hands is presented in this communication. The cases were congenital, morphologically similar and showed loss of four fingers, most often postaxial. The affected arm was reduced in size compared to the contralateral limb and there was distortion of palmer creases. All cases were sporadic and non-syndromic in nature. The characteristics of these cases were concordant with the symbrachydactyly type III or monodactylous type, when classified according to the scheme proposed by Blauth and Gekeler (1973). The malformation resulted in permanent quality-of-life impairment in these subjects and warrant prosthetic management. Detailed physical and phenotypic features of the patients have been presented. PMID:27182274

Phenotypic manifestation of congenital transverse amputation of autopod in Pakistani subjects.

PubMed

Riaz, Hafiza Fizzah; Lal, Karmoon; Ullah, Saif; Bhatti, Nadeem Ahmad; Ullah, Waheed; Malik, Sajid

2016-01-01

Terminal transverse deficiency of forearm is a very rare limb malformation. Most of the cases have traumatic etiology and congenital presentation is less common. A series of six individuals with transverse deficiency through the hands is presented in this communication. The cases were congenital, morphologically similar and showed loss of four fingers, most often postaxial. The affected arm was reduced in size compared to the contralateral limb and there was distortion of palmer creases. All cases were sporadic and non-syndromic in nature. The characteristics of these cases were concordant with the symbrachydactyly type III or monodactylous type, when classified according to the scheme proposed by Blauth and Gekeler (1973). The malformation resulted in permanent quality-of-life impairment in these subjects and warrant prosthetic management. Detailed physical and phenotypic features of the patients have been presented.

Co-ingestion of amatoxins and isoxazoles-containing mushrooms and successful treatment: A case report.

PubMed

Garcia, Juliana; Costa, Vera M; Costa, Ana Elisa; Andrade, Sérgio; Carneiro, Ana Cristina; Conceição, Filipe; Paiva, José Artur; de Pinho, Paula Guedes; Baptista, Paula; de Lourdes Bastos, Maria; Carvalho, Félix

2015-09-01

Mushroom poisonings occur when ingestion of wild mushrooms containing toxins takes place, placing the consumers at life-threatening risk. In the present case report, an unusual multiple poisoning with isoxazoles- and amatoxins-containing mushrooms in a context of altered mental state and poorly controlled hypertension is presented. A 68-year-old female was presented to São João hospital (Portugal) with complaints of extreme dizziness, hallucinations, vertigo and imbalance, 3 h after consuming a stew of wild mushrooms. The first observations revealed altered mental state and elevated blood pressure. The examination of cooked mushroom fragments allowed a preliminary identification of Amanita pantherina. Gas chromatography-mass spectrometry (GC-MS) showed the presence of muscimol in urine. Moreover, through high-performance liquid chromatography-ultraviolet detection (HPLC-UV) analysis of the gastric juice, the presence of α-amanitin was found, showing that amatoxins-containing mushrooms were also included in the stew. After 4 days of supportive treatment, activated charcoal, silybin and N-acetylcysteine, the patient recovered being discharged 10 days post-ingestion with no organ complications. The prompt and appropriate therapy protocol for life-threatening amatoxins toxicity probably saved the patient's life as oral absorption was decreased and also supportive care was immediately started. Copyright © 2015 Elsevier Ltd. All rights reserved.

Motivational interviewing with a depressed adolescent.

PubMed

Brody, Amanda E

2009-11-01

Motivational interviewing (MI) is a potentially useful tool for clinicians who are exploring ways to improve treatment outcomes with depressed clients. MI techniques may be particularly appropriate with depressed adolescents, for whom motivation to engage in therapy is often a problem and who often experience ambivalence about life choices. The present article presents a case description of MI with a depressed adolescent who was ambivalent about what life change to pursue. MI was used to help the client identify conflicts between her values, learn how they were contributing to her distress, and move toward resolving them. Advantages and limitations of these techniques are discussed.

Preserving the Future from the Demands of the Present

ERIC Educational Resources Information Center

Ardaiolo, Frank P.

2010-01-01

This chapter offers a case study of how one institution has implemented budget reductions. Using a narrative approach, the vice president for student life reviews the issues faced and the processes used to implement the changes.

Principles of Biomedical Ethics

PubMed Central

Athar, Shahid

2012-01-01

In this presentation, I will discuss the principles of biomedical and Islamic medical ethics and an interfaith perspective on end-of-life issues. I will also discuss three cases to exemplify some of the conflicts in ethical decision-making. PMID:23610498

Test-retest reliability of a computer-assisted self-administered questionnaire on early life exposure in a nasopharyngeal carcinoma case-control study.

PubMed

Mai, Zhi-Ming; Lin, Jia-Huang; Chiang, Shing-Chun; Ngan, Roger Kai-Cheong; Kwong, Dora Lai-Wan; Ng, Wai-Tong; Ng, Alice Wan-Ying; Yuen, Kam-Tong; Ip, Kai-Ming; Chan, Yap-Hang; Lee, Anne Wing-Mui; Ho, Sai-Yin; Lung, Maria Li; Lam, Tai-Hing

2018-05-04

We evaluated the reliability of early life nasopharyngeal carcinoma (NPC) aetiology factors in the questionnaire of an NPC case-control study in Hong Kong during 2014-2017. 140 subjects aged 18+ completed the same computer-assisted questionnaire twice, separated by at least 2 weeks. The questionnaire included most known NPC aetiology factors and the present analysis focused on early life exposure. Test-retest reliability of all the 285 questionnaire items was assessed in all subjects and in 5 subgroups defined by cases/controls, sex, time between 1 st and 2 nd questionnaire (2-29/≥30 weeks), education (secondary or less/postsecondary), and age (25-44/45-59/60+ years) at the first questionnaire. The reliability of items on dietary habits, body figure, skin tone and sun exposure in early life periods (age 6-12 and 13-18) was moderate-to-almost perfect, and most other items had fair-to-substantial reliability in all life periods (age 6-12, 13-18 and 19-30, and 10 years ago). Differences in reliability by strata of the 5 subgroups were only observed in a few items. This study is the first to report the reliability of an NPC questionnaire, and make the questionnaire available online. Overall, our questionnaire had acceptable reliability, suggesting that previous NPC study results on the same risk factors would have similar reliability.

Congenital craniopharyngioma treated by radical surgery: case report and review of the literature.

PubMed

Kageji, Teruyoshi; Miyamoto, Takeshi; Kotani, Yumiko; Kaji, Tsuyoshi; Bando, Yoshimi; Mizobuchi, Yoshifumi; Nakajima, Kohei; Nagahiro, Shinji

2017-02-01

Craniopharyngiomas are 5-10 % of all pediatric tumors, but are seldomly encountered in the perinatal period. Only seven instances of a truly antenatal diagnosis of a congenital craniopharyngioma that subsequently underwent radical surgery have been reported. We present the case of a patient who received the diagnosis of a suprasellar tumor during the prenatal period and received radical surgery. We report a case of a neonatal craniopharyngioma treated surgically. The pregnancy progressed uneventfully until a routine ultrasound at 37 weeks of gestation showed a 15 × 15 mm high echoic mass in the center of the fetal head. Neonatal Gd-enhanced T1-weighted MRI at 5 days of life showed a homogenously enhanced mass (16×22×15 mm) in the sellar and suprasellar lesion. As the tumor showed rapid growth at the 3rd month of life, the patient underwent a surgical treatment and the mass was totally removed. Three years later, the physical and mental development of the patient was normal, and Gd-MRI studies showed no tumor recurrence. The present case is the eighth case of a truly antenatal diagnosis of a craniopharyngioma that underwent successful radical surgery. Craniopharyngioma is a benign tumor and thought to be a slow growing tumor in childhood. The results of radical surgery were very poor, and the mortality and morbidity rates were high in the previous reports due to the huge size of tumor at operation. The present case demonstrated the rapid growth in short interval of Gd-MRI. This is the first report of tumor kinetics of congenital craniopharyngioma with previous reports. The calculated tumor doubling time in our case was 37 days.

The bactericidal effect of shock waves

NASA Astrophysics Data System (ADS)

Leighs, J. A.; Appleby-Thomas, G. J.; Wood, D. C.; Goff, M. J.; Hameed, A.; Hazell, P. J.

2014-05-01

There are a variety of theories relating to the origins of life on our home planet, some of which discuss the possibility that life may have been spread via inter-planetary bodies. There have been a number of investigations into the ability of life to withstand the likely conditions generated by asteroid impact (both contained in the impactor and buried beneath the planet surface). Previously published data regarding the ability of bacteria to survive such applied shockwaves has produced conflicting conclusions. The work presented here used an established and published technique in combination with a single stage gas gun, to shock and subsequently recover Escherichia coli populations suspended in a phosphate buffered saline solution. Peak pressure across the sample region was calculated via numerical modelling. Survival data against peak sample pressure for recovered samples is presented alongside control tests. SEM micrographs of shocked samples are presented alongside control sets to highlight key differences between cells in each case.

Evaluation of Adolescents Diagnosed with Acne Vulgaris for Quality of Life and Psychosocial Challenges.

PubMed

Eyüboglu, Murat; Kalay, Incilay; Eyüboglu, Damla

2018-01-01

Acne vulgaris is a common skin condition which affects most adolescents. It has a major impact on quality of life and psychosocial well-being. The aims of the study were to examine the psychosocial effects of acne on adolescents and changes in quality of life, and to reveal any difference in the possible effect between genders. In addition, an investigation of the association between acne severity and quality of life as well as psychosocial stress was conducted. The present study included 164 adolescents with a mean age of 12-18 years and was diagnosed with acne vulgaris without any previous treatment. The control group consisted of 188 healthy volunteers. Acne severity was evaluated by the global acne grading system. All patients filled in a Children's Dermatology Life Quality Index, Pediatric Quality of Life Questionnaire (PedsQL), and a Strength and Difficulties Questionnaire (SDQ). The scores of SDQ and PedsQL were significantly lower in the case group. There was no significant correlation found between the genders in the control group for acne severity and scale scores. No significant correlation was found between acne severity and psychosocial challenges. The results of the present study show that acne has a significant effect on quality of life for adolescents, and this has an impact on their psychosocial life. Another important finding of the present study is that worsening in quality of life is not affected by some factors such as duration, severity of acne and age.

27 CFR 70.164 - Surrender of property subject to levy in the case of life insurance and endowment contracts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the case of life insurance and endowment contracts. (a) In general. This section provides special rules relating to the surrender of property subject to levy in the case of life insurance and endowment... subject to levy in the case of life insurance and endowment contracts. 70.164 Section 70.164 Alcohol...

5 -year complex clinical and histopathological follow-up of a case of early gastric carcinoma (signet ring cells type).

PubMed

Serban, D; Branescu, C; Savlovschi, C; Simion, G; Mihai, A; El-Khatib, A; Tudor, C; Nica, A; Vancea, G; Ghelase, M; Dascalu, A M

2016-01-01

The paper presents the case of a male patient, hospitalized for acute abdomen due to perforated callous ulcer. Though the clinical appearance suggested a benign pathology, the histopathological exam of the resection piece showed multicentric early gastric carcinoma, signet ring cell type. At the patient's request, total gastrectomy was not performed, a conservative solution being chosen instead. Superior digestive endoscopy with biopsy and oncological dispensarization was performed one month after surgery, then at every 6 months. After 2 years of benign results, the histopathological exam revealed the presence of malign singlet ring cells in the bioptic specimen. Respecting the patient's option of preserving a good quality of life, subtotal gastrectomy with Pean type gastroenteroanastomosis was performed followed by postoperatory chemotherapy. Endoscopic and oncological follow-up were performed at every six months for another 3 years (up to present), and the evolution was favorable with no local or metastatic recurrence. Histopathological examination was of great help in the surgical management of this case, allowing a fortunate early diagnosis, a conservative surgical approach, and the preserving of a good quality of life.

Neonatal cholestatic hepatitis from carbamazepine exposure during pregnancy and breast feeding.

PubMed

Frey, Bernhard; Braegger, Christian P; Ghelfi, Daniela

2002-04-01

To report a case of transient cholestatic hepatitis occurring in an infant between the third and seventh weeks of life, most likely due to carbamazepine exposure during pregnancy and breast feeding. A boy, born to an epileptic mother who had been treated with carbamazepine monotherapy throughout pregnancy and breast feeding, experienced asphyxia at birth with transient hepatic dysfunction in the first week of life. After full recovery from asphyxia, he experienced a second period of liver dysfunction, presenting as cholestatic hepatitis that lasted approximately 5 weeks. Infectious and metabolic etiologies as well as extrahepatic biliary atresia were excluded. Carbamazepine is known to induce hepatic damage in children and adults. As the drug crosses the placenta and is excreted into breast milk, infants of mothers taking carbamazepine might also develop liver dysfunction. In addition to the present case, there are 2 well-documented case reports of cholestasis in association with transplacental and transmammary carbamazepine exposure. Carbamazepine-induced hepatitis may occur in association with prenatal exposure and breast feeding. This may expose infants to unnecessary diagnostic procedures, and should therefore be mentioned in the company's product information.

Artificial-life researchers try to create social reality.

PubMed

Flam, F

1994-08-12

Some scientists, among them cosmologist Stephen Hawking, argue that computer viruses are alive. A better case might be made for many of the self-replicating silicon-based creatures featured at the fourth Conference on Artificial Life, held on 5 to 8 July in Boston. Researchers from computer science, biology, and other disciplines presented computer programs that, among other things, evolved cooperative strategies in a selfish world and recreated themselves in ever more complex forms.

[The importance of early diagnosis and intervention in children diagnosed with reading disorder. Case studies].

PubMed

Törö, Krisztina; Balázs, Judit

2015-06-01

Reading Disorder (RD) belongs to Specific Learning Disorders within the chapter of Neurodevelopmental Disorders in the Diagnostic and Statistic Manual of Mental Disorders 5th edition. Previous research shows that the time of the diagnosis of RD - early (before starting school) or late - has a great impact on the prognosis. In the current paper we present the cases of two children diagnosed with RD. Our cases demonstrate that if RD is diagnosed in early childhood, the child's and his/her family's quality of life can be influenced in a positive direction, while late recognition of RD might influence the child's and the family's quality of life negatively. For these reasons it is important that experts recognize RD in time, start appropriate treatment and give proper support to children diagnosed with RD and their families.

The Meaning of Social Participation for Daily Mobility in Later Life: an Ethnographic Case Study of a Senior Project in a Swedish Urban Neighbourhood.

PubMed

Stjernborg, Vanessa

2017-01-01

This paper presents an ethnographic case study that aims to understand the meaning of social participation in a neighbourhood for daily mobility in later life. In the study, the mobility of the participants of a senior-citizen project was monitored over 18 months. The project was founded as a result of a municipal district's targeting of social sustainability. The results show that social participation had positive effects on the daily mobility of the participants. The implementation of broad-minded thinking from the municipality and the cooperation of various municipal actors were shown to be essential for the positive outcome of this project.

[Tumorous space occupying lesions of the scapula. An analysis of preoperative assessment of invasion].

PubMed

Erlemann, R; Davies, A M; Edel, G; Wuisman, P; Peters, P E; Grundmann, E

1988-02-01

The radiographic and histological morphology of 38 tumors lesions of the scapula are analyzed. Osteochondromas (n = 12), chondrosarcomas (n = 7), plasmacytomas (n = 4) and Ewing's sarcomas (n = 3) were the most frequent neoplasms. The radiographically determined growth rates allowed an estimate of the dignity in all cases. Benign lesions were only observed in the first five decades of life, and were mostly located in the scapular blade. Most tumors found in the acromion and in the glenoid region and all lesions diagnosed in the 6th to the 8th decades of life were malignant. In 63.2% of cases correct diagnosis of the type of lesion present was possible on radiographic examination.

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.

Off-road religion? A narrative approach to fundamentalist and occult orientations of adolescents.

PubMed

Streib, H

1999-04-01

Results of qualitative biographical research on Christian fundamentalist converts and de-converts, and on occultist adolescents are presented and documented using case studies. Research focused on life themes and on biographical processes and transformations. Contrastive comparison of the cases resulted in typologies of Christian fundamentalist biographies and of "ways of dis-enchantment". These indicate that obligation to a tradition is no longer the model for religious socialization. Its competitors are biographical trajectories which can have the following characteristics: heresy is taken for granted, religious search is like an open life-style preference (accumulative heretic); ritual coping with life themes is predominant; and religious search follows the motive of sensation-seeking. A typology of religious styles is applied as an interpretive framework for (a) explaining the formation of fundamentalist orientations and (b) understanding development and transformation in religious biographies. Copyright 1999 The Association for Professionals in Services for Adolescents.

Maternal Filicide among Women Admitted to Forensic Psychiatric Institutions in Malaysia: Case Series.

PubMed

Razali, S; Salleh, R M; Yahya, B; Ahmad, S H

2015-06-01

To examine the characteristics of maternal filicide and describe the adverse life events experienced by women who have committed filicide and been hospitalised in forensic psychiatric institutions in Malaysia. Registration records from 2000 through 2012 of female patients from 2 main forensic psychiatric institutions in Malaysia were reviewed. The medical records of patients who had committed maternal filicide were selected and descriptively evaluated. A total of 18 cases of maternal filicide were identified. Family dysfunction that presented with marital discord, domestic violence, or husband with substance abuse was the main stress experienced by the women. Three social circumstances, including an adolescent who became a victim of date rape; immigrants who experienced sexual abuse; and filicide-suicide precipitated by financial difficulties were highlighted. Women who committed filicide had experienced various difficulties in their life. The presence of such life events might alert mental health professionals to investigate the possibility of filicide among their patients.

Building a new life: a chaplain's theory based case study of chronic illness.

PubMed

Risk, James L

2013-01-01

This article presents the case study of spiritual care for a patient suffering from Parkinson's disease who was referred to the chaplain in an out-patient depression research program. The chaplain's interventions were informed by an application of narrative theory, and the article demonstrates how this theory enabled the chaplain to help a patient develop new coping strategies for dealing with chronic disease. Using narrative theory, the chaplain assisted the patient to develop a new sense of identity as a spiritual, contingent self as the disease eroded his physical self and former life. The article includes a description of a patient's spiritual needs, chaplain interventions, and an outcomes measure of those interventions. The author argues that narrative theory provides chaplains with a language to identify and craft the unique intervention that spiritual care has in the life trajectory of this Parkinson's patient and other patients dealing with chronic illnesses.

Breast reconstruction with a free DIEP (TRAM) flap complicated by cardiac tamponade and arrest: a case report.

PubMed

Pratt, G F; Faris, J G; Lethbridge, M; Teh, L G

2009-03-01

Breast reconstruction with free-tissue transfer is now well established and provides excellent aesthetic results. There has been an increasing swing in the literature in the use of internal mammary vessels as the preferred recipient vessels for this procedure. We present a case of a hitherto undocumented life-threatening complication related to the use of these vessels.

Life on a Tricycle: A Case Study of Language Impairment from 4 to 19

ERIC Educational Resources Information Center

Brinton, Bonnie; Fujiki, Martin; Robinson, Lee A.

2005-01-01

This article presents a longitudinal case study of a child named Cody identified with specific language impairment. Cody was followed from 4 to 19 years of age, at which time he compared his social skills with those of peers: "It's like they're driving sports car and I'm on a tricycle." His initial long- and short-term intervention goals are…

Rural Community Action: A Series of Case Studies of Action Projects in Small New York State Communities. Miscellaneous Bulletin 116.

ERIC Educational Resources Information Center

Preston, James C.; Halton, Katherine B.

The report presents case studies of 7 community action projects which were undertaken by New York communities with populations under 10,000 and which show how local leaders can improve the quality of life in their communities. The report describes the background, initiation, expansion, implementation, consequences, and highlights of the projects,…

Toxocariasis-associated cardiac diseases--A systematic review of the literature.

PubMed

Kuenzli, Esther; Neumayr, Andreas; Chaney, Matthew; Blum, Johannes

2016-02-01

Toxocariasis, caused by Toxocara canis or Toxocara catis, is a worldwide occurring parasitic disease, reaching high prevalences especially in tropical and subtropical countries. The clinical presentation can range from asymptomatic seropositivity to life threatenting disease, depending on the organ system involved. Cardiac involvement, one of the possible manifestations of human Toxocara spp. infection, is rarely reported in case reports. As far as we know, no systematic reviews of clinical presentations have been published till now and no clear recommendations regarding the treatment of Toxocara spp. infection involving the heart exist. In a systematic review of the literature, 24 published cases of Toxocara spp. infection involving the heart were identified. The cardiac entities described included myocarditis, pericarditis, and Loeffler's endocarditis. The clinical presentation ranged from asymptomatic or mild disease to life threatening myocarditis/pericarditis with heart failure or cardiac tamponade, leading to death. In most cases, the diagnosis was based on a combination of clinical, laboratory and radiological findings. Only in three of the nine cases in which histological analysis was performed (either pre- or post-mortem), granulomas or remnants of the parasite were detected. In the other six cases, findings were non-specific; the damage of the heart was equally caused by direct invasion of the larvae and by immunological reactions, either caused by the systemic hypereosinophilia or by the presence of the larvae in the tissue. The treatment regimen described mostly consisted of anthelmintic drugs in combination with corticosteroids. Even though dosage and duration of treatment varied widely, ranging from days to months, most patients were treated successfully. Cardiac involvement in Toxocara spp. infection is a rare but potentially life-threatening complication of a very common disease. The therapeutic regimens vary widely especially with regard to the duration of therapy, however, the combination of an anthelmintic drug and a corticosteroid appears to be a valuable option. For the daily clinical work, tissue manifestation by parasites should be considered in cases of unspecific organ manifestations, (i.e. heart, lungs, liver), accompanied by fever and eosinophilia with or without allergic skin rashes. Copyright © 2015 Elsevier B.V. All rights reserved.

Life-Threatening Atypical Case of Acute Generalized Exanthematous Pustulosis.

PubMed

Tajmir-Riahi, Azadeh; Wörl, Petra; Harrer, Thomas; Schliep, Stefan; Schuler, Gerold; Simon, Miklos

2017-01-01

Antibiotics are known to cause severe cutaneous adverse reactions, such as the rare acute generalized exanthematous pustulosis (AGEP). Unlike Stevens-Johnson syndrome or toxic epidermal necrolysis, AGEP is rarely life-threatening. Systemic involvement is not typical, and if present usually coincides with a mild elevation of the hepatic enzymes and a decrease in renal function. Hence, AGEP is known to have a good prognosis and to be life-threatening only in elderly patients or patients with chronic diseases. Herein, we report a case of AGEP in a young healthy male leading to systemic inflammatory response syndrome and to treatment in an intensive care unit after being treated with 5 different antibiotics. Initial symptoms were not indicative for AGEP and the patient's course of disease led promptly to critical cardiorespiratory symptoms and systemic inflammatory response syndrome. We assume that the administration of the 5 different antibiotics resulted in type IV allergy as well as secondary infection with Enterococcus faecium and Staphylococcus aureus, while the underlying periodontitis also contributed to the severity of this case. © 2017 S. Karger AG, Basel.

A quality of life quandary: a framework for navigating parental refusal of treatment for co-morbidities in infants with underlying medical conditions.

PubMed

Kunz, Sarah N; McAdams, Ryan M; Diekema, Douglas S; Opel, Douglas J

2015-01-01

Parental refusal of a recommended treatment is not an uncommon scenario in the neonatal intensive care unit. These refusals may be based upon the parents' perceptions of their child's projected quality of life. The inherent subjectivity of quality of life assessments, however, can exacerbate disagreement between parents and healthcare providers. We present a case of parental refusal of surgical intervention for necrotizing enterocolitis in an infant with Bartter syndrome and develop an ethical framework in which to consider the appropriateness of parental refusal based upon an infant's projected quality of life. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

Martian paleolakes and waterways - Exobiological implications

NASA Technical Reports Server (NTRS)

Scott, David H.; Rice, James W., Jr.; Dohm, James M.

1991-01-01

Mars may have had an early environment similar to earth's that was conductive to the emergence of life. In addition, increasing geologic evidence indicates that water, upon which terrestrial life depends, has been present on Mars throughout its history. This evidence suggests that life could have developed not only on early Mars but also over longer periods of time in longer lasting, more element local environments. It is suggested that paleolakes may have provided such environments. Unlike the case on earth, this record of the origin and evolution of life has probably not been erased by extensive deformation of the Martian surface. The work reported in this paper has identified eleven prospective areas where large lacustrine basins may once have existed.

Polyflex stenting of tracheomalacia after surgery for congenital tracheal stenosis.

PubMed

Tibballs, James; Fasulakis, Stephen; Robertson, Colin F; Berkowitz, Robert G; Massie, John; Brizard, Christian; Rose, Elizabeth; Bekhit, Elhamy; Eyres, Robert; Ragg, Philip

2007-01-01

Polyflex self-expanding stents (Rüsch, Germany) were used in three young children who had presented with life-threatening long-segment tracheal stenosis with bronchial stenosis in two cases. Two children had slide tracheoplasties and subsequently aortic homografts and another tracheal resection and autotracheoplasty. However, in all cases persistent lower tracheal malacia necessitated stenting. Complications of granuloma, stent migration or dislodgement occurred in all cases. A fatal tracheo-aortic fistula occurred in one child. Granuloma in one was treated successfully with steroids. One child survives.

Life-threatening complications associated with acute monocytic leukaemia after dental treatment.

PubMed

Koulocheris, P; Metzger, M C; Kesting, M R; Hohlweg-Majert, B

2009-03-01

It is highly recommended to conduct a prophylactic check for any dental problems on patients who suffer from leukaemia before chemotherapy begins. Bacteraemia caused by oral microflora may be very dangerous for patients with haematological malignancies. However, it should be noted that the prophylactic process itself might bring about life-threatening complications if there is only a short interval between dental treatment and the beginning of chemotherapy, or if the dental treatment is too aggressive. We present a case where this prophylactic procedure produced life-threatening complications for a patient with acute myeloid leukaemia.

The data life cycle applied to our own data.

PubMed

Goben, Abigail; Raszewski, Rebecca

2015-01-01

Increased demand for data-driven decision making is driving the need for librarians to be facile with the data life cycle. This case study follows the migration of reference desk statistics from handwritten to digital format. This shift presented two opportunities: first, the availability of a nonsensitive data set to improve the librarians' understanding of data-management and statistical analysis skills, and second, the use of analytics to directly inform staffing decisions and departmental strategic goals. By working through each step of the data life cycle, library faculty explored data gathering, storage, sharing, and analysis questions.

Neonatal carnitine palmitoyltransferase II deficiency associated with Dandy-Walker syndrome and sudden death.

PubMed

Yahyaoui, Raquel; Espinosa, María Gracia; Gómez, Celia; Dayaldasani, Anita; Rueda, Inmaculada; Roldán, Ana; Ugarte, Magdalena; Lastra, Gonzalo; Pérez, Vidal

2011-11-01

Neonatal onset of carnitine palmitoyltransferase II (CPT II) deficiency is an autosomal recessive, often lethal disorder of the mitochondrial beta-oxidation of long-chain fatty acids. It is a rare multiorgan disease which includes hypoketotic hypoglycemia, severe hepatomuscular symptoms, cardiac abnormalities, seizures and lethargy, as well as dysmorphic features. Until now, only 22 affected families have been described in the literature. An increasing number of mutations are being identified in the CPT2 gene, with a distinct genotype-phenotype correlation in most cases. Herein we report a new case of neonatal CPT II deficiency associated with Dandy-Walker syndrome and sudden death at 13 days of life. CPT II deficiency was suggested by acylcarnitine analysis of dried-blood on filter paper in the expanded newborn screening. Genetic analysis of the CPT2 gene identified the presence of a previously described mutation in homozygosity (c.534_558del25bpinsT). All lethal neonatal CPT II deficiency patients previously described presented severe symptoms during the first week of life, although this was not the case in our patient, who remained stable and without apparent vital risk during the first 11 days of life. The introduction of tandem mass spectrometry to newborn screening has substantially improved our ability to detect metabolic diseases in the newborn period. This case illustrates the value of expanded newborn screening in a neonate with an unusual clinical presentation, combining hydrocephalus and sudden death, that might not commonly lead to the suspicion of an inborn error of metabolism. Copyright © 2011 Elsevier Inc. All rights reserved.

A rare cause of respiratory distress and edema in neonate: Panhypopituitarism.

PubMed

Dursun, Fatma; Kirmizibekmez, Heves; Metin, Fazilet

2017-01-01

Clinical presentation of hypopituitarism may be variable in the neonate. Symptoms are generally nonspecific, ranging from absent to severe, and even life-threatening, due to adrenocorticotrophic hormone deficiency. Presently described is a case of unexplained respiratory distress and edema in a neonate. Initial screening revealed panhypopituitarism. Respiratory distress improved after replacement treatment with hydrocortisone and thyroxine.

Teaching African Geography from a Global Perspective. Resource Packet.

ERIC Educational Resources Information Center

African-American Inst., New York, NY. School Services Div.

An interdisciplinary focus on the teaching of African geography is presented in this module, arranged by three major topics. Topic I stresses the African view that water is the sustainer of life, presents a case study of the Nile River, and discusses the significance of rivers as natural boundaries that delineate political units. Topic II gives…

Science and Society: The Case of Acceptance of Newtonian Optics in the Eighteenth Century

ERIC Educational Resources Information Center

Silva, Cibelle Celestino; Moura, Breno Arsioli

2012-01-01

The present paper presents a historical study on the acceptance of Newton's corpuscular theory of light in the early eighteenth century. Isaac Newton first published his famous book "Opticks" in 1704. After its publication, it became quite popular and was an almost mandatory presence in cultural life of Enlightenment societies. However, Newton's…

Digital life storybooks for people with dementia living in care homes: an evaluation

PubMed Central

Subramaniam, Ponnusamy; Woods, Bob

2016-01-01

Background and aim There is increasing interest in using information and communication technology to help older adults with dementia to engage in reminiscence work. Now, the feasibility of such approaches is beginning to be established. The purpose of this study was to establish an evidence-base for the acceptability and efficacy of using multimedia digital life storybooks with people with dementia in care homes, in comparison with conventional life storybooks, taking into account the perspectives of people with dementia, their relatives, and care staff. Methods Participatory design was used to create a life story movie based on a previously completed conventional life storybook with six older adults with dementia (four females; mean age 82 years). Relatives were involved in helping the participant to provide additional information and materials for the digital life storybook. In this multiple case study design, both quantitative and qualitative approaches were used. For quantitative purposes, a set of questionnaires that had been completed three times before and after the conventional life storybook was developed were repeated 4 weeks after the life story movie was completed. Semistructured interview questions were designed to collect feedback from participants, relatives, and care staff. Results The result indicated that five of the six participants showed additional improvement in measures of quality of life and autobiographical memory. All participants showed improvement or stability in depression scores. Thematic analysis showed that, participants, relatives, and care home staff viewed digital life storybooks as a very useful tool triggering memories and (largely) positive emotions. Participants’ case vignettes were presented to document the impact of digital life storybook. PMID:27698556

Digital life storybooks for people with dementia living in care homes: an evaluation.

PubMed

Subramaniam, Ponnusamy; Woods, Bob

2016-01-01

There is increasing interest in using information and communication technology to help older adults with dementia to engage in reminiscence work. Now, the feasibility of such approaches is beginning to be established. The purpose of this study was to establish an evidence-base for the acceptability and efficacy of using multimedia digital life storybooks with people with dementia in care homes, in comparison with conventional life storybooks, taking into account the perspectives of people with dementia, their relatives, and care staff. Participatory design was used to create a life story movie based on a previously completed conventional life storybook with six older adults with dementia (four females; mean age 82 years). Relatives were involved in helping the participant to provide additional information and materials for the digital life storybook. In this multiple case study design, both quantitative and qualitative approaches were used. For quantitative purposes, a set of questionnaires that had been completed three times before and after the conventional life storybook was developed were repeated 4 weeks after the life story movie was completed. Semistructured interview questions were designed to collect feedback from participants, relatives, and care staff. The result indicated that five of the six participants showed additional improvement in measures of quality of life and autobiographical memory. All participants showed improvement or stability in depression scores. Thematic analysis showed that, participants, relatives, and care home staff viewed digital life storybooks as a very useful tool triggering memories and (largely) positive emotions. Participants' case vignettes were presented to document the impact of digital life storybook.

The most conserved genome segments for life detection on Earth and other planets.

PubMed

Isenbarger, Thomas A; Carr, Christopher E; Johnson, Sarah Stewart; Finney, Michael; Church, George M; Gilbert, Walter; Zuber, Maria T; Ruvkun, Gary

2008-12-01

On Earth, very simple but powerful methods to detect and classify broad taxa of life by the polymerase chain reaction (PCR) are now standard practice. Using DNA primers corresponding to the 16S ribosomal RNA gene, one can survey a sample from any environment for its microbial inhabitants. Due to massive meteoritic exchange between Earth and Mars (as well as other planets), a reasonable case can be made for life on Mars or other planets to be related to life on Earth. In this case, the supremely sensitive technologies used to study life on Earth, including in extreme environments, can be applied to the search for life on other planets. Though the 16S gene has become the standard for life detection on Earth, no genome comparisons have established that the ribosomal genes are, in fact, the most conserved DNA segments across the kingdoms of life. We present here a computational comparison of full genomes from 13 diverse organisms from the Archaea, Bacteria, and Eucarya to identify genetic sequences conserved across the widest divisions of life. Our results identify the 16S and 23S ribosomal RNA genes as well as other universally conserved nucleotide sequences in genes encoding particular classes of transfer RNAs and within the nucleotide binding domains of ABC transporters as the most conserved DNA sequence segments across phylogeny. This set of sequences defines a core set of DNA regions that have changed the least over billions of years of evolution and provides a means to identify and classify divergent life, including ancestrally related life on other planets.

An unusual case of crescentic lupus nephritis presenting with normal renal function.

PubMed

Manohar, Sandhya; Subramanian, Chamundeswari; Lakshmi, Kameswari

2015-11-01

Lupus nephritis is a life-threatening manifestation of systemic lupus erythematosus (SLE). This is commonly suspected when lupus patients present with elevated serum creatinine levels. But it is important to be aware that even patients with advanced disease in the kidney from SLE can have normal renal function, thus requiring a high index of suspicion. We present the case of a patient who presented with nonspecific musculoskeletal symptoms and was diagnosed with SLE. He also had nephrotic range proteinuria but his serum creatinine was normal. A renal biopsy revealed diffuse proliferative crescentic lupus nephritis. We have reviewed the literature for correlation between crescents; a sign of severe glomerular damage and creatinine levels.

Causation and the origin of life. Metabolism or replication first?

PubMed

Pross, Addy

2004-06-01

The conceptual gulf that separates the 'metabolism first' and 'replication first' mechanisms for the emergence of life continues to cloud the origin of life debate. In the present paper we analyze this aspect of the origin of life problem and offer arguments in favor of the 'replication first' school. Utilizing Wicken's two-tier approach to causation we argue that a causal connection between replication and metabolism can only be demonstrated if replication would have preceded metabolism. In conjunction with existing empirical evidence and theoretical reasoning, our analysis concludes that there is no substantive evidence for a 'metabolism first' mechanism for life's emergence, while a coherent case can be made for the 'replication first' group of mechanisms. The analysis reaffirms our conviction that life is an extreme expression of kinetic control, and that the emergence of metabolic pathways can be understood by considering life as a manifestation of 'replicative chemistry'.

Application of Pharmacokinetics and Pharmacodynamics in Product Life Cycle Management. A Case Study with a Carbidopa-Levodopa Extended-Release Formulation.

PubMed

Modi, Nishit B

2017-05-01

Increasing costs in discovering and developing new molecular entities and the continuing debate on limited company pipelines mean that pharmaceutical companies are under significant pressure to maximize the value of approved products. Life cycle management in the context of drug development comprises activities to maximize the effective life of a product. Life cycle approaches can involve new formulations, new routes of delivery, new indications or expansion of the population for whom the product is indicated, or development of combination products. Life cycle management may provide an opportunity to improve upon the current product through enhanced efficacy or reduced side effects and could expand the therapeutic market for the product. Successful life cycle management may include the potential for superior efficacy, improved tolerability, or a better prescriber or patient acceptance. Unlike generic products where bioequivalence to an innovator product may be sufficient for drug approval, life cycle management typically requires a series of studies to characterize the value of the product. This review summarizes key considerations in identifying product candidates that may be suitable for life cycle management and discusses the application of pharmacokinetics and pharmacodynamics in developing new products using a life cycle management approach. Examples and a case study to illustrate how pharmacokinetics and pharmacodynamics contributed to the selection of dosing regimens, demonstration of an improved therapeutic effect, or regulatory approval of an improved product label are presented.

Hinduism and death with dignity: historic and contemporary case examples.

PubMed

Dewar, Rajan; Cahners, Nancy; Mitchell, Christine; Forrow, Lachlan

2015-01-01

An estimated 1.2 to 2.3 million Hindus live in the United States. End-of-life care choices for a subset of these patients may be driven by religious beliefs. In this article, we present Hindu beliefs that could strongly influence a devout person's decisions about medical care, including end-of-life care. We provide four case examples (one sacred epic, one historical example, and two cases from current practice) that illustrate Hindu notions surrounding pain and suffering at the end of life. Chief among those is the principle of karma, through which one reaps the benefits and penalties for past deeds. Deference to one's spouse or family is another important Hindu value, especially among Hindu women, which can impact the decision-making process and challenge the Western emphasis on autonomy. In addition, the Hindu embrace of astrology can lead to a desire to control the exact time of death. Confounding any generalizations, a Hindu patient may reject or accept treatments based on the individual patient's or family's interpretation of any given tradition. Through an awareness of some of the fundamental practices in Hinduism and the role of individual interpretation within the tradition, clinicians will be better able to support their Hindu patients and families at the end of life. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

Severe congestive heart failure patient on amiodarone presenting with myxedemic coma: a case report.

PubMed

Shaheen, Mazen

2009-01-01

This is a case report of myxedema coma secondary to amiodarone-induced hypothyroidism in a patient with severe congestive heart failure (CHF). To our knowledge and after reviewing the literature there is one case report of myxedema coma during long term amiodarone therapy. Myxedema coma is a life threatening condition that carries a mortality reaching as high as 20% with treatment. The condition is treated with intravenous thyroxine (T4) or intravenous tri-iodo-thyronine (T3). Patients with CHF on amiodarone may suffer serious morbidity and mortality from hypothyroidism, and thus may deserve closer follow up for thyroid stimulating hormone (TSH) levels. This case report carries an important clinical application given the frequent usage of amiodarone among CHF patients. The myriad clinical presentation of myxedema coma and its serious morbidity and mortality stresses the need to suspect this clinical syndrome among CHF patients presenting with hypotension, weakness or other unexplained symptoms.

Seven cases of fatal aconite poisoning: forensic experience in China.

PubMed

Liu, Qian; Zhuo, Luo; Liu, Liang; Zhu, Shaohua; Sunnassee, Ananda; Liang, Man; Zhou, Lan; Liu, Yan

2011-10-10

This paper presents seven fatal cases of aconite poisoning encountered in the Tongji Center for Medicolegal Expertise in Hubei (TCMEH), China, from 1999 to 2008 retrospectively. In six of the cases, deaths occurred after drinking homemade medicated liquor containing aconite, and in one case death was due to ingestion of traditional Chinese medication containing aconite. Forensic autopsy and pathological examinations ruled out the presence of physical trauma or life-threatening diseases. Diagnosis of aconite poisoning was made after postmortem toxicological analysis. Animal experiment was performed in one case demonstrating that the medicated liquor could cause death rapidly. We present the autopsy and histopathological findings, toxicological analysis, and results of animal experiment done on samples from those seven cases. As an important herbal Chinese medicine, Aconitum species deserve special attention, especially because it contains poisonous alkaloids. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Haemoglobin sickle D disease: A presentation with ischaemic stroke.

PubMed

Afzal, Hasnain; Umair, Syed Farrukh

2016-03-01

Haemoglobin-D, Los Angeles or Haemoglobin D-Punjab is not a rare variant of haemoglobin worldwide especially in Punjab, North western India, and South Asian continent. It can be inherited rarely as homozygous causing no symptoms or heterozygous with Haemoglobin A, commonly not related to clinical symptomatology. However, these variants can co-exist rarely with other haemoglobinopathies such as thalassemia or haemoglobin-S. We describe the case of doubly heterozygous Hb-SD Punjab in a 8 year old girl who presented with ischaemic stroke. Before this case, only one case has been reported but it was with reversible hyperbilirubinaemia in Hb-SD from Rawalpindi, Pakistan. This case images the propensity for occurrence of rare phenotype within our population and underlines the importance of genotyping to avoid erroneous management and poor counseling hence preventing life altering complications which our case developed.

Conceptual Framework To Extend Life Cycle Assessment Using Near-Field Human Exposure Modeling and High-Throughput Tools for Chemicals.

PubMed

Csiszar, Susan A; Meyer, David E; Dionisio, Kathie L; Egeghy, Peter; Isaacs, Kristin K; Price, Paul S; Scanlon, Kelly A; Tan, Yu-Mei; Thomas, Kent; Vallero, Daniel; Bare, Jane C

2016-11-01

Life Cycle Assessment (LCA) is a decision-making tool that accounts for multiple impacts across the life cycle of a product or service. This paper presents a conceptual framework to integrate human health impact assessment with risk screening approaches to extend LCA to include near-field chemical sources (e.g., those originating from consumer products and building materials) that have traditionally been excluded from LCA. A new generation of rapid human exposure modeling and high-throughput toxicity testing is transforming chemical risk prioritization and provides an opportunity for integration of screening-level risk assessment (RA) with LCA. The combined LCA and RA approach considers environmental impacts of products alongside risks to human health, which is consistent with regulatory frameworks addressing RA within a sustainability mindset. A case study is presented to juxtapose LCA and risk screening approaches for a chemical used in a consumer product. The case study demonstrates how these new risk screening tools can be used to inform toxicity impact estimates in LCA and highlights needs for future research. The framework provides a basis for developing tools and methods to support decision making on the use of chemicals in products.

Successfully treated necrotizing fasciitis using extracorporeal life support combined with hemoadsorption device and continuous renal replacement therapy.

PubMed

Eid, Maroua; Fouquet, Olivier; Darreau, Cédric; Pierrot, Marc; Kouatchet, Achille; Mercat, Alain; Baufreton, Christophe

2018-03-01

Necrotizing fasciitis represents a life-threatening infectious condition that causes spreading necrotisis of superficial fascia and subcutaneous cellular tissues. We describe the case of a patient diagnosed with septic and toxic shocks leading to multiple organ failure successfully treated with a combination of extracorporeal life support, continuous renal replacement therapy, and a hemoadsorption device. A 41-year-old patient presented with necrotizing fasciitis and multi-organ failure. Initial extracorporeal life support therapy was implanted, compensating for systolic failure. Due to acute renal failure that persisted in time, continuous renal replacement therapy was added. Despite these treatments and as a last attempt to control the septic condition, a CytoSorb ® hemoadsorption device was installed in parallel to the extracorporeal life support circuit and two sessions were run. During the days following CytoSorb ® treatment, hemodynamic stabilization was observed, as well as normalization of lactic acidosis and blood parameters. This case describes the successful use of CytoSorb ® with continuous renal replacement therapy and extracorporeal life support in a combined way to overcome a critical phase of septic shock in a young adult patient. This combination of treatments turned out to be efficient for this patient in the context of necrotizing fasciitis.

Economics of Concrete and Wood Tie Track Structures

DOT National Transportation Integrated Search

1978-08-01

This report presents results from an evaluation of the economic benefits of concrete- versus wood-tie track. The analysis includes the life-cycle capital, maintenance, and renewal costs for concrete- and wood-tie track for four specific test cases an...

Pediatric Critical Care Transport as a Conduit to Terminal Extubation at Home: A Case Series

PubMed Central

Noje, Corina; Bernier, Meghan L.; Costabile, Philomena M.; Klein, Bruce L.; Kudchadkar, Sapna R.

2016-01-01

Objective To present our single-center’s experience with three palliative critical care transports home from the pediatric intensive care unit (PICU) for terminal extubation. Design, Setting, Patients All cases were identified from our institutional Pediatric Transport database. Patients in the case series were terminally ill children unable to separate from mechanical ventilation in the PICU, who were transported home between January 1, 2012 and December 31, 2014 for terminal extubation and end-of-life care according to their families’ wishes. Interventions, Measurements, Main Results The rate of palliative care transports home for terminal extubation during the study period was 2.6 per 100 deaths. The patients were 7 months, 6 years, and 18 years old and had complex chronic conditions. The transfer process was protocolized. The families were approached by the PICU staff during multidisciplinary goals-of-care meetings. Parental expectations were clarified and home hospice care was arranged pre-transfer. All transports were performed by our pediatric critical care transport team, and all terminal extubations were performed by physicians. All patients had unstable medical conditions and urgent needs for transport to comply with the families’ wishes for withdrawal of life-support and death at home. As such, all three cases presented similar logistical challenges, including establishing do-not-resuscitate status pre-transport, having limited time to organize the transport, and coordinating home palliative care services with available community resources. Conclusions Though a relatively infrequent practice in pediatric critical care, transport home for terminal extubation represents a feasible alternative for families seeking out-of-hospital end-of-life care for their critically ill technology-dependent children. Our single-center experience supports the need for development of formal programs for end-of-life critical care transports to include patient screening tools, palliative care home discharge algorithms, transport protocols, and resource utilization and cost analyses. PMID:27801708

A case of postmenopausal androgen excess.

PubMed

Lambrinoudaki, Irene; Dafnios, Nikos; Kondi-Pafiti, Agathi; Triantafyllou, Nikos; Karopoulou, Evangelia; Papageorgiou, Anastasia; Augoulea, Areti; Armeni, Eleni; Creatsa, Maria; Vlahos, Nikolaos

2015-10-01

Ovarian steroid cell tumors are very rare but potentially life-threatening neoplasms. They represent less than 0.1% of all ovarian tumors, typically present in premenopausal women and frequently manifest with virilization. Signs of hyperandrogenism may appear in postmenopausal women due to tumorοus and non-tumorοus adrenal and ovarian causes as well due to the normal aging process. In any case, steroid cell tumor should be suspected in postmenopausal women who present with rapid progressive androgen excess symptoms. This report describes a case of a 67-year-old postmenopausal woman with signs of hyperandrogenism, where an ovarian steroid cell tumor was diagnosed and treated by laparoscopic bilateral salpingo-oophorectomy and synchronous hysterectomy.

Facing the challenges of ventricular hypertrophy: the eyes don't lie.

PubMed

Rodrigues, Patrícia; Santos, Mário; Marinho, António; Cabral, Sofia; Vieira, Miguel; Reis, Hipólito; Palma, Paulo; Torres, Severo

2014-10-01

We describe the case of a 47-year-old man with new-onset heart failure who was found to have severe biventricular wall thickening. We present comprehensive data from invasive and non-invasive multimodality imaging, genetic and histologic tests, and briefly describe their importance in the final diagnosis. To our knowledge, this is the first case of the Portuguese variant of familial amyloid polyneuropathy presenting with heart failure in the fifth decade of life. This is an unusual case report, but also an illustration of how to approach any patient with suspected infiltrative cardiomyopathy. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

[Toxic shock syndrome after open ankle fracture].

PubMed

Klüter, T; Fitschen-Oestern, S; Weuster, M; Fickenscher, H; Seekamp, A; Lippross, S

2015-07-01

The treatment of open fractures is a challenge for the attending surgeon. Depending on the severity, the risk of infection rises up to 50%. Local infection up to the point of sepsis can develop in spite of surgical and antimicrobial therapy. The present case demonstrates the case of an 18-year-old man who developed toxic shock syndrome (TSS) after an open ankle fracture. This potentially life-threating syndrome usually presents with the main symptoms of fever, hypotension and exanthema and is caused by toxins, such as toxic shock syndrome toxin 1 (TSST-1) and staphylococcal enterotoxins A-D. In some cases it is associated with cardiopulmonary decompensation and can rapidly progress to multiorgan failure.

Primary renal angiosarcoma with progressive clinical course despite surgical and adjuvant treatment: A case report

PubMed Central

CELEBI, FILIZ; PILANCI, KEZBAN NUR; SAGLAM, SEZER; BALCI, NUMAN CEM

2015-01-01

Angiosarcoma is an extremely rare, high-grade malignancy, which accounts for <2% of all soft-tissue sarcomas. Cases of primary renal angiosarcoma represent 1% of these. Angiosarcomas involving the kidney usually originate from metastatic skin lesions or primary visceral lesions and most often occur in the sixth and seventh decades of life. The present study describes a case of primary renal angiosarcoma that presented as a large right-sided renal mass with symptoms of flank pain. Despite surgical removal of the tumor, recurrent disease with associated lung metastases was identified at the surgical site following adjuvant chemotherapy. The patient succumbed to the disease 13 months after the diagnosis. PMID:25789072

Including exposure variability in the life cycle impact assessment of indoor chemical emissions: the case of metal degreasing.

PubMed

Golsteijn, Laura; Huizer, Daan; Hauck, Mara; van Zelm, Rosalie; Huijbregts, Mark A J

2014-10-01

The present paper describes a method that accounts for variation in indoor chemical exposure settings and accompanying human toxicity in life cycle assessment (LCA). Metal degreasing with dichloromethane was used as a case study to show method in practice. We compared the human toxicity related to the degreasing of 1m(2) of metal surface in different exposure scenarios for industrial workers, professional users outside industrial settings, and home consumers. The fraction of the chemical emission that is taken in by exposed individuals (i.e. the intake fraction) was estimated on the basis of operational conditions (e.g. exposure duration), and protective measures (e.g. local exhaust ventilation). The introduction of a time-dependency and a correction for protective measures resulted in reductions in the intake fraction of up to 1.5 orders of magnitude, compared to application of existing, less advanced models. In every exposure scenario, the life cycle impacts for human toxicity were mainly caused by indoor exposure to metal degreaser (>60%). Emissions released outdoors contributed up to 22% of the life cycle impacts for human toxicity, and the production of metal degreaser contributed up to 19%. These findings illustrate that human toxicity from indoor chemical exposure should not be disregarded in LCA case studies. Particularly when protective measures are taken or in the case of a short duration (1h or less), we recommend the use of our exposure scenario-specific approach. Copyright © 2014 Elsevier Ltd. All rights reserved.

Eosinophilic pustular folliculitis of infancy: a series of 15 cases and review of the literature.

PubMed

Hernández-Martín, Ángela; Nuño-González, Almudena; Colmenero, Isabel; Torrelo, Antonio

2013-01-01

Eosinophilic pustular folliculitis (EPF) of infancy is characterized by the presence of pustular lesions containing eosinophils. It is the least well-characterized of the EPF diseases. We sought to define the clinical and histopathologic features of the condition. We conducted a retrospective review of the clinical data and histologic findings of 15 patients given the diagnosis of EPF of infancy at the Hospital Niño Jesús, Madrid, Spain, from 1995 to 2011, and of patient data published in MEDLINE with such a diagnosis from the disease description (1984-2011). A total of 61 cases were collected. The disease was more common in males than females (ratio 4:1), and presented before 14 months of life in 95% of cases (mean 6.1 months; median 5 months). All patients had recurrent outbreaks and scalp involvement, and 65% had lesions on areas of the body other than the scalp. Tissue eosinophilia was present in all cases; however, true follicular involvement was observed only in 62% of cases in which histologic study was available. More than 80% of the patients were cured by 3 years of age (mean 25.3 months; median 18 months). Topical steroids were effective in 90% of cases. This was a retrospective study. EPF of infancy presents most often in the first 14 months of life and usually resolves by 3 years of age. All patients showed scalp involvement, tissue eosinophilia, and recurrent outbreaks. The condition does not require aggressive treatment, as it is benign and self-limiting. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Partial penectomy and penile reconstruction. Initial surgical management of localized penile cancer.

PubMed

Pérez-Niño, J; Fernández, N; Sarmiento, G

2014-01-01

Surgical management for penile carcinoma is mutilating and affects significantly quality of life. Hereby we present our experience on penile reconstruction (PR) immediately after oncologic resection. We included all patients from January 2007 until April 2012 who underwent PR after partial penectomy (PP). Patients included in the study were seen at four different hospitals. All procedures were done by the same surgeon. Information included were: oncological status at the moment of surgery, surgical technique used for reconstruction. Each case was also registered photographically. On follow-up visits data about outcome and patient's satisfaction were registered. During the study period 15 patients underwent PR. Average age at the moment of surgery was 49 years. Average follow-up was 15 months. In 12 patients PR was made at the same time as PP. Of those, four cases underwent glans resurfacing, 2 glandectomy, 6 partial penectomy, and the remaining 3 have had PP in a different time in the past. Every case underwent a split thickness graft procedure. Only 2 patients had postoperative complications. One of them presented urethral stricture and the other graft ischemia. Three patients had positive nodes at the moment of PP and two during the follow-up. None of the cases have presented local recurrence and only one died. On follow-up the remaining patients refer a good quality of life and felt happy with aesthetic results. Given the results presented hereby we propose that PR must be part of the same procedure as the PP. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

Limitations of Routine Verification of Nasogastric Tube Insertion Using X-Ray and Auscultation: Two Case Reports of Life-Threatening Complications.

PubMed

Nejo, Takahide; Oya, Soichi; Tsukasa, Tsuchiya; Yamaguchi, Naomi; Matsui, Toru

2016-12-01

Several bedside approaches used in combination with thoracoabdominal X-ray are widely used to avoid severe complications that have been reported during nasogastric tube management. Although confirmation by X-ray is considered the gold standard, it is not yet perfect. We present 2 cases of rare complications in which the routine verification methods could not detect all the complications related to the nasogastric tube placement. Case 1 was a 17-year-old male who presented with a brain tumor and repeatedly required nasogastric tube placement. Despite normal auscultatory and X-ray findings, the patient's condition deteriorated rapidly after resuming the enteral nutrition (EN). Computed tomography images showed the presence of hepatic portal venous gas (HPVG). Urgent upper gastrointestinal endoscopy showed esophagogastric submucosal tunneling of the tube that required an emergency open total gastrectomy. Case 2 was a 76-year-old man with long-term EN after stroke. While the last auscultatory verification was normal, he suddenly developed extensive HPVG due to gastric mucosal injury following EN, which resulted in progressive intestinal necrosis, general peritonitis, and death. These 2 cases indicated that routine verification methods consisting of auscultation and X-ray may not be completely reliable, and the awareness of the limitations of these methods should be reaffirmed because expeditious examinations and necessary interventions are critical in preventing life-threatening complications.

Is "end of life" a special case? Connecting Q with survey methods to measure societal support for views on the value of life-extending treatments.

PubMed

Mason, Helen; Collins, Marissa; McHugh, Neil; Godwin, Jon; Van Exel, Job; Donaldson, Cam; Baker, Rachel

2018-05-01

Preference elicitation studies reporting societal views on the relative value of end-of-life treatments have produced equivocal results. This paper presents an alternative method, combining Q methodology and survey techniques (Q2S) to determine the distribution of 3 viewpoints on the relative value of end-of-life treatments identified in a previous, published, phase of this work. These were Viewpoint 1, "A population perspective: value for money, no special cases"; Viewpoint 2, "Life is precious: valuing life-extension and patient choice"; and Viewpoint 3, "Valuing wider benefits and opportunity cost: the quality of life and death." A Q2S survey of 4,902 respondents across the United Kingdom measured agreement with these viewpoints; 37% most agreed with Viewpoint 1, 49% with Viewpoint 2, and 9% with Viewpoint 3. Regression analysis showed associations of viewpoints with gender, level of education, religion, voting preferences, and satisfaction with the NHS. The Q2S approach provides a promising means to investigate how in-depth views and opinions are represented in the wider population. As demonstrated in this study, there is often more than 1 viewpoint on a topic and methods that seek to estimate that averages may not provide the best guidance for societal decision-making. © 2018 The Authors. Health Economics Published by John Wiley & Sons Ltd.

A Rare Case: Rupture of Internal Pudendal and Uterine Artery in a Vaginal Delivery.

PubMed

Chughtai, Novera G; Rizvi, Raheela Mohsin

2018-03-01

The management of puerperal hematomas after normal delivery has always been challenging for obstetricians. Vulvar, vulvovaginal, or paravaginal hematomas are common. On the other hand, retroperitoneal hematomas are uncommon and can be life-threatening. The diagnosis of vascular injury is rarely made preoperatively as atonic or traumatic postpartum hemorrhage (PPH), uterine rupture and amniotic fluid embolism are more common differential diagnoses. Injury to internal pudendal and uterine vessels is extremely rare in cases of vaginal delivery and, therefore, the literature on this topic is very scarce. We present a rare case of both internal pudendal and uterine artery rupture in a normal vaginal delivery, which led to massive postpartum hemorrhage. The diagnosis was made on Magnetic Resonance imaging (MRI) and arterial embolization was performed. This case stresses on the need for careful post-delivery monitoring for revealed postpartum hemorrhage. Vascular injury is a rare life-threatening cause of obstetric shock, and active; and timely operative intervention can prevent morbidity and mortality.

Functional Impairment in Adult Sleepwalkers: A Case-Control Study

PubMed Central

Lopez, Regis; Jaussent, Isabelle; Scholz, Sabine; Bayard, Sophie; Montplaisir, Jacques; Dauvilliers, Yves

2013-01-01

Study Objectives: To investigate the restorative quality of sleep and daytime functioning in sleepwalking adult patients in comparison with controls. Design: Prospective case-control study. Setting: Data were collected at the Sleep Disorders Center, Hôpital-Gui-de Chauliac, Montpellier, France between June 2007 and January 2011. Participants: There were 140 adult sleepwalkers (100 (median age 30 y, 55% male) in whom primary SW was diagnosed) who underwent 1 night of video polysomnography. All patients participated in a standardized clinical interview and completed a battery of questionnaires to assess clinical characteristics of parasomnia, daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and health-related quality of life. Results were compared with those of 100 sex- and age-matched normal controls. Interventions: N/A. Measurements and Results: Of the sleepwalkers, 22.3% presented with daily episodes and 43.5% presented with weekly episodes. Median age at sleepwalking onset was 9 y. Familial history of sleepwalking was reported in 56.6% of sleepwalkers and violent sleep related behaviors in 57.9%, including injuries requiring medical care for at least one episode in 17%. Significant associations were found between sleepwalking and daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and altered quality of life. Early-onset sleepwalkers had higher frequency of violent behaviors and injuries. Sleepwalkers with violent behaviors had higher frequency of sleep terrors and triggering factors, with greater alteration in health-related quality of life. Conclusion: Adult sleepwalking is a potentially serious condition that may induce violent behaviors, self-injury or injury to bed partners, sleep disruption, excessive daytime sleepiness, fatigue, and psychological distress, all of which affect health-related quality of life. Citation: Lopez R; Jaussent I; Scholz S; Bayard S; Montplaisir J; Dauvilliers Y. Functional impairment in adult sleepwalkers: a case-control study. SLEEP 2013;36(3):345-351. PMID:23450499

Functional impairment in adult sleepwalkers: a case-control study.

PubMed

Lopez, Regis; Jaussent, Isabelle; Scholz, Sabine; Bayard, Sophie; Montplaisir, Jacques; Dauvilliers, Yves

2013-03-01

To investigate the restorative quality of sleep and daytime functioning in sleepwalking adult patients in comparison with controls. Prospective case-control study. Data were collected at the Sleep Disorders Center, Hôpital-Gui-de Chauliac, Montpellier, France between June 2007 and January 2011. There were 140 adult sleepwalkers (100 (median age 30 y, 55% male) in whom primary SW was diagnosed) who underwent 1 night of video polysomnography. All patients participated in a standardized clinical interview and completed a battery of questionnaires to assess clinical characteristics of parasomnia, daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and health-related quality of life. Results were compared with those of 100 sex- and age-matched normal controls. N/A. Of the sleepwalkers, 22.3% presented with daily episodes and 43.5% presented with weekly episodes. Median age at sleepwalking onset was 9 y. Familial history of sleepwalking was reported in 56.6% of sleepwalkers and violent sleep related behaviors in 57.9%, including injuries requiring medical care for at least one episode in 17%. Significant associations were found between sleepwalking and daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and altered quality of life. Early-onset sleepwalkers had higher frequency of violent behaviors and injuries. Sleepwalkers with violent behaviors had higher frequency of sleep terrors and triggering factors, with greater alteration in health-related quality of life. Adult sleepwalking is a potentially serious condition that may induce violent behaviors, self-injury or injury to bed partners, sleep disruption, excessive daytime sleepiness, fatigue, and psychological distress, all of which affect health-related quality of life. Lopez R; Jaussent I; Scholz S; Bayard S; Montplaisir J; Dauvilliers Y. Functional impairment in adult sleepwalkers: a case-control study. SLEEP 2013;36(3):345-351.

Life-threatening gastrointestinal system bleeding in Hodgkin disease: multidetector CT findings and review of the literature.

PubMed

Akpinar, Erhan; Türkbey, Bariş; Cil, Barbaros Erhan; Canyiğit, Murat; Dündar, Ziya; Balkanci, Ferhun

2007-06-01

Acute lower gastrointestinal system (GIS) bleeding is a life-threatening condition. Immediate determination of the origin of the bleeding is crucial, since hemostatic management must be initiated as rapidly as possible. Colonoscopy, radionuclide studies, and conventional angiography are considered the most important methods for assessing the origin of the bleeding. There are few published reports about the feasibility of computed tomography (CT) in acute GIS bleeding. We present multidetector CT (MDCT) findings in a case of Hodgkin disease status one month post-chemotherapy (CHOP protocol; cyclophosphamide, doxorubicin, vincristine, prednisone) that presented with acute lower GIS bleeding.

Continuum Fatigue Damage Modeling for Use in Life Extending Control

NASA Technical Reports Server (NTRS)

Lorenzo, Carl F.

1994-01-01

This paper develops a simplified continuum (continuous wrp to time, stress, etc.) fatigue damage model for use in Life Extending Controls (LEC) studies. The work is based on zero mean stress local strain cyclic damage modeling. New nonlinear explicit equation forms of cyclic damage in terms of stress amplitude are derived to facilitate the continuum modeling. Stress based continuum models are derived. Extension to plastic strain-strain rate models are also presented. Application of these models to LEC applications is considered. Progress toward a nonzero mean stress based continuum model is presented. Also, new nonlinear explicit equation forms in terms of stress amplitude are also derived for this case.

Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature

PubMed Central

Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

2014-01-01

Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases. PMID:24967021

How individuals with dementia in nursing homes maintain their dignity through life storytelling - a case study.

PubMed

Heggestad, Anne Kari Tolo; Slettebø, Åshild

2015-08-01

The aim of this article was to present and discuss findings on what individuals with dementia do by themselves to maintain or promote their dignity of identity when they live in a nursing home. The majority of residents living in Norwegian nursing homes suffer from dementia. Individuals who suffer from dementia are particularly vulnerable, and their dignity of identity is at risk. It is therefore of great importance to explore how we can maintain their dignity of identity. The study builds on a phenomenological and hermeneutic design. The article reports three cases or life stories based on participant observation in two different nursing homes and interviews with five residents with dementia living in these nursing homes. Fifteen residents with dementia from these nursing home wards were included in the overall study. Individuals with dementia living in nursing homes may use life storytelling or narratives to manage chaos and to find safety in their lives. Storytelling is also used as a way to present and maintain identity. We can see this as a way of maintaining dignity of identity or social dignity. Life storytelling can be seen as an important way of preserving dignity for people with dementia. It is of great importance that health care professionals are open to and listen to the life stories people with dementia tell. As nurses we have an obligation to ensure that dignity is enhanced in care for people with dementia. Knowledge about how residents with dementia use life storytelling as a way to maintain dignity is therefore of great importance to health care workers in nursing homes. © 2015 John Wiley & Sons Ltd.

Evaluation of Adolescents Diagnosed with Acne Vulgaris for Quality of Life and Psychosocial Challenges

PubMed Central

Eyüboglu, Murat; Kalay, Incilay; Eyüboglu, Damla

2018-01-01

Background: Acne vulgaris is a common skin condition which affects most adolescents. It has a major impact on quality of life and psychosocial well-being. Aims: The aims of the study were to examine the psychosocial effects of acne on adolescents and changes in quality of life, and to reveal any difference in the possible effect between genders. In addition, an investigation of the association between acne severity and quality of life as well as psychosocial stress was conducted. Materials and Methods: The present study included 164 adolescents with a mean age of 12–18 years and was diagnosed with acne vulgaris without any previous treatment. The control group consisted of 188 healthy volunteers. Acne severity was evaluated by the global acne grading system. All patients filled in a Children's Dermatology Life Quality Index, Pediatric Quality of Life Questionnaire (PedsQL), and a Strength and Difficulties Questionnaire (SDQ). Results: The scores of SDQ and PedsQL were significantly lower in the case group. There was no significant correlation found between the genders in the control group for acne severity and scale scores. No significant correlation was found between acne severity and psychosocial challenges. Conclusions: The results of the present study show that acne has a significant effect on quality of life for adolescents, and this has an impact on their psychosocial life. Another important finding of the present study is that worsening in quality of life is not affected by some factors such as duration, severity of acne and age. PMID:29692454

Te Rita Papesch: Case Study of an Exemplary Learner of Maori as an Additional Language

ERIC Educational Resources Information Center

Ratima, Matiu Tai; Papesch, Te Rita

2014-01-01

This paper presents a case study of the life experiences of one exemplar adult second language Maori learner--Te Rita Papesch. Te Rita was one of 17 participants who were interviewed as a part of the first author's PhD study which sought to answer the question: what factors lead to the development of proficiency in te reo Maori amongst adult…

A Study on Preschoolers' Conceptual Perceptions of States of Matter: A Case Study of Turkish Students

ERIC Educational Resources Information Center

Demirbas, Murat; Ertuðrul, Nurcan

2014-01-01

The purpose of the present study is to identify preschoolers' conceptual perceptions of states of matter, this issue that they often come across in their daily and social life. The study was designed as a qualitative case study. The population of the study was comprised of 25 preschoolers studying at two primary schools located in Kýrýkkale and…

Choanal atresia: a case report illusrating the use of computed tomography

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

Shirkhoda, A.; Biggers, W.P.

1982-01-01

Bilateral choanal atresis is often associated with severe asphyxia, immediately after birth and can be the cause of death from suffocation. However, in the unilateral type, the diagnosis is often delayed until the second decade of life or even later. This communication presents a case of bilateral complete choanal atresia, reviews the clinical features, and emphasizes the role of computed tomography in making the diagnosis.

A Case of Congenital Folliculitis Caused by Pseudomonas aeruginosa in a Preterm Neonate.

PubMed

Matsui, Koichiro; Okazaki, Kaoru; Horikoshi, Yuho; Kakinuma, Ryota; Kondo, Masatoshi

2017-07-24

Intrauterine infections are associated with life-threatening neonatal conditions such as sepsis, intracranial hemorrhage, and chronic lung disease. Herein we present a case of generalized congenital folliculitis caused by Pseudomonas aeruginosa in a preterm neonate of 27 weeks gestational age successfully treated with antibiotics. Folliculitis is an important manifestation of intrauterine P. aeruginosa infection, and prompt, effective treatment is crucial to ensuring a good prognosis.

Eating and weight/shape criticism as a specific life-event related to bulimia nervosa: a case control study.

PubMed

Gonçalves, Sonia Ferreira; Machado, Bárbara César; Martins, Carla

2014-01-01

The present study aims to evaluate the occurrence of life events preceding the onset of eating problems in bulimia nervosa patients. A case-control design was used involving the comparison of 60 female subjects who meet DSM-IV criteria for bulimia nervosa with 60 healthy control subjects and 60 subjects with other psychiatric disorders. The RFI (Fairburn et al., 1998) subset of factors that represent exposure to life events in the 12 months immediately before the development of eating problems was used. Women with bulimia nervosa reported higher rates of major stress, criticism about eating, weight and shape and also a great number of antecedent life events during the year preceding the development of eating problems than the healthy control group. However, when compared with the general psychiatric control group only the exposure to critical comments about weight, shape, or eating emerged as a specific trigger for bulimia nervosa. Our findings support the fact that eating and shape/weight criticism in the year preceding the development of eating disturbance seems to be specifically related to bulimia nervosa.

The Virtual Habitat - A tool for dynamic life support system simulations

NASA Astrophysics Data System (ADS)

Czupalla, M.; Zhukov, A.; Schnaitmann, J.; Olthoff, C.; Deiml, M.; Plötner, P.; Walter, U.

2015-06-01

In this paper we present the Virtual Habitat (V-HAB) model, which simulates on a system level the dynamics of entire mission scenarios for any given life support system (LSS) including a dynamic representation of the crew. We first present the V-HAB architecture. Thereafter we validate in selected case studies the V-HAB submodules. Finally, we demonstrate the overall abilities of V-HAB by first simulating the LSS of the International Space Station (ISS) and showing how close this comes to real data. In a second case study we simulate the LSS dynamics of a Mars mission scenario. We thus show that V-HAB is able to support LSS design processes, giving LSS designers a set of dynamic decision parameters (e.g. stability, robustness, effective crew time) at hand that supplement or even substitute the common Equivalent System Mass (ESM) quantities as a proxy for LSS hardware costs. The work presented here builds on a LSS heritage by the exploration group at the Technical University at Munich (TUM) dating from even before 2006.

The transprofessional model: blending intents in terminal care of AIDS.

PubMed

Cherin, D A; Simmons, W J; Hillary, K

1998-01-01

Current terminal care services present dying patients and their families with a dichotomy in service delivery and the intent care between curative treatments and palliative treatments. This arbitrary dichotomy reduces patients' quality of life in many cases and robs patients and families of benefiting from the psychosocial aspects of treatment until the last few weeks of life. This article presents a blended model of care, the Transprofessional Model, in which patients receive both curative and palliative service throughout their care process. The blended intent model differs from traditional home care in that services are provided by a care coordination team composed of nurses and social workers; the traditional model of care is often case managed by a single, registered nurse. The combination of the multi-disciplinary approach to care coordination and training in both curative and palliative services in the Transprofessional Model demonstrates that this blended model of care produces a bio-psychosocial focus to terminal care as compared to a primary focus on curative services present in the traditional model of home care.

Bilateral Parotid Sialadenosis Associated with Long-Standing Bulimia: A Case Report and Literature Review.

PubMed

Garcia Garcia, Blas; Dean Ferrer, Alicia; Diaz Jimenez, Nelida; Alamillos Granados, Francisco Jesus

2018-06-01

Bulimia is a common cause of sialadenosis. This paper presents a case of bilateral parotid sialadenosis associated with long-standing bulimia, and reviews the relevant literature and current treatment options. A 32-year-old woman had severe bilateral parotid sialomegaly for the last 6 years, which had occurred secondary to bulimia nervosa, which she had since 14 years. Treatment with pilocarpine was unsuccessful, so she underwent bilateral conservative parotidectomy. This procedure not only improved the aesthetic appearance of the patient but also improved her social and work life and overall quality of life. Sialomegaly secondary to bulimia results in a major alteration of the aesthetics of a patient's face. Conservative measures are not enough in many cases, and parotidectomy may be the only viable option, as it can also significantly improve adherence to psychiatric treatment for bulimia, in addition to correcting the facial aesthetics.

Cardiogenic shock induced by a voluminous phaeochromocytoma rescued by concomitant extracorporeal life support and open left adrenalectomy.

PubMed

Dang Van, Simon; Hamy, Antoine; Hubert, Noémie; Fouquet, Olivier

2016-10-01

Phaeochromocytoma is a rare catecholamine-secreting tumour involved in 0.1-0.2% cases of hypertension in the general population. Headache, palpitation and paroxystic sweating are the most commonly described symptoms. A few published cases report an acute adrenergic cardiomyopathy, leading to severe cardiogenic shock requiring mechanical circulatory support. We report the case of a 57-year old patient presenting a voluminous phaeochromocytoma of the left adrenal gland revealed by cardiogenic shock and rescued by peripheral extracorporeal life support device (ECLS). Left surrenalectomy has been performed under protective ECLS during the same surgical procedure. The patient was successfully weaned from ECLS on Day 7 after surgery and myocardial function completely recovered when the patient was discharged from the hospital. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Enhanced independence and quality of life through treatment with flotation-Restricted Environmental Stimulation Technique of a patient with both Attention Deficit Hyperactivity Disorder and Aspergers Syndrome: a case report

PubMed Central

Kjellgren, Anette; Bood, Sven-Åke; Norlander, Torsten

2009-01-01

Introduction The objective of this qualitative case report was to describe experiences of flotation-Restricted Environmental Stimulation Technique from the perspective of a woman with Attention Deficit Hyperactivity Disorder, Aspergers syndrome and experiences of depression and distress. Case presentation The respondent is a 36-year-old woman from Sweden, assessed and diagnosed by a neuropsychological multi-professional team in 2006. The 19-session flotation series prolonged during almost one year. Conclusion The positive development of arousal control, activity regulation, sensory integration and interpretation, cognitive functioning and emotional maturity created experiences of personal independence and quality of life. Flotation-restrictive environmental stimulation technique was experienced as a meaningful treatment. Additional studies of treatment for Attention Deficit Hyperactivity Disorder and comorbid disorders in adults using the flotation-restrictive environmental stimulation technique are strongly encouraged. PMID:19829887

A case of severe type of cerebro-costo-mandibular syndrome.

PubMed

Matić, Aleksandra; Velisavljev-Filipović, Gordana; Lovrenski, Jovan; Gajdobranski, Djordje

2016-01-01

Cerebro-costo-mandibular syndrome (CCMS) is a rare disorder, with only 75 cases described in the literature to date. CCMS is characterized by association of micrognathia and specific multiple rib defects. It is accompanied by mental deficiency in considerable number of cases. Sometimes, there are associated anomalies and problems, such as spine deformities, brain, heart, kidney or ear anomalies, feeding difficulties, delayed psychomotor development, and growth impairment. Depending on severity of deformities and consecutive respiratory insufficiency, in about 35–50% of CCMS cases, death occurs during the first year of life. These cases are referred to as severe types of CCMS. In this paper we present a female infant with severe type of CCMS. Diagnosis was established in the first day of life, based on micrognathia and findings of posterior rib-gap defects on the chest X-ray, accompanied by dyspnea. Progressive severe respiratory insufficiency caused by chest and air-way deformities and exacerbated by episodes of pneumonia, led to respiratory failure and death at the age of 7.5 months. CCMS should be considered in every infant with micrognathia and rib-gap defects on chest X-ray.

A rare cause of respiratory distress and edema in neonate: Panhypopituitarism

PubMed Central

Dursun, Fatma; Kirmizibekmez, Heves; Metin, Fazilet

2017-01-01

Clinical presentation of hypopituitarism may be variable in the neonate. Symptoms are generally nonspecific, ranging from absent to severe, and even life-threatening, due to adrenocorticotrophic hormone deficiency. Presently described is a case of unexplained respiratory distress and edema in a neonate. Initial screening revealed panhypopituitarism. Respiratory distress improved after replacement treatment with hydrocortisone and thyroxine. PMID:28971179

The Case for Extant Life on Mars and Its Possible Detection by the Viking Labeled Release Experiment.

PubMed

Levin, Gilbert V; Straat, Patricia Ann

2016-10-01

The 1976 Viking Labeled Release (LR) experiment was positive for extant microbial life on the surface of Mars. Experiments on both Viking landers, 4000 miles apart, yielded similar, repeatable, positive responses. While the authors eventually concluded that the experiment detected martian life, this was and remains a highly controversial conclusion. Many believe that the martian environment is inimical to life and the LR responses were nonbiological, attributed to an as-yet-unidentified oxidant (or oxidants) in the martian soil. Unfortunately, no further metabolic experiments have been conducted on Mars. Instead, follow-on missions have sought to define the martian environment, mostly searching for signs of water. These missions have collected considerable data regarding Mars as a habitat, both past and present. The purpose of this article is to consider recent findings about martian water, methane, and organics that impact the case for extant life on Mars. Further, the biological explanation of the LR and recent nonbiological hypotheses are evaluated. It is concluded that extant life is a strong possibility, that abiotic interpretations of the LR data are not conclusive, and that, even setting our conclusion aside, biology should still be considered as an explanation for the LR experiment. Because of possible contamination of Mars by terrestrial microbes after Viking, we note that the LR data are the only data we will ever have on biologically pristine martian samples. Key Words: Extant life on Mars-Viking Labeled Release experiment-Astrobiology-Extraterrestrial life-Mars. Astrobiology 16, 798-810.

Martian paleolakes and waterways: Exobiological implications

USGS Publications Warehouse

Scott, D.H.; Rice, J. W.; Dohm, J.M.

1991-01-01

The problems of how warm and wet Mars once was and when climate transitions may have occurred are not well understood. Mars may have had an early environment similar to Earth's that was conductive to the ermergence of life. In addition, increasing geologic evidence indicates that water, upon which terrestrial life depends, has been present on Mars throughout its history. This evidence suggests that life could have developed not only on early Mars but also over longer periods of time in longer lasting, more clement local environments. Indications of past or present life most likely would be found in areas where liquid water existed in sufficient quantities to provide for the needs of biological systems. We suggest that paleolakes may have provided such environments. Unlike the case on Earth, this record of the origin and evolution of life has probably not been erased by extensive deformation of the Martian surface. Our work has identified eleven prospective areas where large lacustrine basins may once have existed. These areas are important for future biological, geological, and climatological investigations. ?? 1991 Kluwer Academic Publishers.

Neurocognitive and Family Functioning and Quality of Life Among Young Adult Survivors of Childhood Brain Tumors

PubMed Central

Hocking, Matthew C.; Hobbie, Wendy L.; Deatrick, Janet A.; Lucas, Matthew S.; Szabo, Margo M.; Volpe, Ellen M.; Barakat, Lamia P.

2012-01-01

Many childhood brain tumor survivors experience significant neurocognitive late effects across multiple domains that negatively affect quality of life. A theoretical model of survivorship suggests that family functioning and survivor neurocognitive functioning interact to affect survivor and family outcomes. This paper reviews the types of neurocognitive late effects experienced by survivors of pediatric brain tumors. Quantitative and qualitative data from three case reports of young adult survivors and their mothers are analyzed according to the theoretical model and presented in this paper to illustrate the importance of key factors presented in the model. The influence of age at brain tumor diagnosis, family functioning, and family adaptation to illness on survivor quality of life and family outcomes are highlighted. Future directions for research and clinical care for this vulnerable group of survivors are discussed. PMID:21722062

Gravity wave initiated convection

NASA Astrophysics Data System (ADS)

Hung, R. J.

1990-09-01

The vertical velocity of convection initiated by gravity waves was investigated. In one particular case, the convective motion-initiated and supported by the gravity wave-induced activity (excluding contributions made by other mechanisms) reached its maximum value about one hour before the production of the funnel clouds. In another case, both rawinsonde and geosynchronous satellite imagery were used to study the life cycles of severe convective storms. Cloud modelling with input sounding data and rapid-scan imagery from GOES were used to investigate storm cloud formation, development and dissipation in terms of growth and collapse of cloud tops, as well as, the life cycles of the penetration of overshooting turrets above the tropopause. The results based on these two approaches are presented and discussed.

Isothermal life prediction of composite lamina using a damage mechanics approach

NASA Technical Reports Server (NTRS)

Abuelfoutouh, Nader M.; Verrilli, Michael J.; Halford, Gary R.

1989-01-01

A method for predicting isothermal plastic fatigue life of a composite lamina is presented in which both fibers and matrix are isotropic materials. In general, the fatigue resistances of the matrix, fibers, and interfacial material must be known in order to predict composite fatigue life. Composite fatigue life is predicted using only the matrix fatigue resistance due to inelasticity micromechanisms. The effect of the fiber orientation on loading direction is accounted for while predicting composite life. The application is currently limited to isothermal cases where the internal thermal stresses that might arise from thermal strain mismatch between fibers and matrix are negligible. The theory is formulated to predict the fatigue life of a composite lamina under either load or strain control. It is applied currently to predict the life of tungsten-copper composite lamina at 260 C under tension-tension load control. The calculated life of the lamina is in good agreement with available composite low cycle fatigue data.

On initial steps of chemical prebiotic evolution: Triggering autocatalytic reaction of oligomerization

NASA Astrophysics Data System (ADS)

Bartsev, S. I.; Mezhevikin, V. V.

2008-12-01

Searching for extraterrestrial life attracts more and more attention. However this searching hardly can be effective without sufficiently universal concept of life origin, which incidentally tackles a problem of origin of life on the Earth. A concept of initial stages of life origin is stated in the paper. The concept eliminates key difficulties in the problem of life origin, and allows experimental verification of it. According to the concept the predecessor of living beings has to be sufficiently simple to provide non-zero probability of self-assembling during short (in geological or cosmic scale) time. In addition the predecessor has to be capable of autocatalysis, and further complication (evolution). A possible scenario of initial stage of life origin, which can be realized both on other planets, and inside experimental facility is considered. In the scope of the scenario a theoretical model of multivariate oligomeric autocatalyst is presented. Results of computer simulation of two versions of oligomeric autocatalytic reactions are presented. It is shown that the contribution of monomer activation reaction is essential, and in some cases autocatalysis in polymerizing reaction can be achieved without catalyzing proper monomer binding reaction.

Mineral Surface-Templated Self-Assembling Systems: Case Studies from Nanoscience and Surface Science towards Origins of Life Research.

PubMed

Gillams, Richard J; Jia, Tony Z

2018-05-08

An increasing body of evidence relates the wide range of benefits mineral surfaces offer for the development of early living systems, including adsorption of small molecules from the aqueous phase, formation of monomeric subunits and their subsequent polymerization, and supramolecular assembly of biopolymers and other biomolecules. Each of these processes was likely a necessary stage in the emergence of life on Earth. Here, we compile evidence that templating and enhancement of prebiotically-relevant self-assembling systems by mineral surfaces offers a route to increased structural, functional, and/or chemical complexity. This increase in complexity could have been achieved by early living systems before the advent of evolvable systems and would not have required the generally energetically unfavorable formation of covalent bonds such as phosphodiester or peptide bonds. In this review we will focus on various case studies of prebiotically-relevant mineral-templated self-assembling systems, including supramolecular assemblies of peptides and nucleic acids, from nanoscience and surface science. These fields contain valuable information that is not yet fully being utilized by the origins of life and astrobiology research communities. Some of the self-assemblies that we present can promote the formation of new mineral surfaces, similar to biomineralization, which can then catalyze more essential prebiotic reactions; this could have resulted in a symbiotic feedback loop by which geology and primitive pre-living systems were closely linked to one another even before life’s origin. We hope that the ideas presented herein will seed some interesting discussions and new collaborations between nanoscience/surface science researchers and origins of life/astrobiology researchers.

A Morally Permissible Moral Mistake? Reinterpreting a Thought Experiment as Proof of Concept.

PubMed

Emmerich, Nathan; Gordjin, Bert

2018-03-07

This paper takes the philosophical notion of suberogatory acts or morally permissible moral mistakes and, via a reinterpretation of a thought experiment from the medical ethics literature, offers an initial demonstration of their relevance to the field of medical ethics. That is, at least in regards to this case, we demonstrate that the concept of morally permissible moral mistakes has a bearing on medical decision-making. We therefore suggest that these concepts may have broader importance for the discourse on medical ethics and should receive fuller consideration by those working the field. The focus of the discussion we present is on a particular thought experiment originally presented by Sulmasy and Sugarman. Their case formed the basis of an exchange about the moral equivalence of withdrawing and withholding life-saving treatment. The analysis Sulmasy and Sugarman set out is significant because, contrary to common bioethical opinion, it implies that the difference between withdrawing and withholding life-saving treatment holds, rather than lacks, moral significance. Following a brief discussion of rejoinders to Sulmasy and Sugarman's article, we present a constructive reinterpretation of the thought experiment, one that draws on the idea of suberogatory acts or "morally permissible moral mistakes." Our analysis, or so we suggest, accounts for the differing moral intuitions that the case prompts. However, it also calls into question the degree to which this thought experiment can be thought of as illustrating the moral (non)equivalence of withdrawing and withholding life-saving treatment. Rather, we conclude that it primarily illuminates something about the ethical parameters of healthcare when family members, particularly parents, are involved in decision-making.

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 role of religious beliefs in ethics committee consultations for conflict over life-sustaining treatment.

PubMed

Bandini, Julia I; Courtwright, Andrew; Zollfrank, Angelika A; Robinson, Ellen M; Cadge, Wendy

2017-06-01

Previous research has suggested that individuals who identify as being more religious request more aggressive medical treatment at end of life. These requests may generate disagreement over life-sustaining treatment (LST). Outside of anecdotal observation, however, the actual role of religion in conflict over LST has been underexplored. Because ethics committees are often consulted to help mediate these conflicts, the ethics consultation experience provides a unique context in which to investigate this question. The purpose of this paper was to examine the ways religion was present in cases involving conflict around LST. Using medical records from ethics consultation cases for conflict over LST in one large academic medical centre, we found that religion can be central to conflict over LST but was also present in two additional ways through (1) religious coping, including a belief in miracles and support from a higher power, and (2) chaplaincy visits. In-hospital mortality was not different between patients with religiously versus non-religiously centred conflict. In our retrospective cohort study, religion played a variety of roles and did not lead to increased treatment intensity or prolong time to death. Ethics consultants and healthcare professionals involved in these cases should be cognisant of the complex ways that religion can manifest in conflict over LST. 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/.

[Nocardiosis in immunocompromised host presenting as cellulitis].

PubMed

Asgeirsson, Hilmar; Sigurdardottir, Bryndis

2010-06-01

Nocardia is a rare pathogen of mainly immunocomprised patients. Only two cases of nocardiosis have previously been identified in Iceland. A 92-year-old male on glucocorticoid therapy with metastatic bladder cancer presented with two weeks history of progressive swelling and erythema of the hand and deteriorating cognitive functioning. A brain lesion and pulmonary nodules were identified and Nocardia farcinia was cultured from a hand abscess. The patient was initially treated with trimethoprim/sulfamethoxazole but because of rapid deterioration and old age an end-of-life decision was made. This case of nocardiosis illustrates the importance of uncommon opportunistic infections in immunocompromised Icelandic patients.

Spontaneous Splenic Rupture in Vascular Ehlers-Danlos Syndrome.

PubMed

Batagini, Nayara Cioffi; Gornik, Heather; Kirksey, Lee

2015-01-01

Vascular Ehlers-Danlos Syndrome (VEDS) is a rare autosomal dominant collagen vascular disorder. Different from other Ehler-Danlos Syndrome subtypes, VEDS has poor prognosis due to severe fragility of connective tissues and association with life-threatening vascular and gastrointestinal complications. Spontaneous splenic rupture is a rare but hazardous complication related to this syndrome. To date, only 2 cases have been reported in the literature. Here we present another case of this uncommon complication, occurring in a 54-year-old woman in clinical follow-up for VEDS who presented with sudden onset of abdominal pain and hypotension. © The Author(s) 2015.

Melanotic neuroectodermal tumor of the neurocranium in infancy.

PubMed

Walsh, J W; Strand, R D

1982-01-01

Melanotic neuroectodermal tumors of the neurocranium are a rare but life-threatening disorder of infancy. 11 previously reported cases are reviewed in terms of clinical presentation, radiological diagnosis, and management. A twelfth case, a 4-month-old infant who developed three discrete sites of tumor unilaterally in the neurocranium is presented. Several hypotheses for the mechanism of formation of these tumors are reviewed. The authors propose that the mechanism of formation involves a dysontogenesis of neural crest tissue and that these tumors form, at least in part, from fragments of melanin-containing arachnoid villi which are displaced during embryonic development.

Quality of life in patients with cleft lip and palate after operation.

PubMed

Augsornwan, Darawan; Namedang, Sarakull; Pongpagatip, Sumalee; Surakunprapha, Palakorn

2011-12-01

Cleft lip and cleft palate are the most common craniofacial anomalies. Srinagarind Hospital has 150-200 cases each year. The operating process of care, requires continuity of care involving a multidisciplinary team. When the patients go to hospital for an operation they experience pain, limited activity and also food is very different from normal life. When attending school they suffer speech articulation problems and feel shy and isolated, which has a detrimental affect on their life style and quality of life. The main purpose of the study is to the present study quality of life in patients with cleft lip and palate after operation. The present study is descriptive research using qualitative and quantitative approaches. The studied population were patients age 8-18 years old who were admitted at 3C Ward and Outpatient Department, Srinagarind Hospital. 33 patients were interviewed for the quantitative approach. Guideline for in-depth interview with 15 patients were used for the qualitative approach. Quantitative data were analyzed and presented in frequency, percentage and standard deviation. The qualitative data were analyzed through content analysis. Patients consider their QOL is high level, but in detail they still worry about self concept psychological well-being. From indept interview patients would like to get further treatment to minimize their scar as soon as possible. Patients consider their quality of life as high level, but they would like to get further treatment.

Embolization as the treatment for a life-threatening mandibular arteriovenous malformation.

PubMed

Loureiro, Caio Cesar de Souza; Falchet, Paula Cristina Felix; Gavranich, João; Lobo Leandro, Luiz Fernando

2010-03-01

Mandibular arteriovenous malformation is a severe vascular pathological condition that may lead to life-threatening hemorrhages. In child and teenaged patients, a conservative treatment is preferred to avoid profuse blood loss and/or mutilating alterations in the still-growing patients' face. The aim of this article was to present a case of an 11-year-old boy with an arteriovenous malformation involving the left mandible and treated by means of endovascular embolization with direct lesional delivery of N-butyl-cyanoacrylate glue through transfemoral catheterization.

Full Mouth Oral Rehabilitation by Maxillary Implant Supported Hybrid Denture Employing a Fiber Reinforced Material Instead of Conventional PMMA.

PubMed

Qamheya, Ala Hassan A; Yeniyol, Sinem; Arısan, Volkan

2015-01-01

Many people have life-long problems with their dentures, such as difficulties with speaking and eating, loose denture, and sore mouth syndrome. The evolution of dental implant supported prosthesis gives these patients normal healthy life for their functional and esthetic advantages. This case report presents the fabrication of maxillary implant supported hybrid prosthesis by using Nanofilled Composite (NFC) material in teeth construction to rehabilitate a complete denture wearer patient.

Full Mouth Oral Rehabilitation by Maxillary Implant Supported Hybrid Denture Employing a Fiber Reinforced Material Instead of Conventional PMMA

PubMed Central

Qamheya, Ala Hassan A.; Arısan, Volkan

2015-01-01

Many people have life-long problems with their dentures, such as difficulties with speaking and eating, loose denture, and sore mouth syndrome. The evolution of dental implant supported prosthesis gives these patients normal healthy life for their functional and esthetic advantages. This case report presents the fabrication of maxillary implant supported hybrid prosthesis by using Nanofilled Composite (NFC) material in teeth construction to rehabilitate a complete denture wearer patient. PMID:26557392

Extremely high concentration of folates in premature newborns.

PubMed

Zikavska, T; Brucknerova, I

2014-01-01

Extremely high concentration of folates in premature newborns: case reports. Folates are a group of water soluble compounds, which are important for metabolic processes in human body. These are important during periods of rapid cell growth. The most accurate indicator of long-term folate level status in the body is the determination of red blood cell (RBC) folate concentrations. The optimal level of RBC folate is not known in neonatal period. Authors discuss the reasons for extremely high level of RBC folate concentrations. In our work we present the cases of two premature newborns with extremely high level of RBC folate concentrations, which were analyzed immunochemically on the first day of life and after six weeks of life. In both cases we measured RBC folate concentrations on the 1st day of life. After 6 weeks we found extremely high RBC folate concentration level (5516.67 ng/ml) in the first case after RBC transfusions. In second case after two months of life the RBC folate concentration level was doubled (2335.1 ng/ml) until 24 hours after RBC transfusion compared to levels after birth. The normal range of RBC folate values vary in newborns. The upper limit of daily dose of folic acid in pregnancy and neonatal period is not known. On the other hand it is an easily excreted water-soluble vitamin but in premature newborn it can lead to the disruption of metabolic balance and slow its degradation. Some factors can have an impact on RBC folate concentration. Blood transfusion can be one of the main influences on RBC folate concentration. To clarify these mechanisms further studies are required (Ref. 29).

Case report of precursor B-cell lymphoblastic lymphoma presenting as syncope and cardiac mass in a nonimmunocompromised child.

PubMed

Hahn, Barry; Rao, Sudha; Shah, Binita

2007-08-01

We report the case of a previously healthy, 10-year-old boy who presented to the emergency department with a syncopal episode. In the emergency department, the patient was diagnosed with a right atrial mass, later identified as a precursor B-cell lymphoblastic lymphoma (LL). Most causes of syncope in children are not life threatening. In most cases, it indicates a predisposition to vasovagal episodes. Lymphomas account for approximately 7% of malignancies among children younger than 20 years, are more common in white males and immunocompromised patients, and are predominantly tumors of T-cell origin. Children with non-Hodgkin lymphoma usually present with extranodal disease, most frequently involving the abdomen (31%), mediastinum (26%), or head and neck (29%). Our patient was unique in that he was a nonimmunocompromised, black boy, presenting with syncope in the setting of a large atrial mass identified as a precursor B-cell LL. To our knowledge, there are no reported cases of precursor B-cell LL presenting as syncope and a cardiac mass.

Embolization of congenital intrahepatic porto-systemic shunt by n-butyl cyanoacrylate.

PubMed

Gupta, Vivek; Kalra, Naveen; Vyas, Sameer; Sodhi, K S; Thapa, B R; Khandelwal, N

2009-10-01

Congenital intrahepatic portosystemic venous shunt (IHPSVS) is rare vascular anomaly. We present one case of a 14-month male child who presented with global developmental delay. Child had high ammonia levels with low glutamine and high bile salts on the previous investigations and had history of neonatal seizures since day 13 of life. On admission, serum ammonia levels were elevated to 112micromol/L. Other laboratory investigations including liver and renal function test, and electrolytes were normal. He was, diagnosed to have IHPSVS on the basis of Doppler and CT, and treated by embolization with n-butyl cyanoacrylate (glue). A brief review of diagnostic modalities and endovascular management for the IHPSVS is presented including the present case.

Intraosseous pleomorphic adenoma: case report and review of the literature.

PubMed

Aver-De-Araujo, L M; Chaves-Tarquinio, S B; Neuzling-Gomes, A P; Etges, A

2002-01-01

Pleomorphic adenoma is the most common neoplasm of the salivary glands, affecting mainly the parotid gland. The preferential intraoral site of this tumor is the palate. A case of a 31-year-old woman with an intraosseous pleomorphic adenoma located in the maxilla (left paramedian region), showing an approximate evolution of one year is reported. The present intraosseous case represents a rare location, with the tumor probably originating from glandular epithelial remnants captured during embryogenesis. In a review of the literature of 142 cases of intragnathic localization (24% in the maxilla) are identified. A slight predominance of women was observed (56%), with 55% of the patients being affected during the 5th to 7th decade of life. The tumors were malignant in 94% of the cases, with special predominance of mucoepidermoid carcinoma (65%). Intraosseous pleomorphic adenomas are rare, with the present patient being the 6th case reported in the literature and the second found in the maxilla. Mean age of the 5 previously reported cases was 58.8 years.

Goldston syndrome in a fetus: case report and literature review.

PubMed

Avcu, Serhat; Akdeniz, Hüseyin; Unal, Ozkan; Kurdoğlu, Mertihan

2010-01-01

We present a case of the Goldston syndrome which is the association of polycystic kidneys with Dandy-Walker malformation. The diagnosis was made by ultrasound in twenty second week of gestation. Obstetric ultrasound and fetal MRI studies showed hydrocephalus, agenesis of the cerebellar hemispheres, vermian hypoplasia, cystic dilatation of the 4(th) ventricle, enlargement of the posterior fossa, abdominal distension, and oligohydramnios.. The kidneys were symmetrically enlarged and multicystic. To our knowledge this is the third reported case of Goldston syndrome which was diagnosed during intrauterine life.

Levofloxacin-induced rhabdomyolysis: a case report.

PubMed

John, Febin; Oluronbi, Ruby; Pitchumoni, C S

2016-08-24

Rhabdomyolysis secondary to quinolones is not frequent. There are scarce reports in the literature associating rhabdomyolysis to levofloxacin. We describe a case of levofloxacin-induced rhabdomyolysis. A 52-year-old African-American man presented with muscle tightness after taking three doses of levofloxacin. He had elevated creatine kinase without acute kidney injury. His symptoms resolved after discontinuation of levofloxacin and supportive care. It is fascinating that our patient has a prior history of rhabdomyolysis, likely from levofloxacin. Our case highlights the need to be mindful of this potentially life-threatening complication of levofloxacin.

Caroline Crachami, the Sicilian Fairy: a case of bird-headed dwarfism.

PubMed

Bondeson, J

1992-09-15

One of the most remarkable cases of extreme dwarfism on record is Caroline Crachami, the Sicilian Fairy. She was born in 1815, and was taken to London to be exhibited for money in 1824. Due to her proportional dwarfism, severe intrauterine growth retardation, and typical "bird-headed" profile, Caroline Crachami has by some been diagnosed as a case of the autosomal recessive Seckel syndrome. In this historical vignette, the Sicilian Fairy's life and death are presented in some detail using new material, and the problem of her correct diagnosis is discussed.

Catecholamine crisis during induction of general anesthesia : A case report.

PubMed

Sonntagbauer, M; Koch, A; Strouhal, U; Zacharowski, K; Weber, C F

2018-03-01

Catecholamine crises associated with pheochromocytoma may cause life-threatening cardiovascular conditions. We report the case of a 75-year-old male who developed a hypertensive crisis during induction of general anesthesia for elective resection of a cervical neuroma due to an undiagnosed pheochromocytoma. Hemodynamic instability occurred immediately after the injection of fentanyl, propofol and rocuronium, prior to laryngoscopy and in the absence of any manipulation of the abdomen. In this case report, we present the management of this incident and discuss the underlying pathophysiology triggering a catecholamine crisis.

Rolling Bearing Steels - A Technical and Historical Perspective

NASA Technical Reports Server (NTRS)

Zaretsky, Erwin V.

2012-01-01

Starting about 1920 it becomes easier to track the growth of bearing materials technology. Until 1955, with few exceptions, comparatively little progress was made in this area. AISI 52100 and some carburizing grades (AISI 4320, AISI 9310) were adequate for most applications. The catalyst to quantum advances in high-performance rolling-element bearing steels was the advent of the aircraft gas turbine engine. With improved bearing manufacturing and steel processing together with advanced lubrication technology, the potential improvements in bearing life can be as much as 80 times that attainable in the late 1950s or as much as 400 times that attainable in 1940. This paper summarizes the chemical, metallurgical and physical aspects of bearing steels and their effect on rolling bearing life and reliability. The single most important variable that has significantly increased bearing life and reliability is vacuum processing of bearing steel. Differences between through hardened, case carburized and corrosion resistant steels are discussed. The interrelation of alloy elements and carbides and their effect on bearing life are presented. An equation relating bearing life, steel hardness and temperature is given. Life factors for various steels are suggested and discussed. A relation between compressive residual stress and bearing life is presented. The effects of retained austenite and grain size are discussed.

Fourth branchial complex anomalies: a case series.

PubMed

Shrime, Mark; Kacker, Ashutosh; Bent, John; Ward, Robert F

2003-11-01

Anomalies of the fourth branchial arch complex are exceedingly rare, with approximately forty cases reported in the literature since 1972. The authors report experience with six fourth arch anomalies. Retrospective chart review of six consecutive patients presenting to the pediatric otolaryngology service at a tertiary care center with anomalies referable to the fourth branchial arch. All six patients presented within the first or second decade of life. All six had left-sided disease. Four patients presented with recurrent neck infection, one with asymptomatic cervical masses, and one with a neck mass and respiratory compromise. One patient had prior surgery presented with a recurrence. Diagnosis of fourth arch anomalies was suggested or confirmed by computed tomography and flexible laryngoscopy. Treatment was surgical in five patients; one patient is awaiting surgery. Surgical procedures included resection of the mass and endoscopic cauterization of the inner opening of the cyst. The presentation of a cervical mass, especially with recurrent infections and especially on the left side, in a child in the first or second decade of life heightens suspicion for an anomaly of the fourth branchial arch. Diagnosis can be difficult, but is aided by the use of flexible laryngoscopy, Computed tomography (CT) scanning and ultrasonography. Surgical resection of the cyst and cauterization of its pyriform sinus opening should be undertaken to minimize recurrence.

Pest management update on sunflower midge

USDA-ARS?s Scientific Manuscript database

The sunflower midge (Contarinia schulzi) is a serious insect pest of sunflower, causing bud and head deformation that lead to poor seed development, and in many cases no seed development. This presentation describes the life cycle of the sunflower midge and shows images of infested sunflower heads. ...

19 CFR 207.24 - Hearing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... EXPORTS TO THE UNITED STATES Final Determinations, Short Life Cycle Products § 207.24 Hearing. (a) In... closed, presentations at the hearing shall not include business proprietary information. Notwithstanding... the Secretary no later than three (3) business days before the hearing. In the case of testimony to be...

Brain damage resembling acute necrotizing encephalopathy as a specific manifestation of haemophagocytic lymphohistiocytosis - induced by hypersensitivity.

PubMed

Dai, Dongling; Wen, Feiqiu; Liu, Sixi; Zhou, Shaoming

2016-08-31

Both haemophagocytic lymphohistiocytosis and acute necrotizing encephalopathy are life-threatening condition. It presents major diagnostic difficulties, since it may have a diversity in clinical picture and with many conditions leading to the same clinical presentation. So it is key important to understand the disorders. We report a pediatric case of haemophagocytic lymphohistiocytosis with specific presentation which predominantly featured as acute necrotizing encephalopathy of childhood. We discuss the diagnosis and differential diagnosis, and speculate the etiology of haemophagocytic lymphohistiocytosis is due to hypersensitivity. Haemophagocytic lymphohistiocytosis and brain damage in this case may be induced by hypersensitivity, which have good clinical outcome if diagnosed and treated early.

[Myxedema coma. A case reported].

PubMed

Rebollo-Gómez, Héctor

2010-01-01

Myxedema coma is a life-threatening condition; it is a complication of untreated hypothyroidism and an endocrine emergency. Most patients are elderly women with a previous history of long-standing hypothyroidism which presents during the winter. The myxedema coma has an insidious onset and it is very rare; its recognition can be quite difficult. Once suspected, treatment can be lifesaving and should be start promptly in anticipation of confirmation of the diagnosis by laboratory test. The mortality rate is high. I presented a case of an old woman with myxedema coma with an undiagnosed hypothyroidism, with altered mental status, normal temperature, pneumonia, hyponatremia and high level of creatine phosphokinase, who presented in the emergency room.

End-of-life disposal of high elliptical orbit missions: The case of INTEGRAL

NASA Astrophysics Data System (ADS)

Armellin, Roberto; San-Juan, Juan F.; Lara, Martin

2015-08-01

Nowadays there is international consensus that space activities must be managed to minimize debris generation and risk. The paper presents a method for the end-of-life (EoL) disposal of spacecraft in high elliptical orbits (HEO). The time evolution of HEO is strongly affected by Earth's oblateness and luni-solar perturbation, and this can cause in the long-term to extended interferences with low Earth orbit (LEO) protected region and uncontrolled Earth re-entry. An EoL disposal concept that exploits the effect of orbital perturbations to reduce the disposal cost is presented. The problem is formulated as a multiobjective optimization problem, which is solved with an evolutionary algorithm. To explore at the best the search space a semi-analytical orbit propagator, which allows the propagation of the orbit motion for 100 years in few seconds, is adopted. The EoL disposal of the INTErnational Gamma-Ray Astrophysics Laboratory (INTEGRAL) mission is used as a practical test-case to show the effectiveness of the proposed methodology.

Climate Change Impacts on the Tree of Life: Changes in Phylogenetic Diversity Illustrated for Acropora Corals

PubMed Central

Faith, Daniel P.; Richards, Zoe T.

2012-01-01

The possible loss of whole branches from the tree of life is a dramatic, but under-studied, biological implication of climate change. The tree of life represents an evolutionary heritage providing both present and future benefits to humanity, often in unanticipated ways. Losses in this evolutionary (evo) life-support system represent losses in “evosystem” services, and are quantified using the phylogenetic diversity (PD) measure. High species-level biodiversity losses may or may not correspond to high PD losses. If climate change impacts are clumped on the phylogeny, then loss of deeper phylogenetic branches can mean disproportionately large PD loss for a given degree of species loss. Over time, successive species extinctions within a clade each may imply only a moderate loss of PD, until the last species within that clade goes extinct, and PD drops precipitously. Emerging methods of “phylogenetic risk analysis” address such phylogenetic tipping points by adjusting conservation priorities to better reflect risk of such worst-case losses. We have further developed and explored this approach for one of the most threatened taxonomic groups, corals. Based on a phylogenetic tree for the corals genus Acropora, we identify cases where worst-case PD losses may be avoided by designing risk-averse conservation priorities. We also propose spatial heterogeneity measures changes to assess possible changes in the geographic distribution of corals PD. PMID:24832524

Combinatorial life cycle assessment to inform process design of industrial production of algal biodiesel.

PubMed

Brentner, Laura B; Eckelman, Matthew J; Zimmerman, Julie B

2011-08-15

The use of algae as a feedstock for biodiesel production is a rapidly growing industry, in the United States and globally. A life cycle assessment (LCA) is presented that compares various methods, either proposed or under development, for algal biodiesel to inform the most promising pathways for sustainable full-scale production. For this analysis, the system is divided into five distinct process steps: (1) microalgae cultivation, (2) harvesting and/or dewatering, (3) lipid extraction, (4) conversion (transesterification) into biodiesel, and (5) byproduct management. A number of technology options are considered for each process step and various technology combinations are assessed for their life cycle environmental impacts. The optimal option for each process step is selected yielding a best case scenario, comprised of a flat panel enclosed photobioreactor and direct transesterification of algal cells with supercritical methanol. For a functional unit of 10 GJ biodiesel, the best case production system yields a cumulative energy demand savings of more than 65 GJ, reduces water consumption by 585 m(3) and decreases greenhouse gas emissions by 86% compared to a base case scenario typical of early industrial practices, highlighting the importance of technological innovation in algae processing and providing guidance on promising production pathways.

[Pulmonary hypoplasia: An analysis of cases over a 20-year period].

PubMed

Delgado-Peña, Yanny Paola; Torrent-Vernetta, Alba; Sacoto, Gabriela; de Mir-Messa, Inés; Rovira-Amigo, Sandra; Gartner, Silvia; Moreno-Galdó, Antonio; Molino-Gahete, José Andrés; Castillo-Salinas, Felíx

2016-08-01

Pulmonary hypoplasia is the most frequent congenital anomaly associated with perinatal mortality. A retrospective and descriptive review was conducted on cases of patients diagnosed with pulmonary hypoplasia between 1995 and 2014 in a tertiary university hospital. An analysis was made of the prenatal imaging, clinical manifestations, post-natal diagnostic tests, treatment and management, long-term follow up, and survival data. A total of 60 cases were identified, all of them with prenatal imaging. Sixteen patients required foetal surgery. Congenital diaphragmatic hernia was the most frequent diagnosis. Main clinical presentation was respiratory distress with severe hypoxemia and high requirements of mechanical ventilation. Mortality rate was 47% within first 60 days of life, and 75% for the first day of life. Pneumonia and recurrent bronchitis episodes were observed during follow-up. They had a lung function obstructive pattern, and their quality of life and exercise tolerance was good. High neonatal mortality and significant long-term morbidity associated with pulmonary hypoplasia requires an early diagnosis and a specialised multidisciplinary team management. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Primary chondrosarcoma of the trachea with extensive extraluminal growth.

PubMed

Ryabov, Andrey; Pikin, Oleg; Sokolov, Victor; Volchenko, Nadezda

2017-09-01

Primary chondrosarcoma of the trachea is an extremely rare non-epithelial neoplasm with only few cases published in the literature. We present a rare case of tracheal chondrosarcoma with extensive extraluminal growth. We operated a patient with obstructive tumour of the upper third of the trachea via partial sternotomy. Before surgery, a Hanarostent was put into the trachea to treat a life-threatening stenosis. Postoperative period was uneventful. We discuss the incidence, clinical presentation and treatment options in patients with rare tracheal tumours. In some cases, a multidisciplinary approach (endoscopic intervention followed by surgical resection) is an effective treatment tool. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

[Two cases of Duchenne muscular dystrophy over 40 years after onset].

PubMed

Ishizaki, Masatoshi; Ueyama, Hidetsugu; Masuda, Teruaki; Nishida, Yasuto; Imamura, Shigehiro; Ando, Yukio

2013-01-01

We report two 45 year old men with Duchenne muscular dystrophy. Case 1 showed a deleted exon 50 of the dystrophin gene by MLPA analysis, and Case 2 showed deleted exons 46-52. Both patients presented with severe weakness of the skeletal muscles and respiratory dysfunction, while cardiac involvement was mild and cognitive function was almost normal. The patients are able to shop at a mall, participate in activities, and attend hobbies, although they are bedridden with artificial respiration through tracheotomy. With the progress of the respiratory care and cardiac protective therapy, the prognosis of Duchenne muscular dystrophy has improved remarkably. At present, it is possible to survive over 40 years with maintenance of quality of life, if cardiac damage is not severe.

Infant botulism: first two confirmed cases in Slovenia and literature review.

PubMed

Radšel, Anja; Andlovic, Alenka; Neubauer, David; Osredkar, Damjan

2013-11-01

In Europe, infant botulism is a rare but probably under-diagnosed disease. With the intent to spread the awareness of this potentially life-threatening disease, we present a review of the literature with the emphasis on European epidemiology and a practical approach to diagnosis. We also report the first two confirmed cases of infant botulism in Slovenia and describe our way to the final diagnosis in a clinical setting where all appropriate diagnostic tests and treatment options are not readily available. The second case is particularly interesting, presenting with profound diarrhea following initial constipation, an unlikely symptom for an infant with botulism and possibly caused by Bacteroides fragilis. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Life-threatening intracranial bleeding in a newborn with congenital cytomegalovirus infection: late-onset neonatal hemorrhagic disease.

PubMed

Dallar, Yildiz; Tiras, Ulku; Catakli, Tulin; Gulal, Gonul; Sayar, Yavuz; Selvar, Beray; Alioglu, Bulent

2011-02-01

The authors present a case of a 36-day-old infant with intracranial and intramuscular hemorrhage due to vitamin K deficiency bleeding, who received intramuscular vitamin K prophylaxis at birth. In this case, laboratory tests showed anemia, liver dysfunction with cholestasis, and coagulopathy, consistent with vitamin K deficiency abnormality. Serological analyses showed that cytomegalovirus immunoglobulin (Ig)M and IgG avidity were both positive. The infant was treated successfully with intravenous ganciclovir and blood products. This case suggests that it is imperative to meticulously investigate the etiology in neonates with late-onset hemorrhagic disease of the newborn. Cholestatic liver disease caused by congenital cytomegalovirus infection should be in mind in term infants who presented with late-onset hemorrhagic disease.

Health-related quality of life and satisfaction with case management in cancer survivors.

PubMed

Hsu, Ya-Hui; Chai, Hsiu-Ying; Lin, Yu-Fen; Wang, Chao-Hui; Chen, Shu-Ching

2017-12-01

To (i) investigate the characteristics of health-related quality of life and satisfaction with case management and (ii) to identify factors associated with health-related quality of life in cancer survivors. The level of health-related quality of life can reflect treatment efficacy and satisfaction with cancer care. A cross-sectional study design was adopted. Subjects from the outpatient setting of a cancer centre in northern Taiwan were recruited by consecutive sampling. A set of questionnaires were employed, including a background information form, case management service satisfaction survey (CMSS) and The European Quality of Life Scale (EQ-5D). Descriptive statistics were used to examine levels of health-related quality of life and satisfaction with case management. Pearson's correlation was used to identify relationships between treatment characteristics, satisfaction with case management and health-related quality of life. Multiple stepwise regression was used to identify factors associated with health-related quality of life. A total of 252 cancer patients were recruited. The three lowest scores for items of health-related quality of life were mobility, self-care and usual activities. Cancer survivors with higher mobility, less pain and discomfort, and lower anxiety and depression were more likely to have better health-related quality of life. Mobility, pain and discomfort, and anxiety and depression are important predictive factors of high health-related quality of life in cancer survivors. In clinical care, patients' physical mobility, pain and discomfort, and anxiety and depression are important indicators of health-related quality of life. Case managers should include self-care and symptom management into survivorship care plans to improve health-related quality of life during survival after treatment concludes. © 2017 John Wiley & Sons Ltd.

Experiences of using life histories with health workers in post-conflict and crisis settings: methodological reflections.

PubMed

Witter, Sophie; Namakula, Justine; Alonso-Garbayo, Alvaro; Wurie, Haja; Theobald, Sally; Mashange, Wilson; Ros, Bandeth; Buzuzi, Stephen; Mangwi, Richard; Martineau, Tim

2017-05-01

Life history is a research tool which has been used primarily in sociology and anthropology to document experiences of marginalized individuals and communities. It has been less explored in relation to health system research. In this paper, we examine our experience of using life histories to explore health system trajectories coming out of conflict through the eyes of health workers. Life histories were used in four inter-related projects looking at health worker incentives, the impact of Ebola on health workers, deployment policies, and gender and leadership in the health sector. In total 244 health workers of various cadres were interviewed in Uganda, Sierra Leone, Zimbabwe and Cambodia. The life histories were one element within mixed methods research. We examine the challenges faced and how these were managed. They arose in relation to gaining access, data gathering, and analysing and presenting findings from life histories. Access challenges included lack of familiarity with the method, reluctance to expose very personal information and sentiments, lack of trust in confidentiality, particularly given the traumatized contexts, and, in some cases, cynicism about research and its potential to improve working lives. In relation to data gathering, there was variable willingness to draw lifelines, and some reluctance to broach sensitive topics, particularly in contexts where policy-related issues and legitimacy are commonly still contested. Presentation of lifeline data without compromising confidentiality is also an ethical challenge. We discuss how these challenges were (to a large extent) surmounted and conclude that life histories with health staff can be a very powerful tool, particularly in contexts where routine data sources are absent or weak, and where health workers constitute a marginalized community (as is often the case for mid-level cadres, those serving in remote areas, and staff who have lived through conflict and crisis). © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Experiences of using life histories with health workers in post-conflict and crisis settings: methodological reflections

PubMed Central

Namakula, Justine; Alonso-Garbayo, Alvaro; Wurie, Haja; Theobald, Sally; Mashange, Wilson; Ros, Bandeth; Buzuzi, Stephen; Mangwi, Richard; Martineau, Tim

2017-01-01

Abstract Introduction: Life history is a research tool which has been used primarily in sociology and anthropology to document experiences of marginalized individuals and communities. It has been less explored in relation to health system research. In this paper, we examine our experience of using life histories to explore health system trajectories coming out of conflict through the eyes of health workers. Methods: Life histories were used in four inter-related projects looking at health worker incentives, the impact of Ebola on health workers, deployment policies, and gender and leadership in the health sector. In total 244 health workers of various cadres were interviewed in Uganda, Sierra Leone, Zimbabwe and Cambodia. The life histories were one element within mixed methods research. Results: We examine the challenges faced and how these were managed. They arose in relation to gaining access, data gathering, and analysing and presenting findings from life histories. Access challenges included lack of familiarity with the method, reluctance to expose very personal information and sentiments, lack of trust in confidentiality, particularly given the traumatized contexts, and, in some cases, cynicism about research and its potential to improve working lives. In relation to data gathering, there was variable willingness to draw lifelines, and some reluctance to broach sensitive topics, particularly in contexts where policy-related issues and legitimacy are commonly still contested. Presentation of lifeline data without compromising confidentiality is also an ethical challenge. Conclusion: We discuss how these challenges were (to a large extent) surmounted and conclude that life histories with health staff can be a very powerful tool, particularly in contexts where routine data sources are absent or weak, and where health workers constitute a marginalized community (as is often the case for mid-level cadres, those serving in remote areas, and staff who have lived through conflict and crisis). PMID:28052985

Character in Learning for Life: A Virtue-Ethical Rationale for Recent Research on Moral and Values Education

ERIC Educational Resources Information Center

Arthur, James; Carr, David

2013-01-01

This article has three broad aims. The first is to draw attention what is probably the largest empirical study of moral, values and character education in the United Kingdom to the present date. The second is to outline--sufficient for present purposes--a plausible conceptual or theoretical case for placing a particular virtue-ethical concept of…

The Case for Extant Life on Mars and Its Possible Detection by the Viking Labeled Release Experiment

NASA Astrophysics Data System (ADS)

Levin, Gilbert V.; Straat, Patricia Ann

2016-10-01

The 1976 Viking Labeled Release (LR) experiment was positive for extant microbial life on the surface of Mars. Experiments on both Viking landers, 4000 miles apart, yielded similar, repeatable, positive responses. While the authors eventually concluded that the experiment detected martian life, this was and remains a highly controversial conclusion. Many believe that the martian environment is inimical to life and the LR responses were nonbiological, attributed to an as-yet-unidentified oxidant (or oxidants) in the martian soil. Unfortunately, no further metabolic experiments have been conducted on Mars. Instead, follow-on missions have sought to define the martian environment, mostly searching for signs of water. These missions have collected considerable data regarding Mars as a habitat, both past and present. The purpose of this article is to consider recent findings about martian water, methane, and organics that impact the case for extant life on Mars. Further, the biological explanation of the LR and recent nonbiological hypotheses are evaluated. It is concluded that extant life is a strong possibility, that abiotic interpretations of the LR data are not conclusive, and that, even setting our conclusion aside, biology should still be considered as an explanation for the LR experiment. Because of possible contamination of Mars by terrestrial microbes after Viking, we note that the LR data are the only data we will ever have on biologically pristine martian samples.

Ultra-High Precision Half-Life Measurement for the Superallowed &+circ; Emitter ^26Al^m

NASA Astrophysics Data System (ADS)

Finlay, P.; Demand, G.; Garrett, P. E.; Leach, K. G.; Phillips, A. A.; Sumithrarachchi, C. S.; Svensson, C. E.; Triambak, S.; Grinyer, G. F.; Leslie, J. R.; Andreoiu, C.; Cross, D.; Austin, R. A. E.; Ball, G. C.; Bandyopadhyay, D.; Djongolov, M.; Ettenauer, S.; Hackman, G.; Pearson, C. J.; Williams, S. J.

2009-10-01

The calculated nuclear structure dependent correction for ^26Al^m (δC-δNS= 0.305(27)% [1]) is smaller by nearly a factor of two than the other twelve precision superallowed cases, making it an ideal case to pursue a reduction in the experimental errors contributing to the Ft value. An ultra-high precision half-life measurement for the superallowed &+circ; emitter ^26Al^m has been made at the Isotope Separator and Accelerator (ISAC) facility at TRIUMF in Vancouver, Canada. A beam of ˜10^5 ^26Al^m/s was delivered in October 2007 and its decay was observed using a 4π continuous gas flow proportional counter as part of an ongoing experimental program in superallowed Fermi β decay studies. With a statistical precision of ˜0.008%, the present work represents the single most precise measurement of any superallowed half-life to date. [4pt] [1] I.S. Towner and J.C. Hardy, Phys. Rev. C 79, 055502 (2009).

Ultra-High Precision Half-Life Measurement for the Superallowed &+circ; Emitter ^26Al^m

NASA Astrophysics Data System (ADS)

Finlay, P.; Demand, G.; Garrett, P. E.; Leach, K. G.; Phillips, A. A.; Sumithrarachchi, C. S.; Svensson, C. E.; Triambak, S.; Ball, G. C.; Bandyopadhyay, D.; Djongolov, M.; Ettenauer, S.; Hackman, G.; Pearson, C. J.; Williams, S. J.; Andreoiu, C.; Cross, D.; Austin, R. A. E.; Grinyer, G. F.; Leslie, J. R.

2008-10-01

The calculated nuclear structure dependent correction for ^26Al^m (δC-δNS= 0.305(27)% [1]) is smaller by nearly a factor of two than the other twelve precision superallowed cases, making it an ideal case to pursue a reduction in the experimental errors contributing to the Ft value. An ultra-high precision half-life measurement for the superallowed &+circ; emitter ^26Al^m has been made using a 4π continuous gas flow proportional counter as part of an ongoing experimental program in superallowed Fermi β decay studies at the Isotope Separator and Accelerator (ISAC) facility at TRIUMF in Vancouver, Canada, which delivered a beam of ˜10^5 ^26Al^m/s in October 2007. With a statistical precision of ˜0.008%, the present work represents the single most precise measurement of any superallowed half-life to date. [1] I.S. Towner and J.C. Hardy, Phys. Rev. C 77, 025501 (2008).

Long-term neuropsychological, neuroanatomical, and life outcome in hippocampal amnesia

PubMed Central

Warren, David E.; Duff, Melissa C.; Magnotta, Vincent; Capizzano, Aristides A; Cassell, Martin D.; Tranel, Daniel

2012-01-01

Focal bilateral hippocampal damage typically causes severe and selective amnesia for new declarative information (facts and events), a cognitive deficit that greatly impacts the ability to live a normal, fully-independent life. We describe the case of 1846, a 48-year-old woman with profound hippocampal amnesia following status epilepticus and an associated anoxic episode at age 30. 1846 has undergone extensive neuropsychological testing on many occasions over the 18 years since her injury, and we present data indicating that her memory impairment has remained severe and stable during that time. New, high-resolution structural MRI studies of 1846's brain reveal substantial bilateral hippocampal atrophy resembling that of other well-known amnesic patients. In spite of severe amnesia, 1846 lives a full and mostly independent adult life, facilitated by an extensive social support network of family and friends. Her case provides an example of a rare and unlikely positive outcome in the face of severe memory problems. PMID:22401298

Xanthogranulomatous pyelonephritis presenting as acute pleuritic chest pain: a case report.

PubMed

Chow, Justin; Kabani, Rameez; Lithgow, Kirstie; Sarna, Magdalena A

2017-04-12

Xanthogranulomatous pyelonephritis is a rare and serious manifestation of chronic kidney inflammation that can be life-threatening if not recognized and treated appropriately, often with antibiotics and surgery. Affected patients are most commonly females in their fifth or sixth decade of life with a background of obstructive uropathy, nephrolithiasis, or recurrent urinary tract infections who present with vague nonspecific symptoms. A 43-year-old woman of Russian ethnicity with a history of nephrolithiasis presented to our emergency department with new left-sided pleuritic chest pain amid a 6-week history of constitutional symptoms including fevers, night sweats, and 7 kg of weight loss. Workup for acute coronary syndrome and pulmonary embolism in our emergency department was negative. Given that she was clinically unwell, she was admitted to internal medicine to expedite workup for the cause of her symptoms. A broad differential diagnosis for various infectious, inflammatory/autoimmune, and neoplastic processes was considered. Based on classic radiographic and histopathologic findings, she was ultimately diagnosed with xanthogranulomatous pyelonephritis of her left kidney, which was a direct consequence of chronic inflammation. This inflammation exhibited spread to local tissues and across her left hemidiaphragm, resulting in a unilateral pleural effusion which explained her chest discomfort. She was treated with antibiotics administered intravenously and urgent total nephrectomy with a good functional outcome. Our case illustrates an uncommon but clinically important do-not-miss diagnosis that underlies a common clinical presentation of pleuritic chest pain. The case underscores the importance of maintaining a broad differential diagnosis and organized approach when treating patients with undifferentiated clinical presentations.

Multiple pregnancies with complete mole and coexisting normal fetus in North and South America: A retrospective multicenter cohort and literature review.

PubMed

Lin, Lawrence H; Maestá, Izildinha; Braga, Antonio; Sun, Sue Y; Fushida, Koji; Francisco, Rossana P V; Elias, Kevin M; Horowitz, Neil; Goldstein, Donald P; Berkowitz, Ross S

2017-04-01

To determine the clinical characteristics of multiple gestation with complete mole and coexisting fetus (CHMCF) in North and South America. Retrospective non-concurrent cohorts compromised of CHMCF from New England Trophoblastic Disease Center (NETDC) (1966-2015) and four Brazilian Trophoblastic Disease Centers (BTDC) (1990-2015). From a total of 12,455 cases of gestational trophoblastic disease seen, 72 CHMCF were identified. Clinical characteristics were similar between BTDC (n=46) and NETDC (n=13) from 1990 to 2015, apart from a much higher frequency of potentially life-threatening conditions in Brazil (p=0.046). There were no significant changes in the clinical presentation or outcomes over the past 5 decades in NETDC (13 cases in 1966-1989 vs 13 cases in 1990-2015). Ten pregnancies were electively terminated and 35 cases resulted in viable live births (60% of 60 continued pregnancies). The overall rate of gestational trophoblastic neoplasia (GTN) was 46%; the cases which progressed to GTN presented with higher chorionic gonadotropin levels (p=0.026) and higher frequency of termination of pregnancy due to medical complications (p=0.006) when compared to those with spontaneous remission. The main regional difference in CHMCF presentation is related to a higher rate of potentially life-threatening conditions in South America. Sixty percent of the expectantly managed CHMCF delivered a viable infant, and the overall rate of GTN in this study was 46%. Elective termination of pregnancy did not influence the risk for GTN; however the need for termination due to complications and higher hCG levels were associated with development of GTN in CHMCF. Copyright © 2017 Elsevier Inc. All rights reserved.

Life cycle assessment of EPS and CPB inserts: design considerations and end of life scenarios.

PubMed

Tan, Reginald B H; Khoo, Hsien H

2005-02-01

Expanded polystyrene (EPS) and corrugated paperboard (CPB) are used in many industrial applications, such as containers, shock absorbers or simply as inserts. Both materials pose two different types of environmental problems. The first is the pollution and resource consumption that occur during the production of these materials; the second is the growing landfills that arise out of the excessive disposal of these packaging materials. Life cycle assessment or LCA will be introduced in this paper as a useful tool to compare the environmental performance of both EPS and CPB throughout their life cycle stages. This paper is divided into two main parts. The first part investigates the environmental impacts of the production of EPS and CPB from 'cradle-to-gate', comparing two inserts--both the original and proposed new designs. In the second part, LCA is applied to investigate various end-of-life cases for the same materials. The study will evaluate the environmental impacts of the present waste management practices in Singapore. Several 'what-if' cases are also discussed, including various percentages of landfilling and incineration. The SimaPro LCA Version 5.0 software's Eco-indicator 99 method is used to investigate the following five environmental impact categories: climate change, acidification/eutrophication, ecotoxicity, fossil fuels and respiratory inorganics.

Dire deadlines: coping with dysfunctional family dynamics in an end-of-life care setting.

PubMed

Holst, Lone; Lundgren, Maren; Olsen, Lutte; Ishøy, Torben

2009-01-01

Working in a hospice and being able to focus on individualized, specialized end-of-life care is a privilege for the hospice staff member. However, it also presents the hospice staff with unique challenges. This descriptive study is based upon two cases from an end-of-life care setting in Denmark, where dysfunctional family dynamics presented added challenges to the staff members in their efforts to provide optimal palliative care. The hospice triad--the patient, the staff member and the family member--forms the basis for communication and intervention in a hospice. Higher expectations and demands of younger, more well-informed patients and family members challenge hospice staff in terms of information and communication when planning for care. The inherent risk factors of working with patients in the terminal phase of life become a focal point in the prevention of the development of compassion fatigue among staff members. A series of coping strategies to more optimally manage dysfunctional families in a setting where time is of the essence are then presented in an effort to empower the hospice team, to prevent splitting among staff members, and to improve quality of care.

Evaluating Consumer Product Life Cycle Sustainability with Integrated Metrics: A Paper Towel Case Study

EPA Science Inventory

Integrated sustainability metrics provide an enriched set of information to inform decision-making. However, such approaches are rarely used to assess product supply chains. In this work, four integrated metrics—presented in terms of land, resources, value added, and stability—ar...

Daily use of guaifenesin (Mucinex) in a patient with chronic bronchitis and pathologic mucus hypersecretion: A case report.

PubMed

Storms, William W; Miller, Judi E

2018-01-01

We report an improvement in symptoms and quality of life with long-term use of guaifenesin for the treatment of mucus-related symptoms in a patient with chronic bronchitis, who presented with mucus hypersecretion, cough and dyspnea.

Increased risk for an atypical autism diagnosis following Thimerosal-containing vaccine exposure in the United States: A prospective longitudinal case-control study in the Vaccine Safety Datalink.

PubMed

Geier, David A; Kern, Janet K; Geier, Mark R

2017-07-01

Thimerosal is an organic-mercury (Hg)-containing compound (49.55% Hg by weight) historically added to many multi-dose vials of vaccine as a preservative and still added to some vaccines today. Concerns about the toxic effects from Thimerosal-containing childhood vaccines and the risk of an atypical autism diagnosis were evaluated in this study. A hypothesis-testing, prospective longitudinal, case-control study assessed exposure to Hg from Thimerosal-containing hepatitis B vaccines (TM-HepB) among cases diagnosed with atypical autism (n=164) and controls (n=15,216). Automated medical records for subjects born from 1991 to 2000 and continuously enrolled in the Vaccine Safety Datalink (VSD) database were examined. Cases diagnosed with atypical autism were statistically significantly more likely to have received greater overall and dose-dependent exposures to Hg from TM-HepB vaccines administered within the first month of life, first two months of life, and first six months of life than the controls. Similar phenomena were observed when cases and controls were separated by gender. Routine childhood vaccination is an important public health tool to reduce infectious diseases. The present study provides important epidemiological evidence significantly associating increasing Hg exposure from Thimerosal-containing childhood vaccines and the subsequent risk of atypical autism diagnosis, and suggests that Thimerosal should be eliminated from vaccines. Copyright © 2017 Elsevier GmbH. All rights reserved.

Modelling accelerated degradation data using Wiener diffusion with a time scale transformation.

PubMed

Whitmore, G A; Schenkelberg, F

1997-01-01

Engineering degradation tests allow industry to assess the potential life span of long-life products that do not fail readily under accelerated conditions in life tests. A general statistical model is presented here for performance degradation of an item of equipment. The degradation process in the model is taken to be a Wiener diffusion process with a time scale transformation. The model incorporates Arrhenius extrapolation for high stress testing. The lifetime of an item is defined as the time until performance deteriorates to a specified failure threshold. The model can be used to predict the lifetime of an item or the extent of degradation of an item at a specified future time. Inference methods for the model parameters, based on accelerated degradation test data, are presented. The model and inference methods are illustrated with a case application involving self-regulating heating cables. The paper also discusses a number of practical issues encountered in applications.

An Unusual Case of Alternating Ventricular Morphology on the 12-Lead Electrocardiogram.

PubMed

Sammon, Maura; Dawood, Alveena; Beaudoin, Scott; Harrigan, Richard A

2017-03-01

One of the principal tasks of an emergency physician is identifying potentially life-threatening conditions in the undifferentiated patient; cardiac dysrhythmia is an example of such a condition. A systematic approach to a patient with atypical dysrhythmia enables proper identification of such-life threatening conditions. We describe a 31-year-old man presenting to the emergency department with an undifferentiated dysrhythmia after naloxone reversal of an opiate overdose. A systematic approach to the electrocardiogram led to the rare diagnosis of Wolff-Parkinson-White (WPW) alternans. We review the differential diagnosis of this dysrhythmia and the initial evaluation of a patient with the WPW pattern present on their electrocardiogram. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be prepared to use a systematic approach to an undifferentiated dysrhythmia to identify potentially life-threatening conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

Nursing infant with acquired toxoplasmosis in the first months of life - a case report.

PubMed

Rezende, Hanstter Hallison Alves; Storchilo, Heloísa Ribeiro; Lima, Jaqueline Ataíde Silva; Gomes, Antônio Roberto; Gomes, Taynara Cristina; Souza, Jéssica Yonara de; Avelino, Mariza Martins; Amaral, Waldemar Naves do; Vinaud, Marina Clare; Castro, Ana Maria de

2017-08-24

Toxoplasmosis is caused by Toxoplasma gondii and the probability of this infection occurring in the first months of life is usually low because its transmission is related to eating habits. A 6-month-old nursing infant was diagnosed with acute toxoplasmosis, which was identified through anti- T. gondii IgA, IgM and low-avidity IgG serologic assays, polymerase chain reaction (PCR) and mouse bioassay test although its mother was seronegative. This serological divergence between mother and child led us to interview the mother regarding epidemiological factors. During this interview, she reported that she had given her 2-month-old baby a piece of undercooked beef to suck on. After some time, the baby presented fever and cervical lymphadenitis. This report emphasizes the importance of serological surveys of toxoplasmosis in nursing infants presenting with fever and lymphadenitis, in view of the possible acquisition of toxoplasmosis in the first months of life.

Gingival involvement in oral paracoccidioidomycosis.

PubMed

Silva, Cléverson O; Almeida, Aroldo Dos Santos; Pereira, Alessandro Antônio Costa; Sallum, Antônio Wilson; Hanemann, João Adolfo Costa; Tatakis, Dimitris N

2007-07-01

Paracoccidioidomycosis, a deep mycosis endemic in parts of Latin America, often presents with oral lesions involving the gingiva. Nevertheless, the periodontal literature is devoid of references to oral paracoccidioidomycosis. The purpose of this study was to characterize the gingival involvement in oral paracoccidioidomycosis and to contrast clinical and histopathologic diagnosis of the disease. Differential diagnosis and management of oral paracoccidioidomycosis were reviewed. From January 1995 to October 2006, the files of the Oral Pathology Laboratory, School of Dentistry, Alfenas Federal University, were reviewed to identify cases referred because of a clinical diagnosis of oral paracoccidioidomycosis. Data collected included patient demographics (age, gender, race, and occupation), clinical information (oral lesion location), and histopathologic diagnosis. Forty-six cases were identified, and 34 were histopathologically confirmed as paracoccidioidomycosis. Of the remaining 12 cases, one-half were diagnosed as either carcinoma or dysplastic leukoplakia. Of the 34 confirmed paracoccidioidomycosis cases, 45% presented with multiple site involvement, whereas the gingiva/alveolar process was the most prevalent site overall (52%). The gingiva/alveolar process was the most prevalent site in both multiple and single site cases. The majority of patients were men (88%), white (75%), and in their fourth decade of life (47%). Statistical analysis revealed that patients with gingival/alveolar process involvement were demographically indistinguishable from those without. Oral paracoccidioidomycosis has a strong predilection for the gingiva, whereas patients with gingival lesions do not differ from patients lacking such involvement. Early diagnosis of gingival/oral lesions may prevent life-threatening complications of this mycosis.

A sticky situation: management of spray polyurethane foam insulation in body orifices.

PubMed

Sowerby, Robert J; Sowerby, Leigh J; Vinden, Chris

2011-11-01

Spray polyurethane foam insulation is commonly used in the construction industry to fill gaps, seal, and insulate. We present three cases of intentional spray foam insertion in body orifices and discuss the management of such situations in the emergency department. This series includes a case of oral foam insertion used in a suicide attempt by suffocation and two cases of rectal insertion. All of these cases had potential long-term consequences; one was life-threatening. To our knowledge, this is the first published report on the medical management and removal of foam insulation from body orifices. In all three cases, the foam insulation material was successfully removed after allowing the material to harden.

Quantitative assessment of building fire risk to life safety.

PubMed

Guanquan, Chu; Jinhua, Sun

2008-06-01

This article presents a quantitative risk assessment framework for evaluating fire risk to life safety. Fire risk is divided into two parts: probability and corresponding consequence of every fire scenario. The time-dependent event tree technique is used to analyze probable fire scenarios based on the effect of fire protection systems on fire spread and smoke movement. To obtain the variation of occurrence probability with time, Markov chain is combined with a time-dependent event tree for stochastic analysis on the occurrence probability of fire scenarios. To obtain consequences of every fire scenario, some uncertainties are considered in the risk analysis process. When calculating the onset time to untenable conditions, a range of fires are designed based on different fire growth rates, after which uncertainty of onset time to untenable conditions can be characterized by probability distribution. When calculating occupant evacuation time, occupant premovement time is considered as a probability distribution. Consequences of a fire scenario can be evaluated according to probability distribution of evacuation time and onset time of untenable conditions. Then, fire risk to life safety can be evaluated based on occurrence probability and consequences of every fire scenario. To express the risk assessment method in detail, a commercial building is presented as a case study. A discussion compares the assessment result of the case study with fire statistics.

The management of acute parathyroid crisis secondary to parathyroid carcinoma: a case report.

PubMed

Rock, Kathy; Fattah, Nariman; O'Malley, Diarmuid; McDermott, Enda

2010-01-29

Hypercalcaemic hyperparathyroid crisis is a rare but life-threatening complication of primary hyperparathyroidism. Parathyroid carcinoma is a rare malignancy with an incidence of 0.5% to 4% of all reported cases of primary hyperparathyroidism. We report the case of a 60-year-old Caucasian man with hypercalcaemic hyperparathyroid crisis associated with parathyroid carcinoma. He presented with a classic hypercalcaemic syndrome and his serum calcium and parathyroid hormone levels were at 4.65 mmol/L and 1743 ng/L, respectively. He initially presented with a two-week history of weakness and lethargy and a one-week history of vomiting, polyuria and polydipsia. An emergency left thyroid lobectomy and left lower parathyroidectomy were performed. There was a prompt decrease in his parathyroid hormone level immediately after surgery. Histology revealed that our patient had a 4-cm parathyroid carcinoma. In patients with parathyroid carcinoma, the optimal surgical treatment is en bloc resection with ipsilateral thyroid lobectomy and removal of any enlarged or abnormal lymph nodes. Surgery is the only curative treatment. In our patient, prompt surgical intervention proved successful. At six months the patient is well with no evidence of disease recurrence. This case highlights the importance of considering a hyperparathyroid storm in the context of a parathyroid carcinoma. Parathyroid carcinoma is a rare entity and our knowledge is mainly derived from case reports and retrospective studies. This case report increases awareness of this serious and life-threatening complication. This report also illustrates how prompt and appropriate management provides the best outcome for the patient.

Twenty Months of Evolution Following Sympathectomy on Patients with Palmar Hyperhidrosis: Sympathectomy at the T3 Level is Better than at the T2 Level

PubMed Central

Yazbek, Guilherme; Wolosker, Nelson; Kauffman, Paulo; de Campos, José Ribas Milanez; Puech-Leão, Pedro; Jatene, Fábio Biscegli

2009-01-01

OBJECTIVE To compare two surgical techniques (denervation levels) for sympathectomy using video-assisted thoracoscopy to treat palmar hyperhidrosis in the long-term. METHODS From May 2003 to June 2006, 60 patients with palmar hyperhidrosis were prospectively randomized for video-assisted thoracoscopic sympathectomy at the T2 or T3 ganglion level. They were followed for a mean of 20 months and were evaluated regarding their degree of improvement of palmar hyperhidrosis, incidence and severity of compensatory hyperhidrosis and its evolution over time, and quality of life. RESULTS Fifty-nine cases presented resolution of the palmar hyperhidrosis. One case of therapeutic failure occurred in the T3 group. Most of the patients presented an improvement in palmar hyperhidrosis, without any difference between the groups. Twenty months later, all patients in both groups presented some degree of compensatory hyperhidrosis but with less severity in the T3 group (p = 0.007). Compensatory hyperhidrosis developed in most patients during the first month after the operation, with incidence and severity that remained stable over time. An improvement in quality of life was seen starting from the first postoperative evaluation but without any difference between the groups. This improvement was maintained until the end of the follow-up. CONCLUSION Both techniques were effective for treating palmar hyperhidrosis. The most frequent complication was compensatory hyperhidrosis, which presented stable incidence and severity over the study period. Sympathectomy at the T3 level presented compensatory hyperhidrosis with less severity. Nevertheless, the improvement in quality of life was similar between the groups. PMID:19690657

Histoplasmosis Presenting as Granulomatous Hepatitis: Case Report and Review of the Literature

PubMed Central

Rihana, Nancy A.; Kandula, Manasa; Velez, Ana; Dahal, Kumud; O'Neill, Edward B.

2014-01-01

Background. Histoplasma capsulatum is the most common endemic mycosis in the United States and is a frequent cause of opportunistic infection in immunodeficient hosts. Histoplasmosis is most often self-limiting and goes unrecognized in the immunocompetent population but can progress to disseminated histoplasmosis in patients with an impaired immune system. Liver involvement as a part of disseminated histoplasmosis which usually originates in the lung is well known. However, extrapulmonary hepatic histoplasmosis as a primary manifestation is extremely rare. Case Presentation. We report a rare case of histoplasmosis that presented as persistent fever and abnormal liver function tests in a 66-year-old female with rheumatoid arthritis, receiving infliximab. Conclusion. Emphasizing histoplasmosis as a major cause of acute granulomatous hepatitis and fever of unknown origin in cell mediated immunodeficient population, this case highlights the need for high index of suspicion and the importance of prompt diagnosis since any delay of treatment can be life threatening in this population. PMID:25013413

Histoplasmosis presenting as granulomatous hepatitis: case report and review of the literature.

PubMed

Rihana, Nancy A; Kandula, Manasa; Velez, Ana; Dahal, Kumud; O'Neill, Edward B

2014-01-01

Background. Histoplasma capsulatum is the most common endemic mycosis in the United States and is a frequent cause of opportunistic infection in immunodeficient hosts. Histoplasmosis is most often self-limiting and goes unrecognized in the immunocompetent population but can progress to disseminated histoplasmosis in patients with an impaired immune system. Liver involvement as a part of disseminated histoplasmosis which usually originates in the lung is well known. However, extrapulmonary hepatic histoplasmosis as a primary manifestation is extremely rare. Case Presentation. We report a rare case of histoplasmosis that presented as persistent fever and abnormal liver function tests in a 66-year-old female with rheumatoid arthritis, receiving infliximab. Conclusion. Emphasizing histoplasmosis as a major cause of acute granulomatous hepatitis and fever of unknown origin in cell mediated immunodeficient population, this case highlights the need for high index of suspicion and the importance of prompt diagnosis since any delay of treatment can be life threatening in this population.

Tuberculosis masked by immunodeficiency: a review of two cases diagnosed with chronic granulomatous disease.

PubMed

Nacaroğlu, Hikmet Tekin; Bahçeci Erdem, Semiha; Gülez, Nesrin; Ünsal Karkıner, Canan Şule; Devrim, İlker; Genel, Ferah; Köker, Mustafa Yavuz; Can, Demet

2017-03-01

Chronic granulomatous disease (CGD) is a genetically heterogeneous primary immunodeficiency that is characterized by recurrent and life-threatening infections resulting from defects in phagocyte nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system and granuloma formation due to increased inflammatory response. The most commonly involved organs are the lungs, skin, lymph nodes, and liver due to infection. It may present with recurrent pneumonia, hilar lymphadenopathy, empyema, abscess, reticulonodular patterns, and granulomas due to lung involvement. In recent years, mycobacterial disease susceptibility has been reported in CGD cases. This article presents two male cases, one of whom is aged 18 months and the other is aged 5 years, who were diagnosed with CGD and tuberculosis during examination due to extended pneumonia. This report is presented because CGD should be considered not only in the presence of skin abscesses and Aspergillus infections, but also in the differential diagnosis for cases with BCG-itis and/or tuberculosis. It should be kept in mind that mycobacterial infections can occur during the course of the disease.

Recurrent laughter-induced syncope.

PubMed

Gaitatzis, Athanasios; Petzold, Axel

2012-07-01

Syncope is a common presenting complaint in Neurology clinics or Emergency departments, but its causes are sometimes difficult to diagnose. Apart from vasovagal attacks, other benign, neurally mediated syncopes include "situational" syncopes, which occur after urination, coughing, swallowing, or defecation. A healthy 42-year-old male patient presented to the neurology clinic with a long history of faints triggered by spontaneous laughter, especially after funny jokes. Physical and neurological examination, and electroencephalography and magnetic resonance imaging were unremarkable. There was no evidence to suggest cardiogenic causes, epilepsy, or cataplexy and a diagnosis of laughing syncope was made. Laughter-induced syncope is usually a single event in the majority of cases, but may present as recurrent attacks as in our case. Some cases occur in association with underlying neurological conditions. Prognosis is good in the case of neurally mediated attacks. Laughter may not be recognized by physicians as a cause of syncope, which may lead to unnecessary investigations or misdiagnosis, and affect patients' quality of life.

A comparison of "life threatening injury" concept in the Turkish Penal Code and trauma scoring systems.

PubMed

Fedakar, Recep; Aydiner, Ahmet Hüsamettin; Ercan, Ilker

2007-07-01

To compare accuracy and to check the suitability of the Glasgow Coma Scale (GCS), the Revised Trauma Score (RTS), the Injury Severity Score (ISS), the New Injury Severity Score (NISS) and the Trauma and Injury Severity Score (TRISS), the scoring systems widely used in international trauma studies, in the evaluation of the "life threatening injury" concept established by the Turkish Penal Code. The age, sex, type of trauma, type and localizations of wounds, GCS, RTS, ISS, NISS and TRISS values, the decision of life threatening injury of 627 trauma patients admitted to Emergency Department of the Uludag University Medical School Hospital in year 2003 were examined. A life-threatening injury was present in 35.2% of the cases examined. GCS, RTS, ISS, NISS and TRISS confirmed the decision of life threatening injury with percentages of 74.8%, 76.9%, 88.7%, 86.6% and 68.6%, respectively. The best cut-off point 14 was determined in the ISS system with 79.6% sensitivity and 93.6% specificity. All of the cases with sole linear skull fracture officially decided as life threatening injury had an ISS of 5, a NISS of 6 and the best scores of GCS (15), RTS (7.8408) and TRISS (100%). ISS and NISS appeared to be the best trauma scoring systems that can be used for the decision of life threatening injury, compared with GCS, RTS and TRISS. Thus, ISS and NISS can be acceptable for using the evaluation of the life threatening injury concept established by the Turkish Penal Code.

Model-based prognostics for batteries which estimates useful life and uses a probability density function

NASA Technical Reports Server (NTRS)

Saha, Bhaskar (Inventor); Goebel, Kai F. (Inventor)

2012-01-01

This invention develops a mathematical model to describe battery behavior during individual discharge cycles as well as over its cycle life. The basis for the form of the model has been linked to the internal processes of the battery and validated using experimental data. Effects of temperature and load current have also been incorporated into the model. Subsequently, the model has been used in a Particle Filtering framework to make predictions of remaining useful life for individual discharge cycles as well as for cycle life. The prediction performance was found to be satisfactory as measured by performance metrics customized for prognostics for a sample case. The work presented here provides initial steps towards a comprehensive health management solution for energy storage devices.

Developmental plasticity in schistosomes and other helminths

PubMed Central

Davies, Stephen J.; McKerrow, James H.

2010-01-01

Developmental plasticity in helminth life cycles serves, in most cases, to increase the probability of transmission between hosts, suggesting that the necessity to achieve transmission is a prominent selective pressure in the evolution of this phenomenon. Some evidence suggests that digenean trematodes from the genus Schistosoma are also capable of limited developmental responses to host factors. Here we review the currently available data on this phenomenon and attempt to draw comparisons with similar processes in the life cycles of other helminths. At present the biological significance of developmental responses by schistosomes under laboratory conditions remains unclear. Further work is needed to determine whether developmental plasticity plays any role in increasing the probability of schistosome transmission and life cycle propagation under adverse conditions, as it does in other helminth life cycles. PMID:13678642

[Catatonia].

PubMed

Bruijn, Dirk Jan; Blom, Jan Dirk

2010-01-01

Catatonia is a neuropsychiatric syndrome characterized by dysregulation of the motor system. It is associated with affective disorders, psychosis, and a number of somatic conditions. The condition tends to be undertreated due to under-recognition. This is unfortunate, because various cheap and effective treatment methods are widely available. In this clinical lesson, we present case studies of three patients with schizophrenia and severe catatonic symptoms. They were all treated with lorazepam, in dosages ranging from 2 to 60 mg a day, following which they achieved full remission of their catatonic symptoms. We recommend being alert for catatonia in patients with or without a psychiatric disorder. Early recognition and treatment is vital for the quality of life of these patients, and may in some cases be life-saving. In addition, we recommend a thorough analysis of possible underlying somatic disorders.

Combination liposomal amphotericin B, posaconazole and oral amphotericin B for treatment of gastrointestinal Mucorales in an immunocompromised patient.

PubMed

Anderson, Anthony; McManus, Dayna; Perreault, Sarah; Lo, Ying-Chun; Seropian, Stuart; Topal, Jeffrey E

2017-09-01

Mucormycosis is a life threatening infection caused by fungi in the order Mucorales. Mucormycosis can affect any organ system with rhino-orbital-cerebral and pulmonary infections being the most predominant infection types. Gastrointestinal mucormycosis is rare and accounts for only 4-7% of all cases. Here, we present a case of invasive gastrointestinal mucormycosis in an immunocompromised host treated with systemic and topical anti-mold therapy.

Festival food coma in cystic fibrosis.

PubMed

Pandit, Chetan; Graham, Christie; Selvadurai, Hiran; Gaskin, Kevin; Cooper, Peter; van Asperen, Peter

2013-07-01

Children with cystic fibrosis liver disease and portal hypertension are at risk of developing acute hepatic encephalopathy. Even in the presence of normal synthetic liver function these children may have porto-systemic shunting. We report a case of an adolosecent who had cystic fibrosis liver disease and presented with life threatening hepatinc encephalopathy. This case illustrates that it is necessary to consider an appropriate dietary regimen in adolosecents with liver disease to prevent hepatic decompensation. Copyright © 2012 Wiley Periodicals, Inc.

[Vest recorder used in diagnostics of occasionally occurring supraventricular tachycardia nearby sinus node - a case report].

PubMed

Adamczyk, Karolina; Średniawa, Beata; Mitręga, Katarzyna; Morawski, Stanisław; Musialik-Łydka, Agata; Kalarus, Zbigniew

2016-09-29

Symptoms such as palpitations, fainting, dizziness and unexplained loss of consciousness are often notified by patients in clinical practice. Cardiological causes of these ailments could be various, inter alia, atriaventricular conduction disorders, supraventricular arrythmias or more life-threatening ventricular arrythmias. Diagnostics of these disorders includes a series of basic non-invasive research and more advanced specialistic methods. Presented case report shows problems of arrythmias diagnostics and imperfections of avaible methods.

Student teaching and research laboratory focusing on brain-computer interface paradigms--A creative environment for computer science students.

PubMed

Rutkowski, Tomasz M

2015-08-01

This paper presents an applied concept of a brain-computer interface (BCI) student research laboratory (BCI-LAB) at the Life Science Center of TARA, University of Tsukuba, Japan. Several successful case studies of the student projects are reviewed together with the BCI Research Award 2014 winner case. The BCI-LAB design and project-based teaching philosophy is also explained. Future teaching and research directions summarize the review.

[Non-neoplastic esophageal stenosis: not always so benign].

PubMed

Lorenz, Julie; Vollenweider, Peter; Vuilleumier, Henri; Schwab, Marcos

2013-10-02

Esophageal intramural pseudodiverticulosis is a rare pathology whose etiology is unknown, but which is frequently associated with three highly prevalent entities: esophageal reflux disease, esophageal candidosis and alcoholic esophagitis. With conservative treatment the course of these pathologies is usually benign. However, some severe cases are resistant to conservative treatment and may require more aggressive management. We here present the case of patient suffering from a severe esophagitis complicated by chronic mediastinitis with life-threatening repercussions, requiring esophagectomy as treatment.

A Case of Attempted Suicide in Huntington's Disease: Ethical and Moral Considerations.

PubMed

Furfari, Kristin; Zehnder, Nichole; Abbott, Jean

2016-01-01

A 62-year-old female with Huntington's disease presented after a suicide attempt. Her advance directive stated that she did not want intubation or resuscitation, which her family acknowledged and supported. Despite these directives, she was resuscitated in the emergency department and continued to state that she would attempt suicide again. Her suicidality in the face of a chronic and advancing illness, and her prolonged consistency in her desire to take her own life, left careproviders wondering how to provide ethical, respectful care to this patient. Tension between the ethical principles of autonomy and beneficence is central in this case. The patient's narrative demonstrated that her suicide was an autonomous decision, free from coercion or disordered thinking from mental illness. Beneficence then would seem to necessitate care aligned with the patient's desire to end her life, which created ethical uneasiness for her family and careproviders. The case highlights several end-of-life ethical considerations that have received much recent attention. With ongoing discussions about the legalization of aid in dying across the country, caregivers are challenged to understand what beneficence means in people with terminal illnesses who want a say in their death. This case also highlights the profound moral distress of families and careproviders that arises in such ethically challenging scenarios. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

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.

Rare acute kidney injury secondary to hypothyroidism-induced rhabdomyolysis.

PubMed

Cai, Ying; Tang, Lin

2013-01-01

Acute kidney injury (AKI) caused by hypothyroidism-induced rhabdomyolysis is a rare and potentially life-threatening syndrome. The aim of this study was to investigate the clinical characteristics of such patients. We retrospectively analyzed five patients treated at the Second Affiliated Hospital of Chongqing Medical University with AKI secondary to hypothyroidism- induced rhabdomyolysis from January 2006 to December 2010. Of the five cases reviewed (4 males, age range of 37 to 62 years), adult primary hypothyroidism was caused by amiodarone (1 case), chronic autoimmune thyroiditis (1 case), and by uncertain etiologies (3 cases). All patients presented with facial and lower extremity edema. Three patients presented with weakness, while two presented with blunted facies and oliguria. Only one patient reported experiencing myalgia and proximal muscle weakness, in addition to fatigue and chills. Creatine kinase, lactate dehydrogenase, and renal function normalized after thyroid hormone replacement, except in two patients who improved through blood purification. Hypothyroidism should be considered in patients presenting with renal impairment associated with rhabdomyolysis. Moreover, further investigation into the etiology of the hypothyroidism is warranted.

The TRAP (twin reversed arterial perfusion) sequence - case presentation.

PubMed

Mărginean, Claudiu; Mărginean, Maria Oana; Mureşan, Daniel; Zahiu, LuminiŢa; Horváth, Emőke

2016-01-01

We present a particular case of TRAP (twin reversed arterial perfusion) syndrome, which has a very rarely association of the simultaneous existence of a rudimentary malformed heart and brain, and also other malformations like abdominal wall abnormality, absent bladder with present kidneys, and absence of the lungs, which appear only in a few cases on the receptor twin from this sequence, malformations incompatible with life. A Caucasian 26-year-old pregnant woman, at the first pregnancy, with a monochorionic-diamniotic pregnancy, 26 weeks of gestation was referred to our hospital, for polyhydramnios. The patient delivered a living female newborn, weighing 950 g, with an Apgar score of 2 at one minute - the donor fetus and a second female newborn with multiple malformations, no signs of life and who weighed 2300 g - the receptor fetus. The anatomopathological examination confirmed the TRAP sequence associated with severe facial dysmorphism, bilateral phocomelia and cardiac malformations (rudimentary hypoplastic, univentricular) and a vascular anastomosis between the two umbilical cords. Anemia and cardiac complications which can lead to cardiac failure, appear early during pregnancy and caused the death of the pumping twin. We emphasize that in our case of TRAP sequence, the ultrasound examination established the diagnosis of the syndrome with high accuracy. Therefore, we can conclude that the existence of a rudimentary heart and a vascular anastomosis between the two umbilical cords supports the apparition of TRAP sequence. The early diagnosis of this pathology, the observation of the pregnancy with the help of weekly ultrasounds and the intrauterine interventions can increase the survival chances of the donor fetus from the TRAP sequence.

[Pilocytic astrocytoma of the cerebrum presenting in an elderly patient: a case report].

PubMed

Yoshida, Yuya; Tsukada, Toshiyuki; Hashimoto, Masaaki; Hayashi, Yutaka

2011-09-01

We report a case of pilocytic astrocytoma of the cerebrum presenting in an elderly patient. A 76-year-old man was admitted to our department due to the development of dysarthria. MRI showed a cystic mass with an enhanced small mural nodule in the left frontal lobe. At surgery, the cyst contents were aspirated, and the mural nodule was excised. Histological examination showed a pattern that is usually seen in pilocytic astrocytoma of the cerebellum, including loose and compact areas composed of pilocytic and stellate cells, a few eosinophilic granular bodies, but not Rosenthal fibers. Pilocytic astrocytoma is a common type of pediatric brain tumor that can arise within either the cerebellum or the hypothalamic/chiasmatic region, but rarely seen in the cerebral hemisphere at an advanced age. To our knowledge, only 45 cases of pilocytic astrocytoma of the cerebrum developing in an adult are reported. In those cases, the symptoms of the disease developed during the third decade of life. The onset at a most advanced age as in the present case is thought to be extremely rare.

Metastatic breast carcinoma presenting as unilateral pulsatile tinnitus: a case report.

PubMed

Moore, Andrew; Cunnane, Max; Fleming, Jason C

2015-02-01

Pulsatile tinnitus is a rare symptom, yet it may herald life-threatening pathology in the absence of other symptoms or signs. Pulsatile tinnitus tends to imply a vascular cause, but metastatic disease also can present in this way. Clinicians should therefore adopt a specific diagnostic algorithm for pulsatile tinnitus and always consider the possibility of metastatic disease. A history of malignant disease and new cranial nerve palsies should raise clinical suspicion for skull base metastases. We describe the case of a 63-year-old woman presenting with unilateral subjective pulsatile tinnitus and a middle ear mass visible on otoscopy. Her background included the diagnosis of idiopathic unilateral vagal and hypoglossal nerve palsies 4 years previously, with normal magnetic resonance imaging (MRI). Repeat MRI and computed tomography imaging were consistent with metastatic breast carcinoma. This case raises important questions about imaging protocols and the role of serial scanning in patients at high risk of metastatic disease.

A pseudoleukemic blood differentiation in a 13-year-old child: an extraordinary presentation of Churg-Strauss syndrome.

PubMed

Mutsaers, E R; Witteveen, R; van den Bosch-Ruis, W; Kuijpers, T W; van Houten, M A; van den Berg, J M

2013-03-01

Churg-Strauss syndrome (CSS) is a rare systemic vasculitis of the small- and medium-size vessels. It is mostly seen in elderly patients presenting as de novo asthma, eosinophilia, and vasculitic organ involvement. In childhood, CSS is extremely rare. The course of pediatric CSS is usually severe and often lethal. We present a case of a 13-year-old girl with a short history of asthma, marked eosinophilia, and multiorgan involvement. The extremely high level of blood eosinophilic granulocytes (51.6 × 10(9)/L) prompted a workup for eosinophilic leukemia before the diagnosis CSS could be made. Subsequently, the disease was successfully treated. This case report shows a classical case of childhood CSS, remarkable because of the presence of extreme hypereosinophilia. It underlines the importance of CSS as a life-threatening cause of hypereosinophilia in children.

Cervical hemorrhage due to spontaneous rupture of the superior thyroid artery: Case report and review of the literature.

PubMed

Stenner, Markus; Helmstaedter, Victor; Spuentrup, Elmar; Quante, Gero; Huettenbrink, Karl-Bernd

2010-09-01

Beneath the different reasons for cervical masses, a spontaneous hemorrhage presents a rare and life-threatening condition. We present the rare case of a 62-year-old man who was presented with a dramatically enlarging cervical mass causing respiratory distress because of upper airway compression. An endotracheal intubation was lifesaving and avoided tracheotomy. A CT scan revealed a hematoma in the region of the left external carotid artery. An emergency angiography embolized a ruptured branch of the superior thyroid artery and surgery evacuated the hematoma. We discuss the rarity of the condition, reasons for a spontaneous rupture of the artery, and the diagnostic and treatment strategy. In addition, we review the literature on spontaneous thyroid artery hemorrhages, which, up to now, have been described only for the inferior thyroid artery. We conclude that the optimal management for cases of cervical hematoma is intubation, diagnosis, and angiography before surgery.

Double whammy- acute splenic sequestration crisis in patient with aplastic crisis due to acute parvovirus infection.

PubMed

Minhas, Parminder S; K Virdi, Jaspreet; Patel, Rajeshkumar

2017-07-01

Splenic dysfunction is a major feature of sickle cell disease (SCD) and can manifest as acute splenic sequestration crisis (ASSC), which is the earliest life-threatening complication seen in patients with SCD. Aplastic crisis is another potentially deadly complication of sickle cell disease that develops when erythrocyte production temporarily drops. Infection with parvovirus B-19 frequently causes aplastic crises. These two complications are known to be mutually exclusive due to their classic presentation signs and symptoms but there have been few cases where a patient can have concomitant presentation of both phenomena, which can result in a fatal outcome. These few cases force us to rethink the etiology and subsequent management guidelines of these complications. We present to you a case of an unfortunate 23-year-old female who had both complications occurring at the same time, resulting in death.

Robotic partial nephrectomy for duplex kidney with ectopic ureter draining in the vagina in an adult patient with urinary incontinence.

PubMed

Mahmood, Humza; Hadjipavlou, Marios; Das, Raj; Anderson, Chris

2017-02-06

A duplex kidney system with an ectopic ureter draining into the vagina is a congenital malformation that typically presents as refractory urinary incontinence. Diagnosis is often difficult to establish and delayed due to a low incidence. We present the case of a patient aged 26 years with a life-long history of persistent urinary incontinence. Initial presentation was at childhood; however, the diagnosis went undetermined for 22 years. CT urography revealed a duplex kidney with an atrophic upper pole associated with an ectopic ureter that drained into the vaginal vault. This is the first description of such a case being managed successfully via a robot-assisted partial nephrectomy approach. Ectopic ureteral duplication should be considered in the differential diagnosis for young women with refractory urinary incontinence. Robotic partial nephrectomy is a safe and effective technique to manage such cases. 2017 BMJ Publishing Group Ltd.

Special Feature: Epistemological Paradigms in Evaluation: Implications for Practice. Section 1: "Paradigm Contrast" Case Studies.

ERIC Educational Resources Information Center

Rose, Tom; And Others

1991-01-01

This section presents two pragmatic studies focusing on a real-life situation and specific applications in managerial decision making. One study deals with improving occupational safety in a bedding manufacturing plant, whereas the other concentrates on managing a state mental health program. (SLD)

Resettlement: A Cultural and Psychological Crisis.

ERIC Educational Resources Information Center

Hulewat, Phyllis

1996-01-01

The stages of resettlement and need to integrate past cultural experience into their new life are similar for all immigrants. Describes stages of resettlement and basic elements needed to manage the resettlement process. Three specific groups of clients are identified, and case management methods are presented for dealing with issues raised by…

Subjective Wellbeing: Telling Only Half the Story

ERIC Educational Resources Information Center

Eckersley, Richard

2013-01-01

A new paper presents a strong case for life satisfaction scales (Diener et al. in "Soc Indic Res," 2012). However, it underestimates two important weaknesses in subjective wellbeing (SWB) measures: the contrast between individual satisfaction and social discontent; and the contradictory evidence on the benefits of personal freedom. This commentary…

Alternative Second Language Curricula for Learners with Disabilities: Two Case Studies

ERIC Educational Resources Information Center

Abrams, Zsuzsanna

2008-01-01

According to the National Center for Learning Disabilities (2005), students with disabilities often must demonstrate failure in order to qualify for academic accommodations. For students with disabilities, this failure may be life-altering. The present article argues that alternative curricula (modified teaching and assessment plans) should be…

The Presentation of Science in Everyday Life: The Science Show

ERIC Educational Resources Information Center

Watermeyer, Richard

2013-01-01

This paper constitutes a case-study of the "science show" model of public engagement employed by a company of science communicators focused on the popularization of science, technology, engineering and mathematics (STEM) subject disciplines with learner constituencies. It examines the potential of the science show to foster the interest…

Reframing Reality: Christmas at the Mall.

ERIC Educational Resources Information Center

Long, Nicholas J.; Daniels, Doug

1993-01-01

Presents Life Space Interview (LSI), effective intervention strategy for use during crisis work with troubled students, as it was applied to case of eight-year-old boy attending Option III class for emotionally handicapped students when he accompanied class to mall for holiday shopping trip. Following interview are instructional comments on the…

New Strategies for Improving Rural Family Life.

ERIC Educational Resources Information Center

Coombs, Philip H.

Presented in capsule form for the convenience of busy policy makers, planners, and program managers, this booklet summarizes major findings of a three-year study on practical aspects of rural development, with particular emphasis on ways of alleviating extreme poverty among disadvantaged rural families. Using case studies from Bangladesh, India,…

Pedagogical Approaches to Develop Critical Thinking and Crisis Leadership

ERIC Educational Resources Information Center

Powley, Edward H.; Taylor, Scott N.

2014-01-01

Management schools must be prepared to aid leaders and managers to succeed in uncertain environments. We offer two approaches, each designed for critical thinking skill development, to teach graduate management students about leading in and through potential disruption to organizational life. First, we present a personalized case method that…

"Teachers' Voices for School Change": An Introduction to Educative Research.

ERIC Educational Resources Information Center

Jacobs, Mary-Ellen

1993-01-01

Reviews a book, "Teachers' Voices for School Change" by Andrew Gitlin, on educative research and teacher voice, examining the educative research process which grounds reflection in the life histories of teacher researchers, presenting four case studies on educative research, and reflecting on the educative research process itself.…

Suicide Career: A Young Woman's Story in Phenomenological Perspective.

ERIC Educational Resources Information Center

Babow, Irving; Rowe, Robin

1993-01-01

Presents case study of suicidal woman diagnosed as catatonic schizophrenic in state mental hospital. Account reveals much about woman's life history, suicide career, problems of living, needs for help, and perceptions of relevant systems. Proposed model would use parts of patient's story for preventive intervention regarding suicidal behavior and…

Influence of the impact assessment method on the conclusions of a LCA study. Application to the case of a part made with virgin and recycled HDPE.

PubMed

Simões, Carla L; Xará, Susana M; Bernardo, C A

2011-10-01

Recent legislation has stressed the need to decide the best end-of-life (EoL) option for post-consumer products considering their full life-cycle and the corresponding overall environmental impacts. The life cycle assessment (LCA) technique has become a common tool to evaluate those impacts. The present study aimed to contribute to the better understanding of the application of this technique, by evaluating the influence of the selection of the life cycle impact assessment (LCIA) method in its results and conclusions. A specific case study was chosen, using previous information related to an anti-glare lamellae (AGL) for highway use, made with virgin and recycled high-density polyethylene (HDPE). Five distinct LCIA methods were used: Eco-indicator 99, CML 2 (2000), EPS 2000, Eco-indicator 95 and EDIP 97. Consistent results between these methods were obtained for the Climate change, Ozone layer depletion, Acidification and Eutrophication environmental indicators. Conversely, the Summer smog indicator showed large discrepancies between impact assessment methods. The work sheds light on the advantages inherent in using various LCIA methods when doing the LCA study of a specific product, thus evidencing complementary analysis perspectives.

Eco-efficiency in extended supply chains: a case study of furniture production.

PubMed

Michelsen, Ottar; Fet, Annik Magerholm; Dahlsrud, Alexander

2006-05-01

This paper presents a methodology about how eco-efficiency in extended supply chains (ESCs) can be understood and measured. The extended supply chain includes all processes in the life cycle of a product and the eco-efficiency is measured as the relative environmental and value performance in one ESC compared to other ESCs. The paper is based on a case study of furniture production in Norway. Nine different environmental performance indicators are identified. These are based on suggestions from the World Business Council for Sustainable Development and additional indicators that are shown to have significant impacts in the life cycle of the products. Value performance is measured as inverse life cycle costs. The eco-efficiency for six different chair models is calculated and the relative values are shown graphically in XY-diagrams. This provides information about the relative performance of the products, which is valuable in green procurement processes. The same method is also used for analysing changes in eco-efficiency when possible alterations in the ESC are introduced. Here, it is shown that a small and realistic change of end-of-life treatment significantly changes the eco-efficiency of a product.

The Tree Theme Method in psychosocial occupational therapy: a case study.

PubMed

Gunnarsson, A Birgitta; Jansson, Jan-Ake; Eklund, Mona

2006-12-01

This study aimed to describe the Tree Theme Method (TTM) as a method for intervention in psychosocial occupational therapy. The TTM is based on theories concerning creative activities and occupational storytelling and story making. In order to exemplify the method a case study of a treatment process with follow up was undertaken. The participant was a female client suffering from anxiety and depression. During an interview the client painted symbolic trees on five different occasions with specific variations of the tree theme: a tree symbolizing her present life, her childhood, adolescence, adulthood, and, finally, a tree representing her future. The trees were used as starting points for the client to tell her life story. The intention was that she would find new strategies for how to change her daily life. Three years later there was a follow up stage where the client painted new trees and told her story. Some life themes were identified. The TTM appears suitable for intervention in psychosocial occupational therapy. In future studies the TTM should be subjected to evaluation research based on several clients in order to develop a deeper understanding of the process and what kind of results changes in the TTM intervention may provide.

Achieving Millennium Development Goals 4 and 5: a snapshot of life in rural India.

PubMed

Mullick, S S; Serle, E

2011-09-01

The case studies presented here illustrate the poignant reality of life for mothers and children in rural India. We highlight the challenges of achieving millennium development goals (MDGs) 4 and 5, by exploring the reasons behind maternal and childhood mortality using the three-delays model as a framework. Gender disparities, lack of empowerment of women, poor understanding of life-threatening illness, the inability to know when and where to seek help, security issues, deficiencies in understanding cultural perceptions, poorly equipped health facilities and a lack of skilled personnel are all highlighted. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

A crisis in the analyst's life: self-containment, symbolization, and the holding space.

PubMed

Michelle, Flax

2011-04-01

Most analysts will experience some degree of crisis in the course of their working life. This paper explores the complex interplay between the analyst's affect during a crisis in her lifeü and the affective dynamics of the patient. The central question is "who or what holds the analyst"--especially in times of crisis. Symbolization of affect, facilitated by the analyst's self-created holding environment, is seen as a vital process in order for containment to take place. In the clinical case presented, the analyst's dog was an integral part of the analyst's self-righting through this difficult period; the dog functioned as an "analytic object" within the analysis.

Equivalent linearization for fatigue life estimates of a nonlinear structure

NASA Technical Reports Server (NTRS)

Miles, R. N.

1989-01-01

An analysis is presented of the suitability of the method of equivalent linearization for estimating the fatigue life of a nonlinear structure. Comparisons are made of the fatigue life of a nonlinear plate as predicted using conventional equivalent linearization and three other more accurate methods. The excitation of the plate is assumed to be Gaussian white noise and the plate response is modeled using a single resonant mode. The methods used for comparison consist of numerical simulation, a probabalistic formulation, and a modification of equivalent linearization which avoids the usual assumption that the response process is Gaussian. Remarkably close agreement is obtained between all four methods, even for cases where the response is significantly linear.

Addison's disease presenting with perimyocarditis.

PubMed

Baranski Lamback, Elisa; Morandi, Grazia; Rapti, Eleni; Christov, Georgi; Brogan, Paul A; Hindmarsh, Peter

2018-01-26

Polyglandular autoimmune syndrome (PGA) and eosinophilic granulomatosis with polyangiitis (EGPA) do not seem to represent a coincidental association. A case of a 15-year-old boy is reported who presented with severe systemic inflammation, perimyocarditis and cardiogenic shock, in whom EGPA was initially suspected and later diagnosed with autoimmune adrenalitis with PGA. The severity of the systemic inflammation and perimyocarditis suggests a more widespread autoimmune-mediated process. Autoimmune adrenal insufficiency should be considered in all cases of pericarditis and perimyocarditis, especially when the severity of clinical manifestations exceeds the expected for the severity of the cardiac findings, as timely identification and prompt treatment may be life-saving.

Standing up to the black cloud: case example of narrative therapy in the motor vehicle sector.

PubMed

Gibson, Michelle

2015-01-01

Using a case study, this article presents narrative therapy as an effective psychotherapy practice for work with victims of motor vehicle accidents. By troubling the standard cognitive behavioral approaches as deficit focused, narrative therapy is outlined as an approach that is focused on the skills and values present in the client's life; it is an approach that allows the client to take authorship over his or her concerns and enact change. This article is meant to be an example of narrative therapy's usefulness and open space for conversation about rehabilitation therapies that focus less on structure and more on strength.

Necrotizing Fasciitis of the Upper Extremity, Case Report and Review of the Literature

PubMed Central

Nazerani, Shahram; Maghari, Ahmad; Kalantar Motamedi, Mohammad Hosein; Vahedian Ardakani, Jalal; Rashidian, Nikdokht; Nazerani, Tina

2012-01-01

ABSTRACT Necrotizing fasciitis is a rare, life-threatening infection most commonly seen in patients with diabetes mellitus, intravenous drug abuse, and immunocompromised conditions. The extremities are the primary sites of involvement in as many as two thirds of the cases. In a significant proportion of patients, the extremities are involved as a result of trauma, needle puncture or extravasation of drugs. The infection is usually polymicrobial. Treatment involves broad-spectrum antibiotics and multiple surgical debridements or amputation. We present a patient with necrotizing fasciitis of the upper limb and present our experience with this often lethal condition. PMID:24350113

Squamous cell carcinoma in exstrophy of the bladder.

PubMed

Sharma, Pramod Kumar; Pandey, Praveen Kumar; Vijay, Mukesh Kumar; Bera, Malay Kumar; Singh, Jitendra Pratap; Saha, Kaushik

2013-08-01

Exstrophy of the bladder is a rare congenital anomaly with an incidence of about 1 per 50,000 newborns. The malignant potential of the exstrophied bladder mucosa is well known; 95% are adenocarcinomas, and 3% to 5% are squamous cell carcinomas. Most of the malignant tumors (60%) associated with an exstrophy of the bladder occur during the fourth and fifth decades of life. Of the remaining, about 20% each occur after 60 years and before 40 years. Here we present a case in which squamous cell carcinoma developed in an unrepaired exstrophy of the bladder. We present the management of the case and a brief review of the literature.

Squamous Cell Carcinoma in Exstrophy of the Bladder

PubMed Central

Pandey, Praveen Kumar; Vijay, Mukesh Kumar; Bera, Malay Kumar; Singh, Jitendra Pratap; Saha, Kaushik

2013-01-01

Exstrophy of the bladder is a rare congenital anomaly with an incidence of about 1 per 50,000 newborns. The malignant potential of the exstrophied bladder mucosa is well known; 95% are adenocarcinomas, and 3% to 5% are squamous cell carcinomas. Most of the malignant tumors (60%) associated with an exstrophy of the bladder occur during the fourth and fifth decades of life. Of the remaining, about 20% each occur after 60 years and before 40 years. Here we present a case in which squamous cell carcinoma developed in an unrepaired exstrophy of the bladder. We present the management of the case and a brief review of the literature. PMID:23956833

Differences of Munchausen syndrome by proxy according to predominant symptoms in Japan.

PubMed

Fujiwara, Takeo; Okuyama, Makiko; Kasahara, Mari; Nakamura, Ayako

2008-08-01

The purpose of the present paper was to investigate differing characteristics of Munchausen syndrome by proxy (MSBP) between subjects with predominantly physical symptoms and those with predominantly psychological symptoms. A questionnaire survey was sent to 11 leading doctors in the child abuse field in Japan, each located in different hospital-based sites. Child abuse doctors answered questions regarding the characteristics of MSBP subjects for whom they had helped care. The differences of characteristics between groups were analyzed using Fisher's exact test for categorical variables and Mann-Whitney U-test for continuous variables. Among 21 reported MSBP subjects, 16 MSBP subjects with predominantly physical symptoms (PHY) and five MSBP subjects with predominantly psychological symptoms (PSY) were found. PHY were more likely to be produced, whereas PSY cases were more often simulated. PHY cases were more often life-threatening than PSY cases, but decisions made by the Child Guidance Center surrounding the custodial outcome of MSBP victims did not differ between PHY and PSY cases. Social welfare services that need to decide on custody for MSBP victims should recognize the relatively high risk of life-threatening danger of PHY cases in their family of origin.

Towards A Model-Based Prognostics Methodology for Electrolytic Capacitors: A Case Study Based on Electrical Overstress Accelerated Aging

NASA Technical Reports Server (NTRS)

Celaya, Jose R.; Kulkarni, Chetan S.; Biswas, Gautam; Goebel, Kai

2012-01-01

A remaining useful life prediction methodology for electrolytic capacitors is presented. This methodology is based on the Kalman filter framework and an empirical degradation model. Electrolytic capacitors are used in several applications ranging from power supplies on critical avionics equipment to power drivers for electro-mechanical actuators. These devices are known for their comparatively low reliability and given their criticality in electronics subsystems they are a good candidate for component level prognostics and health management. Prognostics provides a way to assess remaining useful life of a capacitor based on its current state of health and its anticipated future usage and operational conditions. We present here also, experimental results of an accelerated aging test under electrical stresses. The data obtained in this test form the basis for a remaining life prediction algorithm where a model of the degradation process is suggested. This preliminary remaining life prediction algorithm serves as a demonstration of how prognostics methodologies could be used for electrolytic capacitors. In addition, the use degradation progression data from accelerated aging, provides an avenue for validation of applications of the Kalman filter based prognostics methods typically used for remaining useful life predictions in other applications.

Vascular Ehlers-Danlos Syndrome With a Novel Missense COL3A1 Mutation Present With Pulmonary Complications and Iliac Arterial Dissection.

PubMed

Gu, Guangchao; Yang, Hang; Cui, Lijia; Fu, Yuanyuan; Li, Fangda; Zhou, Zhou; Zheng, Yuehong

2018-02-01

Vascular Ehlers-Danlos syndrome (vEDS) is a life-threatening connective tissue disorder due to its high tendency of arterial and organ rupture. Pulmonary complications in vEDS are rare. We present a young male patient with vEDS who developed severe pulmonary complications and severe rupture of the iliac artery at different stages of his life. Vascular Ehlers-Danlos syndrome was diagnosed based on clinical manifestations and confirmed by the identification of COL3A1 gene mutation. Due to high bleeding tendency and weak cardiopulmonary capacity, conservative treatment was taken for him. To our knowledge, this is the first report of vEDS case in which the patient developed both pulmonary complications and dissection of large arteries. Our report emphasizes the importance of considering vEDS when an adolescent develops unexplained pulmonary cysts with fragility of lung tissues. Genetic counseling and close monitoring should be performed for earlier diagnosis and prevention of severe complications of large arteries. The typical presentations of vEDS were also discussed by means of a review of case reports on vEDS with pulmonary complications.

Doxorubicin-induced second degree and complete atrioventricular block.

PubMed

Kilickap, Saadettin; Akgul, Ebru; Aksoy, Sercan; Aytemir, Kudret; Barista, Ibrahim

2005-05-01

Doxorubicin is one of the most effective chemotherapeutic agents used in the treatment of malignancies. Cardiotoxicity is the most important dose-limiting toxicity of doxorubicin. Although cardiomyopathy is the most well known side effect of doxorubicin, it usually occurs many years after the treatment and relates to cumulative doxorubicin dosage. Another form of doxorubicin cardiotoxicity is arrhythmia which may occur at any time and after any dosage. However, doxorubicin-induced arrhythmia is rarely a life-threatening side effect. In this report, we present a case in which there were doxorubicin-induced life-threatening arrhythmias.

[Phaeochromocytoma revealed by a cardiogenic shock treated by extracorporeal life support].

PubMed

Contargyris, C; Nee, L; Saby, C; Kerbaul, F; Peytel, E

2012-12-01

Phaeochromocytoma is a catecholamine-secreting tumour that originates from the chromaffin cells in the adrenal medulla in 85% of the cases. Phaeochromocytoma typically presents with the classic signs and symptoms of paroxysmal hypertension, tachycardia, and episodic headache in young adults. However, it rarely may manifest as cardiogenic shock due to a catecholamine induced cardiomyopathy. We report the use of central extracorporeal life support (ECLS) in a young man admitted to our department because of cardiogenic shock caused by phaeochromocytoma. Copyright © 2012. Published by Elsevier SAS.

Identifying and treating a life-threatening disease.

PubMed

Cole, Beverley

2014-02-01

Meningococcal septicaemia is a life-threatening condition that all nurses working in emergency and urgent care settings are likely to come across during their careers. This article presents, and reflects on, a case study involving a woman with the disease whose signs and symptoms were atypical, and who was not therefore diagnosed with the condition immediately. The author aims to raise awareness among emergency nurses and nurse practitioners of the atypical signs and symptoms of the infection, and its consequences. The article also discusses how referring to patient scenarios can improve practice.

Elevated temperature biaxial fatigue

NASA Technical Reports Server (NTRS)

Jordan, E. H.

1983-01-01

Biaxial fatigue is often encountered in the complex thermo-mechanical loadings present in gas turbine engines. Engine strain histories can involve non-constant temperature, mean stress, creep, environmental effects, both isotropic and anisotropic materials and non-proportional loading. Life prediction for the general case involving all the above factors is not a practicable research project. The current research program is limited to isothermal fatigue at room temperature and 1200 F of Hastalloy-X for both proportional and non-proportional loading. An improved method for predicting the fatigue life and deformation response under biaxial cycle loading is sought.

Advanced Life Support Water Recycling Technologies Case Studies: Vapor Phase Catalytic Ammonia Removal and Direct Osmotic Concentration

NASA Technical Reports Server (NTRS)

Flynn, Michael

2004-01-01

Design for microgravity has traditionally not been well integrated early on into the development of advanced life support (ALS) technologies. NASA currently has a many ALS technologies that are currently being developed to high technology readiness levels but have not been formally evaluated for microgravity compatibility. Two examples of such technologies are the Vapor Phase Catalytic Ammonia Removal Technology and the Direct Osmotic Concentration Technology. This presentation will cover the design of theses two systems and will identify potential microgravity issues.

Tectal gliomas: assessment of malignant progression, clinical management, and quality of life in a supposedly benign neoplasm.

PubMed

Mohme, Malte; Fritzsche, Friederike S; Mende, Klaus C; Matschke, Jakob; Löbel, Ulrike; Kammler, Gertrud; Westphal, Manfred; Emami, Pedram; Martens, Tobias

2018-06-01

OBJECTIVE Tectal gliomas constitute a rare and inhomogeneous group of lesions with an uncertain clinical course. Because these supposedly benign tumors are frequently followed up by observation over many years, the authors undertook this analysis of their own case series in an effort to demonstrate that the clinical course is highly variable and that there is a potential for a progressive biology. METHODS Clinical data analysis of 23 cases of tectal glioma (involving 9 children and 14 adults) was performed retrospectively. Radiographic data were analyzed longitudinally and MR images were evaluated for tumor volume, contrast enhancement, and growth progression. Quality of life was assessed using the EORTC BN20 and C30 questionnaires during follow-up in a subgroup of patients. RESULTS The patients' mean age at diagnosis was 29.2 years. The main presenting symptom at diagnosis was hydrocephalus (80%). Six patients were treated by primary tumor resection (26.1%), 3 patients underwent biopsy followed by resection (13.1%), and 3 patients underwent biopsy only (13.1%). For additional treatment of hydrocephalus, 14 patients (60.9%) received shunts and/or endoscopic third ventriculostomy. Radiographic tumor progression was observed in 47.9% of the 23 cases. The mean time between diagnosis and growth progression was 51.5 months, and the mean time to contrast enhancement was 69.7 months. Histopathological analysis was obtained in 12 cases (52.2%), resulting in 5 cases of high-grade glioma (3 cases of glioblastoma multiforme [GBM], grade IV, and 2 of anaplastic astrocytoma, grade III), 5 cases of pilocytic astrocytoma, 1 diffuse astrocytoma, and 1 ganglioglioma. Malignant progression was observed in 2 cases, with 1 case progressing from a diffuse astrocytoma (grade II) to a GBM (grade IV) within a period of 13 years. Quality-of-life measurements demonstrated distinct functional deficits compared to a healthy sample as well as glioma control cohorts. CONCLUSIONS Analysis of this case series shows that a major subpopulation of tectal gliomas show progression and malignant transformation in children as well as in adolescents. These tumors therefore cannot be considered inert lesions and require histological confirmation and close follow-up. Quality-of-life questionnaires show that tectal glioma patients might benefit from special psychological support in emotional, social, and cognitive functionality.

Endovascular management of radiotherapy-induced injury to brachiocephalic artery using covered stents.

PubMed

Cenizo, Noelia Maria; Gonzalez-Fajardo, Jose A; Ibanez, Maria A; Gastambide, Victoria; Martin-Pedrosa, Miguel; Gutierrez, Vicente; Taylor, James; Vaquero, Carlos

2014-04-01

Actinic vascular lesions tend to be stenotic-occlusive lesions. In this article, we present 2 exceptional cases of pseudoaneurysms caused by radionecrosis of the supra-aortic trunks. Both patients were treated by a retrograde carotid approach and deployment of a self-expanding covered stent. Proper exclusion of the pseudoaneurysm was attained in both cases; the first patient remained asymptomatic 12 months later; the second patient died of mediastinitis. Compared with conventional surgery, endovascular management is a viable, less invasive alternative in select patients, especially in life-threatening cases. Copyright © 2014 Elsevier Inc. All rights reserved.

A Giant Vulvar Mass: A Case Study of Cellular Angiofibroma

PubMed Central

Aydın, Ümit; Terzi, Hasan; Turkay, Ünal; Eruyar, Ahmet Tuğrul; Kale, Ahmet

2016-01-01

Cellular angiofibroma is a mesenchymal tumor that affects both genders. Nucci et al. first described it in 1997. Cellular angiofibroma is generally a small and asymptomatic mass that primarily arises in the vulvar-vaginal region, although rare cases have been reported in the pelvic and extrapelvic regions. It affects women most often during the fifth decade of life. The treatment requires simple local excision due to low local recurrence and no chance of metastasization. The current study presents a case of angiofibroma in the vulvar region that measured approximately 20 cm. PMID:27293929

Stevens-Johnson Syndrome After Armodafinil Use.

PubMed

Holfinger, Steven; Roy, Asim; Schmidt, Markus

2018-05-15

We present the case of a 21-year-old woman in whom Stevens-Johnson syndrome (SJS) developed after initiation of armodafinil. Although this rare and life-threatening reaction is listed on armodafinil's label, no cases have been reported in the literature. This case, in addition to an update of the drug's label after post-marketing research, both support the link between armodafinil and SJS. Providers should maintain a high clinical suspicion for SJS when starting therapy to minimize associated morbidity and mortality by discontinuing armodafinil at the onset of first symptoms. © 2018 American Academy of Sleep Medicine.

Rare occurrence of metastasis from lung cancer to the anus: case report and review of the literature.

PubMed

Al-Tarakji, Mohannad; Feilchenfeldt, Jonas; Haidar, Abdulrazzaq; Szabados, Lajos; Abdelaziem, Sherif; Sayed, Ali; Toro, Adriana; Di Carlo, Isidoro

2016-06-08

Anal metastases from lung cancer are infrequent, and there are only 10 published cases. Life expectancy is no longer than 1 year after diagnosis because of the typically advanced stage of disease. Treatment, which is typically inefficient, is administered with the intent to cure or avoid local complications. We report a case of a patient with non-small cell lung cancer presenting with perianal metastasis mimicking an abscess. Because perianal masses may be misdiagnosed, patients with lung and other cancers should be evaluated for metastatic disease.

Chronicle of a death foretold: a case of catastrophic vascular Behcet's disease.

PubMed

Planer, David; Leibowitz, David; Elitzur, Yair; Korach, Amit; Hiller, Nurith; Chajek-Shaul, Tova

2007-03-01

A 20-year-old man with Behcet's disease characterized by recurrent arterial aneurysms presented with a new aortic root aneurysm. This patient previously had aneurysms of the coronary arteries and vein, as well as ruptured renal artery aneurysm. Chronic maintenance immunosuppressive therapy was recommended due to the catastrophic nature of the disease, which the patient refused to take. The patient died shortly after admission. This case demonstrates the unique catastrophic natural history of vascular Behcet's disease with recurrent life-threatening arterial events, and this case stresses the therapeutic dilemma of maintenance immunosuppressive therapy in selected patients.

ROHHAD in a 9-year-old boy — clinical case.

PubMed

Kot, Karolina; Moszczyńska, Elżbieta; Lecka-Ambroziak, Agnieszka; Migdał, Marek; Szalecki, Mieczysław

2016-01-01

ROHHAD syndrome (Rapid-onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation) is characterized by rapid-onset obesity in young children, hypoventilation, and hypothalamic and autonomic dysfunction. The exact aetiology of the disease remains unknown, and the number of reported cases seems to be underestimated. We present the case of a nine-year-old male patient suspected of ROHHAD due to weight gain since early childhood, decreased height velocity, hypoventilation, hypodipsia, excessive perspiration, and pyrexial episodes. The presented symptoms, and laboratory and imaging findings met the criteria of ROHHAD syndrome. ROHHAD should be considered in differential diagnosis for obesity in children. Early identification of the disease prevents potential complications specific for the syndrome, in particular a life-threatening cardio-pulmonary arrest. Patients with ROHHAD require regular follow-up by a multidisciplinary team.

Dysphagia lusoria: a late onset presentation.

PubMed

Bennett, Alice Louise; Cock, Charles; Heddle, Richard; Morcom, Russell Kym

2013-04-21

Dysphagia lusoria is a term used to describe dysphagia secondary to vascular compression of the oesophagus. The various embryologic anomalies of the arterial brachial arch system often remain unrecognised and asymptomatic, but in 30%-40% of cases can result in tracheo-oesophageal symptoms, which in the majority of cases manifest as dysphagia. Diagnosis of dysphagia lusoria is via barium swallow and chest Computed tomography scan. Manometric abnormalities are variable, but age-related manometric changes may contribute to clinically relevant dysphagia lusoria in patients who present later in life. Our report describes a case of late-onset dysphagia secondary to a right aortic arch with an aberrant left subclavian artery, which represents a rare variant of dysphagia lusoria. The patient had proven additional oesophageal dysmotility with solid bolus only and a clinical response to dietary modification.

Carnitine-acylcarnitine translocase deficiency with c.199-10 T>G and novel c.1A>G mutation: Two case reports and brief literature review.

PubMed

Yan, Hui-Ming; Hu, Hao; Ahmed, Aisha; Feng, Bing-Bing; Liu, Jing; Jia, Zheng-Jun; Wang, Hua

2017-11-01

Carnitine-acylcarnitine translocate deficiency (CACTD) is a rare and life-threatening, autosomal recessive disorder of fatty acid β-oxidation characterized by hypoketotic hypoglycemia, hyperammonemia, cardiomyopathy, liver dysfunction, and muscle weakness; culminating in early death. To date, CACTD cases screened from the Chinese mainland population, especially patient with compound heterozygote with c.199-10T>G and a novel c.1A>G mutation in the SLC25A20 gene has never been described. Herein, we report 2 neonatal cases of CACTD identified from the mainland China. These 2 patients were presented with severe metabolic crisis and their clinical conditions deteriorate rapidly and both died of cardiorespiratory collapse in the first week of life. We present the clinical and biochemical features of 2 probands and a brief literature review of previously reported CACTD cases with the c.199-10T>G mutation. The acylcarnitine profiles by tandem-mass-spectrometry and the mutation analysis of SLC25A20 gene confirmed the diagnosis of CACTD in both patients. Mutation analysis demonstrated that patient No. 1 was homozygous for c.199-10T>G mutation, while patient No. 2 was a compound heterozygote for 2 mutations, a maternally-inherited c.199-10T>G and a paternally-inherited, novel c.1A>G mutation. Both patients were treated with an aggressive treatment regimen include high glucose and arginine infusion, respiratory, and circulatory support. The first proband died 3 days after delivery due to sudden cardiac arrest. The second patient's clinical condition, at one time, was improved by high glucose infusion, intravenous arginine, and circulatory support. However, the patient failed to wean from mechanical ventilation. Unfortunately, her parents refused further treatment due to fear of financial burdens. The patient died of congestive heart failure in the 6th day of life. We report the first 2 cases of CACTD identified from the mainland China. Apart from a founder mutation c.199-10T>G, we identified a novel c.1A>G mutation. Patients with CACTD with a genotype of c.199-10T>G mutation usually presents with a severe clinical phenotype. Early recognition and appropriate treatment is crucial in this highly lethal disorder. This case series highlights the importance of screening for metabolic diseases including CACTD in cases of sudden infant death and unexplained abrupt clinical deterioration in the early neonatal period.

SAM syndrome is characterized by extensive phenotypic heterogeneity.

PubMed

Taiber, Shahar; Samuelov, Liat; Mohamad, Janan; Cohen Barak, Eran; Sarig, Ofer; Shalev, Stavit Allon; Lestringant, Gilles; Sprecher, Eli

2018-03-31

Severe skin dermatitis, multiple allergies and metabolic wasting (SAM) syndrome is a rare life-threatening inherited condition caused by bi-allelic mutations in DSG1 encoding desmoglein 1. The disease was initially reported to manifest with severe erythroderma, failure to thrive, atopic manifestations, recurrent infections, hypotrichosis and palmoplantar keratoderma. We present 3 new cases of SAM syndrome in 2 families and review the cases published so far. Whole exome and direct sequencing were used to identify SAM syndrome-causing mutations. Consistent with previous data, SAM syndrome was found in all 3 patients to result from homozygous mutations in DSG1 predicted to result in premature termination of translation. In contrast, as compared with patients previously reported, the present cases were found to display a wide range of clinical presentations of variable degrees of severity. The present data emphasizes the fact that SAM syndrome is characterized by extensive phenotypic heterogeneity, suggesting the existence of potent modifier traits. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Warfarin-induced toxic epidermal necrolysis in combination therapy of Henoch-Schönlein purpura nephritis: a case report.

PubMed

Kasahara, Katsuaki; Gotoh, Yoshimitsu; Kuroyanagi, Yoshiyuki; Nagano, China

2017-07-14

Toxic epidermal necrolysis (TEN) is a rare life-threatening condition almost exclusively attributed to drugs. The main etiologic factors for TEN are sulphonamides, anticonvulsants, and antibiotics; however, there are no published reports of warfarin causing TEN. We present the case of a 3-year-old patient who developed TEN while receiving treatment for Henoch-Schönlein purpura nephritis (HSPN). With multiple-drug therapy comprising prednisolone, mizoribine, dipyridamole, and warfarin, it is difficult to detect which drug is the causative agent. While in most cases, diagnosis of the causative drug is based on clinical history without a lymphocyte transformation test (LTT), we performed the test three times and identified the causative drug as warfarin at the late phase. We continued HSPN treatment without warfarin, and results showed good renal function without life-threatening complications. To our knowledge, this is the first report about TEN caused by warfarin. Repeated LTTs could be useful for identifying TEN-causative drugs even in the late phase.

Treatment of Paroxysmal Perceptual Alteration in Catatonic Schizophrenia by Switching to Aripiprazole from Risperidone: A Case Report.

PubMed

Yamashita, Satoko; Miyaoka, Tsuyoshi; Nagahama, Michiharu; Ieda, Masa; Tsuchie, Keiko; Wake, Rei; Horiguchi, Jun

2016-01-01

Paroxysmal perceptual alteration (PPA) is the occurrence of brief and recurrent episodes of perceptual changes. It is mainly caused by the treatment of schizophrenia patients with antipsychotics. However, diagnosis of PPA is not very prevalent among psychiatrists, partly due to underrecognition or misunderstanding that it is a worsening of psychiatric symptoms. If psychiatrists do not understand PPA, they cannot treat it appropriately, and the patient's quality of life is impaired. We present a case of PPA in catatonic schizophrenia that was successfully treated by switching to aripiprazole from risperidone. We suggest that the disappearance of PPA in our case was due to both discontinuing risperidone, which completely blocks D2 receptors, and replacing it with aripiprazole, which is characterized as a partial agonist of D2 receptors. Treatment of PPA will improve medication adherence and quality of life. It is important to recognize PPA as a possible side effect of treatment with antipsychotics.

Life-threatening hypersplenism due to idiopathic portal hypertension in early childhood: case report and review of the literature

PubMed Central

2010-01-01

Background Idiopathic portal hypertension (IPH) is a disorder of unknown etiology and is characterized clinically by portal hypertension, splenomegaly, and hypersplenism accompanied by pancytopenia. This study evaluates the pathogenic concept of the disease by a systematic review of the literature and illustrates novel pathologic and laboratory findings. Case Presentation We report the first case of uncontrolled splenic hyperperfusion and enlargement with subsequent hypersplenism leading to life-threatening complications of IPH in infancy and emergent splenectomy. Conclusions Our results suggest that splenic NO and VCAM-1, rather than ET-1, have a significant impact on the development of IPH, even at a very early stage of disease. The success of surgical interventions targeting the splenic hyperperfusion suggests that the primary defect in the regulation of splenic blood flow seems to be crucial for the development of IPH. Thus, beside other treatment options splenectomy needs to be considered as a prime therapeutic option for IPH. PMID:20961440

Health-related quality of life of irritable bowel syndrome patients in different cultural settings.

PubMed

Faresjö, Ashild; Anastasiou, Foteini; Lionis, Christos; Johansson, Saga; Wallander, Mari-Ann; Faresjö, Tomas

2006-03-27

Persons with Irritable bowel syndrome (IBS) are seriously affected in their everyday life. The effect across different cultural settings of IBS on their quality of life has been little studied. The aim was to compare health-related quality of life (HRQOL) of individuals suffering from IBS in two different cultural settings; Crete, Greece and Linköping, Sweden. This study is a sex and age-matched case-control study, with n = 30 Cretan IBS cases and n = 90 Swedish IBS cases and a Swedish control group (n = 300) randomly selected from the general population. Health-related quality of life, measured by SF-36 and demographics, life style indicators and co-morbidity, was measured. Cretan IBS cases reported lower HRQOL on most dimensions of SF-36 in comparison to the Swedish IBS cases. Significant differences were found for the dimensions mental health (p < 0.0001) and general health (p = 0.05) even after adjustments for educational level and co-morbidity. Women from Crete with IBS scored especially low on the dimensions general health (p = 0.009) and mental health (p < 0.0001) in comparison with Swedish women with IBS. The IBS cases, from both sites, reported significantly lower scores on all HRQOL dimensions in comparison with the Swedish control group. The results from this study tentatively support that the claim that similar individuals having the same disease, e.g. IBS, but living in different cultural environments could perceive their disease differently and that the disease might affect their everyday life and quality of life in a different way. The Cretan population, and especially women, are more seriously affected mentally by their disease than Swedish IBS cases. Coping with IBS in everyday life might be more problematic in the Cretan environment than in the Swedish setting.

Vertical distribution of microphysical properties in radiation fogs - A case study

NASA Astrophysics Data System (ADS)

Egli, S.; Maier, F.; Bendix, J.; Thies, B.

2015-01-01

The present study investigates the validity of a theoretical liquid water content (LWC) profile in fog layers currently used for satellite based ground fog detection, with a special focus on the temporal dynamics during fog life cycle. For this purpose, LWC profiles recorded during two different fog events by means of a tethered balloon borne measurement system are presented and discussed. The results indicate a good agreement in trend and gradient between measured and theoretical LWC profiles during the mature stage of the fog life cycle. The profile obtained during the dissipation stage shows less accordance with the theoretical profile. To improve the agreement between theoretical and measured LWC profiles, the evolutionary stages during the fog life cycle should be incorporated. However, the variability within the prenoted measurements points out that more LWC profiles during a great variety of different fog events have to be collected for a well-justified adaptation of the theoretical LWC profile, considering fog life cycle phases in the future. In general, this underlines the existing knowledge gap regarding the vertical distribution of microphysical properties in natural fogs.

Experiencing leisure in later life: a study of retirees and activity in Singapore.

PubMed

Thang, Leng Leng

2005-12-01

In a society faced with rapid aging and extended life expectancy, older persons in Singapore are just beginning to see retirement as a new era in their lives that can be quite different from the later life experiences of their own parents. Presenting an ethnographic case study of one of the first retiree activity centers in Singapore, this article will examine (a) how older persons cope with retirement, social, and cultural norms, and (b) the strategies older adults adopt in order to stay relevant in a fast-paced society. The ethnographic study shows that extrafamilial social support and opportunities for new experiences in learning and leisure contribute significantly to positive and active living in old age. Although the discussion of aging in Asia usually focuses on the problems of health, finances, and caregiving, the present study suggests the need for policy makers to pay equal attention to issues such as activity participation in old age. Participation in leisure activities may act as a preventive measure to delay the onset of aging-related problems, while at the same time enhancing life satisfaction among seniors.

Gender and work orientations in conditions of job insecurity.

PubMed

Charles, Nickie; James, Emma

2003-06-01

This paper explores women's and men's work orientations in conditions of job insecurity, arguing that it is time to move beyond essentalist conceptions of work orientations and central life interests in order to understand the significance of paid work in people's lives. Data from a qualitative study are presented which show that the significance of paid work and the priority given to home and work are affected by experiences of job insecurity, changing domestic circumstances and stage in the life cycle and that this is the case for both women and men. Conversely, the significance of paid work can affect how job insecurity is experienced and its impact on individuals and their families. The assumption that men's work orientations are homogeneous and that work is their central life interest is not supported by the findings presented here and it is argued that the significance of work in men's and women's lives is more variable than has hitherto been recognized. To capture this variability it is time to move away from the acrimony of the debate over women's work orientations and notions of a central life interest which underpin it.

Integrative harm reduction psychotherapy: a case of substance use, multiple trauma, and suicidality.

PubMed

Tatarsky, Andrew; Kellogg, Scott

2010-02-01

Harm reduction is a new paradigm that seeks to reduce the harmful consequences of substance use and other risky behaviors without requiring abstinence. This article discusses integrative harm reduction psychotherapy, one application of harm reduction principles to psychotherapy. Seven therapeutic tasks are described with attention to clinical process, skills, and strategies. A case is presented that illustrates the application of this approach with life-threatening substance use that was related to multiple trauma and suicidal depression. (c) 2010 Wiley Periodicals, Inc.

The right to die--ethical dilemmas in persons with spinal cord injury.

PubMed

Rundquist, Jeanine M

2002-01-01

The right to die can be a controversial topic, and health care workers in the rehabilitation setting may find themselves in the center of this heated debate. This article presents a case study of a patient with tetraplegia, Daniel, and his choices regarding life and death. The case study will be examined through the use of ethical principles as well as from a legal standpoint. Social, cultural, and economic issues are also discussed. Guidelines for possible resolution to the conflict are offered.

[Two cases of anaphylactoid reaction after administration of sugammadex].

PubMed

Ohshita, Naohiro; Tsutsumi, Yasuo M; Kasai, Asuka; Soga, Tomohiro; Kanamura, Tomomi; Katayama, Toshiko; Iseki, Akio; Tomiyama, Yoshinobu; Tanaka, Katsuya

2012-11-01

Anaphylaxis during anesthesia is a rare but life-threatening event. Sugammadex is a recently introduced drug that was specifically designed for the reversal of rocuroium and vecuronium-induced neuromuscular block. We describe the cases of a 74-year-old man and a 29-year-old man who developed an anaphylactoid reaction to sugammadex, presenting with cardiovascular collapse. Initial management consisted of fluid administration and intermittent i.v. ephedrine, epinephrine, and hydrocortisone. The patients made uncomplicated recovery and were discharged.

The nasogastric tube syndrome: two case reports and review of the literature.

PubMed

Apostolakis, L W; Funk, G F; Urdaneta, L F; McCulloch, T M; Jeyapalan, M M

2001-01-01

The nasogastric tube syndrome is a potentially life-threatening complication of an indwelling nasogastric (NG) tube. The syndrome is thought to result from ulceration and infection of the posterior cricoid region with subsequent dysfunction of vocal cord abduction. This dysfunction may present as complete loss of vocal cord abduction manifested as serious airway compromise. Reports of this syndrome are infrequent, with only 29 cases published to date. Two additional cases of nasogastric tube syndrome diagnosed at the University of Iowa Hospitals and Clinics over a 2-year period are presented. A search of MEDLINE (1966 through February 1999), including review of those articles' references identified seven previous publications, including 29 case reports. These 29 cases are reviewed and the findings summarized. Twenty-nine cases of NG tube syndrome are identified, with 16 of these occurring in the preantibiotic period. Including the two cases presented here, 15 contemporary patients are examined. Among these 15 cases, 10 required tracheostomy, on average 8.5 days after NG tube placement. Although the fully manifested syndrome presents quite dramatically, we suspect that a clinical spectrum of severity exists with less severe cases going unrecognized. Consistent with previous reports, we found that direct visualization of the postcricoid region is required to rule out the diagnosis and recommend such action be taken whenever the diagnosis is suspected. Treatment should include establishment of a safe airway, removal of the tube whenever possible, antibiotic therapy, and antireflux therapy.

[Nineteen cases of school-aged children with degenerative or metabolic neurological disorders initially presenting with learning difficulty and/or behavior disturbance].

PubMed

Honzawa, Shiho; Sugai, Kenji; Akaike, Hiroto; Nakayama, Tojo; Fujikawa, Yoshinao; Komaki, Hirofumi; Nakagawa, Eiji; Sasaki, Masayuki

2012-07-01

We reported 19 cases of school-aged children. They were initially judged to have learning difficulty or school maladaptation because of attention deficits, hyperactive behaviors or poor school performance, followed by the diagnosis such as degenerative or metabolic neurological diseases. The patients consisted of 4 cases of adrenoleukodystrophy, 5 cases of dentatorubral-pallidoluysian atrophy, 3 cases of Sanfilippo syndrome, 3 cases of subacute sclerosing panencephalitis, and each one case of juvenile Gaucher disease, juvenile Huntington disease, juvenile metachromatic leukodystrophy and Leigh disease. They had markedly poor school performance, and/or abnormal behaviors, followed by seizures, character disorders or psychomotor regression. The diagnostic clues included brain CT scan and/or MRI, peculiar facial appearance and notable family histories. When the children were indicated to have learning difficulty or maladjustment to school life, we should make deliberate differential diagnoses before concluding that they have a learning disorder and/or attention-deficit/hyperactivity disorder. Instead they should be recommended to visit child neurologists, when they present with any problems as aforesaid.

Third branchial cleft anomaly presenting as a retropharyngeal abscess.

PubMed

Huang, R Y; Damrose, E J; Alavi, S; Maceri, D R; Shapiro, N L

2000-08-31

Branchial cleft anomalies are congenital developmental defects that typically present as a soft fluctuant mass or fistulous tract along the anterior border of the sternocleidomastoid muscle. However, branchial anomalies can manifest atypically, presenting diagnostic and therapeutic challenges. Error or delay in diagnosis can lead to complications, recurrences, and even life-threatening emergencies. We describe a case of an infected branchial cleft cyst that progressed to a retropharyngeal abscess in a 5-week-old female patient. The clinical, radiographic, and histologic findings of this rare presentation of branchial cleft cyst are discussed.

A PetriNet-Based Approach for Supporting Traceability in Cyber-Physical Manufacturing Systems

PubMed Central

Huang, Jiwei; Zhu, Yeping; Cheng, Bo; Lin, Chuang; Chen, Junliang

2016-01-01

With the growing popularity of complex dynamic activities in manufacturing processes, traceability of the entire life of every product has drawn significant attention especially for food, clinical materials, and similar items. This paper studies the traceability issue in cyber-physical manufacturing systems from a theoretical viewpoint. Petri net models are generalized for formulating dynamic manufacturing processes, based on which a detailed approach for enabling traceability analysis is presented. Models as well as algorithms are carefully designed, which can trace back the lifecycle of a possibly contaminated item. A practical prototype system for supporting traceability is designed, and a real-life case study of a quality control system for bee products is presented to validate the effectiveness of the approach. PMID:26999141

A PetriNet-Based Approach for Supporting Traceability in Cyber-Physical Manufacturing Systems.

PubMed

Huang, Jiwei; Zhu, Yeping; Cheng, Bo; Lin, Chuang; Chen, Junliang

2016-03-17

With the growing popularity of complex dynamic activities in manufacturing processes, traceability of the entire life of every product has drawn significant attention especially for food, clinical materials, and similar items. This paper studies the traceability issue in cyber-physical manufacturing systems from a theoretical viewpoint. Petri net models are generalized for formulating dynamic manufacturing processes, based on which a detailed approach for enabling traceability analysis is presented. Models as well as algorithms are carefully designed, which can trace back the lifecycle of a possibly contaminated item. A practical prototype system for supporting traceability is designed, and a real-life case study of a quality control system for bee products is presented to validate the effectiveness of the approach.

Life Cycle Assessment of Bio-diesel Production—A Comparative Analysis

NASA Astrophysics Data System (ADS)

Chatterjee, R.; Sharma, V.; Mukherjee, S.; Kumar, S.

2014-04-01

This work deals with the comparative analysis of environmental impacts of bio-diesel produced from Jatropha curcas, Rapeseed and Palm oil by applying the life cycle assessment and eco-efficiency concepts. The environmental impact indicators considered in the present paper include global warming potential (GWP, CO2 equivalent), acidification potential (AP, SO2 equivalent) and eutrophication potential (EP, NO3 equivalent). Different weighting techniques have been used to present and evaluate the environmental characteristics of bio-diesel. With the assistance of normalization values, the eco-efficiency was demonstrated in this work. The results indicate that the energy consumption of bio-diesel production is lowest in Jatropha while AP and EP are more in case of Jatropha than that of Rapeseed and Palm oil.

Computer program to assess impact of fatigue and fracture criteria on weight and cost of transport aircraft

NASA Technical Reports Server (NTRS)

Tanner, C. J.; Kruse, G. S.; Oman, B. H.

1975-01-01

A preliminary design analysis tool for rapidly performing trade-off studies involving fatigue, fracture, static strength, weight, and cost is presented. Analysis subprograms were developed for fatigue life, crack growth life, and residual strength; and linked to a structural synthesis module which in turn was integrated into a computer program. The part definition module of a cost and weight analysis program was expanded to be compatible with the upgraded structural synthesis capability. The resultant vehicle design and evaluation program is named VDEP-2. It is an accurate and useful tool for estimating purposes at the preliminary design stage of airframe development. A sample case along with an explanation of program applications and input preparation is presented.

Quality of life of patients who underwent aesthetic rhinoplasty: 100 cases assessed with the Glascow Benefit Inventory.

PubMed

Kotzampasakis, Dimitrios; Piniara, Anastasia; Themelis, Sotirios; Kotzampasakis, Stylianos; Gabriel, Eustratios; Maroudias, Nikos; Nikolopoulos, Thomas

2017-09-01

The aim of the present study is to assess the long-term effect of classic rhinoplasty on patients' quality of life. Outcomes research. The study included 100 operated patients; there were 34 males and 66 females. The ages ranged between 23 and 57 years old, with a mean of 36.4 years. A minimum of 3 years between the operation and the study was selected to assess the long-term effect of the operation on the patients' quality of life and exclude any short-term impressions. The time elapsed between surgery and the time of the study ranged from 3 to 13 years, with a mean of 6.8 years. Patients were assessed using the Glasgow Benefit Inventory, which has been proven valid and reliable in ear, nose, and throat interventions. From the 100 patients included in the study, 92 reported improvement in their quality of life due to the operation and only eight worsening. In the social support subscale, 97 patients reported better quality of life, and only three patients reported worse quality of life. The patients' overall life markedly improved, reaching a mean of 80% in the Glasgow Benefit Inventory. The present long-term study using a validated and reliable instrument concludes that rhinoplasty improves the quality of life of patients in all sectors. 2c Laryngoscope, 127:2017-2025, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Cotard Delusion in the Context of Schizophrenia: A Case Report and Review of the Literature

PubMed Central

Bott, Nicholas; Keller, Corey; Kuppuswamy, Malathy; Spelber, David; Zeier, Joshua

2016-01-01

Background: The Cotard delusion (CD) is one of a variety of narrowly defined monothematic delusions characterized by nihilistic beliefs about the body’s existence or life itself. The presence of CD within the context of schizophrenia is rare (<1%), and remains understudied. Case: ‘Mr. C’ is a 58-year-old veteran with a prior diagnosis of schizophrenia, who presented with CD in the context of significant depression, suicidal ideation, violence, and self-harm behavior. He perseverated in his belief that he was physically dead and possessed by demons for several weeks. This delusion was reinforced by his religious belief that life was an attribute of God, and by inference, he as a human, was dead. His condition gradually improved over the course of treatment with Divalproex and quetiapine with discussions about the rationale for his belief. Upon discharge, Mr. C. demonstrated awareness of his fixation on death and an ability to redirect himself. Discussion: This case highlights the need to better understand the co-occurrence of CD in schizophrenia, their differentiation, the increased risk of violence and self-harm behavior in this presentation, and how specific events and religious factors can influence delusional themes of CD. Pharmacotherapy and aspects of cognitive-behavioral therapy may be effective in ameliorating these symptoms in CD. PMID:27656159

Foetal trauma, body memory and early infant communication: a case illustration.

PubMed

Merchant, John

2015-11-01

This paper presents the complex case of a male patient who started life as an unwanted pregnancy and adoptee in an era of socio-cultural shame and blame. When able to contact his birth mother later in life, he experienced a number of confronting synchronicities as well as visions which he felt were related to failed abortion attempts and to other pre- and post-natal events. The case material lends weight not only to Freud's, Ehrenwald's and FitzHerbert's assertions that the earliest form of mother-infant communications is telepathic in nature but that this mode of communication can be retained if emotional trauma inhibits normal developmental processes. Contemporary neuroscience research is presented supporting the hypothesis that emotional memory can become imbedded in the psyche/soma of the foetus. Such memory traces can later emerge into imagery and/or words if the traumatic impingement has been substantial enough and if other defensive strategies are in place. Clinical implications are then suggested regarding analysts' attention to the emotional conditions underpinning their patients' conceptions and foetal development; the connection to projective identification components of the countertransference as being aspects of the earliest telepathic mother/infant communication channel and the need for reductive analyses in analyst training programmes. © 2015, The Society of Analytical Psychology.

A polysomnographically documented case of adult somnambulism with long-distance automobile driving and frequent nocturnal violence: parasomnia with continuing danger as a noninsane automatism?

PubMed

Schenck, C H; Mahowald, M W

1995-11-01

A case of childhood-onset somnambulism is reported in which a 43-year-old man presented with repeated sleep-related injuries incurred during violent nocturnal activity, which included frenzied running, throwing punches and wielding knives. He had also driven an automobile a long distance during a presumed somnambulistic state. His wife had been repeatedly injured, and she felt that her life was threatened by his nocturnal violence 2-3 times yearly. Polysomnography (PSG) documented multiple episodes of complex and violent behaviors arising exclusively from stage 3/4 sleep, thus confirming the diagnosis of somnambulism. Other causes of sleep-related violence were excluded. The patient responded promptly to treatment with bedtime clonazepam, and benefit was maintained at 5-year follow-up. Although this strictly clinical case did not have any legal repercussions, it does carry forensic implications, particularly when placed in the context of the published medical literature on PSG-documented parasomnias (somnambulism, rapid eye movement sleep behavior disorder) containing explicit examples of recurrent violence, at times life-threatening, directed toward the bed partner and others. Thus, a new medical-legal concept is proposed, consisting of "parasomnia with continuing danger" as a noninsane automatism. Treatment guidelines, within the context of forensic medicine, are presented.

Clinical characteristics and HLA alleles of a family with simultaneously occurring alopecia areata.

PubMed

Emre, Selma; Metin, Ahmet; Caykoylu, Ali; Akoglu, Gulsen; Ceylan, Gülay G; Oztekin, Aynure; Col, Esra S

2016-06-01

Alopecia areata (AA) is a T-cell-mediated autoimmune disease resulting in partial or total noncicatricial hair loss. HLA class II antigens are the most important markers that constitute genetic predisposition to AA. Various life events and intense psychological stress may play an important role in triggering AA attacks. We report an unusual case series of 4 family members who had simultaneously occurring active AA lesions. Our aim was to evaluate the clinical and psychiatric features of 4 cases of active AA lesions occurring simultaneously in a family and determine HLA alleles. The clinical and psychological features of all patients were examined. HLA antigen DNA typing was performed by polymerase chain reaction with sequence-specific primers. All patients had typical AA lesions over the scalp and/or beard area. Psychological examinations revealed obsessive-compulsive personality disorder in the proband's parents as well as anxiety and lack of self-confidence in both the proband and his sister. HLA antigen types were not commonly shared with family members. These findings suggest that AA presenting concurrently in members of the same family was not associated with genetic predisposition. Shared psychological disorders and stressful life events might be the major key points in the concurrent presentation of these familial AA cases and development of resistance against treatments.

Teaching astronomy with case studies

NASA Astrophysics Data System (ADS)

Slater, Timothy F.

2015-11-01

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

Exploring the life cycle management of industrial solid waste in the case of copper slag.

PubMed

Song, Xiaolong; Yang, Jianxin; Lu, Bin; Li, Bo

2013-06-01

Industrial solid waste has potential impacts on soil, water and air quality, as well as human health, during its whole life stages. A framework for the life cycle management of industrial solid waste, which integrates the source reduction process, is presented and applied to copper slag management. Three management scenarios of copper slag are developed: (i) production of cement after electric furnace treatment, (ii) production of cement after flotation, and (iii) source reduction before the recycling process. A life cycle assessment is carried out to estimate the environmental burdens of these three scenarios. Life cycle assessment results showed that the environmental burdens of the three scenarios are 2710.09, 2061.19 and 2145.02 Pt respectively. In consideration of the closed-loop recycling process, the environmental performance of the flotation approach excelled that of the electric furnace approach. Additionally, although flash smelting promotes the source reduction of copper slag compared with bath smelting, it did not reduce the overall environmental burdens resulting from the complete copper slag management process. Moreover, it led to the shifting of environmental burdens from ecosystem quality damage and resources depletion to human health damage. The case study shows that it is necessary to integrate the generation process into the whole life cycle of industrial solid waste, and to make an integrated assessment for quantifying the contribution of source reduction, rather than to simply follow the priority of source reduction and the hierarchy of waste management.

Childhood trauma, attachment style, and a couple's experience of terminal cancer: case study.

PubMed

McLean, Linda M; Hales, Sarah

2010-06-01

The primary objective of this article is to elucidate the significance of psychosocial distress and risk in a sub-population of end-stage cancer patients and their spouse caregivers who present with an especially challenging attachment style and histories of childhood trauma. The case study presented highlights the need to both identify and offer an empirically validated couple-based intervention, along with a multi-disciplinary team approach over the trajectory of the illness and at end of life. A validated marital protocol (emotionally focused couple therapy [EFT]) is modified for this population and conducted by an EFT-trained psychologist as part of a pilot investigation as to the feasibility and effectiveness of EFT for the terminal cancer population. Measures of marital distress, depression, hopelessness, and attachment security are completed at baseline and subsequent intervals, as reported in another publication. Attachment insecurity and the exquisitely intimate relationship with caregiving and care receiving are underscored, given the couple's traumatic childhood history. The couple described herein, followed from diagnosis of metastatic disease to end of life illuminates the potential effectiveness of a modified EFT protocol, and underscores the need to both identify and intervene with a population potentially at significantly high risk for marital distress, suicidality, depression, and hopelessness. The benefits of a multidisciplinary team is evident as the patient's symptoms of physical distress increased toward end of life and she returned to earlier behaviors, namely suicidal ideation and an attempt to alleviate her experience of suffering. The strength of the marital bond, possibly as a result of the intervention, and the efforts of the multidisciplinary team approach, demonstrate potential to mitigate a catastrophic end of life and a complicated spousal bereavement. This case study adds to the current empirical literature in an area that is currently under-studied and under-reported.

Pediatric Critical Care Transport as a Conduit to Terminal Extubation at Home: A Case Series.

PubMed

Noje, Corina; Bernier, Meghan L; Costabile, Philomena M; Klein, Bruce L; Kudchadkar, Sapna R

2017-01-01

To present our single-center's experience with three palliative critical care transports home from the PICU for terminal extubation. We performed a retrospective chart review of patients transported between January 1, 2012, and December 31, 2014. All cases were identified from our institutional pediatric transport database. Patients were terminally ill children unable to separate from mechanical ventilation in the PICU, who were transported home for terminal extubation and end-of-life care according to their families' wishes. Patients underwent palliative care transport home for terminal extubation. The rate of palliative care transports home for terminal extubation during the study period was 2.6 per 100 deaths. The patients were 7 months, 6 years, and 18 years old and had complex chronic conditions. The transfer process was protocolized. The families were approached by the PICU staff during multidisciplinary goals-of-care meetings. Parental expectations were clarified, and home hospice care was arranged pretransfer. All transports were performed by our pediatric critical care transport team, and all terminal extubations were performed by physicians. All patients had unstable medical conditions and urgent needs for transport to comply with the families' wishes for withdrawal of life support and death at home. As such, all three cases presented similar logistic challenges, including establishing do-not-resuscitate status pretransport, having limited time to organize the transport, and coordinating home palliative care services with available community resources. Although a relatively infrequent practice in pediatric critical care, transport home for terminal extubation represents a feasible alternative for families seeking out-of-hospital end-of-life care for their critically ill technology-dependent children. Our single-center experience supports the need for development of formal programs for end-of-life critical care transports to include patient screening tools, palliative care home discharge algorithms, transport protocols, and resource utilization and cost analyses.

Health, Quality of Care and Quality of Life: A Case of Frail Older Adults

ERIC Educational Resources Information Center

Hsieh, Chang-Ming

2009-01-01

This study explores the relationship between health, quality of care of geriatric case management and quality of life for the purpose of furthering the understanding of the relationship between quality of life and geriatric case management. Using survey data from a group of frail older adults, this study assesses the relative merit of two…

Temporary Black Henna Tattoos and Sensitization to para-Phenylenediamine (PPD): Two Paediatric Case Reports and a Review of the Literature.

PubMed

Panfili, Elisa; Esposito, Susanna; Di Cara, Giuseppe

2017-04-14

Background : The use of temporary henna tattoos has increased dramatically in recent years, especially in children and adolescents. To obtain a darker colour and prolong the life of the tattoo, red henna, a plant-derived substance, is typically added to para -phenylenediamine (PPD). The mixture is called temporary black henna tattoo (TBHT). Because of its molecular characteristics, PPD can induce skin sensitization that may cause various clinical manifestations with successive exposures, among which the most common is allergic contact dermatitis (ACD). This report describes two paediatric cases of PPD sensitization and ACD after the exposure to TBHT and summarizes the literature on this emerging clinical problem. Case Presentation : We describe two cases of childhood-onset ACD that occurred 2 and 10 days, respectively, after the application of a TBHT during the summer holidays. Patch tests showed an evident positive response to 1% PPD in both cases. Sensitization to PPD occurred in the first case because a previous henna tattoo did not result in overt symptoms; in the second case, the reaction occurred after the same tattoo was retouched. In both cases, hypopigmentation persisted and both the patients and their families were advised to avoid further contact with PPD-containing materials and substances that could lead to cross-reactions. Conclusions : Sensitization to PPD is a growing phenomenon in children. The most common cause appears to be exposure to TBHT in which PPD might be present at unknown or high concentrations. Once sensitization occurs, patients may experience severe clinical symptoms which can present with a persistent hypopigmentation when they are re-exposed to substances that contain or cross-react with PPD. Given the widespread use of PPD, TBHT could adversely affect the daily life of paediatric patients; thus, for this reason, this practice as a fashion accessory must be discouraged. In addition, it is extremely important to provide scientific information on the risks of TBHT to consumers, especially to adolescents and to the parents of younger children to prevent PPD sensitization.

A calculation model to half-life estimate of two-proton radioactive decay process

NASA Astrophysics Data System (ADS)

Tavares, O. A. P.; Medeiros, E. L.

2018-04-01

Partial half-life of the radioactive decay by the two-proton emission mode has been estimated for proton-rich nuclei of mass number 18 < A < 68 by a model based on the quantum mechanical tunneling mechanism through a potential barrier. The Coulomb, centrifugal and overlapping contributions to the barrier have been considered within the spherical nucleus approximation. The present calculation method has been shown to be adequate in reproducing the existing experimental half-life data for 19Mg, 45Fe, 48Ni, and 54Zn 2p-emitter nuclides within a factor six. For 67Kr parent nucleus the calculated partial 2p-decay half-life has been found to be ten times greater than the recent, unique measured value at RIKEN Nishina Center. Prediction for new, yet unmeasured cases of two-proton radioactivity are also reported.

Coaching Family Caregivers to Become Better Problem Solvers When Caring for Persons with Advanced Cancer.

PubMed

Dionne-Odom, J Nicholas; Lyons, Kathleen D; Akyar, Imatullah; Bakitas, Marie A

2016-01-01

Family caregivers of persons with advanced cancer often take on responsibilities that present daunting and complex problems. Serious problems that go unresolved may be burdensome and result in negative outcomes for caregivers' psychological and physical health and affect the quality of care delivered to the care recipients with cancer, especially at the end of life. Formal problem-solving training approaches have been developed over the past several decades to assist individuals with managing problems faced in daily life. Several of these problem-solving principles and techniques were incorporated into ENABLE (Educate, Nurture, Advise, Before Life End), an "early" palliative care telehealth intervention for individuals diagnosed with advanced cancer and their family caregivers. A hypothetical case resembling the situations of actual caregiver participants in ENABLE that exemplifies the complex problems that caregivers face is presented, followed by presentation of an overview of ENABLE's problem-solving key principles, techniques, and steps in problem-solving support. Though more research is needed to formally test the use of problem-solving support in social work practice, social workers can easily incorporate these techniques into everyday practice.

Lupus Anticoagulant-hypoprothrombinemia Syndrome (LAC-HPS) in Children With Systemic Lupus Erythematosus: Report of 3 Cases.

PubMed

Komvilaisak, Patcharee; Wisanuyotin, Suwannee; Jettrisuparb, Arunee; Wiangnon, Surapon

2017-11-01

Lupus anticoagulant, also known as lupus antibody, is generally associated with thrombosis rather than bleeding events. Lupus anticoagulant-hypoprothrombinemia syndrome in children is rather rare but can lead to mild to life-threatening bleeding. Here, we report 3 cases of lupus anticoagulant-hypoprothrombinemia syndrome associated with systemic lupus erythematosus. They initially presented with mucocutaneous bleedings, and subsequently developed other symptoms fulfilling the laboratory criteria for systemic lupus erythematosus. Case 2 and 3 had significant epistaxis and intracerebral hemorrhage responded to systemic corticosteroid along with fresh frozen plasma. Three cases demonstrated acquired hypoprothrombinemia with no correction of mixing studies. Case 1 had low factor X level, which has never been reported previously. In all 3 cases, their coagulogram returned to normal level after corticosteroid treatment.

Use of Ketamine in Elderly Patients with Treatment-Resistant Depression.

PubMed

Medeiros da Frota Ribeiro, Carolina; Riva-Posse, Patricio

2017-11-15

The purpose of this paper is to provide a review of the use of ketamine as an antidepressant for treatment-resistant depression (TRD) in the geriatric population. Available treatment options for late-life treatment-resistant depression are limited and include electroconvulsive therapy and transcranial magnetic stimulation as well as possible pharmacologic augmentation. Ketamine has been shown to be a promising treatment in TRD; however, data regarding the use of ketamine in the elderly includes only five case reports. We discuss the use of ketamine for late-life TRD and present two cases where ketamine led to a significant and sustained improvement in depressive symptoms. Ketamine is a promising treatment for geriatric patients with TRD. Further studies in the elderly will provide valuable insights into the use of ketamine for a population much in need of safe and effective treatments for TRD.

Case Report: Diabetic Foot Ulcer Infection Treated with Topical Compounded Medications.

PubMed

Agbi, Kelechi E; Carvalho, Maria; Phan, Ha; Tuma, Cristiane

2017-01-01

An adult diabetic male with three toes amputated on his right foot presented with an ulcer infection on his left foot, unresponsive to conventional antifungal oral medication for over two months. The ulcerated foot wound had a large impairment on the patient's quality of life, as determined by the Wound-QoL questionnaire. The compounding pharmacist recommended and the physician prescribed two topical compounded medicines, which were applied twice a day, free of charge at the compounding pharmacy. The foot ulcer infection was completely resolved following 13 days of treatment, with no longer any impairment on the patient's quality of life. This scientific case study highlights the value of pharmaceutical compounding in current therapeutics, the importance of the triad relationship, and the key role of the compounding pharmacist in diabetes care. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

The use of recombinant factor VIIa in a patient with Noonan syndrome and life-threatening bleeding.

PubMed

Tofil, Nancy M; Winkler, Margaret K; Watts, Raymond G; Noonan, Jacqueline

2005-05-01

To present a case report of a patient with Noonan syndrome who developed life-threatening gastrointestinal bleeding shortly after cardiac surgery that was successfully treated with recombinant factor VIIa. Case report. Pediatric intensive care unit of a children's hospital. Ten-month-old with Noonan syndrome and massive gastrointestinal bleeding resulting in severe hypovolemic shock. Recombinant factor VIIa was used in this patient's severe bleeding associated with Noonan syndrome after no other supportive measures were successful. Recombinant Factor VIIa significantly decreased the patient's bleeding and allowed his hypovolemic shock to improve. Ultimately, the patient made a complete recovery. Noonan syndrome has a constellation of both cardiac and noncardiac malformations including an increased risk of bleeding, and recombinant factor VIIa is an important agent in the treatment of significant bleeding.

Applied psychophysiology, clinical biofeedback, and rehabilitation neuropsychology: a case study--mild traumatic brain injury and post-traumatic stress disorder.

PubMed

Ackerman, Rosalie J

2004-11-01

This article presents a case study of a 39-year-old European American married woman with a history of child and adolescent incest,marital rape, and physical abuse from her husband for more than 10 years. She was referred to a pain clinic for treatment of headaches and Tourette's syndrome. The client was evaluated with the Ackerman-Banks Neuropsychological Rehabilitation Battery to identify neuropsychological strengths and weaknesses. The Vulnerability to Stress Audit was used to identify life events that were positively and negatively influencing her life. The client was treated for mild traumatic brain injury, post-traumatic stress disorder,cognitive difficulties, impulsivity, confabulation, low frustration tolerance, and inability to evaluate and make decisions about socially appropriate behaviors. Treatment involved traditional psychotherapy, hypnosis, cognitive rehabilitation, biofeedback training, electromyography, finger temperature, and blood pressure.

Case management in oncology rehabilitation (CAMON): the effect of case management on the quality of life in patients with cancer after one year of ambulant rehabilitation. a study protocol for a randomized controlled clinical trial in oncology rehabilitation.

PubMed

Bachmann-Mettler, Irene; Steurer-Stey, Claudia; Senn, Oliver; Wang, Mathyas; Bardheci, Katarina; Rosemann, Thomas

2011-04-28

Cancer diseases and their therapies have negative effects on the quality of life. The aim of this study is to assess the effectiveness of case management in a sample of oncological outpatients with the intent of rehabilitation after cancer treatment. Case management wants to support the complex information needs of the patients in addition to the segmented structure of the health care system. Emphasis is put on support for self-management in order to enhance health - conscious behaviour, learning to deal with the burden of the illness and providing the opportunity for regular contacts with care providers. We present a study protocol to investigate the efficacy of a case management in patients following oncology rehabilitation after cancer treatment. The trial is a multicentre, two-arm randomised controlled study. Patients are randomised parallel in either 'usual care' plus case management or 'usual care' alone. Patients with all types of cancer can be included in the study, if they have completed the therapy with chemo- and/or radiotherapy/surgery with curative intention and are expected to have a survival time >1 year. To determine the health-related quality of life the general questionnaire FACT G is used. The direct correlation between self-management and perceived self-efficacy is measured with the Jerusalem & Schwarzer questionnaire. Patients satisfaction with the care received is measured using the Patient Assessment of Chronic Illness Care 5 As (PACIC-5A). Data are collected at the beginning of the trial and after 3, 6 and 12 months. The power analysis revealed a sample size of 102 patients. The recruitment of the centres began in 2009. The inclusion of patients began in May 2010. Case management has proved to be effective regarding quality of life of patients with chronic diseases. When it comes to oncology, case management is mainly used in cancer treatment, but it is not yet common in the rehabilitation of cancer patients. Case management in oncology rehabilitation is not well-established in Switzerland. A major challenge of the study will therefore probably be the recruitment of the patients due to the physicians' and patients' scarcely existing awareness of this issue. Trial registrationISRCTN41474586

Astrobiology: The Case for Venus

NASA Technical Reports Server (NTRS)

Landis, Geoffrey A.

2003-01-01

The scientific discipline of astrobiology addresses one of the most fundamental unanswered questions of science: are we alone? Is there life elsewhere in the universe, or is life unique to Earth? The field of astrobiology includes the study of the chemical precursors for life in the solar system; it also includes the search for both presently existing life and fossil signs of previously existing life elsewhere in our own solar system, as well as the search for life outside the solar system. Two of the promising environments within the solar system being currently considered are the surface of the planet Mars, and the hypothesized oceans underneath the ice covering the moon Europa. Both of these environments differ in several key ways from the environments where life is found on Earth; the Mars environment in most places too cold and at too low pressure for liquid water to be stable, and the sub-ice environment of Europa lacking an abundance of free energy in the form of sunlight. The only place in the solar system where we know that life exists today is the Earth. To look for life elsewhere in the solar system, one promising search strategy would be to find and study the environment in the solar system with conditions that are most similar to the environmental conditions where life thrives on the Earth. Specifically, we would like to study a location in the solar system with atmospheric pressure near one bar; temperature in the range where water is liquid, 0 to 100 C; abundant solar energy; and with the primary materials required for life, carbon, oxygen, nitrogen, and hydrogen, present. Other than the surface of the Earth, the only other place where these conditions exist is the atmosphere of Venus, at an altitude of about fifty kilometers above the surface.

On the ability of plant life-history strategies to shape bio-geomorphologic interactions

NASA Astrophysics Data System (ADS)

Schwarz, Christian; van Belzen, Jim; Zhu, ZhenChang; Bouma, Tjeerd; van de Koppel, Johan; Gourgue, Olivier; Temmerman, Stijn

2017-04-01

Previous work studying bio-geomorphologic interactions in intertidal habitats underlined the importance of wetland vegetation shaping their environment (e.g. tidal channel networks). Up to this point the potential of wetland vegetation to shape their environment was linked to their physical plant properties, such as stiffness, stem diameter or stem density. However the effect of life-history strategies, i.e. the mode of plant proliferation such as sexual reproduction from seeds, non-sexual lateral expansion or a combination of the former two was hitherto ignored. We present numerical experiments based on a wetland ecosystem present in the Western Scheldt Estuary (SW, the Netherlands) showing the importance of life-history strategies shaping bio-geomorphologic interactions. We specifically compare two extremes in life-history strategies, (1) one species solely establishing from seeds and relying on their mass recruitment (Salicornia europea); And a second species (Spartina anglica) which relies on a mixed establishment strategy consisting of seed dispersal and asexual lateral expansion through tillering, with a very low seed recruitment success per year. Based on conducted numerical experiments using TELEMAC2D we show that the Spartina-case facilitates relative low channel densities with pronounced channel networks, whereas the Salicornia-case favors high channel densities with less pronounced intertidal channels. The conducted numerical experiments are the first indication showing that plant proliferation strategies exert a major control on emerging patterns in bio-geomorphologic systems. This provides a deeper understanding in the constraining factors and dynamics shaping the emergence and resilience of bio-geomorphologic systems.

Timing and documentation of key events in neonatal resuscitation.

PubMed

Heathcote, Adam Charles; Jones, Jacqueline; Clarke, Paul

2018-04-30

Only a minority of babies require extended resuscitation at birth. Resuscitations concerning babies who die or who survive with adverse outcomes are increasingly subject to medicolegal scrutiny. Our aim was to describe real-life timings of key resuscitation events observed in a historical series of newborns who required full resuscitation at birth. Twenty-seven babies born in our centre over a 10-year period had an Apgar score of 0 at 1 min and required full resuscitation. The median (95% confidence interval) postnatal age at achieving key events were commencing cardiac compressions, 2.0 (1.5-4.0) min; endotracheal intubation, 3.8 (2.0-6.0) min; umbilical venous catheterisation 9.0 (7.5-12.0) min; and administration of first adrenaline dose 10.0 (8.0-14.0) min. The wide range of timings presented from real-life cases may prove useful to clinicians involved in medical negligence claims and provide a baseline for quality improvements in resuscitation training. What is Known: • Only a minority of babies require extended resuscitation at birth; these cases are often subject to medicolegal interrogation • Timings of key resuscitation events are poorly described and documentation of resuscitation events is often lacking yet is open to medicolegal scrutiny What is New: • We present a wide range of real-life timings of key resuscitation events during the era of routine newborn life support training • These timings may prove useful to clinicians involved in medical negligence claims and provide a baseline for quality improvements in resuscitation training.

Ares V an Enabling Capability for Future Space Astrophysics Missions

NASA Technical Reports Server (NTRS)

Stahl, H. Philip

2007-01-01

The potential capability offered by an Ares V launch vehicle completely changes the paradigm for future space astrophysics missions. This presentation examines some details of this capability and its impact on potential missions. A specific case study is presented: implementing a 6 to 8 meter class monolithic UV/Visible telescope at an L2 orbit. Additionally discussed is how to extend the mission life of such a telescope to 30 years or longer.

Continent vesicovaginal fistula

PubMed Central

de Toledo, Luís Gustavo Morato; Santos, Victor Espinheira; Maron, Paulo Eduardo Gourlat; Vedovato, Bruno César; Fucs, Moacyr; Perez, Marjo Deninson Cardenuto

2013-01-01

ABSTRACT Vesicovaginal fistula is an abnormal communication between the bladder and vagina and represents the most frequent type of fistula in the urinary tract. The most common cause in Brazil is iatrogenic fistula, secondary to histerectomia. Classically these women present continuous urinary leakage from the vagina and absence of micturition, with strong negative impact on their quality of life. We present a case of totally continent vesicovaginal fistula, with a follow-up of 11 years with no complications. PMID:23579756

Dance as a Treatment Approach with a Multidisabled Child: Implications for School Counseling.

ERIC Educational Resources Information Center

Lasseter, Jan; And Others

1989-01-01

Describes dance therapy with multidisabled children. Presents case study involving girl with cerebral palsy, mental retardation, and emotional problems with goal of helping her adjust to everyday life and function as nearly as possible as a normal individual. Recommends common movements be combined extemporaneously or in cooperation with a…

49 CFR 260.23 - Form and content of application generally.

Code of Federal Regulations, 2010 CFR

2010-10-01

... opinion; in the case of leased equipment to be rehabilitated or improved with the proceeds of the... analyses and studies that have been performed to determine present and future demand for rail services or... other conditions that have caused or may cause serious injury or loss of life to the public or...

A Change of Administration: A Significant Organizational Life Event.

ERIC Educational Resources Information Center

Stine, Deborah E.

The case study presented in this paper illustrates how the succession process for principals is similar to that described by Gabarro in his study of corporate succession. Leader succession involves five major stages: (1) taking hold; (2) immersion; (3) reshaping; (4) consolidation; and (5) refinement. Success most frequently occurs in conjunction…

Wittgenstein's Contextualist Approach to Judging "Sound" Teaching: Escaping Enthrallment in Criteria-Based Assessments

ERIC Educational Resources Information Center

Stickney, Jeff Alan

2009-01-01

Comparing the early, analytic attempt to define "sound" teaching with the current use of criteria-based rating schemes, Jeff Stickney turns to Wittgenstein's holistic, contextualist approach to judging teaching against its complex "background" within our "form of life." To exemplify this approach, Stickney presents cases of classroom practice…

Exoplanet environments to harbour extremophile life

NASA Astrophysics Data System (ADS)

Janot-Pacheco, Eduardo; Lage, Claudia A. S.; Lima, Ivan G. P.

2010-02-01

In this contribution, we estimate the temperature at the surface of known exoplanets and of their putative satellites for two albedo extreme cases (Venus and Mars) and present a selection of extremophiles living on Earth that can live under those conditions. We examine also the possibility of survival of microorganisms in planetary systems of variable stars.

Long-Range Planning: A Case Study.

ERIC Educational Resources Information Center

Vance, Carmen L.; And Others

1987-01-01

Describes the use of one model to guide the long-range planning process of the Department of Residential Life, within the Division of Student Affairs and Services, at the University of Connecticut. Suggestions derived from the use of the model over a three-year planning cycle are presented for other housing officers to consider. (NB)

Marasmus or Recovery? The Effects of Cutbacks in Federal Agencies.

ERIC Educational Resources Information Center

Rubin, Irene S.

1984-01-01

Based on case study data from five federal agencies, a tentative theoretical model of the life cycle of federal agencies is presented. It is concluded that for most agencies, decline, once begun, will be continuous, but for a few the hope of congressional rescue may provide motivation for improved management. (Author/RM)

Anxiety Disorders.

ERIC Educational Resources Information Center

Dickey, Marilyn

Anxiey, in general, helps one to cope. It rouses a person to action and gears one up to face a threatening situation. It makes students study harder for exams, and keeps presenters on their toes when making speeches. But an anxiety disorder can prevent one from coping and can disrupt daily life. Anxiety disorders are not just a case of…

Daddy's Gone to Colorado: Male-Staffed Child Care for Father-Absent Boys.

ERIC Educational Resources Information Center

Brody, Steve

1978-01-01

The article presents the goals, methods, and case examples of The Nutury, a predominantly male-staffed child care center serving single-parent children. The primary goal is to provide consistent relationships with men for children without a male model in their home. Clinical observations reveal positive life-styles and attitudes. (LPG)

Evaluation of the quality of life in subjects with a history of severe anaphylactic reaction to the Hymenoptera venom.

PubMed

Nowak, Natalia; Bazan-Socha, Stanisława; Pulka, Grażyna; Pełka, Karolina; Latra, Paulina

2015-01-01

Sensitization to the Hymenoptera venom is one of the main causes of anaphylaxis in Poland. Venom immunotherapy is the only effective treatment in such cases. Comprehensive patient care includes also education. The aim of our study was to assess the state of knowledge and to evaluate the quality of life and the anxiety level in patients allergic to the Hymenoptera venom after anaphylactic reaction. The survey was carried out in the period of the insects flight in 61 adult subjects (35 wasp and 26 bee allergic), using a validated Vespid Allergy Quality of Life Questionnaire (VQLQ), Hospital Anxiety and Depression Scale, and subjective assessment of anxiety level. The majority of respondents received venom immunotherapy. Sensitized to the wasp venom had significantly impaired quality of life (VQLQ score) as compared to the bee venom allergic (p = 0.014). The intensity of anxiety decreased with the duration of immunotherapy (p = 0.01). The majority of subjects knew how to recognize and treat anaphylaxis, but only 8% employed an identification card and about 50% implemented rules of the pre-exposition prophylaxis. History of a severe anaphylaxis to the Hymenoptera venom affected the quality of life. Venom immunotherapy reduced anxiety. We hope that presented surveys and their results might be useful in qualifying for immunotherapy in clinically uncertain cases.

Stressful life events and catechol-O-methyl-transferase (COMT) gene in bipolar disorder.

PubMed

Hosang, Georgina M; Fisher, Helen L; Cohen-Woods, Sarah; McGuffin, Peter; Farmer, Anne E

2017-05-01

A small body of research suggests that gene-environment interactions play an important role in the development of bipolar disorder. The aim of the present study is to contribute to this work by exploring the relationship between stressful life events and the catechol-O-methyl-transferase (COMT) Val 158 Met polymorphism in bipolar disorder. Four hundred eighty-two bipolar cases and 205 psychiatrically healthy controls completed the List of Threatening Experiences Questionnaire. Bipolar cases reported the events experienced 6 months before their worst depressive and manic episodes; controls reported those events experienced 6 months prior to their interview. The genotypic information for the COMT Val 158 Met variant (rs4680) was extracted from GWAS analysis of the sample. The impact of stressful life events was moderated by the COMT genotype for the worst depressive episode using a Val dominant model (adjusted risk difference = 0.09, 95% confidence intervals = 0.003-0.18, P = .04). For the worst manic episodes no significant interactions between COMT and stressful life events were detected. This is the first study to explore the relationship between stressful life events and the COMT Val 158 Met polymorphism focusing solely on bipolar disorder. The results of this study highlight the importance of the interplay between genetic and environmental factors for bipolar depression. © 2017 Wiley Periodicals, Inc.

A case of ulcerative colitis complicated with bronchiolitis obliterans organizing pneumonia (BOOP) and air leak syndrome.

PubMed

Aydoğdu, Müge; Gürsel, Gül; Özyilmaz, Ezgi; Akyürek, Nalan; Memış, Leyla

2012-01-01

Extraintestinal manifestations of inflammatory bowel diseases are well recognized and mainly affect the joints, skin, liver, and eyes; however, clinically significant pulmonary involvement is very rare. Early identification of pulmonary involvement is important and will be life-saving. We report herein a case of an ulcerative colitis patient, presenting with acute respiratory distress syndrome and bilateral recurring pneumothorax, pneumomediastinum and subcutaneous emphysema, i.e., air leak syndrome. He was diagnosed with open lung biopsy as bronchiolitis obliterans organizing pneumonia most probably due to viral etiology and responded well to steroid therapy, with almost complete resolution of radiographic and clinical findings. In inflammatory bowel disease patients, bronchiolitis obliterans organizing pneumonia developing due to viral or fungal infectious etiology or due to the inflammatory bowel disease itself may progress to acute respiratory distress syndrome and may present with air leak syndrome. Early detection is important and life-saving, since bronchiolitis obliterans organizing pneumonia often responds well to steroid treatment provided an infectious etiology has been excluded or adequate antimicrobial therapy has already been initiated.

Bilateral Vocal Cord Palsy with Arnold Chiari Malformation: A Rare Case Series

PubMed Central

Arora, Nikhil; Meher, Ravi; Bhargava, Eishaan K.

2016-01-01

Stridor in paediatric age group is not an uncommon presentation to the ENT emergency. The range of differential diagnosis is vast. The presentation may vary from noisy breathing to severe respiratory distress and apnea. Early and meticulous diagnosis is crucial for the management as the condition may be life threatening. We report a rare case series of 3 infants with Arnold Chiari Malformation who presented to the hospital with stridor and were diagnosed with bilateral vocal cord palsy. These 3 infants had similar underlying neurological condition with hydrocephalus and raised intracranial pressure. Chiari malformation is the one of the most common congenital central nervous system anomaly associated with bilateral vocal cord paralysis. However, the presentation is rare. This article, thus, emphasizes the significance of early diagnosis and immediate management of this condition. PMID:27790480

Cardiovascular manifestations of phaeochromocytoma.

PubMed

Prejbisz, Aleksander; Lenders, Jacques W M; Eisenhofer, Graeme; Januszewicz, Andrzej

2011-11-01

Clinical expression of phaeochromocytoma may involve numerous cardiovascular manifestations, but usually presents as sustained or paroxysmal hypertension associated with other signs and symptoms of catecholamine excess. Most of the life-threatening cardiovascular manifestations of phaeochromocytoma, such as hypertensive emergencies, result from a rapid and massive release of catecholamines from the tumour. More rarely, patients with phaeochromocytoma present with low blood pressure or even shock that may then precede multisystem crisis. Sinus tachycardia, with palpitations as the presenting symptom, is the most prevalent abnormality of cardiac rhythm in phaeochromocytoma, but tumours can also be associated with more serious ventricular arrhythmias or conduction disturbances. Reversible dilated or hypertrophic cardiomyopathy are well established cardiac manifestations of phaeochromocytoma, with more recent attention to an increasing number of cases with Takotsubo cardiomyopathy. This review provides an update on the cause, clinical presentation and treatment of the cardiovascular manifestations of phaeochromocytoma. As the cardiovascular complications of phaeochromocytoma can be life-threatening, all patients who present with manifestations that even remotely suggest excessive catecholamine secretion should be screened for the disease.

Constructing an Interdisciplinary Context for Definition of Life

NASA Astrophysics Data System (ADS)

Tsokolov, S. A.

One of the main problems in understanding life is that that lifecannot be defined as a self-evident phenomenon. Instead, definitions of life inevitably depend on the context: social, ethical, theological, and scientific. Even in a purely scientific context, different scientific disciplines and approaches provide a variety of criteria related to life. My intention is to define life in an interdisciplinary context, where the class of living systems can be presented as a particular case in series of systems: physical, chemical, prebiotic, biotic, ecological, social, cognitive, etc. related by a universal principle. To this end, the first step in establishing general criteria for life is to define the essential features of life processes. The very functional principle of living beings is circular organization (feedback circularity) embedded on different levels of organization: molecular, genetic, cellular, neural, behavioural, mental, and social. Understanding that the degree of system's wholeness, i.e. degree of feedback net integration can serve as a primary parameter, we can in principle construct an interdisciplinary context in which different systems including living beings can be analyzed, defined and compared.

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.

Temporal Visualization for Legal Case Histories.

ERIC Educational Resources Information Center

Harris, Chanda; Allen, Robert B.; Plaisant, Catherine; Shneiderman, Ben

1999-01-01

Discusses visualization of legal information using a tool for temporal information called "LifeLines." Explores ways "LifeLines" could aid in viewing the links between original case and direct and indirect case histories. Uses the case of Apple Computer, Inc. versus Microsoft Corporation and Hewlett Packard Company to…

Implications of the Schiavo Case for Understanding Family Caregiving Issues at the End of Life

ERIC Educational Resources Information Center

Roscoe, Lori A.; Osman, Hana; Haley, William E.

2006-01-01

The case of Mrs. Terri Schiavo illustrates common themes in family caregiving at the end of life but is distinctive from most family caregiving situations in other ways. As occurred in Mrs. Schiavo's case, family members do act as both caregivers and decisionmakers for their loved ones at the end of life, often without the benefit of written…

A Study of Manifestations of Extrapulmonary Tuberculosis in the ENT Region.

PubMed

Akkara, Stani Ajay; Singhania, Ankit; Akkara, Ajay George; Shah, Arti; Adalja, Mayur; Chauhan, Nirali

2014-01-01

Though tuberculosis (TB) primarily affects lungs, extra pulmonary tuberculosis (EPTB) is also common, especially in high disease load areas and mainly manifests in ENT region. To study the different manifestations of tuberculosis in ENT region in terms of presentation, disease process, treatment and outcome. Records of patients diagnosed and treated for TB in the ENT region at our institute's DOTS centre for a two and half year period were analysed for presenting complaints, examination findings, diagnostic features, treatment modes and outcome. Out of 3750 cases diagnosed as TB, 230 had EPTB. 211 cases had ENT manifestations. Majority of the cases were male and in the fourth decade of life. Commonest manifestation was cervical lymphadenopathy with 201 cases. Fine needle aspiration cytology was mostly diagnostic and category I anti TB treatment (AKT) achieved cure. The six cases of TB otitis media presented with ear discharge, sometimes bloody and had varied tympanic membrane findings and facial palsy in two cases with different types and degrees of hearing loss. Diagnosis was confirmed by histology of tissue removed during surgery. Patients completed category I AKT. Hearing and facial palsy did not improve. There were three cases of TB laryngitis and one of nasal TB both of which were confirmed by tissue diagnosis and responded well to AKT. Most of the results in the present study conform to findings of other studies. High degree of suspicion is necessary to reach diagnosis. Category I AKT is effective. Some cases may require surgery.

[Life-threatening hypophosphatemia in 74-year-old woman with recurrent pneumonia and progressive muscular atrophy].

PubMed

Shahnazaryan, Urszula; Popow, Michał; Rosłon, Marek

2016-02-01

Although hypophosphatemia can be a serious threat to health and life, it is a problem rarely taken into consideration in the differential diagnosis in the current clinical practice. The aim of the study was to present the description of hypophosphatemia issues in the context of the threat they may pose to the health and life when undiagnosed. 74-year-old internal charged woman , with progressive destruction for a few years, recurrent pneumonia, and a compression fracture of the spine, was admitted to hospital because of fainting and general deterioration. In the course of the performed diagnostics primary hyperparathyroidism was diagnosed with pre-existing inadequate severe hypophosphatemia. Because the presented clinical picture, only partially tie in symptomatology of primary hiperparathyroidism, the diagnostic process was targeted to search for other causes of both hypophosphatemia and symptoms reported by the patient. Finally, in addition to PHPT ( primary hyperparathyroidism) also vitamin D deficiency and tuberculosis was found. The fact that the treatment of infectious disease led to the phosphatemia standardization , and thus to significant improvement of the overall demonstrates, shows the significant contribution of tuberculosis in the pathogenesis of phosphate deficiency in this case. Our case is an example of confirming the need for a thorough and multidirectional analysis of the clinical picture, which is a prerequisite for a correct diagnosis. © 2016 MEDPRESS.

The bioethics of separating conjoined twins in plastic surgery.

PubMed

Lee, Michelle; Gosain, Arun K; Becker, Devra

2011-10-01

The incidence of craniopagus twins approximates four to six per 10 million births. Although rare, surgical separation of conjoined twins poses significant technical and ethical challenges. The present report uses the case of craniopagus twins AD and TD to examine the bioethical issues faced by a multidisciplinary medical team in planning the separation of craniopagus twins. AD and TD are craniopagus twins conjoined at the head. TD's head is conjoined to the back of AD's head. Neurologically, AD has the dominant cerebral circulation. TD has two normal kidneys, whereas AD has none. AD depends on TD's renal function and, on separation, will require either a kidney transplant or lifelong dialysis. This case report reviews one approach to analyzing and solving complex ethical dilemmas in pediatric plastic surgery. The principles reviewed are (1) autonomy and informed consent, focusing especially on the role of children in the informed consent process; (2) beneficence and nonmaleficence, two intricately intertwined principles because separation could potentially cause irreversible harm to one twin while improving the quality of life for the other (as separation is not a life-saving procedure, is it ethical to perform a procedure with unknown surgical risk to improve children's quality of life?); and (3) justice (is it fair to allocate excessive medical resources for the twins' separation?). The present report explores the ethics behind such decisions with respect to the separation of conjoined twins.

The Three Domains of Conservation Genetics: Case Histories from Hawaiian Waters

PubMed Central

2016-01-01

The scientific field of conservation biology is dominated by 3 specialties: phylogenetics, ecology, and evolution. Under this triad, phylogenetics is oriented towards the past history of biodiversity, conserving the divergent branches in the tree of life. The ecological component is rooted in the present, maintaining the contemporary life support systems for biodiversity. Evolutionary conservation (as defined here) is concerned with preserving the raw materials for generating future biodiversity. All 3 domains can be documented with genetic case histories in the waters of the Hawaiian Archipelago, an isolated chain of volcanic islands with 2 types of biodiversity: colonists, and new species that arose from colonists. This review demonstrates that 1) phylogenetic studies have identified previously unknown branches in the tree of life that are endemic to Hawaiian waters; 2) population genetic surveys define isolated marine ecosystems as management units, and 3) phylogeographic analyses illustrate the pathways of colonization that can enhance future biodiversity. Conventional molecular markers have advanced all 3 domains in conservation biology over the last 3 decades, and recent advances in genomics are especially valuable for understanding the foundations of future evolutionary diversity. PMID:27001936

Understanding the life cycle surface land requirements of natural gas-fired electricity

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

Jordaan, Sarah M.; Heath, Garvin A.; Macknick, Jordan

The surface land use of fossil fuel acquisition and utilization has not been well characterized, inhibiting consistent comparisons of different electricity generation technologies. We present a method for robust estimation of the life cycle land use of electricity generated from natural gas through a case study that includes inventories of infrastructure, satellite imagery and well-level production. Approximately 500 sites in the Barnett Shale of Texas were sampled across five life cycle stages (production, gathering, processing, transmission and power generation). Total land use (0.62 m 2 MWh -1, 95% confidence intervals +/-0.01 m 2 MWh -1) was dominated by midstream infrastructure,more » particularly pipelines (74%). These results were sensitive to power plant heat rate (85-190% of the base case), facility lifetime (89-169%), number of wells per site (16-100%), well lifetime (92-154%) and pipeline right of way (58-142%). When replicated for other gas-producing regions and different fuels, our approach offers a route to enable empirically grounded comparisons of the land footprint of energy choices.« less

Understanding the life cycle surface land requirements of natural gas-fired electricity

DOE PAGES

Jordaan, Sarah M.; Heath, Garvin A.; Macknick, Jordan; ...

2017-10-02

The surface land use of fossil fuel acquisition and utilization has not been well characterized, inhibiting consistent comparisons of different electricity generation technologies. We present a method for robust estimation of the life cycle land use of electricity generated from natural gas through a case study that includes inventories of infrastructure, satellite imagery and well-level production. Approximately 500 sites in the Barnett Shale of Texas were sampled across five life cycle stages (production, gathering, processing, transmission and power generation). Total land use (0.62 m 2 MWh -1, 95% confidence intervals +/-0.01 m 2 MWh -1) was dominated by midstream infrastructure,more » particularly pipelines (74%). These results were sensitive to power plant heat rate (85-190% of the base case), facility lifetime (89-169%), number of wells per site (16-100%), well lifetime (92-154%) and pipeline right of way (58-142%). When replicated for other gas-producing regions and different fuels, our approach offers a route to enable empirically grounded comparisons of the land footprint of energy choices.« less

Characterizing Exoplanet Habitability with Emission Spectroscopy

NASA Astrophysics Data System (ADS)

Robinson, Tyler

2018-01-01

Results from NASA’s Kepler mission and other recent exoplanet surveys have demonstrated that potentially habitable exoplanets are relatively common, especially in the case of low-mass stellar hosts. The next key question that must be addressed for such planets is whether or not these worlds are actually habitable, implying they could sustain surface liquid water. Only through investigations of the potential habitability of exoplanets and through searches for biosignatures from these planets will we be able to understand if the emergence of life is a common phenomenon in our galaxy. Emission spectroscopy for transiting exoplanets (sometimes called secondary eclipse spectroscopy) is a powerful technique that future missions will use to study the atmospheres and surfaces of worlds orbiting in the habitable zones of nearby, low-mass stars. Emission observations that span the mid-infrared wavelength range for potentially habitable exoplanets provide opportunities to detect key habitability and life signatures, and also allow observers to probe atmospheric and surface temperatures. This presentation will outline the case for using emission spectroscopy to understand if an exoplanet can sustain surface liquid water, which is believed to be a critical precursor to the origin of life.

Understanding the life cycle surface land requirements of natural gas-fired electricity

NASA Astrophysics Data System (ADS)

Jordaan, Sarah M.; Heath, Garvin A.; Macknick, Jordan; Bush, Brian W.; Mohammadi, Ehsan; Ben-Horin, Dan; Urrea, Victoria; Marceau, Danielle

2017-10-01

The surface land use of fossil fuel acquisition and utilization has not been well characterized, inhibiting consistent comparisons of different electricity generation technologies. Here we present a method for robust estimation of the life cycle land use of electricity generated from natural gas through a case study that includes inventories of infrastructure, satellite imagery and well-level production. Approximately 500 sites in the Barnett Shale of Texas were sampled across five life cycle stages (production, gathering, processing, transmission and power generation). Total land use (0.62 m2 MWh-1, 95% confidence intervals ±0.01 m2 MWh-1) was dominated by midstream infrastructure, particularly pipelines (74%). Our results were sensitive to power plant heat rate (85-190% of the base case), facility lifetime (89-169%), number of wells per site (16-100%), well lifetime (92-154%) and pipeline right of way (58-142%). When replicated for other gas-producing regions and different fuels, our approach offers a route to enable empirically grounded comparisons of the land footprint of energy choices.

Assessing the environmental impacts of freshwater consumption in LCA.

PubMed

Pfister, Stephan; Koehler, Annette; Hellweg, Stefanie

2009-06-01

A method for assessing the environmental impacts of freshwater consumption was developed. This method considers damages to three areas of protection: human health, ecosystem quality, and resources. The method can be used within most existing life-cycle impact assessment (LCIA) methods. The relative importance of water consumption was analyzed by integrating the method into the Eco-indicator-99 LCIA method. The relative impact of water consumption in LCIA was analyzed with a case study on worldwide cotton production. The importance of regionalized characterization factors for water use was also examined in the case study. In arid regions, water consumption may dominate the aggregated life-cycle impacts of cotton-textile production. Therefore, the consideration of water consumption is crucial in life-cycle assessment (LCA) studies that include water-intensive products, such as agricultural goods. A regionalized assessment is necessary, since the impacts of water use vary greatly as a function of location. The presented method is useful for environmental decision-support in the production of water-intensive products as well as for environmentally responsible value-chain management.

Diagnostic tools of early brain disturbances in an asymptomatic neonate with maple syrup urine disease.

PubMed

Terek, Demet; Koroglu, Ozge; Yalaz, Mehmet; Gokben, Sarenur; Calli, Cem; Coker, Mahmut; Kultursay, Nilgun

2013-08-01

Maple syrup urine disease (MSUD) is a rare inherited metabolic disorder resulting from the defective activity of branched-chain 2-ketoacid dehydrogenase complex. Routine screening of newborn with tandem mass spectroscopy on the third day of life may detect elevated branched-chain amino acids in blood before the appearance of encephalopathic symptoms in MSUD cases. If undiagnosed by such a routine screening test, patients often present with encephalopathy and seizures. Clinical neurologic examination is supplemented by electroencephalography and imaging. Here, we report abnormal amplitude-integrated electroencephalography, electroencephalography, magnetic resonance imaging, and magnetic resonance imaging spectroscopy findings in a neurologically asymptomatic male newborn who was diagnosed with MSUD at the third week of life. These neurologic disturbances disappeared at the fourth month of life with appropriate special diet. Therefore, even in already asymptomatic cases, early neurologic deterioration of brain metabolism and structure can be detected with these early laboratory findings, indicating the importance of early diagnosis and management. Patients may also benefit from these investigations during the follow-up period. Georg Thieme Verlag KG Stuttgart · New York.

The Elements of a Good Case

ERIC Educational Resources Information Center

Fossey, Richard; Crow, Gary M.

2011-01-01

In the broad sense, case teaching is an ancient pedagogy. Since time began, teachers have taught other people by drawing on stories from real-life experiences. In a way, then, telling stories taken from real life can be seen as case teaching. Case writing and case teaching in a college or university setting, however, require specific research and…

[Successful electroconvulsive therapy of Cotard syndrome with bitemporal hypoperfusion].

PubMed

Lohmann, T; Nishimura, K; Sabri, O; Klosterkötter, J

1996-05-01

A case study is presented to illustrate a rare condition described by Cotard as "délire de négation". The central symptom is a nihilistic delusion with denial of one's own existence of oneself and that of the external world. In the present case, the syndrome became manifest as an escalation of a recurrent depressive disorder late in life. After initial resistance to therapy, the syndrome was successfully treated with electroconvulsive therapy. For the first time, we report the regional cerebral blood flow measured by 99mTc-HMPAO-SPECT before and after therapy. Before treatment, significant bitemporal hypoperfusion relative to the cerebellum was found, which was no longer demonstrable on remission.

Renal artery embolization in a child with delayed hemodynamic instability from penetrating knife wound.

PubMed

Barras, M; Pearson, E; Cousin, I; Le Rouzic, C; Thepaut, M; Gentric, J-C; Roue, J-M; Yevich, S; de Vries, P

2018-06-14

Penetrating laceration injury in the pediatric population may present as an acute or delayed life-threatening injury. Although emergent intra-arterial embolization is commonly utilized in adults, few cases have been reported for children. Surgical treatment for severe renal laceration injuries may require complete nephrectomy; an unfortunate outcome for a pediatric patient if a renal-preserving alternative is feasible. We present a case of penetrating renal laceration in a 10-year-old boy treated with intra-arterial embolization of the lacerated dominant renal artery and subsequent renal perfusion by an uninjured accessory renal artery allowing for renal preservation. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

An occult aldosterone-producing adenoma initially presenting as hyperosmolar hyperglycaemic state.

PubMed

Kuo, Feng-Chih; Hung, Yi-Jen; Hsieh, Chang-Hsun; Hsiao, Fone-Ching

2012-09-01

Aldosterone-producing adenoma (APA), one of the most common causes of primary hyperaldosteronism, is clinically characterized by hypertension, increased sodium retention, increased potassium excretion and altered glucose metabolism. APA can also manifest in the form of hyperosmolar hyperglycaemic state (HHS), which is a life-threatening acute diabetic complication. Infection and inadequate fluid replacement are the common precipitating and predisposing factors for the occurrence of HHS. Here, we report a case of occult APA with the initial presentation of HHS, in which an unusually rapid correction of diabetes was observed after correct diagnosis and surgical resection of the APA. To our knowledge, this is the first case with such manifestations and outcome.

Bladder perforation associated with hot tub.

PubMed

Kopp, Ryan P; Dato, Paul E; Sur, Roger L

2011-01-01

Bladder perforation is a rare and life-threatening event. Timely diagnosis may prevent further injury-related morbidity and mortality. Aim.  To present a case of bladder injury associated with masturbation in a hot tub. This report describes a case of bladder perforation in a 54-year-old female who presented to the emergency department 2 days after masturbation with a water jet. Following percutaneous drainage and intraoperative closure of the bladder, the patient was discharged on postoperative day four and has had no sequelae. Cross-sectional imaging and cystography can facilitate immediate diagnosis and expeditious treatment of bladder injury associated with masturbation in a hot tub. © 2010 International Society for Sexual Medicine.

[Localized purpura revealing vascular prosthetic graft infection].

PubMed

Boureau, A S; Lescalie, F; Cassagnau, E; Clairand, R; Connault, J

2013-07-01

Prosthetic graft infection after vascular reconstruction is a rare but serious complication. We report a case of infection occurring late after implantation of an iliofemoral prosthetic vascular graft. The Staphylococcus aureus infection was revealed by vascular purpura localized on the right leg 7 years after implantation of a vascular prosthesis. This case illustrates an uncommonly late clinical manifestation presenting as an acute infection 7 years after the primary operation. In this situation, the presentation differs from early infection, which generally occurs within the first four postoperative months. Diagnosis and treatment remain a difficult challenge because prosthetic graft infection is a potentially life-threatening complication. Morbidity and mortality rates are high. Here we detail specific aspects of the clinical and radiological presentation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Laparoscopic cholecystectomy in a patient with Steinert myotonic dystrophy. Case report.

PubMed

Agrusa, A; Mularo, S; Alessi, R; Di Paola, P; Mularo, A; Amato, G; Romano, G

2011-01-01

Myotonic dystrophy (MD) is a serious multi-systemic autosomal dominant disease. The estimated incidence is 1 in every 8000 births, with an estimated prevalence of between 2.1 and 14.3 cases per 100,000 inhabitants. Signs and symptoms vary from a severe form of congenital myopathy, present from birth and often fatal, to a classic form and a delayed form, which generally presents after the age of 50 and in which the only sign is a cataract and life expectancy is completely normal. We describe the clinical case of a 40-year-old woman with Steinert myotonic dystrophy who underwent laparoscopic cholecystectomy (under general anesthesia) for symptomatic gallbladder stones. The conduct of anesthesia in such patients must be carefully considered, as hypothermia, shivering, electrical and mechanical stimulation, and the drugs used can all trigger myotonia.

Beware Swan-Ganz complications. Perioperative management.

PubMed

Asteri, T; Tsagaropoulou, I; Vasiliadis, K; Fessatidis, I; Papavasi-Liou, E; Spyrou, P

2002-08-01

Since the introduction of the pulmonary artery catheter (PAC) in 1970 by Swan et al., various complications are recognized with the insertion and the use of Swan-Ganz catheter. We present two different cases with rare but life threatening complications which had been successfully managed. The first case is a carotid cannulation with an 8.5 Fr introducer sheath, in an attempt to insert a pulmonary catheter via the right internal jugular vein. Two weeks later, the patient was re-admitted to the hospital and when an arteriovenous fistulae (carotid artery-internal jugular vein) was diagnosed, he was treated surgically. The second case presents the rupture of the right atrium in the conjunction with the superior vena cava. This serious cardiac complication was developed during the floatation of the PAC and the lesion was repaired while the mitral valve replacement was in progress.

The Dubai Community Psychiatric Survey. IV. Life events, chronic difficulties and psychiatric morbidity.

PubMed

Bebbington, P; Hamdi, E; Ghubash, R

1998-10-01

The relationship between life events, chronic social difficulties and psychiatric morbidity was investigated in 297 women selected at random as part of the Dubai Community Psychiatric Survey. The PSE-ID-CATEGO system was used to identify psychiatric cases, based on an Index of Definition level of 5 or more. Life events in the 6-month period prior to illness or interview were elicited through the Life Events and Difficulties Schedule. Chronic difficulties were explored through direct questioning based on a list of possible problems. The study demonstrates a significant excess of marked and moderately threatening life events in acute cases of psychiatric disorder (50%) compared to chronic cases (16.7%) and non-cases (27.9%). The association was particularly marked for events in the 3-month period before the onset. Around 33% of psychiatric morbidity may be attributed to marked and moderately threatening life events. Rates for mild events were similar in the three groups of subjects. Subjects experiencing chronic social difficulties included a significantly higher proportion of cases (33.3%) than those who did not experience such difficulties (9.1%). The effect of chronic social difficulties was more pronounced than, and independent of, the effects of life events. There were no interactions between life events and vulnerability factors in their effect on psychiatric morbidity, although numbers were small. The results suggest that the overall influence of life events and chronic difficulties on psychiatric morbidity is commensurate with that in Western societies, despite the different coping traditions of Islam.

Complete body-neck torsion of the gallbladder: a case report.

PubMed

Pu, Ta-Wei; Fu, Chun-Yu; Lu, Huai-En; Cheng, Wei-Tung

2014-10-14

Gallbladder torsion is a rare, acute abdominal disease. It was first reported by Wendell in 1898. Since then, only 500 cases have been reported. Gallbladder torsion occurs in all age groups, although it usually appears in the latter stages of life. The occurrence ratio between women and men is 3:1. Most cases are diagnosed during surgery. The main treatment is surgical detorsion and cholecystectomy. Despite progress in radiologic imaging diagnosis, it is not easy to obtain a precise preoperative diagnosis of gallbladder torsion. In previous reports, only 9.8% of all gallbladder torsion cases were diagnosed preoperatively. We present a case of acute body-neck gallbladder torsion in an elderly man, and we review the radiologic findings of magnetic resonance imaging, computed tomography, and ultrasonography. The radiologic findings in the present case were helpful in obtaining a preoperative diagnosis of gallbladder torsion. The diagnosis was confirmed by T2-weighted magnetic resonance images, which showed an intra-gallbladder segment located between the body and neck of the gallbladder, with a notable crease within this segment.

Influence of Indoor Hygrothermal Conditions on Human Quality of Life in Social Housing.

PubMed

Soares, Sara; Fraga, Silvia; Delgado, Joao M P Q; Ramos, Nuno M M

2015-11-17

Modern societies spend most of their time indoors, namely at home, and the indoor environment quality turns out to be a crucial factor to health, quality of life and well-being of the residents. The present study aims to understand how indoor environment relates with quality of life and how improving housing conditions impacts on individuals' health. This study case will rely on the following assessments in both rehabilitated and non-rehabilitated social housing: i) field measurements, in social dwellings (namely temperature, relative humidity, carbon dioxide concentration, air velocity, air change rate, level of mould spores and energy consumption); ii) residents' questionnaires on social, demogaphic, behavioural, health characteristics and quality of life. Also, iii) qualitative interviews performed with social housing residents from the rehabilitated houses, addressing the self-perception of living conditions and their influence in health status and quality of life. All the collected information will be combined and analysed in order to achieve the main objective. It is expected to define a Predicted Human Life Quality (PHLQ) index, that combines physical parameters describing the indoor environment measured through engineering techniques with residents' and neighbourhood quality of life characteristics assessed by health questionnaires. Improvement in social housing should be related with better health indicators and the new index might be an important tool contributing to enhance quality of life of the residents. Significance for public healthThis study will contribute to understand how indoor environment relates with quality of life and how improving housing conditions impacts on individuals' health, in social housing neighbourhoods. As so, it is important to share the undertaken methodology carried out by a multidisciplinary team, in order to allow other researchers following comparable studies to adopt a similar approach. The case study results will allow to define building rehabilitation policies, improving residents' quality of life and adding great contribution to public health promotion.

[Neonatal purpura fulminans without sepsis due to a severe congenital protein C deficiency].

PubMed

Hmami, F; Cherrabi, H; Oulmaati, A; Bouabdallah, Y; Bouharrou, A

2015-10-01

Severe congenital protein C deficiency is a rare life-threatening coagulopathy. In the early hours of life, the neonate presents with extensive purpura fulminans and substantial skin necrosis contrasting with a preserved general state and a negative infectious exam. Disseminated intravascular coagulation sets in secondarily. Prenatal outset of thrombotic events is a rare situation that worsens the prognosis, especially protein C replacement in utero is not available. We report a case of a male newborn of consanguineous parents who were asymptomatic carriers of heterozygous protein C deficiency. This infant presented prenatal ventricular hemorrhage with hydrocephalus and rapidly extensive postnatal skin necrosis that was not regressive in spite of fresh frozen plasma administrated after 24h of life. Prenatal diagnosis, early recognition, and urgent therapy with protein C replacement and anticoagulant treatment are crucial to improve the prognosis, avoid further damage after delivery, and prevent the devastating consequences of severe protein C deficiency. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Nursing infant with acquired toxoplasmosis in the first months of life – a case report

PubMed Central

Rezende, Hanstter Hallison Alves; Storchilo, Heloísa Ribeiro; Lima, Jaqueline Ataíde Silva; Gomes, Antônio Roberto; Gomes, Taynara Cristina; de Souza, Jéssica Yonara; Avelino, Mariza Martins; do Amaral, Waldemar Naves; Vinaud, Marina Clare; de Castro, Ana Maria

2017-01-01

ABSTRACT Toxoplasmosis is caused by Toxoplasma gondii and the probability of this infection occurring in the first months of life is usually low because its transmission is related to eating habits. A 6-month-old nursing infant was diagnosed with acute toxoplasmosis, which was identified through anti- T. gondii IgA, IgM and low-avidity IgG serologic assays, polymerase chain reaction (PCR) and mouse bioassay test although its mother was seronegative. This serological divergence between mother and child led us to interview the mother regarding epidemiological factors. During this interview, she reported that she had given her 2-month-old baby a piece of undercooked beef to suck on. After some time, the baby presented fever and cervical lymphadenitis. This report emphasizes the importance of serological surveys of toxoplasmosis in nursing infants presenting with fever and lymphadenitis, in view of the possible acquisition of toxoplasmosis in the first months of life. PMID:28902298

Neurofibromatosis type 1 associated with vertebrobasilar dolichoectasia and pontine ischemic stroke.

PubMed

Giannantoni, Nadia Mariagrazia; Broccolini, Aldobrando; Frisullo, Giovanni; Pilato, Fabio; Profice, Paolo; Morosetti, Roberta; Di Lella, Giuseppe; Zampino, Giuseppe; Della Marca, Giacomo

2015-01-01

Neurofibromatosis type 1 (NF1) is a heterogeneous, common, neurocutaneous disorder presenting different complications during a life span, including cerebrovascular dysplasia. To our knowledge this is the first reported case of NF1 associated with vertebrobasilar dolichoectasia and pontine ischemic stroke. We describe a 57-year-old man with NF1 who presented an acute onset right-sided facial palsy and hemiplegia, dysarthria, and gait imbalance. Magnetic resonance imaging showed an acute left paramedian pontine infarct and a hypoplastic right vertebral artery. Brain Computed Tomography Angiography revealed the occurrence of vertebrobasilar dolichoectasia. Co-occurrence of VBD and NF1 might not be merely casual and it may significantly heighten the mortality rate in this multisystem disorder. We suggest a possible role of VBD in the genesis of our patient's clinical-radiological features and prompt the early detection of asymptomatic arteriopathy in individuals with NF1 in order to ameliorate patients' quality of life and life expectancy. Copyright © 2014 by the American Society of Neuroimaging.

Psychoanalytic reflections through the prism of September 11, 2001.

PubMed

Nunberg, Henry; Dahl, Kirsten; Herschkowitz, Samuel; Kantrowitz, Judy L; Neubauer, Peter; Orgel, Shelly; Basch, Samuel; Fogelman, Eva

2011-01-01

An important area for psychoanalytic study is the significance for intrapsychic life of important events taking place in the community of which analyst and analysand are a part. September 11, 2001 provides a vantage point for examination of questions that arise from looking at the interrelationship between current environment and intrapsychic life. Two cases are presented as a focus for discussing the interaction of the memorialized past and occurrences in present reality, the significance for an analysis of analyst and patient sharing the same experience, instigations to progress that a current event may provide and the ways in which communal experience influences intrapsychic life. As a part of the discussion, we ask as well in what ways a common experience may be shared, and the significance of radically different meanings that the same event may have for analyst and analysand. We also pose the question whether the differences and similarities, each in their own way, may serve as progressive forces in the analysis.

An analysis of isothermal, bithermal, and thermomechanical fatigue data of Haynes 188 and B1900+Hf by energy considerations

NASA Technical Reports Server (NTRS)

Radhakrishnan, V. M.; Kalluri, Sreeramesh; Halford, Gary R.

1993-01-01

The low-cycle fatigue behavior of Haynes 188 and B1900+Hf under isothermal, bithermal, and thermomechanical loading conditions has been analyzed on the basis of the total hysteresis energy expended per cycle. It has been observed that in the case of isothermal fatigue the total hysteresis energy correlates well with the fatigue life. In the case of bithermal 'high rate' fatigue, for a given total hysteresis energy per cycle, the fatigue life is equal to or greater than the isothermal fatigue life at the maximum bithermal temperature. This observation could be used to establish a lower bound on life for design purposes. In one case of bithermal creep-fatigue and in thermomechanical fatigue, the life is shorter than that corresponding to the isothermal life at the maximum temperature. The energy supplied, per se, may not always give a systematic correlation with the fatigue life in the cases where time-dependent creep and environmental effects are encountered. Thus, in bithermal creep-fatigue and thermomechanical fatigue, the role of creep and environment and their dependence on the energy supplied have to be properly accounted for before the energy term can be used for life prediction.

Life after acute fibrinous and organizing pneumonia: a case report of a patient 30 months after diagnosis and review of the literature.

PubMed

Kuza, Catherine; Matheos, Theofilos; Kathman, Deirdre; Heard, Stephen O

2016-02-01

Acute fibrinous and organizing pneumonia (AFOP) is a rare histologic interstitial pneumonia pattern recently described in the literature with fewer than 120 cases published. AFOP is often difficult to diagnose and may be mistaken for other pulmonary disorders such as interstitial pneumonias or pneumonitides. Patients often present with vague symptoms of cough, dyspnea, hemoptysis, fatigue, and occasionally respiratory failure. Radiological findings show diffuse patchy opacities and ground glass appearance of the lungs. On histologic examination, intra-alveolar fibrin balls are observed. We discuss a case of a man who presented with hemoptysis and dyspnea and whose open lung biopsy revealed AFOP. We will describe the presentation, diagnosis, and post-discharge course, and review the current literature. There are only 4 cases which have reported the patients' course of disease after 1 year, the longest being 2 years. To our knowledge, this is the only case of AFOP in the literature that describes the course of a patient more than 2 years after the diagnosis of AFOP, and is the most comprehensive review of the current literature. Copyright © 2015 Elsevier Inc. All rights reserved.

Carnitine-acylcarnitine translocase deficiency with c.199-10 T>G and novel c.1A>G mutation

PubMed Central

Yan, Hui-ming; Hu, Hao; Ahmed, Aisha; Feng, Bing-bing; Liu, Jing; Jia, Zheng-jun; Wang, Hua

2017-01-01

Abstract Rationale: Carnitine-acylcarnitine translocate deficiency (CACTD) is a rare and life-threatening, autosomal recessive disorder of fatty acid β-oxidation characterized by hypoketotic hypoglycemia, hyperammonemia, cardiomyopathy, liver dysfunction, and muscle weakness; culminating in early death. To date, CACTD cases screened from the Chinese mainland population, especially patient with compound heterozygote with c.199-10T>G and a novel c.1A>G mutation in the SLC25A20 gene has never been described. Patient concerns: Herein, we report 2 neonatal cases of CACTD identified from the mainland China. These 2 patients were presented with severe metabolic crisis and their clinical conditions deteriorate rapidly and both died of cardiorespiratory collapse in the first week of life. We present the clinical and biochemical features of 2 probands and a brief literature review of previously reported CACTD cases with the c.199-10T>G mutation. Diagnoses: The acylcarnitine profiles by tandem-mass-spectrometry and the mutation analysis of SLC25A20 gene confirmed the diagnosis of CACTD in both patients. Mutation analysis demonstrated that patient No. 1 was homozygous for c.199-10T>G mutation, while patient No. 2 was a compound heterozygote for 2 mutations, a maternally-inherited c.199-10T>G and a paternally-inherited, novel c.1A>G mutation. Interventions: Both patients were treated with an aggressive treatment regimen include high glucose and arginine infusion, respiratory, and circulatory support. Outcomes: The first proband died 3 days after delivery due to sudden cardiac arrest. The second patient's clinical condition, at one time, was improved by high glucose infusion, intravenous arginine, and circulatory support. However, the patient failed to wean from mechanical ventilation. Unfortunately, her parents refused further treatment due to fear of financial burdens. The patient died of congestive heart failure in the 6th day of life. Lessons: We report the first 2 cases of CACTD identified from the mainland China. Apart from a founder mutation c.199-10T>G, we identified a novel c.1A>G mutation. Patients with CACTD with a genotype of c.199-10T>G mutation usually presents with a severe clinical phenotype. Early recognition and appropriate treatment is crucial in this highly lethal disorder. This case series highlights the importance of screening for metabolic diseases including CACTD in cases of sudden infant death and unexplained abrupt clinical deterioration in the early neonatal period. PMID:29137068

[Schizophrenia and Liver Transplantation: Case Report].

PubMed

Diana, Restrepo B; Marle, Duque G; Carlos, Cardeño C

2012-09-01

Liver transplantation is a treatment available for many patients with liver cirrhosis who find in this treatment a way to improve life expectancy and quality of life. Paranoid schizophrenia affects 1% of the general population, produces psychotic symptoms, and runs a chronic course in some cases with significant deterioration in all areas of life. To discuss the case of a patient with liver cirrhosis diagnosed with paranoid schizophrenia during the evaluation protocol for liver transplantation. Case report. We report the case of a 47-year-old woman with liver cirrhosis whose only alternative to improve life expectancy and quality of life was access to liver transplantation. During routine evaluations the liaison psychiatrist observed first-order psychotic symptoms and documented a life story that confirmed the presence of paranoid schizophrenia. Paranoid schizophrenia is a psychiatric disorder common in the general population that can be a part of the medical comorbidities of patients requiring liver transplantation and is not an absolute contraindication to its completion. We are unaware of similar cases of liver transplantation in patients with schizophrenia in our country. We believe this is a big step on the road to overcome the stigma that mental illness imposes on patients. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Oskar Fischer and the study of dementia

PubMed Central

2009-01-01

The centenary of Alois Alzheimer's description of the case of Auguste Deter has renewed interest in the early history of dementia research. In his 1907 paper Alzheimer described the presence of plaques and tangles in one case of presenile dementia. In the same year, Oskar Fischer reported neuritic plaques in 12 cases of senile dementia. These were landmark findings in the history of research in dementia because they delineated the clinicopathological entity that is now known as Alzheimer's disease. Although much has been written about Alzheimer, only little is known about Fischer. The present article discusses Fischer's work on dementia in the context of his life and time. PMID:18952676

Juvenile hyaline fibromatosis: a case report and review of literature.

PubMed

Ribeiro, Sandra Lúcia; Guedes, Erilane L; Botan, Valeria; Barbosa, Alessandra; Freitas, Ernani J

2009-01-01

Juvenile hyaline fibromatosis (JHF) is a rare disease with autosomal recessive inheritance that occurs mainly in childhood and is characterized by the deposition of amorphous hyaline material in the skin and other organs. There are approximately 70 cases reported in the literature. Herein we describe the case of a 14-month-old boy with multiple cutaneous nodules around small and large joints, papulous skin lesions, hyperpigmented plaques and nodules in the perianal region, flexion contractures and stiffness of joints and diffuse osteoporosis. Symptoms were present since the second month of life. Histopathologic studies of joint nodulations demonstrated the presence of hyaline material, confirming the diagnosis of juvenile hyaline fibromatosis.

Evisceration as fetal destructive operation: an art revisited.

PubMed

Rohilla, Minakshi; Aggarwal, Neelam; Singh, Purnima; Jain, Vanita

2015-03-01

Fetal destructive operation is a vanishing art today. In an era of increasing cesarean deliveries it has become a historic event. Incidence of destructive operation has varied from various Indian hospitals 0.09-0.28%. Evisceration is one of the rarest of all destructive operations, performed in cases of cephalopelvic disproportion with large fetal abdominal or thoracic tumors and fetal malformations, which are incompatible with life. Less than 50 cases of fetal evisceration have been reported in the literature so far. We are presenting a case of gross fetal abdominal malformation in a multigravida woman, which necessitated internal podalic version followed by evisceration and breech extraction.

Police officers who commit suicide by cop: a clinical study with analysis.

PubMed

Arias, Elizabeth A; Schlesinger, Louis B; Pinizzotto, Anthony J; Davis, Edward F; Fava, Joanna L; Dewey, Lauren M

2008-11-01

Suicide by cop has become a familiar topic among members of law enforcement, mental health professionals, and the general public. This paper presents two cases where police officers chose to commit suicide by getting other police officers to kill them. The two police officers studied, by examination of closed case files, were found to be similar to civilians who committed suicide by cop on several demographic (gender, age, history of mental illness, and suicide attempts), and situational (stress factors, trigger) variables. The cases help us to understand possible motives and management for individuals who choose to end their life in this manner.

Concentrated liquid detergent pod ingestion in children.

PubMed

Sidhu, Natasha; Jaeger, Matthew W

2014-12-01

Concentrated liquid detergent pods are an emerging public health hazard, especially in pediatric patients. Ingestion is a more common route of exposure for liquid detergent pods compared with non-pod detergents and it tends to be associated with more severe adverse effects. We present 3 cases that demonstrate the varied clinical symptoms resulting from detergent pod ingestion. These cases not only demonstrate findings such as gastrointestinal and respiratory symptoms but also show more rare neurological symptoms. The cases highlight the dangers of concentrated liquid detergent pod ingestion. To help prevent further life-threatening injuries, there is a need for more consumer information and provider knowledge about the potential adverse complications.

[Epilepsy and epileptic syndromes during the first year of life].

PubMed

Durá-Travé, T; Yoldi-Petri, M E; Hualde-Olascoaga, J; Etayo-Etayo, V

To analyse the epidemiological characteristics and the relative distribution of the different types of epilepsy and epileptic syndromes during the first year of life. An analysis was performed of the patient records of all patients with epilepsy diagnosed during their first year of life who were submitted to a developmental check-up in the year 2007. The sample consisted of 60 patients (27 boys and 33 girls). Epidemiological and clinical data were collected, together with the findings from complementary examinations. The diagnostic criteria applied were those of the International League Against Epilepsy. The mean age at the time of diagnosis was 6.3 months. The mean follow-up time was 7.6 years. The aetiology was symptomatic in 40 cases (66.7%), cryptogenic in 16 (26.7%) and idiopathic in four cases (6.7%). Neuroimaging tests detected abnormalities in 34 patients (56.7%). West's syndrome (30%), symptomatic focal epilepsies (23.3%) and epilepsies linked to specific syndromes (16.7%) were the epileptic syndromes with the highest prevalence. Learning disabilities were observed in 82.5% of the children. Most epilepsies that present during the first year of life are symptomatic and/or cryptogenic, and are accompanied by psychoneurological impairment and/or resistance to therapy, which condition cognitive disorders that are eligible for specialised psycho-pedagogical intervention.

The tropopause inversion layer in baroclinic life cycles over the North Atlantic: a pre-WISE case study and climatology

NASA Astrophysics Data System (ADS)

Kaluza, Thorsten; Hoor, Peter; Kunkel, Daniel

2017-04-01

Studies of baroclinic life cycles recently revelead that the tropopause inversion layer (TIL) in the extratropics is significantly strengthened by diabatic processes related to moist tropospheric dynamics as well as by breaking of the baroclinic wave itself. However, these findings summarize the results from idealized model simulations and the contribution from processes related to baroclinic life cycles relative to other processes enhancing the lower stratospheric static stability (stratospheric dynamics, seasonal variation of radiative feedbacks) to the observed TIL at midlatitudes has yet to be assessed. Further the role of the TIL for stratosphere-troposphere exchange (STE) is currently still under debate. In preparation of the up-coming field campaign WISE (Wave driven isentropic exchange) we explore the state and variability of the TIL over the North Atlantic between August and October in analysis model data. We use high resolution operational analysis from the European Center for Medium Range Weather Forecast to study the mesoscale structure of the TIL. The main focus is on case studies of the TIL in real baroclinic life cycles, in particular on small scale enhancements within the baroclinic disturbances and the relation to STE. Moreover, a summary is presented about the quasi climatological state of the tropopause location and sharpness over the North Atlantic over recent years.

Life-threatening bleeding and radiologic intervention after aesthetic surgeries with minimal invasive approaches: report of two cases.

PubMed

Kim, Youn-Hwan; Kim, Jong-Do; Visconti, Giuseppe; Kim, Jeong-Tae

2010-10-01

In this article, the authors report two cases of life-threatening bleeding after cosmetic surgeries that have been successfully treated with radiologic intervention. A 25-year-old female and a 35-year-old female presented at their institutions because of postoperative bleeding after intraoral mandibular angle ostectomy and endoscopic-guided trans-axillary breast augmentation, respectively. A ruptured traumatic pseudo-aneurysm of the right superficial temporal artery was diagnosed in the first case and a haematoma posterior to the right pectoralis major, due to active bleeding from a perforator of internal mammary artery, in the second case. Attempts were made to stop the haemorrhage using standard methods, but failed. Therefore, superselective microcatheter angioembolisation has been successfully performed in both the cases. At 22-month follow-up for the first case and at 12-month follow-up for the second case, the patients are asymptomatic and the cosmetic outcomes are being preserved. With radiologic intervention, the authors gained satisfactory results in the above-mentioned situations. Using this, with only local anaesthesia and the absence of incisions, a precise approach with immediate treatment to the haemorrhaging site is possible. This can be an excellent solution for arterial bleeding that is difficult to access anatomically after aesthetic surgeries, and in selected cases. Furthermore, this procedure is less disfiguring and preserves the aesthetic surgery outcomes. Copyright 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Buddhist ethics and end-of-life care decisions.

PubMed

McCormick, Andrew J

2013-01-01

Buddhism has grown in the United States in the past 50 years. Immigrants come following long traditions. American converts are more eclectic. The first Buddhist precept prohibiting harm to living things, the virtue of compassion, and the goal of a peaceful death provide guidance for ethical decision making regarding organ donation, withholding and withdrawing life-sustaining treatment, voluntary cessation of eating, physician aid in dying, and euthanasia. Concepts and views from three Buddhist traditions and views of master practitioners are presented. Case examples illustrate some of the differences within Buddhism. Suggestions for social workers are provided.

Preparing Graduate Students for Industry and Life Long Learning: A Project Based Approach

NASA Astrophysics Data System (ADS)

Thompson, J. Barrie; Edwards, Helen M.

The case is made that by undertaking projects that have a real-world dimension the students are more likely to gain the skills and abilities which industry requires. Background information is presented relating to links between academia and industry and the role of student projects. Details are given of taught masters level computing programmes at the University of Sunderland and the project that each involves. A particular approach that has enabled hundreds of successful projects to be undertaken with industry ever year is then described along with an assessment of its effectiveness in giving students life-time skills.

[Diagnosis and surgical treatment of adrenocortical cancer with invasion into great veins].

PubMed

Kharnas, S S; Ippolitov, L I; Polunin, G V; Vetshev, S P; Slobodyanik, A S; Saliba, M B; Kovalenko, A A; Lukich, K V

2015-01-01

To estimate immediate and remote resaults of treatment of adrenocortical cancer with invasion into great veins. It was analyzed survey and treatment results in 3 patients with adrenocortical cancer and invasion into renal veins and inferior vena cava. Radical surgery with tumoral thrombi removal from great vessels was performed in all cases. There were no complications and deaths in early postoperative period. Life expectancy after surgery was 6, 13 and over 58 months. At present time surgical intervention for adrenocortical cancer with invasion into great veins is single method to prolong patients' life.

A Hairy Situation: Laser Hair Removal after Oral Reconstruction.

PubMed

Shields, Bridget E; Moye, Molly S; Bayon, Rodrigo; Sperry, Steven M; Wanat, Karolyn A

2018-03-01

To present a case series of 4 patients who underwent postoperative hair removal using the long-pulsed Alexandrite or Nd:YAG laser following intraoral cutaneous flap reconstruction. Patients underwent epilation in dermatology clinic with long-pulsed Alexandrite or Nd:YAG lasers, spaced 8 weeks apart, until hair removal was achieved. All patients achieved improvement in hair removal regardless of initial flap donor site with significant improvement in quality of life and minimal side effects. The long-pulsed Alexandrite and Nd:YAG represent safe and effective treatment options to improve patient quality of life following intraoral flap repair following excision of malignancy.

Endovascular Management of Ureteroarterial Fistula: A Rare Potentially Life Threatening Cause of Hematuria

PubMed Central

Copelan, Alexander; Chehab, Monzer; Cash, Charles; Korman, Howard; Dixit, Purushottam

2014-01-01

Ureteroarterial fistula is a rare, potentially life-threatening cause of hematuria characterized by an abnormal channel between a ureter and artery. The rarity of this condition, complexity of predisposing risk factors and intermittence of symptoms may delay or obscure its diagnosis. With a high index of suspicion and careful angiographic evaluation, embarking on this condition is not only possible but sets the stage for curative intervention. We report a case of a ureteroarterial fistula presenting with intermittent hematuria, successfully diagnosed at angiography and managed with endovascular stent graft placement. PMID:25426238

[Pregnancy-induced haemolytic anaemia].

PubMed

Karagiozova, J; Masseva, A; Ivanov, St; Marinov, B; Kulinska, R; Boiadjiev, D; Jordanova, D

2014-01-01

This is the clinical case of a primiparous eight month pregnant female, presenting with symptoms of pregnancy-induced acute haemolytic anaemia (haemolytic aneamia provoked by an immune mechanism, intra- and extra-erythrocyte defects, and HELLP syndrome were excluded). The anaemia progressed to become life-threatening for both the pregnant women and the foetus, which brought the following questions into consideration: diagnosis of anaemia during pregnancy; dosing of corticosteroid therapy; possibility of giving birth to a viable foetus and prognosis for next pregnancies. Owing to the inter-disciplinary efforts, the life and health of this pregnant woman were preserved, but the foetus was lost.

Health-related quality of life of irritable bowel syndrome patients in different cultural settings

PubMed Central

Faresjö, Åshild; Anastasiou, Foteini; Lionis, Christos; Johansson, Saga; Wallander, Mari-Ann; Faresjö, Tomas

2006-01-01

Background Persons with Irritable bowel syndrome (IBS) are seriously affected in their everyday life. The effect across different cultural settings of IBS on their quality of life has been little studied. The aim was to compare health-related quality of life (HRQOL) of individuals suffering from IBS in two different cultural settings; Crete, Greece and Linköping, Sweden. Methods This study is a sex and age-matched case-control study, with n = 30 Cretan IBS cases and n = 90 Swedish IBS cases and a Swedish control group (n = 300) randomly selected from the general population. Health-related quality of life, measured by SF-36 and demographics, life style indicators and co-morbidity, was measured. Results Cretan IBS cases reported lower HRQOL on most dimensions of SF-36 in comparison to the Swedish IBS cases. Significant differences were found for the dimensions mental health (p < 0.0001) and general health (p = 0.05) even after adjustments for educational level and co-morbidity. Women from Crete with IBS scored especially low on the dimensions general health (p = 0.009) and mental health (p < 0.0001) in comparison with Swedish women with IBS. The IBS cases, from both sites, reported significantly lower scores on all HRQOL dimensions in comparison with the Swedish control group. Conclusion The results from this study tentatively support that the claim that similar individuals having the same disease, e.g. IBS, but living in different cultural environments could perceive their disease differently and that the disease might affect their everyday life and quality of life in a different way. The Cretan population, and especially women, are more seriously affected mentally by their disease than Swedish IBS cases. Coping with IBS in everyday life might be more problematic in the Cretan environment than in the Swedish setting. PMID:16566821

The Case for Biocalculus: Design, Retention, and Student Performance

PubMed Central

Eaton, Carrie Diaz; Highlander, Hannah Callender

2017-01-01

Calculus is one of the primary avenues for initial quantitative training of students in all science, technology, engineering, and mathematics fields, but life science students have been found to underperform in the traditional calculus setting. As a result, and because of perceived lack of its contribution to the understanding of biology, calculus is being actively cut from biology program requirements at many institutions. Here, we present an alternative: a model for learning mathematics that sees the partner disciplines as crucial to student success. We equip faculty with information to engage in dialogue within and between disciplinary departments involved in quantitative education. This includes presenting a process for interdisciplinary development and implementation of biology-oriented Calculus I courses at two institutions with different constituents, goals, and curricular constraints. When life science students enrolled in these redesigned calculus courses are compared with life science students enrolled in traditional calculus courses, students in the redesigned calculus courses learn calculus concepts and skills as well as their traditional course peers; however, the students in the redesigned courses experience more authentic life science applications and are more likely to stay and succeed in the course than their peers who are enrolled in traditional courses. Therefore, these redesigned calculus courses hold promise in helping life science undergraduate students attain Vision and Change recommended competencies. PMID:28450445

Pervasive refusal syndrome. Three German cases provide further illustration.

PubMed

Jans, Thomas; Ball, Juliane; Preiss, Maike; Haberhausen, Michael; Warnke, Andreas; Renner, Tobias J

2011-09-01

Pervasive refusal syndrome (PRS) has been proposed as a new diagnostic entity among child and adolescent psychiatric disorders. It is characterized by a cluster of life-threatening symptoms including refusal of hood intake, decreased or complete lack of mobilization, and lack of communication as well as retreat from normal life activities. Active refusal to accept help as well as neglect of personal care have been core features of PRS in the limited number of cases reported in the last decade. There have, however; been cases with predominantly passive resistance, indicating the possibility that there may be a continuum from active refusal to passive resistance within PRS. Postulating this continuum allows for the integration of "depressive devitalization" -- a refusal syndrome mainly characterized by passive resistance -- into the concept of PRS. Here, three case vignettes of adolescent patients with PRS are presented. The patients' symptomatology can be allocated on this continuum of PRS. PRS and dissociative disorders are compared in greater detail and contrasted within this discussion of differential diagnoses at the poles of such a continuum. PRS is a useful diagnosis for cases involving symptoms of predominating refusal and retreat which cannot satisfactorily be classified by existing diagnostic categories, and which can mostly clearly be separated from dissociative disorder.

Acute catecholamine cardiomyopathy in patients with phaeochromocytoma or functional paraganglioma.

PubMed

Giavarini, Alessandra; Chedid, Antoine; Bobrie, Guillaume; Plouin, Pierre-François; Hagège, Albert; Amar, Laurence

2013-10-01

Phaeochromocytomas and paragangliomas (PPGL) can cause acute catecholamine cardiomyopathy (ACC). We assessed the prevalence of ACC and compared the presentation of cases with and without ACC in a large series of PPGL. Single centre retrospective study. Hypertension Unit, University Hospital, Paris. 140 consecutive patients with PPGL, referred from January 2003 to September 2012. Left ventricular ejection fraction (LVEF), perioperative mortality. Fifteen patients (11%) had suffered an ACC, occurring in 14 cases before the diagnosis of PPGL. Precipitating factors were identified in 11 cases. Twelve patients presented with acute pulmonary oedema, including 10 with cardiogenic shock, requiring life support in eight cases. Seven patients (five with pulmonary oedema) presented with acute chest pain and cardiac dysfunction. Electrocardiographic abnormalities were present in 14 cases: ST segment elevation or pathological Q waves, ST segment depression, and/or diffuse T wave inversion. Six patients displayed classical (apical ballooning) or inverted (basal/mid ventricular stunning) takotsubo-like cardiomyopathy. Coronary arteries were always normal on angiography. In patients with ACC, median LVEF rose from 30% (IQR 23-33%) during ACC to 71% (50-72%) before surgery (n=11, p<0.001). Median LVEF before PPGL surgery was 65% (51-72%) and 65% (60-70%) in patients with and without a history of ACC, respectively (not significant). PPGL may present as ACC in 11% of cases, excluding patients dying from undiagnosed tumours. Left ventricular dysfunction is usually reversible before surgery. PPGL should be suspected in patients with acute heart failure without evidence of valvular or coronary artery disease.

Mesalamine-induced myopericarditis - A case report.

PubMed

Bernardo, Sónia; Fernandes, Samuel Raimundo; Araújo-Correia, Luís

2016-11-01

Myopericarditis has occasionally been reported as a side effect of mesalamine in patients with inflammatory bowel disease. We present a 20-year-old woman with ulcerative colitis admitted with chest pain. After thorough investigation she was diagnosed with myopericarditis potentially related to mesalamine. There was complete clinical and laboratorial recovery following drug withdrawal. Although uncommon, the possibility of myopericarditis should be considered in patients with inflammatory bowel disease presenting with cardiac complaints. Early recognition can avoid potential life-threatening complications.

Estimating increment-decrement life tables with multiple covariates from panel data: the case of active life expectancy.

PubMed

Land, K C; Guralnik, J M; Blazer, D G

1994-05-01

A fundamental limitation of current multistate life table methodology-evident in recent estimates of active life expectancy for the elderly-is the inability to estimate tables from data on small longitudinal panels in the presence of multiple covariates (such as sex, race, and socioeconomic status). This paper presents an approach to such an estimation based on an isomorphism between the structure of the stochastic model underlying a conventional specification of the increment-decrement life table and that of Markov panel regression models for simple state spaces. We argue that Markov panel regression procedures can be used to provide smoothed or graduated group-specific estimates of transition probabilities that are more stable across short age intervals than those computed directly from sample data. We then join these estimates with increment-decrement life table methods to compute group-specific total, active, and dependent life expectancy estimates. To illustrate the methods, we describe an empirical application to the estimation of such life expectancies specific to sex, race, and education (years of school completed) for a longitudinal panel of elderly persons. We find that education extends both total life expectancy and active life expectancy. Education thus may serve as a powerful social protective mechanism delaying the onset of health problems at older ages.

Self-defining memories, scripts, and the life story: narrative identity in personality and psychotherapy.

PubMed

Singer, Jefferson A; Blagov, Pavel; Berry, Meredith; Oost, Kathryn M

2013-12-01

An integrative model of narrative identity builds on a dual memory system that draws on episodic memory and a long-term self to generate autobiographical memories. Autobiographical memories related to critical goals in a lifetime period lead to life-story memories, which in turn become self-defining memories when linked to an individual's enduring concerns. Self-defining memories that share repetitive emotion-outcome sequences yield narrative scripts, abstracted templates that filter cognitive-affective processing. The life story is the individual's overarching narrative that provides unity and purpose over the life course. Healthy narrative identity combines memory specificity with adaptive meaning-making to achieve insight and well-being, as demonstrated through a literature review of personality and clinical research, as well as new findings from our own research program. A clinical case study drawing on this narrative identity model is also presented with implications for treatment and research. © 2012 Wiley Periodicals, Inc.

Libraries of life: using life history books with depressed care home residents.

PubMed

Plastow, Nicola Ann

2006-01-01

Depression is a common, and often undetected, psychiatric disorder in geriatric care home residents. Reminiscence, an independent nursing therapy used by a variety of health and social care professionals, can prevent or reduce depression. This practice development project explored the use of reminiscence life history books as an interpersonal therapeutic tool with 3 depressed care-home residents living in residential care and skilled nursing facilities. The process of choosing to produce a book, assessment of capabilities, and methods of construction are described using 3 illustrative case studies. Three themes emerged: reviewing the past, accepting the present, and dreaming of an alternative future. This project demonstrated that life history books, tailored to individual needs and abilities, can facilitate reminiscence and reduce depression by increasing social interaction. The benefits to residents, their families, and care staff are discussed and the relevance to nursing practice highlighted.

Quality of life in adolescents and adults with CHARGE syndrome.

PubMed

Hartshorne, Nancy; Hudson, Alexandra; MacCuspie, Jillian; Kennert, Benjamin; Nacarato, Tasha; Hartshorne, Timothy; Blake, Kim

2016-08-01

Health-related Quality of Life and the Impact of Childhood Neurologic Disability Scale were collected for 53 patients with CHARGE syndrome aged 13-39 years with a mean academic level of 4th grade. The most prevalent new and ongoing issues included bone health issues, sleep apnea, retinal detachment, anxiety, and aggression. Sleep issues were significantly correlated with anxiety, self-abuse, conduct problems, and autistic-like behaviors. Problems with overall health, behavior, and balance most affected the number of social activities in the individual's life. Sensory impairment most affected relationships with friends. Two contrasting case studies are presented and demonstrate that the quality of life exists on a broad spectrum in CHARGE syndrome, just as its physical features range from mild to very severe. A multitude of factors, including those beyond the physical manifestations, such as anxiety and sleep problems, influence quality of life and are important areas for intervention. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

[Retrospective analysis of Mexican National Addictions Survey, 2008. Bias identification and correction].

PubMed

Romero-Martínez, Martín; Téllez-Rojo Solís, Martha María; Sandoval-Zárate, América Andrea; Zurita-Luna, Juan Manuel; Gutiérrez-Reyes, Juan Pablo

2013-01-01

To determine the presence of bias on the estimation of the consumption sometime in life of alcohol, tobacco or illegal drugs and inhalable substances, and to propose a correction for this in the case it is present. Mexican National Addictions Surveys (NAS) 2002, 2008, and 2011 were analyzed to compare population estimations of consumption sometime in life of tobacco, alcohol or illegal drugs and inhalable substances. A couple of alternative approaches for bias correction were developed. Estimated national prevalences of consumption sometime in life of alcohol and tobacco in the NAS 2008 are not plausible. There was no evidence of bias on the consumption sometime in life of illegal drugs and inhalable substances. New estimations for tobacco and alcohol consumption sometime in life were made, which resulted in plausible values when compared to other data available. Future analyses regarding tobacco and alcohol using NAS 2008 data will have to rely on these newly generated data weights, that are able to reproduce the new (plausible) estimations.

The Case for a Gaian Bottleneck: The Biology of Habitability.

PubMed

Chopra, Aditya; Lineweaver, Charles H

2016-01-01

The prerequisites and ingredients for life seem to be abundantly available in the Universe. However, the Universe does not seem to be teeming with life. The most common explanation for this is a low probability for the emergence of life (an emergence bottleneck), notionally due to the intricacies of the molecular recipe. Here, we present an alternative Gaian bottleneck explanation: If life emerges on a planet, it only rarely evolves quickly enough to regulate greenhouse gases and albedo, thereby maintaining surface temperatures compatible with liquid water and habitability. Such a Gaian bottleneck suggests that (i) extinction is the cosmic default for most life that has ever emerged on the surfaces of wet rocky planets in the Universe and (ii) rocky planets need to be inhabited to remain habitable. In the Gaian bottleneck model, the maintenance of planetary habitability is a property more associated with an unusually rapid evolution of biological regulation of surface volatiles than with the luminosity and distance to the host star.

A case at last for age-phased reduction in equity.

PubMed Central

Samuelson, P A

1989-01-01

Maximizing expected utility over a lifetime leads one who has constant relative risk aversion and faces random-walk securities returns to be "myopic" and hold the same fraction of portfolio in equities early and late in life--a defiance of folk wisdom and casual introspection. By assuming one needs to assure at retirement a minimum ("subsistence") level of wealth, the present analysis deduces a pattern of greater risk-taking when young than when old. When a subsistence minimum is needed at every period of life, the rentier paradoxically is least risk tolerant in youth--the Robert C. Merton paradox that traces to the decline with age of the present discounted value of the subsistence-consumption requirements. Conversely, the decline with age of capitalized human capital reverses the Merton effect. PMID:2813438

[Developmental outcome of extremely low birth weight infants (<1,000 g) during the first three years of life].

PubMed

Jiménez Martín, A M; Servera Ginard, C; Roca Jaume, A; Frontera Juan, G; Pérez Rodríguez, J

2008-04-01

Obstetrics and Perinatal Care has improved in the last few years. As a result there has been a significant increase in preterm babies and longer survival. The risk of abnormalities in their development is high; they need follow up, prompt action and prevention from the neonatal period. We evaluated 116 preterm babies, birth weight less than or equal to 1,000 grams, admitted to our Unit over 5 years. Seventy five neonates survived after the neonatal period (64.7 %). We studied the development during the first three years of life. The number of admissions of extremely low birth weigh infants has increased by 100 % in the last five years and the survival has increased by 15 %. Failure to thrive was the most frequent problem; in the first 2 years of life neonatal growth retardation was present in more than 50 % of cases (58 % 1st year, 57 % 2nd year, 40 % 3rd year). Catch-up growth occurred except in infants who had intrauterine growth retardation. Motor function disorders were the most serious; minor alterations in this system were the most frequent but usually did not compromise the life of the patient. Cerebral palsy was present in 14 % in the 1st year of life, 17,4 % 2nd year and 19 % 3rd year. Retinopathy of prematurity was very high in our group (74 %), but ophthalmic sequela were infrequent (3.2 % 1st year, 3.9 % 2nd year, and 3.4 % 3rd year); similarly with hearing function (deafness 2.0 %). Only some mild or moderate language development delay was present and psychomotor development was normal in the majority of cases and those who were retarded improved with time. Nowadays there is a significant increase in the incidence and survival of extremely low birth weigh infants. They have a higher risk of abnormal development. The most frequent problem is failure to thrive and the most serious is cerebral palsy. Major ophthalmic and hearing sequela are rare. Psychomotor and language development is normal in the majority of these patients.

High-Precision In Situ 87Sr/86Sr Analyses through Microsampling on Solid Samples: Applications to Earth and Life Sciences

PubMed Central

Di Salvo, Sara; Casalini, Martina; Marchionni, Sara; Adani, Teresa; Ulivi, Maurizio; Tommasini, Simone; Avanzinelli, Riccardo; Mazza, Paul P. A.; Francalanci, Lorella

2018-01-01

An analytical protocol for high-precision, in situ microscale isotopic investigations is presented here, which combines the use of a high-performing mechanical microsampling device and high-precision TIMS measurements on micro-Sr samples, allowing for excellent results both in accuracy and precision. The present paper is a detailed methodological description of the whole analytical procedure from sampling to elemental purification and Sr-isotope measurements. The method offers the potential to attain isotope data at the microscale on a wide range of solid materials with the use of minimally invasive sampling. In addition, we present three significant case studies for geological and life sciences, as examples of the various applications of microscale 87Sr/86Sr isotope ratios, concerning (i) the pre-eruptive mechanisms triggering recent eruptions at Nisyros volcano (Greece), (ii) the dynamics involved with the initial magma ascent during Eyjafjallajökull volcano's (Iceland) 2010 eruption, which are usually related to the precursory signals of the eruption, and (iii) the environmental context of a MIS 3 cave bear, Ursus spelaeus. The studied cases show the robustness of the methods, which can be also be applied in other areas, such as cultural heritage, archaeology, petrology, and forensic sciences. PMID:29850369

The Case for Medieval Drama in the Classroom: An Approach through Performance.

ERIC Educational Resources Information Center

Lieblein, Leanore; Pare, Anthony

1983-01-01

Argues that medieval drama in performance suggests a number of important issues about the nature of literature, particularly about the way narrative and dramatic art can express the life of a community. Presents a series of exercises that start with familiar, nonthreatening situations in order to approach the richness of medieval plays and the…

[Congenital valvular heart disease with high familial penetrance].

PubMed

Dattilo, Giuseppe; Lamari, Annalisa; Tulino, Viviana; Scarano, Michele; De Luca, Eleonora; Mutone, Daniela; Busacca, Paolo

2012-12-01

Bicuspid valve aortic (BVA) is one of the most common congenital malformations. Only 20% of patients preserves a normal valve function throughout life. There are sporadic and familial forms, the latter to autosomal dominant. We present a case of familiarity of BVA high penetrance. Patient with aortic stenosis by BVA, is the father of two children with BVA.

The Use of Educational Game Design and Play in Higher Education to Influence Sustainable Behaviour

ERIC Educational Resources Information Center

Mercer, Theresa G.; Kythreotis, Andrew P.; Robinson, Zoe P.; Stolte, Terje; George, Sharon M.; Haywood, Stephanie K.

2017-01-01

Purpose: The purpose of this paper is to discuss a novel life cycle approach to education for sustainable development (ESD) where the students become "design thinkers". Design/methodology/approach: A case study on the creation, development and utilisation of educational games by university students is presented. The paper discusses the…

Use of a Quick Personal Inventory Scale to Help in the Addiction Treatment Process.

ERIC Educational Resources Information Center

Danic, Jerry J.

This paper discusses a treatment approach to addiction counseling which emphasizes the need for information in the areas of major life problems, problem-causing behaviors, early family experiences, and self-esteem or self-image. This treatment process is outlined. The Danic Quick Personal Inventory Scale is presented in a sample case study.…

Integrating Mission-Based Values into Accounting Curriculum: Catholic Social Teaching and Introductory Accounting

ERIC Educational Resources Information Center

Hise, Joan Vane; Koeplin, John P.

2010-01-01

This paper presents several reasons why mission-based values, in this case Catholic Social Teaching (CST), should be incorporated into a university business curriculum. The CST tenets include the sanctity of human life; call to family, community, and participation; rights and responsibilities; option for the poor and vulnerable; the dignity of…

Experiences from ICT-Based Teacher Education: Technology as a Foundation for Active Learning

ERIC Educational Resources Information Center

Eriksen, Odd

2004-01-01

This article presents a case study of ICT implementation within a teacher education programme in Norway. The background and context are described, including a brief discussion of the characteristics of contemporary family life in Norway and the experiences and expectations of students with respect to the use of information technology in schools.…

Development and Evaluation of a Virtual Campus on Second Life: The Case of SecondDMI

ERIC Educational Resources Information Center

De Lucia, Andrea; Francese, Rita; Passero, Ignazio; Tortora, Genoveffa

2009-01-01

Video games and new communication metaphors are quickly changing today's young people habits. Considering the actual e-learning scenarios, embedded in a fully technological enabled environment it is crucial to take advantage of this kind of capabilities to let learning process gain best results. This paper presents a virtual campus created using…

Development of Male Social Justice Allies of Women in College: A Case Study Investigation of Possibilities for Change

ERIC Educational Resources Information Center

Rice, Penny J.

2009-01-01

College students have been socialized within a patriarchal, male dominated system and have accumulated many life experiences prior to arriving on campus. These experiences could present challenges in communication, may limit the students' ability to develop intimate and meaningful relationships with others, and create struggles during and after…

Equal Justice Under Law: The Supreme Court in American Life.

ERIC Educational Resources Information Center

Harrell, Mary Ann

The document describes the establishment, development, procedures, and some landmark cases of the U.S. Supreme Court. The objective is to explore the history of the court and to explain its role in the American system of government. The booklet is presented in four chapters. The first chapter, entitled "A Heritage of Law," offers…

Heart failure presenting as myxedema coma: case report and review article.

PubMed

Chaudhari, Dhara; Gangadharan, Venkat; Forrest, Terry

2013-05-01

Hypothyroidism is a common medical problem easily treated when diagnosed but requiring regular follow-up and patient medication compliance. At times, this diagnosis can go untreated resulting in the development of severe consequences such as Myxedema Coma. Of all the clinical symptoms, cardiovascular manifestations tend to be especially severe and often life threatening.

Heart failure presenting as myxedema coma: case report and review article.

PubMed

Chaudhari, Dhara; Gangadharan, Venkat; Forrest, Terry

2014-02-01

Hypothyroidism is a common medical problem easily treated when diagnosed but requiring regular follow-up and patient medication compliance. At times, this diagnosis can go untreated resulting in the development of severe consequences such as Myxedema Coma. Of all the clinical symptoms, cardiovascular manifestations tend to be especially severe and often life threatening.

Excerpts from: Transitioning Youth with Mental Health Needs to Meaningful Employment and Independent Living

ERIC Educational Resources Information Center

Woolsey, Lindsey; Katz-Leavy, Judith

2008-01-01

Transition is an awkward period of life for any young adult. Many youth with diagnosed mental health needs experience poor transition outcomes and are among this country's least understood and most vulnerable youth. This report presents the findings from case studies of five promising program sites and identifies program design features that…

The New Faculty Members' Concerns: The Case of Jordanian Universities

ERIC Educational Resources Information Center

Qudais, Mahmoud Abu; Al-Omari, Aieman; Smadi, Rana

2009-01-01

The present study aimed to identify and interpret concerns of the new faculty members in Jordanian universities. A total of 336 new faculty members who participated in this study were asked to rate their perceptions of issues related to teaching, research, service, balancing work and home life and the academic culture of their workplace. Means and…

Management of sexuality problem in quadriplegia: a brief summary.

PubMed

Wiwanitkit, Viroj

2010-09-01

Quadriplegia is a serious group of spinal disability. Cases with quadriplegia usually present unsatisfactory sexual life. In male, the main problem is the ability to reach orgasm deficient. In female, pregnancy problem should be noted. Management of sexuality problem in quadriplegia is of interest. In this article, the author will briefly review on this topic.

Promoting Community Wellbeing: The Case for Lifelong Learning for Older Adults

ERIC Educational Resources Information Center

Merriam, Sharan B.; Kee, Youngwha

2014-01-01

Community wellbeing is a function of many factors working in concert to promote an optimal quality of life for all members of a community. It is argued here that the promotion of lifelong learning among older adults can significantly contribute to community wellbeing. The aging society is a worldwide phenomenon presenting both opportunities and…

A Review of the Short Life of the U.S. Open University

ERIC Educational Resources Information Center

Krenelka, Lynette M.

2009-01-01

This article presents the findings of a single case study of the United States Open University (USOU), including factors affecting its demise and success. Interviews were conducted with administrators, board members, associate faculty, and staff who played a major role in the planning and operation of the USOU, and pertinent documents were…

Embedding Research in a Field-Based Module through Peer Review and Assessment for Learning

ERIC Educational Resources Information Center

Nicholson, Dawn T.

2011-01-01

A case study is presented of embedding research in a final year undergraduate, field-based, physical geography module. The approach is holistic, whereby research-based learning activities simulate the full life cycle of research from inception through to peer review and publication. The learning, teaching and assessment strategy emphasizes the…

The Configuration of Social Subjectivity in an Innovative Educational Institution in Brazil

ERIC Educational Resources Information Center

de Oliveira Campolina, Luciana; Martínez, Albertina Mitjáns

2016-01-01

The aim of this article is to present a case study of an innovative school and illustrate how social aspects, in their subjective dimension, participate in educational innovation. According to the theoretical propositions from González Rey's cultural-historical theory of subjectivity, social aspects in the life of groups, institutions,…

Metaphors and Sense of Teaching: How These Constructs Influence Novice Teachers

ERIC Educational Resources Information Center

Massengill, Donita; Mahlios, Marc; Barry, Arlene

2005-01-01

The purpose of this study was to identify the root metaphors of secondary classroom teachers and to observe ways in which these constructs influence teachers' work with their students and their environments. Specifically, five case studies of novice teachers were presented. Results indicated that the metaphor of life as a tree was the most common…

Life in the Village: Teacher Community and Autonomy in an Early Childhood Education Center

ERIC Educational Resources Information Center

Blank, Jolyn

2009-01-01

This article presents findings from a qualitative case study of a public early childhood education center whose motto, the familiar African proverb "It takes a village to raise a child," reflects the emphasis given to teacher community in the official school discourse. The meanings teachers gave to professional community were investigated.…

Gaming in Second Life via Scratch4SL: Engaging High School Students in Programming Courses

ERIC Educational Resources Information Center

Pellas, Nikolaos; Peroutseas, Efstratios

2016-01-01

While pedagogical and technological affordances of three-dimensional (3D) multiuser virtual worlds in various educational disciplines are largely well-known, a study about their effect on high school students' engagement in introductory programming courses is still lacking. This case study presents students' opinions about their participation in a…

A Network Implementation Class Exercise: BusinessQuest Business Incubator, LLC

ERIC Educational Resources Information Center

Arling, Priscilla A.

2009-01-01

One way to bring concepts to life in an introductory data networks course is for students to physically build a network that addresses a real business problem. However it can be challenging to find a suitable business problem, particularly if the network can exist only during the class period. This case presents a realistic business scenario and…

Deconstructing Phonetic Transcription: Covert Contrast, Perceptual Bias, and an Extraterrestrial View of "Vox Humana"

ERIC Educational Resources Information Center

Munson, Benjamin; Edwards, Jan; Schellinger, Sarah K.; Beckman, Mary E.; Meyer, Marie K.

2010-01-01

This article honours Adele Miccio's life work by reflecting on the utility of phonetic transcription. The first section reviews the literature on cases where children whose speech appears to neutralize a contrast in the adult language are found on closer examination to produce a contrast ("covert contrast"). This study presents evidence…